Early marriages leads to low self-esteem of young girls

The focus of this study is to be acquainted with the level of trust and reliance regarding reproductive health concerns among early married females. Many females around the globe are subjected to early marriage with immature minds and bodies, and they are forced to shoulder heavy duties, early pregnancies, harsh family behaviors, family disputes, behavioral problems and understanding problems. Early pregnancies and other health problems have a great impact on their self-esteem, confidence level and their trust on elders to share their problems. When females are married at early age, they are not only deprived of their education but they are also not aware of the health consequences and their solutions. A cross-sectional observational study was conducted in Karachi and data was collected through detailed interview among 100 subjects [married and unmarried females]. 41.98% of the unmarried girls relied on lady doctors for their reproductive health problems whereas 37.50% of married girls approached mothers and few talked to lady doctors while most of them were not sharing theirs obstacles with anyone. It is concluded that females in their teens before marriage had normal self-esteem and courage to share their problems, on the other hand early marriages were found to cause a decline in their levels of self-esteem due to domestic pressures, less social buck up, fears of in-laws and husbands

Dental erosion frequency among its different etiological factors

Dental Erosion one of the uprising threat to the community and a challenge to a dentist represents with specific signs and pattern depending upon its etiological factors though having common symptoms

Aims and objective: To determine the frequency of dental erosion among its different etiological factors and the patterns formed by each

Methods: Study was done at four tertiary health care centers, three educational institutes and one chemical industry in which a total of 463 individuals aged 5-75 years [mean=35 years] were examined and assessed for dental erosion. A structured questionnaire was designed and administered on these 463 individuals, dental erosion grading was done according to Eccles and Jenkins erosion scale. The data collected was then entered into the SPSS-11 for analysis and tabulated into percentages

Results: Highest frequency with a strong correlation is seen among GERD and dental erosion i.e., 82.4% with [p < 0.000] followed by occupational exposure to acidic environment 67%, asthma 56%, cerebral palsy 50% and juices and beverages 16%

Conclusion: General dental practitioners should know and identify these patterns in order to determine the causative factor and hence prevent further tooth loss through proper management and treatment

Knowledge, attitude and practices of dentists of pakistan regarding informed Consent

Though ongoing medical advancements has helped the man kind in many ways but it has also tailored the attitude of both the doctors and the patient to insecurity. It has now become immensely important to protect legal and ethical rights of the patients and as well as that of the doctors. Therefore, the application of the informed consent has become immensely important almost in all health care disciplines

Aims: The aim of the study was to gather base-line information on consent knowledge, attitude and practices of dentists of the different cities of Pakistan with the view of utilizing this information in dental practice of this population

Methods: A cross sectional survey was done at different cities of Pakistan including Lahore, Karachi, Peshawar, Quetta and Islamabad. A total of 359 dentists were studied for the practice of informed consent [1C] by filling a self-designed, semi-structured questionnaire in a one-to-one interview by the researcher

Results: The data recorded was then entered in SPSS. 16 and analyzed. Knowledge and attitude of the dentists is seen to be considerably high as compared to their practices which means that they are over reporting in relation to what they know about the essence of consent and hence its application. A need of proper legislature and its implementation is necessary for the improvement of practice of informed consent

Conclusion: Refresher courses regarding 1C practice should be introduced on regular basis among the medical and dental professionals

Early marriage; a root of current physiological and psychosocial health burdens

It is confirmed that early marriage and early childbirth leads to higher rates of adolescent fertility and pregnancy related complications. According to UNICEF [1994] unfortunately the mortality rate of the married girls aged between 15-19 years is twice as compare to the girls who marry after the age of 20 years. As their bodies are immature that's why their health is affected by giving birth to a child. Millions of children are affected by the tradition of early marriage at is being practiced and widespread in many regions of South Asia. Early marriage is also called as child marriage that is marriage below the age of 18 when girls are too weak to shoulder their responsibilities physiologically, psychologically and socially. Early married females are more prone to diseases like HIV/AIDS and obstetrics obstacles. They are also affected psychologically and they may become victim of depression, anxiety and other mood disorders. An observational study was conducted between married and unmarried female to know their perspective about getting married early and to highlight whether it is a positive response according to them. Results showed that in relation to unmarried girls the married females were also not in favor of getting married early as they are equally invaded by health problems. Mental distress and depressive symptoms are more common in married females. Girls prefer doctors for concerning their reproductive health problems while girls can also concerned their mothers but they are in minority. Many health consequences are being reported by early married females and they were hesitated to share them with their in laws. Most of them approached lady doctors whereas few were relying on their mothers for their problems to be solved. Marriages below the age of 18 is not helping the females infract its demolishing their self esteem, their will to study and their physiological well being also

Good clinical practice; education as a necessitate for radiology

A good clinical practice [GCP] is an ethical and scientific quality act from oldest enduring customs in the historic times of medicine. As the guiding ethical code it is primarily known for its edict to do no harm to the tolerant. However, the complexities of modern medicine research necessitate a more elaborate set of guidelines that address a physician's ethical and scientific responsibilities such as obtaining informed consent or disclosing risks of these biohazards. Our country in last decades has excelled so much in terms of offering training programs for these professional to bridge the gap between the therapeutic interventions and knowledge of these working individuals. We have done a survey on both male and female working in specific hospitals in Karachi. They were interviewed about their skills, duties and knowledge about standards of clinical practice. With reference to the patient care and conditions they were inquired about the medical background, awareness of the sufferer's ailment and ethical concerns like patient safety and rights. We have found nearly disappointing results as most of these workers were ignorant of the fact that they lack basic knowledge of related responsibilities of concerned patients. Rest of the data also gave the evidence for a huge breach among the awareness, education and realistic approach in this selected workforce. We suggest that caregivers must be aware of indications and have strong medical foundation of the concerned departments where they are serving. We propose the medical education and clinical workshops of this set of serving individuals at ground levels along with the technical fine tuning with the help of case studies and good clinical practice

Neonatal deaths in Pakistan: managing the challenge

Every hour 450 neonatal deaths occur worldwide and approximately 4 million babies die during first week of their life. The middle and low income countries bear most of the neonatal mortality where more than half of these deaths occur in households. Pakistan is among six countries which account for 50% of all child deaths worldwide. Most of these deaths occurring in households are preventable. This review attempts to determine gaps either in our health system and practices for neonatal care to present a roadmap for the effective neonatal health programming in resource limited settings. The review methodology used three pronged approach. Firstly, we searched data bases such as PubMed, Cochrane, WHO regional database to catalogue international experiences. Secondly, a detailed document review for sorting the local evidence regarding neonatal health was performed. The third step of the review methodology used open search for indexing the neonatal care specific programmes both in the public and the private health sector. Neonatal death entails a multitude of socio-economic and health system related factors. Health system related factors are substandard care, inadequate training, low staff competence and inefficient resources including equipment and medication while illiteracy, cultural practices and low socio-economic status also contribute to soaring neonatal deaths. The success of community based programmes specific to neonatal health is primarily dependent on socio-economic and political factors, health infrastructure and health system factors. Devising short, medium and long term strategies to bring down high neonatal mortality rates are critically needed at this point in time. Improvements in service delivery of neonatal health specific programmes and capacity development of community health workforce are short and medium term strategies in order to augment home based care. Long term strategies include empowerment of communities and relocation of health budgets towards betterment of primary health care services

Comparison of serum vitamin D and plasma PTH levels between prc and post-menopausal females at tertiary care hospital in Rawalpinidi

Objective: To determine the relationship between increasing age of females and falling levels al vitamin D [25 [OH] D] and PTH. Materials and Methods: It was a comparative cross sectional study conaucted in conformance with good clinical praclices. It was conduted at Fauji Foundation Hospital Rawalpindi from May 2009 to May 2011. Females 15-35 years of age [group 1] and in all female patients above 50 years of age [group 2] were included. Both groups comprised participants from the lowe socioeconomic strata. Results: In group 1, mean age was 22.38 years. Serum 25 [OH] D levels ranged from 4 nmol/L 250 nmol/L. Plasma PTH levels ranged from 4 pg/ml to 35.4 pg/ml. In group 2, age range af patienls 50 - 86 years and mean age in this group of paticrds was 60.37 years. Serum 25 [OH] D Icvrsls range from 4 nmol/L to 123 nmol/L. Plasma PTH levels ranged from 9.2 pg/ml to 218 pg/ml. By the USA of a culoff of 20 nmol/l, 23% women less than 35 years of age and 42% women above 50 years of age were classified as having a vitamin D deficiency. By the us of a cutoff of 50 nmol/l, 65% women less than 35 years of age and 51% of women above 55 years of age were classified as having a vitamin D insufficiency. Correlation studies between age and 25 [DH] D of both groups showed negative correlation; hence signify that increasing age of pelients result in hllir.ly 25 [OH] D levels. Conclusions: Scrum 25 [OH] D levels were significantly lower in post-menopairsal woman as compared to premenopausal. Plasma PTH levels had a negative correlation with serum 25 [OH] D with increasing age

Synergistic effects of ezetimibe with low dose simvastatin in lowering lipid parameters-a pilot study

To find out see the effect on lipid parameters by using a combination of the two drugs. This was a randomized, double-blind, placebo-controlled trial conducted in conformance with good clinical practices and consisted of 2 phases: A total of 39 patients were enrolled in the study. Patients were randomly assigned to receive either simvastatin alone or a combination of simvastatin plus ezetimibe. It was conducted at Fauji Foundation Hospital Rawalpindi from July 2008 to September 2008. Mean baseline total cholesterol ranged from 5.29 to 8.87 mmol/ L. The results indicated that the total cholesterol levels reduced significantly [p <0.05] from the baseline when patients were given 10 mg Simvastatin. Upon reduction of dose of simvastatin to 5 mg and addition of ezetimibe 10 mg, the levels of total cholesterol reduced even further [p<0.05]. Similar results were seen with triglyceride levels [p<0.05]. There was no statistically significant difference in LDL-C levels from the baseline with the use of simvastatin 10 mg alone. However coadministration of ezetimibe [10mg] to simvastatin [5mg] caused a statistically significant reduction in LDL-C levels from the baseline. There was no effect on HDL-C, ALT, blood glucose levels. The pilot study confirmed the effectiveness of ezetimbe in lowering total cholesterol and LDL-C levels in combination with reduced doses of simvastatin. Ezetimibe should be considered an effective lipid-lowering agent that can be used in conjunction with simvastatin at the beginning of therapy, or included in the treatment of patients who do not achieve their total and low-density lipoprotein cholesterol goal with statins alone

Her-2/neu gene overexpression in breast carcinoma and its association with clinicopathological characteristics of the disease

To assess the frequency of Her-2/neu gene amplification in breast cancer and its association with clinicopathologic characteristics of the disease. Cross-sectional comparative study. Study was carried out at Surgical Unit I, Holy Family Hospital, Rawalpindi, from January 2005 to December 2006. A total of 50 patients diagnosed of having breast cancer on biopsy of breast lump were included in the study. All patients underwent mastectomy and samples were submitted to AFIP [Armed Forces Institute of Pathology, Rawalpindi] for histopathology and determination of estrogen and progesterone receptors and Her-2/neu gene amplification. Moreover, association of Her-2/neu amplification to other characteristics like tumor size, node involvement, histological grade and presence of estrogen and progesterone receptors were also studied. Out of 50 patients, 18 [36%] were positive for Her-2/neu over expression. Among the various prognostic factors, age showed a statistically significant relation to Her-2/neu positivity [p=0.001]. The Her-2/neu positive cancers were larger in size [mean size of 7.9 +/- 3.615 and 5.4 +/- 1.906 cm in Her-2/neu positive and negative cases respectively; p=0.002]. Her-2/neu positive cases had statistically significant relation to number of involved lymph nodes [mean number of 9.9 and 4.4 lymph nodes in Her-2/neu positive and negative cases respectively; p=0.001]. Tumor grade and nuclear grade had no statistically significant relation to Her-2/neu status [p=0.19 and 0.434 respectively]. Both estrogen and progesterone receptors are inversely related to Her-2/neu positivity [p=0.028 and 0.006 respectively]. The pathological and clinical characteristics of Her-2/neu positive and negative subsets differ, and Her-2/neu over. expression was associated with other poor prognostic factors of age, tumor size and number of nodes involved. There was an inverse relation of Her-2/neu status and hormone receptor

Leiomyoma of the urinary bladder with bladder stone

Leiomyoma of the urinary bladder is a rare benign mesenchymal tumour. We describe here a case of leiomyoma of the urinary bladder in a 65-year-old gentleman who presented with haematuria, passage of clots and combined obstructive and irritative urinary symptoms. The investigations revealed a vesical calculus and a mass on the left lateral wall of the urinary bladder. Cystolitholapaxy and transurethral resection of the tumour was performed. Histopathological report of the resected tumour revealed a leiomyoma of the urinary bladder. So far, a leiomyoma of the urinary bladder and a concomitant vesical calculus have not been described in literature