Knowledge, attitude and practices of dentists about hepatitis B and C infection in Lahore

To assess the knowledge, attitude and practices of dentists of public and private sector in Lahore about Hepatitis B and C infection. This cross-sectional analytical study was conducted on private dental practitioners and public sector dental surgeons working in hospitals of Lahore. Private sector dentists of Lahore working in Shahdara, Badami Bagh, Mughalpura, Baghbanpura, Gulberg, Shadman, Mozang, Feroz pur Road, Model Town, Multan Road, Johar Town and Tohkher Niaz Baig were selected for the study. In the public sector hospitals, dental surgeons were selected from Demont Morency Dental College and Hospital, Mayo Hospital, Services Hospital, Govt. Mozang Hospital, Jinnah Hospital, Lahore General Hospital, Mian Munshi Hospital, Sheikh Zaid Hospital, Railway Hospital, Wapda Hospital and Combined Military Hospital by using convenient sampling technique. A self-administered, close- ended questionnaire was used and information was gathered about their knowledge, attitude and practices for HBV/HCV infection and its prevention. Data was entered in the SPSS-13 computer program. Frequency and percentages were calculated for different segments and comparison between the two groups was performed by using z-test for proportion. p-value

Efficacy of fix dose combination [atorvastatin and amlodipine] in treatment of uncontrolled hypertension and dyslipidemia

Background: The fixed-dose combination containing the antihypertensive agent amlodipine and the statin, atorvastatin, is the first combination of its kind designed to treat two risk factors for cardiovascular disease [CVD], i.e., hypertension and dyslipidemia. In this study, blood pressure an lipid lowering effects of combination of amlodipine and atorvastatin were evaluated in uncontrolled hypertensive patients. Methods: Thirty patients both male and female in the age group 35–60 years attending the Hypertensive Clinic of PMRC FJMC suffering from uncontrolled hypertension wer selected. Baseline blood pressure was checked after half hour rest in sitting and standing position using mercury sphygmomanometer. Blood sample was collected from all patients after overnight fasting for assessment of serum cholesterol, triglycerides, LDL and HDL cholesterol levels. They were prescribed with fixed dose combination of 5 mg amlodipine and 10 mg atorvastatin. Patients were followed for their blood pressure measurement after every 4 weeks up to 12 weeks. At the end of 12 weeks their fasting blood sample was taken again for determination of serum cholesterol, triglyceride, LDL and HDL cholesterol levels. Results: Systolic blood pressure after 4, 8 and 12 weeks was significantly lower at all intervals from baseline. When systolic blood pressure after 8 and 12 weeks was compared with 4 weeks, the effect was again significant [p=0.024, p=0.002 respectively].There was no significant reduction seen in 8 versus 12 weeks [p=0.493]. Diastolic blood pressure at 4, 8 and 12 weeks was significantly lower from baseline. Diastolic blood pressure after 4 and 8 weeks when compared with 8 and 12 weeks was not significantly low [p=0.99 and 0.91 respectively]. Lipid profile of the patients was significantly reduced from baseline after twelve weeks of fixed dose combination of treatment [p<0.000]. Conclusion: Combination therapy proved to be effective in controlling hypertension and dyslipidemia than single pill. It also improved patient's compliance. It is suggested that polypill should be prescribed instead of multiple drugs. Keywords: combination therapy, atorvastatin, amlodipine, uncontrolled hypertension, dyslipidemia

Risk factors for syphilis and HIV infection in pregnant women attending a tertiary care public sector hospital

Syphilis, a sexually transmitted disease which seemed to have disappeared or had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. Appropriate treatment of pregnant women often prevents such complications. To study the frequency of syphilis in pregnant women attending a tertiary care public sector hospital, and see the positivity for HIV/AIDS among syphilis positive women. This cross sectional and interventional study was conducted among pregnant women attending Sir Ganga Ram hospital for antenatal care at PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Blood samples from 2000 women were collected after taking consent. The blood was tested for syphilis by Treponema Pallidum Haemagglutination.History of the subjects for risks factors was also taken. Syphilis positive women were further screened for human immunodeficiency virus positivity. The treponemal antibodies were detected in less than one percent [9] pregnant women. The highest positivity was observed among age group of 21-26 years. Women in third trimester were significantly more infected with syphilis. Risk factors included husband's history with frequent traveling and drug abuse. All husbands of syphilis positive women were also positive. All syphilis positive women and their husbands were negative for Human immunodeficiency virus /Acquired immune deficiency syndrome. Less than 1% of pregnant women were infected with syphilis, and most of the spouses of these positive women were either travelers or drug addicts. Screening for syphilis should continue in pregnant cases and high risk individuals

Syphilis screening: outcome and interventions at an antenatal clinic

Syphilis, a sexually transmitted disease which seemed to had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. While appropriate treatment of pregnant women often prevents such complications. To study the frequency of syphilis in pregnant women coming to a public sector hospital and see the pregnancy outcome of positive mothers and disease transmission in neonates. This cross sectional and interventional study was conducted at PMRC Research Centre, Fatima Jinnaha Medical College, Lahore among pregnant women attending Sir Ganga Ram hospital for antenatal care. Blood samples from 2000 women were collected after taking consent from them. The blood was tested for syphilis by using Treponema pallidum haemagglutination assay. Infected mothers were administered intramuscularly with 2.4 million units of benzathine benzylpenicillin [penicillin G] after testing for hypersensitivity and followed for delivery outcomes such as abortion, miscarriage, intrauterine growth restriction, low birth weight, preterm delivery and still birth. Neonates born to infected women were examined for signs of congenital syphilis including non immune hydrops, jaundice, skin rash, pseudo paralysis and running nose along with blood test for either infection. Medical and reproductive histories were also obtained from women and recorded on a proforma. The treponemal antibodies were detected in 9[0.45%] pregnant women. The highest positivity was obtained among age group of 21-26 years. There was no statistically significant difference of acquiring infection among women of different age, education, and socioeconomic backgrounds. Women in third trimester were significantly more infected with syphilis. Out of 9 couples 3 refused treatment, 1 received only one dose of penicillin, 2 received two doses while only three couples completed all doses. Delivery outcome included one abortion, two preterm deliveries and none of the neonate had sign of congenital syphilis. Only one couple consented for blood sampling of their neonate which was positive for syphilis and was referred to pediatrician. Only 9[0.45%] of pregnant women were infected with syphilis, which can seriously complicate pregnancy and result in spontaneous abortion, and preterm delivery. Screening for syphilis in pregnant women is recommended to detect infected woman who requires treatment to prevent further transmission of this disease to new born

Antenatal screening of women for hepatitis B and C in an out-patient department

To determine frequency of hepatitis B virus [HBV] and hepatitis C virus [HCV] and its clinical manifestation in pregnant women. A cross-sectional descriptive study. Pregnant women visiting the Gynaecology and Obstetrics out patient's department of Sir Ganga Ram Hospital Lahore for antenatal check-ups from October 2006 to March 2007 were screened for hepatitis B and C. Immune- chromatography was used for initial screening and diagnosis was confirmed by ELISA technique. Data collection included maternal age, parity, symptoms or past history of jaundice, fatigue, tiredness, insomnia, depression, dyspepsia, fever, anorexia and pale stool. Risk factors investigated include past history of some surgical procedures, the dental visit, blood transfusion, tattooing, hospitalization and history of injection. Among the screened population, 7.3% out of 2439 ladies were positive for anti HCV and 2.2% for HBsAg while dual infection with HBV and HCV was observed in 0.08%. Symptoms observed in hepatitis B patients were fatigue [90%], depression and pale stool [70%], anorexia [60%], jaundice [57.2%], fever [56.4%] and dyspepsia [51.2%]. In hepatitis C antibody positive patients fatigue was the main symptom [95.7%] followed by pale stool [84.5%] and depression [80.2%]; 63.3% had insomnia, 59.1% had anorexia, 50.7% had fever, 50.7% had jaundice and 43.6% had dyspepsia. Past history of blood transfusion was reported by 32.3% patients, surgery by 42.2% and tattooing was observed in 0.70%. One or more tooth extraction was reported by 50.2% subjects, and 49.25% had history of repeated injections. The frequency of sero-positivity for HBsAg and HCV among pregnant women is alarming. These sero-positive mothers are not only predisposed to chronic consequences of hepatitis, but also are a continuous threat to their off springs and care providers. Hence, there is a direct need for further epidemiological studies and to take measures for prevention and control of the disease