Hypertension in working and non working women attending OPD of a tertiary care private sector hospital in Karachi

To compare the frequency of hypertension in working and non- working women attending OPD of a Private sector hospital of Karachi. Comparative Cross Sectional Study A comparative cross sectional survey of women visiting medical OPD was conducted in a private sector hospital of Karachi from January 2010 to November 2011. Study was conducted on working and non working women having age 20 years and above coming for treatment in OPD of a Private sector hospital of Karachi from January, 2011 to November 2011. Taking ethical consideration, data was collected by interviewing method. Besides socio-economic data, Blood pressure, weight and height were measured to calculate BMI for defining obesity. BMI more than 30 were considered obese. Data was analyzed by using statistical package SPSS version 16.0. Chi square test was applied to see the significance difference in both the groups at P<0.05. Over all 540 women included in the study, 250[46.3%] were working women and 290 were non-working [53.7%]. Among the working women 88[35.2%] were hypertensive whereas among non working women 173 [59.7%] were hypertensive [p<0.000]. Most of the hypertensive working women were of the age group 40-49 years [44.4%] whereas hypertensive non working women were of age group 30-39 years. Among the working women 38% were obese while in non working women 56% were obese. Our study shows that hypertension and obesity is more common in non working women as compare to working women and its shows that it's not the working which is the risk for developing hypertension rather there are other factors which increases the risk of hypertension and there is need of further studies

Dog bite, rabies and vaccination failure

To highlight the health implications due to increasing population of stray dogs and outline the problems of post exposure prophylaxis. Design: Two case reports on rabies with failure of postexposure prophylaxis. Setting: Medical unit of the teaching hospital, Ayub Medical College, Abbottabad. Both the cases developed rabies and expired despite postexposure rabies vaccination. First case presented with psychiatric features. Postexposure rabies vaccination should not be relied upon, in our health setup, unless its efficacy has been confirmed by measurement of protective antibody titre Case 1: A young man aged 21 years was admitted to the medical unit with complaints of headache malaise and nausea for the last two days. There was no history of fever, cough, diarrhea head injury or drug addiction. On further questioning he confided that he was harbouring snakes in his throat. He attributed his illness to something taken in the train while coming from Karachi to Peshawar three days ago. He was found to be anxious and agitated, was slow to respond. Neurological examination of the cranial nerves, sensory motor system, deep tendon reflexes and planter response did not reveal any abnormality. There was no spinal tenderness or neck rigidity. Rest of the systemic examination was also not of any positive diagnostic avail. A tentative diagnosis of psychiatric illness, possibly schizophrenia was made while encephalitis could not be excluded at this stage. His preliminary blood tests and serum biochemistry was reported as normal as were his chest radiograph and C.T. scan of the brain. C.S.F report revealed three white blood cells /ml and protein content of 55 mg/dl. He was empirically started on third generation cephalosporins and was given benzodiazepizes. He developed lacrimation and hypersalivation during the next two days and he was found affirmative for hydrophobia and aerophobia. He was alleged to be bitten by the dog ayear ago but was vaccinated from the local dispensary. He went into coma on the first day of hospitalization and died of hypoapnea the next day. His attendants were advised postexposure prophylaxis for rabies. Case 2: The second case of rabies was brought to the hospital with typical symptoms of rabies with aerophobia and hydrophobia and agitation. He drifted into coma over the next few days and was taken by the attendants to their home anticipating the impending death. He was bitten by the dog three months ago and was given vaccine from the office of the District Health Officer. The type of the vaccine and the vaccination schedule followed was not known