Prevalence of irritable bowel syndrome and it's risk factors among medical students of Peshawar, Pakistan

Background: Irritable bowel syndrome is a disorder of gastrointestinal tract that is related to psychological dysfunction and is effected by the social, environmental and psychological factors. This study focuses on the various aspects of prevalence, risk factors and outcomes of the irritable bowel syndrome in medical college students

Objectives: To study the prevalence and risk factors of irritable bowel syndrome among medical students of Peshawar, Pakistan

Study design, settings and duration: A cross-sectional study was conducted in Khyber Medical College, Khyber Girls Medical College, Rehman Medical College, Peshawar Medical College, Peshawar from January 2017 to June 2017

Subjects and Methods: A sample size of about 552 medical students were taken by using WHO sample size calculator using 95% confidence interval and 5% margin of error through simple random sampling technique. Data was collected by administering a semi structured questionnaire and analyzed using SPSS version 20

Results: The prevalence of IBS was 13.4% in males and 17.5% in females. IBS was positively associated with factors like stress and sleep disturbance and negatively associated with risk factors like exercise, smoking, living standards, household income and spicy food

Conclusion: Keeping in view of high occurrence of IBS among medical colleges and university students, there is need to aware the students from the possible negative outcomes of this condition

Association of obstetrical variables with induction to expulsion interval in misoprostol-induced mid-trimester abortion

Objective: To investigate significance association of obstetric history [maternal age, gravidity, parity, gestational age and previous LSCS] with induction to expulsion interval [IEI] in Misoprostol-induced- Mid-Trimester [MI-MT] abortion cases

Methodology: This prospective cohort study was conducted at CMH Nowshera from January 2014- June 2015. One hundred and six candidates were included. Termination of pregnancy was carried out with Misoprostol using two regimens. Regimen A included 400ug Misoprostol given 6 hourly with maximum of 4 doses for 24 hours for gestational age 13-20 weeks. In Regimen B 200ug Misoprostol with the same protocol was given for gestational age 21-26 weeks. Failure of induction was considered after 72 hours. Cohort was stratified according to categorical variables of maternal age, parity, gravidity, gestational age and previous LSCS. Outcome variable was Induction to expulsion interval [IEI]

Results: Null hypothesis [H0] of no significant association between obstetrical variables [maternal age, parity, gravidity, gestational age, previous LSCS] and outcome variable [IEI] was tested using chi square and Fisher's exact tests with 1000 bootstrapping. Simpson's paradox effect was adjusted using Restriction method. Significant associations were found between gravidity, gestational age and previous LSCS with IEI [P value <0.05], that is, lower gravidity; higher gestational age and presence of previous LSCS were associated with longer IEI

Conclusion: This study emphasized the significance of obstetric history in MI-MT abortion cases. It also emphasized important obstetrical parameters to consider hence provide guidance to clinicians and researchers for counseling, antenatal care and treatment in such cases.

Neonatal outcome with instrumental vaginal delivery: a study at PNS Shifa

To evaluate neonatal outcome in terms of Apgar score after forceps and ventouse delivery in pregnant ladies indicated to have instrumental deliveries. Randomized control trial. This study was conducted at Labor ward of department of obstetrics and gynecology, PNS SHIFA Karachi, between Dec 2007 to Mar 2008. The target population were all pregnant subjects who visited labor room for delivery. Out of these patients, subjects who were indicated an assisted vaginal delivery for necessary management of labor were formally requested to participate in the study after various exclusions. Instrumentation was done in only those patients with singleton term pregnancy with cephalic presentation and vertex at + 1 to +3 stations. Patients with an indication for assisted vaginal delivery [n=105], were randomized for ventouse [n=53] and forceps delivery [n=52]. Instruments used were Wrigley's outlet forceps and vacuum extractor [V.E] with silicone cups. Data was recorded on specially designed Proforma. Post delivery neonatal outcome in terms of Apgar score at one minute and five minutes were compared between two modalities. The subjects undergoing forceps delivery had a significantly higher Apgar score [8.36 +/- 1.27] at 1 minute in comparison to those subjected to vacuum delivery [7.53 +/- 1.56]. The differences in Apgar score at 5-minutes [forceps delivery: 9.136 + 1.01 vs vacuum delivery 9.00 + 1.19], were not statistically significant. Outlet forceps assisted vaginal deliveries had better neonatal outcome in terms of Apgar score in comparison to ventouse

Relationship between silica dust exposure and chronic obstructive pulmonary disease in workers of dust generating industries of district Peshawar

Chronic Obstructive Pulmonary Disease is a common cause of morbidity worldwide. This study was conducted to assess the relationship between silica dust inhalation and COPD among workers of dust generating industries. This cross sectional study was conducted in three main industrial regions of Peshawar i.e. Industrial Estate Hayatabad, Industrial area Ring Road and Industries of Warsak Road Peshawar. A preformed questionnaire was used to interview 160 workers, 40 each from stone-grinding, ceramics, pottery and brick industries respectively. Only workers having worked for more than five years were selected through convenient sampling. A total of 160 workers were interviewed out of which 56[35%] were symptomatic while 104[65%] were asymptomatic. Among symptomatic ones, 20[19.8%] were in 20-40years age group and 36[61%] in 41-60 years age group. In regard to exposure status, 7[26%] were symptomatic in those exposed for 5-10 years, 29[31.5%] amongst those exposed for 11-15 years and 20[49%] in those exposed for 15-20 years. With respect to working hours, none was symptomatic in those who had worked for 6 hours or less while 56[40%] were symptomatic in those who had worked for 8 or more hours. Among 128 smokers, 48[37.5%] were symptomatic and amongst 32 non-smokers 8[25%] were symptomatic. Amongst the symptomatic cases symptoms appeared within 5-10 years in 7[12.5%] of the cases, within 10-15 years in 29[51.8%] of the cases and within 15-20 years in 20[35.7%] of the cases. The major symptoms reported were cough in 56[100%] of the cases, dyspnea in 48[85.7%] and wheezing in 49[87.5%] of the symptomatic cases. The study revealed that majority of respondents who were exposed to silica dust for ten years or more, had respiratory problems. The severity of the problems was directly proportional to the duration of exposure to silica dust, density of dust [maximum in stone crushing], hours of daily exposure and other contributory factors like tobacco smoking and increasing age