ABSTRACT
Objectives: To analyze prevalence of anxiety and depression among doctors serving in a tertiary care hospital in Lahore, with a study of impact of relevant demographic features
Methods: A cross sectional study was conducted at Combined Military Hospital, Lahore, from February 2014 to Jan 2015. Participants were doctors serving in subject hospital for at least six months duration. Standardized Hospital Anxiety Depression Score [HADS] inventory was selected as inventory. Formal approval from hospital ethical committee and written informed consent from participants were obtained. Demographic characteristics of participants were recorded as independent variables; anxiety and depression scores being outcome variables. Data analysis was done via descriptive statistics [SPSS-20], qualitative data expressed as frequencies, percentages; quantitative as mean +/- standard deviation[SD]. Cross tabulation was done via chi-square, p-value < 0.05 considered as significant
Results: Out of 203 volunteers, 97[47.78%] responded. Score of anxiety was 7.04 +/- 4.470, maximum being 19, scores of depression was 4.94 +/- 3.605, maximum score being 15. Mild to moderate anxiety and depression were revealed in 33[34%] and 24[24.8%] respectively, while 7[7.2%] and 1[1.0%] had severe anxiety and depression respectively. There was strong positive relation between anxiety and depression[p<0.001]. There was significant impact of service years on depression[p-0.011] and gender on anxiety[p-0.002],9[17.31%] males and 24[53.33%] females had mild to moderate anxiety while 4[7.69%] males and 3[6.66%] females revealed severe anxiety and other variables did not reveal significant impact on HADS scores
Conclusion: Doctors showed high grades of anxiety and depression. They must be promptly screened and managed at all medical institutions
ABSTRACT
Objective: To analyze trends of use of methods of contraception along with study of impact of various demographic and social factors on contraception in Peshawar, Pakistan
Methods: A cross-sectional descriptive study with random purposive sampling was conducted at Combined Military Hospital Peshawar, from Mar 2015-Nov 2015. Self-designed questionnaire with demographic details and questions pertinent to contraceptive practices was utilized as study instrument. Females reporting to concerned hospital for contraceptive advice and prescription were distributed with questionnaire and written informed consent form. Formal approval was taken from ethical committee of hospital. Data was analyzed via descriptive analysis [SPSS-21], qualitative data was expressed as frequencies and percentages; quantitative as mean +/- standard deviation [SD]. Main outcome variable i-e contraceptive device used; was cross-tabulated with independent variables
Results: Response rate was 53.2% [n-426]. Usage of contraceptive device was as follows; 51.2% Nil, 9.4% barriers, 22.3% oral/injectable hormones, 13.4% IUCDs, 3.8% sterilization. There was a strong relationship between type of contraceptives used and age [p<0.001], client's education [p<0.001], husband's education [p<0.001], number of children [p<0.001], religion [p0.013], socioeconomic class [p<0.001], and religious beliefs about use of contraceptives [p<0.001]. More Muslims considered contraception irreligious than non-Muslims [p 0.02]. There was no significant impact of husbands' pressure to not to use contraceptives on type of contraception practised [p 0.114]
Conclusion: Contraceptive devices are under-utilized in the study participants. Multidisciplinary approach should be applied to enhance client education, awareness and counseling to utilize these devices more appropriately and regularly
ABSTRACT
Objective: To study the level of job satisfaction among doctors serving in a tertiary care hospital in Lahore and ascertain its co-relation with multiple demographic variables which had a profound impact. Methods: This cross sectional study with non-probability purposive sampling was conducted at Combined Military Hospital, Lahore, from February 2014 to November 2014. Subjects were doctors serving in that hospital for minimum six months duration. Pre-formed questionnaires were distributed to volunteers [average filling time was 3 ½ to 7 minutes]. Multiple demographic features were independent variables. Outcome variable was job satisfaction. Statistical analysis was done via descriptive statistics [SPSS 20], data expressed as mean +/- standard deviation [SD]. Results: Out of 263 doctors serving in hospital, 203 [77.91%] volunteered to participate; response rate by depositing the filled forms was 47.78% [97 doctors]. Amongst the respondents, 10 [10.3%] doctors had below average job satisfaction, 32[33.0%], 21[21.6%], 21[21.6%] and 13[13.3%] had average, above average, well above average and outstanding job satisfaction respectively. There was significant relation between job satisfaction and age group of the doctors [p 0.025], education [p 0.015], service years [p 0.013] income per month [p<0.001]. There was no significant impact of gender [p 0.540], marital status [p 0.087], number of children [p 0.153], current employment [p 0.71], nature of job [p 0.204], working hours [p 0.089], additional duties [p 0.421] and socioeconomic class [p 0.104] on outcome variable. Conclusion: A significant number of doctors was found discontented with their job, which may consequently impact their yield/ performance. The job satisfaction can be substantially improved if these contributory factors are aptly addressed at all tiers
ABSTRACT
To assess the frequency of hydrocephalus in postoperative cases of myelomeningocele and the need of ventriculoperitoneal shunt placement. Descriptive study CMH Rawalpindi from Sep 2008 to Nov 2009. Forty patients of either sex with myelomeningocele were included. These patients did not have hydrocephalus at the time of presentation. They were operated upon for myelomeningocele. Postoperative follow up was carried out at 1, 2 and 3 months to look for the development of hydrocephalus. Data was analyzed using SPSS version 17. Out of forty patients 22 [55%] were males and 18 [45%] were females. The age ranged from newborn to 10 months. Thirty five [87.5%] patients had lumbosacral myelomeningocele, 2 [5%] patients thoracic, 2[5%] patients cervical while one patient [2.5%] presented with both cervical and lumbosacral myelomeningocele. Postoperatively 21 [52.5%] patients developed hydrocephalus which were subsequently confirmed on CT scan head and were then subjected to ventriculoperitoneal shunting. High frequency of hydrocephalus was observed in postoperative cases of myelomeningocele and patients presenting with one entity must be looked for the other. Postoperative cases of myelomeningocele should be regularly followed for the evidence of hydrocephalus
ABSTRACT
To evaluate the role of topical glyceryl trinitrate [0.2% GTN] on the clinical features of acute anal fissure. A prospective, open label therapeutic trial was carried out at Combined Military Hospital, Kharian Cantonment during one calendar year. All adult males and females presenting with acute anal fissure were included. Patients with chronic anal fissure, associated pathology [hemorrhoids, fistula in ano], age < 15 years, previous surgery of anal canal were excluded. The diagnosis was based upon history and physical examination. A detailed history was taken regarding their symptoms like painful defecation, bleeding per rectum, constipation and itching. Then the patients were examined to look for anal fissure, associated mucus discharge and sphincter tone and recorded in the proforma. 0.2% topical GTN ointment was prescribed twice daily for local application in the anal canal with the help of cotton pledget on a stick [soaked completely in ointment]. The duration of treatment was four weeks and their symptomatology and healing of anal fissure was assessed weekly. A total of 40 patients were treated in this study. Age varied between 22 - 51 years. 36 patients [90%] were male while only 4 patients [10%] were females. Painful defecation [100%], bleeding PR [87.5%] constipation [50%], and itching [40%] were the main complaints. Posterior fissure was seen in 85%, anterior fissure in 12.5%, while both anterior and posterior fissures were seen in 2.5% of patients. Out of 40 patients 21 had complete healing of anal fissure while 03 patients recovered partially. Thus the healing rate was 60%. Topical glyceryl trinitrate is an effective treatment modality for acute anal fissure
Subject(s)
Humans , Male , Female , Fissure in Ano/therapy , Nitroglycerin , Nitroglycerin/administration & dosageABSTRACT
Screening women for asymptomatic bacteriuria [ASB] on the first antenatal visit is a part of standard obstetric care. Treating women with ASB decreases the chances of maternal and f0etal complications. This study was conducted to find out the spectrum of urine pathogens and their drug susceptibility pattern for ASB during pregnancy. The study was conducted in the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, from September 2001 to March 2002. Two hundred and ninety women, apparently normal with confirmed pregnancy, were registered. A voided midstream urine specimen was collected and cultured. A significant growth i.e. >/= 105 organisms/ml was identified with Analytical Profile Index 20 tests for identification of Enterobacteraceae [API-2o-E] and for Gram positive cocci by other standard methods. The prevalence of ASB was found 6.2%. Antimicrobial sensitivity was determined by disc diffusion Kirby Bauyer method after matching the turbidity with 0.5 McFarland's standard. Most of the recommended drugs were found to have encouraging results, however, Escherichia coli showed 66.67% resistance to ampicillins and sulphonamides. Enterobacters showed 100% resistance to ampicillins, cephalosporins and nitrofurantoin. Staphylococcus saprophyticus showed 66.67% resistance to ampicillins and sulphonamides. It was concluded that detection of ASB during pregnancy and appropriate use of antimicrobials is only possible after culture of urine. Empirical anti-microbial therapy cannot be relied upon because of possible risk of resistance
Subject(s)
Humans , Female , Pregnancy Complications , Pregnancy , Microbial Sensitivity Tests , Urine/microbiologyABSTRACT
This study was conduct to know about the real and present situation in our set up where tetanus still remains an important cause of morbidity and mortality despite free availability of a safe and effective vaccine. The study was conducted in medical unit of DHQ teaching hospital D. I. Khan over a period of four years. A total of 150 cases of tetanus were studied with 120 patients being males and 30 females. Diagnosis of tetanus was based on clinical examination. The patients were given conventional therapy for tetanus and comparison was made with other studies. Among these 150 patients of tetanus, 29 [19.3%] patient died, 22 being males and 7 females. Mortality rate in adult patients with tetanus is lower than reported in most other studies
ABSTRACT
A number of studies have shown the impact of attending the classes during the session on examination results of students. Students with good lecture attendance show good results while those with poor lecture attendance are at risk for poor performance in the examinations. In this study we wanted to test this in students of basic medical sciences in our set up. All the students in Basic Medical Sciences of Gomal Medical College, D.I. Khan, Pakistan, during the session 1999-2000 were enrolled for this study. Performance of these students in one of their three annual term tests, which covered duration of studies for four months, from February 2000 to May 2000, was analyzed. Students were grouped into two, Group-A with =75% attendance and Group-B with <75% attendance. The frequency of failure in the two groups was compared using the chi square test. Results of the term test showed that the percentage of failure in students of Group-B with less than 75%, attendance was significantly higher when compared to Group-A with equal or more than 75% attendance. Our results supported the previous studies showing that attendance in the classes during teaching sessions had a direct impact on performance of students in the examinations. Students with good attendance show good results while those with poor attendance are at risk for poor performance during examinations in basic medical sciences