ABSTRACT
Background: Tuberculosis [TB] in children is clearly linked to TB in adults therefore active household contact tracing is an important method of early diagnosis and treatment particularly in high-TB-burden countries
Objectives: To estimate the prevalence of TB among household contacts of children suffering from tuberculosis using active contact tracing and linking them to TB program for treatment
Subjects and Methods: A total of 125 children suffering from active tuberculosis [index cases] aged 12 years or less were randomly selected from the outpatient department of a tertiary care hospital of Hyderabad. Using their home address, all house hold members of the index cases [sharing one kitchen] were identified. The households were visited by a team including a doctor and the supported staff and were screened for TB using history, physical examination, sputum for AFB and X-ray of chest. Clinical suspects were divided in to two populations, equal to or less than 12 years of age and greater than this age. All suspected cases were brought to outpatient's department of the hospital where children were examined and diagnosed by pediatrician and adults were examined by the pulmonologist
Results: There were 125 children and 1365 household members. Prevalence of active TB in adult household contacts was 8.1% and among children was 5.7%. Mother, father, grand parents or siblings were the source of disease spread in children. Family history of TB was present in 95% [pulmonary 78%, extra-pulmonary 22%]
Conclusion: Tuberculosis in children is mostly spreading from household member hence deeply required to undertake active contact tracing in each new case that is diagnosed or being treated
Policy message: National and Provincial TB programs should advocate and undertake active screening of all household contacts of all TB cases
Subject(s)
Child , Child, Preschool , Female , Infant , Infant, Newborn , Humans , Male , Tuberculosis, Pulmonary/prevention & control , Contact Tracing , Child , Cross-Sectional Studies , Tertiary Care CentersABSTRACT
Obesity is now recognized as one of the major public health issues all over the world. In Pakistan, it is a silent epidemic striking significantly because we are still struggling with health and economic burdens of malnutrition, infectious diseases and high infant mortality rates. In epidemiological studies age, sex and ethnic background all have to be taken into consideration, particularly when determining the health risk with obesity.Females are more vulnerable to be affected by obesity related health issues. Body Mass Index [BMI] is a surrogate measure of assessing obesity in terms of height and weight. It does not give any insight into regional body fat distribution. BMI is not a reliable measurement of body composition in individuals particularly in females having high body fat, rather more specifically it is excess abdominal fatness, quantified by waist circumference measurement, which is a better considered measure for assessing abdominal obesity in females
ABSTRACT
Objective:To explore knowledge, attitudes and practices regarding contraceptive use in females and to determine the socio cultural barriers that influence contraceptive uptake and contribute to significant unmet needs of family planning
Materials and Methods:This hospital based cross sectional survey was carried out from March 2015 to September 2015 at the Gynaecology and Obstetrics outpatient clinics [OPD] of two hospitals of Karachi, Liaquat National Hospital and PNS SHIFA Hospital. 383 females of age 18-49 years were enrolled after taking informed written consent. Knowledge, attitude and practices on contraception were evaluated with the help of predesigned questionnaire
Results: Mean age of participants was 30.12+ 3.05, youngest being 18 years old, while the eldest was 49 years old. Majority [64%] of the participants were housewives.Knowledge about contraceptive methods was found in 97.1%. Media was found to be main source of information. Regarding contraceptive practices, 48% women were currently using some method of contraception. Among these the most widely used method was condoms [46%]. 52% women were not currently using any method of contraception. Husband and mother in law opposition were found to be the strongest reason for not using any contraception
Conclusion:Inspite of having good knowledge, utilization of contraceptives were less because of preference for a large family norm, religious myths, cultural barriers and family opposition
ABSTRACT
Objective: To evaluate the effectiveness of student's clerkship as an approach to community based medical education in improving the health of community
Materials and Methods: This interventional study was conducted at Ziauddin Medical College; Karachi from December 2006 to December 2007.Data was collected by using structured questionnaire after the approval of university ethical review committee.Before collecting the data informed written consent was obtained from all study participants. Baseline data was recorded from100 enrolled families. Medical students visited the enrolled families on fortnightly basis during which they carried out detailed counseling and interactive sessions. At the end of four month, post intervention data was recorded and all baseline parameters were compared with
Results: The pre and the posttest results showed significant improvement in the knowledge of mothers regarding prevention and management of diarrhea
Conclusion: Community-based education can be used as effective tool in improving the health of community. Health services should support the community based interventions to improve the knowledge and practices of mother which can contribute effectively towards improving infant and child health
ABSTRACT
Objective: To evaluate the social barrier that influence males and females for using contraception and to evaluate the association of educational status and age with the use of contraceptives
Materials and Methods: This cross sectional study was conducted at PNS SHIFA hospital, Bahria University Medical and Dental College [BUMDC] from 1st July 2015 till 1st September 2015. A predesigned questionnaire was used for the study. 350 participants were included and sampling technique of non-probability convenient sampling was followed. Data was analyzed on SPSS version 23
Results: Out of 96 males, 18 used contraceptives while in females out of 254 only 84 were using it. When assessed the relationship between education and contraceptive use, p-value for males was 0.026 which was highly significant whereas, in females it was non-significant. The top most reasons among non-users were desire to have children, lack of knowledge in males and in females' husband's opposition and non interest. Maximum use of contraception was observed between 34-41 years of age among both males and females
Conclusion: The social barriers that influenced males from using contraception were: wanted to have children, lack of knowledge, religious views whereas, in females they were husband's opposition, lack of interest and fear of side effects. There is need to improve the education status of females. Religious scholars must play their role to increase use of contraception
ABSTRACT
Objectives: To ascertain the knowledge, attitude and practice of general practitioners towards diabetes mellitus
Study Design: Cross sectional study
Duration of Study: From July 2009 to October 2009
Place of the study: The cases were collected from various areas of Hyderabad like Latifabad, Qasimabad, Hussainabad, Pretabad and Tando Jam, Hosrri
Material and Methods: One hundred general practitioners were selected in this study were excluded. A written questionnaire was filled by each doctor that included the 4 questions of each domain of knowledge, practice and attitudes. The knowledge was assessed by levels of blood glucose, random and fasting, practices assessed by treatment options and attitudes by advising to their patients for obesity, diet and pregnancy. The frequencies were taken of known or unknown
Results: out of 100 participants 35 belonged to periphery and 65 to major areas of Hyderabad. The mean +/- SD age was 41+/- 3.5 years and means +/- SD duration of practice was 10.4+/- 5.7 years. Each doctor had seen 10 diabetic patients per day. Out of 100 doctors, 55 answered correctly and 45 were poor to all domain
Conclusion: This study explored the knowledge, attitudes and practices regarding diabetes in Hyderabad among general practitioners and identified the need for improvement in managing diabetes. Awareness and education regarding diabetes is recommended to improve the health-care services provided by general practitioners
ABSTRACT
Objective: To evaluate the effect of combination therapy of Nigella sativa and Trigonella foenum-graecum seeds on body mass index [BMI] in type 2 diabetic patients.
Setting: This clinical trial was conducted in the diabetic outpatient clinics of Isra University Hyderabad and Liaquat University of Medical and Health Sciences Jamshoro, from March to August 2008
Design:A randomized clinical trial
Subjects and Methods: For this study, Type 2 diabetic patients on glibenclamide, who gave written consent to volunteer in the study, were randomly divided into two groups. Fifty patients in group A [control group] were kept on glibenclamide, while 50 patients in group B [test group] were given capsules containing combined powders of N. sativa and T. foenum-graecum seeds in addition to their routine dose of glibenclamide. Patients in both groups were treated for 3 months. BMI was calculated for every patient at the start and after 3 months of therapy
Results: A favorable impact of combination therapy with N. sativa and T. foenum-graecum seeds in reducing BMI was noted in the test group in comparison to the control group, but overall differences between groups were not statistically significant
Conclusion: This study indicates that combination therapy of N. sativa and T. foenum-graecum has some effectiveness in controlling BMI in type 2 diabetic patients. Further study with an adequate sample size is recommended
ABSTRACT
Objective: To determine the frequency of different sexual dysfuctions in type 2 diabetic males attending Diabetic OPD of Isra University Hospital and in private setup at Hyderabad
Design: Observational study
Duration of Study: March 2008 to August 2008
Methods: One-hundred type 2 diabetic males were enrolled by purposive sampling technique after obtaining a well informed consent. The different sexual dysfunctions were explained in the language best understood by the subject. Inclusion criteria was type 2 diabetic males of 35-65 years in age taking oral hypoglycemic agents for at least 5-years with HbA1c <9%. Patients with hypertensions, and any other endocrine disease like hypogonadism, thyroid and marked renal or hepatic insufficiency were excluded from the study. Frequencies, proportions and means with standard deviations are calculated for respective types of data
Results: Erectile dysfunction was most frequent, which was present in 55 patients, premature ejaculationin 20, hypoactive sexual desire disorder in 15 and retrograde ejaculation in 10 patients
Conclusion: Diabetes is associated with different sexual dysfunctions and most common is erectile dysfunction
ABSTRACT
Objective: to determine the coagulation abnormalities in patients with lung cancer
Study design: case-control study
Place and duration: department of Pathology Isra University Hospital Hyderabad, Sindh - Pakistan, and Department of Medicine Liaquat University of Medical and Health Sciences Jamshoro, Sindh - Pakistan, from June 2006 to December 2007
Patients and methods: seventy subjects were recruited for the study by non-probability convenient sampling technique. Forty freshly diagnosed histopathology proven lung cancer patients were taken as cases, whereas 30 healthy subjects comprised the control group. Platelet count [PLT] was done on hematology analyzer while prothrombin time [PT], activated partial thromboplastin time [APTT] and plasma D-dimer tests were performed by commercially available kits at Department of Pathology, Isra University Hospital Hyderabad, and Sindh - Pakistan. T test was applied to determine the significance of differences between two groups whereas P value up to .05 was taken as significant
Results: the mean +/- SD PLT in cases and controls was 394 +/- 170 and 216 +/- 73 respectively. The mean +/- SD values for these respective groups were for PT 14.7 +/- 0.5 and 12.6 +/- 0.4, for APTT 41.5 +/- 6.2 and 25.8 +/- 3.7. D-dimer levels were <500 in all 30 controls whereas these were up to 2000 in cases
Conclusion: there is a strong relationship between coagulation abnormalities and lung cancer. D-dimer is very sensitive for evaluation of fibrinolysis related with lung cancer
ABSTRACT
Objective: to determine the predisposing factors of pregnancy induced hypertension in women of our community
Methods: an observational study was conducted at Gynecology and Obstetrics Department of Isra University Hyderabad from July 2007 to June 2008. Women with pregnancy induced hypertension were recruited in this study by convenient sampling from antenatal outpatient department, admitted patient in the ward and prelabour room. A restructured proforma was filled in which their age, BMI, parity, gestational age and gestational age when PIH [pregnancy induced hypertension] was diagnosed, regarding diabetes, multiple gestation, cardiac and liver disease, history of PIH in previous pregnancies and positive family history of PIH were recorded
Results: one hundred pregnant women were included in the study. We found 59% of women in age group of 30-40 years, 52% were overweight, 50% were multiparous and 15% were of grand-multiparous, 43% of women had history of PIH in previous pregnancies, 9% had positive family history and 12% were with diabetes. Twin pregnancy was seen in 3% , cardiac disease in 2% , renal disease in 1% , and hepatic disease in 1%
Conclusion: the observations of present study indicate that women between 30-years and 40-years of age, overweight [BMI >25-kg/m2], multipara, diabetic and who had history of PIH in previous pregnancies are at higher risk of developing pregnancy induced hypertension
ABSTRACT
To find out incidence of H. pylori anti bodies in non ulcer dyspepsia patients admitted in people's medical college hospital, Nawabshah. A prospective study was conducted at Department of medicine, unit III peoples medical college hospital, Nawabshah from March 2003 to Oct 2004. The patients admitted in medical unit-3 in PMCH, Nawabshah with dyspeptic symptoms. Any organic disease was excluded by upper G I T endoscopy. H. pylori antibodies were done by kit method. A total of 100 patients were taken. 60% were female and 40% were male. H. pylori antibodies were positive in 45 [45%] subjects. H. Pylori is significantly positive in non-ulcer dyspepsia patients. So every patient of non ulcer dyspepsia should be evaluated for H. Pylori antibodies