Evaluation of changes in serum albumin level during different stages of pregnancy

Objectives: 1.To determine changes of serum albumin level during progression of pregnancy. 2. To assess hypoalbuminaemia as an early indicator of pregnancy induced hypertension

Study Design: Comparative cross sectional study

Place and Duration of Study: The study was conducted at Biochemistry department of Liaquat University of Medical and Health Sciences, Jamshoro with the collaboration of Gynecological and obstetric department of Liaquat University Hospital, Jamshoro/Hyderabad from 1.8.2008 to 31.7.2009

Materials and Methods: One hundred and twenty pregnant women of different gestational stages were selected through convenient sampling. The women suffering from any systemic disease were excluded from the study. The data regarding subjects was collected on a prtested questionnaire. The blood samples were collected through sterilized disposable syringes from the anterior cubital vein by venipuncture and were transferred into test tube and allowed to clot and then centrifugeted and the readings were noted for each blood sample. Results were analyzed by SPSS version 14. Continuous predictor variable and its relationship to the outcome variable was examined to ensure its modeling as a linear term. where possible. The independent effect of each variable significantly associated with serum albumin level was assessed at significance level of P tilde. 05. Students t -test was applied to compare levels of serum albumin in case and control subjects

Results: The women of 25 years had highest percentage of 22%; the highest percent of 12% were in their 28th weeks of pregnancy. At the significant level of P= 0.05 Pearson's coefficient was -0.267 and p-value was 0.003. As the duration of pregnancy advanced, level of serum albumin decreased in our study subjects

Conclusion: Appropriate measures should be taken to prevent fluctuation in serum albumin level which ultimately cause high maternal and neonatal mortality

Obstructed labor; risk factors and outcome among women delivered in a tertiary care hospital

The women of developing countries are at risk of pregnancy-related complications including pre-eclampsia/ eclampsia, obstructed labor, sepsis etc. Obstructed labor results due to three delays while woman is full term and is in labor. If detected and managed early and correctly, the pregnancies can be made safe and may result in birth of healthy babies. [1] To assess frequency of obstructed labor among pregnant women. [2]To determine socio-demographic risk factors associated with obstructed labor among study population. [3]To determine outcomes of obstructed labor among pregnant women. It was a hospital based descriptive cross sectional study. Two months. Department of Gynaecology and Obstetrics units I, II and III of Liaquat University Hospital [LUH] Hyderabad. To estimate the frequency, risk factors and outcomes of obstructed labor as of third trimester adverse pregnancy outcomes and to seek association of this adverse pregnancy outcome with the socio-demographic characteristics of the pregnant women i.e. their age, residence, parity, level of education and socio economic class. Out of total six hundred and nine women enrolled in the study, only 22 [3.61%] were in obstructed labor. 63.64% of them were of age > 30 years. More than 60% women in obstructed labor had reported from rural areas; and more than eighty percent of them were illiterate and belonged to lower socio-economic class. Only 4.55% of the women in obstructed labor were the booked cases. All the cases of obstructed labor were at full term. Cesarean section was done on 90.90% women. Not a single maternal mortality was reported among women enrolled in the study as obstructed labor. Neglected obstructed labor is a major public health issue. It can be avoided by addressing various socio-demographic determinants of pregnant women

Informed consent; awareness and practice among general medical practitioners

Introduction: Informed consent is the back bone of patients' autonomy. The advancement in medical technology has further increased its importance. In the developing countries including Pakistan, general physicians play a vital role in providing health care to the patients but unfortunately majority of them are unaware about the ethical aspects of their medical practice

Methodology:

Objectives: 1. To determine the level of awareness about informed consent among general practitioners. 2. To assess the association between various socio-demographic factors to the awareness about informed consent

Study Design: Community based cross sectional study

Settings: General medical practitioners of district Hyderabad were the study population

Period Of Study: Two months

Material and Methods: One hundred and forty subjects were selected for the study through purposive non-probability sampling. A pretested self-administered questionnaire was the tool for the data collection. The data was analyzed by using SPSS version 16.The variables of interest were gender of general practitioners, their age, level of qualifications, residence and occasions when informed consent was taken. The association between various socio-demographic variables was determined by applying Chi-square test at

Results: One hundred and forty general medical practitioners of varying ages from 32-60 years participated in the study. The mean age of the general physician was 39 +/- 1.8 years. The awareness about informed consent was found among 128[91.4%] subjects but unfortunately only 45.7%of them actually practiced it. The results regarding awareness as well as practice of informed consent among males and females were however not significant [p=0.520]. The young general practitioners i.e age 31-40 years were less practicing informed consent as compared to older general practitioners i.e. age 51-60 years and onwards [p= 0.04].The physicians practicing in urban areas were more cognizant about informed consent [p=0.05].Informed consent from patients was obtained before giving local anesthesia [80%], blood transfusion [24.3%]and before examination of female patients [46.4%]

Conclusions: Informed consent taking is not a routine process adopted by general medical practitioners so there is a strong need for general practitioners to change their attitude and acknowledge the patient's autonomy by taking informed consent, which is the basis of modern medical ethics

Third trimester pregnancy outcome and the associated risk factors among women admitted in maternity wards of a tertiary care hospital in Hyderabad

Objectives: To estimate frequency of third trimester pregnancy adverse outcomes and to seek association of adverse pregnancy outcomes with the socio-demographic characteristics of pregnant women

Study design: A descriptive cross sectional study

Place and duration: Maternity wards of Liaquat University Hospital [LUH] Hyderabad. Study was conducted for duration of two months

Methodology: The study subjects were all pregnant women and data including demographic data was collected through questionnaire based interviews from pregnant women, duty doctors, history records regarding pregnancy outcomes and necessary laboratory investigation reports

Results: Frequency of adverse pregnancy outcomes was 15.44%. Ante-partum hemorrhage was the most frequently occurring event [36.17%]; while eclampsia was the second most commonly reported event [29.79%]. Maternal age did not reveal any statistical association [p= 0.06]; while educational status [p=0.05], rural residence [p=0.03], race [0.05], working status [0.02] were statistically significantly associated and low socio economic status was strongly associated with adverse pregnancy outcomes [p=0.001]

Conclusions: Ante-partum hemorrhage was the frequently reported adverse pregnancy outcome besides eclampsia, obstructed labour and preterm delivery. The maternal socio-demographic characteristics like low educational status, rural residence, low socioeconomic status, women's' working status were associated with these adverse pregnancy outcomes

Tetanus toxoid [TT-2] coverage and its associated socio-demographic factors among married women of reproductive age in urban and slum areas of hyderabad

Neonatal tetanus is vaccine preventable infection and a cause of neonatal mortality in our country. TT- vaccination of women at child bearing age can safeguard women and reduce neonatal mortality. To assess the TT-2 coverage among women at reproductive age in Hyderabad urban and slum areas. To determine the socio-demographic risk factors influencing the TT-vaccination coverage. A community based cross sectional study. This study was conducted in Hyderabad city areas [Gari Khata, Noorani Basti], Latifabad Unit No: 5, 11, 12 and Qasimabad [Phase I, Sehrish Nagar, Nasim Nagar] from 15[th] June-15[th] August 2014. 220 women of child bearing age were approached through convenience sampling. Questionnaire based interviews and examining the vaccination cards were study tools. Data comprised of categorical and continuous variables and was analyzed by SPSS Version 16. Categorical variables were analyzed by chi-square test; mean and standard deviation was calculated for continuous variables and were analyzed by applying student t-test. The p-value

Effectiveness of core stabilization exercises versus Mckenzie's exercises in chronic lower back pain

To determine the effectiveness of core stabilization and McKenzie's exercises on intensity of pain, disability and lumbo-pelvic stability was compared in non-specific chronic low back pain [CLBP] patients. Randomized controlled trial study. This study was conducted at Departments of Physical Therapy, Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences Karachi and Peoples University of Medical and Health Sciences, Nawabshah during 2012-13. Thirty patients with non-specific CLBP were enrolled through convenience sampling and were randomly assigned core stabilization and McKenzie exercises. Intensity of pain, disability, and lumbo-pelvic stability were evaluated by Visual Analouge Scale, The Oswestry disability Questionnaire, and Stibilizer Pressure Biofeedback Unit, respectively. Eighteen sessions were done for both groups. T-tests and ANCOVA test were used for statistical analysis [p<0.05]. Although the score of pain decreased in both groups [p<0.05], the decrease of intensity of pain was more than in Core Stabilization Exercises Group [p<0.05]. The score of disability questionnaire decreased in stabilization exercise group [p<0.05]. During Knee Lift Abdominal and Bent Knee Fall Out maneouvres, pressure of biofeedback unit did not significantly differ before and after interventions, in both groups [p>0.05]. The stabilization exercises can reduce pain and disability in nonspecific CLBP patients

Self medication practices among residents of slum areas of qasimabad, Hyderabad

Self medication is the practice of treating ailments with medicines which are available without prescription. There is a lot of public and professional concern about the irrational use of drugs. To assess self medication practices among residents of urban slum areas of Taluka Qasimabad, District Hyderabad and to determine the underlying factors for it. A community based descriptive cross sectional study. This study was carried out among residents of peri-urban areas of Taluka Qasimabad, District Hyderabad from 15[th] October 2012 to 15[th] December 2012. Study tools, sample size and sampling technique: Data was collected through questionnaire based interviews from responders. Three hundred and eighty five responders were selected by convenience sampling. The prevalence of self medication was calculated in percentage. The qualitative and quantitative variables were analyzed in SPSS version 16 by applying various tests of significance. Total three hundred and eighty five respondents participated in the study; among them 207 were practicing self medication. 57% of the subjects were in age group 18-30 years [p=0.04]. There was male preponderance [90.3%] showing significant association with self medication practice [p=0.01]. Easy availability of medicines was the main reason for self practice [62.8%]; various analgesics were the most commonly used drugs [58.5%]. Self medication is the common practice among peri-urban residents; availability of low cost drugs is one of the most important determinants for this practice

Pattern of respiratory diseases respiratory diseases with cement and associated socio-demographic factors among workers of zeal pak cement factory,. site area, Hyderabad

The occupational dust leads to various respiratory diseases. It is a major health problem among factory workers and is under reported in everyday scene of medical practice. To assess the frequency of occupation related lung diseases among study population. To seek association of socio-demographic characteristics with occurrence of lung diseases among study population. Descriptive cross sectional study. This study was conducted in the Zeal Pak Cement factory, site area, Hyderabad for a period of one year. Data was collected by filling a questionnaire; subjects were selected by convenience sampling. Frequencies were computed, chi-square test was applied to see any statistical analysis of various categorical variables. Among 100 subjects examined, the frequency of respiratory diseases was found among 83% workers. 70% subjects belonged to labour class who were closely exposed to occupational dusts. 58% of the subjects were earning < rs:4000 /month; however no association of socio-economic status was seen with occurrence of respiratory diseases [p=0.06]. 63% workers belonged to age group 31-40 years. Chronic bronchitis was the most commonly presenting respiratory disease i.e. 37%, while cor pulmonale reported in 4% of the workers. Silicosis along with tuberculosis was reported among workers of age group 40-50 [p=0.01]. The high frequency of occupation dust related respiratory diseases warrants further research in order to design preventive strategies against them

Maternal age and parity as risk factors for preterm births and low birth weight among newborns delivered in outskirts of district Mirpurkhas

To estimate the frequency of preterm births and low birth weight occurring in union council Jhudo, District Mirpurkhas. To seek association of preterm births and low birth weight with maternal age and parity. Descriptive cross sectional. This study was conducted at Union council Jhudo, District Mirpurkhas. From June 2012 to September 2012. Three hundred households having a new born of age upto seventy two hours. Subjects were selected through convenience sampling method. Among total of three hundred, the frequency of preterm births was 37 [12.33%]; while the frequency of low birth weight was 83 [27.66%]. All the preterm babies were low birth weight. There were 121 women [40.33%] at advanced age, among them preterm delivery was recorded in only 17 women [14.04%] [p=0.16]. Low birth weight babies were delivered to 31 women at advanced maternal age [25.61%] [p=0.04]. Among three hundred recently delivered women, 113 were primipara [37.66%], 98 [32.66%] were multipara and 89 [29.66%] were grand multiparas. Primiparity was seen statistically significantly associated with low birth weight [0.02]; and as parity increased, it did not show significant association with low birth weight.[p=0.12]. Low birth weight and preterm births are still major public health problems in our community. The advanced maternal age and high parity are the risk factors for them in rural and semi-urban areas

Neonatal sepsis - its determinants and outcome among newborns admitted in neonatal intensive care unit [NICU], Liaquat university hospital Hyderabad

Neonatal sepsis is a life threatening emergency and is one of the commonest causes of neonatal mortality in developing countries. It is very difficult to diagnose because of multiple risk factors and non specific clinical signs. To assess frequency of neonatal sepsis and to identify its determinants and outcomes among newborns. Hospital based descriptive cross sectional study. This study was conducted at Neonatal Intensive Care Unit, Liaquat University Hospital Hyderabad from 1[st] July 2011-31[st] October 2011. The data was collected through questionnaire based interviews from duty doctors regarding health status of neonates along with laboratory investigation reports. The criteria for the case diagnosis was maternal history, newborns' clinical findings and laboratory diagnostic work up including blood culture, blood cell counts and C-reactive proteins. The results were analyzed by using SPSS version 16 for various socio-demographic variables and for the outcome of the disease. Among total 236 newborns admitted in NICU, 115 neonates [48.7%] were diagnosed as neonatal sepsis. Gender of new borne was not related with occurrence of neonatal sepsis, but males were at greater risk of developing sepsis from nosocomial infection. [p= 0.04]. Strong association was also seen for neonates who were low birth weight [p= 0.01], had maternal peripartum history [p=0.01], and family's poor socio-economic background [p=0.02]. Neonatal sepsis was frequent presentation of the new borne admitted in NICU; it was associated with wide variety of risk factors