Awareness of viral hepatitis in ten villages of district nowshera

Viral hepatitis is a cause of great concerns the world over and more so in the developing countries like Pakistan. Its incidence has increased to alarming proportions and is likely to increase further in near future. This study was conducted to assess awareness of a rural community to Hepatitis B and C. A cross-sectional study was conducted from November 2007 to October 2008, in ten villages of District Nowshera. Questionnaire was designed to assess their knowledge about viral Hepatitis. Data was computed using SPSS version 10. A total of 3654 respondents were interviewed, 642 [17.6%] were aware that Hepatitis B and C were diseases of liver and transmitted by a virus. Respondents reported that there were multiple routes of transmission of this disease. Used syringes were the most common factor reported to be responsible for spread of this disease, followed by dental apparatus, injuries caused by nail cutters and sexual contact. One fifth [20%] of the respondents were unable to identify any physical sign or symptom of the disease. Television, Doctors and Radio appeared to be the most popular sources of information used for obtaining health information on these diseases this was reported by 43%.42% and 40% of the population respectively. Knowledge and awareness regarding the causative agent, mode of transmission and the consequences of Hepatitis B and C are poor in rural communities

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

Bronchodilator response to nebulized salbutamol in elderly patients with stable C.O.P.D

To assess the response of elderly patients with stable COPD to beta-2 agonist. Material and This inter ventional study was conducted in Pulmonology unit, Lady Reading Hospital, Peshawar. Patients were recruited after considering inclusion and exclusion criteria. A detailed history and clinical examination performed. On first day, baseline pulmonary function test [PET] [FEV 1, FVC, FEV1/FVC, PEFR] was taken. Then 3 ml normal saline [placebo] was administered via cho-neb nebulizer. PET measurements were repeated after 15, 30, 60 and 120 minutes. The best of three readings was recorded. On next day, the same protocol was applied except that placebo was replaced by nebulized salbutamol 5 mg [1 ml] plus 2 ml normal saline was administered via nebulizer. Out of 40 patients fulfilling entry criteria 30 completed the study. Age range was from 60-80 years. The mean baseline for FEV1 and FVC were 0.52 and 0.76 respectively. There was no significant difference in the mean baseline values on two days. The results expressed as mean and peak percentage changes about the baseline are shown in tabular and graphical form. 60% patients responded to salbutamol and 25% to normal saline. Analysis of variance comparing change in FEV1 between salbutamol and normal saline revealed highly significant drug effect [P<0.01]. The drug effect comparing changes in EV.0 was statistically not significant [P>0.05]. Salbutamol can produce useful bronchodilatation in elderly patients with stable COPD which can be readily assessed using spirometry

Assessment of knowledge, attitude and skills of lady health workers

Government of Pakistan launched National Program for Family Planning and Primary Health Care in 1994. Lady Health Worker has a key role in providing these services. This study was designed to assess the quality of these services. It was a descriptive, cross-sectional study, conducted at District Kohat, Pakistan, in July 2005. Lady Health Workers with a job experience of more than 24 months were interviewed to assess their knowledge, attitude and skills, in terms of variables according to their job description. These variables included home visits, antenatal care, family planning, newborn care, vaccination, growth monitoring, common diseases, medicines and referrals. Fifty lady health workers were interviewed. Knowledge of lady health workers was above 36%, attitude score above 88% and skill assessment score above 86%. Sixty four percent lady health workers had established their health houses. Seven lady health workers showed non-satisfactory results with poor health house management. Much improvement in skills was required in the use of contraceptives. There was poor display of knowledge regarding vaccination schedule and insufficient knowledge 36% for the doses of common medicines. This study opened a window to peep through deficiencies of health system. It showed that most of the LHWs had optimum knowledge and an optimistic attitude. Deficiencies were seen in vaccination and contraception. It is recommended to arrange workshops and courses for LHWs on regular basis to refresh their knowledge

Essential newborn care practice in hospital versus home deliveries

Newborn mortality is one of the most neglected health problems in the developing world. In Pakistan it also remains very high. Most of these deaths could be prevented through cost-effective interventions. A large proportion of births continue to occur at homes. The study was undertaken to describe newborn care practices in the hospital and at homes, as an initiative to focus this alarming problem. This comparative cross-sectional study was carried out during the months of June and July 2005 in District Mardan, Pakistan. Data was collected and compared in hospital-based and community based deliveries. Gynae labour suite in District Headquarter Hospital Mardan was chosen as hospital-based facility. Irum colony in Mardan city was taken as community-based population. Information from 30 delivery cases was gathered; half the cases were hospital-based and half at homes. Sampling method was convenient. Descriptive statistical analysis was performed. The result of this study showed that among hospital deliveries 80% were conducted by nurses, 20% by skilled dais and none by doctor. Among these cleanliness was kept in 33%, cord care 100%, thermal protection 83.3%, breast feeding initiation within an hour was noted in 66.6%, spontaneous breathing was 100%. All of the home based deliveries were conducted by unskilled birth attendants. Among these; cleanliness 16.6%, cord care 80%, thermal protection 100%, breast feeding within an hour 14%, spontaneous breathing 100%. In both of these groups eye care was 0%, and immunization was 100%. This small scale study highlighted the deficiencies in the newborn care. Both hospital practices and traditional ones neglected the basic principles of newborn cleanliness, early breast feeding, eye care and cord care. A community based essential newborn care strategy is recommended