Incidence of false sero-negative blood donor cases for hepatitis-C in public and private hospitals of city district Faisalabad

Background: Hepatitis C is a worldwide public health problem nowadays. World Health Organization [WHO] estimates that 3 percent of the world population is infected with HCV. Voluntary blood donors have a very high prevalence of HCV infection especially in the developing world. The blood and blood components can be obtained from volunteer donors, direct donors, paid donors, or through autologous donation, hence the donors should be carefully interviewed and tested before blood donation

Objectives: To assess the incidence of false sero-negative Hepatitis-C blood donors and evaluate the costs, benefits and effectiveness of specific Tests of Hepatitis-C in public and private hospitals of city district, Faisalabad

Study Design: It was a cross-sectional hospital based study

Setting and Duration: The study was conducted in 3 public sector and 3 Private sector Hospitals of City district of Faisalabad. The study was conducted for one Year during 2010-2011

Sampling procedure: Non-probability Convenient sampling technique was employed

Sample size: The study included 600 blood donors who deposited their blood in the blood banks of the above hospitals for transfusion purposes

Results: The majority of the blood donors 70.83% were between the age of 18-25 years. Despite the fact that all the donors, in government and private hospitals groups respectively were found initially negative for hepatitis C on routine diagnostic test, yet considerable number of individuals, 14 [4.60%] and 46 [15.33%] in government and private hospitals groups, respectively were found unexpectedly positive for hepatitis C when scrutinized on ELISA diagnostic test. The results were found to be statistically significant when the P value was less than 0.05 [P<0.05]

Conclusion: All the individuals irrespective of their group were screened to be sero-negative for hepatitis -C, when tested on the routine laboratory test. But when their blood serum was tested by ELISA method, a sizeable number of individuals in both government and private hospital groups were screened as sero-positive for HCV. This state of uncertain performance of the routine laboratory test has given rise to unreliability of the diagnosis of hepatitis C by the routine test. It is, therefore, strongly recommended that only ELISA method should be ordered for authentic diagnosis of hepatitis C

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

Dengue fever its diagnosis, treatment, prevention andcontrol

Background: Dengue virus has emerged as a majorpublic health problem worldwide in the recentdecades. The incidence of this infection has increasedin tropics and subtropics including Pakistan. It is onethe most common and perhaps the most dangerousviral disease transmitted by mosquitoes. Currentepidemic of dengue fever of 2011 in Pakistan hashighlighted the lack of direction and neglect of thisdevastating disease. Now it is of fundamentalimportance to implement public health measures andalso to improve management of Dengue HemorrhagicFever and Dengue shock syndrome in our hospitals

Objectives: The objectives of this review article areto;1. Describe the epidemiology, virology, riskfactors,clinical features, diagnosis andmanagement of dengue fever.2. Determine the complications of dengue fever.3. Find out different modalities for prevention andcontrol of dengue fever.4. Provide awareness to the public about thisdisease and to dispel undue fears

Conclusion: Fever is the symptom present in almostall patients .Bleeding leads to serious complicationsin dengue fever. No effective vaccine or antiviralagents are available to treat dengue infection at themoment

Prognosis and Control: Attempts tocontrol dengue vector [mosquitoes] and effectivevaccine remain the important preventive measures

Millennium development goals; Achieving the goal no.4 [reduce child mortality] and goal no.5 [improve maternal health] in two districts of Punjab Pakistan

The Maternal mortality rate in Pakistan remains unacceptably high To study the awareness of immunization and breast feeding and the utilization of family-planning methods by the women of rural districts of Punjab, Pakistan. A Cross-sectional study. The study was conducted in Vehari and Chakwal districts of Punjab, Pakistan. May-July 2010. A total of 100 women were included in the study. Data was collected, cleaned, tabulated and analyzed. Among the hundred sampled women 58 [58%] were educated, and the commonly involved age group in the sample was 21-30 year accounting for 59% of the women. Among these 61% of the women have visited a family planning center, while the contraceptive prevalence rate [CRP] is 39%. Thirty eight [54%] out of the 70 multi-parous women have given birth with an interval of approximately 2 years. Only 6 [8.75%] have an optimum [safe] interval of 3 years. Among the total 90 child bearing women 74[82.22%] have got vaccinated their children, 46 [62.16%] of these are completely vaccinated according to the information obtained from the EPI vaccination cards. Among the 13[17.56%] who haven't vaccinated their children 10 [62.5%] complained of lack of awareness regarding the importance of vaccination. Five [31.25%] complained of inaccessibility to the BHU. Out of the 90 interviewed women 61 [67.7%] were vaccinated with tetanus toxiod during pregnancy. 82 [82%] women are aware of the benefits of breast feeding. 88[97.7%] out of total 90 child bearing women have breast fed their children with the percentage decreasing to 83.33% after 6-11 months of age and only 39[43.33%] counting breast till 1.5-2year [optimum age] of age. 53[58.88%] started weaning their child between 6-11 months of age. Direct causes of Neonatal Deaths were, 30% birth asphyxia and injuries, 35% due to infections [tetanus, sepsis, pneumonia, diarrhea], 20% due to complication of pre-maturity, 5% congenital anomalies and 20% due to other causes. There's a need for mass education regarding EPI and it's compliance so that the target set under MDGs is achieved. Though women of the rural areas are aware of the advantages of breast feeding there is a lot of variation in the duration that the children are breastfed and weaned, so there is a need for the provision of standardized nutritional to the mothers by the health workers.

Road traffic accidents; fatalities in Faisalabad

To study the road traffic accident [RTA] fatalities in Faisalabad, in relation to vulnerability of victims, their socio demographic characteristics and to identify the risk factors of fatal RTAs. A descriptive retrospective study. Post Mortem Unit, Allied Hospital, Punjab Medical College [PMC] Faisalabad. From January to December, 2006. Eighty-five dead bodies of fatal RTAs brought for Medico legal autopsies, to Allied Hospital, [PMC] Faisalabad, during calendar year 2006 were included in study for Post Mortem Examination. In this study maximum cases of road traffic accident were among males [91%], male to female ratio was approximately 9:1. Maximum incidence of RTA was in the age range of 21 to 50 years comprising 55.29% and commonest age group involved was 21-30 years accounted for [21.18%]. Most common victims were pedestrians 41.18% followed by motorcyclists 29.41% and cyclists 16.47%. Incidence was more common in the pedestrian. Road traffic accident is the leading cause of deaths and disabilities worldwide and it is needed to prevent them. Road traffic crashes are predictable and therefore preventable. In order to combat the problem, there is a need for close coordination and collaboration, using a holistic and integrated approach, across many sectors and many disciplines

Rabies: a highly fatal but preventable disease

Rabies is a highly infectious viral disease of central nervous system caused by rabies Lyssa virus type-1. It is also known as hydrophobia and is transmitted to human being mostly by the rabid carnivorous animals

Objectives: 1-To understand the pathogenesis of the disease rabies and be able to manage this problem most effectively. 2- To be able to avoid preventable deadly complication of this disease. 3- To give awareness about right treatment and remove wrong concepts among the public about this highly fatal disease

Conclusion: treatment. Rabies can be managed effectively with various modalities like wound management, vaccination and use of Rabies immune-globulins [RIG] as active and passive immunization according to the category of the exposure

Prognosis and outcome: With tissue or cell cultured vaccine the results are good while nerve tissue vaccines have too many disadvantages and are of uncertain efficacy. Failure to use RIG in category iii bite is often a reason for failure of therapy

Prevalence of depression among tuberculosis patients

Objectives: To find out frequency of depression among Tuberculosis [TB] patients, to study the causes of depression in them and its effect on treatment and prognosis of T.B

Study Design: Cross-Sectional Study

Study Area: Department of Chest Medicine District Head Quarters and Red Crescent T.B Hospital, Faisalabad

Duration of Study: March - May 2009. Study Population: TB patients admitted in Department of Chest Medicine DHQ and Red Crescent T.B Hospital, Faisalabad

Sample Size: Sample size was 60 TB patients

Sampling Technique: Convenience sampling technique

Data Collection Tool: Beck's Depression Inventory-II[BDI-II in Urdu] semistructured questionnaire was used for data collection for all TB patients who were able to understand it. Diagnosis was made as per Diagnostic and Statistical Manual of Mental Disorders, Fourth edition [DSM-IV]

Results: Depression was present in about 80% of the hospitalized TB patient. It was more common in males about 86%, while in the females it was about 71%. According to age, young and elderly patients were found to be more affected. Majority of the TB patients had moderate depression, while some had severe and mild depression. Main causes of depression among the male TB patients 24.7% were due to altered social relationship and among female TB patients 23.33% were due to TB stigma

Conclusion: It is concluded from this study that 80% patients were suffering from depression. The frequency of depression was found to be 86% among males; while 71% of the female patients were found to be depressed. Main causes of depression among the male TB patients were altered social relationship and among female patients TB stigma. Depression had adverse effect on drug compliance and TB treatment

Level of empowerment of women

To investigate the level of empowerment of women in accordance with human rights. A cross-sectional study. Residence Colony of Punjab Medical College, Faisalabad. Period: August-September 2007. There were 600 houses and 6 Blocks A, B, C, D, E and F in the colony. By Simple random sampling 10 houses were taken from each Block by drawing lots. Sixty married womens between the age of 25 -45 years [One from each house] were interviewed using a pre-tested structured questionnaire. The mean age of the respondents was 37.2 years. Among the total 60 [100%] women, 16 [26.6%] were illiterate, while 44 [73.3%] had primary education and above. Only 10 [22.2%] out of 44 educated women had graduate and above degree. Thirty-eight [63.3%] women had the opportunity to use the reproductive health services and family planning, while 22 [36.6%] could not utilize the family planning methods. A total of 40 [66.6%] women had good nutritional status, while 20 [33.3%] had imbalances in nutrition. Nineteen [31.6%] women were doing jobs in different public and private institutions, while 41[68.3%] had not got opportunity for jobs. Thirty-three [55%] women had monthly income less than Rs.10,000/- per month and 27[45%] had Rs.10,000/- and above. Forty [66.6%] women were given importance and active participation in decision making, in children marriages, house-hold and in political process [vote casting] at all levels, while 20[33.3%] were not given importance in decision making of above matters. Forty -three [71.6%] woman were given their right of inheritance / property. Fourteen [23.3%] women were forced to wear veil while going out of house. Forty [66.6%] woman admitted to have suffered from violence either psychological, physical or sexual in their life. Safe drinking water supply was available to 30 [50%] women, however sewage disposal, toilet facilities with in house were available to majority of the respondents. Atotal of 40 [66.6%] women were over all empowered. Women do have human rights as well. The results obtained from this study are encouraging but not up to the standards of International Human rights Principles, which are universal, inalienable; indivisible; interdependent and interrelated

Problems faced by the nurses during duty hours

To find out the job related problems faced by nurses during duty hours and to know their effects on their personal life, behavior with colleagues, senior nurses, administrators and patients. A Cross sectional study. Allied Hospital Faisalabad, a tertiary care health Institution attached with Punjab Medical College [PMC] Faisalabad. From 1[st] May to 30[th] June 2007. The study was conducted among the charge nurses and student nurses working in Allied Hospital Faisalabad. Data were collected by convenient sampling of 100 nurses, through structured questionnaire which were tabulated and analyzed. A total of 100 nurses participated, out of which 34% were charge nurses and 66% were student nurses. Needle prick injury was the most common accidental hazard among student nurses [48%] and charge nurses [35%], as the P. value was 0.189 so there was no significance difference/association between the two groups of nurses. Musculo-skeletal Problems were commonly found among [23%] charge nurses whereas [15%] student nurses also experienced musculo-skeletal pains during duty hours, as the P. value was 0.189 so there was no significance difference/association between the two groups of nurses related to Musculoskeletal Problems. Regarding problems due to work overload, irritability [35%], sleep disturbances [18%], emotional instability [35%], and mental stress [35%] were found among charge nurses whereas headache [33%], mental stress [27%] and emotional instability [33%] were reported in student nurses. Latex allergy was found among [36%] of charge nurses while [18%] student nurses also reported the same problem due to use of rubber gloves, Twenty-two [33%] student nurses had lack of support from seniors and [39%] students reported difficulty in communication with physicians and senior nursing administrators, whereas [35%] among charge nurses had communication problems with their seniors. As the P value was 0.659, so there was no significance difference / association between the two groups of nurses regarding support from seniors and communication. Needle prick injury was more common among student nurses whereas problems due to work overload were found in majority of charge nurses. Day to day problems faced by the nurses during duty hours could be reduced or prevented through the appropriate measures by concerned authorities

Nutritional survey of 8[th] october 2005 earthquake hit area of district Bagh

Earthquake disasters affect the well-being and health of people, by plunging them into greater risks of food deprivation, ill-health and nutritional deficiency diseases. To determine the type and pattern of food consumption against its availability to the earthquake-affected people, and to see the nutritional status of vulnerable groups. It was a cross-sectional survey carried out from November, 2006 to May, 2007 in Mallot, District Bagh of Azad Jammu and Kashmir. A sample size of 150 houses was determined for the survey and all individuals in these houses were evaluated. A pre-tested 5 module questionnaire was administered to collect the relevant data. The household information regarding food availability and consumption was collected from the family heads, women and children. Of 675 individuals seen, 202[30%] were below 10 years of age. A poor nutritional status in under 5 children was observed as 51[49.51%] had severe stunted growth, and 26[25.24%] were severely underweight. While, 38[47%] non-pregnant and 20[49%] lactating women had good health with normal weight. The food availability did not meet the dietary requirements of family members. The food consumption by household family members was below their recommended daily allowance due to less food availability. However, micronutrient deficiency signs were not commonly visualized in the population due to the therapeutic campaign launched by the Government. Only 56[8.3%] had signs of protein-energy malnutrition followed by iron deficiency anemia in 52[7.7%], dental caries in 44[6.5%], vitamin A deficiency in 31[4.6%] and iodine deficiency in 20[3.0%] individuals. Serum vitamin A, urinary iodine and haemoglobin levels in lactating mothers were within the normal ranges to be 31.53microg/dl, 121.76 micro g/l and 12.2 gm/dl, respectively. Malnutrition was a major health problem in under 5 children. Women were less affected by malnutrition. Less food consumption by the vulnerable groups was observed due to less food availability in the households

Knowledge regarding AIDS among pre-clinical and clinical medical students

To assess knowledge among preclinical and Clinical medical students of Punjab Medical College regarding Acquired Immunodeficiency Syndrome [AIDS]. A Cross-Sectional Study. 1435 Students of Clinical And Pre-Clinical Departments Of Punjab Medical College, Faisalabad. Sample Size and Technique: 101 Medical Students by Simple Random Sampling. A Pre-Tested, Semi-Structured, [Self Administrated] Questionnaire regarding knowledge about AIDS. Study Area/ Duration: Punjab Medical College, Faisalabad, from April - June 2009. Awareness related to pathogenesis of AIDS among preclinical students was 71.89% and among clinical students was 77.4%.Awareness related to transmission of AIDS among preclinical students was 62.24% and among clinical students was 67.3%. Awareness related to prevention of AIDS among preclinical students was 70.06% and among clinical students was 75.63%. Clinical medical students are comparatively better informed about pathogenesis, transmission and prevention of AIDS so more attention should be provided in order to impart more clinical aspects of medical sciences to pre-clinical students. Furthermore we should try to achieve close to 100% knowledge regarding AIDS in medical students

Chronic renal failure; association of diabetes mellitus

To find the effect of diabetes mellitus on the development of Chronic renal failure [CRF]. Descriptive Cross-sectional study. Allied Hospital, Faisalabad. From May 2008 to June 2008. Forty-Five patients of CRF were selected for study by convenient method technique from admitted patients in dialysis unit of Allied Hospital Faisalabad. In our study, out of 45 patients of CRF, 25 [55.6%] were found to be diabetic. The effect of diabetes on the development CRF was highest in age group of 71-85 years that was 100%. In this study diabetes mellitus was found to be more prevalent among married CRF patients [62%] as compared to unmarried patients among whom it was [17%]. Among the male CRF patients 54% were diabetic, while among the female CRF patients 57% were diabetic. Percentage of CAF patients having diabetes mellitus was 55.6%. From the above results it is concluded that effect of diabetes mellitus on the development of CRF increases with age. Diabetes mellitus was found to be more prevalent among female CRF patients and also among the married CRF patients. The development of Chronic renal failure can be prevented by early diagnosis and treatment of diabetes mellitus

TB-DOTS program; appraisal of role of lady health workers as treatment supporters

To assess the performance of Lady Health Workers [LHWs] in collection, storage and distribution of drugs and evaluate their effectiveness regarding TB suspect identification, referral, directly observing the intake of medicine, default identification and health education in TB-DOTS program. A cross-sectional study. In district Toba Tek Singh from January to Sep 2006. One hundred and two LHWs were selected randomly and interviewed using a structured pre-tested questionnaire. Among 102 LHWs, 76.5% were trained in TB-DOTS. Sixty four [62.7%] had qualification matric and above. Collection of the drugs was being performed properly by 87.3%, while 83.4% were storing the anti-TB drugs at proper places. Anti-TB drugs were being distributed to patients daily by 95.1%. Under the direct supervision of LHWs 69.6% of TB patients had completed treatment. In the areas of 58.8% LHWs, TB patients were declared cured after 8 months treatment. Defaulted TB cases were present, in the areas of 19.6% LHWs, while 12.8% of the LHWs had relapsed TB cases in their areas. Most of the LHWs [85.3%] had proper record of medicine and of the patients [84.3%]. The experienced and TB-DOTS trained LHWs of urban areas, in the age group of 41 -50 years had overall good performance. The LHWs having qualification matric and above had better performance than the LHWs having middle qualification. TB-DOTS program in district Toba Tek Singh was working successfully and it should be continued with some improvements and innovations