Biomonitoring of Toxic Effects of Pesticides in Occupationally Exposed Individuals

BACKGROUND: Workers in pesticide manufacturing industries are constantly exposed to pesticides. Genetic biomonitoring provides an early identification of potential cancer and genetic diseases in exposed populations. The objectives of this biomonitoring study were to assess DNA damage through comet assay in blood samples collected from industry workers and compare these results with those of classical analytical techniques used for complete blood count analysis. METHODS: Samples from controls (n = 20) and exposed workers (n = 38) from an industrial area in Multan, Pakistan, were subjected to various tests. Malathion residues in blood samples were measured by gas chromatography. RESULTS: The exposed workers who were employed in the pesticide manufacturing industry for a longer period (i.e., 13-25 years) had significantly higher DNA tail length (7.04 μm) than the controls (0.94 μm). Workers in the exposed group also had higher white blood cell and red blood cell counts, and lower levels of mean corpuscular hemoglobin (MCH), MCH concentration, and mean corpuscular volume in comparison with normal levels for these parameters. Malathion was not detected in the control group. However, in the exposed group, 72% of whole blood samples had malathion with a mean value of 0.14 mg/L (range 0.01-0.31 mg/L). CONCLUSION: We found a strong correlation (R2 = 0.91) between DNA damage in terms of tail length and malathion concentration in blood. Intensive efforts and trainings are thus required to build awareness about safety practices and to change industrial workers' attitude to prevent harmful environmental and anthropogenic effects.

Viral hepatitis c in thalassaemia: determination of antibody hcv frequency in mutitransfused thalassaemia patients

Background: Thalassemias are a group of genetic blood diseases. These patients are blood transfusion dependent because of genetic inability to produce hemoglobin according to body needs. Due to repeated transfusions, these patients are vulnerable to HCV, HBV and HIV like blood transmitted diseases. The purpose of this study is to determine post transfusion HCV frequency in these patients

Objective: To assess prevalence of antibody HCV in multi-transfused Thalassaemia patients. Study Setting: The study was conducted at Thalassaemia Center, DHQ Hospital Faisalabad located in Central Punjab, Pakistan. The record of the Thalassemia children registered in this center during 1[st] Jan 2012 to 31[st] Dec 2014 was reviewed. Study Design

Methodology: A descriptive cross sectional study was conducted on 416 Thalassemia children registered in Thalassemia Center DHQ Hospital Faisalabad. Out of these 379 children were included while 37 excluded due to incomplete record. The demographic data, blood transfusion history and lab tests details were taken from patient files. The HCV diagnostic laboratory techniques used were Rapid manual, confirmed by Enzyme Linked Immunosorbent Assay [ELIZA]

Results: Out of 379 Thalassemia patients, HCV positive found were 123 [32.45%]. The study population age was in range of 1- 19years while age range of HCV affected group was 5-19 years. Out of total 379, male were 235 [62%] and female were 144 [38%] while in total 123 HCV affected group 82 [66.67%] were male and 41 [33.33%] female. In total of 379 Thalassemic children having multiple transfusions, 123 [32.45%] were HCV +ve. Among 353 Thalassemic children having positive blood groups, 111 [31.44%] were HCV +ve while 12 [46.15%] were HCV +ve in 26 children with negative blood groups. Among 235 male, 82 [34.89%] were HCV +ve and 41 [28.47%] HCV +ve in 144 female children. Hepatomegaly was 75% in HCV +ve while 65% in HCV -ve groups. The splenomegaly was almost 80% in all groups

Conclusion: Despite use of screened blood transfusions in this center, still there is alarming proportion of HCV affected blood receiving patients. In this study Antibody HCV prevalence was higher [46.15%] in Thalassemic children with negative blood groups than [31.44%] positive group children. In total HCV +ve patients, 2/3 [66.67%] were male and 1/3 [33.33%] female group. This study warrants attention to improve HCV diagnostic and instrument sterilization techniques to minimize the risk of HCV infection

Roads traffic accidents: an epidemiological study of road traffic accidents in tertiary care hospital

Background: Road Traffic Accident [RTA] is growing public issue and fall among four top causes of mortality and morbidity. Many people [of all age groups], die daily during playing in streets or travelling on roads. Main causes of these accidents are lack of driving skills, distracted and prolonged driving, use of intoxicants, use of mobile phone during driving, defective roads, over loading and inadequate government administrative structure. These accidents are predictable and largely preventable through multi-disciplinary coherent strategies

Objective: To study epidemiological factors, compliance with traffic rules and pattern of accidental injuries

Methods: This study is descriptive cross sectional, carried out at DHQ Hospital Faisalabad. The data was obtained from patients of RTA arriving at Accident and Emergency Department [Trauma Center], from 1[st] January 2016 to 30[th] June2016. During this period 583 patients of RTA were reported to this center. The study variables were socio demographic, human, environmental and time factors. Statistical analysis was done in percentages, linear / logarithmic trends and chi-square test to know strength of association between these variables

Results: Among total 583 RTA cases, male victims were 449 [77.02%] and female 134 [22.98%]. Majority of cases 256[43.91%] were in age group of 15-29 years. Victims of RTA from rural areas were 194 [33.28%] while 389 [66.72%] were from urban / sub-urban areas. People from low economical strata were 198 [33.96%], moderate 310 [53.17%] and victims with illiteracy level were 135 [23.16%] and having education up to school were 304 [52.14%]. Human factor, cell phone user were 29 [4.97%]. Victims observing traffic rules were 93 [15.95%] while only 17 [30.19%] practiced PPM. Human factor regarding casual attitudes was observed in 47 [8.06%] cases. Maximum accidents occurred during office/school and market opening / closing timings i.e. 08-00 to 12-00 hours, 180 [30.87%] with fatality 27 [04.63% of this time events and 24.12% of total fatality] and 12-00 to 16-00 hours 136 [23.33%] with 4.29% fatality of total events and 22.32% of total fatality]. Fatality was maximum during evening, 35 [6.00%] of evening RTA's and 31.25% of total fatality. Environmental factors, worst weather was observed in 35 RTA's [6.00%], narrow and repairable roads shared in 69 cases [11.84%] while in old repairable vehicles were 17 [2.92%]. RTA in two wheeler vehicles/one wheeler were 271+59=330 [56.60%], in auto rickshaw [three wheeler] 106 [18.18%] and in pedestrian 85 [14.58%]. Pattern of head injury was found in 72 RTA's [12.35%] while limb injuries 76 [13.04%]. Mortality occurred in 112 [19.21%] cases while mild to severe morbidity was observed in 471 [80.79%] cases

Conclusion: This study concluded that male youth shared major portion of RTA victims. Morbidity and mortality was high in riders of two wheelers and in persons having head injuries. All the contributory factors were largely preventable through multi-pronged approach

Knowledge, attitude and practice [KAP] of dengue fever in adult semi-Urban and rural population of central Punjab Pakistan

Objective: to assess Knowledge, Attitude and preventive measures practiced by semi-urban / rural adult population of central Punjab regarding dengue fever

Study setting: independent University Hospital Faisalabad located in semi urban area of Jinnah Town [District Faisalabad] was selected for this study

Study Design: a cross sectional Descriptive study was conducted among the adult patients and their attendants from semi-urban/rural area attending OPD IUH

Study Population: adult patients/their attendants aged 18 years and above from both sexes and from all economical strata attending OPD of IUH were asked to take part in the study

Materials and Methods: Inclusive criteria: participant should be residing in Jinnah Town Faisalabad for the last one year

Sample Size: 550 adult individuals were taken by convenient sampling from the OPD patients and their attendants of IUH as a representative sample of total population of Jinnah Town. 95% confidence interval, 5% sampling error, assumption of 50% knowledge and attitude prevalence and 15% non-response rate were decided prior to study

Results: 550 individuals were enrolled for study, 50 participants decline to continue study. Analysis showed that 83.8% participants have adequate knowledge about vector, 38.6% know about dengue fever, 83.2% have good attitude about dengue fever, 86.6% participants use some of the preventive measures to protect themselves from mosquito

Conclusion: more Awareness Campaigns regarding dengue fever are still needed in rural area to have adequate level of KAP to control and prevent dengue fever epidemics. Due to low literacy level, there is gap between knowledge and practices. Health services in rural areas are insufficient, understaffed and un-accessible due to lack of roads/transport indicating differential allocation of resources for rural areas

Appraisal of Hepatitis-B and Hepatitis-C prevalence

Objective: to asses prevalence of HBV and HCV among healthy blood donors

Study Setting: Blood Transfusion Services Center DHQ Hospital Faisalabad. [Blood donation record of blood donors]

Study Design: retrospective review of blood donation record of blood donors, who attended this center from 1[st] Jan 2014 to 31[st] Dec 2014

Materials and Methods: the blood donation record of 32028 persons was reviewed who visited BTSC DHQ Hospital Faisalabad for donation of blood. The donors were selected according to International donor selection criteria. All the blood donors were screened for HBV and HCV by "Rapid Method."

Results: review and analysis of blood donation record of 32028 screened blood donors showed that 11.16% blood donors were female [ n= 3574 ] and 88.84% were male [n=28454].Among total, 609 blood donors were HBV positive i.e.1.90% and 2724 were HCV positive i.e. 8.50%

Conclusion: this study concluded that the prevalence of HBV and HCV among healthy blood donors of this area, HBV to be in low endemic group [<2 %] while HCV in high endemic group [>8%]. Female donors are proportionately less than male donors

Tuberculosis; patients knowledge, attitude and perceptions

Tuberculosis is one of the major public health problems in Pakistan. Pakistan ranks fifth amongst TB high-burden countries worldwide and accounts for 61% of the TB burden in the WHO Eastern Mediterranean Region. To describe knowledge, attitudes, and perceptions among the patients of pulmonary tuberculosis about their disease attending outpatient department at independent university hospital Faisalabad. A descriptive cross-sectional study. August to September 2014. Out patients department at Independent University Hospital Faisalabad. A total of 197 patients from OPD. Systematic random sampling technique. After an informed consent a pretested questionnaire were used to collect the information from the patient. SPSS-17were used to calculate the frequencies and percentages. Out of 197 respondents were 55.3% [109] male, 44.7% [88] female and 63% [125] were earning below 10000 rupees per month. As for as knowledge is concerned 50% of the patients viewed that TB is transmitted through contact with the patients having tuberculosis, 83%labelled cough of long duration as commonest sign, 60% viewed that it can be prevented by avoiding contact with patients, 57% labeled healthcare staff as their source of information, 65.9% perceived TB as an infectious disease, 55% stress as cause of disease, 85% as not curable disease. Poor knowledge and false perceptions are the main constrain in the control of TB in Pakistan

Learning preferences; teaching medical faculty

Introduction: This study has focused to know the learning preferences among faculty considering different methodologies and considering about CME to improve healthcare

Objectives: To identify the gaps in knowledge regarding CME in medical faculty of Lahore and to see the awareness of the CME among them

Study Design: This is a cross-sectional study of medical faculty in Lahore

Settings: Three hospitals in Lahore are included from both private/ public sectors. Period: It was conducted over a period of 2 months from JULY, 2014 to August, 2014

Methods: A questionnaire comprising of 21 questions was distributed at random for data collection among doctors having done post graduation

Results: Most of the faculty members who attended CME found it as useful tool for improving the knowledge and techniques for better patient care

Conclusions: Majority teachers are not interested in CME and do not participate and ask for some incentives

Job satisfaction of physicians and teachers; regular verses contract basis jobs

Objectives: To determine the level of job satisfaction of physicians and teachers having regular jobs and those having contract based jobs and to compare level of job satisfaction between these types of jobs and between the two professions

Study design: Cross sectional study

Duration and place of study: This study was conducted with teachers and physicians recruited at different schools, colleges and hospitals of Faisalabad in six months from October, 2008 to March 2009

Subjects and methods: A sample of 200 participants, 100 physicians [50 regular and 50 on contract basis] from public hospitals and 100 teachers [50 regular and 50 on contract] from public schools and colleges was drawn through purposive convenient sampling technique

Result: In overall profession wise analysis teachers scored higher on job satisfaction scale [m=131.98] than physicians [m=126.98]. Personals having regular jobs had lower job satisfaction [m=128.52] than professionals have contract jobs [m=130.45]

Conclusion: Contract based jobs carry higher levels of job satisfaction for employees than the regular based jobs

Tuberculosis management; how well do our medical practitioners know in Lahore Hospitals?

Background: Medical practitioners are the main source of health care for patients in Pakistan due to their availability at all times. Limited information is available related to the management of Tuberculosis [TB] among the practitioners

Study Design: Cross sectional study

Setting: Through stratified random sampling among the practitioners of Lahore, Punjab

Period: May 2014 to August 2014

Methods: They were presented with a questionnaire and their answers examined according to the international designed strategy for TB management

Results: TB management has a positive relationship with experience, awareness, source of awareness and continuing medical education and a negative relationship with qualification. 95 % of doctors agreed to go for further investigation but only 40% knew that 2 sputum samples were required for proper diagnosis. Only 32% doctors knew TB resistant drugs were to be given in drug resistant cases

Conclusion: Most doctors in Pakistan lack sufficient knowledge regarding tuberculosis management and prompt measures shall be taken to improve it