Adherence to antiretroviral therapy in HIV-positive, male intravenous drug users in Pakistan

Background: Human immunodeficiency virus [HIV] is fifth leading cause of mortality and disability among infectious diseases worldwide. HIV burden is increasing annually and compliance with antiretroviral therapy [ART] is low among intravenous drug users, especially in developing countries.

Aim: To determine the adherence level to ART among HIV-positive intravenous drug users in Karachi Pakistan.

Methods: A cross-sectional study was conducted in 2015. A pretested questionnaire was administered to 375 of 3000 people who inject drugs, registered at the Civil Hospital in Karachi, Pakistan.

Results: The mean age was 30 years, 181 were married, 179 were illiterate and 287 had income < 5000 rupees per month. Only 63 patients were adherent to ART and 343 were alcoholics. Nonadherence was greater in patients who were single and did not have children. The most common reason for missing ART was that they simply forgot to take the tablets.

Conclusion: We conclude that adherence to ART among intravenous drug users was low. Family cohesion and support were essential to maintain adherence to ART

Health-seeking behaviour of people living with HIV/AIDS and their satisfaction with health services provided at a tertiary care hospital, Karachi, Pakistan

Appropriate health-seeking behaviour is important as it allows prompt treatment for a condition and this can reduce complications and improve quality of life. This study aimed to assess the health-seeking behaviour and satisfaction with health care services of people living with HIV/AIDS attending the HIV/AIDS clinic of the Civil Hospital in Karachi. A total of 182 patients were interviewed using a pretested semi-structured questionnaire. Mean age of the participants was 32.31 [SD 7.91] years, 76.9% were male, 81.3% had no education and 75.8% were employed. Only 23.6% showed positive health-seeking behaviour and 57.7% were satisfied with the health care services. In logistic regression analysis, the cost of treatment per visit < US$ 5 and duration of HIV infection < 2 years were significantly associated with health-seeking behaviour. Efforts are needed to improve the health-seeking behaviour of people living with HIV/AIDS at the clinic and the health services offered

frequency of smear positive malaria and socio-demographics factors of patients visiting the microscopy center of a tertiary care civil Hospital, Khairpur

Objective: The aim of the study was to determine the frequency of smear positive malaria and sociodemographic factors of patients visiting the Microscopy center of Civil hospital Khairpur

Methods: A cross-sectional study was conducted January 2016 to April 2016 by using structured questionnaire to assess frequency of smear positive malaria among patients visiting Microscopy center of Civil Hospital Khairpur. About 138 patients who were prescribed Malaria Parasite [MP] Test by the doctors were selected by using consecutive sampling technique and interviewed regarding their socio-demographic characteristics. Data was entered and analyzed by using SPSS version 21

Results: Out of total 138 participants, 55.5% were males, Majority were less than forty years of age with highest range of 25-40 years. Malaria parasite test was found to be positive in 6.5 % participants and the most common identified species was Plasmodium Vivax

Conclusion: This study suggests that Malaria is endemic in certain areas of Khairpur District and Plasmodium Vivax is the most common species affecting the people who visited Microscopy centre for the Malaria Parasite [MP] test. Health education and community participation would be needed to eliminate the Malaria from community

Oral hygiene status of private and public school children from nine towns of Karachi City

The object of study was to appraise oral hygiene status of school-children of 6-years and 12-years in both public and private schools selected from nine different towns of Karachi city. An observational type of analytical cross sectional study of 1600 school-children, belonging 6 years and 12 years of age, were conducted among nine different towns of Karachi city. Sampling selection was based on cluster sampling technique. At the first stage, nine towns out of total eighteen towns were selected randomly. In the next stage, from each selected town one private and one public school were identified randomly. Selected sample of school-children were examined for plaque and gingivitis by using Loe and Silness plaque and gingival index. The overall plaque index score of the sample was found to be more than three fourth [n=1373, 85.8%] with the mean value of 1.18 [ +/- 0.73], indicating fair levels of plaque presence among school-children. Age wise plaque index scores were found to be statistically significant but gender wise statistically non-significant results were found [p?0.53]. The overall gingival index scores of school-children was found to be more than one fourth [n=445, 27.8%] with mean value of 0.43 [ +/- 0.77], reporting mild gingivitis among the study sample. Both age and gender wise mean gingival index was found to be statistically significant. Moreover, oral hygiene status [plaque and gingival index] were reported statistically significant among private and public school- children. This study suggests that more than half of the school-children had presence of dental plaque, whereas more than one third of them had mild gingivitis. This highlights the need for an unmet dental care services as well as community oriented health education and promotion in order to induce primary and primordial mode of prevention among school going children

Profile of psychiatric patients attending outpatient clinic of a tertiary care hospital, Karachi

The objective of this study is to determine the frequency of psychiatric illnesses among patients attending psychiatric outpatient department of tertiary care hospital Karachi. Cross sectional study. This study was conducted in Psychiatric Out - patient Department of a Tertiary Care Public Sector Hospital of Karachi from July 2014 to December 2014. About 560 psychiatric patients profile was determined during July -2014 toDecember 2014. The patients were diagnosed and classified on the basis of DSM -IV criteria by a consultant psychiatrist. The patient complete profile was obtained from the Hospital record. The Data obtained was entered and analyzed by using SPSS version 21. Among the total five hundred and sixty psychiatric patients, 51.5 % were males and 48.5% were females. Fifty percent of the patients had Depression, 30.9% patients had anxiety, 29% had psychosis and 24% patients had Schizophrenia. More than half of the patients belong to young age group 20 - 40 years. About ninety four percent patients were not referred and reached to the hospital in advance stages of diseases. This study concluded that the proportion of Psychiatric illnesses are high and majority of patients had depression, major victims of the psychiatric disorders are from most productive age group of our society which is an alarming situation and majority not referred by any physician seeking consultation on self- help basis

Colored text enhances learning power of medical students "a new concept of learning"

To assess colored text motivates, enhances concentration and learning Skills of medical students. To assess colored text helps in memory retention and release stress, anxiety of medical students A Cross Sectional Study This study was carried out among the medical students of Sindh and Dow medical College, Karachi from March to December 2010, A sample 341 student was drawn through systemic random sampling. Every 5[th] student was selected, ischiaria chart was used for color blindness and Students were divided into 2 groups. One group was given paragraph with important points written in bold black, second group with important points written in different colored. Data was collected through structured questionnaire, entered and analyzed on SPSS version 16. Out of 341 students, 83.60% students were motivated by colored text, 80.90% students maintained interest, 74.80% student's maintained concentration, 77.10% students had memory retention and 53.1% student had released their stress and anxiety. Overall 84.80% students preferred colored text over black and white text. The study proved significant difference between the two groups, students with colored text showed good memory retention, motivation, concentration, Stress was also relieved by colored text

Incidence of "stress syndrome" or type A personality in medical students

1. To assess the frequency of type A personality in medical students. 2. To compare different personality types of medical students from 1st to final year. A cross sectional study. This study was conducted at the Department of Community Medicine, SMC, DUHS, Karachi from 15th, May to 25th, November 2010. A sample size of 140 students was drawn by using systemic random sampling; every 22nd student from each year was selected according to the roll numbers from first year to final year in Sindh, Dow Medical College and Karachi. Data was collected through a structured questionnaire. Three personalities [Type A, Type AB, Type B] Personality Types: Type B Scores 0-35 Personality Types: Type AB Scores 36-45 Personality Types: Type A Scores 46-80. Out of 140 students, 42 were males, 69 were females. The results showed Type A personality was 82.9%, Type AB 16.4%, TYPE B was 0.7%. Students having type A personality in first year were 92.85%, in second year 100%, in third year 46.4%, in fourth year 85.7%, in final 89.2%. Type A personality in males were found to be 92.30% as compared to females 83.67%. Students who took their tasks very seriously 45%, easily got Irritated 51.4%, Restless during studies 32.1%, dissatisfied with task performed 49.3%, Work conscious 43.6%. On the basis of these results majority of the medical students fall in the category of type A personality, surprisingly 100% students of 2nd year fall in type A category. The study proved major population of medical students had Type A personality which showed they were tensed, impatience, aggressiveness, time conscious, concerned about their studies, highly competitive, ambitious, vulnerable to stress related diseases

Frequency of infectious diseases among flood affected people at district Rajanpur, Pakistan

To identify the frequency of infectious diseases among flood victims during and after disaster at district Rajanpur, Punjab, Pakistan. A cross sectional study was conducted from 15[th] to 31[st] August 2010 at 17 flood affected places of District Rajanpur of Punjab Province, Pakistan. A total of 7814 affected people were interviewed consecutively by using semi-structured questionnaire visiting the relief camps during the study period. Information was obtained after taking informed consent regarding infectious diseases: Acute Respiratory Tract Infection, Eye Infection, Gastrointestinal Tract Infection, Ear Infection, Skin and Soft tissue Infection, and suspected Malaria. Data was entered and analyzed by using SPSS version 16.0. The results showed that the distribution of infectious disease cases presented to relief camps were Gastrointestinal cases [Acute Diarrhea]-30%, Skin and Soft Tissue Infection [33%], Eye [Conjunctivitis]-07%, Ear, Nose and Throat Infection [05%], Respiratory Tract Infection [21%], and Suspected Malaria [4%]. Their mean age was 23.15 +/- 17.53 years. Our study concluded that there was a high frequency of infectious diseases. The morbidity and mortality resulting from infectious diseases can be minimized if public health intervention efforts are implemented in a timely and coordinated fashion

Knowledge, attitude and practices of mothers regarding immunization of one year old child at Mawatch Goth, Kemari town, Karachi

To assess the knowledge, attitude and practices of mothers regarding immunization of one year old child at Mawatch Goth, Kemari town, Karachi, Pakistan. A cross sectional study was conducted among mothers having one year old child at Mawatch Goth, Kemari town, Karachi in February 2007. All mothers having less than one year old child were interviewed through a semi structured questionnaire regarding immunization knowledge attitude and practices. The data collected through a questionnaire entered and analyzed by using SPSS program version 15. Majority of the mothers were illiterate, belonging to low-income group and not aware about the name of diseases in EPI Program. Majority [70%] of women started routine immunization of the child. The reasons for missing vaccination schedule were lack of understanding of next appointment, non availability of health staff, mild flu and others reasons like household work. About thirty one percent mothers quit immunization after missing one dose. Health care staff was the main source of information. A positive attitude was reflected from both the parents towards immunization. A significant number stated that vaccination is contraindicated in mild illness of child. The knowledge of our mothers about vaccination was found inadequate with strong positive attitude and limited practices

Mothers' knowledge about EPI and its relation with age-appropriate vaccination of infants in peri-urban Karachi

To evaluate the relation between the knowledge of mothers about EPI vaccinations and their infant's coverage. Effect of other socio-demographic variables on mothers' knowledge and child's coverage was also assessed. A cross-sectional survey was conducted, utilizing World Health Organization's thirty-cluster sampling strategy. All households with at least one infant were considered eligible. After obtaining verbal consent, the mother was interviewed to assess her knowledge and attitudes towards EPI vaccination. Infant's coverage status was verified by checking EPI card or verbal inquiry. A knowledge score was developed by summing all correct answers. A total of 210 mothers [7 per cluster] were identified and interviewed. The number and proportion of mothers correctly identifying the seven EPI diseases were as follows; Tuberculosis 57 [27.1%], Diphtheria 53 [25.2%], Pertussis 71 [33.8%], Tetanus 70 [33.3%], Measles 85 [40.5%], Polio 91 [43.3%] and Hepatitis B 65 [31.0%]. Only ninety four [44.8%] children were appropriately vaccinated for their age. In the multivariate model, mothers' knowledge was not significantly associated with appropriate vaccination of their children [p = 0.22], however, mothers' education was found to be significant [p < 0.001]. Mothers' knowledge about EPI vaccination in peri-urban Karachi was quite low and not associated with their children's EPI coverage. Mothers' educational status, however, was significantly associated with Child's coverage. This finding depicts a better health seeking behaviour of a more educated mother

Knowledge about ionising and non-ionising radiation among medical students

The majority of patients remain concerned about radiation exposure and the health risk associated to it. A doctor is a person who can answer all pertinent questions regarding radiation and can satisfy their patients. Medical students, who are future doctors, can acquire this capability during their clinical rotation in the radiology department. The study is to assess knowledge, hazards, misconceptions and misunderstanding among medical students regarding equipments using ionizing and non-ionizing radiation. A questionnaire was self administered to medical students of a private medical college of Karachi. One hundred and twelve students who had completed their clinical rotation in the radiology department from fourth and final year MBBS class were included in the study. The obtained data was analyzed using statistical software. Nearly 40% of the students accepted that objects in the X-ray room emit radiation after an X-ray procedure and nearly the same percentage agreed that protective measures should be taken while performing an ultrasound and that dangerous radiation is emitted from good quality microwave equipment. Slightly more than one-third students viewed that gamma rays are more hazardous than X-rays while the same percentage agreed that intravenous contrast material used in angiogram is radioactive. Sixty-seven percent students agreed that nuclear material used in medicine is potentially explosive while 18% of students were in the opinion that MRI emits ionizing radiation. Twenty-eight percent of the students believe that a radiologist have a shorter life span as compared to other medical specialist. The majority of medical students in both years have limited knowledge about various aspects of radiation sources, the risk involved and its protection. Better teaching methods and programmes are required for medical students in the subject of radiology

Awareness and pattern of utilizing family planning services among women attending urban health care center Azizabad Sukkur

To assess level of awareness and pattern of utilizing family planning services among women [15-49 years] of reproductive age at Urban Health Center, Azizabad Sukkur, Sindh. A cross-sectional study was conducted from April to June 2005 at Urban Health Care Center Azizabad Sukkur. Two hundred women of reproductive age group were interviewed by using a PRE tested semi structured questionnaire visiting the health care center during the study period. Information was obtained after taking informed consent regarding socio demographic characteristics, knowledge, attitude and pattern of utilizing family planning services. The data was entered and analyzed by using statistical package SPSS version 13. About 75% of women and 42.5% husbands were found illiterate, 85% women were housewives, 69.5% were married before 18 years of age and 54% had nuclear family. Regarding desired number of children women responded one child [3%], 2-3 children [11%], 4-5 [37.5%], more than five children [36%], 5.5% said that children are God gifted and 7% did not answer. About 60% of women reported use of at least one contraceptive method and 40% had never used any contraceptive method. The women who received counseling from the health care provider were 48.5% and only 6% received information through media. Religious prohibition, shortage of female staff and cost of family planning contraceptive methods were the main reasons identified for not utilizing contraceptive methods. The unsatisfactory variables were long waiting hours at the center, non-availability of contraceptive, shortage of the female staff and cost. Limited number of women was aware and practice contraception in the area and utilization of family planning services were low. The efforts should be made for providing information to couple and improving quality of family planning services in the area

Knowledge attitude and Practices about leprosy in a fishing community in Karachi Pakistan

To determine the level of knowledge, attitude and practices regarding leprosy in a fishing community of Karachi. A cross-sectional study was conducted at Muach Goth Kemari Town Karachi, from June-August 2005. About 300 people who did not have leprosy were interviewed randomly using a structured pre tested questionnaire. The inclusion criteria were adult, non diseased and resident of Muach Goth Kemari town. The findings of this study showed lack of knowledge about the cause, sign symptom, treatment and prevention of disease. The attitude towards the patient was found positive showing sympathy but at the same time significant level of stigma was found about the leprosy patient among the community. The majority of people did not receive any health education session or attended any seminar on leprosy and only 3% were aware of leprosy center in the area. The community lacks knowledge about leprosy. Emphasis must be given on Health education. A high positive attitude was found with significant level of stigma. Only educational efforts can bring about change to over come the disease and improve knowledge of the people

Pattern of antenatal care provided at a public sector hospital Hyderabad Sindh

To assess the pattern of antenatal care provided to the pregnant women and to determine their level of satisfaction for provision of services. This cross-sectional study was conducted at a public sector hospital of Hyderabad Sindh, the data was collected in the month of October 2004. The data was collected by using a pre-tested semi-structured Questionnaire, during the month of October 2004. A total of 161 women consecutively attending antenatal care clinic were included in the study. The variables included were socio-demographic like age, education, occupation and income, maternal and child health variables and level of satisfaction about antenatal care provided. The data was analyzed by using statistical package SPSS version 11. The mean age of women was 29.08 +/- 3.95 years, majority were housewife, 43.5% women were illiterate, 47.2% had primary education and 9.3% had secondary level of education. About 66% were from low-income group, i.e., earning less than 3000 rupees. About 71% were multi gravida, 67% had live births and 32% had history of abortions. Four had history of Intra uterine deaths. Only 22.4% reported that they use contraceptive for spacing. About 50% of the women were dissatisfied with the services available. The reasons identified for dissatisfaction were long waiting time, inadequate medicine supply and incomplete tetanus vaccination were also reported. This study concluded that antenatal care provided needs improvement and require attention to improve the quality of services provided

Pattern of tobacco consumption among adult women of low socioeconomic community. Karachi, Pakistan

To assess pattern and to determine risk factors associated with tobacco consumption in various forms among adult women above 18 years of age in a low socioeconomic community of Manora Island, Karachi. A cross-sectional survey was conducted and 200 adult women above 18 years of age were selected using systematic sampling with random start from a community of 5000 people in Manora Island, Karachi. There were 400 households in the community. Every 2nd household was visited and a woman above 18 years was selected. A semi-structured pre-tested questionnaire was administered to respondents by investigators. Data on tobacco consumption and other variables such as age, sex, marital status, education, employment and stress and anxiety related symptoms were obtained. A total of 104 [52%] reported tobacco consumption. Use of huqqa [hubble bubble] was more prevalent [79%]. Women above 30 years of age, being married and living in a joint family were more likely to consume tobacco. Illiterate women as compared to women with more than five years of schooling were more likely to consume tobacco [OR=3.16,95% CI=1.13-7.72]. Women having household income more than 5000 rupees were more likely to consume tobacco [OR=2.63,95% CI=1.36-5.09] and face more financial difficulties at home [OR=4.72, 95% CI=2.45-9.81]. Women consuming tobacco reported anxiety related symptoms more as compared to women who did not consume tobacco. Our study concluded that in this particular study setting, huqqa is the commonest form of tobacco consumption among women of low socioeconomic class. They start huqqa usually in childhood and after marriage by peer pressure especially in joint families. Women consuming tobacco report more psychosomatic symptoms and financial difficulties at home