Study about the knowledge and attitude of antenatal women on postnatal care and immunisation

Background: Optimum postnatal care, exclusive breast feeding and vaccination are the most essential factors for the adequate growth and development of a child. Interventions to improve these can result in reduction in infant morbidity and mortality. The study was done to assess the knowledge level and attitude of antenatal mothers on postnatal care and immunisation.Methods: This is a cross-sectional descriptive study done in a private medical college in Kerala conducted during September 1 to 31st 2018. All pregnant ladies attending the medical college hospital for antenatal check-up during the study period and willing to participate were included. Data collection was done by interviewing the participants using pretested and edited questionnaire and analysed by applying proportions.Results: The awareness about postnatal care and breast feeding was good among participants while lacking in a few aspects. Majority of them had the right knowledge about pre-lacteal feeds, colostrum and timing of initiation of breast feeding. But there was a gap between the knowledge they possessed and what they practised when it comes to vaccination.Conclusions: There is a need to educate antenatal mothers about various aspects of vaccination and postnatal care.

Association of socio-demographic characteristics with pattern of health seeking behavior among hepatitis C patients in Pakistan

Objectives: To identify association between socio-demographic characteristics and pattern of health seeking behavior among hepatitis C patients in Karachi, Pakistan

Study design, settings and duration: A descriptive, cross-sectional study done at Aga Khan University Hospital and the Civil Hospital Karachi between March and May 2013

Patients and Methods: Hepatitis C patients who were coming for treatment at the above 2 sites underwent a filling of questionnaire by the researcher. The questionnaire collected basic demographic information and their health seeking behavior i.e. visit to traditional healer or spiritual healer or medical doctor. Sample size of 250 patients was calculated. Analysis was done by using Chi square test and Fisher's exact test. p-value of 0.05 was considered as statistically significant

Results: A total of 250 hepatitis patients were interviewed. The study showed that patient's occupation and educational level had significant association with their first visit either to a spiritual healer or traditional healer. More educated group consulted the medical doctor while those with none or low education initially went to see spiritual healers [p < 0.008] and second visit was made to traditional healers [p < 0.002]. Patients with larger number of children went less often to visit a medical doctor on their second visit [p = 0.007], and family members belonging to the medical field were more likely to make their first visit to doctors [p < 0.05]

Conclusion: Socio-demographic characteristics greatly influence the pattern of health seeking behavior among hepatitis C patients

Awareness about hepatitis C among patients suffering from hepatitis C in Karachi, Pakistan

Objectives: To assess the level of awareness about hepatitis C among patients suffering from hepatitis C in Karachi. Pakistan. Study design, settings and duration: A descriptive, cross-sectional study, conducted among hepatitis C patients recruited from the Aga Khan University Hospital and the Civil Hospital, Karachi, between March and May 2013

Patients and Methods: A sample size of 247 was calculated using the Open Epi software. Data were collected using a questionnaire and all eligible patients were briefed about the study purpose, risks, benefits, and their rights as participants. All patients who agreed to participate gave written informed consent. The completed questionnaire took a maximum of 2530 minutes. For the data analysis, frequencies and percentages were computed to find out the estimated proportions of different variables

Results: A total of 250 HCV patients participated in the study. Most of the patients had incorrect knowledge about transmission of disease where 76.8% said that it is transmitted through sharing of towel/clothes, coughing [75.2%] or eating in same utensils [53.6%]. Tattooing [66.4%], kissing [66%], sexual intercourse [54.4%], ear and nose piercing [53.6%] were also identified as transmission sources. Almost 91% patients had misconceptions that preventive vaccine for hepatitis C infection is available. Almost 61% patients thought that exposure to needles/syringes was the cause of their hepatitis C while 22% said it was medical instruments. Food and water as the cause of their hepatitis was reported by 19.1%

Conclusion: Patients suffering from hepatitis C have misconceptions about disease transmission, its risk factors, and the availability of preventive vaccine for hepatitis C. There is a dire need to improve public awareness about common diseases and their prevention

Content validity of a tool measuring medication errors

The objective of this study was to determine content and face validity of a tool measuring medication errors among nursing students in baccalaureate nursing education. Data was collected from the Aga Khan University School of Nursing and Midwifery [AKUSoNaM], Karachi, from March to August 2014. The tool was developed utilizing literature and the expertise of the team members, expert in different areas. The developed tool was then sent to five experts from all over Karachi for ensuring the content validity of the tool, which was measured on relevance and clarity of the questions. The Scale Content Validity Index [S-CVI] for clarity and relevance of the questions was found to be 0.94 and 0.98, respectively. The tool measuring medication errors has an excellent content validity. This tool should be used for future studies on medication errors, with different study populations such as medical students, doctors, and nurses

Validity and reliability testing: Urdu translated modified response to symptoms questionnaire

To determine validity and reliability of the Urdu translated, modified "Response to symptoms questionnaire" [RSQ] among acute coronary syndrome [ACS] patients in Karachi. A qualitative, tool validation study. Two tertiary care hospitals in Karachi, the Aga Khan University Hospital, Karachi and the Karachi Institute of Heart Diseases, from December 2010 to April 2011. After making certain modifications, the original tool in English was translated into Urdu. Next, five cardiology experts evaluated the tool for its content and face validity. Test retest and inter rater reliabilities were computed for the RSQ using 5% of the total sample size of the parent study. Sufficient conceptual and semantic equivalence was found between the Urdu and English versions of the modified RSQ. Content validity index was calculated to be 1 for both relevance and linguistic clarity. Test retest and inter rater reliabilities were calculated to be 95.9% and K = 0.97, respectively. The Urdu translated modified RSQ has sufficiently acceptable content validity, test retest and inter rater reliability; hence, it should be used by the researchers for the evaluation of factors associated with pre-hospital delay among Urdu speaking ACS patient populations

Psychosocial experiences of women with vesicovaginal fistula: a qualitative approach

Vesicovaginal fistula [VVF] is a condition associated with a number of physical and psychological consequences. In order to gain a deeper understanding of the issues faced by women diagnosed with VVF, a qualitative exploratory study was carried out to explore the experiences of women suffering from VVF. The study included 8 women hospitalized with the diagnosis of vesicovaginal fistula at Kohi Goth Women's Hospital, Karachi, Pakistan. Semi structured interviews of each participant were conducted, recorded, and transcribed. Five major themes were identified, among which all of the participants experienced physical discomforts, psychological disturbances, issues with social and interpersonal relationships and financial constraints. However, concerns with religious practices were experienced by 87.5% of the participants. Pakistani women who are suffering through VVF face many challenges. Combined efforts should be made to offer supportive services to women suffering from this condition.

Sexually abused children suffer in silence

Child abuse is a global issue, and its incidences are increasing alarmingly in Pakistan. It severely impacts the physical mental and social well being of an individual. It does not only damage individual's life but also affect the society and nation at large. Therefore, there is a dreadful need to direct our attention towards identification and rehabilitation of child abuse cases. Health care providers need to be equipped with formal training to deal with this significant problem in a broader perspective. This paper reviews the current literature and identifies the causes and impact of child sexual abuse in Pakistan by incorporating a case study. Furthermore, it predominantly highlights the role of health care providers to curb the menace of child abuse. It is recommended that the issue of child abuse should be addressed at different levels by integrating in the academic and health curriculum. In addition, health care providers should empower parents and communities to combat this widespread issue

influence of psychosocial factors on academic performance of adolescents: a quality assurance project

Adolescence is a time of rapid psychological and physiological changes and is associated with anxiety and mental distress. This project looks at the potential of school-based programs to reduce these negative effects of academic performance in both the short-and long-term. This study was conducted in a private school in Karachi, Pakistan between October 1998 and December 2006 on 305 students with low academic performance. Results show that students scoring low grades had a mean of 55 +/- 2.8 and postintervention score of 56 +/- 2.6. The intervention package significantly created a difference in reducing the number of students receiving low grades. Qualitative analysis showed that study participants had enhanced self-esteem, confidence levels, positive attitudes towards learning, improved time management and decision-making skills. This suggests that in an academic institution, the presence of a professional support system enhances learning and coping mechanisms

Role of self-efficacy in promoting healthy behavior: smoking cessation as an example

Self-efficacy is defined as an individual's perceived capability to perform a behavior for accomplishment of a desirable goal. Enhanced personal self-efficacy is associated with a positive self-concept and self-appraisal of personal control which develops through experiences of mastery and the anticipation of competent performance. This paper aims to analyze the role of self-efficacy in promoting healthy behavior. A case scenario has been discussed to support the concept of self-efficacy in promoting healthy behavior taking smoking cessation as a case

Teaching experience and reflection

The standard of education can be improved if educators actively assess themselves or have someone else evaluate their teaching skills. Reflection on multiple aspects of teaching can be used as a powerful tool for worldwide educationists. Teaching, particularly in nursing discipline, strives to move beyond the simple divulgence of facts and knowledge. It widens student's horizons, stimulates their intellects, and teaches them to become self directed. This manuscript is a qualitative review of observations in a class of nursing with context to teaching skills and its impact on students' interest in learning during the class. The authors have used their reflections to discuss the ways to improve teaching methodology and related them with various teaching learning theories

Assessment of awareness regarding diabetic retinopathy among patients visiting diabetic clinic Sir Ganga Ram hospital, Lahore

Background: The worldwide prevalence of Diabetes Mellitus [DM] has risen dramatically. Diabetics are 25 times more likely to become blind than non-diabetics due to Diabetic Retinopathy [DR]. The DR can either be treated or at least delayed by diagnosis at an early stage which is possible by regular ophthalmoscopic examination. Hyperglycemia is the major pathogenetic factor for DR. Studies show reduction in rate of progression of DR by good glycaemic control and treatment can be offered at an early stage of DR. These goals require awareness of diabetics about complications of DM especially diabetic retinopathy

Subjects and Methods: This study was carried on 250 patients who presented in diabetic clinic at Ganga Ram Hospital [SGRH], Lahore. Ophthalmoscopy was done on dilated pupils of all diabetic patients. Awareness was assessed by questionnaire

Results: Out of 250 diabetic patients, 72 [28.8%] had DR. The stage of DR advanced with increased BSL and duration of DM. Only 20% of patients were aware of DR while only 3.2% had awareness about regular ophthalmoscopic examination; none came for follow-up

Conclusion: Diabetic retinopathy could be prevented or delayed by good glycaemic control and Laser therapy, if detected early by regular ophthamolscopic examination. For this it is vital to increase the awareness about the complications of DM specially DR by educating the patients through the health care professionals and public seminars

Stages of diabetic retinopathy and its relationship with blood sugar level and duration of diabetes mellitus

Background: The worldwide prevalence of Diabetes Mellitus [DM] has risen. Diabetics are 25 times more likely to become blind than non-diabetics due to Diabetic Retinopathy [DR]. The DR could either be delayed or treated by diagnosis at an early stage which is possible by regular ophthalmoscopic examination. Hyperglycemia is the major pathogenetic factor for DR and frequency and progression from non-proliferative to proliferative increases with increasing duration of DM. Studies show reduction in the rate of progression of DR from non-proliferative [background to pre-proliferative to proliferative] by good glycaemic control and treatment with laser can be offered if treating physician identifies it at an early stage

Material and Methods: This descriptive and analytical study was carried out on 250 patients visiting diabetic clinic at Sir Ganga Ram Hospital, Lahore. The aim of this study was to identify the stages of DR and to find effect of BSL and duration of DM on stages of DR

Subjects and Methods: BSL was measured with glucometer. Ophthalmoscopy was done on dilated pupils and stages were noted as background, pre-proliferative and proliferative DR

Results: Out of 250 diabetic patients 72 [28.8%] had DR. The stage of DR had advanced with increased BSL and duration of DM

Conclusion: With increasing duration of DM and poorly controlled BSL, diabetic retinopathy progresses from background to pre-proliferative to proliferative stage. Sight threatening DR can be delayed by good glycaemic control or treated by timely laser therapy which requires identification of stages of DR at an early occasion

Clinicopathological features in 102 cases of Hirschsprung disease

Hirschsprung disease [HD] is a predominantly childhood disorder of intestinal motility with a multifactorial and polygenic etiology. The objective of this study was to document the clinical and pathological features of HD in Kuwait, which has an estimated consanguinity rate of 54%.We analyzed all rectal and colonic biopsies [n=268] for suspected HD identified from the records in the Pathology Department of Al-Sabah Hospital for the period between 1994 and 2004. One hundred and two patients [87 males and 15 females] had historically confirmed HD. Fifty-eight [57%] were neonates [<1 month of age], while 21% were more than 4 months old. The diagnosis was based on open biopsy in 11 cases and rectal biopsies in 91 cases. Nine patients with open biopsies presented as intestinal obstruction, necrotizing enterocolitis, or perforation. The extent of the disease was unknown in 13 patients. There were 67 males and 3 females with short segment HD. Nine had long segment, two ultra-short segment and eight total colonic aganglionosis [TCA]. Five TCA cases involved the small intestine. A skip area was observed in two cases. Six patients had other anomalies. A positive family history for HD was established in three patients. Two of these were male siblings from a consanguineous marriage and had Waardenburg syndrome. This study has highlighted an exceptionally strong male predominance of short segment and a relatively high frequency [5.6%] of small intestinal involvement in HD in Kuwait. These data call for a more detailed epidemiological study with special emphasis on genetics

Idiopathic perforation of caecum in a neonate: case report

We report perforation of the caecum without a demonstrable cause in a three days old, healthy, male neonate. He presented with abdominal distention and constipation. Abdominal radiograph showed massive pneumoperitoneum. Caecal perforation was found on exploration. The perforation was closed and a protective proximal ileostomy was performed. The rest of the large intestine and small bowel appeared normal. Hirschsprung's disease was ruled out by multiple seromuscular biopsies. At a three monthly followup after closure of ileostomy, the baby showed normal weight gain without any symptoms

Coronary artery disease in elderly patients

The prevalence of coronary artery disease [CAD] and its associated morbidity and mortality increase as age advances. Our study was aimed at analyzing the demographics, risk factors, presentation and mortality of CAD among geriatric patients admitted at Sir Ganga Ram Hospital, Lahore, Pakistan. A total of 200 patients, aged 60 years and above, admitted consecutively to various departments were included in the study. CAD was present in 81[40.5%] patients, 45 [55.5%] females and 36 [45.5%] males. Following risk factors were found in the CAD patients: hypertension in 59[89.8%], diabetes mellitus in 36[58.1%], dyslipidemia in 4[5%], cardiac failure in 21[25.9%] stable angina in 15[18.5%] 9[11.2%] had unstable angina; 32 [39.5%] suffered from acute myocardial infarction, symptomatic in 17[21%] and silent in 15[18.5%]. Seven [53.9%] patients who died were suffering from CAD. We concluded that carrying a high index of suspicion in the elderly, even in asymptomatic patients, with early identification and treatment of risk factors might improve the prognosis of CAD in this age group

Neonatal congenital diaphragmatic hernia: an optional management strategy in Kuwait

Evaluation of the survival rate in neonate with congenital diaphragmatic hernia [CDH] treated with gentle ventilation, very delayed surgical repair and selective use of surfactant therapy in absence of extra corporeal life support devices. A prospective study of twenty three neonates admitted to lbn Sina Hospital for surgical correction of congenital diaphragmatic hernia between July 1996 to October 1998. These babies were stabilized before transfer pre-operatively at their respective neonatal units under guidelines using gentle ventilation permitting hypercapnia, surfactant therapy and a very delayed surgical correction. Fourteen male and nine female newborns with CDH presented in the first few hours of life, their mean birth weight is 2.850kg [range 2.050-4.300kg]. Twenty patients survived a period of pre-operative medical stabilization ranged between 3-10 days [mean +/- 4.08 days]. Post operative duration of mechanical ventilation ranged between 1-27 days [mean +/- 6.5 days]. Seventeen patients survived i.e. survival rate of 74%. These data demonstrate a significant good survival rate of early presenting CDH neonates with gentle ventilation and very delayed surgical repair

Awareness of sexually transmitted diseases in selected sample in Karachi

Sexually Transmitted Diseases [STDs] are a major public health problem in developing countries [Adler, 1996]. The purpose of this study was to asses women's knowledge level about STDs. METHODOLOGY: A cross sectional survey was done and data collected through a semi-structured interview. A convenient sample of 30 sexually active females between the ages of 15-45 years from an urban community in Karachi was selected for the study. The survey findings showed that 30% of the women reported that they had adequate knowledge and 20% partial knowledge. Thus almost three-quarters of the respondents indicated either inadequacy or lack of knowledge about STDs. Our results establish a need for STD clinics at Community-based Primary Health Care [PHC] Centers. These clinics need to address screening, treatment and health education issues in relation to STDs for the target population