Health care service quality: a comparison of public and private hospitals in karachi

The objective of the study was to compare the levels of patient satisfaction with the health service quality between the public and private hospitals in Karachi, so that their gaps, if any, may be identified and incorporated in future programs and policies. Cross sectional comparative study. This study was conducted in one public and one private hospitals in Karachi from May 2013 to July 2013. A random sample of 400 patients, 200 each from both public and private hospitals was drawn. Data was collected, on a pre-tested and pre coded questionnaire, and analyzed using SPSS version 16.0 level of satisfaction between patients in both the public and private health care settings were compared. The results of the study revealed that 75% of the patients availing health care services at the public hospital were not satisfied with the overall hygiene and cleanliness. 58.5% of the patients at public hospital were not involved in decision making regarding their own treatment. As for the patients availing services at the private hospital, 83.5% mentioned that they were provided with adequate privacy by their physician and hospital staff;however, 51% of the respondents replied that they had to pay huge medical bills which were beyond their affordability. Significant difference was found in the patients' satisfaction level with the quality of health care services provided in the private and public hospitals, with private hospitals performing better in most of the aspects of health care service delivery

Cardiovascular and renal protection in type 2 diabetic hypertensive patients. the role of calcium channel blockers

To study the effects of Calcium Channel Blocker [Amlodipine] as monotherapy in diagnosed hypertensive, non-insulin dependent diabetes mellitus [NIDDM] patients. Prospective study. This study was conducted at Jinnah post graduate medical centre [JPMC] Karachi, in collaboration with the department of medicine JPMC, Karachi from July 2010 to January 2011. This study is to examine the effects of Amlodipine in type 2 diabetic hypertensive patients with base line proteinuria. 20 normal subjects were also selected as a control group with CCB [Amlodipine] baseline to final change for SBP as well as DBP was significantly reduced i.e.24.70 % [p<0.001] and 16.20% [p<0.001] respectively. CCB showed 44% [p<0.001] reduction in FBS, creatinine clearance reduced by 8.10% [p<0.5], serum potassium reduced by 4.50%, non significant increase in serum urea i.e.3.70% and serum creatinine i.e. 3.8% was observed. Aim of treating hypertension is to control or limit its cardiovascular complications; CCB and are the drug of choice in controlling blood pressure and to prevent the progress of cardiovascular events in patients without diabetic nephropathy as well as reserves for add-on therapy in hypertensive patients complicated with diabetic nephropathy

Effect of metformin on ovulation in PCOS

To evaluate the effect of metformin on ovulation in patients having Polycystic Ovarian Syndrome [PCOS]. This clinical trial was carried out in a private infertility clinic of Karachi on fifty infertile PCOS females with individual study period of 3 months. A total of 57 infertile PCOS females with ages between 20-40 years were enrolled after a written consent. Only 50 subjects completed the study. Metformin HC1 thrice daily was given to fifty infertile PCOS females with ages between 20-40 years for three months. Plasma progesterone level was done at day-0 and day-90, besides fasting serum glucose, insulin, follicle stimulating hormone, luteinizing hormone, prolactin and testosterone at day- 0 as per requirement for the diagnosis of PCOS. 33 [66%] patients developed regular cycles and 11 [22%] patients showed improvement in their cycles at day-90. Serum progesterone level showed an increase from a mean +/- SD of 1.3 +/- 0.3 to 9.5 +/- 5.1 at day-0 to day-90. On statistical evaluation it was found to be significant with P-value of 0.001. Metformin promotes ovulation in PCOS patients

Comparison of propofol and sevoflurane for laryngeal mask airway insertion [LMA] in adults

To compare the effects of Porpofol and Sevoflurane in Laryngeal Mask Airway insertion. This study was quasi experimental was carried out in the Department of Anesthesiology, Surgical Intensive Care and Pain Management, Dow Medical College and Civil Hospital Karachi, Dow University of Health Sciences. The duration of the study was six months. In this study 60 patients schedule for elective surgery were enrolled which were divided into two groups. The average age of the patients was 25.1 +/- 10.6 years [95% CI; 23.7-29.0]. Out of 60 patients, 28 [46.6%] were males and 32 [53.3%] were females with 1:0.8 male to female ratio. Gender difference was not statistically significant between the groups [Chi-Square= 0.601; P=0.44]. The average age, weight and LMA insertion time were not statistically significant between groups. Induction time was significant between groups. Induction time was significantly higher in porpofol group [B] than in the sevoflurane group [A]. Condition of LMA insertion of 24 [80%] patients were excellent [score = 18] and 6 [20%] patients were satisfactory [Score between 16 to 17] in group A while condition of LMA insertion of 28 [93.3%] were excellent and 2 [6.7%] were satisfactory in group B. This study concludes that porpofol is a better anesthetic agent for insertion of LMA as compared to sevoflurane by using loss of eye lash reflex as the end point for induction