Perspectives on domestic violence: case study from Karachi, Pakistan

There is no adequate profile of domestic violence in Pakistan although this issue is frequently highlighted by the media. This case study used qualitative and quantitative methods to explore the nature and forms of domestic violence, circumstances, impact and coping mechanisms amongst selected women victims in Karachi. Violence was a continuum: all the women reported verbal abuse, often escalating into physical, emotional, sexual and economic abuse. The husband was the most common perpetrator. Women suffered in silence due to sociocultural norms, misinterpretation of religious beliefs, subordinate status, economic dependence and lack of legal redress. Besides short-term local measures, public policy informed by correct interpretation of religion can bring about a change in prevailing societal norms

Antituberculosis drug induced hepatitis

To study the incidence of drug induced hepatitis due to antituberculosis therapy. Descriptive study. Department of Internal medicine, Isra University Hospital Hyderabad, from January 2004 to December 2004. Medical records of all patients treated with antituberculosis therapy were ret rospectively reviewed. 215 patients were treated and 18 [8.4%] patients developed hepatitis. Rifctmpicin caused hepatitis in 2 [0.9%] patients. Isoniazid caused hepatitis in 11 [5.4%] cases. In 5 [2.3%] cases causative drug was unknown. In these cases, the patient died [four cases] or was lost to follow up [one case]. Among 215 treated cases, 4 patients [1.86%] died. Patients should be carefully monitored for the side effects of antituberculous sis chemotherapy

Ofloxacin: laboratory evaluation of the antibacterial activity of 34 brands representing 31 manufacturers available in Pakistan

Objective: To evaluate the antibacterial effectiveness of 34 competitive Ofloxacin products representing 31 manufacturers available in the local market, on 3 standard Quinolone-sensitive American Type Culture Collection [ATCC] bacterial cultures of E.coli, Proteus vulgaris and Staphylococcus aureus

Design: A blind assessment of 29 Ofloxacin brands in tablet form, and 5 in pre-mixed injectable solution collected by The Network for Consumer Protection in Pakistan, Islamabad, with trade and manufacturers names of the products veiled by blanking

Setting: The appraisal was conducted in Karachi at the Department of Microbiology, Jinnah University for Women, and Dr. Essa's Lab and Diagnostic Centre, in March 2003

Method: Direct aqueous suspensions along with 3 additional serial dilutions of each product were used to challenge the 3 target bacteria by the disc-diffusion method. The resultant inhibition-zone diameters were recorded for comparison of antibacterial activity

Results: Comparatively effective but varying antibacterial results were seen using Proteus and Staph aureus; however, alarming differences were recorded when E.coli was targeted. With this organism, excellent inhibition zone diameters were observed with Eracin [CCL], Ofloxacin [Shin Poong], Oflobid [Hilton] and Oflobiotic [Zafa]; others gave good, moderate or poor zones, while 4 shockingly exerted no visible effect: these included 3 single-vial injectable suspensions purported to represent Brookes [Quinon], Bosch [Tariflox] and Hoechst/Aventis [Tarivid], and the GlaxoSmithKlein's tablet Floxy

Conclusion: A significant variation in antibacterial activity of marketed Ofloxacin brands, some representing pharmaceutical giants, demonstrated by simple disc diffusion zone diameter comparison raises serious questions whether the less effective ones obtained in Islamabad and also purchased in Karachi for comparison were flawed, counterfeit or sub-standard preparations

COX-2 inhibitors: What's the message for practising physician?

The development of Cox-2 inhibitors as potentially gastro-safe NSAIDs is based on the notion that Cox-1 predominates in the stomach, yielding protective prostaglandins, while Cox-2 is induced in inflammation giving rise to pain, swelling and stiffness. The conventional NSAIDs are the most widely prescribed drugs. Despite excellent efficacy in rheumatic disorders their toxicity can lead to significant morbidity and mortality. With the introduction of Cox-2 specific inhibitors, there is a widespread belief that at last safe anti-inflammatory drugs are at hand and are being used extensively.This article reviews the available data regarding their safety on gastrointestinal and cardiorenal systems. It will help the physicians to make a decision while prescribing these drugs to their patients especially who have risk factors

Factors affecting unsuccessful referral by the lady health workers in Karachi, Pakistan

To estimate the proportion of patient referral and to identify the factors associated with unsuccessful referral in Karachi, Pakistan. In a cross-sectional survey, a total of 347 patients referred to different health care facilities by the LHWs were interviewed. Data was collected using a structured questionnaire, on demographic characteristics of patients [age, sex, income etc] and potential factors [seriousness of medical condition, distance of health facility, attitude of health center staff etc] that can affect patient referral outcome. An overall referral rate of 55% was found in this study. Out of a total of 347 patients interviewed, 265 [76.4%] were successful while 82 [23.6%] were unsuccessful referrals. Multivariate logistic regression analysis showed that objection to referral [Adjusted OR, 2.96; CI: 1.44-5.52], never referred before [Adjusted OR, 1.25; CI: 1.34-6.90], not visited the referral site before [Adjusted OR, 4.04; CI: 2.50-6.08] and no knowledge of who to meet at the referral site [Adjusted OR, 1.30; CI: 1.01-2.96] were the factors associated with unsuccessful referral. Other factors found significant were duration of the illness of the patient, anyone not known at the referral site and failure of LHW to follow up. Our study found that a significant proportion of patients seen by the LHWs are referred to different health facilities. Improved management skills of LHWs for simple medical problems would probably reduce the number of referrals. Efforts should also be directed to enhance the communication and counseling skills of LHWs, which may reduce a significant proportion of unsuccessful referrals