Tetanus immunization. Knowledge amongst healthcare workers of the emergency department at a tertiary care hospital

Background: A high prevalence rate of neonatal and adult tetanus in Pakistan reflects the failure of health care systems to provide adequate immunization. Health care workers [HCWs] of emergency departments [ED] are generally at the frontline to deal with patients of road traffic accidents, trauma and burns. However, it has been observed that these patients receive incomplete preventive measures to combat tetanus

Objective: To assess the knowledge of tetanus immunization among healthcare workers [HCW] of the emergency department [ED] at a tertiary care hospital

Methods: A cross sectional study was conducted on 104 HCWs of ED of Ziauddin University. A structured questionnaire was filled by HCWs during April and May 2014. Data were analyzed on SPSS 20.0. Categorical variables were presented as frequency and percentage, while continuous variables were presented as mean. P value of <0.05 was considered significant

Results: Total 104 HCWs from ED participated in the study. Only 11.8% [12] HCWs were aware of the correct dosing schedule in children under 12 years of age. 56.3% [58] and 68% [70] were aware of correct schedule in adult population and in pregnant females, respectively. Knowledge of tetanus immunization in different types of wounds according to previous immunization status of patients was also found inadequate

Conclusion: HCWs of ED have inadequate knowledge about tetanus prone injuries and its immunization, which needs to be addressed

frequency of shisha [waterpipe] smoking in students of different age groups

To determine the frequency of waterpipe smoking in students of different age groups. Cross-sectional survey. Karachi, Pakistan, from February 2012 to February 2013. The subjects were divided into two age groups. Group-I comprised of 13 - 17 years old randomly selected students from O' Level schools in Karachi and group-2 included 23 - 27 years old undergraduate and postgraduate students again randomly selected from various institutions in Karachi. A questionnaire was filled with prior consent, basic education on waterpipe smoking was given, and all the questions of the survey form were explained to the subjects according to context. In group-1, 39% students smoked waterpipe. Most students had been smoking waterpipe for the last 2 years. In group-2, 48% individuals smoked waterpipe, majority of smokers indulged in the last 5 years and among them, most were falling within the last 2 years. The frequency of waterpipe smoking in teenage students was 39% and older students for 48%. Social and recreational use of waterpipes is widespread among both groups despite being acknowledged by majority as a health hazard.

Association of hypertension and diastolic dysfunction with type-2 diabetes mellitus

To evaluate the prevalence of hypertension and diastolic dysfunction [LVDD] with normal ejection fraction in type-2 diabetes mellitus. Two hundred twelve diabetic patients [98 females and 114 males] from January 2005 to June 2006 were enrolled in this study. Their ages ranged from 35 to 65 years with mean age of 55 years. Patients with Diabetes Mellitus Type-2, Hypertension: BP[3]140/90 [with or without medication] Body Mass Index[3]30, Waist-Hip ratio>0.90. Left Ventricular Diastolic Dysfunction [LVDD] and Serum Triglyceride and HDL Cholesterol were included. Result: Out of 212 patients, 104[49%] were found to be hypertensive [both systolic and diastolic] and 12 patients [5.6%] were found to be suffering from isolated systolic hypertension. Hence total number of hypertensive patients was 116 [54.6%]. Thirty two patients were found to be suffering from diastolic dysfunction. Hypertension and Diabetes are interlinked and show how micro and macrovascular complications of diabetes are increased when two conditions occur together. The LVDD is much more prevalent than previously suggested in patients with type-2 diabetes mellitus. Hence LVDD is an early marker of diabetic cardiomyopathy

Stroke recovery and outcome in diabetes

To compare the outcome in stroke among the diabetics and non-diabetics patients. Design: A comparative study. Place and Duration of Study: Jinnah postgraduate medical centre during the period of eight months. Subjects and Acute stroke patients with diabetes and hypertension were included, hypertensives comprised the non-diabetic group, along with other risk factors. There was no significant difference in the outcome in the two groups according to the Katz scale. Our study did not show much difference in the outcome in the diabetics versus the non-diabetics