Trends in family planning practices of women in child bearing age: a community based survey in Northern peri-urban areas of Lahore

Background: Pakistan being the sixth most populous country in the world needs to control its population explosion as well as understand the importance of family planning practices and its inherent relationship with improved maternal health

Objectives: This study was conducted with the aim to assess the family planning practices in the Northern Peri-Urban areas of Lahore, Pakistan

Subjects and Methods: Community based survey was conducted on 852 households by interviewing married females aged 15 - 49 years with the help of a pretested structured questionnaire. Every third household was selected by employing systematic random sampling

Results: Mean age of the women was 19 +/- 3.54 years with mean number of pregnancies 4.05 +/- 2.50. Contraceptive prevalence rate was 36%. Most preferred method of contraception was tubal ligation 37% and condoms 29% vasectomy being the least preferred. Tubal ligation 10%, condoms 6.5% and intrauterine contraceptive device 2.6% was the choice for females aged 15 - 20 years. Women having four to six pregnancies were opting for tubal ligation 10.3% [p-value <0.0001]

Conclusion: In the Northern Peri-urban areas of Lahore, contraception is being practiced at the same rate as in the rest of the province. It is pertinent for improved maternal health to ensure maximum utilization of family planning services within this community

Pattern of addiction and its relapse among habitual drug abusers in Lahore, Pakistan

This study assessed the pattern of drug abuse and the reasons for relapse of addiction among male drug addicts seeking rehabilitative services in different centres in Lahore, Pakistan. A cross-sectional survey was conducted on male drug abusers from April to December 2016. Nonprobability purposive sampling was done to collect a sample of 119 participants. A structured questionnaire and in-depth interviews were used for data collection. Out of 119 participants, 71.4% were in the age group 15-35 years. Educational levels were low in the majority, with 68.1% below secondary education. Unmarried [51.3%] and unemployed [44.5%] participants were at the greatest risk of using drugs. The age of addiction in 45% of patients was 5 years. Reasons for starting drug abuse were recreation [37%], curiosity [34.5%], and life-changing events [14.3%]. Reasons for relapse included association with former addicts, negative reactions from family, inability to manage the craving and work/social stress

Risk factors associated with diabetes in periurban community, Lahore Pakistan

Objectives: To identify factors [sociodemographic characteristic, behavioural factors, health care advice and physical measurements like weight, height, waist and hip circumferences] associated with diabetes

Methods: This study was conducted in the Nain Sukh which is a peri-urban area near Lahore between January till August 2016. A sum of 1080 households of both gender with age between 15-69 years were interviewed through a structured questionnaire and necessary measurements were taken. The data analysis was done by using SPSS version 17. All the recommended ethical clearance both institutional as well as individual levels were duly taken

Result: The mean age of the participants was 34 years +/- 14SD with female predominance. Total prevalence of diabetes was found to be 9.8% out of which 83% were females between age of 45-69 years [p<0.00]. Diabetes was significantly associated with obesity with 33% participants were overweight while 42% were obese [p<0.00]. Diabetes was also significantly associated with central obesity, positive family history [p<0.000]. Almost 45% of the households were advised to reduce weight and take special diet [p<0.000]

Conclusion: The diabetes is significantly associated with positive family history and deranged BMI both overweight and obesity along with central obesity .This can only be prevented by health education and life style modifications

Peer assisted versus expert assisted learning: a comparison of effectiveness in terms of academic scores

To compare the effectiveness of peer assisted learning versus expert assisted learning in terms of academic scores. Cross over-randomized control trial followed by a cross-sectional survey. Fatima Memorial Hospital, College of Medicine and Dentistry, Lahore, during January to October 2012. This study was conducted on 4th year MBBS students. The students were randomly divided in two groups by lottery method following their roll numbers. The groups A and B were dealt with Peer Assisted Learning [PAL] and Expert Assisted Learning [EAL] respectively. Effectiveness of both methods of learning was calculated on the basis of academic scores obtained in MCQ tests. One best answer type of MCQs were used and their construct validity was checked by other senior faculty members. After crossover of groups and altered teaching strategy, academic scores were compared again within the group and the comparable group. Student's views about this technique were measured by Likert's scale. P-values were obtained by applying independent and paired t-tests and considered statistically significant at >/= 0.05. There were 70 students of 4th year MBBS which included 24 [34.3%] males and 46 [65.7%] females. The Crohnbach's alpha value of these MCQs was 0.64. Scores of MCQ test were compared by applying independent t-test and p-value obtained was 0.971; after cross over p-value was 0.468 which was not significant between the results obtained by two learning strategies. Twenty five students [46.3%] said that PAL is an effective technique. Thirty eight [70.4%] students found it easy to communicate with a peer. For incorporation of PAL in curriculum of community medicine, 24 [44.4%] students voted in its favour. Peer assisted learning has proved of equivalent efficacy in terms of students score in MCQs test as expert assisted learning

Prevalence of contraceptive practices in married women of Nainsukh village near Lahore

Overpopulation is one of the biggest problems faced globally by many developing countries which include Pakistan as well. Pakistan is the seventh most populous country of the world. By 2050 Pakistan will be ranked as the fourth largest nation of the world and its population will grow to 285 million. This study was planned to evaluate the prevalence of contraceptive use in a semi urban area Nainsukh near Lahore, Pakistan and to find out the major factors playing role in selection of contraceptive method. The contraceptive prevalence rate was 35.2% among married females of Nainsukh. It was observed that the most common method used by couples was condom used by 11.70% of the respondents. OCP were used by 4.6%, IUCD by 6.5%. Tubal ligation was opted by 4.6% of the participants. Major source of information was family planning center for 24.8% and friends gave this information to 14.98% of the women. Mother in law 5.9%, dai 9.1%, media 7.8% were other sources. Mean duration of use of contraceptive method was reported to be 2.45 +/- 1.81 years. The most common reason of not using any contraceptive method was lack of awareness 29% and religious beliefs 23%. Approximately 58.3% of the clients were getting contraception facilities from private sector. Source of supply was lady doctor for 6.2% and LHW by 5.2%. About 5.5% of the females reported abortion as a choice to be used for contraception and only 4.2% were aware of emergency contraceptive methods

Medical students' perspective about role-plays as a teaching strategy in community medicine

To assess the students' perspective about role-plays conducted as a teaching methodology in community medicine. A quasi-experimental study. Department of Community Medicine at Fatima Memorial College of Medicine and Dentistry from July to November 2010. A probability technique of simple random sampling was used to collect 63 students from the third and fourth year MBBS who were randomly distributed in five sub-groups. They were variously ascribed the roles of obsceners, participants and helpers. A questionnaire was distributed to collect student's responses. The data was analyzed on SPSS version 17 to compare the responses. Chi-square test was applied and p-value was fixed at < 0.05 as significant. Sixty-three students were selected as participants of this study in which 46 belonged to the fourth year MBBS class [73%] and 17 were third year MBBS students [27%]. There were 13 male [20.6%] and 50 female [79.4%] students. Role-plays were identified as most effective method of teaching [n = 25, 37.9%] followed by lectures [n = 17, 25.8%, p = 0.054]. Fifty-two students [78.5%] admitted that role-plays improved their knowledge of the subject, 55 [84.6%] said that it will help them in their clinical performance. Fifty-nine participants [89.4%] found role-plays interesting and 49 [74.2%] wanted to incorporate role-plays as a part of curriculum. Fifty-six of the participants [88.9%] agreed that role-plays improved their communication skills. Twenty-one participants [31.8%] believed that it helped them in making acquaintance with the local situation. Forty-six students [76.7%] identified role-plays as a feasible way of andragogy [p = 0.005] and 48 [76.2%] said that it provoked critical thinking about the subject [p = 0.038]. Fifty-four students [85.7%] admitted that their attention span was better in role-plays as compared to lectures [p = 0.047]. Role-plays were well accepted by the students as an effective teaching methodology and can be incorporated as a part of teaching strategies in Community Medicine

Medico-legal aspects of alleged rape victims in Lahore

To describe the socio-demographic along with the medico-legal characteristics of rape victims reporting to a female police station of Lahore. Study Design: Observational study. Female Police Station in Shadman, Lahore, from, June 1995 to January 2009. A total of 74 cases of alleged rape victims were identified while reviewing all available police files concerning reported rapes and attempted rapes from 1995 to 2008. The data was gathered on preformed questionnaires after conducting the pilot study. All information about victims and alleged offenders were extracted from the police files including socio-demographic profile of the accused and victim both. Use of weapon, evidence of physical and genital r trauma, assailant identification and his relationship with the victim, number of accused persons and location of rape was noted in each case. Examination by doctor and obtaining the specimens were also identified and was related to the outcome of the court case. Chi-square test was applied to determine the association of rape with age and educational status of the victim and the accused. A total of 74 cases of alleged rape were reported in the study period at Shadman Female Police Station. Maximum number of victims was reported in the age group 10-19 years [n=46, 62.2%]. Majority of the accused belonged to 20-39 years' age group constituting 64.8% of the total. Regarding educational status 45 [60.8%] of the victims and 51 [68.9%] of the accused were illiterate. Significant association was found between the educational status of rape victims and accused [p = 0.016] but not between their ages [p = 0.862]. The maximum incidence of rape was reported in unmarried [n = 55, 74.3%] and unemployed [n =61, 82.4%] women. In 14 cases [19%] use of weapon was reported. Physical trauma was reported in 29 [39%] and genital trauma in 14 [19%] cases. The accused were identified as family friends [25%] and neighbours [23%] respectively. Only 21% of the victims were examined by doctor and specimens were obtained in only 14.9% of the cases. Acquittal of the accused was observed in 43% of the cases while 34% cases were still pending; conviction of the accused was observed in only 5% of the cases. Rape victims usually belong to young age group between 10-19 years majority of being unmarried and unemployed. Only a smaller fraction of the victims were examined by doctor and specimens were obtained in only few of the cases

Bullying of medical students

To assess the frequency and forms of bullying experienced by medical students, and the associated factors. Cross-sectional questionnaire-based survey. The study was conducted at a private Medical College of Lahore, from January to February 2010. All the students of first and fourth year classes were included in the study with voluntary and anonymous participation. Self administered-questionnaires were given to the students which were completed by them in the presence of the surveyor. A modified version of the British Medical Associations [BMA] medical student's welfare and education survey form was used for data collection. The data was recorded and analyzed using the statistical package for social sciences version 16.0. Data was described in the form of frequencies and percentages. Chi-square test and Fisher exact test were used to test statistical significance between categorical variables at p

Factors affecting medical specialty preferences and associated gender differences in fourth year MBBS students

To Identify factors affecting medical specialty preferences and associated gender differences in Fourth Year MBBS students. This was a Cross-sectional survey conducted on fourth year MBBS students of Lahore Medical and Dental College through a Preformed Structured questionnaire by non probability sampling technique. The student were told that the survey was voluntary and were given a choice of refusal but fortunately all the students in the class participated in the survey [n=120]. Data was collected during January 2009. Data was analyzed using SFSS v. 16.0. Descriptive statistics were computed, and the relationship between specialty preference and categorical variables [gender, reasons for choosing a particular specialty] were evaluated using Pearson Chi square test. A calculated p value of

Medical education: views and recommendations by final year MBBS students of a private medical college in Lahore

To obtain the views and recommendations of final year MBBS medical students of Lahore Medical and Dental College, Lahore about various aspects of the current medical education. Cross-sectional survey. Lahore Medical and Dental College, Lahore in October and November 2007. Preformed close ended structured questionnaire regarding medical teaching and evaluation methods and recommendations was used to collect the data from students of final year MBBS [n=120] at Lahore Medical and Dental College. SPSS 15 program was used for analysis. Data was presented as frequency percentages. A majority of the students [79%] thought that multimedia was the most effective teaching tool, [54%] students viewed 45 minutes as ideal lecture duration. Measures suggested to improve the examination results were regular tests [54%], improved lecture content [32%] and regular tutorials [10%]. MCQ's were the mode of examination questions preferred by 62% of students. Recommendations given by students for improving the current medical education were better teaching [26%] followed by increased motivation in students 54 [16%] and more hands-on training/practical field work [12%]. Medical students in this study preferred multimedia, lecture duration less than 45 minutes and MCQ's as their preferred mode of evaluation. Students recommended increased emphasis on better lectures, increasing learning motivation in students and more hands on training/practical field work to improve current medical teaching

Reasons for selection of nursing profession in Pakistan

Nursing is the backbone of health care delivery system. There are various factors which influence the choice of selecting nursing as profession. [1] To find out the socio demographic profile of nurses working at Ghurki Trust Teaching Hospital [GTTH] Lahore. [2] To explore the reasons for selection of this profession. A cross sectional descriptive study. From October 2009 to January 2010. GTTH, Lahore. All the nurses working in Ghurki Trust Teaching Hospital, Lahore are included in this study and their responses are obtained with a self administered questionnaire. A total of 77 nurses participated in our study. The age distribution of these nurses has shown that a large number of nurses, 49 [63.6%] belonged to age group between 20 to 30 years. There were 26 [33.8%] nurses who had done B. Sc nursing. About 72 nurses [93.5%] have monthly income more than Rs.10.000. Majority of them, 48 [62.3%] are unmarried. 41 [53.2%] of the nurses selected this profession due to their own personal interest, 15 nurses [19.5%] selected this profession due to their parental influence. 12 nurses [15.6%] selected this profession for serving humanity. 9[11.7%] selected this profession to support their family. Approximately 25 nurses [32.5%] said that there are other family members working in the same profession. It was noted that out of these 25 nurses, 10 [40%] had their sisters in the same profession. Nursing forms the backbone of health care delivery system of a country. Decision makers in health sector need to understand that human resource development. Particularly nursing requires revolutionary changes. As public health policy makers, it is imperative that we investigate the reasons for selection of nursing profession to attract and retain these important partners in health care provision

Congenital heart disease: knowledge and myths in parents attending cardiology department of children hospital and institute of child health, Lahore

To assess the parental knowledge and myths related to etiology of congenital heart disease. A cross sectional descriptive study. Out patient department, indoor and echocardiography rooms of Children Hospital and Institute of Child Health [CH and ICH] Lahore, in two weeks of October, 2007. Convenient sampling technique was used to recruit 299 children between 1 month and 14 years of age, suffering from congenital heart disease. Cases of rheumatic fever and associated congestive cardiac failure were excluded from the study group. A structured questionnaire was used to interview parents of the study group. Descriptive statistics was determined in terms of percentages. Out of total 299 patients included in this study, 132 were in the age group of 1 -5 years [44%], with the mean age 1.86 years +/- 0.886 SD. 200 were males [67%] and 99 were females [33%]. The respondents included 71% mothers and 27% fathers. Ventricular septal defect [VSD] was the most common disease encountered in 128 children [43%], Regarding the causes of congenital cardiac defects, parents blamed cousin marriage [41%], inheritance [26%], increased maternal age [16%], maternal smoking [16%] and paternal smoking [39%]. Other responses included evil spirits, moon and sun eclipses and bad wishes/evil I eye. 57% of the respondents said that there is no relationship between gender and congenital cardiac malformation and 85% respondents believed that there is no relation with the food taken in pregnancy and subsequent cardiac defects. High Salt intake was considered as an associated factor by 47 [15%] of the respondents. Naming the cause of cardiac malformations, 41% of the parents said drugs taken in pregnancy, 13% of the respondents blamed alcohol, cocaine and opium intake. Among parents, 73% were aware of the fact that maternal health is important for disease causation in neonates but could not name any particular disease. The parents of those children, who have congenital malformation, have different myths and fallacies associated with disease causation. Adequate health education strategies should be adopted towards mass dissemination of information in the community about this important issue

Weaning; knowledge and practices

To evaluate the awareness and practices regarding weaning in lactating mothers of infants. A cross sectional descriptive study. At pediatrics OPD in Ghurki Trust Teaching Hopsital, Lahore. From October to December 2007. A non probability convenience sampling was done to collect data from 50 mothers who were attending out patient department along with their infants on a pre-formed questionnaire. After gathering, data was analyzed and presented in the form of tables and graphs. In the present study, 66% mothers were in the age group of 20-29 years, all were house wives, 34% were matriculate and 72% lived in joint family system Mean age of weaning was 4-6 months in more than 64% of the sample. Among the women interviewed, 44% used home-made weaning diets, 30% used mixture of homemade and commercially prepared diets, while 16% used only commercially prepared diets. Breast feeding was continued during and after weaning, by 64% of respondents along with weaning diets. Mothers need to be educated about the importance of weaning, the recommended age of weaning and about the types of weaning food. This can be achieved by using lady health workers and lady health visitors and the mass media. Importance of breast feeding with weaning diet should be emphasized upon

Seroprevalence of transfusion transmissible infections [TTIS] in blood donors

To find out the seroprevalence of HIV, Hepatitis B, C virus and Trepenoma Pallidum among the healthy blood donors, at Ghurki Trust Teaching Hospital, Lahore. Descriptive study. Blood Bank of GTTH, Lahore, from 1st January to 31st December 2008. All healthy blood donors reporting to blood bank in the specified study period were screened for HIV, Hepatitis B, C and Syphilis. A total of 6659 donors were screened, out of these 512 donors [7.69%] were seropositive for Hepatitis C, 113 [1.70%] were sero positive for Hepatitis B, 35 [0.5%] were seropositive for syphilis and only 3 [0.05%] had shown seropositivity for HIV. Transfusion transmissible infections are a major threat associated with unscreened blood donations. In Pakistan the prevalence of Hepatitis B and C is very high in occult form. Selection of healthy blood donors and public awareness programs targeting local community will be an important measure to stop its transmission through blood transfusion

Diabetes mellitus; awareness among individuals attending out patient department of Ghurki trust teaching hospital

To assess the awareness of diabetes in individuals attending Out Patient Department of Ghurki Trust Teaching Hospital. Descriptive study design. Out Patients Department, Ghurki Teaching Hospital, Lahore. The study was conducted among a sample of 50 individuals, recruited by convenience sampling technique. Data was collected, by administering a structured questionnaire, during a two week period in December 2006. Data was presented in the form of tables and graphs. General Awareness of Diabetes Mellitus in the participants of our study was poor. Only 16% recognized it as a disease of the pancreas while 50% considered it to be a disease of other systems. Majority of the respondents [78%] had no idea about the types of the disease. When asked about the communicability of diabetes, 76% considered it to be non-communicable, 10% thought it to be communicable. Among the respondents, 78% thought diabetes is inheritable. When asked about its prevention, 54% considered avoiding sugar as the best way to prevent diabetes, while only 9% believed weight reduction to be important. Regarding the management of diabetes, 40% of respondents considered medication, 27% thought of diet modification as a better way, 18% considered exercise, while only 6% named weight reduction. The participants of the present study lacked awareness of types of diabetes, its mode of inheritance, its prevention and management

Immunization status; assessment of children between 1 - 3 years coming to OPD of children hospital and institute of child health, Lahore

To assess the immunization status of children between 1-3 years of age coming to the Children Hospital and Institute of Child Health, Lahore. Descriptive study. The study was conducted at OPD of Children Hospital and Institute of Child Health, Lahore. The data was collected in two weeks in December, 2006. Information was gathered from parents about the immunization status of 50 children and awareness of parents of these children about the vaccine preventable diseases, using a pre-tested questionnaire comprising of close ended questions. The results were presented in the form of tables and graphs. The data was collected for 28 male children [56%] and 22 female children [44%]. According to parents, 29 children [58%] were delivered at hospitals, whereas, 21 children [42%] were born at home. Maximum immunization was done at Government hospitals [47%]. About 40% of the children had their first immunization at the time of birth. Only 17% of the parents could easily recall vaccination of their children against polio, about 14% of parents could name pertussis, 13% of parents named tuberculosis, about 12% of parents could name hepatitis and measles, diphtheria was known to only 7% of parents and tetanus was named about 5% of parents. Among the parents, 18% could not answer this question. Nearly all the children [98%] had taken polio drops at home. The best source of information about immunization program was declared to be the health care providers [33%], mass media [23%], mother/mother in law [19%], and other family members [17%]. The present study concludes that 99% of children coming to OPD of Children Hospital were immunized for Polio, despite the lack of awareness among parents about vaccination against other communicable diseases. The best source of information about immunization was the health care providers, mass media and family members

Prevention of hepatitis B; knowledge and practice among first year MBBS students

To assess the knowledge and practice of first year MBBS students, for the prevention of Hepatitis B. Descriptive study. The study was conducted at Lahore Medical and Dental College. Lahore. The data was collected in two weeks in December, 2006. A total of 50 students were recruited using a non probability random sampling technique, through the lottery method. A pre-tested structured questionnaire was administered to collect information about the knowledge and practice of students about the prevention of hepatitis B. Data was presented in the form of simple tables and graphs. Out of 50 students, majority [96%] responded that it was a disease of liver. Regarding knowledge about the communicability of Hepatitis B, 78% said it was communicable, 19% assumed that it was water borne. Other responses included spread via blood transfusion [28%], through use of injection [21%], close physical contact [8%] and un-hygienic conditions [18%]. For prevention of Hepatitis B, the more common responses were, provision of clean water [24%], improvement in hygiene [27%], restriction to single sex partner [6%], avoidance of sharing syringes and needles [19%], screening blood before transfusion [9%] and vaccination [15%]. The high risk group was identified as the poor people living in unhygienic conditions [34%], surgeons [32%], barbers [12%], Intravenous drug users [8%], recipient of blood transfusion [6%] and uneducated people [6%]. Only 1 respondent [2%] said that sex workers could be at risk of getting this disease. When inquired about their vaccination status, 66% of students admitted to have been vaccinated against Hepatitis B, while 34% of have not been vaccinated. The present study concludes that there is lack of awareness among the medical students entering into the profession about the hazards of Hepatitis B, its routes of spread and its modes of prevention. Similarly, all the students were not vaccinated against Hepatitis B, which made the m very vulnerable to this disease