Perception of medical students for choice about their career

Background: Career counseling to medical students is vital for future needs of health care system

Objective: To assess the perception of students in choosing the medical profession and their future career planning

Methodology: This cross-sectional study was conducted at Sheikh Zayed Medical College/Hospital, Rahim Yar Khan Pakistan, comprising 152 medical students. The questionnaire included questions on demographic information like age, sex, and year of study, reasons for choosing medical profession, future plans for specialization and choice of career in Pakistan or abroad, and their plans after graduation. SPSS 16 was used for data entry and statistical analysis

Results: Total number of study subjects was 152. Female participants were 62%. Mean age of participants was 22 +/- 2 year.77 [51%] students said they chose the medical profession because their parents wanted them to be doctors; while 50 [33%] chose the career to serve ailing humanity. Regarding specialization, in this study, 13.2% wanted to specialize in Surgery, 14.5% in Medicine, 3% in Public Health, while 24.3% did not want to pursue the medical profession and applied for positions in civil service by appearing in the Central Superior Services [CSS]. While 68%[103] students wanted to pursue the medical profession in Pakistan, the rest preferred to go to the United Kingdom 18.4%, 10% in America and 4% in Australia

Conclusion: Our study showed that most of the medical students selected medical profession due to parental and peer pressure. It was found that one third wanted to leave the country after graduation and one third wanted to leave the profession after graduation. It shows the lack of career counseling at undergraduate level in country

Health seeking behavior among psychiatric patients attending psychiatry outdoor of a tertiary care hospital

Background: Psychiatric illness is mental disorder or mental illness that can be explained as mental or behavior pattern that causes either suffering or poor ability to function in ordinary life. In our country psychiatric problems are increasing day by day. Very little has been done in South Punjab in this regard

Objective: To assess the health seeking behavior among psychiatric patients attending Psychiatric OPD of Sheikh Zayed Hospital, Rahim Yar Khan

Methodology: Study Design: Cross-sectional study. Setting: Psychiatry Outdoor, Sheikh Zayed Hospital, Rahim Yar Khan. Duration: From 15 February to 15 May 2016. Sample Size:116 patients were interviewed. Apredesigned and pre-tested questionnaire was used for the data collection. Subjects of study were all the patients who were suffering from Psychiatric illness between 18-65 years of age and of either sex. Atotal of 116 consecutive patients were included in the study. The questionnaire was prepared and presented. It included variables on age, sex, socioeconomic status, family history, occupation, marital status and education and questions on health seeking behavior, like Health care provider, 1 contact, 2 contact, 3 contact and 4 contact, distance travelled for health care. All data was collected after getting informed verbal consent from patients. Data was entered and analyzed by using SPSS 16. The frequencies and percentages were calculated on categorical variables. Means and Standard Deviation were calculated on numerical variables. The data was entered and analyzed by using SPSS version 16

Results: There were total of 116 subjects included in study. 64% patients were males and 36% were females. 32.8% were illiterate while 36.2% had primary level education. 81% mothers and46.6% fathers of patients were illiterate. 63.8% patients were married and 67.2% were living in urban areas. Among 116 patients, 41.4% has depression, 19% epilepsy, 17.2% anxiety, 12.1 % schizophrenia and 10.3 % insomnia. Out of those, 56.9% of the patients went to Spiritual healer, 20.7% to Psychiatrist, 13.8% to Physician and 8.8% to Hakim overall in the study for the treatment of their psychiatric problems

Conclusion: This study showed that more than half of the patients with psychiatric problems went to Spiritual healers as first contact for health care. There is a dire need of health education programme to launch for the sensitization of people regarding to improve quality of life of psychiatric patients and improve health seeking behaviour

Mega cisterna magna diagnostic dilemma

Objective: To determine the frequency of isolated mega cisterna magna [MCM] in Saudi population, compare the accuracy of fetal ultrasound with postnatal neuro-imaging, report the associated central nervous system [CNS] anomalies on postnatal neuro-imaging

Study Design: Retrospective study

Place and Duration of Study: King Fahad Armed Forces Hospital Jeddah Saudi Arabia from Jan 2007 to July 2011

Material and Methods: This was a retrospective study conducted at King Fahad Arrmed Forces Hospital Jeddah, Saudi Arabia. We included all reported cases of fetal mega cisterna magna from January 2007 till July 2011. Ante-natal and postnatal records and neuro-imaging studies of all the cases were reviewed and documented on the database. Neurological assessment was done by Pediatric Neurology Consultant at an average age of 8 months of life

Results: MCM was diagnosed in 26 [0.12%] on fetal scans [15 male and 11 females]. Post natal scans were available for 20/26 [77%] and 6/26 [23%] cases were missing. Of the 20 post natal scans, 12 [60%] scans were normal and 8 [40%] scans were abnormal. The following abnormalities were detected: 3 [37.5%] cerebellar hypoplasia, 2 [25%] partial dysgenesis of corpus callosum, 2 [25%] cases were confirmed as MCM and 1 [12.5%] arachnoid cyst. Neuro-developmental assessment was reported as normal in 50% of the cases with associated CNS anomalies

Conclusion: The association of MCM with major CNS anomalies is significant in this study population. Post natal neuro-imaging confirmation is required for all fetuses with mega cisterna magna on fetal sonography

Audit of childhood tetanus patients admitted in tertiary care hospital

Background: Childhood tetanus has high mortality and is preventable

Objective: To enlist the risk factors of childhood tetanus among patients admitted in a tertiary care hospital. Methodology: Study design: Cross sectional study. Place and duration of study: Children ward, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1 September 2012 to 28 February 2015. In this study 97 patients were included. Their parents were interviewed according to the given performa. The data was entered and analyzed by using SPSS version 19

Results: Out of 97 patients, the fathers of 68[64%] patients and mothers of 84 [86%] patients were either illiterate or primary education only. Most 57 [58%] of the patients belonged to a low socioeconomic family having the monthly income of less than PKR 10,000. The fathers of 37[38%] patients were Sindhi. 57[58.76%] patients were from rural areas. Most 69 [71%] of the affected patients were boys, age range of 5 to 10 years, was found 39 [40%] of patients were boys, age range of 5 to 10 years, was found in 39 [40%] of patients

Conclusion: The various factors which are responsible for the development of childhood tetanus were; poor educational status of the parents, Sindhi, ethnicity, low socioeconomic status and rural area residence

Prevalence of needle stick injuries among doctors and nurses working in Sheikh Zayed hospital Rahim Yar Khan

Background: Needle stick injuries remains potential source of transmission of infections

Objective: To determine the prevalence of needle stick injuries among doctors and nurses working in Sheikh Zayed Hospital Rahim Yar Khan

Methodology: This cross sectional study was conducted from 1[st] June to 31[st] December 2014. All the nurses and medical officers who were listed in the medical superintendent office of the Sheikh Zayed Hospital Rahim Yar Khan were included in the study. A structured, self administered questionnaire was designed to describe the occurrence of needle-stick injuries among respondents. The questionnaire sought information about socio-demographic characteristics such as age, sex, marital status and years of experience. The questionnaire also included information about the frequency of being stuck by a needle or a sharp instrument while at work during the last six months. A yes/no response were used to assess whether the doctor/nurse reported the injury. The participants were asked about the reasons of needle stick injuries and how they managed the incident. Data analysis was performed using SPSS, version 17. The chi-square test was used to assess the association between duration of service and needle stick injuries

Results: Total of 308 health care workers [HCWs] participated in this study which included 173 medical officers and 135 nurses. About half of the medical officers were in the age category of 30 to 39 years while half of the nurses in 20 to 29 years of age. Among these HCWs 27.8% medical officers and 25.2% nurses had above 10 years of work experience. Needle stick injury was reported by 22.54% doctors and 37.78% nurses in the past six months and it was found significantly higher among nurses as compared to doctors [p=0.001]. Among perceived reasons of needle stick injuries the most frequently reported reason was workload [48.7% doctors, 56.9% nurses] followed by Recapping of needle [30,8% doctors, 21.6% nurses], hurriedness [12.8% doctors, 13.7% nurses] and non-cooperation of patient [7.7% doctors, 7.8% nurses]. After needle stick injury only 38.5% doctors and 25.5% nurses washed it with disinfectant. Duration of service was significantly associated with needle stick injury among doctors [p=0.000] and nurses [p=0.000]

Conclusion: In summary, we conclude that the frequency of Needle stick injury among Health Care Workers is high and duration of service was significantly associated with needle stilck injuries

Knowledge and practices of breast feeding among nurses working in public sector hospitals of Bahawalpur City

Background: Knowledge of breast feeding is essential among healthcare providers

Objective: To determine level of knowledge and practices of breastfeeding among nurses working in public sector pediatric and obstetric units of Bahawalpur City

Methodology: Study design: Cross sectional study. Place and Duration: Public sector hospitals of Bahawalpur City from 1 [st] June to 31[st] December 2013. All nurses working in Pediatric and Obstetrics departments for more than one month were included in the study after taking verbal consent. Information was collected through a structured questionnaire. Questions for assessing level of knowledge were feeding of colostrum, initiation of breastfeeding within half hour after delivery, duration of exclusive breastfeeding, total duration of breastfeeding, maximum interval between two feeds, continuation of breastfeeding during adverse health conditions of mother like fever, diabetes mellitus, hepatitis [B, C], active pulmonary tuberculosis and continuation of breastfeeding in adverse health conditions of children like, diarrhea, fever, respiratory tract infections and malnutrition. Practices of breastfeeding were evaluated among married nurses having one a live child of less than 2 years of age by asking breastfeeding her child currently, initiated breastfeeding within half hour after birth of her child, fed colostrum to infant or discarded, exclusively breastfed till age of 6 months and maximum interval between two feeds. Data was analyzed by using SPSS version 17. Scoring method was used to assess level of knowledge and practices of breastfeeding. One mark was given for correct answer and zero for incorrect. Knowledge was categorized into good if score was more than 70%, transitory if score between 50- 70% and below 50% were labeled as having poor knowledge

Results: Out of 13 aspects asked about knowledge of breastfeeding highest knowledge was found about continuation of breastfeeding if child is suffering from diarrhea [79.31%] followed by correct knowledge about feeding of colostrum [75.86%] and about exclusive breastfeeding for 6 months [68.10%]. The duration of service was directly related with level of knowledge [p=0.0000]. Our study revealed that 29.16% nurses initiated breastfeeding within half hour of delivery, 16.66% were breastfeeding her child currently, 12.5% Fed colostrum to her child and practices of exclusive breastfeeding till age of 6 months and correct interval between two feeds was not observed by any study participant

Conclusion: There was poor knowledge and lack of proper practices of breastfeeding among nurses

Vaccination status of measles diagnosed children admitted in Sheikh Zayed Hospital Rahim Yar Khan

Background: Measles, though being a vaccine preventable disease, is still a major public health problem in many developing countries. It is a significant problem in Pakistan despite vaccine coverage rates reported at 80%

Objective: To assess the vaccination status among measles diagnosed children admitted in Sheikh Zayed Hospital Rahim Yar Khan

Patients and Methods: This cross sectional study was conducted on 100 children at pediatric ward of Sheikh Zayed Hospital Rahim Yar Khan. Detailed history and physical examination of all the hospitalized patients with measles or complications of measles was filled in a performa consisting of questions regarding age, gender, residence, socioeconomic status and vaccination status of children. Questions were asked from mothers/attendants of measles diagnosed children. After collection of data, it was entered and analyzed by using SPSS version 16

Results: A total of hundred hospitalized children with measles or complications of measles were included. 24% children were completely vaccinated against measles, 18% were incompletely vaccinated whereas 58% were not vaccinated. 44% were from urban area while 56% children were belonging to rural areas

Conclusion: Our study showed that majority of children were not vaccinated against measles. Programmes targeting mothers of lower socio-economic status such has those with no education, those in most poor households and with many children are required. Such programmes may include health education and immunization campaigns at the community level to improve coverage

Frequency and risk factors for myopiaamong children visiting ophthalmology outpatient department of Bahawal victoria hospital, Bahawalpur

Background: Myopia is one of the preventable cause of visual impairment

Objective: Objective of this study was to determine the frequency and risk factors for myopia among children [6-12 years] visiting Ophthalmology outpatient department of Bahawal Victoria Hospital, Bahawalpur

Patients and Methods: It was cross sectional study conducted in Ophthalmology outpatient, department of Bahawal Victoria Hospital, Bahawalpur from 1[st] July, 2012 to 30[th] June 2013. After taking ethical approval from hospital ethical committee, all the children aged 6-12 years visiting Ophthalmology outpatient department, whose parents had endorsed informed written consent, were included in the study. After collecting personal detail of each participant, and noting risk factors from their parents by using questionnaire, the visual acuity of each child was checked by using Snellen's chart. The children having visual acuity less than 6/6 in at least one eye underwent refraction by using retinoscopy after 1% cyclopentolate eye drops had been instilled at least half an hour previously. Data was entered and analyzed by using SPSS version 17. Spherical equivalents equal to or more than -0.50 D in either eye was taken as myopic. Chi square test was applied to see any statistical difference if existed and p-value

Results: Out of total 2936 children, 57.93% were myopic. 32.86% children were in the age group of 6-8 years, 54.67% in 9-11 years and 12.47% were >/= 12 years of age. 67.37% children were females. Family history of myopia was positive in 65.8% children. The reading hours of 17.3% children were 8 hours per day in 6.48%. The duration of TV watching was 4 hours in 2.02% children. 60.72% of the children were spending their time in playing video games or using computer for 4 hours

Conclusion: There is strong association of myopia with near work and parental myopia

Antioxidant and antibacterial activities of Hibiscus Rosa-sinensis Linn flower extracts

Antioxidant and antibacterial potential of different solvent extracts of locally grown Hibiscus rosa-sinensis Linn was evaluated. The antioxidant activity was assessed by estimation of total flavonoids contents, total phenolic contents, DPPH free radical scavenging activity and percentage inhibition of linoleic acid oxidation capacity. Agar disc diffusion method was used to assess antibacterial potential of crude extract of H. rosa-sinensis. The yield of the crude extracts [23.21 +/- 3.67 and 18.36 +/- 2.98% in 80% methanol and ethanol solvents was calculated, respectively. Methanol and ethanol extract of H. rosa-sinensis showed total phenolics 61.45 +/- 3.23 and 59.31 +/- 4.31 mg/100g as gallic acid equivalent, total flavonoids 53.28 +/- 1.93 and 32.25 +/- 1.21 mg/100g as catechine equivalent, DPPH free radical scavenging activity 75.46 +/- 4.67 and 64.98 +/- 2.11% and inhibition of linoleic acid oxidation potential 75.8 +/- 3.22 and 61.6 +/- 2.01% respectively, was measured. Antibacterial study against three human pathogens such as staphlococus sp. Bacillus sp. and Escherichia coli showed growth inhibitory effect in the range of 12.75 +/- 1.17 to 16.75 +/- 2.10 mm. These results showed H. rosasinensis indigenous to Kallar Kahar and its allied areas bear promising medicinal values and could be used for developing herbal medicines to target oxidative stress and infectious diseases.

Novel indium-111 labeled gastrin peptide analogues [MG-CL1-4]: synthesis and quality control

Radiolabeled neuropeptides are widely investigated to diagnose and therapy of tumors. These peptides get internalization after binding with particular receptors at the surface of cells and finally move to lysosome. Internalization into tumor cells helps in mapping the infected site. Minigastrin peptide analogues [MG-CL1-4] were synthesised and labeled with 111-In radioisotope under different sets of conditions for imaging CCk-2 receptor bearing tumors. Different parameters such as temperature [80-100[degree]C], pH [4-12], incubation time [5-30 minutes] and dilution effect were investigated to get the maximum labeling yield and stability. The results indicated that MG-CL1-4 is successfully labeled with indium-111 at pH 4.5 with heating at 98[degree]C for 15 minute. At these conditions i.e. heating, pH and incubation minimum oxidized and maximum labeling yield, more than 94 %, was obtained. The labeling stability was studied by incubating the radiolabeled complex for predefined time points in PBSA and blood serum. Results show that more than 90% radiolabeled MG-CL1-4 remained intact

Development and implication of a capillary electrophoresis methodology for ciprofloxacin, paracetamol and diclofenac sodium in pharmaceutical formulations and simultaneously in human urine samples

This work studies the development of a simple and fairly rapid methodology for simultaneous determination/ separation of three frequently co-administered drugs; ciprofloxacin [CIP], paracetamol [PCT] and diclofenac sodium [DIG] using capillary electrophoresis [CE] with UV detection at 260 nm. Separation was achieved in only 6.5 min with a simple buffer of sodium tetraborate [50 mM] at pH 9.0. The Parameters affecting the separation and detection were optimized. The calibration curves were linear in the range of 5-500 microg/mL for CIP, 5-250 micro g/mL for PCT and 1-125 microg/mL for DIC sodium under the optimized conditions. The lower limit of detection [LOD] was found to be 1 microg/mL for CIP and PCT and 0.5 microg/mL for DIC. The method was successfully used for the analysis of drugs in commercial pharmaceutical formulations and simultaneously from patient's urine sample with RSD 0.5-2.4%. Results obtained with CE method are compared with standard HPLC procedure and were found in good agreement

Neural tube defects; prevalence in population of Rahim Yar Khan

To know the frequency of NTD among total births in teaching Hospital Rahim Yar Khan and to know the possible causes of neural tube defects in area of Rahim Yar Khan. Prospective study. Department of Obstetrics and Gynaecology Sheikh Zayed Medical College/Hospital Rahim Yar Khan. One year from November 2006 to October 2007. All pregnant mothers were registered in the study but only those were selected who were diagnosed during pregnancy or after delivery as a case on NTD. Out of 6701 live births, a total of 52 cases were diagnosed at NTD. The information was collected by taking history along with ultrasound findings and biochemical tests. The incidence came out is 2-8/1000 live births. The maternal mean age was 28.9 years and more common in primigravida i.e. 33% and 30% were grand multigravida. 75.3% of women belonged to low income group, and were not taking proper balanced diet. 80% lived in Joint family and 96.2% females were house wives. 96% cases of NTD were detected by ultrasound at mean gestation of 21.66 wks. The most common NTD was anencephaly found in 67% of cases, spina bifida 29% and encephalocele was found only in 4% of cases. The male; female ratio was 2:3. 74% of women had Hb level less than 10 mg/dl and in 20 women the type of anaemia was macrocytic-hypochromic. Low socio-economic status, poverty and poor dietary habits may be factors for higher incidence of neural tube defects. Our study provides new data for the health care providers to improve health facilities and their utilization and iron and folic acid supplementation targeted to all women of child bearing age to prevent neural tube defects

Diabetes Mellitus; frequency among general population of Rahim Yar Khan

To determine the frequency of diabetes mellitus and to assess the level of awareness about diabetes amongst persons attending a free health camp in cultural festival of Rahim Yar Khan. Cross sectional observational study. Three days free health camp arranged in a cultural festival in Rahim Yar Khan. Over all frequency of type II diabetes was 19.38% and the frequency of diabetes increased both in men and women with increasing age [p<0.001]. Newly diagnosed subjects were 6.77% and these do not know that they were suffering from diabetes. 18.92% subjects were having glucose intolerance and 61.70% subjects were having random blood glucose level within normal limits. Diabetes was correctly defined by 57% subjects and this was significantly associated with educational level, suffering from the disease and presence of disease amongst family members. 14.62% gave history of presence of disease in their families. As compared to females, males were more suffering from disease and these were consuming more foods and snacks than females [p<.0.01]. High frequency of diabetes mellitus was observed amongst the study population. This may be due to health consciousness and higher level of educational status in the subjects who participated. Emphasis on health education and preventive strategies are needed to increase public awareness and early detection of high risk groups and risk factors of this common disease in our country. The lifestyle behaviors and environmental factors are strong modifiers of diabetes The life style changes and interventions in early age may prove to be more effective than interventions done at a later stage

Late hemorrhagic disease of newborn [HDN]

To assess the clinical profile and risk factors of patients with late hemorrhagic disease of newborn. The study was conducted at the Department of Pediatric, Bahawal Victoria Hospital, Bahawalpur from June 2004 to May 2006 and Sheikh Zayed Hospital Rahim Yar Khan from June 2006 to May 2007. All the infants above the age of 7 days admitted in Pediatric unit with vitamin-K deficiency bleeding were evaluated. Thirty two infants the criteria of late HDN; 24 [75%] were male and 8 [25%] female. Majority of the babies i.e. 24 [75%] were in the age group 4 to 12 weeks. All were born at term and were on exclusive breastfeeding. The place of delivery was home in 18 [56%] while the remaining 14 [44%] were born in hospital/private clinics. Prophylactic vitamin-K was not given to any of the infants at birth or later. Majority of the infants 24 [75%] presented with neurological features, Intracranial hemorrhage is the commonest presentation of late HDN carrying significant morbidity and subsequent mortality. As there is ample evidence that late hemorrhagic disease of the newborn is prevalent because of lack of vitamin-K prophylaxis at birth hence prophylactic vitamin-K administration at birth is a deadly desirable intervention to avoid this potentially preventable life threatening condition

Acute poisoning in children: etiological agents, risk factors and outcomes

A total of 70 patients were thus included. The patients were followed till discharge. A Proforma was filled and results were analyzed on SPSS version 10 of computer programme. All consecutive patients of poisoning who visited the Emergency Ward during the study period fulfilling inclusion criteria were enrolled. The mean age was 2.89 years with range of 6 months to 10 years. Male to female ratio was 1.5:1. Kerosene was the commonest agent accounting for 50% of all cases, followed by pharmaceutical products [14.3%] and chemicals [12.9%]. Storage of Kerosene in empty bottles of beverages and lack of proper storage of drugs were the commonest risk factors identified. Oral ingestion was the most common route of intoxication. Most of the patients [84.3%] were discharged without any sequelae. Overall mortality was 5.7%. Conclusion most of toxic substances to which children were exposed were those stored in eatable containers i.e. kerosene oil. Minority of children with accidental poisoning developed serious toxicity. Parents can prevent many of these accidents by identifying, adequately storing and locking away toxic material