Predictors of treatment interruption in pulmonary tuberculosis patients

Tuberculosis [TB] is a common and deadly infectious disease caused by mycobacterium, mainly mycobacterium tuberculosis.1 The World Health Organization declared TB a global health emergency in 1993.2 This is a cross sectional descriptive study. To identify factors predicting treatment interruption in pulmonary tuberculosis patients under DOTS [Directly Observed Treatment Short Course] strategy in District Lahore. It is conducted on 421 pulmonary tuberculosis patients under DOTS, in district Lahore, Pakistan in 2006 - 07. At the end of the treatment period, the treatment interrupters were 31 / 421 [7.4%]. Among them 25 / 421 [5.9%] were defaulters, while 6 / 421 [1.4%] were non-compliers. Analysis showed a significantly increased risk of treatment interruption among those who need to travel in order to get medicine [p < 0.0001], those who need to travel a distance of more than 30 minutes walk to get medicine [p < 0.0001], those who occasionally need to buy medicine [p = 0.024] and those patients who were directly observed by health care provider [p < 0.0001]. The issue of treatment interruption in tuberculosis patients and the factors identified in the study, need to be addressed, so the compliance can be improved

Frequency and underlying factors of myopia among medical students

Refractive error may be defined as a state in which the optical system of the nonaccommodating eye fails to bring parallel rays of light to focus on the retina. Especially myopia has become a very common problem. Myopia is a refractive error in which eye fails to see distant objects properly. To estimate the frequency of myopia among MBBS students of AIMC; to point out the under lying factors of myopia; and to compare these factors among myopics and emmetropes in a Cross Sectional Comparative, study form March 2010 to September 2010. Two hundred and two [202] students from all the five M.B.B.S classes were examined. Around 40 students were selected from each class by systematic random sampling technique, their visual acuity was checked using Snellen's Chart and Diopters were checked in Eye Deptt. To assess factors a semi-structured questionnaire was filled by the interviewer. Frequency of myopia was observed as 57.6%. Mean refractive error was-2.12D. A total of 61% of females and 51.5% of males were myopic. First and second year students had greater percentage of myopia with 61.1%. Out of 117 myopic students, 71 [60.7%] had positive family history of myopia, whereas 22 [18.8%] did not. [p=0.000003]. The mean reading hours per day of myopics were 3.31, while others had an average of 3.60 hours daily. Difference between daily time spent on writing activity by myopics and non-myopics was insignificant [p=0.544]. The myopics watched television for an average of 2.24 hours daily and the non-myopics had a mean of 2.71 hours of watching television daily. Similarly, our study did not show any significant statistical relationship between working on computer, sleeping habits of students and amount of physical exercise done daily [p=0.266, 0.968 and 0.305 respectively]. Dietary factors did not show any significant relationship with myopia. Prevalence of myopia was high among AIMC students [57.6%]. 1st and 2nd year students had greater percentage indicating that it is increasing in the younger age group. Significance of genetic predisposition was well appreciated in our study

Socio-demographic differentials and health services utilization practices among known hyperglycemic females

To find out the health utilization practices among known hyperglycaemic females of age 4o and above and to compare the rates among women of different socioeconomic strata. It is an analytical cross-sectional study. One hundred known hyperglycaemic females of age 40 and above were interviewed and required information was collected by structured questionnaire through house to house survey. Fifty eight [58%] women seek treatment for diabetes mellitus [DM] type 2, while 42 did not, for one or another reason. Among single women, utilization rates were high [73%], as compared to married coupled women [51.4%]. Education [p = 0.00031], occupation [p = 0.0003], family income > Rs. 15000/ cap./ m [p = 0.0013], small family size > 7 [p = 0.0009], positive family history of diabetes mellitus type 2, BMI > 28, hypertension with D.M. type 2 [B.P > 140/90, P=0.00011] and among females with previous history of gestational DM [utilization rate 100%, p=0.00038] were significantly associated with high utilization rates. Distance of health care facility [> 5km], cost of travel, cost of drugs, family income < Rs. 1500/ cap/m. and low perception for serious complications of disease were the reasons for low utilization rates. Gender discrimination, faith in quacks and spiritual healers, myths regarding treatment, unsafe travelling and treatment from male doctors were not identified as risk factors for non utilisation of health services for the management of D.M type 2. Health seeking practices and utilization rates among hyperglycaemic females of this defined rural community were not very low [58%]. No perception for serious complications of D.M. and economic constraints were the main reasons for non utilisation of health services as compared to socio-cultural factors and myths

Abortion prevalence and socio-demographic differentials

This study was performed to estimate the prevalence of abortions and to evaluate its association with the socio-demographic factors in an urban slum. The data was collected based on recall obstetric history fromi86 females through systematic r and om sampling from 01.04.2001 to 30.06.2001. It was found that the abortion rate was 419.35/1000 women of reproductive age group. Abortion ratio was 109.39/1000 live births. There was strong association of induced abortion with non-Muslim family, working of female and illiteracy of husb and. On the other h and gravidity 5 or above [increasing gravidity] was statistically associated with total abortions. It was concluded that there is an unmet need for controlling unwanted pregnancies and promoting birth spacing among Pakistani women. Some important social and demographic factors determine the abortion behavior in Pakistan

Hyperglycaemic females: an ignored iceberg

This community based study was conducted in a village of Lahore District, Pakistan. All 293 females [age 40 and above] residing in the village were interviewed and capillary venous blood glucose level was measured by Glucometer, randomly and 2 hours after 75 gram of glucose load [after informed consent]. Cut off point was taken at > /= 200mg/dl. Raised blood glucose levels were found among 54 [28%] females that is quite a high prevalence, of these 37 [68%] hyperglycaemic females were not taking regular exercise [p=0.004], 35 [65%] had family income / capita / month /= 140/90] was among 21 [39%], highly significant [p=0.0034]. Association of B.M.1 and hyperglycaemia is non significant. Positive family history of diabetes was observed in 20 [37%] females [p=0.010]. The study concluded that the total burden of hyperglycaemia among females is alarmingly high. There is a dire need to make the female population aware about diabetes, its prevention and control. Mass teaching, specifically regarding self estimation and self care is the need of the day. The objective of this study was to calculate the burden of hyperglycaemia among females and the underlying factors related to hyperglycaemia.

Feto maternal outcome in eclampsia

A total of 152 consecutive patients were taken for this study which was carried out in Lady Wallingdon Hospital, Lahore - Pakistan. The data was collected from gravid females having fits with or without raised blood pressure [>=140/ 90] and albuminuria, during antenatal, natal and postnatal period [hospital stay] with the help of Structured Questionaire. Uniform treatment regime [Diazepam for control of convulsions, alpha methyldopa and Nifedipine as antihypertensive agent] was administered. A total of 9417 females were delivered during this period, out of these 152 [16/1000 pregnant women] were eclamptic, 9800 were unhooked cases. 129 [84.86%] women had fits in antepartum period, 4[02.63Y] and 19[12.50%] had intrapartum and post partum fits respectively. M.M.R. during the year 1999 was 4.59/1000 live births and eclampsia contributed 11 maternal deaths [27.58%], [P=0.00, R.R=23.04]. Among 152 eclamptic women, 11[7%] died. While out of 721 perinatal deaths 45 [6.24%] were among eclamptic mothers [P=0.00, R. R. =5.07]. Eclampsia has strongly significant adverse impact on Mothers and foetus. This could he avoided by sincere provision of integrated, adequate and affordable MCH services especially during antenatal care