Awareness and knowledge regarding risk factors and common symptoms of cervical cancer among female students of Rawalpindi

Objective: To assess the knowledge, attitudes and practice among medical students regarding cervical cancer risk factors, common symptoms and preventive measures

Study Design: Descriptive cross-sectional study

Place and Duration of Study: Foundation Medical University, Rawalpindi from 1st Jul 2016 to 30th Jun 2017

Material and Methods: A total of 173 pre clinical female student of MBBS who give consent were enrolled in the study by non-probability consecutive sampling technique. With informed written consent, data were collected on pretested questionnaire. Data were presented as frequencies and percentages

Results: Total 173 students were enrolled with response rate of 98%. Age ranged from 18-21 years. Fifty three [31%] students had family history of cervical cancer. Majority of the students 101 [59%] had heard about cervical cancer. Knowledge about etiological agent [38, 22%], HPV vaccine available for infection prevention [11, 6%] and its Pap smear screening [61, 36%] was poor. Abnormal vaginal discharge was the most common symptom [98, 57%]. Overall response of symptoms was poor. An attitude towards diagnostic measures for cervical cancer was positive. A total of 127 [74%] students responded that every adult girl should be vaccinated against cervical cancer, 137 [73%] voted for regular cytological examination however 88 [56%] were not in opinion of doing pap testing as OPD procedure

Conclusion: Our study revealed poor knowledge about cervical cancer risk factors and symptoms among female students. Awareness programs are required for early detection and treatment of this fatal cancer

Anxiety among the young cardiac patients - a neglected illness

Objective: To explore the prevalence of anxiety among young cardiac patients visiting tertiary care hospital, Rawalpindi

Study Design: Observational cross-sectional study

Place and Duration of Study: Rawalpindi Institute of Cardiology [RIC], from 27[th] Jun to 30[th] Sep 2016

Material and Methods: After ethical clearance and approval of the supervisor of Rawalpindi Institute of Cardiology, data were collected from the OPD patients of Rawalpindi Institute of Cardiology over a period of one month. Patients were briefed about the nature of study and after informed written consent, information was collected through face to face interviews by trained data collectors using General anxiety Disorder [GAD] scale. SPSS-21 was used for data analysis

Results: A total 237 patients were interviewed and male to female ratio was 1.4:1 [140:97]. Age ranged from 20-40 years with mean of 32 +/- 5.2 years. Overall prevalence of anxiety was 25.5%. There was not statistically significant difference observed in anxiety levels between male [23, 9%] and females [25, 11%], [p-value: 1.000]. The participants were divided into 4 age groups and group 4 [36-40 years] was most affected group. However, none of the group showed statistically association with age groups. A statistically significant relationship is found with unemployment and anxiety [OR: 2.8, p-value: <.005]. However there was no relationship between duration of cardiac illness and anxiety [p-value: .588]

Conclusion: Moderate level of anxiety was most prevalent among the 30-40 years age group

Child Labour in Pakistan - A tip of an iceberg

To study the basic demographic characteristics of child laborers and to ascertain their working conditions. This cross sectional study was conducted in district Rawalpindi from January to September 2008 and 700 children between 4 - 18 years were enrolled after taking informed consent from both children and their masters. Information on demography and work details was recorded on a structured performa. Total 700 children 4-18 years old with mean age of 13.5 years were enrolled. Male: Female ratio was 5.4:1. Most of the children [401] had a family size of 5-8 members. In 634 cases, 1-4 family members were earning while 05 had 10-12 earning members. Only 479 [68%] children ever attended school, mostly [291, 42%] till primary level. 258 children's families had monthly income of more than PKR 8000, 210PKR 6000-8000, 167 PKR 4000-5000 and 63 families were earning less than PKR 3000/ month. Mostly [270] worked in shops. Reason of work was low family income in 222 and poverty in 207 children. 283 children worked for 7-10 hours per day, 216 for 07 days, 115 for 4-6 hours, 45 for more than 12 hours and 39 for 1-3 hours. Maximum monthly pay was 1000- 2000 rupees in 187 and minimum 500 rupees per month in 106 children. 284 cases sustained injury while at work. Most child labourers are male with a family size of 5-8 members, never attended any school and living in a family whose monthly income is less than 8000 Pakistani Ruppee. The major reason of work was low family income and poverty

assessment of effectiveness of immunotherapy in pollen allergic patients

Background: Allergen-specific immunotherapy[SIT] is a well established treatment option forpatients with allergic rhinitis with or withoutassociated asthma that can modify the allergicdisease process

Aim: To assess clinical efficacy ofimmunotherapy in patients presenting with pollenallergy

Study design: A cross sectional hospitalbased study

Settings and Duration: Conducted atAllergy Center, National Institute of Health [NIH],Islamabad during April - October 2011

Subjectsand Methods: 100 patients visiting the AllergyCenter, NIH with more than two years history ofrhinitis, sneezing, asthma of both genders wereincluded. All patients had positive skin prick test.Selected subjects were explained about the nature ofthe study and informed consent to participate in thestudy was taken from them. Information on commonclinical presentation, duration of allergy, duration ofvaccine use, change in disease attacks after vaccine,and quality of life was recorded on pre developedand pre tested questionnaire

Results: A total of100 patients were enrolled. 57 patients were foundto have allergy against grass, 33 against pollen treeand 53 wereallergic to weed. Common clinical symptoms weresneezing [93%], runny nose [90%] and wheezing[87%] followed by redness in 69% of cases.Majority 66 [65.3%] had positive family history forallergy while 34 [33.7%] did not. Time for whichpatients were on immunotherapy was 1, 2, and 3years where majority being on vaccine for one year.Before vaccine only 12 patients used to have lessacute and frequent attacks compared to 88 patientswho had severe attacks. After starting allergyvaccine 71 patients had complete relief with noacute attacks at all, however 05 patients startinghaving more frequent acute attacks than beforewhereas 24 patients reported having less attacks butnot complete relief. Quality of life in terms of day today activities and freedom to move out withouthaving acute symptoms was improved in 82% ofcases while 18% of the patients did not have suchimprovement

Conclusions: Immunotherapy servesto build up long term resistance against thesensitized allergen. Avoidance to allergen, use ofmedication and immunotherapy are the threeregimes employed to combat the disease

Contraceptives knowledge and practices in district Rawalpindi: a hospital based study

To assess the knowledge and practices of contraception and reasons for non utilization of family planning services at Rawalpindi, Pakistan. A cross sectional survey. Fauji Foundation Hospital Rawalpindi from January 2007 to September 2007. This study was designed to investigate contraceptive knowledge and practice in Pakistani women attending a tertiary care hospital. A sample of 200 married women of reproductive age were interviewed to record their age, educational status, relatives practicing contraception, knowledge about contraceptive methods, source of the information and family support for contraception. Simple convenience sampling technique was used in this study. Close ended questionnaire was used to record the information. Subjects [99%] of study population were aware of currently available contraceptives and among them [48%] were practicing these methods. Educated females were [71%] and 93% practiced contraception while [29%] were uneducated and among them [47%] practiced contraception. [51%] of Females were supported by their families for practicing contraception. Source of information for [53%] was health service providers and for [39%] female was mass media. Most of [67%] female relatives also practiced contraception .Only [3%] of the subject's did not practice because of fear of Allah and [32%] had some other reasons. Level of Knowledge in study population was high but there was a huge gap of practice of contraception. Reasons for not practicing was not religious rather it was social pressure

Child laborers; abuse is universal at Rawalpindi

In Pakistan there are about 3.3 Million unprotected child laborers. They are constantly exposed to all kinds of dangers and abuse intimidating the future of the country. These child laborers are without the basic necessities of life including food, shelter, schooling and healthcare services, which has devastating effects on our socio-economic fabric. It is quite imperative to comprehend and unveil the perilous picture of the working conditions of child laborers and the abuse inflicted upon them at such an impressionable age. Cross sectional study. Rawalpindi city including workshops, shops and streets of Rawalpindi. January 2008-Dec 2008. Objective: To assess the presence of any Verbal, Physical and Sexual abuse among the child laborers at Rawalpindi city. Out of the total sample of 700 study subjects 315 [45%] of the Child laborers reported being abused whereas 385 [55%] reported no abuse. Out of the fraction which reported to be abused the break up is as follows. 214 [67.9%] reported verbal abuse, 75 [23.8%] reported Physical abuse and 25 [7.9%] reported sexual abuse. This study concluded that the child laborers are open to the elements of the adversities that come along with their work environment. The government should be urged to take necessary steps to trim down the abuse against child laborers and its frightening effects on their families, society and nation at large by constituting strict laws and ensuring their speedy implementation

Through service learning to provide social justice

In Pakistan there are 3.3 Million child laborers without healthcare services and educational opportunities, which affect our social fabric. We report how structured 'Service Experience' helped broaden medical students understanding of social justice. To produce health professionals who are ready to work for a cause without voracity. A Cross sectional survey through a focal group discussion. Do opportunities for structured Service Learning help modify student's perception of their role as doctors in society? Foundation University Medical College, Islamabad. Fifteen months, from January 2008-April 2009. Fifteen students interviewed 700 child laborers using a piloted interview form during a fifteen months period. Focus group discussions were held with these students to discuss their experiences. Qualitative analysis of the discussion is reported. Students empathized that children worked on a contractual basis averaging $1 per 10 hours with no meals. Parents encouraged them to earn money and they felt more satisfied pleasing them. Children didn't attend school because of the school quality and fear of abuse. "Our exposure to child labor had been limited; this has taken us to the core of the issue. We now feel responsible as a physician and a leader to ensure 'security of children in every respect' as part of their health." "We will avoid employing children at our homes and will council parents, trying to be role models for others." "As future leaders we will propose measures including establishment of free quality educational systems with paid vocational tracks." Service learning will inculcate empathy for the oppressed groups of the community and also develop a social and civic responsibility in medical students

To assess the relations between breast feeding and illness in children under two years of age with particular reference to respiratory tract infections

The study was carried out to examine the relation between the breast feeding and morbidity as a result of respiratory illness and infection in the children less than two years of age. This is a prospective analysis of 131 children attending the outdoor peadriatic department of Federal Government Services Hospital, Islamabad during the month of February 2006. A close ended pretested questionnaire was filled after taking informed consent from patient's parents. Out of total 131 enrolled cases [76 male and 55 female] 62 [47%] were breast fed; 56 [43%] bottle fed; while 13 [10%] had mix feeding. Among 38 children, having past history of respiratory tract infections episodes in last one month, only 04 [10%] were breast fed and remaining 34 [90%] were either bottle fed or had partial breast feeding. Out of 62 breast fed children, only 04 [6%] had recurrent episodes of respiratory tract infections, on the other hand out of 56 bottle fed 32 [57%] had previous history of respiratory illness. In our study there is a significant correlation between breast feeding and reduction in number of respiratory tract infections episodes. Predominant breast feeding for at least six months and partial breast feeding for up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection in infancy