audit of the quality of care indicators for the management of diabetes in family practice clinics in Karachi, Pakistan

Management of diabetes is a painstaking and careful approach. This study was aimed to evaluate the quality of care for the management of diabetes provided by family practitioners to their patients having diabetes. This is a retrospective audit of medical records conducted in a tertiary care teaching hospital of private sector in Karachi for one month. For this study, 150 medical records of patients with type 2 diabetes that visited family practice clinics for their diabetes care were examined. A total of 88 patient's medical records were selected and analyzed who attended the studied clinics for at least one year and had minimum of four out-patient visits. Majority [68%] of the audited medical records were of females. Of the total medical records analyzed, only one-quarter of the cases qualified the criteria of 'excellent' or 'good' diabetes care. Monitoring of body weight of the patient was only one indicator which was according the recommendations in 100% case at every visit. The other nearest quality of care indicator documented was blood glucose advice at every visit in 79.5% [95% CI: 71.1-87.9] of cases. Physical activity advised/reinforced at every visit was least observed [27.3%; 95% CI: 18.0-36.6]. In addition, blood sugar control was reported in less than a quarter [23.9%] with 95% CI of 15.0-32.8. This work has identified a big gap in the management of type 2 diabetes provided by family practitioners. In addition, majority of the patients found to have poor glycemic control. Interventions are suggested to improve the quality of diabetes care. More such audits and research are recommended at the larger scale

Distribution of lower urinary tract symptoms [LUTS] in adult women

To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms. Design: Cross-sectional analytical study. Place and Duration of Study: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002. Subjects and A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center. Fifty-two% of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence was the highest reported complaint [38.4%] followed by burning [34.4%], frequency [26%], painful micturition [20.4%], urge incontinence [18.8%], incomplete emptying of bladder [14.4%], dribbling [12.4%] and poor stream [8.4%]. Forty-three% of the women with LUTS never consulted a health care provider for their problem. Although the distribution of LUTS among females was found to be high, the patients did not consider it important enough to consult a health care provider. There is a need to create awareness among females regarding LUTS and the need to consult a health care provider for their problems

Use of folk remedies among patients in Karachi Pakistan

The concept that food is medicine is being practiced in certain parts of the world, with positive outcomes on health of the population. We have such practice in Pakistan but it needs to be brought in line with the available scientific evidence. The study was conducted on 270 patients, visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the use of folk remedies for medicinal uses. Substantial use of folk remedies for different medical conditions has been documented. The remedies included cinnamon, ginger, cloves, cordimon, sesame oil, poppy seeds, honey, lemon, table salt, eggs and curd. The medical conditions in which folk remedies are used in respondents' view, include conditions such as common cold, cough and flu to more serious conditions such as asthma, jaundice and heat stroke. Conclusions: We have found a substantial use of folk remedies for treatment of medical conditions. There is a need to organize their use on scientific lines