A Study of the Knowledge, Attitudes and Practices Regarding Needle Stick Injuries among Health Care Workers in Government Health Facilities of District Bandipora, J&K

Introduction: Needle stick injuries are often neglecteddespite being an important occupational hazard, withpotential to transmit infectious diseases. There is a need forraising awareness about them among all cadres of health careworkers. The current study was done to assess the problem inGovernment Health facilities of a rural district of J&K.Material and methods: Descriptive cross sectional study wasdone using all the secondary and 40% of the primary healthfacilities of the district. Study was conducted among doctors,paramedics and waste handlers. Statistics involved wereproportions or percentages, assessed by chi square test.Results: about 85% health workers considered needle stickinjury as a matter of concern. 27% were recapping the needleafter use. 12% had suffered a needle stick injury in the last oneyear and only half of them were immunized for Hepatitis B.Conclusion: There is a need of sensitization of the variouscadres of healthcare staff which is necessary to decreasethe risk of occupational exposure of infectious diseaseswith significant focus on waste handlers. There is a needfor enhancing the coverage of Hepatitis B immunizationespecially among the waste handlers who form the mostvulnerable group.

Screening for dementia in older adults using Mini-Cog scale from a rural setting of Kashmir division

Background: Dementia is common in the geriatric population. It has been suggested that early detection leads to benefits for the patient and their family and cuts the costs. The solution to this problem lies in the development of brief and easily applicable tests that are acceptable to patients, their caregivers, and health professionals. The current study was undertaken for screening for dementia using Mini-Cog scale.Methods: Cross sectional study from District Budgam of Kashmir Division done on individuals aged >60 yrs after providing informed consent. All participants underwent comprehensive evaluations using the Mini-Cog scale for Dementia.Results: The overall prevalence of dementia was 57.5%. Majority of the individuals with dementia were illiterate (49.8%) and had completed up to primary education (63.2%). However no statistical significance was seen between marital and educational status with dementia. About 70.8% of the individuals with dementia were not aware of the availability of facilities related to mental issues.Conclusions: Need of the hour is to develop culturally appropriate interventions that could be integrated with dementia services within the primary health care system.

Farmers' use of mobile phone for accessing agricultural information in Pakistan: / Papel do celular para entrega de informações agrícolas em um distrito carente da

ABSTRACT: Agriculture is considered as the main driving force in Pakistan's economy employing 45% of the country's labor force and generating 20% of national GDP Agriculture sector of Pakistan is facing numerous challenges including non-adoption of agricultural technology at the farm level, due to farmers' lack of access to the latest information. In this context, the current study focusses on the use of the mobile phone in accessing agricultural information among the farmers of the of district Muzaffargarh,Punjab, Pakistan. A multistage sampling technique was used to collect data from the two tehsils (cities/sub-districts) of Muzaffargarh formulating a total sample of 180 farmers. SPSS computer-based Software was used for analyzing the data. Results revealed that 91.2% of the farmers indicated mobile phone ownership. It was further reported that 87.20 % of the farmers used private sectors advisory staff to obtain agriculture information. Market information was ranked as the highest accessed information among the rest of farm-related use. Easy access to updated information and connectivity with stakeholders were reported as the highest perceived benefits of mobile phone use (4.63 & 4.72 mean). Findings reported that farmers' limited aptitude of Mobile phone usage and lack of awareness of information sources as major constraints in farm-related use of the Mobile phone. On the basis of findings, the current study provided recommendations and policy implications for utilizing the true potential of these ICT-enabled solutions in agriculture.

RESUMO: A agricultura é considerada como a principal força motriz na economia do Paquistão, empregando 45% da força de trabalho do país e gerando 20% do PIB nacional. O setor agrícola dos paquistaneses enfrenta inúmeros desafios, incluindo a não-adaptação da tecnologia agrícola entre os agricultores, devido a falta de acesso dos agricultores às informações agrícolas mais recentes. Neste contexto, o estudo atual enfoca o papel do telefone celular na disseminação de informações agrícolas entre os agricultores do distrito Muzaffargarhof Punjab, Paquistão. Uma técnica de amostragem em múltiplos estágios foi usada para coletar dados dos dois tehsils (cidades / sub-distritos) de Muzaffargarh, formulando uma amostra total de 180 agricultores. O software baseado em computador SPSS foi usado para analisar os dados. Os resultados mostraram que 91,2% dos agricultores tinham propriedade de telefones celulares. Verificou-se ainda que 87,20% dos agricultores contatam o pessoal consultivo do setor privado para obter informações sobre a agricultura. As informações de mercado foram classificadas como as mais acessadas entre os demais usos relacionados à fazenda (média de 41,45). O acesso fácil a informações atualizadas e a conectividade com as partes interessadas são relatados como os maiores benefícios percebidos do uso de telefones celulares entre os agricultores com valores médios de 4,63. e 4,72, respectivamente. Os resultados relataram que a capacidade limitada dos agricultores de usar o telefone celular e a falta de conhecimento das fontes de informação como principais restrições ao uso do telefone celular relacionado à fazenda. Com base nos resultados, recomenda-se a realização de sessões de treinamento com as comunidades agrícolas para criar conscientização e educá-las sobre o uso do telefone celular.

GC-MS and HPLC profiles of phenolic fractions of the leaf of Telfairia occidentalis

Telfairia occidentalis possesses high antioxidant activity. However, the antioxidant components of the plant have not yet been identified. This study was undertaken to identify the phenolics in the leaf of the plant. Extract and fractions of the leaf of the plant were analysed using the HPLC and GCMS. HPLC analysis revealed the presence of gallic acid [22.19microg/mg], catechin [29.17microg/mg], caffeic acid [9.17microg/mg], ferulic acid [0.94microg/mg], sinapic acid [1.91 microg/mg] and 4-hydroxy benzoic acid [43.86 microg/mg] in the aqueous extract. Phenolics fraction contained gallic acid [0.88 microg/mg], catechin [2.70microg/mg], caffeic acid [7.92microg/mg], ferulic acid [2.72microg/mg], benzoic acid [6.36microg/mg], pcoumaric acid [1.48microg/mg], quercetin [12.00microg/mg]. Only caffeic acid [2.50microg/mg], ferulic acid [0.44microg/mg] and quercetin [8.50microg/mg] were detected in the flavonoid fraction. While GCMS analysis showed the presence of methylparaben; ethylparaben; benzoic acid; 4-hydroxy-2-methoxy-3,5,6-trimethyl-, methyl ester; 4-hydroxy-3-methoxy; phenol, 5-methoxy-2-[methoxymethyl]-; phenol, 5-methoxy-2, 3- dimethyl; and phenol, 2-[2-benzothiazolyl]-. This study is the first to reveal the identity of some phenolics components of the leaf of Telfairia occidentalis

Aetiological factors of non-traumatic duodenal perforation

Background: Each year peptic ulcer disease affects 4 million people around the world. Perforation of the duodenum due to peptic ulcer remains a considerable medical problem causing high morbidity and mortality. This study aimed to determine the major aetiological factors of non-traumatic duodenal Perforations

Methods: It was a cross-sectional study carried out in Surgical 'B' Unit, Ayub Teaching Hospital, Abbottabad, Pakistan from 15[th] Jun 2012 to 15[th] May 2015. One hundred and eighty-six patients were recruited for the study. Data was collected and analysed on SPSS-23

Results: Mean age of the study participants was 48.4+/-7.14 years. Male to female ratio was 3:5. The main causative agent was H. pylori [54.30%], 22.04% were smokers, 6.99% had history of using NSAIDS, and 31 [16.67%] patients had more than one causative factor. There was strong association found between age groups and socio-economic status [p=0.004], and literacy level of the respondents [p=0.003]

Conclusion: Non-perforated duodenal ulcers are significantly associated with middle-aged people, low socioeconomic status, NSAIDS, smoking, and H. pylori

Vesico vaginal fistula repair with wide bore tube for urinary drainage

Objective: To assess the efficacy of wide bore tube in vesicovaginal fistula repair for urinary drainage

Study Design: Observational / descriptive / cross sectional study

Place and Duration of Study: This study was carried out in the Department of Gynae and Obs at Medical College/District Headquarter Hospital Mirpur Azad Kashmir from May 2009 to July 2012

Materials and Methods: All the patients were evaluated with history, physical examination and required labs

Cystoscopy was done in all patients before surgery. Repair was done in two layers. Bladder was drained with 20fr open end drain for first 72 hours, which was replaced with Foley catheter

Results: Total 28 patients with mean age 31 years [18-49 yrs], twenty three [82.1%] patients were having primary fistula while five [17.9%] had undergone surgical repair before

Location of fistulas were trigonal in 20 [71.4%] patients, supra trigonal 6 [21.4%] patients and 2 [7.1%] were involving the urethra. Twenty one [75%] patients were managed through vaginal route which include both trigonal and supra trigonal fistulas, remaining 7 [25%] repairs were done through the abdominal route. In twenty seven [96.4%] patients the repair was successful on removal of catheter

Conclusion: Approach for repair of VVF depends upon the preference and experience of surgeon. Success rate can be improved by following basic principles and good urinary drainage with drain

Health issues and wellbeing; working children in carpet industry in Punjab, Pakistan

Children are perceived as the future of any country. With this in mind, child labor does nothing but destroy the future of the children. Carpet weaving is destructive for children because children often sit in odd positions for extensive hours, inhaling dust and working in inadequate lighting situations, all these aspects are hazardous to the wellbeing of children. Child carpet weavers have to face occupational damages and diseases. To identify the factors contributing to child labor and effects of work-related health issues on the wellbeing of carpet weavers. Cross sectional survey. Punjab province. A sample of 320 carpet child workers of age group 8-17 years was interviewed. A well-structured questionnaire was constructed to collect the data. The SPSS/PC + 20.0 Statistical Package for Social Sciences were used for analyzing the data. The study found that majority of the respondents was facing the problem of body aches, backbone problem, eye strain and general exhaustion and cuts and wounds. The significant relationship was observed between work-related illness [type of illness] and the personal wellbeing of carpet working children. It was strongly suggested that comprehensive strategy consisting of macro as well as micro policies is to be commenced to control, reduce and eradicate. The ill effects related to carpet weaving. The participation of children in carpet weaving industry should be stopped or at least immunizad present. The carpet workers immediately need concentrated efforts not only to solve their work-related issues, but also to make them productive adult in their own wellbeing as well as in the welfares of society

Uterine rupture; four years experience on seventy four cases in secondary care hospital

To determine frequency and to identify social, demographic and obstetrical causes of rupture uterus in Bagh Azad Jamu Kashmir and to define appropriate recommendations for its prevention and effective management. A descriptive case series study. DHQ Hospital Bagh at AJK. 1[st] September 2008 to 30[th] September 2012 was done. Data was entered on pre-design preform included age, parity, booked or un-booked cases, time delay to reach hospital and etiological factors. Incidence of rupture uterus is 1:185 deliveries. Mostly occurred in grand multipara and injudious use of syntocinon and neglected labor are most common cause. Skilled birth attendant, free transportation and avoidance of undue use of syntocinon in peripheral health center are key element for better maternal outcome

Comparative efficacy of H[1] blocker, H[2] blocker, and corticosteroid individually and in combination in resolution of sign and symptoms of acute Urticaria

To compare the efficacy of H[1] blocker, H[2] blocker, corticosteroid in combination or individually in resolution of the sign and symptoms of acute urticaria. Randomized control trial. This study was carried out at Medical Department, Naseer Teaching Hospital, Peshawar, Khyber Pakhtunkhwa [KPK] for the period of six months [July 2012 through December 2012]. In this study 140 adult patients of both gender with acute urticaria were treated with either H[1] blocker [group A], H[2] blocker [group B] or in combinations of H[1] blocker + H[2] blocker [group C], H[1] blocker + H[2] blocker + dexamethasone [group D], H[1] blocker + dexamethasone [Group E], H[2] blocker + dexamethasone [Group F] or Dexamethasone [group G] alone. The end points were resolution of sign and symptoms in each group of patients [minimum 3 hours after treatment]. Pregnant females, anemic and Patients with cardiac disease were excluded. H[1]+ H[2] blockers + dexamethasone found to be most effective therapeutic combination [95% of patients] in resolution of sign and symptoms of acute urticaria, followed by H[1] blocker + dexamethasone [90%] and H[1]+ H[2] blockers [85%]. This study concludes that the combination of H[1]+H[2] blockers + dexamethasone is more effective in relieving the patient from the sign and symptom of acute urticaria as compared to H[1] blocker or H[2] blocker or dexamethasone given alone or in combination of any two

Women reproductive health security; role of spousal communication

Around the world, the right to health and especially reproductive health right are far from a reality for many women. Reproductive health is of growing concern today. Reproductive health therefore implies that people are able to have a satisfying and safe sexual life and that they have the capability to reproduce and the freedom to decide if, when and how after to do so. Reproduction is a dual commitment but so after in much of the world, it is seen as wholly the women's responsibility. There are four major problems commonly encountered by women in family planning and contraceptive use: accessibility to family planning information and services, quality of services, gender responsibilities and spousal communication. These problems become major obstacles preventing women from regularity fertility or exercising the reproductive rights. The importance of good health and education to women's well being and that of her family and society cannot be overstated. Spousal Communication is crucial step toward increasing women's participation in improving their health rights. Therefore the study was conducted to investigate the perception of married women about the role of spousal communication in establishing reproductive health security. For this purpose 200 married women of age group 15-45 with having at least one living child were selected through multistage sampling technique from urban areas of district Faisalabad. The study explored in bi-variate analysis that those women who were educated, younger and had a high economic status had a perception that the spousal communication plays a significant role in the development of women's attitude towards their reproductive health security

Reproductive health gender roles and relations as predictors of practicing of reproductive health rights among married women and men in Punjab, Pakistan

Practicing reproductive health rights is not an individual attribute but an outcome negotiated between partners. Large differentials can place the less powerful partner at risk by reducing his or her ability to negotiate safer sexual relations. Negotiation between partners is affected by material assistance which is given by men. Hence, the present study was designed to gauge the extent of practicing the reproductive health rights among married men and women and to see the relationship between respondents' characteristics and practicing of reproductive health rights by them. A cross-sectional survey was carried out from Punjab province. Well designed interviewing schedules were constructed in the light of research objectives and the conceptual framework of the study to collect data and draw inferences. A representative sample of 700 married women and 600 men were interviewed. The SPSS/PC+ 15.0 Statistical Package for Social Sciences were used for analyzing the data. A strong and positive association between the demographic characteristics of married men and women and their attitude towards the reproductive health behavior and those women who were currently engaged in paid jobs had highly favorable and consistent attitude towards RHR-Practices. It was strongly suggested that encourage women's employment by increasing their education level and creating jobs in every department and encourage women's participation in decision making process

Case fatality rate and etiological factors of malnutrition in children less than 5 years of age

To calculate the case fatality rate and etiological factors of malnutrition in children less than 05 years of age presenting to a tertiary care hospital. A descriptive cross sectional study was conducted in the admitted patients in the Department of Pediatrics and Neonatology, Lady Reading Hospital, Peshawar, during one and an half year period from January 2009 to June 2010. A total of 976 patients [aged from 0 day to 60 months, both male and female] with various diseases were recorded as samples. The frequency of different types and grades of malnutrition and important etiological factors for malnutrition in these children were scrutinized. Case fatality was also calculated among the malnourished children. Out of 976, 294 [30.12%] were malnourished. Among these, majority [n= 195, 66.3%] were in the age range of 13-60 months, with mean age of 36.20 + 3.82 months. Many [n=157, 53.4%] were male children with male to female ratio of 1.14:1. majority 139 [44.28%] had grade I malnutrition. The commonest medical etiological factors was chronic or recurrent diarrhea n=205, 69.72%], anemia [n=139, 47.27%], respiratory tract infections [n=115, 39.11%]; and inadequate feeding history [n=111, 37.75%]. Most prominent social etiological factors were poverty [n=236, 80.27%], uneducated mothers [n=223, 75.85%], more than 2 children under 5 years in family [n=136, 46.25%] cases. Case fatality [mortality] rate was 40 [13.6%]. Majority of malnourished children are males between the age of 13 to 60 months. Mass media campaign should be started for the eradication of malnutrition in children

Papillary thyroid carcinoma; the frequency of multifocality in patients undergoing total thyroidectomy

At Mayo Hospital Lahore, from August 2010 to April 2011. Was to determine the frequency of multifocality among all cases presented with papillary thyroid carcinoma [PTC] planned to undergo total thyroidectomy [TT]. Data of all patients of PTC was collected from inpatient department of East Surgical ward. All the patients underwent total thyroidectomy by same team of consultant surgeons. A total of 35 patients of PTC with mean age of 37.94 years were included. Multifocal tumor was found in 31.4%. Out of them, 72.7% were females and 27.3% males. This case series showed that a multifocality is highly prevalent in PTC and total thyroidectomy should be done as the treatment for PTC, to eliminate the additional tumor foci in thyroid gland and prevent its recurrence

Standardization of micropropagation techniques for Aloe vera: a pharmaceutically important plant

Aloe vera [Syn Aloe barbadensis Mill.], a medicinal plant, has a great potential in cosmetic and drug industry due to presence of more than 200 bioactive compounds. Natural propagation of Aloe vera, by means of suckers, is very slow and insufficient to meet the increasing demand of pharmaceutical and cosmetic industries. Shoot tip was used as an explant for in vitro regeneration of Aloe vera. Explants were disinfested with the use of 0.1% mercuric chloride and 0.5% sodium hypochlorite, and washed thoroughly with autoclaved distilled water. Solid MS medium was used with addition of different concentrations of 6-benzyl aminopurine and Alpha -naphthalene acitic acid. After 7 weeks of inoculation, greatest number of shoots [11.18] and highest shoot length [12.15cm] were found in MS medium supplemented with 0.5 mg 1[-1] 6-benzylaminopurine [BAP] along with same concentration of Alpha -naphthalene acitic acid [NAA]. Best rooting [84.67%] was found in medium supplemented with 1.5 mg 1[-1] of indole butyric acid [IBA]. The rooted explants were then gradually acclimatized and shifted to green house

Pyogenic granuloma of scrotum case report and review of literature

Pyogenic granulomas are common, acquired, vascular lesions of the skin traumatically. We present adult patient who developed pyogenic granuloma on scrotum, only second case report in English literature

Risk factors for preterm births in lady reading hospital, Peshawar

To determine the various maternal and neonatal risk factors of preterm birth. A descriptive case series was conducted from 1st January 2010 to 3Jxt December 2010. In this study all cases, a live Pre term birth [PTB] [29 - <37 weeks] by vaginal delivery or caesarean section and their mothers were included. A total of 205 [04.04%] neonates were identified as premature neonates. Majority [29.3%] were in the age range of 2 days with mean age of 1.5073 +/- 1.2627 days. Out of 205, 51.7% were male and 48.3% were female. Maternal age of 21-35 years was recorded in majority 79.51% with mean age of 28.10 +/- 5.8982 years. Majority of mothers [96.1%] were illiterate, 76.6% belonged to rural areas, 76.1% belonged to poor class, 35.1% were multiparas. A history of Premature rupture of membrane [PROM] was found in 61% cases, history of burning micturition 4.9%, physical injuries 0.5%, polyhydramnios 14.14%, previous low birth weight baby 41.5%, threaten abortion 27.8%, antepartum hemorrhage 36.1%, previous perinatal loss 31.2%, previous premature birth 30.2%, maternal pyrexia 14.1%, previous twins 6.3% and placenta previa 4.4%. Frequency of prematurity was 04.04%. Among the various risk factors maternal age, illiteracy, rural residence, poverty, joint family setup, history of PROM, previous low birth weight babies, history of antepartum hemorrhage, multiparity, previous perinatal loss, previous premature babies, threaten abortion, were the prominent risk factors found in majority of cases

Glucose intolerance in relation to socioeconomic status and gender in population of Srinagar city

To assess the pattern of type -2 diabetes in different socioeconomic groups in the urban and peri-urban areas of Srinagar city. A detailed questionnaire on the Socioeconomic and Clinical background of the 1040 subjects was collected. After an overnight for blood fasting blood samples were drawn for determination of plasma glucose. Diagnosis of diabetes was based on the American Diabetes Association [ADA 2004]. The overall Prevalence of the diabetes in the study population was 6.05% which included 4.03% of known diabetic and 2.02% undiagnosed subjects. There was significant difference between the prevalence of type 2 diabetes in men and women [3.6%vs 8.3% respectively, P=0.0013]. Subjects belonging to higher socioeconomic status had greater prevalence of diabetes compared to lower 17.4% vs 3.2% [P<0.001][middle class [class II and Class III] versus lower class[Class IV]respectively]. Socioeconomic factors influence the occurrence of diabetes in this study population, with prevalence being more come in the middle class

Prevalence of rhesus type and abo incompatibility in jaundiced neonates

To determine the prevalence of Rh and ABO incompatibility in jaundiced neonates. This hospital based descriptive study was conducted in Pediatrics Unit, Lady Reading Hospital Peshawar. A total of 200 neonates with clinically diagnosed jaundice were included in the study. Out of 200 neonates 70% were male and 30%female. Majority of neonates 99.5% age was ranged from 0-10 days while only 0.5% neonate was 13 days. Out of 200 neonates, the frequency of ABO-incompatibility and Rh-incompatibility in jaundiced neonates in this study was 22.5% and 12.5% respectively. Out of the remaining 65.5% cases physiological jaundice was diagnosed in 40.5% neonates, prematurity in 15% neonates and G6PD in 9.5% neonates. Among 22.5% cases of ABO incompatibility there were 16.5% males and 6% females. Majority 15% presented on 1[st] day of life, followed by 3% on 2[nd] and 3[rd] day of life respectively, 1% on 4[th] day, 0.5% on 5[th] day of life. Out of 200 neonates presented with jaundice, prevalence of ABO-incompatibility was found to be 22.5% followed by Rh-incompatibility 12.5%

Colorectal carcinoma: a comparative study between barium enema and colonoscopy with histopathologic correlation

Tumors of the colon and rectum are among the commonest of all gastrointestinal malignancies. It is a potentially curable disease, highly dependant on early diagnosis. The two most widely used diagnostic tools are the double contrast barium enema and colonoscopy. This study compares their diagnostic value in correlation with histopathology. This prospective study was conducted at Radiology Department, CMH Bahawalpur from September 2008 to September 2010. Total of 49 patients fulfilled the inclusion criteria. Patients of both sex and different age groups were included in the study. They underwent barium enema examination by the radiologist at Combined Military Hospital, Bahawalpur. In each of these patients colonoscopy was carried out after 02 weeks of barium enema by standard methods after proper preparation. Biopsies of all positive and suspicious lesions were obtained during colonoscopy. Histopathology was carried out at the laboratory. The findings were recorded and analyzed on SPSS 10.0. Of the 49 patients, 33 [67%] were males and 16 [32.65%] were females. The mean age of the study group was 53.5 Yrs [Range 25-82 yrs]. Histopathology revealed that out of 49 patients 46[93%] had colorectal carcinoma. Barium enema correctly diagnosed neoplastic lesions in 38 [77.55%] patients, whereas colonoscopy diagnosed correctly in 32 [65.30%] patients. Barium enema and Colonoscopy are complementary examinations with almost comparable sensitivity. Barium enema is safer, cost effective and more tolerated by the patients than colonoscopy therefore it should be preferred for initial evaluation of the colorectal carcinoma in our setup

Acute appendicitis mimics pelvic disease clinically in women of reproductive age

To analyze the clinical behaviour of acute appendicitis and pelvic disease in the women of reproductive age with special reference to ruptured right ovarian cyst/ectopic pregnancy. Study Observational. West Surgical Ward, Mayo Hospital Lahore. Duration: January-June 2006. All the women >12 years of age with the physical signs of acute appendicitis were included in the study. Age ranged from 13-44 years with the mean of 21 [median 18] years. Anorexia and shifting of pain were hallmark of acute appendicitis while sudden severe localized pain in right iliac fossa and tachycardia without fever were more specific to ruptured ovarian cyst/ectopic pregnancy. Tenderness and rebound tenderness were common with varying in intensity in each of the two diseases. Appendicectomy was done in all patients by making Gridiron incision in 150[75%], muscle cutting in 31[15.5%] and Lanz's incision in 19[9.5%] patients. Retrocaecal appendix was found in 150[75%] and pelvic in 42[21%] patients. Ruptured right ovarian cyst was present in 11[5.5%], ruptured right ectopic pregnancy in 6[3%] and ovulation bleeding in 4[2%] patients. Morbidity observed in the study was 9.5% with no mortality. In the context of limited available medical imaging modalities, detailed history and good clinical performance are the main diagnostic tools with no increase in the rate of negative appendicectomy in developing countries