Integration of preventive and curative health services for flood survivors by lumhs - a successful health care model for preparedness of future floods in Pakistan [A Community Based Research Survey]

OBJECTIVES: The objectives of this study are to collect demographic data of survivors for assessing the related common disease, to identify steps in implementation of essential preventive and curative care for flood survivors and to develop health care model for super flood disaster preparedness in Indus valley areas

STUDY DESIGN: It was a cross sectional descriptive Epidemiological Study /survey. Date was collected through structured and designed proforma. This proforma was tested. 4[tth] year MBBS students were filling proforma and survey work supervised by Faculty of department of Community Medicine and public health sciences and LUMHS clinical faculty members. The study was conducted on survivors and internally displaced people [IDPs /survivors] during super Indus river flood in August and September 2010 to observe and evaluate the role of medical university for the preventive and curative health services for flood victims to reduce the morbidity, mortality and miseries in disaster times

PLACE OF STUDY: The flood victim camps on both sides of Indus river bank from Sehwan to Kotri covering districts Dadu, Jamshoro, Matiari and Hyderabad and also tent cities at Sehwan, Sabzi Mandi Hyderabad and Ghulshan-e-Shahbaz Jamshoro

DURATION OF STUDY: 8[th] August 2010 to 31st December 2010

RESULTS: Total 161700 Flood Survivors were provided health care by LUMHS medical teams, Faculty consultant, Doctors, Students and Paramedics through organizing free medical camps in tent cities and mobile camps. There were 113190 [70%] Female survivors and 48510 [30%] were Males survivors. The health teams provided curative care to 59500 [36.79%] and preventive care to 102200 [63.21] super flood survivors. Ten thousands were sheltered at the land of LUMHS campus and tent city. The common diseases were Diarrhea [21%], ARI [16%], Malaria [07%], Skin Diseases [17%], Eye Infections [08%], Ear Infections [04%], Malnutrition [15%], Injuries [02%], Sleep Disorders [0,5%], Heat Stroke [0.3%], Dog Bite [0.1%] and Unspecified [0.1%]

CONCLUSION: Flood survivors need preventive and curative care. The medical university can directly provide emergency health care and can contribute human resources comprising Faculty, Doctors, Students and Paramedics. 161700 were beneficiaries of LUMHS developed health care model which is one of the indigenous and successful model for future flood disaster preparedness in Pakistan. The WHO acknowledged LUMHS services for flood victims. Professor Noshad Ahmed Shaikh, Vice Chancellor, Liaquat University of Medical and Health Sciences, Jamshoro supervised and visited camps regularly

Analysis of retinal signs in patients with primary hypertension

OBJECTIVE OF STUDY: To detect retinal signs in patients with primary hypertension

DESIGN OF STUDY: Hospital based prospective study

PLACE OF STUDY: Department of Medicine Unit II, Chandka Medical College Hospital Larkana

DURATION OF STUDY: One year from January 2010 to December 2010

MATERIAL AND METHODS: Our study included evaluation of 495 patients of age greater than 20 years with primary systemic hypertension [BP>139/89mmHg] for presence of retinopathy

The hypertension was detected by physician with sphygmomanometer and the retinopathy was detected by ophthalmologist with fundoscopy. The type and severity of hypertensive retinopathy was graded on the basis of KEITH-WAGENER CLASSIFICATION. The investigations advised were complete blood cell count, complete urine examination; sugar fasting, lipid profile, blood urea, serum creatinine, electrocardiogram, echocardiography and X-Ray chest PA-view. Only known patients of primary hypertension were included in this study and patients of primary hypertension with other retinal vessel diseases and secondary hypertension were excluded

RESULTS: We evaluated 495 patients, 317[64.04%] males and 178 [35.95%] females aged 20 years and above. [P value=<0.001, X[2] Value=34.29, df=4]. The hypertensive retinopathy was present in 223[45.1%] patients and absent in 272[54.9%] patients [P value= <0.045, X[2] value=6.19, df=2]. The severity and grading of retinopathy seen was, grade-I hypertensive retinopathy in 108 [48.4%,n=223] patients, grade-II in 71[31.8%, n=223], grade-III retinopathy in 36[16.1%, n=223] patients and grade-IV in 8 [3.6%, n=223] patients. [P value=<0.0001, X[2] Value=52.76, df=6]

CONCLUSION: With early detection of retinal signs in primary hypertensive patients, the eyes and other systemic complications of primary hypertension can be prevented