Predicting wellbeing in irregular shift workers

Objective of the study was to assess wellbeing and its relationship with sleep pattern from the biological rhythm science aspect. Cross sectional study. This study was carried out at Dow University Hospital. Dow university of Health Sciences Karachi from November 2013 to January 2014. This was a non-interventional cross sectional study. Wellbeing was measured in the study subjects [health care provider] working in irregular shift .To profile wellbeing, the instrument used was an integrated questionnaire. This measuring tool has a established scale based on subjective feeling of wellbeing [happiness] where higher score suggested a higher level of wellbeing, low scores suggested a fragile level of wellbeing. Subjects were interviewed and their reply was documented. Influences of a misaligned sleepcycle was measured on positive emotion scale quantitatively. Results revealed a decreased strength of wellbeing amongst rotatory shift workers. Mean scores inferred from happiness scale in the present study was 3.75 +/- 1.02. It was concluded that sleep/wake misalignment is associated with emotional fatigue. With the introduction of biofeedback as an intervention in certain stress related disease. It has become mandatory to open new windows and option which has become essential in experimental research for applied purpose

Profile of psychiatric patients attending outpatient clinic of a tertiary care hospital, Karachi

The objective of this study is to determine the frequency of psychiatric illnesses among patients attending psychiatric outpatient department of tertiary care hospital Karachi. Cross sectional study. This study was conducted in Psychiatric Out - patient Department of a Tertiary Care Public Sector Hospital of Karachi from July 2014 to December 2014. About 560 psychiatric patients profile was determined during July -2014 toDecember 2014. The patients were diagnosed and classified on the basis of DSM -IV criteria by a consultant psychiatrist. The patient complete profile was obtained from the Hospital record. The Data obtained was entered and analyzed by using SPSS version 21. Among the total five hundred and sixty psychiatric patients, 51.5 % were males and 48.5% were females. Fifty percent of the patients had Depression, 30.9% patients had anxiety, 29% had psychosis and 24% patients had Schizophrenia. More than half of the patients belong to young age group 20 - 40 years. About ninety four percent patients were not referred and reached to the hospital in advance stages of diseases. This study concluded that the proportion of Psychiatric illnesses are high and majority of patients had depression, major victims of the psychiatric disorders are from most productive age group of our society which is an alarming situation and majority not referred by any physician seeking consultation on self- help basis

Medically unexplained symptoms and emotional disorders among school children

Objective: To determine the frequency of unexplained physical symptoms in 5-15 years old children and its association with emotional disorder in psychiatric clinic of a public sector hospital

Study Design: Cross-sectional descriptive study

Place and Duration of Study: This study was conducted in the Department of Paediatric OPD, DIMC, DUHS, Karachi from January 2015 to June 2015

Materials and Methods: 144 samples of 5-15 years old children of both genders with somatic /physical symptoms fulfilling the inclusion criteria which were referred to the Psychiatry clinic. Semi structured questionnaire based on Urdu version of SDQ parent version were filled by the parents to assess the emotional problems in these children

Results: Analyses were completed for sample of 135 patients. 9 were excluded due to incomplete questionnaire. The mean age of children was 10.95 years. Pain predominated as physical symptoms in 5-10 years age group was pain, it included abdominal pain, headaches, limb pain, backache, chest pain. Fatigue, difficulty in breathing tremors, jerky movement and nausea and vomiting were more common in females. Anxiety disorder n=51 [50%], depression n=28 [28%], and somatoform disorder n=22 [22%] were the psychiatric comorbidities observed in these children

Conclusion: Children presenting with unexplained medical symptoms are often not managed appropriately by the Pediatricians due to lack of awareness. Majority of children presenting with MUS suffer from emotional disorders

indications of electroconvulsive therapy in Pakistan

Objective: To determine the indications and contraindications of electroconvulsive therapy [ECT] among psychiatrist working in Pakistan

Study Design: Cross-Sectional Study

Place and Duration of Study: This study was conducted at the Department of Psychology DOW International Medical College, Karachi, from May 2013 to May 2014

Materials and Methods: A semi structured questionnaire was mailed to Psychiatrist through emails, the questionnaire consisted of questions and the participants were required to choose one out of five responses of each question. It measured the issues that were pertinent to our use of ECT covered aspects of its use in its indicationsand contraindications and frequency of use. It has been used as second line treatment option in majority of cases. It has been used with success in mood and psychoticdisorders

Results: The use of ECT was frequent total of 75% patients and majority showed improvement in their clinical condition Its practice must comply with pre anesthetic assessment to prevent any post ECT complications. There is no absolute contraindication but risk factors like raised intracranial pressure

Conclusions: ECT is an effective non pharmacologic biological treatment and predominantly for depression, but also for schizophrenia. The practice of ECT is frequent in our country

Behavioral risks factors associated with spread of dengue infections: a community based study

Objective: To determine the behavioral risks factors associated with spread of dengue infections in a rural community of Gulshan-e-Iqbal town, Karachi, Pakistan

Methods: A questionnaire based cross sectional survey was conducted during September 2013- February 2014 in union councils of Gulshan-e-Iqbal town, Karachi. The sample size was 350. Systematic random sampling was used for selecting the study subject, from each household taken as one unit. Sample was taken from a total of 3225 houses to achieve total sample of 350 households. All the data was entered and analysed by using SPSS software version 15. Means with standard deviation for numerical variables and proportions for categorical variables are presented. Chi square test was performed to find the association of behavioral risks factors with spread of dengue infections in a rural community of Karachi, Pakistan

Results: Dengue infection was clinically diagnosed in 203 [58%] patients and were hospitalized during August 2012 to February 2013. Among all patients, higher frequency was found in the middle age group 37 to 54 years i.e. 44% [n=154].The behaviors of self-mosquito bite protection [p<0.01], selfprevention in breading mosquitoes [p<0.01], density of vegetation [p<0.01], behaviors regarding lack of self-efficacy in controlling vector [p<0.01] and lack of preventive measure in community [p<0.01] were significantly associated with transmission of dengue infections

Conclusion: The behavioral risks factors associated with spread of dengue infections in a rural community included lack of preventive measure in community, lack of comprehension of Health belief models, lack of knowledge,lack of self- prevention in breading mosquitoes, high density of vegetation and lack of self-efficacy in controlling vector

Maternal psychiatric morbidity and childhood malnutrition

To determine maternal psychiatric morbidity and its relation with malnutrition in their children. It was a case control study conducted at Nutrition Rehabilitation Unit of Department of Pediatrics, Civil Hospital Karachi, Pakistan from March to September 2011. Samples included hundred children between 3 to 36 months of age. The number of cases and control were fifty each. Children with moderate and severe malnutrition according to WHO classification were included in the case group whereas controls were children of the same age group and normal weight, coming to the department with common illnesses like acute respiratory infections, diarrhea, during the same time period. Mothers of both groups were screened for a probable psychiatric morbidity using HADS; "The Hospital Anxiety and Depression Scale", a psychiatric screening instrument. The score of more than eleven on either sub scale of HADS was considered significant for presence of psychiatric illness in the mothers. Data was analyzed through SPSS 15. Statistical analysis of data was done by using Odds ratio, stratification and logistic regression for each variable in both case and control groups. Maternal HADS score was significantly high >21 in 50% of cases whereas in controls it was 46% [O.R=0.85 [95%Cl=0.38-1.86]. Of the malnourished 90% and controls, 84% belong to low income status OR=1.71 [95% CI 0.52-5.6] whereas low birth weight was 64% in cases and 56% in controls OR=1.39 [95% Cl 0.62-3.11]. Maternal mental health affects the nutritional status of the children. Anxiety and depression are common psychiatric illnesses found in our society as suggested by significantly high HADS scores of mothers in both cases and control groups. It also shows that it is difficult to establish a straightforward relationship between maternal psychiatric illnesses and poor nutritional status of their children. However increasing age of mothers, low birth weight of child, increasing family size and low income are associated important risk factors for predicting increasing HADS scores in mothers of malnourished children.

Mental health morbidity in children: a hospital based study in child psychiatry clinic

To determine the frequency and pattern of mental health morbidity in children attending "Psychiatry Clinic" in Paediatric OPD of a tertiary care hospital. This was a cross-sectional study conducted at psychiatric clinic of Paediatric OPD at civil hospital Karachi. Two hundred children upto the age of 14 years were included in the study. These children were assessed by a semi-structured interview based on P-CHIPS [Child Interview for Psychiatric Syndrome] and diagnosis of various psychiatric illnesses was further confirmed by DSMIV diagnostic criteria. Psychiatric disorders were more frequent in males 126 [63%] compared to females 74 [37%]. Majority of patients affected were between 5-10 years of age [62.5%]. Among the psychiatric disorders, oppositional defiant disorders were [20%], ADHD were [17%], elimination disorders and anxiety disorders were [11%] each. Other less frequent psychiatric problems were mood disorder, somatoform disorders, specific developmental disorders, emotional and habit disorders. Mental health morbidity is an important issue in children attending the psychiatry clinic in the Paediatric OPD. Sensitization of parents, teachers and physicians is required, so that timely referral for psychiatric consultation is ensured before a critical illness develops