Hospital waste management in the teaching hospitals of Karachi

To evaluate the current practices of segregation approaches, storage arrangements, collection and disposal systems in the teaching hospitals of Karachi. A cross-sectional survey was conducted in eight teaching hospitals of Karachi, using convenient sampling technique. The instrument of research was a self administered questionnaire, with four sections, relating to the general information of the institution, administrative information, information regarding Health Waste Management personnel and a check-list of Hospital Waste Management activities. Out of eight hospitals visited 2 [25%] were segregating sharps, pathological waste, chemical, infectious, pharmaceutical and pressurized containers at source. For handling potentially dangerous waste, two [25%] hospitals provided essential protective gears to its waste handlers. Only one [12.5%] hospital arranged training sessions for its waste handling staff regularly. Five [62.5%] hospitals had storage areas but mostly it was not protected from access of scavengers. Five [62.5%] hospitals disposed off their hazardous waste by burning in incinerators, two [25%] disposed off by municipal landfills and one [12.5%] was burning waste in open air without any specific treatment. No record of waste was generally maintained. Only two [25%] hospitals had well documented guidelines for waste management and a proper waste management team. There should be proper training and management regarding awareness and practices of waste disposal. Research must be undertaken to seal existing gaps in the knowledge about hospital waste management. The hospital waste management guidelines enacted on 7th June 2004 should be followed and regulated by law enforcement agencies rigorously [JPMA 55:192;2005].

Family planning and general practitioners. Knowledge, attitudes and practices of family planning among general practitioners in Karachi. A comparative study between KAP of G.P.S about family planning in a recent survey and a survey done elght years ago

Family Planning practices are very low in Pakistan with a resultant population explosion. General practitioners who are the primary health care providers can be an important resource for family planning services provided they have adequate knowledge, their attitudes are positive and they educate their patients for the use of contraceptives willingly. This study is done recently to assess the knowledge, attitudes and practices of GPs regarding family planning and to compare it with a similar study done eight years back as a pre requisite of MPH. Subjects: General practitioners [GPs] of Karachi regardless of their age, sex, caste and creed. Methodology/design: Both the studies which are to be compared were cross sectional involving 100 GPs each, 25 from each of Karachi's four districts. A self administered questionnaire was distributed among available GPs and collected the next day. The data collected was then entered into a database and analyzed by SPSS. Following results were found. First survey showed that only 34% of GPs had adequate knowledge about contraception, 26% had positive attitudes and 42% were willing to practice it in their clinics, provided some form of incentive is given to them. Second survey showed that 58% of GPs had adequate knowledge, 47% had positive attitudes and 54% were willing to practice in their clinics, provided some form of incentive is given to them. Comparison between the two surveys shows that the level of knowledge about contraception has improved by 24% during eight years, the positivity level has also improved by 21% and the increase in practice level has improved by 12% only. This improvement is seen because most of the GPs have attended various courses and seminars organized by NGO's, governmental agencies, various associations and other related national and international organizations. The low level of improvement in practices of contraception is because of time constraints, lack of incentives and lack of motivation and drive

Infant feeding practices Knowledge, attitudes and practices of infant feeding amongst mothers

To assess the knowledge, attitudes and practices of infant feeding amongst mothers of various cast, creed and cultures. Methodology/ Study Design: The study is a cross-sectional one involving mothers who attend the OPD of National Institute of Child Health, [N.I.C.H.] Karachi and who have at least one live infant. The study was conducted by face to face interview of mothers with an open ended questionnaire. The data was entered in the database and later analyzed by SPSS. Result: Out of the 100 mothers interviewed at the OPD of NICH, JPMC, Karachi, 57% of the mothers had good knowledge about infant feeding including breast feeding and weaning, 26% had average knowledge and 17% had poor knowledge. Regarding attitudes towards breast feeding and weaning, 30% mothers had highly positive attitudes, 27% had weakly positive attitude and 43% mothers had negative or reluctant attitudes. 27% mothers had highly positive practices, 38% mothers had reluctant practices and 35% mothers had negative practices. Our mothers do not have adequate knowledge about infant feeding and its various aspects and even those who are well informed do not practice it willingly because of illiteracy, social and cultural practices, effects of media and advertisements and blind faith on western and modernized feeding practices

Awareness about DOTS amongst medical teachers of private and public sector medical colleges of Karachi

To assess knowledge of medical teachers belonging to private and public sector medical colleges of Karachi, regarding the widely accepted domiciliary treatment strategy of tuberculosis, that is 'DOTS' - Directly Observed Treatment Short course. Methodology / Study Design: This was a cross-sectional study, the study population, comprised of teachers from three public and three private medical colleges, of the rank of demonstrators and assistant professors. A sample of 120 subjects were interviewed. Convenient Sampling was done as those faculty members who were present on the day were interviewed. The survey was conducted by a self administered questionnaire comprising of questions related to personal information, knowledge of DOTS, details of complications of tuberculosis, diagnosis and its treatment. The data collected was analyzed by using SPSS system. Out of the 120 study subjects [60 from private and 60 from public sector medical colleges], 50 teachers [42%] had good knowledge regarding epidemiology, complications and diagnostic tests of tuberculosis, 42 [35%] teachers had average knowledge and 28 teachers [23%] had poor knowledge. Teachers from public and private sector medical colleges had a very striking difference. The teachers of private sector medical colleges / universities were mostly post-graduates, therefore had better scores as compared to Public sector teachers. The medical teachers who practiced in the evenings got higher scores as compared to non-practicing teachers. Conclusions: The medical teachers of private medical college were more aware and knowledgeable as compared to medical teachers of public sector college. The source of knowledge being a workshop or a seminar on tuberculosis treatment and prevention. For creating awareness and motivating the teachers / trainers of future doctors. Government or the national tuberculosis control program must emphasize on dissemination of knowledge through every media and source available in order to combat this highly infectious disease of our country

AIDS - the new global epidemic. What should be done to combat with this emergency?

It is high time for the government and NGO's to join hands in combating this growing menace which might play havoc with our lives in near future, if not now. We still have time to educate our masses regarding the ways in which the disease is transmitted and prevented. This is possible only with commitment at all levels and not mere lip service by top government functionaries and health professionals. This is a review article

Common causes of absenteeism in school children a descriptive study of three groups of school children observed for a period of five years

Absenteeism is a common feature in academic institutions. Its causes and effects differ from age to age and institution to institution. This study is based upon the information gathered and observations noted during five years of period when the author was a medical officer in schools. School children from Montessori to matric ranging from two and a half years to 1 5 years of age, residing and studying in an upper class locality and school of Federal 'B' Area. The study was conducted on school going children through a performa which was to be filled by the parents and counter signed by teachers regarding the cause of absenteeism. The children were grouped according to their classes rather than their ages which are often not correct. Three groups were identified. Group 1 had children of Montessori, kindergarten and nursery and the usual age ranges from two and a half years to 5 years. Group 2 included children from Class 1 to 5 and the age groups was from 5 to 10 years. Group 3 had children of Class 6 to 10 and the age group was 10 to 15. This grouping was done on the basis of similarity of complaints and attitudes towards school, common in particular ages. Group 1 showed an average of 10.49% of absentees per day and the commonest cause of absenteeism was simple yelling and crying and refusal to go to school, rather than any sound medical problem. Group 2 showed an average of 5.93% of absentees per day. The commonest causes was either pain in abdomen with vomiting or fever, cough and coryza. Group 3 had 5.35% of absentees/day and the commonest causes were headache and fever or chest pain and cough. If we compare the results of the three groups; we find a pattern compatible with the age groups. Group 1 had small children who were attached to mothers and did not like to leave them and therefore cried and yelled when forced to go to school and started vomiting many a times. 'Group 2 had children from 5 to 10 years, they were more independent and settled in the school. Even then they complained of pain in abdomen but on investigations, no significant pathology was found. Sometimes they were really ill and had fever, headaches, cough and coryza. Group 3 comprised of children who were quite grown up and therefore more settled in schools and less commonest causes of their absenteeism were head, chest pain, fever and cough