First aid facilities in the school settings: are schools able to manage adequately?

Background and Objective: Children spend most of their time in schools and are vulnerable to injuries and mild ailments, hence requiring first-aid care. School teacher can provide immediate first-aid care in the absence of any health professional. This study assesses first-aid facilities within school premises and assessment of teachers on first aid training

Methods: A cross sectional study was conducted from July-December 2017, participants were full time school teachers of both public and private sectors at both primary and secondary levels, having a minimum of one year experience. Questionnaire was filled on one to one basis by taking oral interview

Results: Out of 209 teachers, 72.7% were from private sector. Stomachache was the most common medical incident [82.29%] requiring first-aid care in schools. First aid box was available in all schools but its contents were not satisfactory. Sick bay was not found in any school. 68.42% of teachers were not trained in first-aid management because of lack of opportunity, however 56% were willing to enroll in any first aid training and majority [91.38%] considered it essential for their professional life

Conclusion: First aid facilities at various schools of Karachi and availability of trained teachers who can provide first aid care is unsatisfactory

Outcome of dietary intervention on weight and Anthropometric indices of overweight and obese females: a randomized controlled trial

Objective: To study impact of dietary intervention and counseling on weight and anthropometric indices of obese females

Study Design: Prospective randomized controlled trial

Place and Duration of Study: This study was conducted at Pakistan Navy Ship [PNS] Shifa, from Feb 2014 to Sep 2014. Patients and Methods: Study subjects were 320 obese females from Karachi, Pakistan, aged 20 to 40 years. Before randomization all baseline anthropometric measurements were recorded. After that females were randomly placed into intervention and control groups. Anthropometry and 24-hour dietary recall were used for nutritional assessment. Intervention strategy was individualized diet plan by registered dietitian according to base line body weight and anthropometric indices of study subject. Primary outcome was the change in body weight and body mass index

Results: The final analysis was run on 280 participants [intervention=127, control=153]. Both intervention and control group were comparable with respect to anthropometric variables at start except intervention group had more body mass index [BMI] [28.024 +/- 3.561]. A significant change was observed in body weight [p=0.001], BMI [p=0.001], waist circumference [p=0.001], hip circumference [p=0.01], waist hip ratio [p=0.04] in an intervention group while control group only showed significant reduction in waist circumference [p=0.041]. Intervention group showed significant improvement in dietary behavior which was depicted by increased intake of fruit and fiber consumption [p=0.001], reduction in consumption of simple carbohydrates [p=0.001], animal protein [p=0.001] and fatty food [p=0.001]. Control group showed decrease in waist circumference in response to reduction in dietary fat intake and increase intake of fruits [p=0.001] and vegetables [p=0.042]

Conclusion: The results of our study have positively demonstrated that nutritional intervention among obese females was successful in reducing weight and BMI. Reduction inwaist and hip circumference and change in diet behavior were also observed as secondary outcome variable

Increasing burden of abdominal obesity in females and its aftermaths

Obesity is now recognized as one of the major public health issues all over the world. In Pakistan, it is a “silent epidemic” striking significantly because we are still struggling with health and economic burdens of malnutrition, infectious diseases and high infant mortality rates. In epidemiological studies age, sex and ethnic background all have to be taken into consideration, particularly when determining the health risk with obesity.Females are more vulnerable to be affected by obesity related health issues. Body Mass Index [BMI] is a surrogate measure of assessing obesity in terms of height and weight. It does not give any insight into regional body fat distribution. BMI is not a reliable measurement of body composition in individuals particularly in females having high body fat, rather more specifically it is excess abdominal fatness, quantified by waist circumference measurement, which is a better considered measure for assessing abdominal obesity in females

Assessment of parents' attitude toward EPI [expanded program on immunization] in tertiary care hospitals of Karachi

Objective:To assess parents' attitude toward EPI [Expanded program on Immunization] in three Tertiary Care Hospitals of Karachi

Materials and Methods:This cross sectional hospital based study was conducted at three tertiary care hospitals of Karachi,PNS SHIFA Hospital, Jinnah Postgraduate Medical Center [JPMC] and Liaquat National Hospital [LNH] from a period of 20th July to 20th September, 2015. A structured questionnaire based interview was conducted on150 parents of children less than 5 year of age visiting for vaccination at these three tertiary care hospitals.Data was analyzed using SPSS version 23

Results:A total of 150 parents were interviewed, out of which 93 [62.0%] parents vaccinated their child immediately after birth, 148[98.7%] parents considered EPI as beneficial for their child's health, 113 [75.3%] parents were found to be aware of the complete vaccination schedule, 56[37.3%] parents had appropriate knowledge regarding vaccines and diseases enlisted on the EPI card, 139 [92.7%] parents kept the record of vaccination schedule, 143[95.3%] parents didn't ignored vaccination due to increased number of children and 21[14%]parents had fear regarding vaccination program

Conclusion:Parent's attitude toward EPI was positive. However, knowledge about vaccines and diseases and vaccines enlisted on EPI card was low

Basic concepts of diabetes mellitus

Pakistan is at the seventh position on diabetes prevalence rates. Many risk factors are linked to the development of type 2 diabetes like increased body mass index [BMI], altered body lipids, increased blood pressure, smoking, less physical activity ,bad dietary habits, family history, and also some genes. Environmental factors together with a genetic tendency for diabetes set off an autoimmune response that causes damage of the pancreatic Beta-cells over prolong duration leading to type 1diabetes. Failure of Beta cell compensation for insulin resistance causes impaired glucose tolerance that can exhibit as type 2diabetes.Diabetes Mellitus either type 1 or type 2 can lead to various acute and chronic complications. Diagnosis can be made on levels of blood glucose concentration, urine ketone test, glycosylated hemoglobin [HbA1c], glycated serum protein and glycated serum albumin. Type 1 diabetic patients are directly given insulin. Patients with type 2 diabetes may be managed with diet and exercise. However when diet and exercise fail to control raised blood sugar level, an oral antidiabetic agent is started. This may be added with more drug[s] from the same family and or insulin depending upon the glycemic index of the patient.Type 2 diabetes is a progressive disease in which ultimately the function of Beta cells decreases, and eventually exogenous insulin may be required to maintain blood sugar level. This review thoroughly describes the prevalence, classification, etiology, pathophysiology,complications, diagnostic criteria and treatment of Diabetes Mellitus

Community based medical education: improving the health of community

Objective: To evaluate the effectiveness of student's clerkship as an approach to community based medical education in improving the health of community

Materials and Methods: This interventional study was conducted at Ziauddin Medical College; Karachi from December 2006 to December 2007.Data was collected by using structured questionnaire after the approval of university ethical review committee.Before collecting the data informed written consent was obtained from all study participants. Baseline data was recorded from100 enrolled families. Medical students visited the enrolled families on fortnightly basis during which they carried out detailed counseling and interactive sessions. At the end of four month, post intervention data was recorded and all baseline parameters were compared with

Results: The pre and the posttest results showed significant improvement in the knowledge of mothers regarding prevention and management of diarrhea

Conclusion: Community-based education can be used as effective tool in improving the health of community. Health services should support the community based interventions to improve the knowledge and practices of mother which can contribute effectively towards improving infant and child health

Knowledge, attitude and self-reported hand washing practice among healthcare staff of military hospital, Rawalpindi

Hand washing can be regarded as one of the most effective and important hygiene promotion programmes for community as well as hospital based settings. A cross sectional survey was carried out at Military Hospital, Rawalpindi, over 03 months from September to November 2012. The survey was conducted to assess the knowledge, attitude and self-reported hand washing practice among healthcare staff [nurses] working in family OPD and ward. Data was entered and analyzed in SPSS 16. Descriptive statistics was used in the form of numbers and percentages. It was believed by 95% of staff that handwashing can reduce infection rates in hospitals. Among the respondents, 24.2% expressed strong dissent on washing hands only with water, however, 22.5% considered it enough. Patients never [50%], sometimes [21.7%], seldom [19.2%], often [9.2%] asked health care staff about hand washing. Staff reported their practice of hand washing before touching patients as often [32.5%], sometimes [37.5%], seldom [20.8%] and never [9.2%]