Factors influencing health seeking behaviour among residents of Basawa community, Sabon Gari l.G.A. Kaduna State, Nigeria

Background: The health of the citizenry is crucial to the growth and development of any nation. Nigeria is riddled with poor health indices ranging from maternal mortality to infant mortality rates. It has been established that health-seeking behaviour has a strong influence on health status, morbidity and mortality indices of a society. It also drives utilisation of health services and is affected by predisposing, enabling and need factors. This study assessed the factors influencing health-seeking behaviour among residents of Basawa community, Sabon Gari LGA, Kaduna State, Nigeria. Method: This was a descriptive cross-sectional study carried out in September 2017 among 125 residents of Basawa community selected by systematic sampling technique. Data was collected using asemi-structured interviewer-administered questionnaire and analysed with SPSS version 21. The results were presented as tables and charts among others. Level of statistical significance was set at p <0.05. Results: The mean age of the respondents was 42±10 years. Majority of the respondents were male (60.8%) and married (90.4%). About two-thirds of the respondents delayed for more than 24 hours before seeking healthcare. Long waiting time (55.2%), the attitude of health workers (22.4%) and the high cost of drugs (22.4%) were given as barriers to health care utilisation. High cost of services, type and severity of illness and attitude of health care workers are the main determinants of health-seeking behaviour. There was a statistically significant relationship between education, monthly income and delay in seeking health care. Conclusion: The study showed several factors that influence health care seeking behaviour. In view of the multifactorial determinants of health-care seeking behaviour, there is need for health workers to be trained and retrained to improve on their attitude, and the provision of community-based social health insurance scheme by the government among others

Comparison of microcoils and polyvinyl alcohol particles in selective microcatheter angioembolization of non variceal acute gastrointestinal hemorrhage

To compare the efficacy of polyvinyl alcohol [PVA] particles with microcoils in angiembolisation of non variceal acute gastrointestinal haemorrhage. This is a retrospective cross-sectional study of patients who underwent transcatheter angioembolization from January, 1995 to December, 2013 at Aga Khan University Hospital, Karachi. Patients were divided into two groups on basis of use of either microcoils or PVA particles and compared in terms of technical success, clinical success, re-bleeding and ischemic complication rates. Chi [chi[2]] square and Fisher's exact tests were applied and a P-value of less than 0.05 was considered statistically significant. Fifty seven patients underwent angioembolization. Microcoil and PVA particles embolization was performed in 63% [36/57] and 35% [20/57] cases respectively. Technical success was achieved in all cases [100%]. Clinical success rate was higher in microcoils group [92%] than PVA particles group [75%] with statistically significant P value [p=0.048]. Ischemic complication was seen in one case [3%] in the microcoil group, while no such complications were seen in the PVA particles group. In angioembolization of non variceal acute gastrointestinal haemorrhage microcoils are better than Polyvinyl alcohol particles with higher clinical success and lower re-bleed rates

Laboratory surveillance of malaria at District Bahawalpur Punjab, Pakistan

Background: In Pakistan malaria is prevalent in different parts of all the four provinces. The estimated number of annual malaria cases in Pakistan is 1.5 million. The climate of Pakistan is conducive for malarial transmission

Objective: The present study was planned to determine the laboratory surveillance of malaria in Bahawalpur District over a period of five years

Patients and Methods: The present descriptive study was conducted on malarial epidemiology in Bhawalpur region over a period of 5 years from 2007 to 2011. The study was conducted by collecting data from those health facilities where malaria screening was done routinely. Thick and thin smears were taken by the trained personal on glass slides and stained by Giemsa technique. They were then examined microscopically for the diagnosis and specification of malarial parasite. Doubtful samples were sent to consultant haematologists at tertiary level health facilities for confirmation

Results: Annual parasite index was highest in 2007 i.e. 0.091. Slide positivity rate was highest [0.21] in 2007 and dropped [0.01] in 2010. Annual Blood Examination Rate was also highest [4.28] in 2007

Conclusion: Our findings showed that annual blood examination rate, slide positivity rate and annual parasite index continued to drop during the study period

Antimicrobial and clinical profile of uropathogens isolated at a tertiary care level laboratory

Background: Urinary tract infection is common in all age groups. It is more common in females, immunocompromised patients and those who have been catheterized or had some other invasive procedure of urinary tract. Gram negative and gram positive microorganisms are responsible for UTI. Sensitivity of uropathogens to antimicrobial drugs has changed over the past many years

Objective: The present study was planned to determine the common uropathogens, their antimicrobial sensitivity and clinical profile at a tertiary level health facility

Material and Methods: In this cross sectional study, urine samples of two hundred symptomatic patients were studied and the underlying pathogens were identified by appropriate methods. The present study was conducted from 1st May, 2009 to 31st May, 2012 in Ayub Teaching Hospital, Abbottabad. This study was conducted from 1st May, 2009 to 31st May, 2012, in Ayub Teaching Hospital, Abbottabad. Subsequently their sensitivity to antibiotics was determined by the recommended method. The data was entered and analyzed in SPSS 15

Results: Female patients were more than males. Increased frequency and dysuria were observed in all patients. E.coli was the commonest pathogen identified, followed by Klebsiella, Staphylococcus and Pseudomonas species. E.coli was sensitive to aminoglycosides, carbapenum and quinolones in decreasing order of frequency. Klebseilla and pseudomonas are sensitive to nor floxacin, whereas, Staphylococcus are sensitive to quinolones

Conclusion: E.coli remains the most common uropathogen. Antimicrobial sensitivity of uropathogens showed a changing pattern

Clinical presentations in immune thrombocytopenic purpura

Thrombocytopenia is an important cause of mucocutanaeous bleeding in adult and paediatric patients. Immune thrombocytopenia is one of the common causes of thrombocytopenia. Its clinical presentations vary from patient to patient, not studied in our area previously. The present study was planned to see the frequency of clinical presentations of Immune Thrombocytopenic Purpura [ITP] in our patients. This prospective study was conducted on 125 patients with ITP, diagnosed by exclusion of secondary causes of thrombocytopenia. Bone marrow examination was performed on all the patients. Bruising, epistaxis and gum bleeding were the commonest clinical presentations in adults and children. Bleeding was more severe in acute cases. Increased menstrual bleeding was seen in female patients. Bruising, epistaxis and gum bleeding are the commonest clinical presentations of ITP. Our results are not much different from those of the other studies conducted in Pakistan.

audit of morbidity and mortality of hospitalised neonates in neonatal care unit of a tertiary care hospital in abbottabad

Background: Perinatal as well as neonatal mortality record in our country is one of the highest in the world. Home deliveries, lack of adequate facilities, poverty and lack of education are some of the important known causes. The present study was planned to determine neonatal mortality in Hazara. Methods: Hospital records of neonatal admissions at Ayub Teaching Hospital [ATH] Abbottabad from 1 st January 2007–31st December 2007 were analysed retrospectively. Percent neonatal mortality was calculated from the record, along with the causes of neonatal mortality. Results: A total of 1705 neonates were admitted in the study period at the department of neonatology Ayub Teaching Hospital Abbottabad. Out of 1, 705 neonates 947 [56%] were males while 857 [44%] were females with a male to female ratio of 1.24:1. Majority, 1, 411 out of 1, 705 [83%], of the neonates was admitted during the 1st week of their life, mean age 6 days. Asphyxia, sepsis and prematurity were the three most common causes of neonatal admissions contributing 27%, 26% and 24% respectively. Overall mortality was 11%. Conclusion: Neonatal mortality is an important contributing factor to infant mortality in Hazara Division. Majority of patients was admitted in the first week of life which indicates that good antenatal and natal care can reduce the mortality and morbidity of our neonates. Improvement in the prenatal, natal and nursery care as a whole can reduce the neonatal mortality in preterm as well as full term neonates. Keywords: Neonatal Mortality, Morbidity, Asphyxia

Prole of tumour necrosis factor in pathogenesis of radicular cyst

Background: The radicular cyst is very common odontogenic cyst of the jaws, which is usually associated with a tooth with necrotic pulp. The cyst formation requires proliferation of the epithelial rest cells of Malassez present in the periodontal ligament.. Proliferation of epithelial rest cells of Malassez is an essential event in the Pathogenesis of radicular cyst. The wall of the cyst contains epithelial cells, macrophages, fibroblasts and other cells. TNF is one of inflammatory mediators, which is produced by macrophages and monocytes. This study was carried out to investigate the role of tumour necrosis factor in the pathogenesis of radicular cyst, which is by far the commonest cystic lesion of the jaws. Methods: Explants from 20 radicular cysts were cultured in vitro to grow the epithelial cells. However, the cultures were rapidly contaminated with fibroblasts and it was impossible to grow the epithelial cells separately. Therefore, the proliferative effect of Tumour Necrosis Factor [TNF] was studied on mammalian epithelial cells. Results: TNF at low concentration had a proliferative effect on the epithelial cells, which may play some role in pathogenesis of radicular cyst. Conclusion: TNF stimulated the epithelial cell proliferation in low concentration and inhibit the proliferation in higher concentrations. These two effects may have some implications in the pathogenesis of radicular cyst

Identification of genetic imbalances of nasopharyngeal carcinoma [NPC] by comparative genomic hybridization [CGH]

Nasopharyngeal Carcinoma [NPC] is highly prevalent in southern China and southeast Asia. To unveil the molecular basis of this endemic disease, comparative genomic hybridization [CGH] technique was used to identify imbalanced genetic alterations in this malignancy. Chromosornal gains that were found in this study were 4q26 [20%] and 11q13-q14 [20%], while chromosomal losses were 20p12 [40%] and 13q21-q31 [20%]. These preliminary results suggest that there may be activation of oncogenes in the gain regions and suppression of tumour suppressor gene in the loss regions

Seroprevalence of hepatitis B in outdoor female patients of reproductive age group at Ayub Teaching Hospital Abbottabad

Hepatitis B is inflammation of the liver caused by a Hepatitis B virus, having a parenteral mode of entry and infecting millions of people around the world. The present study was planned to assess the seroprevalence of Hepatitis B in women of reproductive age in Hazara in order to promote disease prevention in the perinatal period by vaccination against Hepatitis B. Women 15-45 years old belonging to Hazara Division were included in this descriptive, cross-sectional study conducted over a period of one year at the Department of Microbiology, Ayub Medical College, Abbottabad in collaboration with the Department of Pathology, Ayub Teaching Hospital, Abbottabad from 1[st] March 2006 to 28[th] February 2007. Non-probability convenience sampling was done to select 500 females from those visiting Ayub Teaching Hospital Abbottabad as outdoor patients or accompanying person. History, examination, and serum alanine aminotransferase estimation were followed by the initial screening for Hepatitis B surface Antigen [HBsAg] using immunochromatographic device. Enzyme linked Immunosorbent assay was used to confirm the presence of HBsAg. HBsAg was detected in 3% of the women. History of multiple injections was present in 100%, blood transfusion in 22%, dental procedure in 46% and surgical procedure in 43% of the subjects. Only 1% women had been vaccinated. Seroprevalence of the Hepatitis B is not different from the figures reported by the studies previously conducted on general population in Pakistan. However it is different from those reported for the special groups

Seroprevalence of hepatitis C in pregnant females of hazara division

Hepatitis C Virus [HCV], the causative agent of Hepatitis C is prevalent in different countries including Pakistan. Studies have been conducted on various aspects of HCV in Pakistan. The present study was planed to see the prevalence of hepatitis C in pregnant females of Hazara Division. Five hundred pregnant females of reproductive age group from Hazara Division selected by non probability convenient sampling technique were studied from 1st March 2006 to 28th February 2007 at Ayub Teaching Hospital, and District Headquarter Hospitals Abbottabad, Haripur and Mansehra. After initial serving by immunology technique positive cases were confirmed by Enzyme Linked Immunosorbant Essay [ELISA]. Seroprevalence of HCV in pregnant females of Hazara division was 8.9%. Females aged from 25-35 constituted the largest group among positive cases. HCV was more prevalent in District Abbottabad as compared to the other districts of Hazara division. Seroprevalence of HCV in pregnant females of Hazara Division is different from the figures already reported form the other parts of Pakistan

Clinical outcome in measles patients hospitalized with complications

Measles is a highly communicable viral illness and is common cause of childhood mortality and morbidity. Keeping in view the high prevalence of measles in the developing world, we carried out this study to look into the complicated measles cases and clinical outcome in patients admitted in children ward of Ayub Teaching Hospital. Detailed history and physical examination of all the hospitalized patients with complication of measles were recorded in a proforma. Immunization and nutritional status of each admitted patient was assessed and the clinical outcome of measles was compared with demographic profile. One hundred thirty six hospitalized patients with complications of measles were studied. There was 60.3% male and 57.3% of patients were vaccinated against measles. Malnourished patients were 71.35% and had longer hospital stay [>5 days]. Pneumonia [39.7%] and diarrhoea [38.2%] were the commonest complications. Seven children died and encephalitis [57.1%] was the commonest cause of death. The most common complications of measles are pneumonia and diarrhoea with dehydration requiring admission. Malnutrition results in more complications and longer hospital stay. Mortality is significantly associated with encephalitis

Seroprevalence of hepatitis B and hepatitis C in health care workers in Abbottabad

Hepatitis B and C viruses [HBV and HCV] are hepatotropic viruses causing viral hepatitis, chronic liver disease and hepatocellular carcinoma. Modes of infection are more or less similar. HBV is vaccine preventable while HCV is not. They are prevalent in different parts of the world including Pakistan. The rate of prevalence varies from region to region and among different population segments. The present study was planned to see the prevalence of HBV and HVC among health care workers in various hospitals of Abbottabad. The study was conducted at the District Headquarter Teaching Hospital Abbottabad over a period of one year on 125 health care workers of different categories and either sex. Brief history was taken from each individual and physical examination was performed. Blood samples were taken for HBV and HC serology. Positive sera were confirmed by 3rd generation ELISA. As much as 8% individuals were positive for HBV or HCV. HBV alone was seen in 3 out of 10 [30%] individuals. HCV alone was also found in 3 out of 10 [30%] individuals. HBV and HCV co-infection was seen in 4 out of 10 [40%] individuals. Dental procedures, needle prick and surgical procedures were found the common risk factors. Blood transfusion was known in 2 out of 10 [20%] individuals. Family history of hepatitis was not positive in any individual. Results of the present study differ from those of the previous studies conducted on health care workers in Pakistan

Pattern of malarial infection diagnosed at Ayub teaching hospital Abbottabad

Malaria is endemic in Abbottabad and the adjoining areas like many other parts of the country Depending upon the environmental conditions different species of malarial parasite are found in different areas. The pesent study was planned to see the pattern of malarial infection diagnosed at Ayub Teaching Hospital, Abbottabad. Giemsa stained thick and thin blood films of indoor and outdoor febrile patients sent to the laboratory of Ayub Teaching Hospital Abbottabad with a suspicion of malaria, were examined. Thick film was examined for the diagnosis of malaria while thin films were seen to know the species. Out of 1994 patients screened, 145 [7.2%] were found infected. Plasmodium vivax was seen in the majority [12.47.2%]. Plasmodium falciparum was the second common species detected in 24.1% cases. Mixed infection was seen in 3.44% cases while Plasmodium malariae and ovale was not seen in any patient. Plasmodium vivax was the commonest type of malaria diagnosed at Ayub Teaching Hospital, Abbottabad, during 2002-2004

Guillain Barre syngdrome: the leading cause of acute flaccid paralysis in hazara division

Acute flaccid paralysis [AFP] can be caused by a number of conditions. A common preventable cause is poliomyelitis which is still being reported in Pakistan, Guillain Barre syndrome [GBS], also know as Acute Inflammatory Demyelinating Polyneuropathy, is another common cause of acute flaccid paralysis. It is important to recognize GBS in childhood as parents consider all acute flaccid paralysis to be due to poliomyelitis. The present study was designed to know the frequency of different causes of acute flaccid paralysis in Hazara division. Hazara division during the period January 2003 to December 2004. acute flaccid paralysis was flaccid paralysis was investigated by appropriate laboratory tests, such as serum electrolytes, virus and other enteroviruses. Diagnosis of Poliomyelitis was confirmed by stool testing for poliovirus. 74 patients presented with AFP during the study period. 36 were male and 38 were female. Guillain Barre syndrome and enteroviral encephalopathy were the two leading causes of acute flaccid paralysis. Majority of the cases were reported from Mansehra district. Children of age groups 12 to 24 months and > 96 months constituted the majority [20% each]. Guillain Barre syndrome was the leading cause of acute flaccid paralysis reported from various parts of Hazara division

Comparison of diagnostic BCG test with Mantoux test in children with suspicion of tuberculosis

Mantoux's test has been used conventionally in testing for tuberculosis. Some studies have observed that the Diagnostic BCG Test [Bacille-Calmette-Gueurin] gives better results as compared to the Mantoux's test. This study was designed to compare the Diagnostic BCG Test with Mantoux's test in children, with suspicion of tuberculosis, in our set-up. This study was conducted at Paediatric Department of Services Hospital and Post-Graduate Medical Institute, Lahore, from June, 1997 to May, 1998. A total of 100 patients, less than 15 years of age, who either came to the paediatric outpatient department or were admitted in the hospital, having suspicion of tuberculosis, and who had not been vaccinated for tuberculosis, were included in the study. Both the tests were administered simultaneously, and as a result, the BCG test was positive in 81 patients, while Mantoux's test was positive in 50 patients. The BCG test was positive in all of the patients where Mantoux's test was positive. The BCG test was positive in 84% of severely malnourished children while Mantoux's test was positive in only 4.8% of such patients. In tuberculosis meningitis and respiratory tuberculosis, BCG test was more conclusive [85.7% and 90.9%, respectively] than Mantoux's test [14.3% and 45.5%, respectively]. In this study, the Diagnostic BCG test gave a better yield as compared to the Mantoux's test. The difference was more obvious in tuberculous meningitis, respiratory tuberculosis and children with severe malnutrition