Barriers to exclusive breastfeeding in children under 6 months of age in district kasur

Objectives: The objectives of my study were to identify major factors which prevent mothers to breastfeed their infants in the first six months and to analyze the behavioral constraints to develop a suitable strategy for strengthening the practices of exclusive breastfeeding

Study Design: Descriptive Study

Methodology: The study was conducted on 37 subjects, who were mothers with young children under six months of age and were not breastfeeding their children due to any reason. The study was based on direct interview taken at DHQ Hospital Kasur and BHU Rao Khan Wala in the district Kasur. The interviews lasted for about half an hour with each subject. Subjects who were breastfeeding regularly or who were HIV, Hepatitis and other diseases positive were not included. The interviews were conducted in a separate room with least disturbance. Quantitative data like age was presented by mean and standard deviation while qualitative data education, profession were presented by frequency and percentages. SPSS [version 20] software was used for data analysis

Results: The mean age of infants of group [62.1%] was of 2.2 months ± 0.7 and other group of infants [37.9%] was of mean age 5.2 months +/- 0.6. The mean weight [kg] and standard deviation of the index children at birth was 3.1 [kg] +/- 0.2. Among index infants 37.8% were male infants and 62.2% were female infants. By place of birth of children, 75.6% births took place in a health facility. 32.4% mothers were illiterate. 13.5% mothers were on job. Only 83.7% females had fed colostrum to their infants. 62.1% mothers were those who never fed their infants. 27.0% were those who initially fed their infants for short period of time and then stopped feeding who fed irregularly was 10.8%. Important factor identified was insufficient milk production [65.2%] with significance of p-value = <0.05 and Sickness of mothers and consequently advised by doctor to avoid breastfeeding to their infants, was contributing [52.1%] with significance value p= <0.05 among mothers who never breastfed their infants under six months of age

Conclusion: Inadequate milk production and mothers' sickness were most commonly stated factors

Sexual health among young sexually active females with vaginal candidiasis

Background: sexual health among females in a low middle income country like Pakistan substantially affects quality of life. Vaginal Candidiasis is a common infection found among the females leading to discomfort and pain during the sexual intercourse

Objective: to determine the sexual health, among young sexually active females with vaginal candidiasis

Methodology: it was a cross sectional study conducted in Nawaz Sharif Social Security Teaching Hospital, Lahore from 1[st] January to 31[st] December 2015. Two hundred sexually active married females between 16 - 22 years of age were selected by non- probability convenience sampling after obtaining their informed verbal consent. Three groups of study subjects were selected, Group A, Candida Positive, Group B, Candida negative and Group C with Vaginitis due to other cause. Complaints which were recorded and analyzed were dyspareunia, itching, vaginal discharge and vulvar soreness. Data through a pretested questionnaire was collected, entered in and analyzed by Statistical Package for Social sciences [SPSS] version 16

Results: in group A, 54% have dyspareunia, in group B, 17% were having dyspareunia and in Group C, 29% have dyspareunia. Growth of candida and oral contraceptive use was significantly associated with dyspareunia. [p<0.05]

Conclusion: this study showed that candida infection affects sexual health and is the major factor that hinders sexual intercourse due to dyspareunia. Use of oral contraceptives is an associated contributing factor in dyspareunia due to recurrent candidiasis

Knowledge, skill and attitude of community midwives regarding intrauterine devices for family planning in Lahore

Objective: Study was designed to assess the knowledge, skill and attitude of community midwives before and after three days training workshop on the subject insertion of intrauterine device, as a tool for family planning

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at Community Medicine, Sharif Medical and Dental College, Jati Umra, Lahore and Department of Public Health, The University of Lahore from January 2015 to June 2015

Materials and Methods: An intervention study was conducted by collecting data from designing structured questionnaire which was answered by the midwives taking part in the training to evaluate their basic knowledge, skill and attitude towards use of intrauterine devices. This study was based on three phases. 1] assessment 2] intervention 3] evaluation. Thirty community midwives in the community based maternity homes of Lahore was selected as subjects. Data through a pretested questionnaire was collected and analyzed by statistical package for social sciences [SPSS]

Results: 50-70% of community midwives had the basic knowledge of IUD, insertion skill and its benefits, before going through the training. After the training, knowledge of IUD, its insertion skill and advice to women increased up to 85-100% among the participants. Results clearly show that the knowledge of the community midwives regarding use of IUDs use as a family planning tool was minimal and increased after getting the training

Conclusion: Study finding suggested that training is essential for the community midwives for improving their knowledge, technical skill for insertion of IUD, and aptitude for counseling to the families upon follow up visits

Frequency of healthy overweight adult females in a cluster

Objective: To find out the frequency of healthy overweight / obese females as determined by body mass index in a cluster

Study Design: Descriptive / cross sectional study

Place and Duration of Study: This study was conducted at the Out-Patient Department of CMH Landi Kotal hospital from 1[st] Jan 2016 to 30[th] June 2016

Materials and Methods: non-probability convenience sampling between 18-24 years of age was taken. They were subject to anthropometric and body mass index measurements. Blood pressure and resting heart rate were taken. Further data was collected by a questionnaire, based on socio-demography, physical activity, self- perception of body weight and health status. Informed consent was taken prior conducting the study

Results: Among 500 females, mean age was 19 +/- 1 year, and age range was 18 to 24 years. 436 cases belonged to rural areas and 64 cases belonged to urban areas. 104 individuals [20.8%], belonged to group 1; 320 [64%] individuals belonged to group 2; 60 [12%] individuals belonged to group 3; 16 [3.2%] individuals belonged to group 4. Blood pressure and pulse rate were recorded under standard conditions in all groups [Table 1]. None of the individuals had irregular pulse. All females responded to the pre-tested questionnaire. According to the collected data, 89% knew that overweight was related to diseases. About losing weight; 18% individuals replied as dieting, 22% individuals replied as exercise, 54% individuals replied both dieting and exercise and 6% individuals did not know the way to lose weight

Conclusion: Frequency of overweight / obesity was 15% among healthy adult females. Health awareness campaigns to deliver the message for healthy eating habits, regular exercise and maintaining ideal weight will be extremely helpful in controlling the obesity in the community

Needle stick injuries: knowledge, attitude, practices [KAP] and frequency of hepatitis B and C among nursing students in Karachi

Objective: The objectives were to determine the Knowledge, Attitude, Practices regarding needle stick injuries [NSI] and frequency of Hepatitis B and C among nursing students at two tertiary care hospitals of Karachi

Study Design: Cross-sectional study

Place and Duration of Study: This study was conducted at the Department of Medicine, DMC, JPMC and Hilton Pharma, Karachi from January 2014 to June 2014

Materials and Methods: This study was carried out on NSI exposed 214 nursing students from 1[st] year to 4[th] year, visiting their respective hospitals and engaging in clinical activities. A hundred of those students who reported needle stick injuries randomly selected and screened for Hepatitis B surface antigen [HbsAg] and anti-HCV in sera

Results: Approximately thirty four percent [34%] of the students reported to have NSI one time. Out of the 214 students only 143 [66.8%] of the students were aware of the Universal Precaution Guidelines while 71 [33.2%] were unaware of it. After getting NSI only 18.2% reported it to the infection control team while 81.8% failed to report it. Of the 100 students randomly selected for screening, four tested positive for HbsAg and two tested positive for Anti-HCV

Conclusion: Allowing nursing students to practice without prior knowledge of their immune status poses a major risk of acquiring hazardous infections. Prior to practice, students should be ingrained with the universal precaution guidelines and screened for blood borne infections that should be followed up every year

potential role of resistin in atherosclerosis and ischaemic heart disease

Objectives: To investigate the relationship between serums resistin levels and ischaemic heart disease and severity of ischaemic heart disease

Study design: Cross sectional descriptive study

Place and duration: This study was conducted in the Department of Physiology, Basic Medical Sciences Institute [BMSI], Jinnah Post Graduate Medical Center and the National Institute of Cardiovascular Diseases [NICVD], Karachi from 1[st] September 2008 to 30[th] April 2009

Methodology: After informed consent, ninety patients with confirmed diagnosis of coronary artery disease [CAD], diagnosed on the basis of history, physical examination, classical ECG changes and raised cardiac enzymes, were enrolled and divided into 3 equal groups: 30 patients each for acute myocardial infarction [AMI] unstable angina [UA] and stable angina [SA] and 30 healthy individuals were recruited as controls. Serum resistin levels were determind by ELISA [Resistin kit by SPI bio, Bertin Pharma, France Plate reader 800, manufactured by Biotech, USA]. Complete blood count [CBC], Creatine kinase MB isoenzyme [CKMB] and Cardiac Troponin I [Trop I] were measured by standard laboratory methods

Results: Serum resistin levels were found to be increased in CAD patients and to increase in parallel with increasing severity of CAD. Serum resistin levels were also positively correlated with CKMB, Trop I and white blood cell [WBC] count

Conclusion: The results suggest that human resistin may play an important role in the pathogenesis of atherosclerosis and ischaemic heart disease

Effectiveness of sodium hyaluronate eye gel in patients with dry eye disease: a multi-centre, open label, uncontrolled study

To assess the effectiveness of sodium hyaluronate Eye Gel in Dry Eye Disease [DED] patients. A Multi-center, Open-label, Uncontrolled clinical trial was conducted in different centers of Pakistan. Ten ophthalmologists conducted this study in which 250 diagnosed patients with dry eye disease were enrolled after obtaining a written informed consent. Ten patients were dropped out during the study period. All patients were assessed as per following criteria for enrolling a patient into the study: Tear Film Break - up time [TBUT]

Prevalence of geriatric diseases among parents of medical doctors in Lahore

The burden of geriatric diseases has a significant impact upon the socio-cultural, socioeconomic and administration of health services. The study was carried out to identify a burden of geriatric conditions, magnitude of disease problems and involvements of body systems in the parents of medical doctors from Lahore. After taking the consent, interview based active disease surveillance/information was collected from a total of 137 medical doctors and their parents. They were interviewed about the health status of their parents and recorded in a pre-tested questionnaire. The prevalence of each system involved in each of the category of parents was compared by ANOVA at a significant alpha level of 0.05. Prevalence of cardiovascular diseases was the highest, [18.61%], followed by musculoskeletal [10.21%] and digestive system [9.12%]. The ranking of other systems in descending order was 4.74%, 3.64% and 1.82% for the respiratory system, urogenital system, and ENT respectively due to single system involvement. A cumulative prevalence due to all diseases in terms of disease load/burden of diseases in both mothers and fathers was 53.28% due to single system involvement and 67.51% because of multiple system involvement. Fifty three percent of the older population, who were above the age of 60, were sick due to the involvement of one body system and sixty eight percent had multiple body systems involvement.

Impact of socioeconomic factors on nutritional status in primary school children

Child malnutrition is a major public health and development concern in most of the poor communities leading to high morbidity and mortality. Various studies have highlighted the factors involved. The present study focuses on socioeconomic inequality resulting in malnutrition. Objectives of the Study were to find the Impact of socio-economic factors on nutritional status in primary school children. It was a cross sectional survey conducted at Lahore from February to August 2005 among primary schools from public and private sectors to assess the nutritional status of primary school going children age 5-11 years belonging to different socio economic classes of the society. Systematic random sampling technique was applied to collect the sample. Body Mass Index in relation to NHANES reference population was used for assessing nutritional status. The nutritional status of children from lower socio economic class was poor as compared to their counter parts in upper socio economic class. Children with BMI <5[th] percentile were 41% in lower class while in upper class it was 19.28%. Prevalence of malnutrition was 42.3% among children of illiterate mothers as compare to 20% in those of literate mothers. Poverty, low literacy rate, large families, food insecurity, food safety, women's education appears to be the important underlying factors responsible for poor health status of children from low socioeconomic class. It requires economic, political and social changes as well as changes for personal advancement mainly through educational opportunities to improve the nutritional status of the children