Maternal morbidity and mortality in Pakistan - an overview of major contributors

Objective: To assess the trend of the proportion of maternal mortality ratio [MMR] due to common direct causes that are the major contributors in Pakistan

Study Design: Descriptive method study

Place and Duration of Study: The study was conducted in Jun 2014

Material and Methods: Descriptive method study was conducted in June 2014. Data collected in different time periods from articles published between 01 Jan 2005 to 31 Dec 2012 in medical journals, proceedings of workshops/conferences as well as from newsletters of the National Committee of Maternal Health [NCMH] along with global borden of disease [GBD] 2013 to estimate MMR. Data were later tabulated accordingly in June 2014

Results: In the hospitals over 80% of the deaths are due to direct causes. Direct causes account for 78.1% of deaths, hemorrhage being the most common followed by sepsis, eclampsia, rupture of the uterus, and abortions. The contributors were greater in booked multi-gravid as of 20 to 40 years, para 3 to 5, under matric education and with less than Rs. 10,000 monthly income

Conclusion: Massive hemorrhage and uncontrolled hypertension are major contributors of maternal morbidity in Pakistan

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

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