An overview of smoking practices in Pakistan.

Smoking remains a major player in morbidity and mortality worldwide. It is a matter of immense public health importance as single leading cause of preventable deaths. The aim of this study was to assess smoking practices that prevail across Pakistan & Attitude of people towards this issue. We conducted an extensive search on major databases as well as search of bibliography of published literature for studies assessing Attitudes and Practices of tobacco smoking that prevail across Pakistan. Data from available studies was abstracted and utilized in preparation of this manuscript. After screening of 613 articles, we were able to identify 22 studies matching our criteria for inclusion. Majority of studies reported adolescence as time of initiation. Average national prevalence was 21.6%. A significant portion of smokers comprised of females. The prevalence of smoking in healthcare professionals ranged from 32 - 37%. Passive smoking was a major contributor of tobacco exposure. Prevalence of 'Shisha' use was 33%. Smoking continues to be a major Public Health issue in Pakistan. The prevalence in healthcare professionals and adolescents is alarming. Adequate measures need to be taken to ensure its control.

RADIOLOGY EDUCATION: A PILOT STUDY TO ASSESS KNOWLEDGE OF MEDICAL STUDENTS REGARDING IMAGING IN TRAUMA.

BACKGROUND: Trauma remains one of the most frequent presentations in emergency departments. Imaging has established role in setting of acute trauma with ability to identify potentially fatal conditions. Adequate knowledge of health professionals regarding trauma imaging is vital for improved healthcare. In this work we try to assess knowledge of medical students regarding imaging in trauma as well as identify most effective way of imparting radiology education. METHOD: This cross-sectional pilot study was conducted at Aga Khan University Medical College & Khyber Girls Medical College, to assess knowledge of medical students regarding imaging protocols practiced in initial management of trauma patients. RESULTS: Only 40 & 20% respectively were able to identify radiographs included in trauma series. Very few had knowledge of correct indication for Focused abdominal sonography in trauma. Clinical radiology rotation was reported as best way of learning radiology. CONCLUSION: Change in curricula & restructuring of clinical radiology rotation structure is needed to improve knowledge regarding Trauma imaging.

Knowledge, attitudes and practices of parents regarding antibiotic use in children.

BACKGROUND: Emerging resistance to antimicrobial chemotherapy is becoming a challenge for medicine in recent times. Un-prescribed use of antibiotics is a major contributor to development of this problem. In Pakistan access to antibiotics remains unchecked and hence results in it are over use. The aim of this study was to assess knowledge of parents regarding use of antibiotics, its associated problems, their source of information and their expectations from Paediatricians for prescription of anti-biotics. METHODS: This is a questionnaire based cross sectional study conducted in Hayatabad town, District Peshawar. Parents who were consenting, had children aged between 0-16 years, and were not related to medical profession were included in study. Total number of participants interviewed was 400. Analysis was done using prevalence ratios. RESULTS: Most of the participants were mothers. Majority of respondents were literate with education up till level of Graduation. 64% mentioned that they enjoyed a good access to healthcare. Most common source for use of antibiotics was Physician. 35% mentioned that antibiotics must be administered in any case of fever, 47% thought antibiotics to increase recovery time and 51% knew that antibiotics have their own side effect. The most common reason to administer un-prescribed antibiotics was same antibiotic being prescribed by a physician earlier followed by family member or pharmacist recommending use of antibiotic. Lack of resources was denied as a reason for self-administration of antibiotics by majority of parents. CONCLUSION: There is a need of intervention to increase awareness regarding judicious use of antibiotics and to check un-prescribed dispensing of antibiotics.

'Student Lady Health Visitors': their stress profile and willingness to practice.

BACKGROUND: Lack of Reproductive health facilities including high maternal and neonatal mortality is a major problem of our region. Skilled healthcare providers like Lady Health Visitors can play a significant role in improving parameters of reproductive healthcare. The objectives of this study were to assess stress profiles in student lady health visitors and their willingness to practice in future. METHODS: Cross sectional survey conducted at two public health schools in District Peshawar with student Lady Health Visitors as study participants. RESULTS: Majority (64.4%) of respondents were satisfied with their choice of career, 78% thought they had adequate knowledge to practice independently, 47.7% thought that their life in this profession will be stressful. Most of them were facing financial difficulties during their course, 84.8% enjoyed support of their family in choice of career, 50-82% reported psychosomatic problems arising as result of stress in their lives. CONCLUSION: Most of the respondents were happy with their choice of profession and were willing to practice in future. High prevalence of stress in lives of respondents warrants counselling services by institutions.

Lung carcinoma: its profile and changing trends.

BACKGROUND: Lung Carcinoma is the leading causes of morbidity and mortality worldwide with an incidence of 1.3 million cases per year. This study was undertaken to determine prevalence of various histological types of lung carcinoma and to analyse their changing trends with time. METHODS: This is a retrospective analytical study. A total of 330 cases of lung carcinoma were analysed from 2003 to 2008. Cases from Khyber Pakhtunkhwa and Federally Administered Tribal Area (FATA) were included in this study. Furthermore, only cases of lung carcinoma were considered while other malignancies were excluded. RESULTS: Squamous Cell carcinoma was found in 42.7% of cases. Overall male to female ratio was 2.67:1. Prevalence of Squamous Cell carcinoma increased from 32% to 57.9% while that of Small Cell carcinoma increased from 12% to 17.1%. Unspecified type showed decrease from 36% to 5.3%. Increase in the prevalence of Squamous Cell carcinoma was found in both males and females while change in the prevalence of Small Cell carcinoma was found on!y in males. CONCLUSION: Squamous Cell carcinoma was the most prevalent variant of lung carcinoma in our region, followed by Adenocarcinoma. Male to female ratio across different histological patterns did not show significant variation. Increase in the prevalence of Squamous Cell carcinoma was statistically significant in both males and females while in case of Small Cell carcinoma change in its prevalence was also significant in males.