Frequency and risk factors for intestinal parasitic infection in children under five years age at a tertiary care hospital in Karachi.

OBJECTIVE: To assess the frequency and risk factors for intestinal parasitic infection in children under five years age at a tertiary care hospital, Karachi. METHODS: A cross sectional survey of 269 children under five years was conducted at a tertiary care hospital on a pretested self-administered questionnaire. Stool smears were examined under light microscope with direct saline smear and lugol's iodine solution. Parasitic detection was confirmed by formalin ethyl acetate concentration method. RESULTS: Stool test positive for parasites was found in 185 (68.8%) children. Majority of children 144 (53.5%) were among 4-5 years of age. Less than one third (20.4%) showed moderate malnutrition (p = 0.05) while 44.6% were found to have mild anaemia (p < 0.001). Giardia lamblia was the most common parasite (25.3%) identified. Only 40% of children were found to wash hands with soap after using the toilet (p < 0.001). Eating mud/pica was present in 36% children (p < 0.001). Less than half (48%) of the mothers said that they do not purify drinking water (p < 0.001). CONCLUSION: The frequency of intestinal parasitic infection was found to be high among children under five years. Major contributory factors were lack of hand washing and drinking unpurified water along with habit of eating mud/pica. This study identifies at-risk population of less than five years of age who could benefit from health education of parents.

Knowledge of medical students regarding diabetes mellitus at Ziauddin University, Karachi.

OBJECTIVE: To assess knowledge among medical students of Ziauddin University regarding Diabetes Mellitus. METHODS: A cross sectional survey of medical students from first year to final year at the medical college was conducted on a pretested self-administered questionnaire. Students were divided into preclinical and clinical years for analysis. RESULTS: A total of 366 students participated, with 145 (39.6%) from the preclinical group and 221 (60.4%) from the clinical group. Overall 89% students knew that diabetes is a metabolic disorder, 78% knew that pancreas is the site of insulin production and 77% students correctly identified main target organ of insulin. Regarding presentation, 67% said polyphagia, 50% said weight loss while only 18% claimed pruritus vulvae to be the presenting symptom. Majority from the clinical group (95%) while 86% of preclinical group knew about risk factors for diabetes (p = 0.003). Regarding prevention, 89% of clinical group knew that diabetes is preventable but 49% preclinical students did not have an idea of prevention (p < 0.001). A large number from clinical group (87%) said that there is some criteria of screening for diabetes while only 30% of preclinical group knew about screening (p < 0.001). Correct diagnostic criteria for diabetes according to WHO was identified by 55% clinical and only 6% of preclinical students (p < 0.001). Over two-third (78%) of clinical while only 50% of preclinical students said that diabetes should not always be treated with drugs (p < 0.001). CONCLUSION: The knowledge of students about diabetes was more in the clinical group as compared to the preclinical group, whereas, overall knowledge of the students was adequate. Medical students are the future physicians, therefore the medical curriculum should lay emphasis on educating students, patient based clinically oriented approaches for dealing with this epidemiologically important disease.

Knowledge regarding breastfeeding practices among medical students of Ziauddin University Karachi.

OBJECTIVE: To assess knowledge among medical students of a private medical college regarding breast-feeding practices. METHODS: A cross sectional survey of medical students from first year to final year at a private medical college was conducted on a pretested self-administered questionnaire. Students were divided into preclinical and clinical years for analysis. RESULTS: A total of 344 students participated with 159 (47.6%) from the preclinical group and 185 (53.7%) from the clinical group. The mean age of respondents was 22 +/- 1.5 years. Overall 69% students knew that breastfeeding should be initiated immediately after birth, 42% said that exclusive breastfeeding should be continued for 4-6 months and 33% said that weaning should be started between 4-6 months. Regarding giving colostrum to the newborn, 14% students felt that it should be discarded and 12% from both groups thought that colostrum was harmful. Over two-third (76%) from clinical group and 61% from preclinical group were of the opinion that breastfeeding should be started immediately after birth (p = 0.009). Correct age to start weaning was identified by 71% of the clinical group, whereas, the preclinical group stated it to be 7-9 months of age (p < 0.001). CONCLUSION: The knowledge of students regarding breastfeeding was more in the clinical group as compared to the preclinical group, whereas, overall knowledge of the students regarding breastfeeding was low. Medical students being the future physicians will be the first line in dealing with mothers and breastfeeding related problems. The medical curriculum should lay emphasis on counseling regarding maternal and child nutrition.

Awareness of hypertension among patients attending primary health care centre and outpatient department of tertiary care hospital of Karachi.

OBJECTIVE: To compare awareness of hypertension among patients attending Primary Health Care Centre (PHC) and outpatient department (OPD) of a tertiary care hospital of Karachi. METHODS: Cross sectional survey of patients more than 18 years of age without any complication of hypertension in a squatter settlement of Karachi through non-probability convenient sampling. RESULTS: A total 202 patients were approached, 49 (24%) were males and 153 (76%) were females. Majority of the patients attending tertiary care OPD (80%) and 56% from PHC group believed that hypertension could lead to cardiovascular disease (CVD). On inquiring the duration of taking antihypertensive drugs, 61% from tertiary care OPD group and 31% of PHC group said they are taken only for few months (p < 0.001). Over two-third (77%) of patient of tertiary OPD were not doing exercise and not avoiding oily and heavy food to keep their weight under control. Large number of OPD patients (91%) used oil for cooking in comparison to PHC group (78%) who utilized ghee (p < 0.001). CONCLUSION: This study showed a marked difference in awareness regarding hypertension in urban slum and middle class community, which can be attributed to the level of education. This outcome reveals need for more awareness campaigns especially in the squatter settlement with special emphasis on lifestyle modifications along with pharmacological therapy for the better control of hypertension.

Risk factors assessment for hypertension in a squatter settlement of Karachi.

OBJECTIVE: To assess the risk factors for hypertension in adults (age more than 15 years) in a squatter settlement of Karachi. METHODS: Cross-sectional survey of adults more than 15 years old in a squatter settlement of Karachi through random sampling method. RESULTS: A total of 327 adults were approached, 165 (50.5%) were males and 162 (49.5%) females. Blood pressure was measured in 63 (38%) males and 135 (83%) females. Out of which, 11 (17.5%) males and 19 (14%) females were screened hypertensive. Hypertensives were older as compared to normotensives (p < 0.001). The mean BMI of hypertensives (25.6 +/- 4.5 kg/m2) was significantly higher (p = 0.008) than normotensives (22.9 +/- 5.0 kg/m2). Hypertensives were 9.7 times more likely to be diabetic as compared to normotensives in this study (p < 0.001). On analyzing the relationship of hypertension with other variables, no significant difference was noticed for education (p = 0.68), smoking status (p = 0.46), family history (p = 0.31) and occupation (p = 0.27). CONCLUSION: Prevention and control of hypertension is essential as the life expectancy is increasing in developing countries as well. The main emphasis according to this study, should be on controlling the BMI through weight reduction and regular exercise. Awareness about the risk factors for hypertension among the population is required to decrease the double burden on the society.

Knowledge of students regarding hepatitis and HIV/AIDS of a private medical university in Karachi.

OBJECTIVE: To determine and assess the level of awareness among students of a private medical college regarding HIV/AIDS, Hepatitis B and C. METHODS: A survey was conducted to assess the awareness of medical students on HIV/AIDS, hepatitis B and C. They were asked to fulfill a pre-tested structured questionnaire. The variables accessed were their knowledge of disease regarding etiology, mode of transmission, and prevention. RESULTS: A total of 267 students participated, with 117 (43.8%) students from pre-clinical years and 150 (56.2%) from the clinical years. The male female ratio was 1:2, mean age of respondents was 21 +/- 1.5 years. Majority of the students (98%) agreed that an infected person is a major source of transmitting these infections. Almost all (95%) students knew that blood transfusion was an important source of transmitting these infections. Wearing gloves (87%) and safe disposal of sharps waste (98%) were known by the students to be the ways to protect against these infections. A significant difference was noted on comparing the knowledge between preclinical and clinical students regarding medical / surgical procedures causing these infections (p<0.001) and also regarding the ways to protect against these diseases (p=0.001). CONCLUSION: There is a lack of awareness among the medical students entering into the profession. It is the need of the hour to emphasize on practicing universal precautions. In addition, some preventive measures should be taken by the management of the universities and medical students to avoid the occurrence of these problems.