Patient Attitudes towards Physician Nonverbal Behaviors during Consultancy: Result from a Developing Country.

Background. Nonverbal behaviors have a significant impact on patients during consultations. This study was undertaken to find out the attitudes and preferences of the patients regarding nonverbal communication during consultations with physicians, in a tertiary care hospital. Methods. A questionnaire based cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, Pakistan, during the months of January to March 2012. All patients (>18 years of age) coming for consultancy in the family medicine clinics were approached; out of 133, 120 agreed to participate. The subjects were asked questions regarding physician's comforting touch and eye contact and their responses were noted. The data were analyzed using SPSS and chi-square test was used to identify corelations. Results. Overall, 120 patients were enrolled. About 58.3% were men and 41.7% were women with a mean age of 34.9 ± 10.9 years. 95.8% were Muslims and 57.6% had more than 12 years of education. Among females 74% wanted supportive touch from doctors, used to comfort the patient (45%) or to show respect (27.5%) or as healing (30%). 86.1% of the respondents believe that establishing eye contact with the patient shows that the doctor is attentive towards his/her patient. The eye contact should be brief but regular (54.1%) and prolonged staring (36.7%) makes them uncomfortable. Conclusion. Nonverbal communication helps to strengthen the doctor-patient relation as patients do appreciate positive touch and eye contact from their physicians.

Prevalence and clinical profile of insulin resistance in young women of poly cystic ovary syndrome: A study from Pakistan.

OBJECTIVE: The aim was to estimate the prevalence of Insulin Resistance (IR) in Poly Cystic Ovary Syndrome (PCOS) and analyze its clinical parameters. METHODOLOGY: This observational study was conducted at Dow University Hospital during June 2011 till May 2012. Patients of PCOS were selected, an anthropometric measurement, examination and fasting blood test for sugar (FBS) and insulin was performed. Data was collected on pre designed questionnaire, was analyzed by SPSS version 16. RESULTS: Forty-six cases of PCOS were included in the study. Prevalence of IR was 34.78%. Mean age of patients was 23.72 ± 4.37 years. Waist Hip Ratio (WHR) was raised in 42 (91.30%), acanthosis was found in 26(56.50%), impaired FBS was seen in 9 (19.6%) and raised fasting insulin in 16 (34.8%) patients. There was significant association between acanthosis and WHR (0.044) and between acanthosis and FBS (0.008). Correlation studies between parameters showed a significant correlation between Waist & Hips (0.93), similarly Waist & WHR showed positive correlation (0.59), at p< 0.01. Significant positive correlation was also found between waist and FBS (0.32) and FBS & WHR (0.378). CONCLUSION: Acanthosis nigrican, raised WHR and FBS are significant parameters for insulin resistance in cases of Poly Cystic Ovary Syndrome (PCOS).

Informed consent, privacy and confidentiality practised by doctors of a tertiary care hospital in a developing country.

BACKGROUND: This aim of this study was to assess the degree to which the doctors of a public sector hospital in Karachi adhere to medical ethics during their consultations. MATERIAL AND METHODS: A cross-sectional study was conducted in Civil Hospital, Karachi, Pakistan, during April-June 2010. 337 patients from Out Patients Departments (OPDs) and wards were recruited through consecutive sampling. A pre-tested structured questionnaire was administered to the participants and they were asked about their demographic profile, and their doctor's practices regarding obtaining informed consent, respecting privacy and confidentiality, and treatment modalities. Written informed consent was taken from all the participants. Data was analysed using SPSS version 16.0, and a p-value of < 0.05 was considered as statistically significant. RESULTS: The mean age of the study population was 38.4 ± 15.0 years. There was an equal ratio of males and females. Our study showed that informed consent was obtained from 66.4% of patients. 56.9% of patients responded that they were not informed about the side effects of the prescribed medicines. 74% females were satisfied with the privacy maintained during the consultation. 64.8% were assured of the confidentiality of their information. Regarding advertisement by doctors, 46.5% of patients said it should be done. CONCLUSION: There has been a marked improvement as compared with the previous practices of biomedical ethics by the doctors of this public sector hospital. However, awareness sessions should be conducted to update / improve the knowledge of ethics among doctors to help them translate their knowledge into practice.

Belief in charity giving (sadqa) and its role in healing: results of a survey conducted at a teaching hospital in karachi, pakistan.

OBJECTIVES: To study patients' belief and practice about Sadqa (charity) and its role in recovery from illness and restoration of health. This study will determine whether such belief and practice is related to any demographic factors such as sex, education, and religious sects. METHODS: A questionnaire was designed that included the demographic profile of patients and questions in accordance to the study objective. It was administered to 400 patients or their attendants against the calculated sample size of 385. There were very few refusals to participate with response rate of around 98%. The study objective was explained to all participants, written consent was obtained and full confidentiality was assured. RESULTS: The mean age of the study population was 34.33 years, majority of the patients were males with 65.6% having grade XII or higher education. The practice of giving sadqa/charity for healing was significantly associated with females (p<0.001); Ismaili sect (p=0.017); educational level of grade V (p=0.03); graduate (p=0.041); being housewives (p<0.001), students (p=0.048) and employees in private services (p<0.001). Approximately 85% of the study population gave sadqa/charity for healing diseases and 84.8% believed that sadqa/charity heals diseases. According to 97.5% of the participants, medical treatment should be combined along with sadqa/charity for healing. CONCLUSION: This study highlights the importance of the patients' attachment to charity giving and expectation that it will lead to recovery from illness. Future research in this area should be qualitative rather than quantitative to explore more about beliefs, attitude and behavior of the individuals. It is recommended that health care professionals should consider and also respect patients' and relatives beliefs about sadqa and charity; clashing with their beliefs during provision of medial care should be avoided.