Knowledge, attitudes and practice of university students regarding waterpipe smoking in Pakistan.

OBJECTIVES: To study the awareness, perceptions and practice of university students in Karachi, Pakistan, with regard to shisha (waterpipe) smoking. DESIGN: Cross-sectional survey conducted among students at four different universities of Karachi, selected through random cluster sampling. RESULTS: A total of 450 participants, 59.6% males (n=268) and 40.4% females (n=182), were included in the study. About half of the participants reported having ever smoked shisha (n=241, 53.6%). On examining factors associated with starting shisha smoking, curiosity was found to be the most common reason (n=148, 61.4%), followed by pleasure-seeking (n=113, 46.9%), peer pressure (n=55, 22.8%), boredom (n=43, 17.8%) and stress (n=26, 10.8%). Of 241 participants who had ever smoked waterpipes, the majority (n=149, 61.8%) were current smokers. A vast majority of participants (n=269, 60%) considered waterpipe smoking to be less unhealthy than cigarette smoking. Boredom in youth, use of waterpipe in leisure activities and peer pressure were identified as the most common reasons for the escalating popularity of waterpipe smoking in Pakistan. CONCLUSIONS: Waterpipe smoking is very popular among Pakistani university students, and knowledge among university students about the dangers of waterpipe smoking is alarmingly low.

Knowledge of primary paediatric care providers regarding attention deficit hyperactivity disorder and learning disorder: a study from Pakistan.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) and learning disorder (LD) remain prevalent globally and are also speculated to have a high occurrence in Pakistan. An early diagnosis and intervention in these disabilities is imperative for achieving good clinical and functional outcomes. This can be ensured by an effective screening at the level of primary paediatric care in the developing countries. We aimed to explore the ability of general practitioners (GPs) and paediatricians in Pakistan to screen for ADHD and LD based on their awareness regarding the risk factors and symptomatology of ADHD and LD. METHODS: A total of 96 paediatricians and 98 GPs practising in Karachi, Pakistan were included in the study. Data was collected employing a self-administered questionnaire. RESULTS: Only 13.7 percent of the GPs and 21.6 percent of the paediatricians were shown to have knowledge sufficient to effectively screen for/diagnose ADHD. Alarmingly, not a single GP was adequately familiar with the established risk factors and clinical symptoms of LD. The level of knowledge was not influenced by age, gender, and clinical practice attributes of the physicians. Doctors who regularly read medical journals and attend medical education seminars showed slightly better trends. CONCLUSION: We hypothesise that this demonstrated lack of knowledge at the level of primary care in Pakistan prevents an early screening of ADHD and LD. A multipronged strategy targeted at the provision of objective screening tools for primary paediatric care providers, regular continuing medical education seminars and an emphasis on paediatric mental health in undergraduate and postgraduate curricula may ensure an early detection of ADHD and LD in Pakistan.

Use of psychoactive drugs among patients visiting outpatient clinics in Karachi, Pakistan.

INTRODUCTION: This study was conducted to determine the proportion of usage of psychoactive drugs, and to identify factors associated with its use among patients visiting outpatient clinics of a tertiary care hospital in Karachi, Pakistan. METHODS: A cross-sectional study was conducted involving 461 adult (age 18 years and above) patients, who were surveyed by using interviewer-administered questionnaires. All interviews were conducted by a medical students. Out of the total number of participants, 242 (52.5 percent) were males and 219 (47.5 percent) were females. RESULTS: In all, 118 (25.6 percent) of the respondents were using some sort of psychoactive drugs, however, only 20 (4.3 percent) study subjects were diagnosed with any psychiatric illness. Factors found to be significantly associated with usage of psychoactive drugs included belonging to the female gender (p-value equals 0.019), older (more than 50 years) age (p-value is less than 0.001), being married (p-value equals 0.004), having formal schooling of up to 12 years (p-value equals 0.001) and physical inactivity (p-value equals 0.004). In addition, those whose family members were using psychoactive drug(s) or who suffered from non-communicable diseases were more likely to use psychoactive drugs in comparison to others (p-value is less than 0.001). CONCLUSION: The use of psychoactive drugs is quite common in our patients regardless of having any psychiatric disease. Efforts are required to control and prevent the abuse of these drugs. Education and awareness programmes for doctors and patients may help to prevent the inappropriate use of psychoactive drugs. Regulatory intervention to control use of these drugs is also recommended.