Healthy ageing: Assessment of health-promoting lifestyle among the elderly population in Karachi Pakistan.

BACKGROUND: The growth in the elderly population is predicted to expand exponentially and developing countries like Pakistan have about two-third of the global elderly population. It is vital to maintain the health of the elderly aged population to reduce disabilities and health-care cost. AIM: This study aimed to determine the health promotion practices among the older aged population in Pakistan and to explore the factors associate with adopting healthy lifestyle practices. MATERIALS AND METHODS: This was a cross-sectional study spanning from 2019 to 2020 conducted on 317 participants of age more than 60 years in Pakistan. The participants included healthy attendants of patients visiting the outpatient clinics of different disciplines in the Liaquat National Hospital Karachi through purposive sampling technique. The health-promoting practices were assessed using Health-Promoting Lifestyle Profile II Questionnaire. The factors that determined the healthy practices among the elderly population were identified using independent t-test and analysis of variance and Tukey test, with a significance level of P < 0.05. IBM SPSS Statistics 22 was used for data entry and analysis. RESULTS: The highest subscale was detected from interpersonal relationships and spiritual growth. The lowest score was detected from physical activity. The scores differed significantly by occupation, education, and the marital status of the participants. Females, unmarried people, those who were less educated, and participants relying on others for financial support had lower health-promoting lifestyle scores. CONCLUSION: The overall health-promoting practices were good among the old-aged population of Pakistan. These practices differed particularly for physical activity, spiritual growth, and interpersonal relationships.

Knowledge scores in annual and modular curriculum among medical students from Karachi, Pakistan.

OBJECTIVE: To compare the knowledge scores of basic medical subjects in annual versus modular system among undergraduate medical students. METHODS: A cross-sectional survey was conducted on 4th year undergraduate medical students of annual and modular system of Liaquat National Medical College, Pakistan. Study was conducted from 30th November 2017 to 1st June 2018 for a total of 6 months. Sample size was calculated to be 82 students. The data was collected using a structured questionnaire. The student's t-test was applied to compare the mean difference of knowledge scores between the two groups. RESULTS: Students in modular system retained better knowledge of anatomy as compared to annual students. However, the annual system students retained higher knowledge in subjects of community medicine and pharmacology. Mean knowledge score among students for annual system was 12.98 ± 2.92 and semester system was 13.1 ± 3.03. There was no significant difference observed in overall mean knowledge scores between the two groups (p=0.85). CONCLUSIONS: Students in the annual system scored higher in pharmacology and community medicine. This highlighted the need to address the issues of time allocation and implementation strategies for the subjects in the new system. There was no difference between overall knowledge scores in each group, hence, it would be inappropriate to conclude that one system is superior to the other.

Prevalence and predictors of respiratory symptoms and illnesses among farmers: a cross-sectional survey, Pakistan.

BACKGROUND: Occupational exposures are one of the major causes of chronic respiratory symptoms and illnesses, where farming and its related activities make a significant contribution, especially in low- and middle-income countries such as Pakistan. AIMS: This study aimed to estimate burden of chronic respiratory symptoms and illnesses among farmers and to identify associated factors. METHODS: A translated version of American Thoracic Society Division of Lung Disease questionnaire (ATS-DLD-78A) was used among 381 farmers in Thatta District, Pakistan in 2011. Logistic regression analysis was used to assess the association between socio-demographic and occupational risk factors and respiratory illnesses. RESULTS: Chronic wheeze was reported in 65.9% of farmers exposed to pesticides compared to 34.1% of farmers not exposed (P-value: 0.10). Frequencies of other health events were almost similar among the two groups. On multivariable logistic regression analysis every 5 year increase in age of the farmer increased the risk of having respiratory illnesses by 18% (Adjusted OR [AOR]: 1.18; 95% CI: 1.03-1.35). Each 1000 Pakistani Rupees (PKR) increase in household income increased the risk of having respiratory illnesses by 10% (AOR: 1.10; 95% CI: 1.01-1.25). CONCLUSIONS: Occupational Health and safety is a neglected area in many parts of the country especially when it comes to farmers. This study highlights the importance of factors other than pesticides impacting the respiratory health of the farmers, emphasizing on those who smoke tobacco.

An insight into frequency and predictors leading psychiatric patients to visit faith healers: A hospital-based cross-sectional survey, Karachi, Pakistan.

BACKGROUND: Psychiatric illnesses have recently escalated in numbers, with patients resorting to various forms of healthcare providers, including faith healers. This delays early psychiatric treatment, resulting in further mental health deterioration of the patient. Various factors impact the mode of treatment preferred by psychiatric patients. AIMS: To determine the frequency of psychiatric patients visiting faith healers, presenting at the outpatient department of Liaquat National Hospital, Karachi, Pakistan, and to explore the predictors that direct them toward visiting faith healers. METHODS: This cross-sectional survey was conducted using a semi-structured pre-tested questionnaire, employing a total of 219 male and female psychiatric patients. Patients were recruited through non-random consecutive sampling technique. SPSS 18 was used for statistical analysis. RESULTS: About 32% of the patients had visited a faith healer in their lifetime. Frequency of current visitors declined; the most frequent reason being stated was no relief from their treatment. Students, patients of upper middle class and those coming for initial visit to a psychiatrist were more likely to visit a faith healer. Patients who knew of someone previously visiting a faith healer were less likely to have visited a faith healer. CONCLUSION: This study highlights the importance of a multisectoral approach to dealing with psychiatric patients to help in bridging the treatment gap in mental health.

External lead contamination of women's nails by surma in Pakistan: Is the biomarker reliable?

Adverse health effects of heavy metals are a public health concern, especially lead may cause negative health impacts to human fetal and infantile development. The lead concentrations in Pakistani pregnant women's nails, used as a biomarker, were measured to estimate the lead exposure. Thirteen nail samples out of 84 nails analyzed contained lead higher than the concentration (13.6 µg/g) of the fatal lead poisoning case, raising the possibility of an external contamination. Eye cosmetics such as surma are recognized as one of the important sources of lead exposure in Pakistan. We collected in Pakistan 30 eye cosmetics made in Pakistan, Saudi Arabia and western countries. As the metal composition analysis by energy dispersive X-ray fluorescence spectrometry revealed that some surma samples contained lead more than 96%, the surma might contaminate the nail specimen. Scanning electron microscopy observations showed that lead-containing surma consists of fine particle of galena (ore of lead sulfide) in respirable dust range (less than 10 µm). In addition, relative in vitro bioavailability of lead in the surma was determined as 5.2%. Thus, lead-containing surma consists of inhalable and bioavailable particles, and it contributes an increased risk of lead exposure. Moreover, the relationship between the surma and the lead-contaminated nails by lead isotope ratios analysis indicated the potential of lead contamination in nails by surma. These results suggest that lead in the nails was derived both from body burden of lead and external contamination by lead-containing surma. Therefore, nail is not suited as a biomarker for lead exposure in the countries where surma used, because we may overestimate lead exposure by surface lead contamination in the nail by surma.

PERSPECTIVES REGARDING ANTENATAL CARE, DELIVERY AND BREAST FEEDING PRACTICES OF WOMEN FROM BALUCHISTAN, PAKISTAN.

BACKGROUND: Antenatal Care is one of the fundamental rights for women to safeguard their health. Neonatal mortality rates have remained relatively static, compared to the decline in infant and under 5 mortality rates, adverse practices regarding breast feeding and pre-lacteal feeds being the important factors responsible. This study aimed to explore the Antenatal Care, delivery and breastfeeding practices in three districts of Baluchistan. METHODS: It was a qualitative phenomenological design using Constructivist approach. The study was conducted in three districts of Baluchistan province, Gwadar, Quetta, Qila Saifullah. There were a total of 14 Focus Group Discussions with women regarding Antenatal Care, delivery and Breastfeeding practices, followed by audio taping, transcription as verbatim and analysis through Nvivo version 2. A process was deployed for identification and reporting of the components in order to ensure quality and validity of the qualitative findings. RESULTS: Across the sites, women attended ANC at least once. However, their descriptions of ANC often varied. The women preferred Dais instead of doctors, due to the affordability, customs and availability. A lack of trained doctors and long distances to get a check-up lead to home deliveries in the study setting. Colostrum was discarded by majority of the mothers, while prelacteal feed was a common practice. CONCLUSION: This paper has explored factors affecting ANC attendance, delivery and breast feeding practices across three settings. Both the demand and supply side factors have an important influence on practices.

Knowledge, attitude and practices regarding respiratory symptoms among textile workers of Karachi, Pakistan: a cross-sectional survey.

OBJECTIVES: To determine the prevalence and predictors of good knowledge, appropriate attitude and appropriate protective practices regarding respiratory symptoms among textile workers, and to determine the association of knowledge, attitude and practices with respiratory symptoms. METHODS: The cross-sectional study was conducted in 2009 and comprised male workers from 15 textile mills in and around Karachi. A structured and pre-tested questionnaire was used which included questions to explore the knowledge, attitude and practices regarding respiratory symptoms. SPSS 19 was used for statistical analysis. RESULTS: The study had a sample size of 372 and found prevalence of good knowledge to be in 182 (48.9%) workers and appropriate attitude in 302 (81%), while only 80 (21%) were practising these measures appropriately. Being educated and older than 38 years of age, belonging to Sindhi ethnicity, and working in the weaving section were significant (p<0.05) predictors of knowledge, attitude and practices. Generally, there was no significant association of knowledge, attitude and practices with respiratory symptoms (p>0.05). CONCLUSIONS: There was low prevalence of appropriate practices, high prevalence of good knowledge and attitude, indicating an interplay of several other social and environmental factors which need to be explored.

Sex-based difference in the perception of exercise and level of physical activity among residents of Karachi City, Pakistan.

OBJECTIVES: To identify sex-based differences in the perception of benefits and barriers toward exercise and to determine the sex- and age-based differences in the level of physical activity (PA) among adult residents of Karachi. METHODS: Three hundred adult individuals were included in cross sectional survey conducted during July-October 2010. Perception of benefits and barriers to exercise and the level of PA were measured through a questionnaire. Differences in the perception of benefits and barriers of exercise and level of PA were calculated with age and sex strata. RESULTS: Women perceived more barriers to exercise than men (P-value < 0.001). In all age strata women have higher ranks for domestic-related physical activity while men have higher ranks for job-related PA. Leisure time PA were significantly lower for females in all age groups. Total PA is also affected by age and socioeconomic status, higher among people having monthly income < 6000 rupees and lower in males > 45 years of age. CONCLUSION: Sex-based differences exists in the level of PA and perception regarding exercise in mega city of Pakistan. There is a need to design programs that influence PA determinants connected to sex to prevent impending epidemic of non communicable diseases.