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1.
J Pak Med Assoc ; 70(5): 872-877, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32400745

RESUMEN

OBJECTIVE: To assess the feedback of final year medical students on paediatric lectures delivered over a year. METHODS: The descriptive, cross-sectional study was conducted at Karachi Medical Dental College, Abbassi Shaheed Hospital, Karachi, and comprised final year medical students who were exposed to the scheduled lectures in paediatrics from April 2016 to May 2017. After the completion of the designated lectures, an evaluation of the lectures was done by the students who rated the lecture(s) on whether the lectures were clear, interesting, easy to take notes from, thought-provoking and relevant to the course. The evaluation was done anonymously on pre designed evaluation forms which were collected by volunteer third year medical students. Data was analysed and expressed as frequencies and percentages. RESULTS: Of the 212 students, 112(52.8%) agreed strongly that the lectures were clear, 50(33%) found them interesting, 56(26.4%) said the lectures were easy to take notes from, for 58(27.3%) the lectures were thought-provoking, and 118(55.6%) found them relevant to the course. CONCLUSIONS: Majority of the students agreed that the lecture was clear and relevant to the course, but the lectures were generally not found to be easy to take notes from.


Asunto(s)
Educación de Pregrado en Medicina , Docentes Médicos/normas , Pediatras , Pediatría/educación , Enseñanza/normas , Adulto , Actitud , Curriculum , Educación de Pregrado en Medicina/métodos , Educación de Pregrado en Medicina/organización & administración , Educación de Pregrado en Medicina/normas , Femenino , Humanos , Masculino , Pakistán , Pediatras/educación , Pediatras/psicología , Pediatras/estadística & datos numéricos , Satisfacción Personal , Percepción Social , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos
3.
J Pak Med Assoc ; 68(12): 1848-1850, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30504956

RESUMEN

From June 2018, onwards, there has been an upsurge of multi-resistant enteric infections in children admitted from various catchment areas of Abbasi Shaheed Hospital (ASH). This is a serious concern as very few antibiotics are available to treat the children. Children from June 2018 to September 2018 of age groups 5.7 ± 2.84 (range 1.6 to 11 years), referred to ASH, for admission, with clinical suspicion of enteric fever and having received a third generation injectable cephalosporin by a general practitioner, for 5 days or more, with no response, and continuation of fever, were included. A total number of 137 patients had culture proven salmonella typhi, of whom 61(44.52%) showed sensitivity only to meropenem, 45 (32.8%) to azithromycin,13(9.4%)to fosfomycin, 11(8.02%) to Amoxicillin/clavulanic acid, 5 patients showed sensitivity to ceftriaxone(3.64%) and one had sensitivity to amikacin. All patients were treated successfully for 10 days and discharged home. There were no reported complications at follow-up. Multi-Drug Resistance (MDR) enteric fever appears to be a major health concern in Karachi. Mass immunization with oral live attenuated Typhi 21a or injectable unconjugated Vi typhoid vaccine, rational use of antibiotics, improvement in public sanitation facilities, availability of clean drinking water, promotion of safe food handling practices and public health education are vital in the prevention of MDR enteric fever.


Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana Múltiple , Salmonella typhi , Fiebre Tifoidea , Antibacterianos/uso terapéutico , Azitromicina/farmacología , Azitromicina/uso terapéutico , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Masculino , Meropenem/farmacología , Meropenem/uso terapéutico , Pakistán , Salmonella typhi/efectos de los fármacos , Salmonella typhi/patogenicidad , Fiebre Tifoidea/tratamiento farmacológico , Fiebre Tifoidea/microbiología
4.
J Pak Med Assoc ; 68(6): 919-925, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29887616

RESUMEN

There are only a few Doctors of Philosophy (PhDs) in Biomedical Sciences from Pakistan and there are a number of misconceptions in our country regarding them. This may be due to a lack of knowledge regarding the existence of available programmes or a lack of will or interest in acquiring such a degree. While several PhD programmes exist all over the world, such programmes are lacking in our region even though the Higher Education Commission (HEC) is trying to promote PhD through multiple means and resources. This review discusses the concepts of academicians and clinicians about a PhD, especially in Biomedical Sciences; importance of such a programme; whether Pakistan should have this programme; state of current PhD holders and companies that employ them in well-developed countries e.g. the United States of America. At the same time it also emphasises the need for supervisors to be interested in and promoting availability of PhD programmes, and recognising that there are very few qualified supervisors who have a research experience at an international level.


Asunto(s)
Investigación Biomédica , Educación de Postgrado en Medicina , Educación de Postgrado , Humanos , Pakistán
5.
East Mediterr Health J ; 23(10): 678-687, 2017 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-29270968

RESUMEN

Toxic metals and deficiency/excess of trace elements can have adverse effects on health. The aim of this study was to quantify toxic metals lead, cadmium and trace elements zinc, copper, aluminium (Al) and Iron (Fe) levels in pregnant women, cord blood and meconium of new-born infants from industrial zones of Karachi, Pakistan. Analytical research was performed from 2011-2012 in low socio-economic pregnant mothers and newborn infants from 20 towns near Sindh Industrial Trading Estates, Federal B industrial area and Korangi industrial areas, Karachi, where environmental pollution was anticipated. Blood samples of pregnant women (n = 416), cord blood (n = 309) and meconium (n = 309) were analyzed quantitatively for metals and trace elements. Results indicated that mothers residing in steel towns were found to have the highest levels of lead. Meconium contained high levels of toxic heavy metals and trace elements compared to cord blood and maternal blood. Maternal blood toxic metals were present in high quantities. Therefore, safety measures should be taken when industrial waste is disposed of in order to prevent population contamination.


Asunto(s)
Sangre Fetal/química , Exposición Materna/estadística & datos numéricos , Meconio/química , Efectos Tardíos de la Exposición Prenatal/sangre , Oligoelementos/análisis , Aluminio/análisis , Cadmio/análisis , Cobre/análisis , Femenino , Humanos , Hierro/análisis , Pakistán , Embarazo , Oligoelementos/sangre , Zinc/análisis
7.
J Pak Med Assoc ; 64(11): 1255-9, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25831641

RESUMEN

OBJECTIVE: To determine the frequency pattern of CHO, protein and fat intake in 24 hours by Pakistani school children of different socioeconomic and cultural backgrounds) 6 to 16 years of age. METHODS: The cross-sectional study was a multistage stratified sampling, done in a part of nationwide survey funded by the Higher Education Commission, Pakistan (HEC, Ref no: 20-441/R&D/2008). Sample collection of the study was done from 2006-2009, and growth centile charts have already been published (JPMA 2012; 62:367-77). This is the final paper of the completed project and includes data on only the nutritional status. Final statistical analysis of the nutrition aspect was done from 2012 to 2013 and comprised assessment of quality and quantity of CHO, protein and fats consumed by healthy schoolchildren in a 24 hrs recall (breakfast, brunch, lunch, tea time, dinner and bed time). Food records of 11, 237 school children were subjected to United States Department of Agriculture food exchange list. SPSS 18 was used for statistical analysis. RESULTS: The age range of the study subjects was 6-16 years, and they represented different areas of Pakistan. The consumption of CHO was high (range: 60-74%) compared to protein (10-12%) and fat (18-32%). CONCLUSION: Schoolchildren in Pakistan were found to be taking a deficient amount of protein and fat in their daily diet, while. CHO intake was higher than normal.


Asunto(s)
Pueblo Asiatico , Dieta/etnología , Alimentos , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Estado Nutricional/etnología , Pakistán , Factores Socioeconómicos
8.
J Pak Med Assoc ; 64(3): 275-80, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24864599

RESUMEN

OBJECTIVES: To determine the association of terrorism with psychiatric morbidity by Hospital Anxiety Depression scale among medical students in Karachi, Pakistan. METHODS: The questionnaire based cross-sectional survey was conducted from February to March 2011 and comprised students of the Institute of Physical and Medical Rehabilitation and the Dow Medical College, Dow University of Health Sciences, Karachi. The study tool was a validated Hospital Anxiety Depression scale questionnaire. The data was analysed on SPSS 16. Factor analysis was performed to check which factors had the most influence. RESULTS: Overall there were 1036 respondents. The impact of terrorism on physical, social and mental health was 40 (3.9%), 178 (17.2%) and 818 (79%) respectively. There was an association of terrorism in 980 (84.6%) respondents with psychiatric morbidity. CONCLUSION: There was an association of terrorism with psychiatric morbidity in majority of respondents. The significant risk factors were age, gender, physical, mental and social health and the desire to live in Pakistan.


Asunto(s)
Ansiedad/diagnóstico , Depresión/diagnóstico , Estudiantes de Medicina/psicología , Terrorismo/psicología , Adolescente , Adulto , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Masculino , Tamizaje Masivo , Pakistán/epidemiología , Encuestas y Cuestionarios
9.
J Pak Med Assoc ; 64(6): 649-52, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25252483

RESUMEN

OBJECTIVES: To determine the frequent factors in women and children subjected to sexual assaults seeking medical care at Jinnah Postgraduate Medical Center, Karachi. METHODS: A cross sectional study was conducted in the Medico legal Department of Jinnah Postgraduate Medical Center, Karachi, Pakistan. Sexual assault victims seeking medical care and medico legal reports from Jan 2007-June 2010 were included in the study. The sampling technique was non-probability purposive. All women were informed regarding the confidentiality of their records and written informed consent was taken. In case of female children the consent was taken from both parents/guardians. The data was analyzed on statistical package for social sciences version 15. RESULTS: There were 180 women and children examined and interviewed after the Sexual assault. The mean age (years) was 19.24 +/- 7.33. Mostly reported victims were raped and abused both 162 (90%) and only rape was reported in 18 (10%).The physical, local, Abdominal and Pelvic examination showed fresh act of violence in sexual assault victims in 83 (46.1%) cases. The sexual assault was confirmed in 75 (41.7%) cases. CONCLUSION: The fresh sexual assault acts confirmed in 41%. The frequent factors in women and children subjected to sexual assaults were adult women (18-40 Years), two third victims brought by police after 6-24 hours of rape, 90% reported both sexual assault and physical violence, in two third cases no weapon used and no external marks of body injuries observed.


Asunto(s)
Violación/estadística & datos numéricos , Violencia/estadística & datos numéricos , Adolescente , Adulto , Niño , Abuso Sexual Infantil/estadística & datos numéricos , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Pakistán/epidemiología
10.
J Pak Med Assoc ; 64(8): 980-2, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25252539

RESUMEN

Double outlet right ventricle (DORV) is characterised by arousal of the aorta and the pulmonary vessel from the right ventricle, and is always accompanied by a ventricular septal defect (VSD). Our patient, a twenty days-old female child, presented to the Paediatrics Unit I of Civil Hospital, Karachi, with complaints of generalised cyanosis and reluctance to feed since birth. Apart from the fact that the neonate was cyanosed with increased respiration, the physical examination was unremarkable. Two-dimensional echocardiography revealed two atrial septal defects (ASD), a ventricular septal defect (VSD) in the membranous area, continuous with primum ASD, resulting in an atrioventricular canal defect. The aorta was dilated with the pulmonary artery stenosis. The left ventricle was rudimentary, and both of the great vessels were arising from the dominant right ventricle. Despite the rarity, DORV with complex anatomy should be considered among the probable differential diagnoses for infants presenting with generalised cyanosis since birth.


Asunto(s)
Ventrículo Derecho con Doble Salida/diagnóstico , Defectos de la Almohadilla Endocárdica/diagnóstico , Estenosis de la Válvula Pulmonar/congénito , Estenosis de la Válvula Pulmonar/diagnóstico , Diagnóstico Diferencial , Resultado Fatal , Femenino , Defectos de los Tabiques Cardíacos , Humanos , Recién Nacido
11.
J Pak Med Assoc ; 64(5): 524-9, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-25272537

RESUMEN

OBJECTIVE: To review the articles published in the Journal of Pakistan Medical Association from 1953 to 2009 and to assess the components of each article by a pretested proforma containing a checklist of items based on modified 'Strengthening the Reporting of Observational Studies in Epidemiology' statement. METHODS: The retrospective study was conducted at the office of the Journal of Pakistan Medical Association, Karachi, from February to November 2010. A checklist of items in the modified 'Strengthening the Reporting of Observational Studies in Epidemiology' statement was made after discussion among the authors of the study to finally include a revised checklist of 45 items instead of the checklist of 22 items of the statement. A total sample size of 370 was calculated. Simple randomisation was done for selection of articles from each year. For each article, major and minor items were documented. Data was fed into SPSS version 15. RESULTS: The scientific quality of reporting of most of the components of Introduction, Results and Discussion sections have improved progressively with time (p < 0.001) whereas most components of Methodology have remained consistent. CONCLUSION: A change in trend over time was observed over the study period in major and minor items of the articles in the Journal, showing improved reporting of various sub-components of articles.The modified 'Strengthening the Reporting of Observational Studies in Epidemiology' statement provides a checklist that may be used to improve the quality of articles.


Asunto(s)
Publicaciones Periódicas como Asunto/tendencias , Bibliometría , Humanos , Pakistán , Estudios Retrospectivos , Sociedades Médicas
12.
J Pak Med Assoc ; 64(2): 230-6, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24640825

RESUMEN

OBJECTIVE: To compare the expected (perceptions of their environment at the beginning of their 1st year) versus actual perceptions (perceptions at the end of 1st year) of 1st year students at Dow University of Health Sciences. METHODS: The 'expected' perceptions of the students were recorded at the beginning of their 1st year (n = 411) of medical education when they entered the medical school using Dundee Ready Educational Environment Measure (DREEM). DREEM is a validated and self-administered inventory which focuses on learning, teachers, self-confidence and academic as well as social environment. The 'actual' perceptions were then recorded at the end of their first year (n = 405) of education when they had received adequate exposure of their environment. The 2 records were then compared. RESULTS: The total expected DREEM score was 118/200 and the total actual DREEM score was 113/200. The expected domain (Students' perceptions of learning, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of atmosphere, and students' social self-perceptions) scores were 28/48, 26/44, 20/32, 28/48, and 16/28. The actual domain scores were 27/48, 23/44, 19/32, 27/48, 16/28. However both the actual and expected scoring displayed satisfactory environment for learning. Significant differences (p < 0.0001) were found in the two samples. CONCLUSION: In general the results displayed that the students perceived the environment positively but the significant difference found in the two samples, demonstrated that their expectations were not met.


Asunto(s)
Actitud del Personal de Salud , Educación de Pregrado en Medicina/métodos , Ambiente , Percepción , Estudiantes de Medicina/psicología , Estudios Transversales , Evaluación Educacional , Femenino , Humanos , Aprendizaje , Masculino , Estudios Retrospectivos , Facultades de Medicina , Medio Social , Encuestas y Cuestionarios
13.
Educ Health (Abingdon) ; 26(2): 117-21, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24200734

RESUMEN

CONTEXT: Previously, in a low-income country with limited resources like Pakistan, biomedical research was conducted mostly by individuals working in private organizations. Recently, there has been an upsurge in the number of medical students conducting research in both private and public medical colleges of Karachi, Pakistan. We investigated student perceptions of the reasons behind the increase in biomedical research among medical students of private and public medical colleges in Karachi, Pakistan. METHODS: This cross-sectional study was conducted at four medical universities of Karachi, using structured data collection tool. Participants included medical students who stated that they were interested in medical research. We assessed how many had been involved in research or stated that they intended to be, and tallied students' stated reasons why they were involved in research. Chi-square analyses were used to assess if year of training, institution, and other factors were associated with the likelihood of past or current actual research involvement. RESULTS: Out of the 398 students with research interest who participated in the study, 349 (88%) stated that they intended to do research projects in their undergraduate years. At the time of the study, only 202 (51%) reported that they had actually conducted research. The reasons given for engaging in research for a minority included personal interest (n = 136; 34%), while majority stated that their motivation was to improve their curriculum vitae (75%) and/or to be more competitive for a residency in the United States (43%). The reasons students gave for involvement in research were related to whether their schools were public versus private and to their year of study. DISCUSSION: According to students' reports, improving one's curriculum vitae to get a strong residency in the USA appeared to be a principal reason for the increase in biomedical research in Karachi. The challenges of research, such as lack of good mentors and increased work-load were reported to affect few students' ability to engage in research.


Asunto(s)
Investigación Biomédica/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos , Estudios Transversales , Países en Desarrollo/estadística & datos numéricos , Educación Médica/estadística & datos numéricos , Humanos , Motivación , Pakistán/epidemiología , Estudiantes de Medicina/psicología
15.
J Pak Med Assoc ; 63(4): 448-53, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23905439

RESUMEN

OBJECTIVE: To evaluate the distinct histopathological changes of chronic hepatitis C (CHC) non-responders in association with viral genotypes. METHODS: This cross-sectional study was conducted at the histopathology section of the Dow Diagnostic Research and Reference Laboratory, Dow University of Health Sciences in collaboration with Sarwar Zuberi Liver Centre, Civil Hospital, Karachi from September 2009 to August 2011. Seventy-five non-responders (end-treatment-response [ETR] positive patients) from a consecutive series of viral-RNA positive CHC patients with known genotypes were selected. Their genotypes and pertinent clinical history was recorded. They were subjected to liver biopsies which were assessed for grade, stage, steatosis, stainable iron and characteristic histological lesions. RESULTS: Majority of the patients (63, 84%) had genotype 3 while 12(16%) cases had genotype 1. The genotype 1 patients had significantly higher scores of inflammation (p < 0.03) and fibrosis (p < 0.04) as compared to genotype 3. Steatosis was significantly present in all genotype 3 patients in higher scores (p < 0.001) compared to genotype 1. Stainable iron scores were generally low in the patients in this study, however, it was more commonly seen in genotype 3.The distribution of characteristic histological lesions was noteworthy in both the groups, irrespective of genotype. CONCLUSION: In this series, the predominant genotype was 3. However, genotype 1 patients were more prone to the aggressive nature of the disease with significantly higher scores of inflammation and fibrosis. Steatosis was characteristically observed in genotype 3 group. Stainable iron could not be attributed as a cause of non-response.


Asunto(s)
Hígado Graso/patología , Hepacivirus/genética , Hepatitis C Crónica/patología , Cirrosis Hepática/patología , Hígado/patología , Adulto , Antivirales/uso terapéutico , Biopsia , Hígado Graso/virología , Femenino , Genotipo , Hepatitis C Crónica/tratamiento farmacológico , Hepatitis C Crónica/virología , Humanos , Hierro/metabolismo , Hígado/metabolismo , Hígado/virología , Cirrosis Hepática/virología , Masculino , Persona de Mediana Edad , Insuficiencia del Tratamiento , Adulto Joven
16.
J Pak Med Assoc ; 63(12): 1566-70, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24397113

RESUMEN

OBJECTIVE: To investigate the causes for loss-to-follow-up of hepatitis patients at a liver centre of a tertiary care hospital. METHODS: A representative sample of 165 patients who were lost to follow-up during 2009 to 2010 was chosen and a cross-sectional descriptive study was performed. All hepatitis patients included were screened for antibody to hepatitis C virus (HCV Ab) and hepatitis B virus surface antigen (HbsAg), and were tested through polymerase chain reaction (PCR) and genotyping. Laboratory investigations, ultrasounds, personal habits, visits to hakeems and use of other alternative medications, occupations and income per month, education, and other basic information was also recorded. Those who did not return for follow-up were contacted and inquired about their reasons for loss-to-follow-up. Based on this data, the patients were categorised into four different groups according to reasons of loss to follow up: non-compliance, alternative medication, monetary issue and poor prognosis. RESULTS: The entire sample size of 165 patients who were lost to follow-up was included in the study. 14 (8.5%) patients were hepatitis B virus (HBV) positive. Of these patients, 1 (7.1%) was lost due to alternative medication and the rest (n=13; 92.9%) were lost to follow-up due to non-compliance. Amongst the 151 (91.5%) hepatitis C virus (HCV) positive patients, 2 (1.3%) were lost due to monetary issues, 17 (11.3%) were lost due to alternative medication, 4 (2.6%) were lost due to poor prognosis and 128 (84.8%) were lost due to non-compliance. CONCLUSION: This study shows that most patients were lost to follow-up due to non-compliance. It is important for physicians to design better counselling programmes to make the patient compliant enough to go through the complete treatment.


Asunto(s)
Hepatitis B/epidemiología , Hepatitis D/epidemiología , Perdida de Seguimiento , Adulto , Estudios Transversales , Femenino , Hepatitis C/epidemiología , Humanos , Masculino , Pakistán/epidemiología , Reacción en Cadena de la Polimerasa , Atención Terciaria de Salud
17.
J Pak Med Assoc ; 63(1): 143-7, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23865156

RESUMEN

OBJECTIVE: To assess the trend of attendants accompanying inpatients and its effect on a tertiary care hospital in Karachi. METHODS: A cross sectional study was carried out at CHK, through interview-based questionnaires targeting three groups of interest viz. patients admitted in the wards and stable enough to answer questions appropriately, attendants residing at CHK premises and heads of hospital departments or administrative Resident Medical Officers. RESULTS: Out of 281 patients, 149 (53.03%) had only one attendant staying with them, 74 (26.34%) had two, 39 (13.88%) had more than two and 19 (6.76%) had none. Out of 240 attendants, 204 (85%) planned to stay within the hospital till discharge of their patient while 24 (10%) till a week and 12 (5%) for two weeks. Out of 21 administrative heads, 18 (85.71%) faced problems due to presence of extra attendants and 3 (14.29%) did not. However, all 21 (100%) agreed that there were risks associated with presence of too many attendants; which were financial burden 13 (61.9%), infections 14 (66.67%), physical violence 11 (52.38%), disturbance of hospital sanctity 13 (61.91%), and crimes 10 (47.62%). CONCLUSION: Our study suggested that there was a significant trend for patients to be accompanied by multiple attendants at CHK. Although hospital did not have to provide food and shelter to them, but their presence in large numbers was in violation to hospital protocols. In view of the hospital administration multiple attendants caused hindrance in duties of staff and posed infections and security risks.


Asunto(s)
Hospitalización , Hospitales Públicos , Atención Terciaria de Salud , Visitas a Pacientes , Actitud del Personal de Salud , Estudios Transversales , Humanos , Pakistán
18.
J Pak Med Assoc ; 63(3): 414-8, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23914656

RESUMEN

OBJECTIVE: To study the factors associated with the risk of preterm birth among local population of Karachi, Pakistan. METHODS: This case control study was carried out on all those patients who were admitted in the post-partum wards of Civil Hospital and Abbasi Shaheed Hospital Karachi, during the period of January to May 2011. A total of 600 patients were part of this study. All those women who had preterm delivery (delivery at <37 weeks of gestation) were grouped together as case-group (n=300), while women who had term delivery (delivery ?37 and <42 weeks of gestation) were grouped as control-group (n=300). Data was collected by the help of a questionnaire which included questions related to the previous and current gestational history of the mothers, their nutritional status, drug addictions, urogenital, dental or systemic diseases they suffered, along with any physical or emotional stress they experienced during pregnancy. Last menstrual period and ultrasound reports were brought into use to calculate the precise gestational age of the baby. Data collected from the two groups were then compared to find out the possible risk factors of preterm delivery. RESULTS: A total of 600 subjects were divided into two equal groups of cases (n=300) and controls (n=300). There were 30 (10%) patients in the case-group and 33 (11%) patients in the control-group who were above 35 years of age (p<0.05). At the time of delivery, 111 (37%) cases and 51 (17%) controls weighed <50 kg (p <0.01). There were 264 (88%) cases and 117 (39%) controls with a haemoglobin level <10 gm/dL (p <0.01). In the case-group, 15 (5%) patients had a history of previous multiple preterm deliveries, 24 (8%) had one previous preterm delivery, and 261 (87%) had no previous preterm delivery. In the control-group, no patient had a history of multiple preterm deliveries, 15 (5%) had one previous preterm delivery, and 285 (95%) had no previous preterm deliveries (p<0.05). Common symptoms experienced in the gestational period in the case-group were dizziness/weakness (228; 76%), pain/malaise (213; 71%) and emotional stress such as anger (207; 69%). In the control-group the distribution was as follows: dizziness/weakness (168; 56%), emotional stress such as anger (165; 55%) and pain/malaise (141; 47%) (p<0.01). In the case-group, 69 (23%) women consumed fish, milk and pulses on a weekly basis, 177 (59%) on a monthly basis, and 54 (18%) did not take them at all. In the control-group, 174 (58%) patients consumed fish, milk and pulses on weekly basis, 90 (30%) on a monthly basis, and 36 (12%) did not take them at all (p<0.01). About 66 (22%) patients from the case-group and 21 (7%) in the control-group had evidence of periodontal disease on physical examination (p<0.05). CONCLUSION: Low maternal weight, multiple previous preterm deliveries, periodontal diseases, maternal anaemia, physical and emotional stress are among the factors associated with the risk of preterm birth among the local population delivering in tertiary care, governmental hospitals of Karachi, Pakistan.


Asunto(s)
Nacimiento Prematuro , Adulto , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Femenino , Humanos , Recién Nacido , Modelos Logísticos , Pakistán/epidemiología , Embarazo , Factores de Riesgo , Encuestas y Cuestionarios
19.
J Pak Med Assoc ; 63(2): 289-94, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23894919

RESUMEN

OBJECTIVE: To evaluate the relationship between diet and socioeconomic conditions and find out the prevalence of stress and Hypertension in different socioeconomic classes. METHODS: A cross-sectional study was conducted from May 2010 to October 2011, 176 people from four different socio economic Strata (low class, low middle class, upper middle class, and high class) were selected, which were defined on the basis of monthly income. Complete dietary intake was assessed with the last 3 days' dietary record, dietary patterns and restrictions. Background information and Stress level were evaluated by a preformed questionnaire and blood pressure was taken with the aneroid manometer. RESULT: A total of 176 people were interviewed for diet, blood pressure and stress was measured. The High socioeconomic Stratum was found to have the highest number of people having hypertension 15 (27.8%), taking medications 21 (38.9%), 18 (33.3%) multi vitamin supplements, and with an overall lower calorie intake 1617.31 +/- 698.99 as compared to other strata. It also had the highest number of people who thought they were active 44 (81.5%). The High middle Socioeconomic Stratum was similar with the High class, in having the most hypertensive people 10 (27.8%) and they had least chance of developing stress related health illnesses 6 (16.7%). Individuals living below poverty line had the highest prevalence ratio of stress 16 (36.4%) and they were considered as least physically active 30 (68.2%). CONCLUSION: Highest frequency of Hypertension was in high class and high middle income group. The low class had the highest ratio of stress. There was a difference in type of food, but not much in calorie intake.


Asunto(s)
Conducta Alimentaria , Hipertensión/epidemiología , Clase Social , Estrés Psicológico/epidemiología , Adulto , Registros de Dieta , Ingestión de Energía , Humanos , Persona de Mediana Edad , Pakistán/epidemiología , Prevalencia , Adulto Joven
20.
J Pak Med Assoc ; 63(6): 798-802, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23901694

RESUMEN

OBJECTIVES: To determine the seroprevalence of human immunodeficiency virus, hepatitis B and C, and to study the associated risk factors in garbage scavengers of Karachi. METHODS: The cross-sectional study was performed in a colony inhabited by low socioeconomic garbage-collecting people. Data was collected from April to December 2011. After informed consent and pre-test counselling, a set of questions were asked from a questionnaire, and 5cc of blood was drawn for pathological testing. SPSS 18 was used for statistical analysis. RESULTS: A total of 141 males agreed to participate in the study with a mean age of 21.33+/-9.28 years. Most of the respondents (n=67; 47.5%) were in the age group 11-20 years; 86 (61%) were single; 89 (63%) were illiterate and 127 (90%) had a monthly income less than Rs.10,000. Prevalence of hepatitis B was 18.8% (n=22), followed by 8.5% (n=10) and 0.85% (n=1) of hepatitis C and HIV respectively. Besides, 108 (77%) collected needles/syringes and 76 (54%) got pricked more than once. Only 23 (16%) wore gloves while collecting garbage. Overall, 79 (56%) had a history of sexual contact; 18 (23%) had three or more partners. CONCLUSION: The important factors contributing to the high prevalence of hepatitis B and C were needle prick injuries, bare-handed/bare-footed collection of garbage, poor vaccination status, improper garbage disposal system and the site of waste collection.


Asunto(s)
Residuos de Alimentos , Infecciones por VIH/epidemiología , Hepatitis B Crónica/epidemiología , Hepatitis C Crónica/epidemiología , Exposición Profesional/efectos adversos , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Pakistán/epidemiología , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Estudios Seroepidemiológicos , Encuestas y Cuestionarios , Adulto Joven
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