Needle stick injuries among health care workers of public sector tertiary care hospitals of Karachi.

OBJECTIVE: To estimate the frequency of needle stick injuries (NSI) among health care workers (nurses, student nurses and paramedical staff) in public hospitals of Karachi. STUDY DESIGN: Cross sectional, observational. PLACE AND DURATION OF STUDY: This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008. METHODOLOGY: Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was entered in Epi Data and analyzed in SPSS version 15. RESULTS: A total of 417 health care workers participated in the study. Mean age of the participants was 24+/-11 years. Estimated proportion of participants with history of at least one time NSI was found in 66%. Around 13% (n=54) had one or more NSI in the previous one month at work and half of them were affected by non-sterile needle. None of them sought medical care. Almost 90% of them were not wearing gloves or taking any other protective measures at the time of injury. CONCLUSION: There can be serious consequences of needle stick injuries in public hospitals as large proportion of injuries involve non-sterile used needles and health care workers do not take appropriate measures of protection.

Drinking water contamination by chromium and lead in industrial lands of Karachi.

OBJECTIVES: To identify and quantify chromium and lead as contaminant in water sources of Karachi. METHODS: This water assessment survey was conducted from June 2007 to February 2008 in all the 18 towns of Karachi. In total 216 water samples were collected from ground (n=108) and surface water sources (n = 108). Water samples were collected in a liter polyethylene acid resistant bottle with extreme care to prevent contamination and concentrations of heavy metals (chromium and lead). Metallic ion contents were estimated by Atomic Absorption Spectrophotometer. Statistical analysis was done by applying T-test and chi-square for continuous and categorical variables respectively at 95% confidence level; Pearson correlation was also determined between chromium and lead concentrations. RESULTS: A total of 187 water samples had lead concentration higher than the maximum acceptable concentration (MAC) in drinking water, established by WHO (10 PPB) and lead contaminated sources were in significantly higher proportion than chromium contaminated water samples (n = 49) [chi2 = 128; P- < 0.001]. Mean chromium concentration in ground water was (micro = 49; SE = 3.8) was significantly higher than mean chromium concentration (micro = 33, SE = 3.5) in surface water (P = 0.003). There was a significant and positive correlation between chromium and lead concentrations in ground water (P = 0.04) however Pearson correlation was not significant for surface water (P = 0.6). Industrial towns (Korangi, Landhi and SITE) had significantly higher concentration of chromium (micro = 82.4; SE = 8.9) in their ground and tap water as compared to the mean chromium concentration (micro = 33; SE = 2.2) in the water samples of rest of the towns of Karachi (P < 0.001). CONCLUSION: Chromium and Lead levels are high in almost all ground water sources, however extremely high concentrations were found in industrial areas. Presence of any one of the heavy metal contamination necessitate the need for the estimation of other heavy metals as significant positive correlation was found between chromium and lead concentration, indicating the possibility of similar contamination sources in Karachi.

Psychiatry as a career: a survey of factors affecting students' interest in psychiatry as a career.

The objectives of this study were to determine the characteristics of medical students and graduates interested in choosing psychiatry as a career and the obstacles in choosing this field of medicine. Two private and two public medical institutes were surveyed from June 2007 to August 2007. A self-administered questionnaire was distributed to third, fourth and final year students and to medical graduates doing their internship in these four medical institutes. A total of 909 medical students and graduates participated in the study. Seventeen percent of participants responded positively regarding their interest in psychiatry as a career. Significantly higher proportion belonged to private medical institutes (14% vs. 24%, P-value =0.001). There was no significant difference in reporting interest for psychiatry in regard to age, sex, year in medical school and whether or not the participant had done a psychiatry ward rotation. However significantly higher proportion of participants (22%, n=43) were reporting their interest in the field of psychiatry who had done more than a month long psychiatry ward rotation as compared to those participants (14%, n=54) with less than a month or no psychiatry rotation (P-value=0.01). More students were reporting their interest in psychiatry with a family history of psychiatric illness as compared to without family history (24% vs 16%, P-value=0.03). In conclusion, students and graduates with more than a month long rotation in psychiatry, studying in private medical colleges and with a family history of psychiatric illness were more interested in choosing psychiatry as a career.

Non-fatal limb injuries in motorbike accidents.

OBJECTIVE: To determine frequency and pattern of non-fatal limb injuries in motorbike accidents victims. STUDY DESIGN: Cross-sectional observational study. PLACE AND DURATION OF STUDY: Study was conducted at Jinnah Postgraduate Medical Centre (JPMC), Karachi, from October 2006 to March 2007. METHODOLOGY: Trained data collectors prospectively collected data from the emergency department of JPMC, Karachi using structured pre-tested questionnaires. All motorbike accident victims presented to Emergency department with single or multiple bone injury in body extremities were included. Head injury patients who had first presented to neuro-surgery department were excluded. Motorbike accident victims with soft tissue injuries were also excluded from this study. Chisquare test was applied to find out statistical significance at 95% confidence level. P-value < 0.05 was considered as significant. RESULTS: A total of 137 (39%) patients presented with tibial injury among the study sample of 348 patients, which was significantly higher than the bone injuries of the body part (p<0.001). Out of those, in 26% of patients, fibula was also involved along with tibia fracture. Other bone injuries included femur (16%), radius (9.2%), humerus (8.3%) and others. Radius was the commonest injured bone and in highest proportion among upper limb injuries (p<0.001). Overall, 66% of the injuries in motorbike involved lower limb fractures. The highest proportion of motorbike accidents were observed on Saturdays (31%). Majority of the accident victims were in the age group between 16 and 30 years (41% accident cases), 27% in age group 30 to 45 years, 15% in 45 to 60 years and 5% in >60 years. Those with less than 15 years accounted for 12% of cases. CONCLUSION: Tibial bone is at the greatest risk in motorbike accidents probably due to its superficiality and exposed position while riding motorbike. Protective measures need to be taken for the prevention of disability associated with lower limb involvement in motorbike accidents.