THE QUANTITATIVE EVIDENCE OF MALARIAL TRANSMISSION AND ITS ASSOCIATES IN BAHAWALPUR, PAKISTAN.

BACKGROUND: Malaria transmission is an extremely complex condition that is manifested differently in different parts of the world. In Pakistan, malaria is still endemic in many areas. Plasmodium vivax and Plasmodium falciparum are identified to be the most prevalent species of malaria in-Pakistan. A great deal of work regarding malarial transmission is available at regional level in Pakistan but the evidence of malaria with its associates in Bahawalpur is scarce. The present study was planned to see the pattern of malarial transmission in the city of Bahawalpur, Pakistan. METHODS: In this cross-sectional study data on 1623 subjects was collected. Giemsa stain thick and thin blood films were used as diagnostic tools for malarial transmission. Bivariate statistical analysis in addition was employed to identify the associates of malarial prevalence. RESULTS: Out of 1623 subjects screened, 70 (4.3%) were found infected. Plasmodium vivax was seen in the majority 61 (77.2%). Plasmodium falciparum was the second common-species identified in 16 (22.8%) cases. As expected place of residence, window screening, malarial knowledge and behaviours of sleeping were seen to be significant associates of malarial transmission in Bahawalpur. CONCLUSION: The findings revealed that Bahawalpur falls in the category of low to moderate level malarial transmission as compared to other regions of Pakistan. Plasmodium vivax was the commonest type of malaria diagnosed in Bahawalpur. Geographic location, house safety, malarial knowledge, and behaviour of sleeping are the highly significant associates of malarial transmission in Bahawalpur.

Modelling survival data of thalassaemia patients in Pakistan.

BACKGROUND: Fatimid Foundation with its centers serves as a charitable organization for millions of blood disease carriers in Pakistan. This retrospective survival study is an analysis of the Thalassaemia patients registered in Multan centre who are followed up to nine years to assess the gender risk of death. METHODS: Data on 120 patients of Thalassaemia during 1994-2002 was analyzed. The standard Kaplan-Meier and Nelson-Aalen procedures were used to compare the survival function of the male and female patients of Thalassaemia. The statistical significance was also assessed using log rank test. The Cox Proportional Hazards (PH) model using a forward selection procedure was used to identify the potential factors associated with the increase risk of death. RESULTS: By ignoring the censoring, the average survival time of males and females were calculated to be 1308.1 and 1574.7 days respectively. The average hazard rate for the female group was 0.00033 and for the male group it was 0.00061. The median survival time was estimated from the Kaplan-Meier survival curves (Males: 1400 days, Females: 1785 days). Under the censoring mechanism, the mean survival time for males was calculated to be 1465.82 days with standard error of 146 days, where as for females it was calculated to be 1855.26 with standard error of 151.82 days. When considering death as event of interest Under the Cox modelling approach, we found a male patient of Thalassaemia was 1.484 times more likely to die when compared to his female counterpart. When considering the iron over load as the event of interest, we found a male patient of Thalassaemia was 1.753 fold more likely to reach excessive Haemochromatosis level compared to female patient. CONCLUSION: The analysis reinforces that female group prognosis is better than the male group. Further, our analysis of real survival data set shows that the high status of Haemochromatosis level is associated with the increased risk of death in patients with Thalassaemia with other possible confounders.

Pattern of Vitamin D among Pakistani Pregnant Women.

Vitamin D deficiency is an emerging health concern around the world, highly prevalent in south Asian population, despite abundant sunlight. In Pakistan, all age groups are vulnerable to Vitamin D deficiency including pregnant women. This systematic review aimed to determine the pattern of Vitamin D deficiency among Pakistani pregnant women as well as exploring the causes and possible interventions that have had a substantial effect on improving the vitamin D level. Three databases (PubMed, Pub Get and Google Scholar), for the present review up to 2016, were used for the identification of published peer reviewed original relevant studies regarding Vitamin D deficiency among Pakistani pregnant women with the keywords Vitamin D or 25-hydroxyvitamin D or 25(OH)D in combination with pregnant women. Five studies were included for the final analysis. Vitamin D deficiency was common and highly prevalent among Pakistani pregnant women and their neonates. The main reasons for this were found to be avoiding sun exposure, quality of diet, and lower intake of calcium. Maternal vitamin D supplementation was found to be a key intervention to improve the maternal and neonatal vitamin D status. These review findings can be emerging in ensuring the adequate vitamin D level for Pakistani pregnant women during pregnancy, ultimately to achieve positive maternal and neonate's health outcomes.

Job satisfaction among doctors working at teaching hospital of Bahawalpur, Pakistan.

BACKGROUND: Doctor's profession has long been among one of the most attractive professions in Pakistani society, but doctors are increasingly getting dissatisfied with their jobs. The focus of this study is to point out the most prominent factors of job dissatisfaction among doctors working at Bahawal-Victoria Hospital / Quaid-e-Azam Medical College, Bahawalpur. METHODS: A questionnaire was mailed to a random sample of 60 out of 244 doctors working at Bahawal-Victoria Hospital / Quaid-e-Azam Medical College, Bahawalpur. Questions included satisfaction with respect to designation, income, service structure, career prospects etc. RESULTS: Overall 56% doctors were not satisfied with the level of their income. It is found that 92% of all the doctors were neither satisfied with the present service structure nor with the career prospects in Pakistan. Further, 78% of the doctors would like to serve abroad. Main factors contributing towards job satisfaction were designation and working environment whereas service structure turned out to be the source of dissatisfaction. CONCLUSIONS: Most of the doctors in all ranks and with different qualifications were not found satisfied with their job due to lack of proper service structure and low salaries.