Reasons for failure to quit: a cross-sectional survey of tobacco use in major cities in Pakistan.

BACKGROUND: Tobacco dependence has been defined as a chronic relapsing disease. Around 5 million annual tobacco-related deaths have been reported worldwide. The majority of smokers want to quit but are not successful. OBJECTIVES: To screen our population for tobacco use, gauge the baseline demographics of tobacco users and assess factors associated with failed attempts to quit. METHODS: Free health camps supervised by a physician were held across two major cities of Pakistan. All consenting participants were administered a questionnaire and had their exhaled carbon monoxide (CO) levels measured. RESULTS: Of 12 969 participants successfully enrolled, the mean age was 31.4 ± 10.0 years. More than three quarters were aged 20-40 years (n = 10 168, 78.4%). The overall average CO level was 12.0 ± 8.0 ppm. The majority of the participants wanted to quit, and nearly everyone had received advice about quitting. The majority had tried smoking cessation pharmacotherapy. Friends/peer pressure (n = 1554, 12%), anxiety (n = 681, 5.3%), tobacco dependence (n = 1965, 15.2%) and stress/mood changes (n = 390, 3.0%) were the most widely observed reasons for failure to quit in study participants. CONCLUSION: The information provided by this study can guide the development of more targeted intervention programmes for smokers who wish to quit.

Energy recovery from grass using two-phase anaerobic digestion.

Municipal solid wastes are major sources of air, water and soil contamination. There is a need for alternative waste management techniques to better utilize the waste and minimize its adverse environmental impact. A two-phase pilot-scale bio-fermentation system was used to evaluate the feasibility of producing methane from grass waste, a major constituent of solid wastes. The bi-phasic system consists of a solid phase and a methane phase. Leachate is re-circulated through the solid phase until a desired level of volatile fatty acid (VFA) is accumulated in the leachate. The leachate is then transferred to the methane reactor where the VFA is converted to methane. The results showed that 67% of the volatile solids in the waste can be converted into soluble chemical oxygen demand in a period of six months. The system produced an average of 0.15 m3 of methane per kg of grass. The average methane concentration in the produced gas was 71%. A mathematical model was developed to estimate the methane and carbon dioxide concentrations in the gas phase as a function of reactor properties.

Perception about family physicians: results of a survey of patients visiting specialist clinics for treatment.

OBJECTIVE: To study the perceptions about Family Medicine among patients visiting Specialist Physicians for treatment. METHOD: A questionnaire based survey was conducted at the Specialist Clinic, Aga Khan University Hospital, Karachi, Pakistan, in June 2004. Trained volunteers administered the questionnaire among patients visiting Specialist Physicians for treatment. Confidentiality was ensured to all patients and written informed consent was taken as part of the ethical requirements for the conduct of the study. SPSS computer software and Microsoft Excel were used for data management. RESULTS: A total of 100 patients visiting the Specialist Clinic were interviewed, of which fifty four (54%) were women and forty six (46%) were men. The mean age was 36.3 years. Twenty four (24%) respondents had graduate education. Being well-mannered, being familiar with a family's medical history and possessing the abilities to conduct proper checkups were quoted as main characteristics of Family Physicians by thirty eight (38%), seventeen (17%) and twenty five (25%) respondents respectively. If they had a chest pain, fifty six (56%), forty three (43%) and one (1%) respondents would consult a Family Physician, Cardiologist and Chest Specialist, respectively. CONCLUSION: We have documented perceptions regarding family medicine among patient's visiting Specialist Physicians for treatment. It is recommended that programs highlighting role and functions of family medicine should be started for the public.