Assessment of frequency, risk category and intervention needs in psychoactive drug users by using WHOASSIST Questionnaire among medical students in Karachi.

OBJECTIVE: To determine the frequency of use of various psychoactive drugs among medical students in an urban setting, and to assess the risk category and intervention needs. Methods: The descriptive cross-sectional study was conducted from January to June 2018 at four medical education institutions of Karachi; 2 each randomly selected from registered public and private sectors. From the clinical classes of each institution, fourth year was randomly chosen by lottery method. Data was collected using the Alcohol, Smoking and Substance Involvement Screening Test version 3.0. Data was analysed using SPSS 20. RESULTS: Of the 445 respondents, 270(60.7%) were male and 175(39.3%) were females. The overall mean age was 21.3±1.7 years (range: 17-27 years). Of the total, 273(61.3%) had never used any psychoactive substance, 97(21.8%) had used at least one, 34(7.6%) at least two, 23(5.2%) three, while 18(4%) had tried four or more psychoactive drugs in their lifetime. The most commonly used drug was tobacco, reportedly used by 117(26.3%) respondents, and, among them, 40(34%) were in low risk/no intervention category, 71(60.6%) in moderate risk/brief intervention category and 6(5.1%) in high risk/intensive treatment category. The use of psychoactive drug was significantly more in male compared to female students(p<0.05). CONCLUSIONS: Tobacco was the most commonly used psychoactive drug among medical students though the use of cocaine, cannabis, alcohol, amphetamine, inhalants and sedatives was also significant. Psychoactive drug use was more common in males compared to females.

Effect of antenatal counselling on early initiation of breastfeeding, an interventional study at two Federal Hospitals, Islamabad Pakistan.

OBJECTIVE: To determine the effect of antenatal counselling at term on early initiation of breastfeeding. METHODS: The prospective, questionnaire-based study was conducted at two state-run hospitals in Islamabad, Pakistan, from July to December 2016. One hundred subjects at the Federal General Hospital represented intervention group A and received special antenatal counselling regarding benefits of early initiation of breastfeeding, while 100 subjects at the Islamabad Polyclinic formed control group B and received routine counselling. Data was analysed using SPSS Version 20. RESULTS: Of the 200 subjects initially enrolled, 185 were included in the data analysis , 91 in the intervention group (A) and 94 among the control group (B) and Rest were excluded due to missing data. In group A, 46 (50.5%) women initiated breastfeeding within one hour of childbirth, while in group B 17 (18.08%) women did early inititation (p <0.001). CONCLUSION: Counselling was seen to be associated with early initiation of breastfeeding.

Relation between Depressive Disorder and Iron Deficiency Anemia among Adults Reporting to a Secondary Healthcare Facility: A Hospital-Based Case Control Study.

OBJECTIVE: To determine the relationship between iron deficiency anemia and depressive disorder; and identify the correlation between severity of anemia and depressive disorder. STUDY DESIGN: Descriptive, analytical study. PLACE AND DURATION OF STUDY: Department of Psychiatry and Medical Reception Center, Sindh Rangers Hospital, Karachi (a secondaryhealthcare facility), from January to July 2017. METHODOLOGY: Depressive disorder was diagnosed by psychiatrist on ICD 10 criteria and severity of symptoms was assessed on HAM-D rating scale. Hundred cases and equal number of age and gender matched controls were enrolled in the study. A semi-structured proforma was used for documenting the socio-demographic factors and outcome variables. Blood samples were taken for Hemoglobin (Hb) level and peripheral film from both groups. RESULTS: Median Hb levels were 11.9 (IQR=1.27)) for depressed patients versus 12.9 (IQR=1.3) for healthy participants. Significant difference between Hb levels of two groups was found (p<0.001), i.e. depressed participants were found to have higher frequency of anemia (73%) as compared to non depressed participants (16%, p=0.001). Spearman rank correlation coefficient for Hb level and depression was -0.429 (p<0.01), showing significant negative correlation. The odds for Hb level were 0.487 (0.37-0.64), which showed that cases are less likely to be found with higher Hb levels as compared to controls (p<0.001). CONCLUSION: This study concludes that there is relationship between iron deficiency anemia and depressive disorder; and severity of symptoms of DD increases with degree of IDA.