Beliefs about causes of psychotic disorders and subsequent help-seeking behaviour in caregivers presenting at the Department of Psychiatry, Civil Hospital, Karachi.

OBJECTIVE: To assess the beliefs about causes of psychotic disorders and subsequent help-seeking behaviour in caregivers. Methods: The descriptive cross-sectional study was conducted at the Department of Psychiatry, Civil Hospital, Karachi, from September 2020 to February 2021, and comprised caregivers of patients with psychotic disorders. Data was collected using a questionnaire that was filled up by caregivers mentioning their beliefs about the cause of the disorder and subsequent help-seeking behaviour. Data was analysed using SPSS 22. RESULTS: Of the 162 participants, 69(42.6%) were male and 93(52.4%) were female. The overall mean age was 39.9+12.9 years. The majority 157(96.9%) subjects were Muslims. In terms of beliefs, anxious personality 62(38.3%), evil eye 62(38.3%) and God's will 56(34.6%) were the major choices picked. With respect to help-seeking behaviour, the choices most picked were taking the patient to a psychiatrist 129(79.6%), praying 108(66.6%) and taking the patient to a family physician 103(63.6%). CONCLUSIONS: There was found to be sufficient awareness among the caregivers, but help-seeking behaviour needed to improve considerably.

A survey of violence and vulgarity in children television programmes: A content analysis, and assessment of perceptions of parents and children (ViCTiM study).

OBJECTIVE: To quantify the depiction of violence and vulgarity in television programmes for children, and to assess the perception and practices of parents and children about television programmes meant for children. METHODS: We conducted this mixed-methods cross-sectional study in Karachi, Pakistan in the months of August-September 2018, after approval from the ethics review board of Dow University of Health Sciences, Karachi. First, a content analysis of over 102 hours of various television programmes meant for children was performed in the light of the guidelines set out by the World Health Organisation, the United States Federal Communication Commission and the Pakistan Electronic Media Regulatory Authority. Seven trained researchers sampled the children prime time throughout a week, including the weekends, using a structured tally sheet. Subsequently, interviews were conducted with dyad of parent-children from the employees' list of a public-sector university. A questionnaire was also administered to assess the practices and perceptions of the parents-children dyad about the programmes. Data was analysed using SPSS 24. RESULTS: Of the 173 subjects, 84(48.6%) were parents and 89(51.4%) were children. The mean age of the children was 9.8±3.7 years. Content analysis comprised 6130 minutes, of which 5442(88.8%) had depictions of violence and vulgarity. Depiction of violence and vulgarity was prevalent on television channels that were watched the most, but there was no significant difference in this regard (p=0.238). Of the parents, 68(81%) expressed concern over the effect of screen time and content on the mental health of their children. CONCLUSIONS: Television programmes meant for children were found to be inappropriate with seriously high proportion of violence and vulgarity in their contents.

Behavior and Practices of Type 2 Diabetic Patients Regarding Obesity: A Cross-Sectional Study.

Background Obesity is a major public health concern and is associated with incident cardiovascular diseases. A very few studies around the globe have assessed how type 2 diabetic (T2D) patients comprehend obesity. Our study aims to evaluate the concerns and behaviors of T2D patients regarding obesity in a developing country like Pakistan. Methods A cross-sectional study was conducted in Karachi during the period of December to February 2020 in which T2D patients were assessed for their comprehension of how obesity affects their disease and concerns, as well as their practices such as weight loss activities and dietary habits. Data analysis was performed using Statistical Package for the Social Sciences Version 24 (IBM Corp., Armonk, NY, USA). Results Of 417 T2D patients inducted in our study, 265 (63.5%) knew their ideal body weight, whereas only 221 (52.9%) knew how to measure it. Among those who were willing to lose weight, this was mostly due to a wish to avoid further complications of obesity (N=155 [73.1%]) and also peer/family pressures (N=124 [58.5%]) among other reasons. More obese (N=68 [43.6%]) than non-obese participants (N=87 [33.3%]) were willing to consult a doctor to help them reduce weight. Participants had adopted various strategies to reduce weight, of which increasing exercise (N=242 [85.8%]) and healthy eating (N=162 [57.4%]) were most popular. Conclusions There is a need to address barriers to weight loss among T2D patients in Pakistan and to provide patients with pragmatic guidelines on how to make sustainable lifestyle changes to help reduce and maintain their body weight.

Type 2 Autoimmune Hepatitis in a Male Patient with a Rare Complication of Vasculitis.

Autoimmune hepatitis (AIH) is chronic inflammation of hepatocytes due to immune cells attacking the patient's own hepatocytes, histologically characterized by interface hepatitis. The disease can be serious, and if left untreated, it can lead to cirrhosis of the liver and eventual liver failure. It occurs more frequently in females. The standard treatment for AIH includes corticosteroids. There are two main treatment regimens, which include either prednisolone alone or prednisone and azathioprine. Although, liver transplantation is certainly the treatment of choice, it has not yet been established on a large scale worldwide. We present here the case of a 22-year-old male, with autoimmune hepatitis and unspecified vasculitis.

Oral and cutaneous myiasis in a five-year-old child from Karachi, Pakistan.

Myiasis is a pathological condition in which there is a pestilence of fly larvae feeding on living or dead tissues. This disease is common in the tropics and subtropics of Africa and America and rarely affects humans. Our case report describes a five-year-old boy from Karachi, Pakistan with a history of extraction sockets and incisional biopsy of the left parotid lymph node. Lack of proper wound maintenance led to infestation of maggots both over the overlying skin of the left parotid region and the posterior oral cavity. The plan was wound debridement both outside and intra-orally under local anesthesia and the removal of maggots. A cotton swab impregnated with turpentine oil was placed on the wounds for a few minutes. The wounds were then properly debrided with pyodine and hydrogen peroxide. Around 15 to 16 maggots were extracted from the wound on the left parotid region using medical forceps whereas five maggots were extracted from the intraoral wound with the help of turpentine oil and forceps. This case demonstrates the importance of oral health and proper wound management, and also that myiasis, despite its distinctiveness, can be managed by promoting awareness of the disease and by suitable treatment methods.