Association between maternal chronic apical periodontitis (CAP) and low birth weight preterm birth (LBWPT).

OBJECTIVE: To determine the association between maternal chronic apical periodontitis and low birth weight preterm birth. METHODS: The case-control study was conducted at the Gynaecology Ward of the Civil Hospital, Karachi, from September 2017 to April 2018, and comprised women aged 19-48 years with singleton pregnancy delivering spontaneously. The subjects were examined for the presence of periodontitis. The mothers who delivered low birth weight preterm babies were the cases in group A and those who delivered normal birth weight babies were the controls in group B. On the delivery day, after the subject having been moved to the room, data was collected through a questionnaire to record demographic details, history of pregnancy and information about the newborn. The radiographs were assessed for the presence of chronic apical periodontitis. The association between maternal chronic apical periodontitis and low birth weight preterm birth was subsequently determined. Data was analysed using SPSS 24. RESULTS: Of the 200 subjects, 100(50%) were in group A with a mean age of 27.17±5.11 years, and 100(50%) were in group B with a mean age of 27.08±4.90 years. Low birth weight preterm birth was associated with education level and family size (p<0.05). There was no association between maternal chronic apical periodontitis and low birth weight preterm birth (p>0.05). CONCLUSIONS: There was no association between maternal chronic apical periodontitis and low birth weight preterm birth.

Prevalence of obesity and its risk factors among school children in Karachi, Pakistan.

A cross-sectional questionnaire study was conducted during 2012 in private and public-sector schools of Karachi to determine the prevalence and factors influencing overweight and obesity among school children (aged 11-15 years). Sociodemographic characteristics and dietary habits were explored. The CDC Growth Chart was used to record height and weight. Of a total of 887 children, being overweight and frankly obese was found in 169 (19.1%) and 96 (10.8%), respectively. Of these, 176 (66.4%) were from private schools, and significant associations were found in 202 (76.2%) who were spending > 2 h/day watching television and 139 (52.5%) sleeping > 8 h/day.

Adherence to antiretroviral therapy in HIV-positive, male intravenous drug users in Pakistan.

BACKGROUND: Human immunodeficiency virus (HIV) is fifth leading cause of mortality and disability among infectious diseases worldwide. HIV burden is increasing annually and compliance with antiretroviral therapy (ART) is low among intravenous drug users, especially in developing countries. AIM: To determine the adherence level to ART among HIV-positive intravenous drug users in Karachi Pakistan. METHODS: A cross-sectional study was conducted in 2015. A pretested questionnaire was administered to 375 of 3000 people who inject drugs, registered at the Civil Hospital in Karachi, Pakistan. RESULTS: The mean age was 30 years, 181 were married, 179 were illiterate and 287 had income < 5000 rupees per month. Only 63 patients were adherent to ART and 343 were alcoholics. Nonadherence was greater in patients who were single and did not have children. The most common reason for missing ART was that they simply forgot to take the tablets. CONCLUSION: We conclude that adherence to ART among intravenous drug users was low. Family cohesion and support were essential to maintain adherence to ART.

Health-seeking behaviour of people living with HIV/AIDS and their satisfaction with health services provided at a tertiary care hospital, Karachi, Pakistan.

Appropriate health-seeking behaviour is important as it allows prompt treatment for a condition and this can reduce complications and improve quality of life. This study aimed to assess the health-seeking behaviour and satisfaction with health care services of people living with HIV/AIDS attending the HIV/AIDS clinic of the Civil Hospital in Karachi. A total of 182 patients were interviewed using a pretested semi-structured questionnaire. Mean age of the participants was 32.31 (SD 7.91) years, 76.9% were male, 81.3% had no education and 75.8% were employed. Only 23.6% showed positive health-seeking behaviour and 57.7% were satisfied with the health care services. In logistic regression analysis, the cost of treatment per visit < US$ 5 and duration of HIV infection < 2 years were significantly associated with health-seeking behaviour. Efforts are needed to improve the health-seeking behaviour of people living with HIV/AIDS at the clinic and the health services offered.

Pattern of unintentional burns: A hospital based study from Pakistan.

BACKGROUND: Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. METHODS: A cross-sectional questionnaire based survey was conducted in Burns Centre of Civil Hospital Karachi, Pakistan and 324 hospitalized adult patients with unintentional burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile. The source of burn, affected body part and place of injury acquisition in terms of home, outside or work were also noted. Logistic regression model was conducted using SPSS software. RESULTS: Out of 324 patients, 295 (91%) had unintentional burn by self and 29 (9%) had unintentional burn by others. Male gender were 2.37 times and no schooling were 1.75 times more likely to have self-inflicted unintentional burn. Lower limb and head and neck were less likely to involve in unintentional burn by self. CONCLUSION: The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self.

Severity of burn and its related factors: A study from the developing country Pakistan.

BACKGROUND: Burns are leading cause of fatal injuries and major cause of morbidity and mortality in developing countries. The major obstacle in controlling severity is factors related to burn. This study determines frequency of burns and the factors related to it in Karachi, Pakistan. METHODS: A cross-sectional study was conducted and 384 hospitalized adult patients with burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile, intent of burn, severity of burn, health hazards, physical and psychological characteristics. TBSA burn of >15% was considered as higher severity of burn. RESULTS: Higher severity of burns was found in 76.3% patients. Multivariate analysis showed that higher severity of burns were significantly associated with age less than 25 years (OR 2.7, 95% CI 1.5-4.9), never had been to school (OR 3.1, 95% CI 1.7-5.9) and intentional burn (OR 20.6, 95% CI 5.0-84.9). CONCLUSION: Majority of patients had higher severity of burn. The intent of injury was intentional, age less than 25 years and no schooling were found significantly associated with higher severity of burns.

Knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in coastal areas of Karachi.

BACKGROUND: Migrant populations are at high risk of Human Immuno Deficiency Virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Studies of HIV/AIDS knowledge, attitudes and practices among fishermen in developing countries have shown gaps in knowledge and fear of contagion with ambivalent attitudes towards HIV/AIDS and inconsistent universal precautions adherence. The aim of this study was to determine the knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in a coastal area of Karachi, Pakistan. METHODS: Community based cross sectional study was conducted among fishermen in coastal area of Karachi from June to September 2012. A total of 297 adult fishermen were selected by using simple random sampling technique from different sectors of coastal village. Data were collected using a structured validated questionnaire. The frequency distribution of both dependent and independent variables were worked out. Comparisons of knowledge, attitude and practices regarding HIV/AIDS by socio-demographic characteristics were made using logistic regression. RESULTS: Out of 297 fishermen, majority had in-appropriate knowledge (93.6%), negative attitude (75.8%) and less adherent sexual practices (91.6%). In univariate analysis, lower education and higher income were significantly associated (OR 2.25, 95% CI, 1.11, 4.55), (OR = 3.04 CI 1.03-9.02, p value 0.04) with negative attitude and un-safe practices towards HIV/AIDS respectively, whereas no significant association of socio-economic characteristics with knowledge, attitude and practices were observed in multivariate analysis. CONCLUSIONS: This study suggests that fishermen had very poor knowledge, negative attitudes towards HIV and AIDS and had unsafe sexual practices which suggest that they lack the basic understanding of HIV/AIDS infection. Extensive health education campaign should be provided to the vulnerable sections of the society for the control of HIV/AIDS.

The frequency of smoking and common factors leading to continuation of smoking among health care providers in tertiary care hospitals of Karachi.

BACKGROUND: The primary objective of the study was to find out the frequency of tobacco smoking among health care providers in tertiary care hospitals of Karachi. The secondary objective was to identify the common factors responsible for the continuation of smoking. METHOD: This cross sectional study was conducted in the wards and out-patient departments of three selected tertiary hospitals of Karachi. A total of 180 health care providers were enrolled in the study using proportionate stratified sampling. Postgraduate students, house officers and trainees were excluded from the study. Data were collected from randomly selected health care providers using survey methodology. SPSS v. 20.0 was used to enter and analyze the data. RESULTS: Fifty two participants out of 180 were smokers for past one year (28.9%). Among them, 21 (11.7%) smoked more than 5 cigarettes per day. Twenty smokers (11.1%) were found to smoke due to peer influence. It was found that those who were influenced by their peers were 8.33 times more prone to be addicted to smoking than those who were less influenced. Similarly, the likelihood of addiction increased up to 76.9% with the lack of incentives. CONCLUSION: Our results clearly indicate that a large number of health care providers smoke which should be a serious concern. Hence our health agencies should take immediate action in order to curtail the heaving burden of smoking and its related health consequences.

Comparison of knowledge, attitude and practices of betelnut users in two socio-economic areas of Karachi.

OBJECTIVE: To gain an insight on the knowledge, attitude and practices of those who chew betel nut in two different socioeconomic regions of Karachi. METHODS: The cross-sectional study was conducted in Saddar and Defence areas of Karachi over a five-week period in March-April 2012. Individual interviews following verbal consent were conducted using a pre-coded questionnaire, which was divided into 3 sections to analyse the knowledge, attitude and practices of the chewers. The data was entered and analysed using SPSS v. 16.0. Pearson's chi-square was used as the primary statistical test. RESULTS: A total of 370 subjects, 185 (50%) from each area, comprised the study. Majority of the chewers in Defence had higher educational qualification and income. Most of the participants in both areas acknowledged that betel nut chewing can potentially result in mouth (n = 274; 74.1%) and throat cancers (n = 267; 72.2%). A large part of the sample (n = 299; 80.8%) conceded that betel nut chewing is a bad habit, and almost half the sample was addicted to it (n = 194; 52.4%). CONCLUSION: Awareness regarding the detrimental effects of betel nut was satisfactory amongst the subjects, but the population was not willing to quit the habit. We recommend a two-pronged approach, offering widespread educational and awareness campaigns to prevent increased consumption of betel nuts, and professional counselling services for those already addicted.

Prevalence and factors related to dental caries among pre-school children of Saddar town, Karachi, Pakistan: a cross-sectional study.

BACKGROUND: Dental caries is highly prevalent and a significant public health problem among children throughout the world. Epidemiological data regarding prevalence of dental caries amongst Pakistani pre-school children is very limited. The objective of this study is to determine the frequency of dental caries among pre-school children of Saddar Town, Karachi, Pakistan and the factors related to caries. METHODS: A cross-sectional study of 1000 preschool children was conducted in Saddar town, Karachi. Two-stage cluster sampling was used to select the sample. At first stage, eight clusters were selected randomly from total 11 clusters. In second stage, from the eight selected clusters, preschools were identified and children between 3- to 6-years age group were assessed for dental caries. RESULTS: Caries prevalence was 51% with a mean dmft score being 2.08 (±2.97) of which decayed teeth constituted 1.95. The mean dmft of males was 2.3 (±3.08) and of females was 1.90 (±2.90). The mean dmft of 3, 4, 5 and 6-year olds was 1.65, 2.11, 2.16 and 3.11 respectively. A significant association was found between dental caries and following variables: age group of 4-years (p-value < 0.029, RR = 1.248, 95% Bias corrected CI 0.029-0.437) and 5-years (p-value < 0.009, RR = 1.545, 95% Bias corrected CI 0.047-0.739), presence of dental plaque (p-value < 0.003, RR = 0.744, 95% Bias corrected CI (-0.433)-(-0.169)), poor oral hygiene (p-value < 0.000, RR = 0.661, 95% Bias corrected CI (-0.532)-(-0.284)), as well as consumption of non-sweetened milk (p-value < 0.049, RR = 1.232, 95% Bias corrected CI 0.061-0.367). CONCLUSION: Half of the preschoolers had dental caries coupled with a high prevalence of unmet dental treatment needs. Association between caries experience and age of child, consumption of non-sweetened milk, dental plaque and poor oral hygiene had been established.

Mothers' knowledge about EPI and its relation with age-appropriate vaccination of infants in peri-urban Karachi.

OBJECTIVES: To evaluate the relation between the knowledge of mothers about EPI vaccinations and their infant's coverage. Effect of other socio-demographic variables on mothers' knowledge and child's coverage was also assessed. METHODS: A cross-sectional survey was conducted, utilizing World Health Organization's thirty-cluster sampling strategy. All households with at least one infant were considered eligible. After obtaining verbal consent, the mother was interviewed to assess her knowledge and attitudes towards EPI vaccination. Infant's coverage status was verified by checking EPI card or verbal inquiry. A knowledge score was developed by summing all correct answers. RESULTS: A total of 210 mothers (7 per cluster) were identified and interviewed. The number and proportion of mothers correctly identifying the seven EPI diseases were as follows; Tuberculosis 57 (27.1%), Diphtheria 53 (25.2%), Pertussis 71 (33.8%), Tetanus 70 (33.3%), Measles 85 (40.5%), Polio 91 (43.3%) and Hepatitis B 65 (31.0%). Only ninety four (44.8%) children were appropriately vaccinated for their age. In the multivariate model, mothers' knowledge was not significantly associated with appropriate vaccination of their children (p = 0.22), however, mothers' education was found to be significant (p < 0.001). CONCLUSION: Mothers' knowledge about EPI vaccination in peri-urban Karachi was quite low and not associated with their children's EPI coverage. Mothers' educational status, however, was significantly associated with Child's coverage. This finding depicts a better health seeking behaviour of a more educated mother.

Dietary habits and life style among the students of a private medical university Karachi.

OBJECTIVES: To determine the dietary habits and life style of the students of a private medical university in Karachi. METHODOLOGY: A cross-sectional study was conducted at Baqai Medical University, from August 2005 to September 2005. A total of 384 medical students from the batches of 2002 to 2005 participated in this study. A pre-tested semi structured questionnaire was self administered to the students after taking their consent. The data included sociodemographic characteristics, life style, exercise, dietary habits and family history of diabetes mellitus. The collected data was analyzed by statistical program SPSS version 11. RESULTS: Out of the total participants, 53.4% were male and 46.6% were female students. The mean age was 20 +/- 1.58 years. The average income of the household of students was 50,000 Pakistani rupees per month. Only 7% students were tobacco users. About 33% students had a history of diabetes mellitus among their parents. Nearly ninety-seven percent reported consumption of junk food while 60% reported use of whole grain food in their diet. Seventy percent students walked 30 minutes and 47% exercised daily. According to the body mass index, 58.3% students were of normal weight and 41.7% were overweight. No significant difference was found among male and female students when dietary habits and life style were compared by sex. Junk food and soft-drink consumption was associated with being overweight. Eating whole grain food and doing exercise showed a protective association against overweight. CONCLUSION: Unhealthy lifestyle and poor dietary habits were highly prevalent in the overweight study population. Type-2 diabetes mellitus was common among parents and grandparents of the students making them prone to this disorder. Our study concluded that dietary and exercise counselling is necessary as a preventive strategy.

Knowledge about ionising and non-ionising radiation among medical students.

BACKGROUND: The majority of patients remain concerned about radiation exposure and the health risk associated to it. A doctor is a person who can answer all pertinent questions regarding radiation and can satisfy their patients. Medical students, who are future doctors, can acquire this capability during their clinical rotation in the radiology department. The study is to assess knowledge, hazards, misconceptions and misunderstanding among medical students regarding equipments using ionizing and non-ionizing radiation. METHODS: A questionnaire was self administered to medical students of a private medical college of Karachi. One hundred and twelve students who had completed their clinical rotation in the radiology department from fourth and final year MBBS class were included in the study. The obtained data was analyzed using statistical software. RESULTS: Nearly 40% of the students accepted that objects in the X-ray room emit radiation after an X-ray procedure and nearly the same percentage agreed that protective measures should be taken while performing an ultrasound and that dangerous radiation is emitted from good quality microwave equipment. Slightly more than one-third students viewed that gamma rays are more hazardous than X-rays while the same percentage agreed that intravenous contrast material used in angiogram is radioactive. Sixty-seven percent students agreed that nuclear material used in medicine is potentially explosive while 18% of students were in the opinion that MRI emits ionizing radiation. Twenty-eight percent of the students believe that a radiologist have a shorter life span as compared to other medical specialist. CONCLUSION: The majority of medical students in both years have limited knowledge about various aspects of radiation sources, the risk involved and its protection. Better teaching methods and programmes are required for medical students in the subject of radiology.

Dietary habits and life style among the students of a private medical university Karachi.

OBJECTIVES: To determine the dietary habits and life style of the students of a private medical university in Karachi. METHODOLOGY: A cross-sectional study was conducted at Baqai Medical University, from August 2005 to September 2005. A total of 384 medical students from the batches of 2002 to 2005 participated in this study. A pre-tested semi structured questionnaire was self administered to the students after taking their consent. The data included socio-demographic characteristics, life style, exercise, dietary habits and family history of diabetes mellitus. The collected data was analyzed by statistical program SPSS version 11. RESULTS: Out of the total participants, 53.4% were male and 46.6% were female students. The mean age was 20 +/- 1.58 years. The average income of the household of students was 50,000 Pakistani rupees per month. Only 7% students were tobacco users. About 33% students had a history of diabetes mellitus among their parents. Nearly 97% reported consumption of junk food while 60% reported use of whole grain food in their diet. Seventy percent students walked 30 minutes and 47% exercised daily. According to the body mass index, 58.3% students were of normal weight and 41.7% were overweight. No significant difference was found among male and female students when dietary habits and life style were compared by sex. Junk food and soft-drink consumption was associated with being overweight. Eating whole grain food and doing exercise showed a protective association against overweight. CONCLUSION: Unhealthy lifestyle and poor dietary habits were highly prevalent in the overweight study population. Type-2 diabetes mellitus was common among parents and grandparents of the students making them prone to this disorder. Our study concluded that dietary and exercise counselling is necessary as a preventive strategy.

Assessment of EPI (expanded program of immunization) vaccine coverage in a peri-urban area.

OBJECTIVE: To determine the age-appropriate EPI coverage of under one year old children and Tetanus Toxoid (TT) coverage of their mothers (15-49 years) in peri-urban Karachi and to determine the factors associated with low coverage. METHODS: A cross-sectional study was carried out by utilizing WHO thirty-cluster sampling technique, seven households with infants, were randomly selected per cluster. Child's mother was interviewed by using a structured pre-tested questionnaire, regarding the EPI coverage of her child, her own TT coverage and other demographic and potential risk factors for low vaccination coverage. RESULTS: Forty five percent of the infants were age-appropriately vaccinated. The TT coverage of mothers for the index pregnancy was 57.3% for both doses of the vaccine. In the multivariate model four factors i.e., type of house construction (proxy indicator of socio-economic status), mother's TT vaccination status, years since marriage and parents' educational status were found to be significantly associated with children's immunization status. CONCLUSIONS: We concluded that the EPI coverage of Gadap town, Karachi is quite low. Education of both parents plays a significant role in child's immunization coverage. Improving the educational status of parents can potentially improve the immunization coverage.

Myths about diabetes mellitus among non-diabetic individuals attending primary health care centers of karachi subrubs.

OBJECTIVE: To determine the myths and misconception about diabetes mellitus among non-diabetics attending primary health care centers of Gadap town, Karachi. DESIGN: Cross-sectional study. Place and Duration of the Study: Primary Health Care Centers, Gadap Town, Karachi, during the month of July 2005. PATIENTS AND METHODS: Data was collected from four primary health care centers, located at Gadap Town, Karachi, and about 198 non-diabetic patients, above 18 years of age, and resident of Gadap Town, coming consecutively during the month of July 2005, were interviewed after taking the informed consent by using a semi-structured pre-tested questionnaire regarding prevailing myths about diabetes mellitus. The data collected was entered and analyzed by using a statistical package SPSS 11.0. Myths are defined as stories shared by a group, as part of the cultural identity. RESULTS: There were 198 participants in the study. Mean age of study participants was 40 years with standard deviation of 13, while approximately two thirds, 62.6%, were females. About 39% had history of type II diabetes mellitus in family. Overall myths related to diabetes mellitus were common among the individuals, males reported myths pre-dominantly contagiousness of diabetes (p= < 0.03), diabetics becoming more ill (p=<0.009) and belief in spiritual treatment for permanent cure of diabetes (p=< 0.006). People having 5-16 years of education were less misconceived as compared to illiterates. The variables that showed significant difference were over-eating, causing diabetes (p= < 0.006), diabetics falling ill more than others (p=< 0.04), eating less starch (p= < 0.0006) and alternative treatment like spiritual treatment (p=< 0.00001). Family history of diabetes was also found significantly associated with reporting myths. CONCLUSION: Frequency of reporting myths was significantly high in this study with preponderance of males, family history of diabetes mellitus and educational status. Education serves as protective factor, hence efforts should be made to promote education and health awareness regarding the disease, with more emphasis on addressing myths regarding diabetes mellitus.

A community based study about knowledge and practices regarding tobacco consumption and passive smoking in Gadap Town, Karachi.

OBJECTIVE: To determine the proportion of people consuming tobacco in various forms, level of knowledge and practices regarding various harmful effects of tobacco and passive smoking. METHODS: A cross-sectional study was conducted at Ghulam Mohammad Jokhio Goth, a small semi urban community of Gadap Town Karachi, which comprises of a population approximate 2225. About 157 people were interviewed regarding their tobacco consumption practices through a semi structured pre-tested questionnaire from June to August 2005. There were 314 households in the community and every alternate household was selected with a random start. The study subject was selected among all the adult members of 18 years age and above present at the time of interview in the household by lottery method and the questionnaire was administerd to those who were resident of GM Goth after taking consent. RESULTS: In our study 110 (70%) people were tobacco consumers, 47% were knowledgeable about hazards of smoking, 22% were aware about passive smoking, and 90% started consuming tobacco below 20 years of age. The most popular form of tobacco was pan 40%, cigarette 39% and hookah 19%. Eighty four percent were regular smokers. Only 13.6% took counseling, 26.3% tried to quit smoking but none of them succeeded. About 23.5% smokers suffered from cough and headache due to smoking. When age, sex, marital status, income of the household, education and knowledge about hazards of smoking was compared, age and knowledge showed significant association while other variables did not show any significant association. CONCLUSION: Our study concluded that high proportion of people including men and women consume tobacco. Most of them were unaware about tobacco consumption hazards, and passive smoking.

Pattern of antenatal care provided at a public sector hospital Hyderabad Sindh.

BACKGROUND: To assess the pattern of antenatal care provided to the pregnant women and to determine their level of satisfaction for provision of services. METHODS: This cross-sectional study was conducted at a public sector hospital of Hyderabad Sindh, the data was collected in the month of October 2004. The data was collected by using a pre-tested semi-structured Questionnaire, during the month of October 2004. A total of 161 women consecutively attending antenatal care clinic were included in the study. The variables included were socio-demographic like age, education, occupation and income, maternal and child health variables and level of satisfaction about antenatal care provided. The data was analyzed by using statistical package SPSS version 11. RESULTS: The mean age of women was 29.08 +/- 3.95 years, majority were housewife, 43.5% women were illiterate, 47.2% had primary education and 9.3% had secondary level of education. About 66% were from low-income group, i.e., earning less than 3000 rupees. About 71% were multi gravida, 67% had live births and 32% had history of abortions. Four had history of Intra uterine deaths. Only 22.4% reported that they use contraceptive for spacing. About 50% of the women were dissatisfied with the services available. The reasons identified for dissatisfaction were long waiting time, inadequate medicine supply and incomplete tetanus vaccination were also reported. CONCLUSION: This study concluded that antenatal care provided needs improvement and require attention to improve the quality of services provided.