Publications by authors named "Sajida Naseem"

29 Publications

  • Page 1 of 1

Maternal depression and its correlates: A longitudinal study.

J Pak Med Assoc 2021 Jun;71(6):1618-1622

Department of Community and Family Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.

Objective: To estimate the burden of antenatal and postpartum depression, and to explore possible predictors of perinatal depression.

Methods: The longitudinal study was conducted at the Department of Obstetrics and Gynaecology, Shifa International Hospital and its Community Healthcare centre in Islamabad, Pakistan, from October 2018 to May 2019, and comprised women in their third trimester of pregnancy. Socioeconomic and obstetrical history was recorded on a proforma, and the Edinburgh Postnatal Depression Scale was used for screening of depression. Data was analysed using SPSS version 23.

Results: Of the 200 women, 71(35.5%) were primigravida and 129(64.5%) were multigravida. The overall mean age was 27.1±5.08 years. Further, 64(32%) women belonged to the low-income group, 99(49.5%) middle-income and 37(18.5%) to upper-income group. Women in postnatal period had higher depression scores than women in antenatal period (p<0.05). Antenatal depression increased the risk of postpartum depression (p<0.05). In women having unplanned pregnancies, or being multigravida, or belonging to middle and lower socioeconomic classes, the chances of perinatal depression were higher (p<0.05).

Conclusions: Antenatal depression was strongly associated with postpartum depression, indicating that the former was a significant predictor of the latter. Social class and parity were also found to be directly linked with perinatal depression.
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http://dx.doi.org/10.47391/JPMA.352DOI Listing
June 2021

DNA barcoding of spiders from agricultural fields.

Mitochondrial DNA B Resour 2019 Nov 20;4(2):4144-4151. Epub 2019 Nov 20.

Department of Zoology, University of Education Lower Mall Campus Lahore, Lahore, Pakistan.

In the present study, DNA barcoding was used to assess the percentage accuracy of morphological base identification of spiders from the agriculture fields of district Layyah, Punjab, Pakistan. A total of 872 spiders were captured from June to August of 2017. All the collected spiders were brought to molecular laboratory at GC University Lahore, preserved in 95% ethanol and stored at -20 °C until the DNA extraction. Spiders were evaluated morphologically on the basis of different identification Keys and Catalogs. Morphological identification revealed the presence of 12 families, 29 genra and 49 species. To evaluate the authenticity of morphological identification, tissue samples of 96 specimens were sent to Canadian Center for Biodiversity and Genomics, University of Guelph, Canada. A 658-base pair sequence of COI (Cytochrome c Oxidase Subunit I) of 90 specimens was retrieved successfully, which confirmed the presence of 11 families, 25 genra and 47 species. On the basis of molecular results, all the misidentified specimens were then allotted the correct taxon. Overall accuracy of morphological based identification was 88%. It is concluded from the present study that morphological investigations to identify a spider, are satisfactory but to enhance the accuracy, pace and credibility of results, molecular technique like DNA barcoding is considerable. Furthermore, to magnify authenticity of evaluation of spiders, integrated barcoding- combination of molecular methods and conventional taxonomy- is compulsory.
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http://dx.doi.org/10.1080/23802359.2019.1693283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707727PMC
November 2019

Effect of Pesticides on Biological Control Potential of Neoscona theisi (Araneae: Araneidae).

J Insect Sci 2019 Mar;19(2)

Department of Zoology, University of Sargodha, Sargodha, Pakistan.

The present study was designed to record the effect of λ-cyhalothrin, Bifenthrin, and Glyphosate on the mortality, avoidance behavior, foraging activity, and activity of Acetylcholine esterase (AChE) and Carboxylesterase (CarE) in Neoscona theisi (Walckenaer, 1841). Highest mortality (70%) in N. theisi was recorded against λ-cyhalothrin. However, Glyphosate was found to be least toxic. Spider spent less time on insecticides/herbicide-treated surfaces. Insecticides/herbicide-treated N. theisi consumed less prey than untreated control spiders. Similarly, when N. theisi were offered insecticide/herbicide-treated prey, they consumed significantly less. Increased AChE and CarE activities were recorded in insecticides/herbicide-treated spiders as compared to control group. Total protein contents were less in insecticides/herbicide-treated spiders than control group. The results revealed that λ-cyhalothrin is more harmful to spiders as compared to Bifenthrin and Glyphosate. It is suggested that the effect of all pesticides used in agro-ecosystem on beneficial insects should be evaluated before using them in the fields.
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http://dx.doi.org/10.1093/jisesa/iez024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435917PMC
March 2019

Thoracic impalement injury: A survivor with large metallic object in-situ.

Chin J Traumatol 2018 Dec 20;21(6):369-372. Epub 2018 Sep 20.

Department of Surgery, Bahawal Victoria Hospital, Quaid-E-Azam Medical College, Bahawalpur, Pakistan.

Impalement injuries, is a severe form of trauma, which are not common in civilian life. These injuries rarely occurs in major accidents. Abdomen, chest, limbs and perineum are often involved due to their large surface area. Thoracic impalement injury is usually a fatal injury, due to location of major vessels and heart in the thoracic cavity. These injuries are horrifying to site, but the patients who are lucky enough to make it to hospital, usually survive. Chances of survival are larger in right sided impalement injuries while central injuries are always died at the scene. Our patient, 25 years old male, was brought to the emergency room (ER) with large impaled metallic bar (about 2.5 feet long) in situ, in right sided chest. The patient was immediately shifted to operation room (OR) and was operated, his recovery was uneventful without any sequelae. Such patients should be treated and resuscitated according to advanced trauma life support (ATLS) protocols and operated without any delay for further investigations. Such operations are carried out by the most experienced surgeon team available. The impaled objects should not be processed if not necessary to avoid major hemorrhage and damage to vital structures, until the patient is in operation room. Large size and unusual position of impaled objects, makes the job difficult for surgeons/anesthetists. Although horrifying at scene, patients with thoracic impalement injuries are mostly young and healthy, and those who survive the pre-hospital phase are potentially manageable with proper resuscitation. Usually these patients make recovery without any further complications.
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http://dx.doi.org/10.1016/j.cjtee.2018.08.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354130PMC
December 2018

Satisfaction of Female Patients with Health Care Services at the Peri-urban Community Health Centre in Islamabad.

Cureus 2018 Aug 4;10(8):e3101. Epub 2018 Aug 4.

Community and Family Medicine, Shifa International Hospital, Islamabad, PAK.

Objective To evaluate the satisfaction levels of female patients with the availability and quality of health care services provided at the Community Health Centre (CHC) in Nurpur Shahan, a deprived peri-urban locality in Islamabad. Methods This cross-sectional study was carried out among 346 randomly selected female patients who attended the CHC in Nurpur Shahan from January to March, 2018. Data was collected by face to face interviews using a pre-tested self-designed questionnaire. Data was analysed using SPSS version 23 (IBM Corp., Armonk, NY, USA). Results Female patients were largely satisfied with the behaviour (96%) and competence (97.1%) of doctors, the attitude of the paramedical staff (93.6%), quality of medicines (93.6%) and basic facilities at the CHC including drinking water, bathrooms, and cleanliness. Patients had mixed satisfaction levels with various aspects of antenatal services, post-natal care, immunization services as well as the location of CHC (58.7%), availability of prescribed medicines (67.1%) and affordability of laboratory tests at the centre (63.3%). Major areas of discontent were health education regarding breastfeeding and immunization, the average waiting time to see a doctor, the waiting area, and family planning services. Conclusion Although patient satisfaction levels with certain health care services were good, there is considerable room for improvement in other aspects of provided services at the CHC.
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http://dx.doi.org/10.7759/cureus.3101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6173271PMC
August 2018

Quality of life of post-graduate medical students working in private and public hospitals in Punjab as measured by WHOQOL-BREF questionnaire.

J Pak Med Assoc 2018 Jun;68(6):908-913

Shifa College of Medicine, Islamabad, Pakistan.

Objective: To determine the impact of the type of specialty and hospital on the quality of life of medical consultants and residents..

Methods: This cross-sectional study was conducted at leading hospitals in Punjab and Islamabad Capital Territory from June 2016 to January 2017 to assess the quality of life of medical consultants and residents doing clinical practice for more than 6 months in private and public hospitals. The World Health Organisation Quality of Life - BREF instrument was used to assess the quality of life of the subjects. SPSS 21 was used to analyse the data.

Results: Of the 1,154 respondents, 677(58.7%) were male while 477(41.3%) were female. The physical health domain had the highest overall mean score of 66.10±11.40 while the psychological health domain had the lowest overall mean score of 64.13±9.88. Physical health domain, psychological health domain, and social relationship domain score were found to be significantly higher in male doctors compared to female doctors (p<0.05). Overall, quality of life was rated as good by 743(64.4%) and very good by 324(28.1%) subjects.

Conclusions: Physical health scroes were better than psychological health scores among the participants.
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June 2018

Knowledge of Dengue Among Students Exposed to Various Awareness Campaigns in Model Schools of Islamabad: A Cross-Sectional Study.

Cureus 2018 Apr 10;10(4):e2455. Epub 2018 Apr 10.

Department of Community and Family Medicine, Shifa International Hospital, Islamabad, Pakistan.

Objective To determine the knowledge of dengue among school students exposed to various awareness campaigns in model schools of Islamabad. Methods We conducted a cross-sectional study of students who were studying in Islamabad Model School for Girls F-7/2 and Islamabad Model College for Boys F-7/3 from September 2017 to October 2017. Students in the ninth and tenth grades who were willing to participate in the study and who were studying in the school for more than six months were included in the study. The data was collected through a self-constructed questionnaire. Cronbach's alpha was used to assess the internal consistency of the questionnaire, and it was found to be 0.83. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 21 (IBM, Armonk, NY). Results Out of 601 participants, 345 (57.4%) were males and 256 (42.6%) were females. The mean age of the participants was 14.72±1.09. About 380 participants (63.2%) were studying in the ninth grade and 221 participants (36.8%) were studying in the tenth grade. A majority of the participants (67.2%) had poor knowledge of dengue. The participants scored highest in knowledge of prevention of the dengue domain and scored the lowest in knowledge of transmission of dengue. A majority of the participants (72.9%) reported that they acquire knowledge about dengue fever through television and radio. About 44.60% of the participants reported that they acquired knowledge about dengue fever through awareness campaigns in school. Conclusions The knowledge of the students was found to be insufficient despite several awareness campaigns. There is a need to re-evaluate the structure of the awareness campaigns as they fail to reach their target. Electronic media was identified as the most useful source of knowledge, and its incorporation can help increase the effectiveness of awareness campaigns.
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http://dx.doi.org/10.7759/cureus.2455DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991922PMC
April 2018

Dietary habits and practices of type-2 diabetic patients in a tertiary care centre of Islamabad, Pakistan.

J Pak Med Assoc 2018 May;68(5):825-830

Shifa International Hospitals Ltd Islamabad, Pakistan Shifa College of Medicine, ShifaTameer-e-Millat University, Islamabad, Pakistan.

Objective: To determine the relation between food intake and diabetes control.

Methods: This cross-sectional study was carried out at Department of Medicine and Endocrinology, Shifa International Hospital, Islamabad, Pakistan, from July 2016 to February 2017, during which type-2 diabetes patients were interviewed using a structured questionnaire. Demographics, intake of high glycaemic index foods consumed in each food group, and general dietary practices were assessed by means of number of meals per day and adherence to the dietary plan. Glycated haemoglobin A1c values were recorded as well. SPSS 21 was used for data analysis.

Results: Of the 180 patients, 100(55.6%) were taking three meals a day. Besides, 108(60%) had an income >Rs50,000. Moreover, 127(70.6%) patients were not aware of the type of diabetes, while 117(65%) patients had high glycated haemoglobin levels. Furthermore, 148(82.2%) made a change in diet following diabetes diagnosis, while 168(93.3%) had recommended food available in their house, and 65(36.1%) followed a strictly-recommended dietary schedule. A statistically significant association was found between the consumption of different desserts/sweets and glycated haemoglobin levels (p=0.008) followed by fruit intake like mangoes (p=0.004) and grapes (p=0.02).

Conclusions: There is a need to educate diabetics regarding diet management in terms of glycaemic index of foods.
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May 2018

Knowledge of Postgraduate Medical Trainees Regarding Epidemiology.

Cureus 2018 Feb 8;10(2):e2171. Epub 2018 Feb 8.

Internal Medicine, Shifa College of Medicine, Islamabad, Pakistan.

Introduction An understanding of epidemiology is fundamental for designing research and understanding evidence-based medicine (EBM). The purpose of our study was to determine the knowledge of epidemiology among postgraduate medical trainees. Methods We carried out a cross-sectional study from January 2017 to June 2017 at the Regional Centre Islamabad, College of Physicians and Surgeons Pakistan. About 204 postgraduate medical trainee were enrolled in the study after taking written consent. All of the participants were working as a postgraduate medical trainee in different hospitals of Rawalpindi and Islamabad. A self-designed structured questionnaire containing 20 multiple choice questions regarding knowledge of epidemiology was given to all the participants. Knowledge of epidemiology was measured and compared with gender, hospital, and previous history of research. Statistical Package for the Social Sciences (SPSS), version 21.0 (IBM, Armonk, NY) was used for data analysis. Results Out of 204 participants, 46.1% participants were males while 53.9% were females. The mean age of the participant was 28.5 ± 2.5. Majority fo the trainees (33.8%) were training in an Internal Medicine residency program. Most of the trainees (76%) had average knowledge of epidemiology while 18.6% of the trainees had good knowledge. Only 17.6% had some experience of research projects in the past, but this was not related to knowledge of epidemiology (p > 0.05). Conclusion Only 18.6% of the postgraduate trainees had good knowledge regarding epidemiology and 76% had average knowledge. This knowledge did not relate to their gender, hospital settings, and previous experience of conducting research proposals and articles.
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http://dx.doi.org/10.7759/cureus.2171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896870PMC
February 2018

Oral Health Practices Among Pakistani Physicians.

Cureus 2018 Jan 21;10(1):e2093. Epub 2018 Jan 21.

Family Medicine, Alam Hospital, Pakistan.

Introduction In most healthcare models, the first interaction of a patient is with a general physician. The inspection of the oral cavity is a mandatory component of the general physical examination performed by a physician. This helps detect any oral pathology and make suitable referrals. Therefore, adequate oral health awareness is essential for physicians. Our study aimed at evaluating the oral health practices among physicians working in a private teaching setup in Islamabad, Pakistan. Methods A cross-sectional study involving 144 physicians teaching undergraduate medical students at Shifa College of Medicine and its affiliated hospital, Shifa International Hospital, was conducted. Participants were interviewed through a self-designed questionnaire. Later, each participant demonstrated their teeth brushing technique on a standard model of the oral cavity, which was assessed against a checklist conforming to the modified bass technique. A video clip showing the aforementioned brushing technique was shown at the end of the interview. The collected data was analyzed on IBM's statistical package for the social sciences (SPSS) version 21.  Results Toothpaste was the top choice (97.2%) of teeth cleaning tool with 69% participants brushing their teeth two times a day and 56.9% using toothbrushes with bristles of medium texture. The use of mouthwash (32.6%) and dental floss (11.1%) was considerably low. Dental caries and teeth discoloration were seen in 46.5% and 43.8% physicians, respectively. An alarmingly low number of physicians (31.9%) claimed to have read guidelines regarding oral health. This translated into most participants (78.5%) visiting a dentist only when needed. Only 4.9% participants performed all components of the modified bass technique to clean teeth on the oral cavity model, with up to 22.9% unable to perform a single step accurately.  Conclusion The oral health knowledge and practices of physicians were found to be suboptimal and necessitate the integration of oral health awareness in the medical curriculum. A multiprofessional approach with physicians in crucial roles is required to address the burden of dental diseases globally.
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http://dx.doi.org/10.7759/cureus.2093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862468PMC
January 2018

Postgraduate Medical Trainees Understanding of Biostatistics: A Pre- and Post-Research Methodology Workshop Experience.

J Coll Physicians Surg Pak 2018 03;28(3):196-200

Statistician, Army Medical College, PAFMJ, Rawalpindi.

Objective: To evaluate understanding of biostatistics among postgraduate medical trainees before and after biostatistics workshop.

Study Design: Quasi experimental study.

Place And Duration Of Study: Regional Centre, Islamabad, College of Physicians and Surgeons Pakistan, from March to September 2017.

Methodology: Two hundred and seventy postgraduate trainees were enrolled after taking informed consent. Structured questionnaire containing 21 multiple choice questions regarding understanding and application of biostatistics was given to all participants on the first and the last day of workshop and compared pre- and post-workshop by McNemar test of significance. SPSS version 21 was used for data analysis with p-value <0.05 as significant level.

Results: The response rate was 100%. Among these participants, males were 81 (30%) and females were 189 (70%), mean age was 28.5 ±2.5 years. One hundred and twenty-five (46%) postgraduate trainees were from Islamabad. Most of the doctors were in the first year (37%) and second year (57%) of their training. With total correct answers of 42.9% (preworkshop) and 57% (post-workshop), p-value was <0.001.

Conclusion: Understanding regarding application of biostatistics in research among PGTs improved significantly and immediately after teaching biostatistics in research methodology workshop.
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http://dx.doi.org/10.29271/jcpsp.2018.03.196DOI Listing
March 2018

Frequency of carrier screening and preventive orientation among first degree relatives of Thalassaemia patients.

J Pak Med Assoc 2018 Jan;68(1):50-54

Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad.

Objective: To get preliminary data regarding the prevention of thalassaemia major in future generations.

Methods: This Knowledge Attitude Practices study was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from January to June 2016, using non-probability purposive sampling. Parents of children undergoing transfusion were interviewed. Questionnaires were used to collect demographics and data about awareness, attitude and frequency of screening among the first degree relatives of a thalassaemia major patient. SPSS 20 was used for data analysis.

Results: Of the 270 respondents 240(88.9%) had utilised screening services for their asymptomatic children and had a positive attitude towards prevention, but 30(11.1%) families did not screen asymptomatic children for thalassaemia minor. Besides, 49(18.1%) families had more than one thalassaemia major child in their nuclear family, while, 3(1.1%) were unwilling to let their children undergo tests. Nine (3.3%) respondents said they will not ask a prospective daughter/son-in-law to get tested for thalassaemia minor, while 194(71.9%) respondents had had cousin marriages.

Conclusions: There were significant gaps in awareness among affected families.
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January 2018

Frequency of different lifestyle modification measures among patients with GERD based on monthly income.

J Pak Med Assoc 2017 Nov;67(11):1791-1794

Department of Community Medicine, Shifa College of Medicine. Islamabad, Pakistan.

A cross-sectional study was carried out at Shifa International Hospital Islamabad over a period of 6 months, to determine the frequency and compare the different lifestyle modifications among patients with Gastroesophageal Reflux Disease (GERD) of different monthly income groups. Two hundred patients of GERD were enrolled in the study and divided into two groups based on monthly income less than and more than Rs. 30,000 respectively. Data was analyzed using SPSS 21. Descriptive statistics were calculated. Chi-square test was applied keeping p-value <0.05. Mean age was 40±13 years, 82 (41%) males and 118 (59%) females. Walking was undertaken by 32% after meals and 87.5% consumed tea. Significant difference was seen between income groups and higher intake of fried and spicy foods respectively. Thus, effort needs to be made in creating awareness and counseling patients to practice lifestyle modifications to reduce GERD symptoms and stop sole reliance on medications.
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November 2017

Oral Hygiene Practices and Teeth Cleaning Techniques Among Medical Students.

Cureus 2017 Jul 18;9(7):e1487. Epub 2017 Jul 18.

Federal Medical and Dental College, Islamabad, Pakistan.

Objectives Oral health is essential for general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infections and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual's capacity to bite, chew, smile, and speak; it affects psychosocial well-being too. The objective of our study was to assess teeth cleaning techniques and oral hygiene practices among medical students. Methods The data of the study were collected in two stages. The first stage involved the administration of a self-constructed questionnaire among medical students. In the second step, the students were asked to demonstrate their teeth cleaning techniques on a model. A standard teeth cleaning checklist was used to evaluate the students. The students were then given the checklist and a video on teeth cleaning techniques was shown to them. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 21.  Results Out of a total of 444 students, 256 (57.7 percent) were males while 188 (42.3 percent) were females. About 254 (57.2 percent) participants were preclinical medical students while 190 (42.8 percent) were clinical year medical students. A majority of medical students used medium consistency toothbrushes (177; 39.9 percent) and soft consistency toothbrushes (137; 30.9 percent). Most medical students (248; 55.9 percent) brushed two times a day while 163 (36.7 percent) brushed only one time. About 212 (47.7 percent) of the medical students used mouthwash along with a toothbrush while only 36 (8.1 percent) used floss along with a toothbrush. About 157 participants (35.4 percent) changed their toothbrush once in two months while 132 (26.7 percent) changed their toothbrush once in three months. The mean duration that participants brushed their teeth was 134.99 ± 69.01 seconds. Conclusion Medical students were found to have a faulty teeth cleaning technique. There is a dire need to spread awareness about correct teeth cleaning techniques because poor oral hygiene can have a detrimental effect on the overall health and quality of life of an individual.
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http://dx.doi.org/10.7759/cureus.1487DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602443PMC
July 2017

Maternal health status in terms of utilisation of antenatal, natal and postnatal services in a Periurban setting of Islamabad: A community based survey.

J Pak Med Assoc 2017 Aug;67(8):1186-1191

Shifa College of Medicine, Islamabad, Pakistan.

Objective: To determine the maternal health status in terms of antenatal, natal and postnatal care.

Methods: This cross-sectional study was conducted at Shifa College of Medicine, Islamabad, Pakistan, from August 2015 to February 2016, and comprised married women living in Nurpur Shahan, a peri-urban community..A systemic random sampling method was used to raise the study sample. Only members of the household aged18 to 45 years and permanent residents of that area were selected. SPSS 21 was used to analyse the collected data.

Results: There were 1,275 participants in the study with an overall mean age of 31.6±8 years. The mean age of marriage was 19±3.6 years while the mean age of first childbirth was 20.8±3.6 years. Besides, 950(74.5%) participants had undergone an antenatal check-up. Moreover, 685(53.7%) underwent delivery in a hospital, 433(34%) had postnatal check-up, and 432(33.9%) were using contraception. Participants who had undergone hospital delivery were 18.7 times more likely to have taken prenatal care and 6.9 times more likely to utilise postnatal care compared to participants who had not utilised antenatal care (p<0.001).

Conclusions: Most of the participants did not give significant importance to postnatal care.
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August 2017

Practice of breastfeeding and Immunisation in a periurban community in Pakistan.

J Pak Med Assoc 2017 May;67(5):682-687

Federal Medical and Dental Medical College, Islamabad, Pakistan.

Objective: To assess the practice of breastfeeding and immunisation in a peri-urban community and correlate it with maternal care during pregnancy of the index child.

Methods: This community-based, cross-sectional survey was conducted at Shifa Tameer-e-Millat University and Shifa College of Medicine, Islamabad, Pakistan, from June 2014 to January 2016, using a self-generated questionnaire. Systemic random sampling method was used to collect data. SPSS 21 was used to analyse the data and to find associations between maternal care and practices of breastfeeding.

Results: There were 1,275 participants in the study. The mean age of the participants was 31.61±8.026 years and the mean number of family members was 7.28±3.42. Overall, 1,121(87.9%) women had exclusively breastfed all their children while 906(71.1%) women had their children fully vaccinated. The mean duration of exclusive breastfeeding was 5.30±1.31 months while the mean duration of mixed breastfeeding was 16.70±8.62 months. Mothers who were given prenatal care were 2.60 and 2.91 times more likely to do exclusive breastfeeding and immunisation, respectively, compared to women who were not given prenatal care (p<0.05).

Conclusions: There is a dire need to focus more on routine services compared to massive immunisation and breastfeeding campaigns.
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May 2017

Safe drinking water and sanitary measures: A cross-sectional study in peri-urban community of Islamabad.

J Pak Med Assoc 2017 Feb;67(2):220-224

Community Medicine, ShifaTameer-e-Millat University, Islamabad and Shifa College of Medicine, Pakistan.

Objective: To assess sources of drinking water and its methods of disinfection, sanitary situation and waste disposal methods.

Methods: This cross-sectional study was conducted over a period of 6 months from April 2015 to September 2015 in the village of Nurpur Shahan, a peri-urban slum area of Islamabad, Pakistan. Systemic random sampling method was employed to gather data from an adult household member aged between 18 and 45 years through a structured questionnaire. SPSS 21 was used for data analysis..

Results: A total of 2,078 households were included in the study. The mean age of the participants was 31.5±8.17 years. Moreover, 1,600(77%) residents did not disinfect drinking water. Boiling was the most common 378(18.2) method of disinfection. Majority of the households 1,936(93.2%) had latrine inside their houses. The most common mode of waste disposal was burning 951(45.8%), followed by dumping 601(28.9%) and throwing away in the street 415(20%).

Conclusions: Most participants did not disinfect drinking water.
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February 2017

Use of mitochondrial COI gene for the identification of family Salticidae and Lycosidae of spiders.

Mitochondrial DNA A DNA Mapp Seq Anal 2018 01 13;29(1):96-101. Epub 2016 Nov 13.

b Department of Zoology , Government College University , Lahore , Pakistan.

In recent years, DNA barcoding has become quite popular for molecular identification of species because it is simple, quick and an affordable method. Present study was conducted to identify spiders of most abundant families, i.e. Salticidae and Lycosidae from citrus orchards in Sargodha district using DNA barcoding. A total of 160 specimens were subjected to DNA barcoding but, sequences up to 600 bp were recovered for 156 specimens. This molecular approach proved helpful to assign the exact taxon to those specimens which were misidentified through morphological characters in the study. We were succeeded to discriminate six species of Lycosidae and nine species of Salticidae through DNA barcoding. Results revealed the presence of clear barcode gap (discontinuity in intra- and inter-specific divergences) for members of both families. Furthermore, the maximum intra-specific divergence was less than NN (nearest neighbour) distance for all species. This suggested the reliability of DNA barcoding for spider's identification up to species level. We got 98% success in our study. It is concluded from present study that DNA barcoding is more reliable tool especially for immature spiders, when morphological characters are ambiguous.
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http://dx.doi.org/10.1080/24701394.2016.1248428DOI Listing
January 2018

Role of sodium-restricted dietary approaches to control blood pressure in Pakistani hypertensive population.

J Pak Med Assoc 2016 Jul;66(7):837-42

Federal Medical and Dental College, Islamabad, Pakistan.

Objective: To assess the change in systolic and diastolic blood pressure in post-interventional phase through dietary approaches to stop hypertension/salt-restricted diet.

Methods: This randomised controlled clinical study was conducted from February 2014 to March 2015 at the Armed Forces Institute of Cardiology, Rawalpindi, and Ali Medical Centre, Islamabad, Pakistan, and involved hypertensive patients and matching controls. The control group followed routine diet while the intervention group was given a diet plan containing 1,500mg of sodium providing 2,000 calories. Both groups were advised not to consume sodium-rich foods. Paired sample t-test was applied to determine the change in blood pressure among the groups at two different occasions.

Results: Of the 1,492 participants, 710(47.6%) were controls and 782(52.4%) were in the interventional group. Overall, 417(27.9%) participants got their blood pressure checked less than twice in six months, while 409(27.4%) had it done on a regular basis. Moreover, 941(63.1%)) subjects had a family history of high blood pressure and 149(10.0%) participants did not exercise at all. The overall mean age was 53.42±9.302 years. Mean systolic blood pressure and diastolic blood pressure after five weeks was 126.33±3.35 and 84.40±3.04mmHg in the intervention group, and128.41±3.52 and 84.04±2.953mmHg in the control group. Changes in blood pressure between the two groups were minimal but statistically significant (p<0.05).

Conclusions: A diet which is restricted in salt, rich in fruits, vegetables, and low-fat dairy foods and reduced saturated and total fat can substantially lower blood pressure. Such a diet offers an additional nutritional approach to the prevention and treatment of hypertension.
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July 2016

COMFORT LEVEL OF POST GRADUATE RESIDENTS WORKING IN DIFFERENT CLINICAL DOMAINS IN MANAGING COMMON OPHTHALMIC CONDITIONS.

J Ayub Med Coll Abbottabad 2016 Jan-Mar;28(1):89-93

Background: Ophthalmological conditions are frequently encountered in almost all clinical specialties. Assessing the adequacy of ophthalmology teaching in undergraduate medical education is important in order to diagnose and manage different ophthalmological conditions. The objective of this study was to determine the comfort level of post graduate residents working in different clinical domains in managing common ophthalmic conditions.

Methods: A cross sectional survey involving 277 post graduate residents was carried out over a period of six months in both private and public tertiary care hospital. A questionnaire containing two sections and 17 variables in total were distributed among Medical Residents of different specialties except ophthalmology residents. Participants of the study were selected through consecutive non probability sampling.

Results: Mean hours of classroom based ophthalmology instruction during undergraduate program was 59.38 hours (55.9) and mean hours of clinical based ophthalmology instruction during undergraduate program was 62.73 hours (60.8) 54% were either "not comfortable" or "somewhat comfortable" in managing common ophthalmic condition. Conclusion: Teaching hours in under graduate program meet or exceed requisite criteria. However graduating doctors generally feel that the time spent does not provide them with the comfort and skill level required to care for patients with ocular presentations.
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August 2016

INSECTICIDE RESISTANCE IN THE GROUND SPIDER, Pardosa sumatrana (THORELL, 1890; ARANEAE: LYCOSIDAE).

Arch Insect Biochem Physiol 2016 Sep 17;93(1):55-64. Epub 2016 Jun 17.

Department of Zoology, GC University, Faisalabad, Pakistan.

Elevated levels of insecticides detoxifying enzymes, such as esterases, glutathione S-transferases (GSTs), and cytochrome P-450 monooxygenases, act in the resistance mechanisms in insects. In the present study, levels of these enzymes in the insecticide-resistant ground spider Pardosa sumatrana (Thorell, 1890) were compared with a susceptible population (control) of the same species. Standard protocols were used for biochemical estimation of enzymes. The results showed significantly higher levels of nonspecific esterases and monooxygenases in resistant spiders compared to controls. The activity of GSTs was lower in the resistant spiders. Elevated levels of nonspecific esterases and monooxygenases suggest their role in metabolic resistance in P. sumatrana. The reduced levels of total protein contents revealed its possible consumption to meet energy demands.
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http://dx.doi.org/10.1002/arch.21341DOI Listing
September 2016

Prevalence of non-communicable diseases and their risk factors at a semi-urban community, Pakistan.

Pan Afr Med J 2016 31;23:151. Epub 2016 Mar 31.

Shifa College of Medicine, Shifatameer E Millat University, Islamabad, Pakistan.

Introduction: Pakistan is currently facing the double burden of communicable (38%) and non- communicable diseases (49%) according to WHO NCD Country Profiles 2014. About 50% of all deaths are attributed to NCD's. The objective of this study was to determine the burden of non-communicable diseases in semi urban community of Islamabad.

Methods: We carried a cross sectional study to estimate the burden of non-communicable diseases in an urban setting, a community based cross sectional survey covering 1210 households was carried out over a period of three months. Households were selected through consecutive non-probability sampling, among which adult females and males who were permanent resident of the community were interviewed through a structured questionnaire in urdu language. SPSS version 21 was used to analyze the data. Descriptive statistics were calculated.

Results: About 38.7% individuals had High BP / IHD, 34.4% had oro-dental health problems, 24.3% were physically disabled and 14.6% had diabetes. Among the risk factors, 48.2% were tobacco user, 13.60% were drug abuser and 1.8% alcoholics.

Conclusion: We conclude that the prevalence of non-communicable diseases is quite high in the above setting as compared to the National indicators, which demands timely intervention to curtail the existing burden of NCD.
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http://dx.doi.org/10.11604/pamj.2016.23.151.8974DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894738PMC
February 2017

Quality of life of Pakistani medical students studying in a private institution.

J Pak Med Assoc 2016 May;66(5):579-83

Federal Medical and Dental College, Islamabad, Pakistan.

Objective: To find the quality of life of medical students using a World Health Organisation questionnaire.

Methods: The cross-sectional study was conducted in February 2015 at Shifa College of Medicine, Islamabad, Pakistan, and comprised students studying in an integrated medical education system. The shortened version of World Health Organisation Quality of Life questionnaire comprising 26 items was used. Consecutive non-probability sampling was used to collect data which was analysed using SPSS 21.

Results: Out of 417 medical students, 185(44.4%) were male and 232(55.6%) were female. Of them, 165(39.6%) were in pre-clinical years, while 252(60.4%) were in clinical years. Overall, 347(83.2%) students rated their quality of life as "good" or "very good". Environmental domain had the highest mean score of 70.43±16.38 while Psychological Health domain had the lowest mean score of 66.48±15.64.

Conclusions: Medical education affects students' health, thus their quality of life varies. Identification of this is very important, since long-term stress can induce some permanent personality changes in individuals.
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May 2016

Rotavirus vaccine--a new hope.

J Pak Med Assoc 2014 Oct;64(10):1211-6

Diarrhoea due to Rotavirus is the leading cause of mortality among children less than 5 years of age in developing countries. Though Rotavirus vaccine has been approved by FDA since 2006 it has not been incorporated in the EPI schedule of Pakistan. Objective of our study was to explore the clinical efficacy, cost effectiveness and safety of Rotavirus vaccine in infants and children against diarrhoea caused by Rotavirus. Online search yielded a total of 103 articles out of which 31 articles were included for perusal. Newly-developed vaccines have been found to have combined efficacy of 61.2-64.6% in African Countries and 82.1-84.7% in Europe and Latin America against Rotavirus-induced diarrhoea. Rotavirus vaccine is a very effective option in terms of efficacy, cost and safety against viral diarrhoea caused by Rotavirus. Consideration should be given to include this vaccine in EPI programme of developing countries.
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October 2014

Two years experience with tunneled dialysis catheters in patients requiring haemodialysis.

J Pak Med Assoc 2014 Jul;64(7):758-61

Objective: To look for survival rate and major reasons behind the failure of tunnelled dialysis catheters in patients on haemodialysis.

Methods: The retrospective study was conducted at the Department of Interventional Radiology, Shifa International Hospital, Islamabad, and comprised records of 100 consecutive subjects from a list of patients in whom tunnelled cuffed catheters were placed from February 2009 to January 2011 and were followed up for two years. Data was collected on a proforma from the hospital database and medical records of patients. SPSS 19 was used for statistical analysis.

Results: Of the total 122 catheters placed in 100 patients, 49 (40.16%) were lost to follow-up. Of the remaining 73 (59.83%) catheters, 38 (52%) had achieved their desired function, while 35 (48%) failed to achieve the target duration. Among the reasons of catheter failure, infection was the commonest at 13 (37.14%) with infection rate of 0.24 per 1000 catheter days. According to Kaplan Meier analysis, catheter survival rates at 60, 90 and 180 days were 89%, 77% and 64% respectively. Mean effective duration of catheter was 129 +/- 117 days.

Conclusion: Tunnelled dialysis catheters can be safely used as vascular access till the maturation of fistula and may be an alternative to Arterio-Venous Fistula or graft for long-term vascular access if indicated.
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July 2014

End treatment response with pegylated interferon among chronic hepatitis C non-responders.

J Coll Physicians Surg Pak 2011 Jun;21(6):334-7

Medical Unit-II, Benazir Bhutto Hospital / Rawalpindi Medical College, Rawalpindi.

Objective: To determine the frequency of end treatment virologic response (ETR) with pegylated interferon alpha and ribavirin in treatment of chronic hepatitis C patients who failed to respond to interferon plus ribavirin therapy given for at least 24 weeks.

Study Design: Descriptive study.

Place And Duration Of Study: Medical Unit-II, Benazir Bhutto Hospital, Shafi Clinic Rawalpindi and PAEC Hospital Islamabad, Pakistan, from July 2008 to June 2009.

Methodology: Patients with hepatitis C who were non-responders to previous treatment with standard interferon and ribavirin, were given Pegylated Interferon alpha plus ribavirin. Total duration of treatment was 24 weeks for genotypes 2 and 3 and 48 weeks for genotypes 1 and 4. The primary end point was undetectable HCV RNA by polymerase chain reaction assay at the completion of therapy.

Results: Out of the 44 enrolled patients, 24 (54.5%) were males and 20 (45.5%) were females. Mean age of patients was 45.25±7.14 years. HCV genotypes were 3 in 64%, 2 in 30% and 7% each had genotypes 1 and 4. Both the early virological response and end of treatment response was seen in 75% patients.

Conclusion: There was a high ETR rate of 75 in previous non-responders to conventional combination therapy. This high ETR as compared to international data is because of existence of favourable genotypes in our country which is encouraging in the treatment of non-responders.
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http://dx.doi.org/07.2011/JCPSP.334337DOI Listing
June 2011

Status of hospital infection control measures at seven major tertiary care hospitals of northern punjab.

J Coll Physicians Surg Pak 2010 Apr;20(4):266-70

Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi.

Objective: To determine the availability and implementation of various hospital infection control measures at tertiary care hospitals.

Study Design: Survery.

Place And Duration Of Study: National Institute of Science and Technology, Islamabad, from June through August 2008.

Methodology: Seven tertiary care very busy hospitals were selected; one from Islamabad, 5 from Rawalpindi, and one from Lahore. A detailed proforma was designed addressing all the issues pertaining to hospital infection control measures. Air sampling was done and growth yielded was identified by standard methods.

Results: Analyses revealed that all of the hospitals had an Infection Control Committee. Microbiological diagnostic facilities were adequate at all the hospitals and overall microorganism yield was very high. Antibiotic policy was claimed by most, not available on ground. Majority of the operation theatres were without proper air flow system and autoclaves were not being regularly monitored. There was no proper disposal for sharps and needles. Incineration was not the usual mode for infectious waste.

Conclusion: The results of the present study imply availability of proper hospital infection control policies with need of strict implementation of such measures.
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http://dx.doi.org/04.2010/JCPSP.266270DOI Listing
April 2010

Impediments to prenatal diagnosis for beta thalassaemia: experiences from Pakistan.

Prenat Diagn 2008 Dec;28(12):1116-8

Armed Forces Post Graduate Medical Institute, Department of Community Health Sciences, Rawalpindi, Pakistan.

Objective: To investigate the practices of parents of beta thalassaemia children towards utilization of prenatal diagnosis (PND) in Pakistan.

Methods: A cross-sectional study was done between April and September 2007 at two thalassaemia treatment centers in Rawalpindi and Islamabad. Simple random sampling was employed to interview 215 parents of thalassaemic children. Parents of thalassaemic children who were not planning to have any more children were excluded from the study. A structured questionnaire with preassigned values was developed for collection of data.

Results: Out of the 215 respondents, 149 (69%) families had a pregnancy following the birth of the registered thalassaemic child. Among 149 couples, 90 (60%) did not request PND. The main reasons for underutilization of PND included lack of awareness (23%), high cost (23%), poor access (17%), delay in seeking (16%) and advice against the test (12%). A significant improvement in the use of PND was observed with increasing mother's education (p < 0.016).

Conclusion: PND for thalassaemia is available in Pakistan for over a decade but its use remains limited. There is a need to increase its utilization by addressing various impediments noted in this study.
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http://dx.doi.org/10.1002/pd.2133DOI Listing
December 2008

Interaction studies of omeprazole with mefloquine, pyrimethamine and sulfadoxine.

Pak J Pharm Sci 2006 Oct;19(4):314-21

Department of Chemistry, University of Karachi, Karachi-75270, Pakistan.

Mefloquine hydrochloride, pyrimethamine and sulfadoxine as readily tolerated antimalarial drugs that are highly active against both usual and multidrug resistant strains of Plasmodium falciparum. Omeprazole reduce gastric acid secretion, irreversibly by inhibition of H+-K+ ATPase of the apical membrane of the parietal cell. In order to study the drug interactions of the later with antimalarials, in vitro availability of omeprazole has been studied in presence of mefloquine hydrochloride, pyrimethamine and sulfadoxine. The availability of antimalarial drugs was found to be influenced considerably in presence of omeprazole. The effect of dissolution mediums, simulating various body environments with respect to pH and the influence of temperature on these interactions has been examined in order to elucidate the mechanism of these interactions.
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October 2006
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