EFFECTS OF HEALTH-SEEKING BEHAVIOR ON COMPLIANCE OF LONG-TERM TREATMENT AMONG GLAUCOMA PATIENTS

Objectives: The objectives of the study were to determine the level of non-compliance with long-term glaucoma therapy in patients presenting in glaucoma department of Al-Shifa Trust Eye Hospital and to identify the health-seeking predictors affecting it. Methods: A cross-sectional study of 5 months was conducted on glaucoma patients who are taking follow-up visits in glaucoma department for 6 months or more. The level of compliance with glaucoma medication (dependent variable) was assessed through a scale at first and further transformed into binary variable afterward. Chi-square test of independence was used followed by logistic regression to find out the predictors of compliance. Results: A total of 200 patients participated in the study. Majority of them were from urban background (n=125, 62.5%) and were diagnosed with glaucoma 1–5 years (n=104, 52%) back. Almost 16.00% of patients were not giving follow-up on given appointment. Moreover, 10.00% were not taking proper medications and prescribed dosage of medications was not taken by 21.5%. Intraocular pressure was higher than normal limits in 13.00%. Self-medication (χ2 (df) =5.44(1), 0.01, OR=0.28 (0.09–0.81) and doctor-patient communication (χ2(df)=18.25(1), 0.03, OR= 2.27 (1.06– 4.86) were significant health-seeking predictors of glaucoma treatment compliance. Conclusion: Blindness due to glaucoma is an avoidable condition if underlying factors such as self-medication is discouraged and doctor-patient communication can be improved in the glaucoma department

The value of intermittent growth monitoring in primary health care programmes

The objective of growth monitoring is to detect early growth faltering before the child becomes severely malnourished. It has been found in many large projects in the private sector and in Government run Primary Health Care (PHC) programmes that monthly weighing is not feasible which makes it impossible to develop a functional outreach programme on a sustainable basis. This study is an attempt to propose an intermittent growth monitoring which is operationally feasible for large scale PHC programmes in the public sector. A historical prospective study was conducted to find out the correlation of weights of children at different ages with weights at subsequent months. Two hundred and ninety-two growth cards of children were selected from two squatter settlements of Karachi which are having a PHC programme through the Aga Khan University. At six months, about 71% of children were within the normal range, with increasing age from 10% to 39% of these children shifted to grade I Protein Energy Malnutrition (PEM). When weights of children for each month were correlated with weights at all other months up to 24 months, it was found that correlation coefficient at 6th and 9th month were significant (P value \u3c 0.001). Probability of developing malnutrition at different weights and ages were also calculated. The results indicate that malnutrition starts appearing at 6 months and weights at 6 months and to a lesser extent at 9 months are better prognostic indices of future malnutrition. Intermittent weighing of children can help in early identification of high risk children who can then be managed and even be prevented from developing future malnutrition

Patientenbetreuung im Geriatriezentrum/Pflegeheim

Die Pflege ist durch so viele Rituale geprägt, dass mitunter einfaches Nachdenken, Nachlesen, Diskutieren und etwas Mut zur Veränderung ausreichen, um einen anderen Weg zu beschreiten. Mit anderen Worten: Eine wissenschaftliche Bearbeitung ist oft, wie etwa durch eine aufwendige For-schung, nicht erforderlich. Der erste Schritt sollte sein, alle Rituale zu identifizieren sowie sinnvolle und fragwürdige Anteile zu prüfen. Nicht alles, was Pflegende routinemäßig durchführen, ist Unsinn, auch traditionelle Maßnahmen könnten durchaus wiederbelebt werden. Vermutlich liegen wertvolle Anteile in einzelnen „Maßnahmen“, einem mitfühlenden Blick, einer tröstenden Berührung, einem richtigen Wort oder einer wesentlichen Beobachtung. Die Pflegeperson tut etwas, weil es schon immer so gemacht wurde. Vielleicht sind solche Handlungen in den heiligen Steintafeln, den Dienstvorschriften verewigt oder vielleicht hat auch bloß der Satz „ Die Oberschwester hätte es gern so“ diese Wirkung. Wie auch immer, die Pflegeperson muss nicht über das Problem nachdenken und eine adäquate Lösung finden, denn die Handlung ist ein Ritual. Eine andere Perspektive zeigt die Rolle der Pflegeperson auf, die lediglich Anweisungen ihrer Vorgesetzten in der unangefochtenen Tradition des Gehorsams ausführt, die Teil des viktorianischen Erbes ist, mit dem die Pflege auch heute noch zu kämpfen hat. Dieses Erbe verlangt Beachtung der Hierarchie und auch den Gehorsam gegenüber Männern, die nach viktorianischen Wertvorstellungen von Natur aus den Frauen überlegen sind. Nicht zufällig sind die meisten Pflegenden Frauen und die meisten Ärzte Männer. (vgl. Ford&Walsh, 2000)The care seems influenced by so many rituals that sometimes simple reflection, future reference, discussion and some courage enough to change, to tread a different path. In other words: often is a scholarly and not through some sophisticated research is required. The first step should be to identify rituals to considers meaningful and questionable shares. Not everything that carer routinely performs nonsense; even traditional measures could well be revived. Probably be valuable shares between individual “measures” a compassionate glace, a comforting touch, a real word or a significant observation Nursing. Nursing homes have one, the generally recognized state of scientific knowledge, appropriate quality of housing, care and support to secure. They also have the task of protecting the interests and needs of residents from degradation and to maintain independence, self determination and selfempowerment or increase. An important prerequisite for the fulfilments of such claims is the presence of adequate staffing. Carer does something because it was made always like this. Perhaps such acts in the sacred stone tablets, the Staff have been immortalized, or maybe even just the phrase:” The head nurse would have liked it so "this effect. However, the caregiver must not think about the problem and find an adequate solution, because the act is a ritual. A different perspective points to the role of caregiver, which performs only their superior in the tradition of unquestioned obedience, which is part of the Victorian heritage, with the care of today still has to fight. This heritage requires consideration of the hierarchy and obedience to men who are superior to Victorian values by nature to women. Not by chance, most men’s are doctors and most nurses are women. This work is to explain how the care happens in reality and the problems that accompany nurses during their work. The aim was therefore to describe relations in geriatric nursing center so that load factors in the development on the part of the nursing staff are conducive In this context, in a section was a disturbing factors explain the concerns, the problems in the inpatient care area to highlight from the nursing perspective

New Iterative AM Estimation Procedure for Fitting the Simple Linear Measurement Error Models

This article proposed a modified AM estimation procedure. The procedure uses the grouping estimators iteratively after dividing the sample into clus- ters. Then, the grouping AM procedure used to fit the structural relationship with measurement error considering there is no equation error model. The performance of the iterative grouping estimator is compared with the tra- ditional two group estimators. Simulation study showed that in terms of mean square error the proposed estimator is robustify the traditional two group estimator. A real data analysis for studying the relationships between happiness rate and the corruption perceptions index in the Arabs states is discussed

Causes of reproductive age mortality in low socioeconomic settlements of Karachi

The Maternal and Infant Mortality Survey (MIMS) was conducted in eight squatter settlements of Karachi. The female mortality rate was 151.0 per 100,000 women aged 10-49 years and the maternal mortality ratio was 281 per 100,000 livebirths. The leading causes of deaths among women were complications of pregnancy (28.1%), infectious diseases (24.8%), cardiovascular diseases (20.7%), neoplasia (10.7%) and trauma (10.7%). Hemorrhage (47.1% of all maternal deaths), tuberculosis (40.0% of all infectious disease deaths), oropharyngeal cancer (23.1% of all neoplastic deaths), and burns (61.5% of all trauma deaths) were among the major causes identified. Maternal deaths were associated with young age and nulliparity (p-value \u3c 0.01), and a higher proportion occurred in the hospital or on the way to the hospital as compared to non-maternal deaths

Risk factors for intrauterine growth retardation: results of a community-based study from Karachi

There is a serious lack of community-based information on low birthweight or intrauterine growth retardation from Pakistan. A community based prospective study was conducted in four squatter settlements of Karachi, to examine the prevalence and risk factors for adverse pregnancy outcome. This paper reports on the prevalence and risk factors for intrauterine growth retardation (age) among 755 singleton births. The incidence of intrauterine growth retardation was 25.4% (192 intrauterine growth retarded and 563 appropriate for gestational age). Major socioeconomic risk factors identified were low maternal education (RR = 1.4, 95% CI = 1.0,2.1) and poor housing material (RR = 1.7, 95% CI = 1.0,3.0). Among the significant biologic factors, primiparity (RR = 1.9, 95% CI = 1.4,2.7), consanguinity (RR = 1.4, 95% CI = 1.4,2.7), consanguinity (RR = 1.4, 95% CI = 1.1,1.8), short birth to CI = 1.1,2.1), short stature (RR = 2.2, 95% CI = 1.6,3.0), low maternal weight (RR = 2.0, 95% CI = 1.6,2.5) and non-vegetarian diet (RR = 2.3, 95% CI = 1.3,4.2) were especially important. Investigations to assess the adverse mortality and morbidity effects of intrauterine growth retardation are ongoing

Dietary factors and Type 2 diabetes in the Middle East : what is the evidence for an association? - A systematic review.

This review aims to search and summarise the available evidence on the association between dietary factors and type 2 diabetes mellitus (T2DM) in Middle Eastern populations, where diabetes prevalence is among the highest in the world. Electronic databases were searched; authors, libraries, and research centres in the Middle East were contacted for further studies and unpublished literature. Included studies assessed potential dietary factors for T2DM in Middle Eastern adults. Two reviewers assessed studies independently. Extensive searching yielded 17 studies which met the inclusion criteria for this review. The findings showed that whole-grain intake reduces the risk of T2DM, and potato consumption was positively correlated with T2DM. Vegetables and vegetable oil may play a protective role against T2DM. Dietary patterns that are associated with diabetes were identified, such as Fast Food and Refined Grains patterns. Two studies demonstrated that lifestyle interventions decreased the risk of T2DM. In summary, the identified studies support an association between some dietary factors and T2DM; however, many of the included studies were of poor methodological quality so the findings should be interpreted with caution. The review draws attention to major gaps in current evidence and the need for well-designed studies in this area

Psychiatric morbidity: prevalence, associated factors and significance

A cross-sectional observational systematic study was carried out on ambulatory patients at a tertiary care hospital to determine the probable prevalence, associated factors and significance of psychiatric morbidity by using an Urdu translation of the hospital anxiety and depression (HAD) scale over a period of 6 days in a week. Results showed a prevalence of 38.4% which is slightly higher than what has been generally reported (30%). Two variables, i.e., female sex and being a housewife were significantly related with the outcome. An attempt has been made to identify the probable reasons for this and some suggestions laid down for further work