Assessment of childhood domestic injuries among joint and nuclear families of Karachi

To assess the frequencies and factors of domestic injuries among children aged less than 5 years. This is a cross sectional study, in which parents who have child less than 5 years of age were targeted. A total of 246 participants had provided satisfactory information and they were approached by non-probability purposive sampling technique from January 2016 to June 2016. The data was entered in Excel and then imported to SPSS 19.0 for inferential analysis. In this study, 89.8% (n = 221) mothers and 10.2% (n = 25) father who had participated. 52.08% (n = 123) parents were from joint family. The different types of domestic injuries faced by children were fall (52%), sharp cut (36%), and burn (31%) and Temporary fever, rashes and scratches were the most common consequence of domestic injury as experienced by 57% children. No any significant difference (p \u3e 0.05) in the storage practices of different household hazardous item was observed among the parents living in joint and nuclear family system. Protecting children from domestic injury is a multi-dimensional approach. It needs parent’s education, manufacturer guidance, Government regulation and joint community efforts for proper and safe storage of household items. These measures will aid in reducing the burden of childhood domestic injuries

Problems Faced and Difference in Quality of Life Among The Elderly Population of Suburban Areas of Twin Cities

Objective: To evaluate the problems faced and the difference in the quality of life among the elderly population of three suburban areas of twin cities of Pakistan.Setting and duration: This study was conducted in three suburban setting around Islamabad and Rawalpindi in a duration of six months from February to August 2017.Methodology: A total of 110 participants consisting on 55 males and 55 female were selected for the study. This cross sectional survey was conducted on a geriatric population of age more than 60 years. The elders having any disease, psychological or physical disorder were excluded from the study. In this study, we used the Quality of life Instruments developed by WHO (WHOQOL-BREF) which is a validated and one of the most widely used tools in QoL research. Informed consent was taken from all the participants prior to the study. The data form all the participants was collected through face to face interviews and entry with analysis was done through SPSS v. 21.Results: Majority 58 (52.73%) of the participants were of age interval of 60-64 years followed by 39 (35.45%) in the age group of 65-69 years. A large number 41 (37.27%) of elderly participants were uneducated. Most 63 (57.27%) of the participants of the study were living in the extended family system. Main bulk 49 (44.55%) of the study sample belonged to families having a monthly income of 16000-25000 rupees, followed by 25 (22.73%) families having an income of 26000-35000 rupees. The main source of income was a dependency on children. The most common 24 (21.82%) problem faced was related to financial issues, followed by loneliness 22 (20%). Majority 68 (61.82%) of the study sample replied that the bahaviour of family members is friendly and politely with them. The QoL score for physical health, psychological health, social relationship and environment were significantly higher in male participants as compared to female counterparts. The overall quality of life on the basis of the quality of life score QoL was significantly better in male participants as compared to female participants.  Conclusions: The overall quality of life on the basis of quality of life score QoL was significantly better in male participants as compared to female participants. Their busy children or family conflicts and misapprehensions instigate their miserable moments of older life

Contributing factors and their association with blood pressure control amongst hypertensive patients

Objective: To assess contributing factors and their association with blood pressure control amongst hypertensive patients.Methodology: This cross sectional comparative study was conducted at OPD general medicine dept, Pakistan Institute of Medical Sciences, from July to December 2018. Hypertensive patients of both genders, having age more than 18 years, and on antihypertensive medication form at least six months were included in the study. Optimally controlled BP was defined as an average systolic BP < 140 and diastolic BP < 90 mmHg if the patient is younger than 60 years, or an average systolic BP < 150 and diastolic BP < 90mmHg if patient was older than 60 years. Logistic regression was applied to assess the effect of different factors on blood pressure control of the hypertensive patients.Results: In the study sample majority 107 (55.4%) of the patients belonged to 41-60 years age group, and females 106 (54.9%) were predominant. Main bulk 155 (80.3%) of the patients was married and mostly 80 (41.5%) patients had monthly income in the range of 25000-50000. About half 89 (46.1%) of the patients enrolled for the study were doing adequate physical activity. Optimized blood pressure was found in 92 (47.67%) patients.Conclusion: The proportion of hypertensive patients whose blood pressure was optimally controlled was relatively low and less than half of patients had blood pressure in acceptable limits. Age group (41-60) years, routine use of vegetable on most days of week, physical activity, adherence to treatment and taking less than three drugs have a strong relationship with blood pressure to keep in optimized limits

The scope and role of family medicine in health care system of Pakistan: perceptions of health care professionals

Objective: To assess and compare the discernments of medical students and healthcare professionals about family medicine as a distinct speciality, and effect of awareness session on their comprehension.  Methodology: This cross-sectional study was conducted on 4th year and final year under graduate students and professional doctors working in different hospital of twin cities of Rawalpindi and Islamabad. A lecture on “family medicine and its scope as a career” was arranged for the students of 4th year and final year students. Similarly, a workshop on “family medicine and its scope as a career” was arranged and professional doctors were invited. A predesigned self-administered questionnaire already used by a similar study, was given to all the students before and after the awareness session to students and doctors. Results: A total of 225 participants were included consisting on 170 undergraduate students and 55 professional doctors working in different hospitals of twin cities. There were 68 (40%) male participants in undergraduate and 30 (54.54%) male participants among professional doctors. The mean age of undergraduate students was 21.45+1.26 years and mean age of professional doctors was 32.65+3.35 years. Less than half 80 (47.06%) of the undergraduate students had knowledge about the family medicine as speciality but in professional doctors almost all 50 (90.91%) participants know family medicine as speciality. Almost all undergraduate students 145 (85.29%) and professional doctors 52 (94.54%) feel that family medicine can improve the health care in Pakistan. Conclusion: It is necessary to include the family medicine as part of curriculum for undergraduate medical students to develop interest in this newly emerging vital speciality, which can help in betterment of health care in this country

Diabetic foot self-care: associated risk factors, awareness and practice among type II diabetic patients

Objective: To evaluate associated risk factors, awareness and practice level of diabetic foot self-care among type II diabetic patients.Methodology: A cross-sectional study was conducted at outpatient departments of Akbar khan Niazi teaching hospital and PIMS hospital from June to December, 2018. All adult patients diagnosed as Diabetes Mellitus (DM) type 2 for at least one year without any foot related complication were selected. The questionnaire included on demographics and questions related to diabetes, awareness and practice of foot self-care.Results: A total of 196 patients were enrolled, majority 116 (59.18%) of which had age of 41-60 years with 105 (53.57%) of male participants, 76 (38.78%) patients were illiterate and 93 (47.45%) were unemployed or retired. Majority of the participants 109 (55.61%) had monthly income of 25000-50000. Eighty-eight (44.90%) patients were overweight and 32 (16.33%) obese. Majority 113 (57.65%) had diabetes from 5-10 years. On the basis of HbA1c level only 58 (29.59%) patients had HbA1c level of less than 7.0%. Significant number of patients had poor knowledge (41.3%) and practice level (39.8%) regarding foot care.Conclusion: Almost half of our patients attending primary healthcare centers have limited awareness and practice regarding diabetic foot self-care

Diabetic foot self-care: associated risk factors, awareness and practice among type II diabetic patients

Objective: To evaluate associated risk factors, awareness and practice level of diabetic foot self-care among type II diabetic patients.Methodology: A cross-sectional study was conducted at outpatient departments of Akbar khan Niazi teaching hospital and PIMS hospital from June to December, 2018. All adult patients diagnosed as Diabetes Mellitus (DM) type 2 for at least one year without any foot related complication were selected. The questionnaire included on demographics and questions related to diabetes, awareness and practice of foot self-care.Results: A total of 196 patients were enrolled, majority 116 (59.18%) of which had age of 41-60 years with 105 (53.57%) of male participants, 76 (38.78%) patients were illiterate and 93 (47.45%) were unemployed or retired. Majority of the participants 109 (55.61%) had monthly income of 25000-50000. Eighty-eight (44.90%) patients were overweight and 32 (16.33%) obese. Majority 113 (57.65%) had diabetes from 5-10 years. On the basis of HbA1c level only 58 (29.59%) patients had HbA1c level of less than 7.0%. Significant number of patients had poor knowledge (41.3%) and practice level (39.8%) regarding foot care.Conclusion: Almost half of our patients attending primary healthcare centers have limited awareness and practice regarding diabetic foot self-care

Impact of Vitamin D3 Supplementation on Overweight and Obese Individuals

Objective: To determine the effect of Vitamin D3 supplementation on overweight and obese individuals Methodology: This descriptive Cross Sectional Study was done. The participants in the study were selected from medical outpatient departments of three public sector hospital of Islamabad and Rawalpindi, from January to June 2018. All overweight of obese patients were  randomly divided into two equal groups of 88 participants in each group, by random number table method. Group A was an intervention group who were given vitamin D3 and Group B, was given placebo. Vitamin D3 (dose) supplementation was given for 12 weeks. Anthropometric parameters including BMI, waist circumference, and waist to hip ratio was recorded at the start of the study and was noted on a predesigned performa. After completion of treatment repeat serum Vit. D3 level and anthropometric measurements were done. Results: The mean age in vitamin D group was 38.46 ±7.28 years and in placebo group 37.85±8.25 years. There was insignificant (p-value > 0.05) difference in body weight (76.56±11.25 vs. 75.85±10.76) before and after intervention among participants of vitamin D group. The comparison of waist circumference (92.78±7.35 vs. 92.24±7.21) and hip circumference (107.74±7.45 vs. 106.45±7.12) showed no any significant (p-value > 0.05) change after the intervention. There was a minor change in BMI on baseline 29.65±3.26 and after three months of intervention 29.38±3.1 kg/m2 but this difference was not statistically significant (p-value > 0.05). Conclusion: The supplementation with vitamin D3 during 12 weeks did not improve the anthropometric parameters like body weight, waist and hip circumference and BMI. So the correction of serum vitamin D3 level does not help in decreasing the anthropometric parameters

Immature Platelet Fraction in Patients with Chronic Liver Disease, A Marker for Evaluating Cirrhotic Changes.

Objective: To evaluate the role of Immature platelet fraction in patients with chronic liver disease, a marker for evaluating cirrhotic changes. Methodology: This case control study was conducted at department of Pathology, Aziz Fatima Medical and Dental College, Faisalabad, over a period of Seven months from June 2020 to January 2021. A total of 126 participants were included in the study consisting of 63 patients with chronic liver disease in group A and 63 participants without any known disease in group B as control. The IPF master program in combination with XE-2100 multiparameter automatic hematology analyzer was used to measure the immature platelet fraction. Ethylene diamine tetraacetic acid was used to collect the blood sample for IPF measurement and was maintained till analysis on room temperature. Ten repeated analyses, immediately and after 24 hours were done for reproducibility of IPF%. Results: The mean age of liver disease patients was 52.35 ± 13.64 years and in control group the mean age was 51.62 ± 11.27 years. There was no significant (p-value > 0.05) difference between both groups based on age and gender. The hemoglobin level and red cell count was found to be significantly (p-value < 0.05) reduced in cases group. While white blood cells count was comparable in both groups. The mean platelet count was significantly (p-value < 0.05) less in cases group (163.5 ± 90.4 vs 233.4 ± 54.5 (x10*3/µl). The mean value of immature platelet fraction (IPF%) was significantly (p-value < 0.05) raised in cases group (5.62 ± 2.92 vs 3.06 ± 1.87). The multivariate discriminant analysis (MDA) score showed a significant (p-value < 0.05) association with chronic hepatis as compared to other liver related diseases. Conclusions: In chronic liver disease patients, there is an inverse relationship between platelet count and IPF% with decreased platelet count and increased IPF%. The proposed MDA function can be used to identify the cirrhotic changes in liver disease patients

Herbal remedies used for the management of urolithiasis in Abbottabad, Northern Pakistan

The current study was performed to evaluate the ethnobotanical uses of medicinal plants to treat and prevent kidney diseases, especially urolithiasis in the Abbottabad region, Northern Pakistan. Field surveys were conducted from 2014–2016 in various rural and tribally dwelled hilly areas like Ayubia National Park, Sherwan and Thandiani. Ethnobotanical information about the medicinal plants employed to treat urinary ailments was obtained from well-informed sources like local healers (hakims) and residents (men/women), who had vast knowledge of local plants uses. The questionnaire method was adopted to record the information and queries were made to verify the information. Informed consent was obtained from each informant before conducting the interview process. Quantitative ethnobotanical indices were calculated for each recorded species. Correlation analysis between the RFC, UV and FL% was tested by Pearson’s correlation, SPSS (ver. 16). A total of 38 plant species belonging to 27 families were being used in the study area to treat Urolithiasis or kidney stone diseases. Asteraceae was the most dominant family with 5 species. Local people used different methods of preparation for different plant parts; among them, decoction was the popular and dominant way of preparation (52.6%), followed by powder (18.4%), extracts (15.7%), juice (7.8%) and cooked (5.2%). The highest UV was recorded for Rumex acetosa L. (1.14) followed by Agrimonia eupatoria L. (1.1), Equisetum ramosissimum Desf. (1.05), Aerva lanata L. (1.04), Eclipta alba Hassak. (1.03). Moreover, twenty-three species were recoded with above 50% Fidelity level. It was found that most of the plant species (16 species) were explicitly used to remove kidney stones. All the obtained data about the ethnomedicinal uses of plants to treat urinary tract ailments are alphabetically categorized to their botanical name/family, local name, phytoconstituents, dosage and route of administration, along with quantitative indices value. All the collected ethnomedicinal plants require a thorough scientific investigation for isolation, identification, biochemical assays, toxicities and evaluation of pharmacological activities of the phytoconstituents, especially of the plants recorded with a high-fidelity level before their usage in clinics

Plant Invasion and N₂O Emission in Forest Ecosystems

Nitrogen (N) is a key factor for any ecosystem and has been found limited for biomass production. More N in forest ecosystem and their efficient utilization will contribute to the maximization in their growth, competition, and reproduction. Invasive plants capture and utilize more N than native plants and accelerate N cycles through altering the structure and community of soil microbes and the litter decomposition rates, under microclimate conditions, resulting in an increase of N availability. All these factors are promoting the invasiveness of plants and cause further ecological and economic damage and decline in native biodiversity. Plant invasions affect soil microbial community, soil physiochemical properties, and litter decomposition rates, promoting N cycle and releasing more nitrous oxide (N2O) into the atmosphere, further facilitating global warming, causing changes in the geographic ranges of some invasive species. Also, a better understanding of the mechanism, affecting factors, impacts, and control of the invasive species will lead to proper forest management. Proper and effective management will ensure the control of invasive species which includes invasive plant inventory, early deduction and rapid response, management plan and implication, and government support