Prevalence of non-communicable diseases and their risk factors at a semi-urban community, 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 noncommunicable diseases in semi urban community of Islamabad. Methods: We carried a cross sectional study to estimate the burden of noncommunicable 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.Pan African Medical Journal 2016; 2

Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan : Evidence from two longitudinal cohort studies 15 years apart

Funding Information: Study 1 was funded through the Applied Diarrheal Disease Research Program at Harvard Institute for International Development with a grant from USAID (Project 936–5952, Cooperative Agreement # DPE-5952-A-00-5073-00), and the Aga Khan Health Service, Northern Areas and Chitral, Pakistan. Study 2 was funded by the Pakistan US S&T Cooperative Agreement between the Pakistan Higher Education Commission (HEC) (No.4–421/PAK-US/HEC/2010/955, grant to the Karakoram International University) and US National Academies of Science (Grant Number PGA-P211012 from NAS to the Fogarty International Center). The funding bodies had no role in the design of the study, data collection, analysis, interpretation, or writing of the manuscript. Publisher Copyright: © 2020 The Author(s).Peer reviewedPublisher PD

Utilization of health needs assessment survey for delivering health education by medical students in community based education program at Shifa College of Medicine

Background: Health Needs Assessment (HNA) is a recommended public health tool to plan for community health services. In order to look into the status of a community’s health, elements of Primary Health Care needs to be assessed. Community Based Education (CBE) is in practice at Shifa College of Medicine (SCM), Islamabad as part of 4th year Community and Family Medicine Clerkship. As narrated by Magzoub, there are 3 classes of CBE. Among the service oriented programs there is community development and health interventions. With an aim to improve health care delivery at Nurpur Shahan through CBE, a Primary Health Care Centre in collaboration with Rotary and SCM is in place. Objectives: 1. To determine the health needs of Nurpur Shahan community based on elements of PHC 2. To assess students performance regarding deliverance of heath education to the community at the Primary Health Care Centre. Methods: A Cross Sectional Survey for the HNA was carried out at Nurpur Shahan after taking approval from the Institutional Review Board of Shifa Tameer –e- Millat University. For this purpose Muslim Colony with a registered population of 3,500 adjacent to Rotary Clinic was selected for data collection. This was surveyed by 4th year Medical students while they were attending Community & Family Medicine (CFM) clerkship. This project is spread over a period of one year through the entire CFM clerkship of 5 batches, so far one clerkship has undergone this project. Questionnaire designed for this study has been divided into 9 sections questions regarding Demography and Elements of PHC .A sample size of 500 was calculated using WHO sample size calculator keeping an arbitrary figure of 50% for the health needs; absolute precision required 4.5%, level of significance 95%. As such data of 100 households per clerkship was collected, thus achieving a sample size of 500 at the end of 5 clerkships. Households were approached through community based workers through simple random sampling. Survey was carried out by interviewing the house hold lady after taking informed consent with the help of a questionnaire which was translated into Urdu after validating through pilot testing. Following collection of data, students entered the data in SPSS and performed data analysis under supervision to identify the health needs. Two days student led interactive sessions were then conducted for the community members from whom data collection was done through interactive session at Rotary clinic. Students’ performance regarding the HNA survey performance was assessed through checklist, which has been adapted from WHO report on Community-based Education of Health Personnel 1987. • Data was entered and analysed using SPSS version 19.0. Descriptive statistics were calculated for both Qualitative and Quantitative variables. For qualitative variables, frequency and percentage were calculated. For quantitative variables, mean ± SD were calculated. Results: Out of a total of 100 households surveyed in one clerkship, the most common health needs identified included: non-availability of safe drinking water 80.76%, solid waste disposal by throwing away in open 76%, oro-dental health problems in 48%, smoking in 48%, antenatal visits less than 4 in 43%, , Hypertension in 43%, Tuberculosis in 25% , physical disability in 30%, contraception use among couples in 29%, incomplete immunization in 15% under 1 year of age Out of 20 students in one clerkship, 8 performed satisfactory while 2 scored excellent on the health education. Conclusions: Identification of health needs through community based survey by the students of CFM would help to provide targeted services at the PHC. Moreover, deliverance of health education by the students helped to build their confidence and improve their communication skills by interacting with community. This project can be utilized to achieve the CANMED’s competencies in undergraduates. Key words: HNA, Health Education, PHC, CB

Utility of mitochondrial COI gene for identification of wild ungulate species of conservational importance from Pakistan

Most of the ungulates of Pakistan are either threatened or endangered species and their solitary and inaccessible life style makes them difficult to study. Therefore, estimating biodiversity, monitoring illegal trades and detecting commercial food frauds involving these species is a challenge for zoologists and conservation biologists. Here, we have attempted to exploit the discriminating power of mitochondrial COI gene to identify and to generate barcodes of the wild ungulate species of conservational importance found in Pakistan. 86 specimens of 19 wild ungulate species found in Pakistan were analyzed for their COI sequences. This is the first generated molecular data for many of these endemic and nearly endemic species. Intra and interspecific distances revealed distinct barcode gap for each species and a Neighborhood-joining tree able to discriminate all species into their respective clades. In conclusion, mtCOI is a powerful discriminatory tool for the taxonomic classification of ungulates especially for species that are inaccessible and require noninvasive sampling

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

<p>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.</p

Maternal depression and its correlates – a longitudinal study

Objective: To estimate the burden of Antenatal Depression (AND) and Postpartum Depression (PPD) and explore possible predictors of Perinatal Depression (PND). Methods: A longitudinal study was conducted in the department of obstetrics and gynecology in Shifa International hospital and its community health care center in Islamabad, Pakistan from October 2018 to May 2019 after taking Ethical approval of institutional review board and ethical committee. It included 200 women in their third trimester of pregnancy. Women not consenting, chronic or critically ill, having psychological disorders, medical co morbid or on medications were excluded. Socioeconomic and obstetrical history was recorded on a separate Performa and Edinburgh Postnatal Depression Scale was used for screening of depression in these women. SPSS was used for data analysis. Linear regression analysis was done to see the association between antenatal and postpartum depression scores. Results: Women in postnatal period had higher Depression scores than women in antenatal period. 12.5% women had AND whereas 36.5% had PPD. Results also suggest that AND increases the risk of PPD. The results also imply that PPD scores are higher in women having unplanned pregnancies and multigravida. Moreover, women belonging to middle and lower class were more prone to PND. Conclusion: It was concluded that AND was strongly associated with PPD indicating AND to be a significant predictor of PPD. Social class and parity are directly linked with prevalence of PND. Continuous..

Perception of undergraduate medical students regarding civic responsibility through service learning by visiting persons with different abilities

Objectives: Addressing various attitudes of students, can be a challenging task for educationists, so it is generally embedded in the hidden curriculum in most Medical Institutes. The purpose of this study was to build up civic duty among undergraduates, rooted in their learning objectives of the curriculum through a visit to the school of children with different abilities (CFSPF). Materials and Methods: In year 4, students of Shifa College of Medicine during the clerkship of Community Medicine, were taken on a field visit which is part of the curriculum. CFSP is privately run by an NGO, it has 45 enrolled individuals with different mental and physical abilities. The medical students visited CFSPF in small groups for 8 months (Sep 2019 to April 2020) where they interacted with the individuals with special needs in their environment. Students were able to practice empathy through the general physical examination and other entertaining activities. In this qualitative study, this strategy was assessed by exploring the medical student’s perceptions. Results: Focus Group discussions were conducted with the medical students and themes identified were: interaction with children having different abilities, being thankful to the Almighty, philanthropy, learning to empathize, the feeling of including them in our society, selfless smile, the contribution of services, and developing various attributes. Conclusion: Students found the visit to a school for children with different abilities useful. The interaction in a different environment has revealed opportunities for a wider scope of learning. Keywords: Civic responsibility, Empathy, Persons with different abilities, Service learning

An indirect evaluation of medical residents’ research writing skills by research synopsis review

Objective: To scrutinise the research proposals of medical residents for inadequacies in writing dissertation synopsis. Method: The analytical cross-sectional study was conducted at the regional centre of the College of Physicians and Surgeons Pakistan, Islamabad, Pakistan, and comprised synopsis from January to June 2020 of postgraduate residents attached with different hospitals in Rawalpindi and Islamabad.  For evaluation purposes, an institutional checklist was used that had 4 domains: general, epidemiological, statistical, and bibliographical review. These were assessed by a single epidemiologist. Data was analysed using SPSS 21. Results: Of the 400 research proposals, 224(56%) were submitted by male and 176(44%) by female residents. Also, 208(52%) proposals were submitted by residents at public-sector hospitals, and 114(28.5%) by those at private-sector hospitals, while 78(19.5%) were from military hospitals. Significant association of errors was found with training institutions, speciality and duration of training (p0.05). Conclusion: Majority of the research proposals lacked correct understanding of all the concepts related to research. Difference in research writing skills across specialties and training institutions may be related to the lack of availability of research assistance and good mentorship. Key Words: EBM, Residents, CPSP, Research, EBP, Epidemiology, Statistics

DNA barcoding of spiders from agricultural fields

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