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Background: Maternal depression and anxiety can predispose the women to higher risk of complications. The COVID-19 pandemic is a unique stressor which may affect the mental and psychological well-being of pregnant women. Aim: To determine prevalence of depression and anxiety and related factors in pregnant women during COVID-19. Methods: This multicenter analytical cross-sectional study was carried out from August 2021 to December 2021 in six cities of Pakistan. Two stage sampling technique was used to include sample of 400 pregnant women. Patient Health Questionnaire-9 (PHQ-9) and Corona virus Anxiety Scale (CAS) were used to measure depression and anxiety level along with self-constructed questionnaire to record socio-demographic profile. Data entry and analysis was done in SPSS version 23. Association between variables was assessed by applying Chi square test and strength of association was measured by binary logistic regression. p-value ≤ 0.05 was taken as statistically significant. Results: Mean age of participants was 27.25±5.22 years. The mean gestational age was 23.5±9.6 weeks. About 37.1% had mild depression. Moderate depression was found in 7.8% and moderately severe depression in 0.5% participants. Significant association was found between depression and no physical activity (p value=0.02), not having spouse support (p value=0.03), perceived vulnerability to get COVID (p value=0.004) and fear of infection to baby (p value=0.05). Only 3.25% participants had dysfunctional anxiety. Conclusion: Findings of the study would be helpful for policy makers to launch health awareness campaigns about regular physical activity, role of social support and seeking medical advice for mental well-being during pregnancy. Keywords: COVID-19, Anxiety, Depression, Mental health, Pregnancy

Background: The prison population of any country is a high-risk population because of a lack of access to regular health care facilities. This research was planned to assess the gender differences in the health status of the imprisoned population of Lahore.Patients and methods: An analytical cross-sectional study was conducted in Kot Lakhpat Jail in the province of Punjab, near Lahore, from January to August 2019. After getting permission from Inspector General, Police of Punjab, a sample of 320 inmates of Kot Lakhpat Jail was collected through a simple random sampling technique. Data was collected on a structured questionnaire based on history and examination. Data was entered in SPSS version 23, and the chi-square test was applied to assess the gender differences in health status, p-value ≤ 0.05 was taken as significant.Results: General examination revealed that 143 (44.7%) had refractory errors, and 34 (10.6%) had mild deafness. Common infection in males were scabies (p = 0.002), Sore throat (p =0.015) and urinary tract infections (p=0.015). Hepatitis C was present in high frequency (9.1%). Assessment of sexually transmitted diseases showed discharge in 10.6%, vesicular herpetic eruptions in 8.8%, and ulcers in private parts in 3.8% of the sample. Males showed a significantly high frequency of hypertension (p =0.052) and arthritis (p=0.024). Evaluation of mental health status revealed significant high rates of depression in females (p =0.000) and a high frequency of insomnia (p=0.000). Social health problems revealed a high frequency of smoking in males (p=0.000) and feeling of stigmatization in females (p=0.000).Conclusion: Male jail inmates showed high frequencies of scabies, sore throat and urinary tract infection, and hypertension. Females showed higher rates of depression, insomnia, and feeling of stigmatization.

Background: Construction industry is one of the most hazardous and accident prone occupation causing around 270 million accidents and 2 million deaths annually. In Pakistan reporting of incidence of occupational injuries and accidents is low. The present study aimed to determine the physical and mental health profile of construction workers in Lahore, Pakistan. Subjects and methods: An analytical cross-sectional study was conducted among construction workers in Lahore from January 2020 to September 2020. The study included 181 participants by using non-probability convenience sampling technique. Data was collected by using a self-structured, pre-tested questionnaire. Data was analyzed using SPSS version 23. Chi-square test was applied and p-value

Objectives: To find out the major health problems and barriers in getting health care by transgender community in Lahore, Pakistan. Methods: An analytical cross-sectional study was conducted in transgender community of Lahore from January to October 2020. The study included 214 participants from different areas of Lahore by targeting their “gurus”. Non-probability, snow-ball sampling technique was used to collect required sample size. Data was collected by using a structured questionnaire. Data were analyzed using SPSS version 23. Results were generated in form of tables and graphs. Chi square test and Fischer’s exact test were used to find out associations between health seeking behavior with their transgender status and p value was fixed as ≤ 0.05 as significant. Results: Among total 214, 78.5% were transgender females and 21.5% were transgender male. Among the common health problems were depression (56%), anxiety (59%) and genital tract ulcers (45%). About 70% transgender seek health care from government hospitals. Among total 214 participants, 70% reported that they receive poor quality of health care. The main reasons of not getting proper care is non acceptance (20.7%), feeling ashamed (28.7%), non-availability of CNIC (44.5%) and un-affordability (6.1%). Significant association of transgender female with consultation with doctors (p=0.013), seeking care at government hospitals (p =0.038) poor experience at health care facility (0.050), neglect during medical treatment (p=0.015) and feeling of discrimination during treatment (p= 0.042). Conclusion: Transgender community face physical, mental, social and reproductive health issues. About 70% trans-genders receive poor quality of health care services. Non acceptance, feeling ashamed, non-availability of CNIC and non-affordability have been reported as major barriers in getting desired health care. doi: https://doi.org/10.12669/pjms.38.1.4375 How to cite this:Manzoor I, Khan ZH, Tariq R, Shahzad R. Health Problems & Barriers to Healthcare Services for the Transgender Community in Lahore, Pakistan. Pak J Med Sci. 2022;38(1):138-144. doi: https://doi.org/10.12669/pjms.38.1.4375 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To find out correlation of body measurements and exercise with blood pressure among medical students in Lahore, Pakistan. Study Design: Correlational study. Place and Duration of Study: Akhtar Saeed Medical and Dental College, Lahore, from May to Jul 2018. Methodology: A sample of 332 students was recruited through simple random sampling technique. Resting blood pressure in sitting position along with body mass index of respondents were taken after informed consent. Results: Mean age of respondents was 21.06 ± 1.53 years. Mean sitting systolic blood pressure was 117.5 ± 8.24mm Hg, Mean sitting diastolic blood pressure was 77.9 ± 7.05mm Hg. Significant association was found between weight and both Systolic (r=1, p≤0.00) and Diastolic (r=0.01, p=0.05) blood pressure. Height was negatively correlated with systolic blood pressure (r=-0.004) and diastolic blood pressure (r=-0.07). Body mass index was also significantly associated with systolic blood pressure (r=1, p≤0.00) and diastolic blood pressures (r=0.14, p=0.00). Significant association is found between systolic blood pressure and exercise with number of days (r=-0.15, p=0.05) and diastolic blood pressure (r=-0.11, p=0.00) and duration of exercise with systolic blood pressure (r=-0.13, p=0.01) and diastolic blood pressure (r=-0.16, p=0.04). Conclusion: Weight and Body mass index are positively correlated with systolic and diastolic blood pressure.Keywords: , , , .

Background: Dysmenorrhea is an important health issue of young adult females that badly affects their quality of life and academic performance. This study aimed to determine prevalence, impact, management practices and factors associated with dysmenorrhea among medical students. Methods: This analytical cross-sectional study was conducted in Akhtar Saeed Medical & Dental College Lahore from August 2020 to December 2020. Using Cochran’s sample size calculator and rounding off, sample size of 400 female students was calculated. Convenience sampling technique was used. A self-constructed questionnaire was used which was designed after extensive literature search. Pain intensity was estimated using Visual Analogue Scale (VAS). Data were entered and analyzed in SPSS version 23. Chi square test was applied to find association between variables. A p-value of < 0.05 was considered statistically significant. Results. Mean age of participants was 21.07 ± 2.58 years. Prevalence of dysmenorrhea was 79.5%. Statistically significant association was found between dysmenorrhea and participant’s age (p value=0.002), marital status(p value=0.001), family income(p value=

Objectives: Study was conducted to assess the nutritional status of children below 5 years of age using mid upper arm circumference (MUAC) and its determinants. Materials & Methods: This analytical cross-sectional study was carried out in Akhter Saeed Teaching Hospital Lahore and Lady Wallington Hospital Lahore from April 2019 till Oct 2019. Using systematic random sampling technique, 225 children were enrolled in the study. A self -structured questionnaire was used to record sociodemographic details and feeding practices. MUAC was measured by a non-stretch measuring tape. Malnutrition was categorized into severe acute malnutrition (MUAC; Results: The mean age of children is 2.43± 0.75 years. Malnutrition was observed in 54.6% participants. Severe acute malnutrition (SAM) was found in 59 (26.2%) children and moderate acute malnutrition (MAM) was found in 64 (28.4%). Children at the risk of developing malnutrition were 32 (14.2%) while remaining 70 (31.1%) were well nourished. The percentage of severe malnutrition was more in female children. Delayed initiation of breast feeding (p value=0.008), poor economic status (p value=0.004), incomplete immunization status (p value=0.003), poor appetite (p value=0.001) and frequent episodes of illness (p value= Conclusion: Prevalence of malnutrition in children aged Keywords: Malnutrition, MUAC, under-five children

Background: Diarrhea is the second major cause of mortality in children worldwide. Timely interventions by caregivers who are mainly mothers, can contribute towards a favorable prognosis of this condition in children. Aim: The purpose of conducting this study was to assess maternal knowledge and the practices regarding prevention of diarrheal diseases in children under the age of 5 years. Setting: This study was carried out in three hospitals at Lahore, Pakistan. Methods: An analytical cross-sectional study was conducted from January to July 2020 and a convenience sampling technique was used for data collection. Data was collected from 158 mothers of children under 5 years of age by using a self-structured, pre-tested questionnaire. Chi square test was applied and p-value

Background: Pakistan has one of the highest rates of preterm births, nearly 16 for every 100 babies born. Around 4% of these premature babies, are at highest likelihood of death. The objective of this study was to assess association of multiple risk factors with preterm birth in Pakistani women. Patients and methods: An analytical cross-sectional study was carried out in Obstetrics and Gynecology Department of Akhtar Saeed Trust Hospital and Farooq Hospital, West Wood Branch, Lahore from October 2018 to December 2019. Total 116 pregnant females who gave birth to preterm babies with gestational age between 20-37 weeks were included. Data about patients’ socio-demographic profile, previous obstetric history and current gestational profile was collected using closed ended structured questionnaire. Variables were presented in the form of frequency tables. Chi-square and Fisher exact test were applied to establish association of various risk factors and preterm presentation of patients’ in hospital. A p-value ≤ 0.05 was taken as significant. Results: Out of 116 participants, 49 (42.2%) were aged between 20-25 years, 47 (40.5%) were illiterate. Of the total sample 60 (51.7 %) participants were obese (BMI >30). Eighty-two (70.7%) patients were multigravida and 65 (56.1%) gave the history of previous cesarean section. Significant association was found between preterm birth and multi-parity (p=0.001), previous history of abortion (p=0.000), intrauterine death (p=0.001), infertility (p=0.04), cesarean-section (p=0.000), and inter-pregnancy interval of less than 24 months (p=0.007). Other significant factors associated with preterm labour were urinary tract infections (p=0.001), documented fever more than 101oF (p=0.000), anemia (p=0.000), singleton pregnancy (p=0.000) and cephalic fetal presentation (p=0.002), during current pregnancy. Conclusion: Multi-gravidity, history of abortion, intrauterine death, previous infertility, cesarean-section, inter-pregnancy interval of less than 24 months, UTI, genital tract infection, anemia, singleton pregnancy and cephalic fetal presentation during current pregnancy were observed to be significantly associated with preterm births.

Objective: The study aimed to determine the knowledge about disease and perception of the role of media regarding COVID-19 among non-medical students.Study Design: Cross-sectional analytical study.Place and Duration of Study: This study was conducted in educational institutions of Punjab including University of Lahore, National University of Science and Technology, COMSATS University, Forman Christian College University, University of Management and Technology, Punjab University, GC University Faisalabad, The University of Agriculture Faisalabad, University of Engineering & Technology, University of Central Punjab, Islamia University Bahawalpur and Lahore College of Women University from June 2021 to November 2021.Materials and Methods: Using the convenience sampling technique, a sample of 400 non-medical students was included in the study. A self-constructed pre-tested questionnaire was used to collect data. Data was entered and analyzed in SPSS version 23. Independent t-test and ANOVA were applied to find the association between variables. A p-value of ≤ 0.05 was considered statistically significant.Results: Mean age of participants was 21.45± 2.16 years. About 38.7% used three or more sources of information. The most reliable source of media (37.75%) was social media updates. About 77.5% of participants used mass media daily and an increase in social media usage was reported by 88% of participants. The mean score related to knowledge was 14.09±4.5 out of 20. A statistically significant difference was found in the knowledge score of groups based upon sources of information (p =

Background: Ischemic heart disease (IHD) is one of the leading causes of mortality in Pakistan. With advancement in research, multiple causes have contributed in development of web of causation of this public health issue. The objective of this study was to assess gender differences in risk factors associated with ischemic heart disease in patients presenting at the biggest cardiology hospital of Lahore. Patients and methods: A comparative cross-sectional study was carried out in Punjab Institute of Cardiology, Lahore from January to August, 2018 on a sample of 296 diagnosed patients of IHD, through non-probability consecutive sampling technique. Data was collected on pretested questionnaire. The data was analyzed using SPSS version 22. Chi-Square test of significance was applied and a p-value ≤0.05 was considered statistically significant. Results: The mean age of participants was 45±12 years with predominance of male patients (71.3%). Frequency of risk factors for IHD included increase body mass index (83.8%), hypertension (61%), insufficient physical activity (43%), diabetes (38.5%) and smoking (23%). Increase serum cholesterol was reported in 95% and triglycerides in 99% of the participants. Gender difference was significant with females residing in urban population (p=0.054) and exercise routine (p=0.034). Males showed high tendency of IHD with smoking pattern (p

Background: Traffic constables are exposed to various occupational health hazards worldwide. This study is planned to assess occupational health hazards in traffic constables in Punjab, Pakistan. Subjects and Methods: A descriptive cross-sectional study was conducted in different cities of Punjab including Lahore, Gujranwala, Bahawalpur, Bahawalnagar, Sialkot and Islamabad from March till August 2018. A sample of 384 traffic personals were selected by using non-probability convenient sampling technique. Retired traffic constables and those with work experience less than a year were excluded. A pretested questionnaire was used to conduct the interviews after taking informed consent. Data was collected and analyzed using SPSS version 22 and presented in frequency tables and charts. Results: Maximum number of constables belonged to 31-40 years of age group. Among them 98.7% were male, 25% were having education level above graduation. Results of physical health hazards showed that 53% of warden were smoker, 16.14% were known diabetics and 19.53% were found to be hypertensive. Other physical ailments included respiratory problems (23.4%), hearing impairment or loss (15.88%) and various eye ailments (13.28%). Additionally, 9.1% of participants had evidence of lead poisoning, 33.84% complaints of tightness in muscles and 13.72% of headache, whereas 35.7% had met an accident in the last year. Prevalence of stress and anxiety were 30% and 33.33%. Regarding social health issues 36.7% reported that they were unable to give family time and 42.48% felt lack of independence due to their occupation. Job satisfaction was reported by 50%. Conclusion: The traffic constables in Punjab suffer from a large number of physical, mental and social health issues. Their perception about their occupational health hazards is low and needs improvement through imparting health education.

Objectives: To estimate frequency of stunting and associated factors in children aged less than five years in a tertiary care hospital of Lahore. Methods: An Analytical cross-sectional study was conducted in Pediatrics Outpatient Department at Akhtar Saeed Trust Teaching Hospital, Lahore from December 2017 to July 2018. Two hundred children of ages under five years coming to outdoor for treatment of minor ailments were included after informed consent from their parents. Non-probability, convenient sampling technique was used to collect sample. Data collected and analyzed on SPSS version 19. To find out association of stunting with multiple qualitative variables, chi-square test was applied and p-value was fixed at ≤ 0.05 to be significant. Results: Out of 200 children screened in OPD, 42 (21.0%) were found to be stunted. The total percentage of stunting in male children was 28 (66.6%) and in female children were 14 (33.3%). Stunting was significantly associate with male gender (p=0.047), joint family system (p=0.049), low literacy level in mothers (p=0.031), unvaccinated status (p=0.003) and history of bottle feeding (p=0.037). Conclusion: The frequency of stunting in children less than five years of age is 42 (21.0%). The significant risk factors associated with stunting were found as male gender (p= 0.047), joint family system (p=0.049), low maternal education (p=0.031), unvaccinated status(p=0.03).

OBJECTIVES: 1: To investigate the relationship among dispositional optimism, psychological resilience, coping strategies and quality of life (QoL) among burn survivors, 2: To find out the impact of dispositional optimism and coping on QoL among burn survivors. METHODS: This cross-sectional study was conducted at Burn Unit of Pakistan Institute of Medical sciences (PIMS) Islamabad, Pakistan. Two hundred and thirty post-burn survivors, ranging in age from 18 to 64 years were selected using purposive sampling technique. Dispositional optimism scale, psychological resilience scale, QoL scale and coping strategies scales were used to measure variables. RESULTS: Out of 230 patients 123 (53.5%) were males and 107 (46.5%) were females. About 54.3% (n=125) were married. Majority (n=126; 54.8%) had flame burn. Duration of burns was up to two months in 70.9% (n=163) cases. Results revealed highly significant positive correlations between psychological resilience and dispositional optimism (r=0.807), problem-focused coping (r=0.724) and supportive coping (r=0.598) but significantly negative correlation with emotion focused coping (r= -0.559) while emotion focused coping is negatively correlated with mental QoL (r=-0.378) and supportive coping (r=-0.138). Multiple regression analysis revealed that dispositional optimism, problem-focused and supportive coping have significant impact upon the QoL (p

Introduction: Corona pandemic has resulted in a high mortality rate among health care professionals. The purpose of this study was to assess the knowledge and practices of health care providers during this pandemic in Punjab, Pakistan. Methods: A web based cross sectional survey was conducted during 2nd of April to 20th April 2020 targeting health care professionals working in Punjab, Pakistan. A sample of 540 participants was collected using non probability, convenient sampling technique. Data was generated by using on line google forms after taking IRB approval from institution. Results: Adequate knowledge was found among health care providers regarding diagnostic tests, modes of transmission, incubation period and preventive strategies. Significant association was seen in knowledge of post graduate and MBBS doctors (Bachelor of Medicine and Bachelor of Surgery) regarding viral etiology (p = 0.006), sign and symptoms (p = 0.000), risk factors (p = 0.000) and mortality rates (p = 0.001). Hand washing was considered as best preventive measure by 95% of the health care providers. Conclusion: Post graduate doctors have better knowledge regarding corona virus disease transmission, risk factors, incubation period and preventive strategies as compared to undergraduate doctors.

Objectives: To estimate frequency of stunting and associated factors in children aged less than five years in a tertiary care hospital of Lahore. Methods: An Analytical cross-sectional study was conducted in Pediatrics Outpatient Department at Akhtar Saeed Trust Teaching Hospital, Lahore from December 2017 to July 2018. Two hundred children of ages under five years coming to outdoor for treatment of minor ailments were included after informed consent from their parents. Non-probability, convenient sampling technique was used to collect sample. Data collected and analyzed on SPSS version 19. To find out association of stunting with multiple qualitative variables, chi-square test was applied and p-value was fixed at ≤ 0.05 to be significant. Results: Out of 200 children screened in OPD, 42 (21.0%) were found to be stunted. The total percentage of stunting in male children was 28 (66.6%) and in female children were 14 (33.3%). Stunting was significantly associate with male gender (p=0.047), joint family system (p=0.049), low literacy level in mothers (p=0.031), unvaccinated status (p=0.003) and history of bottle feeding (p=0.037). Conclusion: The frequency of stunting in children less than five years of age is 42 (21.0%). The significant risk factors associated with stunting were found as male gender (p= 0.047), joint family system (p=0.049), low maternal education (p=0.031), unvaccinated status (p=0.03). doi: https://doi.org/10.12669/pjms.36.3.1370 How to cite this:Fatima S, Manzoor I, Joya AM, Arif S, Qayyum S. Stunting and associated factors in children of less than five years: A hospital-based study. Pak J Med Sci. 2020;36(3):581-585. doi: https://doi.org/10.12669/pjms.36.3.1370 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To determine the prevalence of refractive errors among medical students and identify associatedfactors.Study Design: Analytical, cross-sectional study.Place and Duration of Study: The study was conducted in the Department of Community Medicine at AkhtarSaeed Medical and Dental College, Lahore from September 2020 to December 2020.Materials and Methods: The study included 300 medical students using convenience sampling technique. Aself- structured pre- tested questionnaire was used. All medical students including MBBS, BDS, Pharm –D andallied health sciences were included in the study. Those students who did not give consent were excluded fromthe study. Data analysis was done with SPSS version 23. Chi square test of significance was applied to findassociation between the variables and p-value < 0.05 was considered statistically significant.Results: Refractive error was observed in 203 students (67.7%). The commonest refractive error was myopia(37%) followed by hypermetropia (23.7%) and astigmatism (7%). The prevalence of refractive errors wassignificantly associated with positive family history (p value=

This study assessed the pattern of drug abuse and the reasons for relapse of addiction among male drug addicts seeking rehabilitative services in different centres in Lahore, Pakistan. A cross-sectional survey was conducted on male drug abusers from April to December 2016. Nonprobability purposive sampling was done to collect a sample of 119 participants. A structured questionnaire and in-depth interviews were used for data collection. Out of 119 participants, 71.4% were in the age group 15-35 years. Educational levels were low in the majority, with 68.1% below secondary education. Unmarried (51.3%) and unemployed (44.5%) participants were at the greatest risk of using drugs. The age of addiction in 45% of patients was18 years and 40% had been abusing substances for5 years. Reasons for starting drug abuse were recreation (37%), curiosity (34.5%), and lifechanging events (14.3%). Reasons for relapse included association with former addicts, negative reactions from family, inability to manage the craving and work/social stress.نمط الإدمان والانتكاس بين متعاطي المخدرات المعتادين في لاهور، باكستان.سعدية بتول، إرم منظور. شمائله حسنين، أسلم باجوا، مسلم عباس، مها محمود، حنا سهيل.تقيّم هذه الدراسة نمط تعاطي المخدرات وأسباب الانتكاس والرجوع إلى الإدمان في صفوف مدمني المخدرات من الذكور الذين يسعون للحصول عى خدمات إعادة التأهيل في المراكز المختلفة في لاهور، باكستان. ولقد أُجري مسح مقطعي عى مدمني المخدرات الذكور في الفرة من أبريل/نيسان إلى ديسمبر/كانون الأول 2016. وأجري اختيار غرضي غر عشوائي لجمع عينة من 119 مشاركاً. واستُخدم استبيان مهيكل وأُجريت مقابات معمّقة لجمع البيانات. ومن بن المشاركين البالغ عددهم 119 مشاركاً، كان 71.4% في الفئة العمرية 15-35 سنة. وأُفيد بانخفاض مستويات التعليم في أغلب العينة، حيث كان % 68.1 دون مستوى التعليم الثانوي. وشكّل غر المتزوجن (% 51.3) والعاطلون عن العمل (% 44.5) الفئتن الأكثر تعرضاً لمخاطر تعاطي المخدرات. وكان سن الإدمان في % 45 من الحالات أقل من 18 عاماً، حيث تبن أن أغلبية الحالات كانت تتعاطى المواد المخدرة لأكثر من 5 سنوات (%40). وتراوحت أسباب البدء في تعاطي المخدرات بن الترفيه (% 37)، والفضول (% 34.5)، والتعرض لأحداث غرت مجرى الحياة (14.3%). أما أسباب الانتكاس فتضمنت الارتباط بمدمنن سابقين، وردود الأفعال السلبية من جانب الأسرة، وعدم القدرة عى التحكم في الرغبة في التعاطي وضغوط العمل/الضغوط الاجتماعية.Schéma de dépendance et de rechute parmi les toxicomanes habituels à Lahore, Pakistan.La présente étude avait pour objectif d’évaluer les schémas d’abus de substances psychoactives et les causes de rechute parmi les hommes toxicomanes recherchant des services de réadaptation dans différents centres de Lahore, au Pakistan. Une enquête transversale a été conduite sur les utilisateurs de substances psychoactives de sexe masculin entre avril et décembre 2016. Un échantillonnage non probabiliste par choix raisonné a été réalisé afin d’établir un échantillon de 119 participants. Un questionnaire structuré et des entretiens approfondis ont été utilisés pour la collecte de données. Sur les 119 participants, 71,4 % appartenaient au groupe d’âge des 15-35 ans. Les niveaux d’éducation étaient faibles dans la plupart des cas, 68,1 % n’ayant pas atteint l’enseignement secondaire. Les hommes célibataires (51,3 %) et chômeurs (44,5 %) étaient exposés à un risque accru de toxicomanie. L’âge de la mise en place de la dépendance était inférieur à 18 ans chez 45 % des patients, 40 % d'entre eux consommant des substances psychoactives depuis plus de 5 ans. L’aspect récréatif (37 %), la curiosité (34,5 %) et les changements de vie (14,3 %) comptaient parmi les raisons pour lesquelles les patients commençaient à utiliser des substances psychoactives. Les causes de rechute incluaient le regroupement avec d’anciens toxicomanes, les réactions négatives de la famille, l’incapacité à gérer le manque, et le stress professionnel et social.

not applicable

The Acquired Immunodeficiency Syndrome (AIDS) is a disease associated with stigmatization and discrimination worldwide. Even the health care professionals show negative attitude towards these patients. Worldwide need of health education is felt to address the gap in knowledge and attitude of health care professionals while dealing with patients suffering from this disease.It was an educational interventional study, conducted in Fatima Memorial College of Medicine and Dentistry in 2015. The sample was collected through Non-Probability purposive technique, targeting both male and female health care professionals interested in attending health education sessions on HIV-AIDS. A self-administered questionnaire was used to assess the knowledge of thirty participants for pre- and post- intervention.The study participants included public health professionals (50%), dentists (16.7%) and clinical professionals (33.3%). A significant difference was observed in knowledge of health care professionals after intervention considering the important reasons as deteriorating moral value (p=0.045) for HIV epidemic in Pakistan, prevalence status of HIV/AIDS (p=0.046), awareness about the free voluntary counselling and testing (VCT) centres /services (p=0.019), interaction with an HIV positive person (p=0.01), discriminatory attitudes due to family member (p=0.032) and availability of services for people living with HIV in Pakistan (p=0.02).Health educational intervention is a powerful tool for increasing awareness of health care professionals.

Background and Objectives: During the past few decades, females had been making conscious decision to have antenatal checkup from skilled health care provider due to improved education which had played a vital role to enhance their awareness regarding the importance of this comprehensive health service. The objective was to find out the perception of females of child bearing age about the importance of antenatal care during their last pregnancy, living in a suburban community of Kot-Lakhodare Lahore. Methods: Females of reproductive age (15-49 years) living in Kot-Lakhodare were enrolled. Through a structured questionnaire, using convenient sampling technique, 1224 females of childbearing were interviewed through a cross sectional survey. The study was completed between January till August 2016. Question pertaining to their sociodemographic characteristics, perception about the importance of antenatal care services and comorbid conditions during the last pregnancy were asked. Data was analyzed by using SPSS version 21. The ethical approval both institutional and individual were duly taken. Results: Mean age was 32 ±7.8SD years with education up to primary. Three quarter of females were un- employed with monthly income less than rupees 25,000 / month. All females 869(73%) who had perception about importance of antenatal checkup during their last pregnancy had no history of anemia, hypertension, diabetes and abortion (p

Background and Objectives: During the past few decades, females had been making conscious decision to have antenatal checkup from skilled health care provider due to improved education which had played a vital role to enhance their awareness regarding the importance of this comprehensive health service. The objective was to find out the perception of females of child bearing age about the importance of antenatal care during their last pregnancy, living in a suburban community of Kot-Lakhodare Lahore. Methods: Females of reproductive age (15-49 years) living in Kot-Lakhodare were enrolled. Through a structured questionnaire, using convenient sampling technique, 1224 females of childbearing were interviewed through a cross sectional survey. The study was completed between January till August 2016. Question pertaining to their sociodemographic characteristics, perception about the importance of antenatal care services and comorbid conditions during the last pregnancy were asked. Data was analyzed by using SPSS version 21. The ethical approval both institutional and individual were duly taken. Results: Mean age was 32 ±7.8SD years with education up to primary. Three quarter of females were un- employed with monthly income less than rupees 25,000 / month. All females 869(73%) who had perception about importance of antenatal checkup during their last pregnancy had no history of anemia, hypertension, diabetes and abortion (p

Objective: To assess the sociodemographic factors affecting parental knowledge regarding availability of screening services for thalassemia major. Methods: A cross sectional study was conducted among biological parents of thalassemic children at three registered centers of blood transfusion in Lahore. A sample of 186 parents was selected through systematic random sampling. A pretested questionnaire was used to collect data. IRB clearance was obtained and informed consent was taken before data collection. Data was analyzed at SPSS version 23 and chi square test was applied and p value was fixed at ≤ 0.05 as significant. Results: Parents of registered thalassemic children have adequate knowledge about Disease transmission and screening services. 91% of the participants knew that thalassemia major gets transmitted through parents. Cousin marriage was mentioned as a source of transmission by 77% of the participants. 91% of the parents knew about prenatal screening and 89% about premarital screening. Knowledge of parents was significantly associated with male gender, higher education and income. Conclusion: Male gender, higher education and income are associated with better knowledge of parents.

Needs assessment helps in situation analysis and setting priorities for establishing a faculty development program to ensure quality improvement in education. The objective of this study was to identify areas for faculty development in order to incorporate them in continuing medical education program.It was a cross sectional survey conducted from 2014 to 2015 in Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A non-probability consecutive sampling technique was used to include 195 faculty members from MedicalDental College of all cadres. Data was collected through a self-administered questionnaireanalysed using SPSS 20. Chi square was applied and p-value of ≤0.05 was considered to be significant..Out of 194 participants, 133 belonged to clinical departments and 61 to basic Sciences, with a higher proportion of female faculty members. (p=0.025). Importance of DME was recognized by 97% clinical and 95.1% basic science faculty. Faculty development program was considered essential by 69.1% of the clinical faculty30.9% of the basic faculty. (p=0.185). The priority areas identified were educational psychology (p=0.030), teaching skills (p=0.341), assessment techniques (p=0.296), educational research (p=0.849), management skills (p=0.797), work-based ethicsconduction of meeting. (p=0.01p=0.003). About 71.25% of the clinical teachers and 28.8% of the basic subject teachers have never attended any medical education program (p=0.001). The area of highest motivation was teaching (p=0.002), research (p=0.052), patient care (p=0.001) and administration (p=0.870).This survey reinforces the need of an effective faculty development program targeting training in teaching methodologies and assessment tools.

Background: Hepatitis B & C are emerging public health issues in Pakistan. One of the responsible factors for transmission of these diseases is use of razors by barbers and use of instruments on nails by saloon workers.Methodology: A cross sectional survey was conducted in Lahore depending upon zonal distribution from January to August 2016.396 barbers and salon workers were selected through cluster sampling technique. Data was collected through a structured questionnaire after informed consent following guideline of IRB. Cross tabulations were done on the basis of gender distribution after application of Chi square test of significance and p value was fixed at ≥ 0.05. Results: Major of the barbers and saloon workers ranged in the age bracket of 26- 35 years (40.2%).Females constituted 232(58.6%) whereas males were 164(41.4%). Formally trained participants were 220(55.6%). An alarmingly high percentage, 213(53.9%)& 182 (46.1%) were unaware of the transmission of Hepatitis B& C respectively. Major source of information regarding Hepatitis was TV167 (42.2%). Still a large proportion 102(25.8%) were not using disposable blades for shaving and 40% never had concept of sterilizing instruments. A significant difference was observed in knowledge of female workers who were formerly trained in their occupation (p= 0.00).Conclusion:Asignificant fraction of participants were unaware that their occupation is a source of infection transmission of Hepatitis B & C. Increase health education and awareness campaigns are required to increase knowledge to stop the chain of transmission.

Nursing is the backbone of health care delivery system. There are various factors which influence the choice of selecting nursing as profession. Objectives: (1) To find out the socio demographic profile of nurses working at Ghurki Trust Teaching Hospital (GTTH) Lahore. (2) To explore the reasons for selection of this profession. Study design: A cross sectional descriptive study. Duration of study: From October 2009 to January 2010. Setting: GTTH, Lahore. Subjects and Methods: All the nurses working in Ghurki Trust Teaching Hospital, Lahore are included in this study and their responses are obtained with a self administered questionnaire. Results: A total of 77 nurses participated in our study. The age distribution of these nurses has shown that a large number of nurses, 49 (63.6%) belonged to age group between 20 to 30 years.There were 26 (33.8%) nurses who had done B. Sc nursing. About 72 nurses (93.5%) have monthly income more than Rs.10,000. Majority of them, 48 (62.3%) are unmarried. 41 (53.2%) of the nurses selected this profession due to their own personal interest, 15 nurses (19.5%) selected this profession due to their parental influence. 12 nurses (15.6%) selected this profession for serving humanity. 9(11.7%) selected thisprofession to support their family. Approximately 25 nurses (32.5%) said that there are other family members working in the same profession. It was noted that out of these 25 nurses, 10 (40%) had their sisters in the same profession. Conclusions: Nursing forms the backbone of health care delivery system of a country. Decision makers in health sector need to understand that human resource development. Particularly Nursingrequires revolutionary changes. As Public health policy makers, it is imperative that we investigate the reasons for selection of nursing profession to attract and retain these important partners in health care provision.

Objective: To assess the parental knowledge and myths related to etiology of congenital heart disease. Design: A crosssectional descriptive study. Place and Duration of Study: Out patient department, indoor and echocardiography rooms of Children Hospitaland Institute of Child Health (CH & ICH) Lahore, in two weeks of October, 2007. Patients and Methods: Convenient sampling technique wasused to recruit 299 children between 1 month and 14 years of age, suffering from congenital heart disease. Cases of rheumatic fever andassociated congestive cardiac failure were excluded from the study group. A structured questionnaire was used to interview parents of the studygroup. Descriptive statistics was determined in terms of percentages. Results: Out of total 299 patients included in this study, 132 were in theage group of 1 -5 years (44%), with the mean age 1.86 years ± 0.886 SD. 200 were males (67 %) and 99 were females (33%). The respondentsincluded 71% mothers and 27% fathers. Ventricular septal defect (VSD) was the most common disease encountered in 128 children (43%).Regarding the causes of congenital cardiac defects, parents blamed cousin marriage (41%), inheritance (26%), increased maternal age(16%), maternal smoking(16%) and paternal smoking (39%). Other responses included evil spirits, moon and sun eclipses and bad wishes/evileye. 57% of the respondents said that there is no relationship between gender and congenital cardiac malformation and 85% respondentsbelieved that there is no relation with the food taken in pregnancy and subsequent cardiac defects. High Salt intake was considered as anassociated factor by 47 (15%) of the respondents. Naming the cause of cardiac malformations, 41% of the parents said drugs taken inpregnancy, 13% of the respondents blamed alcohol, cocaine and opium intake. Among parents, 73% were aware of the fact that maternal healthis important for disease causation in neonates but could not name any particular disease. Conclusion: The parents of those children, who havecongenital malformation, have different myths and fallacies associated with disease causation. Adequate health education strategies shouldbe adopted towards mass dissemination of information in the community about this important issue.

Objective: To determine the smoking patterns of medical students of 4th year MBBS. Design: A cross-sectional survey. Setting:Lahore Medical and Dental College (LMDC), Lahore, Pakistan. P e r i o d : From November to December 2006. M e t h o d o l o g y : The 50 medicalstudents of 4th year MBBS, who were current smokers. A structured questionnaire was used to collect the data. Descriptive statistics wasdetermined in terms of percentages. Results: In present study, 48% students started smoking between 14-17 years of age, 34% started tosmoke between ages 18-21 years and 18% of them had been smoking for past 4-6 yrs. Main reason to commence smoking included curiosity(27%), need to look glamorous (22%), peer pressure (16%) and stress relieving (10%). When probed about numbers of cigarettes smoked daily,the response of majority was that 32% of students admitted to smoking 1 -5 cigarettes, similar number admitted to smoking 6-10 cigarettes, and30% of students smoked more than 20 cigarettes. Among the respondents, 41 % had a brother who was a smoker and 37% had a father whowas a smoker. More than half the respondents (58%) said that their parents were unaware of their smoking habit. Regarding awareness aboutthe medical hazards of smoking, 31% of students named cancer, 29% mentioned heart disease, 18% were familiar with COPD and only 7%referred to stroke. The main concerns of respondents regarding smoking were fear of being discovered by their parents (22%), psychologicaldependence (20%) and physical dependence (18%). Only 50% of students tried to quit smoking, using hypnosis and substitutes like nicotinegum and nicotine patches. Conclusion: Tobacco smoking among medical students is alarming. These findings not only raise concerns for thefuture health of our medical students but also their credibility and effectiveness as health promoters for population at large.

Objective: To assess the awareness of diabetes in individuals attending Out Patient Department ofGhurki Trust Teaching Hospital. Design: Descriptive study design. Place of Study: Out Patients Department, GhurkiTeaching Hospital, Lahore. Methodology: The study was conducted among a sample of 50 individuals, recruited byconvenience sampling technique. Data was collected, by administering a structured questionnaire, during a two weekperiod in December 2006. Data was presented in the form of tables and graphs. Results: General Awareness ofDiabetes Mellitus in the participants of our study was poor. Only 16% recognized it as a disease of the pancreas while50% considered it to be a disease of other systems. Majority of the respondents (78%) had no idea about the types ofthe disease. When asked about the communicability of diabetes, 76% considered it to be non-communicable, 10%thought it to be communicable. Among the respondents, 78% thought diabetes is inheritable. When asked about itsprevention, 54% considered avoiding sugar as the best way to prevent diabetes, while only 9% believed weightreduction to be important. Regarding the management of diabetes, 40% of respondents considered medication, 27%thought of diet modification as a better way, 18% considered exercise, while only 6% named weight reduction.Conclusion: The participants of the present study lacked awareness of types of diabetes, its mode of inheritance, itsprevention and management.

Lectures are considered most effective mode of information transfer amongst teachers and students in medical education, but in recent years there has been a noticeable decline in the attendance of lectures. Our objective was to assess the reasons of medical students' disinterest in lectures.A cross-sectional survey was conducted in Department of Community Medicine, Fatima Memorial College of Medicine and Dentistry from December 2010 to June 2011. A non-probability technique of consecutive sampling was used to collect 307 participants from all five years of MBBS. Reasons of disinterest of medical students were asked in the questionnaire. The data was analysed on SPSS-17. Chi square test was applied and p-value was fixed ator = 0.05 as significant.Factors affecting the lecture attendance of these medical students include distance of residence from the college 215 (70%), strictness of teacher in marking attendance 227 (73.9%), interest in subject 216 (70.4%), subject is part of examination 257 (83.7%), and university requirement 249 (81.1%). The personality traits of teacher affecting attendance of medical students in lectures include good communication 216 (70.4%), command on subject 194 (63.2%), students' interaction in class 180 (58.6%), friendly attitude 202 (65.8%), good control on class 163 (53.1%), punctuality 100 (32.6%), sense of humour 160 (52.1%), and humane behaviour 135 (44%).The interest of medical students can be enhanced and better attendance achieved with slight modifications in identified reasons.

Needle-stick injury (NSI) is a major occupational health and safety issue faced by healthcare professionals globally. This study was aimed to assess the frequency and factors associated with NSIs in nurses of a tertiary health care facility in Lahore, Pakistan. It also focuses on safety measures adopted by these nurses after a needle stick injury.This cross-sectional descriptive study was conducted in Ghurki Trust Teaching Hospital, Lahore from October 2009 to January 2010. All nurses have participated in the study with a response rate of 99%. These responses were obtained via a pretested self-administered questionnaire. The data was analysed using SPSS-16. Percentages of the categorical variables were computed and represented in various statistical data presentation forms, for analysis and comparison. Chi-square test was applied as a test of significance with fixing the p-value of 0.05 as significant.Out of 77 nurses who participated in our study, only 33 (42%) nurses were aware of the occupational hazards of their profession when they joined nursing. Needle stick injury was reported by 40 (71.9%) of the nurses in last one year. About 17 (31.5%) were injured at the time of recapping the syringe. The availability of needle cutters in the hospital was reported by 75 (97.4%) nurses while only 46 (60%) of them had undertaken a sharp management training course. Approximately 50 (64.9%) nurses failed to use gloves while administering injections. After getting stuck by a contaminated needle 71 (92%) of the nurses cleaned the wound with a spirit swab, 67 (87%) washed the area with soap and water and 58 (75%) applied a readily available bandage. Only 38 (49%) went on to inform the higher officials about a needle stick injury. Fifty-seven (74%) of the nurses were vaccinated against HBV, and 56 (72.2%) of needle stick injured nurses proceeded for HBV screening, while 53 (68.6%) for HCV and 37(48.5%) for HIV.Needle stick injury is the most important occupational health hazard in nurses with alarmingly high rates. Reporting to the concerned authorities, screening of nurses after needle stick injury and promotion of safety measures against it should be greatly encouraged.

To assess the students' perspective about role-plays conducted as a teaching methodology in community medicine.A quasi-experimental study.Department of Community Medicine at Fatima Memorial College of Medicine and Dentistry from July to November 2010.A probability technique of simple random sampling was used to collect 63 students from the third and fourth year MBBS who were randomly distributed in five sub-groups. They were variously ascribed the roles of obsceners, participants and helpers. A questionnaire was distributed to collect student's responses. The data was analyzed on SPSS version 17 to compare the responses. Chi-square test was applied and p-value was fixed at0.05 as significant.Sixty-three students were selected as participants of this study in which 46 belonged to the fourth year MBBS class (73%) and 17 were third year MBBS students (27%). There were 13 male (20.6%) and 50 female (79.4%) students. Role-plays were identified as most effective method of teaching (n = 25, 37.9%) followed by lectures (n = 17, 25.8%, p = 0.054). Fifty-two students (78.5%) admitted that role-plays improved their knowledge of the subject, 55 (84.6%) said that it will help them in their clinical performance. Fifty-nine participants (89.4%) found role-plays interesting and 49 (74.2%) wanted to incorporate role-plays as a part of curriculum. Fifty-six of the participants (88.9%) agreed that role-plays improved their communication skills. Twenty-one participants (31.8%) believed that it helped them in making acquaintance with the local situation. Forty-six students (76.7%) identified role-plays as a feasible way of andragogy (p = 0.005) and 48 (76.2%) said that it provoked critical thinking about the subject (p = 0.038). Fifty-four students (85.7%) admitted that their attention span was better in role-plays as compared to lectures (p = 0.047).Role-plays were well accepted by the students as an effective teaching methodology and can be incorporated as a part of teaching strategies in Community Medicine.

The health care utilisation of a population is dependent on their health seeking behaviour which is determined by their physical, political, socio-economic and socio-cultural aspects.This particular study is conducted to identify the determinants and the patterns of health services utilisation by the postgraduate students of Allama Iqbal Open University in Pakistan. It was a cross-sectional study and conducted from December 2008 to April 2009 in Allama Iqbal Open University Islamabad.A non-probability convenience sampling was done in post graduate students who were enrolled for Masters Degree at Allama Iqbal Open University Islamabad. Data was collected on a self administered, pre-tested questionnaire to identify the pattern of utilisation of health care services by this educated class. Data was labelled and entered in SPSS version 16. Chi-square test is applied as a test of significance with fixing the p value at 0.05 as significant.Only 129 students 32 males, 97 females) out of 250 responded to the questionnaire with the response rate of only 51.6%. The sociodemographic profile of the participants shows that 71 (55%) belong to age group 20-29 years, followed by 43 (33.3%) in age group 30-39 years. The marital status of the participants had a significant association with selection of health care services (p = 0.04). Twenty-four (75%) of the males and 67 (65%) of the females were using private sector facilities. Age, marital status and income of the study subjects had significant association with selection of the provider with p values of 0.000, 0.047 and 0.051 respectively.The health care system in Pakistan comprises the public as well as private health facilities. In Pakistan vast majority of doctors resides in urban area and attracts the educated class towards private sector. Utilisation of public health care facility is not the main priority of the educated class of the country. Government officials should pay attention to make it more convenient for general public.

To assess the frequency and forms of bullying experienced by medical students, and the associated factors.Cross-sectional questionnaire-based survey.The study was conducted at a private Medical College of Lahore, from January to February 2010.All the students of first and fourth year classes were included in the study with voluntary and anonymous participation. Self administered-questionnaires were given to the students which were completed by them in the presence of the surveyor. A modified version of the British Medical Associations (BMA) medical student's welfare and education survey form was used for data collection. The data was recorded and analyzed using the statistical package for social sciences version 16.0. Data was described in the form of frequencies and percentages. Chi-square test and Fisher exact test were used to test statistical significance between categorical variables at p0.05.More than half the students 70 (66%) had experienced some form of bullying in the past 6 months at the Medical College. It was found that 70% (49) of the students who were bullied were females. Sixty-seven percent of students reported experiencing a bullying episode at least once in a month, 26% less than once in a month and 7% at least once in a week. The most common forms were verbal abuse (n=44, 63%) and behavioural gestures i.e. making faces (n=36, 51%), followed by having been ignored or excluded (n=20, 29%). The common perpetrators of all types of bullying were fellow students followed by Professors. Feeling lonely or sad (p=0.024), not having a close friend (p=0.049) and knowledge amongst respondents regarding the availability of support services in their college (p=0.019) were significantly associated with being bullied.Most medical students reported of having been bullied in the last 6 months at the College, with verbal abuse being the commonest form of maltreatment and fellow students followed by Professors being the frequent perpetrators. A history of feeling lonely or sad, not having a close friend and knowledge amongst respondents regarding the availability of support services in their college were significantly associated with these experiences.

To describe the socio-demographic along with the medico-legal characteristics of rape victims reporting to a female police station of Lahore.Observational study.Female Police Station in Shadman, Lahore, from, June 1995 to January 2009.A total of 74 cases of alleged rape victims were identified while reviewing all available police files concerning reported rapes and attempted rapes from 1995 to 2008. The data was gathered on preformed questionnaires after conducting the pilot study. All information about victims and alleged offenders were extracted from the police files including socio-demographic profile of the accused and victim both. Use of weapon, evidence of physical and genital trauma, assailant identification and his relationship with the victim, number of accused persons and location of rape was noted in each case. Examination by doctor and obtaining the specimens were also identified and was related to the outcome of the court case. Chi-square test was applied to determine the association of rape with age and educational status of the victim and the accused.A total of 74 cases of alleged rape were reported in the study period at Shadman Female Police Station. Maximum number of victims was reported in the age group 10-19 years (n=46, 62.2%). Majority of the accused belonged to 20-39 years' age group constituting 64.8% of the total. Regarding educational status 45 (60.8%) of the victims and 51 (68.9%) of the accused were illiterate. Significant association was found between the educational status of rape victims and accused (p = 0.016) but not between their ages (p = 0.862). The maximum incidence of rape was reported in unmarried (n = 55, 74.3%) and unemployed (n =61, 82.4%) women. In 14 cases (19%) use of weapon was reported. Physical trauma was reported in 29 (39%) and genital trauma in 14 (19%) cases. The accused were identified as family friends (25%) and neighbours (23%) respectively. Only 21% of the victims were examined by doctor and specimens were obtained in only 14.9% of the cases. Acquittal of the accused was observed in 43% of the cases while 34% cases were still pending; conviction of the accused was observed in only 5% of the cases.Rape victims usually belong to young age group between 10-19 years majority of being unmarried and unemployed. Only a smaller fraction of the victims were examined by doctor and specimens were obtained in only few of the cases.

To obtain the views and recommendations of final year MBBS medical students of Lahore Medical and Dental College, Lahore about various aspects of the current medical education.Cross-sectional survey.Lahore Medical and Dental College, Lahore in October and November 2007.Preformed close ended structured questionnaire regarding medical teaching and evaluation methods and recommendations was used to collect the data from students of final year MBBS (n=120) at Lahore Medical and Dental College. SPSS 15 program was used for analysis. Data was presented as frequency percentages.A majority of the students (79%) thought that multimedia was the most effective teaching tool, (54%) students viewed 45 minutes as ideal lecture duration. Measures suggested to improve the examination results were regular tests (54%), improved lecture content (32%) and regular tutorials (10%). MCQ's were the mode of examination questions preferred by 62% of students. Recommendations given by students for improving the current medical education were better teaching (26%) followed by increased motivation in students 54 (16%) and more hands-on training/practical field work (12%).Medical students in this study preferred multimedia, lecture duration less than 45 minutes and MCQ's as their preferred mode of evaluation. Students recommended increased emphasis on better lectures, increasing learning motivation in students and more hands on training/practical field work to improve current medical teaching.