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Background: Oral cancer is currently one of the major public health problems globally. Awareness of the risk factors of oral cancers may result in patients seeking medical advice earlier, which in turn can lead to early detection and a better prognosis of such lesions. Literature also reports lack of awareness to be the most common barrier to care-seeking by oral cancer patients. Objective: To determine oral cancer awareness and its associated factors among among dental patients attending free consultation camp in a tertiary care hospital in Karachi. Methods: A cross-sectional study was conducted in a tertiary care dental hospital in district Malir, Karachi, from January 2019 to June 2019. After checking eligibility and taking verbal informed consent, the participants were interviewed using a questionnaire to assess their oral cancer awareness. Data were analyzed on SPSS version 20. Crude and adjusted odds ratio with 95% confidence interval were computed using binary logistic regression to determine the association of demographic characteristics with awareness. Results: The median age of study participants was 37 (IQR=45-29) years whereas 105 (65.2%) of them were female. The mean awareness score of the participants was 8.94±2.71. Moreover, only 34 (21.1%) participants had adequate awareness whereas 127 (78.9%) had inadequate awareness regarding oral cancer. In a multivariable model, education of the patients was found to be associated with adequate awareness regarding oral cancer. Conclusion: It was concluded that certain gaps exist in the awareness of dental patients regarding oral cancer, and apart from the education, none of their demographic characteristics significantly influenced it.

Objective: To determine the knowledge, attitude and practices regarding management of biomedical waste among the house officers and nursing staff in teaching hospitals of District South, Karachi. Methods: A cross sectional knowledge, attitude and practice survey was conducted from November 2018 to April 2019 among the house officer and the nursing staff working at different teaching hospitals of District South, Karachi. A total of 196 house officers and staff nurses were included in the study after checking their eligibility. The participants were interviewed by the principal investigator with the help of a structure questionnaire develop specifically for this study. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using Mann Whitney U test and Kruskal Wallis H test whereas the significance level was set at 0.05. Results: The study results revealed that among demographic variables categories of age and profession had significantly different mean knowledge rank (p

Background: Diabetes mellitus is one of the most common public health issues globally whose incidence is on the rise, particularly in middle-income and low-income countries. Primary care physicians are the first line of defense in treating and directing diabetics and their families. Despite this, available literature points out a lack of awareness among them regarding type 2 diabetes mellitus and its management. Objective: To determine the awareness and its associated factors regarding type 2 diabetes mellitus and its management among medical practitioners working in different health facilities of Karachi. Method: A cross-sectional study was conducted from June 2016 to November 2017 on medical practitioners working at different public and private health establishments of Districts Malir and Korangi, Karachi. Data from 208 conveniently sampled medical practitioners from the randomly selected union councils of these two districts were collected through the study questionnaire after taking their verbal informed consent. Data were analyzed on SPSS version 21. Crude and adjusted odds ratio with 95% confidence interval were computed using binary logistic regression to determine the association of study variables with adequate awareness. Results: A total of 328 medical practitioners were approached out of which only 208 returned the questionnaire yielding a response rate of 63.4%. The median age of study participants was 38 (IQR=47-30) years. 148 (71.2%) of them were males whereas 168 (80.8%) of them were privately employed. It was found that 146 (70.2%) participants had adequate awareness whereas 62 (29.8%) had inadequate awareness regarding type 2 diabetes mellitus and its management. Univariate and multivariable analysis showed that none of the demographic characteristics of the practitioners were significantly associated with awareness. Conclusion: Medical practitioners were found to be adequately aware of many aspects of diabetes mellitus type 2 and its management. Their awareness, however, was not associated with their demographic characteristics.

Objective: To assess learning styles and preferred teaching methodologies of medical students in relation to year of study. Methods: A cross-sectional study was carried out among 523 medical students of Baqai Medical College, Baqai Medical University, Karachi, from May 2019 to October 2019. All male and female students from first to final year, who attended the undergraduate MBBS program in the medical college, were included in the study. The study questionnaire was administered to all enrolled undergraduate medical students, from first to fifth year, on the campus out of which 523 forms were collected. The study instrument was a questionnaire containing students’ demographic details, David Kolb’s Learning Style Inventory 4.0 and their preferred teaching methodologies scored using a 5 point Likert scale. The association of various learning styles and preferred teaching methodologies with year of study was assessed by using Pearson chi-square test. Results: Out of 523 students who returned the form 518 had completed the questionnaire. A majority of the students had imagining or experiencing learning style. No change in learning style was observed between years of study. The top three teaching methodologies with highest mean scores were small group discussion (3.58±1.12), problem based learning (3.56±1.11) and demonstration on models (3.54±1.20). A significant association between some preferred teaching methodologies and year of study was found such as interactive lecture (p=0.011), problem based learning (p=0.026), small group discussion (p=0.024), and one way lecture (p=0.028) while a highly significant association was noted in case of student presentation (p=0.001). Conclusion: The present study showed that different years of study at medical schools did not significantly affect students’ learning styles, although the students did change their preferences to some teaching methodologies. Longitudinal studies are necessary to reveal whether there is an effect of learning styles over time in medical education.

Objectives: To assess the frequency of self-medication and its associated factors among outpatients. Methods: A cross-sectional study was conducted at the outpatient department of Fatima Hospital, Baqai Medical University, from May 2019 to September 2019. After checking eligibility, a total of 360 outpatients were included in the study using the convenience sampling technique. Being aged 18 years or above and belonging to either gender were the study's inclusion criteria, whereas refusal to give verbal informed consent was the exclusion criterion of the study. The data was collected by interviewing the study participants using a structured questionnaire. Statistical package for social sciences version 21 was used for data analysis, while inferential analysis was performed using univariate and multivariable binary logistic regression. Results: The study results showed that 118 (32.8%) of the participants were suffering from a chronic illness, 240 (66.7%) of them kept medicines at their houses, 235 (65.3%) of them self-medicated, whereas the mean duration of their self-medication was found to be 9.90 ± 8.51 years. Moreover, age, educational status, employment status, and keeping medicines at the house were significantly associated with self-medication of the participants were those who were aged 50 years or above (AOR,7.83; 95% CI,2.27-27.04; p=0.001), able to read and write (AOR, 4.36; 95% CI, 1.58-11.98; p=0.004) and kept medicines at the house (AOR, 46.35; 95% CI, 20.07-107.06; p

A cross-sectional survey was conducted from February 2016 to September 2016 to assess knowledge, attitude and practices regarding implants among women of childbearing age visiting Reproductive Health Services Center, Civil Hospital,Karachi. A total of 396 adult non-pregnant married females of child bearing age, from 18 to 49 years old, were interviewed using a structured questionnaire.Only153 (38.6%) of therespondentshad knowledge about implants whereas out of them 122 (79.7%) acquired it from family planning clinics. Almost two third of them (n=267, 67.4%) were in favor of using implants as a contraceptive method. Moreover, 244 (61.6%) of them were of the opinion that if given the choice, they will use implanon though out of total 316 (79.8%) respondents who ever used contraceptives, only 3 (0.9%) used implants.Despiteafavorable attitude, limited knowledge and poor practices of the respondents highlighted the study findings. Keywords: Knowledge, Attitude, Contraception, Progestins, Continuous...

Objective: To assess tuberculosis related knowledge, attitude and practice among final year medical students of Karachi. Methods: A cross-sectional study was conducted in two medical colleges located in different districts of Karachi from January 2017 to June 2017. Being a final year medical student of the college was the inclusion criterion whereas refusal to give written informed consent was the exclusion criterion of the study. Data were collected on a structured questionnaire administered by the principal investigator to all the participants. Data collected were analyzed using SPSS statistical package version 20. Results: Around two-thirds students knew that tuberculosis cannot be treated only on radiographic findings while a majority of them knew about the treatment regimens but knowledge about the different TB medicines and their side effects was variable. About 90% of the students believed that directly observed treatment short course therapy is effective while a similar number believed Bacille Calmette Guerin vaccination prevents tuberculosis. A fair number of students (63.1%) practice wearing of face mask while a majority (89.3%) of them reported that contagious patients should be isolated. Over 95% of the students stated that they give tuberculosis patients counseling and health education. Conclusion: Majority of students had correct knowledge, attitude and practices regarding tuberculosis. Increased exposure and education to medical students in both academic and clinical settings is recommended.

Objective: To determine the awareness regarding weaning and its associated factors among mothers in Kashmore, rural Sindh. Methods: A cross-sectional study was conducted among infant’s mothers regarding awareness for weaning at Kashmore, a rural community in interior Sindh, from March 2108 to November 2018. The inclusion criteria were age of mothers 30 years or above and child’s age more than two years whereas mothers refusing to give verbal informed consent were excluded from the study. A total of 200 mothers were included in the study and were interviewed by using a questionnaire designed specifically for the study. Data were analyzed using statistical package for social sciences version 20 while Mann Whitney U test and Kruskal Wallis H test were used for inferential analysis. The study duration spanned over 9 months. Results: The mean age of the mothers was 27.1 ± 6.3 years and the average number of children for every household was 2.4 ± 1.3. When participants were asked about what weaning foods should be given to assess their awareness, 176 (88.0%) mothers said bread or roti, 153 (76.5%) said yogurt, 144 (72%) said boiled rice, 133 (66.5%) said vegetables, 130 (55.0%) said suji or kheer, 95 (47.5%) said egg yolk while only 71 (35.5%) said fruits. The study results further showed that among the socio-demographic characteristics compared the mean awareness scores of the mothers were significantly different across categories of mothers’ education (p

Objective: To determine the frequency of skin diseases and its associated factors among patients visiting a dermatology clinic in Karachi. Methods: A cross sectional study was carried out from December 2018 to May 2019 at Baqai Institute of Health sciences, Baqai Medical University, Karachi. Available relevant data of all patients visiting a selected dermatology clinic in Karachi for a period of two years, from 1st January 2017 to 31st December 2018, were retrospectively gathered and recorded on the study questionnaire by the principal investigator. Statistical package for social sciences version 19.0 was used for analysis. Chi-square test was applied to check associations between the independent variables and the study outcome whereas the significance level was set at 0.05. The duration of the study was six months. Results: The study findings revealed that the highest frequency of skin diseases among the patients was of psoriasis (25.3%), followed by dermatitis (23.3%), scabies (14.1%), fungal infection (11.9%), acne (9.0%), folliculitis (4.4%), atopic dermatitis (4.1%), keloid (3.2%), warts (2.8%) and vitiligo (1.9%). Moreover, 51.2% of the patients came in the summer season. The study results also showed that season was found to be significantly associated with the diagnosis of the patients both among patients aged 25-49 years (p

A cross-sectional awareness survey was conducted among final year MBBS students of ISRA University, Hyderabad from May 2017 to November 2017. After checking eligibility and taking verbal informed consent, 100 participants were included in the study and interviewed using a self-administered questionnaire. Data was analyzed on Statistical Package for Social Sciences version 21. The study results showed that 29 (29%) of the study participants got information about family planning methods from health care providers, 27 (27%) through social circle, 24 (24%) through mediawhile 20 (20%) through conference, meetings and events. Furthermore, 42 (42%) of the participants correctly identified all permanent family planning methods, 65 (65%) correctly identified temporary family planning methods, 47 (47%) correctly identified short-term family planning methods whereas 54 (54%) correctly identified long term family planning methods. Efforts by both public and private sector to enhance awareness regarding family planning methods among medical students are recommended

A cross-sectional survey was carried out to determine the factors associated with self-reported glycemic control among outpatients with diabetes mellitus type 2 visiting a private tertiary care hospital of Karachi, from July to October, 2018. A total of 185 participants of either gender, aged 30 years, with obesity and a self-reported diagnosis of diabetes mellitus type 2 for at least 1 year were included in the study and interviewed using a structured questionnaire. Data were analyzed on statistical package for social sciences version 21 whereas chi-square test and binary logistic regression were used for inferential analysis. The study results showed that regular medicine intake, regular exercise and weight change during the previous year were significantly associated with self-reported glycemic control of the patients (p

BackgroundAntibiotics are regularly prescribed by dental professionals in their practice, for the purpose of dental treatment as well as for the prevention of infection. The inappropriate use of antibiotics is a significant factor in the rise of antibiotic resistance. There is an immediate need for the advancement of prescribing guidelines and instructive polices to encourage the rational and appropriate utilization of medications especially antibiotics in dentistry.ObjectiveThe aim of this study was to identify the frequency of antibiotic prescription for treating dental infections in children among dentists in teaching institutions of Karachi, Pakistan and whether they are adhering to the prescribed international guidelines.MethodsA cross-sectional study was conducted in three private and two public colleges of Karachi. After taking written informed consent and checking the inclusion criteria, a total of 380 participants were interviewed using a pre-designed validated questionnaire which included demographic profile and clinical case scenarios. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using chi-square test. The significance level was set at 0.05.ResultsOf the 380 subjects, a majority (71.3%) treated 15 or less children per month (n = 271) while 28.7% of dentists (n = 109) treated more than 15 children per month. Overall adherence to American Academy of Pediatric Dentistry guidelines was low from 26.1% to 44.2%. The difference between adherence of dentists with low and high volume of pediatric patients was significantly different for case scenarios 1, 3, 4 and 5 (pConclusionsThis study shows that majority of dentists, particularly dentists with high volume of pediatric patients lacked adherence to professional guidelines for prescribing antibiotics for treating dental infection in children. There seem to be a lack of harmony between the recommended professional guidelines and the antibiotic prescribing pattern of dentists. Regular updates and continuing medical education for the health professionals regarding comprehensible and specific professional guidelines may lead to improved adherence of antibiotics prescription amongst dentists.

Abstract Objective: To assess oral health-related knowledge, attitude and practices and their associated factors among 3rd year BDS students in public sector dental colleges of Karachi. Methods: A cross-sectional survey was carried out to assess oral health-related knowledge, attitude and practices among 3rd year BDS students from November 2018 to April 2019. 3rd year BDS students of either gender in public sector dental colleges of Karachi were included in the study whereas those refusing to give verbal informed consent were excluded from the study. After checking eligibility, a total of 372 3rd year BDS students from five public sector dental colleges of Karachi were included in the study by using a convenience sampling technique. Data were collected by the principal investigator using a pre-tested structured questionnaire. Data were entered on Statistical Package for Social Sciences version 19. After checking normality, the inferential analysis was carried out using the Mann Whitney U test whereas the significance level was set at 0.05. Results: The study results showed that the knowledge and attitude regarding oral health of dental students were overall satisfactory, however their practices were not found to be satisfactory. Moreover, it was found that the mean rank of knowledge score was significantly different across various categories of age 'p=0.001' whereas the mean rank of practice score was significantly different across various categories of gender 'p=0.005'. Conclusion: It was concluded that knowledge score was significantly different across categories of age while practice score was significantly different across categories of the gender of the students. Serious efforts are recommended to be taken by all stakeholders in order to motivate dental students so that they can translate their adequate knowledge and positive attitude regarding oral health into appropriate practices.

Abstract Objective: To assess depression and its associated factors among patients coming to the dental OPD of a public and a private dental college of Karachi. Methods: A cross-sectional study was carried out in public and a private dental college of Karachi from November 2018 to May 2019. The inclusion criterion of the study was being 18 years of age or above whereas those who refused to give written informed consent were excluded from the study. After checking eligibility and taking written informed consent, a total of 250 participants were included in the study using systematic random sampling. These dental outpatients were interviewed by the principal investigator with the help of a pretested structured questionnaire that contained questions about socio-demographic information, dental risk factors and questions from Patient Health Questionnaire-9. Data were analyzed on the statistical package for social sciences version 21. Inferential analysis was performed using chi-square test whereas the significance level was set at 0.05. Results: The study results revealed that 70 (28.0%) participants had minimal depression, 99 (39.6%) had mild depression, 45 (18.0%) had moderate depression, 28 (11.2%) had moderately severe depression whereas 8 (3.2%) had severe depression. Moreover, among demographic characteristics, only monthly income (p=0.037) and family history of depression (p

Objective: To assess dental anxiety and its associated factors among patients visiting OPD of differ- ent tertiary care dental hospitals of Karachi. Methods: A cross-sectional study was conducted from April 2018 to November 2018 in two public and two private dental colleges of Karachi namely Karachi Medical and Dental College, Dr. Ishrat-ul-Ibal Khan Institute of Oral Health Sciences, Hamdard Dental College and Baqai Dental College. Being aged ³ 18 years of either gender were the inclusion criteria whereas refusal for a written informed consent was the exclusion criterion.After checking eligibility and taking written informed consent, a total of 247 participants were interviewed by the principal investigator using a questionnaire which included Corah's Dental Anxiety Scale and Dental Concerns Assessment. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using chi-square test and Mann-Whitney U test after checking normality. The significance level was kept at 0.05. Results: The study findings revealed that 2.4% of the patients interviewed were severely anxious, 8.1% were highly anxious, 37.2% were moderately anxious while 54.3% were not at all anxious. Moreover, patients with younger age and monthly household income between 16000 and 75000 ru- pees had significantly higher mean dental anxiety scores. Conclusion: The study findings revealed that up to 45.7% patients were anxious up to some degree. There is a need for better understanding of factors potentially increasing anxiety in dental patients in order to avoid them as negative experiences in past are known to trigger dental anxiety in future.

Objective: To assess pressurised metered dose inhaler technique of the nursing staff in different government hospitals of Karachi. Methods: A cross-sectional study was carried out in four randomly chosen government hospitals of Karachi. After checking for study criteria and obtaining written informed consent, a total of 120 nurses were interviewed and then given a placebo inhaler to demonstrate their inhaler technique. The reference for assessment was the 12-step inhalation technique suggested by the American College of Chest Physicians. Results: The study results revealed that out of the 12 steps of the inhaler technique, only 3 steps were followed by a majority of the study participants i.e. taking the cap off (64.2%), putting the metered dose inhaler in mouth with lips sealed (59.2%) and breathing in slowly by pressing down the metered dose inhaler (62.5%). The mean inhaler technique score of the study participants was 3.18 ± 2.34 out of 12 and only 1 (0.8%) of them had correct inhaler technique. Furthermore, the mean inhaler technique score was significantly higher for higher education level (p=0.001) and greater experience (p