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Introduction: Stigmatization, social exclusion and consequent banishment from the society makes transgender's life even tougher; isolating, pushing and forcing them into inappropriate conducts/habits like selling sex. This study investigates the association of social exclusion/victimization with high-risk behaviors among transgender community of Rawalpindi and Islamabad (Pakistan). Methods: Through a cross-sectional study design, a sample of 189 transgender community living in twin cities of Rawalpindi and Islamabad was selected using snowball sampling technique. A validated close ended questionnaire was used to estimate the high-risk behaviors. Multivariate logistic regression was used to explore the competing outcomes associated with suicidal risk, selling sex and substance abuse. Results: Majority study participants 77.8% experienced physical attacks with institutional discrimination even higher (91.5%). Commercial sex work and drug abuse was reported in 39.2% and 37.6% respectively. The prevalence of suicide ideation was high (38.6%) however, suicide attempted rate was less (18.5%). In the multivariate logistic regression, compared to those with no risk, being physically attacked increased the odds of both attempting (OR=2.18) and contemplating suicide and selling sex (OR=4.10). Nevertheless, the relative impact of institutional victimization on suicidal behavior was higher among those who were targeted on the basis of their gender identity or expression (AOR = 6.20, CI = 1.58-24.29, p=0.009). Conclusion: The transgender community is socially excluded by the Pakistani society where they experience high levels of physical abuse and face discriminatory behavior in daily life. Such attitudes make them vulnerable for risky behaviors; forcing them to become commercial sex workers, begging, drugs use and even suicidal ideation. [ABSTRACT FROM AUTHOR]

Background and Objectives: Medico legal cases are essential component of medical practice and comprise most important constituent of emergencies. The reporting of such cases is imperative to recognize their socioeconomic burden on any country. The present study was conducted to scrutinize different categories of medico legal cases and characteristics of the victims at casualty department of tertiary care hospital Rawalpindi. The objective of the study was to find out the frequency of various categories of medico legal cases and major characteristics of victims at tertiary care hospital, Rawalpindi. Methods: This was a cross-sectional study on 3105 registered cases in medico legal record of the casualty department of Benazir Bhutto hospital, Rawalpindi from January 2015 to December 2015. The hospital is located on the main road in densely populated central area of the city. The data was collected on age, sex, month-wise distribution of various medico legal cases, weapon inflicting the injury, blunt trauma or physical assault, firearm injuries and road traffic accidents. The data thus obtained was analyzed using SPSS; observations were presented in tables and graphs. Results: Out of all 3105 registered medico legal cases, reported cases caused by Road Traffic Accident 1230 (40%) followed by blunt injury or physical assault 966 (32%) cases, 19% by sharp weapons, 5% by poisoning, and 4% by firearm injuries. In our study out of 3105 cases, almost three quarter of victims (73%) were below 30 years of age, with a decreasing frequency beyond this age, males were predominantly inflicted 2516 (81%) as compared to females 589 (19%). The reported road traffic accidents cases from urban areas were high (74%) as compared to those from rural locality (37%). In cases of blunt trauma, sharp weapon injuries and firearm injuries, there was a huge preponderance of victims from rural areas (65%), (62%) and 61% respectively, with urban cases constituting less. Conclusion: Road traffic injuries are one of the foremost causes of medico legal cases followed by blunt trauma and sharp weapon injuries. The emerging medico legal cases are neglected epidemic in most of the developing countries comprising a considerable public health problem. [ABSTRACT FROM AUTHOR]

Introduction: Low birth weight is a key determinant of infant survival health and development. There are many maternal and biological risk factors for it. The objective of this study is to determine the frequency and associated risk factors of low birth weight. Materials and Methods: This cross-sectional study was carried out in the department of obstetrics and gynecology; Al Razi hospital, Rawalpindi from 1st June 2016 till 1st June 2020. The total sample size was 20,681 which was the total number of births during these years in this hospital setting Results: The overall frequency of LBW was found to be 8.9%. Female babies were more likely to have LBW (9.9%) as compared to male babies (7.9%) with a significant p-value. LBW babies had poor APGAR scoring as compared to normal weight (p=0.000). 252 (75%) of the premature babies were LBW. Among primigravida women, 796 (10.8%) gave birth to LBW babies. Conclusion: It was concluded that gestational age, parity, maternal weight gain during pregnancy, history of miscarriages, and several antenatal visits were significantly associated with low birth weight. LBW was associated with a poor APGAR score. [ABSTRACT FROM AUTHOR]

Introduction: Breast Cancer is the rising Public health problem of the world. Pakistan is bearing a high disease burden not only in Asian countries but in the whole world. Pakistan ranks highest in Breast cancer and accounts for almost 34.6%of female cancers. The incidence of the disease in Asian countries is quite different from that in Western countries regarding age i.e. (40-50 years.) while (60-70 years) in Western countries. This study was based on assessing the knowledge regarding breast cancer, risk factors, and screening practices to determine the barriers in the path of the community to seek medical care. Materials and Methods: A cross-sectional study was done between October to December 2019 on 310 females participants of ages from 25 to 70 years, residents of Islamabad, the capital of Pakistan, and knowledge was assessed by applying a self-responding questionnaire. Results: Using SPSS version 23 and chi-square tests, the results showed that 87.7% of participants knew about the prevalence of Breast Cancer. Whereas, 90.3% of the females with the disease are not aware of their illness and show a strong association (p-value is less than 0.05) between knowledge regarding breast cancer and screening tests. Conclusion: The study concluded that 90% of socio-cultural barriers are in the path of access to medical facilities and 90% of participants believed that the non-availability of female doctors in health facilities is a big barrier to access to health. Access to medical facilities should be made easy by promoting health education and removing the fear of results, making small health facility units. [ABSTRACT FROM AUTHOR]

Objective: To assess knowledge and practices of critical care health professionals related to ventilator associated pneumonia., Methods: This cross-sectional survey was conducted at eight tertiary care public and private hospitals of Islamabad/Rawalpindi, Pakistan, from September 2015 to March 2016, and comprised healthcare professionals. Stratified random sampling was used. Data was collected using close-ended validated questionnaire. SPSS 22 was used for data analysis., Results: Of the 153 participants, 45(29.4%) were doctors, 91(59.4%) were nurses and 17(11.1%) were respiratory therapists. The overall mean age was 31±8.14 years. The overall mean knowledge and practice scores regarding prevention of ventilator-associated pneumonia were 11.14±3.12 and 8.83±1.53, respectively. The mean knowledge score was 11.77±3.84 for physicians, 10.84± 2.91 for nurses and 10.82±1.94 for respiratory therapists. However, the best practice scores were seen in the respiratory therapists 9.64±0.78 (p=0.008)., Conclusions: The majority of the participants had adequate knowledge and even better practices, particularly respiratory therapists.

Objective: To determine the burden on the caregivers of patients receiving dialysis treatment., Methods: This cross-sectional study was carried out in four different dialysis centres of Rawalpindi, Pakistan, from June 1 to December1, 2015, and comprised attendants of patients receiving dialysis. The data was collected from the attendants of patients receiving dialysis, and caregiver burden was measured using the Zarit Burden Interview questionnaire. SPSS 22 was used for data analysis., Results: Of the 164 subjects, 97(59%) were females. The majority of caregivers reported stress for caring (2.28±1.31), patients asking for more help than needed (2.14±1.13), health problems (1.03±1.11), financial constraints (1.70±1.15) and little time for self-care (2.15±1.21). Besides, 107(65%) caregivers perceived the burden of their patients as mild to moderate. A positive correlation was found between the duration of a person on dialysis, daily hours of care-giving and the total burden score of his/her caregiver (p<0.05 each)., Conclusions: Care-giving can create enormous burdens on caregivers, affecting their physical and psychological health.

Objective: To ascertain the prevalence of risk factors for ischemic stroke in Pakistani patients at Shifa International Hospital (SIH), Islamabad, Pakistan., Methods: This retrospective cross-sectional study included patients of either gender, with no age limit admitted to the Department of Neurology at Shifa International Hospital, Islamabad, Pakistan, with the diagnosis of stroke verified by brain CT scan during a period of 2 years from January 2007 to December 2009. The data were analyzed by grouping our patients according to their age based on the frequency of risk factors. Group 1; 25-55 years (23.8%), group 2; 56-71 years (43.4%), and group 3; 72-103 years (32.7%)., Results: A total of 418 patients were included in the study; 137 patients were excluded due to incomplete information. The data from the remaining 281 were analyzed. The mean age of the population was 65 ± 0.8 years, and the male to female ratio was 1.30:1. The most frequent risk factors included hypertension 86.8% followed by diabetes mellitus 59.8%, dyslipidemia 59.1%, and smoking 18.1%. The highest frequency of 4 risk factors was present in the age group 56-71. Gender distribution of risk factors showed that hypertension and dyslipidemia are major risk factors in group 1. Abnormal high-density lipoproteins (HDL) emerged as the major lipid among 3 groups, especially in group 1, which predisposed to stroke., Conclusion: A decrease in HDL and control of blood pressure is important to reduce the risk of stroke especially in early age (namely, ≥ 25 years) and could become an increasingly useful tool to identify patients at a high risk of stroke.