The International Journal of Frontier Sciences

Background: Obesity is a major epidemic of developed world that is now extending to developing countries and is the risk factor of pre-eclampsia which is the major contributor to maternal and foetal morbidity & mortality. Objective: To determine the frequency of preeclampsia in obese primigravida women visiting the Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan. Methodology: This cross-sectional descriptive study was conducted in Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan from January 2018 to December 2018. All the Primigravida women with singleton pregnancy of gestational age ? 26 weeks assessed by ultrasound between 20-35 years of age were included in the study by non-probability consecutive method. After obtaining ethical approval from hospital ethical committee and informed written consent from all the study subjects, relevant data were documented in a predefined data sheet and body mass index (BMI) was calculated by using the formula: Weight (kg) / Height2 (m). Women having blood pressure (BP) of 140/90 mmHg or above in third trimester of gestation measured on at least two occasions, 6 hours or more apart accompanied by proteinuria of 300 mg per 24 hours or above in previously normotensive were labelled as preeclampsia and first-time pregnant women having BMI ? 30 were taken as obese. Statistical analysis was performed by using computer-based software, Statistical Package for Social Science (SPSS) for windows version 17.0. Mean and standard deviation was calculated for numerical data like age. Frequencies and percentages were calculated for categorical variables. Chi-square test was performed to find the statistical difference regarding preeclampsia distribution between groups and ‘p’ value <0.05 was considered as a lowest level of significance. Results: Mean age of the respondents in the study was 27.08±3.59 years. Majority of the women were between the ages of 26-30 years (53.30%). The mean gestational age of the respondents was 34.50±4.33 weeks and most of the women had gestational age ? 36 weeks (46.70%). Frequency of obesity in pregnancy was 15.4% and frequency of preeclampsia in obese primigravida was 55.3%. Conclusion: It is concluded that frequency of preeclampsia is higher in obese primigravida compared to non-obese primigravida. Full article

Background: Hand hygiene is a general term referring to any action of hand cleansing by using water and detergent and for the removal of transient microorganisms from hands. Hand hygiene is recognized as the leading measure to prevent cross-transmission of microorganisms and to reduce the incidence of healthcare associated infections. There are many experiences that the lack of knowledge, attitude and poor practice in hand hygiene in healthcare workers transmit infection in patients and in other healthcare workers. Methodology: This descriptive study was conducted in Gulab Devi Chest Hospital. I had taken 100 healthcare workers to complete my research. The sampling technique of my research was cross-sectional sampling technique, use to collect the data. Results: In this research knowledge was not good in all HCWs, Overall knowledge of hand hygiene by all HCWs was less than 50%. The attitude in nurses and medical student in this research was moderate doctors and technologists have poor attitude in hand hygiene. The practices among HCWs in Gulab Devi Chest Hospital were also poor which was less than 50%. Conclusion: The HCWs in Gulab Devi Hospital had poor knowledge, practices on hand hygiene. However, attitudes of medical student and nursing had satisfactory. Full article

Primary and Secondary Healthcare Department of Punjab, Pakistan has outsourced its clinical laboratory services at various secondary level hospitals in the province. Methodology adapted to outsource these facilities was based on phasing out the process. While methodology adapted to selection of service provider was on the basis of bidding. Two service providers contracted the procuring agency to deliver services to general public. In the first phase, clinical laboratory services of DHQ Hospital Chakwal were outsourced to a private laboratory service of the country. This communication aims on the methods adopted by Pathology Department of the hospital to evaluate the technical efficiency of the service. Full article

Abstract Background: Use of the World Health Organization’s (WHO) Safe Childbirth Checklist (SCC) has been associated with a significant reduction of maternal mortality. Method: A descriptive cross-sectional survey conducted at a tertiary care hospital of Rawalpindi in labour room and postnatal ward from February 2018 to July 2018. A sample size of 359 was estimated using WHO sample size calculator and were enrolled using purposive sampling technique. A close ended WHO standardized questionnaire covering the 22 elements of WHO SCC was used. Frequencies and percentages were documented of variables and data was analysed using SPSS version 23. Results: Mean age of participants was 27 ± 4.25 years. On admission, it was observed that being centre of excellence and referral, there was 100% availability of gloves and supplies to clean hands before and after each vaginal examination. Just before pushing or caesarean, it was found that in 342 (95.3%) patients, assistant was identified to help at time of birth. Immediately after one hour of birth, it was noted that 79 (22%) patients were bleeding abnormally and were immediately addressed. We also found out that only 79 (22%) of the mothers were counselled regarding family planning. Almost half of the participant mothers 182 (50.7%) or their companions were counselled regarding danger signs and to seek care immediately which should have been 100%. Conclusion: Excellent adoption of some of the element up to 100% was observed while some of the elements of checklist were poorly adopted; noticeable was counselling regarding family planning options immediate postpartum. Full article

The competitive healthcare system and healthcare environment, modern hospitals with substantial investment, healthcare reforms, availability of specialized persons in hospital management, health services management, the success of quality management programs in developed nations and high interest of international health organizations like WHO has led the developing countries like Pakistan to pay due attention to quality in national healthcare system. Since the time of independence healthcare system in Pakistan is striving for improvements. Despite of the physical infrastructure and availability of qualified workforce for service delivery there are gaps in strategic and operational planning which resulted in poor quality health services. The leaders in healthcare has little awareness that the quality management is an organized specialty to improve the quality of healthcare. It is need of the hour that healthcare leaders in Pakistan must integrate quality improvement activities in strategic and operational planning process of healthcare system. This the only way to maximize the benefits of healthcare system and restore the rapidly deteriorating public trust. Full article

Abstract: Introduction: Globally it is documented that CVD has multi-factorial aetiology and many factors like increased BMI, hypertension (HTN), stress and diabetes determine the risk of CVD. The prevalence of risk factors for cardio vascular disease (CVD) is on increase in the developing nations of the world. Objectives: The purpose of the study was to find out the prevalence of cardiovascular disease and its risk factors among employees of Sindh Government in Karachi, Pakistan.Method: It was hospital based cross sectional study. A total of 150 subjects (govt employees of Sindh Government) were interviewed by using consecutive sampling technique. Data on serum cholesterol, BMI, blood pressure, history of hypertension, diabetes and cardiovascular diseases was collected, in addition to demographic data. Results: Out of 150 subjects interviewed, 20.6% reported to have CVD. The most prevalent risk factor was hypertension, found in 58% respondents. Other risk factors were diabetes (45%), sedentary life style (50%), obesity (28%), dyslipidaemia (30%), smoking (20%), positive family history (26%). In 6% of subjects, three major risk factors were present. The risk factors, strongly associated with CVD in our study were diabetes (p<0.01), hypertension (p<0.001) and family history of CVD (p<0.02). There is strong association of increasing age on risk of developing CVD (p< 0.001). Conclusion: The results show that there is high frequency of CVD risk factors in employees of health department in Karachi. The high prevalence of risk factors, especially hypertension, sedentary life style, obesity and diabetes should be of great concern. Full article

Abstract: Objectives: To assess the frequency of eye makeup use among female doctors and its association with ocular surface disease Index (OSDI). Study Design: Analytical Cross-Sectional Study Place and Duration of Study: It was conducted from Jan 2018 to May 2018 at a tertiary care hospital Rawalpindi. Materials and Methods: Sample size calculated using WHO sample size calculator was 272 with margin of error 5% and confidence level of 95%. A WHO Standardized OSDI Questionnaire was used to asses for the severity of ocular surface disease and frequency of application of eye makeup. Females were also inquired about adoption of safety guidelines while applying and removing eye makeup. Results were displayed as frequencies and percentages and Chi Square test was applied to assess statistical significance among frequency of makeup use and severity of ocular symptoms. Results: Frequency of Eye makeup use as stated by the participants was less than three times among 37% and it was more than three times a week among 63% participants. Once a week users were only 24.7%. Among users it was found that majority 49.3% had normal scores while 55(24.2%) had mild disease, 11.5% had moderate disease and only 15% had severe disease. Some questions were added in questionnaire to assess the safety practices regarding eye makeup use. It was quite satisfactory to know that 73.1% of the participants do check expiry date of products before use, don’t share their products with others 62.1% and take off makeup before going to sleep 78.4%. However, the situation was quite opposite in some other practices as only 42.3% do patch test before applying makeup and 34.8% check constituents before purchasing the make up as to some of the constituents they might be sensitive. Conclusion: This study shows the utilization of eye make-up is extensive and related to the perception of ocular discomfort. With such widespread use of these products, more research is needed to assess the effect on the ocular surface and tear film, which can be underestimated. Full article