Objective: Pregnancy and depression affect each other. The main objective of our study was to find out frequency of antenatal depression during last trimester and associated risk factors among pregnant female visiting a tertiary care private institution of Lahore, Pakistan. Methods: This study was conducted at Shalamar Hospital a private tertiary care institution of Lahore during May 2017 to June 2018. Assuming 18% prevalence with design effect 1.5 and 97% confidence interval the calculated sample size was 417. To avoid dropouts the questionnaire was administered to 450 pregnant females in their last trimester that is with gestational age above 28 weeks. In this study we used a modified version of Goldberg’s depression scale in Urdu language for data collection. Wherever needed the data collection team read out aloud the questionnaire to the participants who did not know how to read and write. Informed consent in a written form (in Urdu language) was taken from every study participant after explaining the participants about the research. If the participant did not know how to read and write, the interviewers narrated out aloud the script of informed consent for them and got it signed later by the participants. The confidentiality, anonymity and privacy of the study participants were preserved. Ethical approval of this study was obtained from Institutional Review Board of Shalamar Institute of Health Sciences. Data entry and analysis was finalized by using SPSS version 20. Results: The prevalence of depression among women seeking antenatal care during their last trimester according to Goldberg Depression Scale was 40.89% (n=184).Whereas, 30.4% (n=137), 8.67% (n=39) and 1.78% (n=8) suffered from mild, moderate and severe depression respectively. The associations between passive smoking (p < 0.01), family history of preeclampsia (p < 0.05) and depression among family members (p < 0.05) with antenatal depression during last trimester were significant. Conclusion: According to Goldberg Depression Scale, 40.89% (n=184) of pregnant women seeking antenatal care in private tertiary care institution of Lahore suffered from depression. How to cite this:Sabir M, Nagi MLF, Kazmi TH. Prevalence of antenatal depression among women receiving antenatal care during last trimester of pregnancy in a tertiary care private institute of Lahore. Pak J Med Sci. 2019;35(2):---------. doi: https://doi.org/10.12669/pjms.35.2.649 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.

Background: This study, therefore aims to assess the frequency and the factorscontributing to the needle stick injuries among health care workers of a tertiary care privatehospital of Lahore. Setting: Shalamar Hospital Lahore, Pakistan a tertiary care private institution.Period: July and August 2015. Study Design: Cross-sectional study. Methods: A modifiedstructured pre-tested questionnaire containing both open and close-ended questions wasadministered to 160 study participants. The selected candidates were thoroughly briefed aboutthe study and informed consent was obtained. Confidentiality and anonymity of the participantswas maintained. Data entry was done on SPSS version 20 for Microsoft Windows. Results: Theresponse rate was 97%. Among all respondents (n=122), almost 41% (n= 63) were medicaldoctors and 34% (n= 53) were nursing staff. A small proportion of 4% (n= 6) belonged to thedental surgical background as well. Of all the surveyed participants, 45% (n=69) had eversuffered from needle stick/ sharps injury during their medical job and career, whereas, 34%(n=53) had suffered from a needle stick injury during the last year. Nearly 63% (n=47) reportedthat the cause of injury was accidental, 16% (n=25) acknowledged lack of awareness, 7%(n=10) acknowledged improper equipment and 4% (n=6) accused lack of training as the majorcause of needle stick injuries. A hefty 34% (n=53) believed that there existed no protocols in theinstitution regarding needle stick injuries, while another 50% (n=78) stated that they were notaware of the hospital protocols regarding needle stick injuries if there existed any. A disturbing34% (n=53) assume that they should recap the needles after using them. There was a strongstatistical association p<.001 between establishment of hospital protocols regarding needlestick or sharps injury and an event of needle stick injury suffered by the health care workersduring last year. Conclusion: The needle stick injuries can be prevented by the eradication ofhazard causing equipment’s, prevention through engineering measures, administrative controlsand last but not the least personal protective measures.

Background: The utilization of medication by individuals in an attempt totreat self-recognized symptoms themselves is termed self-medication. Medical students faceobscurity when they seek health care for themselves. This study was conducted to assessthe prevalence of self-medication among the private undergraduate medical students of aprivate medical college of Lahore to assess the students’ attitudes regarding the practice ofself-medication. Study Design: Cross sectional study. Setting: The participants were studentsof Shalamar Medical and Dental College, Lahore a Private Institute, in Lahore. Period: Mayto September 2015 (5 months). Methods: The sampling frame constituted of 600 eligiblestudents. The sample size of 192 was calculated assuming 76% prevalence of self-medicationpractice with 5% relative precision and 95% confidence interval. Systematic random samplingwas utilized to administer a modified, self-administered, structured questionnaire. Institutionalreview board (IRB) of Shalamar Institute of Health Sciences granted permission to carry outthe research. The questionnaires were distributed to a sample of 200 subjects after a signedinformed consent was obtained. The data entry and analyses were done in SPSS for Windowsversion 20.0. Results: The response rate was 100%. The average age of the participants(n= 200) was 21.7 ±1.5 years. Almost 83% (n= 159) of students admitted to practice selfmedicationwith a different range of antibiotics. Convenience 62% (n= 124) was chosen to bethe main reason of self-medication followed by cost saving 14% (n= 28) and lack of trust inprescribing physician 12% (n= 24). Fever 18% (n= 77), sore throat 19% (n= 81) and cough18% (n= 79) were the main reasons for self-medication. Opinion of family members 30% (n=60), personal previous experiences 25% (n= 49) and doctor’s previous prescription 18% (n=35) were major criterion for selection of antibiotic. Local community pharmacies were used asa source of obtaining antibiotics for self-administration by 72% (n =144). The relation betweenself-medication and type of antibiotic taken in consideration before use was highly significant,Χ2 (1, n= 200) = 12.37, p<.001. The relation between local community pharmacies as a sourceof getting antibiotics for self-administration and self-medication was also highly significant, Χ2(1, n= 200) = 17.87, p<.001. Conclusion: Self Medication with antibiotics and analgesics iscommon among undergraduate medical students. Local community pharmacies play a criticalrole as a source of disbursement of antibiotics.

Psychological stress is prevalent in medical schools and is associated with depression. The personal and social sacrifices young medical apprentices have to make in order to sustain a fine academic outcome in an exceedingly competitive education sets them under enormous strain. The estimated prevalence of depression among private medical students has been 19% in United States, 49% in India, and 60% in Pakistan. Pakistan boasts highest prevalence of depression globally among undergraduate private medical students. Additionally a lack of any prior study in this institution, this study aimed to find prevalence of depression in the undergraduate private medical college of Lahore. Setting: The subjects were students of Shalamar Medical and Dental College, Lahore a private institution, in a metropolitan urban population. Study Design: Cross sectional study based on systematic random sampling technique. Methods: A modified, self-administered, structured questionnaire based on Goldberg's depression scale was distributed to a sample of 240 subjects during March 2014, till October 2014. Higher total scores refer to higher depression levels. Prior to the initiation of research permission was sought from the institution's ethical review committee. The data entry and analyses were done in SPSS for Windows version 20.0. Results: The response rate was 80%. The age of students (n= 164) averaged 21.1 ±1.4 years. The prevalence of depression among undergraduate medical students of our setting was almost 63% (n= 122). Thirty one percent (n=59) were possibly mildly depressed, 9% (n=17) borderline depressed, 19% (n=37) mild to moderate cases, 20% (n=39) moderate to severe cases and 3 % (n=6) were severely depressed students. Almost 85% (n= 40) of the students from second year suffered from depression the highest prevalence among all undergraduate medical years. A substantial 41% (n= 36) and 42 % (n= 37) of students suffering from depression admitted to the use of taking stimulants like amphetamines and caffeine respectively. Conclusion: The prevalence of depression is highest among the students of second academic year. Terminal illness of a family member and effect of law and order situation of the country also compromise the mental health of undergraduate medical students.

ORIGINAL PROF-3598ABSTRACT… Background: The utilization of medication by individuals in an attempt to treat self-recognized symptoms themselves is termed self-medication. Medical students face obscurity when they seek health care for themselves. This study was conducted to assess the prevalence of self-medication among the private undergraduate medical students of a private medical college of Lahore to assess the students' attitudes regarding the practice of self-medication. Study Design: Cross sectional study. Setting: The participants were students of Shalamar Medical and Dental College, Lahore a Private Institute, in Lahore. Period: May to September 2015 (5 months). Methods: The sampling frame constituted of 600 eligible students. The sample size of 192 was calculated assuming 76% prevalence of self-medication practice with 5% relative precision and 95% confidence interval. Systematic random sampling was utilized to administer a modified, self-administered, structured questionnaire. Institutional review board (IRB) of Shalamar Institute of Health Sciences granted permission to carry out the research. The questionnaires were distributed to a sample of 200 subjects after a signed informed consent was obtained. The data entry and analyses were done in SPSS for Windows version 20.0. Results: The response rate was 100%. The average age of the participants (n= 200) was 21.7 ±1.5 years. Almost 83% (n= 159) of students admitted to practice selfmedication with a different range of antibiotics. Convenience 62% (n= 124) was chosen to be the main reason of self-medication followed by cost saving 14% (n= 28) and lack of trust in prescribing physician 12% (n= 24). Fever 18% (n= 77), sore throat 19% (n= 81) and cough 18% (n= 79) were the main reasons for self-medication. Opinion of family members 30% (n= 60), personal previous experiences 25% (n= 49) and doctor's previous prescription 18% (n= 35) were major criterion for selection of antibiotic. Local community pharmacies were used as a source of obtaining antibiotics for self-administration by 72% (n =144). The relation between self-medication and type of antibiotic taken in consideration before use was highly significant, Χ 2 (1, n= 200) = 12.37, p<.001. The relation between local community pharmacies as a source of getting antibiotics for self-administration and self-medication was also highly significant, Χ 2(1, n= 200) = 17.87, p<.001. Conclusion: Self Medication with antibiotics and analgesics is common among undergraduate medical students. Local community pharmacies play a critical role as a source of disbursement of antibiotics.

Pakistan is not only undergoing a demographic progression but it is also tormenting from epidemiological transition. Demographic transition is evident because birth rates are increasing (28.6 per thousand population in 2017) while death rates (7 per thousand population in 2017) are decreasing consequential to a population explosion1. In Pakistan and many other developing countries epidemiological evolution has led to a twofold encumber of disease2.

Background: Chronic Liver Disease is frequently related with psychiatricco morbidity disorders like depression and anxiety. Psychological disorders are a directmanifestation of Hepatitis C infection. Objectives: The objective was to assess the frequency ofdepression among patients of CLD presenting to the Shalamar Hospital, Lahore a tertiary careprivate institution. Study Design: Cross-sectional study. Setting: Shalamar Hospital Lahore,Pakistan a tertiary care private institution. Period: Four months period (June till September2015). Methods: It was carried out on a convenience sample of 200 patients admitted inShalamar Hospital, Lahore. The HADS questionnaire was used to assess the frequency ofdepression among the patients suffering from chronic Liver Diseases. The selected participantswere meticulously briefed and signed informed consent was acquired. Selected patients werefurther comprehensively briefed about the study and confidentiality, anonymity and privacy ofthe participants was preserved. Ethical approval was sought from Institutional Ethical ReviewBoard of Shalamar Institute of Health Sciences. The data entry and statistical analyses weredone using SPSS version 20. Results: The response rate was 97%. Amongst all, 53% (n =102) were males and 47% (n = 91) were females. About 80% (n = 155) were married whereas 20% (n = 38) were unmarried. Among all patients of chronic liver disease 65% (n = 124)were positive for Hepatitis C Virus Antibody, while 25% (n = 49) were positive for Hepatitis BS Antigen. Of all the participants 32% (n = 61) received blood transfusions and almost 58% (n= 111) had a close family member who suffered from Hepatitis C. About 53% (n = 102) of thepatients were suffering from borderline or clinical depression (p < .000), whereas 56% (n = 108)of the participants suffered from borderline or clinical anxiety (p < .000). Conclusion: Patientssuffering chronically with Hepatitis C have higher than normal occurrence of depression andanxiety symptoms.

Psychological stress is prevalent in medical schools and is associated withdepression. The personal and social sacrifices young medical apprentices have to makein order to sustain a fine academic outcome in an exceedingly competitive education setsthem under enormous strain. The estimated prevalence of depression among private medicalstudents has been 19% in United States, 49% in India, and 60% in Pakistan. Pakistan boastshighest prevalence of depression globally among undergraduate private medical students.Additionally a lack of any prior study in this institution, this study aimed to find prevalence ofdepression in the undergraduate private medical college of Lahore. Setting: The subjects werestudents of Shalamar Medical and Dental College, Lahore a private institution, in a metropolitanurban population. Study Design: Cross sectional study based on systematic random samplingtechnique. Methods: A modified, self-administered, structured questionnaire based onGoldberg’s depression scale was distributed to a sample of 240 subjects during March 2014,till October 2014. Higher total scores refer to higher depression levels. Prior to the initiation ofresearch permission was sought from the institution’s ethical review committee. The data entryand analyses were done in SPSS for Windows version 20.0. Results: The response rate was80%. The age of students (n= 164) averaged 21.1 ±1.4 years. The prevalence of depressionamong undergraduate medical students of our setting was almost 63% (n= 122). Thirty onepercent (n=59) were possibly mildly depressed, 9% (n=17) borderline depressed, 19%(n=37) mild to moderate cases, 20% (n=39) moderate to severe cases and 3 % (n=6) wereseverely depressed students. Almost 85% (n= 40) of the students from second year sufferedfrom depression the highest prevalence among all undergraduate medical years. A substantial41% (n= 36) and 42 % (n= 37) of students suffering from depression admitted to the use oftaking stimulants like amphetamines and caffeine respectively. Conclusion: The prevalence ofdepression is highest among the students of second academic year. Terminal illness of a familymember and effect of law and order situation of the country also compromise the mental healthof undergraduate medical students.