Introduction: Warfarin is a commonly utilized anticoagulant in the management of thrombosis, either prevention or treatment, with bleeding problems as one of the major adverse effect because of its narrow therapeutic index. Objective: To determine the frequency of various factors leading to warfarin toxicity which was defined as patients presented with International Normalized Ratio (INR) greater than five. Setting: Department of Adult Cardiology at National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. Methodology: The study type is descriptive, cross sectional. All patients who fulfilled the inclusion criteria and visited Department of Adult Cardiology at NICVD, Karachi, Pakistan were included. After ethical approval and informed and written consent. The collected data was entered using IBM SPSS - 21, for variables that were continuous mean Standard Deviation was calculated and for variables that were categorical frequency percentage were calculated. Results: Total of 87 patients with warfarin toxicity were included. 52 patients (60%) were males & 35 (40%) were females with the mean age of 48.5287 ± 13.1386 years. The factors leading to warfarin toxicity were dietary non-compliance 19 patients (21.83%), drug non-compliance in 18 (20.68%), drug-drug interactions in 12 (13.79%), irregular follow up in 23 (26.39%) and deranged liver functions in 26 (29.88%) patients. Conclusion: Warfarin toxicity has multifactorial causes. Deranged liver functions and irregular follow up of patients accounted for the most prominent factors leading to warfarin toxicity.

Objectives: To determine the impact of having private health insurance during the period of maternity on low birth-weight (LBW) infants.Methods: This retrospective case-control study was carried out at a tertiary care hospital in Tabuk, Saudi Arabia, between January 2020 and January 2021. Using non-probability sampling, secondary medical data were obtained at the Department of Obstetrics & Gynecology from two groups: insured and non-insured mothers who had 150 LBW infants (LBWI) (<2.5 kg) as well as normal newborns. Data were analyzed using SPSS, version 24 (IBM Corp., Armonk, NY). A univariate analysis was performed for each variable followed by a logistic regression analysis to explain the relationship between the dependent (LBW) and independent variables (health insurance status, prenatal care, and inter-pregnancy interval).Results: Out of 300 mothers, the majority were in the age group 21-34 years (86%). The LBWI mothers were insured in about 55% of cases. Around 43% had insurance for 1-2 years, and 44.7% of insured mothers were covered by a "class A" health plan. The findings revealed a significant correlation between the duration of maternal insurance coverage period and LBW; it reduced the risk of LBW by 95% CI. The inter-pregnancy interval was 51.3%, with a p-value of 0.33. Conclusion: Private health insurance offers coverage, stability, and consistency in Saudi Arabia, which results in better birth outcomes by decreasing both infant mortality and morbidity rates among insured females.

No abstract

Background: Obesity tends to appear in modern societies and constitutes a significant public health problem with an increased risk of cardiovascular diseases. Objective: This study aims to determine the agreement between actual and perceived body image in the general population. Methods: A descriptive cross-sectional study design was conducted with a sample size of 300. The data were collected from eight major populated areas of Northern district of Karachi Sindh with a period of six months (10th January 2020 to 21st June 2020). The Figure rating questionnaire scale (FRS) was applied to collect the demographic data and perception about body weight. Body mass index (BMI) used for assessing the actual body weight status. Cohen's Kappa statistics were performed. Results: Out of 300 participants, n=143 were males, and n=157 were females. In reality, according to BMI, 6 % were underweight, 47 % were average, 28 % were overweight, and 19 % were obese. According to perception, 8% of participants were underweight, 39 % were average, about 45% were overweight, and 8 % were obese. The mean score of real BMI was 25. 51±5.62 and figure rating score was 4.81±1.75. r value showed a strong positive relationship between both variables with a a P-value of <0.001. Cohen's Kappa score was 0.362. The rate of agreement between actual and perceived body weight status in the general population was 53.88%, and the disagreement rate was 46.12% Conclusion: There was a weak agreement in the perception and realities of the self-image of people have the wrong impression about their body image.