Objective:The study aimed to determine vitamin D status and frequency of its determinants related to diet, clothing, lifestyle and exposure to sunlight among young healthy medical students living in Karachi, Pakistan.Methods:This cross sectional study included responses gathered on questionnaire from medical students of Karachi Medical &Dental College from 4th of August 2017 till 30th April 2018. All the participants were healthy young adult’s year of age who gave written informed consent to participate in the study. Questions regarding demographics, sun exposure, diet, clothing, living patterns and any symptoms like pain or body aches were recorded. Serum 25 (OH) vitamin D3, calcium and phosphorus levels were measured through laboratory examination. For serum 25OHD, the cutoff values ≤ 20ng /ml, ≥ 21-29ng /ml, and ≥ 30ng/ml were defined as deficiency, insufficiency, and sufficiency respectively.Results:Total number of medical students enrolled in the study was 221.Among total participants 191 (86.43%) were females and 30 (13.57%) were males. Mean ± SD age was almost similar (23.00 ± 2.56 vs. 23.03 ± 2.05). Majority of the females 115 (60.2%) had BMI within normal range, and were predominantly single 164 (85.9%). Vitamin D deficiency was found in 197 (89.14%), insufficiency in 16 (7.24%), and only 8 (3.62%) had sufficient levels. Determinant factors reported by deficient group (n=197); fabric color (dark mix) 87.3%, fabric material (synthetic + mix) 48.7%, full length of sleeves by 45.7%, exposure to sun only on hands and face during outdoors was reported by 64.5%, milk up to 250 cc was consumed by 77.2%, one egg per day in diet was taken by 56.9% and intake of cod liver oil was less common in only 27.4%.Conclusion:Deficiency of vitamin D is common among healthy young adults particularly females which emphasize need to add vitamin D supplements in their routine diet.
Objectives: The study aimed to determine dietary Intake patterns in women with GDM and Non-GDM, a comparative study in a tertiary care hospital, Pakistan. Methods: This comparative cross sectional study was conducted through questionnaire spread over a period of six months of pregnant women visiting to Abbasi Shaheed Hospital for ante-natal visit having 24 to 28 weeks of gestation. With the written consent of the participants dietary intake patterns were assessed in GDM & Non-GDM subjects by a three day 24 hours’ recalls and food frequency questionnaire. A 24-hour dietary recall chart is a dietary assessment tool in which participants were asked to recall all food and drink they have consumed in the last 24 hours. The FFQ (food frequency questionnaire) provide a list of foods and participants were asked how often they eat each item on the list. This FFQ has 70 food items. The food frequency was reported as never, per year, per month, once a week, once and a day. The reported intake of food was converted into nutrients intake (carbohydrate, protein, fat) which was calculated by reported intake frequency of each food multiplied by reported portion size and its respective nutrient composition, summing over all foods by a trained Nutritionist. Results: A total of 75 participants with GDM, and 75 with Non-GDM were enrolled in this study over a period of six months. It was observed that dietary intake patterns have a significant association with GDM. Those who consume carbohydrate mainly containing diet have likely to have GDM. It has been seen that those who have family history of diabetes are more likely to have GDM. Family dietary patterns can affect risk of GDM. Our study has shown that timings of meals did not find have any significant association with GDM. Conclusion: Dietary patterns strongly influence the risk of GDM. The most contributing factors to risk of GDM are higher intake of carbohydrate rich diet and lesser consumption of fruits and vegetables. doi: https://doi.org/10.12669/pjms.38.7.5889 How to cite this:Nadeem S, Khatoon A, Rashid S, Ali F. Dietary Intake patterns in women with GDM and Non-GDM: A comparative study. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5889 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: Every year, 2.7 million stillbirths occur worldwide, mostly in developing countries. The United Nations Sustainable Development Goals (SDGs) include reducing childhood mortality under five years of age. Perinatal death audit is an intervention to reduce preventable neonatal mortality. The aim of this study was to determine the Perinatal Mortality Rate (PMR) and the factors responsible for perinatal deaths at a Tertiary Care Hospital in Karachi-Pakistan. Methodology: This was a prospective study of all the stillbirths and early neonatal deaths in Abbasi Shaheed Hospital Karachi, Gynecology Unit I. Details of each perinatal death were filled in the standard form. We used Aberdeen Obstetric classification to classify causes of perinatal deaths. Results: There were 1627 deliveries and 43 perinatal deaths during the study period. Our study's perinatal mortality rate was 27.14/1000 births, and the stillbirth rate was 13.25/1000 births. Antepartum hemorrhage (APH), pregnancy-induced hypertension (PIH) and anemia were the common causes of perinatal deaths. Conclusion: Antepartum hemorrhage, pregnancy-induced hypertension and anemia are the leading causes of perinatal deaths. Most of these complications can be reduced by educating women and providing effective antenatal care.
Objective: To determine the accuracy of fetal transverse cerebellar diametermeasurement in the prediction of gestational age in growth restricted fetuses. Material andmethods: This controlled was conducted at Sobhraj Maternity Hospital, Karachi from July 2012to June 2013. A total of 100 pregnant women in the third trimester of pregnancy satisfying theeligibility criteria were included. Among these 50 were fetuses with normal fetal growth and50 growth restricted fetuses. Results: The mean transverse cerebellar diameter in the fetusesshowing normal growth was not statistically different from the mean transverse cerebellardiameter in the growth restricted fetuses (p-value = 0.219). Conclusions: Transverse cerebellardiameter measurement can be used reliably for accurate estimation of gestational age in growthrestricted fetuses.
Objectives: To determine the physical activity patterns among pregnant women at a tertiary care hospital in, Pakistan. Methods: A cross sectional study was conducted through questionnaire for a span of eight months (from 17th July, 2020 till 20th March, 2021) amongst pregnant women visiting Abbasi Shaheed Hospital for ante-natal visit including paramedical staff having 24 to 28 weeks of gestation. With the written consent of participants, the physical activity was assessed by a validated self-reported Pregnancy Physical Activity Questionnaire (PPAQ) having 32 questions to determine the duration; frequency, intensity and type of physical activity during pregnancy. Participants were asked to select the physical activity and time spent on it per day during the current gestational period. From the PPAQ, average weekly energy expenditure in Metabolic Equivalent of Task (MET-h-week) was calculated. Demographic data including age, ethnicity, socioeconomic status, parity, literacy and working status were recorded. Results: A Total of 229 participants of different ethnicities were enrolled. House hold and care giving type of activities of moderate to light intensity were commonly practiced by our pregnant women. Whereas multi gravida were involved in light physical activities. The Punjabi and Baluchi women mostly took occupational type of physical activities. Working women were physically more active than household women. Around 186 (80%) of the participants had no idea that they should take antenatal exercises during pregnancy. Conclusion: The study concluded that house hold and care giving type activities with moderate to light intensity were commonly carried by pregnant women. Majority of them had no knowledge of antenatal exercise. doi: https://doi.org/10.12669/pjms.38.4.4809 How to cite this:Nadeem S, Khatoon A, Rasheed S, Munim TF. The physical activity patterns among pregnant women at a tertiary care hospital in, Pakistan. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4809 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.
Objective: To assess diagnostic accuracy of visual inspection of cervix with 3-5% acetic acid(VIA) as a screening method for early detection of cervical intraepithelial neoplasia and early cervical cancer.Method: This cross-sectional study was conducted at Gynecology & Obstetrics Department Unit-1, Abbasi Shaheed Hospital, Karachi, from April 2017 to September 2018. Participants were included in the study through non-probability convenience sampling technique. Married, non-pregnant and sexuallyactive women aged between 21-50 years were included in the study. Demographic information and relevant history was taken followed by the procedure for VIA. Acetowhite changes were noted after application of 5% acetic acid on the cervix. The result of the test was documented as positive or negative. Colposcopy was done in all VIA positive cases and suspicious cases with abnormal looking cervix. Biopsy of the cervix was taken for histopathology to assess the results of VIA. SPSS version-20 was used for statistical analysis.Results: There were 323 subjects with a mean age of 35.5 ± 7.6.Out of 323 participants only 6 were found VIA positive (1.86). On histopathology, only two cases were found positive (0.62%), one early invasive cervical cancer and one CIN1. Sensitivity, specificity, positive predictive value and negative predictive value of visual inspection of cervix after acetic acid application was 100%, 57%, 40%, 100%respectively and the diagnostic accuracy was 66.7%. Conclusion: Visual inspection of cervix with 3-5% acetic acid is highly sensitive, screening method for cervical cancer. It is quite simple, affordable and better screening modality for detecting cervical cancer at an early stage.
Background: Thyroid hormones are vital for fetal development and regulation of neuropsychological function. Therefore an adequate amount of thyroid hormone levels are necessary for brain development cognitive function. Newborn screening for congenital hypothyroidism is a great achievement in preventive medicine. Screening for hypothyroidism disorder using heel prick samples is considered essential for preventing intellectual dysfunction and delayed growth. The objective of the present study was to determine the frequency of hypothyroidism disorder in newborns. Methodology: A cross-sectional study was conducted at Abbasi Shaheed Hospital, Gynae & Obstetrics Department, Karachi, Pakistan. Blood samples were obtained from 257 neonates between 3rd & 5th day after birth by the heel prick method. Babies of Mothers having thyroid diseases were excluded from the study. Serum Thyroid-stimulating hormones (TSH) were tested using the enzyme-linked immunosorbent assay method. Newborn serum TSH > 20 miu/L was considered abnormal. Results: The overall mean age of neonates was 3.47 ± 0.57 days. Out of the total 257 neonates screened, female babies had higher TSH levels and congenital hypothyroidism was found in 4(1.55%) cases. The observed mean TSH level was 4.09 ± 0.24 mIU/L. Conclusion: In conclusion, the observed frequency of neonatal hypothyroidism in this single-center study prompts the need for early screening and diagnosis. The screening should be included in the post-natal period to prevent sequels associated with hypothyroidism for timely diagnosis and treatment of newborns.
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