Background: Despite effective methods of treatment, half of the diabetic patients fail to achieve good glycemic control. Type 2 Diabetics who have knowledge about their disease and treatment can play an active role in their diabetes care and are more likely to achieve optimal blood glucose and HbA1c levels. The objective of this study is to assess knowledge of complications of type 2 Diabetes mellitus and its association with treatment compliance in patients visiting a public sector diabetes clinic.Materials and Methods: The study was a descriptive correlational study conducted at the Diabetes Clinic of Benazir Bhutto Hospital that encompassed 180 participants who were positive for type 2 diabetes mellitus. The study took place in 6 months from February to July in 2018. The participants were selected by non-probability convenience sampling, and informed consent was taken from the participants. They were assessed by a questionnaire-based interview. Data were analyzed via the Statistical Package for Social Sciences (SPSS), version 22 by applying descriptive statistics.Results: Out of 180 participants, the mean age was 51.53 years (72.8% females and 27.2% males), 46.7% were taking oral hypoglycemic agents while 53.3% were on insulin. Respondents compliant with anti-diabetic drugs were 73.8%. The main reasons for non-compliance include forgetting to take medicine (43.5%), side effects of medications (10.9%), feeling that too many medications were prescribed (10.9%), or high dose was given (8.7%), and interference with meal plans (8.7%). A higher score of knowledge was associated with better compliance with treatment.Conclusions: The knowledge of complications of diabetes and compliance with treatment is inadequate in patients visiting diabetes clinics. Those who have higher scores showed better compliance with the treatment.

Background: Around 20% of patients with chronic hepatitis C infection (HCV) have persistently normal alanine aminotransferase (PNALT) levels. These patients are considered to have mild degree of histological hepatic damage. This study was conducted to compare the histological degree of necro-inflammation and stage of fibrosis among HCV patients with PNALT and patients with persistently or intermittently elevated serum ALT (PIEALT) levels..Methods: This study includes 154 untreated patients with serological and histological diagnosis of chronic HCV infection. A total of 70 patients with PNALT (group A) and 84 patients with PIEALT (group B) were identified and treated with 6 months interferon therapy. Histological grade of necro-inflammatory activity and the stage of fibrosis was evaluated by Ishak scoring system. HCV-RNA quantification was done by real-time polymerase chain reaction (PCR). Further univariate and multivariate analysis was done to evaluate correlation between patients characteristics and significant hepatic fibrosis..Results: Out of one hundred and fifty four patients, mean ALT was 30.59 ± 5.59 U/L in group A as compare to 68.65 ± 23.17 U/L in group B (p = 0.001). Patients with PNALT were younger (p = 0.005) with milder grade of necrosis (p = 0.037), lower serum HCV viral load (p = 0.044) and significant achievement of sustained virological response (p = 0.012) as compare to patients with abnormal ALT. Different variable were also analysed by univariate and mutivaraite analysis among patients with significant and insignificant fibrosis. High serum HCV-RNA level was found to be the independent variable predictive of advanced fibrosis among HCV infected patients (OR = 0.89; 95% CI = 1.65-1.94; p < 0.001) with r2 = 80%.Conclusions: Our study suggests that normal serum ALT does not mean healthy liver. So, histological evaluation is still an essential tool to assess liver damage precisely.

Background: Pakistan is one of the 34 countries yet to achieve the neonatal tetanus global elimination target set by the World Health Organization. Lack of vaccination, inadequate knowledge about prevention, and unsafe practices are major causes of spread. The study aims to determine the effectiveness of health education messages in improving tetanus health literacy among women age 16 to 45 years.Methods: The quasi-experimental study which was carried out from April 2018 to June 2018 at Holy Family Hospital, Rawalpindi consisted of 150 female respondents of age 16 to 45 years selected by non-probability convenience sampling. Written informed consent was taken from each participant. Afterward, respondents were sequentially delivered pre-test proforma, health education message (verbally and in the form of the pamphlet), and a post-test proforma after a gap of 2 days. The pre-test and post-test proformas assessed knowledge about tetanus. Data were analyzed via SPSS version 22.Results: Out of 150 women 20.1% were uneducated and 79.9% were educated. The area of residence was urban for 83.3% and rural for 16.7%. Mean tetanus health literacy scores increased significantly from 6.32 ± 2.85 to 10.55 ± 3.87 (p=0.01). Health education message was more effective for students and employees compared with housewives (p=0.01). Similarly, women possessing higher education were more likely to have high scores on post-tests (p=0.01).Conclusions: The health education message is effective in improving tetanus health literacy among women.

Background: The objective of this study was to assess the willingness of medical doctors to work in rural areas. The study also aimed to elucidate the factors influencing the decision of doctors to work in rural versus urban location of clinical practice. Methods: It is a cross-sectional study that was conducted from 8th January 2016 to 18th January, 2016 including randomly selected House officers (Hos), Postgraduate Trainees (PGTs) and Medical Officers (MOs) working in various departments of Holy Family Hospital, Rawalpindi using a self-administered semi-structured questionnaire. The questions related to demographic details, future plans and willingness of doctors. Factors facilitating or preventing them from accepting a rural position were also enquired about. Results: Thirty (30%) of the respondents were found willing to work inrural areas while 45% were neutral and 25% had a negative attitude towards practice in rural areas. Factors significantly related to rural choice of practice included rural place of birth (p value=.001), previous experience of having lived in rural settings (p value= .001)payment of fees by parents rather than by family or loans (p value=.001) and with the doctors' expectations of whether they are likely to work in rural/urban/foreign locations (p value=.001). Conclusion: The study shows that most of the doctors who have a rural birthplace/ experience of living are more willing to work in rural areas. Therefore, if the government wants to fill the vacant posts in rural locales, scholarship schemes for students from rural areas should be increased.

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