Background: Ischemic Heart Disease (IHD) is a leading cause of morbidity and mortality worldwide. IHD results from myocardial ischemia, and occurs whenever perfusion outgrows the demand. Though lethal, but can be prevented by modification of predisposing conditions, most important are diabetes and hypertension. Almost fifty percent of IHD patients are found hypertensive with or without being diabetic. The objective of the study was to determine association of diabetes and hypertension as risk factors for IHD patients Methods: This was a hospital-based cross-sectional study that included 199 IHD patients of 35-70 years age, visiting Civil Hospital Karachi, a tertiary care public sector hospital, from September 2017 to January 2018 by using non-probability convenient sampling technique. The patients were approached in the hospital and briefed about the purpose of the study. A pre-tested, structured close ended questionnaire was used to collect the data. Data entry and analysis were done by using SPSS version 20.0. A p-value of <0.05 was considered as statistically significant. Results: Out of 199 participants, 156 (78%) were males while 43 (22%) were females; 119 60%) were 56-65 years of age. Family history of ischemic heart diseases was unremarkable in 126 (63%) patients. In total, 122 (61%) were diabetic; among them, 24 were of less than 40years and 98 of more than 40years of age. The older age of the diabetics had a direct association with the risk of IHD (p-value <0.05). About 83% had a non-significant family history for diabetes; and 83% of the total study participants were having a sedentary lifestyle. Out of 199, 166 (83%) had never checked their blood pressures earlier. The lifestyle, diet, addiction, and duration of hypertension had a strong association with IHD (p-value <0.05). Conclusion: IHD occurs more frequently in males of 56-65 years age, with insignificant family history for IHD and diabetes. The IHD is associated with hypertension and diabetes along with sedentary lifestyle, unhealthy diet and smoking/tobacco addiction.

Background: Health insurance usually covers the expenditure during patient hospitalization. To achieve universal health coverage, it is mandatory to cover the middle-income groups under the government health insurance scheme. According to the review of literature, there is very limited knowledge present on health insurance and the factors determining its coverage among this group. Objective: The study was conducted to analyze the coverage of health insurance and its factors among the middle class households in urban areas. Study design: It is a community based study. This study was conducted on 210 participants attended the community medicine department of our hospitals for the duration of one year from November 2021 to October 2022. Material and Methods: The study was conducted on 210 participants. The written consent was taken from the participants and they were fully aware of the study. Interviews were conducted to find the issues and the point of view of clients and health insurance providers. It was also evaluated that what factors are liked by clients about the health insurance scheme. Results: There were three categories made to find the client’s perspective. One of them was lack of awareness. Then there were monetary issues. There were 28% participants that reported that they have recently insured themselves. There were 62% participants already insured in the past and 62% said that they have never insured themselves. Conclusion: Middle income families had better health insurance coverage than lower middle class. High premium charges, poor financial condition, lack of guidance, lack of knowledge about benefits of health insurance are some of the factors that lower the prevalence of health insurance. Keywords: Health insurance and financial condition.