Despite explicit warning from the National Institute of Health, Pakistan experienced its first chikungunya outbreak in the metropolis of Karachi. We underscore the attention of health authorities and healthcare professionals towards contributing factors associated with this outbreak and the measures required to combat this viral disease.

A843body mass index (BMI) ≥ 30. 62.2% of respondents reported taking steps to lose weight. These respondents were more likely to be female, of higher socioeconomic status, and more knowledgeable about their health (all p< .05). Among respondents who were trying to lose weight, only 27.5% had consulted a specialist. The primary reason for weight loss was to improve health (60.8%). Despite these intentions, success was limited. Only 34.3% reported having lost weight in the past 6 months (43.3% reported gaining weight) and the mean weight change was 0.5 kilograms (SD = 7.3). The most common treatments used for weight loss included exercise and dieting; 27.6% and 17.1% of respondents have used an over the counter (OTC)/herbal product and a prescription medication, respectively. Discontinuation rates were high with these treatments, as only between 28.0% and 48.8% of respondents who ever used OTC/ herbal products and prescription medications, were currently using those methods. Mean monthly out-of-pocket costs for OTC and prescription medications (combined) did not vary by socioeconomic status. ConClusions: The majority of respondents were taking steps to lose weight, employing a variety of strategies. Unfortunately, success of these strategies was limited. Additional weight loss treatments and increased obesity management advice may help improve weight loss success.

A731Objectives: Menopause is a nettlesome phase of women life. A prior knowledge of menopausal changes will not only help women to cope up with this change but it will also increase their quality of life. Current study aims to analyze knowledge and attitudes of postmenopausal women towards menopause. MethOds: A crosssectional survey was conducted from November, 2011 to September, 2012 among representative sample of women aged 45-60 years belonging to three major cities of Punjab, Pakistan. A team of five trained researchers distributed questionnaire to participants via convenience sampling after obtaining consent. Total of 1000 participants were approached (200 via each researcher). 783 completed the questionnaire making response rate of study as 78%. Results: 78% and 22% respondents have natural menopause and surgically induced menopause respectively. The mean knowledge and attitude score of participants was 45.13 ± 9.23 and 52.32 ± 11.21 respectively. 48% of the participants had poor, 35% had moderate and 17 % had good knowledge regarding awareness, sign and symptoms and causes of menopause. Majority (69.12 %) of participants had positive attitude towards menopause except use of HRT therapy. 51.7 % patients had good socioeconomic status and had good knowledge compared to 49.3 % of participants with poor socioeconomic status (p= 0.031). A higher education level (p= 0.041), good socio-economic status (p= 0.012), and surgically induced menopause (0.032) were the demographic factors that showed statistically significant association with higher knowledge and positive attitude towards menopause. cOnclusiOns: The knowledge of menopausal women regarding signs, symptoms, causes and treatments of menopause was poor in two cities (Faisalabad, Lahore) as compared to Islamabad. It might be due to good socioeconomic status and higher education level of participants residing in Islamabad . Health care professionals and authorities should take initiatives to aware menopausal women regarding menopause so that they can cope up better with this phase of life.Objectives: In observational studies, subjects are assigned to treatment groups without the benefits of randomization, resulting in potential bias in the estimation of the treatment effect. We assess the performance of 5 different statistical methods used for bias correction and causal inference under different conditions -multivariate regression (MR), propensity score matching (PSM), propensity score stratification (PSST), doubly robust estimation (DR) and inverse probability treatment weighting (IPTW). MethOds: We simulated the outcomes of two hypothetical treatments having three continuous covariates that are correlated with the treatments and with each other. We varied the sample size, noise levels, and tested the methods under conditions of model misspecification. To evaluate performance of the methods, we used two measures: correct identification of a statistically significant treatment effect (p < 0.05) and the root-mean-squared error for the treatment effect. Results:...

A909and age > 40 years (OR: 1.8, P= 0.014). ConClusions: Conclusively, patients with severe dengue illness accompanying by involvements of several organs and old age should be given prime importance in order to avoid their longer stay in the hospital.

Suprapubic catheters (SPC) have advantages over urethral catheters with respect to decreased bacteriuria and greater patient acceptability. Catheter encrustation is one of the most common intricacies of SPC and treated with extracorporeal shock wave lithotripsy and endoscopy lithotripsy. We reported a case of blocked, encrusted SPC along with urethral injury that was further complicated by pulmonary embolism. All conventional techniques to treat encrustation were not suitable due to worsening of urethral injury and risk of bleeding as patient was taking anti-coagulants. Therefore, we adopted a safe and quick procedure by which a 5 mm 0° cystoscope was inserted and encrusted part of catheter was fragmented using artery forceps leading to removal of catheter without jeopardy to catheter track and patient`s safety.