Estimating oral polio vaccine coverage dropouts for equitability: evidence from Pakistan

Objective: To analyze the effectiveness of expanded program on immunization [EPI] in Pakistan by finding proportion of children who have received at least one dose of oral polio vaccine [OPV] to prevent poliomyelitis but failed to receive 2[nd] and 3[rd] dose before the end of their 1[st] year of life. Study Design: Retrospective study. Place and Duration of Study: The study was carried out at Sustainable Development Institute, COMSATS Institute of Information Technology and National Defense University Islamabad, from Jan 2015 to Mar 2016

Material and Methods: Method of multivariate regression and odds ratio were used on Pakistan demographic and house hold survey micro-datasets to analyze the effectiveness of expanded program on immunization [EPI] in Pakistan by finding the proportion of children who have received at least one dose of oral polio vaccine [OPV] to prevent poliomyelitis. Drop-out [DO] rate was calculated in order to assess effectiveness of coverage-breadth

Results: Gaps in service delivery, ineffective communication with mothers and entwined poverty dimensions are contributors to low coverage statistics and Drop-out [DO] rate of children in context of polio vaccination. Female children do not benefit to the same extent from polio vaccination efforts as male counterparts. Empowered mothers with good health seeking behavior care better for their children. Education is another key factor with major impact on health system service utilization and acceptability

Conclusion: Gaps in service delivery, ineffective communication with mothers and entwined poverty dimensions are contributors to low coverage statistics. Education is the key factor with major impact on health system service utilization and acceptability. Due to cultural norms in society gender discrimination is observed in all provinces which shows that girls are more likely to be vulnerable as compare to their male counterparts

Short-term outcome of early laparoscopic cholecystectomy

Background:Laparoscopic cholecystectomy is being used in increasing frequency for cholecystectomy

Objective:To evaluate the short-term outcome of early laparoscopic cholecystectomy in terms of length of hospital stay, complications and patient satisfaction

Methodology: After approval of the institute's research evaluation committee, this cross sectional study was conducted at the department of General and laparoscopic surgery, Hayatabad Medical Complex, Peshawar from 1 January to 31 December 2015. Clinical features, operative findings and postoperative outcome was recorded in terms of length of stay [LOS], complications and overall patient satisfaction. The data was entered and analyzed by using SPSS version 20

Results: Mean age was 48.31 years +/- 10.86 with 13 [24.1%] males and 41 [75.9%] females. The overall no to low satisfaction rate was 13[24.07%], while 7[12.96%] patients remained neutral. The rest of the 34[63%] patients rated their satisfaction as high or adequate. Significantly associated complications to open cholecystectomy included development of postoperative pyrexia [p = 0.006], wound infection [p < 0.001], and seroma formation [p < 0.001]. The distributions of median satisfaction scores were statistically significantly different for the two groups of procedures [p < 0.001]

Conclusion: laparoscopic cholecystectomy is a safe and effective choice for patients of gallstone disease with significantly shorter length of stay and higher overall satisfaction rates

Impact of marine pollution in green mussel Perna viridis from four coastal sites in Karachi, Pakistan, North Arabian Sea: Histopathological observations.

Pathological changes are regarded as a standard technique to monitor the effects of pollutants in marine animals. Histopathological examination of the population of green mussel Perna viridis (L.) from four sites in Pakistan, namely, Manora Channel, Rehri Creek, Sandspit Backwaters and Bhanbore was conducted. The first three sites are on the Karachi coast, whereas the fourth one, Bhanbore is situated outside Karachi, and is considered to be less polluted. Two types of parasites, Rickettsia-like organisms and metacestode were found in the mussels studied. In the present study, we observed various pathological lesions, such as inflammatory responses, granulocytomas, lipofuscin pigments, vacuolation in the digestive gland and gonads, lamellar fusion and dilated hemolymphatic sinus in the gills of P. viridis. These observations indicate the extent of environmental pollution in the studied areas. Although, Bhanbore is considered to be relatively less polluted compared to other three sites, the present results have revealed that the waters of Bhanbore are also polluted as evidenced by the pathological changes observed in the mussels collected from there.

Emerging human health pertinent to modern agriculture. Critical review

In developing countries week and dispersed link has been shown between agriculture and human diseases. In this regard present review was conducted and revealed several examples that there exist strong link between agriculture and diseases. Review categorized the major disease into zoonotic, vector borne and food associated. Zoonotic diseases were found to be transmitted by the livestock. Some of these diseases are also associates with vectors that were found to be transmitted by the agriculture. Mosquito is the major vector transferring malaria, cholera and skin diseases. Agricultural intensification is the major source of their climate change through increased emission of green house gases. Agricultural intensification, ecological disturbance and inadequate agricultural managements are the dominant reason revealed. Rate of future agricultural diseases such as zoonotic diseases emergence or reemergence will be closely linked to the evolution of the agriculture-environment nexus. Meanwhile, the available research is not enough to address these issues. Agriculture sector is for peace and sustainability and to strengthen this sustainability there is dire need of Convergence is needed between integrated pest management strategies and integrated vector management strategies to help farmers improve their agricultural practices while minimizing environmental risks to health. In addition, further research by the medical scientists and agricultural scientists is needed to explore the epidemiology of various diseases caused by the agricultural activities through promotion of vector

Scintigraphic evaluation of kienbock's disease in comparison to plain radiography

Kienbock's disease is a rare pathology of uncertain etiology, resulting in osteonecrosis of lunate bone. The authors present interesting images for comparison of both plain radiography and bone scan findings done in a young male laborer.

Calcification of the lateral collateral ligament of the knee: a rare cause of acute knee pain

Calcification of the lateral collateral ligament is a rare phenomenon, which can cause acute knee pain. The management is usually conservative and there is subsequent resolution of the calcification seen on initial radiographs. It is important to exclude more sinister pathology such as septic arthritis as a cause of pain. We report the case of an elderly lady who presented with acute knee pain. Initial radiographs showed calcification at the lateral aspect of the knee joint. The pain settled with conservative management. Resorption of calcification was demonstrated on subsequent radiographs

Role of imaging in renal transplant complications - a hospital based study

Thirty five thousands patients receive renal transplants every year world wide. This study was conducted to determine and evaluate the diagnostic role and accuracy of Ultrasonography including Doppler analysis and Radionuclide Scanning in patients with renal transplant complications. It was an observational study. Cases were collected from AFIU, MH and Jinnah Memorial Hospital Rawalpindi. Ultrasound and Doppler analyses were done in the Radiology Department of CMH Rawalpindi. Renal isotope scans were performed at NMC Rawalpindi. A total number of 52 patients were studied. Male female ratio was 42 to 10 [80.8% to 19.2%]. The post-transplant duration was 02 days to 06 years. The most frequent complications were peri-transplant fluid collection [27%], followed by rejection of transplant [25%] and cyclosporine nephrotoxicity [11.54%]. Other complications which were also observed were Acute Tubular Necrosis [7.69%] and hydronephrosis [15.4%]. Ultrasound is excellent modality to evaluate location, volume and change in volume of Perinephric fluid collection. Radionuclide imaging detects altered or diminished renal function due to acute tubular necrosis, rejection of transplant and toxicity from medications. Radionuclide imaging is most useful modality for assessing renal function. Standard for evaluating vascular complications is angiography, however duplex Doppler ultrasound is an excellent non invasive method for screening. Other transplant complications like abnormalities of collecting system and renal parenchyma are well evaluated by both ultrasound and radionuclide imaging