ABSTRACT
Only few epidemiological studies have examined the rate of active H. pylori infection in the symptomatic population in Pakistan. This retrospective study presents the laboratory data collected during the past 13 years (2002 to 2015) from 2315 symptomatic patients referred to the BreathMAT Lab, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad for the diagnosis of active H. pylori infection using the 13C Urea Breath Test. Rate of infection and its association with gender and age were evaluated. The overall rate of active H. pylori infection was 49.5% and there was no association of this rate of infection with gender. An increase in rate of infection was observed with increasing age with significant difference (p < 0.05). The patients that tested negative for this infection might be having symptoms due to stress and indiscriminate use of non-steroidal antiinflammatory drugs (NSAIDs) in this community. The fact that half of the symptomatic patients were negative needs to be highlighted and further suggests that symptomatic patients should be tested by the 13C UBT before prescribing antibiotic treatment for H. pylori eradication. In addition, there is a need to educate this community about the harmful and side effects of self medication and overuse of NSAIDs.
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Epidermal Growth Factor Receptor (EGFR) is mostly deregulated and over expressed in ovarian cancer, which is directly linked with STAT3 activation that leads to the accumulation of anti-apoptotoc events and thus, platinum drug resistance occurs. Regarding this, increasing of platinum drug sensitivity by targeting EGFR receptor along with platinum drugs is one of the major strategies in ovarian cancer treatment. In this context, using molecular simulation studies, the present study described the structural and functional properties of silibinin as a potential inhibitor of EGFR tyrosine kinase, and also its metabolic profile had been investigated by SOM prognosis. According to the results, silibinin have shown the significant binding energy by interacting with important residues in the active site. Again, it also processed medium absorption profile with no Fe accessibility. Furthermore, the study is also useful for further clinical based studies and also for the validation of toxicological and pharmacokinetic study.
ABSTRACT
Objectives: To evaluate the different modes of clinical presentation of multinodular goiter, its association with environmental risk factors and outcome of subtotal thyroidectomy in these patients
Methods: It was a case series conducted at Madina Teaching Hospital from January 2012 to Dec 2012. All patients presenting in surgical department with multinodular goiter were included in study. Data was analyzed by SPSS version 19
Results: Out of 100 patients presenting with multinodular goiter, 59% were in the euthyroid state, 39% had thyrotoxicosis while only 2 of these had hypothyroidism. Goiter was more common in females [79%] and between 31 to 40 years of age. Maximum number of patients was from Chiniot [46%]. Majority [53%] patients presented with history longer than 5 years. The thyroid function status was not significantly associated with duration of swelling [p = 0.290]. Age of the patient was significantly associated with their clinical presentation [p 0.013]. Among the 39 26[66%] patients belonged to endemic areas and 12 [33%] patients had history of iodine intake while 15 [38%] patients had family history of Goiter. Most common post operative complication was hematoma formation [6%]
Conclusion: The increasing evidence of thyrotoxicosis among multinodular goiter patients might be associated with increased intake of iodine in endemic areas for goiter prophylaxis, family history of thyrotoxicosis and delayed presentation. This area needs further research to explore other underlying factors for this changed clinical presentation in different parts of the world. Furthermore, subtotal thyroidectomy is safe surgical option in benign multinodular goiters with low morbidity
ABSTRACT
Prevalence of H. pylori infection is higher in developing countries including Pakistan. The basic purpose of this study was to investigate the prevalence of H. pylori infection and determination of possible risk factors. A prospective epidemiologic survey of H. pylori infection was accomplished in 2008 and 2009 involving 516 asymptomatic individuals of Barakaho, Islamabad, Pakistan. Data were obtained by questionnaire and H. pylori positivity was checked by 13C UBT. A total of 516 individuals participated in the study of which 384 [74.4%] were positive for H. pylori infection. The prevalence was 73.5% in males and 75.4% in females [p = 0.622] and increased with increasing age [p < 0.001]. Presence of household animals [p = 0.004] and more family members [p = 0.025] were significantly correlated with H. pylori prevalence while no association was seen with other risk factors such as education level, drinking water source, number of rooms in house and monthly family income. High prevalence of H. pylori infection in Pakistani population is comparable to the data of developing countries. H. pylori infection was significantly associated with presence of household animals and more family members
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High frequency of Helicobacter [H.] pylori infection has been reported in Pakistan mainly for dyspeptic patients, while the published data is inadequate regarding asymptomatic population. The non-invasive [13]C urea breath test [UBT] was used to determine the frequency of H. pylori infection in 516 asymptomatic individuals and to find out its association with gender and age. Overall prevalence was 74.4% [384/516] while 63.5% [113/178] children were positive for [13]C-UBT and the percentage increased with age in both the genders with significantly higher prevalence in adolescents [p=0.003] and adults [p < 0.001]. Moreover, there was non-significant between the prevalence of H. pylori infection in males and females in all age categories. The reported high frequency of H. pylori infection warrants further studies to identify epidemiological and environmental risk factors
ABSTRACT
The vacuolating cytotoxin VacA and cytotoxin associated gene product CagA, encoded by vacA and cagA are major virulence determinants associated with pathogenesis of Helicobacter pylori. The presence and prevalence of two major H. pylori virulence associated genes among gastric biopsies of Pakistani children were investigated in the current study. Fifty one gastric biopsy specimens of children were analysed for 16S rRNA, vacA and cagA genes using PCR. The results showed that 21 (41.2%) biopsies were positive for H. pylori as determined by 16S rRNA PCR. In the 21 H. pylori positive gastric biopsies, 19 (90.5%) showed vacA s1a, 1 (4.75%) was vacA s1b and 1 (4.75%) was vacA s2 whereas, 5 (23.8%) were vacA m1 and 16 (76.2%) were vacA m2. None of the H. pylori positive biopsies carried vacA s1c subtype. The cagA gene was found in 13 (61.9%) of H. pylori infected biopsies and different vacA combinations were found with or without cagA gene. H. pylori was detected with high frequency of cagA while vacA s1a and vacA m2 regions with vacA s1a/m2 genotype were predominant in H. pylori infected gastric biopsies of children.
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Smoking kills. That has been known for years. Most people know that smoking is bad for health. Smoking, more than any other factor cuts people's life expectancy. But they do not still give up. Similarly the other behaviors like family planning, unsanitary habits causing infestations, etc. affect people health. Health Behavior Change Strategic Model suggests the processing of unfelt need of a particular behavior toward expressed need or demand through different stages i.e. Sensitization, Education, Motivation and Action. At the end of the last stage the client does not only act as guided but advocates others too for that particular action, for example, giving up smoking
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Humans , Behavior , Tobacco Smoke Pollution , Smoking/adverse effects , Health Behavior , Life ExpectancyABSTRACT
This article proposes practical suggestions in detail for successful implementation of District Health Government. A Simple Model for management of Change as recommended by World Health Organization is suggested to transform the existing health services system toward District Health Government. Thus it is argued that Government takes action to create shared vision of future, dissatisfaction with existing system and introduce initial practical steps in order to overcome Inertia [resistance to change] and to implement new District Health Government System successfully through 1. Use of consultation, seminars, discussion papers, workshops 2. Consensus decisions 3. Regular training opportunities. 4. Consistent Job Requirements. 5. Simple new procedures
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World Health Organization , Managed Care Programs , Organizational Innovation , Patient Care Management , Health ServicesABSTRACT
In our country, the role of government in the provision of health services is much smaller than that of the private sector. The health expenditure is generally lagging behind due to overall funding constraints. According to the World Bank study, Public and private expenditure on health in Pakistan represents 3.45 of GDP while public expenditure alone amounts to 1% of the GDP, a low figure by international standards. The recurrent expenditure although appearing relatively protected is also under considerable strain. Thus this paper suggests to introduce Effective Cost-Sharing and Subsidy Systems in order to meet increasing burden of illness and high population growth with all or one of following components: o Enhancement of user fees. o Introduce public-private partnership. o Financial grants to non-profit organizations. o Incentives to for-profit private sector. o Health Insurance. o Lottery or quiz system
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Delivery of Health Care , Health Expenditures , Insurance, Health , Organizations , Hospitals, PrivateABSTRACT
An attempt has been made on blood survey of refugees of Kashmir settled in Muzafferabad, Azad Kashmir during July-September, 1997. A total of 300 sample specimens were collected. Among these blood films, the results showed that 7% persons suffered from malaria parasite. The prevalence of plasmodium vivax was 6.33% and that of P. falciparum was 0.67%. Infection in female was 61.9% and in male 38.1% Age wise prevalence of the disease was highest [8.4%] for age group 11-20 years and lowest [6.12%] in age group 31-40 years. Seasonal variation was also noted with the highest [9%] infection of malaria in August and lowest [5%] in September