Pattern of joints involvement in Kashin-Beck disease: a local osteochondropathy in China

Kashin-Beck Disease [KBD] is an endemic osteochondropathy. The disease starts in childhood and attacks the growth of joint cartilage, the joints become deformed and painful, and the worst forms result in dwarfism. The most frequent joints involved are the finger, wrist, ankles, knees and elbows. In this study the pattern of joints involved in KBD was studied. A total of 368 patients aged above 13 from 6 villages in endemic areas of the Shaanxi province, located in the northwest of China, were selected through multistage stratified sampling. The patients were diagnosed based on the clinical criteria for diagnosis of KBD. The patients were administered with a battery of questionnaires along with clinical examination for joint involvement. The patients presented both as oligoarticular as well as polyarticular pattern. Smaller joints were more frequently involved with a proximal-distal pattern. The number of joints involved increased with the severity of the disease. Proximal smaller joints are more frequently involved in the disease. The involvement of bigger joints takes place in later stages of disease, i.e., in the second and third degree. The pattern of joint involvement shows some correlation with Rheumatoid Arthritis which needs further investigation and comparative studies

Doctors perception about staying in or leaving rural health facilities in district Abbottabad

An imbalance exists between offered medical services and needed health care for the people in rural areas of Pakistan. Many studies have found non-availability, of health care providers as major contributors to the poor health indicators of the rural areas. Methods and An endeavor to attend the issue has been made through a cross-sectional survey of the Medical Officers working in the different health facilities of District Abbottabad. The study found that the doctors are neither trained to work in rural setups nor they are given proper facilities and service structure to work there. They perceive to face disadvantages affecting their social, professional and family life, if they join in rural areas. Recommendations: This study recommends strengthening of Community Oriented Medical Education for motivating doctors towards participation in rural health services. Doctors working in rural health facilities might be given financial and professional incentives and a conducive environment to retain them