Incisional endometriosis: report of 3 cases

Incisional endometriosis is an underappreciated phenomenon in general surgery. It may occur more commonly than believed. The preoperative diagnosis often mistaken with other pathologic conditions. Cases of three women are presented who had complaints of pain and abdominal mass along with prior history of caesarean section. In all patients surgical excision was done

[Anxiety-depressive disorders among irritable bowel syndrome [IBS] patients]

Psychiatric disorders are common in Irritable Bowel Syndrome [IBS] patients. Prevalence of psychiatric disorders varies in IBS patients in different societies. To determine the prevalence of psychiatric disorders [anxiety-depression] in IBS patients in Rasht. In this cross-sectional study, 256 IBS patients were selected [using criteria of Rome III] and evaluated for psychiatric disorders. In the first phase, subjects were screened by GHQ28. In the second phase, those patients who had scores equal or more than 23 were assessed through semi-structured psychiatric interview. Socio-demographic variables including age, gender, marital status, educational level and occupation, were recorded as well. P-values less than 0.05 were considered statistically significant. Among 256 subjects 30 patients [11.7%] had no significant psychiatric symptoms and 226 subjects [83 male, 143 female] suffered from some degrees of psychiatric problems. After performing semi-structured psychiatric interview; 190 subjects [74.2%] had anxiety-depressive problems [89 patients were suffered from pure anxiety disorders, 41 patients suffered from depressive disorders and 60 patients had co-morbid anxiety-depressive disorders]. In anxiety disorders; generalized anxiety disorder [53.7%] and in depressive disorders; dysthymia [53.5%] had the most frequencies, 53.7% and 53.5% respectively. In comparisone of anxiety-depressive subjects [190 persons] and normal subjects [66 persons], there was a significant statistical differences between the gender [P=0.019], occupation [P=0.002] and intensity of IBS [P<0.001]. Although, further studies are needed to determine the relations of demographic variables and types of IBS with psychiatric disorders, it seems to more attention to the psychiatric disorders of some specific patients suffering from IBS is helpful to their treatment

impact of the disease early warning system in responding to natural disasters and conflict crises in Pakistan

The disease early warning system [DEWS] was introduced in the immediate aftermath of the 2005 earthquake in Pakistan, with the objective to undertake prompt investigation and mitigation of disease outbreaks. The DEWS network was replicated successfully during subsequent flood and earthquake disasters as well as during the2008-09 internally displaced persons'crisis. DEWS-generated alerts, prompt investigations and timely responses had an effective contribution to the control of epidemics. Through DEWS, 1360 reported alerts during 2005-09 averted the risk of disease outbreaks through pre-emptive necessary measures, while the 187 confirmed outbreaks were effectively controlled. In the aftermath of the disasters, DEWS technology also facilitated the development of a disease-surveillance system that became an integral part of the district health system. This study aims to report the DEWS success and substantiate its lead role as a priority emergency health response intervention

Health workers for change: a tool for promoting behaviour change among health providers

Sensitizing health providers to customers' needs and women's health remains a challenge to the Pakistani health system. The Health Workers for Change methodology has been demonstrated to improve provider-client relationships in certain African and Latin American countries. This paper describes the experience of using Health Workers for Change participatory workshops in Pakistan to sensitize male and female health providers to gender issues. Health care providers identified the unmet needs of women clients as a function of individual, household and social factors, and, unlike the African experience with this tool, not predominantly confined to factors associated with the health facility