Rising HIV seroconversion rates & associated risks among employees of organization ‘X’: A case control study, Pakistan, 2017

Background and Objectives: In 2004 Pakistan escalated from ‘low-prevalence’ to ‘concentrated’ phase of HIV epidemic. Despite global decline in HIV incidence since 1997, rate of HIV infections in Pakistan is persistently rising since 1990. Available literature focusses on key populations or localized outbreaks limited by short study duration and regional applicability of results. We studied HIV seroconversion trends over a period of 8 years in a geographically diverse population and evaluated associated risk factors.&#x0D; Methods: A desk review of HIV surveillance data from 2010 to 2017 was carried out at Armed Forces Institute of Pathology. A case was defined as any adult employed in organization ‘X’, initially screened for HIV but later seroconverted on ELISA and western blot. Case-control study was conducted on cases diagnosed in 2017. Age and sex matched controls were identified from same population sub-group. Structured telephonic interviews were conducted and statistical analysis done at 5% margin of error.&#x0D; Results: The annual HIV diagnosis rate remained relatively stable till 2015 (&lt; 40 /100,000/yr) after which it rose sharply to 60/100,000/yr in 2016. Upward trend continued in 2017 to reach 125/100,000/yr (&gt;200% increase from baseline). Acquisition of HIV was significantly associated with commercial sex activities (OR=9; 95%CI: 1.25-395).&#x0D; Conclusion: HIV seroconversion rates among employees of organization X have increased significantly in the past two years. Unlike HIV outbreaks previously reported from Pakistan, sexual route seems to be the predominant mode of transmission. Focus is mandated on prevention of sexual transmission of HIV at national level as well for all vulnerable populations.&#x0D; doi: https://doi.org/10.12669/pjms.36.6.1735&#x0D; How to cite this:Mansoor E, Azam N, Niazi SK, Sheikh N, Baig MA, Azim MT, et al. Rising HIV seroconversion rates &amp; associated risks among employees of organization ‘X’: A case control study, Pakistan, 2017. Pak J Med Sci. 2020;36(6):1349-1354.   doi: https://doi.org/10.12669/pjms.36.6.1735&#x0D; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</jats:p

Diagnostic Accuracy of Contrast-Enhanced Computed Tomography (CECT) and Ultrasonography (USG) in Diagnosing Carcinoma Gallbladder keeping Histopathology the Gold Standard

Objective: To evaluate the comparative role of ultrasonography and contrast-enhanced computed tomographyin diagnosis of carcinoma gallbladder. Early experience at a hepatobiliary unit in a tertiary care hospitalStudy Design: Cross sectional study.Place and Duration of Study: The study was carried out at the Hepatobiliary Unit of the Pak Emirates MilitaryHospital, Rawalpindi from July 2021 to June 2022.Materials and Methods: USG and CECT scans were used to assess the diagnostic accuracy of CarcinomaGallbladder. 30 patients, with an average age of 54 years, were part of this study. Patients were included in thestudy based on radiological findings pertinent to gallbladder cancer which include gallbladder fossa massreplacing gallbladder, focal/intraluminal/polypoidal gallbladder growth and asymmetrical/diffuse thickness ofgallbladder. All resected specimens were sent for histological investigation after the operation, histopathologyserving as the Gold standard.Results: On USG and CECT examination, 13.3% of the gallbladders were contracted and reduced in size, while70% were large and distended. CECT has a sensitivity and specificity of 96% and 80%, respectively, in identifyingGB carcinoma. USG scan had a sensitivity and specificity of 92% and 60%. There was a test of agreement isexcellent (Kappa value 0.819) between the two techniques, indicating that the two diagnostic modalities arenearly equivalent in terms of diagnosing carcinoma Gallbladder.Conclusion: The study findings indicate that both USG and CECT scans are ideal, non-invasive, safe imagingmodalities for diagnosing gallbladder carcinoma. CECT scan has an additional advantage in defining theextension of the disease and involvement of surrounding structures including lymph nodes and hepatoduodenal ligament.</jats:p

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically