An open study to assess the safety and efficacy of Heprovac-B vaccine 10 mcg-dose for adults

Heprovac B is a novel recombinant vaccine. There are many vaccines available in Pakistani market but Heprovac B claims to be immunogenic even at 10 meg dose. Aim of the study is to determine whether using 10 meg of Heprovac B vaccine is safe and effective in producing sufficient immunity in Pakistani population. One hundred and twenty five subjects, who fulfilled the Inclusion criteria, were enrolled for the study. Heprovac B was administered in a three-dose regimen given at 0, 1 and 6 months and adverse events were recorded. Immunogenicity was tested by measuring hepatitis B surface antibody one month after each dose received. One month after the 3rd dose 98.7% of the subjects were found to be seroprotected with geometric mean titer of 488.83 mIU/1 after the third dose. Heprovac B, vaccine was well tolerated with minimal reported adverse events. It is safe and 10 mcg is immunogenic in producing antibodies in Pakistani population against Hepatitis B virus

Irritable bowel syndrome and health seeking behaviour in different communities of Pakistan

OBJECTIVE: To investigate the frequency of irritable bowel syndrome (IBS) and health seeking behaviour in patients belonging to different ethnic groups and their squatter settlements in two cities of Pakistan. METHODS: Questionnaire based on Rome II criteria for the diagnosis of IBS was sent to 1167 persons living in, Karachi and Bahawalpur and their squatter settlements in Baloch Colony and Tibba Badar Sher respectively. About 90% (1048) completed the questionnaire. RESULTS: The overall frequency of IBS was 14% with a mean age of 30 +/- 12.5 years and range of 16-85 years. Of the IBS positive patients, 56% (82/146) were males. IBS was significantly more common (p = 0.05) in males belonging to age group 16-30 years. The most common presenting symptoms were abdominal pain (100%), altered bowel habits (51%), and diarrhoea (54%). There was no difference in the prevalence of IBS in Karachi and Baloch Colony as compared to Bahawalpur and Tibba Badar Sher. IBS patients seeking health care advice were 17.6% as compared to 12.6 % non healthcare seekers. Of the healthcare seekers there were 29 (35.4%) males (p = 0.002). The overall mean age of health care seeking IBS patients was 32.8 +/-13.8 years (p \u3c 0.001). All IBS patients seeking healthcare advice had abdominal pain (p \u3c 0.001), while 61% had altered stool consistency (p \u3c 0.001) and 46% had stool frequency (p \u3c 0.001) as compared to IBS non healthcare seekers. CONCLUSION: IBS is seen in both urban and suburban communities. Health seeking behaviour is common in males and with abdominal pain

The Effectiveness of SACP in Controlling Of Concrete Steel Reinforcement in Aggressive Environments

The Arabian Gulf is considered to be one of the world\u27s most aggressive environments for reinforced concrete. Traditional methods of corrosion protection may not be enough to provide the required level of corrosion control for the design life of concrete structures in such environments. Cathodic protection has been found as a viable technique of inhibiting chloride induced corrosion of steel in concrete structures. As an alternative to impressed current cathodic protection ICCP a remarkable developments recently have been made in the application of sacrificial anode cathodic protection as a means of enhancing the performance of patch repair. The main objective of this thesis is to study the effectiveness of application of sacrificial anode cathodic protection (SACP) in preventing or reducing corrosion of steel reinforcement in the reinforced concrete in aggressive environments. Various experimental settings are considered to account for the effectiveness of the sacrificial anodes (SA) locally and globally, immersed and atmospherically exposed, in relatively small and large patch repairs and in both old and new construction. The experiment program was divided into two parts; in-situ and laboratory. In the in-situ program, three columns with significant corrosion were selected, evaluated, repaired and monitored for about one year. Local and global sacrificial anodes were used. In the laboratory part, six slabs were cast; they were designed to simulate old repaired concrete with relatively small and large area of repairs, and new construction. The results of in-situ program demonstrated that sacrificial anodes were working. Protection from corrosion in the columns that were treated by means of local SA was apparent relative to the control. The global SA effect was not equally apparent in such a short period. The results of SACP in new constructed slab showed positive effect in preventing steel from corrosion. Even though the average current density recorded in the slabs was appropriate for CP, the mean depolarsation potentials considerably short of the required level. It should be stated, however, that the intention was not to install sacrificial CP system but to study the performance of the sacrificial anodes in conditions where corrosion of steel reinforcement may be occurring nearby. This reflects the fact that electrochemical equilibration under polarizing conditions requires a considerable period of time to be established, particularly in the case of passive steel The use of SACP in patch repairs has been proved to give cathodic protection to concrete. An electrochemical cell was formed in which SA was anode and surrounding steel was cathode as was seen from the potential results. This was clearer in the 20-year-old column than in newly cast laboratory slabs. Throughout the tests to date, the anodes have been found to be an effective method for controlling the problems associated with incipient anode generation and the premature failure of areas surrounding repairs in concrete, which are suffering from chloride, related corrosion

Frequency of irritable bowel syndrome in college students.

Background: This study was carried out to investigate the presence of irritable bowel syndrome (IBS) in college students and compare its distribution in the non-medical college and medical college students. Methods: We collected data from 508 students by inviting them to fill out a questionnaire based on Rome II criteria for the diagnosis of IBS from November 2001 to February 2004. Two major cities Karachi and Bahawalpur were selected and it was coordinated by the section of Gastroenterology, Department of Medicine, Aga Khan University Hospital and Quaid-e-Azam Medical College, Bahawalpur. Results: A total of 508 subjects with males 43 %(220/508) and female 57 % (288/508) mean age 22 ± 2.8 years responded to the questionnaire.The overall frequency of IBS among college students was 34 % (171/508).There were 41 % (107/263) non-medical college and 26 % (64/245) medical college students with IBS. Abdominal pain was present in 100 % (171/171) with altered frequency of stool in 58 % (100/171) (p\u3c 0.001,OR 12.5, CI 7.9-20.0) of students with IBS. The medical advice was sought by 38 % (65/171) in IBS group with 46 % (30/65) non-medical college school and 54 % (35/65) medical student (p=0.001, OR 1.9, CI 1.3-2.8). Conclusion IBS is common in younger adult population of Pakistan. Its prevalence is higher in non-medical college students but health care seeking behavior was more common in medical students

An appraisal of the World Bank role in the development of education in Pakistan with a focus on higher education

The World Bank, like many other non-governmental organisations, is engaged in the developing countries with an objective to bring social and economic development. In Pakistan, the World Bank (WB) appeared on the horizon soon after the independence of the country in 1947. Hitherto, for the development of different sectors including education, WB has lent billions of dollars and launched hundreds of projects in Pakistan. This research has been conducted to have an in-depth look into the role played by the WB in the development and progress of education sector from 1964 to 2009. In this study, a special focus has been given to the higher education. The author has evaluated the volume of the WB lending, nature of the projects, the shares for the sub-sectors of education, changes and trends in the investment in education sector. An attempt also has been made to evaluate the possible impact of the WB loans and projects on the education sector in general and higher education sub-sector in particular. The WB investments in education sector have also been compared with other sectors to have a broader picture. For new readers and those who are interested in education statistics a detailed county profile, on the basis of most recent data, has also been presented and discussed in this article. This practical information on the country profile can be very helpful in establishing a better understanding of the present scenario, condition and status of education in Pakistan. Moreover it will help to understand the need and significance of national and international organisations for education. Keywords: The World Bank, education, higher education, projects, lending, investment, development, impac

Expansion of quality assurance mechanism in south Asian higher education system: an empirical analysis

Higher education institutions in south Asia are faced with two fold pressure; need to expand and demand to enhance the quality. In this region mechanism of quality assurance is at very nascent stage and faced with problems of resources limitations: economic resources are insufficient and human resources are under-developed. But the expansion and implementation of QA mechanism is helping to improve the quality of higher education and better utilization of resources. Assistance of international organizations, which are working for quality assurance mechanism, is important to enhance human capacity QA mechanisms’ credibility. This study is designed to map the state of higher education and quality assurance, to investigate into the role of international organization (INQAAHE) in the expansion of QA and to probe the questions: What are south Asian countries doing for quality enhancement and assurance? How is it expanding? What are the national needs? Keywords: Higher Education, Quality Assurance, INQAAHE, South Asi

Irritable bowel syndrome in health care professionals in Pakistan

Objective: To evaluate the symptomatology of irritable bowel syndrome (IBS) among health care professionals attending an IBS symposium in a tertiary care university hospital. Method: A questionnaire designed to incorporate Manning and Rome II criteria was distributed among participants of an IBS symposium, most of them were health care professionals. A total of 100 questionnaires were distributed, 41 had symptoms fulfilling criteria of IBS. In these patients male: female ratio was 28:13 with age range 18-68. Results: The predominant symptom was abdominal pain 87.8 % (36/41) which was aggravated post-prandially 72.2% (29/41), relieved following defecation in 87 % (35/41) with a sense of incomplete evacuation 85.3% (35/41) and distention after defecation in 80.4 % (33/41). Anxiety and depression was present in 80% (33/41) as an extra intestinal symptom. Conclusion: Irritable bowel syndrome is common in health care workers with intestinal and extraintestinal manifestations being equally common (JPMA 53:405;2003

The impact of continuing professional development on EFL faculty employed in federal universities in the United Arab Emirates

The main aim of this thesis is to explore the continuing professional development (CPD) of expatriate English as a Foreign Language (EFL) teachers employed in the foundation English programme of federal universities in the United Arab Emirates (UAE). In order to understand the phenomenon of CPD from the perspective of experienced teachers in the context this study explores their perceptions about CPD; along with their choice of CPD initiatives and the reasons and factors which impact on their choice. It also explores teachers’ suggestions about improving CPD in their context. It is expected that the results of this thesis will create awareness of these aspects among experienced EFL teachers, their institutions, local CPD organisations and as well as the community of experienced expatriate tertiary teachers of EFL. It is also expected that the study will raise implications to consider for improving the CPD experience of teachers in the context. Data was obtained using face to face individual and focus group interviews with volunteers who were foundation EFL teachers with a minimum of five years teaching experience in the context. Results revealed that participants in the study valued CPD as lifelong professional evolution that resulted in evident change. High preference emerged for participation in learning through participation in activities that provided opportunities for dialogue and collaboration. However, participants experienced less empowered and without a voice in the implementation of the institutional CPD agenda. Similarly disillusionment was experienced with CPD organisations’ standardized initial teacher education focused CPD. The study highlights how when teachers feel less empowered in their existing professional and occupational communities, they exercise their agency in finding alternative means of professional development. One result of this situation is the emergence of teacher initiated communities where learning takes place in an environment of mutual shared understandings. This also illuminates the existence of untapped expertise in the context which if exploited can benefit federal institutions; their teachers, CPD providers and subsequently others in the context. The main implication arising from this study is for federal universities, teachers and CPD providers to work in tandem and attempt to establish teacher learning communities of practice within the institution for situated learning within the context of practice

Baseline and On-Treatment High-Density Lipoprotein Cholesterol and the Risk of Cancer in Randomized Controlled Trials of Lipid-Altering Therapy

ObjectivesWe sought to examine the relationship between high-density lipoprotein cholesterol (HDL-C) levels and the risk of the development of cancer in large randomized controlled trials (RCTs) of lipid-altering interventions.BackgroundEpidemiologic data demonstrate an inverse relationship between serum total cholesterol levels and incident cancer. We recently reported that lower levels of low-density lipoprotein cholesterol are associated with a significantly higher risk of incident cancer in a meta-analysis of large RCTs of statin therapy. However, little is known about the relationship between HDL-C levels and cancer risk.MethodsA systematic MEDLINE search identified lipid intervention RCTs with ≥1,000 person-years of follow-up, providing baseline HDL-C levels and rates of incident cancer. Using random-effects meta-regressions, we evaluated the relationship between baseline HDL-C and incident cancer in each RCT arm.ResultsA total of 24 eligible RCTs were identified (28 pharmacologic intervention arms and 23 control arms), with 625,477 person-years of follow-up and 8,185 incident cancers. There was a significant inverse association between baseline HDL-C levels and the rate of incident cancer (p = 0.018). The inverse association persisted after adjusting for baseline low-density lipoprotein cholesterol, age, body mass index (BMI), diabetes, sex, and smoking status, such that for every 10-mg/dl increment in HDL-C, there was a 36% (95% confidence interval: 24% to 47%) relatively lower rate of the development of cancer (p < 0.001).ConclusionsThere is a significant inverse association between HDL-C and the risk of incident cancer that is independent of LDL-C, age, BMI, diabetes, sex, and smoking

Illuminating the dark side-vitamin D status in different localities of Karachi

Abstract This study was conducted to determine the association between place of residence (grouped into neighbourhoods), and 25-hydroxy D (25[OH]D) levels of individuals of Karachi. Addresses of 4788 individuals tested for 25[OH]D at the clinical laboratory of the Aga Khan University (AKU), Karachi, from January 2007 to June 2008 were reviewed. The neighbourhoods were categorized into ten, based on locality attributes. A high overall prevalence (74%) of vitamin D deficiency (VDD) was observed. There was a significant difference (p-value \u3c 0.01) between mean log 25[OH]D levels amongst neighbourhoods grouped according to distinct housing structure attributes and localities. A high frequency of VDD in all the studied localities of an urban city warrant dietary vitamin D supplementation and food fortification