Association between asthma and dental caries amongst 12 - 15 years old children: A school-based cross-sectional study in karachi, pakistan

Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children. Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted prevalence ratios with 95% CI were reported. Total 554 children, 306 (56.3%) boys and 43.7% girls participated in the study. Mean age of children was 13.2 ± 0.05 years. Total number of children with DMFT \u3e 0 was 30.5%. The decayed component contributed largely (22.8%) to the DMFT score. Overall prevalence of asthma was 20%. Prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. Adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.6 - 1.3) after adjusting for carious food intake, age, oral hygiene index and dentist visit; the association between asthma and dental caries turned out to be in-significant.Conclusions: There was no association observed between asthma and dental caries among the children examined in this study

Oral Health Status Among Pregnant Women Attending Gynae OPD of Tertiary Care Hospital in Rawalpindi

Objective: The objectives of this study were to determine the oral health status and treatment needs using DMFT & CPITN indices in pregnant women attending Gynae OPD of tertiary care Hospital in Rawalpindi, to Determine Association of Oral health status using DMFT and CPITN with socioeconomic status and to determine oral health status of various trimesters of pregnancy Materials and methods: An analytical cross-sectional study was carried out to assess the oral health status and treatment needs among pregnant women at Tertiary Care Hospital, Rawalpindi from April’ 2020 to September’ 2020. Consecutive sampling was used to select the study participants. An adaptive version of WHO questionnaire was used. Results were presented in the form of frequency tables. Chi square test of statistics was applied to assess the association between categorical DMFT and CPITN with the sociodemographic characteristics of the participating females. Results: The mean DMFT score pregnant females was 2.41 + 2.30 and were belonged to a middle socioeconomic status 43.8% (n=173). About 61.8% (n=244) of participants had DMFT total score 1-7. Whereas, majority of the participants were reported bleeding gums on probing 30.6% (n=121) on assessment by CPITN. The participating pregnant females also depicted the worsening of periodontal tissues (P=0.00) and dentition status (P=0.02). Socioeconomic status was not significantly associated with dentition (P=0.39) and periodontal status (P=0.69). Conclusion: The study revealed that oral health status was deteriorated during pregnancy. Education and gestational period were strong indicator for oral health status among pregnant women. Bleeding gums were reported in majority of participants during second trimester of pregnancy. Socioeconomic status was not significantly associated with oral health status by CPITN and DMFT score

Assessing the efficiency of sub-national units in making progress towards universal health coverage: Evidence from Pakistan

The World Health Report 2010 encourages countries to reduce wastage and increase efficiency to achieve Universal Health Coverage (UHC). This research examines the efficiency of divisions (sub-provincial geographic units) in Pakistan in moving towards UHC using Data Envelop Analysis. We have used data from the Pakistan National Accounts 2011-12 and the Pakistan Social Living and Measurement Survey 2012-13 to measure per capita pooled public health spending in the divisions as inputs, and a set of UHC indicators (health service coverage and financial protection) as outputs. Sensitivity analysis for factors outside the health sector influencing health outcomes was conducted to refine the main model specification. Spider radar graphs were generated to illustrate differences between divisions with similar public spending but different performances for UHC. Pearson product-moment correlation was used to explore the strength and direction of the associations between proxy health systems organization variables and efficiency scores.The results showed a large variation in performance of divisions for selected UHC outputs. The results of the sensitivity analysis were also similar. Overall, divisions in Sindh province were better performing and divisions in Balochistan province were the least performing. Access to health care, the responsiveness of health systems, and patients\u27 satisfaction were found to be correlated with efficiency scores.This research suggests that progress towards UHC is possible even at relatively low levels of public spending. Given the devolution of health system responsibilities to the provinces, this analysis will be a timely reference for provinces to gauge the performance of their divisions and plan the ongoing reforms to achieve UHC

Efficacy of Laser Capsulotomy in the Treatment of Posterior Capsule Opacification

Background: Neodymium – Ytrium – Aluminim – Garnet (Nd:YAG) laser capsulotomy is an effective treatment of posterior capsule opacification , but is not without its attendant risks Methods: In this interventional study, 200 Eyes with posterior capsule opacification (PCO) were subjected to Nd:YAG laser for posterior capsulotomy using ZEIS visualas YAG II plus system, under topical anaesthesia and dilated pupil with tropicamide eye drops with the help of Abraham Capsulotomy YAG Laser Lens. The patients were assessed for early complications after one hour, next day and after one week and the final visual acuity recorded with best correction. Results:Prior to Nd:YAG laser capsulotomy only 7% (14) patients had good best corrected visual acuity (6/18). After one week follow-up there was significant improvement in (73%) patients (122). The overall rate of early complications was 28.7%. Conclusion: The Nd:YAG laser posterior capsulotomy is a safe outdoor procedure with good visual outcome

Using costing to facilitate policy making towards Universal Health Coverage: findings and recommendations from country-level experiences

As countries progress towards universal health coverage (UHC), they frequently develop explicit packages of health services compatible with UHC goals. As part of the Disease Control Initiative 3 Country Translation project, a systematic survey instrument was developed and used to review the experience of five low-income and lower-middle-income countries-Afghanistan, Ethiopia, Pakistan, Somalia and Sudan-in estimating the cost of their proposed packages. The paper highlights the main results of the survey, providing information about how costing exercises were conducted and used and what country teams perceived to be the main challenges. Key messages are identified to facilitate similar exercises and improve their usefulness. Critical challenges to be addressed include inconsistent application of costing methods, measurement errors and data reliability issues, the lack of adequate capacity building, and the lack of integration between costing and budgeting. The paper formulates four recommendations to address these challenges: (1) developing more systematic guidance and standard ways to implement costing methodologies, particularly regarding the treatment of health systems-related common costs, (2) acknowledging ranges of uncertainty of costing results and integrating sensitivity analysis, (3) building long-term capacity at the local level and institutionalising the costing process in order to improve both reliability and policy relevance, and (4) closely linking costing exercises to public budgeting

Addressing the UHC Challenge Using the Disease Control Priorities 3 Approach: Lessons Learned and an Overview of the Pakistan Experience

Background: Pakistan developed its first national Essential Package of Health Services (EPHS) as a key step towards accelerating progress in achieving Universal Health Coverage (UHC). We describe the rationale, aims, the systematic approach followed to EPHS development, methods adopted, outcomes of the process, challenges encountered, and lessons learned. Methods: EPHS design was led by the Ministry of National Health Services, Regulations & Coordination. The methods adopted were technically guided by the Disease Control Priorities 3 Country Translation project and existing country experience. It followed a participatory and evidence-informed prioritisation and decision-making processes. Results: The full EPHS covers 117 interventions delivered at the community, health centre and first-level hospital platforms at a per capita cost of US$29.7. The EPHS also includes an additional set of 12 population-based interventions at US$0.78 per capita. An immediate implementation package (IIP) of 88 district-level interventions costing US$12.98 per capita will be implemented initially together with the population-based interventions until government health allocations increase to the level required to implement the full EPHS. Interventions delivered at the tertiary care platform were also prioritised and costed at US$6.5 per capita, but they were not included in the district-level package. The national EPHS guided the development of provincial packages using the same evidence-informed process. The government and development partners are in the process of initiating a phased approach to implement the IIP. Conclusion: Key ingredients for a successful EPHS design requires a focus on package feasibility and affordability, national ownership and leadership, and solid engagement of national stakeholders and development partners. Major challenges to the transition to implementation are to continue strengthening the national technical capacity, institutionalise priority setting and package design and its revision in ministries of health, address health system gaps and bridge the current gap in financing with the progressive increase in coverage towards 2030