Evaluation of immune response to hepatitis B vaccine in health care workers at a tertiary care hospital in Pakistan: an observational prospective study

Background: Seroconversion rates reported after Hepatitis B virus (HBV) vaccination globally ranges from 85–90%. Health care workers (HCWs) are at high risk of acquiring HBV and non responders\u27 rates after HBV vaccination were not reported previously in Pakistani HCWs. Therefore we evaluated immune response to HBV vaccine in HCWs at a tertiary care hospital in Karachi, Pakistan.Methods: Descriptive observational study conducted at Aga Khan University from April 2003 to July 2004. Newly HBV vaccinated HCWs were evaluated for immune response by measuring serum Hepatitis B surface antibody (HBsAb) levels, 6 weeks post vaccination. Results: Initially 666 employees were included in the study. 14 participants were excluded due to incomplete records. 271 (41%) participants were females and 381(59%) were males. Majority of the participants were young (50 years of age. Male non responders were more frequent (18%) than female (8%). Conclusion: Seroconversion rate after HBV vaccination in Pakistani HCWs was similar to that reported in western and neighboring population. HCWs with reduced immune response to HBV vaccine in a high disease prevalent population are at great risk. Therefore, it is crucial to check post vaccination HBsAb in all HCWs. This strategy will ensure safety at work by reducing nosocomial transmission and will have a cost effective impact at an individual as well as at national level, which is very much desired in a resource limited country

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Evaluation of Feeding Stimulant Mixed with Chemical and Bio Insecticides on Certain Lepidopterous Pests and their Natural Enemies in Cotton and Soybean Fields

The Efficiency of feeding stimulants (Bioenhencer) was studied alone and in combinations with chemical insecticides or entomopathogens against the defoliating pests, Spodoptera littoralis (Boisd.) and Spodoptera exigua Hbn. (in fields of cotton and soybean) and the bollworms Pectinophora gossypiella Saunders and Earias insulana Boisd. (in cotton field), at Kafr El-Sheikh governorate during the season 2003. Its adversely influence on the natural enemies associated these pests in the two fields, were also undertaken. Laboratory results indicated that the feed stimulant was exhibited at a high degree of efficiency against the target lepidopterous larvae when combined with the chemical insecticide and the bioinsecticides. But no obvious effect was found when it was used alone. Field results indicated that, the addition of Bioenhencer (5%) to the chemical and bio insecticides enhanced their activity, where the damaged rate significantly affected in these treated plots as compared to the untreated ones, on both cotton and soybean fields. Moreover, bioenhancer and the bioinsecticide had the least harmful effect on the entomophagous insect populations. Journal of Applied Sciences and Environmental Management Vol. 8 (2) 2004: 77-8

Evaluation of Feeding Stimulant Mixed with Chemical and Bio Insecticides on Certain Lepidopterous Pests and their Natural Enemies in Cotton and Soybean Fields

The Efficiency of feeding stimulants (Bioenhencer) was studied alone and in combinations with chemical insecticides or entomopathogens against the defoliating pests, Spodoptera littoralis (Boisd.) and Spodoptera exigua Hbn. (in fields of cotton and soybean) and the bollworms Pectinophora gossypiella Saunders and Earias insulana Boisd. (in cotton field), at Kafr El-Sheikh governorate during the season 2003. Its adversely influence on the natural enemies associated these pests in the two fields, were also undertaken. Laboratory results indicated that the feed stimulant was exhibited at a high degree of efficiency against the target lepidopterous larvae when combined with the chemical insecticide and the bioinsecticides. But no obvious effect was found when it was used alone. Field results indicated that, the addition of Bioenhencer (5%) to the chemical and bio insecticides enhanced their activity, where the damaged rate significantly affected in these treated plots as compared to the untreated ones, on both cotton and soybean fields. Moreover, bioenhancer and the bioinsecticide had the least harmful effect on the entomophagous insect populations. @JASE

Evaluation of immune response to Hepatitis B vaccine in health care workers at a tertiary care hospital in Pakistan: an observational prospective study

Abstract Background Seroconversion rates reported after Hepatitis B virus (HBV) vaccination globally ranges from 85–90%. Health care workers (HCWs) are at high risk of acquiring HBV and non responders' rates after HBV vaccination were not reported previously in Pakistani HCWs. Therefore we evaluated immune response to HBV vaccine in HCWs at a tertiary care hospital in Karachi, Pakistan. Methods Descriptive observational study conducted at Aga Khan University from April 2003 to July 2004. Newly HBV vaccinated HCWs were evaluated for immune response by measuring serum Hepatitis B surface antibody (HBsAb) levels, 6 weeks post vaccination. Results Initially 666 employees were included in the study. 14 participants were excluded due to incomplete records. 271 (41%) participants were females and 381(59%) were males. Majority of the participants were young (50 years of age. Male non responders were more frequent (18%) than female (8%). Conclusion Seroconversion rate after HBV vaccination in Pakistani HCWs was similar to that reported in western and neighboring population. HCWs with reduced immune response to HBV vaccine in a high disease prevalent population are at great risk. Therefore, it is crucial to check post vaccination HBsAb in all HCWs. This strategy will ensure safety at work by reducing nosocomial transmission and will have a cost effective impact at an individual as well as at national level, which is very much desired in a resource limited country.</p