Pakistan is a low income country with more than 10million hepatitis C virus(HCV)infections and the burden is on continuous raise.Accurate viral genotyping is very critical for proper treatment of the infected individu...Pakistan is a low income country with more than 10million hepatitis C virus(HCV)infections and the burden is on continuous raise.Accurate viral genotyping is very critical for proper treatment of the infected individuals as the sustained virological response of the standard antiviral interferon therapy is genotype dependent.We observed at our diagnostic center that15.6%of HCV patient’s samples were not genotypeable by using Ohno et al method.The genotyped samples showed that 3a(68.3%)is the major prevalent genotype in Pakistan followed by 2a(10.3%),3b(2.6%),1b(1.5%),2b(1.2%)and 1a(0.5%).Presence of large number of untypable HCV variants in the current study highlights an important issue of health care setup in Pakistan.Untypable HCV cases create difficulties in treatment of these patients.The problem of routine diagnostics setup of Pakistan should be addressed on priority basis to facilitate the medical professionals in patient’s treatment and to help in achieving the maximum sustained virological response.展开更多
End Polio Pakistan program still has to overcome many hurdles;unfortunately on 8th February2016 first polio case of the year has surfaced in Karachi.It seems that battle against polio demands little bit more convictio...End Polio Pakistan program still has to overcome many hurdles;unfortunately on 8th February2016 first polio case of the year has surfaced in Karachi.It seems that battle against polio demands little bit more conviction and motivation.WHO has set a goal of polio eradication in Pakistan till 2018,in order to evaluate the success of this target;polio eradication campaign in Pakistan has been analyzed in different perspectives.Our analysis indicated that major obstacles in eradication are low literacy rate,poor health infrastructure,lack of planning,natural disaster,economic crisis,counter insurgencies and almost no protection for polio health workers.WHO has allocated new funds to tackle this problem,now there is a need to spend this money more effectively with proper planning and honest deployment of funds.展开更多
In Pakistan which ranked second in terms of hepatitis C virus(HCV) infection, it is highly needed to have an established diagnostic test for antiviral therapy responseprediction. Interleukin 28B(IL-28B) genetic testin...In Pakistan which ranked second in terms of hepatitis C virus(HCV) infection, it is highly needed to have an established diagnostic test for antiviral therapy responseprediction. Interleukin 28B(IL-28B) genetic testing is widely used throughout the world for interferon based therapy prediction for HCV patients and is quite helpful not only for health care workers but also for the patients. There is a strong relationship between single nucleotide polymorphisms at or near the IL-28 B gene and the sustained virological response with pegylated interferon plus ribavirin treatment for chronic hepatitis C. Pakistan is a resource limited country, with very low per capita income and there is no proper social security(health insurance) system. The allocated health budget by the government is very low and is used on other health emergencies like polio virus and dengue virus infection. Therefore it is proposed that there should be a well established diagnostic test on the basis of IL-28 B which can predict the antiviral therapy response to strengthen health care set-up of Pakistan. This test once established will help in better management of HCV infected patients.展开更多
Pakistan is declared a cirrhotic state by WHO because of high prevalence of Hepatitis C virus(HCV). It is proposed that there are more than 10 million infected individuals in Pakistan. Keeping in mind the scenario, on...Pakistan is declared a cirrhotic state by WHO because of high prevalence of Hepatitis C virus(HCV). It is proposed that there are more than 10 million infected individuals in Pakistan. Keeping in mind the scenario, one should expect to have proper surveillance system for HCV monitoring across the country not only for high risk groups but also for general population as well. Monitoring the general population is of considerable help to identify the hot spots for infection spread and will help in designing effective strategies. In this study the current available data from last 6 years is analyzed. The results showed that the range of HCV seroprevalence in general population in Pakistan varied from 3.13%-23.83%. Similarly year wise HCV prevalence showed great variation and the prevalence was 9.57%, 6.04%, 7.46%, 4.9% and 11.04% in 2010, 2011, 2012, 2013 and 2014 respectively. The current analysis declared that available data is not sufficient and is not presenting the original picture of the situation. On these basis, a proper surveillance system is proposed across the country to get an actual picture of the infection for better management in future and massive community education programmes should be warranted in identified hot spots across the country.展开更多
Background:Echinococcosis has a worldwide geographical distribution with endemic foci on every inhabited continent.Due to the frequent outbreaks in different parts of Pakistan in the recent past,echinococcosis is bein...Background:Echinococcosis has a worldwide geographical distribution with endemic foci on every inhabited continent.Due to the frequent outbreaks in different parts of Pakistan in the recent past,echinococcosis is being described as a neglected tropical disease and is considered one of the most neglected parasitic diseases in the country.In endemic regions,predominantly settings with limited resources,there are high numbers of echinococcosis patients,as these communities do not have access to appropriate treatment.In Pakistan,there are limited reports on echinococcosis.The disease is prevalent in human and livestock,but this has not been sufficiently explored yet.Pakistan is an agricultural country and due to the disease’s zoonotic mode of transmission,there is a dire need of future research on it.The present paper is an effort to highlight the importance of echinococcosis in Pakistan.Discussion:There is a dire need for future research on echinococcosis in Pakistan as very few investigations had been carried out on this topic thus far.The prevalence of the disease in neighbouring countries highlights that Pakistan might be at severe risk of this zoonotic infection and further supports the need for more research.In Pakistan,the majority of the population lives in rural areas with limited acess to proper hygienic/sanitary facilities.These conditions favour the outbreak of diseases such as echinococcosis.The limited available data could result in higher outbreaks in the future,and thus cause the already weak healthcare system to overburden.The country has a meagre annual budget for health,which is being spent on known infections such as polio,dengue fever and hepatic viral infections.A proper surveillance system for echinococcosis is required across the country as treatment is usually expensive,complicated and may require extensive surgery and/or prolonged drug therapy.Development of new/novel drugs and other treatment modalities receives very little,if any,attention.Prognostic awareness programmes against this infection involve deworming of the infected animals,improved food inspection and slaughterhouse hygiene,and public education campaigns.Conclusion:Future research on echinococcosis is anticipated to demonstrate whether the epidemiology,diagnosis and recombinant vaccines/antibodies relating to echinococcosis can meet the quality standards(purity,potency,safety and efficacy)defined by the World Health Organization.Research work should be carried out on the epidemiology and serodiagnosis of echinocossis in the different areas of Pakistan,which will be useful for the proper eradication of echinococcosis in this region.The health department should implement awareness-raising campaigns for the general public in order to reduce the burden of disease.展开更多
Background:Cystic echinococcosis(CE)is a human and animal health problem in many endemic areas worldwide.It is considered a neglected zoonotic disease caused by the larval form(hydatid cyst)of Echinococcus spp.tapewor...Background:Cystic echinococcosis(CE)is a human and animal health problem in many endemic areas worldwide.It is considered a neglected zoonotic disease caused by the larval form(hydatid cyst)of Echinococcus spp.tapeworm.There are limited studies on echinococcosis in Pakistan.Methods:A cross-sectional survey was conducted to find out recent knowledge,attitudes and practices on the occurrence of cystic echinococcosis in butchers and dog owners in both urban and rural areas of Rawalpindi/Islamabad regions,Pakistan.The quantitative data was collected in the form of questionnaires to investigate the knowledge and awareness of CE among community members and their routine practices that were behind the factors involved in hydatid cyst infection.The practices and infrastructure of abattoirs/butcher shops and their role in transmission of cystic echinococcosis were also evaluated in the present study.Results:The participants involved in the study were dog owners and people who kept animals.A total of 400 people were interviewed and 289 questionnaires were received.The results showed that only 4.1%of people have heard about the disease,and 58.1%were closely associated with dogs.Sixty-three percent of dogs in study area were consuming uncooked organs(e.g.liver,lung,etc.)of slaughtered animals,while 100%of dogs at butcher shops were consuming uncooked organs.Home slaughtering was common in 20.06%.Among butchers,32.3%had heard about zoonoses and 7.61%knew about CE.The statistical analysis showed that there was highly significant difference(P<0.05)among most of the practices that were associated with the prevalence of CE.Conclusions:It was concluded from the present study that,the knowledge and awareness of CE among people of Rawalpindi/Islamabad were low.Because of dogs and poor knowledge of CE among community members and butchers,the transmission of echinococcosis is facilitated.Therefore,there is urgent need to strengthen awareness and health education among people,as well as proper practices related to the CE not only in the study area,but also in other areas of Pakistan.展开更多
To the Editor:Regeneration is a common phenomenon among many animals including;starfish,salamander,zebrafish and flatworms.These creatures have a natural ability to regrow their accidentally lost body parts,for exampl...To the Editor:Regeneration is a common phenomenon among many animals including;starfish,salamander,zebrafish and flatworms.These creatures have a natural ability to regrow their accidentally lost body parts,for example flatworms can regenerate their lost head.[1]But not all organisms can regenerate their whole body organs.However,this natural phenomena is akin with the modern day advancement in stem cell biology and developmental biology,which has enabled scientists to not only study organs in vitro but also achieve new frontiers in regenerative medicine[2].展开更多
文摘Pakistan is a low income country with more than 10million hepatitis C virus(HCV)infections and the burden is on continuous raise.Accurate viral genotyping is very critical for proper treatment of the infected individuals as the sustained virological response of the standard antiviral interferon therapy is genotype dependent.We observed at our diagnostic center that15.6%of HCV patient’s samples were not genotypeable by using Ohno et al method.The genotyped samples showed that 3a(68.3%)is the major prevalent genotype in Pakistan followed by 2a(10.3%),3b(2.6%),1b(1.5%),2b(1.2%)and 1a(0.5%).Presence of large number of untypable HCV variants in the current study highlights an important issue of health care setup in Pakistan.Untypable HCV cases create difficulties in treatment of these patients.The problem of routine diagnostics setup of Pakistan should be addressed on priority basis to facilitate the medical professionals in patient’s treatment and to help in achieving the maximum sustained virological response.
文摘End Polio Pakistan program still has to overcome many hurdles;unfortunately on 8th February2016 first polio case of the year has surfaced in Karachi.It seems that battle against polio demands little bit more conviction and motivation.WHO has set a goal of polio eradication in Pakistan till 2018,in order to evaluate the success of this target;polio eradication campaign in Pakistan has been analyzed in different perspectives.Our analysis indicated that major obstacles in eradication are low literacy rate,poor health infrastructure,lack of planning,natural disaster,economic crisis,counter insurgencies and almost no protection for polio health workers.WHO has allocated new funds to tackle this problem,now there is a need to spend this money more effectively with proper planning and honest deployment of funds.
文摘In Pakistan which ranked second in terms of hepatitis C virus(HCV) infection, it is highly needed to have an established diagnostic test for antiviral therapy responseprediction. Interleukin 28B(IL-28B) genetic testing is widely used throughout the world for interferon based therapy prediction for HCV patients and is quite helpful not only for health care workers but also for the patients. There is a strong relationship between single nucleotide polymorphisms at or near the IL-28 B gene and the sustained virological response with pegylated interferon plus ribavirin treatment for chronic hepatitis C. Pakistan is a resource limited country, with very low per capita income and there is no proper social security(health insurance) system. The allocated health budget by the government is very low and is used on other health emergencies like polio virus and dengue virus infection. Therefore it is proposed that there should be a well established diagnostic test on the basis of IL-28 B which can predict the antiviral therapy response to strengthen health care set-up of Pakistan. This test once established will help in better management of HCV infected patients.
文摘Pakistan is declared a cirrhotic state by WHO because of high prevalence of Hepatitis C virus(HCV). It is proposed that there are more than 10 million infected individuals in Pakistan. Keeping in mind the scenario, one should expect to have proper surveillance system for HCV monitoring across the country not only for high risk groups but also for general population as well. Monitoring the general population is of considerable help to identify the hot spots for infection spread and will help in designing effective strategies. In this study the current available data from last 6 years is analyzed. The results showed that the range of HCV seroprevalence in general population in Pakistan varied from 3.13%-23.83%. Similarly year wise HCV prevalence showed great variation and the prevalence was 9.57%, 6.04%, 7.46%, 4.9% and 11.04% in 2010, 2011, 2012, 2013 and 2014 respectively. The current analysis declared that available data is not sufficient and is not presenting the original picture of the situation. On these basis, a proper surveillance system is proposed across the country to get an actual picture of the infection for better management in future and massive community education programmes should be warranted in identified hot spots across the country.
基金We are very thankful to TUBITAK(2216-Research Fellowship Programme for International Researchers)for providing us with the opportunity and funding to work.
文摘Background:Echinococcosis has a worldwide geographical distribution with endemic foci on every inhabited continent.Due to the frequent outbreaks in different parts of Pakistan in the recent past,echinococcosis is being described as a neglected tropical disease and is considered one of the most neglected parasitic diseases in the country.In endemic regions,predominantly settings with limited resources,there are high numbers of echinococcosis patients,as these communities do not have access to appropriate treatment.In Pakistan,there are limited reports on echinococcosis.The disease is prevalent in human and livestock,but this has not been sufficiently explored yet.Pakistan is an agricultural country and due to the disease’s zoonotic mode of transmission,there is a dire need of future research on it.The present paper is an effort to highlight the importance of echinococcosis in Pakistan.Discussion:There is a dire need for future research on echinococcosis in Pakistan as very few investigations had been carried out on this topic thus far.The prevalence of the disease in neighbouring countries highlights that Pakistan might be at severe risk of this zoonotic infection and further supports the need for more research.In Pakistan,the majority of the population lives in rural areas with limited acess to proper hygienic/sanitary facilities.These conditions favour the outbreak of diseases such as echinococcosis.The limited available data could result in higher outbreaks in the future,and thus cause the already weak healthcare system to overburden.The country has a meagre annual budget for health,which is being spent on known infections such as polio,dengue fever and hepatic viral infections.A proper surveillance system for echinococcosis is required across the country as treatment is usually expensive,complicated and may require extensive surgery and/or prolonged drug therapy.Development of new/novel drugs and other treatment modalities receives very little,if any,attention.Prognostic awareness programmes against this infection involve deworming of the infected animals,improved food inspection and slaughterhouse hygiene,and public education campaigns.Conclusion:Future research on echinococcosis is anticipated to demonstrate whether the epidemiology,diagnosis and recombinant vaccines/antibodies relating to echinococcosis can meet the quality standards(purity,potency,safety and efficacy)defined by the World Health Organization.Research work should be carried out on the epidemiology and serodiagnosis of echinocossis in the different areas of Pakistan,which will be useful for the proper eradication of echinococcosis in this region.The health department should implement awareness-raising campaigns for the general public in order to reduce the burden of disease.
文摘Background:Cystic echinococcosis(CE)is a human and animal health problem in many endemic areas worldwide.It is considered a neglected zoonotic disease caused by the larval form(hydatid cyst)of Echinococcus spp.tapeworm.There are limited studies on echinococcosis in Pakistan.Methods:A cross-sectional survey was conducted to find out recent knowledge,attitudes and practices on the occurrence of cystic echinococcosis in butchers and dog owners in both urban and rural areas of Rawalpindi/Islamabad regions,Pakistan.The quantitative data was collected in the form of questionnaires to investigate the knowledge and awareness of CE among community members and their routine practices that were behind the factors involved in hydatid cyst infection.The practices and infrastructure of abattoirs/butcher shops and their role in transmission of cystic echinococcosis were also evaluated in the present study.Results:The participants involved in the study were dog owners and people who kept animals.A total of 400 people were interviewed and 289 questionnaires were received.The results showed that only 4.1%of people have heard about the disease,and 58.1%were closely associated with dogs.Sixty-three percent of dogs in study area were consuming uncooked organs(e.g.liver,lung,etc.)of slaughtered animals,while 100%of dogs at butcher shops were consuming uncooked organs.Home slaughtering was common in 20.06%.Among butchers,32.3%had heard about zoonoses and 7.61%knew about CE.The statistical analysis showed that there was highly significant difference(P<0.05)among most of the practices that were associated with the prevalence of CE.Conclusions:It was concluded from the present study that,the knowledge and awareness of CE among people of Rawalpindi/Islamabad were low.Because of dogs and poor knowledge of CE among community members and butchers,the transmission of echinococcosis is facilitated.Therefore,there is urgent need to strengthen awareness and health education among people,as well as proper practices related to the CE not only in the study area,but also in other areas of Pakistan.
文摘To the Editor:Regeneration is a common phenomenon among many animals including;starfish,salamander,zebrafish and flatworms.These creatures have a natural ability to regrow their accidentally lost body parts,for example flatworms can regenerate their lost head.[1]But not all organisms can regenerate their whole body organs.However,this natural phenomena is akin with the modern day advancement in stem cell biology and developmental biology,which has enabled scientists to not only study organs in vitro but also achieve new frontiers in regenerative medicine[2].
