Search

The study was designed to investigate the causes of dropout at primary level in Pakistan. Descriptive research method was adopted by using both quantitative and qualitative techniques for data collection. The study sought to get the opinion of education managers, teachers, parents and community members on various factors causing high dropout at primary level. Data was collected from 208 education managers and 291 primary school teachers. Twelve districts and 96 schools across the country were included in the sample. Moreover, focus group discussion was held with community members and parents in each sample school and district to solicit their opinion about causes of dropout. All the possible factors causing dropout were grouped into socio-economic factors, physical factors, geographical factors, teacher related factors, family related factors, teaching learning material related factors, administrative related factors, child related factors, and facilities in schools related factors.

Objectives: This study compares hearing outcomes of two prosthesis materials, bone and titanium, used in ossiculoplasty. Design: This retrospective nationwide registry‐based study uses data systematically collected by the Swedish Quality Registry for Ear Surgery (SwedEar). Setting: The data were obtained from clinics in Sweden that perform ossiculoplasty. Participants: Patients who underwent ossiculoplasty using either bone or titanium prostheses were registered in SwedEar between 2013 and 2019. Main Outcome Measures: Hearing outcome expressed as air–bone gap (ABG) gain. Results: The study found no differences between bone and titanium for ABG or air conduction (AC) for either partial ossicular replacement prostheses (PORP) or total ossicular replacement prostheses (TORP). In a comparison between PORP and TORP for ABG and AC outcomes, regardless of the material used, PORP showed a small advantage, with an additional improvement of 3.3 dB (95% CI [confidence interval], 0.1–4.4) in ABG and 2.2 dB (95% CI, 1.7–4.8) in AC. In secondary surgery using TORP, titanium produced slightly better results for high‐frequency pure tone average. The success rate, a postoperative ABG ≤20 dB, was achieved in 62% of the operations for the whole group. Conclusion: Both bone and titanium used to reconstruct the ossicular chain produce similar hearing outcomes for both PORP and TORP procedures. However, titanium may be a preferable option for secondary surgeries involving TORP. The success rate, a postoperative ABG ≤20 dB, is consistent with other studies, but there is room for improvement in patient selection criteria and surgical techniques. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to describe child health in relation to housing renovations in more than 800 rental units, consisting of repairs of dilapidated kitchens and bathrooms, in the disadvantaged neighbourhood of Herrgården in Rosengård, Malmö, Sweden. Methods: Data on housing conditions and self-reported health were collected during home visits to families living in Herrgården (building renovations area) and a comparison area (neighbouring Törnrosen, with generally better housing conditions). At baseline, 130 families with 359 children participated, while 51 families with 127 children participated at follow-up. All data were collected between 2010 and 2012. Additionally, regional register data on health-care usage/in- and outpatient contacts within the public health-care system between 2008 and 2013 were also collected for all 8715 children registered as living in the two areas. Results: Self-reported health seemed to somewhat improve in both areas, with 74% versus 86% and 78% versus 88% reporting good or very good health in Herrgården and in the comparison area at baseline and follow-up, respectively. In Herrgården, crowdedness increased, while it decreased in the comparison area. The number of health-care contacts remained stable over time in Herrgården, while it decreased in the comparison area. Conclusions: Partial housing renovations did not seem to result in clear health improvements as measured with the indicators used in the present study. This could possibly be due to persisting health effects due to increased crowdedness or persisting poor housing conditions, as only kitchens and bathrooms were renovated. [ABSTRACT FROM AUTHOR]

Background: The incidence rate risk of testicular cancer has increased over the last four decades, and the most significant increase has been among Caucasian men in Nordic countries. Second-generation immigrant studies indicate a significant role of environmental exposure in testicular cancer. Methods: We conducted a nationwide register-based case-control study including 6,390 testicular cancer cases registered in the Danish Cancer Registry between 1989 and 2014. Up to four age-matched controls for each case (n = 18,997) were randomly selected from the Civil Registration System. Ambient air pollution levels were estimated at addresses of cases and controls with a state-of-the-art air pollution modeling system. Results: We mostly found ORs close to 1.00 and with 95% confidence intervals (CI) spanning 1.00. Exposure during the year preceding birth was associated with ORs for nitrogen dioxide (NO2) of 0.87 (95% CI, 0.77-0.97) per 10 µg/m³ and for organic carbon of 0.84 (95% CI, 0.72-0.98) per 1 µg/m³. Exposure during the first 10 years of life was associated with ORs for organic carbon of 0.79 (95% CI, 0.67-0.93) per 1 µg/m³, for ozone (O3) of 1.20 (95% CI, 1.07-1.34) per 10 µg/m³, and for secondary inorganic aerosols of 1.07 (95% CI, 1.00-1.15) per 1 µg/m³. Conclusions: Early-life exposure to NO2 and organic carbon (OC) was associated with lower risk for testicular cancer whereas early-life exposure to O3 and secondary inorganic aerosols (SIA) was associated with higher risk. Impact: We report both positive and negative associations between ambient air pollutants and risk of testicular cancer, dependent on pollutant, exposure time window, and age at diagnosis. This is the first study to investigate such associations. [ABSTRACT FROM AUTHOR]

This review highlights the importance of air quality in the African urban development process. We address connections between air pollution and (a) rapid urbanization, (b) social problems, (c) health impacts, (d) climate change, (e) policies, and (f) new innovations. We acknowledge that air pollution levels in Africa can be extremely high and a serious health threat. The toxic content of the pollution could relate to region-specific sources such as low standards for vehicles and fuels, cooking with solid fuels, and burning household waste. We implore the pursuit of interdisciplinary research to create new approaches with relevant stakeholders. Moreover, successful air pollution research must regard conflicts, tensions, and synergies inherent to development processes in African municipalities, regions, and countries. This includes global relationships regarding climate change, trade, urban planning, and transportation. Incorporating aspects of local political situations (e.g., democracy) can also enhance greater political accountability and awareness about air pollution. [ABSTRACT FROM AUTHOR]

There is limited evidence regarding a possible association between exposure to ambient air pollutants and the risk of non‐Hodgkin lymphoma (NHL). Previous epidemiological studies have relied on crude estimations for air pollution exposure and/or small numbers of NHL cases. The objective of our study was to analyze this association based on air pollution modeled at the address level and NHL cases identified from the nationwide Danish Cancer Registry. We identified 20,874 incident NHL cases diagnosed between 1989 and 2014 and randomly selected 41,749 controls matched on age and gender among the entire Danish population. We used conditional logistic regression to estimate odds ratios (ORs) and adjusted for individual and neighborhood level sociodemographic variables. There was no association between exposure to PM2.5, BC, O3, SO2 or NO2 and overall risk of NHL but several air pollutants were associated with higher risk of follicular lymphoma, but statistically insignificant, for example, PM2.5 (OR = 1.15 per 5 μg/m3; 95% CI: 0.98–1.34) and lower risk for diffuse large B‐cell lymphoma (OR = 0.92 per 5 μg/m3; 95% CI: 0.82–1.03). In this population‐based study, we did not observe any convincing evidence of a higher overall risk for NHL with higher exposure to ambient air pollutants. What's new? Known risk factors of non‐Hodgkin lymphoma (NHL) appear to be involved in only a small percentage of NHL cases. However, while other factors are suspected of influencing NHL risk, including socioeconomic factors and outdoor air pollution, existing evidence is inconclusive. In this investigation of outdoor air pollution and NHL risk in NHL patients diagnosed between 1989 and 2014 in Denmark, no association was detected between long‐term air pollution exposure at an individual's residence and overall NHL risk. Air pollution was insignificantly associated with increased risk of follicular lymphoma and reduced risk of diffuse large B‐cell lymphoma, two common NHL subtypes. [ABSTRACT FROM AUTHOR]

Background : Particulate matter (PM) is classified as a group 1 human carcinogen. Previous experimental studies suggest that particles in diesel exhaust induce oxidative stress, inflammation and DNA damage in kidney cells, but the evidence from population studies linking air pollution to kidney cancer is limited. Methods : We pooled six European cohorts (N = 302,493) to assess the association of residential exposure to fine particles (PM 2.5), nitrogen dioxide (NO 2), black carbon (BC), warm season ozone (O 3) and eight elemental components of PM 2.5 (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) with cancer of the kidney parenchyma. The main exposure model was developed for year 2010. We defined kidney parenchyma cancer according to the International Classification of Diseases 9th and 10th Revision codes 189.0 and C64. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. Results : The participants were followed from baseline (1985–2005) to 2011–2015. A total of 847 cases occurred during 5,497,514 person-years of follow-up (average 18.2 years). Median (5–95%) exposure levels of NO 2 , PM 2.5 , BC and O 3 were 24.1 μg/m3 (12.8–39.2), 15.3 μg/m3 (8.6–19.2), 1.6 10−5 m−1 (0.7–2.1), and 87.0 μg/m3 (70.3–97.4), respectively. The results of the fully adjusted linear analyses showed a hazard ratio (HR) of 1.03 (95% confidence interval [CI]: 0.92, 1.15) per 10 μg/m³ NO 2 , 1.04 (95% CI: 0.88, 1.21) per 5 μg/m³ PM 2.5 , 0.99 (95% CI: 0.89, 1.11) per 0.5 10−5 m−1 BCE, and 0.88 (95% CI: 0.76, 1.02) per 10 μg/m³ O 3. We did not find associations between any of the elemental components of PM 2.5 and cancer of the kidney parenchyma. Conclusion : We did not observe an association between long-term ambient air pollution exposure and incidence of kidney parenchyma cancer. •A large sample size was obtained by pooling six cohorts with harmonized covariates. •A newly developed Europe-wide spatial land-use regression model was applied. •Results did not indicate a role of air pollutants in development of kidney cancer. [ABSTRACT FROM AUTHOR]

Background and aims: Asthma is one of the most common respiratory diseases in the world. Research has shown that temporal increases in air pollution concentrations can aggravate asthma symptoms. The aim of this study was to assess whether individuals living in areas with higher air pollution concentrations responded differently to short-term temporal exposure to air pollution than those living in lower air pollution areas. Method: The study was designed as a case-crossover study in Scania, Sweden. Outcome data was visits to primary health care clinics with asthma as the main complaint during the years 2007 to 2010. Nitrogen dioxide levels were obtained from 21 different air pollution monitoring stations. Short-term exposure was defined as the average concentration four days prior to the visit. Data was pooled for areas above and below a two-year average NO2 concentration of 10 μg/m3, dispersion modelled with an emission database. Results: The short-term association between NO2 and asthma visits seemed stronger in areas with NO2 levels below 10 μg/m3, with an odds ratio (OR) of 1.15 (95% confidence interval (CI): 1.08–1.23) associated with a 10 μg/m3 increase in NO2 compared to areas above 10 μg/m3 NO2 levels, where corresponding OR of 1.09 (95% CI: 1.02–1.17). However, this difference was not statistically significant. (p = 0.13) Conclusions: The study provided some evidence, although not statistically significant, that short-term associations between air pollution and asthma may depend on background air pollution levels. However, we cannot rule out that the association is due to other spatially dependent factors in Scania. The study should be reproduced in other study areas. [ABSTRACT FROM AUTHOR]

Objectives: To describe the home environment in terms of housing conditions and their association with child health in a disadvantaged immigrant population. Design: A cross-sectional observational study. Setting: Enrolment took place during 2010-2011 in Rosengård, Malmö, Sweden. Participants: Children aged 0-13 years in 2 study neighbourhoods were recruited from local health records and from schools. 359 children participated, with a participation rate of 40%. Data on health, lifestyle and apartment characteristics from questionnaire-led interviews with the mothers of the children were obtained together with data from home inspections carried out by trained health communicators. Outcome measures: Logistic regression analysis was used to estimate ORs for various health outcomes, adjusted for demographic information and lifestyle factors. Results: The housing conditions were very poor, especially in one of the study neighbourhoods where 67% of the apartments had been sanitised of cockroaches, 27% were infested with cockroaches and 40% had a visible mould. The association between housing conditions and health was mostly inconclusive, but there were statistically significant associations between current asthma and dampness (OR=4.1, 95% CI 1.7 to 9.9), between asthma medication and dampness (OR=2.8, 95% CI 1.2 to 6.4), and between mould and headache (OR=4.2, 95% CI 1.2 to 14.8). The presence of cockroaches was associated with emergency care visits, with colds, with headache and with difficulty falling asleep, and worse general health was associated with mould and presence of cockroaches. Conclusions: The associations between dampness and asthma, and the association between mould and headache, are in line with current knowledge. The presence of cockroaches seemed to be associated with various outcomes, including those related to mental well-being, which is less described in the literature. The results of the present study are hypothesis generating and provide strong incentives for future studies in this study population. [ABSTRACT FROM AUTHOR]

Exposure to outdoor air pollution is associated with adverse health effects. Previous studies have indicated higher levels of air pollution in socially deprived areas. To investigate associations between air pollution and socio-demographic variables, comorbidity, stress, and green space at the residence in Denmark. We included 2,237,346 persons living in Denmark, aged 35 years or older in 2017. We used the high resolution, multi-scale DEHM/UBM/AirGIS air pollution modelling system to calculate mean concentrations of air pollution with PM 2.5 , elemental carbon, ultrafine particles and NO 2 at residences held the preceding five years. We used nationwide registries to retrieve information about socio-demographic indicators at the individual and neighborhood levels. We used general linear regression models to analyze associations between socio-demographic indicators and air pollution at the residence. Individuals with high SES (income, higher white-collar worker and high educational level) and of non-Danish origin were exposed to higher levels of air pollution than individuals of low SES and of Danish origin, respectively. We found comparable levels of air pollution according to sex, stress events and morbidity. For neighborhood level SES indicators, we found high air pollution levels in neighborhoods with low SES measured as proportion of social housing, sole providers, low income and unemployment. In contrast, we found higher air pollution levels in neighborhoods with higher educational level and a low proportion of manual labor. People living in an apartment and/or with little green space had higher air pollution levels. In Denmark, high levels of residential air pollution were associated with higher individual SES and non-Danish origin. For neighborhood-level indicators of SES, no consistent pattern was observed. These results highlight the need for analyzing many different socio-demographic indicators to understand the complex associations between SES and exposure to air pollution. • Individuals with high SES had higher air pollution levels at the residence. • Individuals of non-Danish origin had higher air pollution levels at the residence. • Neighborhood-level SES showed no consistent association with air pollution. • Air pollution at the residence was similar according to sex, stress events, and morbidity. [ABSTRACT FROM AUTHOR]

Objective To determine particulate matter smaller than 2.5 mm (PM2.5) levels at various hospitality and entertainment venues of Karachi, Pakistan. Methods This was a descriptive cross-sectional study conducted at various locations in Karachi, during July 2009. Sampling was performed at 20 enclosed public places, including hospitality (restaurants and cafe's) and entertainment (snooker/billiard clubs and gaming zones) venues. PM2.5 levels were measured using an aerosol monitor. Results All entertainment venues had higher indoor PM2.5 levels as compared to the immediate outdoors. The indoor PM2.5 levels ranged from 25 to 390 µg/m³ and the outdoor PM2.5 levels ranged from 18 to 96 µg/m³. The overall mean indoor PM2.5 level was 138.8 µg/m³ (6112.8). Among the four types of venues, the highest mean indoor PM2.5 level was reported from snooker/billiard clubs: 264.7 µg/m³ (685.4) and the lowest from restaurants: 66.4 µg/m³ (657.6) while the indoor/outdoor ratio ranged from 0.97 to 10.2, highest being at the snooker/billiard clubs. The smoking density ranged from 0.21 to 0.57, highest being at gaming zones. The indoor PM2.5 concentration and smoking density were not significantly correlated (Spearman's correlation coefficient=0.113; p=0.636). Conclusions This study demonstrates unacceptably high levels of PM2.5 exposure associated with secondhand smoke (SHS) at various entertainment venues of Karachi even after 8 years since the promulgation of smoke-free ordinance (2002) in Pakistan; however, better compliance may be evident at hospitality venues. The results of this study call for effective implementation and enforcement of smoke-free environment at public places in the country. [ABSTRACT FROM AUTHOR]

Leukemia is one of the most common forms of hematologic malignancy, which can affect people of all ages. We previously showed an association between exposure to ambient particulate matter 2.5 μg (PM 2.5) and risk for leukemia in adults. The aim of this study was to investigate which PM 2.5 constituents were responsible for our previous observation. This is a nationwide register-based case-control study. We identified 14,983 persons diagnosed with leukemia at age 20 or above, 1989–2014, in the Danish Cancer Registry. We selected up to four sex and age-matched controls per case at random from the entire Danish population (n = 51,613). We modelled concentrations of ambient PM 2.5 and its constituents at the addresses of cases and controls for the 10-year period before index date with a state-of-the-art multiscale air pollution modeling system. We used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables. The results showed higher risk for overall leukemia in association with interquartile range exposure to PM 2.5 (OR = 1.09; 95% CI: 1.02, 1.17), black carbon (BC) (OR = 1.02; 95% CI: 1.00, 1.03), secondary inorganic aerosols (SIA) (OR = 1.15; 95% CI: 1.03, 1.29) and its components ammonium (NH 4) (OR = 1.08; 95% CI: 1.00, 1.17) and nitrate (NO 3) (OR = 1.08; 95% CI: 1.02, 1.14). In leukemia subtype analysis, statistically significant associations were found for AML with PM 2.5 (OR = 1.14; 95% CI: 1.00, 1.29), BC (OR = 1.03; 95% CI: 1.00, 1.07), SIA (OR = 1.23; 95% CI: 1.01, 1.51), NH 4 (OR = 1.16; 95% CI: 1.01, 1.34) and NO 3 (OR = 1.12; 95% CI: 1.01, 1.24). The association between PM 2.5 and leukemia persisted in two pollutants models including sum of primary emitted black and organic carbon (BC + OC), secondary organic aerosols (SOA), or sea-salt. The association between black carbon (BC) and leukemia persisted in two pollutants models including organic carbon (OC). The three pollutant model with sulfate (SO 4), NH 4 and NO 3 showed an association with NO 3 but not with SO 4 or NH 4. Ambient concentrations of the PM 2.5 components BC, NH 4 and NO 3 at the residence showed associations with risk of incident leukemia in adults. • "This is a Danish register-based case-control study utilizing all adult leukemia cases between 1989 and 2014.". • "Validated exposure modeling system with high temporal and spatial resolution was used for exposure assessment.". • "Particulate matter constituents were associated with increased risk of adult leukemia incidence.". [ABSTRACT FROM AUTHOR]

Particulate matter (PM) air pollution is a complex mixture and the various PM constituents likely affect health differently. The literature on the relationships among specific PM constituents and the risk of cancer is sparse. In this study, we aimed to evaluate the association of PM 2.5 and its constituents with the incidence of non-Hodgkin lymphoma (NHL) and the two main NHL subtypes. We undertook a nationwide register-based case-control study including 20,847 cases registered in the Danish Cancer Registry with NHL between 1989 and 2014. Among the entire Danish population, we selected 41,749 age and sex-matched controls randomly from the Civil Registration System. We assessed modelled outdoor PM concentrations at addresses of cases and controls with a state-of-the-art multi scale air pollution modelling system and used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables. The 10-year time-weighted average concentrations of PM 2.5 , primary carbonaceous particles (BC/OC), secondary inorganic aerosols (SIA), secondary organic aerosols (SOA) and sea salt were 17.4, 2.3, 7.8, 0.3, and 4.1 μg/m3, respectively among controls. The results showed higher risk for NHL in association with exposure to BC/OC (OR = 1.03; 95% CI: 1.00, 1.07, per interquartile range (IQR)) and SOA (OR = 1.54; 95% CI: 1.13, 2.09, per IQR). The results indicated a higher risk for follicular lymphoma in association with several PM components. Including PM 2.5 (OR = 1.16; 95% CI: 0.98–1.38), BC/OC (OR = 1.05; 95% CI: 0.97–1.14), SIA (OR = 1.44; 95% CI: 0.80–1.08), SOA (OR = 4.52; 95% CI: 0.86–23.83) per IQR. This is the first study on PM constituents and the risk of NHL. The results indicated an association with primary carbonaceous and secondary organic PM. The results need replication in other settings before any firm conclusion can be reached. • Particulate matter constituents were associated with increased risk of non-Hodgkin lymphoma. • This is a Danish register-based case-control study utilizing all non-Hodgkin lymphoma cases between 1989 and 2014. • The Particulate matter constituents indicated a higher risk for follicular lymphoma. [ABSTRACT FROM AUTHOR]

There is increasing evidence that environmental manganese (Mn) exposure early in life can have negative effects on children's neurodevelopment and increase the risk of behavioral problems, including attention deficit hyperactivity disorder (ADHD). Factors that may contribute to differences in sensitivity to Mn exposure are sex and genetic variation of proteins involved in the regulation of Mn concentrations. Here we investigate if sex and polymorphisms in Mn transporter genes SLC30A10 and SLC39A8 influence the association between Mn exposure and ADHD-related behavioral problems in children. The SNPs rs1776029 and rs12064812 in SLC30A10 , and rs13107325 in SLC39A8 were genotyped by TaqMan PCR or pyrosequencing in a population of Italian children (aged 11–14 years; n = 645) with a wide range of environmental Mn exposure. Mn in surface soil was measured in situ using XRF technology or modeled by geospatial analysis. Linear regression models or generalized additive models (GAM) were used for analyzing associations between soil Mn and neurobehavioral problems assessed by the Conners' behavior rating scales (self-, and parent-reported). Gene-environment interactions (Mn transporter genotype x soil Mn) were evaluated using a genetic score in which genotypes for the three SNPs were combined based on their association with blood Mn, as an indication of their influence on Mn regulation. We observed differences in associations between soil Mn and neurobehavior between sexes. For several self-reported Conners' scales, girls showed U-shaped relationships with higher (worse) Conners' scoring at higher soil Mn levels, and several parent-reported scales showed positive linear relationships between increasing soil Mn and higher Conner's scores. For boys, we observed a positive linear relationship with soil Mn for one Conner's outcome only (hyperactivity, parent-reported). We also observed some interactions between soil Mn and the genetic score on Conner's scales in girls and girls with genotypes linked to high blood Mn showed particularly strong positive associations between soil Mn and parent-reported Conners' scales. Our results indicate that sex and polymorphisms in Mn transporter genes contribute to differences in sensitivity to Mn exposure from the environment and that girls that are genetically less efficient at regulating Mn, may be a particularly vulnerable group. • Influence of sex and genetics on Mn exposure vs neurobehavior was evaluated. • Stronger associations between soil Mn and behavioral problems in girls than boys • SNPs in Mn transporter genes influenced sensitivity to Mn exposure in girls. • Girls with inefficient Mn regulation may be particularly sensitive to Mn exposure. [ABSTRACT FROM AUTHOR]

Welders are exposed to high levels of metal particles, consisting mainly of iron and manganese (Mn) oxide. Metal particles, especially those containing Mn can be neurotoxic. In this exploratory study, we evaluated associations between welding and expression of 87 putative neurology-related proteins in serum in a longitudinal approach. The study cohort from southern Sweden included welders working with mild steel ( n = 56) and controls ( n = 67), all male and non-smoking, which were sampled at two timepoints (T1, T2) 6-year apart. Observed associations in the longitudinal analysis (linear mixed models) were further evaluated (linear regression models) in another cross-sectional sample which included welders ( n = 102) and controls ( n = 89) who were sampled only once (T1 or T2). The median respirable dust levels for welders after adjusting for respiratory protection was at T1 0.6 (5-95 percentile: 0.2-4.2) and at T2 0.5 (0.1-1.8) mg/m 3 . The adjusted median respirable Mn concentration was at T2 0.049 mg/m 3 (0.003-0.314) with a Spearman correlation between adjusted respirable dust and respirable Mn of r S = 0.88. We identified five neurology-related proteins that were differentially expressed in welders vs. controls in the longitudinal sample, of which one (nicotinamide/nicotinic acid mononucleotide adenylyltransferase 1; NMNAT1) was also differentially expressed in the cross-sectional sample. NMNAT1, an axon-protective protein linked to Alzheimers disease, was upregulated in welders compared with controls but no associations were discerned with degree of exposure (welders only: years welding, respirable dust, cumulative exposure). However, we identified five additional proteins that were associated with years welding (GCSF, EFNA4, CTSS, CLM6, VWC2; welders only) both in the longitudinal and in the cross-sectional samples. We also observed several neurology-related proteins that were associated with age and BMI. Our study indicates that low-to-moderate exposure to welding fumes is associated with changes in circulating levels of neurology-related proteins., (Copyright © 2020 Gliga, Taj, Wahlberg, Lundh, Assarsson, Hedmer, Albin and Broberg.)

Objective: To estimate the frequency of needle stick injuries (NSI) among health care workers (nurses, student nurses and paramedical staff) in public hospitals of Karachi., Study Design: Cross sectional, observational., Place and Duration of Study: This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008., Methodology: Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was entered in Epi Data and analyzed in SPSS version 15., Results: A total of 417 health care workers participated in the study. Mean age of the participants was 24+/-11 years. Estimated proportion of participants with history of at least one time NSI was found in 66%. Around 13% (n=54) had one or more NSI in the previous one month at work and half of them were affected by non-sterile needle. None of them sought medical care. Almost 90% of them were not wearing gloves or taking any other protective measures at the time of injury., Conclusion: There can be serious consequences of needle stick injuries in public hospitals as large proportion of injuries involve non-sterile used needles and health care workers do not take appropriate measures of protection.

The objectives of this study were to determine the characteristics of medical students and graduates interested in choosing psychiatry as a career and the obstacles in choosing this field of medicine. Two private and two public medical institutes were surveyed from June 2007 to August 2007. A self-administered questionnaire was distributed to third, fourth and final year students and to medical graduates doing their internship in these four medical institutes. A total of 909 medical students and graduates participated in the study. Seventeen percent of participants responded positively regarding their interest in psychiatry as a career. Significantly higher proportion belonged to private medical institutes (14% vs. 24%, P-value =0.001). There was no significant difference in reporting interest for psychiatry in regard to age, sex, year in medical school and whether or not the participant had done a psychiatry ward rotation. However significantly higher proportion of participants (22%, n=43) were reporting their interest in the field of psychiatry who had done more than a month long psychiatry ward rotation as compared to those participants (14%, n=54) with less than a month or no psychiatry rotation (P-value=0.01). More students were reporting their interest in psychiatry with a family history of psychiatric illness as compared to without family history (24% vs 16%, P-value=0.03). In conclusion, students and graduates with more than a month long rotation in psychiatry, studying in private medical colleges and with a family history of psychiatric illness were more interested in choosing psychiatry as a career.

Objective: To determine frequency and pattern of non-fatal limb injuries in motorbike accidents victims., Study Design: Cross-sectional observational study., Place and Duration of Study: Study was conducted at Jinnah Postgraduate Medical Centre (JPMC), Karachi, from October 2006 to March 2007., Methodology: Trained data collectors prospectively collected data from the emergency department of JPMC, Karachi using structured pre-tested questionnaires. All motorbike accident victims presented to Emergency department with single or multiple bone injury in body extremities were included. Head injury patients who had first presented to neuro-surgery department were excluded. Motorbike accident victims with soft tissue injuries were also excluded from this study. Chisquare test was applied to find out statistical significance at 95% confidence level. P-value < 0.05 was considered as significant., Results: A total of 137 (39%) patients presented with tibial injury among the study sample of 348 patients, which was significantly higher than the bone injuries of the body part (p<0.001). Out of those, in 26% of patients, fibula was also involved along with tibia fracture. Other bone injuries included femur (16%), radius (9.2%), humerus (8.3%) and others. Radius was the commonest injured bone and in highest proportion among upper limb injuries (p<0.001). Overall, 66% of the injuries in motorbike involved lower limb fractures. The highest proportion of motorbike accidents were observed on Saturdays (31%). Majority of the accident victims were in the age group between 16 and 30 years (41% accident cases), 27% in age group 30 to 45 years, 15% in 45 to 60 years and 5% in >60 years. Those with less than 15 years accounted for 12% of cases., Conclusion: Tibial bone is at the greatest risk in motorbike accidents probably due to its superficiality and exposed position while riding motorbike. Protective measures need to be taken for the prevention of disability associated with lower limb involvement in motorbike accidents.