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Blindness and visual impairment are major causes of noncomrnunicable diseases in Pakistan. Two national population-based blindness surveys conducted in 1988 and 2002-04 demonstrated a reduction in prevalence of blindness from 1.78% to 0.9% with a significant drop in cataract blindness as a result of accelerated nationwide interventions and eye care integration in primary health care. In addition, between 2006 and 2008, 88 facilities were upgraded as a result of the national eye health programme. These measures resulted in a 279% increase in eye outpatient attendances and a 375% increase in eye surgeries performed. Investment in human resources development and policy change contributed significantly to the sustainability of the programme. Key challenges facing the programme include aligning national eye health strategies with health system strengthening informed through health systems research. This paper attempts to document this extraordinary success.

Congenital cystic adenomatoid malformation (CCAM) is a rare developmental, non-hereditary, hamartomatous abnormality of the lung with adenomatoid proliferation of cysts resembling bronchioles. It is usually unilateral with involvement of a single lobe. We report an unusual case of a 33-year-old man who presented with this disease with the involvement of an entire lung. We discuss the patient's pathogenesis, histological findings, clinical presentation, imaging characteristics and treatment, and review the associated literature.

Human foetal and infant tissues were studied to test the hypothesis that microbes have a role in switching on interferon-alpha (IFN-alpha) synthesis. Foetal tissues were essentially 'germ free', while the infants had been exposed to a normal microbial environment in life. IFN-alpha was first seen at 9 weeks gestation in macrophages in the liver and thereafter was seen in macrophages in most other organs. When infant lungs were compared with foetal lungs, a statistically significant increase in the number of macrophages and the percentage of these cells expressing IFN-alpha was noted in the infant lungs. No such change was observed in spleen, liver and thymus following birth. These findings suggest that there is a basal production of IFN-alpha by macrophages that is not dependent on microbial products, but that such products can enhance synthesis of this cytokine.

Deux cas d'adenome sebace attache au conduit auditif externe et remplissant la conque de l'oreille sont presentes en raison de leur rarete, leur taille exceptionnellement grande et la presence d'une surface huileuse particuliere qui constitue une indication importante pour le diagnostic