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Home > Transfusion Transmitted Viral Infections in High Risk Groups of Khyber Pakhtunkhwa, Pakistan

Transfusion Transmitted Viral Infections in High Risk Groups of Khyber Pakhtunkhwa, Pakistan

Thesis Info

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Author

Sobia Attaullah

Program

PhD

Institute

Islamia Collage Peshawar

City

Peshawar

Province

KPK

Country

Pakistan

Thesis Completing Year

2012

Thesis Completion Status

Completed

Subject

Natural Sciences

Language

English

Link

http://prr.hec.gov.pk/jspui/bitstream/123456789/8192/1/sobia%20phd%20thesis.pdf

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676727628569

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Introduction Blood transfusion is a specialized modality of patient management to sustain health and life, but carries a definite risk of acquisition of transfusion transmitted virus (TTV) infections particularly in resource limited settings. TTV infections are of great concern because of their asymptomatic nature, protracted viremia, highly variable course and of fatal, chronic and life threating disorders. The prevalence of TTVs among the blood recipients reflects the disease burden among the blood donors and general population. Material and method The study population was categorized in two groups on the basis of the history of blood transfusion: individuals with no history of blood transfusion were categorized as control group and individuals with history of blood transfusion were categorized as high risk group. High risk group was further divided into four sub groups; thalassemia, hemophilia, hemodialysis, and surgical patients. Sera of all individuals were investigated for the presence of HBsAg, anti-HCV and anti-HIV by using immune-chromatigraphic tests, followed by molecular analysis by PCR for the detection of viral DNA and RNA and genotypes. Result The study population consists of 4,607 individuals, 2,032 individuals comprised control group and 2,575 individuals comprised high risk group. Overall, 21.12% (973) individuals showed the evidence of TTV, among them 3.6% (166) was positive for HBsAg, 17.39% (801) was positive for anti-HCV and 0.13% (6) was positive to HBV&HCV while no individual was positive to HIV. 75 individuals were positive to HBV DNA, 18 individuals (27.69%) were classified into genotype B, 11 (16.92%) genotype C, 35 (53.84%) genotype D and 1 (1.54%) genotype F, 10 xi (15.38%) untypeable. 366 individuals were positive to HCV RNA, HCV genotypes 1 was detected in 71 (20.9%) individuals, genotype 2 in 17 (5.01%), genotype 3 in 182 (53.69%), genotype 4 in 16 (4.72%), genotype 5 and genotype 6 in 16 (4.72%), mixed genotype in 25 (7.37%) and untypeable in 32 (0.69%). In control group, 77 (3.7%) individuals was confirmed positive for TTV. Total 0.59% (12) individuals were positive for HBsAg, of which 58.33% (7) were male and 41.7% (5) were female, while HBV DNA was positive in 91.66% (11) individuals. Anti-HCV was positive in 3.2% (65) individuals, of which 58.46% (38) were male and 41.54% (27) were female, while HCV RNA was positive in 69.23% (45) individuals. In high risk group, 973 (4.8%) individuals was confirmed positive for TTV. 3.6% (166) individuals were positive for HBsAg, 64.93% males and 35.06% females, while HBV DNA was positive in 1.6% (75) individuals. Anti-HCV was positive in 17.39% (801) individuals, 18.83% were males and 12.73% were female, HCV RNA was positive in 7.94% (366) individuals. Dual infection was detected in 0.13% (6) individuals. HBsAg were detected in 11.86% (58) thalassemia patients, 11.54% (42) hemophilia patients, 2.75% (22) in patients undergoing hemodialysis and 3.47% (32) of patients with surgery. Anti-HCV were detected in 29.24% (143) thalassemia patients, 43.96% (160) hemophilia patients, 41.93% (335) of patients undergoing hemodialysis and 10.62% (98) of patients with surgery. Co-infection with HBV and HCV was encountered in 0.63% (5) of patients undergoing hemodialysis and 0.11% (1) of patients with surgery. Statistical significance was observed for TTVs between thalassemia patients and hemophilia patients (χ2=24.31, p<0.00001), thalassemia patients and xii surgical patients (χ2= 69.174, p<0.00001), surgical patients and HD, (χ2= 127.594, p<0.00001), surgical patients and hemophilia patients (χ2= 96.835, p<0.0001) and HD and hemophilia patients (χ2= 6.158, p=0.013082). However, the difference between thalassemia patients and HD (χ2= 2.173, p=0.14045) was not statistically significant. Conclusion The present study critically evaluated prevalence of three major transfusion-associated infections, namely infections by HIV, HCV, and HBV. The present investigation showed i. A substantial percentage of the individuals harbored TTV infections (21.21%). ii. The prevalence of TTV was high (34.8%) in high risk group in comparison to the control group (3.7%) and thus ranked at high risk for TTVs infection. TTV Infection prevalence was 9.41 folds higher in high risk group than in control group. It showed that TTVs continue to endanger safe blood supply in a country. iii. The frequency of HCV was high (17.39%) in both high risk group and control group in comparison to HBV positivity (3.6%), the situation is alarmingly and is a matter of concern and effort. iv. The prevalence of untypeable genotypes of HBV and HCV was alarming v. TTV positivity rate increase with increase in the age in high risk group as their transfusion requirements increased with age, thus they were more prone to these infections. vi. The prevalence of mixed genotypes of HCV was matter of concern. vii. This burden of TTV showed that prevention of spread of TTV should be the main goal at the current time. xiii viii. The over flaws in blood transfusion services can be overcome by development of a fair and organized system for safe blood screening, monitoring the implementation strategies for recruitment and retention of safe donors. Recommendation The occurrence of TTV infections should still be monitored carefully to reduce the rate of infections to ensure safer and more reliable blood for transfusion. Education regarding awareness about TTVs, screening strategies, sensitization and vaccination must be carried out to ensure that people are well enlightened and protected from viral diseases. All individuals particularly patients receiving blood transfusion should complete vaccination for Hepatitis B before starting transfusion. Strict and concrete efforts are required to cut down the infection rate through proper screening of blood and blood products, strict emphasis on receiving the vaccine, uniform strict criteria for donor selection.
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اداسی کی برکھا میں بھیگی شاعری

اداسی کی برکھامیں بھیگی شاعری
میر اور ناصر کی شعری کائنات سے محمد ندیم صادق نے اپنے لگائو کا ثبوت ’’جگر خوں کروں ہوں میں‘‘کی صورت میں فراہم کیا ہے۔اس مجموعے میں شامل غزلیں اور نظمیںایک ہی کتھا سنا رہی ہیں۔خوف، اداسی، تنہائی اور نارسائی میں گندھی بیدار راتوں کی کتھا۔
دل میں کیسا خوف بھرا ہے
پھول کھلے تو ڈر لگتا ہے
رات گئے تک ان گلیوں میں
کوئی آوارہ پھرتا ہے
کلی جو کھل کر پھول بنی تھی
پھول کسی نے توڑ لیا ہے
مندرجہ بالا اشعار جس کیفیت کی عکاسی کر رہے ہیں اسے قنوطیت سے تعبیر کیا جا سکتا ہے مگر کسی روشن تخلیقی لمحے میںشاعر نے اس فضا سے باہر نکلنے کا راستا، خوش کن یادوںاور فطرت کے حسن سے وابستگی کی صورت میںتلاش کیا ہے۔
یادوں کی بارش میں صادق
کب سے بیٹھا بھیگ رہا ہے
ساغر میں اک پھول کھلا ہے
سارا جنگل مہک اُٹھا ہے
سادگی اور لہجے کی دھیمی آنچ نے جذبے کے خالص پن کولفظوں کے بنائو سنگھار میں گم نہیں ہونے دیا۔حسّیاتی رنگ و آہنگ میں ڈھلی امیجری اور معروضی تلازمات بھی داخلی کیفیات کے ہی عکاس ہیں۔
شہر کی سڑکیں تو ٹھنڈی ہیں
لیکن میرا دل جلتا ہے
پیار محبت کرنے والا
کورا کاغذ پڑھ سکتا ہے
تیرے شہر میں آ کر مجھ کو
اپنا آپ ہی بھول گیا ہے
میر نے (۳۰ رکنی ہندی بحر)میں درجنوں لاجواب غزلیں کہی ہیں اور ناصر نے (۱۶ رکنی ہندی بحر) کا مسحور کن تجربہ کیا ہے۔اس بحرِ ہزار موج کے اتار چڑھائومیں دلی کیفیات کازیروبم خوب محسوس کیا جا سکتا ہے۔ بید ِ مجنوں کی سی لچکیلی یہ مترنم بحرتربیت یافتہ قاری پر اپنا جادو خوب جگاتی ہے۔ندیم صادق نے ناصر کی تقلید میں اس بحر کو اختیار کیا ہے۔
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ہماری دینی ترجیحات، ایک لمحہ فکریہ

If the determining of religious priorities is correct then religion also remains in its original state and the effects of religion also appear clear and conspicuous and if the priorities go wrong, then humanity goes far beyond the actual religion. And the attitudes of the religious oriented people also become a source of doubts regarding religion. And the low regard of religious personality also leads to the disgrace of the religion. Before we take a deep look at our religious priorities, it is important to understand that what is the importance of priorities in life and what is meant by religious priorities.

Health Status of Elderly Women in Socio- Economic and Cultural Context in Punjab Pakistan

Aging’ previously regarded as an emerging problem of the industrialized countries is now recognized as a global phenomenon. Currently, more than half of the world’s women aged 60 years and over are living in developing regions, i.e. 198 million compared with 135 million in the developed regions. Aging being an important global phenomena has attracted the attention of sociologists who are looking into the socio- economic and cultural antecedents of the process of ageing. The present study was planned to be conducted in Punjab province of Pakistan. Multistage Random Sampling Technique was used. According to this technique, sampling is done in two or more stages. At the first stage, from 36 districts of the ‘Punjab’ province, two districts were selected randomly. These were ‘Faisalabad’ and Rawalpindi’. At the second stage, out of eight towns, (of each district) two towns were randomly selected from each of the two districts, constituting a sampling of four towns. At the third Stage, two union councils (one rural and one urban) were randomly selected from each of the four above mentioned towns to constitute a sample of eight union councils. The desired sample of 500 respondents was to be divided on two districts of the ‘Punjab’ province. Both quantitative and qualitative methods (focus group) were used to collect data. Information on selected demographic and socio-cultural variables i.e. age, education, income, housing/living arrangements, nutritional status, social support and social network of the elderly women was collected through well organized interview schedule. Influence of these independent variables was observed on the ‘health status’ of elderly women (social, mental/ psychological and physical health status).Both independent and dependent variables were measured by operational zing and constructing the indexation. Analysis of data was made on the basis of uni-variate, bi-variate and multivariate analysis. Findings of uni-variate analysis: Mean age of the women was 69.4, around 35.0 percent were ‘widows’, 94.8 percent were living with their married/unmarried children. Only 13.4 percent of the elderly women and 26.6 percent of their husbands were literate. Only 3.4 percent of respondents were involved in some type of economic activity. The mean no. of children was around 5 children. Findings of bi-variate analysis: Statistical test indicated that the age of the elderly women was inversely related with the health status. However education, income, housing / living arrangements, nutritional status, social support and social network of the elderly women was positively associated with their health status. Findings of multivariate analysis: Results of ordinal regression analysis also showed that family income, housing/living arrangements, nutritional status, social support and social network had highly significant influence on the health status of the elderly women. Study suggests that the policy makers as well as health providers need to focus on the health and well-being of the older population, particularly in the context of poverty, low levels of education, nutrition and poor health system.