Introduction: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a condition resulting from abnormal development before birth of the tube that carries food from the mouth to the stomach (the esophagus). Over the passage of time, there is a modification in treatment modialities that has enhanced the overall outcome of disease. It is also recognized that prompt diagnosis with appropriate clinical management and expeditious referral to a tertiary care center had a dramatic impact on the improved survival of these infants. Hence, this study aimed to determine the outcomes of surgical treatment of “Esophageal Atresia” with or without “TrachioEsophageal Fistula” among newborn at French Medical Institute for children, Kabul, Afghanistan. Methodology: An analytical retesrospective hospital based research study was conducted to accomplish study objectives. Records of 165 newborns who were admitted with EA/TEF and had undergone survey at French Medical Institute for Children (FMIC), Kabul, Afghanistan were reviewed. Data was collected through a self-developed structured questionnaire. Data was analyzed with the help of Statisitical Package for Social Sciences version 19.0. Chi-square test of independence was run and P-value was computed to determine an association between factors and outcome of EA/TEF among newbrons. Results: A total of 165 newborns who were admitted with the diagnosis of Esophageal Atresia with or without Trachoe-Esophageal Fistula and undergone surgery were recruited in this study. Most of the study participants (61.21%) were males. Majority of the cases (69.09%) had birth weight of 2 to 3 kg and had type “C” classification of EA+TEF. In terms of their ages at the time of surgery, most of them were aged less than 1 week during the surgical procedure. Around 31% of the cases had an associated anomaly VACTERL. Around 69% of the cases had survived post surgery. Most of the cases had developed complication like: stenosis, fistula and recurrence. With regard to length of stay during treatment, around 83% of newborns stayed for more than 10 days. This study has manisfested that weight, presence of anomaly VACTERL, and complications after surgery were significantly associated with outcome of Surgical procedure among newborns with the diagnosis of EA+TEF admitted to FMIC hospital.Conclusion: The condition of EA+TEF is quite prevalent among newborns in Afghanistan. Weight of newborn, presence of anomaly VACETRL , and complication were found as a significant determinants of outcomes of surgery for newborns with EA+TEF. It is important to design interventions which could help in improving the outcomes of surgery
"The Cosmic Palette: Exploring Colors in Art and Culture" delves into the profound role of colors in shaping the world of art and culture. This article takes readers on a vibrant journey through history, examining the significance of colors in different societies, their psychological impact, and the ways in which artists have harnessed them to convey emotions, ideas, and cultural narratives. From the symbolism of red to the serenity of blue, this exploration sheds light on the universal language of color that transcends boundaries and connects humanity in a kaleidoscope of experiences.
Relations between the United States and Pakistan have a long history spread over nearly six decades. Though these relations have seen various phases of engagements and estrangements, this study takes into account the changing facets of the US- Pakistan relations in the wake of the collapse of Soviet Union in early 1990s till 9/11(2001). The era under focus saw the acute type of estrangement between the two states. In the changed geostrategic scenario, the US strategic priorities had changed. Pakistan lost her strategic worth for the US policymakers. The issue of Pakistan’s controversial nuclear program resurfaced that further pushed these states apart from each other. Pressler Amendment (1985) was invoked by the US and sanctions were applied against Pakistan. Based on such a policy, all the US economic and military assistance to Pakistan was completely choked. The US policy of nuclear non- proliferation was vigorously brought into play. However, these coercive measures proved counterproductive and Pakistan became an overt nuclear state in May 1998. Nuclear proliferation was another manifestation of the failure of this US policy. In late 1990s, terrorism caught US attention and it became a focal point of her foreign policy. To eliminate this menace, Pakistan was urged to help American agencies. But this further heightened tension between them. Thus, US-Pakistan relations were greatly marred throughout the 1990s. This dissertation analyzes the causes and effects of the event-related ties between Pakistan and the United States and founds the divergence of interests as the main cause of trust deficit in their relationship. The US agenda was global while Pakistan sought after her narrow local objectives. But both wished national security for their nations. It explores how the US policy of sanctions towards Pakistan failed and gave rise to nuclear proliferation. It evaluates the economic, social, political costs of the US benign neglect towards Pakistan. Due to the US strategic myopia, Pakistan’s strategic worth was overlooked that gave terrorism a chance to flourish in the region. This study specially highlights the main areas of conflict and cooperation between Pakistan and the United States and enumerates the ways and means to mitigate the misperceptions between them. Some policy recommendations are also put forward to convert the US-Pakistan relations into strategic partnership characterized with equality and mutual co-existence.