Background and Objectives: In 2004 Pakistan escalated from ‘low-prevalence’ to ‘concentrated’ phase of HIV epidemic. Despite global decline in HIV incidence since 1997, rate of HIV infections in Pakistan is persistently rising since 1990. Available literature focusses on key populations or localized outbreaks limited by short study duration and regional applicability of results. We studied HIV seroconversion trends over a period of 8 years in a geographically diverse population and evaluated associated risk factors.
Methods: A desk review of HIV surveillance data from 2010 to 2017 was carried out at Armed Forces Institute of Pathology. A case was defined as any adult employed in organization ‘X’, initially screened for HIV but later seroconverted on ELISA and western blot. Case-control study was conducted on cases diagnosed in 2017. Age and sex matched controls were identified from same population sub-group. Structured telephonic interviews were conducted and statistical analysis done at 5% margin of error.
Results: The annual HIV diagnosis rate remained relatively stable till 2015 (< 40 /100,000/yr) after which it rose sharply to 60/100,000/yr in 2016. Upward trend continued in 2017 to reach 125/100,000/yr (>200% increase from baseline). Acquisition of HIV was significantly associated with commercial sex activities (OR=9; 95%CI: 1.25-395).
Conclusion: HIV seroconversion rates among employees of organization X have increased significantly in the past two years. Unlike HIV outbreaks previously reported from Pakistan, sexual route seems to be the predominant mode of transmission. Focus is mandated on prevention of sexual transmission of HIV at national level as well for all vulnerable populations.
doi: https://doi.org/10.12669/pjms.36.6.1735
How to cite this:Mansoor E, Azam N, Niazi SK, Sheikh N, Baig MA, Azim MT, et al. Rising HIV seroconversion rates & associated risks among employees of organization ‘X’: A case control study, Pakistan, 2017. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.1735
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To evaluate the comparative role of ultrasonography and contrast-enhanced computed tomographyin diagnosis of carcinoma gallbladder. Early experience at a hepatobiliary unit in a tertiary care hospitalStudy Design: Cross sectional study.Place and Duration of Study: The study was carried out at the Hepatobiliary Unit of the Pak Emirates MilitaryHospital, Rawalpindi from July 2021 to June 2022.Materials and Methods: USG and CECT scans were used to assess the diagnostic accuracy of CarcinomaGallbladder. 30 patients, with an average age of 54 years, were part of this study. Patients were included in thestudy based on radiological findings pertinent to gallbladder cancer which include gallbladder fossa massreplacing gallbladder, focal/intraluminal/polypoidal gallbladder growth and asymmetrical/diffuse thickness ofgallbladder. All resected specimens were sent for histological investigation after the operation, histopathologyserving as the Gold standard.Results: On USG and CECT examination, 13.3% of the gallbladders were contracted and reduced in size, while70% were large and distended. CECT has a sensitivity and specificity of 96% and 80%, respectively, in identifyingGB carcinoma. USG scan had a sensitivity and specificity of 92% and 60%. There was a test of agreement isexcellent (Kappa value 0.819) between the two techniques, indicating that the two diagnostic modalities arenearly equivalent in terms of diagnosing carcinoma Gallbladder.Conclusion: The study findings indicate that both USG and CECT scans are ideal, non-invasive, safe imagingmodalities for diagnosing gallbladder carcinoma. CECT scan has an additional advantage in defining theextension of the disease and involvement of surrounding structures including lymph nodes and hepatoduodenal ligament.
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