Factors associated with incomplete child immunization in Pakistan: findings from Demographic and Health Survey 2017-18.

OBJECTIVE: The objective of this analysis was to explore the determinants of incomplete immunization in children aged 12-23 months. STUDY DESIGN: A secondary analysis was conducted on cross-sectional survey data from Pakistan Demographic and Health survey 2017-2018. METHODS: The present study was confined to children aged 12-23 months at the time of survey giving a sample size of 2048. Complete immunization was described as having received a dose of BCG (Bacille Calmette Guerin), four doses of oral polio vaccine (OPV0, OPV1, OPV2, and OPV3), three doses of pentavalent and pneumococcal vaccine, and one dose of measles vaccine. Multivariable logistic regression was used to explore the association between outcome and predictor variables. RESULTS: The findings showed that the likelihood of being incompletely immunized was higher for the children of Baluchistan (adjusted odds ratio [aOR] = 6.38; 95% confidence interval [CI] = 4.18-9.71), Federally Administered Tribal Areas (aOR = 6.2; 95% CI = 3.97-9.71), Sindh (aOR = 3.24; 95% CI = 2.33-4.49), Khyber Pakhtunkhwa (aOR = 2.13; 95% CI = 1.54-2.97), Islamabad (aOR = 3.656; 95% CI = 2.34-5.69), and Gilgit Baltistan (aOR = 2.320; 95% CI = 1.50-3.57) relative to those of Punjabi children. Lower odds of partial vaccination were seen among the children of educated mothers (primary or higher) and those who were born at a health facility. CONCLUSION: Improving maternal literacy rate, providing easy access to health facilities, and minimizing regional disparities can improve the immunization status of children in Pakistan.

'We need to share our stories': the lives of Pakistanis with intellectual disability and their guardians.

INTRODUCTION: The experiences of Pakistanis with intellectual disabilities (IDs) and their family members have been underexplored empirically. METHOD: The present study sought to address this gap by understanding the lives of five Special Olympics Pakistan athletes and their guardians through PhotoVoice. FINDINGS: Through thematic analysis, we present the primary theme concerning Pakistan's cultural context that provides an empirical exploration of cultural beliefs about intellectual disability, cultural expectations and support received by people with intellectual disabilities and their guardians. DISCUSSION: We discuss implications for research and practice.

Self-Reported bruxism and associated factors in Israeli adolescents.

Little is known about the epidemiological characteristics of sleep and awake bruxism (SB and AB) in adolescents. The aims of the study were: to assess the prevalence rates of self-reported SB and AB in Israeli adolescents; to determine the associations between SB/AB and several demographical, exogenous and psychosocial factors in Israeli adolescents; and to investigate the possible concordance between SB and AB. The study made use of a questionnaire. The study population included 1000 students from different high schools in the centre of Israel. Prevalence of self-reported SB and AB in the Israeli adolescents studied was 9·2% and 19·2%, respectively. No gender difference was found regarding the prevalence of SB and AB. Multiple variable regression analysis revealed that the following predicting variables were related to SB: temporomandibular joint sounds (P = 0·002) and feeling stressed (P = 0·001). The following predicting variables were related to AB: age (P = 0·018), temporomandibular joint sounds (P = 0·002), oro-facial pain (P = 0·006), and feeling stressed (P = 0·002) or sad (P = 0·006). A significant association was found between SB and AB; that is, an individual reporting SB had a higher probability of reporting AB compared with an individual who did not report SB (odds ratio = 5·099). Chewing gum was the most common parafunction reported by adolescents. The results of this study demonstrate that self-reports of AB and SB are common in the Israeli adolescents population studied and are not related to gender. The significant correlation found between SB and AB may be a confounding bias that affects proper diagnosis of bruxism through self-reported questionnaires only.

Purinoceptor desensitization impairs but does not abolish the non-cholinergic motor transmission in rat isolated urinary bladder.

In order to determine the effectiveness of purinoceptor desensitization in blocking the non-cholinergic motor transmission in rat detrusor, isolated preparations of urinary bladder, pretreated with atropine 3 microM + indomethacin 10 microM were contracted by alpha, beta-methylene-ATP, a stable analogue of ATP and by electrical stimulation at frequencies of 1, 2, 4, 8 and 16 Hz. The mean maximum tension generated by alpha, beta-methylene-ATP was 43% of that by electrical field stimulation. Desensitization to the contractile action of alpha, beta-methylene-ATP was achieved by administration of alpha, beta-methylene-ATP 10 microM, three times at 10 min intervals. Responses to electrical field stimulation were reduced following induction of alpha, beta-methylene-ATP desensitization but a sizeable proportion of the response persisted (51% at 1 Hz; 29% at 8 Hz). Tetrodotoxin 0.5 microM abolished the responses to electrical field stimulation, persisting after alpha, beta-methylene-ATP desensitization. It is concluded that ATP is unlikely to be the sole non-cholinergic motor transmitter in the rat detrusor.