Transplant tourism outcome: a single center experience.

BACKGROUND: Transplant tourism is the term used for patients who travel abroad for transplantation. Transplant tourism has always been surrounded with controversy regarding how these organs were obtained, the donor's care after transplantation, and the recipient outcome. Many authors have found that the outcome of the recipients in transplant tourism is inferior to those transplanted in their own countries. However, most these studies were small, with the latest one including only 33 patients. Here, we describe the outcome of 93 patients who were transplanted abroad compared with local transplantation. MATERIAL AND METHODS: All transplant patients who were followed up at our Nephrology Clinic from 1998 until 2008 were identified using our data base system. We selected patients transplanted from 2003 and forward because the computerized system for laboratory and electronic records began operation that year. RESULTS: A total of 165 patients were identified (93 in the tourist group and 72 in the local one). Transplant tourists had a higher rate of acute rejection in the first year compared with local transplantation (27.9% vs. 9.9, P=0.005), higher mean creatinine at 6 months and 1 year (120 vs. 101 micromol/L, P=0.0007, 113 vs. 98 micromol/L, P=0.008). There was no statistical difference in graft or patient survival in 1 or 2 years after transplantation. However, transplant tourist had a higher rate of cytomegalovirus infection (15.1% vs. 5.6%, P=0.05) and hepatitis C seroconversion (7.5% vs. 0%, P=0.02). CONCLUSION: Transplant tourists had a more complex posttransplantation course with higher incidence of acute rejection and infectious complications.

Mother's health-seeking behaviour and childhood mortality in Pakistan.

"The paper examines the mother's health-seeking behaviour and childhood mortality in Pakistan. This is based on the 1990-91 Pakistan Demographic and Health Survey (PDHS).... It was found that neonatal, infant, and child mortality rate is the highest among children of mothers aged less than 20 years. Infant and child mortality rate is likewise higher among first and higher order births than among births of second or third order. It was further found that mortality declines as the length of the birth interval increases. The results reveal that the education of mother has significant effect on the neonatal, infant and child survival.... Health care factors such as antenatal care, place of delivery, assistance at delivery and immunisation also influenced neonatal, infant and child mortality."

Measuring the education gap in primary and secondary schooling in Pakistan.

PIP: The aim of this study was to examine the changes and differences by gender and urban/rural status in primary and secondary school enrollment, school utilization, and continuation ratios in Pakistan between 1975 and 1985. The government in its 5-year plans had targeted increases in school enrollment which were not met. Progress has been slow and nearly 50% of school-age children do not attend primary schools, e.g., the target for achieved level of enrollment in primary school in 1989-90 was 80.6% and the actual enrollment was 49.3%. In the interregional comparisons, it was assumed that the imprecise measures of school-age population in the denominator of school ratio were at least uniform, since adjustment was not possible. The trend was for lower girl's participation in schools in all regions, particularly rural areas and with the exception of urban Punjab girls. The highest male participation was in urban Sindh (76% in 1984-85); the highest female participation was 68% in 1984-85 in urban Punjab. In secondary schools, there was an increasing trend in enrollment for boys and girls only in urban schools. The largest gaps between girls and boys enrollment in secondary schools was in NWFP and Balochistan. Rural secondary school enrollment was very low at about 16% for boys and 2.5% for girls aged 10-14 years in 1984-85. Continuation rates in primary grades were mixed and changed by gender and province. The trend was for more boys than girls continuing in school. Almost 33% of rural boys completed the primary grades between 1980 and 1985. Greater variation between provinces was apparent in urban areas. The highest continuation for boys was in the Punjab and the highest for girls was in the Frontier Province in 1984-85. About 76% of boys and 58% of girls continued their secondary education in urban areas in 1984-85. Utilization rates of educational institutions indicated that primary schools in rural area were underused, and in urban areas overcrowded (50 or more students/class). The secondary school level utilization rates varied by gender and urban/rural residence. Urban areas were overcrowded with more than 70 students/class for boys and 50 or more for girls.^ieng

The demand for fertility control in Pakistan.

PIP: The analysis of fertility and contraceptive use data for Pakistan is directed toward estimating the likelihood of contraceptive use. Data are drawn from the 1975 Fertility Survey, the 1979-80 Population, Labor Force, and Migration Survey, the 1984-85 Contraceptive Prevalence Survey, and the 1990-91 Demographic and Health Survey. Increased demand for family planning is construed to be reflected in the excess number of children over the desired number of children according to the Easterlin and Crimmons and the Bulatao and Lee frameworks. A higher probability of contraceptive use is expected to be related to having a large family. Findings indicate that there was a lack of correspondence between the desire for no more children and actual use of contraception. The proportion desiring no more children was 40-50%. In the logistic model, the findings show that the likelihood of contraceptive use in all surveys was significantly increased with women's education, urban residence, and family planning accessibility. The number of living and desired children were independent of each other, and neither factor influenced significantly the demand for contraception. The nature of and magnitude of the effect varied for each survey. The generalized conclusion was that contraceptive use is not being used by women who desire no more children. Although contraceptive use has increased over time, the number of desired children has remained stable. The suggestion is to target women aged 35-44 years who appear to have achieved their desired fertility and to expand levels of education and economic and social opportunities for women.^ieng

The action of cycloheximide on the action potential and protein synthesis in medullated Xenopus axons.

Cycloheximide depresses maximum rate of change in membrane potential observed during the rising phase of the action potential in single medullated axons of Xenopus. To,e course of depression is independent of cycloheximide concentration over a range that almost completely inhibits leucine incorporation into axonal proteins.