Transcatheter closure of patent ductus arteriosus using ado device: retrospective study of 149 patients.

BACKGROUND: Patent ductus arteriosus (PDA) is a common form of congenital heart disease and forms about 5-10% of congenital heart diseases. Surgical closure is safe and effective; however, certain patients may experience some morbidity. Recently, transcatheter closure of PDA using the Amplatzer duct occluder has been shown to be safe and efficacious. OBJECTIVES: To evaluate whether transcatheter closure with this device offers an alternative to surgical closure of PDA. PATIENTS AND METHODS: Between July 2006 to July 2008, 149 patients (98 females and 51 males) with PDA underwent cardiac catheterization in an attempt to close their PDA by transcatheter approach using Amplatzer duct occluder device. RESULTS: The patient's age ranged from 4 months to 45 years (median 5 years). Successful PDA closure was achieved in 136 patients (91.2%) with 100% complete closure rate within 24 hours after the procedure. Thirteen patients (8.7%) had unsuccessful attempts, 11 (7.3%) of them had failure of deployment of the device, while embolization of the device occurred in two of the patients (1.3%). CONCLUSIONS: Amplatzer duct occluder device is safe and effective for closure of different types and sizes of PDA with low rate of complication.

Availability of expanded programme of immunization services provided to children in a rural Pakistani village.

OBJECTIVES: To evaluate the immunization status of children under 5 years age, living in the Nurpur Shahan area and to identify various factors which influenced the rate of immunization. METHODS: A cross sectional study was conducted in which mothers of children under 5 years of age were questioned about the immunization of their children and the immunization services provided in the area. Systematic random sampling was used and the collected data was analyzed using SPSS v. 10.0. RESULTS: The overall immunization rate in the children of Nurpur Shahan was 77.4%. This study found strong correlations to immunization rates in children. Increased educational status of the mother, greater maternal immunization during pregnancy, and home delivery of vaccines, were all directly linked to higher rates of immunization amongst children. Lack of awareness, followed by inadequate facilities were the most commonly cited reasons for discontinuing the programme or abstaining from it altogether. CONCLUSION: The EPI coverage in Nurpur Shahan is quite well established, but still left room for improvement. Factors that encouraged higher immunization rates were more educated mothers, better awareness and availability of door-to-door services.