RESUMEN
To assess the causes of low tetanus toxoid (TT) vaccination coverage in pregnant women a mixture of quantitative and qualitative methods were adopted at the community, primary health care delivery and management levels in Lahore district, Pakistan. Out of a random sample of 362 women who had delivered during the previous 3 months, 87% recalled receiving 2 doses of TT. The main reasons for non-vaccination were poor knowledge about the importance of TT (32% of women) or the place and time to get vaccinated (18%). According to the managers and primary health care medical officers, the main reasons for low coverage were lack of awareness about the importance of vaccination among the public and misconceptions about TT vaccination (e.g. that it was a contraceptive).
Asunto(s)
Actitud del Personal de Salud , Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud/psicología , Mujeres Embarazadas/psicología , Toxoide Tetánico , Vacunación/psicología , Adolescente , Adulto , Concienciación , Causalidad , Estudios Transversales , Escolaridad , Femenino , Grupos Focales , Encuestas de Atención de la Salud , Humanos , Persona de Mediana Edad , Pakistán , Aceptación de la Atención de Salud/estadística & datos numéricos , Embarazo , Atención Prenatal/estadística & datos numéricos , Investigación Cualitativa , Características de la Residencia , Factores Socioeconómicos , Encuestas y Cuestionarios , Vacunación/estadística & datos numéricosRESUMEN
Osteonecrosis of the knee comprises two separate disorders, primary spontaneous osteonecrosis which is often a self-limiting condition and secondary osteonecrosis which is associated with risk factors and a poor prognosis. In a series of 61 knees (38 patients) we analysed secondary osteonecrosis of the knee treated by a new technique using multiple small percutaneous 3 mm drillings. Total knee replacement was avoided in 59 knees (97%) at a mean follow-up of 3 years (2 to 4). Of the 61 knees, 56 (92%) had a successful clinical outcome, defined as a Knee Society score greater than 80 points. The procedure was successful in all 24 knees with small lesions compared with 32 of 37 knees (86%) with large lesions. All the procedures were performed as day cases and there were no complications. This technique appears to have a low morbidity, relieves symptoms and delays more invasive surgery.
Asunto(s)
Articulación de la Rodilla/cirugía , Osteonecrosis/cirugía , Adulto , Femenino , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Procedimientos Ortopédicos/efectos adversos , Procedimientos Ortopédicos/métodos , Osteonecrosis/diagnóstico por imagen , Osteonecrosis/fisiopatología , Fotofluorografía/métodos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
To assess the causes of low tetanus toxoid [TT] vaccination coverage in pregnant women a mixture of quantitative and qualitative methods were adopted at the community, primary health care delivery and management levels in Lahore district, Pakistan. Out of a random sample of 362 women who had delivered during the previous 3 months, 87% recalled receiving 2 doses of TT. The main reasons for non-vaccination were poor knowledge about the importance of TT [32% of women] or the place and time to get vaccinated [18%]. According to the managers and primary health care medical officers, the main reasons for low coverage were lack of awareness about the importance of vaccination among the public and misconceptions about TT vaccination [e.g. that it was a contraceptive]