Sexual risk-taking among homeless young people in Pakistan.

Homeless young people who engage in sex work are at increased risk of HIV and other sexually transmitted infections like chlamydia, gonorrhoea, syphilis and herpes. Semi-structured interviews were conducted with 29 homeless young people between the ages of 16 and 25 years from Rawalpindi, Pakistan, to explore how sexual practices were mediated through social and contextual conditions. Participants engaged in sex for a range of reported reasons, most commonly to generate income, but also to build intimacy and to establish intimate partnerships which could bring physical protection and social and emotional support. Although participants were aware of the sexual health risks attached to condomless sex, they engaged in it due to the social obligations of intimate partnerships, financial considerations and to better manage potentially violent situations. Instead of condoms, participants used alternate methods like withdrawal, oral sex, post-sex douching and specific sexual positions. These were not always useful, and some methods might have inadvertently increased their risk of HIV. The study findings suggest that an integrated health promotion approach that goes beyond the health sector and a singular emphasis on risk awareness may help reduce young people's risk of homelessness and sexual health risks.

Estimation of ionized calcium, total calcium and albumin corrected calcium for the diagnosis of hypercalcaemia of malignancy.

OBJECTIVE: To measure levels of ionized calcium, total calcium and albumin corrected calcium in patients with different malignant disorders for the diagnosis of hypercalcaemia of malignancy. DESIGN: A case control comparative study. PLACE AND DURATION OF STUDY: The study was carried out in the Department of Pathology, Army Medical College Rawalpindi, Armed Forces Institute of Pathology and Department of Oncology CMH, Rawalpindi from March 2003 to December 2003. SUBJECTS AND METHODS: Ninetyseven patients of various malignant disorders, admitted in the Department of Oncology, CMH, Rawalpindi, and 39 age and gender-matched disease-free persons (as control) were included in the study. Blood ionized calcium (Ca++), pH, sodium (Na+) and potassium (K+) were analysed by Ion selective electrode (ISE) on Easylyte auto analyser. Other related parameters were measured by colourimetric methods. RESULTS: Blood Ca(++) levels in patients suffering from malignant disorders were found significantly high (mean +/- SD: 1.30+017 mmol/L) as compared to control subjects (mean +/- SD 1.23+0.03 mmol/L) (p<0.001). The number of patients with hypercalcaemia of malignancy detected by Ca(++) estimation was significantly higher (38%) as compared to total calcium (8.4%) and albumin corrected calcium ACC (10.6%) (p<0.001). There was no statistically significant difference in other parameters e.g. phosphate, urea, creatinine, pH, Na+ and K+ levels in study subjects and controls. CONCLUSION: Detection of hypercalcaemia can be markedly improved if ionized calcium estimation is used in patients with malignant disorders.