ABSTRACT
Pakistan suffered from a massive earthquake in October 2005 that caused the deaths of more than 87 000 people. As a result of this calamity, around 3.5 million affected people had no access to information. In these scenarios, community media became an important catalyst. In developing countries, radio had proved far more accessible and useful than any other medium. But because of this natural hazard, local media also suffered heavily as dozens of journalists died and media houses and press clubs were destroyed. The current study attempted to explore the role of frequency modulation (FM) radio stations working in the earthquake hit areas in Pakistan. These stations were temporarily setup to inform the victims about the rehabilitation and reconstruction plans of the agencies involved. The data has been collected qualitatively through five focus group discussions which were conducted in the earthquake affected areas. Twelve in-depth interviews were also conducted for this purpose with FM stations personnel. The results revealed that the FM radio stations played a very important role in the rehabilitation phase by providing vital information to the victims, relief agencies and government. Lifesaving information like weather updates, precautionary measures in the tents, public service announcements and encouraging messages provided some hope to the victims to restart a normal life, and also motivated the students to restart their studies in makeshift schools.These FM networks became the voice of the affected people and helped a lot in bridging the communication gaps between the affected, relief agencies and government, and also ensured citizens' participation in decision-making processes.
Subject(s)
Hypertension/complications , Syncope/diagnosis , Syncope/etiology , Ventricular Outflow Obstruction/diagnosis , Ventricular Outflow Obstruction/etiology , Diagnosis, Differential , Female , Fluid Therapy , Humans , Hypertension/therapy , Middle Aged , Recurrence , Syncope/therapy , Ventricular Outflow Obstruction/therapyABSTRACT
BACKGROUND: The methotrexate (MTX) polyglutamate assay has been validated in adults with arthritis. OBJECTIVE: We sought to assess clinical response rates and the value of the methotrexate polyglutamate assay in MTX-treated children with inflammatory skin diseases. METHODS: In this retrospective review, 46 MTX-treated children with a diagnosis of atopic dermatitis, psoriasis, or psoriasis-eczema overlap were serially assessed with the methotrexate polyglutamate assay. RESULTS: In all, 38 children (83%) achieved good to excellent response: 27 (59%) within 12 weeks and 11 (24%) after dose-adjustment. Good to excellent responses were highest for psoriasis/overlap: 15 of 16 (94%), compared with 23 of 30 (77%) with atopic dermatitis. Mean maximum polyglutamate levels were 31.5 nmol/L for responders versus 18.1 nmol/L for nonresponders (P = .035). This difference was also significant for the subset with atopic dermatitis, but not for those with psoriasis/overlap. After dose modification, late responders ultimately achieved a significantly higher mean maximum methotrexate polyglutamate assay (41.9 nmol/L) compared with nonresponders (P = .002). LIMITATIONS: Retrospective design and small sample size were limitations. CONCLUSIONS: MTX is an effective treatment for the majority of children with inflammatory skin diseases, but a subset requires dose modification to achieve good to excellent response. Methotrexate polyglutamate assay levels reflect response to treatment, but are most useful to support dose modification among children who fail to respond within 12 weeks.
Subject(s)
Dermatitis, Atopic/drug therapy , Eczema/drug therapy , Methotrexate/analogs & derivatives , Polyglutamic Acid/analogs & derivatives , Psoriasis/drug therapy , Administration, Oral , Adolescent , Age Factors , Child , Child, Preschool , Cohort Studies , Dermatitis , Dermatitis, Atopic/diagnosis , Dose-Response Relationship, Drug , Drug Administration Schedule , Eczema/diagnosis , Female , Follow-Up Studies , Humans , Male , Methotrexate/blood , Methotrexate/therapeutic use , Polyglutamic Acid/blood , Polyglutamic Acid/therapeutic use , Psoriasis/diagnosis , Retrospective Studies , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
OBJECTIVES/HYPOTHESIS: To evaluate the prevalence of nocturnal enuresis in children diagnosed with sleep disordered breathing (SDB) and the effect of adenotonsillectomy (T&A) on nocturnal enuresis. STUDY DESIGN: Systematic review of the literature. METHODS: Systematic review of the literature was performed using PubMed and Ovid. A systematic analysis of the literature was performed from 1980 to 2010 to identify children who had SDB and enuresis. A subset of children with enuresis who underwent T&A for SDB were also studied. RESULTS: A total of 14 studies were reviewed. A total of 3,550 children had SDB, of which one-third (n = 1,113) had a diagnosis of enuresis. Age range was 18 months to 19 years. Seven studies (n =1,360) had data on patients who underwent T&A for SDB with follow-up data on enuresis. The mean sample size was 194, with a median follow-up of 6 months and age range of 2 to 18 years. Preoperative prevalence of enuresis was 31% (426/1,360). A total of 587 children were followed after T&A. The postoperative prevalence of enuresis was 16% (95/587; P < .0002, two-tailed). Most studies did not make a distinction between primary and secondary enuresis. The age range of the subjects (18 months to 19 years) likely included some patients with developmentally acceptable enuresis. CONCLUSIONS: SDB in children is associated with nocturnal enuresis. T&A is associated with a significant improvement in enuresis in children with SDB. There is a need for randomized controlled trials to look at the role of T&A in children with SDB and enuresis.