Evaluation of Immunization Coverage in the Rural Area of Peshawar, Khyber Pakhtunkhwa.

BACKGROUND: In children, the leading cause of morbidity and mortality is infectious disease. Immunization is one of the most cost-effective methods for child survival. The purpose of the survey is to assess access and coverage of immunizations in the rural areas of the District Peshawar, Khyber Pakhtunkhwa. METHODS: A cross­sectional study was conducted in a rural population area of District Peshawar from February 2016 to April 2016 using the WHO's 30 cluster sampling method for evaluation of immunization coverage. RESULTS: A total of 390 children aged 12-23 months were included in the study. It was found that 67.94% of the children were fully immunized against vaccine-preventable diseases. Thirty percent of the children were partially immunized; the percentage of unimmunized children was 2.06%. Immunization cards were issued to and available with 58.8% of the subjects. The most common cause of partial immunization was a lack of information regarding vaccinations (27%). Immunization against measles was found to be low (67%). Those using private facilities were more likely to be completely immunized as compared to government facilities. CONCLUSIONS: Immunization coverage in our survey was 68%. Sustained efforts are required to achieve universal coverage of immunization. Significant interventions are required, especially in areas that are more rural and less educated.

Role of Sex Hormone Levels and Psychological Stress in the Pathogenesis of Autoimmune Diseases.

The aim of this review article is to assess the connection between psychological stress and sex hormones and their effect on the development of autoimmune diseases. Psychological stress describes what people feel when they are under mental, physical, or emotional pressure. We searched for online articles using MEDLINE®, Embase, Cochrane Library and Google Scholar. Our research yielded a total of 165 articles out of which 30 articles were considered for further perusal. The articles were reviewed from February 2016 to February 2017. Case reports and patients suffering from hematolymphoid malignancies and active infections were excluded from the review. Estrogen and testosterone are potential physiological regulatory factors for the peripheral development of CD4+CD25+ T regulatory cells. Stress at any age leads to the depletion of estrogen and testosterone stores in the body, leading to the loss of expansion of T regulatory cells, making the immature B cells evade the negative selection at the germinal center, or in other words, leading to the loss of central tolerance, a triggering event in autoimmune diseases like systemic lupus erythematosus. Autoimmune diseases in women are most likely due to changes in estrogen levels during mental, physical, pre-menopausal, post-menopausal, and pregnancy-induced stress. We conclude that modulating estrogen in females (pre-menopausal and post-menopausal) and testosterone in males can be used to treat stress-related immune imbalance resulting in autoimmune diseases in both sexes.