Global Analysis of RTS, S/AS01 Malaria Vaccine Acceptance Rates and Influencing Factors: A Systematic Review.

Malaria remains a significant global health challenge, with Plasmodium parasites transmitted by Anopheles mosquitoes causing substantial morbidity and mortality. Despite historical efforts, malaria continues to affect millions worldwide, particularly in tropical regions. This systematic review aimed to assess the acceptability of the RTS, S/AS01 malaria vaccine among diverse populations. A comprehensive search strategy was employed across databases such as Cochrane Library, Embase, Google Scholar, and Medline. Studies were included based on specific criteria, including observational and cross-sectional designs involving adults. Data extraction and analysis were conducted meticulously, encompassing key variables related to vaccine acceptance rates and influencing factors. Analysis of 18 studies involving 18,561 participants revealed an overall malaria vaccine acceptance rate of 87.51%, ranging from 32.26% to 99.30%. Significant variations were observed based on demographics, with Ghana and Nigeria reporting high acceptance rates. Factors influencing acceptance included knowledge levels, past vaccination experiences, community preferences, and engagement in malaria prevention behaviors. Concerns about adverse reactions and regional disparities were noted as potential barriers to acceptance. This review highlights the importance of understanding public perceptions and concerns regarding malaria vaccines to enhance vaccine coverage and uptake. Tailored communication strategies, advocacy efforts, and targeted education interventions are crucial for addressing misconceptions and increasing vaccine acceptance. Policy recommendations should consider demographic and regional factors to ensure effective implementation of malaria vaccination programs, ultimately contributing to global malaria prevention efforts and public health initiatives.

ROLE OF SURGICAL APPROACHES INFLUENCING TUMOUR RECURRENCE IN NASOPHARYNGEAL ANGIOFIBROMA.

BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumour constituting less than 1% of all head & neck tumours. This tumour has an aggressive local behaviour if left untreated. Surgery is the mainstay of treatment with no common consensus on a single approach. Tumour stage and surgical approaches are the major determinants of outcome. The objective of this study was to evaluate the influence of surgical approaches on tumour recurrence in patients with nasopharyngeal angiofibroma. METHODS: This descriptive study was conducted in the Department of ENT and Head and Neck Surgery, PIMS, Islamabad and Ayub Medical Institution, Abbottabad from Jan 2010 to Jan 2014 consisting of 34 diagnosed cases of nasopharyngeal angiofibroma. All patients were treated surgically while radiotherapy was given in a few. All patients were followed up for one year. RESULTS: Among 34 patients, 25 were treated by lateral rhinotomy approach with medial maxillectomy, 5 by mid-facial degloving approach and 3 by transpalatine approach. One patient with cavernous sinus involvement was treated by radiotherapy. Patients were followed up for one year both by clinical examination and imaging if needed. Recurrence was found in 15% (5/33) patients and postop radiotherapy was given to them. CONCLUSION: Lateral rhinotomy approach with medial maxillectomy is highly effective even in advanced stage JNA for complete removal of the disease. Postoperative radiotherapy is an effective adjuvant.

Efficacy of topical clotrimazole in treatment of otomycosis.

BACKGROUND: Otomycosis is a common condition affecting external ear and ears with chronic suppurative otitis media, and has a tendency for recurrence. Objective of this study was to determine the efficacy of topical clotrimazole in the treatment of otomycosis. METHODS: This descriptive study was conducted at the outpatient department of ENT, Ayub Teaching Hospital Abbottabad, from Jul 2012 to Dec 2012. A total of 101 patients were included in this study. The results were compared and analysed regarding age, gender, presenting complaints and efficacy of clotrimazole. RESULTS: A total of 101 patients of otomycosis were included in the study. Male to female ratio was 0.71:1. Patients of 15 years and above were included in the study. Adults were more affected by otomycosis than the younger age group. The efficacy of clotrimazole in treatment of otomycosis was observed in 89 (94.12%) while in 12 (5.88%) patients no efficacy was seen. Age and gender have no role in efficacy of Clotrimazole in treatment of Otomycosis. CONCLUSION: Topical clotrimazole is effective in the treatment of Otomycosis.

Early complications of elective and emergency tracheostomy.

BACKGROUND: Tracheostomy is a life saving procedure when it is performed for an appropriate indication and surgical technique. The aim of this study was to compare the early complications of elective and emergency tracheostomy in our setup. METHODS: This comparative study was conducted at the ENT Department. Hayatabad Medical (Complex (HMC) from March 2009 to March 2010. A total of 100 patients included in this study were divided in to two equal groups, group A undergoing elective tracheostomy and group B undergoing emergency tracheostomy. The results of hundred patients were compared and analysed from stand point of age, sex, disease pattern, operative procedure and postoperative complications associated with tracheostomy. RESULTS: A total of 100 patients were included with age ranging from 17 to 88 years. The average age was 35 years in elective cases and was 32 years in emergency cases. The male to female ratio was 2.9:1 in elective cases and 4.6:1 in emergency cases. The overall complications rates were 38% in elective cases and 56% in emergency cases. CONCLUSION: Early complications of emergency tracheostomy are more common than elective tracheostomy.