Objectives: The main aim of this study was to determine the level of knowledge about rheumatoid arthritis disease among patients presenting with arthralgia in a tertiary care teaching hospital, Pakistan. Materials and Methods: A cross-sectional study during the period of September 2015 - March 2016 in the Medical Out-Patient Department, Shaheed Mohtarma Benzir Bhutto Medical University Hospital, a tertiary care teaching hospital in Larkana, Pakistan. Patients above 40 years of age of either gender were included in the study. A non-probability purposive sampling technique was employed to include the participants in the study. A pre-designed questionnaire with open and close ended questions was used. The questionnaire in English language was also translated in local language to facilitate the participants. All the statistical analysis was conducted using Stata statistical software 14. Results: A total number of 251 participants completed the questionnaires. 42 (56.6%) were from rural settings, while 233 (92.8%) were females. The overall mean age was 59 ± 8.69 years. There were 139 (55.4%) of the participants were ≥ 60 years of age. The average BMI was 23.1 ± 4.3. Moreover, 144 (57.4%) participants were found noneducated. The duration of the disease was less than 10 years in 154 (61.4%) of the participants. While, 157 (62.5%) participants were not knowing about factors which contribute to the onset of rheumatoid arthritis. We observed that, on the basis of responses to the relevant questions, only 4 (1.6%) participants were considered fully aware. Conclusion: We observed lack of knowledge in majority of the participants presenting with arthralgia. The public awareness and education through different vertical programs as well as through social media in the country which can play very important role. Bangladesh Journal of Medical Science Vol.18(4) 2019 p.808-813

The association of HCV in development of NHL is well established, but no data is available from Pakistan. This study will bring light to this issue. The observations are eye opener for policy makers to persue this issue in our society.Background: Hepatitis C virus (HCV) is the most common cause of chronic liver disease in Pakistan (1). Globally, an estimated 170 million people are infected with HCV, with approximately 3-4 million new cases each year (2, 3). Currently, the prevalence of HCV in Pakistan is 4-7% (4-6). HCV is a hepatotropic virus that causes chronic hepatitis in at least 80% of infected individuals. If untreated, 20-30% of the cases will eventually develop cirrhosis, with average latency of 15-25 years, and hepatocellular carcinoma, at the rate of 1-5% per year and average latency of 20-30 years (3, 7). Objectives: We examined the association between HCV infection and non-Hodgkin's lymphoma (NHL). Patients and Methods: This 2-year case control study was conducted From january 1, 2009 to december 31, 2010. A total of 292 NHL patients underwent staging, according to the Ann Arbor staging criteria, and were graded, according to the Working Formulation Classification. Anti-HCV antibodies (Abs) were used in an enzyme-linked immunosorbant assay (ELISA) to detect HCV in blood samples from the 292 NHL patients and 1168 age-and sex-matched control patients (2 groups) who met our selection criteria. The chisquare test was applied to compare anti-HCV Ab seropositivity in the cases and controls, and odds ratio values were computed. The NHL patients were divided into anti-HCV Ab seronegative and seropositive groups to compare the effect of anti-HCV Ab seropositivity on NHL stages and grades. A P value of 0.05 was considered statistically significant. Results: A total of 52 (17.8%) cases, including 45 (7.7%) controls in group 1 (1st degree relatives) and 50 (8.6%) controls in group 2 (non-hematological malignancy), showed positive results for anti-HCV Abs and had a odds ratio value of 2.59 (95% CI: 1.69-3.97) for group 1 and 2.31 (95% CI: 1.52-3.50) for group 2 (P value of 0.000 for both groups). NHL patients who showed positive results for anti-HCV Abs were likely to be middle-aged patients (40-60 years; odds ratio, 3.68; 95%CI: 2.07-6.50). Anti-HCV Ab seropositivity did not significantly affect the grades and stages of NHL. Conclusions: NHL is strongly associated with anti-HCV Ab seropositivity (odds risk, 2-2.5), and seropositive cases were generally middle-aged and younger patients.

Context: Hepatitis B viral infection, specially in children, is an unsolved global health issue. National and international vaccination programs, as the main means to prevent this infection, have been operating for years. This meta-analysis study was launched to investigate the vaccination efficacy in under five-year-old children in Iran. Evidence Acquisition: In this research, all national databases including, SID, Magiran, Iran medex, Iran doc, and Medlib, as well as international databases, including PubMed, Medline, and ISI were searched for published articles associated with evaluation of seroconversion rates after hepatitis-B vaccination in Iranian children. The search was performed in the Persian and/or English language and in under five-year-old children in Iran. The variance of each study was calculated using the binomial distribution formula. The results of studies were combined using random-effects meta-analysis model. Data were analyzed using STATA version 12. Results: In the present research, 11 studies, performed from 2000 to 2017, were investigated. The number of samples in these 11 studies were 3063 children (1592 males and 1471 females). In the studies, the efficacy range of the hepatitis-B vaccine in under fiveyear-old children in Iran was 89% (95% CI: 86%-93%) with high heterogeneity (P value for heterogeneity was 0.001, I 2 = 92.9). Range of efficacy for males and females was 85% (95% CI: 78 to 91) and 88% (95% CI: 83 to 93), respectively. Conclusions: The hepatitis B virus (HBV) vaccination program in Iran seems to be highly effective although some questions, such as the effect of gender on responsiveness to vaccine and heterogeneity of different data, remain unclear.