This study provides preliminary evidence for the feasibility and effectiveness of behavioral parenting training for children with ADHD in Pakistan and represents a critical first step in identifying evidence-based treatments for Pakistani children with ADHD.

Background A transformation of healthcare is underway, from a sellers' market to a consumers' market, where the satisfaction of the patient's needs is part of the definition of quality. Patient satisfaction surveys are widely used to judge service quality, but clinicians are sceptical about them because they are too often poorly designed measures that do not lead to improvements in the quality of care.Aim To explore the use of patient satisfaction survey data in identifying problems with the provision of inpatient care for older people.Methods A case study using secondary analysis of postal survey data about older people's experiences of health and social care services, obtained during the evaluation of the National Service Framework for Older People in [2005][2006].The survey asked about experiences of inpatient care and of discharge from hospital, and sought perceptions of the avoidability of the admission.Settings and participants A total of 4170 people aged 50 years and over returned a postal questionnaire in six local authority areas of England. Responses from 584 who had experienced a recent overnight stay in hospital are reported and discussed. FindingsThe response rate was 35%, ranging from 26% to 44% in the six areas surveyed.The great majority of those who had recent direct experience of inpatient care reported that they had been engaged in decision-making, that staff promoted their independence and maintained their dignity.There were widespread examples, however, of the opposite experiences. Discharge from hospital was problematic for about one-third of survey respondents with this experience, and there were different accounts of poorly managed discharges from all areas.Conclusions Case studies using local survey data can be used as formative assessments of services.The response rate to the survey and the likelihood of responder bias mean that patient satisfaction survey data of this sort cannot be used to judge or compare services in a summative way, but DECLARATIONS Competing interestsNone declared Funding Funded by the Healthcare Commission T/03/56/MG and sponsored by King's College London Ethical approval MREC approval was gained for the postal survey section of the evaluation (reference number 05/MRE09/33) Guarantor SI Contributorship JM was the lead applicant on the proposal and was overall project manager. RC was a co-applicant on the proposal, facilitated groups, trained the researchers and analysed the qualitative data. MC

Male and female residents of four slums in Dhaka, Bangladesh, and four slums in Islamabad, Pakistan, were interviewed about household and environmental stressors and about their mental distress and physical health. Within each city, the slums differed in terms of household-level variables (e.g., number of people and number of rooms per house) and contextual variables (e.g., number of families sharing a water source). Although there were gender differences in both cities, there were more gender differences and the gender differences were stronger in Islamabad than in Dhaka, consistent with the Islamic influence in the two countries.

Objective: To study the frequency of In-Stent Restenosis and its treatment in patients undergoing Percutaneous Coronary Intervention for coronary artery disease. Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Cardiology, Armed Forces Institute of Cardiology & National Institute of Heart disease (AFIC/NIHD) Rawalpindi, from Jul 2017 to Jul 2019. Methodology: All the patients who underwent Percutaneous Coronary Intervention for Coronary Artery Disease at our institute were considered for this study. A consecutive sampling method was used and inclusion/exclusion criteria was applied. Following data was obtained; 1) Demographic information and clinical risk factors like history of hypertension, hyperlipidemia, diabetes mellitus, smoking, coronary artery disease characteristics(number of diseased arteries, bifurcation lesions, calcification, chronic total occlusions-CTO and tortuosity) 3), Stent factors (under expansion, fracture, longitudinal miss, stent gap). Data recording, storage, assessment and analysis was done by using SPSS software version 21. Results: Among 1332 cases, 50 had In-Stent Restenosis with overall prevalence of 3.75%. Mean age of the patients with In-Stent Restenosis was 58.76 (± 9.97), with 45 (90%) male and 5 (10%) female. Diabetes Mellitus was the commonest risk factor (22.9%) followed by Hypertension (18%). Sixty four percent of the patients (n=32) had Single Vessel Coronary Artery Disease, 14 (28%) had Double Vessel Coronary Artery Disease and 4 (8%) had Tripple Vessel Coronary Artery Disease. Left Anterior Descending was the commonest coronary artery that developed In-Stent Restenosis, followed by Right Coronary Artery and Left Circumflex respectively. Previously deployed stents which developed In-Stent Restenosis showed longitudinal geographical miss in 16%, stent under expansion in 6% and stent gap in 4%. There was statistically significant association (p-value=0.02) between stent length and frequency of In-Stent Restenosis and it was commonest in stents longer than 30 mm. Eighty six percent(n=43) of In-Stent Restenosis cases in our study group was treated with Drug Eluting Stent followed by Drug Eluting Balloon in 32% and Plain Old Balloon Angioplasty in 22%. Conclusion: History of diabetes mellitus and greater stent length were major risk factors in developing In-Stent Restenosis in our study. DES was the commonest treatment modality used.Keywords: , , .