JPMA. The Journal of the Pakistan Medical Association
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Procalcitonin (PCT) is a marker of the inflammatory response to infection. In the present study the serum PCT of 46 pulmonary tuberculosis patients, 46 non-tuberculosis pulmonary disease and 46 healthy subjects were analyzed using semiquantitative PCT-Q kit. ⋯ Using cut-off value of 0.5 ng/ml, The sensitivity, specificity positive predictive value and negative predictive value for serum PCT in distinguishing tuberculous from nontuberculous pulmonary disease were 36.9%, 63.1%, 50% and 50%, respectively. According to our results the serum PCT is not a reliable marker for diagnosis of pulmonary tuberculosis due to low sensitivity and specificity.
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The delivery of health and family planning services in Pakistan is the respective mandate of the Ministry of Health/departments of health and the Ministry of Population Welfare. This institutional separation creates issues due to marginalization of family planning and reproductive health as core health issues. The government of Pakistan has made several attempts in the past to merge both the institutional hierarchal arrangements. ⋯ The latter are envisaged to be a yardstick for public delivery of services and the basis of contractual relationships in new management arrangements, which involve a role for the private sector. The short to medium term strategies proposed in this paper centre on a range of specific collaborative measures with a view to building capacity for the broader systems transformation. Sustained political and institutional commitment will be needed to implement these recommendations.
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Pakistan launched its Maternal, Neonatal and Child Health (MNCH) programme in 2006 in collaboration with the World Health Organization (WHO) and other partners to bridge gaps and upscale interventions aimed at reducing mortality and achieving the Millennium Development Goals (MDGs). The country will have an uphill task in meeting by 2020, the 2015 targets set for attainment of MDGs 4 and 5. The current Contraceptive Prevalence Rate (CPR) level of 30% is considerably below the 60% target set for 2020 and the current Total Fertility Rate (TFR), estimated at 4, is significantly higher than the set target of 2.1. ⋯ To significantly reduce IMR and MMR and improve RH/FP outcomes, the two ministries must challenge the status quo and promote the coordination of health and population policies, improve MNCH/RF and FP management practices including monitoring and supervision, deploy, train and motivate the health workforce and strengthen the health system. Functional integration must also aim at ensuring use of appropriate technologies and uninterrupted provision of supplies and equipment. This viewpoint, which is related to the Heartfile Report, aims at diagnosing outstanding challenges at the field level, as well as factors contributing to successful implementation of MNCH/RH and FP and their progress towards achieving Millennium Development Goals (MDGs) 4 and 5.