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Biomedical subjects

Rashid Chotani

Publications and source records attributed to Rashid Chotani.

7 recordsLinked to original sources

Tuberculin reactivity among health care workers in nonhospital settings.

BACKGROUND: We used workers' compensation data to identify health care workers at risk of tuberculosis exposure in the hospital and nonhospital environment. METHODS: We identified State Fund workers' compensation claims having a documented tuberculin skin test (TST) conversion (size >or=10 mm) with a previous negative skin test between 1996 and 2000 in the State of Washington. RESULTS: Health care workers experienced an overall accepted workers' compensation claim rate of 2.3 claims/10,000 full-time equivalent employees (FTEs) per year for tuberculin reactivity. Receptionists accounted for the largest number, with 18.4% tuberculin reactivity claims. The number of tuberculin reactivity claims was the highest for offices and clinics of doctors of medicine (3.7 per 10,000 FTEs), followed by medical laboratories (2.6 per 10,000 FTEs). CONCLUSION: This study allowed characterization of employees in various nonhospital health services locations with higher number of tuberculin reactivity.

Adult↗

Rabies deaths in Pakistan: results of ineffective post-exposure treatment.

OBJECTIVES: To estimate the incidence of rabies and the effectiveness of post-exposure treatment (PET) in Pakistan. METHODS: Rabies cases admitted from July 1993 to December 1994 to a public rabies isolation hospital were analyzed. Two samples (one sample each from a separate peripheral site) of a single batch of sheep brain vaccine (SBV) were also tested for potency by the National Institute of Health (NIH) test in May 1997. RESULTS: Forty patients were admitted with a history of clinical rabies. The median age was 22 years and 55% were under 15. Thirteen (23%) victims did not receive any vaccine; the remaining 27 (67%) received SBV only, and of these, 16 (40%) received a full course of SBV. No rabies immunoglobulins (RIG) or cell culture vaccines were administered. There were frequent power blackouts and no back-up supply at the public hospital. In-house potency testing of the vaccine batch by the manufacturer was adequate, although it was not tested by the World Health Organization (WHO) recommended NIH test. Samples of SBV of the same batch collected at the peripheral sites showed no potency. Rabies incidence was estimated to range between 7.0 to 9.8 cases per million annually. CONCLUSION: A multi-sectorial approach is needed to decrease rabies incidence in Pakistan. Public and healthcare practitioner education on prompt and appropriate PET, especially the use of cost-effective cell culture intradermal regimens, is needed urgently. The NIH test should be employed for vaccine potency testing. An independent agency is needed for monitoring vaccine quality and strategies are needed for maintaining cold chain. SBV should be replaced by locally manufactured second-generation cell culture rabies vaccine. Purified equine rabies immunoglobulin (ERIG) should be manufactured locally to meet national needs. Furthermore, effective dog control strategies should be implemented to decrease the rabies reservoir.

Adolescent↗

Challenges and opportunities for humanitarian relief in Afghanistan.

Afghanistan is in the midst of a profound humanitarian crisis resulting primarily from long-standing armed conflict, a devastating drought, and massive population migration. The economy, government, and health care system are in shambles. Currently, as many as 5 million Afghans are in camps either as refugees in neighboring countries or as internally displaced persons within Afghanistan. Much of the rest of the population is in dire need of basic essentials such as food, water, shelter, and basic medical care. Those attempting to carry out humanitarian relief face many daunting challenges, such as reaching remote locations, coping with a dangerous security situation, and working with limited resources. However, there are opportunities in the short run to save many lives and substantially improve the plight of Afghans by carrying out appropriate and effective emergency relief programs. Over the long term, effective medical and public health relief efforts will be an essential part of rehabilitating and rebuilding this devastated country.

Afghanistan↗