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Dera Ismāīl Khān, Pakistan

Basharat Z.,Shifa International Hospital | Zahid A.,District Headquarter Teaching Hospital
Infectious Diseases of Poverty | Year: 2014

Background: Street children are a global phenomenon, with an estimated population of around 150 million across the world. These children include those who work on the streets but retain their family contacts, and also those who practically live on the streets and have no or limited family contacts. In Pakistan, many children are forced to work on the streets due to health-related events occurring at home which require children to play a financially productive role from an early stage. An explanatory framework adapted from the poverty-disease cycle has been used to elaborate these findings. Methods: This study is a qualitative study, and involved 19 in-depth interviews and two key informant interviews, conducted in Rawalpindi, Pakistan, from February to May 2013. The data was audio taped and transcribed. Key themes were identified and built upon. The respondents were contacted through a gatekeeper ex-street child who was a member of the street children community. Results: We asked the children to describe their life stories. These stories led us to the finding that street children are always forced to attain altered social roles because health-related problems, poverty, and large family sizes leave them no choice but to enter the workforce and earn their way. We also gathered information regarding high-risk practices and increased risks of sexual and substance abuse, based on the street children's increased exposure. These children face the issue of social exclusion because diseases and poverty push them into a life full of risks and hazards; a life which also confines their social role in the future. Conclusion: The street child community in Pakistan is on the rise. These children are excluded from mainstream society, and the absence of access to education and vocational skills reduces their future opportunities. Keeping in mind the implications of health-related events on these children, robust inter-sectoral interventions are required. © 2014 Abdullah et al.; licensee BioMed Central Ltd.

Ramzan M.H.,Khyber Medical University | Ramzan M.,Peshawar Medical College | Ramzan F.,Gomal University | Wahab F.,Khyber Medical University | And 3 more authors.
Archives of Iranian Medicine | Year: 2015

Background: Regulation of reproduction is now considered to be carried out by the kisspeptin and its receptor, GPR54 or Kisslr. Mutations of either Kissl or Kisslr in humans and mice result in profound hypogonadotropic hypogonadism. The present study was aimed to determine whether the levels of kisspeptin are associated with male infertility.Methodology: The study involved 176 male subjects aged 18-50 years including 26 fertile and 150 infertile. Infertile subjects were further subdivided according to WHO guidelines of semen analysis into 22 asthenozoospermia, 08 asthenoteratozoospermia, 18 azoospermia, 58 normozoospermia, 06 oligozoospermia, 12 oligoasthenozoospermia and 26 oligoasthenoteratozoospermia. Thorough clinical examinations excluded those suffering from chronic health problems. Serum kisspeptin levels were measured by enzyme immunoassay (EIA) and follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were estimated by chemiluminescence assay (CLIA).Results: The results of the present study have revealed that kisspeptin levels were significantly lower in all infertile males as compared to the fertile males. Significantly low LH and testosterone levels were observed in all infertile groups as compared to fertile group. FSH levels were significantly lower in normozoospermic and azoospermic as compared to fertile males, while no significant difference was observed between the other infertile and fertile group.Conclusion: The study revealed that serum kisspeptin levels were observed significantly lower in the infertile as compared to fertile males, indicating that the kisspeptin might be associated with the fertility problems in males. © 2015, Academy of Medical Sciences of I.R. Iran. All rights reserved.

Ramzan M.H.,Khyber Medical University | Ramzan M.,Peshawar Medical College | Khan M.M.,Peshawar Medical College | Ramzan F.,Gomal University | And 4 more authors.
Turkish Journal of Medical Sciences | Year: 2015

Background/aim: About 10%–15% of couples around the world suffer from infertility. Male infertility is responsible directly or indirectly in ~60% of cases. A deficiency in semen is the most common cause of male infertility. Materials and methods: The study included 180 male subjects aged 18–50 years with 26 fertile and 154 infertile. The infertile subjects were further subdivided according to the WHO guidelines of semen analysis (2010) into different clinical groups. Sperm DNA damage was estimated using a neutral comet assay. Plasma gonadotropin and testosterone levels were measured using a chemiluminescence as say. Results: The results of the study revealed no significant differences in semen volume, pH, and liquefaction time between the fertile and all infertile groups. However, sperm concentration, sperm vitality, and sperm motility were significantly lower in all infertile groups as compared to the fertile males. The morphological forms of the sperm and its DNA fragmentation varied significantly between the fertile and infertile males. Reproductive hormone levels were observed to be significantly lower in the infertile than in the fertile males. Conclusion: Sperm DNA fragmentation was higher in all of the infertile subjects as compared to the fertile ones. Reproductive hormone levels varied significantly between the infertile patients and the fertile ones. © TÜBİTAK.

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