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Full-Text Articles in Medicine and Health Sciences

Identification And Management Of Atherosclerotic Cardiovascular Disease Risk In South Asian Populations In The U.S., Anandita Agarwala, Priyanka Satish, Mahmoud Al Rifai, Anurag Mehta, Miguel Cainzos-Achirica, Nilay S. Shah, Alka M. Kanaya, Garima V. Sharma, Dave L. Dixon, Salim S. Virani Mar 2023

Identification And Management Of Atherosclerotic Cardiovascular Disease Risk In South Asian Populations In The U.S., Anandita Agarwala, Priyanka Satish, Mahmoud Al Rifai, Anurag Mehta, Miguel Cainzos-Achirica, Nilay S. Shah, Alka M. Kanaya, Garima V. Sharma, Dave L. Dixon, Salim S. Virani

Office of the Provost

South Asians (SAs, individuals with ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) are among the fastest growing ethnic subgroups in the United States. SAs typically experience a high prevalence of diabetes, abdominal obesity, and hypertension, among other cardiovascular disease risk factors, which are often under recognized and undermanaged. The excess coronary heart disease risk in this growing population must be critically assessed and managed with culturally appropriate preventive services. Accordingly, this scientific document prepared by a multidisciplinary group of clinicians and investigators in cardiology, internal medicine, pharmacy, and SA-centric researchers describes key characteristics of traditional and …


Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M. Talha, Gregg C. Fonarow, Salim S. Virani, Javed Butler Dec 2022

Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M. Talha, Gregg C. Fonarow, Salim S. Virani, Javed Butler

Office of the Provost

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant …


Drug-Resistant Bacterial Infections: We Need Urgent Action And Investment That Focus On The Weakest Link, Christiane Dolecek, Sadia Shakoor, Buddha Basnyat, Tochi Okwor, Benn Sartorius Nov 2022

Drug-Resistant Bacterial Infections: We Need Urgent Action And Investment That Focus On The Weakest Link, Christiane Dolecek, Sadia Shakoor, Buddha Basnyat, Tochi Okwor, Benn Sartorius

Department of Pathology and Laboratory Medicine

Despite high mortality and morbidity, drug-resistant bacterial infections remain the forgotten pandemic. We argue for strengthening of diagnostics, WASH (water, sanitation, and hygiene) and infection prevention and control to reduce drug-resistant infections, as an integral part of sustainable high-quality health services, particularly in low- and middle-income countries.


Oral N-Acetyl Cysteine Versus Rectal Indomethacin For Prevention Of Post Ercp Pancreatitis: A Multicenter Multinational Randomized Controlled Trial, Pezhman Alavinejad, Nguyen-Phuong Nhu Tran, Omid Eslami, Omar El Shaarawy, Omar El Shaarawy, Ahmad Hormati, Seied Saeed Seiedian, Abazar Parsi, Mohammed Hussien Ahmed, Amna Subhan Butt Nov 2022

Oral N-Acetyl Cysteine Versus Rectal Indomethacin For Prevention Of Post Ercp Pancreatitis: A Multicenter Multinational Randomized Controlled Trial, Pezhman Alavinejad, Nguyen-Phuong Nhu Tran, Omid Eslami, Omar El Shaarawy, Omar El Shaarawy, Ahmad Hormati, Seied Saeed Seiedian, Abazar Parsi, Mohammed Hussien Ahmed, Amna Subhan Butt

Section of Gastroenterology

Background: This multicenter multinational RCT designed to compare the efficacy of suppository indomethacin and NAC for prevention of PEP.
Methods: During a 6-month period, all of the ERCP cases in seven referral centers were randomly assigned to receive either 1200 mg oral NAC, indomethacin suppository 100 mg, 1200 mg oral NAC plus indomethacin suppository 100 mg or placebo 2 hours before ERCP. The primary outcomes were the rate and severity of any PEP.
Results: A total of 432 patients included (41.4% male). They were originally citizens of 6 countries (60.87% Caucasian). They were randomly allocated to receive either NAC (group …


Identifying Differences: A Key Step In Precision Cardiovascular Disease Prevention, Mahmoud Al Rifai, Salim S. Virani, Vijay Nambi Aug 2022

Identifying Differences: A Key Step In Precision Cardiovascular Disease Prevention, Mahmoud Al Rifai, Salim S. Virani, Vijay Nambi

Office of the Provost

No abstract provided.


Incidence Of Typhoid And Paratyphoid Fever In Bangladesh, Nepal, And Pakistan: Results Of The Surveillance For Enteric Fever In Asia Project, Mohammad Tahir Yousafzai, Sadia Shakoor, Irum Fatima Dehraj, Junaid Mehmood, Rozina Thobani, Aneeta Hotwani, Najeeb Rehman, Seema Irfan, Abdul Momin Kazi, Mohammed J. Hunzai Jul 2022

Incidence Of Typhoid And Paratyphoid Fever In Bangladesh, Nepal, And Pakistan: Results Of The Surveillance For Enteric Fever In Asia Project, Mohammad Tahir Yousafzai, Sadia Shakoor, Irum Fatima Dehraj, Junaid Mehmood, Rozina Thobani, Aneeta Hotwani, Najeeb Rehman, Seema Irfan, Abdul Momin Kazi, Mohammed J. Hunzai

Department of Paediatrics and Child Health

Background: Precise enteric fever disease burden data are needed to inform prevention and control measures, including the use of newly available typhoid vaccines. We established the Surveillance for Enteric Fever in Asia Project (SEAP) to inform these strategies.
Methods: From September, 2016, to September, 2019, we conducted prospective clinical surveillance for Salmonella enterica serotype Typhi (S Typhi) and Paratyphi (S Paratyphi) A, B, and C at health facilities in predetermined catchment areas in Dhaka, Bangladesh; Kathmandu and Kavrepalanchok, Nepal; and Karachi, Pakistan. Patients eligible for inclusion were outpatients with 3 or more consecutive days of fever in the last 7 …


Potential Impact Of 2017 American College Of Cardiology/American Heart Association Hypertension Guideline On Contemporary Practice: A Cross-Sectional Analysis From Ncdr Pinnacle Registry, Aliza Hussain, Salim S. Virani, Luke Zheng, Ty J. Gluckman, William B. Borden, Frederick A. Masoudi, Thomas M. Maddox Jun 2022

Potential Impact Of 2017 American College Of Cardiology/American Heart Association Hypertension Guideline On Contemporary Practice: A Cross-Sectional Analysis From Ncdr Pinnacle Registry, Aliza Hussain, Salim S. Virani, Luke Zheng, Ty J. Gluckman, William B. Borden, Frederick A. Masoudi, Thomas M. Maddox

Office of the Provost

Background Clinical implications of change in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the diagnosis and management of hypertension, compared with recommendations by 2014 expert panel and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7), are not known. Methods and Results Using data from the NCDR (National Cardiovascular Data Registry) PINNACLE (Practice Innovation and Clinical Excellence) Registry (January 2013-Decemver 2016), we compared the proportion and clinical characteristics of patients seen in cardiology practices diagnosed with hypertension, recommended antihypertensive treatment, and achieving blood pressure (BP) goals …


Determinants Of Domestic Violence Among Women Of Reproductive Age (15-49 Years) In Quetta, Balochistan-A Mixed-Method Protocol, Salman Muhammad Soomar, Sarmad Muhammad Soomar May 2022

Determinants Of Domestic Violence Among Women Of Reproductive Age (15-49 Years) In Quetta, Balochistan-A Mixed-Method Protocol, Salman Muhammad Soomar, Sarmad Muhammad Soomar

Department of Emergency Medicine

Background: Worldwide, domestic violence (DV) is a cause of death and disability among women aged 15-49 years. In Pakistan, DV appears in different forms, and only 3.2% of women report any DV. There are various factors associated with DV against women. The data are sparse for the Balochistan province due to the under-reporting and scattered population. This research study aims to determine the factors associated with DV and the types of violence among women of reproductive age. Also, to understand the perspective of community leaders and healthcare workers (HCWs) for developing interventions for DV prevention against women of reproductive age …


Suicide Prevention In Bangladesh: The Role Of Family, S M Yasir Arafat, Tamkeen Saleem, Todd M. Edwards, Syeda Ayat-E-Zainab Ali, Murad M. Khan Apr 2022

Suicide Prevention In Bangladesh: The Role Of Family, S M Yasir Arafat, Tamkeen Saleem, Todd M. Edwards, Syeda Ayat-E-Zainab Ali, Murad M. Khan

Department of Psychiatry

Background: Suicide is a public health problem that gets little attention in Bangladesh especially in prevention aspects. Recent studies revealed that a significant portion of risk factors is closely related to family events. However, potential prevention strategies considering the family structure and involving family dynamics of Bangladesh have not been discussed.
Objectives: We aim to highlight areas of family vulnerability and resilience when the threat of suicide is present, as well as the potential roles of family in suicide prevention in Bangladesh.
Methods: We conducted a thorough narrative and focused literature search and synthesized evidence based on available articles discussing …


Viral Hepatitis - The Road Traveled And The Journey Remaining, Ghulam Fareed Malik, Noval Zakaria, Muhammad Ibrahim Majeed, Faisal Wasim Ismail Mar 2022

Viral Hepatitis - The Road Traveled And The Journey Remaining, Ghulam Fareed Malik, Noval Zakaria, Muhammad Ibrahim Majeed, Faisal Wasim Ismail

Section of Gastroenterology

Hepatitis is defined as inflammation of the liver and is commonly due to infection with The hepatotropic viruses - hepatitis A, B, C, D and E. Hepatitis carries one of the highest disease burdens globally and has caused significant morbidity and mortality among different patient populations. Clinical presentation varies from asymptomatic or acute flu-like illness to acute liver failure or chronic liver disease, characterized by jaundice, hepatomegaly and ascites among many other signs. Eventually, this can lead to fibrosis (cirrhosis) of the liver parenchyma and carries a risk of development into hepatocellular carcinoma. Hepatitis B and C are most notorious …


Inflammatory Bowel Disease And Atherosclerotic Cardiovascular Disease In U.S. Adults-A Population-Level Analysis In The National Health Interview Survey, Khurram Nasir, Isaac Acquah, Amit K. Dey, Tanushree Agrawal, Syed Zawahir Hassan, Kerri Glassner, Bincy Abraham, Eamonn M M. Quigley, Ron Blankstein, Salim S. Virani Mar 2022

Inflammatory Bowel Disease And Atherosclerotic Cardiovascular Disease In U.S. Adults-A Population-Level Analysis In The National Health Interview Survey, Khurram Nasir, Isaac Acquah, Amit K. Dey, Tanushree Agrawal, Syed Zawahir Hassan, Kerri Glassner, Bincy Abraham, Eamonn M M. Quigley, Ron Blankstein, Salim S. Virani

Office of the Provost

Objectives: To evaluate the association between inflammatory bowel disease (IBD) and atherosclerotic cardiovascular disease (ASCVD) and whether this association is modified by age or sex.
Methods: We conducted a cross-sectional analysis using data from the 2015-2016 National Health Interview Survey (NHIS). The exposure of interest was self-reported IBD. The outcome of interest was prevalent ASCVD, which included a history of angina, myocardial infarction or stroke. We used survey-specific descriptive statistics to obtain weighted national estimates for IBD and ASCVD prevalence. Logistic regression models were used to assess the association between IBD and ASCVD, progressively adjusting for demographics and traditional risk …


Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta Mar 2022

Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children


Hypertension Guidelines And Coronary Artery Calcification Among South Asians: Results From Masala And Mesa, Jaideep Patel, Anurag Mehta, Mahmoud Al Rifai, Michael J. Blaha, Khurram Nasir, John W. Mcevoy, Ambarish Pandey, Alka M. Kanaya, Namratha R. Kandula, Salim S. Virani Feb 2021

Hypertension Guidelines And Coronary Artery Calcification Among South Asians: Results From Masala And Mesa, Jaideep Patel, Anurag Mehta, Mahmoud Al Rifai, Michael J. Blaha, Khurram Nasir, John W. Mcevoy, Ambarish Pandey, Alka M. Kanaya, Namratha R. Kandula, Salim S. Virani

Office of the Provost

Untreated hypertension may contribute to increased atherosclerotic cardiovascular disease (ASCVD) risk in South Asians (SA). We assessed HTN prevalence among untreated adults free of baseline ASCVD from the MASALA & MESA studies. The proportion of participants who received discordant recommendations regarding antihypertensive pharmacotherapy use by the 2017-ACC/AHA and JNC7 Guidelines across CAC score categories in each race/ethnic group was calculated. Compared with untreated MESA participants (n = 3896), untreated SA (n = 445) were younger (55±8 versus 59±10 years), had higher DBP (73±10 versus 70±10 mmHg), total cholesterol (199±34 versus 196±34 mg/dL), statin use (16% versus 9%) and …


Prevalence Of And Sociodemographic Disparities In Influenza Vaccination Among Adults With Diabetes In The United States, Priyanka Bhugra, Reed Mszar, Javier Valero-Elizond, Gowtham R. Grandhi, Salim S. Virani, Miguel Cainzos-Achirica, Farhaan S. Vahidy, Saad Omer, Khurram Nasir Sep 2020

Prevalence Of And Sociodemographic Disparities In Influenza Vaccination Among Adults With Diabetes In The United States, Priyanka Bhugra, Reed Mszar, Javier Valero-Elizond, Gowtham R. Grandhi, Salim S. Virani, Miguel Cainzos-Achirica, Farhaan S. Vahidy, Saad Omer, Khurram Nasir

Office of the Provost

National estimates describing the overall prevalence of and disparities in influenza vaccination among patients with diabetes mellitus (DM) in United States are not well described. Therefore, we analyzed the prevalence of influenza vaccination among adults with DM, overall and by sociodemographic characteristics, using the Medical Expenditure Panel Survey database from 2008 to 2016. Associations between sociodemographic factors and lack of vaccination were examined using adjusted logistic regression. Among adults with DM, 36% lacked influenza vaccination. Independent predictors of lacking influenza vaccination included age 18 to 39 years (odds ratio [OR] 2.54; 95% confidence interval [CI], 2.14-3.00), Black race/ethnicity (OR 1.29; …


Curbing The Hepatitis C Virus Epidemic In Pakistan: The Impact Of Scaling Up Treatment And Prevention For Achieving Elimination, Aaron G. Lim, Huma Qureshi, Hassan Mahmood, Saeed Hamid, Charlotte F. Davies, Adam Trickey, Nancy Glass, Quaid Saeed, Hannah Fraser, Josephine G. Walker, Apr 2018

Curbing The Hepatitis C Virus Epidemic In Pakistan: The Impact Of Scaling Up Treatment And Prevention For Achieving Elimination, Aaron G. Lim, Huma Qureshi, Hassan Mahmood, Saeed Hamid, Charlotte F. Davies, Adam Trickey, Nancy Glass, Quaid Saeed, Hannah Fraser, Josephine G. Walker,

Department of Medicine

Background: The World Health Organization (WHO) has developed a global health strategy to eliminate viral hepatitis. We project the treatment and prevention requirements to achieve the WHO HCV elimination target of reducing HCV incidence by 80% and HCV-related mortality by 65% by 2030 in Pakistan, which has the second largest HCV burden worldwide.
Methods: We developed an HCV transmission model for Pakistan, and calibrated it to epidemiological data from a national survey (2007), surveys among people who inject drugs (PWID), and blood donor data. Current treatment coverage data came from expert opinion and published reports. The model projected the HCV …


Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan2 Uzma Rahim Khan2 Uzma Rahim Khan2 Feb 2018

Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan2 Uzma Rahim Khan2 Uzma Rahim Khan2

Department of Anaesthesia

Objective:

Health care providers (HCPs) are at risk of occupational exposure to HIV infection. In developing world these exposure occur due to general lack of awareness, education and structured training of HCPs. The objective of the study was to asses if continuing medical education symposium can be used as an effective educational tool to improve attitude, awareness and knowledge regarding occupational exposure to HIV infection. This quasi-experimental study was conducted among HCPs from Karachi, Pakistan. After assessing the baseline knowledge, awareness, and attitude by means of pretest; HCPs were reassessed with posttest after an education symposium on occupational exposure to …


Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan Feb 2018

Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan

Department of Anaesthesia

Objective:

Health care providers (HCPs) are at risk of occupational exposure to HIV infection. In developing world these exposure occur due to general lack of awareness, education and structured training of HCPs. The objective of the study was to asses if continuing medical education symposium can be used as an effective educational tool to improve attitude, awareness and knowledge regarding occupational exposure to HIV infection. This quasi-experimental study was conducted among HCPs from Karachi, Pakistan. After assessing the baseline knowledge, awareness, and attitude by means of pretest; HCPs were reassessed with posttest after an education symposium on occupational exposure to …


A Mixed Methods Study To Assess The Effectiveness Of Food-Based Interventions To Prevent Stunting Among Children Under-Five Years In Districts Thatta And Sujawal, Sindh Province, Pakistan: Study Protocol, Sumra Kureishy, Gul Nawaz Khan, Shabina Arrif,, Khizar Ashraf, Angela Cespedes, Atif Habib, Imtiaz Hussain, Asmat Ullah, Ali Turab, Imran Ahmed, Shehla Zaidi, Sajid Bashir Soofi Jan 2017

A Mixed Methods Study To Assess The Effectiveness Of Food-Based Interventions To Prevent Stunting Among Children Under-Five Years In Districts Thatta And Sujawal, Sindh Province, Pakistan: Study Protocol, Sumra Kureishy, Gul Nawaz Khan, Shabina Arrif,, Khizar Ashraf, Angela Cespedes, Atif Habib, Imtiaz Hussain, Asmat Ullah, Ali Turab, Imran Ahmed, Shehla Zaidi, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Maternal and child malnutrition is widely prevalent in low and middle income countries. In Pakistan, widespread food insecurity and malnutrition are the main contributors to poor health, low survival rates and the loss of human capital development. The nutritional status trends among children exhibit a continuous deteriorating with rates of malnutrition exceeding the WHO critical threshold. With the high prevalence of maternal and child malnutrition, it is important to identify effective preventative approaches, especially for reducing stunting in children under-five years of age. The primary aim of this study is to assess the effectiveness of food-based interventions to …


Preferred Features Of E-Mental Health Programs For Prevention Of Major Depression In Male Workers: Results From A Canadian National Survey, Jianli Wang, Raymond W. Lam, Kendall Ho, Mark Attridge, Bonnie M. Lashewicz, Scott B. Patten, Alain Marchand, Alice Aiken, Norbert Schmitz, Zul Merali Jun 2016

Preferred Features Of E-Mental Health Programs For Prevention Of Major Depression In Male Workers: Results From A Canadian National Survey, Jianli Wang, Raymond W. Lam, Kendall Ho, Mark Attridge, Bonnie M. Lashewicz, Scott B. Patten, Alain Marchand, Alice Aiken, Norbert Schmitz, Zul Merali

Brain and Mind Institute

Background: Major depression is a prevalent mental disorder and imposes considerable burden on health and productivity. Men are not immune to major depression, yet they often delay seeking help because of perceived stigma and gender norms. E-mental health programs hold potential for early prevention of major depression. However, we have little knowledge about men's preferences for design features of e-mental health programs.

Objectives: The objective of this study was to (1) estimate and compare the proportions of Internet use for medical information, preferred design features, and likely use of e-mental health programs; (2) examine factors associated with the likely use …


World Allergy Organization-Mcmaster University Guidelines For Allergic Disease Prevention (Glad-P): Vitamin D, Juan José Yepes-Nuñez, Alessandro Fiocchi, Ruby Pawankar, Carlos A. Cuello-Garcia, Yuan Zhang, Gian Paolo Morgano, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Shreyas Gandhi, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny Rosenwasser, Hugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda, Susan Waserman, Holger J. Schünemann, Jan L. Brożek May 2016

World Allergy Organization-Mcmaster University Guidelines For Allergic Disease Prevention (Glad-P): Vitamin D, Juan José Yepes-Nuñez, Alessandro Fiocchi, Ruby Pawankar, Carlos A. Cuello-Garcia, Yuan Zhang, Gian Paolo Morgano, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Shreyas Gandhi, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny Rosenwasser, Hugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda, Susan Waserman, Holger J. Schünemann, Jan L. Brożek

Paediatrics and Child Health, East Africa

Background: The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20–30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases.

Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of vitamin D in primary prevention of allergic diseases.

Methods: Our WAO guideline panel identified the most relevant clinical questions and performed a …


Chronic Bronchitis And Chronic Obstructive Pulmonary Disease (Copd) Among Textile Workers In Karachi, Pakistan, Asaad Ahmed Nafees, Zafar Fatmi, Muhammad Masood Kadir, Nalini Sathiakumar May 2016

Chronic Bronchitis And Chronic Obstructive Pulmonary Disease (Copd) Among Textile Workers In Karachi, Pakistan, Asaad Ahmed Nafees, Zafar Fatmi, Muhammad Masood Kadir, Nalini Sathiakumar

Community Health Sciences

Objective: To determine the frequency and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan.
Study design: Cross-sectional survey.
Place and duration of study: Karachi, Pakistan, from October to December 2009.
Methodology: Male textile workers from 15 mills of Karachi were inducted. Data was collected using American Thoracic Society respiratory questionnaire (ATS-DLD-78-a) and spirometry.
Results: Out of 372 participants, 29 (7.8%) workers had chronic bronchitis (4, 9.1% aged ≥40 years) and 25 (6.7%) had COPD (12, 27.2% aged ≥40 years). Workers with chronic bronchitis had significantly decreased lung function compared to the healthy workers. Those reporting severe …


Using A Tailored Health Information Technology- Driven Intervention To Improve Health Literacy And Medication Adherence In A Pakistani Population With Vascular Disease (Talking Rx) - Study Protocol For A Randomized Controlled Trial, Ayeesha Kamran Kamal, Abdul Muqeet, Kashfa Farhat, Wardah Khalid, Anum Jamil, Ambreen Gowani, Aliya Amin Muhammad, Fabiha Zaidi, Danyal Khan, Touseef Elahi, Shahrukh Sharif, Syedah Saira Bokhari, Nasir Rahman, Fateh Ali Tipoo Sultan, Saleem Sayani, Salim S. Virani Mar 2016

Using A Tailored Health Information Technology- Driven Intervention To Improve Health Literacy And Medication Adherence In A Pakistani Population With Vascular Disease (Talking Rx) - Study Protocol For A Randomized Controlled Trial, Ayeesha Kamran Kamal, Abdul Muqeet, Kashfa Farhat, Wardah Khalid, Anum Jamil, Ambreen Gowani, Aliya Amin Muhammad, Fabiha Zaidi, Danyal Khan, Touseef Elahi, Shahrukh Sharif, Syedah Saira Bokhari, Nasir Rahman, Fateh Ali Tipoo Sultan, Saleem Sayani, Salim S. Virani

Section of Internal Medicine

Background: Vascular disease, manifesting as myocardial infarction and stroke, is a major cause of morbidity and mortality, especially in low- and middle-income countries. Current estimates are that only one in six patients have good adherence to medications and very few have sufficient health literacy. Our aim is to explore the effectiveness and acceptability of Prescription Interactive Voice Response (IVR) Talking Prescriptions (Talking Rx) and SMS reminders in increasing medication adherence and health literacy in Pakistani patients with vascular disease.
Methods: This is a randomized, controlled, single center trial. Adult participants, with access to a cell phone and a history of …


Translating Knowledge For Action Against Stroke--Using 5-Minute Videos For Stroke Survivors And Caregivers To Improve Post-Stroke Outcomes: Study Protocol For A Randomized Controlled Trial (Movies4stroke)., Ayeesha Kamran Kamal, Adeel Khoja, Bushra Usmani, Nargis Asad, Asma Ahmed, Iqbal Azam, Sarah Saleem, Saleem Sayani Jan 2016

Translating Knowledge For Action Against Stroke--Using 5-Minute Videos For Stroke Survivors And Caregivers To Improve Post-Stroke Outcomes: Study Protocol For A Randomized Controlled Trial (Movies4stroke)., Ayeesha Kamran Kamal, Adeel Khoja, Bushra Usmani, Nargis Asad, Asma Ahmed, Iqbal Azam, Sarah Saleem, Saleem Sayani

Department of Medicine

Background: Two thirds of the global mortality of stroke is borne by low and middle income countries (LMICs). Pakistan is the world’s sixth most populous country with a stroke-vulnerable population and is without a single dedicated chronic care center. In order to provide evidence for a viable solution responsive to this health care gap, and leveraging the existing >70 % mobile phone density, we thought it rational to test the effectiveness of a mobile phone-based video intervention of short 5-minute movies to educate and support stroke survivors and their primary caregivers.

Methods: Movies4Stroke will be a randomized control, outcome assessor …


World Allergy Organization-Mcmaster University Guidelines For Allergic Disease Prevention (Glad-P): Probiotics, Alessandro Fiocchi, Ruby Pawankar, Carlos Cuello-Garcia, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Shreyas Gandhi, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny Rosenwasser, Hugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda-Ortiz, Susan Waserman, Juan José Yepes-Nuñez, Jan L. Brożek, Holger J. Schünemann Jan 2015

World Allergy Organization-Mcmaster University Guidelines For Allergic Disease Prevention (Glad-P): Probiotics, Alessandro Fiocchi, Ruby Pawankar, Carlos Cuello-Garcia, Kangmo Ahn, Suleiman Al-Hammadi, Arnav Agarwal, Kirsten Beyer, Wesley Burks, Giorgio W. Canonica, Motohiro Ebisawa, Shreyas Gandhi, Rose Kamenwa, Bee Wah Lee, Haiqi Li, Susan Prescott, John J. Riva, Lanny Rosenwasser, Hugh Sampson, Michael Spigler, Luigi Terracciano, Andrea Vereda-Ortiz, Susan Waserman, Juan José Yepes-Nuñez, Jan L. Brożek, Holger J. Schünemann

Paediatrics and Child Health, East Africa

Background: Prevalence of allergic diseases in infants, whose parents and siblings do not have allergy, is approximately 10% and reaches 20–30% in those with an allergic first-degree relative. Intestinal microbiota may modulate immunologic and inflammatory systemic responses and, thus, influence development of sensitization and allergy. Probiotics have been reported to modulate immune responses and their supplementation has been proposed as a preventive intervention.

Objective: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations about the use of probiotics in the prevention of allergy.

Methods: We identified the most relevant clinical questions and performed a systematic review …


Sexual Violence And Sub-Saharan Migrants In Morocco: A Community-Based Participatory Assessment Using Respondent Driven Sampling, Ines Keygnaert, Abdessamad Dialmy, Altay Manço, Jeroen Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman Dec 2014

Sexual Violence And Sub-Saharan Migrants In Morocco: A Community-Based Participatory Assessment Using Respondent Driven Sampling, Ines Keygnaert, Abdessamad Dialmy, Altay Manço, Jeroen Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The European Union contracted Morocco to regulate migration from so-called “transit migrants” from Morocco to Europe via the European Neighbourhood Policy. Yet, international organisations signal that human, asylum and refugee rights are not upheld in Morocco and that many sub-Saharan migrants suffer from ill-health and violence. Hence, our study aimed at 1) investigating the nature of violence that sub-Saharan migrants experience around and in Morocco, 2) assessing which determinants they perceive as decisive and 3) formulating prevention recommendations.

Methods: Applying Community-Based Participatory Research, we trained twelve sub-Saharan migrants as Community Researchers to conduct in-depth interviews with peers, using Respondent …


Who Guidance Grounded In A Comprehensive Approach To Sexual And Reproductive Health And Human Rights: Topical Pre-Exposure Prophylaxis, Manjula Lusti-Narasimhan, Rajat Khosla, Rachel Baggaley, Marleen Temmerman, Elizabeth Mcgrory, Tim Farley Sep 2014

Who Guidance Grounded In A Comprehensive Approach To Sexual And Reproductive Health And Human Rights: Topical Pre-Exposure Prophylaxis, Manjula Lusti-Narasimhan, Rajat Khosla, Rachel Baggaley, Marleen Temmerman, Elizabeth Mcgrory, Tim Farley

Obstetrics and Gynaecology, East Africa

Introduction: Two new microbicide products based on topical (vaginal) application of antiretroviral drugs – 1% tenofovir gel and the dapivirine ring – are currently in late-stage clinical testing, and results on their safety and effectiveness are expected to become available in early 2015. WHO guidelines on the use of topical pre-exposure prophylaxis (topical PrEP) are important in order to ensure that these new prevention products are optimally used.

Discussion: Given that these new topical PrEP products are designed to be woman initiated and will likely be delivered in reproductive health settings, it is important to ensure that the …


Sexual Violence And Sub-Saharan Migrants In Morocco: A Community-Based Participatory Assessment Using Respondent Driven Sampling, Ines Keygnaert, Abdessamad Dialmy, Altay Manço, Jeroen Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman Jan 2014

Sexual Violence And Sub-Saharan Migrants In Morocco: A Community-Based Participatory Assessment Using Respondent Driven Sampling, Ines Keygnaert, Abdessamad Dialmy, Altay Manço, Jeroen Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The European Union contracted Morocco to regulate migration from so-called “transit migrants” from Morocco to Europe via the European Neighbourhood Policy. Yet, international organisations signal that human, asylum and refugee rights are not upheld in Morocco and that many sub-Saharan migrants suffer from ill-health and violence. Hence, our study aimed at 1) investigating the nature of violence that sub-Saharan migrants experience around and in Morocco, 2) assessing which determinants they perceive as decisive and 3) formulating prevention recommendations.

Methods: Applying Community-Based Participatory Research, we trained twelve sub-Saharan migrants as Community Researchers to conduct in-depth interviews with peers, using Respondent …


Long Term Effectiveness Of Cognitive Behavior Therapy For Treatment Of Postpartum Depression: A Systematic Review And Meta-Analysis, Tahira Perveen, Sajid Mahmood, Ibrahim Gosadi, Jaishri Mehraj, Sana Sadiq Sheikh Oct 2013

Long Term Effectiveness Of Cognitive Behavior Therapy For Treatment Of Postpartum Depression: A Systematic Review And Meta-Analysis, Tahira Perveen, Sajid Mahmood, Ibrahim Gosadi, Jaishri Mehraj, Sana Sadiq Sheikh

Department of Obstetrics & Gynaecology

Background: The existing trials on the long term effectiveness of cognitive behavior therapy (CBT) for the treatment of postpartum depression have conflicting results. Therefore, we performed a systematic review to summarize the current evidence.
Methodology: Literature search was performed using electronic databases Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsychINFO were explored from January 2000 to March 2013.
All peer-reviewed English-published randomized controlled trials were eligible if they assessed the long term (at least at 24 weeks post partum) effectiveness of CBT versus standard postpartum care for prevention of postpartum depression. Data from eligible studies were …


Hidden Violence Is Silent Rape: Sexual And Gender-Based Violence In Refugees, Asylum Seekers And Undocumented Migrants In Belgium And The Netherlands, Ines Keygnaert, Nicole Vettenbu, Marleen Temmerman May 2012

Hidden Violence Is Silent Rape: Sexual And Gender-Based Violence In Refugees, Asylum Seekers And Undocumented Migrants In Belgium And The Netherlands, Ines Keygnaert, Nicole Vettenbu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Although women, young people and refugees are vulnerable to sexual and gender-based violence (SGBV) worldwide, little evidence exists concerning SGBV against refugees in Europe. Using community-based participatory research, 223 in-depth interviews were conducted with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Responses were analysed using framework analysis. The majority of the respondents were either personally victimised or knew of a close peer being victimised since their arrival in the European Union. A total of 332 experiences of SGBV were reported, mostly afflicted on them by (ex-)partners or asylum professionals. More than half of the reported violent …


Nothing As Practical As A Good Theory? The Theoretical Basis Of Hiv Prevention Interventions For Young People In Sub-Saharan Africa: A Systematic Review, Kristien Michielsen, Matthew Chersich, Marleen Temmerman, Tessa Dooms, Ronan Van Rossem Jan 2012

Nothing As Practical As A Good Theory? The Theoretical Basis Of Hiv Prevention Interventions For Young People In Sub-Saharan Africa: A Systematic Review, Kristien Michielsen, Matthew Chersich, Marleen Temmerman, Tessa Dooms, Ronan Van Rossem

Obstetrics and Gynaecology, East Africa

This paper assesses the extent to which HIV prevention interventions for young people in sub-Saharan Africa are grounded in theory and if theory-based interventions are more effective. Three databases were searched for evaluation studies of HIV prevention interventions for youth. Additional articles were identified on websites of international organisations and through searching references. 34 interventions were included; 25 mentioned the use of theory. Social Cognitive Theory was most prominent (n = 13), followed by Health Belief Model (n = 7), and Theory of Reasoned Action/Planned Behaviour (n = 6). These cognitive behavioural theories assume that cognitions drive sexual behaviour. Reporting …