Digital Commons Network^™

Mortality And Cardiovascular And Respiratory Morbidity In Individuals With Impaired Fev 1 (Pure): An International, Community-Based Cohort Study, Mylinh Duong, Shofiqul Islam, Sumathy Rangarajan, Darryl Leong, Om Kurmi, Koon Teo, Kieran Killian, Gilles Dagenais, Scott Lear, Romaina Iqbal

Community Health Sciences

Background: The associations between the extent of forced expiratory volume in 1 s (FEV₁) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary across populations is unknown.
Methods: In this international, community-based cohort study, we prospectively enrolled adults aged 35-70 years who had no intention of moving residences for 4 years from rural and urban communities across 17 countries. A portable spirometer was used to assess FEV₁. FEV₁ values were standardised within countries for height, age, and sex, and expressed as a percentage of the country-specific predicted …

The Incidence, Aetiology, And Adverse Clinical Consequences Of Less Severe Diarrhoeal Episodes Among Infants And Children Residing In Low-Income And Middle-Income Countries: A 12-Month Case-Control Study As A Follow-On To The Global Enteric Multicenter Study (Gems), Karen L. Kotloff, Dilruba Nasrin, William C. Blackwelder, Yukun Wu, Tamer Farag, Sandra Panchalingham, Samba O. Sow, Anita K. M. Zaidi, Shahida Qureshi, Farheen Quadri

Department of Paediatrics and Child Health

Background: Diarrheal diseases remain a leading cause of illness and death among children younger than 5 years in low-income and middle-income countries. The Global Enteric Multicenter Study (GEMS) has described the incidence, aetiology, and sequelae of medically attended moderate-to-severe diarrhoea (MSD) among children aged 0-59 months residing in censused populations in sub-Saharan Africa and south Asia, where most child deaths occur. To further characterise this disease burden and guide interventions, we extended this study to include children with episodes of less-severe diarrhoea (LSD) seeking care at health centres serving six GEMS sites.
Methods: We report a 1-year, multisite, age-stratified, matched …

Regional Variation In Comorbid Prediabetes And Diabetes And Associated Factors Among Hypertensive Individuals In Rural Bangladesh, Pakistan, And Sri Lanka, Liang Feng, Aliya Naheed, H. Asita De Silva, Imtiaz Jehan, Rubhana Raqib, Md Tauhidul Islam, Nathasha Luke, Anuradhani Kasturiratne, Hamida Farazdaq, Sahar Senan, Tazeen Jafar, Cobra-Bps Study Group

Community Health Sciences

We aimed to explore the cross-country variation in the prevalence of comorbid prediabetes or diabetes and determine the sociodemographic, lifestyle, and clinical factors, especially body mass index (BMI) and waist circumference, associated with comorbid diabetes in individuals with hypertension in rural South Asia. We analyzed cross-sectional data of 2426 hypertensive individuals of ≥40 years from 30 randomly selected rural communities in Bangladesh, Pakistan, and Sri Lanka. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dL without use of antidiabetic treatment and diabetes as FPG ≥126 mg/dL or use of antidiabetic medication. The prevalence (95% CI) of …

Gene Lifestyle Interactions With Relation To Obesity, Cardiometabolic, And Cardiovascular Traits Among South Asians, Shafqat Ahmad, Syeda Sadia Fatima, Gull Rukh, Caren E. Smith

Department of Biological & Biomedical Sciences

The rapid rise of obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) during the last few decades among South Asians has been largely attributed to a major shift in lifestyles including physical inactivity, unhealthy dietary patterns, and an overall pattern of sedentary lifestyle. Genetic predisposition to these cardiometabolic risk factors may have interacted with these obesogenic environments in determining the higher cardiometabolic disease prevalence. Based on the premise that gene-environment interactions cause obesity and cardiometabolic diseases, we systematically searched the literature and considered the knowledge gaps that future studies might fulfill. We identified only seven published studies that …

Sedentary Lifestyle And Framingham Risk Scores: A Population-Based Study In Riyadh City, Saudi Arabia, Aljohara M. Alquaiz, Amna Siddiqui, Ambreen Kazi, Mohammad Ali Batais, Ali M. Al-Hazmi

Community Health Sciences

Background: Studies from Saudi Arabia have reported a continued increase in the prevalence of cardiovascular diseases and their associated risk factors. The objective of this study was to measure the gender differences in the cardiovascular disease (CVD) risk based on Framingham risk scores (FRS) and to explore the association of FRS with sedentary life style including physical inactivity, sitting time and central obesity among Saudi adults.
Methods: A cross-sectional survey was conducted on 2997 Saudi adults (males = 968, females = 2029) selected from 18 primary health care centres in Riyadh city, from December 2014 to August 2015. A detailed …

Retrospective Study Of Patients With Hyperphenylalaninemia: Experience From A Tertiary Care Center In Pakistan, Sibtain Ahmed, Hafsa Majid, Lena Jafri, Aysha Habib Khan, Zeba Zulfiqar Ali, Bushra Afroze

Department of Pathology and Laboratory Medicine

Objective: To assess the clinical and biochemical features as well as outcome of perphenylalaninemia patients.
Methods: The descriptive retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from January 2013 to February 2017 of plasma amino acid analysed at the Biochemical Genetic Laboratory of patients with phenylalanine levels >120 umol/L. Medical charts of patients registered with the Metabolic Clinics were reviewed, while outside referrals were contacted by telephone to collect data on a pre-structured questionnaire. Data was analysed using SPSS 21.
Results: Of the 18 patients, 13(72%) were males. Overall median age was 606 days …

Contextual Design Choices And Partnerships For Scaling Early Child Development Programmes, Kate M. Milner, Raquel Bernal Salazar, Sunil Bhopal, Alexandra Brentani, Pia Rebello Britto, Tarun Dua, Melissa Gladstone, Esther Goh, Jena Hamadani, Muneera Rasheed

Department of Paediatrics and Child Health

Translating the Nurturing Care Framework and unprecedented global policy support for early child development (ECD) into action requires evidence-informed guidance about how to implement ECD programmes at national and regional scale. We completed a literature review and participatory mixed-method evaluation of projects in Saving Brains®, Grand Challenges Canada® funded ECD portfolio across 23 low- and middle-income countries (LMIC). Using an adapted programme cycle, findings from evaluation related to partnerships and leadership, situational analyses, and design for scaling ECD were considered. 39 projects (5 'Transition to Scale' and 34 'Seed') were evaluated. 63% were delivered through health and 84% focused on …

Lifestyle, Cardiovascular Risk Knowledge And Patient Counselling Among Selected Sub-Saharan African Family Physicians And Trainees. African Journal Of Primary Health Care & Family Medicine, Pius O. Ameh, Kenneth Yakubu, Miriam Miima, Olugbemi Popoola, Gulnaz Mohamoud, Klaus B. Von Pressentin

Family Medicine, East Africa

Background: Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies.

Aim: The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA.

Setting: FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA.

Methods: A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following …

A Mixed Method Multi-Country Assessment Of Barriers To Implementing Pediatric Inpatient Care Guidelines, Kirkby D. Tickell, Dorothy I. Mangale, Stephanie N. Tornberg-Belanger, Celine Bourdon, Johnstone Thitiri, Molline Timbwa, Jenala Njirammadzi, Wieger Voskuijl, Ali Faisal Saleem, Zaubina Kazi

Department of Paediatrics and Child Health

Introduction: Accelerating progress in reducing child deaths is needed in order to achieve the Sustainable Development Goal child mortality target. This will require a focus on vulnerable children-including young children, those who are undernourished or with acute illnesses requiring hospitalization. Improving adherence to inpatient guidelines may be an important strategy to reduce child mortality, including among the most vulnerable. The aim of our assessment of nine sub-Saharan African and South Asian hospitals was to determine adherence to pediatric inpatient care recommendations, in addition to capacity for and barriers to implementation of guideline-adherent care prior to commencing the Childhood Acute Illness …

Mental Health Services For Youth In The Eastern Mediterranean Region: Challenges And Opportunities (Editorial), Atif Rahman, Hesham M. Hamoda, Afarin Rahimi-Movaghar, Murad M. Khan Dr., Khalid Saeed

Department of Psychiatry

The Global Burden of Disease study shows that the burden from mental and substance use disorders, measured in Disability Adjusted Life Years (DALYs), has steadily risen in the Eastern Mediterranean Region (EMR) over the last three decades and is higher than the global average for almost all EMR countries). Even more alarming is the finding that depression, self-harm, anxiety and conduct disorders constitute four of the top 10 causes of DALYs among girls and boys aged 15-19 years and suicide is a leading cause of adolescent mortality.

Factors Associated With Anemia Among Women Of The Reproductive Age Group In Thatta District: Study Protocol, Sumera Aziz Ali, Zahid Abbasi, Anam Feroz, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Sarah Saleem

Community Health Sciences

Background: Maternal anemia is a leading public health issue placing pregnant women at higher risk of low birth weight, preterm birth, perinatal mortality, and neonatal mortality. Women in developing countries are at higher risk of anemia which could be either due to micronutrient deficiencies, hemoglobinopathies, infections or other socio-demographic factors. Thus, it is highly essential to explore the factors of anemia among women of the reproductive age group in order to design suitable interventions. The primary objective of this study is to assess the biological and socio-demographic factors that are associated with anemia among the women of the reproductive age …

Progress In Adolescent Health And Wellbeing: Tracking 12 Headline Indicators For 195 Countries And Territories, 1990–2016, Peter S. Azzopardi, Stephen J. C. Hearps, Kate L. Francis, Elissa C. Kennedy, Ali H. Mokdad, Nicholas J. Kassebaum, Stephen Lim, Caleb M. S. Irvine, Theo Vos, Alex D. Brown, Surabhi Dogra, Stuart A. Kinner, Natasha S. Kaoma, Mariam Naguib, Nicola J. Reavley, Jennifer Requejo, John S. Santelli, Susan M. Sawyer, Vegard Skirbekk, Marleen Temmerman, Jordan Tewhaiti-Smith, Joseph L. Ward, Russell M. Viner, George C. Patton

Obstetrics and Gynaecology, East Africa

Background: Rapid demographic, epidemiological, and nutritional transitons have brought a pressing need to track progress in adolescent health. Here, we present country-level estimates of 12 headline indicators from the Lancet Commission on adolescent health and wellbeing, from 1990 to 2016.

Methods: Indicators included those of health outcomes (disability-adjusted life-years [DALYs] due to communicable, maternal, and nutritional diseases; injuries; and non-communicable diseases); health risks (tobacco smoking, binge drinking, overweight, and anaemia); and social determinants of health (adolescent fertility; completion of secondary education; not in education, employment, or training [NEET]; child marriage; and demand for contraception satisfied with modern methods). We drew …

Protecting Women And Children In Conflict Settings, Zulfiqar Ahmed Bhutta, Michelle F. Gaffey, Karl Blanchet, Ron Waldman, Kamran Abbasi

Department of Paediatrics and Child Health

No abstract provided.

Global Monitoring Of Antimicrobial Resistance Based On Metagenomics Analyses Of Urban Sewage, Rene S. Hendriksen, Patrick Munk, Patrick Njage, Bram Van Bunnik, Luke Mcnally, Oksana Lukjancenko, Timo Röder, David Nieuwenhuijse, Rumina Hasan, Sadia Shakoor

Department of Pathology and Laboratory Medicine

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, …

A Consensus On Malnutrition In Africa: A Report From The Micronutrient Deficiency Awareness Forum (Nairobi 2017), David Githanga, Alex Awiti, F. Were, T. Ngwiri., M. Y. Nyarko, N. Shellack

East Africa Institute

While most forms of malnutrition are easy to identify at an early age, micronutrient deficiency also manifests in form of “Hidden Hunger”, where children could seem to be well fed, but still suffer from deficiencies due to lack of key micronutrients in their diets whose absence is hard to detect. While the symptoms of micronutrient deficiency may not be obvious in the short-term, they translate into cognitive deficiencies in the longterm that negatively affect the economic productivity of these infants when they become adults, perpetuating the malnutrition cycle. The Micronutrient Deficiency Awareness Forum was held in April 2017 in Nairobi …

Microbiological Safety Of Areca Nut-Containing, Ready-To-Eat Chewing Substances Common Among Pakistani Paediatric Population: A Pilot Study, Anjiya Sulaiman, Hina Saeed Zuberi, Seema Irfan, Kulsoom Ghias

Department of Biological & Biomedical Sciences

Objective: To evaluate microbiological contamination of areca nut-containing, ready-to-eat chewing substances easily accessible to vulnerable paediatric population.
Methods: A pilot study was conducted at the Aga Khan University Medical College from June to October 2016 on twelve samples of areca nut-containing chewing substances (four supari, paan masala and gutka each) collected from various localities of Karachi. These were evaluated individually for total colony counts, hygiene indicator organisms, pathogenic organisms, and levels of aflatoxin. Microbial contamination was analysed using pour-plate method. Fungal aflatoxin levels were measured by enzyme-linked immunosorbent assay (ELISA)..
Results: Wet gutka preparations were contaminated by Escherichia coli and …

Effectiveness Of 10-Valent Pneumococcal Conjugate Vaccine Against Vaccine-Type Invasive Pneumococcal Disease In Pakistan, Atif Riaz, Syed Mohiuddin, Sara Husain, Mohammad Tahir Yousafzai, Muhammad Sajid, Furqan Kabir, Najeeb Rehman, Waseem Mirza, Basit Salam, Naila Naila, Khatidja Pardhan, Anita K. M. Zaidi, Syed Asad Ali

Department of Paediatrics and Child Health

Objective: To assess the effectiveness of 10-valent pneumococcal conjugate vaccine (PCV10) against invasive pneumococcal disease (IPD) due to vaccine serotypes of Streptococcus pneumoniae post introduction of the vaccine into the routine immunization program in Pakistan.
Methods: A matched case-control study was conducted at 16 hospitals in Sindh Province, Pakistan. Children aged (eligible to receive PCV10) who presented with radiographically confirmed pneumonia and/or meningitis were enrolled as cases. PCR for the lytA gene was conducted on blood (for radiographic pneumonia) and cerebrospinal fluid (for meningitis) samples to detect S. pneumoniae. The proportion of IPD due to vaccine serotypes (including vaccine-related serogroups) …

Femoral Vein Transposition Arteriovenous Fistula Is A Feasible Option In "Selected" Patients As Hemodialysis Access, Zia Ur Rehman, Asfia Arham, Ziad Sophie

Section of Cardiothoracic Surgery

Introduction: Lower extremity hemodialysis access is offered to the patients who have severe central venous stenosis. Femoral vein transposition arteriovenous fistula (FV tAVF) is an alternative to lower leg arteriovenous prosthetic grafts. Its safety and patency is under observation.
Materials and Methods: This is a retrospective review of patients who had FV tAVF between January 2011 and March 2016. Preoperative clinical findings, intraoperative findings, postoperative complications, and patency of the AVF were noted and analyzed.
Results: There were 7 patients who underwent FV tAVF during this study period. Most patients were female (6 : 1), with mean …

Joint Association Of Urinary Sodium And Potassium Excretion With Cardiovascular Events And Mortality: Prospective Cohort Study, Martin O'Donnell, Andrew Mente, Sumathy Rangarajan, Matthew J. Mcqueen, Neil O'Leary, Lu Yin, Xiaoyun Liu, Sumathi Swaminathan, Rasha Khatib, Romaina Iqbal

Community Health Sciences

Objective: To evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults.
Design: International prospective cohort study.
Setting: 18 high, middle, and low income countries, sampled from urban and rural communities.
Participants: 103 570 people who provided morning fasting urine samples.
Main outcome measures: Association of estimated 24 hour urinary sodium and potassium excretion (surrogates for intake) with all cause mortality and major cardiovascular events, using multivariable Cox regression. A six category …

Effect Of 10-Valent Pneumococcal Conjugate Vaccine On The Incidence Of Radiologically-Confirmed Pneumonia And Clinically-Defined Pneumonia In Kenyan Children: An Interrupted Time-Series Analysis, Micah Silaba, Michael Ooko, Christian Bottomley, Joyce Sande, Rachel Benamore, Kate Park, James Ignas, Kathryn Maitland, Neema Mturi, Anne Makumi

Imaging & Diagnostic Radiology, East Africa

Background: Pneumococcal conjugate vaccines (PCV) are highly protective against invasive pneumococcal disease caused by vaccine serotypes, but the burden of pneumococcal disease in low-income and middle-income countries is dominated by pneumonia, most of which is non-bacteraemic. We examined the effect of 10-valent PCV on the incidence of pneumonia in Kenya.

Methods: We linked prospective hospital surveillance for clinically-defined WHO severe or very severe pneumonia at Kilifi County Hospital, Kenya, from 2002 to 2015, to population surveillance at Kilifi Health and Demographic Surveillance System, comprising 45000 children younger than 5 years. Chest radiographs were read according to a WHO standard. A …

Healthy Heart Africa-Kenya: A 12-Month Prospective Evaluation Of Program Impact On Health Care Providers' Knowledge And Treatment Of Hypertension, Elijah N. Ogola, Francis O. Okello, Jane L. Herr, Elizabeth Macgregor-Skinner, Ashling Mulvaney, Gerald Yonga

Internal Medicine, East Africa

Background: Given the rising burden of hypertension in Africa, the Healthy Heart Africa program was developed to improve access to quality hypertension care in the primary care setting. The Healthy Heart Africa program provides a comprehensive, coordinated intervention directed at health care providers (HCPs) and the general public.

Objective: The impact of Healthy Heart Africa on HCPs' knowledge of hypertension and facility-level services in Kenya was evaluated by a 12-month prospective study.

Methods: Intervention facilities were selected by stratified random sampling and matched to similar control facilities. Intervention facilities received a hypertension treatment protocol, equipment, training and patient education materials, …

Early Neonatal Vitamin A Supplementation And Infant Mortality: An Individual Participant Data Meta-Analysis Of Randomised Controlled Trials, Rajiv Bahl, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Biannual vitamin A supplementation is a well-established survival tool for preschool children 6 months and older in vitamin A deficient populations but this schedule misses the opportunity to intervene on most young infant deaths. Randomised trials of neonatal vitamin A supplementation (NVAS) in the first few days of life to assess its impact on under 6-month mortality in low/middle-income countries have had varying results.
Methods: Investigators of 11 published randomised placebo-controlled NVAS trials (n=163 567 children) reanalysed their data according to an agreed plan and pooled the primary outcomes of mortality from supplementation through 6 and 12 months of …

The Salt Between The Beans: A Qualitative Study Of The Role Of Auxiliary Midwives In A Hard-To-Reach Area Of Myanmar, Kyu Kyu Than, Stanley Luchters, Khaing Nwe Tin, Thazin La, James Beeson, Alison Morgan

Population Health, East Africa

Background: Auxiliary Midwives (AMWs) are unpaid volunteer health workers assisting qualified paid midwives in maternal and child health care mainly in hard-to-reach areas of Myanmar. This paper describes the relationship between AMWs and the health system in providing maternal and child services as perceived by the community, AMWs themselves and health care providers in one remote township of Myanmar.

Method: A qualitative study was conducted in Ngape Township, Myanmar. A total of 15 focus group discussions with midwives, AMWs, community members and mothers were conducted. Ten key informant interviews were performed with national, district and township level health planners and …

Health Care Seeking For Maternal And Newborn Illnesses In Low- And Middle-Income Countries: A Systematic Review Of Observational And Qualitative Studies, Zohra S. Lassi, Philippa Middleton, Zulfiqar Ahmed Bhutta, Caroline Crowther

Woman and Child Health

Background: In low- and middle-income countries, a large number of maternal and newborn deaths occur due to delays in health care seeking. These delays occur at three levels i.e. delay in making decision to seek care, delay in access to care, and delay in receiving care. Factors that cause delays are therefore need to be understand to prevent and avoid these delays to improve health and survival of mothers and babies.
Methods: A systematic review of observational and qualitative studies to identify factors and barriers associated with delays in health care seeking.
Results: A total of 159 observational and qualitative …

Diabetes Prevalence Survey Of Pakistan (Dps-Pak): Prevalence Of Type 2 Diabetes Mellitus And Prediabetes Using Hba1c: A Population-Based Survey From Pakistan, Azizul L Hasan Aamir, Saeed A. Mahar, Faisal Masood Qureshi, Ibrar Ahmad, Ali Jawa, Aisha Sheikh, Abbas Raza, Sheraz Fazid, Zahid Jadoon, Osama Ishtiaq

Section of Diabetes, Endocrinology and Metabolism

Objectives: We conducted a Pakistan-wide community-based survey on the prevalence of type 2 diabetes using glycated haemoglobin (HbA1c) as the screening test. The aim was to estimate diabetes prevalence across different demographic groups as well as all regions of Pakistan.

Design, settings and participants: Multistaged stratified cluster sampling was used for the representative selection of people aged ≥20 years, residing in 378 sampled clusters of 16 randomly selected districts, in this cross-sectional study. Eligible participants had blood drawn for HbA1c analyses at field clinics near to their homes. The oral glucose tolerance test (OGTT) was conducted on a subsample of …

Association Between Leptin, Obesity, Hormonal Interplay And Male Infertility, Sofia Amjaad, Mukhtiar Baig, Nida Zahid, Sundus Tariq, Rehana Rehman

Department of Surgery Docs

Male infertility is a major health problem worldwide. We investigated a possible association between leptin, obesity, hormonal interplay and male infertility. This cross-sectional study of 313 males (178 infertile and 135 fertile) was carried out in 2017. The subjects were categorised by body mass index (BMI) and body fat percentage (BF%) into normal weight, overweight and obese. Significantly higher levels of BMI and BF% (p-value < 0.001) and lower levels of FSH, LH, testosterone, and SHBG (p-value < 0.001) were found in infertile males. However, no significant difference was observed in leptin levels (p-value = 0.35). Leptin levels were significantly higher, and all the sex hormones were significantly lower (p-value < 0.001) in obese subjects, whereas according to BF% only leptin, FSH and SHBG were significantly different. Leptin showed a significant positive correlation with BMI and BF% (p < 0.001). A strong positive link to serum testosterone was found with age, FSH, and LH (p < 0.001) and a negative one with BMI and BF% (p < 0.001). In mutivariable anlaysis, after adjusting for the other covariates, a significant association between FSH and testosterone (p-value <0.001) was found. Serum leptin levels did not differ significantly in fertile and infertile groups, and no association was found with infertility. Furthermore, male obesity was found to be associated with infertility with the decrease in levels of sex hormones.

Global Surgery: Building Healthy Surgical Systems., Taylor Leposa, Bria Johnston, Sohail Asghar Dogar, Henry Rice, Tamara Fitzgerald

Department of Surgery Docs

Global Surgery (GS) is a movement that advocates access of every individual to safe and affordable surgery despite geographic location or socioeconomic status. It has recently received increased attention within the global health arena, but many patients are still without access to care because of geographical, social and economic disparities. Due to the multi-disciplinary nature of surgical services, GS requires that a worldwide network of healthy surgical systems be developed and sustained. Healthy surgical systems have many components, and this paper will briefly address 3 of those components: Improved access to care, safety and quality, and multidisciplinary strengthening.

Association Between Asthma And Dental Caries Amongst 12 - 15 Years Old Children: A School-Based Cross-Sectional Study In Karachi, Pakistan, Wajeeha Zahid, Shafquat Rozi, Farhan Raza Khan, Nida Zahid, Muhammad Masood Kadir

Community Health Sciences

Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children.
Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.
Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted …

Labrad : Vol 45, Issue 1 - February 2019, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Cardiac Manifestation of Inherited Metabolic Disorders
• Utility of Plasma Homocysteine in Identifying Inherited Metabolic Disorders (IMDs)
• Chediak-Higashi Syndrome, an Inherited Disorder in Phagocytic Function
• Radiology-Pathology Correlation Rare Diseases of Bone
• Dried Blood Spot (DBS) Sampling: A Method for Blood Collection without Venipuncture
• Newborn Screening Program for Congenital Hypothyroidism
• Rare Disease in Dermatopathology
• Screening for Carbohydrate Metabolism Disorders by Sugar Chromatography in Urine
• Hypophosphatasia a Rare Skeletal Disorder

Neurodevelopmental Milestones And Associated Behaviours Are Similar Among Healthy Children Across Diverse Geographical Locations, José Villar, Michelle Fernandes, Manorama Purwar, Eleonora Staines-Urias, Paola Di Nicola, Leila Cheikh Ismail, Roseline Ochieng, Fernando Barros, Maria Carvalho, Elaine Albernaz

Paediatrics and Child Health, East Africa

It is unclear whether early child development is, like skeletal growth, similar across diverse regions with adequate health and nutrition. We prospectively assessed 1307 healthy, well-nourished 2-year-old children of educated mothers, enrolled in early pregnancy from urban areas without major socioeconomic or environmental constraints, in Brazil, India, Italy, Kenya and UK. We used a specially developed psychometric tool, WHO motor milestones and visual tests. Similarities across sites were measured using variance components analysis and standardised site differences (SSD). In 14 of the 16 domains, the percentage of total variance explained by between-site differences ranged from 1.3% (cognitive score) to 9.2% …