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Full-Text Articles in Medicine and Health Sciences

Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan Dec 2019

Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan

Department of Paediatrics and Child Health

Abstract are not provided by the author/publisher


Determinants Of Linear Growth Faltering Among Children With Moderate-To-Severe Diarrhea In The Global Enteric Multicenter Study, Rebecca L. Brander, Patricia B. Pavlinac, Judd L. Walson, Grace C. John-Stewart, Marcia R. Weaver, Abu S. G Faruque, Anita K. M. Zaidi, Dipika Sur, Samba O. Sow, M Jahangir Hossain Nov 2019

Determinants Of Linear Growth Faltering Among Children With Moderate-To-Severe Diarrhea In The Global Enteric Multicenter Study, Rebecca L. Brander, Patricia B. Pavlinac, Judd L. Walson, Grace C. John-Stewart, Marcia R. Weaver, Abu S. G Faruque, Anita K. M. Zaidi, Dipika Sur, Samba O. Sow, M Jahangir Hossain

Department of Paediatrics and Child Health

Background: Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD.
Methods: Using data from the Global Enteric Multicenter Study of children 0-23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of ≥ 0.5 length-for-age z-score [LAZ]). Linear regression was used to estimate associations with ΔLAZ. A …


The Epidemiological Burden Of Obesity In Childhood: A Worldwide Epidemic Requiring Urgent Action, Mariachiara Di Cesare, Maroje Sorić, Pascal Bovet, J Jaime Miranda, Zulfiqar Ahmed Bhutta, Gretchen A. Stevens, Avula Laxmaiah, Andre-Pascal Kengne, James Bentham Nov 2019

The Epidemiological Burden Of Obesity In Childhood: A Worldwide Epidemic Requiring Urgent Action, Mariachiara Di Cesare, Maroje Sorić, Pascal Bovet, J Jaime Miranda, Zulfiqar Ahmed Bhutta, Gretchen A. Stevens, Avula Laxmaiah, Andre-Pascal Kengne, James Bentham

Department of Paediatrics and Child Health

Background: In recent decades, the prevalence of obesity in children has increased dramatically. This worldwide epidemic has important consequences, including psychiatric, psychological and psychosocial disorders in childhood and increased risk of developing non-communicable diseases (NCDs) later in life. Treatment of obesity is difficult and children with excess weight are likely to become adults with obesity. These trends have led member states of the World Health Organization (WHO) to endorse a target of no increase in obesity in childhood by 2025.
Main body: Estimates of overweight in children aged under 5 years are available jointly from the United Nations Children's Fund …


A Novel Training Simulator For Portable Ultrasound Identification Of Incorrect Newborn Endotracheal Tube Placement – Observational Diagnostic Accuracy Study Protocol, Hasan S. Merali, Mark O. Tessaro, Khushboo Q. Ali, Shaun K. Morris, Sajid Bashir Soofi, Shabina Ariff Nov 2019

A Novel Training Simulator For Portable Ultrasound Identification Of Incorrect Newborn Endotracheal Tube Placement – Observational Diagnostic Accuracy Study Protocol, Hasan S. Merali, Mark O. Tessaro, Khushboo Q. Ali, Shaun K. Morris, Sajid Bashir Soofi, Shabina Ariff

Department of Paediatrics and Child Health

Background: Endotracheal tube (ETT) placement is a critical procedure for newborns that are unable to breathe. Inadvertent esophageal intubation can lead to oxygen deprivation and consequent permanent neurological impairment. Current standard-of-care methods to confirm ETT placement in neonates (auscultation, colorimetric capnography, and chest x-ray) are time consuming or unreliable, especially in the stressful resuscitation environment. Point-of-care ultrasound (POCUS) of the neck has recently emerged as a powerful tool for detecting esophageal ETTs. It is accurate and fast, and is also easy to learn and perform, especially on children.
Methods: This will be an observational diagnostic accuracy study consisting of two …


Frequency Of Early Morbidities In Low Birth Weight Neonates At The Aga Khan University Hospital, Karachi, Saroop Chand, Fayaz Ahmed Memon, Muhammad Hussain Shah, Abdul Lateef Leghari, Parveen Uzma, Rohan Advani, Muhammad Sohail Salat, Shabina Ariff Nov 2019

Frequency Of Early Morbidities In Low Birth Weight Neonates At The Aga Khan University Hospital, Karachi, Saroop Chand, Fayaz Ahmed Memon, Muhammad Hussain Shah, Abdul Lateef Leghari, Parveen Uzma, Rohan Advani, Muhammad Sohail Salat, Shabina Ariff

Department of Paediatrics and Child Health

Background:
Globally, approximately 14.6% children are born with low birth weight (LBW) annually. In Pakistan, this figure however reaches approximately 16%. Low birth weight infants are vulnerable to develop early morbidities like hypothermia, hypoglycemia, respiratory distress syndrome and hypocalcemia. There is a scarcity of statistics which creates a gap in development of strategies for improving quality of care in developing countries. The aim of our study was to determine the frequency of early morbidities such as respiratory distress syndrome (RDS), hypoglycemia, hypothermia and hypocalcemia in low birth weight neonates.
Methodology:
prospective descriptive study was conducted via non-probability sampling technique from …


Rethinking Community Based Strategies To Tackle Health Inequities In South Asia, Zulfiqar Ahmed Bhutta, Abhay Bang, Kaosar Afsana, Bishal Gyawali, Mohammed Shafiq Mirzazada, Renuka Jayatissa Nov 2019

Rethinking Community Based Strategies To Tackle Health Inequities In South Asia, Zulfiqar Ahmed Bhutta, Abhay Bang, Kaosar Afsana, Bishal Gyawali, Mohammed Shafiq Mirzazada, Renuka Jayatissa

Department of Paediatrics and Child Health

No abstract provided.


Evaluation Of A Maternal, Neonatal And Child Health Intervention Package In A Rural District Of Pakistan: A Quasi-Experimental Study, Atif Habib, Kirsten I. Black, Camille Raynes Greenow, Mushtaq Mirani, Sajid Muhammad, Fariha Shaheen, Monika Christofori Khadka, Annette Vondeling, Shabina Ariff, Sajid Bashir Soofi Nov 2019

Evaluation Of A Maternal, Neonatal And Child Health Intervention Package In A Rural District Of Pakistan: A Quasi-Experimental Study, Atif Habib, Kirsten I. Black, Camille Raynes Greenow, Mushtaq Mirani, Sajid Muhammad, Fariha Shaheen, Monika Christofori Khadka, Annette Vondeling, Shabina Ariff, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Pakistan is among the countries which have the highest maternal, neonatal and child mortality rates. Immediate efforts are required to enable Pakistan to achieve the health related sustainable development goals. The continuum of care interventions can substantially reduce the mortality burden, however local evidence to implement them is lacking in Pakistan. We implemented the maternal, neonatal and child health intervention package comprised of health facility strengthening, capacity building, continuum of care interventions and community mobilization and evaluated its effectiveness on maternal, neonatal and child health care practices and neonatal mortality.
Methods: The intervention package was delivered through existing public …


Chronic Maternal Depressive Symptoms Are Associated With Reduced Socio-Emotional Development In Children At 2 Years Of Age: Analysis Of Data From An Intervention Cohort In Rural Pakistan, Clariana V R. De Oliveira, Muneera Rasheed, Aisha K. Yousafzai Nov 2019

Chronic Maternal Depressive Symptoms Are Associated With Reduced Socio-Emotional Development In Children At 2 Years Of Age: Analysis Of Data From An Intervention Cohort In Rural Pakistan, Clariana V R. De Oliveira, Muneera Rasheed, Aisha K. Yousafzai

Department of Paediatrics and Child Health

Background: Maternal depression affects a high proportion of women during the antenatal and postnatal period in low- and middle-income countries. While maternal depression is recognized as a significant risk for poor early child development that warrants interventions, the effects of chronic maternal depression on children's development are less understood.
Objective: To determine the association of chronicity of maternal depressive symptoms and early child development in a rural population in southern Pakistan.
Materials and Methods: This study employs data from the "Pakistan Early Child Development Scale-Up Trial," a randomized controlled study that evaluated the integration of responsive stimulation and nutrition interventions …


Association Of Exposure To Civil Conflict With Maternal Resilience And Maternal And Child Health And Health System Performance In Afghanistan, Nadia Akseer, Arjumand Rizvi, Zaid Ahmad Bhatti, Jai K. Das, Karl Everett, Aneesa Arur, Mickey Chopra, Zulfiqar Ahmed Bhutta Nov 2019

Association Of Exposure To Civil Conflict With Maternal Resilience And Maternal And Child Health And Health System Performance In Afghanistan, Nadia Akseer, Arjumand Rizvi, Zaid Ahmad Bhatti, Jai K. Das, Karl Everett, Aneesa Arur, Mickey Chopra, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance: Current studies examining the effects of Afghanistan's conflict transition on the performance of health systems, health service delivery, and health outcomes are outdated and small in scale and do not span all essential reproductive, maternal, newborn, and child health interventions.
Objective: To evaluate associations of conflict severity with improvement of health system performance, use of health services, and child nutrition outcomes in Afghanistan during the 2003 to 2018 reconstruction period.
Design, setting, and participants: This population-based survey study included a sequential cross-sectional analysis of individual-level panel data across 2 periods (2003-2010 and 2010-2018) and a difference-in-differences design. Surveys included …


Women And Children Living In Areas Of Armed Conflict In Africa: A Geospatial Analysis Of Mortality And Orphanhood, Zachary Wagner, Sam Heft-Neal, Paul H. Wise, Robert E. Black, Marshall Burke, Ties Boerma, Zulfiqar Ahmed Bhutta, Eran Bendavid Oct 2019

Women And Children Living In Areas Of Armed Conflict In Africa: A Geospatial Analysis Of Mortality And Orphanhood, Zachary Wagner, Sam Heft-Neal, Paul H. Wise, Robert E. Black, Marshall Burke, Ties Boerma, Zulfiqar Ahmed Bhutta, Eran Bendavid

Department of Paediatrics and Child Health

Background:
The population effects of armed conflict on non-combatant vulnerable populations are incompletely understood. We aimed to study the effects of conflict on mortality among women of childbearing age (15–49 years) and on orphanhood among children younger than 15 years in Africa.
Methods:
We tested the extent to which mortality among women aged 15–49 years, and orphanhood among children younger than 15 years, increased in response to nearby armed conflict in Africa. Data on location, timing, and intensity of armed conflicts were obtained from the Uppsala Conflict Data Program, and data on the location, timing, and outcomes of women and …


Use Of Machine Learning Algorithms For Prediction Of Fetal Risk Using Cardiotocographic Data, Zahra Hoodbhoy, Mohammad Noman, Ayesha Shafique, Ali Nasim, Devyani Chowdhury, Babar Hasan Oct 2019

Use Of Machine Learning Algorithms For Prediction Of Fetal Risk Using Cardiotocographic Data, Zahra Hoodbhoy, Mohammad Noman, Ayesha Shafique, Ali Nasim, Devyani Chowdhury, Babar Hasan

Department of Paediatrics and Child Health

Background: A major contributor to under-five mortality is the death of children in the 1st month of life. Intrapartum complications are one of the major causes of perinatal mortality. Fetal cardiotocograph (CTGs) can be used as a monitoring tool to identify high-risk women during labor.
Aim: The objective of this study was to study the precision of machine learning algorithm techniques on CTG data in identifying high-risk fetuses.
Methods: CTG data of 2126 pregnant women were obtained from the University of California Irvine Machine Learning Repository. Ten different machine learning classification models were trained using CTG data. Sensitivity, precision, …


Binge-Watching Behaviours: The Impact On Medical Students In Pakistan, Zouina Sarfraz, Muzna Sarfraz, Azza Sarfraz Oct 2019

Binge-Watching Behaviours: The Impact On Medical Students In Pakistan, Zouina Sarfraz, Muzna Sarfraz, Azza Sarfraz

Department of Paediatrics and Child Health

No abstract provided.


Frequency And Early Complications Of Late Preterm Infants: A Descriptive Analysis From Two Secondary-Care Hospitals Of Karachi, Waqar Khowaja, Abdul Lateef Leghari, Shabbir Hussain, Shabina Ariff, Iqtidar Khan Sep 2019

Frequency And Early Complications Of Late Preterm Infants: A Descriptive Analysis From Two Secondary-Care Hospitals Of Karachi, Waqar Khowaja, Abdul Lateef Leghari, Shabbir Hussain, Shabina Ariff, Iqtidar Khan

Department of Paediatrics and Child Health

Introduction:
Globally, prematurity accounts for 12.7% of all live births while late preterm accounts for around three-fourth (73%) of these premature births. In Pakistan, the prevalence of prematurity is approximately 18.89%. Late preterm infants often have weight and size similar to some term infants, but they are still metabolically and physiologically immature. Hence, these infants, as compared to term infants, are at a higher risk of developing medical complications, which results in higher morbidity and mortality during the birth hospitalization. We aim to determine the frequency of early complications in late preterm infants during their stay at Aga Khan Secondary-care …


Factors Leading To Meconium Aspiration Syndrome In Term- And Post-Term Neonates, Saroop Chand, Aamna Salman, Razia Mustafa Abbassi, Abdul Rehman Siyal, Fayaz Ahmed Memon, Abdul Leghari Leghari, Ashmal Sami Kabani, Sajid Ali Sep 2019

Factors Leading To Meconium Aspiration Syndrome In Term- And Post-Term Neonates, Saroop Chand, Aamna Salman, Razia Mustafa Abbassi, Abdul Rehman Siyal, Fayaz Ahmed Memon, Abdul Leghari Leghari, Ashmal Sami Kabani, Sajid Ali

Department of Paediatrics and Child Health

Background:
Meconium aspiration syndrome (MAS) is considered a major cause of respiratory morbidity. It is a common issue encountered in the delivery room and newborn nursery. There is a need to identify the factors that lead to MAS to develop strategies to screen such patients at an early stage to decrease the mortality and morbidity. The objective of this study was to determine the factors leading to MAS in neonates delivered at ≥37 weeks of gestational age.
Methods:
A cross-sectional study was conducted through non-probability consecutive sampling technique at Liaquat University Hospital, Hyderabad from August 2016 to February 2017. All …


Addressing Childhood Undernutrition And Development Through Education And Lipid-Based Supplements, Jai K. Das, Rehana Salam Sep 2019

Addressing Childhood Undernutrition And Development Through Education And Lipid-Based Supplements, Jai K. Das, Rehana Salam

Department of Paediatrics and Child Health

No abstract provided.


Pathobiome Driven Gut Inflammation In Pakistani Children With Environmental Enteric Dysfunction, Najeeha Talat Iqbal, Sana Syed, Furqan Kabir, Zehra Jamil, Tauseef Akhund, Shahida Qureshi, Jie Liu, Jennie Ma Z, Shan Guleria, Andrew Gewirtz, Christopher Duggan P, Molly Hughes A, Kamran Sadiq, Asad Ali Aug 2019

Pathobiome Driven Gut Inflammation In Pakistani Children With Environmental Enteric Dysfunction, Najeeha Talat Iqbal, Sana Syed, Furqan Kabir, Zehra Jamil, Tauseef Akhund, Shahida Qureshi, Jie Liu, Jennie Ma Z, Shan Guleria, Andrew Gewirtz, Christopher Duggan P, Molly Hughes A, Kamran Sadiq, Asad Ali

Department of Paediatrics and Child Health

Environmental Enteric Dysfunction (EED) is an acquired small intestinal inflammatory condition underlying high rates of stunting in children <5 years of age in low- and middle-income countries. Children with EED are known to have repeated exposures to enteropathogens and environmental toxins that leads to malabsorptive syndrome. We aimed to characterize association of linear growth faltering with enteropathogen burden and subsequent changes in EED biomarkers. In a longitudinal birth cohort (n = 272), monthly anthropometric measurements (Length for Age Z score- LAZ) of asymptomatic children were obtained up to 18 months. Biological samples were collected at 6 and 9 months for the assessment of biomarkers. A customized TaqMan array card was used to target 40 enteropathogens in fecal samples. Linear regression was applied to study the effect of specific enteropathogen infection on change in linear growth (ΔLAZ). Presence of any pathogen in fecal sample correlated with serum flagellin IgA (6 mo, r = 0.19, p = 0.002), fecal Reg 1b (6 mo, r = 0.16, p = 0.01; 9mo, r = 0.16, p = 0.008) and serum Reg 1b (6 mo, r = 0.26, p<0.0001; 9 mo, r = 0.15, p = 0.008). At 6 months, presence of Campylobacter [β (SE) 7751.2 (2608.5), p = 0.003] and ETEC LT [β (SE) 7089.2 (3015.04), p = 0.019] was associated with increase in MPO. Giardia was associated with increase in Reg1b [β (SE) 72.189 (26.394), p = 0.006] and antiflic IgA[β (SE) 0.054 (0.021), p = 0.0091]. Multiple enteropathogen infections in early life negatively correlated with ΔLAZ, and simultaneous changes in gut inflammatory and permeability markers. A combination vaccine targeting enteropathogens in early life could help in the prevention of future stunting


Early Life Child Micronutrient Status, Maternal Reasoning, And A Nurturing Household Environment Have Persistent Influences On Child Cognitive Development At Age 5 Years: Results From Mal-Ed, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Caulfield, Laura L. Pendergast, Jessica C. Seidman, Beena Koshy, Reeba Roshan, Rita Shrestha, Erling Svensen, Muneera Rasheed Aug 2019

Early Life Child Micronutrient Status, Maternal Reasoning, And A Nurturing Household Environment Have Persistent Influences On Child Cognitive Development At Age 5 Years: Results From Mal-Ed, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Caulfield, Laura L. Pendergast, Jessica C. Seidman, Beena Koshy, Reeba Roshan, Rita Shrestha, Erling Svensen, Muneera Rasheed

Department of Paediatrics and Child Health

Background: Child cognitive development is influenced by early-life insults and protective factors. To what extent these factors have a long-term legacy on child development and hence fulfillment of cognitive potential is unknown.
Objective: The aim of this study was to examine the relation between early-life factors (birth to 2 y) and cognitive development at 5 y.
Methods: Observational follow-up visits were made of children at 5 y, previously enrolled in the community-based MAL-ED longitudinal cohort. The burden of enteropathogens, prevalence of illness, complementary diet intake, micronutrient status, and household and maternal factors from birth to 2 y were extensively measured …


Beyond Sequencing: Re-Visiting Annotations For Pjl As A Test Case, Waqasuddin Khan, Aisha Ghani, Muhammad Bilal Azmi, Safina Abdul Razzak Jul 2019

Beyond Sequencing: Re-Visiting Annotations For Pjl As A Test Case, Waqasuddin Khan, Aisha Ghani, Muhammad Bilal Azmi, Safina Abdul Razzak

Department of Paediatrics and Child Health

Objectives: Current developments in sequencing techniques have enabled rapid and high-throughput generation of sequence data. however, there is a growing gap between the generation of raw sequencing data and the extraction of meaningful biological information. variant annotation is a crucial step in the analysis of genome sequencing data. incorrect or incomplete annotations can cause researchers to dilute interesting variants in a pool of false positives. we require consistent, accurate and reliable annotation of variants for making diagnostic and treatment decisions. current annotation depends on the set of transcripts, and software used can be managed, with sufficient care, in the research …


Study Of Environmental Enteropathy And Malnutrition (Seem) In Pakistan: Protocols For Biopsy Based Biomarker Discovery And Validation, Najeeha Talat Iqbal, Sana Saeed, Kamran Sadiq, Marium N. Khan, Junaid Iqbal, Jennie Z. Ma, Fayaz Umrani, Sheraz Ahmed, Elizabeth A. Maier, Lee A. Denson, Shahida Qureshi, Syed Asad Ali Jul 2019

Study Of Environmental Enteropathy And Malnutrition (Seem) In Pakistan: Protocols For Biopsy Based Biomarker Discovery And Validation, Najeeha Talat Iqbal, Sana Saeed, Kamran Sadiq, Marium N. Khan, Junaid Iqbal, Jennie Z. Ma, Fayaz Umrani, Sheraz Ahmed, Elizabeth A. Maier, Lee A. Denson, Shahida Qureshi, Syed Asad Ali

Department of Paediatrics and Child Health

Background:
Environmental Enteropathy (EE), characterized by alterations in intestinal structure, function, and immune activation, is believed to be an important contributor to childhood undernutrition and its associated morbidities, including stunting. Half of all global deaths in children < 5 years are attributable to under-nutrition, making the study of EE an area of critical priority.
Methods:
Community based intervention study, divided into two sub-studies, 1) Longitudinal analyses and 2) Biopsy studies for identification of EE features via omics analyses. Birth cohorts in Matiari, Pakistan established: moderately or severely malnourished (weight for height Z score (WHZ) < − 2) children, and well-nourished (WHZ > 0) children. Blood, urine, and fecal samples, for evaluation of potential biomarkers, will be collected at various time points from all participants (longitudinal …


Ampa Receptor Glua2 Subunit Defects Are A Cause Of Neurodevelopmental Disorders, Vincenzo Salpietro, Christine L. Dixon, Hui Guo, Oscar D. Bello, Jana Vandrovcova, Stephanie Efthymiou, Reza Maroofian, Gali Heimer, Salman Kirmani, Shahnaz H. Ibrahim Jul 2019

Ampa Receptor Glua2 Subunit Defects Are A Cause Of Neurodevelopmental Disorders, Vincenzo Salpietro, Christine L. Dixon, Hui Guo, Oscar D. Bello, Jana Vandrovcova, Stephanie Efthymiou, Reza Maroofian, Gali Heimer, Salman Kirmani, Shahnaz H. Ibrahim

Department of Paediatrics and Child Health

AMPA receptors (AMPARs) are tetrameric ligand-gated channels made up of combinations of GluA1-4 subunits encoded by GRIA1-4 genes. GluA2 has an especially important role because, following post-transcriptional editing at the Q607 site, it renders heteromultimeric AMPARs Ca2+-impermeable, with a linear relationship between current and trans-membrane voltage. Here, we report heterozygous de novo GRIA2 mutations in 28 unrelated patients with intellectual disability (ID) and neurodevelopmental abnormalities including autism spectrum disorder (ASD), Rett syndrome-like features, and seizures or developmental epileptic encephalopathy (DEE). In functional expression studies, mutations lead to a decrease in agonist-evoked current mediated by mutant subunits compared to …


Outcome Of Inadvertent High Dose Bcg Administration In Newborns At A Tertiary Care Hospital, Karachi- Case Series, Sonia Qureshi, Khalil Ahmad, Paras Fatima, Rabia M. Hassan, Farheen Sherali, Naureen Lalani, Fyezah Jehan, Syed Asad Ali, Farah Qamar Jul 2019

Outcome Of Inadvertent High Dose Bcg Administration In Newborns At A Tertiary Care Hospital, Karachi- Case Series, Sonia Qureshi, Khalil Ahmad, Paras Fatima, Rabia M. Hassan, Farheen Sherali, Naureen Lalani, Fyezah Jehan, Syed Asad Ali, Farah Qamar

Department of Paediatrics and Child Health

Bacillus Calmette-Guérin (BCG) vaccine is given to newborns soon after birth. BCG vaccine overdose has been rarely reported. Here we report the outcome of newborns who accidently received high dose BCG at a tertiary care hospital, Karachi. We reviewed records of 26 newborns, who accidentally received intradermal high dose BCG, used for the treatment of urinary bladder cancers and 80 times higher dose than the BCG used for routine vaccination. The incident happened from 14-16th April, 2016 at Aga Khan University Hospital, Karachi. Analysis was carried out using SPSS. A total of 23/26(88.5%) newborns were followed for atleast 3 months …


Factors Associated With The Discontinuation Of Modern Methods Of Contraception In The Low Income Areas Of Sukh Initiative Karachi: A Community-Based Case Control Study, Rozina Thobani, Saleem Jessani, Iqbal Azam Syed, Sayyeda Reza, Neelofar Sami, Shafquat Rozi, Farina Abrejo, Sarah Saleem Jul 2019

Factors Associated With The Discontinuation Of Modern Methods Of Contraception In The Low Income Areas Of Sukh Initiative Karachi: A Community-Based Case Control Study, Rozina Thobani, Saleem Jessani, Iqbal Azam Syed, Sayyeda Reza, Neelofar Sami, Shafquat Rozi, Farina Abrejo, Sarah Saleem

Department of Paediatrics and Child Health

Introduction:
Discontinuation of a contraceptive method soon after its initiation is becoming a public health problem in Low middle income countries and may result in unintended pregnancy and related unwanted consequences. A better understanding of factors behind discontinuation of a modern method would help in designing interventions to continue its use till desired spacing goals are achieved. |
Objective:
To determine factors associated with the discontinuation of modern contraceptive methods within six months of its use compared to continued use of modern method for at least six months in low-income areas of Karachi, Pakistan.
Method:
Community-based case-control study was …


Effect Of Diabetic Counseling Based On Conversation Map As Compared To Routine Counseling On Diabetes Management Self-Efficacy And Diabetic Distress Among Patients With Diabetes In Pakistan: A Randomized Controlled Trial (Study Protocol), Rubina Qasim, Sarfaraz Masih, Mehwish Hussain, Akhter Ali, Ajmal Khan, Yousaf Shah, Hakim Shah, Mohammad Tahir Yousafzai Jul 2019

Effect Of Diabetic Counseling Based On Conversation Map As Compared To Routine Counseling On Diabetes Management Self-Efficacy And Diabetic Distress Among Patients With Diabetes In Pakistan: A Randomized Controlled Trial (Study Protocol), Rubina Qasim, Sarfaraz Masih, Mehwish Hussain, Akhter Ali, Ajmal Khan, Yousaf Shah, Hakim Shah, Mohammad Tahir Yousafzai

Department of Paediatrics and Child Health

Background:
Novel interactive and pictorial health education tool named Diabetes Conversation Map (DCM) might be effective for the improvement of diabetes management self-efficacy (DMSE) and diabetes distress (DD) among diabetic patients in lower middle-income setting. This study protocol will assess the effectiveness of DCM as compared to routine care (RC) to improve DMSE, decrease DD and glycated hemoglobin (HbA1c) among patients with type 2 diabetes (T2DM).
Methods:
This will be two arms randomized controlled trial, conducted at national institute of diabetes and endocrinology (NIDE) in Karachi, Pakistan. A sample of 120 T2DM patients of age 30–60 years with suboptimal diabetes …


Association Of Early Interventions With Birth Outcomes And Child Linear Growth In Low-Income And Middle-Income Countries: Bayesian Network Meta-Analyses Of Randomized Clinical Trials, Jay J. Park H., Mei Lan Fang, Ofir Harari, Louis Dron, Ellie G. Siden, Reham Majzoub, Virginia Jeziorska, Kristian Thorlund, Edward J. Mills, Zulfiqar Ahmed Bhutta Jun 2019

Association Of Early Interventions With Birth Outcomes And Child Linear Growth In Low-Income And Middle-Income Countries: Bayesian Network Meta-Analyses Of Randomized Clinical Trials, Jay J. Park H., Mei Lan Fang, Ofir Harari, Louis Dron, Ellie G. Siden, Reham Majzoub, Virginia Jeziorska, Kristian Thorlund, Edward J. Mills, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance:
The first 1000 days of life represent a critical window for child development. Pregnancy, exclusive breastfeeding (EBF) period (0-6 months), and complementary feeding (CF) period (6-24 months) have different growth requirements, so separate considerations for intervention strategies are needed. No synthesis to date has attempted to quantify the associations of interventions under multiple domains of micronutrient and balanced energy protein and food supplements, deworming, maternal education, water sanitation, and hygiene across these 3 life periods with birth and growth outcomes.
Objective:
To determine the magnitude of association of interventions with birth and growth outcomes based on randomized clinical trials …


Armed Conflicts And National Trends In Reproductive, Maternal, Newborn And Child Health In Sub-Saharan Africa: What Can National Health Surveys Tell Us?, Ties Boerma, Hannah Tappis, Ghada Saad-Haddad, Jai K. Das, Dessalegn Y. Melesse, Jocelyn Dejong, Paul Spiegel, Robert Black, Cesar Victora, Zulfiqar Ahmed Bhutta Jun 2019

Armed Conflicts And National Trends In Reproductive, Maternal, Newborn And Child Health In Sub-Saharan Africa: What Can National Health Surveys Tell Us?, Ties Boerma, Hannah Tappis, Ghada Saad-Haddad, Jai K. Das, Dessalegn Y. Melesse, Jocelyn Dejong, Paul Spiegel, Robert Black, Cesar Victora, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Armed conflicts are widespread in sub-Saharan Africa and considered to be an important factor in slowing down national progress in reproductive, maternal, newborn and child health (RMNCH). The measurement of the impact of conflicts on national levels and trends in RMNCH is difficult. National surveys conducted before and sometimes during and after conflicts are a major source of information on the national and local effects of conflicts on RMNCH. We examined data from national surveys in 13 countries in sub-Saharan Africa with major conflicts during 1990–2016 to assess the levels and trends in RMNCH intervention coverage, nutritional status and mortality …


Advancing Measurement And Monitoring Of Reproductive, Maternal, Newborn And Child Health And Nutrition: Global And Country Perspectives, Tanya Marchant, Zulfiqar Ahmed Bhutta, Robert Black, John Grove, Catherine Kyobutungi, Stefan Peterson Jun 2019

Advancing Measurement And Monitoring Of Reproductive, Maternal, Newborn And Child Health And Nutrition: Global And Country Perspectives, Tanya Marchant, Zulfiqar Ahmed Bhutta, Robert Black, John Grove, Catherine Kyobutungi, Stefan Peterson

Department of Paediatrics and Child Health

No abstract provided.


Nash-Wo-Numa (Childhood Growth & Development) Study Protocol: Factors That Impact Linear Growth In Children 9 To 15 Years Of Age In Matiari, Pakistan, Susan C. Campisi, Yaqub Wasan, Sajid Bashir Soofi, Suneeta Monga, Daphne J. Korczak, Wendy Lou, Olle Soder, Ashley Vandermorris, Khadija N Humayun, Ayesha Mian, Peter Szatmari, Zulfiqar Ahmed Bhutta Jun 2019

Nash-Wo-Numa (Childhood Growth & Development) Study Protocol: Factors That Impact Linear Growth In Children 9 To 15 Years Of Age In Matiari, Pakistan, Susan C. Campisi, Yaqub Wasan, Sajid Bashir Soofi, Suneeta Monga, Daphne J. Korczak, Wendy Lou, Olle Soder, Ashley Vandermorris, Khadija N Humayun, Ayesha Mian, Peter Szatmari, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Introduction: Adolescence is a time of significant physical and emotional change, and there is emerging concern that adolescents living in low- and middle-income countries (LMIC) may face substantial challenges in relation to linear growth and mental health. Data on the global burden of stunting after 5 years of age are limited, but estimates suggest up to 50 per cent of all adolescents in some LMIC are stunted. Additionally, many LMIC lack robust mental health care delivery systems. Pakistan has one of the world's largest populations of adolescents (10 to 19 years) at approximately 40 million. The Nash-wo-Numa study's primary objective …


Association Of Nutritional Status Measures With Self-Efficacy And Experiencing Depressed Mood Among Pakistani Young Women (P10-090-19), Jo-Anna Baxter, Yaqub Wasan, Sajid Bashir Soofi, Imran Ahmed, Zulfiqar Ahmed Bhutta Jun 2019

Association Of Nutritional Status Measures With Self-Efficacy And Experiencing Depressed Mood Among Pakistani Young Women (P10-090-19), Jo-Anna Baxter, Yaqub Wasan, Sajid Bashir Soofi, Imran Ahmed, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Objectives:
We aimed to assess self-efficacy and the experience of depression-related emotions among non-pregnant adolescent and young women (15–23 years) living in rural Pakistan, and determine their association with measures of nutritional status.
Methods:
Outcomes were assessed from the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial baseline data (n = 25,279). Self-efficacy and depression-related emotions were determined and categorized using the general self-efficacy scale (low, moderate, and high) and DASS-21 tool (normal, mild, moderate, severe, and extremely severe), respectively. Nutritional status was evaluated using hemoglobin concentration (HemoCue Hb 301 System) and body mass index (BMI). Associations were assessed using ordinal …


Nurturing Environments And Nutrient-Rich Diets May Improve Cognitive Development: Analysis Of Cognitive Trajectories From Six To Sixty Months From The Mal-Ed Study (Or10-01-19), Benjamin Mccormick, Laura Caulfield, Stephanie Richard, Laura Pendergast, Laura Murray-Kolb, Mal-Ed Network Investigators Jun 2019

Nurturing Environments And Nutrient-Rich Diets May Improve Cognitive Development: Analysis Of Cognitive Trajectories From Six To Sixty Months From The Mal-Ed Study (Or10-01-19), Benjamin Mccormick, Laura Caulfield, Stephanie Richard, Laura Pendergast, Laura Murray-Kolb, Mal-Ed Network Investigators

Department of Paediatrics and Child Health

Objectives: To identify clusters of cognitive developmental trajectories and associated differentiating factors of children aged 6 to 60 months old in 5 low to middle-income sites.
Methods: We followed 835 children and assessed anthropometry at enrolment (≤ 17 d old); bi-weekly illness data (0–24 and 60 mo); non-diarrheal and diarrheal stools (0–24 mo) analyzed for a panel of enteropathogens; quantitative complementary food intakes (9–24 and 60 mo); micronutrient status (Fe, Zn, Vit A; 7, 15, and 24 mo); quality of the child's home environment (6, 24, and 60 mo) and maternal reasoning ability and depressive symptoms via questionnaire. Child cognitive …


Effect Of Lipid-Based Nutrient Supplement - Medium Quantity On Reduction Of Stunting In Children 6-23 Months Of Age In Sindh, Pakistan: A Cluster Randomized Controlled Trial (Or25-06-19), Sajid Bashir Soofi, Gul Nawaz Khan Nawaz Khan, Cecilia Garzon Jun 2019

Effect Of Lipid-Based Nutrient Supplement - Medium Quantity On Reduction Of Stunting In Children 6-23 Months Of Age In Sindh, Pakistan: A Cluster Randomized Controlled Trial (Or25-06-19), Sajid Bashir Soofi, Gul Nawaz Khan Nawaz Khan, Cecilia Garzon

Department of Paediatrics and Child Health

Objectives:
We evaluated the effectiveness of a locally produced lipid-based nutrient supplement - medium-quantity (LNS-MQ) known as Wawamum to prevent stunting in children 6–23 months of age in Thatta and Sujawal districts of Sindh province, Pakistan. Methods: A cluster randomized controlled trial was conducted and a total of 870 children between 6–18 months old were enrolled. Children in the intervention group received 50 grams/day of Wawamum for 6 months, while children in the control group received standard government health services, not including Wawamum. The primary outcome was stunting risk reduction among children 6–23 months of age.
Results:
Children who received …