Breastfeeding Associated with Intestinal Parasitic Infections among Children Up to Two Years of Age at Selected Health Facilities in Karachi, Pakistan

Background: Intestinal parasitic infections have been a worldwide public health issue. The most vulnerable population is children due to their immature immune systems and nutritional requirements. IPIs are associated with improper sanitation, no access to safe water and improper hygiene, economic uncertainty, and social marginalization. Objective: This study aimed to determine the association of breastfeeding with IPIs among children up to two years of age at selected health facilities in Karachi, Pakistan. Methods: The study was conducted among 160 children up to two years of age, out of which 80 were breastfed and 80 were nonbreastfed. The study was carried out in selected health facilities in Karachi, Pakistan, from October 2022 to January 2023. The study design was analytical cross-sectional, and the data was collected through a structured questionnaire. The questionnaire included questions related to the demographics of the children and their mothers, feeding practices, hygiene practices, and the health status of the children. Results: The overall prevalence of IPIs among children up to two years of age was 36.9%, with Entamoeba histolytica and Giardia Lamblia being the most common parasites identified. Breastfeeding was significantly associated with a lower risk of IPIs (OR: 2.02, 95% CI: 1.05-3.90). Other factors associated with IPIs included age 0 to 12 months (OR: 0.30, 95% CI: 0.12-0.74), the habit of fingernails trimming (OR:0.35, 95% CI: 0.17-0.72), mother’s hand washing before preparing food (OR: 0.44, 95% CI: 0.22-0.85), method of purifying drinking water (OR: 0.45,95% CI: 0.21-0.86) and history of diarrhea, abdominal pain, excessive crying, and perianal itching (OR: 1.96, 95% CI: 1.02-3.76), (OR: 1.96, 95% CI: 1.02-3.76), (OR: 2.88, 95% CI: 1.47-5.64) and (OR: 3.15, 95% CI: 1.50-6.60), respectively. Conclusion: Our study highlights the prevalence of IPIs among children up to two years of age in Karachi, Pakistan. Breastfeeding was found to be protective against IPIs, while other factors such as age, the habit of fingernail trimming, hand washing, water purification, and symptoms of infection were found to be associated with a higher risk of IPIs

Effect of Tobacco Use during Pregnancy on Fetal Birth Weight Born to Women between 18-35 years in Thatta District

Background: Consumption of tobacco in its various forms is widespread and a serious public health issue globally. Although smoking is the predominant common method of tobacco use, the consumption of smokeless tobacco has increased in recent decades. Smokeless tobacco products are becoming more popular among women. In Pakistan, the overall prevalence of smokeless tobacco among males and females is 7%, out of which 10% are women which may be linked to poor reproductive outcomes and other health issues. Objective: The purpose of the study was to determine the effect of smokeless tobacco use during pregnancy on fetal birth weight. Methods: A case-control study was conducted at the five basic health units (BHU) of Thatta District, which were Garho, Ghora Bari, Dhabeji, Chattochand, and Jhimpeer from October 2022 – January 2023. A total of 300 mothers were included by consecutive sampling technique in the study and among them, 150 mothers who gave birth to a low-birth-weight baby i.e., birth weight < 2.5 kg were enrolled as a case, and another 150 mothers who gave birth to a normal birth weight baby i.e., birth weight ≥ 2.5 kg were enrolled as a control. Data collection involved face-to-face interviews utilizing a validated questionnaire, with strict adherence to ethical considerations throughout the study. Results: In a study of 300 participants from Thatta District’s five basic healthcare units, multivariate logistic regression revealed significant factors influencing tobacco use during pregnancy. Housewives had 1.862 times higher odds of tobacco use than employed individuals, and individuals aged 20–35 had 1.802 times higher odds than those aged 36-50. Smokeless tobacco, particularly most of the mothers in this study used gutka (47.3%) and chaliya (26%). Smokeless tobacco Gutka and Chaliya, increased the likelihood of tobacco use during pregnancy. Considering the frequency of smokeless tobacco use and healthcare provider recommendations emerged as important determinants. Conclusion: Our study underscores the prevalence of smokeless tobacco use during pregnancy in Thatta, Karachi, Pakistan, with significant implications for low-birth-weight babies. This highlights the need for targeted public health interventions, like antenatal care, alongside further research to inform evidence-based strategies for maternal and child health promotion in the regio

Bilateral retractile testis: A possible risk factor for male infertility

Healthy youth is an asset and strength for economic and social growth of any society. Developmental changes during puberty of youngsters need proper guidance to avoid future physical, physiological and psychological ailments. Bilateral Retractile Testis (BRT) is a health problem if remains unnoticed till adolescence can lead to tribulations. BRT may affect testicular parenchyma and spermatogenesis. Cremasteric muscles (muscles attached with testes) pull the testes up into groin so it randomly moves up and down and do not reside in its natural pouch always. It has been a controversial issue in male infertility as retraction may affect infertility. Objective: To estimate the prevalence of male infertility among patients with Bilateral Retractile Testis. Methodology: A total of 200 male patients were enrolled after the power calculation, with different reproductive health problems between the age of 18 - 40 years during the year 2016 at Reproductive health clinic Jinnah Post Graduate Medical Center (JPMC), Karachi. 25 male patients were reported with infertility and BRT. The data was collected using self-developed questionnaire including outdoor patients’ physical check-up, manual testicular examination as size and shape were done. Patient height, weight, blood pressure, their lifestyle, and dressing regarding wearing tight jeans habits were asked. Semen analysis was carried out showing abnormality in sperm count, motility or morphology and entered and analysed in the SPSS version 10. Means and percentages were calculated. Result: Out of 200 male infertile patients, a total of 25 (12.5%) patients with a diagnosis of BRT were found in the sample with the mean age of 29 years. Moreover, it was identified that those having BRT also have low motility of the sperms. Based on the results it was concluded that BRT is a possible cause of male infertility in Pakistani population. Conclusion: BRT is a possible risk factor to affect sperm motility and low sperm motility can lead to male infertility. The study estimates the prevalence of 12.5% among our sampled men

Maternal risk factors associated with low birth weight among women 15-35 years in hospital births of Karachi, Pakistan : a case control study

BW (LBW) is an important and potentially preventable public health problem. It is the major determinant of neonatal and infant mortality in developing countries and it contributes largely to the overall burden of childhood mortality and morbidity. Although medical advances have played a major role in lowering infant mortality, the impact on the prevalence of LBW appears to have been minimal. The objective of this study was to evaluate the modifiable maternal risk factors associated with LBW among women age 15 - 35 years in hospital births of Karachi. This was a retrospective case control study carried out in the general wards of three hospitals of Karachi that draw patients from urban, suburban and rural areas. Cases were defined as mothers of newborns weighing less than or equal to 2.5 kilograms while controls were defined as mothers of newborns weighing greater than 2.5 kilograms at the time of birth. 262 cases and 262 controls of age 15 - 35 years without a known medical illness who delivered live-born singleton baby through vaginal delivery or caesarian sections without congenital malformations and with the gestational age between 37-42 weeks at the general wards of the selected hospitals were enrolled from hospital records within one day of delivery. Fetal factors such as preterm delivery, multiple pregnancy, and congenital abnormalities were not included in the study. Information was gathered regarding demographic and socioeconomic status, previous pregnancies, antenatal care during current pregnancy, morbidity during pregnancy, maternal nutritional status, strenuous physical activity and smoking. The odds ratios of anemic mothers and maternal iron supplement use during pregnancy to deliver low birth weight baby were (OR 6.2; 95% CI3.56, 10.80) and (OR 2.88; 95% CI 1.83, 4.54) respectively. With every 1 kg increase in maternal post partum weight the odds of low birth weight baby decreased (OR 0.97; 95% CI 0.95, 0.99). Odds was greater among females than male babies (OR 1 .59; 95% CI 1.09, 2.32). With every one year increase in maternal age the odds increased (OR 1.03; 95% CI 0.98, 1.07). However, strenuous working conditions, maternal food consumption, antenatal care, socio-demographic factors and history of previous pregnancies were not associated with the higher odds of low birth weight. Maternal anemia, iron intake and postpartum weight are related to newborns\u27 birth weight. Reducing malnutrition among childbearing women should not be confined to interventions only during pregnancy. A life cycle approach to women\u27s nutrition is not only important to their health but also to the health of their children and families. Women should be assessed for diet adequacy during family planning visits (hemoglobin measurement, diet history); education should be provided in elementary and secondary schools on nutrition and health care

Association of deliberate Self Harm among patients with Bipolar Disorder in Karachi

Aim: To evaluate the association of suicide attempt among bipolar disorder patients and evaluate the associated risk factors. Methodology: The target population of the study was adult psychiatric patients who visited the outpatient department of an institute of behavioral sciences in Karachi. A case-control study was conducted in the outpatient department of two major psychiatric services in Karachi. Participants of age above 15 years were recruited through non-purposive sampling and data was collected by a structured questionnaire. Results: From January to April 2021, of the 146 selected psychiatric patientsa, high prevalence of suicide attempts was observed in patients with young age between 20 to 30 years (p=0.000) Almost41.1%of participants were illiterate and 63% belonged to low socioeconomic status) Approximately 43.8% (p=0.00) cases had a history of mental trauma and 24.7% 76.7% (p=0.007) cases had a family history of suicide. It was found that 91.8% (p=0.00) of depression was related to suicide attempt the factors associated with suicide attempt were females, young age, illiteracy, lower socioeconomic status, presence of bipolar disorder, substance abuse, mental trauma, depression, family history of suicide and self-harm. Conclusion: We conclude that there is an association between suicide attempts and bipolar disorder. Mental illnesses are becoming an emerging public health problem. Deeper research into the relationship between suicide attempts and substance abuse, or family history and awareness in psychiatric patients is needed. Keywords:Bipolar Disorder, Suicide Attempt, Self-Harm, Trauma, Suicidal Ideation</jats:p

A Case Report of Male infertility and Gynecomastia in High Altitude Area: Clinical Evaluation and Management

Gynecomastia is a common abnormality of breast tissue among men. It is the benign enlargement of male breast glandular tissue. In this report a narrative approach was followed for the qualitative inquiry of three men from the high altitude areas of Pakistan. They presented with gynecomastia and infertility. These men were approached for clinical examination, lab investigations, and further management. The semen findings of these patients showed oligospermia, azoospermia or necrospermia. Serum Prolactin was found to be high and they were overweight with increased breast development. The Serum Prolactin, FSH, LH levels, and Testosterone levels were measured in these patients with infertility. The laboratory investigations of our patients showed high prolactin and estrogen levels. All these men were reported stress due to erectile dysfunction and infertility. The reasons of male infertility in the high-altitude areas of Pakistan need to be explored further. Keywords: Male infertility, gynecomastia, high altitude</jats:p

A case report of male infertility and gynecomastia in high altitude area: Clinical evaluation and management

Gynecomastiais a common abnormality of breast tissue among men. Itis the benign enlargement of male breast glandular tissue.In this report anarrative approachwasfollowed for the qualitative inquiry of three men from the high altitude areas of Pakistan. They presented with gynecomastia and infertility. These men were approached for clinical examination, lab investigations,and further management.Thesemenfindings ofthese patients showed oligospermia, azoospermia ornecrospermia. Serum Prolactin was found to be high and they were overweight with increasedbreast development. The Serum Prolactin, FSH, LH levels,andTestosteronelevels were measured in these patients with infertility.The laboratory investigations of our patients showed highprolactin and estrogen levels.All these men were reported stress due to erectile dysfunctionand infertility. The reasons of male infertility in the high-altitudeareas of Pakistan need to be explored further

A Case Report of Male infertility and Gynecomastia in High Altitude Area: Clinical Evaluation and Management

Gynecomastia is a common abnormality of breast tissue among men. It is the benign enlargement of male breast glandular tissue. In this report a narrative approach was followed for the qualitative inquiry of three men from the high altitude areas of Pakistan. They presented with gynecomastia and infertility. These men were approached for clinical examination, lab investigations, and further management. The semen findings of these patients showed oligospermia, azoospermia or necrospermia. Serum Prolactin was found to be high and they were overweight with increased breast development. The Serum Prolactin, FSH, LH levels, and Testosterone levels were measured in these patients with infertility. The laboratory investigations of our patients showed high prolactin and estrogen levels. All these men were reported stress due to erectile dysfunction and infertility. The reasons of male infertility in the high-altitude areas of Pakistan need to be explored further. Keywords: Male infertility, gynecomastia, high altitude</jats:p

Impact of Continuous Positive Airway Pressure Therapy on Body Weight in patients with Obstructive Sleep Apnea

Aim: To determine the impact of Continuous Positive Airway Pressure therapy on body weight in Obstructive Sleep Apnea patients and assess the relationship between the weight change and other associated symptoms of Obstructive Sleep Apnea. Methods: From a Tertiary care Hospital, Karachi we enrolled 184 Obstructive Sleep Apnea patients of both gender with age more than 18 years of whom 92 patients were exposed to Continuous Positive Airway Pressure while 92 patients were not exposed. In a pre-and post-treatment, information on height, weight, Body mass Index, and neck circumference were recorded. Sleep score was evaluated through Epworth Sleepiness Scale. Results: Results revealed that CPAP effects on weight and BMI. 24% of participants exposed with CPAP gained weight (p=0.03) whereas 72% of participants reduced the weights (p=0.004). The paired t-test showed the mean difference of 3.53±7.5kg (mean±SD, p-value: 0.00). The multivariate analysis showed that CPAP lessens the poor concentration (OR: -4.852; p-value: &lt;0.001), decreases daytime sleepiness (OR: -3.91; p-value: &lt;0.001) and the persons who used dietary plan with CPAP therapy were 6.3 times (p-value: &lt;0.001) more likely to change the weight. Conclusion: The weight of the patient changes with the treatment of OSA after taking a minimum of six months of CPAP therapy. The frequency of weight change in this study population was directed toward weight loss. Elimination of OSA symptoms is directly linked with weight reduction. Keywords: Obstructive sleep apnea, Continuous Positive Airway Pressure therapy, Bodyweight.</jats:p