Childhood maltreatment and adulthood obesity among a sample of twin and sibling pairs: Results from the MIDUS Study

Introduction: Approximately 3 million child maltreatment (CM) referrals are made each year to state and social service agencies (U.S. Department of Health and Human Services- Children’s Bureau, 2012). This number appears to be an underestimate of the size of the problem however. Survey data collected by the Children’s Bureau of the U.S. Department of Health and Human Services estimates that about six million children are maltreated in the U.S. per year. CM negatively impacts the mental and physical health and social outcomes of victims in childhood and adulthood. For example, CM has been linked to obesity and overweight in children and adults. Similar to CM, overweight and obesity are also associated with various long-term and short-term health conditions for children and adults. Beyond the specific provision of food and modeling of eating and exercise behaviors, other family factors have been shown to relate to obesity including disorganized family environments, low parental supervision, maternal antipathy, child maltreatment, and family dysfunction. Objective: To examine the relationship between CM and obesity using a large sample of twin and sibling pairs, I will first examined the simple relationship between various form of abuse and obesity, and then, following the methodology of Vámosi et al. (2011), examine twin and sibling pairs to look at differences in experiences of CM and obesity. Methods: The current study used the Midlife Development in the United States (MIDUS), a public use longitudinal data set with information in the areas of physical, emotional/mental, and lifestyle characteristics of individuals in their 20’s, 40’s, and 60’s. The data set also includes nationally representative data about sibling and twin pairs. The MIDUS I had a sample of 7,108 participants. The MIDUS II was a follow-up of the MIDUS I and included 4,963 participants. The main variables I used were Body Mass Index (BMI) and CM, which was measured through the Conflict Tactics Scale. I controlled for various variables that contribute to overweight or obesity, such as socioeconomic status, educational attainment, physical activity, and depression. The comparison of twin and non-twin sibling data was of particular interest because of the strong genetic component of obesity. Results: Analyses were conducted using SPSS. I first examined simple correlations between abuse variables and obesity. Next, I conducted regression analyses examining the relationship between abuse and obesity, while controlling for gender, educational attainment, age, and several other variables associated with CM and obesity. The third analyses focused on examining differences in the abuse – obesity relationship between twin and sibling pairs. There was a small, negative relationship between BMI continuous and emotional abuse and physical abuse. There was a small, positive relationship between each form of abuse and BMI categories. Discussion: Although statistically significant results were found, they were small. The relationship between obesity and overweight and experience of CM is valid after controlling for various predictors, like health insurance, depression, and self-rated physical and emotional health. Public health practitioners should be sensitive to the physical health of victims of CM, especially concerning obesity and overweight. Many public health practitioners focus on the mental and emotional health of victims of CM, but they should also be made aware of the impact that CM has on physical health. There are several limitations. Regarding the CM variables, participants may have had difficulties recalling events from their childhood, so recall bias is a major limitation. Another limitation is that much of the data is self-reported which could have led to some data, like BMI, being inaccurate. Finally, we do not know the quality of the phone interviews or how well phone interviewers were trained

Coil embolization of wide neck cerebral aneurysms using balloon remodeling technique-initial experience in pakistan

The balloon remodeling technique [BRT] was developed for neuroendovascular treatment of wide-necked cerebral aneurysms. Herein, we describe our initial experience of aneurysm embolization using BRT in Pakistan with the new double-lumen balloon catheters (Sceptor C and Ascent) and Hyperform balloon micro catheter and discuss its benefits

Endovascular treatment of spontaneous indirect high flow carotid cavernous fistula with a covered stent.

The treatment of symptomatic carotid-cavernous fistulas [CCF] has been historically treated in the developed world through the endovascular route. We report our first case of using a covered stent in a patient with spontaneous CCF. Method: Single patient with spontaneous indirect high flow CCF treated with a covered stent. We present retrospective analysis of technical success, initial and 6-month follow-up angiography and clinical outcome. Result: The stent was successfully navigated and deployed covering the CCF orifice. Immediate post stent deployment angiography showed marked reduction in flow and complete occlusion at 6-months. Clinically, patient showed near-complete recovery at 6 months. Conclusion: With proper neuroendovascular training and experience, use of a covered stent is cost effective and feasible for the treatment of CCFs in under developed countries

Association of Hepcidin with Hepatitis C induced Diabetes Mellitus

To compare serum hepcidin levels ofpatients with hepatitis C induced diabetes mellituswith healthy controlsMethods: Sixty individuals were included in thestudy. Thirty were diagnosed cases of chronichepatitis C who developed diabetes mellitus duringthe course of HCV infection. Thirty age and gendermatched healthy controls were included. Individualswith acute hepatitis C, familial diabetes mellitus,iron deficiency anemia, recent history of bloodtransfusion, iron or erythropoietin supplementationand inflammatory diseases like rheumatoid arthritis,renal, cardiac, pulmonary diseases and on interferontherapy were excluded from the study. Bloodsamples were collected from all the individuals andserum hepcidin levels were measured by ELISA.Results: Significant decrease in serum hepcidinlevels was found in patients with the chronichepatitis C and diabetes mellitus having mean valueof 2.7±1.03ng/ml as compared with controls havingmean value of 28.5±5.3ng/ml. The difference amongthe two groups was significant at p-value of <0.001.Conclusion: Serum hepcidin levels in patientswith chronic hepatitis C with diabetes mellitus aresignificantly less as compared to healthy controls

ASSESSMENT OF ROOT CANAL WORKING LENGTH EMPLOYING MANUAL AND ROTARY INSTRUMENTATION TECHNIQUE. AN IN VITRO STUDY

Background: The objective of root canal treatment is to eliminate infection and irritants from the root canal system.Working length determination and maintenance are essential for the success of treatment. To determine changes in root canal working length after preparation with manual or rotary instrumentation technique. Methods: This In vitro Quasi Experimental study was carried out over a period of six months. Mandibular molars, extracted due to caries or periodontal reasons and mesiobuccal canals, with curvature between 20- 400 were included.In Group A preparation was carried out with ProTaper instruments and in group B with manual Nickel Titanium files. An ISO #15 NiTi file was placed in the canal and radiograph taken to determine working length.Upon completion of preparation, radiograph with #30 NiTi file was taken and working length assessed. Changes in working length were assessed by comparing preoperative and postoperative values. Data analysis was done withPaired and Independent sample ttests using Statistical Package for the Social Sciences (SPSS) version 20.0 available at university campus. P-value < 0.005 was taken as statistically significant. Results: Working length was better maintained in ProTaper group as compared to group prepared with Manual Ni-Ti instruments. Conclusion: ProTaper instrumentation technique maintained working length better than manual instrumentation technique

Building Consumer-Based Brand Equity in Retail Banks: A Quantitative Study On a Pakistani Star Bank

Firms are striving to increase their brand equity that ultimately leads to an increase in profitability. The purpose of the study is to identify the causal relationship of endorser's credibility with Brand credibility and its meditating role on consumer-based brand equity in the banking sector of Pakistan. 384 active HBC account holders taken as the sample and data collected through a comprehensive questionnaire. Correlation and regression analysis were conducted to test the factors of attractiveness, expertise, trustworthiness, and popularity on Brand credibility and further its effect on Brand equity. The results suggest that in banking sector firm Expertise of endorser is the most significant factor followed by trustworthiness and popularity that influence brand credibility and attractiveness does not have any impact on brand credibility. The study provides an understanding of brand building strategy, and it also highlights a clear brand differentiation strategy for bank brands.DOI: 10.15408/etk.v17i2.672

Frequency and Distribution of Endodontically Treated Teeth

Objective: To determine the distribution and pattern of carious teeth involvement in permanent teeth requiring endodontic treatment. Study Design: Cross-sectional study. Place and Duration of Study: Dental Section of The Aga Khan University Hospital, Karachi, from September 2004 to March 2005. Methodology: Data was collected from the dental records of patients. Tooth was the unit of evaluation. Variables studied were demographics, tooth type, etiology of endodontic treatment and pattern of caries involvement. Data was analyzed using chi-square test and Fischer’s exact test. Results: The total number of patients was 190; total number of teeth involved were 235. Females had more endodontically treated teeth than males. There was no significant difference in the distribution of etiology of endodontic treatment in both genders (p=0.564). An increasing trend of endodontic procedure was observed with the increasing age of patients. Caries was the most common etiological factor leading to endodontic treatment (p = 0.011). Class-II cavity i.e. proximal surface of teeth was the most commonly involved surface in endodontically involved teeth (p \u3c 0.001). More molars had been endodontically treated followed by premolars and anterior teeth. Conclusion: Caries was the most common etiologic factor; lower molars were the most commonly involved and lower anteriors the least commonly involved teeth in endodontic procedure. Significant association was observed between etiology and tooth type. Significant association was found between cavity classification and etiology of endodontic treatment with class-II caries being most common