Perceptions of anti-smoking messages amongst high school students in Pakistan

<p>Abstract</p> <p>Background</p> <p>Surveys have provided evidence that tobacco use is widely prevalent amongst the youth in Pakistan. Several reviews have evaluated the effectiveness of various tobacco control programs, however, few have taken into account the perceptions of students themselves regarding these measures. The aim of this study was to determine the most effective anti-smoking messages that can be delivered to high-school students in Pakistan, based on their self-rated perceptions. It also aimed to assess the impact of pictorial/multi-media messages compared with written health warnings and to discover differences in perceptions of smokers to those of non-smokers to health warning messages.</p> <p>Methods</p> <p>This study was carried out in five major cities of Pakistan in private English-medium schools. A presentation was delivered at each school that highlighted the well-established health consequences of smoking using both written health warnings and pictorial/multi-media health messages. Following the presentation, the participants filled out a graded questionnaire form, using which they rated the risk-factors and messages that they thought were most effective in stopping or preventing them from smoking. The Friedman test was used to rank responses to each of the questions in the form. The Wilcoxon Signed Rank test used to analyze the impact of pictorial/multi-media messages over written statements. The Mann Whitney U test was used to compare responses of smokers with those of non-smokers.</p> <p>Results</p> <p>Picture of an oral cavity cancer, videos of a cancer patient using an electronic voice box and a patient on a ventilator, were perceived to be the most effective anti-smoking messages by students. Addiction, harming others through passive smoking and impact of smoking on disposable incomes were perceived to be less effective messages. Pictorial/multi-media messages were perceived to be more effective than written health warnings. Health warnings were perceived as less effective amongst smokers compared to non-smokers.</p> <p>Conclusion</p> <p>Graphic pictorial/multi-media health warnings that depict cosmetic and functional distortions were perceived as effective anti-smoking messages by English-medium high school students in Pakistan. Smokers demonstrated greater resistance to health promotion messages compared with non-smokers. Targeted interventions for high school students may be beneficial.</p

Central adiposity is significantly higher in female compared to male in Pakistani type 2 diabetes mellitus patients

Background: Type 2 diabetes mellitus (DM) rates are increasing rapidly in South Asians. Cardiovascular complications are more frequent and occur earlier in our patients than patients in many other ethnic groups. Reasons for this are not fully understood.AIMS: The aim of this study is to evaluate the body total and central fat percentage in type 2 Diabetes Mellitus patients and to check correlation with BMI, waist circumference and metabolic profile.SETTINGS AND Design: A cross-sectional study conducted at endocrine clinic, Aga Khan University Hospital Karachi, Pakistan, from May to December 2012.MATERIALS AND Methods: Patients of either gender with type 2 diabetes mellitus were randomly selected. A separate proforma for each patient was recorded for demographics, risk factors, bioelectrical impedance measurement for body fat and investigations.STATISTICAL ANALYSIS: Correlation between body fat and other covariate were compared by Pearson correlation coefficient test. A P \u3c 0.05 was considered significant. SPSS19.0 was used to analyze the data.Results: One hundred and seventy five patients (95 male and 80 female) with mean age of 54.1 ± 12 years were evaluated. Mean duration of diabetes was 8.1 years, mean HbA1c was 8.1% and 53.7% were on oral agents and rest were on insulin with or without oral agents. Hypertension was present in 65.7%, 13.7% had known coronary artery disease and 2.3% had cerebrovascular disease. Mean BMI in males was 29.1 ± 4.74 kg/m(2) and females 31.7 ± 5.3 kg/m(2). Mean waist circumference in males was 107.3 ± 16.6 cm and 103 ± 12 cm in females. Total body fat percentage (%BF) in males was 30.9 ± 7.1% and females 40 ± 8.2% with 89% of the total cohort having total body fat percentage above the normal, less than 25% central fat percentage was 13.3 ± 5.2% in males and 14.6 ± 5.5% in females with 79.4% of cohort having increased central fat (normal \u3c9%). Total and central body fat correlated with BMI (r = 0.68, P \u3c 0.001) and waist circumference (r = 0.66, P \u3c 0.001) but not with HbA1c, triglyceride level or with fasting or random blood glucose levels. Women had significantly higher total body fat percentage compared to men (P \u3c 0.001) although central fat percentage was similar in both sexes.CONCLUSIONS: High body fat percentage, waist circumference are seen especially in woman and central body fat percentage in both sexes among patients with type 2 diabetes mellitus in Pakistan. Body fat percentage should be measured and followed as this may be an important contributing factor to the high macrovascular complication rate in this part of world

Dual-chamber versus single chamber pacemakers, a systemic review and meta-analysis on sick sinus syndrome and atrioventricular block patients

Aims: The atrioventricular block (AVB) is a conduction system problem that results from the impairment in the transmission of an impulse from the atria to the ventricle, the disease has many etiologies. This article aimed to evaluate the efficacy and safety of dual and single-chamber pacemakers in patients with SSS and AVB. Methods: An electronic search of PubMed (Medline), EMBASE, and Google Scholar was performed from 2000 till August 15th, 2022. Retrieved articles were exported to Endnote Reference Library Software, where duplicate studies were removed from the list, and only articles meeting the eligibility criteria of this study were selected. RevMan 5.4 and STATA 16 software were used for the analysis. The modified Cochrane Collaboration's risk of bias and New-castle Ottawa scale were used for quality assessment of RCTs and observational studies respectively. Results: This study is composed of 8953 patients with sick-sinus syndrome and atrioventricular block. A total of thirteen outcomes are included in this meta-analysis, out of which atrial fibrillation significantly favored dual chamber [OR = 1.29; 95 % CI = 1.05–1.59; P = 0.01 I2 = 29 %] and overall complications [OR = 0.48; 95 % CI = 0.29–0.77; p = 0.03 I2 = 0 %] and pneumothorax [OR = 0.31; 95 % CI = 0.10–0.93; p = 0.04, I2 = 0 %] were satisfied by single-chamber pacing. Conclusion: This study concluded that neither single-chamber nor dual-chamber pacemakers are superior to each other, but they are unique in their own ways as the results of this study manifest remarkable reduction in atrial fibrillation rates and pneumothorax using dual-chamber and single-chamber pacemakers respectively