Risk factors for cardiovascular disease in school children--a pilot study.

OBJECTIVE: To assess the frequencies of risk factors for cardiovascular disease in school children. The information may help in designing interventions aimed at modifying unhealthy lifestyle in children, which may reduce the later incidence of cardiovascular disease in adults. METHODS: A cross-sectional study was conducted on 206 students (ages 14-18 years), enrolled in higher secondary school. Students were interviewed about their lifestyles, family history of cardiovascular disease and its risk factors. Moreover, they were assessed for height, weight and blood pressure. RESULTS: Twenty nine percent of the children were physically inactive, 31% were taking unhealthy diet daily, 21% were overweight (BMI \u3e or = 25) and 6% were smokers. History of paternal smoking was reported by 36% of the children, and among them 76% of fathers smoked in the presence of their children. Family history of cardiac disease, hypertension and diabetes were positive in 4%, 23% and 16% of the children respectively. Overall, 58% of the children had at least one modifiable risk factor. CONCLUSION: Majority of the children had modifiable risk factors for cardiovascular disease. Prevention efforts are required early in life, using strategies for behavioral modification and health promotion

Knowledge about hepatitis B and C among patients attending family medicine clinics in Karachi

Knowledge about hepatitis B and C was assessed in a cross-sectional study of 300 adults aged 18 or older attending family medicine clinics at The Aga Khan University Hospital, Karachi. Most knew that hepatitis B and C are viral diseases that primarily affect the liver, but knowledge about risk factors for disease transmission was poor. Approximately 70% knew that hepatitis B is vaccine preventable; 60% had the misconception that hepatitis C is also vaccine preventable. The majority incorrectly believed that people with hepatitis B or C should follow the diet \u27parhaiz\u27. Generally women knew more than men about the diseases. This study suggests that health education about these infections should be provided to the public. Family physicians can play an important role in educating people about the prevention of these diseases

Prevalence and factors associated with anxiety and depression among family practitioners in Karachi, Pakistan

Objective: We aimed to assess anxiety and depression and to identify the factors associated with these conditions among family practitioners in Karachi, Pakistan.Methods: A self-reported postal survey was conducted among 540 family practitioners in Karachi during the months of July - August 2003. Aga Khan University Anxiety and Depression Scale (AKUADS) was used to assess anxiety and depression. Additional questions were also inquired to get information about socio-demographic, professional and lifestyle characters.Results: Using AKUADS, 155 (39%) family practitioners had anxiety and depression. Mutlivariate analysis disclosed five factors to be significantly associated with anxiety and depression; these were female sex (AOR = 6.4, 95% CI 3.2-12.6); age group of \u3c 35 years (AOR = 23.3, 95% CI 9.0-60.3); lack of regular exercise (AOR = 4.9, 95% CI 2.4-10.2) and working for more than 48 hours per week (AOR = 12.7, 95% CI 6.2-26.2).CONCLUSION: This study reveals that prevalence of anxiety and depression among family practitioners in Karachi is high and higher than general population in Karachi. Further research and intervention studies are required to identify preventive measures in this regard and also to assess the impact of these interventions

Optimum deployment of multiple UAVs for coverage area maximization in the presence of co-channel interference

The use of unmanned aerial vehicle (UAV) as aerial base stations can provide wireless communication services in the form of UAV-based small cells (USCs). Thus, the major design challenge that needs to be addressed is the coverage maximization of such USCs in the presence of co-channel interference generated by multiple UAVs operating within a specific target area. Consequently, the efficient deployment strategy is imperative for USCs while optimizing the coverage area performance to compensate the impact of interference. To this end, this paper presents a coordinated multi-UAV strategy in two scenarios. In the first scenario, symmetric placement of UAVs is assumed at a common optimal altitude and transmit power. In the second scenario, asymmetric deployment of UAVs with different altitudes and transmit powers is assumed. Then, the coverage area performance is investigated as a function of separation distance between UAVs which are deployed in a certain geographical area to satisfy a target signal-to-interference-plus-noise ratio (SINR) at the cell boundary. Finally, the system-level performance of a boundary user is studied in terms of the coverage probability. Numerical results unveils that the SINR threshold, the separation distance, and the number of UAVs and their formations should be carefully selected to achieve the maximum coverage area inside and to reduce the unnecessary expansion outside the target area. Thus, this paper provides important design guidelines for the deployment of multiple UAVs in presence of co-channel interference

Promoting motivation towards community health care: A qualitative study from nurses in Pakistan

Based on the extensive health care needs of Pakistani population, the idea of Community Health Nursing was introduced in 1985. The educational nursing institutes adopted nursing curriculum in order to produce competent nurses to meet the rising demands of society. However, very few numbers of nurses choose community health nursing as their career pathway in Pakistan. Based on the current observation, enhancing motivation among graduate nurses has always been viewed as a great challenge for the academic nursing institutions. This study was intended to explore motivating and de motivating factors in nurses towards community Health Nursing. By utilizing self concept based model of motivation, semi structured interviews were conducted with newly graduated nurses, nurse educators and nursing students. The findings revealed that certain traits, values and competencies are required to motivate nurses as well as to build their capacity towards working effectively in the community setting. Moreover, through this study several realistic recommendations by the participants are highlighted that could foster motivation among future nurses towards this field

Macrovascular complications and their associated factors among persons with type 2 diabetes in Karachi, Pakistan--a multi-center study

Objective: To assess the prevalence of macrovascular complications and factors associated with these complications among persons with Type 2 diabetes.Methods: A multi-center, cross-sectional survey was conducted in three diabetes clinics of Karachi from November 2000 to April 2001. Six hundred and seventy-two persons were interviewed to determine the prevalence of ischemic heart disease (IHD), cerebrovascular disease (CVA) and diabetic foot (DF). Demographic data and co-variables obtained include age, sex, duration of diabetes, body mass index (BMI), smoking status, exercise habits and history of hypertension (HTN).Results: Overall, 26.4%, 6.8% and 3.9% of individuals had IHD, CVA and DF respectively. Multiple logistic regression analysis showed that subjects having IHD were more likely to have HTN (AOR=1.88, 95% CI 1.31-2.69), not performing regular exercise (AOR = 2.09, 95% CI 1.39-3.17) and be current smokers (AOR = 1.85, 95% CI 1.10-3.10) Subjects having CVA were more likely to have diabetes for more than 5 years (AOR = 1.94, 95% CI 0.97-3.87). Males were more prone than females to have DF (AOR = 3.48, 95% CI 1.46-8.31). Those who had DF were more likely to have diabetes for more than 5 years (AOR = 3.29, 95% CI 1.09-9.89) and of reporting current smoking (AOR = 4.01, 95% CI 1.49-10.71).CONCLUSION: Large proportions of persons with Type 2 diabetes were suffering from preventable macrovascular complications in Karachi, Pakistan. There is a need to develop risk factor modification interventions to reduce the impact of long-term complications

Cost of diabetes care in out-patient clinics of Karachi, Pakistan

<p>Abstract</p> <p>Background</p> <p>Diabetes Mellitus (DM) is a growing epidemic and the cost of treating diabetes is largely increasing. The objective of this study was to estimate the cost-of-illness of DM among attendees of out-patient clinics in Karachi, Pakistan. This is the first study conducted from a societal perspective to estimate the cost of managing diabetes in Pakistan.</p> <p>Methods</p> <p>A prevalence-based 'Cost-of-Illness' study for diabetes care was conducted in six different out-patient clinics of Karachi, Pakistan from July to September 2006. A pre-tested questionnaire was administered to collect the data from 345 randomly selected persons with diabetes.</p> <p>Results</p> <p>The annual mean direct cost for each person with diabetes was estimated to be Pakistani rupees 11,580 (US$ 197). Medicines accounted for the largest share of direct cost (46%), followed by laboratory investigations (32%). We found that increased age, the number of complications and longer duration of the disease significantly increase the burden of cost on society (p < 0.001). Comparing cost with family income it was found that the poorest segment of society is spending 18% of total family income on diabetes care.</p> <p>Conclusion</p> <p>This study concluded that substantial expenditure is incurred by people with diabetes; with the implication that resources could be saved by prevention, earlier detection and a reduction in diabetes co-morbidities and complications through improved diabetes care. Large scale and cost-effective prevention programs need to be initiated to maximise health gains and to reverse the advance of this epidemic.</p

Proximity of Residence to Bodies of Water and Risk for West Nile Virus Infection: A Case-Control Study in Houston, Texas

West Nile virus (WNV), a mosquito-borne virus, has clinically affected hundreds of residents in the Houston metropolitan area since its introduction in 2002. This study aimed to determine if living within close proximity to a water source increases one's odds of infection with WNV. We identified 356 eligible WNV-positive cases and 356 controls using a population proportionate to size model with US Census Bureau data. We found that living near slow moving water sources was statistically associated with increased odds for human infection, while living near moderate moving water systems was associated with decreased odds for human infection. Living near bayous lined with vegetation as opposed to concrete also showed increased risk of infection. The habitats of slow moving and vegetation lined water sources appear to favor the mosquito-human transmission cycle. These methods can be used by resource-limited health entities to identify high-risk areas for arboviral disease surveillance and efficient mosquito management initiatives

Attitude towards gender roles and violence against women and girls (VAWG): Baseline findings from an RCT of 1752 youths in Pakistan

Background: Violence against women is driven by gender norms that normalize and justify gender inequality and violence. Gender norms are substantially shaped during adolescence. Programs offered through schools offer an opportunity to influence gender attitudes toward gender equity if we understand these to be partly shaped by peers and the school environment.Objective: We present an analysis of the baseline research conducted for a randomized controlled trial with 1752 grade 6 boys and girls and their attitudes toward gender roles, VAWG, and associated factors.Methods: We used baseline data from a cluster randomised control study. Interviews were conducted in 40 public schools in Hyderabad, with 25–65 children per school. Questions were asked about attitudes toward gender roles, peer-to-peer perpetration, and victimization experiences, and family life, including father- or in-law-to- mother violence and food security. Multiple regression models were built of factors associated with gender attitudes for boys and girls.Results: Our result have shown youth attitudes endorsing patriarchal gender beliefs were higher for boys, compared to girls. The multiple regression model showed that for boys, patriarchal gender attitudes were positively associated with hunger, depression, being promised already in marriage, and being a victim and/or perpetrator of peer violence. For girls gender attitudes were associated with hunger, experiencing corporal punishment at home, and being a perpetrator (for some, and victim) of peer violence.Conclusion: Youth patriarchal attitudes are closely related to their experience of violence at school and for girl’s physical punishment, at home and for boys being promised in early marriage. We suggest that these variables are indicators of gender norms among peers and in the family. The significance of peer norms is that it provides the possibility that school-based interventions which work with school peers have the potential to positively impact youth patriarchal gender attitudes and foster attitudes of gender equality and respect, and potentially to decrease youth victimization and perpetration