Psychological Well-Being in Childhood and Cardiometabolic Risk in Middle Adulthood: Findings From the 1958 British Birth Cohort

Childhood adversity is linked to poor cardiometabolic outcomes, but less is known about positive childhood factors. Using data from 4,007 members of the 1958 British Birth Cohort, we investigated whether children with greater psychological well-being had lower adulthood cardiometabolic risk. At age 11, participants wrote essays about their future. Two judges rated each essay for nine psychological well-being items (Finn’s r = .82–.91), which were combined into a standardized overall score (Cronbach’s α = .91). When participants reached age 45, nurses assessed their blood pressure, heart rate, lipids, glycosylated hemoglobin, fibrinogen, and C-reactive protein, which were standardized and summed for total cardiometabolic risk. Regressions indicated that children with greater psychological well-being had lower cardiometabolic risk (b = −0.14, 95% confidence interval [CI] = [−0.28, −0.006]): specifically, healthier total cholesterol (b = −0.04, 95% CI = [−0.07, −0.003]) and triglycerides (b = −0.06, 95% CI = [−0.09, −0.02]). Childhood psychological well-being may promote adulthood cardiometabolic health

X-linked agammaglobulinemia - first case with bruton tyrosine kinase mutation from Pakistan

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency with more than 600 mutations in Bruton tyrosine kinase (Bkt) gene which are responsible for early-onset agammaglobulinemia and repeated infections. Herein we present a case of a 3-year-old boy with history of repeated diarrhoea and an episode of meningoencephalitis with hemiplegia. The workup showed extremely low levels of immunoglobulin with low CD+19 cells. Genetic analysis showed Btk mutation 18 c.1883delCp.T628fs. To the best of our knowledge this is the first report of a case of XLA confirmed by molecular technique from Pakistan

CAPITAL & EARNINGS MANAGEMENT: EVIDENCE FROM THE BANKING SECTOR OF PAKISTAN

This paper examines the relationship of loan loss provisions with the capital and earnings management in the banking sector of Pakistan. The study applies the Clustered Robust Linear Regression while examining the panel models when the data had heteroscedasticity and autocorrelation in it. This regression is used to remove the effects of these disturbances from the dataset. The study targets 25 banks (Islamic and commercial banks) from the banking sector of Pakistan. Descriptive analysis showed that the banks are engaged in the use of loan loss provisions for their capital and earnings management practices. The results of Clustered Robust Linear Regression showed a significant relationship of Tier1 and EBTLLP on the dependent variable LLP. This significant relationship depicts the strong influence of loan loss provisions (LLPs) on the capital and earnings management of the banks in Pakistan. In further research perspective, the time duration of the study can be extended, and more variables can be added. It can also include a comparative study amongst different banks in Pakistan

Serum Macromineral Levels in Estrual, Fertile, Subfertile and Pregnant Mares Kept Under Two Different Managemental Conditions

This study was conducted on 300 mares kept under one of the two managemental conditions: field (individual management) and farm (organizational management). Mares were categorized as estrual, fertile, subfertile or pregnant. Any possible relationship between fertility and serum levels of sodium, magnesium, phosphorus, potassium and calcium was investigated. The serum sodium level differed significantly (P<0.05) among all groups of mares at both conditions, with pregnant mares having the highest and subfertile the lowest levels. Also, independent of the condition, the pregnant mares had significantly higher (P<0.05) serum potassium levels compared with subfertile ones. Serum calcium levels were significantly higher in estrual mares when compared with those of pregnant mares under farm management or subfertile mares under field conditions. In each group, mares kept under farm management had significantly higher serum magnesium levels but significantly lower serum calcium levels than those of mares kept under field. In estrual group, mares raised under field condition had significantly higher serum phosphorus levels. These results sufficiently provide the foundation for more rigorous and controlled studies to establish a firm basis for fertility versus serum-mineral-profile relationship. Moreover, due to marginally adequate serum mineral levels in mares kept under both managements, supplementation with mineral mixture was recommended for optimum fertility

Prevalence and risk factors associated with multi-drug resistant organisms (MDRO) carriage among pediatric patients at the time of admission in a tertiary care hospital of a developing country. A cross-sectional study

Background: The rise of Multidrug-resistant organisms (MDROs) poses a considerable burden on the healthcare systems, particularly in low-middle income countries like Pakistan. There is a scarcity of data on the carriage of MDRO particularly in the pediatrics population therefore, we aimed to determine MDRO carriage in pediatric patients at the time of admission to a tertiary care hospital in Karachi, Pakistan, and to identify the risk factors associated with it.Methods: A cross-sectional study conducted at the pediatric department of Aga Khan University Hospital (AKUH) from May to September 2019 on 347 children aged 1-18 years. For identification of MDRO (i.e., Extended Spectrum Beta-Lactamase (ESBL) producers, Carbapenem Resistant Enterobacteriaceae (CRE), Vancomycin Resistant Enterococci (VRE), Methicillin Resistant Staphylococcus aureus (MRSA), Multidrug-resistant (MDR) Acinetobacter species and MDR Pseudomonas aeruginosa), nasal swabs and rectal swabs or stool samples were cultured on specific media within 72 h of hospitalization. Data was collected on a predesigned structured questionnaire on demographics, prior use of antibiotics for \u3e 48 h in the last 6 months, history of vaccination in last 6 months, exposure to health care facility regardless of the time of exposure, ICU stay for \u3e 72 h, and about the prior use of medical devices (urinary catheter, central venous lines etc.) in last 1 year. Statistical analysis was performed by Standard statistical software.Results: Out of 347 participants, 237 (68.3%) were found to be MDRO carriers. Forty nine nasal swabs from 346 children (14.2%) showed growth of MRSA. The majority of the stool/rectal swabs (n = 222 of 322; 69%) collected were positive for MDRO. The most isolated species were ESBL Escherichia coli 174/222 (78.3%) followed by ESBL Enterobacter species 37/222 (16.7%) and ESBL Klebsiella pneumoniae 35/222 (15.8%). On univariate analysis, none of the risk factors showed statistically significant association with MDRO carriage.Conclusion: Overall, a high prevalence of MDRO carriage was identified among admitted pediatric patients. Implementation of systematic screening may help to identify true burden of MDROs carriage in the health care settings

Is More, Better? Relationships of Multiple Psychological Well-Being Facets with Cardiometabolic Disease

Objective: Cardiometabolic disease (CMD) is a leading cause of death and disability worldwide. Assessments of psychological well-being taken at one time point are linked to reduced cardiometabolic risk, but psychological well-being may change over time and how longitudinal trajectories of psychological well-being may be related to CMD risk remains unclear. Furthermore, psychological well-being is a multidimensional construct comprised of distinct facets, but no work has examined whether sustaining high levels of multiple facets may confer additive protection. This study tested if trajectories of four psychological well-being facets would be associated with lower risk of self-reported nonfatal CMD. Method: Participants were 4,006 adults aged ≥50 years in the English Longitudinal study of Ageing followed for 18 years at biyearly intervals. Psychological well-being facets were measured in Waves 1–5 using subscales of the Control, Autonomy, Satisfaction, and Pleasure scale. Latent class growth modeling defined trajectories of each facet. Incident CMD cases were self-reported at Waves 6–9. Cox regression models estimated likelihood of incident CMD associated with trajectories of each facet individually and additively (i.e., having persistently high levels on multiple facets over time). Results: After adjusting for relevant covariates, CMD risk was lower for adults with persistently high versus persistently low levels of control and autonomy. When considering potential additive effects, lower CMD risk was also related to experiencing persistently high levels of ≥2 versus 0 psychological well-being facets. Conclusions: Findings suggest having and sustaining multiple facets of psychological well-being is beneficial for cardiometabolic health, and that effects may be additive

Tidal induced variation in the distribution, abundance and diversity of mesozooplankton along the Karachi coast, Pakistan

Temporal variations in biomass, abundance, diversity and species composition of mesozooplankton in relation to the tidal state were studied. Mesozooplankton sampling was carried out twice at the ebb and flood tides at fixed stations closed to Phitti creek (P) and Manora channel (M) near the Karachi coast during February 1999. The average percent abundance of mesozooplankton was high at ebb tide i.e., 66% and 63% whereas, low on flood tide i.e.,34% and 37%, at both stations respectively. However, there were no differences in species composition with tidal fluctuations at both sites. The mesozooplankton community was typically composed of 22 groups, out of which copepod was the most abundant group (comprising % of the total zooplankton) at both sites. During the flood tide high diversity 0.11 ± 0.021 was observed in Phitti creek, but no difference was observed at Manora channel. The species richness was high (2.30 ± 0.01273 and 2.38 ± 0.502) in the Manora channel at both ebb and flood tides, respectively, whereas the dominance values were high at Phitti creek. Complete randomized design ANOVA showed that there was no significant difference in abundance of mesozooplankton between stations and tides nested in stations, but the difference was significant for the diversity and equitability. On the short temporal scale the tidal cycle additionally determines changes in the zooplankton composition

Adolescent Psychological Assets and Cardiometabolic Health Maintenance in Adulthood: Implications for Health Equity

Background Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals—particularly members of minoritized racial and ethnic groups—meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. Methods and Results Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994–1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self‐esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0–5). In Waves 4 (2008; mean age=28 years) and 5 (2016–2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01–1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00–1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. Conclusions Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities

Detection of typhoid carriers by duodenal fluid culture in a tertiary care hospital, Karachi: A cross-sectional study

We aimed to detect typhoid carriers by performing duodenal fluid culture in patients in a tertiary care hospital in Pakistan. A cross-sectional study was conducted during 2017 at the Aga Khan University Hospital, Karachi. Patients who underwent upper gastrointestinal endoscopy were included. Participants were interviewed, and duodenal fluid samples were taken for culture to detect Salmonella typhi (S. typhi) and paratyphi. A polymerase chain reaction on 100 randomly selected sub-samples was also conducted. A total of 477 participants were enrolled. The mean age was 42.4±15.5 years. History of typhoid fever was present in 73 (15.3%) participants. Out of the 477 duodenal fluid cultures tested for various micro-organisms, 250 (52.4%) were positive. Neither S. typhi nor paratyphi were isolated. S. typhi was also not detected by PCR. To better detect S. typhi carriage in general population, future studies should target people with gall bladder diseases and screen them using culture and PCR based methods