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

Coping styles and depression among patients with solid organ cancers attending two tertiary care hospitals of Karachi: a cross sectional study.

Cancer undoubtedly affects patients in all aspects. Cancer diagnosis is a stressful event and coping is the primary mechanism used to adjust and counteract the stress. This study aims to assess the coping styles and prevalence of depression among solid organ cancer patients during treatment phase, attending two tertiary care hospitals of Karachi. A cross-sectional survey was conducted among solid organ cancer patients at Aga Khan University Hospital and Jinnah Post Graduate Medical Center. Coping and depression were assessed by Brief COPE and Self Reporting Questionnaire (SRQ) 20 respectively. Purposive sampling technique was used to recruit 488 patients. Coping styles are reported as mean ± SD. Prevalence has been computed for depression and Chi-square test is used to assess the relationship of depression with different variables. Correlation was assessed for coping styles and depression. The frequently used coping styles were active coping, acceptance, religion and self-distraction. 48.4% depression was estimated among patients. The significantly positive correlation of depression was found with active coping, planning, self-blame, venting, use of emotional support and substance use. While depression correlated negatively with acceptance, religion, self-distraction and humor. Depression was significantly associated with study sites, age, socioeconomic quintiles, past history of hospitalization and substance use. Our research addressed the missing element of mental health in oncology. Depression is a common mental ailment and often the initial manifestation towards deterioration of mental health. Each cancer patient copes differently which either promotes or hinders their fighting spirit. Hence, mental health screening and counseling are recommended in the treatment protocol of cancer patients. Also, support group interventions can help cancer patients to cope effectively

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

Long-COVID and its physical and neurological symptoms in adults: A systematic review

This review was carried out with the objective to study patterns of neurological, psychological and other physical consequences of COVID-19 in the long term. The guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) had been followed; 22 articles, published during January 2020 to September 2021, were selected. Original research, review articles, editorial and viewpoints were included. Google Scholar, Medline, and PubMed were searched through 2020 till 2021.Data collection in selected studies was performed mainly through the online survey, telephone survey, use of medical records, and patient interviews. This systematic review contains the studies conducted in the American, Asian and European countries. The major outcomes identified were the neurological, psychological, and other long-term chronic manifestations of COVID‐19. This review demonstrates that long-COVID has started to bring a huge wave of patients, the count of them being millions now, who can enter a phase of disability due to neurological damages if not treated during the early course of illness. Though more disabling than lethal, long-COVID patients with a neurological deficit is expected to overburden the healthcare system globally which is already been struggling to handle acute COVID-19 patients in this once-in-a-lifetime pandemic

Prevalence of menopause, chronic illnesses and life style of middle aged women in Karachi, Pakistan

: Objectives: To determine the prevalence of menopause, chronic illnesses and lifestyle of middle aged women in Karachi, Pakistan. Design: A Cross Sectional survey was conducted among women of 40-60 years living in socio-economically different areas of Karachi. Information was gathered on their current menstrual status, age at menopause, body mass index, exercise habits, weekly recall of food consumed and chronic illnesses. These variables were also examined according to the socio economic status of the area where women reside. Results: A total of 1764 women in age group 40-60 years were interviewed. The prevalence of menopausal women in this age group was 39.3 percent (%). The mean age at menopause was 45.2 (±3.8) years. Only seven percent of women were doing some kind of exercise and approximately eighty percent had their Body Mass Index ≥ 23 kg/m2 according to Asian Standard. Approximately 31 percent (%) of women reported eating any type of meat at least four times a week, of these most were from higher income area. Majority consumed meat less than three times a week. Similar pattern was observed for consumption of fruits and milk. Approximately 36 percent (%) of women reported diabetes mellitus, hypertension, cardio vascular heart disease and arthritis. Conclusion: The sedentary life style, obesity and chronic illnesses are highly prevalent and are serious emerging public health problem for 40-60 years old women of Karachi. We recommend that awareness about balanced diet, exercise and healthy eating habits should be inculcated in women early in life, where possible through schools and media. Health policies and public health messages should be formulated according to the various stages of life cycle of women, so that women can prepare themselves for the next stage of life

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

Stillbirths in an urban community in Pakistan

Objective: The purpose of this study was to determine stillbirth risk factors and gestational age at delivery in a prospective developing country birth cohort.STUDY Design: At 20-26 weeks of gestation, 1369 Pakistani women were prospectively enrolled in the study; the gestational age was determined by ultrasound evaluation, and risk factors and pregnancy outcomes were assessed.Results: The stillbirth rate was 33.6 of 1000 births, despite the fact that 96% of the women received prenatal care, 83% of the women were attended by skilled providers in the hospital, and a 20% of the women underwent cesarean delivery. Fifty-one percent of stillbirths occurred at \u3e or = 37 weeks of gestation and 19% occurred from 34-36 weeks of gestation. Only 4% of the births had congenital anomalies. Hemoglobin of \u3c 8 g/dL, vaginal bleeding, and preeclampsia were associated with increased stillbirth risk.CONCLUSION: In this developing country with reasonable technical resources defined by hospital delivery and a high cesarean delivery rate, stillbirth rates were much higher than rates in the United States. That most of the stillbirths were term and did not have congenital anomalies and that the death appeared to be recent suggests that many Pakistani stillbirths may be preventable with higher quality obstetric care

Dating gestational age by last menstrual period, symphysis-fundal height, and ultrasound in urban Pakistan

Objective: To compare the accuracy of the reported date of the last menstrual period (LMP) with that of symphysis-fundal height (SFH) in the estimation of gestational age (GA), using an ultrasound (US) scan as reference. Methods: Gestational age was concurrently assessed by the 3 methods in this prospective, population-based, pregnancy-outcome study conducted in Hyderabad, Pakistan, from June 18. 2003, through August 31, 2005, with 1128 women between 20 and 26 weeks of a singleton pregnancy. Results: The mean GA was less by ultrasound than by SFH measurement or the reported LMP, and the mean differences with the US result were statistically significant (PConclusion: The SFH measurement was found to be more accurate than the reported LMP as a tool to estimate GA and therefore date of delivery, but neither were as accurate as a US scan

Identification and Characterization of the Caspase-Mediated Apoptotic Activity of Teucrium mascatense and an Isolated Compound in Human Cancer Cells

Plants of the genus Teucrium (Lamiaceae or Labiatae family) are known historically for their medicinal value. Here, we identify and characterize the anticancer potential of T. mascatense and its active compound, IM60, in human cancer cells. The anti-proliferative effect of a T. mascatense methanol extract and its various fractions were analyzed in MCF-7 and HeLa cells in a dose- and time dependent manner. The dichloromethane fraction (TMDF) was observed to be the most effective with cytotoxicity against a more expanded series of cell lines, including MDA-MB-231. A time and dose-dependent toxicity profile was also observed for IM60; it could induce rapid cell death (within 3 h) in MCF-7 cells. Activation of caspases and PARP, hallmarks of apoptotic cell death pathways, following treatment with TMDF was demonstrated using western blot analysis. Inversion of the phosphatidylserine phospholipid from the inner to the outer membrane was confirmed by annexin V staining that was inhibited by the classical apoptosis inhibitor, Z-VAK-FMK. Changes in cell rounding, shrinkage, and detachment from other cells following treatment with TMDF and IM60 also supported these findings. Finally, the potential of TMDF and IM60 to induce enzymatic activity of caspases was also demonstrated in MCF-7 cells. This study, thus, not only characterizes the anticancer potential of T. mascatense, but also identifies a lead terpenoid, IM60, with the potential to activate anticancer cell death pathways in human cancer cells