Prevalence of hypertension and associated factors in Jalalabad City, Nangarhar Province, Afghanistan

Background: Hypertension affects an estimated one billion people, worldwide. It is a public health challenge characterized by increased morbidity, mortality, as well as cost to the community and health systems. The goal of this study is to determine the prevalence of hypertension and characterize associated risk factors in an urban setting in Afghanistan.Methods: A cross-sectional study of adults aged 25-65 years was conducted in Jalalabad city from May to June 2013 using the World Health Organization STEPwise approach to surveillance (WHO STEPS). A multistage technique was used to enroll 1,200 participants in the study. Demographic and socio-economic variables were collected via individual interviews using the WHO STEPS survey, after which blood samples were collected using a locally developed standard operating procedure (SOP). Bivariate and multivariable analyses were performed to explore the association between hypertension and associated factors.Results: A total of 1,180 adults (40% males, 60% females) of 25-65 years of age were surveyed. The response rate was 98.5 % and the prevalence of hypertension was 28.4. Independent risk factors of hypertension were found to be: age ? 50 (AOR = 3.42, 95% CI: 2.50 – 4.76); sex (AOR = 0.58, 95% CI: 0.38 – 0.88); obesity (AOR = 2.1, 95% CI 1.49 – 2.94); and diabetes (AOR = 1.75, 95% CI: 1.10 – 2.79). Independent protective factors were physically demanding occupations (AOR = 0.55, 95% CI: 0.36 – 0.85); physical activity itself (AOR = 0.69, 95% CI: 0.47 – 0.99) and consuming more vegetables (AOR = 0.59, 95% CI: 0.38 – 0.93).Conclusion: This urban setting in Afghanistan evidenced a high prevalence of hypertension; age, obesity, and diabetes were identified as risk factors and physical activity and consuming more vegetables were protective. These findings have implications for future public health intervention and clinical efforts

Prevalence of Risk Factors for Non-Communicable Diseases in the Adult Population of Urban Areas in Kabul City, Afghanistan

Background: Non-Communicable diseases (NCDs) are a major global problem. This study aims to estimate the prevalence of common risk factors for NCDs among the adult population in urban areas of Kabul city, Afghanistan.Methods and Materials: This study was conducted from December 2011 through March 2012 and involved a survey of 1169 respondents, aged 40 years and above. Multistage cluster sampling was used for participant selection, followed by random sampling of the participants. The World Health Organization STEPwise approachfor Surveillance (STEPS) was modified and used for this study. Results: The overall prevalence of smoking was 5.1% (14.7% men versus 0.3% women) and using mouth snuff was 24.4% in men and 1.3% in women. The prevalence of obesity and hypertension were 19.1% and 45.2 % in men and 37.3% and 46.5% in women. Prevalence of diabetes was 16.1% in men and 12% in women. The overall prevalence of obesity, hypertension and diabetes mellitus was 31.2%, 46% and 13.3%, respectively. On average, subjects consumed 3.37 servings of fruit and 2.96 servings of leafy vegetables per week. Mean walking and sitting hours per week (as proxies for physical activity) were 19.4 and 20.5, respectively. A multivariate model demonstrated that age was a significant risk factor for obesity (OR=1.86), diabetes (OR=2/09) and hypertension (OR=4.1). Obesity was significantly associated with sex (OR=1.65). Conclusion: These results highlight the need for interventions to reduce and prevent risk factors of non-communicable diseases in urban areas of Kabul City, Afghanistan

Diabetes Mellitus Among Adults in Herat, Afghanistan: A Cross-Sectional Study

Introduction: Diabetes is reaching epidemic levels in Afghanistan. This study identifies the risk factors associated with diabetes in Herat City, Afghanistan, and explores the prevalence of previously undiagnosed diabetes.Methods: A cross-sectional study was conducted using multistage cluster sampling by adopting the World Health Organization’s (WHO) STEPwise approach to Surveillance (STEPS). We enrolled 1129 participants aged 25-70 years between May and June of 2015 (47.4% males, 52.6% females). A structured questionnaire was used for data collection of demographic, socioeconomic, and behavioral factors. Investigators collected anthropometric measurements and blood samples from study participants. A multivariable logistic regression model was used to identify factors associated with diabetes prevalence.Results: We found that the prevalence of diabetes in Herat City was 9.9% (9.8% in males and 10.1% in females). Of the 1129 respondents, only 3.3% were previously diagnosed with diabetes or were under treatment, whereas 6.6% of respondents were previously undiagnosed. The multivariable analyses showed that age, frequency of rice consumption, type of cooking oil, and systolic blood pressure were associated with diabetes. Conclusions: This is one of the first studies to discuss the high prevalence of undiagnosed diabetes in Herat, Afghanistan. This study found several modifiable factors that were associated with diabetes in Herat, Afghanistan. Future reduction of disease burden should focus on these factors in the development of the most optimal diabetes prevention programs

Fine needle aspiration cytology of thyroid nodule: diagnostic accuracy and pitfalls

Background: To evaluate the utility of FNAC in patients with Thyroid Nodule. Methods: Records of all patients treated surgically for thyroid nodule(s) at Aga Khan University Hospital from January 2000 to December 2004 were reviewed. The patients who had pre operative FNAC as first line of the evaluation and the final post operative histopathology report available were included in the study. Results: 125 patients (90 female 35 male) had thyroid surgery. The cytological diagnosis was made according to following categories: Benign, Follicular lesion, Malignant and Inadequate sampling. Among 63 Benign cases , 57 were benign and 6 turned out to be malignant. Among 44 cases from Follicular group , 31 were benign and 13 were malignant. Out of 15 patients from Malignant group, 14 were malignant and 1 was benign. Among three patients from the Inadequate sampling group , 2 turned out to be benign and one was malignant. The overall results showed a sensitivity of 98%, specificity of 70%, and positive predictive value of 91%, negative predictive value of 93% and diagnostic accuracy of 91%. Conclusion: We conclude that FNAC is an invaluable and minimally invasive procedure for pre operative assessment of patients with a thyroid nodule in our setting as well. FNAC has high sensitivity in picking up malignancy in thyroid and also has high diagnostic accuracy in the evaluation of thyroid nodules

Frequency of NSAID induced peptic ulcer disease

Objective: To determine the frequency of peptic ulcer disease in patients on nonsteroidal anti-inflammatory drugs (NSAID). Methods: Record of eight hundred and twenty consecutive patients undergoing upper gastrointestinal (GI) endoscopy; from January 1998 to December 2000 were reviewed. The endoscopic diagnosis varied from gastritis, peptic ulcer to duodenitis. The use of NSAID was documented by reviewing medical records of patients with peptic ulcer. Results: Peptic ulcers were found in 43% (353/820) patients. NSAID associated peptic ulcers were identified in 14.7% (52/353) patients. Diclofenac and aspirin were most common NSAIDs associated with peptic ulcers in 32.7% (17/52) and 30.7% (16/52) patients, respectively. Duodenal ulcer was more common than gastric ulcer 65.3% (34/52) and 42.3% (22/52), respectively. H. pylori infection was present in 46% (24/52) of the cases. NSAIDs treatment and / or H. pylori infection compared to non NSAIDs and non H. pylori infected peptic ulcer disease were significantly associated with gastric ulcer (p = 0.004) and duodenal ulcer (p = 0.009) respectively. Conclusion: NSAID-associated peptic ulcer disease is common in Pakistan and most frequently associated with gastric and duodenal ulcer. H. pylori infection is common in association with NSAID related peptic ulcers (JPMA 56:218;2006

New Criteria for Meromorphic Multivalent Alpha-Convex Functions

The aim of the present paper is to obtain sufficient condition for the class of meromorphic p-valent alpha convex functions of order ξ and then to study mapping properties of the newly defined integral operators. Many known results appeared as special consequences of our work

Analysis of Ellis Fluid in Wire Coating

The focus of the present work is concerned with the study of wire coating analysis using Ellis fluid. Using the binomial series method, closed form solution is obtained and further in the closed form of solution, we discussed a special case for the parameter , and obtained the expressions for axial velocity, shear stress, average velocity, volume flow rate and temperature distribution. Thickness of the coated wire and force on the total wire are also calculated. The effect of different parameters of interest on the variation of the velocity profile, volume flow rate, shear stress, radius of coated wire and force on the total wire are discussed and presented graphically

Climatic data acquisition system for satellite communications

Several climatic dynamic phenomena such as rain and turbulence can seriously affect the quality of satellite communications. This project presents the design and implementation of a data acquisition system. The system provides accurate vital information to facilitate proper analysis of anticipated problems so that solutions can be incorporated when designing earth-satellite systems. Signals from the beacon of MEASAT3 located at 91.5ËšE orbit is received by a 2.4 meter Parabolic dish. The signal is measured in real-time by a Spectrum Analyzer using a General Purpose Interface Bus (GPIB) cable which provides high speed transmission. The system is equipped with a synchronized 0.2mm tipping bucket rain gauge. For data logging and analysis a system was developed using LabView version 8.6. The logging process involves data recording every 0.1 second