Abuse among school going adolescents in three major cities of Pakistan: is it associated with school performances and mood disorders?

To assess the proportion of various types of abuses and their association with school performances and psychological stress among adolescents from three major cities of Pakistan. The cross-sectional school survey was conducted from March to September 2009, comprising adolescent students at six schools in Karachi, Lahore and Quetta. Data was collected using a self-administered and pre-tested questionnaire by trained medical students. SPSS 16 was used for statistical analysis. Of the 414 subjects in the study, there were 223[54%] boys and 191[46%] girls with an overall mean age of 14.36 +/- 1.08 years. In all, 140[33.7%] participants were physically abused and 236[57%] participants were verbally abused in the preceding 12 months. Besides, 245[59.2%] were involved in physical fight and 195[47.1%] had suffered injury during the preceding year. There were 171[41.4%] subjects having suffered bullying during the same period. Verbal abuse [p=0.05], physical fight [p=0.05] and bullying [p<0.001] were significantly associated with poor school performances among adolescents. Physical abuse [p=0.05], verbal abuse [p=0.003], injury [p=0.02] and bullying [p<0.001] were significantly associated with psychological stress. Various types of abuse were quite prevalent in adolescents that were significantly associated with poor school performance and poor mental health

investigate the association between the development of coronary heart disease and serum levels of adiponectin

To investigate the association between the development of coronary heart disease and serum levels of Adiponectin. It was a case control study done at the Department of Physiology Basic Medical Sciences Institute [BMSI] Jinnah Post Graduate Medical Centre [JPMC] in colaboration with Abassi Shaheed Hospital Karachi. The study included total 100 subjects, 50 subjects with angiographically confirmed coronary heart disease and 50 normal healthy age and gender matched controls. All the subjects were breifed about the the nature of the study and an informed concent were taken from all the recruits. Adiponectin serum concentration was found [7.1microL] in coronary disease patients, and the serum concentration of adiponectin in control subjects was [11.98 microL]

Preventable Lifestyle Risk Factors for Non-Communicable Diseases in the Pakistan Adolescents Schools Study 1 (PASS-1) / 예방의학회지

OBJECTIVES: The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents. METHODS: In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis. RESULTS: Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% were also current smokers. More than one-third of participants chewed betel nut, and one-quarter used oral tobacco. More girls were physically inactive (OR, 4.07; 95% CI, 2.69 to 6.17), whereas a greater proportion of boys were current smokers (OR, 2.17; 95% CI, 1.19 to 3.91), exposed to passive smoking (OR, 2.57; 95% CI, 1.72 to 3.83), and using betel nut (OR, 2.03; 95% CI, 1.34 to 3.06). Only 3.1% of the participants were without any preventable lifestyle risk factor for NCDs, and over 80% had > or =2 factors. Co-existence of risk factors was independently associated with fathers being blue-collar workers (aOR, 3.57; 95% CI, 1.07 to 11.92) and parents not treating their child fairly (aOR, 5.05; 95% CI, 1.29 to 19.78). CONCLUSIONS: Most of the adolescents studied had preventable risk factors for NCDs. These results warrant comprehensive and integrated interventions to prevent lifestyle risk factors, and parents are front-line stakeholders.

comparison of the effects of gamma glutamyltransferase on age and obesity among normal, hypertensive and type 2 diabetics

The purpose of this work was to compare the effects of Gamma Glutamyltransferase on age and obesity among normal, hypertensive and type 2 diabetics. It is a cross-sectional study which was conducted in the department of Physiology B.M.S.I., J.P.M.C. Karachi from December 2006 to October 2007. All subjects who have never used alcohol in their lifetime were selected. A total of 100 normal, 50 each diabetic and hypertensive patients were recruited to the study. Increase in age was significantly associated with raised GGT levels in normal, hypertensive and type 2 diabetic subjects [p < 0.01]. GGT levels were significantly [p < 0.001] greater in both hypertensive and diabetic subjects compared to normal subjects. The study confirms the relation between age obesity with GGT levels among non-alcoholics. This study also indicates the significance of GGT among diabetics and hypertensive patients

Brain natriuretic peptide, systolic and diastolic blood pressures

Hypertension is an increasingly important medical and public health issue. Because of life time risk of hypertension Joint National Committee-7 introduced a new term "Pre-hypertension" for those with systolic blood pressure 120-139 mmHg and diastolic blood pressure 80-89 mmHg. Individuals prone to the development of hypertension often have a hyperdynamic circulation antedating the onset of hypertension by several years. Brain Natriuretic Peptide is a new promising cardiovascular risk marker due to its association with high blood pressure via its key role in salt and water homeostasis and hence blood pressure. This study was designed to find out the levels of plasma Brain Natriuretic Peptide in normotensive, pre-hypertensive and newly diagnosed hypertensive and to observe its association with increasing values of blood pressure. This was an cross-sectional study conducted in the Department of Physiology Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi. Study included 85 adult males, aged between 20-60 years, non- smokers, non- diabetic and having no other chronic illness. Systolic blood pressure and diastolic blood pressure values were measured and divided into three groups on the basis of normotensive to hypertensive as stated by Joint National Committee -7. Brain Natriuretic Peptide was assayed by AxSym technology. Brain Natriuretic Peptide developed a positive and statistically significant correlation with both systolic and diastolic blood pressures and was also found out to be significantly raised in prehypertensive group. His study concluded that Brain Natriuretic Peptide is positively related with increasing values of both variables i.e. systolic as well as diastolic blood pressures. It also concluded out Brain Natriuretic Peptide to be significantly elevated in pre-hypertensive stage which may remain increased in sustained hypertension

Evaluation of serum leptin levels during normal pregnancy and in pre-eclampsia

The present study was designed to compare the serum leptin levels in normal pregnancies with those pregnancies which are complicated by pre-eclampsia and to investigate the possibility of leptin being a marker of severity of pre-eclampsia. This was a comparative cross-sectional study, conducted at the Department of Gynaecology and Obstetric, Jinnah Postgraduate Medical Centre [JPMC], Karachi. For this purpose 45 primigravidas with normal pregnancy and 45 primigravidas with pre-eclamptic pregnancy were selected who were in their third trimester All the subjects were of the same maternal age, gestational age, height and weight. Serum leptin levels were determined by immunoenzymometric assay. The study included 90 patients, divided into two groups. The serum leptin levels were found to be elevated in pre-eclamptic group as compared to normal pregnancy. When comparison was made on the basis of severity of pre-eclampsia, the serum leptin levels were found to be increased in severe group as compared to mild group. From this study it was concluded that the levels of serum leptin were higher in pre-eclamptic group when compared to controls during the third trimester of pregnancy indicating the possible role of leptin in the pathogenesis of pre-eclampsia. Also the elevated level of leptin may help in the prediction of the disease and may serve as a marker of severity of pre-eclampsia

Rate of decrease in hemoglobin/hematocrit levels among male patients with various degrees of chronic renal insufficiency

To correlate the rate of decrease in hemoglobin/ hematocrit levels with decrease in creatinine- clearance among male patients with various degrees of chronic renal insufficiency. A cross sectional analytical study. Department of Physiology, BMSI, JPMC, Karachi, in collaboration with Department of Nephrology, JPMC, Karachi. The study included 75 subjects, distributed into five groups of 15 subjects each. First group [control] comprising of normal subjects with Creatinine clearance [Cr. C1] above 90 ml/min, and remaining four groups i.e, group II [Cr. C1 60-90 ml/min], group III [Cr. C1 30-59 ml/min], group IV [Cr. C1 15-29 ml/min and group V [Cr C1 < 15 ml/min], comprising of patients with increasing severity of the renal insufficiency. All the subjects were males. Their hemoglobin and hematocrit levels were analyzed and statistically compared. As compared to control group, there was a 6.85%. 11.46%, 29.09% and 49.93% decrease in hemoglobin levels when subjects or group II, III, IV and V were taken into consideration. Similarly there was 8.45%, 18.13%, 29.47% and 54.00% decrease in hematocrit levels, in the same order. The rate of decrease in hemoglobin and hematocrit levels goes higher as the renal excretory function falls lower

Identification of sensitive and specific markers for typhoid fever: the rapid detection

Typhoid fever is common in Pakistan and several developing countries, especially among children. There has been a continuous search for a simple and reliable test that can be carried out in a small laboratory, for an early and rapid diagnosis. For this purpose, Typhidot test and TUBEX test have been evaluated in the present study. Blood samples from 131 patients with age range of 2-10 years presented with 4 days of fever. The patients were recommended for the detection of 1gM and IgG antibodies to Salmonella typi. Typoidot test was positive for both IgG and 1gM antibodies to S. typhi in our samples. Typhidot test gave a sensitivity of 100 percent and specificity of 80 percent when bacteraemic patients were analyzed. It has been concluded that the Typohidot is a quick and easy-to-perform test that requires no special equipment and training of staff for interpretation of results. The ELISA results for 1gM and IgG were more sensitive and specific than any combination of the Widal test, and hence it could be a useful tool for the serologic diagnosis of typhoidal fever with a single blood sample

Gender difference in hemoglobin/hematocrit levels among patients with various degrees of chronic renal insufficiency

To observe the gender difference in hemoglobin/hematocrit levels among patients with various degrees of chronic renal insufficiency. A cross-sectional analytical study. Department of Physiology, BMSI, JPMC, Karachi, in collaboration with Department of Nephrology, JPMC, Karachi. The study included 150 subjects, distributed into five groups of 30 subjects each. First group [control] comprising of normal subjects [Cr.Cl >90 ml/min] and remaining four groups [group II [CrCl 60-90 ml/min], group III [CrCl 30-59 ml/min, group IV [CrCl 15-29 ml/min] and group IV [CrCl <15 ml/min]], comprising of patients with increasing severity of the renal insufficiency. Half of the subjects in each group were males. Their hemoglobin and hematocrit levels were analyzed and were statistically compared. As compared to control group, there was a 6.85%, 11.46%, 29.09% and 49.93% decrease in hemoglobin levels in case of males versus 5.15%, 9.24%, 24.24% and 49.0% decrease in case of females when subjects o -group II, III, iv and V were taken into consideration. Similarly, there was 8.45%, 18.13%, 29.47% and 54.0% decrease in hematocrit levels in case of males versus 4.71%, 11.31%, 22.58% and 50.98% decrease in case of females, in the same order. There is a slight gender difference in hemoglobin and hematocrit levels among patients with various degrees of chronic renal insufficiency

Assessment of homocysteine levels in preeclampsia

Assessment of Homocysteine levels in preeclampsia. A cross-sectional analytical study. Department of Physiology, BMSI, JPMC, Karachi in collaboration with Department of Gynecology and Obstetrics, JPMC, Karachi from March 2005 to November 2005. Study included 90 subjects distributed into three groups of 30 subjects each. 30 were apparently health subjects. 30 mild pre-eclamptic and 30 severely prerec lamptic. Clinical details were collected. Fasting blood samples were drawn by adopting aseptic methods and serum was analyzed for Homocysteine levels by !Mx Analyzer method. Among 90 screened subjects Homocysteine in 30 normal subjects was 6.61 mmol/L. 30 mild preeclamptic subjects showing 12.65 mmol/L was highly significant as compared to normal. However; 30 severe preeclamptic subjects shows mean Homocysteine level 14.44 mmol/L as compared to normal. The difference in both groups weir statistically highly significant as compared to normal subjects. Concluded that serum homocysteine levels were strongly associated with preeclampsia, which suggests that elevated circulating homocysteine may be involved in pathogenesis of uteroplacental vascular disease associated with preeclampsia, which may he a risk marker in pregnant women

Effect of lithium carbonate on serotonin [5'HT] and creatine phosphokinase [CPK] in depressed patients

Depression is an illness that involves feelings of sadness lasting for two weeks or longer, often accompanied by a loss of interest in life, hopelessness, and decreased energy. It is a medical illness linked to changes in the biochemistry of the brain. Lithium is used for acute mania or prevention of recurrences of bipolar manic-depressive illness in adults. Lithium is a toxic drug and not metabolized in the body. Twenty patients with manic depression, 5 with hypomania and 5 hysteria were taken in the study. Effect of lithium on biochemical parameters like serotonin [5'hydroxy tryptamine], CPK and lithium were determined. Lithium treatment when applied to patients suffering from depression increases level of 5'HT, which is beneficial. However, increase in levels of serum CPK and lithium also occurs which may be toxic. Hence care needs to be taken in treatment to avoid brain damage to patients. It is therefore concluded that during lithium treatment careful monitoring of lithium blood level must be done to ensure adequate therapeutic efficacy without toxicity

Effects of acute exetcise on serum vitamin E levels in physically trained and untrained healthy adults

This study was carried out to evaluate changes in serum vitamin E levels in physically trained and untrained adults after an acute bout of physical exercise. Results indicate a significant rise in 1-hour post exercise serum vitamin E levels in trained group in comparsion to their immediate post exercise levels. No such increase was found in untrained group individuals, whose 1-hour post exercise serum vitamin E levels remained almost same as immediate post exercise levels. It can be concluded therefore that exercise training results in increased mobilization of vitamin E from it depots after exercise

Comparison of plasma protein concentration and haematological parameters in type-1 and type-2 diabetics of short and long duration

Diabetes mellitus is the most common metabolic disorders, characterized primarily by relative or absolute insufficiency of insulin secretion and concomitant insensitivity or resistant to the metabolic action of insulin on target tissues leading to metabolic derangement. These metabolic derangements are translated into alteration in blood constituents, thus affecting the characteristic of blood. The purpose of this study was to evaluate hematological and biochemical parameters in blood of diabetics of short and long term duration. Hematocrit, ESR, serum sugar, fibrinogen, total serum protein, albumin, and globulin were determined in shortand long-term type-1 and type-2 diabetics, and in healthy control subjects. Hematocrit, ESR, serum sugar, fibrinogen, total serum protein, and albumin concentration of both short- and long-term type-1 diabetics were significantly greater than those of the non-diabetics controls. There were no significant differences between short- term type-2 diabetics and the controls in the parameters like hematocrit, ESR, fibrinogen and globulin. However, hematocrit, ESR, serum glucose, fibrinogen, total serum protein, and albumin of long-term type-2 diabetics were significantly elevated above those of the controls. Based on the reported association of these parameters with diabetic complications, our results suggest that there could be an earlier development of complications in type-1 than in type-2 diabetics

Sever hypothyroidism Effect of L- thyroxine therapy on the lipid contents of serum lipoproteins

Thyroidal status has s well known effect on lipid metabolism. Thyroid insufficiency may cause secondary hyperlipidemia, but effect of short course [pound l2 weeks] L-thyroxine therapy on elevated high density lipoprotein cholesterol [HDL-c] is controversial. Particularly the effect of short course of L-thyroxine therapy on elevated levels of various serum lipoproteins in severely hypothyroid patients.[serum T[4] levels <15 mmol/L and hTSH >150 mU/L] has not been established. To assess the efficacy of L-thyroxine therapy in normalizing the elevated lipid contents of various serum lipoprotein fractions in severe primary hypothyroidism in the local population. DESIGN: Controlled clinical trial. PATIENTS AND METHODS: 17 male patients referred to Punjab Institute of Nuclear Medicine, Faisalabad, mean age [mean age 32 +/- 18 years, ranging 23-67 years], having serum levels of T[4] <15 mmol/L and hTSH >150 mU/L were selected. pre-therapy fasting blood samples was taken at the time of diagnosis. All subjects became euthyroid after 9 weeks of L-thyroxine therapy with gradual increase of dosing from 50 to 150 [micro] g/d. Post-therapy fasting blood was taken after 12 weeks of L-thyroxine therapy. With L-thyroxine therapy euthyroid state was achieved within 9 weeks and all patients became free from signs and symptoms of hypothyroidism. Serum triacylglycerols, total cholesterol and LDL-c levels were reduced significantly [P <0.01] but there was a slight reduction in the serum HDL-c levels. CONCLUSIONS: L-thyroxine therapy in severe hypothyroidism does have a cardioprotective effect by normalizing the elevated levels of TAGs, total cholesterol and LDL-c