Asymptomatic dengue infection in adults of major cities of Pakistan

OBJECTIVE@#To determine the asymptomatic dengue infection in adults of Pakistani population.@*METHODS@#This study was conducted in five major cities (Islamabad, Karachi, Lahore, Multan, and Peshawar) of Pakistan. A total of 5 230 adults aged 18 years and above without a history of dengue fever at any point in their life were enrolled from participating laboratories. Those who were confirmed for dengue previously were excluded. Of the total, 62.6% (n = 3 276) were male with an average age of 34.6 years. Participants were briefed about the objectives of the study, and written consent was obtained to perform dengue IgG test using enzyme linked immunosorbent assay. The brief information related to age, gender and area was also taken on proforma.@*RESULTS@#Overall 32.3% (n = 1 691) was having asymptomatic dengue infection which was 67.5% (n = 756) in Karachi followed by 39.1% (n = 391) in Islamabad, 29.9% (n = 316) in Lahore and 21% (n = 228) in Peshawar and none from Multan. More males were affected with asymptomatic dengue infection than females. The asymptomatic dengue infection was significantly higher in different cities; however, there was no significant difference with respect to age groups.@*CONCLUSIONS@#The asymptomatic dengue infection is higher in cities i.e. Karachi, Islamabad and Lahore which are at risk of developing secondary dengue infections. There is a need of awareness among the public about secondary dengue infection.

Asymptomatic dengue infection in adults of major cities of Pakistan

Objective To determine the asymptomatic dengue infection in adults of Pakistani population. Methods This study was conducted in five major cities (Islamabad, Karachi, Lahore, Multan, and Peshawar) of Pakistan. A total of 5 230 adults aged 18 years and above without a history of dengue fever at any point in their life were enrolled from participating laboratories. Those who were confirmed for dengue previously were excluded. Of the total, 62.6% (n = 3 276) were male with an average age of 34.6 years. Participants were briefed about the objectives of the study, and written consent was obtained to perform dengue IgG test using enzyme linked immunosorbent assay. The brief information related to age, gender and area was also taken on proforma. Results Overall 32.3% (n = 1 691) was having asymptomatic dengue infection which was 67.5% (n = 756) in Karachi followed by 39.1% (n = 391) in Islamabad, 29.9% (n = 316) in Lahore and 21% (n = 228) in Peshawar and none from Multan. More males were affected with asymptomatic dengue infection than females. The asymptomatic dengue infection was significantly higher in different cities; however, there was no significant difference with respect to age groups. Conclusions The asymptomatic dengue infection is higher in cities i.e. Karachi, Islamabad and Lahore which are at risk of developing secondary dengue infections. There is a need of awareness among the public about secondary dengue infection.

Prevalence of shisha smoking in college, university and madarsa students aged 20-25 years in Pakistan

To estimate the prevalence of shisha smoking, its trends and associated factors in college, university and madarsa students aged 20-25 years in Pakistan. This survey was done on 7582 subjects belonging to 71 institutions from five cities and Federal Capital Islamabad, using a population based sample. Data was collected using cluster sampling from public/private colleges, universities and madarsas. After taking informed consent, about 10% students from each speciality including both genders were collected using a structured self administered questionnaire designed in Urdu and English. Variables included age, gender, socio-economic status, habits, trends, knowledge and perceptions about shisha smoking. The study was approved by Institutional Review Board. Data was analyzed on SPSS version 15 and chi square was used for statistical significance. Out of 71 educational institutions, 43 were public and 28 private including 8 madarsas. There were 2971 students from professional and 4174 from non-professional institutions. Overall prevalence of shisha smoking was 19.7% [n=1410] being more common in males [29.8%] than females [10.4%] Students started smoking shisha at 17-18 years age [57.2%] and almost 75% started this habit in year 2009-2010. The highest prevalence of shisha smoking was seen in Federal Capital Islamabad [28.1%], and lowest in Peshawar [11.2%]. The shisha smoking was more in professional and private educational institutions [p<0.000] with almost 29% students using it in engineering colleges and none using it in madarsas [alma/alia courses]. The trend was highest in students belonging to high socio-economic status [30.7%] and those already smoking cigarettes [74.1%] Pleasure seeking was the commonest reason for smoking shisha [7.1%] and almost 11% students were influenced by their friends. Shisha cafe's were site used by most smokers and majority preferred double apple or mint flavor. Almost a quarter [23.8%] students smoked shisha just for enjoyment and 12.1% thought that it is less harmful than cigarette smoking. Almost 20% students in colleges and universities are smoking shisha. Majority thinking shisha to be harmless or less harmful than cigarette smoking indicating that knowledge about adverse effects of shisha smoking is tremendously low in this educated youth of our country. Shisha should be subjected to the same regulation as cigarettes and other tobacco products and public should be educated about its harmful effects

Plasma vitamin A, carotene, serm total protein and albumin levels in the school age children and young adults of Multan city

Purpose of this study was to estimate the severity and extent of vitamin A deficiency and to find whether it constitutes a significant public health problem. This study included 446 school children aged 5-17 years and 210 young adults aged 18-22 years of Deeni Madaras. All students were male, normal and apparently healthy. The schools and students of Multan city were selected randomly. It was observed that majority of the children belonged to poor socioeconomic class. In these subjects dietary intake of milk, meat and eggs per week was very low and in many cases the consumption of these commodities was once per month. Intake of other dairy products like butter and butter oil was also not found in many cases. However, consumption of leafy vegetables was common to some extent. Clinical examination showed that none of the children had visual or skin disturbances. To assess the malnutrition, serum total protein and serum albumin were measured in all subjects. Low levels of serum total proteins were found in 52.4% children of age 5-11 years, in 26.6% children of age 12-17 years and in 21.0% young adults of age 18-22 years. Low levels of serum albumin were found in 28% children of age 5-11 years, 37% children of age 12-17 years and in 35% young adults of age 17-22 years. Low or subclinical plasma vitamin A levels were noticed in 81.5% children of age 5-11 years, in 6% children of age 12-17 years and in 12.5% young adults of age 18-22 years. Low or subclinical plasma carotene levels were observed in 64% children of age 5-11 years, in 16% children of age 12-17 years and in 20% young adults of age 18-22 years. This study has shown that clinical features of vitamin A deficiency are not visible in our children, however subclinical deficiency is present which must be corrected for adequate growth and development

Patients with spontaneous chest pain; safety and prognostic value of early dobutamine stress echocardiography

This Study comprised 50 patients with age group of 30-60 years, 40 were female and 10 male patients. All patients underwent serial creatinine phosphokinase enzyme measurements, continuous ECC monitoring for at least 12-24 hours and early Dobutamine Stress Echocardiography [DSE].In patients with negative creatinine kinase enzymes and normal findings of ECG monitoring, [DSE] was considered positive in patients with wall motion abnormalities. Five patients had evidence of early myocardial infarction. In the remaining 45 patients DSE was performed. DSE results were of poor quality in 2, non-diagnostic in 6, negative in 22 and positive in 16 patients. Two patients suffered from tachyarrhythmia, one patient has paroxymal atrial tachycardia [PAT] and other suffered ventricular tachycardia. Both were successfully cardioverted