Awareness and adherence to lifestyle modifications in hypertensive patients presenting to a tertiary care setting.

OBJECTIVE: To assess the level of awareness and adherence to lifestyle modifications in hypertensive patients. METHODS: The descriptive study was conducted from January to June 2019 at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised adult patients of either gender with hypertension history of at least 1 year. Data was collected using a structured questionnaire to evaluate the subjects' awareness and adherence to lifestyle modifications for the control of hypertension. Data was analysed using SPSS 20. RESULTS: Of the 294 patients, 160(54.4%) were women. The overall mean age was 53.3±12.1 years and mean body mass index was 27.1±5.9kg/m2, and mean duration of hypertension was 8.2±7.1 years. There were 122(41.5%) obese and 97(33%) overweight patients. Overall, 201(68.4%) patients had co-morbidities and 40(13.6%) were smokers. Of the total, 205(69.7%) knew the importance of exercise, but 104(35.4%) were doing it; 270(91.8%) were aware of restriction of sodium diet, but 244(83%) were adhering to it; 222(75.5%) knew the importance of dietary approaches to stop hypertension, but 185(62.9%) were adhering to it; and 247(84%) were aware that regular blood pressure measurement and follow-ups were important, but 150(51%) were adhering to it. CONCLUSIONS: The level of awareness regarding lifestyle modifications was found to be high in hypertensive patients, but the status of adherence was not up to the mark.

Prevalence of Aflatoxins in Selected Dry Fruits, Impact of Storage Conditions on Contamination Levels and Associated Health Risks on Pakistani Consumers.

Dry fruits and nuts are nutritious foods with several health-promoting properties. However, they are prone to contamination with aflatoxins at all stages of production and storage. The present study aimed to determine the natural occurrence of aflatoxin B1 (AFB1), aflatoxin B2 (AFB2), aflatoxin G1 (AFG1), aflatoxin G2 (AFG2), and total aflatoxins (AFT) in dates, pistachios, and walnuts collected from four districts of South Punjab (Pakistan), and to assess the associated health risks as estimated by dietary exposure and the Margin of Exposure (MoE) determinations. The contents of AFB1 and AFT in these food products were monitored during storage under three different conditions (open-air, hermetically closed jars, and refrigeration at 4 °C) to determine the most efficient conditions in preventing aflatoxin accumulation. HPLC-fluorescence analysis of 60 samples of these products for aflatoxin contamination showed that 52 (86.7%) samples were contaminated at different levels, with a maximum of 24.2 ng/g. The overall (all samples) mean concentrations of AFB1, AFB2, AFG1, AFG2, and AFT were 3.39 ± 2.96, 1.39 ± 1.68, 1.63 ± 1.48. 1.12 ± 1.23, and 7.54 ± 6.68, respectively. The Estimated Daily Intake (EDI) and MoE of aflatoxins through the consumption of the products ranged from 0.06 ng/kg bw/day to 2.0 ng/kg bw/day and from 84.84 to 2857.13, respectively, indicating that consumers are at high health risk. Significant differences were recorded between aflatoxin levels in the samples stored under different storage conditions, with storage under refrigeration (4 °C) being the most effective in controlling aflatoxin accumulation, although storage in closed jars was also efficient and offers a more flexible alternative to retailers. The findings of the study urge official authorities of Pakistan to implement appropriate regulatory and control measures and surveillance program to alleviate the potential public health risks associated with the consumption of dry fruits and nuts in the scope of their increased consumption.

Assessment of quality of life of stroke survivors and their caregivers presenting to a tertiary care hospital in Pakistan.

OBJECTIVE: To determine the quality of life of stroke survivors and their caregivers presenting to a tertiary care setup. METHODS: The descriptive study was conducted from July to December 2019 at the Neurology Department, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised patients of either gender with ischaemic or haemorrhagic stroke aged 40-70 years and their caregivers. Data was collected using the stroke-specific quality of life Scale and the caregiver quality of life questionnaire. Data was analysed using SPSS 20. RESULTS: Of the 80 patients, 50(62.5%) were males and 30(37.5%) were females. The overall mean age was 61.46±11.80 years, and 56(70%) were aged >55 years. Among the patients, speaking power, mobility and mood were more affected with mean levels of 15.51±8.63, 22.63±8.33 and 19.08±7.05, respectively. The domains of social role, self-care and upper extremity function were also affected with mean values of 19.022±7.06, 15.71±8.81 and 18.88±7.02, respectively. Among the caregivers, the levels of physical wellbeing and functional wellbeing were high 15.07±5.65 and 15.35±5.76, respectively. There were differences in terms of age and gender but the difference was not significant (p>0.05). CONCLUSIONS: The quality of life of stroke survivors was low, and that of caregivers was also quite compromised.