Background: The reported prevalence of infertility in Pakistan is 21% of which 35% is contributed by male factor. Male infertility has multifactorial etiologies ranging from modifiable to genetic risk factors. Among a...Background: The reported prevalence of infertility in Pakistan is 21% of which 35% is contributed by male factor. Male infertility has multifactorial etiologies ranging from modifiable to genetic risk factors. Among all the risk factors that may account for male infertility, obesity is one of the emerging public health problems. Therefore, the aim of the study was to determine the association of obesity with infertility in Pakistani men. Methods: We conducted a case control study. Cases were men with impaired semen parameters and controls did not have impaired semen parameters. Results: The final multivariable logistic regression model after adjusting for the effect of other variables revealed that with every 1 kg/m2 increase in BMI the odds of being infertile was 6% higher as compared to being fertile (aOR = 1.06;95% CI = 1.01, 1.11). Moreover the odds of having education of higher secondary or above was 3 times greater among cases as compared with the controls (OR = 3.10;95% CI = 1.66, 5.77). Furthermore the odds of having previous medical conditions increasing the risk of infertility was higher among cases as compared with the controls (OR = 3.07;95% CI = 1.63, 5.79). Conclusion & recommendations: This study indicates that obesity is an important risk factor for male infertility. Moreover our findings also indicate that higher educational status and previous medical conditions are also associated with male infertility. Thus awareness can be raised through treating physicians and public health messages.展开更多
Background: The concept of resilience is very crucial in promoting positive psychological well-being. However, this construct was never looked among married women of Karachi, Pakistan. Therefore, this study aimed to a...Background: The concept of resilience is very crucial in promoting positive psychological well-being. However, this construct was never looked among married women of Karachi, Pakistan. Therefore, this study aimed to assess the prevalence and the associated risk factors of resilience in Pakistan. Methods: It was a cross-sectional survey, using the Wagnild Resilience Scale (RS) to assess resilience, Beck Depression Inventory II (BDI-II) for measuring depression and Trait Wellbeing Inventory for determining Life Satisfaction. Systematic sampling was employed to enroll 636 participants of aged 20 to 40 years living in two urban squatter settlements of Karachi, Pakistan. Prevalence ratio was computed with their 95% confidence interval. Results: A total of 636 married women participated in the study. The average age of females with low resilience was 29.8 (5.7) whereas the mean age of females with high resilience was 31.1 (5.7). Around 90% of all the participants could speak in Urdu. The prevalence of low resilience among women was 21.9%. Moreover, the prevalence of depression among low resilience group was 43.9% whereas the mean life satisfaction score among females with low resilience was lower than females with high resilience. The females who had low resilience were younger and had no formal/informal education as compared to their counterparts. After controlling for other variables, the prevalence of low resilience was 1.78 times more among depressed females as compared to the non-depressed with a 95% CI: (1.27-2.51). Moreover with every one unit increase in the life satisfaction scores, the prevalence of low resilience decreased 9%. Furthermore, age and informal schooling were also found to be significantly associated with resilience. Conclusion: Depression and life satisfaction are the potential modifiable risk factors for resilience and hence we can improve resilience through interventions that may focus on reducing depression and improving satisfaction towards life. Our study also recommends that health care professionals should be educated about these modifiable risk factors to bring about a change in the society and reduce the mental health illness by promoting constructive adaptation.展开更多
Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers. Methods: T...Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers. Methods: The systematic review was conducted in 2009 and consisted of observational studies in school settings published between January 2005 and January 2009. Smoking status was the main outcome of interest. Following Cochrane style, five steps were followed: setting selection criteria for studies and conducting a literature search;review of abstracts;review of complete articles;data extraction and quality assessment of included studies;and, finally, synthesis of studies. Results: Of the 292 abstracts retrieved, 45 (15.4%) articles were selected for the final review. Inconsistencies were found in the definition of smoking behaviour which impeded generalisability. Individual-level factors had importance, but environmental level factors were also important in studying the aetiology of smoking. Results showed that studies inappropriately reported sample size estimation and important confounding factors. Hierarchical linear modelling, random effects modelling and structural equation modelling were employed in comparatively few studies. Conclusions: There were concerns regarding data analysis of complex surveys. Fifty five percent of reviewed studies ignored environmental effects which may have produced unreliable inferences. Multi-level analysis assisted in understanding school-level effects.展开更多
Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children. Methods: This is a school-based cross-sectional study conducted from January to February 2016....Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children. Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted prevalence ratios with 95% CI were reported. Total 554 children, 306 (56.3%) boys and 43.7% girls participated in the study. Mean age of children was 13.2 ± 0.05 years. Total number of children with DMFT > 0 was 30.5%. The decayed component contributed largely (22.8%) to the DMFT score. Overall prevalence of asthma was 20%. Prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. Adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.6 - 1.3) after adjusting for carious food intake, age, oral hygiene index and dentist visit;the association between asthma and dental caries turned out to be in-significant. Conclusions: There was no association observed between asthma and dental caries among the children examined in this study.展开更多
Introduction: Among young teens, about one in five smokes worldwide. Adolescents spend a considerable amount of their time in school, and the school environment is therefore important for child health practices and ou...Introduction: Among young teens, about one in five smokes worldwide. Adolescents spend a considerable amount of their time in school, and the school environment is therefore important for child health practices and outcomes. Objectives: We aimed to investigate the impact on smoking behavior of the school environment and the personal characteristics of male teenage students attending schools in Pakistan, taking into account the survey sampling structure. Methods: A two-stage cluster sampling with stratification was employed, and we interviewed 772 male secondary school students. We adopted random effect and generalizing estimating equation models. Results: Peer pressure in particular had a strong influence on adolescents smoking;those whose friends smoked were up to 6 times more likely to smoke. Family smoking was also significantly associated with adolescents smoking, but those students whose mother was educated were 50% less likely to smoke. The fitted random effect model indicated that the between school variability was significant (p-value < 0.01), indicating differences in smoking habits between schools. A random coefficient model showed that variability among schools was not significantly different for public and private schools. Conclusion: Public health campaigns for smoking cessation should target not only the individual but also the families of adolescents attending schools.展开更多
Introduction:Tonsillectomy is one of the most common procedures performed in otolaryngology.There are various methods to perform tonsillectomies(cold and hot).Thermal damage and inflammation of the surrounding tissue ...Introduction:Tonsillectomy is one of the most common procedures performed in otolaryngology.There are various methods to perform tonsillectomies(cold and hot).Thermal damage and inflammation of the surrounding tissue using monopolar cautery is said to point to increased pain whereas immediate cooling of the burnt area is thought to reduce pain owing to heat dissipation.Our objective was to determine the difference in mean post‐tonsillectomy pain scores among patients irrigated with cold water(4℃)and in patients not irrigated with cold water.Material and Methods:A quasi‐experimental trial was conducted from January 2016 to December 2017 at a tertiary care hospital.All tonsillectomies were carried out with monopolar cautery at a power of 20 W.Patients either received cold water irrigation post tonsillectomy of the tonsillar bed(intervention arm)or no irrigation(control arm).The pain score was measured on Days 0,1,3,5,and 7.Pain scores were charted on a visual analog scale on the respective days.Results:Seventy‐eight patients were included in the study.The mean age of our patients was 10.26(4.24)years old in the intervention arm,and 11.95(4.19)years old in the control arm.It was observed that the pain was significantly lower in patients with cold water irrigation of the tonsillar fossa on Days 1,3,5,and 7(p=0.001).There were no readmissions postprocedure and none of our patients developed any complications postsurgery.Conclusions:In this trial,we report a reduced pain score at all days of observation in the intervention group.Irrigation of the tonsillar fossa is a safe,cost-effective,and less technically demanding technique that could be employed to reduce postoperative pain.Further studies with randomization,blinding and a larger sample size could further improve on our results.展开更多
文摘Background: The reported prevalence of infertility in Pakistan is 21% of which 35% is contributed by male factor. Male infertility has multifactorial etiologies ranging from modifiable to genetic risk factors. Among all the risk factors that may account for male infertility, obesity is one of the emerging public health problems. Therefore, the aim of the study was to determine the association of obesity with infertility in Pakistani men. Methods: We conducted a case control study. Cases were men with impaired semen parameters and controls did not have impaired semen parameters. Results: The final multivariable logistic regression model after adjusting for the effect of other variables revealed that with every 1 kg/m2 increase in BMI the odds of being infertile was 6% higher as compared to being fertile (aOR = 1.06;95% CI = 1.01, 1.11). Moreover the odds of having education of higher secondary or above was 3 times greater among cases as compared with the controls (OR = 3.10;95% CI = 1.66, 5.77). Furthermore the odds of having previous medical conditions increasing the risk of infertility was higher among cases as compared with the controls (OR = 3.07;95% CI = 1.63, 5.79). Conclusion & recommendations: This study indicates that obesity is an important risk factor for male infertility. Moreover our findings also indicate that higher educational status and previous medical conditions are also associated with male infertility. Thus awareness can be raised through treating physicians and public health messages.
文摘Background: The concept of resilience is very crucial in promoting positive psychological well-being. However, this construct was never looked among married women of Karachi, Pakistan. Therefore, this study aimed to assess the prevalence and the associated risk factors of resilience in Pakistan. Methods: It was a cross-sectional survey, using the Wagnild Resilience Scale (RS) to assess resilience, Beck Depression Inventory II (BDI-II) for measuring depression and Trait Wellbeing Inventory for determining Life Satisfaction. Systematic sampling was employed to enroll 636 participants of aged 20 to 40 years living in two urban squatter settlements of Karachi, Pakistan. Prevalence ratio was computed with their 95% confidence interval. Results: A total of 636 married women participated in the study. The average age of females with low resilience was 29.8 (5.7) whereas the mean age of females with high resilience was 31.1 (5.7). Around 90% of all the participants could speak in Urdu. The prevalence of low resilience among women was 21.9%. Moreover, the prevalence of depression among low resilience group was 43.9% whereas the mean life satisfaction score among females with low resilience was lower than females with high resilience. The females who had low resilience were younger and had no formal/informal education as compared to their counterparts. After controlling for other variables, the prevalence of low resilience was 1.78 times more among depressed females as compared to the non-depressed with a 95% CI: (1.27-2.51). Moreover with every one unit increase in the life satisfaction scores, the prevalence of low resilience decreased 9%. Furthermore, age and informal schooling were also found to be significantly associated with resilience. Conclusion: Depression and life satisfaction are the potential modifiable risk factors for resilience and hence we can improve resilience through interventions that may focus on reducing depression and improving satisfaction towards life. Our study also recommends that health care professionals should be educated about these modifiable risk factors to bring about a change in the society and reduce the mental health illness by promoting constructive adaptation.
文摘Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers. Methods: The systematic review was conducted in 2009 and consisted of observational studies in school settings published between January 2005 and January 2009. Smoking status was the main outcome of interest. Following Cochrane style, five steps were followed: setting selection criteria for studies and conducting a literature search;review of abstracts;review of complete articles;data extraction and quality assessment of included studies;and, finally, synthesis of studies. Results: Of the 292 abstracts retrieved, 45 (15.4%) articles were selected for the final review. Inconsistencies were found in the definition of smoking behaviour which impeded generalisability. Individual-level factors had importance, but environmental level factors were also important in studying the aetiology of smoking. Results showed that studies inappropriately reported sample size estimation and important confounding factors. Hierarchical linear modelling, random effects modelling and structural equation modelling were employed in comparatively few studies. Conclusions: There were concerns regarding data analysis of complex surveys. Fifty five percent of reviewed studies ignored environmental effects which may have produced unreliable inferences. Multi-level analysis assisted in understanding school-level effects.
文摘Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children. Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted prevalence ratios with 95% CI were reported. Total 554 children, 306 (56.3%) boys and 43.7% girls participated in the study. Mean age of children was 13.2 ± 0.05 years. Total number of children with DMFT > 0 was 30.5%. The decayed component contributed largely (22.8%) to the DMFT score. Overall prevalence of asthma was 20%. Prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. Adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.6 - 1.3) after adjusting for carious food intake, age, oral hygiene index and dentist visit;the association between asthma and dental caries turned out to be in-significant. Conclusions: There was no association observed between asthma and dental caries among the children examined in this study.
文摘Introduction: Among young teens, about one in five smokes worldwide. Adolescents spend a considerable amount of their time in school, and the school environment is therefore important for child health practices and outcomes. Objectives: We aimed to investigate the impact on smoking behavior of the school environment and the personal characteristics of male teenage students attending schools in Pakistan, taking into account the survey sampling structure. Methods: A two-stage cluster sampling with stratification was employed, and we interviewed 772 male secondary school students. We adopted random effect and generalizing estimating equation models. Results: Peer pressure in particular had a strong influence on adolescents smoking;those whose friends smoked were up to 6 times more likely to smoke. Family smoking was also significantly associated with adolescents smoking, but those students whose mother was educated were 50% less likely to smoke. The fitted random effect model indicated that the between school variability was significant (p-value < 0.01), indicating differences in smoking habits between schools. A random coefficient model showed that variability among schools was not significantly different for public and private schools. Conclusion: Public health campaigns for smoking cessation should target not only the individual but also the families of adolescents attending schools.
文摘Introduction:Tonsillectomy is one of the most common procedures performed in otolaryngology.There are various methods to perform tonsillectomies(cold and hot).Thermal damage and inflammation of the surrounding tissue using monopolar cautery is said to point to increased pain whereas immediate cooling of the burnt area is thought to reduce pain owing to heat dissipation.Our objective was to determine the difference in mean post‐tonsillectomy pain scores among patients irrigated with cold water(4℃)and in patients not irrigated with cold water.Material and Methods:A quasi‐experimental trial was conducted from January 2016 to December 2017 at a tertiary care hospital.All tonsillectomies were carried out with monopolar cautery at a power of 20 W.Patients either received cold water irrigation post tonsillectomy of the tonsillar bed(intervention arm)or no irrigation(control arm).The pain score was measured on Days 0,1,3,5,and 7.Pain scores were charted on a visual analog scale on the respective days.Results:Seventy‐eight patients were included in the study.The mean age of our patients was 10.26(4.24)years old in the intervention arm,and 11.95(4.19)years old in the control arm.It was observed that the pain was significantly lower in patients with cold water irrigation of the tonsillar fossa on Days 1,3,5,and 7(p=0.001).There were no readmissions postprocedure and none of our patients developed any complications postsurgery.Conclusions:In this trial,we report a reduced pain score at all days of observation in the intervention group.Irrigation of the tonsillar fossa is a safe,cost-effective,and less technically demanding technique that could be employed to reduce postoperative pain.Further studies with randomization,blinding and a larger sample size could further improve on our results.
