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Humayun A.,Federal Postgraduate Medical Institute | Imran N.,King Edward Medical University | Humayun N.,Akhtar Saeed Medical and Dental College
Eastern Mediterranean Health Journal | Year: 2013

Mental health is an important but neglected component of reproductive health. This study aimed to determine the prevalence and risk factors for antenatal depression among women attending for antenatal care at an urban tertiary care hospital in Lahore, Pakistan. In a cross-sectional study, structured questionnaires were filled and screening for depression was done using the Edinburgh postnatal depression scale (EPDS). Out of 506 antenatal attendees 126 (24.9%) had no depression (EPDS scores < 10), 53 (10.5%) scored 10-12 and 327 (64.6%) had EPDS scores > 12. Depression scores (≥ 10) were more common in mothers aged < 20 years (93.7%) than those aged > 35 years (55.0%). Fear of childbirth and separation from husband were identified as significant risk factors for development of antenatal depression, while family history of psychiatric illness was significant protective factor. Domestic violence, drug abuse, lack of support, previous miscarriage and personal history of previous psychiatric illness were not found to be significant risk factors.


Haleem A.,Federal Postgraduate Medical Institute | Khan M.K.,Federal Postgraduate Medical Institute | Chaudhry S.,University of Health Sciences, Lahore | Siddiqui M.I.,University of Umm Al - Qura | Khan A.A.,Federal Postgraduate Medical Institute
BMC Public Health | Year: 2016

Background: Repetition and reinforcement have been shown to play a crucial role in the sustainability of the effect of Oral Health Education (OHE) programs. However, its relevance to school-based OHE imparted by different personnel is not depicted by the existing dental literature. The present study was undertaken to determine the effectiveness of the repeated and reinforced OHE (RR-OHE) compared to one-time OHE intervention and to assess its role in school-based OHE imparted by dentist, teachers and peers. Methods: The study was a cluster randomized controlled trial that involved 935 adolescents aged 10-11 years. Twenty four boys' and girls' schools selected at random in two towns of Karachi, Pakistan were randomly assigned to three groups to receive OHE by dentist (DL), teachers (TL) and peer-leaders (PL). The groups received a single OHE session and were evaluated post-intervention and 6 months after. The three groups were then exposed to OHE for 6 months followed by 1 year of no OHE activity. Two further evaluations at 6-month and 12-month intervals were conducted. The data were collected by a self-administered questionnaire preceded by a structured interview and followed by oral examination of participants. Results: The adolescents' oral health knowledge (OHK) in the DL and PL groups increased significantly by a single OHE session compared to their baseline knowledge (p < 0.05) and the increase was sustained over 6 months. Although one-time OHE resulted in a significant improvement in adolescents' oral health behavior (OHB) related to the prevention of gingivitis in the two groups (p < 0.05), no significant change was observed in their behavior towards prevention of oral cancer. One-time teacher-led OHE was ineffective in improving adolescents' OHK and OHB. The oral hygiene status (OHS) of the participants in all three groups did not change statistically after one-time OHE. The OHK, OHB and OHS indices increased significantly 6 months after RR-OHE than the initial scores (p < 0.001) irrespective of OHE strategy. Although the OHK scores of the DL and PL groups decreased significantly at 12-month evaluation of RR-OHE (p < 0.05), the said score of the TL group; and OHB and OHS scores of all three groups remained statistically unchanged during this period. Conclusions: The repetition and reinforcement play a key role in school-based OHE irrespective of educators. The trained teachers and peers can play a complementary role in RR-OHE. © 2016 Haleem et al.


PubMed | University of Health Sciences, Lahore, University of Umm Al - Qura and Federal Postgraduate Medical Institute
Type: | Journal: BMC public health | Year: 2016

Repetition and reinforcement have been shown to play a crucial role in the sustainability of the effect of Oral Health Education (OHE) programs. However, its relevance to school-based OHE imparted by different personnel is not depicted by the existing dental literature. The present study was undertaken to determine the effectiveness of the repeated and reinforced OHE (RR-OHE) compared to one-time OHE intervention and to assess its role in school-based OHE imparted by dentist, teachers and peers.The study was a cluster randomized controlled trial that involved 935 adolescents aged 10-11 years. Twenty four boys and girls schools selected at random in two towns of Karachi, Pakistan were randomly assigned to three groups to receive OHE by dentist (DL), teachers (TL) and peer-leaders (PL). The groups received a single OHE session and were evaluated post-intervention and 6 months after. The three groups were then exposed to OHE for 6 months followed by 1 year of no OHE activity. Two further evaluations at 6-month and 12-month intervals were conducted. The data were collected by a self-administered questionnaire preceded by a structured interview and followed by oral examination of participants.The adolescents oral health knowledge (OHK) in the DL and PL groups increased significantly by a single OHE session compared to their baseline knowledge (p < 0.05) and the increase was sustained over 6 months. Although one-time OHE resulted in a significant improvement in adolescents oral health behavior (OHB) related to the prevention of gingivitis in the two groups (p < 0.05), no significant change was observed in their behavior towards prevention of oral cancer. One-time teacher-led OHE was ineffective in improving adolescents OHK and OHB. The oral hygiene status (OHS) of the participants in all three groups did not change statistically after one-time OHE. The OHK, OHB and OHS indices increased significantly 6 months after RR-OHE than the initial scores (p < 0.001) irrespective of OHE strategy. Although the OHK scores of the DL and PL groups decreased significantly at 12-month evaluation of RR-OHE (p < 0.05), the said score of the TL group; and OHB and OHS scores of all three groups remained statistically unchanged during this period.The repetition and reinforcement play a key role in school-based OHE irrespective of educators. The trained teachers and peers can play a complementary role in RR-OHE.


Zubair M.,Bolan Medical College | Suhail M.,Federal Postgraduate Medical Institute | Khan M.,Saidu Sharif Medical College | Fatima A.,Lahore Medical and Dental College
Pakistan Journal of Medical and Health Sciences | Year: 2010

An organophosphorus insecticide, chlorpyrifos was tested for the embryotoxicity and teratogenecity in mice. Different sublethal doses of the insecticide i.e. 20, 40, 60 and 80ug/gm body weight were prepared by dissolving it in corn oil in such a way that each 0.1ml of the solution contains desired concentration. The doses were given orally on day 6 of gestation to different experimental groups. The embryos were recovered on day 15 of gestation. A significant decrease in body weight and crown rump length of embryos was noted. Comparatively higher doses proved more toxic and also caused many developmental defects. it is concluded that chlorpyrifos is toxic to developing embryos, especially in the quantities used in this study.


Haque M.A.,University of Heidelberg | Haque M.A.,University of Dhaka | Yamamoto S.S.,University of Heidelberg | Malik A.A.,University of Heidelberg | And 2 more authors.
Environmental Health: A Global Access Science Source | Year: 2012

Background: Bangladesh has been identified as one of the most vulnerable countries in the world concerning the adverse effects of climate change (CC). However, little is known about the perception of CC from the community, which is important for developing adaptation strategies. Methods. The study was a cross-sectional survey of respondents from two villages - one from the northern part and the other from the southern part of Bangladesh. A total of 450 households were selected randomly through multistage sampling completed a semi-structure questionnaire. This was supplemented with 12 focus group discussions (FGDs) and 15 key informant interviews (KIIs). Results: Over 95 percent of the respondents reported that the heat during the summers had increased and 80.2 percent reported that rainfall had decreased, compared to their previous experiences. Approximately 65 percent reported that winters were warmer than in previous years but they still experienced very erratic and severe cold during the winter for about 5-7 days, which restricted their activities with very destructive effect on agricultural production, everyday life and the health of people. FGDs and KIIs also reported that overall winters were warmer. Eighty point two percent, 72.5 percent and 54.7 percent survey respondents perceived that the frequency of water, heat and cold related diseases/health problems, respectively, had increased compared to five to ten years ago. FGDs and KIIs respondents were also reported the same. Conclusions: Respondents had clear perceptions about changes in heat, cold and rainfall that had occurred over the last five to ten years. Local perceptions of climate variability (CV) included increased heat, overall warmer winters, reduced rainfall and fewer floods. The effects of CV were mostly negative in terms of means of living, human health, agriculture and overall livelihoods. Most local perceptions on CV are consistent with the evidence regarding the vulnerability of Bangladesh to CC. Such findings can be used to formulate appropriate sector programs and interventions. The systematic collection of such information will allow scientists, researchers and policy makers to design and implement appropriate adaptation strategies for CC in countries that are especially vulnerable. © 2012 Haque et al; licensee BioMed Central Ltd.


PubMed | Federal Postgraduate Medical Institute and University of Heidelberg
Type: Journal Article | Journal: International journal of hygiene and environmental health | Year: 2014

Cardiovascular diseases (CVD) are major contributors to mortality and morbidity in South Asia. Chronic exposure to air pollution is an important risk factor for cardiovascular diseases, although the majority of studies to date have been conducted in developed countries. Both indoor and outdoor air pollution are growing problems in developing countries in South Asia yet the impact on rising rates of CVD in these regions has largely been ignored. We aimed to assess the evidence available regarding air pollution effects on CVD and CVD risk factors in lower income countries in South Asia. A literature search was conducted in PubMed and Web of Science. Our inclusion criteria included peer-reviewed, original, empirical articles published in English between the years 1990 and 2012, conducted in the World Bank South Asia region (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka). This resulted in 30 articles. Nine articles met our inclusion criteria and were assessed for this systematic review. Most of the studies were cross-sectional and examined measured particulate matter effects on CVD outcomes and indicators. We observed a bias as nearly all of the studies were from India. Hypertension and CVD deaths were positively associated with higher particulate matter levels. Biomarkers of oxidative stress such as increased levels of P-selection expressing platelets, depleted superoxide dismutase and reactive oxygen species generation as well as elevated levels of inflammatory-related C-reactive protein, interleukin-6 and interleukin-8 were also positively associated with biomass use or elevated particulate matter levels. An important outcome of this investigation was the evidence suggesting important air pollution effects regarding CVD risk in South Asia. However, too few studies have been conducted. There is as an urgent need for longer term investigations using robust measures of air pollution with different population groups that include a wider range of air pollutants and outcomes, including early indicators of CVD. These regions are facing burdens from increasing urbanization, air pollution and populations, generally weaker health infrastructure, aging populations and increased incidence of non-communicable diseases, included CVD. The extent to which the problem of air pollution and CVD will impact these countries will depend largely on the information available to inform policy and programs, which are still lacking, political will as well as social and economic development.


Aziz S.,Aljouf University | Aziz S.,The University of Faisalabad | Ahmed S.S.,The University of Lahore | Ali A.,The University of Lahore | And 5 more authors.
Cancer Investigation | Year: 2015

Oral squamous cell carcinoma (OSCC) is considered to be one of themost fatal diseases worldwide, owing to its late diagnosis and lack of availability of established reliable biomarkers. The aim of this study was to highlight the significance of immunosuppressive cytokines as potential biomarkers in OSCC.Whole unstimulated saliva was collected from each individual (30 OSCC patients and 33 age- and gender-matched healthy controls). Immunosuppressive cytokines, including IL-4, IL-10, IL-13, and IL-1RA, were evaluated in each sample using Luminex multianalyte profiling (xMAP) technology on BioPlex instrument. Our results showed that all the studied salivary cytokines were raised in OSCC patients as compared to controls, where IL-10 and IL-13 salivary levels showed statistically significant difference (p=.004 and p=.010, respectively). Mean levels of salivary cytokines in three histologically defined OSCC categories, compared employing one-way ANOVA, showed that salivary levels of IL-1RA were highest in patients having poorly differentiated OSCC tumors as compared to those havingmoderately and well-differentiated tumors (p=.000 and p=.002, respectively). Among OSCC individuals, duration of smokeless tobacco correlated positively with IL-1RA (p=.036).We conclude that salivary levels of immunosuppressive cytokines, IL-4, IL-10, IL-13, and IL-1RA, could prove to be potential biomarkers of OSCC and can be further investigated asmarkers of early detection and disease progression. © 2015 Informa Healthcare USA, Inc.


Latif A.,University of Punjab | Hussain K.,University of Punjab | Bukhari N.I.,University of Punjab | Karim S.,University of Punjab | And 5 more authors.
Journal of the Chemical Society of Pakistan | Year: 2013

A fermented beverage, Kanji, prepared from roots of Daucus carota L. subsp. sativus (Hoffm.) Arcang. var. vavilovii Mazk. (Apiaceae), despite long usage history has not been investigated for analytical studies and biological activities. Therefore, the present study aimed to investigate different types of Kanji samples and various types of extracts/fractions of root of the plant for a number of analytical studies and in vitro antioxidant activities. The Kanji sample, Labmade Kanji, having better analytical and biological profile was further investigated for preliminary clinical studies. The analytical studies indicated that Lab-made Kanji was having comparatively higher contents of phytochemicals than that of the commercial Kanji samples, different types of extracts and fractions (P < 0.05). All the Kanji samples and aqueous and ethanol extracts of fresh roots exhibited comparable antioxidant activities in DPPH assay (52.20 - 54.19%) that were higher than that of methanol extract (48.78%) of dried roots. The antiradical powers (1/EC50) of Lab-made Kanji and aqueous extract were found to be higher than that of the ethanol and methanol extracts. In β-carotene linoleate assay, the Kanji samples showed higher activity than that of the methanol extract, but comparable to that of the vitamin-E and butylated hydroxyl anisole (BHA) (P < 0.05). A preliminary clinical evaluation indicated that Kanji has no harmful effect on blood components, liver function and serum lipid profile. The results of the present study indicate that Kanji is an effective antioxidant beverage.


PubMed | Federal Postgraduate Medical Institute
Type: | Journal: BMC oral health | Year: 2013

Oral health education (OHE) in schools has largely been imparted by dental professionals. Considering the substantial cost of this expert-led approach, the strategies relying on teachers, peer-leaders and learners themselves have also been utilized. However the evidence for comparative effectiveness of these strategies is lacking in the dental literature. The present study was conducted to compare the effectiveness of dentist-led, teacher-led, peer-led and self-learning strategies of oral health education.A two-year cluster randomized controlled trial following a parallel design was conducted. It involved five groups of adolescents aged 10-11 years at the start of the study. The trial involved process as well as four outcome evaluations. The present paper discusses the findings of the study pertaining to the baseline and final outcome evaluation, both comprising of a self-administered questionnaire, a structured interview and clinical oral examination. The data were analyzed using Generalized Estimating Equations.All the three educator-led strategies of OHE had statistically higher mean oral health knowledge (OHK), oral health behavior (OHB), oral hygiene status (OHS) and combined knowledge, behavior and oral hygiene status (KBS) scores than the self-learning and control groups (p<0.001). The mean OHK, OHS and KBS scores of the three educator-led strategies did not differ significantly. The peer-led strategy was, however, found to have a significantly better OHB score than the respective score of the teacher-led strategy (p<0.05). The self-learning group had significantly higher OHB score than the control group (p<0.05) but the OHK, OHS and KBS scores of the two groups were not significantly different.The dentist-led, teacher-led and peer-led strategies of oral health education are equally effective in improving the oral health knowledge and oral hygiene status of adolescents. The peer-led strategy, however, is almost as effective as the dentist-led strategy and comparatively more effective than the teacher-led and self-learning strategies in improving their oral health behavior. SRCTN39391017

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