Prevalence of and factors associated with obesity among Pakistani schoolchildren: a school-based, cross-sectional study.

Childhood obesity is nowadays a concern in the developing world. This cros-sectional study was conducted on 501 randomly selected students from 10 high schools in an urban setting in Hyderabad, Pakistan. Children who were underweight were excluded. Interviews were conducted to determine demographic data, dietary intake, physical activity and other variables that may be associated with obesity. Overall 58 students (12%) had body mass index (BMI)>or=95th percentile, 40 (8%) BMI>or=85th percentile and 403 (80%) had BMI<85th percentile (WHO age- and sex-specific cut-offs). The prevalence of obesity was higher in boys than girls (15% than 8% respectively). In multivariate regression analysis significant risk factors for obesity/overweight were male sex, middle socioeconomic status, poor self-rated athletic ability, trying to lose weight and eating fruit<4 times per week. Childhood obesity is determined by factors in the home, school and society and a multidisciplinary approach is needed to prevention.

Validated HPLC-RI Method for the Determination of Lactulose and its Process Related Impurities in Syrup.

A simple, swift with good sensitivity and reproducibility, HPLC-RI method has been developed for the quantification of lactulose and related compounds (fructose, galactose, epilactose and lactose) in oral suspension formulation. The analysis was carried out by using mobile phase (water and acetonitrile 75:25) at the flow rate of 1.0 ml/min. on isocratic HPLC-RI system. After manipulating mobile phase composition and mobile phase flow rate a good separation of five components was achieved within 15 minutes of run time. This study is beneficial to determine the active ingredient as well as related compounds simultaneously, without using buffer in mobile phase which causes bad resolution and has limitation to analyze on other hyphenated techniques such as LC-MS.

Bis(isovalerylacetone)ethylenediimine nickel(II) as mixed stationary phase for gas chromatography.

Bis(isovalerylacetone)ethylenediimine Nickel (II) (IVA(2)enNi) was examined as a mixed stationary phase with OV1 on Chromosorb G/NAW 60-80 mesh size for gas chromatography (GC) separation of aromatic hydrocarbons, heteroaromatics, alcohols, aldehydes, ketones, esters, nitro-, and amino compounds. Forty-six compounds were examined, and the GC results were compared with those obtained with 3% OV1 on Chromosorb G/NAW 60-80 mesh size under similar operating conditions. Improved resolutions, peak asymmetry, number of theoretical plates, and Kovats indices were obtained on the mixed stationary phase 3% OV1 + 5% IVA(2)enNi (w/w) compared to 3% OV1 column. The stability constant (K(m)), enthalpies (DeltaH), entropies (DeltaS), and Gibbs free energies (DeltaG) of the GC elution on column (2 m x 3 mm i.d.) packed with 3% OV1 + 5% IVA(2)enNi (w/w) on Chromosorb have been calculated. Donor-acceptor complexation in the gas phase indicated by the negative values of enthalpy (-DeltaH) were within 9.4-12.38 Kcal/mol, and Gibbs free energy (-DeltaG) ranged from 1.48 to 4.24 Kcal/mol. The retention time transformation on both the phases were calculated. The obtained ratios from the stationary phases 3% OV1 and 3% OV1 + 5% IVA(2)enNi (w/w) were plotted on the x-axis and y-axis, respectively. Two-dimensional chromatographic plots for alkanes, aromatics, heteroaromatics, ketones, alcohols, esters, and nitro compounds were obtained with coefficient of determination within 0.4934 and 0.9617, which is indicative of some different kinds of interaction of two stationary phases with the solutes.

Are extreme rainfall intensities more frequent? Analysis of trends in rainfall patterns relevant to urban drainage systems.

The fact that climate change is affecting the intensity and frequency of rainfall is well accepted in the scientific community. This is backed by a multitude of reports on the basis of daily rainfall series analysis; however, little research is available for short duration intensities. Due to its significant influence on the behaviour of urban drainage, it is critical to investigate the changes in short duration rainfall intensities. In this study different intensities relevant for the urban drainage and the total rainfall per rain event are analysed. The trend is investigated using the Mann-Kendall test. The rainfall series analysed are from the alpine region Tyrol. The results present differences depending on the duration of the intensity and the series considered, however an increase in the number of extreme events is detectable for short durations for the most series.

Public private mix model in enhancing tuberculosis case detection in District Thatta, Sindh, Pakistan.

OBJECTIVES: To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta. METHODS: Private practitioners (PPs) of district Thatta involved in treatment of TB cases were requested to participate in the study. All consenting physicians were provided with training on Directly Observed Treatment Short course (DOTS) module. In addition to routine cases, TB cases diagnosed by private practitioners through sputum microscopy were also registered with the district TB control program and medicines were provided by NTP. After intervention of PPM-DOTS change in Case Detection Rate (CDR) were estimated. RESULTS: An increased number of sputum smear positive cases were found in the intervention period--the third quarter of 2007, from 188 to 211 and CDR from 69% to 77%. The improvement in case detection rate was significant as this moderately added to the total number of cases detected from the whole of the district Thatta during the study period. CONCLUSION: Public private mix (PPM) model was effective in increasing the CDR of TB cases in district Thatta. It is recommended that the public private partnership model in Tuberculosis case detection needs to be taken on a larger scale so as to reduce the heavy TB burden in the country.

Early appendicectomy in appendicular mass--a Liaquat University Hospital experience.

OBJECTIVES: Appendicular mass is a well-known complication of acute appendicitis. It is conventionally treated conservatively followed by interval appendectomy. This study aimed to determine the feasibility and safety of an early appendectomy in these cases. STUDY DESIGN: Descriptive and comparative. PLACE AND DURATION: Department of Surgery Liaquat University Hospital, Jamshoro/Hyderabad from March 2003 to December 2007. METHODS: One hundred and seventy six (176) patients with appendicular mass were included in this study. Patients were conveniently divided into two groups, A and B with equal distribution of cases (88 Patients each), regardless of age and sex. Immediate appendicectomy was performed in group A patients after preliminary investigations, where as patients in group B were initially treated conservatively followed by interval appendicectomy. RESULTS: A total 114 (64.8%) males and 62 (35.2%) females with a mean age of 25.09 years (Range 8-44 years) are included in the study population. Post-operative wound sepsis occurred in 17 (19.31%) patients in group A. Treatment failure, patient compliance, re-admission and overall expenses are main limitations in group B population. CONCLUSION: Early appendicectomy is a safe and superior option in patients with appendicular mass compared to conventional treatment.

Capillary gas chromatographic determination of methylglyoxal from serum of diabetic patients by precolumn derivatization with 1,2-diamonopropane.

Capillary gas chromatographic (GC) determination of methylglyoxal (MGo) was developed on the basis of precolumn derivatization with 1,2-diaminopropane (DAP) at pH 3. The elution was carried out on an HP-5 (30 m x 0.32 mm i.d.) connected with FID. The linear calibration curve was obtained for MGo within 0.09-1.04 microg/ml with detection limit of 40 ng/ml. Dimethylglyoxal (DMGo) also formed derivative with DAP and eluted and separated from MGo at column temperature 100 degrees C for 1 min with heating rate 30 degrees C/min up to 200 degrees C with run time 4.6 min. The nitrogen flow rate was 1.5 ml/min with split ratio of 10:1, v/v. MGo was determined from serum and urine of diabetics and healthy volunteers. The amounts of MGo from serum and urine of diabetic patients were 0.180-0.260 microg/ml and 0.170-0.250 microg/ml with relative standard deviation (R.S.D.) within 1-4% and 1-3%, respectively. The amounts of MGo from serum of healthy volunteers were 0.032-0.054 microg/ml with an R.S.D. of 1.5-3%. DMGo was not detected from the biological fluids and was used as an internal standard.

Changing spectrum of gallstone disease: an experience of 23 cases less than 10 years of age.

BACKGROUND: An overall increase in the incidence of paediatric cholelithiasis forms the basis of this study, which aims to investigate the overall changing clinical pattern of cholelithiasis. METHODS: This is a retrospective observational descriptive study including twenty three (23) patients with gallstones admitted and operated during June 2006-June 2008 in surgical department of a teaching hospital. All the patients with sonological evidence of gallstones, less than 10 years of age with history of acute or chronic abdominal symptoms are included in the study population. After admission all the subjects were investigated and finally operated by open approach (21 patients) during the same admission. The details of all the patients were recorded on a proforma and statistical analysis done on SPSS version 12. RESULTS: Of the total study population, there were 19 (82.6%) males and 4 (17.39%) females with a mean age of 7 years and a range of 4-10 years. Ultrasound revealed gallstones in all the patients with a varying proportion of the walls of gallbladder. The commonest presentation was abdominal pain in the right upper quadrant, which was vague, and of mild to moderate intensity. In 21 (91.30%) patients, no specific underlying cause was found while two patients (8.6%) had haematological disorder as underlying cause for the gallstones. CONCLUSION: This study indicates an alarming increase in the incidence of idiopathic gallstones in children less than 10 years of age with a distinct male predominance.

Mesh versus non-mesh repair of ventral abdominal hernias.

BACKGROUND: To investigate the relative effectiveness of mesh and suture repair of ventral abdominal hernias in terms of clinical outcome, quality of life and rate of recurrence in both the techniques. METHODS: This is a retrospective descriptive analysis of 236 patients with mesh and non-mesh repair of primary ventral hernias performed between January 2000 to December 2004 at Surgery Department, Liaquat University of Medical and Health Sciences, Jamshoro. The record sheets of the patients were analyzed and data retrieved to compare the results of both techniques for short-term and long-term results. The data retrieved is statistically analyzed on SPSS version 11. RESULTS: There were 43 (18.22%) males and 193 (81.77%) females with a mean age of 51.79 years and a range of 59 (81-22). Para-umbilical hernia was the commonest of ventral hernia and accounted for 49.8% (n=118) of the total study population followed by incisional hernia comprising 24% (n=57) of the total number. There was a significant difference in the recurrent rate at 3 years interval with 23/101 (22.77%) recurrences in suture-repaired subjects compared to 10/135 (7.40%) in mesh repair group. Chronic pain lasting up to 1-2 years was noted in 14 patients with suture repair. Wound infection is comparatively more common (8.14%) in mesh group. The other variables such as operative and postoperative complications, total hospital stay and quality of life is also discussed. CONCLUSION: Mesh repair of ventral hernia is much superior to non-mesh suture repair in terms of recurrence and overall outcome.

Safety, effectiveness and ease of use of a non-reusable syringe in a developing country immunization programme.

Unsterile needles and syringes may transmit blood-borne infectious agents such as HIV and hepatitis B virus. The emergence of these diseases as major public health concerns and the risk of nosocomial transmission has heightened interest in the development of single-use injection devices. WHO and UNICEF embarked on a programme to develop and introduce these devices in 1987. We report on a field trial in Karachi, Pakistan, of the SoloShot (SS) plastic disposable syringe, which has a metal clip in the syringe barrel to prevent second-time withdrawal of the plunger. A conventional disposable syringe (CS) was used as a comparison. We observed 48 vaccinators giving 2400 injections with the SS and 1440 with the CS; 98.7% of SS performed as designed. The average volume required per delivered dose was comparable for the two syringes and was delivered more quickly with SS. Training and experience had a small but statistically significant effect on several aspects of SS use. Vaccinators who indicated a syringe preference preferred SS on 7 out of 9 indicators. SS is safe and effective in preventing reuse and is easier and quicker to use than the CS. Vaccinators require little, if any, special training. It could directly replace disposable syringes in expanded programmes on immunization (EPI) in countries where use of unsterile disposable devices occurs or when sterilization is not practical.

PIP: The emergence of HIV and hepatitis B as major public health problems and the risk of nosocomial transmission demands that syringes and needles either be used one time and disposed of or reused only after thorough sterilization between patients. The World Health Organization and UNICEF launched a program in 1987 to develop and introduce single-use injection devices. Even so, incorrectly sterilized syringes and needles as well as disposables are frequently reused. Alternatives to existing injection devices are therefore clearly needed. The authors report on a field trial in Karachi, Pakistan, of the SoloShot (SS) plastic disposable syringe, which has a metal clip in the syringe barrel to prevent second-time withdrawal of the plunger. The use and acceptance of the SS was compared against that for the conventional plastic disposable (CS) syringe routinely used by the Expanded Program on Immunization in Pakistan. The SoloShot permits a single filling and emptying, after which a metal clip locks the plunger to prevent it from being drawn back a second time. A breakaway notch in the plunger inhibits twistout, while a barrier rib on the plunger guards the clip against intentional defeat. The metal clip is set to permit filling up to 0.575 ml of vaccine with an head space to allow the removal of air bubbles and adjustment for the exact dose. The clip is never in contact with the vaccine liquid. Researchers observed 48 vaccinators giving 2400 injections with the SS and 1440 with the CS. 98.7% of the SS performed as designed. The average volume required per delivered dose was comparable for the two syringes, but was delivered more quickly with the SS. Training and experience had a small but statistically significant effect on several aspects of SS use. Vaccinators who indicated a syringe preference preferred the SS on seven out of nine indicators. One may conclude that the SS is safe and effective in preventing reuse and is easier and quicker to use than the CS. Vaccinators require little, if any, special training. These encouragingly positive findings suggest that the SS could directly replace the CS in expanded programs on immunization in countries where the use of unsterile disposable devices occurs or when sterilization is impractical.