Factors And Determinants Associated With Prevalence Of Anaemia In Adults In Karachi, Pakistan.

Objectives: To assess the demographic and dietary factors associated with the prevalence of anaemia in multi-ethnic urban settings. METHODS: The cross-sectional community-based survey study was conducted from August 2020 to May 2021 in Karachi East district, and comprised healthy adults of either gender aged 20-60 years. Data was collected using a pretested questionnaire. Besides, 4ml sample of whole blood was taken from each participant for haematological analysis. Data was analysed using SPSS 23. RESULTS: Of the 416 subjects, 269(64.7%) were males and 147(35.3%) were females, while 334(80.3%) were aged <30 years and 82(19.7%) were aged >30 years. Anaemia was found in 92(22.1%) subjects. Female gender, lower and middle socioeconomic class, nuclear family type, habit of meal-skipping, and infrequent consumption of sweets and milk were all linked to anaemia (p<0.05). CONCLUSIONS: Less than a quarter of the sample was found to be anaemic. Steps should be taken to address the identified causes of anaemia.

Prevalence and sociodemographic factors associated with stunting and thinness in adolescent females: A cross sectional study from Pakistan.

OBJECTIVE: To explore the prevalence and socio-demographic factors associated with stunting and thinness in adolescent females. METHODS: The survey-based cross-sectional study was conducted in randomly selected schools of the Kotri Taulka of Jamshoro District in Sindh, Pakistan, from October to December 2019, and comprised healthy female adolescents aged 10-19 years. Data about demographic and anthropometric factors was collected using a pre-tested questionnaire. Data was analysed using SPSS 23. RESULTS: There were 393 subjects with mean age 14.93±2.18 years, mean weight 45.9±8.85kg, and mean height 151.6±6.25cm. The prevalence of stunting and thinness was 127(32.31%) and 42(10.68%) respectively. Stunting was more frequent in participants with father's income ≤15000 Pak rupees (p<0.05). CONCLUSIONS: The increased prevalence of stunting and thinness in adolescent females needs to be addressed by the policymakers.

Demographic factors associated with acceptance, hesitancy, and refusal of COVID-19 vaccine among residents of Sukkur during lockdown: A cross sectional study from Pakistan.

BACKGROUND: The World Health Organization has identified vaccine hesitancy among one of the top 10 threats to global health. The ongoing COVID-19 pandemic has devastated global health with higher morbidities and mortality rates. Reducing vaccine hesitancy could achieve immunization. However, different sociodemographic conditions can also hamper these efforts in low- and middle-income countries. The objective of the present study was to assess the demographic factors associated with COVID-19 vaccine acceptance, hesitancy, and refusal among the general Pakistani population. METHODS: This cross-sectional study was conducted during the months of February-March 2021 during the pandemic. Sample size was 479. Snowball sampling strategy was used for data collection. Study questionnaires were distributed online using e-mail, twitter, Facebook, and WhatsApp. RESULT: The overall COVID-19 vaccine acceptance was 40.5%, vaccine hesitancy was 29%, and vaccine refusal was 30% among the study participants. Compared to younger, the vaccine hesitancy and refusal was higher in older people age > 30 years (χ2 = 7.45, p = .02). Compared to males, vaccine refusal was high among females (χ2 = 7.45, p = .02). Vaccine refusal was higher in people with less educated <12 compared to more education (χ2 = 28.68, p < .0001). CONCLUSION: Older people, females, and less education groups are at more risk of COVID-19 infections due to vaccine hesitancy and refusal. We recommend these groups should be focused in COVID-19 vaccine education programs.

Prevalence and Risk Factors Associated with Hepatitis B and C in Nawabshah, Sindh, Pakistan.

In Pakistan, viral hepatitis is a serious public health problem affecting millions of people. Both hepatitis B and hepatitis C infections are spreading rapidly in all provinces of Pakistan, including Sindh, because of lack of knowledge about routes of transmission, low literacy rate, reuse of syringes, piercing, and other factors. However, information about the prevalence and risk factors is inadequate. So, a general population-based study was conducted to determine the prevalence rate and risk factors of hepatitis B and hepatitis C in Nawabshah. Healthy individuals were screened for hepatitis B and hepatitis C using an immunochromatographic rapid test followed by confirmation through ELISA and PCR. Information about sociodemographic and risk factors was obtained through a pretested questionnaire. Descriptive frequencies, odds ratio, and CI were calculated using SPSS software version 23 (IBM Corp, Armonk, NY). In total, 523 participants were screened for hepatitis B and hepatitis C, among whom 232 were females and 291 were males. The overall prevalence of hepatitis C and hepatitis B was 14.3% and 6.7%, respectively. In a bivariate analysis, hepatitis B infection was significantly associated with risk factors such as hospitalization, blood transfusion, needle injury, multiple sex partners, reused syringe, dental extraction, surgery, injectable drug abuse, and shaving at barbershops. Hepatitis C infection was associated with factors including surgery, needle injury, blood transfusion, reused syringes, dental extraction, and shaving at barbershops. The increasing prevalence of hepatitis B surface antigen and hepatitis C virus in Nawabshah is a public health concern. There is dire need to implement preventive measures.

Elevated signature of a gene module coexpressed with CDC20 marks genomic instability in glioma.

Genomic instability (GI) drives tumor heterogeneity and promotes tumor progression and therapy resistance. However, causative factors underlying GI and means for clinical detection of GI in glioma are inadequately identified. We describe here that elevated expression of a gene module coexpressed with CDC20 (CDC20-M), the activator of the anaphase-promoting complex in the cell cycle, marks GI in glioma. The CDC20-M, containing 139 members involved in cell proliferation, DNA damage response, and chromosome segregation, was found to be consistently coexpressed in glioma transcriptomes. The coexpression of these genes was conserved across multiple species and organ systems, particularly in human neural stem and progenitor cells. CDC20-M expression was not correlated with the morphological subtypes, nor with the recently defined molecular subtypes of glioma. CDC20-M signature was an independent and robust predictor for poorer prognosis in over 1,000 patients from four large databases. Elevated CDC20-M signature enabled the identification of individual glioma samples with severe chromosome instability and mutation burden and of primary glioma cell lines with extensive mitotic errors leading to chromosome mis-segregation. AURKA, a core member of CDC20-M, was amplified in one-third of CDC20-M-high gliomas with gene-dosage-dependent expression. MLN8237, a Food and Drug Administration-approved AURKA inhibitor, selectively killed temozolomide-resistant primary glioma cells in vitro and prolonged the survival of a patient-derived xenograft mouse model with a high-CDC20-M signature. Our findings suggest that application of the CDC20-M signature may permit more selective use of adjuvant therapies for glioma patients and that dysregulated CDC20-M members may provide a therapeutic vulnerability in glioma.

MCL1 gene co-expression module stratifies multiple myeloma and predicts response to proteasome inhibitor-based therapy.

Multiple myeloma (MM) is the second most common hematologic cancer, characterized by abnormal accumulation of plasma cells in the bone marrow. The extensive biological and clinical heterogeneity of MM hinders effective treatment and etiology research. Several molecular classification systems of prognostic impact have been proposed, but they do not predict the response to treatment nor do they correlate to plasma cell development pathways. Here we describe the classification of MM into two distinct subtypes based on the expression levels of a gene module coexpressed with MCL1 (MCL1-M), a regulator of plasma cell survival. The classification system enabled prediction of the prognosis and the response to bortezomib-based therapy. Moreover, the two MM subtypes were associated with two different plasma cell differentiation pathways (enrichment of a preplasmablast signature versus aberrant expression of B cell genes). 1q gain, harboring 63 of the 87 MCL1-M members including MCL1, was found in about 80% of the MM with upregulated MCL1-M expression. Clonal analysis showed that 1q gain tended to occur as an early clonal event. Members of MCL1-M captured both MM cell-intrinsically acting signals and the signals regulating the interaction between MM cells with bone marrow microenvironment. MCL1-M members were co-expressed in mouse germinal center B cells. Together, these findings indicate that MCL1-M may play previously inadequately recognized, initiating role in the pathogenesis of MM. Our findings suggest that MCL1-M signature-based molecular clustering of MM constitutes a solid framework toward understanding the etiology of this disease and establishing personalized care. Article Summary: A pathogenic mechanism-guided molecular classification would facilitate treatment decision and etiology research of multiple myeloma. On the basis of the expression levels of a gene module coexpressed with MCL1, we have established a classification scheme assigning multiple myeloma into two subtypes with distinct prognosis, treatment responses and pathogenic backgrounds.