Breakfast patterns in relation to physical activity among school adolescents in Karachi, Pakistan.

BACKGROUND: Unhealthy habits and poor diet patterns are significant concerns among adolescents, impacting their overall quality of life. This study aimed to assess and improve these habits in adolescents. METHODS: This is a cross-sectional study conducted in 2017-2018 in Karachi. The research participants, aged 11-17 years, were drawn from lower-middle-income secondary schools using multistage random selection. Sociodemographics, the Physical Activity Questionnaire for Adolescents (PAQ-A), and breakfast consumption were determined through questionnaire and a food frequency survey. RESULTS: A study of 334 school-going adolescents in Karachi, Pakistan, found that 82% consumed breakfast daily, with chapatti being the preferred choice (72.2%). Physical activity levels varied, but 56.6% engaged in regular activity. No significant differences were found in breakfast consumption by age or parental education. CONCLUSIONS: Understanding South Asian adolescents' breakfast habits is crucial. Promoting healthier breakfast options and increased physical activity are recommended for long-term well-being, with further research needed for targeted interventions.

Does Lifestyle Behaviour Trigger Cardiovascular Risk Factors Among School-Going Adolescents In Pakistan?

OBJECTIVE: To explore the association of gender with risk factors for cardiovascular diseases among adolescents. Method: The cross-sectional study was conducted 2016-2019 in low-income schools in Karachi after approval from the ethics review board of Dow University of Health Sciences, and comprised adolescents of both genders aged 11-17 years. Anthropometric measurements and lifestyle behaviours were used to generate risk profile for cardiovascular diseases. Data was analysed using SPSS 16. RESULTS: Of the 1195 subjects, 468(39.2%) were boys and 727(60.8%) were girls. The mean age was 13.9±1.6 years. Mean family size was 5.9±3.64. Overall, 989(91.3%) participants consumed soft drinks, 44(4%) were smokers, 340(48.4%) consumed betel nut, 215(32.9%) Pan, 125(21.2%) Gutka and 9(1.7%) Bidi. Of the total, 867(83.3%) participants were physically less active than recommended, and daily screen time was >2 hours among 513(45.7%) participants. Body mass index and body fat percentage were significantly higher among girls (p<0.05). Higher rates of diastolic and systolic blood pressure and hand grip strength were observed in boys compared to girls (p<0.05). CONCLUSIONS: Interventional programmes in schools should emphasise the need for healthy lifestyle behaviours, increased physical activity, good eating habits and smoking cessation.

Public perception of isolation, quarantine, social distancing and community containment during COVID-19 pandemic.

BACKGROUND: Effective strategies of prevention have been and can aid in reducing and overcoming contagious diseases including COVID-19, still there is dearth of knowledge regarding general public awareness and perception. The current study aims to determine the existing knowledge and perception of people living in Karachi about isolation, quarantine, social distancing and community containment. METHODS: This cross-sectional online survey was conducted during the months of March and April 2020. The study included men and women of age 18 years and above quarantined during COVID-19. Convenience sampling followed by snowball sampling technique was used. An online structured questionnaire was developed using Google Form. It included questions on socio demographic information, public knowledge and perception about isolation, quarantine, social distancing and community containment. Chi-square test was used for categorical variables and p value of < 0.05 was considered statistically significant. RESULTS: A total of 548 participants were involved in this survey, 34% (n = 184) males with a mean age of 28 ± 10 years ranging from 18 to 75 years. The major source of hearing about COVID-19 was social media (72%, n = 393). Overall knowledge scores revealed that 27% (n = 146) participants had excellent knowledge about symptoms and prevention of the COVID-19. Excellent knowledge of quarantining, isolation and community containment and social distancing was 38% among participants. Participants who had good and excellent knowledge were more likely to have positive perception of isolation (p-value < 0.001). Majority participants (89%, n = 487) felt isolation may or may not be against human rights and this perception was found significantly associated with moderate to excellent knowledge about community mitigation measures (p-value = 0.009). CONCLUSION: This study concludes that optimal public knowledge and perception related to certain aspects of isolation, quarantine, social distancing and community containment exists however knowledge gaps and misperceptions prevail that need to be addressed.

Healthy lifestyle as a preventive measure against victimization among school-going adolescents.

BACKGROUND: Bullying and violence are problems of aggression in adolescents. Healthy lifestyle practices are common health promotion approaches in school settings; however, their association with aggressive behaviours in school-going adolescents is less explored. AIMS: This study examined the associations of healthy lifestyle behaviours including good hygiene, physical activity, recommended diet and refrainment from tobacco use with bully victimization and violence among adolescents. METHODS: Data were obtained from the Global School Health Survey conducted in Pakistan (2009). The study population consisted of school-going adolescents aged 13 to 15 years. We constructed our final dataset using information from 4102 participants. Association of healthy lifestyle behaviours with bully victimization and violence experience were assessed using multivariate logistic regression. RESULTS: Results indicate lower odds of being bullied (good hygiene: OR = 0.62, 95% CI 0.50-0.76, P <0.001; physical activity: OR=0.55, 95% CI 0.40-0.75, P <0.001; abstinence from tobacco: OR=0.43, 95% CI 0.30-0.63, P <0.001) and lower odds of violence (good hygiene: OR=0.68, 95% CI 0.55-0.84, P <0.001; physical activity: OR=0.55, 95% CI 0.43-0.71, P <0.001; abstinence from tobacco: OR=0.48, 95% CI 0.32-0.72, P <0.001), after controlling for socio-demographic and potential confounding factors. CONCLUSIONS: Our study supports the significance of healthy lifestyle as a preventive measure against victimization. Anti-bullying programmes focusing on social-emotional skill development may also consider promotion of healthy lifestyle behaviours among adolescents, aiming at reducing victimization and its related consequences.

Nutritional and lifestyle risk behaviors and their association with mental health and violence among Pakistani adolescents: results from the National Survey of 4583 individuals.

BACKGROUND: Unhealthy behaviors are associated with mental health problems and violence in adolescents, yet their combined association has been understudied. Using the Global School Health Survey, this study examined the association between combined unhealthy behaviors (including fast food, soft drink, smoking, other tobacco products and physical inactivity) and anxiety, suicidal ideation and involvement in physical fight among Pakistani adolescents. METHODS: Data were obtained from the Global School Health Survey conducted in Pakistan (2009). The study population consisted of school going adolescents aged 13 to 15 years. Association of combined unhealthy behaviors with anxiety, suicidal ideation and involvement in physical fight were studied through secondary analysis. We used univariate and multivariate logistic regression analysis by complex sample method, accounting for cluster sampling technique used for data collection. RESULTS: Of the total 4583 students, weighted percentage and unweighted count for one, two, three and four or more unhealthy behaviors was 39.4% (n = 1770), 22.1% (n = 963), 5.9% (n = 274) and 1.2% (n = 62) respectively. The weighted prevalence for anxiety, suicidal ideation and involvement in physical fight were 8.4%, 7.3% and 37.4% respectively. The results of multivariate logistic regression analysis after adjustment showed that students who had four or more unhealthy behaviors had higher odds of; being anxious (OR 2.45, 95%CI 1.31-4.59, p value 0.004), suicide ideation (OR 4.56, 95%CI 2.58-8.07, p value <0.001) and being involved in physical fight (OR 3.15, 95% CI 1.63-6.08, p value <0.001) as compared to those who had not adopted any unhealthy behaviors. CONCLUSIONS: This study suggests that the co-occurrence of unhealthy behaviors is associated with anxiety, suicidal ideation and physical fight among adolescents. These findings should be considered when developing interventions to combat detrimental outcomes of unhealthy behaviors during adolescence.

Ranibizumab for macular edema due to retinal vein occlusions: implication of VEGF as a critical stimulator.

Macular edema is a major cause of vision loss in patients with central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). It is not clear how much of the edema is due to hydrodynamic changes from the obstruction and how much is due to chemical mediators. Patients with macular edema due to CRVO (n = 20) or BRVO (n = 20) were randomized to receive three monthly injections of 0.3 or 0.5 mg of ranibizumab. At the primary endpoint, month 3, the median improvement in letters read at 4 m was 17 in the 0.3-mg group and 14 in the 0.5-mg group for CRVO, and 10 and 18, respectively for the BRVO group. Optical coherence tomography (OCT) showed that compared to injections of 0.3 mg, injections of 0.5 mg of ranibizumab tended to cause more rapid reductions of central retinal thickening that lasted longer between injections, but in 3 months, excess central retinal thickening which is a quantitative assessment of the macular edema, was reduced by approximately 90% in all four treatment groups. There was no correlation between the amount of improvement and duration of disease or patient age at baseline, but there was some correlation between the aqueous vascular endothelial growth factor (VEGF) level at baseline and amount of improvement. These data indicate that excess production of VEGF in the retinas of patients with CRVO or BRVO is a major contributor to macular edema and suggest that additional studies investigating the efficacy of intraocular injections of ranibizumab are needed.