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Background: The World Health Organization recommends that a child should be breastfed up to 2 years of age as it is essential for proper growth and development but population-based studies around the world have found conflicting results on the subject. Our study aims to analyze whether there is a relationship between the duration of breastfeeding and undernutrition among children aged from birth up to 3 years of age in Pakistan. Methods: A secondary analysis of the Pakistan Demographic and Health Survey 2013-2014 with 1072 children aged 3 years and under was conducted. The relationship between breastfeeding duration and undernutrition status was estimated through multiple logistic regression analysis. Results: The prevalence of stunting, wasting and underweight were 40.6%, 15.8% and 33.9% respectively, while prevalence of severe stunting is at 22.5%; severe wasting at 4.5% and severe underweight at 12.2% in children in our study. Odds of being stunted were significantly higher for children in their 3rd year of life [AOR: 4.35, CI 95% = (2.01, 9.33)] compared to children being breastfed in their 2nd year of life [AOR: 2.43, CI 95% = (1.55, 3.79) after being adjusted for maternal, child, demographic and healthcare access variables. Similarly, children being breastfed in their third year of life were more susceptible to developing severe stunting [AOR: 6.19, CI 95% = (3.31, 11.56)] in comparison to children in their second year [AOR: 2.84, CI 95% = (1.81, 4.46)]. There was no significant association between breastfeeding and wasting/severe wasting, or between breastfeeding and underweight/severe underweight. Conclusion: Breastfeeding in the 2nd and 3rd year of life was found to have significant relationship with stunting and severe stunting. Mothers need to be educated about the risks of prolonged breastfeeding to reduce the burden of undernutrition in the country.

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Background: The study aimed to assess the frequency and impact of attention-deficit hyperactivity disorder (ADHD) on behavior, social-emotional development, intelligence, and overall quality of life among school-aged children with congenital heart diseases (CHD). Methodology: A descriptive cross-sectional study was undertaken at the National Institute of Cardiovascular Diseases (NICVD) between July 2021 to August 2021. A total of 100 CHD patients aged 6 to 18 were assessed using the non-probability purposive sampling technique. The data was collected using a questionnaire comprising SNAP-IV 26 Scale that is a screening tool for ADHD. The collected data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) v 24.0. The statistical analysis was carried out with a confidence interval set at 95% and no p-value was determined as a threshold of statistical significance, owing to the qualitative nature of the data. Result: The study comprises n=100 CHD patients, aged 6 to 18 with the mean age ± standard deviation of 11.18 ± 3.914, and males and females stratifiable into 56% and 44% respectively. The ADHD screening identified n=22 (22%) subjects as highly suspected of having ADHD with no statistically significant gender difference (n=10 females vs. n=12 males). The study revealed Ventricular Septal Defect (VSD) to be the most common (28%) congenital heart defect across the in-patient and out-patient settings. VSD is followed by Atrial Septal Defect (ASD) at 24%, Tetralogy of Fallot (TOF) at 22%, Atrioventricular Septal Defect (AVSD) at 19%, and Aortic Stenosis (AS) in 7% of the patients. Out of the 25% facing comorbidities, hypertension dominated the subset of 23%. Conclusion: This study suggests that children with CHD are at an increased risk of developing ADHD, the hyperactive and the combined subtype in particular, compared to the healthy population. About 22 percent of the subjects manifested a typical clinical picture of an ADHD patient with mostly living a ‘somewhat difficult’ life. Keywords: Children, Congenital Heart Disease, CHD, Attention-Deficit Hyperactivity Disorder, ADHD, Ventricular Septal Defect, VSD, Atrial Septal Defect, ASD

Objectives: To determine the prevalence of violence among medical doctors in public sector hospitals of Karachi relating to physical violence, psychological violence (verbal and bullying/mobbing), sexual harassment and racial harassment). Methods:  A cross-sectional study was carried out in three public sector hospitals in Karachi (JPMC, Civil Hospital and Sindh Government Lyari General Hospital Karachi). Medical doctors of any age and gender who worked in outpatient departments, wards, and emergency departments were eligible to participate in the study. A validated WHO-designed questionnaire was used, with questions about exposure to violence, the source and types of violence, and socio-demographic information. In descriptive statistics, frequencies and percentages were reported for all categorical variables. The Chi-square and Fisher's exact tests were used to investigate the relationship between workplace violence and other types of violence. Results: 350 questionnaires were distributed to qualified medical doctors in total. Only 300 of them responded, for an 85.7 percent response rate. The majority of respondents were under the age of 40, and male gender was slightly more exposed to violence. The majority of the doctors were subjected to verbal abuse as well as bullying and mobbing. Conclusion: It was then concluded that any type of violence was common in doctors aged >35 years and male gender was more exposed to any violence as compare to female gander. The main type of violence was verbal violence in our study, whereas racial harassment and sexual harassment was also seen.