Objectives: To compare the effect of active and secondhand smoke to unexposed smoke and to renal functions in young healthy Medical Students. Study Design: Cross sectional study comparative. Setting: Mohi-ud-din Islamic-Medical-College Mirpur AJ&K. Period: Fanuary-2018 to February-2019. Material & Methods: 350 healthy medical students aged 17-19 years were divided into active, secondhand and unexposed to smoke on basis of serum cotinine levels. The estimated GFR was measured by Modification of Diet in Renal Disease equation, albuminuria by albumin to urinary creatinine ratio, BMI by body weight (kg) to height (m2) and blood pressure by mercury manometer. The chronic kidney disease was classified into low, moderate and high risk according to Kidney Disease: Improving-Global Outcomes-2012-guidelines. Results: Out of 350 participants, 49 were active and 126 were of secondhand smoke. Most were male, overweight or obese, have high systolic and diastolic pressure and decreased eGFR. The CKD prevalence was 8.2%, eGFR <60ml/min/1.73 m² noticed in 19% and albuminuria in 26.4% of the participants. The proteinuria in active smokers in comparison with unexposed showed a high OR-5.67-(95%CI-17.17-40.49), cotinine levels >10 ng/mL; OR-5.520-(95%CI-3.67-3.91), systolic BP >140 mmHg; OR-2.50-(95%CI- 0.142-4.968); moderate to severely decreased eGFR, OR-2.478-(95%CI-0.124-4.391) and with high creatinine levels OR-4.300-(95%CI 2.432–7.603). The decreased eGFR showed Odds for obese OR-1.113(95%CI-2.391-5.197), active smokers OR-0.145(95%CI-0.029-0.721) and for systolic blood pressure >140 mmHg OR-6.892-(95%CI-1.414-2.235). Conclusion: Tobacco smoke exposure was associated with proteinuria and decreased eGFR effecting kidney functions in adolescents.
Childhood diarrheal disease is the second leading cause of death globally. All over the world, children below five years of age experience, on average, 3.2 episodes of diarrhea per year. Objectives: To explore an association of maternal education with childhood diarrhea in Pakistan. Study Design: Cross sectional study. Methodology: This study was conducted from Aug 2016 to Jan 2017 in Combined Military Hospital (CMH), Peshawar following approval from ethical review board. Total children under study were 363 aged 2 to 5 years, amid whom 121 were acute diarrhea cases and 242 were healthy controls leading to cases control ratio as 1:2. Data collection was done through semi structured questionnaire asked from mothers. Statistical analysis: Data was analyzed by SPSS software, version 22. To compare the association of maternal education with acute diarrhea, chi square test was applied at 5% level of significance. Statistical significance was taken at p value <0.05. Results: In present study, there was significant association between formal education of mothers and acute diarrhea with a highly statistically significant association (p < 0.001) observed showing increased proportion of childhood diarrhea, with increasing levels of education in mothers. Conclusion: We concluded that a significant increase in childhood diarrhea with higher levels of maternal education refutes the commonly observed finding. We need to further probe the underlying causes to minimize this high observed morbidity. Key Words: Maternal Education, Child Health and Safety and Acute Childhood Diarrhea
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