Case Ascertainment of Pediatric Brain Tumours: The Alberta Experience.

Estimates suggest that brain tumors are underreported in the Alberta Cancer Registry (ACR). While the reporting of malignant tumors is thought to be complete in cancer registries across Canada, the reporting of benign tumors is estimated at 33 percent of the actual number of cases expected within the country.6 There are many international studies that highlight the issues of underreporting of benign brain tumors in cancer registries.

Persistent albuminuria as a surrogate marker of chronic kidney damage among newly diagnosed hypertensives: Prevalence and risk factors in an urban population in Karachi, Pakistan.

Background: Hypertension is a major public health problem worldwide and a key factor for chronic kidney disease (CKD). Detection and treatment of CKD is of paramount importance. Albuminuria is one of the earliest screening markers recommended in patients at increased risk for CKD.

Patterns of cigarillo use among Canadian young adults in two urban settings.

Objectives: Current estimates indicate that cigarillo use has become commonplace among young adults in Canada despite the established risks to health. However, little else is known about patterns of cigarillo use in this subpopulation. The intent of this research was to examine the patterns, attitudes, and beliefs regarding cigarillo use and co-use of cigarillos and cigarettes among Canadian young adults.

Stage at diagnosis and colorectal cancer survival in six high-income countries: a population-based study of patients diagnosed during 2000-2007.

Background: Large international differences in colorectal cancer survival exist, even between countries with similar healthcare. We investigate the extent to which stage at diagnosis explains these differences.

Methods: Data from population-based cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK were analysed for 313 852 patients diagnosed with colon or rectal cancer during 2000-2007.

Daily contact with a patient and poor housing affordability as determinants of pulmonary tuberculosis in urban Pakistan.

Objective: This study aimed to evaluate the factors associated with pulmonary tuberculosis (TB) among individuals aged 15years or more in urban Karachi, Pakistan.

Design And Setting: A case-control design was implemented in three major tertiary-care hospitals to select cases (n=342) with active pulmonary TB (i.e.

Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007.

Background: The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007.

Methods: Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems.

Challenges created by data dissemination and access restrictions when attempting to address community concerns: individual privacy versus public wellbeing.

Background: Population health data are vital for the identification of public health problems and the development of public health strategies. Challenges arise when attempts are made to disseminate or access anonymised data that are deemed to be potentially identifiable. In these situations, there is debate about whether the protection of an individual's privacy outweighs potentially beneficial public health initiatives developed using potentially identifiable information.

Cost-effectiveness of community-based strategies for blood pressure control in a low-income developing country: findings from a cluster-randomized, factorial-controlled trial.

Background: Evidence on economically efficient strategies to lower blood pressure (BP) from low- and middle-income countries remains scarce. The Control of Blood Pressure and Risk Attenuation (COBRA) trial randomized 1341 hypertensive subjects in 12 randomly selected communities in Karachi, Pakistan, to 3 intervention programs: (1) combined home health education (HHE) plus trained general practitioner (GP); (2) HHE only; and (3) trained GP only. The comparator was no intervention (or usual care).

Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial.

Objective: To assess the effectiveness of a community based lifestyle intervention on blood pressure in children and young adults in a developing country setting.

Design: Cluster randomised controlled trial.

Setting: 12 randomly selected geographical census based clusters in Karachi, Pakistan.

A multicentre matched case control study of risk factors for preeclampsia in healthy women in Pakistan.

Background: Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality world-wide. The risk for developing preeclampsia varies depending on the underlying mechanism. Because the disorder is heterogeneous, the pathogenesis can differ in women with various risk factors.

Association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan.

Background: The combination of depression with type 2 diabetes is a public health problem. If diabetes is managed in its initial phase, the morbidity and mortality due to this combination may be prevented at an early stage. Therefore, we aimed to determine the association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan.

Smoking frequency, prevalence and trends, and their socio-demographic associations in Alberta, Canada.

Objectives: To determine the numbers of smokers, smoking prevalence and trends, and to examine their socio-demographic associations in Alberta using data from three Canadian national health surveys undertaken between 2000 and 2005.

Methods: The three surveys collected self-reported health data from Canadians aged 12 years and older. The weighted number of smokers and the smoking prevalence by health region and by urban/rural status were determined.

Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial.

Background: Despite convincing evidence that lowering blood pressure decreases cardiovascular morbidity and mortality, the hypertension burden remains high and control rates are poor in developing countries.

Objective: To assess the effectiveness of 2 community-based interventions on blood pressure in hypertensive adults.

Design: Cluster randomized, 2 x 2 factorial, controlled trial.

Prevalence and factors associated with intestinal parasitic infection among children in an urban slum of Karachi.

Background: Intestinal parasitic infections are endemic worldwide and have been described as constituting the greatest single worldwide cause of illness and disease. Poverty, illiteracy, poor hygiene, lack of access to potable water and hot and humid tropical climate are the factors associated with intestinal parasitic infections. The study aimed to estimate prevalence and identify factors associated with intestinal parasitic infections among 1 to 5 years old children residing in an urban slum of Karachi Pakistan.

Effect of low vs. high dietary sodium on blood pressure levels in a normotensive Indo-Asian population.

Background: Hypertension is a major modifiable risk factor, and while sodium restriction in hypertensive patients appears effective, its role in normotensive individuals remains unclear. We assessed the effect of a low vs. high-sodium diet on blood pressure in normotensive Indo-Asian adults.

Women's social position and health-seeking behaviors: is the health care system accessible and responsive in Pakistan?

To make the health care system more accessible and responsive to women particularly in developing countries, it is imperative to study the health-seeking behaviors and factors determining utilization of health care services. This study was carried out in close collaboration with Aga Khan Health Services, Pakistan (AKHSP) and the Health Department of Northern Areas of Pakistan. Key findings indicate that more than one-third of women did not know the cause of their reported illness.

Where do they go, whom do they consult, and why? Health-seeking behaviors in the northern areas of Pakistan.

This study presents an ethnographic account of health-seeking behaviors and determinants of health service utilization of people living in the rural Northern Areas of Pakistan. Data was gathered from 2004 to 2005 through 10 gender-specific focus group discussions. Sociodemographic characteristics, economic conditions, cultural forces, physical and environmental conditions, and health care service features form the behaviors.

Case-control study of risk factors associated with hepatitis C virus infection among pregnant women in hospitals of Karachi-Pakistan.

Objective: To identify risk factors for hepatitis C virus (HCV) infection among pregnant women seeking antenatal care in tertiary care hospitals of Karachi, Pakistan.

Methods: We enrolled 119 cases and 238 controls. Cases were enzyme-linked immunosorbent assay (ELISA III) positive pregnant women for antibodies to HCV; controls were anti-HCV ELISA negative pregnant women.

Spousal abuse during pregnancy in Karachi, Pakistan.

Objectives: To determine the magnitude of and factors associated with spousal abuse during pregnancy in women presenting to tertiary care hospitals in Karachi, Pakistan.

Methods: Five hundred women who delivered a live singleton baby were interviewed. Physical and/or emotional abuse during pregnancy (PEAP) was the primary outcome measure as determined by the World Health Organization's domestic violence module.

Effect of general practitioner education on adherence to antihypertensive drugs: cluster randomised controlled trial.

Objective: To determine the impact of a simple educational package for general practitioners on adherence to antihypertensive drugs.

Design: Cluster randomised controlled trial.

Setting: Six randomly selected communities in Karachi, Pakistan.

High prevalence of lack of knowledge of symptoms of acute myocardial infarction in Pakistan and its contribution to delayed presentation to the hospital.

Background: We conducted an observational study to determine the delay in presentation to hospital, and its associates among patients experiencing first Acute Myocardial Infarction (AMI) in Karachi, Pakistan.

Methods: A hospital based cross-sectional study was conducted at National Institute of Cardiovascular Disease (NICVD) in Karachi. A structured questionnaire was used to collect data.

Health seeking behaviour and health services utilization trends in national health survey of Pakistan: what needs to be done?

In developing countries, health seeking behaviours and health care services utilization patterns have been studied and the determinants have been classified in physical, socio-economic, cultural and political contexts. This paper is based on a systematic review of peer-reviewed literature on the relationship of factors affecting health service utilization and the focus has been on Pakistan. For this purpose, National Health Survey (NHS) of Pakistan, conducted in 1990-1994, has been critically reviewed.