Association of iron deficiency anemia with dental caries in the permanent first molars of children aged 7-12 years in Karachi, Sindh, Pakistan: protocol for an analytical cross-sectional study.

Introduction: Iron deficiency anaemia (IDA) and dental caries are prevalent diseases among Pakistani children. Limited research has been done to explore their association with permanent teeth. Given the caries susceptibility of permanent first molars and their role in the development of ideal occlusion, this study aimed to estimate caries frequency in these molars and assess its association with IDA in 7-12 year-old children.

Sociodemographic and clinical predictors of quality-of-life outcome in children and young people with primary brain tumour in Karachi, Pakistan: a prospective cohort study.

Background: Children and young people (CYP) with primary brain tumour (PBT) are at high risk for developing late effects, potentially affecting long-term quality of life (QoL). In low-income and middle-income countries, QoL has not been studied in depth in CYP. In the present study, CYP treated for PBTs in Pakistan were evaluated regarding (A) mean change in QoL scores pretreatment and 12 months post-treatment and (B) predictors of change in QoL scores 12 months post-treatment.

Barriers to Performing Essential Surgery at First-Level Hospitals in Pakistan: A Mixed Methods Study.

Introduction: There are numerous reasons for underutilization of the public health sector for surgery in Pakistan. This results in patients being diverted to private hospitals or tertiary care centers in urban areas. Diversions overburden the hospitals and significantly increase out-of-pocket costs for the patients.

Factors associated with the survival of oral cavity cancer patients: a single institution experience from Karachi, Pakistan.

Background: Oral cavity cancer (OCC) represents a significant public health burden in South Asia, ranking as the most prevalent cancer affecting males in Pakistan and contributing considerably to morbidity and mortality. The objective of this study was to evaluate the survival rates in patients diagnosed with OCC in the Pakistani population and identify the factors influencing survival.

Methods: This was a retrospective cohort study conducted at the Aga Khan University Hospital Karachi, Pakistan.

Pneumococcal carriage and changes in serotype distribution post- PCV13 introduction in children in Matiari, Pakistan.

Background: In early 2021, the 10-valent Pneumococcal conjugate vaccine (PCV10) was replaced with 13-valent (PCV13) by the federal directorate of immunization (FDI), Pakistan. We assessed the impact of a higher valent vaccine, PCV13, on the serotype distribution of nasopharyngeal carriage in rural Pakistan.

Methods: Children <2 years were randomly selected from two rural union councils of Matiari, Sindh in Pakistan between September-October,2022.

Relationship of adhesion molecules (ICAM-1 and E-selectin) with ABO blood groups in patients hospitalized with acute myocardial infarction.

Objectives: Adhesion molecules, sICAM-1 and sE-selectin appear to have a major role in the pathogenesis of coronary artery disease (CAD). The focus of this study was to investigate the relationship of sICAM-1 and sE-selectin with ABO blood groups in Pakistani patients hospitalized with acute myocardial infarction (AMI).

Methods: In a case-control study, 116 patients of acute myocardial infarction (AMI) and 116 healthy controls (age range for both: 30 years to 70 years; both males and females) were randomly selected from the Aga Khan University and National Institute of Cardiovascular Diseases, Karachi with informed consent.

Conducting a diabetes mellitus prevention trial in women with GDM in Pakistan: a feasibility study.

Background: Women with gestational diabetes mellitus (GDM) are at a greater risk of developing type 2 diabetes mellitus (T2DM) than women without GDM. Despite this elevated risk, few trials on the prevention of T2DM among South Asian women with GDM have been reported. Therefore, this study aimed to assess the feasibility of conducting a diabetes prevention program on women with a history of GDM to inform the development of a contextually relevant definitive trial.

Association of catechol-o-methyltransferase gene polymorphism with preeclampsia and biomarkers of oxidative stress: Study protocol for a prospective case-control study in Pakistan.

Background: Preeclampsia is one of the three leading causes of worldwide maternal mortality. Oxidative stress-mediated endothelial damage is expected to be an ultimate common mechanism in the pathophysiology of preeclampsia. The role of bioamines is also well-established in the induction of preeclampsia.

Factors associated with changes in the quality of life and family functioning scores of primary caregivers of children and young people with primary brain tumors in Karachi, Pakistan: a prospective cohort study.

Background: There are limited data available, particularly in low- and middle-income countries (LMICs), on the long-term quality of life (QoL) and family functioning of primary caregivers of children and young people (CYPs) affected by primary brain tumors (PBTs). This study aimed to assess the factors associated with the mean change in QoL and family functioning scores of primary caregivers of CYP patients with PBTs 12 months posttreatment.

Methods: This prospective cohort study enrolled CYPs aged 5-21 years with newly diagnosed PBTs and their primary caregivers.

Colorectal Cancer Survival and Its Prognostic Factors in Karachi, Pakistan.

Objective: To determine the survival rates of colorectal cancer (CRC) in the Pakistani population and determine the prognostic factors for survival among the CRC patients.

Study Design: Retrospective cohort study. Place and Duration of the Study: The cancer registry of the Aga Khan University Hospital, Karachi, Pakistan, from 2010 to 2016.

Oral health of chemotherapy patients before and after provision of oral hygiene instructions at a tertiary care hospital: pre-post design.

Objective: Disturbances in the oral mucosa is a major concern among patients undergoing chemotherapy. One of the most significant barriers in the implementation of oral care is the lack of knowledge. The aim of the study was to assess gingival and periodontal health status of chemotherapy patients before and after the provision of oral hygiene instructions.

Neurodevelopmental outcomes following possible serious bacterial infection in early infancy in Karachi, Pakistan: a prospective cohort study.

Background: Pakistan reports a significant burden of neonatal mortality, with infections as one of the major causes. We aim to assess the long-term impact of early infancy infections on neurodevelopmental outcomes during later childhood.

Methods: We conducted a prospective follow-up study of the cohort enrolled at the Karachi site of the Aetiology of Neonatal Infection in South Asia (ANISA) during 2019-2020.

Role of rotavirus vaccine in reducing diarrheal episodes in infants visiting private primary health care clinics in Karachi, Pakistan: A mixed-methods study.

Background: Rotavirus (RV) induced diarrhea led to hospitalization and mortality prior to the introduction of the rotavirus vaccine (RVV). The estimated RVV coverage was 86% in children less than one year of age in Pakistan.

Objectives: To determine the difference in the number of diarrheal episodes among children who received and who did not receive RVV, along with the parental and physician's perspectives on the barriers toward RV immunization in children aged less than 1 year in Karachi, Pakistan.

What happens when private general practitioners receive incentivisation offers from pharmaceutical sales representatives? A qualitative study in Pakistan.

Objectives: Pharmaceutical incentivisation of physicians for profit maximisation is a well-documented health system challenge. This study examined general practitioners' (GPs) reactions to pharmaceutical incentivisation offers in one region in Pakistan.

Methods: We used the Standardised Pharmaceutical Sales Representative (SPSR) method and qualitative interviews with GPs.

Assessing the Feasibility of a Multifaceted Intervention Package for Improving Respiratory Health of Textile Workers: Findings From the MultiTex Pilot Study in Karachi, Pakistan.

We piloted the development and implementation of a multifaceted intervention package for improving respiratory health among textile workers using a pre-post design at six mills in Karachi. The intervention, implemented following a baseline survey (n = 498), included health and safety training of workers and managers, promotion of cotton dust control measures, and the provision of facemasks. Follow-up surveys were conducted at 1, 6, and 12 months post-intervention.

Association between maternal experiences of intimate partner violence and child stunting: a secondary analysis of the Demographic Health Surveys of four South Asian countries.

Objectives: To determine the association between maternal exposure to intimate partner violence (IPV) and child stunting using the Demographic Health Survey (DHS) data comparing four South Asian countries.

Design: A secondary analysis.

Setting: Data from the seventh round of the DHS data of four South Asian countries; Pakistan, Nepal, India and Maldives.

"If the food is finished after my brother eats then we (girls) sleep hungry." Food insecurity and dietary diversity among slum-dwelling adolescent girls and boys in Pakistan: A mixed methods study.

To explore gender differences in food insecurity (FI) and minimum dietary diversity (MDD) among adolescent girls and boys in a slum community in Karachi, we employed an explanatory sequential mixed methods study that included a survey of 391 girls and boys of 10-19 years of age and followed by semi-structured interviews of eight purposely selected food insecure adolescents. Survey data was analyzed by Cox proportional algorithm and adjusted prevalence ratios (APR) with 95% confidence intervals (CI) were estimated for associated factors of FI and thematic analysis was undertaken for qualitative work. Meta inferences for mixed methods study were drawn by joint display analysis of survey results juxtaposed to qualitative findings.

Clinical and psychosocial factors associated with quality of life in patients with head and neck cancer: an analytical cross-sectional study from a lower-middle-income country.

Introduction: The disease course of head and neck (H&N) cancer can severely impair patients' quality of life (QoL). In Pakistan, a South Asian lower-middle-income country (LMIC), psychosocial factors may impact QoL. We aimed to assess QoL and associated factors amongst patients with H&N cancer in Pakistan.

Exploring the relationship between intimate partner violence during pregnancy and stillbirths.

Introduction: The relationship between intimate partner violence (IPV) in pregnancy and stillbirths is poorly understood. We aimed to determine if there was any association between stillbirths and IPV during pregnancy.

Methods: A community-based, matched, case-control study was conducted in 2014, nested within the Maternal and Newborn Health Registry of the Global Network for Women's and Children's Health Research in Pakistan.

Feasibility of a peer-supported, WhatsApp-assisted, lifestyle modification intervention for weight reduction among adults in an urban slum of Karachi, Pakistan: a mixed-methods, single-group, pretest-post-test, quasi-experimental study.

Objectives: This pilot study assessed whether a peer-supported, WhatsApp-assisted lifestyle modification intervention for weight reduction is feasible to execute a definitive trial.

Design: A mixed-methods, single group, pretest and post-test, quasi-experimental study.

Setting: Azam Basti, an urban slum in Karachi, Pakistan.

Effectiveness of inactivated COVID-19 vaccines against SARS-CoV-2 infections among healthcare personnel in Pakistan: a test-negative case-control study.

Objective: During the COVID-19 pandemic, several vaccines that were efficacious in randomised controlled trials were authorised for mass vaccination. In developing countries, inactivated vaccines were widely administered. While inactivated vaccines have been deemed effective in reducing disease severity, for healthcare personnel (HCP), effectiveness against SARS-CoV-2 infections is essential to reduce the risk to vulnerable patients and ensure a stable healthcare workforce.

Psychosocial factors influencing quality of life in patients with primary brain tumors in Pakistan: an analytical cross-sectional study.

Objective: Despite quality of life (QoL) being recognized as an important outcome in neuro-oncology, there is a lack of research from Pakistan where sociocultural differences may influence QoL. This study aimed to measure the QoL in patients with primary brain tumors (PBTs) and assess its association with mental health outcomes and social support.

Results: Our study included a total of 250 patients, with a median age of 42 years (range 33-54 years).

Factors affecting well-being in brain tumor patients: An LMIC perspective.

Introduction: Brain tumor is a devastating and often fatal diagnosis; quality of life and patient well-being are important goals of treatment. This study addresses the gap in culture-specific literature exploring the needs and coping strategies of brain tumor patients within an LMIC setting.

Methodology: A qualitative approach was undertaken using an exploratory descriptive study design.

Association of the BB genotype of the ABO gene with the risk of acute myocardial infarction in hospital-based study.

Objectives: The ABO gene locus has been identified to be associated with myocardial infarction in patients with coronary heart disease. The primary focus of this hospital-based study was to explore the relationship of ABO blood groups and ABO genotypes with acute myocardial infarction (AMI) in Karachi, Pakistan.

Methods: In a comparative cross-sectional study, an equal number of adult AMI patients and healthy controls (n=275 in each group; age range 30-70 years, both males and females) were recruited from the Aga Khan University and NICVD, Karachi, with informed consent.