An innovative Community Mobilisation and Community Incentivisation for child health in rural Pakistan (CoMIC): a cluster-randomised, controlled trial.

Background: Infectious diseases remain the leading cause of death among children younger than 5 years due to disparities in access and acceptance of essential interventions. The Community Mobilisation and Community Incentivisation (CoMIC) trial was designed to evaluate a customised community mobilisation and incentivisation strategy for improving coverage of evidence-based interventions for child health in Pakistan.

Methods: CoMIC was a three-arm cluster-randomised, controlled trial in rural areas of Pakistan.

Efficacy of probiotics for treatment of acute or persistent diarrhoea in children from birth till 10 years: Systematic review and meta-analysis.

Background: Numerous studies have investigated the efficacy of probiotics in treating acute and persistent diarrhoea. However, probiotics have not been established as a recommended management option for diarrhoeal illness by the World Health Organization (WHO). Therefore, we conducted a systematic review of randomised controlled trials to assess the efficacy of probiotics for the management of acute and persistent diarrhoea in children.

Efficacy of nonmedicated middle meatal packing after endoscopic sinus surgery: A systematic review.

Objectives: This review aims to evaluate the utility of nonmedicated middle meatal packing compared to no packing on synechia formation up to 12 weeks after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).

Methods: We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was performed on Medline (PubMed), EBSCO CINAHL plus, CENTRAL, and Clinicaltrials.

Addressing inequities in research for early to mid-career women scientists in low- and middle-income countries: "Supporting Women in Science" programme.

Introduction: The gender disparities and inequities faced by women in academia are widespread, especially in low- and middle-income countries (LMICs). The scholarly output of women scientists remains significantly lower than that of men due to limited opportunities. This widening gap has significant implications for policy-making and prioritizing agendas.

Rationale and approach to evaluating interventions for newborn care in low- and middle-income countries.

Introduction The neonatal period is the most vulnerable time in a child's life, contributing to almost half of all deaths in children under 5 years. Many of these deaths are preventable and are mainly caused by preterm birth, birth asphyxia, or serious infections. Over the past decade, the evidence base for interventions to prevent and manage these causes of neonatal mortality and morbidity in low- and middle-income countries (LMICs) has expanded significantly.

Zinc supplementation for acute and persistent watery diarrhoea in children: A systematic review and meta-analysis.

Background: Zinc is a micronutrient that plays a role in immune system strengthening and regulation of intestinal epithelial cells, and can reduce the duration and severity of diarrhoea. We conducted a systematic review of randomised controlled trials (RCTs) to assess the effectiveness of zinc compared to no zinc for the management of acute and persistent diarrhoea in children.

Methods: We searched PubMed, the Cochrane Library, Scopus, CINAHL, ClinicalTrials.

Low-osmolarity oral rehydration solution for childhood diarrhoea: A systematic review and meta-analysis.

Background: Oral rehydration solution (ORS) is crucial in the management of diarrhoea. Until the early 2000s, the standard formulation of glucose-based ORS with a total osmolarity of 311 mmol/L was being used for this purpose. However, due to concerns about sodium levels and cases of hypernatremia, a low-osmolarity ORS solution (LORS) with an osmolarity of 245mmol/L or less was developed to replace the standard ORS.

Antibiotics for acute watery or persistent with or without bloody diarrhoea in children: A systematic review and meta-analysis.

Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea.

Nutritional Management of Low Birth Weight and Preterm Infants in Low- and Low Middle-Income Countries.

Introduction: Preterm and low birth weight (LBW) infants are at an increased risk of morbidity and mortality compared with their term counterparts, with more than 20 million LBW infants born each year, the majority in lower middle-income countries (LMICs). Given the increased vulnerability and higher nutritional needs of these infants, optimizing feeding strategies may play a crucial role in improving their health outcomes.

Methods: We updated evidence of Every Newborn Series published in The Lancet 2014 by identifying relevant systematic reviews, extracting low-income country (LIC) and LMIC data, and conducting revised meta-analysis for these contexts.

Antenatal Care Strategies to Improve Perinatal and Newborn Outcomes.

Background: Antenatal care strategies (ANC) play a pivotal role in ensuring a healthy gestational period for expectant mothers and promote optimal outcomes for their babies. Implementing these interventions can contribute to a supportive environment for pregnant women, resulting in positive perinatal and neonatal outcomes.

Summary: We summarize evidence for a total of twenty-seven interventions pertaining to ANC from Every Newborn Series published in The Lancet 2014 by identifying the most recent systematic reviews, extracting data from each review, and conducting a subgroup analysis for low-income and lower-middle-income countries (LMICs) for outcomes relevant to maternal and neonatal health.

Use of artificial intelligence for the detection of infection from upper gastrointestinal endoscopy images: an updated systematic review and meta-analysis.

Background: () infection is associated with various gastrointestinal diseases and may lead to gastric cancer. Currently, endoscopy is the gold standard modality used for diagnosing infection, but it lacks objective indicators and requires expert interpretation. In the past few years, the use of artificial intelligence (AI) for diagnosing gastrointestinal pathologies has increased tremendously and may improve the diagnostic accuracy of endoscopy for infection.

The Effectiveness of Regionalization of Perinatal Care and Specific Facility-Based Interventions: A Systematic Review.

Introduction: Appropriate perinatal care provision and utilization is crucial to improve maternal and newborn survival and potentially meet Sustainable Development Goal 3. Ensuring availability of healthcare infrastructure as well as skilled personnel can potentially help improve maternal and neonatal outcomes globally as well as in resource-limited settings.

Methods: A systematic review on effectiveness of perinatal care regionalization was updated, and a new review on facility-based interventions to improve postnatal care coverage and outcomes was conducted.

Developing an AI-based application for caries index detection on intraoral photographs.

This study evaluates the effectiveness of an Artificial Intelligence (AI)-based smartphone application designed for decay detection on intraoral photographs, comparing its performance to that of junior dentists. Conducted at The Aga Khan University Hospital, Karachi, Pakistan, this study utilized a dataset comprising 7,465 intraoral images, including both primary and secondary dentitions. These images were meticulously annotated by two experienced dentists and further verified by senior dentists.

Optimal Strategies for Screening Common Birth Defects in Children of Low- and Middle-Income Countries: A Systematic Review.

Introduction: Congenital anomalies are one of the major causes of the global burden of diseases, and low- and middle-income countries (LMICs) are disproportionately affected. This review assesses the prenatal and postnatal screening methods and compares the prevalence of major congenital anomalies in LMICs.

Methodology: We conducted a systematic search in MEDLINE/PubMed, CINAHL, Cochrane databases of systematic reviews, clinical trials.

Common pediatric surgical conditions and associated health-seeking behaviors in Pakistan: An urban and rural comparative assessment.

Approximately five billion people do not have access to necessary surgical treatment globally and up to 85% of children in LMICs are affected with conditions requiring surgical care by the age of 15 years. It is crucial to identify common surgical conditions in children in Pakistan to inform healthcare professionals and policymakers for effective resource allocation. This representative cross-sectional household survey conducted on children aged 5-10 years assessed existing surgical diseases and healthcare-seeking behaviors in the two largest provinces (Sindh and Punjab) of Pakistan.

Efficacy of Zinc Fortified and Fermented Wheat Flour (EZAFFAW): A randomized controlled trial protocol.

Background: Zinc deficiency poses significant health risks, particularly in low-income settings. This study aims to evaluate the impact of agronomically zinc biofortified (fermented and non-fermented) and post-harvest wheat flour flatbread on zinc status and metabolic health in adolescents and adult women in rural Pakistan.

Methods: A four-arm triple-blind randomized controlled trial will be conducted in a rural district of Pakistan.

Clinical presentation, diagnosis and management of multisystem inflammatory syndrome in children (MIS-C): a systematic review.

Background: Knowledge about multisystem inflammatory syndrome in children (MIS-C) is evolving, and evidence-based standardised diagnostic and management protocols are lacking. Our review aims to summarise the clinical and diagnostic features, management strategies and outcomes of MIS-C and evaluate the variances in disease parameters and outcomes between high-income countries (HIC) and middle-income countries (MIC).

Methods: We searched four databases from December 2019 to March 2023.

COVID-19 vaccine coverage, determinants and inequity amongst refugees and migrants in Pakistan: a cross-sectional study.

Objective: Migrants and refugees are at a disadvantage in accessing basic necessities. The objective of this study is to assess the inequity in access, needs and determinants of COVID-19 vaccination among refugees and migrant populations in Pakistan.

Design: We conducted a mixed-method study comprising a cross-sectional survey and a qualitative study.

Behavior Change Interventions to Address Unhealthy Food Consumption: A Scoping Review.

High intakes of sodium, sugar, saturated fats, and trans-fats contributed to 187.7 million disability adjusted life years from noncommunicable diseases globally. Understanding of the global evidence on interventions to reduce consumption of various types of unhealthy food across diverse contexts is needed.

Malaria in pregnancy: Meta-analyses of prevalence and associated complications.

This review aims to assess the prevalence of malaria in pregnancy during antenatal visits and delivery, species-specific burden together with regional variation in the burden of disease. It also aims to estimate the proportions of adverse pregnancy outcomes in malaria-positive women. Based on the PRISMA guidelines, a thorough and systematic search was conducted in July 2023 across two electronic databases (including PubMed and CENTRAL).

Heated and humidified high flow therapy (HHHFT) in extreme and very preterm neonates with respiratory distress syndrome (RDS): a retrospective cohort from a tertiary care setting in Pakistan.

Objective: To determine the role of heated humidified high flow therapy (HHHFT) as primary respiratory support in spontaneously breathing moderate-late, very and extreme preterm neonates with respiratory distress syndrome (RDS) at a tertiary care hospital from a developing country.

Design: Retrospective cohort study.

Setting: Neonatal intensive care unit of Indus Hospital and Health Network, Karachi, Pakistan.

An evidence gap map of interventions for noncommunicable diseases and risk factors among children and adolescents.

Substance misuse, obesity, mental health conditions, type 1 diabetes, cancers, and cardiovascular and chronic respiratory diseases together account for 41% of disability-adjusted life years linked to noncommunicable diseases (NCDs) among children and adolescents worldwide. However, the evidence on risk factors and interventions for this age group is scarce. Here we searched four databases to generate an evidence gap map of existing interventions and research gaps for these risk factors and NCDs.