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CONCLUSION: Metformin continuation during pregnancy significantly
reduces EPL in women with PCOS. IR may play a significant role in EPL.
J Pak Med Assoc. 2010 Sep;60(9):758-61.
Predictors of Obesity among Post Graduate Trainee
Doctors Working in a Tertiary Care Hospital of Public
Sector in Karachi, Pakistan.
Mahmood S, Najjad MK, Ali N, Yousuf N, Hamid Y.
Department of Community Health Sciences, Aga Khan University, Karachi,
OBJECTIVES: To identify the predictors of obesity among post graduate
trainee doctors working in a tertiary care hospital of public sector at
tertiary care hospitals of public sector in Karachi. Information was collected
from 117 post graduate trainee doctors via pre-tested self administered
questionnaire and standard tools were used for height and weight
measurement. Obesity was deﬁned as body mass index (BMI) > or =23 by
using South Asian cut-oﬀ points. SPSS version 16 was used for data analysis,
and logistic regression technique was applied to come up with predictors of
RESULTS: Frequency of overweight and obesity among doctors was 31.6%
and 28.2% respec vely. Nearly, 18% were using tobacco and family history
of obesity was present in 44%. Approximately 64% doctors were taking
lunch outside home, 76% were taking tea at least once a day, 59% were
taking snacks between meals and 50% were physically inac ve. Predictors
of obesity among doctors include; taking lunch outside home OR = 7.11
(2.28-22.09), snacks between meals OR = 5.36 (1.51-19.03), tea OR = 7.85
(1.63-37.63), physical ac vity OR = 0.18 (0.05-0.57), increase dura on of
training OR = 1.7 (1.15-2.49), family history of obesity OR = 3.35 (1.11-
10.08) and male gender OR = 3.83 (1.07-13.72).
CONCLUSION: Frequency of overweight and obesity was high among post
graduate trainee doctors. Taking lunch outside home, snacks and tea intake
between meals, increase duration of training, family history of obesity,
male gender and lack of physical activity were found to be predictors of
obesity among doctors.
J Ayub Med Coll Abbottabad. 2010 Apr-Jun;22(2):130-3.
Prevalence of Hypertension among Obese and Non-Obese
Patients with Coronary Artery Disease.
Khan SB, Noor L, Hafiz-ur-Rehman, Hameedullah, Hafeezullah M, Awan ZA,
Shahab ud Din, Shah SS.
Department of Cardiology, Postgraduate Medical Institutes, Hayatabad
Medical Complex, Peshawar, Pakistan. firstname.lastname@example.org
degree of obesity is proportional to the rate of development of
cardiovascular diseases, hence, resulting in a dramatic increase in morbidity
and mortality. Apart from obesity, hypertension is another well recognized
risk factor contributing to coronary artery disease (CAD). The precise
prevalence of obesity-related hypertension varies with age, race and
gender; and is yet unknown in our population. The objective of this study
was to determine the prevalence of hypertension in obese and non-obese
patients with diagnosed CAD.
Cardiology Department of Postgraduate Medical Institute, Lady Reading
Hospital, Peshawar from 15th March 2007 to 30th May 2008. A total of 200
pa ents with diagnosed CAD were enrolled, 100 were found obese and 100
hypertensive, 66 (59.46%) of these were obese and 45 (40.54%) non-obese
J Ayub Med Coll Abbottabad. 2010 Jan-Mar;22(1):84-6.
Atherosclerosis in Relation to Fat Penniculus (Obesity)
between Xiphoid and Umbilicus.
Naeem A, Hanif R.
Department of Pathology, Akhtar Saeed Medical College, Lahore, Pakistan.
BACKGROUND: It has been shown that possible influence of body weight is
more evident for coronary than aortic atherosclerosis; and more in men
than women. Coronary heart disease due to obesity in males becomes
signiﬁcant when body mass index (BMI) exceeds 30 (30% overweight) and
does not affect the life expectancy particularly in women. This study was
conducted to asses the relation of thickness of fat penniculus (obesity)
between xiphoid and umbilicus to different atherosclerotic lesions; and to
collect basic data about age and sex distribution of this relation
METHODS: It was prospective descriptive study and conducted at mortuary
of King Edward Medical University, and Department of Pathology, Allama
Iqbal Medical College. Lahore. A total of 130 human autopsies were carried
out in one-and-a-half year of study duration. The ages of the deceased
ranged between 8 and 85 years. Heart aorta and its major branches were
included in this study. In addition, fat penniculus between xiphoid and
umbilicus was measured and atherosclerosis lesions were categorised and
correlated with this parameter. Haematoxylin and Eosin, and different
special stains were done in Pathology Department of Allama Lqbal Medical
College, Lahore to asses to severity of atherosclerosis lesions.
RESULTS: The fatty streaks were present in predominantly more cases with
Fat Penniculus < 20 mm than in asses with Fat Penniculus < 10 mm and < 30
mm. The fibrolipid plaques, complicated and calcified lesions were present
in a dominant number of cases with Fat Penniculus < 30 mm on percentage
Penniculus 20 mm to < 30 mm than in cases with Fat Penniculus < 10 mm
and < 20 mm thickness.
Mol Biol Rep. 2010 Jan;37(1):289-95. Epub 2009 Aug 8.
Plasma Homocysteine and DNA Damage Profiles in
Normal and Obese Subjects in the Pakistani Population.
Bukhari SA, Rajoka MI, Nagra SA, Rehman ZU.
Center for Agricultural Biochemistry and Biotechnology, University of
Agriculture, Faisalabad, Pakistan.
Dependence of plasma total homocysteine (tHcy) and DNA damage profiles
on melanodialdehyde (MDA), oxidative stress, liver function tests (LFT), and
lipids was studied in non-obese and obese subjects in the Pakistani
population. Development of obesity is influenced by both genetic,
biochemical and environmental factors. Plasma homocysteine (Hcy) and
DNA damage proﬁles play a pivotal role in its progression. We studied 160
obesity pa ents and 160 lean subjects. Leukocytes were evaluated for DNA
damage by comet assay and blood plasma for biochemical properties using
commercial kits. Plasma Hcy level and DNA damage were strongly
correlated with triglycerides (P < 0.000), LDL-cholesterol (P < 0.001), systolic
blood pressure (P < 0.001), cholesterol (P < 0.004), MDA (P < 0.004) and
total oxygen stress (P < 0.004) in obese individuals. Both Hyc and DNA
damage were negatively associated with total anti-oxidant response and
globulin. Both Hcy profile and DNA damage may have a role in the
endothelium damage even in the normal range and are related to
triglycerides, ALT, MDA, TOS, HDL- and LDL-cholesterol in the Pakistani
Gynecol Obstet Invest. 2010;69(3):184-9. Epub 2009 Dec 21.
Continuation of Metformin Reduces Early Pregnancy Loss
in Obese Pakistani Women with Polycystic Ovarian
Nawaz FH, Rizvi J.
Department Obstetrics and Gynecology, Aga Khan University Hospital,
Karachi, Pakistan. email@example.com
BACKGROUND: Polycystic ovarian syndrome (PCOS) is the most common
cause of anovulatory infertility worldwide. In addition to a poor conception
rate, pregnancy loss rates are signiﬁcantly higher (30-50%) during the ﬁrst
trimester in women with PCOS. Insulin resistance (IR) in this syndrome is
not only implicated toward early pregnancy loss (EPL) but also pathognomic
for various obstetrical complications during pregnancy. We evaluated the
role of Metformin in the reduction of EPL in women with PCOS who
conceived spontaneously or after induction ovulation with or without
Metformin in the reduction of EPL in women with PCOS. Secondary
outcomes like gestational diabetes, pregnancy-induced hypertension and
intrauterine growth restriction were also analyzed at the end of the study.
MATERIAL AND METHODS: This case-control study was conducted from
March 2005 to March 2008 in the infer lity and antenatal clinics of the
Department of Obstetrics and Gynecology of Aga Khan University Hospital,
Karachi, Pakistan. A total of 197 infer le women with PCOS were included.
'Cases' were women with PCOS who conceived while taking Metformin and
it whom it was continued throughout pregnancy. 'Controls' were women in
whom Metformin was either stopped in first trimester after confirmation of
pregnancy (by serum betaHCG or by ultrasound) or they conceived
spontaneously without the use of Metformin.
(Rotterdam criteria). These women were followed till the final outcome of
pregnancy was achieved. Both groups were compared for risk of EPL. It was
found that continuation of Metformin during pregnancy reduces EPL, i.e.
8.8 vs. 29.4% in cases and controls, respec vely (p < 0.001). In the subset of
women with a prior history of miscarriage, the pregnancy loss rate was
12.5% in the Me ormin versus 49.4% in control group (p = 0.002).
reduces EPL in women with PCOS. IR may play a significant role in EPL.
J Ayub Med Coll Abbottabad. 2010 Jan-Mar;22(1):139-42.
Frequency of Metabolic Syndrome in Patients with Type-2
Ahmed N, Ahmad T, Hussain SJ, Javed M.
Department of Medicine, Ayub Medical College, Abbottabad, Pakistan.
BACKGROUND: Diabetes, Hypertension, Obesity and Ischaemic Heart
Disease have become a problem of public health magnitude with
substantial economic burden both in the developed as well as the
developing countries. Obesity is quite frequent in Type 2 diabetics and also
plays a central role in causing Metabolic Syndrome (MetS). Metabolic
Syndrome significantly increases the incidence of cardiovascular
complications. This study was done to determine the frequency of MetS in
our Type 2 diabe c pa ents as most of the components of MetS can be
modified and identifying/managing these at an early stage might be of
considerable help in reducing cardiovascular complications.
METHODS: This cross-sectional study was done in Medical 'B' and Medical
'A' wards of Ayub Teaching Hospital, Abbo abad from Nov, 08 to April, 09.
Type 2 Diabe c pa ents aged above 40 years who gave informed consent
were included in the study. Data was collected through a structured
proforma. Frequency of Metabolic Syndrome was estimated according to
the IDF consensus worldwide definition of the MetS.
RESULTS: Of the 100 pa ents enrolled in this study 56 were females and 44
were males with a mean age of 59.9 years. Out of these 100 par cipants
seventy six (76%) were diagnosed to have metabolic syndrome. Of the 56
females, forty eight (85.71%) were having metabolic syndrome while
twenty eight (63.63%) of the 44 male par cipants were having the
syndrome. The diﬀerence was sta s cally signiﬁcant (p < 0.05).
CONCLUSION: Frequency of MetS was found to be significantly high in this
study with female preponderance. All the components, except
Hypertension were more frequent in females. Diabetic patients with
metabolic syndrome need more aggressive approach in management so as
to decrease the incidence of cardiovascular complications.
Pakistan Journal of Nutrition ISSN 1680-5194, 2010;9(2):162.
Gender Differences of Body Mass Index in Adults of
Pakistan: A Case Study of Multan City
Muhammad Aslam, Aamir Saeed, G.R. Pasha, Saima Altaf
Obesity is an epidemic health problem worldwide that can result in many
serious and sometimes, fatal diseases. It is very important to study such
prevalence in developing countries, like Pakistan where people cannot
afford the medical tolls, additionally, added to their non-meeting budgets,
due to problems of obesity. The present study addresses the same issue by
taking into account of 2000 adults from Multan city as case study of
Pakistan. Although many of similar studies have also been carried out in the
region but the present study evaluates the obesity prevalence according to
recommendations of World Health Organization that in Asia Pacific Region,
a person is considered to be overweight if BMI > 23 rather BMI > 25 and to
be obese if BMI > 25 rather than if BMI > 30. According to this new
deﬁni on, we report that more than 46% people are overweight (18.95%)
and obese (27.85%). The percentage of normal people is just 28.65 while
24.55% are underweight. We report the mean MBI to be 22.87±0.086 (S.E),
males have 13 kg more weight as compared to that of females have and
males are more than 5 inches taller as compared to females, on the
average. It is noted that mean BMI of males (23.51±0.11) and mean BMI of
females (22.05±0.133) are diﬀerent signiﬁcantly. We ﬁnd that 55.12%
among males and 36.15% among females are either overweight or obese.
The percentile plot of the data also displays the similar picture. We further
report that married people are three times obese as compared to
J Ayub Med Coll Abbottabad. 2009 Oct-Dec;21(4):53-6.
Obesity, Hyperlipidemia, and Hyperuraecemia in Young
and Old Hypertensive Patients.
Ahmed N, Anwar W, Waqas H.
Department of Medicine, Frontier Medical College, Abbottabad, Pakistan.
BACKGROUND: There is strong correlation among hypertension, obesity,
hyperlipidemia and hyperuricemia which are important risk factor for the
cardiovascular disease. Objective of this study was to assess and compare
the prevalence of obesity, hyperlipidemia and hyperuricemia among young
and old hypertensive patients in the local setting.
patient Department at Shahina Jamil Teaching Hospital, Abbottabad, from
September 2007 to February 2008. Eighty-six patients seen in the medical
outpa ent department were enrolled in the study. Pa ents with age 15
years or above and diagnosed as case of systemic hypertension were
included. Patients with endocrine disease, pregnancy, coarctation of aorta,
and renal disease leading to hypertension were excluded from the study.
were included in the study. Patients were divided into younger age group
(age < 46 years) and older age group (age > or = 46 years). Mean Body Mass
Index (BMI) was 29.7 +/- 5.2 in the younger age group and 26.9 +/- 4.7 in
the older age group, mean serum cholesterol level was 192.2 +/- 14.2
mg/dL in younger age group and 190.9 +/- 18.3 mg/dL in the older age
group, mean serum triglyceride level was 170.5 +/- 13.7 mg/dL in younger
age group and 166.6 +/- 21.4 mg/dL in the older age group and mean serum
uric acid levels were 5.6 +/- 0.7 mg/dL in younger age group and 5.7 +/- 1.2
mg/dL in the older age group. Overweight and obese pa ents were 70.9%
with its higher prevalence in younger (86.2%) as compared to older pa ents
(63.2%). Hypercholesterolemia was found in 27.9% of the pa ents, with a
frequency of 24.1% in younger pa ents and 29.8% in the older pa ents.
Hypertriglyceridemia was seen in 66.3% of the pa ents, with a frequency of
69.0% in younger pa ents and 64.9% in the older pa ents. Hyperuricemia
was present in 37.2% of the hypertensive pa ents with a frequency of
34.5% in the younger pa ents and 38.6% in the older pa ents.
hyperuricemia are not associated with the age of the hypertensive patients.
Increased BMI is more frequent in the young as compared to the old
J Ayub Med Coll Abbottabad. 2009 Jul-Sep;21(3):145-8.
Association of Lipoprotein-Alpha with Obesity in Children
and Adolescents in District Swat.
Shah SM, Ihsanullah M, Rasheed A.
Department of Biochemistry, Kohat Institute of Medical Sciences, Kohat,
BACKGROUND: Studies have demonstrated that atherosclerosis has its
silent beginning during childhood. Coronary artery disease, particularly
when it presents early in adult life has been observed to have a familial
tendency. Lipoprotein-alpha [Lp-alpha], has a strong genetic association
and raised levels when combined with obesity increase the risk of
premature coronary heart disease. Thus in adults, has emerged the
possibility of preventing or delaying the coronary artery disease when
appropriate measures are applied early in life. In our study, we assessed the
prevalence of overweight and obesity and its association with Lp-alpha in
the child population of district Swat.
METHODS: The study was carried out in Saidu Teaching Hospital and
Biochemistry Department, Saidu Medical College, Swat, from May to July
2007. Both boys and girls between 10-20 years of age were included. The
prevalence of obesity was detected in 200 subjects by using body mass
index. One hundred subjects were selected to compare the anthropometric
and cardiovascular parameters of obese subjects with control group. Lp-
alpha was measured in children of both the groups.
in adolescent girls was 10%. The prevalence was higher in female subjects,
compared to male subjects. Obese subjects had significantly higher weight,
body mass index, blood pressure values and Lp-alpha levels as compared to
adolescents than in non-obese.
J Ayub Med Coll Abbottabad. 2009 Apr-Jun;21(2):45-8.
Influence of Sibutramine, Orlistat and Ispaghula in
Reducing Body Weight and Total Body Fat Content in
Kazmi SA, Khan M, Mashori GR, Saleem A, Akhtar N, Jahangeer A.
Department of Pharmacology and Therapeutics, Basic Medical Science
Institute, Jinnah Post graduate Medical Centre, Karachi. firstname.lastname@example.org
BACKGROUND: The correlations between combined body fat parameters
and risk factors of obesity explained a portion of the variation in the weight,
BMI and waist circumference, the average number of categorical metabolic
risk factors increases progressively with increasing total body fat content.
There is currently no data available in which influence of drugs can be
assessed on total body fat content. This was a non-randomized,
prospective, open-label, parallel group study was conducted to compare
the effectiveness of sibutramine, orlistat and ispahgula in reducing body
weight and percentage of total body fat content in obese individuals.
clinical trial was conducted from July 2008 to March 2009 in JPMC, Karachi,
Pakistan. The study was based on three arms A (ispahgula), B (orlistat) and
C (sibutramine) comprising 40 pa ents in each. The selec on criteria has
included pa ents from either sex with age 18 years or more with BMI > or
=30 as obese with or without associated risk factors and BMI > or = 27 < 30
as over weight only if any significant risk factor is present. Compliance on
diet chart and instruction for life style modification were assessed monthly.
RESULTS: The comparison of mean difference in percentage of total body
fat content between the groups and within the groups at day 150 is (p-
value) 0.029 and diﬀerence in body weight is (p-value) 0.042 which is
CONCLUSION: Sibutramine is more effective than ispahgula and orlistat in
reducing body weight and percentage of total body fat content in obese
Pakistan Journal of Nutri on 2009;8(11):1766-1772.
Supplementation of Whole Grain on Body Weight and
Lipid Profile in Obese Females of Various Ethnic Groups in
Khan21Department of Zoology, University of Balochistan, Que a, Pakistan
2Ins tute of Pure and Applied Biological Sciences, Bahaudinzakria
University, Multan, Pakistan
Mass Index (BMI), total Cholesterol (CHO), Triglyceride (TG), High Density
Lipoprotein Cholesterol (HDL) and Low Density Lipoprotein Cholesterol
(LDL) in obese female subjects of 4 major ethnic groups in Que a, i.e.,
Pathan (P), Baloch (B), Hazara (H) and Punjabi (PU) were studied. Two
groups each of 32 obese female subjects and comprising 8 subjects from
each ethnic group were chosen from the volunteers on the selection criteria
according to World Health Organiza on (1998). The subjects of the group
taken as control used the conventionally available carbohydrates in meals
and another batch referred as treated subjects consumed 50g cereals in
breakfast and whole grain chapa s in lunch and dinner for 4 weeks. Twelve
hours fasting blood sample was taken from control and whole grain treated
obese subjects a day after the completion of experiment duration. Lower
BMI had been observed in the subjects of all the ethnic groups compared to
their respec ve control, however, signiﬁcantly (p<0.01) only in PU group.
Significantly lower concentration of total cholesterol in fiber consuming
subjects of B (p<0.01) and PU (p<0.05) ethnic groups was demonstrated
compare to their respective controls. Similarly Triglycerides (TG)
concentrations were lesser in all ethnic groups but not significant
statistically. Trend of greater concentration of HDL cholesterol and lower
LDL cholesterol in the fiber taking subjects in all the ethnic groups was only
signiﬁcant (p<0.05) compare to their controls in P and PU groups,
Pakistan Journal of Nutri on, 2009;8(10):1617-1622.
Effect of Walnut on Lipid Profile in Obese Female in
Different Ethnic Groups of Quetta, Pakistan
Khan21Department of Zoology, 1University of Balochistan, Que a, Pakistan
2Ins tute of Pure and Applied Biological Sciences, Bahauddin Zakriya
University, Multan, Pakistan
Four week controlled study was designed to observe the eﬀect of 40 g of
walnut in daily breakfast on Body Mass Index (BMI), total Cholesterol
(CHO), Triglyceride (TG) High Density Lipoprotein (HDL) cholesterol and Low
Density Lipoprotein (LDL) cholesterol in obese female subjects of various
ethnics, i.e. Baloch (B), Pathan (P), Hazara (H) and Punjabi (PU) residing in
Que a region of Balochistan. A batch of 32 obese female subjects, 8 from
each ethnic group as a control and another batch of 32 obese females 8
from each ethnic group as treated were selected. Twelve hour fasting blood
samples a day after stoppage of walnut were taken from obese control and
obese treated subjects. Daily walnut consumption demonstrated
considerable drop in body weight in all ethnic groups residing in Quetta
locality. Marked and statically significant reduction in total cholesterol was
no ced in all ethnic groups i.e. 3.6% (p<0.05), 5.4% (p<0.001), 5.8%
(p<0.01) and 7% (p<0.001) in B, P, H and PU groups respec vely. Baloch
subjects showed signiﬁcant reduc on of 7.8% in TG (p<0.001), similarly
significant lowered TG was also observed in PU group. A significant increase
(p<0.001), (p<0.05) in HDL cholesterol had been observed in B and P group
respectively in walnut consuming subjects. In walnut consuming female
subjects signiﬁcant reduc on (p<0.05), (p<0.01), (p<0.01) in LDL cholesterol
levels was noted in B, P and PU subjects respectively. The positive influence
of walnut on lipid profile suggests that walnut rich diet may have beneficial
effects beyond changes in plasma lipid level.
J Pak Med Assoc. 2009 Aug;59(8):528-32.
Overweight and Obesity in Students of a Dental College of
Karachi: Lifestyle Influence and Measurement by an
Appropriate Anthropometric Index.
Hingorjo MR, Syed S, Qureshi MA.
Department of Physiology, Fatima Jinnah Dental College, Karachi, Pakistan.
and body fat percentage (%BF), as index of overweight and obesity in young
adults. We also intended to find an association between lifestyle
behaviours and obesity.
METHODS: A cross-sectional study was conducted at Fatima Jinnah Dental
College, Karachi, during 2007 to 2008, with 192 ﬁrst year dental students,
(18-21years) of high socioeconomic class. All were ques oned regarding
lifestyle behaviours. Overweight and obesity were estimated by measuring
%BF, BMI, and WC. For %BF, skinfold thickness was measured using skinfold
calipers. BMI > or = 23.0-24.9 kg/m2 was taken as overweight and > or =
25.0 kg/m2 as obese (Asians criteria proposed by Western Paciﬁc Regional
Office of World Health Organization). WC using Asian cutoff values for
overweight and obesity were: males > or = 78 cm and > or = 90 cm; females
> or = 72 cm and > or = 80 cm, respec vely. Body fat percentage used to
deﬁne overweight and obesity was: males 22.1-27.0 and > 27.1; females
27.1-32.0 and > 32.1, respectively. Pearson's correlation was done between
the BMI, WC and %BF with sta s cal signiﬁcance taken at P < 0.01.
+/- 3.88 and 20.98 +/- 4.12 respec vely. WC was 83.63 +/- 10.20 cm in
males and 70.22 +/- 9.36 cm in females. %BF was 22.32 +/- 6.27 in males
and 28.73 +/- 6.65 in females, with an overall 60.8% females and 44.4%
males found to be overweight or obese. Obesity was underpredicted by
BMI when compared to skinfold calipers method. The obese were seen to
skip breakfast more o en [odds ra o (OR): 2.39], take frequent snacks (OR:
1.58), watch television more (OR: 1.58), and were physically less ac ve than
their non-obese counterparts.
of obesity. Lack of sleep and skipping of breakfast, are prominent
promoters of obesity, in addition to other lifestyle behaviours.
PLoS One. 2009;4(3):e4816. Epub 2009 Mar 24.
Prevalence of Obesity in School-Going Children of Karachi.
Warraich HJ, Javed F, Faraz-Ul-Haq M, Khawaja FB, Saleem S.
BACKGROUND: Obesity is an emerging problem in Pakistan. The authors
sought to determine prevalence of obesity and malnutrition in school-going
children, from grades 6(th) to 8(th) of diﬀerent schools of Karachi and
assess associations that affect the weight of the children.
METHODOLOGY/PRINCIPAL FINDINGS: A cross sectional study design with
children studying in grades 6(th) to 8(th) grade, in diﬀerent schools of
Karachi. We visited 10 schools of which 4 consented; two subsidized
government schools and two private schools. A questionnaire was
developed in consultation with a qualified nutritionist. Height and weight
were measured on calibrated scales. A modified BMI criterion for Asian
popula ons was used. Data was collected from 284 students. Of our
sample, 52% were found to be underweight whereas 34% of all the children
were normal. Of the popula on, 6% was obese and 8% overweight. Of all
obese children, 70% belonged to the higher socio-economic status (SES)
group, while of the underweight children, 63.3% were in the lower SES.
Amongst obese children in our study, 65% ate meat every day, compared to
33% of normal kids.
children. Our study shows that socio-economic factors are important since
obesity and overweight increase with SES. Higher SES groups should be
targeted for overweight while underweight is a problem of lower SES. Meat
intake and lack of physical activity are some of the other factors that have
been highlighted in our study.
J Ayub Med Coll Abbottabad. 2009 Jul-Sep;21(3):63-5.
Relation of Hypertension with Body Mass Index and Age
in Male and Female Population of Peshawar, Pakistan.
Humayun A, Shah AS, Sultana R.
Department of Physiology, Khyber Medical College, Peshawar, Pakistan.
BACKGROUND: Hypertension, a condition developed as a result of high
blood pressure is strongly correlated with body mass index (BMI). Obesity
was noted to be a single best predictor of hypertension incidence, and was
regarded as a major controllable contributor to hypertension. Overweight
and obesity is conveniently determined from BMI. Present study was
conducted in Khyber Medical College (KMC) Peshawar to investigate the
relation of hypertension with BMI and age. The objective of the present
investigation is to establish a relationship between hypertension and BMI in
male and female population of Peshawar with consideration of age.
A total of 1006 adult male and female volunteers were the subject of
present research and were categorised in terms of their ages. BMI was
determined from weight and height; the subjects were grouped as normal,
overweight and obese. Hypertension was determined from the measure of
RESULTS: The results show a consistence relation between BMI and
hypertension within age groups in both male and females. The figures
exhibited a relation of age with BMI and hypertension in both males and
CONCLUSION: The results showed a higher trend of hypertension with
increasing BMI. In young females it was noted that with a shift from normal
BMI the incidence of hypertension was very high.
J Ayub Med Coll Abbottabad. 2009 Apr-Jun;21(2):141-4.
Relationship of Body Mass Index and Dyslipidemia in
Different Age Groups of Male and Female Population of
Humayun A, Shah AS, Alam S, Hussein H.
Department of Physiology, Khyber Medical College, Peshawar, Pakistan.
BACKGROUND: BMI is linearly related to the total cholesterol, LDL
cholesterol and triglyceride concentrations and is, however, inversely
related with HDL cholesterol, Dyslipidaemia has been recognized to be
strongly associated with overweight and obesity and its comorbid
conditions. Overweight and obesity is conveniently determined from body
mass index (BMI). Present study was conducted in Khyber Medical College,
Peshawar to investigate the importance of age in relation to BMI with
METHODS: The study was conducted in Khyber Medical College Peshawar
during a span of period covering from 2008 to 2009. A total of 500
volunteer male and female subjects were included, which were grouped
according to age. Lipid profile was obtained against BMI of the subjects,
categorized as normal, overweight and obese in different age groups.
dependent. Dyslipidaemia show an increasing trend with age in both male
and female subjects. In females, dyslipidaemia shows a gradual increase
with age for all BMI categories. However, in males, the trend is different. It
has been observed that the percentage of females having dyslipidaemia
was less as compared to males in the age between 20 and 59 years. On the
other hand, dyslipidaemia shows a dramatic increase in females above the
age of 59 years.
CONCLUSION: There is increase in dyslipidaemia trend in our subjects with
increase in BMI and age.
J Pak Med Assoc. 2009 Jan;59(1):35-8.
Prevalence of Overweight and Obesity among Children
and Adolescents of Affluent Schools in Karachi.
Aziz S, Noorulain W, Zaidi UE, Hossain K, Siddiqui IA.
Sarwar Zuberi Liver Centre, Medical Unit 5, Civil Hospital Karachi, Dow
University of Health Sciences, Karachi, Pakistan.
OBJECTIVE: To estimate the prevalence of overweight and obesity among
children and adolescents of affluent schools of Karachi.
METHOD: This descriptive study is part of an ongoing nationwide project
funded by Higher Education Commission (HEC) Pakistan, to develop growth
centile charts of our children. This survey of three affluent schools of
Karachi was done over a period of three months (from Sept to end Nov,
2007) including 398 children. Socio-economic group was decided based on
monthly income and items such as computer, fridge, television, car etc.
Students from Class 1-10 represen ng age group 6 to 17 years were
included; children were divided into groups A, B, and C representing age of
6-9, 10-13, and 14-17 years respec vely. The children included were
healthy with no history of chronic infection and immunization up-to-date as
per the Expanded Program of Immunization (EPI) schedule of the country.
Body weight was measured in minimum clothing to the nearest 0.1 kg using
a weight scale with calibra on done a er every 25 readings. Body height
was measured in the erect posi on without shoes to the nearest 0.1 cm
using wall mounted stadiometers. A twenty four hour diet chart was
obtained using specially designed questionnaires. The reference definitions
used were those given by the Center for Disease Control (CDC) according to
which children having their BMI plo ed above 95th cen le are obese and
BMI between 85th-95th cen les were "at risk for overweight."
Out of these 398, 24 (6%) were above the 95th cen le (obese) while 77
(19.35%) were between 85th-95th cen les on NCHS charts (at risk for
overweight). The children in group A (6-9 years) showed daily caloric intake
of 2220+/-816 kcal/day, group B showed caloric intake of 2133+/-942
kcal/day and group C a caloric intake of 1976+/-873 kcal/day. Apart from
the overall data, children above 95th cen le and between 85th to 95th
cen le showed a daily caloric intake of 1861+/-849 and 2056+/-895 kcal per
day, respec vely. Approximately 85% of the students when asked about
their daily schedule were leading a predominantly sedentary life style, due
to tuitions, television viewing or internet surfing or indoor games like play
stations (not requiring physical activity).
CONCLUSION: Even with our small sample size the percentage of obese
and overweight children were 6% and 19% of the population studied. This
study suggests that overweight and obesity among these children maybe
due to their sedentary lifestyle and/or lack of intake of proper food
(imbalance in the intake of daily calories, carbohydrate, fat and protein).
Journal of Environmental and Public Health, 2009:5pages
Eﬀect of Physical Ac vity and Obesity on Type 2 Diabetes
in a Middle-Aged Population
Rashid M. Ansari
School of Population Health, University of Queensland, Herston, QLD 4006,
Academic Editor: Ike S. Okosun
of type 2 diabetes. The aim of this study was to examine the eﬀect of
physical activities such as occupational, household and daily lifestyle
ac vi es and obesity on the prevalence of type 2 diabetes in middle-aged
study from the large sample of population-based cross-sectional data
collected in the 1990–1994 by Na onal Health Survey of Pakistan. The
participants completed in-person interviews at baseline; the overall
response rate was 92.6%. The Cox propor onal hazards model was used to
es mate the risk of developing the type 2 diabetes.
Results: Stair climbing was found to be inversely associated with the risk of
diabetes and cycling was also associated with a reduced risk of type 2
diabetes (RR=0.82; 95% CI 0.68–1.00, P=.048). The rela onship between
physical activity and reduced risk of diabetes adjusted for age and body
mass index was sta s cally signiﬁcant only in women (P<.01).
leisure- me exercise or daily ac vity reduces the risk of type 2 diabetes in a
Gomal Journal of Medical Sciences, 2008;6(2).
Study of Obese Persons Profile At D.I. Khan, Nwfp,
Mohammad Hussain Khan, Habibullah Khan, Ghulam Sarwar, Bushra
public health problem. Rates of obesity are rising alarmingly in many parts
of the world. The purpose of this study was to examine different factors as
risk factors for obesity.
MATERIAL & METHODS: This cross-sectional study was conducted at DHQ
Teaching hospital, D.I.Khan, in July 2006. Obese persons a ending the
hospital were chosen using standard definition of obesity based on body
mass index. 330 obese persons were interviewed with a structured
questionnaire. The information was analyzed by descriptive statistical
RESULTS: The age range was 35-45. Female gender was predominant 221
(67%). 257 (68%) belonged to urban community. 60% admi ed that they
had family tendency for obesity. 108 (33%) obese people used to take oil-
rich foods while 66 (20%) were fond of sweets. 33 (10%) were using high-
ﬁber diet in abundance. 82 (25%) were addicted to carbonated beverages.
Food intake frequency was more than three mes in 99 (30%) cases. 112
(34%) had habit of ea ng in between meals.6 ( 2%) used to enjoy fast food.
257 (78%) told that there was no exer on in daily life. 49 (15%) were doing
exercise to reduce their weight but regularity of exercise was only in 33
(10%). 108 (33%) were spending more than 4 hours daily in watching
television. Income status was high in 66 (20%) as more than 30,000 rupees
per month. 16 (5%) had a stress full life. 5 pa ents were using an -
psychiatric medications on prescription.
J Ayub Med Coll Abbottabad. 2008 Oct-Dec;20(4):119-21.
Body Mass Status of School Children of Dera Ismail Khan,
Ramzan M, Ali I, Khan AS.
Department of Chemistry, Gomal University, Dera Ismail Khan, Pakistan.
BACKGROUND: Childhood obesity is a global epidemic involving both
developed and developing countries. It is a stare of over-nutrition with
long-term complications such as dyslipidemia, hypertension, and coronary
artery disease and type-2 diabetes. Underweight is the result of under
nutrition leading to reduction in growth and development of every body
organ especially the Central Nervous System. Long-term under-nutrition
causes failure in linear growth (height) of the child. Growth is further
retarded by the repeated attacks of respiratory infections, diarrhea and
anemia as a result of reduced immunity.
Khan (Private, semi government organizations, and welfare foundations)
having mixed population with some of the wards belonging to high
socioeconomic group. Thorough clinical examination excluded those
suffering from chronic heath problems. Height and weight of each one was
taken body mass index of determined according to 'Quatelet's' index. Body
mass index number was plotted on the CDC S age and gender specific
growth charts 2-20 years for BMI-for age percentile and body mass status
(underweight, normal weight, overweight/at the risk of overweight and
RESULTS: Total 1338 school going children (6-11 years) were examined
with 865 (67.75%) boys and 471 (35.25%) as girls. 13.39%, 72.15%, 8.83%
and 5.61% as underweight, normal weight, overweight and obese
respec vely. Percentage of underweight was higher in girls (25%) than boys
(13.22). Percentage of obesity was higher (5.17%) in boys than girls (1.39%).
education and socioeconomic conditions, easy access to health facilities
and prevention of the gender discrimination, are the remedial measures to
be taken to redress the situation.
Pak J Pharm Sci. 2008 Oct;21(4):327-32.
Desensi za on of Pre and Post Synap c 5-HT-1A Receptor
Responses Following Long Term Consumption of Sugar
Rich Diet: Implications for Sugar-Induced Obesity.
Jabeen B, Haleem DJ.
Neuropharmacology Research Unit,University of Karachi, Karachi 75270,
Pakistan. bushra email@example.com
The present study concerns the eﬀec veness of a selec ve 5-
propylamino) tetralin (8-OH-DPAT) in long term sugar diet treated rats.
Male albino wistar rats were divided into control and test groups. Test
animals were given sugar (5 g/10 ml water) orally for three weeks. Food
intakes and body weight of all rats were measured weekly. After three
weeks control and test animals were further divided into two groups i.e.
saline injected and drug injected. 8-OH-DPAT at a dose of 0.25mg/Kg was
injected to a group of normal diet treated and another group of sugar diet
treated rats. Other two groups were injected with saline. 5-HT syndrome
and food intakes at 2h and 4h were monitored. Then animals were
decapitated to collect brain samples for the es ma on of 5-HT and 5-
hydroxyindole ace c acid (5-HIAA) levels by HPLC-EC method. We observed
that weekly cumulative food intakes increased and body weights decreased
in sugar diet treated rats. 8-OH-DPAT produced hyperactivity syndrome in
both control and sugar treated rats. But these values were smaller in sugar
diet than normal diet treated rats. Hyperphagic eﬀects of 8-OH-DPAT were
greater in normal diet than sugar diet treated rats. 5-HT and 5-HIAA levels
were not altered. The results suggesting a desensitization of pre as well as
postsynap c 5-HT-1A receptors in rats treated with sugar diet are discussed
in the context of a role of sugar diet in the precipitation of obesity and
other neuropsychiatric illnesses.
Metab Syndr Relat Disord. 2008 Sep;6(3):171-5.
Prevalence of Metabolic Syndrome in Pakistan.
Basit A, Shera AS.
Baqai Medical University, Baqai Institute of Diabetology and Endocrinology,
Karachi, Pakistan. firstname.lastname@example.org
Over the past two decades, there has been a striking increase in the
number of people with metabolic syndrome. The prevalence of metabolic
syndrome varies due to lack of an internationally agreed upon definition.
Considering the increased cardiovascular risk among Asian people, a lower
cutoff for waist circumference is defined. Obesity in terms of waist
circumference is found to be 46-68% of the Pakistani popula on, with a
strong association found between arm fat and insulin insensitivity. In
studying dyslipidemia, hypertriglyceridemia is found in 27-54% of the
popula on, whereas 68-81% have low levels of high-density lipoprotein
(HDL). Fifty percent were found to be at high risk of metabolic syndrome
and as being hypertensive. With the high prevalence of all of these
metabolic risk factors, the prevalence of metabolic syndrome in Pakistan
according to different deﬁni ons is reported to be from 18% to 46%,
comparable to the data from other South Asian countries. Thus, metabolic
syndrome should be considered as a prime target for preventive medicine.
The primary management goals for metabolic syndrome are to reduce the
risks of cardiovascular disease and diabetes. Lifestyle-related risk factors
are associated with the metabolic syndrome and diabetes. Unless
preventive programs are properly designed and implemented, we will
continue to treat the majority of the cases after they have already
developed the complications. A prospective primary prevention study is
underway in Pakistan that will help to create a base for public awareness
strategies and nationwide surveillance and prevention programs against
Diabetes Res Clin Pract. 2008 Jun;80(3):399-404. Epub 2008 Mar 4.
Metabolic Risk Factors, Insulin-Resistance and Lifestyle In
Children of Type 2 Diabetes Patients in Karachi, Pakistan.
Sheikh Rashid A, Jabbar A, Michels RP, DeVries JH.
Department of Internal Medicine, Academic Medical Center, Amsterdam,
The Netherlands. email@example.com
AIMS: To assess metabolic risk factors, insulin-resistance and lifestyle in
children aged 8-20 years of patients with type 2 diabetes and to compare
these with children aged 8-20 years of non-diabetic subjects.
37children/adolescents of type 2 diabetes patients and 37 controls from
parents without diabetes. Variables included physical activity, diet,
socioeconomic class, family history, ethnic background, anthropometric
measures, blood pressure and fasting glucose and insulin.
between cases and controls were found for BMI (22.6 vs. 19.1kg/m(2),
p=0.004), waist circumference (70.1 vs. 62.1cm, p=0.014), systolic blood
pressure (104.5+/-15.1 vs. 97.9+/-13.4mmHg, p=0.05), diastolic blood
pressure (66.2+/-10.9 vs. 60.7+/-10.1mmHg, p=0.025). Vegetable intake
(3% of cases having two and 19% one full serving a day vs., respec vely,
14% and 32% amongst controls, p=0.01) was less favourable in cases, and
physical ac vity tended to be (5h vs. 9h/week, p=0.065).
CONCLUSIONS: Children of type 2 diabetes patients have higher BMI and
blood pressure than controls but also lead a less healthy lifestyle. This
suggests that both genetic and lifestyle factors contribute to the increased
risk of metabolic syndrome in children and early preventive measures
towards changing lifestyle could help in prevention.
Saudi J Gastroenterol. 2008 Apr;14(2):53-7.
Symptoms with Body Mass Index.
Zafar S, Haque IU, Tayyab GU, Rehman AU, Rehman AU, Chaudhry NU.
Department of Gastroenterology and Hepatology, Lahore Medical and
Dental College, Lahore, Pakistan. firstname.lastname@example.org
BACKGROUND/AIM: To find a correlation between symptoms of
gastroesophageal reflux disease (GERD) and body mass index (BMI).
MATERIALS AND METHODS: A total of 603 pa ents who presented at
Ghurki Trust Teaching Hospital and Surgimed Hospital Lahore with
symptoms of GERD, were included and interviewed according to a validated
GERD questionnaire. It included questions regarding GERD symptoms and
their severity/frequency. Symptoms were defined: "frequent" if occurred
daily; "occasional," if weekly; and "severe," if they were sufficiently intense
to change lifestyle. Height and weight were also recorded and their BMI
calculated. We used logistic regression analysis was performed to assess
the association between the presence of each specific GI symptom and
BMI. The odds ra os (OR) for a given speciﬁc symptom and 95% conﬁdence
intervals (CI) were computed from the coefficients in logistic regression
RESULTS: The prevalence of obesity was 25.3%, while 38.1% were
overweight. There was an increase in reporting of GI symptoms in obese
individuals compared to those with normal BMI who were taken as
reference group. Frequent nausea, vomiting, early satiety, epigastric pain,
heart burn, regurgitation, postprandial fullness, and dysphagia were
present in 10.4, 5.6, 8.9, 17.2, 10.2, 22.1, 23.5, and 21.7%, respec vely, of
obese subjects compared to 7.9, 1.2, 6.5, 3.5, 4.4, 11.4, 17.1, and 16.6% of
normal BMI subjects. BMI showed a positive relationship with frequent
vomi ng (P = 0.02), epigastric pain (P = 0.03), regurgita on of food (P =
0.02), heart burn (P = 0.002), and postprandial fullness (0.01).
CONCLUSION: The majority of GERD symptoms have a greater likelihood of
occurring with increasing BMI.
Diabetes and Metabolic Syndrome: Clinical Research and Reviews, February
High Prevalence of Obesity, Dyslipidemia and Metabolic
Syndrome in a Rural Area in Pakistan
Naeem Zahid, Bjørgulf Claussen, Akhtar Hussain
Department of General Practice and Community Medicine, University of
dyslipidemia amongst subjects in a rural area of Pakistan.
METHODS: One thousand six hundred and fifty-eight rural individuals aged
20 years and above were randomly included in the study. Lipid proﬁle,
fasting plasma glucose (FPG), BMI, WHR, and body fat percentage (BF%)
were recorded. The prevalence of metabolic syndrome was calculated.
RESULTS: High prevalence of obesity, dyslipidemia and metabolic syndrome
were recorded. They were all more common in women than men.
CONCLUSIONS: Obesity, dyslipidemia and metabolic syndrome are
common. Preventive measures should be applied to reduce the prevalence
of these potential cardiovascular risk factors.
Gynecol Obstet Invest. 2008;65(4):269-74. Epub 2008 Jan 15.
Infertility and Polycystic Ovarian Syndrome: A Study of
Association between Body Mass Index and Intrafamily
Haq F, Rizvi J.
Department of Obstetrics and Gynecology, Aga Khan University Hospital,
BACKGROUND: Polycystic ovarian syndrome (PCOS) is a common
endocrine disorder which causes anovulatory infertility. Obesity is one of
the factors which directly modifies the clinical, biochemical and metabolic
expression of this syndrome. Recently a genetic association of PCOS with
intrafamily marriages has been postulated. This study investigates the
association of environmental factors such as BMI and intrafamily marriages
with the clinical, biochemical and hormonal features of this syndrome.
OBJECTIVE: To determine the relationship of different clinical, biochemical
parameters and hormonal assay with the BMI of women who are known to
have PCOS, and to compare these demographic features with intrafamily
MATERIAL AND METHODS: From January 2005 un l December 2006,
patients attending the infertility clinic at Aga Khan University Hospital,
Karachi, were evaluated for their clinical features. Couples were divided
into 2 groups: group A had a history of ﬁrst-degree intrafamily marriages,
and group B had none. Complete biochemical evaluation was performed by
day-2 serum FSH, LH, prolac n, testosterone and fas ng serum insulin
levels. The results were recorded on a data collection form. Ultrasonic
evaluation was performed with transvaginal ultrasound to check the
morphological appearance of the ovaries. A modified glucose tolerance test
with 75 g glucose was performed and the results were recorded as normal,
impaired and abnormal. Insulin resistance was calculated using the HOMA
RESULTS: During this period 203 pa ents were evaluated for demographic
and biochemical features of PCOS. The prevalence of obesity was 70% with
59.3% women found to have hyperinsulinemia while 52.3% of pa ents had
insulin resistance according to the HOMA index method. Univariate and
multivariate analyses were used to compare the 2 groups. A linear
relationship between oligomenorrhea, family history of diabetes, tonic LH,
high fasting serum insulin levels, insulin resistance and an abnormal glucose
tolerance test was revealed, keeping intrafamily marriage and BMI as
dependent variables. In this popula on 48% of couples were in ﬁrst-degree
intrafamily marriages, suggesting the possibility of a high genetic
predisposition for abnormal metabolic features beside ethnic
CONCLUSION: A linear relationship of high BMI and family marriages has
been seen with insulin resistance, oligomenorrhea and impaired glycemic
control. The number of obese women and the high rate of intrafamily
marriages make our population genetically susceptible to metabolic
J. Med. Sci. (Peshawar, Print), January 2008;6(1):34-42
Assessment of Frequency and the Risk Factors of Obesity
Based on Body Mass Index in 1031 Healthy Adults from
North West Frontier Province of Pakistan
*Noor M, Iman N, Raza U, Zeeshan MF.
*Khyber Teaching Hospital, Peshawar – Pakistan
and developing world. No study has been reported on the frequency of
obesity in North West Frontier Province. In this study we found out the
frequency and the risk factors for obesity based on body mass index (BMI)
in 1031 adults healthy volunteers.
Medical Complex (HMC) and Welfare Clinics in Peshawar City, from
November 2005 ll April 2006 (6 months). A convenient sample of 1031
healthy volunteers accompanying their patient to the Out Patient
Department (OPD), Wards at HMC and at the welfare clinics in the city were
recruited. A structured interview questionnaire was administered to all
participants and their anthropometric measurements taken in a
RESULTS: The mean BMI for the whole sample was 26.9 ± 7.3. The mean
BMI was 31.1 ± 10.4 and 25.4 ± 5.2 in females and males respec vely. The
combined frequency of overweight and obese was 65.8% and 84.6% in
males and females respec vely (p<0.001). Increasing age (p<0.001) in both
sexes, being married (p<0.001) and ownership/use of motorized vehicles
(p<0.001) were posi vely associated with increase in BMI. 77.3% of the
graduates and 73.2% of illiterates were obese or overweight (p<0.001).
99.2% of the housewives and 69.7% of jobless people were obese or
overweight (p<0.001). A sta s cally signiﬁcant associa on of BMI with
awareness was seen among Pakistanis (p=0.002). High Blood pressure was
posi vely associated with higher BMI value (p<0.001).
particularly among females as compared to males and there is positive
association of obesity with occupation, educational status, presence of
vehicles at home, ethnicity, and married marital status. There is no
association of obesity with smoking in our study.
BMJ. 2007 Oct 13;335(7623):762. Epub 2007 Oct 8.
Preventing Childhood Obesity: Two Year Follow-Up
Results from the Christchurch Obesity Prevention
Programme in Schools (Chopps).
James J, Thomas P, Kerr D.
Bournemouth Diabetes and Endocrine Centre, Royal Bournemouth
Hospital, Bournemouth, BH7 7DW. email@example.com
OBJECTIVE: To assess the long term effects of an obesity prevention
programme in schools.
DESIGN: Longitudinal results after a cluster randomised controlled trial.
SETTING: Schools in southwest England.
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