Objectives: To study the environmental and host-related factors predisposing to tuberculosis (TB) in Karachi. Methods: This was a descriptive cross-sectional study, which was conducted at two tertiary care government hospitals. The duration of the study was from September 2009 to February 2010. A total of 250 sputum smear-positive TB patients were included in the study. A questionnaire containing information on age, sex, education and occupation was completed by two separate investigators from each setting. Recall information was elicited about the presence of co-morbidities, any form of addiction or immunosuppression, BCG vaccination and close contact with a tuberculosis patient. Results: Questionnaires were completed for 250 sputum smear-positive pulmonary TB patients. The mean duration of positive sputum TB was 5.39 (SD+4.76) months. 54% patients were male. Diabetes had the maximum prevalence,with approximately 25% patients reporting to have diabetes. Most common addiction was smoking (48%), and 10% of the smokers belonged to the high-risk group (20 or more cigarettes per day). 69.6% patients (N=174) lived in over-crowded houses (=3 persons/room). Conclusions: Multiple environmental and host-related factors are present in the sputum smear-positive cases of Karachi. Thus, an understanding of these risk factors will contribute in the appropriate management of this disease.

Background: The primary objective of the study was to assess the prevalence and degree of malnutrition in District Sialkot, Pakistan. The secondary objective was to assess the frequency of the risk factors associated with malnutrition. Methods: A community-based cross-sectional questionnaire-based study was conducted in different areas of District Sialkot, from January 2003 to June 2003. Children of ages 0 to 60 months were included in the study. Frequencies and percentages were calculated. Results: We found that 771 (53.8%) children were suffering from malnutrition while 662 (46.2%) were normally nourished. Among the malnourished children, 243 (31.5%) were in the first degree, 265 (34.4%) were in the second degree, and 264 (34.1%) were in the third degree malnutrition. Mothers of 416 (29%) children and fathers of 281 (19.6%) children had no formal education. Fathers of 1222 (85.2%) children earned less than Rs.8000/month. Mothers of only 207 (14.5%) children exclusively breast fed their children for six months; and only 450 (31.4%) of the children belonged to a small family size (n = 4). Conclusion: Every second child under the age of five years was malnourished in Sialkot, Pakistan. Illiteracy, large family size, lack of breast feeding, and poverty were the main factors responsible for malnutrition in children of District Sialkot.

Background: Little attention has been given to the relationship of electronic gaming with energy expenditure and cardiovascular responses in young adults. To investigate the effect of electronic gaming on heart rate in adolescents, a cross-sectional study was conducted at the Aga Khan University, Karachi. Methods: Thirty male participants between the ages of 17 to 25 years were recruited for the study. A basal heart rate (HR0) was recorded. They were then asked to play the first race of Burnout Paradise developed by Criterion games on a Microsoft Xbox 360 Premium. All participants played the same course at same difficulty using a standard wireless Xbox 360 controller. Heart rate was recorded after sixty seconds (HR1), one hundred five seconds (HR2) and one hundred fifty seconds (HR3). After resting for five minutes, subjects were put on bicycle ergometry to a moderate speed (5km/hour) for three minutes, thereafter another heart rate (HR4) was recorded. Results: Heart rate increased significantly after playing for 150 seconds (HR3) compared to basal heart rate (HR0); ( 86.60 ± 16.04 /min vs 81.80 ± 15.15 /min; p=0.01). Furthermore, the direction of change was similar to what was observed between HR4 and HR0 (87.60 ± 16.79 /min vs 81.80 ± 15.15 /min; p=0.001). Conclusion: Playing electronic games for one hundred fifty seconds exerts similar effect on heart rate as observed after three minutes of bicycle ergometry. The increase in heart rate observed with electronic gaming raises the question on the implications of increased heart rate in the absence of physical activity. Further work in a larger sample size may elaborate this relationship.