Paper Type	::	Research Paper
Title	::	Effect of Fluorosis On Serum Total Protein Level In A Fluoride Endemic Zone: A Cross-Sectional Observational study
Country	::	India
Authors	::	Suman Chatterjee ||, Prasanta Sinha Mahapatra ||, Pinaki Sarkar
Page No.	::	01-04

Fluorosis is a major public health problem in India now a days as most of the population is dependent on ground water. This cross-sectional observational study has been performed in the fluoride endemic zones of Bankura district of West Bengal to evaluate the effect of fluorosis on serum total protein level. This study was carried out in the Hirbandh block of Bankura, on 80 subjects by using simple random sampling among which 42 were cases. The serum samples were collected from the cases and the serum fluoride was estimated by Ion-Meter and serum total protein level was determined by auto-analyzer and were compared with age and sex matched controls. The serum fluoride was found to have a statistically insignificant relationship with serum total protein in the study group. The serum level of fluoride was higher in study group but the total protein level was lower than those of comparison group. Keywords: serum fluoride, total protein.

[1]. IS: 10500 "Indian Standard Code for Drinking Water" BIS INDIA.
[2]. WHO Guidelines for Drinking Water Equality, World Health Organization,Geneva
[3]. RGNDWM. Prevention & Control of fluorosis in India. Water Quality and Defluoridation Techniques, Volume II, Published by Rajib Gandhi National Drinking Water Mission, Ministry of Rural Development, New Delhi, 1993.
[4]. Andezath SK, et.al. Fluorosis management in India: the impact due to networking between health and rural drinking water supply agencies. JAHS-AISH Publications.2000;260:159-65.
[5]. Guidelines for drinking water quality.Geneva: Who; 2004 world Health Organizationhttps://www.novapublishers.com/catalog/product info.php?products id=15895.

Paper Type	::	Research Paper
Title	::	Orphan diseases, orphan drugs and orphan regulation in USA and EU
Country	::	Macedonia
Authors	::	Zoran Nakov ||, Jasmina Tonic-Ribarska ||, SuzanaTrajkovic Jolevska
Page No.	::	05-10

No single definition for an orphan diseases exists worldwide, but it is generally a disease that affects a small portion of the world population. Despitethe development of science and pharmaceutical technology, the number of rare diseases for which no treatment is available is estimated between 4.000 and 5.000 worldwide. Theanalysis of the finances that are required for research, development and manufacturing of orphan drugssuggest that these drugs are perhaps the most expensive drugs produced by the pharmaceutical industry. The main objective of orphan regulations is to encourage pharmaceutical companies to begin the process of researching and developing of new drugs intended for treatment of orphan diseases. The first legal framework for defining the rules for the marketing authorization of the orphan drugs waspresented by the Food and Drug Administration (FDA) in the 1983.In EuropeanUnion, the regulation fororphan drugs was introducedby the EuropeanMedicinesAgency (EMA) in1999.The FDA orphan drugs regulation is based on three laws, while the EUlegislation is covered by six regulations and two additionalguidelines.The detailed overview of the FDA and EMA orphan drugs regulatory requirements showed that both regulatory authorities provideshortened registration procedure, allow exception from payment of certain fees, provide protocol assistance and stimulate processes of a parallel application for orphan designation. The differencescould be seen in the period of market exclusivity, taxincentives and source of the grants.

[1] EURORDISRare Diseases Europe,Available from: www. eurordis.org(accessed 12 August 2016).
[2] National Academy of Sciences, Institute of Medicine, Profile of rare diseases in Field MJ and Boat MF (Ed.),Rare diseases and orphan products:accelerating research and development, (Washington (DC):The Academy, 2013) 42. Available from: http://books.nap.edu/openbook.php?record_id=12953&page=42.
[3] European Medicines Agency. Medicines for rare diseases, 2013. Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages/special_topics/

general/general_content_000034.jsp&mid=WC0b01ac058002d4eb.
[4] National Academy of Sciences, Institute of Medicine, Profile of rare diseases in Field MJ and Boat MF (Ed.),Rare diseases and orphan products: accelerating research and development, (Washington (DC):The Academy, 2013)16.Available from: http://books.nap.edu/openbook.php?record_id=12953&page=16.
[5] E.Taymor and P.Kanavos,A Comparative Analysis of the Regulatory Requirements of Orphan Medicinal Products in the United States and European Union(London,LSE Healt, 2015).

Paper Type	::	Research Paper
Title	::	Study of phytoplankton in the lake reservoir EL Kansera (Khémisset- Morocco)
Country	::	Moroccoo
Authors	::	Mounia HTITI ||, Mohamed FEKHAOUI ||, Abdelkbir BELLAOUCHOU
Page No.	::	11-18

This study focuses on a deep aquatic ecosystem, the lake dam EL Kansera which is taken a lot of water for irrigation and drinking water supply (AEP) and two cities Kemisset Tiflet. It aims to study the evolution of the phytoplankton community to understand the eutrophication in this Moroccan lake ecosystem. Phytoplankton was followed for two consecutive years 2008 and 2009 marked by climatic variations. During the first year of study, the algal peak is in autumn-winter (110,214mg / l in September) and is dominated by biomass Closterium aciculare Var.Subpronum. Chlorophyll has reached a maximum of 9 mg / l. The following year the algal population is more diverse, following environmental enrichment in nutrients: diatoms (Cyclotella sp and Melosira granulata). Environmental variables (climate, water physical chemistry and exogenous inputs Wadi Beht particular) seem to govern nearly phytoplankton succession in the reservoir El Kansera. Depending on the model of O.C.D.E (1982), the restraint moves from one stage hypereutrophic in 2008 to a eutrophic stage in 2009

[1] N'diaye A.D., Mint Mohamed Salem K., El Kory M.B, Ould Kankou M.O.S.A, Baudu M., J.Mater.Environ. Sci., 5(1) (2014) 320-329. [2] Ben moussa A,Chahlaoui A, Rour E, Chahboune M,J.Mater.Environ.Sci 5(1) (2014) 183-198. [3] Le Cohu, R., Comoy, N., Guitard, J. & Brabet, J. Résumés des communications du 10ème colloque ADLAF, Ile des Embiez. (1990). [4] Derraz, M. (1995). Thèse d'Etat es-sciences à la Faculté de Meknès : 120 pp. [5] Fqih Berrada, D., Berrada, R., Benzekri, M.A. & Jabry, E. (1998). Acte au séminaire «Environnement, Etudes d'impact et développement humain durable», Settat (Maroc).

Paper Type	::	Research Paper
Title	::	Determining the effect of surfactant instillation time in the prognosis of RDS
Country	::	Iran
Authors	::	MinooFallahi ||, Samira Borhani ||, MitraRadfar ||, FahimehAbbasi
Page No.	::	19-23

RDS is the most common cause of respiratory problems of preterm infants in NICU and surfactant is its treatment, there is strong recommendation for early use of this drug for more effectiveness .The goal of this study is assessment the effects ofsurfactant instillation time in the prognosis of RDS Material and method: 96 neonates with RDS according to the age of treatment with surfactant were divided in three groups: early (≤6h), late (6-48 h) and very late (≥48 h). The mortality, pneumothorax, pulmonary hemorrhage, IVH, duration of mechanical ventilation and duration of hospital stay were compared. Result: 67.7% neonates were males. Means of gestational age and birth weight was 31.8±3 weeks and 1900±630gm respectively, 41.6% of neonates were in early group, 55.2%in late group and 3.1%| in very late group .The earliest time for instillation of surfactant was first hour and the latest time was 96th hour .The rate of pulmonary hemorrhage, pneumothorax & mortality in early group was more than late & very late groups., but there wasn't any differences in IVH and mean durationof mechanical ventilation and hospital stay. Conclusion: Although there is evidence that earlier instillation of surfactant has better prognosis in neonates,but in this study prognosis of patients with late and very late treatment was good and this means that delayed utilization of this treatment is useful too.

Keyword:- neonates,RDS, respiratory distress syndrome, surfactant, preterm

[1] Beena D. Kamath, MD, MPH,a Emily R. MacGuire, MSW, MPH,b Elizabeth M. McClure, MEd,b Robert L. Goldenberg, MD,c and Alan H. Jobe, MD, PhDa Neonatal Mortality From Respiratory Distress Syndrome: Lessons for Low-Resource Countries. Pediatrics 2011;127:1139–1146 [2] Richard A. Polin, Waldemar A. Carlo, COMMITTEE ON FETUS AND NEWBORNSurfactant Replacement Therapy for Preterm and Term Neonates with Respiratory Distress. Pediatrics 2014;133:156–163
[3] SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network,Early CPAP versus Surfactant in Extremely Preterm Infants *N Engl J Med 2010; 362:1970-9.
[4] A Fujii1, R Allen, G Doros and S O'Brien Patent ductus arteriosus hemodynamics in very prematureinfants treated with poractantalfa or beractant for respiratory distress syndrome ,Journal of Perinatology (2010) 30, 671–676
[5] Emmanuel Lopez, GéraldineGascoin, Cyril Flamant, Mona Merhi4 , Pierre Tourneux , and Olivier Baudfor the French Young Neonatologist Club.Exogenous surfactant therapy in 2013: what is next? Who, when and how should we treat newborn infants in the future? Lopez et al. BMC Pediatrics 2013, 13:165

Paper Type	::	Research Paper
Title	::	Pregnant women knowledge of nutritional iron deficiency anemia in Al-Baha area
Country	::	Saudi Arabia
Authors	::	M Othman ||, A Alghamdi ||, M Alghamdi ||, W Alkhuraimi ||, A Alshihri ||, AI Alghamdi
Page No.	::	24-29

Iron deficiency (ID) is the leading single nutrient deficiency in the world. Maternal IDA has been linked to higher risk of low birth weight, preterm delivery and infant IDA, which in turn can permanently impair intelligence, motor and behavioral development, and increase risk of future IDA in the offspring. During pregnancy, the maternal body requirement for iron increases to approximately 1000 mg on average. The aims of this study are to determine how is the knowledge of participants toward the risk of iron-deficiency anemia. And the effect of education and occupation in total knowledge of participants.This study was done in 5 Primary healthcare centers (PHCs) in Al-Baha area over two weeks from 24th April to 6th of May 2016. 66 pregnant patients were recruited and participated. Participants were from all parts of the community. This study exposed a defect in the health policy and defect in the education of women in the area. Iron supplementation for pregnant women should be individualized according to their iron status. Appropriate diet education is needed for pregnant women so that they can consume adequate amounts of iron from food and supplements. Keywords:Iron deficiency anemia, Nutrition, AlBaha, Primary healthcare center, Iron supplementation, Diet education

[1] AlAteeq M, AlRusaiess A. Health education during antenatal care: the need for more. International Journal of Womens Health. 2015;7:239–42.
[2] Allen L. Anemia and iron deficiency: effects on pregnancy outcome. American Journal of Clinical Nutrition. 2000;71(suppl 1):1280S-4S.
[3] Alwan N, Hamamy H. Maternal Iron Status in Pregnancy and Long-Term Health Outcomes in the Offspring. Journal of pediatric genetics. 2015;4(2):111-23.
[4] Taha A, Azhar S, Lone T, Murtaza G, Khan S, Mumtaz A, et al. Iron deficiency anaemia in reproductive age women attending obstetrics and gynecology outpatient of university health centre in al-ahsa, saudi arabia. African Journal of Traditional Complementary Alternative Medicine. 2014;11(2):339-42.
[5] Lumish R, Young S, Lee S, Cooper E, Pressman E, Guillet R, et al. Gestational Iron Deficiency Is Associated with Pica Behaviors in Adolescents. Journal of Nutrition. 2014;144:1533-9.

Paper Type	::	Research Paper
Title	::	Design, Fabrication and Characterization of Thrombolytic Activity of Bauhinia Racemosa Extract Loaded Nanoemulsion
Country	::	India
Authors	::	Shruti Ramesh Timane ||, Akelesh.T ||, Manavalan. R ||, Venkatanarayanan. R
Page No.	::	30-35

Background: Thrombosis is the formation of an unwanted clot within a blood vessel or heart. It is the most common abnormality of hemostasis, but it can turn to larger complication causing disturbance in the normal functioning of many organs. Aim: To evaluate the blood related properties, acute oral toxicity, thrombolytic activity of Bauhinia racemosa, and to convert it into an nanoemulsion formulation. Material and Methods: The leaves of the plant were collected from Sulur region, Coimbatore, India. They were then shade dried and extracted with ethanol. This extract was then subjected to acute oral toxicity for 14 days. The extract was then studied for thrombolytic activity and finally designed into an nanoemulsion using Tween 80, ethanol, cinnamon oil, distilled water in varying ratios of 2:1, 3:1, 4:1. The prepared nanoemulsion was then evaluated for release study, based on the release the optimized formulation was selected and further studies like particle size distribution, zeta potential, particle morphology, stability study were carried out. Results: The acute oral toxicity study showed that the extract was safe upto 2000mg/kg of body weight. The thrombolytic activity was carried out by in-vitro method and gave appreciable results. The extract showed activity close to that of the standard. The other evaluation parameters of nanoemulsion like paricle size, zeta potential, particle morphology study was done only for the optimized batch. The particle size and zeta potential reports were good. The stability study shows satisfactory results. Conclusion: Therefore this study was concluded that the Bauhinia racemosa extract loaded nanoemulsion drug delivery is effective for the treatment of thrombosis.

[1] https://en.wikipedia.org/wili/circulatory system.
[2] https://en.wikipedia.org/wiki/blood cell.
[3] Seth SD. Text book of Phrmacology.2nd edition, reed Elsevier India private limited, NewDelhi. 1999; 285-286.
[4] www.flowers of india.net.
[5] Manjit Jaiwal, Rupesh Dudhe, P.K Sharma. Nanoemulsion : an advanced mode of drug delivary system. National centre for biotechnology information, US National library of medicine. April 2015, 5(2):123-127.

Paper Type	::	Research Paper
Title	::	Major depressive disorder: understanding epigenetic basis for pharmacological care
Country	::	China
Authors	::	Ailing Zhou ||, Song Han ||, Hua Yang ||, and Zhaolan Joe Zhou
Page No.	::	36-41

Major depressive disorder (MDD) is a significant health burden that afflict men and women worldwide. Currently, the treatment options are limited with low efficacy. The underlying cause of MDD is largely unknown, but epidemiology studies have pointed to the influence of adverse life events and stressful experiences. In this review, we analyzed previous studies of MDD in both humans and animal models, and raise a hypothesis that stress-induced epigenetic changes may contribute to the pathogenesis of MDD. We propose that stressful experience triggers long-lasting changes in the epigenome, and thereby leading to enduring changes in gene expression that underlie the etiology of MDD. We next discussed current experimental paradigms to model stress-induced behavioral maladaptation in rodents, highlighted the top candidate epigenetic mark, and underscored the top brain region for future studies. In addition, we recommend the adaptation of recently developed CRISPR technology to modify the epigenome in order to assess the causal relationship between epigenetic changes and pathogenesis of MDD. We believe a better understanding of the underlying cause of stress-related neuropsychiatric disorders, such as MDD, will not only improve early diagnosis and intervention, but also reveal new targets and new directions for novel therapeutic development and pharmacological treatments. Key Words–Major Depressive Disorder, Stress, Epigenetics, DNA methylation, Prefrontal Cortex

[1] Kendler, K. S. et al. Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiatry 152, 833-842, doi:10.1176/ajp.152.6.833 (1995).

[2] Caspi, A., Hariri, A. R., Holmes, A., Uher, R. & Moffitt, T. E. Genetic sensitivity to the environment: the case of the serotonin transporter gene and its implications for studying complex diseases and traits. Am J Psychiatry 167, 509-527, doi:10.1176/appi.ajp.2010.09101452 (2010). [3] Franklin, T. B., Saab, B. J. &Mansuy, I. M. Neural mechanisms of stress resilience and vulnerability. Neuron 75, 747-761, doi:10.1016/j.neuron.2012.08.016 (2012).

[4] Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R. & Walters, E. E. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62, 617-627, doi:10.1001/archpsyc.62.6.617 (2005).

[5] Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T. & Kessler, R. C. The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiatry 76, 155-162, doi:10.4088/JCP.14m09298 (2015).

Paper Type	::	Research Paper
Title	::	Subcuticular versus mattress skin closure techniques following OBGYN laparotomies by low transverse incision.
Country	::	India
Authors	::	Akhila Vasudeva ||, Vidyashree G Poojari ||, Shanthala Rudrappa ||, Jyothi Shetty ||, Pratap Kumar
Page No.	::	42-46

Objective: To compare two widely used skin closure techniques – intermittent mattress and continuous subcuticular suturing, for low transverse laparotomy incisions among obstetrics/gynaecological surgeries including caesarean section, myomectomy, hysterectomy etc. Methodology: Prospective observational study of 336 such incisions; 247 mattress and 87 subcuticular. Mattress group had a higher incidence of obesity and previous abdominal surgeries. Scars were assessed between three to seven postoperative days as well as during their postoperative visit between 4-6 weeks.Results: Incidence of wound site induration/ erythema /discharge /surgical site infection were similar in both the groups. Wound dehiscence and postoperative pain Mean score in Visual analogue score were more in mattress than in subcuticular group. At 4-6 weeks, overall patient satisfaction was higher among subcuticular than among mattress group, however objective scoring by patient observer scar assessment scale was similar between the two groups.Conclusion: Mattress suturing leads to poorer immediate skin approximation, more pain, and poorer patient satisfaction compared to subcuticular suturing. However objective scar assessment at 6 weeks yielded similar results for two groups, despite higher prevalence of obesity and previous abdominal surgeries in the former group. Keywords: laparotomy,low transverse incision,skin closure techniques, subcuticular, intermittent mattress.

[1] LJ Draaijers, FR Tempelman, YA Botman, WE Tuinebreijer, E Middlekoop, RW Kreis, PP Van Zuijlen. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. PlastReconstrSurg 2004 Jun; 113(7): 1960-5. [2] KS Gurusamy, CD Toon, VB Allen , BR Davidson. Continuous versus interrupted skin sutures for non-obstetric surgery. Cochrane Database Syst Rev. 2014 Feb 14(2):CD010365 [3] H Wang , S Hong , H Teng, L Qiao, H Yin . Subcuticular sutures versus staples for skin closure after cesarean delivery: a meta-analysis. J Matern Fetal Neonatal Med. 2016 Jan 20:1-32 [4] D Figueroa , VC Jauk,JM Szychowski,R Garner , JR Biggio, WW Andrews , J Hauth, AT Tita. Surgical staples compared with subcuticular suture for skin closure after cesarean delivery: a randomized controlled trial. Obstet Gynecol. 2013 Jan;121(1):33-8. [5] C Sharma , A Verma, A Soni, M Thusoo, VK Mahajan , S Verma. A randomized controlled trial comparing cosmetic outcome after skin closure with 'staples' or 'subcuticular sutures' in emergency cesarean section. Arch Gynecol Obstet. 2014 Oct;290(4):655-9.

Paper Type	::	Research Paper
Title	::	5 years scar dehiscence; case report and theory of occurrence
Country	::	Saudi Arabia
Authors	::	M Othman ||, A Alzahrani ||, S Alghamdi ||, A Alghamdi
Page No.	::	47-49

Scar dehiscence is defined as incomplete disruption of the uterine wall that does not lead to any serious maternal or neonatal consequences. The cause for a uterine scar dehiscence is based on the etiology behind the uterine scar defect or any event that would predispose the cesarean scar to dehisce.We report here on a patient had cesarean section 5 years ago and came now as 36 weeks with scar dehiscence. But the most remarkable is that, the lower edge of the lower segment of the anterior wall of the uterus was completely retracted under the pubic symphysis with intact both corners and no bleeding from the edges. Uterus was repaired. Here we report of the possible scenario to what happen in this patient. Keywords: Dehiscence, rupture uterus, obstetric emergency, silk stitches, lower uterine segment

[1] Bharatam K. Cesarean section uterine scar dehiscence - A review. Uterus & Ovary. 2015;2:e751.
[2] Dhar R, Misra R. Postpartum UterineWound Dehiscence Leading to Secondary PPH: Unusual Sequelae. Case Reports in Obstetrics and Gynecology. 2012;2012:1-.
[3] Mandade K, Chalasani S, DP B, deshpande S. Silent Scar Dehiscence in Previous Lscs Patients: Six Case Reports Our Experience and Review of Literature. IOSR Journal of Dental and Medical Sciences. 2014;13(1 Ver. IX):44-7.
[4] Lofrumento D, Di-Nardo M, De-Falco M, Di-Lieto A. UTERINE WOUND HEALING: A COMPLEX PROCESS MEDIATED BY PROTEINS AND PEPTIDES. Current Protein and Peptide Science. 2016;17(12):1-12.
[5] Song S, Yoo H, Kang B, Ko Y, Lee K, Lee M. Two pregnancy cases of uterine scar dehiscence after laparoscopic myomectomy. Obstetrics and Gynecology Science. 2015;58(6):518-21.

Paper Type	::	Research Paper
Title	::	In Silico Physico-Chemical Comparative Study of Human And Camel Insulin
Country	::	India
Authors	::	Arora Asha|| Kamlesh Pareek|| And Sonam Shah
Page No.	::	50-53

The Physical, Chemical, Conformational, And Energetic Properties Of Amino Acid Residues In Turn Alter The Physiological Properties Of The Activating Protein Molecules. The Sequence Comparison Of Insulin Chain A And Chain B Of Camelus Dromedaries Was Compared To Homo Sapiens . Although The Sequences Differed Only In Four Amino Acids But Their Physico-Chemical Properties Stretched Apart. Camel Milk Insulin Had Large Mutable Affinity For Alanine Which In Turn Is Responsible For –I. High Thermo-Stability Ii. High Aliphatic Index And Iii. High Hydropathicity. Due To This Altered Behavior Of Insulin Molecule In Camel, It Does Not Forms Coagulum And Is Resistant To Proteolysis During Digestion. In Gut Part This Indigestible Insulin Peptide Enters Circulatory System And Regulates Glycemic Loads In Diabetic Patients.

[1] Yagil R And Van Creveld C. Medicinal Use Of Camel Milk. Fact Or Fancy? In: Proceedings Of The 2nd International Camelid Conference On Agro-Economics Of Camelids. Kazakhstan: Almaty;. September P80.
[2] Shamsia Sm. Nutritional And Therapeutic Properties Of Camel And Human Milks. Int J Genet Mol Biol , 2009;1:052e8.
[3] Shori Ab. Comparative Study Of Chemical Composition, Isolation And Identification Of Micro-Flora In Traditional Fermented Camel Milk Products: Gariss, Suusac, And Shubat. J Saudi Soc Agric Sci 2012;11:79e88.
[4] Pareek K, Shah S And Arora A. Casein Protein: Phylogeny Study Of Important Domestic Animals Using Computational Method . Int.J Of Adv. Res. And Biosciences, 2012a , Vol.2 (3):326-337.

[5] Pareek K, Shah S And Arora A. Phylo-Genetic Comparsion Of Kappa Casein Protein Family. Int.J Of Adv. Res. And Biosciences, 2012b ,Vol.1 (4):465-473.

Paper Type	::	Research Paper
Title	::	200 Kashmiri Patients of osteoarthritis Knee Were Studied And Free Drug Combination Versus Fixed Dose Combination of aceclofenac and Diacerin Were assessed For analgesic Efficacy,Safety and Compliance.
Country	::	India
Authors	::	Dr Jawed Ahmad Bhat
Page No.	::	01-20

.

[1] Aggaral V. Prevalance of Rheumatic diseases in India. JK Science. 2003; 5(2): 48-49.
[2] Alhasmi AM. Knee Osteoarthritis related pain: a narrative review of diagnosis and treatment. International Journal of Health Sciences, Qassim University.2014; 8(1): 86-104.
[3] Amitava M, Yunhui WU. Challenges & oppurtunities in achieving Bioequivalence combination for fixed dose combination products. AAPS J. 2012; 14(3): 646-55.
[4] Andrianakos AA, Kontelis LK, Karamitsos DG, et al.Prevalance of symptomatic knee, hand and hip osteoarthritis in Greece. The ESORDIG study. Journal of Rheumatology. 2006; 33(12): 2507-2514.
[5] Awan MMY, Ahmad I, Aziz A. Efficacy and safety of Aceclofenac in the treatment: A randomized double –blind comparative clinical trial versus Diclofenac. Professional Med J.2014; 21(3): 471-476

Paper Type	::	Research Paper
Title	::	Influence of Circadian Rhythm in Radiation Induced Mucositis in Head and Neck Malignancies
Country	::	India
Authors	::	Dr. Vipin George Kuriakose || Dr. Aravindh Sivanandan Anand|| Dr. Krishnannair Jayakumar|| Dr.Anand Radhakrishnan|| Dr. Suma Susan Meloot
Page No.	::	21-26

BACKGROUND: In India , more than 60 % of the head and neck malignancies present as locally advanced disease. Chemoradiation has been the main stay of treatment for the past three decades. In spite of the multimodality treatment, normal tissue toxicity in the form of mucositis has been a limiting factor. MATERIALS AND METHODS: We investigated the plausible impact of circadian rhythm of normal mucosa to the development and severity of mucositis, based on the timing of radiation delivery in patients receiving radiation treatment in head and neck malignancies. We analysed the data of 142 patients of histologically proven squamous cell carcinoma of the head and neck sites ( stage II to IVA ) , treated from January 2014 who underwent radical external beam radiation therapy (EBRT) to a dose of 60 – 66 Gy in 30 – 33 fractions.. All the patients were treated in a cobalt teletherapy unit , with lateral parallel pair ( 60 -66 Gy/33 # ) and low anterior neck ( 50 Gy /25 #) radiation fields. Stage III and IVA patients with normal renal parameters and good performance status received concurrent weekly Cisplatin 40mg/m2. Patients were stratified based on the whether they received EBRT in the morning (8am-11am) or in the evening (5pm-8pm). The clinicopathological characteristics were relatively well balanced in both the groups. RESULTS: Of the analysed 142 patients , 42.47 % versus 60.9 % developed RTOG Grade 3 or 4 mucositis [severe] after morning versus evening EBRT, respectively (p = 0.028) .The median time to development of severe mucositis was prolonged in the morning group ( 6 weeks vs 5 weeks ).Morning EBRT was also associated with significantly lesser no of patients for whom treatment had to be interrupted due to severe mucositis 17.8 % vs .42.0 % ( p = 0.002 ) . DISCUSSION: The potential of chronomodulation at improving therapeutic efficacy has been highlighted through our study and may be utilized more in the clinical setting.

[1] Joshi P, Dutta S, Chaturvedi P, Nair S. Head and Neck Cancers in Developing Countries. Rambam Maimonides Med J. 2014;5(2):e0009.
[2] Pignon J, Bourhis J, Domenge C, Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta analysis of chemotherapy on head and neck cancer. Cancer/Radiothérapie. 2001;5(2):201-202. [3] Cooper JS, Pajak TF, Forastiere AA, et al: Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350::1937,2004-1944
[4] Brizel DM, Albers ME, Fisher SR, et al: Hyperfractionated rradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med 338:1798-1804, 1998
[5] Calais G, Alfonsi M, Bardet E, et al: Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advancedstage oropharynx carcinoma. J Natl Cancer Inst 91:2081-2086, 1999

Paper Type	::	Research Paper
Title	::	Stability Indicating Analytical Method Development, Validation, Method Transfer and Impurity Profile (Related Substances) Of 2,4-Dihydroxy-5-Fluoropyrimidine By Liquid Chromatography
Country	::	India
Authors	::	S.Imam Pasha|| Dr. Mohd Ibrahim|| Dr. V.Murli Balram
Page No.	::	27-33

Stability indicating liquid chromatographic method was developed for related substances [(Pyrimidine-2,4,6 (1H,3H,5H)-trione ,Dihydropyrimidine-2,4,5(3H)-trione ,Uracil,5-Methoxy Uracil, 5-Chloropyrimidine-2,4(1H,3H)-dione)] of 2,4-dihydroxy-5-fluoro pyrimidine , validation was performed on higher presentation i.e. 5 g/100 mL by using Column dimensions of 250mm, 5μm (YMC Pack ODS AQ) with the Flow rate of 1.0 mL/min at Wavelength of 266 nm by Injecting Volume of 20 μL by maintain Run time of 30 minutes.

[1] Bakshi M, Singh S., Development of validated stability-indicating assay methods-critical review. J Pharma Biomed Anal. 2002; 28:1011–40. [2] ICH, Stability testing of new drug substances and products. Geneva: International Conference on Harmonization, IFPMA; 2003. [3] ICH, Stability testing: Photo stability testing of new drug substances and products .Geneva: International Conference on Harmonization, IFPMA; 1996. [4] Gerber, F.; Krummen, M.; Potgeter, H.; Roth, A.; Siffrin, C.; Spoendlin, C. (2004). "Practical aspects of fast reversed-phase high-performance liquid chromatography using 3μm particle packed columns and monolithic columns" [5] Ettre C. (2001). "Milestones in Chromatography: The Birth of PartitionChromatography" .,LCGC. 19 (5): 506–512. Retrieved 2016-02-2

Paper Type	::	Research Paper
Title	::	"Assisted Reproductive Technology (ART) is a solution for Infertility."
Country	::	India
Authors	::	*Miss. S.Almas Nounihar||**Shaik.Liyakhath Ali
Page No.	::	34-38

Reproduction is a process through which the living beings produce their off springs. But in several people due to various causes infertility occurs. Infertility is often thought of as a female concern, but in fact in a third of cases it is because of male problems, such as a low sperm count. In order to solve the infertility problems in human beings the solution up to some extent through modern medical technology is "Assisted reproductive technology". In this article we shall discuss various medical techniques and advances introduced which CREATE Fertility, Gynecologists and Andrologists perform a variety of treatments which are regarded as ART (Assisted reproductive technology) which includes IUI, IVF, IVM, ICSI and Vitrification. The article also throws light on treatment and several drugs of infertility..

1. www.hfea.gov.uk/common-fertility- drugs.html
2. www.webmd.com/infertility - and reproduction/guide/fertility - drugs
3. www.mayoclinic.org/diseases - conditions/infertility/treatment
4. www.resolve.org/family-building-options/iui
5. www.hfea.gov.uk/iui,html
6. https://medlineplus.gov/ency/article/007279.htm

Paper Type	::	Research Paper
Title	::	Assessment of Lebanese Community Knowledge about Over the Counter Common Cold and Cough Medications
Country	::	Lebanese
Authors	::	Fouad Sakr|| Maha Abi Jaoude|| Mariam Dabbous|| Marwan Akel|| Michelle Cherfan|| Jihan Safwan|| Mohammad Iskandarani
Page No.	::	39-41

Background: The purpose of this study is to evaluate patients' knowledge and level of awareness about OTC common cold and cough medications in the Lebanon. Methods: This is a cross-sectional observational community-based study. Patients aged 18 years and above were included. The primary outcome measure is assessment of patients' knowledge about OTC common cold and cough medications. The secondary outcomes included identification of the sources of patients' information, and factors that influence their drug selection. Results: Most patients had good knowledge about OTC common cold and cough medications. As well, most patients were found to read the drug information present on the label, yet not all of them fully understand the drug label. Finally, the major factor that influenced patients' selection for an OTC common cold and cough product was a recommendation by a community pharmacist. Conclusion: Good overall knowledge and level of awareness was found in the Lebanese community with respect to the use of OTC common cold and cough medications. However, most patients were unable to fully understand drug labels. Hence, this requires greater educative efforts from the community pharmacists to ensure an optimal self-care of common cold and cough..

[1] McCaig LF, Burt CW. National hospital ambulatory medical care survey: 2002 emergency department summary. Adv Data 2004;340:1-34.
[2] Sakchainanont B, Ruangkanchanasetr S, Chantarojanasiri T, et al. Effectiveness of antihistamines in common cold. J Med Assoc Thai 1990;73(2),96-101.
[3] Heikkinen T, Jarvinen A. The common cold. Lancet. 2003;361:51–9.
[4] Schroeder K, Fahey T. Over-the-counter medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev 2001;(3):CD001831.
[5] Schroeder K, Fahey T. Systematic review of randomised controlled trials of over the counter cough medicines for acute cough in adults. BMJ 2002;324(7333):329–31.

Paper Type	::	Research Paper
Title	::	Impact of agnihotra on antibiotic properties of piper nigrum
Country	::	India
Authors	::	P.K. Mishra
Page No.	::	42-44

Piper nigrum L.is an important medicinal plant having wide applications in Ayurveda as antibiotic. Experimentally, extract of Piper nigrum extract has proved effective on both gram -' ve as well as gram +'ve bacteria. Agnihotra therapy is another noteworthy systems of treatment of various diseases where fume of some select plant twig clarified butter and pinch of rice, effectively control growth of disease causing bacteria. In present study combined impact of plant extract and Agnihotra on growth of some pathogenic bacteria was studied. It was proved that Agnihotra on growth of some pathogenic bacteria was studied. It was proved that Agnihotra conclusively help in controlling growth of pathogenic bacteria. Hence Agnihotra treatment along with extract of Piper nigrum is suggested.

[1] Kumar, M., Kumar, A., Dandapat, S. and Sinha M.P., Growth inhibitory impact of A. vasica and V. negundo on some human pathogen, The Ecoscan, 4 (spl. Issue), 2013, 241-245.
[2] Kumar, M., Dandapat, S. Kumar, A. and Sinha, M.P., Pharmacological screening of leaf extract of Adhathoda vasica for therapeutic efficacy. Global J. Pharmacol. 8(4), 2014, 494-500.
[3] Ravindran P.N., Black pepper: Piper nigrum series : Medicinal and aromatic plants- Industrial profiles, Center for Medicinal Plants Research, Kerala, India, 2000.
[4] G.R. Pathade and Pranay Abhang, Scientific knowledge of Vedic knowledge Agnihotra, Bhartiya Boudhik Sampada Research Journal of Vijnan Bharati,(44), 2014, 16-26.
[5] Mondkar A.G., Agnihotra effect on serial Microflora, US Satsang 10 (a), 1982.

Paper Type	::	Research Paper
Title	::	Effect Of Oregano Essential Oil On Oxidative Stability Of Low-Acid Mayonnaise
Country	::	Brazil
Authors	::	Izabela Alves Gomes|| Clarissa Terra Lindenblatt|| Lourdes Maria Pessôa Masson|| Flávia dos Santos Gomes|| Otniel Freitas-Silva|| Janine Passos Lima da Silva
Page No.	::	45-52

Mayonnaise is an oil-in-water emulsion considered one of the most popular condiments in the world. Because of the high fat content, it is susceptible to deterioration due to autoxidation, thus requiring use of antioxidants to delay or prevent this process. The use of synthetic antioxidants has been largely replaced by the use of essential oils because they have good antioxidant properties that can protect food against rancidity. This study aimed to evaluate the effect of using oregano essential oil as a natural antioxidant in mayonnaise preparations with low acidity. The essential oil's antioxidant activity was evaluated using the DPPH assay. Samples were also evaluated for acidity, pH and water activity. The results showed that oregano essential oil is rich in phenolic compounds, with good antioxidant activity and acts to protect mayonnaise against oxidation reactions. We conclude that oregano essential oil can be used as a natural antioxidant.

[1] J. Laverse, M. Mastromatteo, P. Frisullo, and M.A. Del Nobile, X-ray microtomography to study the microstructure of mayonnaise, Journal of Food Engineering, 108, 2012, 225-231.
[2] Brasil. MINISTÉRIO DA SAÚDE. AGÊNCIA NACIONAL DE VIGILÂNCIA SANITÁRIA. Resolução nº 276, de 22 de setembro de 2005. Aprova o Regulamento Técnico para Especiarias, Temperos e Molhos. Diário Oficial da República Federativa do Brasil, Brasília, DF, 2005.
[3] R. Xiong, G. Xie, and A.S. Edmondson, Modelling the pH of mayonnaise by the ratio of egg to vinegar, Food Control, 11, 2000, 49-56.
[4] R. H. Olmedo, C.M.A. Nelson, and R. Grosso, Thermal stability and antioxidant activity of essential oils from aromatical plants farmed in Argentina, Industrial Crops and Products, 69, 2015, 21-28. [5] V.C. Ramalho, and N. Jorge, Antioxidantes utilizados em óleos, gorduras e alimentos gordurosos, Revista Química Nova, 29, 2006, 755- 760.

Paper Type	::	Research Paper
Title	::	Prevalence of Diabetes and its Risk Factors in Urban Setting of Kandahar City, Afghanistan-2015
Country	::	Afghanistan
Authors	::	Khwaja Mir Islam Saeed (MD, MSc)
Page No.	::	53-60

Background: National statistics are lacking while prevalence of diabetes is increasing in Afghanistan. Thus, we assessed the prevalence of diabetes and evaluated the relationship of diabetes with its main risk factors in urban citizens in Kandahar city, Afghanistan. Methods and Materials: Using WHO stepwise approach a total of 1165 men and women aged between 25 and 70 years were enrolled in the study using a multi-cluster sampling method in Kandahar city in October-November, 2015. Data were collected using a structured questionnaire for assessing non-communicable diseases and their risk factors. Fasting venous blood sample was collected to assess the lipid profile and fasting blood sugar. Anthropometric measurements of the participants were also taken. Data was analyzed using SPSS version 20. A hierarchical logistic regression analysis was applied in two steps using the enter method to examine the associations between related risk factors and diabetes. Results: The crude prevalence of diabetes to be 22.4%. Out of all respondents 597 (51.2%) were females and 568 (48.8%) males with a mean age of 38.3±11.2 years. Around two thirds (73.2%) were illiterates and (79.3%) were married. 9.7% were smokers and (16.3%) were mouth snuff users. Sixty percent of respondents ate fruits less than 3 days per week and 60% ate vegetables three days or more per week. Almost 6% of subjects practiced vigorous physical activity and 21.3% reported doing moderate physical activity. At multivariate level factors such as age, moderate physical activity, residential life, BMI, level of triglyceride, low density lipoprotein, diet in term of taking vegetables, chicken and rice and finally high blood pressure had independent significant association with diabetes. Conclusion: This study found high prevalence of diabetes in the surveyed population which requires serious attention. Focusing on factors age, physical activity, dietary habits, blood lipids, obesity and blood pressure could contribute in lowering the level of diabetes in urban setting of Kandahar city.

[1] IDF atlas (7th edition update). Brussels, Belgium. International Diabetes Federation. Available at http://www. diabetesatlas.org; 2015
[2] Alemzadeh R, Ali O. Diabetes mellitus. In: Kliegman RM, ed. Kliegman: Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Elsevier Saunders; 2011:chap 583.
[3] Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011;94: 311–21. [2]
[4] World Health Organization. Diabetes. WHO media center. Fact Sheet # 312 November 2009
[5] Wild S. Roglic G. Green A. Sicree R. King H. Global Prevalence of Diabetes: estimates for the year 2000 and projections for 2030.. Diabetic Care.27(5);1047-1053, 2004

Paper Type	::	Research Paper
Title	::	Prevalence and associated factors of Hepatitis B, Hepatitis C and HIV infections among adult citizens in Mazar-e-Sharif city, Afghanistan
Country	::	Afghanistan
Authors	::	Khwaja Mir Islam Saeed (MD, MSc)
Page No.	::	61-72

Background: Viral hepatitis is an important public health challenge worldwide. The objective of this study was to estimate the seroprevalence of HBV, HCV, HIV infections and the risk factors associated to HBV among adult populations in Mazar-e-Sharif city, Afghanistan. Methods and Materials:A total of 1231 adult citizens in Mazar-e-Sharif were included in the study using a cross-sectional design in April-May 2015. Demographic, socioeconomic and lifestyle factors were collected by WHO STEP wise approach. Rapid tests were conducted to identify the prevalence of HBV, HCV, and HIV infections. Statistical analysis performed to find association of factors with HBV. Results: Out of 1231 study subjects 664 (3.9%) were females and 567 (46.1%) males.More than half (59.3%) were illiterates and (83.7%) were married and 72% had income of less than 10000 AFN. 9.9% were smokers and (8.3%) were mouth snuff users. The prevalence of HBV was 5.6% (69 out of 1231) for HBsAg on rapid test and 67 (5.4%) were confirmed positive after ELIZA test. Totally 3 subject (0.2%) were seropositive for anti-HCV on rapid tests. None of subjects had co-infections and none of specimen were positive for HIV infection. By multivariate logistic regression analysis, independent predictors for HBsAg infection were sex, history of jaundice, blood transfusion and living with hepatitis. Conclusion: The prevalence of HBV infection was at intermediate level while it could be much more in high risk groups. Public awareness and health education regarding risk factors for viral hepatitis and encouragement for vaccination is recommended.

[1] World Health Organization, 2012. Prevention and control of viral hepatitis infection: framework for global action, 2012. Available at: http://www.who.int/csr/disease/hepatitis/GHP_Framework_En.pdf?ua=1
[2] Kramer A, Kretzschmar M &Krickeberg K (2010). Modern Infectious Disease Epidemiology, Concepts, Methods, Mathematical Models and Public Health, Springer
[3] Schweitzer A, Horn J, Mikolajczyk RT, Krause G, and Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015; 386: 1546–1555
[4] Joseph FP, Gregory LA, Leigh AF, Yvan JFH, Beth PB (2006). The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. Journal of Hepatology 45-529–538
[5] Basnayake SK, Easterbrook PJ. Wide variation in estimates of global prevalence and burden of chronic hepatitis B and C infection cited in published literature. Journal of Viral Hepatitis, 2016, 23(7): 545–559

Paper Type	::	Research Paper
Title	::	Pattern of Risk Factors for Non-Communicable Diseases (NCD) in Kabul city: A Community Survey using WHO STEP-Wise Approach
Country	::	Afghanistan
Authors	::	Khwaja Mir Islam Saeed (MD, MSc)|| Mohammad Hafez Rasooly (MD, MSc)
Page No.	::	73-80

Background: The non-communicable diseases (NCDs) are emerging pandemic which poses a major health challenges to health systems globally. This study assessed the distribution of key risk factors of NCD among the Kabul adult population in Afghanistan. Methods and Materials: A provincial cross-sectional survey was conducted in November 2015 on the prevalence of NCD risk factors using the WHO STEPS tool. A multistage cluster sampling method was used to randomly select the 1200 participants.The study analysed sample of 1172 adults of age group 25-70 years. Demographic, socioeconomic and behavior data were collected using a structured questionnaire. Fasting venous blood sample was collected to assess the lipid profile and fasting blood sugar. Results: Out of study subjects, 599 (51.1%) were females and 573 (48.9%) males with a general mean age of 38.6±12.2 years. Illiteracy rate was (49.6%) and 77.5% were married. Prevalence of smoking and snuff use were 8.1% and 9.8% respectively. 33.6 % and 34.7% were taking fruits and vegetables three days or more weekly. 9.4% and 20.3% were practicing vigorous and moderate physical activity correspondingly. Almost more than half (57.6%) of study respondents were overweight and obese and 9.1% were recorded raised blood sugar. The prevalence of hypertension and raised blood sugar among adult Kabul citizens was 32.3% and 9.1% respectively. Central obesity was 60 % prevalent among citizens. High level of total cholesterol, LDL, HDL and triglycerides were 30.3%, 42 2%, 52% and 41% accordingly. Conclusion: The high prevalence of overweight and obesity, hypertension, raised blood sugar, central obesity and low levels of taking fruits and vegetable consumption are evidently important among citizens in Kabul. Prevention, treatment and control of NCDs and their risk factors in Kabul is a significant public health problem in the country. A set of interventions with a multi focused multi-sectoral approach need to be designed and implemented..

[1] World Health Organization. Preventing chronic disease: a vital investment. Geneva: WHO; 2005.
[2] WHO (2014) Global status report on non-communicable diseases 2014 Geneva: World Health Organization.
[3] World Health Organization. (2008). 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases. In World Health Assembly document (A61/8):
[4] World Health Organization. Global Health Estimates: Deaths by Cause, Age, Sex and Country, 2000-2012. Geneva, WHO, 2014.
[5] The Political Declaration of the United Nations General Assembly on the Prevention and Control of Non-Communicable Diseases: Commitments of Member States and the way forward .Technical Discussion paper. Fifty-ninth session of the Regional Committee for the Eastern Mediterranean, August2012. Provisional agenda item 4(a) (EM/RC59/3) (http://applications.emro.who.int/docs/RC_technical_papers_2012_3_14578_EN.pdf, accessed 29 July 2015).

Paper Type	::	Research Paper
Title	::	The Burden of Non-communicable Diseases and Key Risk Factors in Kandahar city: Results from Provincial STEPS Survey
Country	::	Afghanistan
Authors	::	Khwaja Mir Islam Saeed (MD, MSc)|| Mohammad Hafez Rasooly (MD, MSc)
Page No.	::	81-88

Background: Non Communicable Diseases (NCDs) are chronic medical conditions, non-infectious with long duration and slow progression. Afghanistan is suffering from double burden of diseases including communicable and noncommunicable. The aim of this study was to determine the risk factors for NCDs among adults population in Kandahar city-Afghanistan. Methods and Materials:A provincial cross-sectional study was conducted from October to November 2015 on the prevalence of NCD risk factors using the WHO STEPS adapted instrument. The study enrolled a random sample of 1165 adults of age group of 25-70 years. Data were collected using a structured questionnaire for assessing non-communicable diseases and their risk factors. Fasting venous blood sample was collected to assess the lipid profile and fasting blood sugar. Anthropometric measurements of the participants were also measured. Data was analyzed using SPSS version 20. Results: Out of all respondents 597 (51.2%) were females and 568 (48.8%) males with overall average age of 38.3±11.2 years. Around two thirds (73.2%) were illiterates and (79.3%) were married. 9.7% were smokers and (16.3%) were mouth snuff users. Sixty percent of respondents ate fruits less than 3 days per week and 60% ate vegetables three days or more per week. Almost 6% of practiced vigorous physical activity and 21.3% of subjects reported doing moderate physical activity. More than half of subjects were overweight or obese. 32.2% had high blood pressure and 22% recorded diabetic. Level of high cholesterol was 30.4%, high triglycerides was 35.7%. Furthermore high level of low density lipoprotein (LDL) was 50.9% and high level of high density lipoprotein (HDL) was 46.6%. The mean level of total cholesterol, HDL, LDL and triglycerides 183 mg/dL, 45.8mg/dL, 107.3 mg/dL and 154.6 mg/dL were respectively. Conclusions: The findings of study revealed a high burden of risk factors for NCDs in the study population, showing the country is experiencing both communicable and noncommunicable concurrently. It is recommended on focusing of interventions to prevent and control the noncommunicable diseases.

[1] World Health Organization. Global status report on noncommunicable diseases 2014. Available on the WHO website (www.who.int)
[2] Wagner KH, Brath H. A global view on the development of NCDs. Prev Med. 2012; 54:S38-41.
[3] Prevention and control of non-communicable diseases. Outcome of the High-Level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases and the First Global Conference on Health Lifestyles and Non-communicable Disease Control. Sixty-fifth World Health Assembly, 20 April 2012. Provisional agenda item 13.1 (A65/6). Geneva: World Health Organization; 2012. http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_6-en.pdf

[4] The global burden of disease: 2004 update. Geneva: World Health Organization; 2008 http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf?ua=1
[5] The Political Declaration of the United Nations General Assembly on the Prevention and Control of Non-Communicable Diseases: Commitments of Member States and the way forward .Technical Discussion paper. Fifty-ninth session of the Regional Committee for the Eastern Mediterranean, August2012. Provisional agenda item 4(a) (EM/RC59/3)

Paper Type	::	Research Paper
Title	::	Pattern of adult obesity in Kabul capital of Afghanistan: a cross sectional study using who stepwise tool
Country	::	Afghanistan
Authors	::	Khwaja Mir Islam Saeed (MD, MSc)
Page No.	::	89-96

Background: Obesity has altered to be a major global health challenge due to considerable increase in prevalence as well as being contributing factor for main noncommunicable diseases. This study aims to identify the prevalence and associated factors of obesity in Kabul city. Methods and Materials: The study was conducted using WHO STEPwise approach among adults of age group of 25-70 years in November 2015 in Kabul city. Demographic, socioeconomic and behavioral variables collected using structured questionnaire. The Body Mass Index (BMI) was calculated by measuring height and weight. Biochemical markers were tested by using blood serums collected from the field. Data was analyzed using SPSS v.20. Results: Out of 1172 study subjects, 599 (51.1%) were females and 573 (48.9%) males. Illiteracy was 49.6%, 77.5% were married, 8.1% were smokers and 9.8% were mouth snuff users. The prevalence of overweight was 36.9% with differentiation of male 32.7% and female 41.2% and the prevalence of obesity was 20.6 % with differentiation of obesity stage I, 14.8% obesity stage II, 4.2% and obesity stage III, 1.6%. The overall mean of BMI was 26.22±5.39 while there is much difference in terms of females (27.33±6.07) and males (25.07±4.28). At multivariate level the factors such as age, gender, central obesity, blood pressure, physical activity and frequency of taking fruits were independently associated with obesity. Conclusions: This study presented high prevalence of obesity as well as overweight in urban setting of Kabul city. It is recommended of focusing on interventions to prevent and control obesity among adult populations mostly females in Kabul city.

[1] Ng M, Fleming T, Robinson M. et al: Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384:766-781.
[2] Farooqi S, et al. Large, rare chromosomal deletions associated with severe early-onset obesity .Nature Journal 2010; 463(7281): 666-670.
[3] World Health Organization. Global strategy on diet, physical activity and health. Geneva: World Health Organization, 2004. http://www.who.int/dietphysicalactivity/en/
[4] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011; 378: 804–14
[5] Jafar TH, Chaturvedi N, Pappas G. Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population. CMAJ 2006;175(9):1071-7

Paper Type	::	Research Paper
Title	::	Prevalence of obesity and some associated factors among adult residents of Mazar-e-Sharif city, Afghanistan
Country	::	Afghanistan
Authors	::	Khwaja Mir Islam Saeed (MD, MSc)
Page No.	::	97-104

Background: Obesity as a major public health problem is defined as fat accumulation in excessive pattern in adipose tissue. This study aims to estimate the prevalence of obesity and determine some risk factors of adults in Mazar-e-Sharif, Afghanistan. Methods and Materials: Using WHO stepwise approach a cross-sectional study was conducted in Mazar-e-Sharif and enrolled adult citizens of 25-70 years. The face to face questionnaire was used to collect demographic, socioeconomic and behavioral factors. Anthropometric measurements including height, weight, waist circumference and blood pressure were done. Subjects with a body mass index ≥ 30 kg/m2 were considered obese. Data management and analysis was done using SPSS. V.20. Results:- The overall prevalence of obesity was 15.4 % (20.5 % women and 9.5 % men). Of total 664 (53.9%) were females and 567 (46.1%) males with a mean age of 40.5±13.2 years. More than half of the respondents (59.3%) were illiterates; majority of respondents (83.7%) were married and more than 85.5% of women were housewives. Nearly 10% were smokers and (8.3%) were mouth snuff users with differentiation of 3.5% among women. The main factors associated with obesity were sex, age, blood pressure, blood sugar and central obesity. Conclusions:- Obesity is a public health problem in Mazar-e-Sharif. Living in urban areas, and those with high blood pressure, high blood sugar and central obesity should be focused for health education campaigns and public awareness.

[1] Marinou K, Tousoulis D, Antonopoulos AS, Stefanadi E, Stefanadis C. Obesity and cardiovascular disease: from pathophysiology to risk stratification. Int J Cardiol. 2010; 138(1):3–8. doi: 10.1016/j.ijcard.2009.03.135.
[2] Ayatollahi S, Ghoreshizadeh Z. Prevalence of obesity and overweight among adults in Iran. Obes Rev. 2010; 11(5):335–337. doi: 10.1111/j.1467-789X.2010.00725.x.
[3] Janghorbani M, Amini M, Willett WC, Gouya MM, Delavari A, Alikhani S. First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity. 2007; 15(11):2797–2808. doi: 10.1038/oby.2007.332.
[4] Seidell J.C. • Halberstadt J. The Global Burden of Obesity and the Challenges of Prevention. Ann Nutr Metab 2015;66(suppl 2):7-12 (DOI:10.1159/000375143)
[5] Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Selected major risk factors and global and regional burden of disease. Lancet. 2002; 360(9343):1347–1360. doi: 10.1016/S0140-6736(02)11403-6.