Conclusion-Cigarette smoking is a major public health problem in this high mountain community of Pakistan, particularly among the male population, the majority of whom begin to smoke quite early in life. A comprehensive tobacco control eVort incorporated into the existing community based health infrastructure is needed. (Tobacco Control 2001;10:e1)

Human displacement is on the rise globally, and the increase in the burden of tuberculosis (TB) is also attributed to migrations worldwide. A significant number of such displacements occur in regions with considerably higher areas of TB burden. Displacements may delay TB diagnosis and treatment, which will possibly lead to TB transmission among healthy individuals. In this study, we assessed the association of existing determinants after a protracted internal displacement of people with delay in TB diagnosis and treatment outcomes. A cross-sectional study was conducted on internally displaced TB patients (IDPs), registered at selected health facilities in three urban districts of Pakistan from March 2019 to February 2020. The univariate and multivariate logistic regression model was used to assess the delay in diagnosis and treatment outcomes. IDPs with delay in initiation of treatment beyond 30 days were at high possibility of unsuccessful TB treatment outcomes (adjusted odds ratio AOR, 2.60; 95% CI 1.06–6.40). Furthermore, the multivariate regression analysis showed a statistically significant association (p > 0.05) between TB patients who were aged 55 to 65 years (AOR, 2.66; 95% CI 1.00–7.07), female patients (AOR, 2.42; 95% CI 1.21–4.81), visited non-formal health provider (AOR, 8.81; 95% CI 3.99–19.46), self-medication (AOR, 2.72; 95 % CI 1.37–5.37), poor knowledge of TB (AOR, 11.39; 95% CI 3.31–39.1), and perceived stigma (AOR, 8.81; 95% CI 3.99–19.4). Prolonged delay in treatment was associated with unfavorable treatment outcomes among IDPs. Migrants and IDPs are more likely to experience an interruption in care due to overall exclusion from social and health care services. Therefore, it is imperative to understand the barriers to providing public health care services, particularly in preventing and treating TB.

Objective: This study was aimed to investigate adherence to TB treatment and outcomes among internally displaced patients in comparison with adjacent settled areas. Methods: The study was designed as an observational cross-sectional study among the TB patients of internally displaced populations (IDPs) of North Waziristan Agency (NWA) and adjacent settled areas of Bannu and Lakki Marwat (NIDPs). Based on the study inclusion and exclusion criteria 330 patients full filled the inclusion criteria and were assigned equally to both IDPs and NIDPs study groups. Odds ratio (OR) with 95% confidence interval was calculated and p-values, 0.05 were considered statistically significant. Results: The treatment outcomes with the status of “cured” and “completed treatment” were better among NIDPs as compared to IDPs. Patients with treatment outcome status of “defaulted treatment”, “without documentary evidence, and “failure” were high in IDPs as compared to NIDPs. Adherence to TB treatment was better among NIDPs (50.9%) as compared to IDPs (39.4%). The patients showing non-adherence to TB treatment were more among IDPS (27.3%) then NIDPs (10.9%). Conclusion: Overall the results of this study revealed a poor adherence to the TB treatment medications with an odds ratio of 0.286, (p<0.05) among IDPs as compared to NIDPs. doi: https://doi.org/10.12669/pjms.37.3.2992 How to cite this:Khan FU, Asghar Z, Tipu MK, Asim-ur-Rehman, Khan A, Tofeeq-ur-Rehman. Effect of displacement on Adherence to TB Treatment: An observational study in TB patients from Internally Displaced Persons of Pakistan. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.2992 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Human displacement is on the rise globally, and the increase in the burden of tuberculosis (TB) is also attributed to migrations worldwide. A significant number of such displacement occur in regions with considerably higher areas of TB burden. Displacements may delay in TB diagnosis and treatment, which possibly will lead to TB transmission among healthy individuals. In this study, we assessed the association of existing determinants after a protracted internal displacement of people with the delay in TB diagnosis and treatment outcomes. A cross-sectional study was conducted on internally displaced TB patients registered at selected health facilities in three urban districts of Pakistan from March 2019 to February 2020. The univariate and multivariate logistic regression model was used to assess the delay in diagnosis and treatment outcomes. IDPs with delay in initiation of treatment beyond 30 days were at high possibility of unsuccessful TB treatment outcomes (adjusted odds ratio AOR,2.60; 95% CI 1.06-6.40). Analysis of factors that affect health seeker behavior and timely treatment showed a significant association (p&lt;0.05) in-between age group 55-65 years (AOR, 2.66; 95% CI 1.00-7.07), female patients (AOR, 2.42; 95% CI 1.21-4.81), visited non-formal health provider (AOR, 8.81; 95% CI 3.99-19.46), self-medication (AOR, 2.72; 95 % CI 1.37-5.37), poor knowledge of TB (AOR, 11.39; 95% CI 3.31-39.1), and perceived stigma (AOR, 8.81; 95% CI 3.99-19.4). Prolong delay in treatment was associated with unfavorable treatment outcomes among IDPs, more specifically. As migrants and IDPs are more likely to experience an interruption in care due to overall exclusion from social and health care services. Therefore, it is imperative to understand the barriers in providing public health care services, particularly in preventing and treating TB.

Background: According to WHO, breast cancer is the most common cancer in the women worldwide, soearly diagnosis is the best way to reduce its morbidity and mortality. Among various risk factors, the relationship between serum lipid profile and breast cancer is still unclear. Therefore, this study was conducted to evaluate this relationship. Methodology: Prospective, descriptive observational study with a comparative study designconducted at Fauji Foundation Hospital, Rawalpindi between November 2018 to April 2019. Results: 140 patients were divided into two groups i.e. cases and controls. Both groups were equally sub divided based on menstrual status. Independent student t-test was applied for comparison between the groups. BMI was significantly higher in the study group as compared to control group (p=0.002). Serum TG and LDL levels were higher in breast cancer patients (p= 0.032 and p=0.07 respectively). Cholesterol level was not statistically different in any group (p= >0.05). Higher HDL levels were seen in pre-menopausal cases (p=0.004) but there was no statistical difference when studied across cases and control groups. Conclusion: As breast cancer is the most common tumor in females, so early diagnosis is the key to reduce its morbidity and mortality. In this study, higher BMI, TG and LDL levels were seen in breast cancer patients as compared to controls. So, it may be concluded that BMI and dyslipidemia have some role in the etiology of breast cancer.