The prevalence of Down syndrome (DS) in the United Arab Emirates (UAE) is high in comparison to the global statistics. The aim of this study is to assess the physical status, feeding problems, parent-child feeding relationship and weight outcome in children and adolescents with DS in the UAE. In this cross-sectional study, 83 individuals aged between 2–19 years with DS were recruited from three humanitarian centres for differently abled in the Emirates of Sharjah and Dubai, UAE. Socio-demographic characteristics; height, weight, BMI and body composition; feeding problems (STEP-CHILD screening tool); and parent-child feeding relationship (child feeding questionnaire—CFQ) were assessed. Correlations and regression analyses were used to determine the relationships and the best predictor of weight outcome (BMI) in DS participants. The median age of the participants was 9 (8) years. Fifty-five (66.3%) males and twenty-eight (33.7%) females constituted a sex ratio of 1.96:1. Five (6.2%) participants were short for their age, and 20.6% were overweight/obese compared to the growth charts for DS population. Body composition of females showed significantly higher percent body fat than males (25.5 (14.3)% vs. 18.2 (4.0)%, p = 0.03; 29.9 (2.8)% vs. 16.3 (12.2)%, p = 0.006) in 5–8.99 years and 12–19.99 years, respectively. The most common feeding difficulties on STEP-CHILD tool were food selectivity (62.2%), continued eating in the presence of food (57.7%) and swallowing without sufficient chewing (50%). Median score of total-CFQ for the parent-child feeding behaviour was 3.2 (1.9); parental restriction 3.3 (1.0); pressure to eat 3.0 (0.8); concern about child weight 3.7 (2.3). Parent-child feeding relationship was significantly positively correlated with feeding problems, and body weight of the participants. The best predictor for BMI was the parental concern about child weight (OR: 1.4, p = 0.02). The findings can be valuable for the health care professionals, parents and caretakers of children and adolescents with DS in emphasizing the need for regular monitoring of their physical status, and feeding behaviours. In addition, it reinforces the role of parents in mindfully managing their child feeding relationship in promoting healthy eating behaviours and weight of their youth with DS.

COVID-19 pandemic has caused global healthcare and economic crises and mass vaccination to acquire herd immunity seem to be the only solution. Present study aimed to evaluate the intent of Pakistani population towards vaccination and to uncover the barriers associated with vaccine reluctance. This cross-sectional study included responses of 855 Pakistani residents. Respondents’ knowledge of COVID-19 infection, intent of vaccination and barriers towards vaccine refusal were evaluated. Participants were categorized on the basis of knowledge score, risk of disease and other demographic characteristics. Descriptive statistics were used for calculating frequencies and percentages, means and Chi-square test was utilized for cross-tabulation. A multinomial logistic regression model was executed to identify the predictors of vaccination intention. Significance level was set at the p-value of ? 0.05. Prevalence of vaccine refusal was 40%. COVID-19 vaccine is not Halal, negative propaganda on social media against the vaccine, discouraging advice from social circle and clerics, concerns regarding efficacy, fear of immediate and late adverse reactions were the major barriers identified towards vaccine hesitancy. Around one-third of the study population did not consider COVID-19 as a serious disease and associate it with conspiracy theory. The mean score of participants towards COVID-19 knowledge was 5.5±1.6 (range: 0-9). Having a college degree, living in an urban area, working in a healthcare field and being in a higher risk category increases the chances of vaccine acceptability.

Objectives: To determine the frequency of clinical anger, adverse childhood experiences, self-esteem, and their mutual relationship among undergraduate medical and sociology students. Methods: In this descriptive cross-sectional study, data from 400 undergraduate medical and sociology students was collected from the Northwest School of Medicine, Peshawar, and the sociology department of the International Islamic University, Islamabad, from July to September 2021. A self-administered questionnaire incorporating a Clinical Anger Scale (CAS), Adverse childhood experience (ACE) scale and Rosenberg self-esteem (RSE) scale was utilized for data collection. Descriptive statistics, ANOVA and logistic regression model were executed to perform data analysis using SPSS. Results: The mean CAS score was 19.65 ± 13.23 suggesting that 60.2% of the participants experienced mild to severe degrees of clinical anger. Females were experiencing more anger issues than males (64% vs 54%, p = 0.040) RSE scale showed that 72.8% of the participants had low self-esteem with a mean score of 12.70 ± 5.43. Besides, 51.5% of the participants had at least one type of adverse childhood experience while 15.8% of the sample population reported being sexually abused in childhood. Significant correlation was found between CAS and age, ACEs and RSE score (p = <0.01). The logistic regression model also suggested that the prevalence of anger was higher in individuals with ACEs (OR = 1.29, 95% CI: 1.12, 1.14, p = <0.001) and low self-esteem (OR = 1.15, 95% CI: 1.09, 1.22, p = <0.001). Conclusion: The high frequency of clinical anger necessitates the implementation of periodic screening across all universities. Keeping in mind the problem of low self-esteem and the history of ACEs, there is an urgent need for the development of strategies to preserve and improve the mental well-being of the young generation. doi: https://doi.org/10.12669/pjms.39.2.6113 How to cite this: Ansar F, Naveed H, Khattak A, Khan SA. Frequency of anger and its potential relationship with Selfesteem and Adverse Childhood Experiences among Medical and Sociology undergraduate students in Pakistan. Pak J Med Sci. 2023;39(2):---------.  doi: https://doi.org/10.12669/pjms.39.2.6113 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.

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