Objective: To find out the prevalence and associated factors of undernutrition in a semi-rural setting. Method: The community-based cross-sectional study was conducted in Tehsil Battagram of Khyber Pakhtunkhwa province, Pakistan, in January and February 2020 after approval from the ethics review committee of Nanjing Medical University, Jiangsu, China, and comprised children aged 6-59 months who had no physical or mental disability. Data was collected using a structured questionnaire. Anthropometric data was analysed using the World Health Organisation Anthro software. Multivariate logistic regression analysis was used to find out the association between dependent variables, like wasting, underweight and stunting, and independent variables , like socioeconomic, child, maternal and environmental characteristics. Data was analysed using SPSS 21. Results: Of the 504 children, 257(51%) were girls and 247(49%) were boys. The largest group was aged 36-47 months 127(25.2%), while the smallest group was aged 6-11 months 56(11.1%). Overall, 94(18.7%) children were wasted, 167(33.1%) were underweight and 248(49.2%) were stunted. Children whose family income was high had low odds for being wasted (odds ratio: 0.59, 95% confidence interval: 0.25-0.71), underweight (odds ratio: 0.30, 95% confidence interval: 0.08-0.72) and stunted (odds ratio: 0.54, 95% confidence interval: 0.30-0.80). Similarly, those children who were exclusively breastfed had low odds of being wasted were (odds ratio: 0.45, 95% confidence interval: 0.32-0.53), underweight (odds ratio: 0.56, 95% confidence interval: 0.42-0.78) and stunted (odds ratio: 0.62, 95% confidence interval: 0.51-0.97). ---Continue

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Background: The ninth month of the Islamic calendar is Ramadan, during which Muslims fast from dawn till sunset. This extended fasting period may affect the management of diabetes in diabetic people. This study aimed to compare the number of visitors to the diabetic Emergency Room (ER) of a private tertiary care hospital in FB Area, Karachi, Pakistan, throughout Ramadan and other lunar months, with diabetes emergencies. Methodology: A retrospective cross-sectional study was conducted utilizing an electronic medical record review of patients with diabetes emergency who visited the ER of a tertiary care hospital between the ninth and eleventh lunar months during the previous two years. Patients with diabetes who visited the ER and were more than 18 years old were included. It established the frequency of ER visits, sociodemographic parameters, and clinical features. The relationships between variables were evaluated using the SPSS Software. Results: During the selected study period, the ER reported a total of 32,134 admissions. There were just 0.61 % of diabetes emergency visits. According to the inclusion criteria, 123 participants were included in the study (64.2% men and 35.7% women). The majority (51.2%) took oral hypoglycemic agents, and more than half (60.97%) had type 2 diabetes. There was a substantial variation in the prevalence of diabetes emergency visits between Shaban, Ramadan, and Shawal, 0.55, 0.32, and 0.27 %, respectively. However, the peak incidence did not occur during Ramadan. Despite identifying specific associations, the study showed no significant differences between the frequency of ER visits during Ramadan and the prior and subsequent lunar months regarding demographic and clinical variables and diabetes profile. Practical Implication: The following investigation will help in designing a plan with suitable diet and antidiabetic agents that will help in balancing the blood sugar levels as well as the glycemic index. Conclusion: In contrast to earlier studies, a decreasing prevalence trend was observed from Shaban to Ramadan to Shawal. This demonstrated that fasting throughout Ramadan has no negative effect on the occurrence of diabetes emergencies compared to other months. During the three-month study period, type 2 diabetes and insulin-treated patients with hyperglycemia were the leading cause of diabetic emergency room visits, with no significant variations across the months. These findings underscore the necessity for primary care physicians to thoroughly evaluate type 2 and insulin-treated individuals and provide comprehensive health education and counseling. Keywords: Ramadan, Diabetes, Fasting, Emergency visit, Antidiabetic agents, Diabetic Ketoacidosis, Hypoglycemia

Iron supplementation and fortification are the well-known approaches to treat iron deficiency anemia (IDA) in women of reproductive age. The objective of the current randomized controlled trial (RCT) was to evaluate the cumulative effects of prebiotics and iron fortification among women of reproductive age. For this purpose, a total of 75 iron deficient women of childbearing age were recruited and randomly divided into 5 groups (4 treatment groups and 1 control group). Four different types of fortified wheat flour were prepared using two iron fortificants (NaFeEDTA and FeSO4) and two prebiotics [inulin and galacto oligosaccharides (GOS)], while control group was treated with iron fortified flour without any prebiotics. Blood samples were collected from overnight fasted women on monthly basis up to 90 days. Hematological indices such as Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) Count and Mean Corpuscular Volume (MCV), as well as iron biomarkers including serum iron, ferritin, transferrin, and Total Iron Binding Capacity (TIBC) were evaluated for analyses. The results showed a considerable positive improvement in all iron biomarkers as well as hematological indices among the treatment groups (P-value < 0.05), as compared to the control group. A maximum Hb (11.86 ± 0.24 mg/dL) and hematocrit value (35.06 ± 1.32%), was reported in group G3 which was treated with fortified wheat flour at a dose of 963 mg/kg GOS + 15 ppm FeSO4. On the other hand, highest mean values for RBC Count (4.73 ± 0.41 mil/mm3), MCV (81.41 ± 3.21 fL), serum iron (75.62 ± 2.79 μg/dL), serum transferrin (16.82 ± 0.30 mg/dL), and TIBC (403.68 ± 7.27 μg/dL) were observed in G4 group receiving the fortified wheat flour at a dose of 963 mg/kg GOS + 30 ppm FeSO4 level. The study concluded that prebiotic fortification along with iron salts helps to enhance iron absorption among iron deficiency anemic women of reproductive age.

The current study was designed to determine the proximate composition, phenolic compounds and antioxidant activity of milk products commonly consumed in Khyber Pakhtunkhwa, Pakistan. Fifteen different milk product samples were collected from 3 different markets in the study area to get a composite sample. AOAC 15 th edition methods were used to analyze moisture, ash, carbohydrates, fats and protein contents of milk products. Atomic absorption spectroscopy and flame photometry were used for mineral analysis. Total phenolic compounds were evaluated by the Folin-Ciocalteu method. The aluminum chloride colorimetric method was used for evaluating total flavonoids contents. Antioxidant activity was assessed by the DPPH method. The results showed that moisture was high in Buttermilk (92.15±0.13 g/100g), ash and proteins in Manpasand (5.71±0.03, 25.36±0.04 g/100g respectively), carbohydrates in Mardani Paida (79.69±0.14 g/100g), and fats in Butter (81.71±0.04 g/100g). Khoa showed the highest amount of calcium and iron (612.00±0.01, 2.756±0.04 mg/100g respectively), while maximum zinc was observed in Cheese (4.80±0.05 mg/100g) and phosphorus in Mardani paida (401.60±0.04 mg/100g). The highest total phenols (37.04±0.61 mg GAE b /100g), total flavonoids (12.027±0.06 mg QE c /100g), and antioxidant activity (18.44±0.05 mgVCE d /100g) were investigated in Green tea with milk. Macro and micronutrient composition of milk products commonly consumed in Khyber Pakhtunkhwa is available now and can be used by nutritionists, dieticians and health care providers in planning a normal and therapeutic diet. Milk products contained phenolic compounds which show antioxidant activity.