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Early life body mass index (BMI) trajectories influence the risk of asthma at 18 years of age. However, it is unclear if these are also associated with other allergic diseases.We investigated the associations between BMI trajectories and subsequent allergic rhinitis, eczema and food sensitisation/allergies.Parent-reported anthropometric data were collected 18 times in the first two years of life from a cohort of 620 participants in a high-risk cohort. Group-based trajectory modelling was applied to develop BMI trajectories. Associations between trajectories and allergic rhinitis, eczema and food sensitisation at 6, 12 and 18 years of age were assessed using logistic regression models. Potential effect modifications by parental allergic disease, sex and allocated infant formula were assessed.We identified five BMI trajectories: average, below average, persistently low, early low and catch up, and persistently high. None showed an association with allergic rhinitis. In participants with maternal allergic rhinitis, 'early-low and catch-up' (OR = 2.83;95%CI 1.34-5.96, PInfants with early-low and catch-up, or below average BMI growth, were at increased risk of allergic rhinitis at 18 years if they had a mother with allergic rhinitis. These results require replication, but suggest that interactions between poor intrauterine growth, failure to thrive and maternal allergies may influence the risk of allergic rhinitis.

BackgroundHigh body mass index (BMI) trajectories from childhood to adulthood are associated with the development of some chronic diseases, but whether such trajectories influence adult asthma has not been investigated to date. Therefore, we investigated associations between BMI trajectories from childhood to middle age (5–43 years) and incidence, persistence and relapse of asthma from ages 43 to 53 years.MethodsIn the Tasmanian Longitudinal Health Study (n=4194), weight and height were recorded at eight time-points between 5 and 43 years of age. BMI trajectories were developed using group-based trajectory modelling. Associations between BMI trajectories and asthma incidence, persistence and relapse from age 43 to 53 years, bronchial hyperresponsiveness (BHR) at age 50 years, and bronchodilator responsiveness at age 53 years were modelled using multiple logistic and linear regression.ResultsFive distinct BMI trajectories were identified: average, low, child high-decreasing, child average-increasing and high. Compared with the average trajectory, child average-increasing and high trajectories were associated with increased risk of incident asthma (OR 2.6, 95% CI 1.1–6.6 and OR 4.4, 95% CI 1.7–11.4, respectively) and BHR in middle age (OR 2.9, 95% CI 1.1–7.5 and OR 3.5, 95% CI 1.1–11.4, respectively). No associations were observed for asthma persistence or relapse.ConclusionsParticipants with child average-increasing and high BMI trajectories from childhood to middle age were at higher risk of incident adult asthma. Thus, encouraging individuals to maintain a normal BMI over the life course may help reduce the burden of adult asthma.

Background Motivating patients through text message (SMS) reminders can improve adherence to a healthy diet and can lead to better diabetes control. This study was carried out to assess the difference in dietary adherence in patients with Type II diabetes, who were sent dietary text message reminders vs. those provided standard care Methods A block randomized control trial was conducted at the Aga Khan University Hospital in Karachi, Pakistan. Patients (n=249), diagnosed with Type II diabetes were invited to participate in the study. At baseline, dietary guidelines were provided to all the study participants. In the intervention arm, three dietary text message reminders were sent per week for 3 months. Adherence to diet was measured by assigning a score to the dietary intake assessed by the Food Frequency Questionnaire (FFQ) both at baseline and after follow-up. Results Mean age of participants in the intervention arm and the control arm was 49.7 (SD =9.94) and 51.3 (SD 9.79) years respectively. The results of the study showed no change in diet quality score from baseline till 3 months of the follow up in the intervention arm compared to the control arm. Odds ratio and confidence interval for the intervention was 1.04(0.96 – 1.14) compared to the control arm. However, diet quality score of overweight participants was 17% (OR: 0.83 CI: 0.70-0.99) less than that of normal weight participants. Each additional score points at baseline resulted in an almost 20% (OR: 1.20 CI: 1.07-1.34) increase in the adherence score at follow-up. Conclusion Findings of the study suggest that there is no effect of dietary text message reminders on the dietary adherence of patients with Type II diabetes in a three months duration study. However, adherence to a healthy diet is better in patients who had a healthy diet to begin with and those who were obese. Trial Approval and Registration Approval for this study was obtained from the Ethical Review Committee (ERC NO: 1981-CHS-ERC-11) of the Aga Khan University Hospital. This trial was registered on “Australian New Zealand Clinical Trials Registry”. Trial registration number is: “ACTRN: ACTRN12612000538842”

The world health organization (WHO), since 1948, has defined health as “a state of complete physical, mental, and social wellbeing, not merely the absence of disease or infirmity†. This was later expanded to include intellectual, environmental, and spiritual health. This is a very remarkable statement, considering that it was originally created in 1948(WHO) [1]. Personal responsibility is the driving force reflected in the above definition of health given by WHO, and the purpose defines destiny to achieve good health. If a state of ongoing health is our choice and purpose, then it is up to us to strive for this destiny ourselves. Life is a gift of God; the degree of health that we hold be a marker for how well we’ve taken care of this wonderful gift. Pakistan is ethnically, linguistically, religiously, and culturally a diverse society [2]. Our culture is a mixed culture. Pakistan is a Muslim country, although most people in Pakistan are Muslims, there is a strong influence of different cultures and their social activities on our culture, for example, Hindu culture influences are visible on our ceremonies and festivals. Despite significant progress has been made in recent years, the development indicators for Pakistan are still low. In addition, poverty is the major problem in our country, every person could not earn 1$ daily according to WHO.

Antenatal care is the care given to pregnant women in order to have a safe pregnancy and a healthy baby. Antenatal care is an important determinant of high maternal mortality rate and one of the basic components of maternal care on which the life of mothers and babies depend. Thus, Antenatal care is a key strategy to improve maternal and infant health. Different studies have found that inappropriate antenatal care has been associated with adverse pregnancy outcomes. Recently the technical working group of World Health Organization has recommended a minimum level of care to be eight visits throughout the pregnancy to reduce the maternal morbidity and mortality. Several studies conducted in different countries on demographic and socio-cultural factors influencing use of maternal health care services, have shown that factors like maternal age, number of living children, education, place of residence, occupation, religion and ethnicity are significantly associated with use of antenatal care. The findings of various factors associated with utilization of antenatal care have not been synthesized collectively. Therefore, there was a need to carry out a literature review to synthesize findings collectively regarding the factors affecting the utilization of antenatal care. Hence the objective of this literature review was to appraise the factors affecting anternatal care utilization among pregnant women. The findings of this literature review could help in planning and developing strategies for utilization of antenatal care ANC among pregnant women.