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Background: Despite significant advancements, primary brain tumors (PBTs) sadly remains a major cause of morbidity and mortality, especially among children and young people (CYP) worldwide. Aims: This study aimed to evaluate the risk factors and late effects of PBTs among CYP and their primary caregivers at tertiary care hospitals in Karachi, Pakistan. Method: Study 1 was a matched case-control study at a private tertiary care hospital. Telephonic interviews were conducted with mothers of 122 cases (CYP with PBTs, ages 5-21) and 122 controls (CYP without tumors, ages 5-21) treated between 2017 and 2022. Conditional logistic regression was used for data analysis with STATA software version 12. Studies II to IV were prospective cohort studies conducted at private and public tertiary care hospitals. Forty-eight CYP with PBTs and their primary caregivers were recruited. CYP were assessed pre-treatment and at 12 months post-treatment for neurocognitive outcomes using validated tools such as the Slosson Intelligence Tool, Raven's Progressive Matrices, and Wechsler Intelligence Scale. Quality of life (QoL) of CYP and their caregivers were evaluated using the Pediatric Quality of Life Inventory. Generalized estimating equations were used for data analysis with STATA software version 12. Study V was a pilot exploratory study. The microRNA expression was assessed using quantitative polymerase chain reaction (qPCR). Data was analyzed by R software. Results: The risk factors of PBTs among CYP were maternal analgesic use, paternal addictive substance use (specially smoking), higher household income, and lower paternal education. Predictors of neurocognitive outcomes in CYP were tumor type, surgical resection, post-treatment seizures, lower socioeconomic status, and low maternal education. Predictors of QoL in CYP were hydrocephalous managed with shunt and/or EVD and surgical resection. Factors affecting the QoL and family functioning of primary caregivers (mothers) included CYPs, Nida Zahid is inviting you to a scheduled Zoom meeting.Topic: PhD Thesis Defense-Nida Zahid Time: Sep 11, 2024 13:00 Amsterdam, Berlin, Rome, Stockholm, ViennaJoin Zoom Meeting https://uu-se.zoom.us/j/9898743266?omn=67966277740Meeting ID: 989 874 3266 One tap mobile+46844682488,,9898743266# Sweden+46850539728,,9898743266# SwedenDial by your location +46 8 4468 2488 Swede +46 850 539 728 Sweden +49 695 050 2596 Germany +49 69 7104 9922 GermanyMeeting ID: 989 874 3266Find your local number: https://uu-se.zoom.us/u/cPotL0R5TJoin by SIP9898743266@109.105.112.2369898743266@109.105.112.235Join by H.323109.105.112.236109.105.112.235 Meeting ID: 989 874 3266

Primary brain tumours (PBTs) are the commonest solid tumours in children and young people (CYP). A study was conducted at a private and a public sector hospital in Karachi, Pakistan, to determine the socio-demographic and tumour -related characteristics of CYP with PBTs between those presenting to the public and private hospitals. A total of 49 patients were included. The commonest PBT was pilocytic astrocytoma (29%). There were no differences in tumour -related characteristics between the two groups. However, parents of CYP with PBTs presenting to the public sector hospital were significantly less educated and had lower household incomes. No significant differences in age, gender, educational status, and ethnicity of CYP with PBTs were observed. Since CYP with PBTs presenting at the public sector hospital were from significantly lower socioeconomic backgrounds and their parents were less educated, it suggests socio-economic disparities in PBT care for CYPs in Karachi, Pakistan.

Background:Brain tumors are a common cause of morbidity, disability, cognitive deterioration and mortality in children, even after treatment. Little is know about the specific causes. The study aimed to assess potential socio-demographic and antenatal factors in primary brain tumor (PBTs) in children and young people (CYP) in Karachi, Pakistan. Designs and methods:A single center hospital based matched case control study in Karachi, Pakistan. Cases were defined as CYP aged between 5 and 21 years with any histological type and grade of primary brain tumor of any histology, stage or grade. Data were collected from parents of 244 patients at the selected center between 2017 and 2021 via telephonic interview. Controls were 5-21 years old CYP admitted with non-oncological diagnoses matched on age and sex. Matched Odds Ratios for predictors of brain tumor in children were derived. Those of statistical significance were included in a multivariable logistic regression model. Results:In the adjusted model, lower paternal education (matched adjusted odds ratio (maOR) 2.46; 95% CI 1.09-5.55), higher household monthly income (maOR 3.4; 95% CI 1.1-10.2), antenatal paternal use of addictive substances (maOR 19.5; 95% CI 2.1-179.8), and antenatal maternal use of analgesics during pregnancy (maOR 3.0; 95% CI 1.2-7.9) were all independently predictive of brain tumors. Conclusion:This matched case-control study found novel associations between maternal use of analgesics, paternal use of addictive substances, higher household income, and lower paternal education and Primary Brain Tumors in Children and Young People. Longitudinal multicenter studies will be required to test these associations prospectively.

Warisha Zahid,1,* Nida Farooqui,2,* Nida Zahid,3,* Khalid Ahmed,2 Muhammad Faraz Anwar,4 Syed Rizwan-ul-Hasan,5 Azhar R Hussain,2 Antonio Sarría-Santamera,6 Syed Hani Abidi2,6 1Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan; 2Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan; 3Department of Surgery, Aga Khan University, Karachi, Pakistan; 4Department of Biochemistry, Bahria University Medical and Dental College, Karachi, Pakistan; 5Department of Computer Science, DHA Suffa University, Karachi, Pakistan; 6Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan*These authors contributed equally to this workCorrespondence: Syed Hani Abidi, Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan, Email m.haniabidi@gmail.comIntroduction: Expression and certain SNPs of interferon lambda 3 and 4 (IFNL3 and 4) have been associated with variable outcomes in COVID-19 patients in different regions, suggesting population-specific differences in the disease outcome. This study examined the association of INFL3 and INFL4 SNPs (rs12979860 and rs368234815, respectively) and nasopharyngeal expression with COVID-19 disease severity in Pakistani patients.Methods: For this study, 117 retrospectively collected nasopharyngeal swab samples were used from individuals with mild and severe COVID-19 disease. qPCR assays were used to determine the viral loads and mRNA expression of IFNL3 and 4 through the Ct and delta Ct methods, respectively. Due to funding limitations, only one SNP each in INFL3 and INFL4 (found to be most significant through literature search) was analyzed using tetra-arm PCR and RFLP-PCR strategies, respectively. The Mann–Whitney U-test was applied to evaluate the statistical differences in the expression of IFNL3/4 genes in the mild and severe groups, while for SNPs, a Chi-square test was