7 research outputs found
Folio
No full textPlatinum EditionGod Bless Them! pp. 1; In Memory of Prof. Khurshid A. Gill. pp. 2; Sandhu, M. Y.-Poetry-Memories of the Bye-gones. pp. 2; Arif Qureshi-In dulcet memory... pp. 3-4; Arif Qureshi-Poetry-Reminiscences. pp. 4; Ravia Shabeen-The Folio (Registering its History). pp. 5-6; Folio (Year by Year). pp. 7-8; Interview-The Living Legend (F.E. Chaudhry is the oldest Formanite alive, to the best of our knowledge). pp. 9-10; Interview-An Hour with Mian Muhammad Somroo. pp. 11-12; Zainab Mohsin-Buildings. pp. 13-14; Agha Mohsin Sohail-Formanites Are Great. pp. 15-17; Once A Formanite... Always A Formanite. pp. 18-20; Haque Nawaz Cheema-Love for my Institution. pp. 21; Agha Saeed-Old is Gold, New is Silver. pp. 22; Lamia Islam Khan-My Favourite Place. pp. 23; Sara Kanwal-Motivation Forever. pp. 24-25; Bilkis Hussain-Before Sunset. pp. 26; Farid A. Malik-Back to 1958. pp. 27-28; The Excellers. pp. 29-30; Position Holders (Convocation 2008). pp. 31; Survey. pp. 33-34; Donald Alfred Smith-Poetry-A Valentine. pp. 35; Easha Farooq-Love - A Human Need. pp. 36; Fatima Majeed-Defining Love. pp. 37; Bahawal Shehryar-A Fundamentalist. pp. 38; Farhat Aziz-Essay-Concept of Love in Christianity and Islam. pp. 39-40; Fatima Tahir-Mother's Love. pp. 41; Rabiya Khawar-A Blessing for the Two Worlds. pp. 42; Anam Khalid-Etymology of Love. pp. 43; Noor Nisha-Beauty of Love. pp. 44; Ayesha Rana-The Ultimate Aim. pp. 45; Madiha Sundas Rana-I Love thee for a Heart that is Kind. pp. 46; Rabiya Khawar-True Love Never Dies. pp. 47; Amina Jamil-Love - A Timeless Essence. pp. 48; Farhan Hashmi-Love Its Immortal. pp. 49; Kashifa Khalid-A Quest. pp. 50; Daud Aziz Khokher-Love!!! pp. 51-52; Bilkis Hussain-The Truth about Love!!! pp. 53; Alvi, M. Zohaib-Love in Politics. pp. 54; Fatima Arif-Waiting to be Loved like Before. pp. 55-56; Azzam Saddique-Essay-My Symphony for the Deaf. pp. 57-59; Rabiya Khawar-The Quaid-e-Azam. pp. 60-61; Tajwar Ali-Essay-The Unique Location of My Gilgit Baltistan. pp. 62-63; Ramla Ashfaq-Turn Minus Into Plus. pp. 64; Furqan Ali Akhtar-My Childhood Love. pp. 65-66; Kashifa Khalid-Silent Screams. pp. 67-68; Beenish Khokhar-Where we Started? Where we end? pp. 69-70; Omer Habib-Falling Apart. pp. 71; Sobia Kiran-A Speech by my Dream-Minister. pp. 72-74; Interview-An Evening with Javed Iqbal. pp. 75-79; Adil Khurram-Story-Deception. pp. 81-82; Shehzad, M. Shehril-Story-Whatever happened to... pp. 83; Bhatti, M. Umar-Story-Spell. pp. 84-85; Usman Khalid-Story-Love. pp. 86; Umer Murtaza Qureshi-Story-Road Kill. pp. 87-88; Shehzad, M. Shehril-Story-...as I sat down, I sensed something was Different... pp. 89; Hassan Noor Assad-Story-Born Again. pp. 90; Muhammad Adeel-Story-The Cookies. pp. 91-92; Waseem Anwar-Poetry-Out West and the Rule of the Law. pp. 93; Zainab Mohsin-Poetry-Life goes on. pp. 94; Bilkis Hussain-Poetry-Paint me, please. pp. 94; Minam Ahmed-Poetry-Mother. pp. 95; Usman Nasir-Poetry-My tears. pp. 95; Jahanzaib Aslam-Poetry-Untitled. pp. 96; Mehwish Shafi-Poetry-A Fairy Who Lives with Me. pp. 96; Rashion Sajid-Poetry-Old days. pp. 97; Abdul Rehman-Poetry-Essence. pp. 97; Saadia Riaz Sehole-Poetry-Can you justify it? pp. 98; Saad Sarfraz Sheikh-Poetry-The Wishlist thing of mine. pp. 98; Razzaq, M. Sarmad-Poetry-Till we meet again. pp. 99; Fariha Qayyum-Poetry-We...The Formanite. pp. 99; Sohaib Zaheer-Poetry-By Love Serve One Another. pp. 100; Fakiha Komal-Poetry-The Lost Love. pp. 100; Irteza Rehman-Poetry-Realization. pp. 101; Sana Jennifer-Poetry-The Art of Giving. pp. 102; Rizwan Kamran-Poetry-Guess! Who is it? pp. 102; Kamran Akram Gondal-Poetry-Common Things. pp. 103; Rabia Ashfaq-Poetry-The Dying Sun. pp. 103; Hafiz Muhammad Hamza Sehole-Poetry-My Dear Parents. pp. 104; Farhan Hashmi-Poetry-Innocence. pp. 104; Ahmed Farooq-Poetry-All I see is You. pp. 105; Sadia Riaz Sehole-Poetry-Life is at Risk. pp. 105; Goraya, M. Furqan-Poetry-Friendship. pp. 106; Omar Farooq-Poetry-Birth. pp. 106; Iqbal, M. Shaheer-Poetry-In the Shades of Blossom. pp. 107; Nauman Ahmed-Poetry-Life is not what I thought it to be. pp. 107; Haider, S. Zulqarnain-Poetry-Truth. pp. 108; Goraya, M. Furqan-Poetry-Examinations. pp. 108; Prof. Arif Qureshi-Poetry-Dreams. pp. 109; Sheraz Ashraf-Poetry-Lonely Heart. pp. 109; Easha Farooq-Poetry-Winter's Tale. pp. 110; Sana Alvi-Poetry-After She Left Me. pp. 110; Sandhu, M. Y.-Poetry-She comes Not. pp. 111; Erum George-Poetry-Change. pp. 111; Muhammad Adeel-Poetry-Peace. pp. 112; Adeel Anwar-Poetry-Vengeance. pp. 112; Azzam Saddique-A ""Prefect"" Story. pp. 113-114; Muhammad Adeel-Flirtation. pp. 115; Saad Sarfraz-Misery Loves Company. pp. 116-117; Haider F. Halim-No Donkeys in New York. pp. 118-119; Lamia Islam Khan-How to prepare a Bride? pp. 120; Saba Zareen-Modern Love Letter. pp. 121; Lamia Islam Khan-Load Shedding. pp. 122; Zafar Khattak-Application to the Staff Editor. pp. 123; Augustine, Milcah-Cartoons. pp. 124-126; Riaz Akbar Somairi-Article-Prospects of Peace in Multicultural South Asia. pp. 127-128; Bakhtawar Khan-Caste System. pp. 129-130; Abdur Rehman Farrukh-Women are not born. They are made. pp. 131-132; Fraaz Mehmud-Romanticism as a Pillar of Nationalism. pp. 133-134; Fizza Ali Shah-Is mobile phone use among youngsters really a menace? pp. 135-136; Mehreen Ali Kasana-One Muffled Scream. pp. 137-138; Kamal ud Din-Dr. Kamal ud Din. pp. 139-140; Miss Zara Hussain. pp. 141; Miss Saima Saleem. pp. 142; Beenish Khokhar-Unforgettable Tour. pp. 143-144; Rizwan Kamran-The Teacher. pp. 145; Maryam Azhar-IT: A New, Challenging Dimension. pp. 146-148; Folio [Urdu] 148 p.Editorial Board (English). 2 pages before Editorial; Advisory Board. 1 page before Editorial; Prof. Khurshid A. Gill & Mr Perviaz Rehmatullah. page 1; F. E. Chaudhry. after page 10; Mian Muhammad Somroo. before page 11; Society Presidents. before page 29; Political Cartoons created by Javed Iqbal (Famous Cartoonist). on 2 pages, after page 79; 20 pages of pictures, Memories, Commencement 2008: Convocation, Valedictory 2009, Sports Day, Line Work, The Story of Yester Years, People Who Make Difference, Campus Life, Societies, Drama. after page 148; Folio Team with Prof Dr K. K. Aziz. after page 8 (Urdu side); Editorial Board (Urdu). 1 page before Urdu Content
Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study
No full textBackground
There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these.
Method
We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality.
Results
1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4–2), (OR = 4.7, 95% CI 3.1–7.6)], female gender [(OR = 1.8, 95% CI 1.4–2.3), (OR = 1.9, 95% CI 1.3–2.9)], shock on admission [(OR = 2.1, 95% CI 1.7–2.7), (OR = 4.8, 95% CI 3.2–7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9–3.2), (OR = 3.9), 95% CI 2.7–5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1–1.6], but not mortality.
Conclusions
This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality
Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021
No full textBackgroundOverweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050. MethodsLeveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends. FindingsRates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989–1·01) adult males and 1·11 billion (1·10–1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397–407] individuals), followed by India (180 million [167–194]) and the USA (172 million [169–174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8–160·3) in males and 104·9% (95% UI 100·9–108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39–4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4–269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121–162) by 2050, making it the country with the fourth-largest population with overweight and obesity. InterpretationNo country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels. FundingBill & Melinda Gates Foundation.This study was funded by the Bill & Melinda Gates Foundation (OPP1152504)
Association of BMI, lipid-lowering medication, and age with prevalence of type 2 diabetes in adults with heterozygous familial hypercholesterolaemia: a worldwide cross-sectional study
No full textBackground: Statins are the cornerstone treatment for patients with heterozygous familial hypercholesterolaemia but research suggests it could increase the risk of type 2 diabetes in the general population. A low prevalence of type 2 diabetes was reported in some familial hypercholesterolaemia cohorts, raising the question of whether these patients are protected against type 2 diabetes. Obesity is a well known risk factor for the development of type 2 diabetes. We aimed to investigate the associations of known key determinants of type 2 diabetes with its prevalence in people with heterozygous familial hypercholesterolaemia.
Methods: This worldwide cross-sectional study used individual-level data from the EAS FHSC registry and included adults older than 18 years with a clinical or genetic diagnosis of heterozygous familial hypercholesterolaemia who had data available on age, BMI, and diabetes status. Those with known or suspected homozygous familial hypercholesterolaemia and type 1 diabetes were excluded. The main outcome was prevalence of type 2 diabetes overall and by WHO region, and in relation to obesity (BMI ≥30·0 kg/m2) and lipid-lowering medication as predictors. The study population was divided into 12 risk categories based on age (tertiles), obesity, and receiving statins, and the risk of type 2 diabetes was investigated using logistic regression.
Findings: Among 46 683 adults with individual-level data in the FHSC registry, 24 784 with heterozygous familial hypercholesterolaemia were included in the analysis from 44 countries. 19 818 (80%) had a genetically confirmed diagnosis of heterozygous familial hypercholesterolaemia. Type 2 diabetes prevalence in the total population was 5·7% (1415 of 24 784), with 4·1% (817 of 19 818) in the genetically diagnosed cohort. Higher prevalence of type 2 diabetes was observed in the Eastern Mediterranean (58 [29·9%] of 194), South-East Asia and Western Pacific (214 [12·0%] of 1785), and the Americas (166 [8·5%] of 1955) than in Europe (excluding the Netherlands; 527 [8·0%] of 6579). Advancing age, a higher BMI category (obesity and overweight), and use of lipid-lowering medication were associated with a higher risk of type 2 diabetes, independent of sex and LDL cholesterol. Among the 12 risk categories, the probability of developing type 2 diabetes was higher in people in the highest risk category (aged 55-98 years, with obesity, and receiving statins; OR 74·42 [95% CI 47·04-117·73]) than in those in the lowest risk category (aged 18-38 years, without obesity, and not receiving statins). Those who did not have obesity, even if they were in the upper age tertile and receiving statins, had lower risk of type 2 diabetes (OR 24·42 [15·57-38·31]). The corresponding results in the genetically diagnosed cohort were OR 65·04 (40·67-104·02) for those with obesity in the highest risk category and OR 20·07 (12·73-31·65) for those without obesity.
Interpretation: Adults with heterozygous familial hypercholesterolaemia in most WHO regions have a higher type 2 diabetes prevalence than in Europe. Obesity markedly increases the risk of diabetes associated with age and use of statins in these patients. Our results suggest that heterozygous familial hypercholesterolaemia does not protect against type 2 diabetes, hence managing obesity is essential to reduce type 2 diabetes in this patient population
30-day Morbidity and Mortality after Cholecystectomy for Benign Gallbladder Disease (AMBROSE): A Prospective, International Collaborative Cohort Study
No full textObjective: This study aimed to assess 30-day morbidity and mortality rates following cholecystectomy for benign gallbladder disease and identify the factors associated with complications. Summary background data: Although cholecystectomy is common for benign gallbladder disease, there is a gap in the knowledge of the current practice and variations on a global level. Methods: A prospective, international, observational collaborative cohort study of consecutive patients undergoing cholecystectomy for benign gallbladder disease from participating hospitals in 57 countries between January 1 and June 30, 2022, was performed. Univariate and multivariate logistic regression models were used to identify preoperative and operative variables associated with 30-day postoperative outcomes. Results: Data of 21,706 surgical patients from 57 countries were included in the analysis. A total of 10,821 (49.9%), 4,263 (19.7%), and 6,622 (30.5%) cholecystectomies were performed in the elective, emergency, and delayed settings, respectively. Thirty-day postoperative complications were observed in 1,738 patients (8.0%), including mortality in 83 patients (0.4%). Bile leaks (Strasberg grade A) were reported in 278 (1.3%) patients and severe bile duct injuries (Strasberg grades B-E) were reported in 48 (0.2%) patients. Patient age, ASA physical status class, surgical setting, operative approach and Nassar operative difficulty grade were identified as the five predictors demonstrating the highest relative importance in predicting postoperative complications. Conclusion: This multinational observational collaborative cohort study presents a comprehensive report of the current practices and outcomes of cholecystectomy for benign gallbladder disease. Ongoing global collaborative evaluations and initiatives are needed to promote quality assurance and improvement in cholecystectomy
Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021
No full textBackground: Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. Methods: Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5–14 years, typically in school and cared for by child health services) and older adolescents (aged 15–24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990–2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. Findings: Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6–96·6) individuals aged 5–14 years and 80·6 million (78·2–83·3) aged 15–24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15–24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5–14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7–17·2) of those aged 5–14 years are forecasted to have obesity by 2050 (186 million [141–221]), compared with 14·2% (11·4–15·7) of those aged 15–24 years (175 million [136–203]). We forecasted that by 2050, there will be more young males (aged 5–14 years) living with obesity (16·5% [13·3–18·3]) than overweight (12·9% [12·2–13·6]); while for females (aged 5–24 years) and older males (aged 15–24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041–50: children and adolescents (males and females aged 5–24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5–14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5–14 years in Australasia; females aged 15–24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15–24 years in high-income North America. Interpretation: Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis. Funding: Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council
