Clinical risk factors associated with the development of wheezing in children less than 2 years of age who required hospitalization for viral lower respiratory tract infections

Knowledge, Attitude, and Perception of Passive Smoking Among Medical and Dental Students of Karachi: A Survey-Based Study

Background

Passive smoking, the involuntary inhalation of tobacco smoke, poses significant health risks; however, its prevalence and impact on medical and dental students in Karachi, Pakistan, remain understudied. Therefore, this research aims to understand the knowledge, attitudes, and practices (KAP) regarding passive smoking among medical and dental students and will help shed light on their awareness, perceptions, and behaviours regarding this public health concern.

Methods

A cross-sectional study was conducted over 3 months, involving 378 medical and dental students (303 medical and 75 dental students)from various universities in Karachi. Participants completed a questionnaire to gather information on demographics, awareness of passive smoking, perceptions of its health effects, and actions taken in response to exposure.

Results

The majority of participants demonstrated awareness of passive smoking 320 (84.7%) and believed that it was essentially linked to active smoking 320 (84.7%). Cigarette smoke was identified as the primary contributor to passive smoking 345 (91.3%). A significant proportion of participants believed that children and pregnant women exposed to passive smoking had elevated health risks. In areas where smoking is not permissible, less than half of the participants 173 (45.8%) reminded smokers about the smoking regulations, and a few even referred smokers for counselling 141 (37.3%). Males are usually indifferent to smokers around them, whereas females are found uncomfortable with smoking in their surroundings.

Conclusion

In conclusion, our study highlights the persistent prevalence of passive smoking among medical and dental students in Pakistan. Enforcing strict tobacco control policies, integrating passive smoking education into medical curricula, and improving communication strategies for smoking cessation interventions are crucial steps towards creating smoke-free environments and healthier lifestyles nationwide. Despite awareness among medical and dental students about the dangers of cigarette smoking, their reluctance to urge regular smokers to quit underscores the need for improved communication between smokers and non-smokers to foster a cleaner and hazard-free environment.

Secondhand smoking, knowledge/attitudes and socioeconomic status among married Bangladeshi women: a cross-sectional study

BACKGROUND

There is a paucity of research on knowledge/attitudes regarding the dangers of exposure to secondhand smoking (SHS) among women. The relationship between exposure to SHS, socioeconomic status (SES) and knowledge/attitudes regarding the risks of SHS has often been ignored. We therefore aimed to examine (1) whether SES and exposure to SHS were independently associated with knowledge/attitudes regarding the risks of SHS; and (2) whether women with low SES and exposure to SHS were uniquely disadvantaged in terms of deficient knowledge and more dismissive attitudes towards the risks of SHS.

DESIGN AND SETTING

Cross-sectional study in the Rajshahi district, Bangladesh.

METHODS

A total of 541 women were interviewed. Knowledge of and attitudes towards the risks of SHS were the outcomes of interest.

RESULTS

A majority of the respondents were exposed to SHS at home (49.0%). Only 20.1% had higher levels of knowledge, and only 37.3% had non-dismissive attitudes towards the risks of SHS. Participants in the low SES group and those exposed to SHS had lower odds of higher knowledge and their attitudes towards the risks of SHS were more dismissive. Regarding deficient levels of knowledge and scores indicating more dismissive attitudes, women in the low SES group and who were exposed to SHS were not uniquely disadvantaged.

CONCLUSIONS

Exposure to SHS and low SES were independently associated with deficient knowledge and scores indicating more dismissive attitudes. Regarding knowledge/attitudes, the negative effect of exposure to SHS extended across all socioeconomic backgrounds and was not limited to women in either the low or the high SES group.

Socio-economic inequalities in secondhand smoke exposure at home in the context of mother-child pairs in Bangladesh

OBJECTIVES

This study aimed to examine socio-economic disparities in mother-child pairs' self-reported and cotinine-measured secondhand smoke (SHS) exposure at home.

STUDY DESIGN

This is a cross-sectional study.

METHODS

This study was conducted in the Rajshahi district of Bangladesh from May to July 2017. A total of 541 mother-child pairs were interviewed for self-reported measured SHS; cotinine-measured saliva test was performed on 263 mothers and 236 children. Mother-child pairs' SHS exposure at home was the outcome of interest.

RESULTS

Overall self-reported prevalence of SHS exposure at home was 49.0%. Self-reported SHS exposure among mothers (50.2%) and children (51.3%) were lower than the prevalence rate of cotinine-measured exposure for mothers (60.5%) and their children (58.9%). Maternal rich bands of wealth were found to be associated with lower likelihood of self-reported (adjusted odds ratio [AOR] = 0.59, 95% confidence interval [CI] = 0.35-0.99) and cotinine-measured SHS exposure among mothers (AOR = 0.17, 95% CI = 0.08-0.37). Maternal rich bands of wealth were also found to be associated with lower likelihood of cotinine-measured SHS exposure among children (AOR = 0.11, 95% CI = 0.07-0.26).

CONCLUSIONS

Socio-economic inequalities exist in exposure to SHS at home. Interventional approaches aimed at reducing SHS at home are urgently needed at public health and healthcare service level, with special focus given to the socioeconomically disadvantaged groups.

Clinical predictors of chest radiographic abnormalities in young children hospitalized with bronchiolitis: a single center study

Purpose

Chest radiography is often performed on patients hospitalized with typical clinical manifestations of bronchiolitis. We aimed to determine the proportion of subjects with pathologic chest radiographic findings and the clinical predictors associated with pathologic chest radiographic findings in young children admitted with the typical presentation of bronchiolitis.

Methods

We obtained the following data at admission: sex, age, neonatal history, past history of hospitalization for respiratory illnesses, heart rate, respiratory rate, the presence of fever, total duration of fever, oxygen saturation, laboratory parameters (i.e., complete blood cell count, high-sensitivity C-reactive protein [hs-CRP], etc.), and chest radiography.

Results

The study comprised 279 young children. Of these, 26 had a chest radiograph revealing opacity (n=24) or atelectasis (n=2). Multivariate logistic regression analysis showed that after adjustment for confounding factors, the clinical predictors associated with pathologic chest radiographic findings in young children admitted with bronchiolitis were elevated hs-CRP level (>0.3 mg/dL) and past history of hospitalization for respiratory illnesses (all P<0.05).

Conclusion

The current study suggests that chest radiographs in young children with typical clinical manifestations of bronchiolitis have limited value. Nonetheless, young children with clinical factors such as high hs-CRP levels at admission or past history of hospitalization for respiratory illnesses may be more likely to have pathologic chest radiographic findings.

Seasonal Cycle and Relationship of Seasonal Rhino- and Influenza Virus Epidemics With Episodes of Asthma Exacerbation in Different Age Groups

Purpose

Seasonal variations in asthma exacerbation (AE) are associated with respiratory virus outbreaks and the return of children to school after vacation. This study aims to elucidate the period, phase, and amplitude of seasonal cycles of AE in 5 different age groups with regard to rhino- and influenza virus epidemics in Korea.

Methods

The number of daily emergency department (ED) visits for AE in all age groups of Korea and the nationwide weekly incidence of rhino- and influenza virus, were obtained for 2008-2012. Fourier regression was used to model rhythmicity, and the Cosinor method was used to determine the amplitude and phase of the cycles in each age group. The cross-correlation function (CCF) between AE and the rhino- and influenza virus epidemics was also calculated.

Results

There were 157,559 events of AE (0.62 events/1,000 individuals/year) during the study period. There were spring and fall peaks of AE in children and adults, but only 1 winter peak in the elderly. The amplitude of the AE peak in infants was higher in spring than in fall (9.16 vs 3.04, P<0.010), and the fall peak was approximately 1 month later in infants than in school children (October 11 vs November 13, P<0.010). The association between AE and rhinovirus was greatest in school children (rho=0.331), and the association between AE and influenza virus was greatest in those aged ≥60 years (rho=0.682).

Conclusions

The rhythmicity, amplitude, and phase of the annual cycle of AE differed among different age groups. The patterns of AE were related to the annual rhino- and influenza virus epidemics.

Association between secondhand smoking in the home and respiratory morbidity in preschool children

Abstract OBJECTIVE Identifying the prevalence of secondhand smoking in the home and its association with morbidity and hospitalization from respiratory causes in preschool children. METHOD This is a cross-sectional study conducted in five early childhood education centers at a public university in São Paulo. Sample size calculation was performed and the participants were randomly determined. Data were collected through questionnaires completed by family members or caregivers of 215 children. Chi-square and Student's t-test were used for the statistical analysis, using a 0.05 significance level. RESULTS The prevalence of secondhand smoke in the household was 15.3%. Bivariate analysis revealed that secondhand smoke in the household was associated with the occurrence of rapid breathing, subdiaphragmatic retractions in the past three months, and treated ear infections/otitis. CONCLUSION A low prevalence of secondhand smoking in the home was found. Secondhand smoke was associated with a higher prevalence of respiratory symptoms and morbidity.