Prevalence and predictors of smoking in Pakistan: results of the National Health Survey of Pakistan.

OBJECTIVE: We analysed data collected during a nationwide cross-sectional household survey to estimate the prevalence of and identify factors associated with smoking in Pakistan. DESIGN: Population-based, cross-sectional survey [National Health Survey of Pakistan (NHSP) 1990-1994]. METHODS: A population-based survey was carried out in Pakistan during 1990-1994. A nationally representative sample of 18,135 individuals aged 6 months and older was surveyed. We restricted this analysis to individuals aged 15 years or older (n=9442). The main outcome measure was self-reported smoking. Smokers were defined as individuals who reported current smoking and having smoked at least 100 cigarettes or 'beddies' during their lifetime. RESULTS: Overall prevalence of smoking was 15.2% [95% confidence interval (CI), 14.5-15.9%]. It was 28.6% (27.3-29.9%) among men and 3.4% (2.9-3.9%) among women. The highest prevalence was reported in men aged 40-49 years (40.9%). The independent predictors of smoking identified in the multivariate logistic regression analysis included age, male gender, ethnicity and illiteracy. CONCLUSIONS: One out of every two to three middle-aged men in Pakistan smoke cigarettes. Our findings suggest that ethnically sensitive smoking control programmes that include measures for improving literacy rates are needed in Pakistan.     

The integral role of the clinical pharmacist in drug-assisted intubation at a newly established children’s major trauma center

International Journal of Clinical Pharmacy - This commentary outlines how the clinical pharmacist can support the safe administration of emergency medications in trauma anesthesia for seriously...     

Contrary to Expectations: Off-Label Transcatheter Aortic Valve Replacement in the Case of Left Ventricular Outflow Tract Obstruction

We present the case of a 71-year-old woman who showed recurrent signs of congestive heart failure with the need of rehospitalization after double valve (mitral and aortic) replacement. Extensive diagnostic workup revealed a moderate aortic stenosis and additionally a significant left ventricular outflow tract obstruction. The tissue overgrowth might be attributed to an inflammatory reaction with extensive pannus deposit after aortic valve surgery. With no-option for re-do surgery we performed the first-in-man off-label valve-in-left ventricular outflow tract procedure with an Edwards Sapien III 23 mm in deep orientation.     

The Latest Evolution of the Medtronic CoreValve System in the Era of Transcatheter Aortic Valve Replacement: Matched Comparison of the Evolut PRO and Evolut R

Objectives

The aim of this study was to investigate the hemodynamic and clinical performance of the Evolut PRO compared with its direct predecessor, the Evolut R.