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Prevalence of Non-Alcoholic Fatty Liver Disease in Overweight and Obese Children Seeking Ambulatory Health Services in Nairobi

Thesis Info

Author

Mburu, Anne Njeri

Department

Paediatrics and Child Health (East Africa)

Program

MEd

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2017

Thesis Completion Status

Completed

Subject

Education

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676727965746

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Introduction: Non-alcoholic fatty liver disease is often an asymptomatic condition one of the leading causes of chronic liver disease and is associated with an increase in cardiovascular morbidity. Being overweight or obese has been positively linked to non-alcoholic fatty liver disease in children. There is evidence to show that when detected early, non-alcoholic fatty liver disease is reversible primarily upon institution of lifestyle changes targeted at weight reduction. Establishing the prevalence of non-alcoholic fatty liver disease in overweight and obese Kenyan children would serve as a benchmark for long term monitoring of associated morbidity and guide in public health policies aimed at early screening and intervention. Objectives: The aim of this study was to investigate prevalence of non-alcoholic fatty liver disease in overweight and obese children aged between six and eighteen years using liver ultrasonography. Methodology: A descriptive cross sectional study was carried out in 103 overweight and obese school aged children aged six to eighteen years seeking ambulatory health care services in Nairobi. Consent was obtained from the primary caregivers. A questionnaire was administered to collect information on bio data. Blood pressure readings were taken and plotted in age and gender specific charts and a liver ultrasound was done to assess and grade fatty changes. Data Analysis: Statistical analyses were conducted using SPSS version 11.5 (SPSS, Chicago, IL, USA). Categorical variables were analyzed using median (IQR) and summarized using frequency counts and percentages. Chi-square test was used to determine odds ratios for association between presence of fatty liver and other categorical variables using 2x2 tables. All clinically important variables were then included in multiple logistic regression model adjusting for age and sex to find if there was any association with fatty liver. All analyses were two-tailed and P-value less than 0.05 was considered statistically significant. Results: A total of 103 children were recruited in the study. The prevalence of fatty liver change was 26.2% (27/103; 95%CI=18.0%-35.8 %). There was no association between sex and fatty liver disease (OR=1.13, p=0.82; 95%CI=0.4-3.2) Obese children were four times more likely to have fatty liver compared to overweight children (OR=4.52 p=0.02, 95%CI=1.4-19.0). Slightly more than a third of the children, 40.8% (n=41) had elevated blood pressure. However, there was no association between elevated blood pressure and fatty liver disease (OR=2.06; p=0.27; 95%CI=0.6-7.6). Older children (13-18 years) were four times more likely to have fatty liver vi
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53. An-Najm/The Star

53. An-Najm/The Star

I/We begin by the Blessed Name of Allah

The Immensely Merciful to all, The Infinitely Compassionate to everyone.

53:01
a. By the star when it sets.

53:02
a. Your companion who has lived amongst you for forty years is neither strayed nor is he deluded,
53:03
a. nor does he speak out of his own personal desire with regard to what he recites to you of The Qur’an,
53:04
a. that which he conveys to you - The Qur’an - it is nothing but a Divine Revelation, being
revealed on to him.

53:05
a. Taught to him by the One of Awesome in Power,

53:06
a. Full of wisdom.
b. HE stood poised,

53:07
a. while HE was on the highest part of the horizon.

53:08
a. Then HE drew near and came close,

53:09
a. so much so that it was left only a space of the strings of two bows – facing each other, surrounding him in all directions - or even closer than that.
53:10
a. So HE revealed on to HIS Servant Muhammad whatever HE revealed.

53:11
a. The Prophet’s heart did not lie about what it saw.
b. He neither perceived it as an illusion nor was it a hallucination.
c. It was a reality.

53:12
a. Are you, then, going to argue with him what he saw?

53:13
a. And, certainly, he saw HIM yet again at another time, too,

53:14
a. by the Lote Tree of the Extremity,

53:15
a. close to which is the...

أثر مؤشرات التغري املناخي يف انتشار بعض اإلمراض املعدية يف حمافظة ذي قار

The study examines the impact of climate change on the spread of some diseases in Thi- Qar Province through collecting and analyzing data about various weather elements and phenomena of some monitoring stations ( Nasiriyah ) for a high-temperature climatic cycle of 78 years (1941-2018). It is divided into seven consecutive and different time periods, 1941-1951, 1952-1962, and 1963-1973, 1974-1984, 1985-1995, 1996-2006, 2007-2018. These elements and phenomena are solar radiation, temperatures (maximum and minimum), wind (Dust storm, rising dust, suspended dust), and the thermal extremes phenomenon (heat and cold waves) The research aims to reveal the reality of trends in climate of the province of thi qar, and find out the reality of the general trend of the elements of climatic different by relying on a series of evidence statistical number of climatic variables for the meteorological station in Nasiriyah especially temperature, wind speed, relative humidity and rainfall, and extreme dust The most important results of the research showed that temperatures trending upward in sync with a clear reduction in the amount of relative humidity and rainfall which threatens a sharp repeating the phenomenon of drought in the future. The research study has found that the City of Nasiriyah ranked first in human diseases for the period 2009-2018, as the reasons for this level of diseases include that Nasiriyah is subject to the recurrence of dusty weather phenomena due to its proximity to the Western Desert Plateau, as well as the lack of cultivated and water-covered areas. This city witnesses serious air pollutions due to the concentration of a large number of factories located near inhabited areas, as well as, the spread of brick factories in the regions of the city, such as, brick factories in the area of El-Islah. This is public services, in addition to the building projects, deterioration of sewage overflow, the spread of epidemics and insects harmful to human health, other climatic environmental pollutants, such as the spread of pollen, plant scents and air allergens, which contributed to the increase in the severity of skin diseases, climate eyes, arthritis and respiratory allergies. The city of Al-Shatra ranked second in the number of people with climatic diseases, Al-Rifai ranked third with infected cases, Souk Al-Shuyoukh ranked fourth, and finally Al-Jibayish ranked fifth and last in people with climatic human diseases for the period 2009-2018 in Dhi- qar province due to the same geographical, climatic, medical, and environmental causes indicated earlier.

The Relationship Between Classroom Environment and Students’ Speaking Skills in a Foreign Language at the Elementary Level

The ability to speak good English in Pakistan is considered a pivotal point around which the success of life moves. Teaching and learning English as a foreign language in the main stream schools of this country, however, revolves around reading and writing. In most classrooms listening and speaking skills are ignored. The reason for focusing on reading and writing is that only these two skills are assessed in examination. Recent research indicates the importance of speaking in this learning process. Oral language, both speaking and listening, is a life time activity; it enhances pupils' understanding of language in both oral and written forms and the way language can be used to communicate. This investigation is a case study focusing on the relationship of the classroom environment and students' speaking skill in an elementary classroom. Major finding indicates that a conducive environment created by the teacher helps students to enhance their speaking skills. For elementary students to be fluent in speaking the target language, the teacher needs to give them opportunities to talk about their own experiences. Physical environment is also important in learning a foreign language. A place is needed where students can have an opportunity to share their ideas closely. The class should be well lighted with moveable furniture to facilitate effective group work. This study found that small group' work is an effective strategy in creating a conducive environment for promoting students' speaking skills. Such a supportive non-threatening environment increases students' learning outcomes, which further brings about the desired change in the teacher's perception about the role of speaking in the learning process. The study also found that small group work is appropriate for students' speaking especially for shy and withdrawn students, where all the students can get a chance to talk about various topics. Teachers' role and responsibility in not limited to influencing the academic and intellectual performance of the students. Teachers can meet this responsibility by stimulating students thinking by encouraging discussions, dialogue, and role-play, and also by describing pictures and guiding students in evaluating the worth of ideas.