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    Impact of opium use on the conventional coronary artery risk factors among outpatients in Afghanistan: A case-control study in Andkhoy city
    (Lahore Medical & Dental Coll, 2021) Hamrah, Mohammad Shoaib; Hamrah, Mohammad Hassan; Hamrah, Mohammad Hussain; Dahi, Toba; Hamrah, Ahamad Tareq
    Background: According to a recent study, opium use like other risk factors, is considered an independent risk factor for Coronary Artery Disease (CAD). Its association with other risk factors increases the risk of CAD. However, debate continues about this association. Aim: To explore the association between the conventional CAD risk factors and opium use among patients visiting an outpatient clinic in Andkhoy, Afghanistan. Methods: The case-control study was performed on 574 patients aged 18 years and above including 161 opium addicts and (case group) and 413 non-addicts (control group) from October 2017 to April 2018. Results: There were 277 males (48.3%) and 297 females (51.7%). The mean age was 53.2 (+/- 13.1) for opium users and 53.9 (+/- 13.5) for non-opium users. Opium use was associated with male gender (OR=8.2, 95% CI: 4.2-16.0), smoking (OR=9.0, 95% CI: 4.7-17.3), decreased Fasting Blood Sugar (FBS) levels (OR=1.0, 95% CI: 1.0-1.1), decreased total cholesterol levels (OR=3.4, 95% CI:1.8-6.2), physical inactivity (OR=3.9, 95% CI: 2.1-7.2), and hypertension (OR=15.1 95% CI: 6.7-33.8). Conclusions: We found that the opium use was associated with male gender, smoking, hypertension, decreased total serum cholesterol levels and decreased FBS levels. However, the association between opium use and the decreased total serum cholesterol levels and decreased FBS levels may be due to short-term hormonal and neural effects. Therefore, it should be advised not use opium as a cardioprotective agent.
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    Nass use and associated factors among outpatients in northern Afghanistan: a cross-sectional study in Andkhoy City
    (European Publishing, 2018) Hamrah, Mohammad Hasssan; Hamrah, Mohammad Shoaib; Hamrah, Mohammad Hussain; Dahi, Toba; Fotouhi, Akbar
    INTRODUCTION Tobacco use is one of the main risk factors for a number of chronic diseases, including cancer, lung diseases, and cardiovascular diseases. Nass is a form of smokeless tobacco. It is used most commonly in Central Asia, Afghanistan, Pakistan, and Iran, and is significantly associated with oral and oesophageal cancers. The aim of this study was to determine the prevalence of nass use and its associated factors among patients attending an outpatient clinic in Afghanistan. METHODS This cross-sectional study was performed in an outpatient clinic in Andkhoy, Afghanistan, from April to July 2017. The study included 387 consecutive patients. The data collection tool was a questionnaire, which includes three main items: demographic, physical, and biomedical measurements. We performed binary logistic regression to identify independent risk factors of nass use. RESULTS The study included 387 participants, of whom 225 were males (58.1%) and 162 were females (41.9%). The overall prevalence of nass use was 48.8% (95% CI: 43.8-53.9%), with the Turkmen ethnic group having significantly higher prevalence than other ethnic groups (58.2%, 95% CI: 50.8-65.3% vs 41.8%, 95% CI: 34.7-49.2%). The mean and standard deviation of the age was 63.9 (17.2) years for nass users and 42.3 (17.4) years for non-users. Based on a multivariate analysis, family history of nass use (OR= 31.4, 95% CI: 12.5-78.5), illiteracy (OR= 8.9, 95% CI: 2.5-31.2), rural residence (OR= 2.0, 95% CI: 1.0-3.9), and unemployment (OR= 5.4, 95% CI: 1.4-21.4) were associated with nass use. CONCLUSIONS Our results indicate that about half of the participants were nass users, and nass use associated factors were family history of nass use, illiteracy, unemployment, and rural residency in outpatient clinics in Afghanistan. More surveillance data are needed on a national level to inform the development of strategies for the prevention and control of nass consumption in Afghanistan.
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    The prevalence and correlates of fissured tongue among outpatients in Andkhoy city, Afghanistan: A cross-sectional study
    (Dove Medical Press Ltd, 2021) Hamrah, Mohammad Hassan; Baghalian, Ali; Ghadimi, Sara; Mokhtar, Saeedeh; Kargar, Mojgan; Dahi, Toba
    Background: Fissured tongue is a common manifestation of the tongue, marked by the presence of multiple prominent grooves or fissures on the dorsal surface of the tongue. However, there is a lack of studies focusing on the prevalence and factors associated with fissured tongue among patients attending an outpatient clinic in Afghanistan. Aim: The purpose of the current study was to determine the prevalence and factors associated with fissured tongue and its effects on the general health of adult outpatients in Afghanistan. Patients and Methods: The cross-sectional survey was conducted among outpatient populations in Andkhoy City, Afghanistan, between September 2019 and December 2019. A convenience technique was applied by including 1182 patient aged 18-80 years. Socio-economic status, smoking, nass use (smokeless tobacco use) and medical data were collected using face-to-face interviews. We used logistic regression analysis to identify factors associated with fissured tongue. A convenience technique was applied by including patient aged 18-80 years. Results: The studied population consisted of 1182 participants, of whom 573 (48.5%) were males and 609 (51.5%) females. The prevalence of fissured tongue was 27.2% (95% CI: 24.7-29.9%) with males having significantly higher prevalence than females (47.5%, 95% CI: 43.3-51.6% versus 8.2%, 95% CI: 6.2-10.7%, p<0.001). Male participants (OR=7.1, 95% CI: 4.8-10.3), diabetes mellitus (OR=1.6, 95% CI: 1.1-2.3) and smokeless tobacco use (OR=12.0, 95% CI: 8.1-17.6) were the only variables independently associated with fissured tongue. Conclusion: This study suggested that there was a high rate of fissured tongue among an outpatient clinic in Andkhoy, Afghanistan. Male gender, diabetes mellitus, and nass consumption were associated with fissured tongue. Therefore, these factors might usefully be targeted in local health promotion, prevention and early intervention programs.
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    Prevalence of coronary artery disease and its risk factors among outpatients in northern Afghanistan: A cross-sectional study in Andkhoy City
    (Lahore Medical & Dental Coll, 2020) Hamrah, Mohammad Hashem; Hamrah, Mohammad Shoaib; Hamrah, Mohammad Hassan; Hamrah, Mohammad Hussain; Hamrah, Ahmad Elias; Dahi, Toba; Anoshahamrah
    Background: Coronary artery disease is the most common form of cardiovascular disease a group of diseases that are a leading cause of mortality worldwide. Aim: To assess the prevalence of coronary artery disease and among patients attending an outpatient clinic in Afghanistan. Methods: We conducted a cross-sectional survey of 2005 patients from April 2018 to December 2018. Information on socio-demographics, smoking, physical inactivity, history of hypertension, diabetes and coronary artery disease were collected using a face-to-face interview. Anthropometric measurements, blood pressure, electrocardiogram and biomedical measurements were performed. Data were analysed using descriptive statistics. Results: The prevalence of coronary artery disease among patients was 17.4%, with females having significantly higher prevalence than males (20.1% versus 14.9%, P=0.02). Hypertension and physical inactivity were more prevalent among females than males (47.9% versus 34.6%, P<0.001), and (66.0% versus 51.4%, P<0.001), respectively. The prevalence of overweight and obesity was greater in females than males (59.8% versus 54.6%, P= 0.019) and a higher proportion of females had dyslipidaemia and diabetes mellitus compared to males (81.8% versus 63.3%, P<0.001, and 30.7% versus 23.0%, P< 0.001), respectively. However, smoking was more prevalent among males than females (46.5% versus 4.1%, P<0.001). Conclusions: The high prevalence of coronary artery disease and its risk factors among outpatients, especially women, attending one outpatient clinic in Afghanistan, highlights an urgentneedto prevent and control the disease in this area.