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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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    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.