Kabol

The first 1000 days of a child's life are vital for brain development and future health. Responsive caregiving during this period supports social and cognitive growth, builds trust, and provides a sense of security. This research aims to adapt and evaluate a newborn parenting education program, originally developed for tertiary care, for use in primary health care settings in Pakistan and Afghanistan. The study focuses on improving parental outcomes and training healthcare providers while assessing the readiness of health systems to expand this program nationally. Participants will receive the Early Childhood Development Newborn Parenting Education Program based on nurturing care and caregiving frameworks proven effective in previous studies. This program will be implemented at selected primary health care facilities of Aga Khan Health Services in Pakistan and Afghanistan. The intervention involves educating parents and training healthcare workers to support responsive caregiving practices in newborns. Throughout the study, researchers will monitor quality of life at birth and track parental confidence, caregiver interactions, and early child development up to six months. They will use scales such as the World Health Organization Quality of Life Scale and the Karitine Parenting Confidence Scale. The study will also assess caregiver responsiveness and collect early development data to understand the program's impact. The goal is to build evidence supporting broader adoption of this intervention in resource-constrained primary care environments.

Researchers are evaluating a Participatory Learning and Action (PLA) based intervention aimed at preventing and controlling Type II Diabetes Mellitus (TIIDM) in rural Kabul, Afghanistan. This study addresses the urgent need for culturally appropriate and evidence-based strategies, given the high and rising prevalence of diabetes in Afghanistan and worldwide, especially in low- and middle-income countries. The intervention adapts a method previously proven effective in rural Bangladesh to the unique social and health system context of Afghanistan. The intervention involves community education sessions lasting 2 to 3 hours, designed to prepare individuals with TIIDM and promote health behavior changes. These sessions are part of a PLA approach that encourages meaningful community participation. The study will implement this intervention over a 10-month period, after which participants will be evaluated using a structured and validated assessment checklist to determine the feasibility and acceptability of the adapted PLA intervention. Participants will be involved through scheduled meetings and education sessions based on the study protocol. Researchers will assess the feasibility and acceptability of the intervention over 10 to 12 months, including baseline and endline evaluations. The study will measure outcomes related to diabetes prevention and control, focusing on social and behavioral health determinants. Participants include adults aged 20 years and older from selected rural clusters in Kabul, with ongoing monitoring to ensure adherence and engagement throughout the study period.

Researchers are conducting a multinational, prospective observational study called the ICU-related Out-of-Pocket Expenses (ICOPE) study in African and Asian countries. This study aims to measure the financial burden on patients and families related to ICU care, focusing on out-of-pocket expenses and catastrophic health expenditure. The study includes both ventilated and non-ventilated patients admitted to participating ICUs during a 14-day recruitment period, with a planned sample size of at least 354 patients. Participants are followed during their ICU stay, which averages about 7 days, and additional follow-ups occur at 30 days and 6 months after admission. The study compares costs between patients receiving invasive mechanical ventilation and those who are not ventilated. It also investigates risk factors for catastrophic health expenditure and documents how families cope with the financial demands of ICU care. Throughout the study, researchers collect data on patient expenses, including direct medical and non-medical costs, as well as indirect costs such as income loss. The main outcomes measured are the out-of-pocket cost per patient episode until ICU discharge and the relative risk of catastrophic health expenditure. The total study duration spans 18 months, allowing for comprehensive assessment of financial impact and coping strategies over time.

Researchers are evaluating the safety and tolerability of Empagliflozin, with or without metformin, in adults aged 18 to 65 years who have Type II Diabetes Mellitus in the Pakistani population. This Phase 4, open-label, prospective, observational study involves 156 patients and aims to monitor common side effects such as hypoglycemia, dehydration, urinary tract infections, fungal infections, nausea, and abdominal discomfort. The study focuses on patients who have not previously used Empagliflozin and have uncontrolled diabetes despite oral antidiabetic medications and lifestyle changes. Patients must have HbA1C levels between 7% and 10% and an estimated glomerular filtration rate (eGFR) of 60 or above. Participants will receive Empagliflozin either alone or combined with Metformin in various dose combinations. The drug doses include Empagliflozin plus Metformin combinations of 5mg/500mg, 5mg/850mg, 5mg/1000mg, 12.5mg/500mg, 12.5mg/850mg, and 12.5mg/1000mg, or Empagliflozin alone at 10mg or 25mg. The study spans 12 months, with safety data collected through a 6-month follow-up period after the last patient's enrollment. Follow-up visits occur at 4 to 6 weeks, 12 weeks, and 24 weeks after starting treatment. During the study, patients will undergo laboratory tests including HbA1C, fasting blood glucose, renal function tests, and urine routine examinations to monitor diabetes control and kidney health. Certified clinical labs will analyze these samples, and patients receive up to 50% discount on study-related lab tests. Researchers will closely watch for adverse effects and treatment tolerability throughout the visits, ensuring patient safety and gathering real-world evidence on the treatment's impact over six months.