Correlation Between Diet History and Nutritional Status of Children Aged 24–59 Months in Tarumajaya, Bekasi in 2019

This study aimed to analyze the correlation between diet history and the nutritional status of pre-school children. This was an analytical observational study using a cross-sectional design. Sam-ples were 96 children aged 24‒59 months in Tarumajaya, Bekasi, West Java. Diet history was obtained from questionnaires containing history of breastfeeding and diet since the infancy period. The children’s heights were measured using a microtoise stature meter. Subjects were considered stunted if their Height-for-Age Z-score was minus 2 or lower according to WHO Child Growth Standard. Data was analyzed using Fisher’s exact test. Out of the 96 children, 16 (16.7%) were stunted. There were 80 (83.3%) children who received exclusive breastfeeding, 51 (53.1%) who received an appropriate frequency of meals, 78 (81.3%) who met the minimum dietary diversity, and 29 (30.2%) who had a minimum acceptable diet. Fisher’s exact test showed that dietary diversity was a significant factor for stunted children (p<0.001)

Language, Power and Gender: A Case Study of Code Switching by Less Educated People In Pakistan

The purpose of this study is to investigate the relation between language, power and gender among less educated people. Less educated people here mean those who passed only middle class examination. Foucault’s theory of power and discourse gave new dimensions to languages. Language is used to exert power (Foucault, 1998). Due to this relationship of language and power, the speakers try to use that language as is enjoying power and high status in their speech community. Those of high status enjoying language is very much seen in the process of code switching where the speakers do code switching from low status enjoying language to high status enjoying language. The major aims of this research were to find out the relation between language and power and how speakers’ use of powerful language varied across gender. This study was quantitative. Data collection was done through questionnaire comprising of two sections. The first section was consisted of 10 close ended questions to know the relation between language and power. The second section of the questionnaire comprising of 10 close ended questions measured the status of Punjabi and Urdu. After careful inquires 30 less educated L1 Punjabi speakers were randomly selected from the city Sheikhupura. Among these 30 participants 15 were male and 15 were female. Audio recording was taken from 14 participants, 7 males and 7 females who had also took part in survey questionnaire to get the data about Urdu code switching. The results collected through the gathered data revealed the L1 Punjabi speakers regarded Urdu as powerful language and they asserted that language and power are closely related with each other. Further women used more powerful language and for this purpose they did more Urdu code switching as compared to men

Higher entropy observed in SARS-CoV-2 genomes from the first COVID-19 wave in Pakistan

Background: We investigated the genome diversity of SARS-CoV-2 associated with the early COVID-19 period to investigate evolution of the virus in Pakistan.Materials and methods: We studied ninety SARS-CoV-2 strains isolated between March and October 2020. Whole genome sequences from our laboratory and available genomes were used to investigate phylogeny, genetic variantion and mutation rates of SARS-CoV-2 strains in Pakistan. Site specific entropy analysis compared mutation rates between strains isolated before and after June 2020.Results: In March, strains belonging to L, S, V and GH clades were observed but by October, only L and GH strains were present. The highest diversity of clades was present in Sindh and Islamabad Capital Territory and the least in Punjab province. Initial introductions of SARS-CoV-2 GH (B.1.255, B.1) and S (A) clades were associated with overseas travelers. Additionally, GH (B.1.255, B.1, B.1.160, B.1.36), L (B, B.6, B.4), V (B.4) and S (A) clades were transmitted locally. SARS-CoV-2 genomes clustered with global strains except for ten which matched Pakistani isolates. RNA substitution rates were estimated at 5.86 x10-4. The most frequent mutations were 5\u27 UTR 241C \u3e T, Spike glycoprotein D614G, RNA dependent RNA polymerase (RdRp) P4715L and Orf3a Q57H. Strains up until June 2020 exhibited an overall higher mean and site-specific entropy as compared with sequences after June. Relative entropy was higher across GH as compared with GR and L clades. More sites were under selection pressure in GH strains but this was not significant for any particular site.Conclusions: The higher entropy and diversity observed in early pandemic as compared with later strains suggests increasing stability of the genomes in subsequent COVID-19 waves. This would likely lead to the selection of site-specific changes that are advantageous to the virus, as has been currently observed through the pandemic

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Jezik, moč in spol: Študija primera menjave kodov pri manj izobraženih ljudeh v Pakistanu

The purpose of this study is to investigate the relation between language, power and gender among less educated people. Less educated people here mean those who passed only middle class examination. Foucault’s theory of power and discourse gave new dimensions to languages. Language is used to exert power (Foucault, 1998). Due to this relationship of language and power, the speakers try to use that language as is enjoying power and high status in their speech community. Those of high status enjoying language is very much seen in the process of code switching where the speakers do code switching from low status enjoying language to high status enjoying language.The major aims of this research were to find out the relation between language and power and how speakers’ use of powerful language varied across gender. This study was quantitative. Data collection was done through questionnaire comprising of two sections. The first section was consisted of 10 close ended questions to know the relation between language and power. The second section of the questionnaire comprising of 10 close ended questions measured the status of Punjabi and Urdu. After careful inquires 30 less educated L1 Punjabi speakers were randomly selected from the city Sheikhupura. Among these 30 participants 15 were male and 15 were female. Audio recording was taken from 14 participants, 7 males and 7 females who had also took part in survey questionnaire to get the data about Urdu code switching. The results collected through the gathered data revealed the L1 Punjabi speakers regarded Urdu as powerful language and they asserted that language and power are closely related with each other. Further women used more powerful language and for this purpose they did more Urdu code switching as compared to men.Namen te študije je raziskati povezavo med jezikom, močjo in spolom med manj izobraženimi ljudmi. Kategorija manj izobraženi se nanaša na tiste ljudi, ki imajo dokončano le srednješolsko izobrazbo. Foucaultova teorija moči in diskurza je v jezik vnesla nove razsežnosti. Foucaultu (1998) predstavlja jezik osnovni mehanizem moči. Zaradi povezave med jezikom in močjo skušajo govorci uporabljati tisti jezik, ki uživa v družbi največjo moč in ugled. Pogosto se dogaja, da govorci nižjih slojev uporabljajo jezik višjih slojev za menjavo kodov.Ta raziskava si prizadeva najti povezavo med jezikom in močjo, nato želi ugotoviti, kako spol govorcev vpliva na uporabo jezika z večjo močjo. Raziskava je kvantitativne narave. Podatke smo zbrali na osnovi vprašalnika, ki je bil sestavljen iz dveh sklopov. Prvi sklop je obsegal 10 tesno povezanih vprašanj, katerih cilj je bil izluščiti povezavo med jezikom in močjo. Drugi sklop vprašalnika iz prav tako 10 tesno povezanih vprašanj je določil status pandžabščine in urdščine. Anketiranih je bilo 30 manj izobraženih govorcev pandžabščine (L1) iz mesta Sheikhupura. Polovica od njih je bilo moških in polovica žensk. Gradivo obsega še zvočne posnetke 14 anketirancev, od tega 7 moških in 7 žensk, ki so sodelovali tudi pri raziskavi o menjavi kodov v urdščini. Rezultati so pokazali, da so govorci pandžabščine (L1) mnenja, da je urdščina jezik moči. Raziskava je še pokazala, da so ženske uporabljale več jezika moči in pogosteje menjavale kode kot moški.

Variants associated with bedaquiline (BDQ) resistance identified in Rv0678 and efflux pump genes in mycobacterium tuberculosis isolates from BDQ naïve TB patients in Pakistan

Background: Mutations in the Rv0678, pepQ and atpE genes of Mycobacterium tuberculosis (MTB) have been reported to be associated with reduced antimycobacterial susceptibility to bedaquiline (BDQ). Resistance conferring mutations in treatment naïve MTB strains is likely to have implications for BDQ based new drug regimen that aim to shorten treatment duration. We therefore investigated the genetic basis of resistance to BDQ in MTB clinical isolates from BDQ naïve TB patients from Pakistan. In addition, mutations in genes associated with efflux pumps were investigated as an alternate mechanism of resistance. Methods: Based on convenience sampling, we studied 48 MTB clinical isolates from BDQ naïve TB patients. These isolates (from our strain bank) included 38 MDR/pre-XDR/XDR (10 BDQ resistant, 8 BDQ intermediate and 20 BDQ susceptible) and 10 pan drug susceptible MTB isolates. All strains were subjected to whole genome sequencing and genomes were analysed to identify variants in Rv0678, pepQ, atpE, Rv1979c, mmpLS and mmpL5 and drug resistance associated efflux pump genes. Results: Of the BDQ resistant and intermediate strains 44% (8/18) had variants in Rv0678 including; two reported mutations S63R/G, six previously unreported variants; L40F, R50Q and R107C and three frameshift mutations; G25fs, D64fs and D109fs. Variants in efflux pumps; Rv1273c (G462K), Rv0507c (R426H) and Rv1634c (E198R) were found to be present in drug resistant isolates including BDQ resistant and intermediate isolates. E198R in efflux pump gene Rv1634c was the most frequently occurring variant in BDQ resistant and intermediate isolates (n = 10). Conclusion: We found RAVs in Rv0678 to be commonly associated with BDQ resistance. Further confirmation of the role of variants in efflux pump genes in resistance is required so that they may be incorporated in genome-based diagnostics for drug resistant MTB