Self-Assembled Bubble Continuous Positive Airway Pressure (CPAP) Device as Primary Respiratory Support for Neonatal Respiratory Distress in Low-Resource Settings

Background: Self-assembled, bubble continuous positive airway pressure is a low-cost noninvasive respiratory support modality used to manage newborns with respiratory distress. Very few local studies have been conducted regarding its use in the management of neonatal respiratory distress. This study was conducted to evaluate the effectiveness of this device as a primary treatment modality for neonatal respiratory distress. Methods: This cross-sectional study was conducted in the Department of Pediatrics, Ziauddin Hospital, Karachi from 1st February 2018-31st July 2018 on neonates (n=200) admitted with respiratory distress, in whom self-assembled bubble continuous positive airway pressure was used as a primary respiratory support. The effectiveness of its use was determined, based on the absence of associated complications, signs of respiratory distress, and oxygen saturation at room air of 94% or more. Data were analyzed by SPSS version 20. The Chi-square test was used for categorical variables and a p-value <0.05 was considered statistically significant. Results: The mean gestational age was 34.3+2.73 weeks, the mean age at initiation of bubble continuous positive airway pressure was 7.7 4 hours, and the mean duration of hospital stay was 4.2 days. The observed failure rate in the study population was 8.5%, while the mortality was only 2%. The finding of respiratory distress syndrome on chest- X-ray with (FiO2) > 60% was observed. In addition, bubble CPAP after 6 hours of the onset of respiratory distress showed significant results (p<0.001). Conclusion: Self-assembled bubble continuous positive airway pressure is a significant and effective treatment modality (p=0.001) in neonatal respiratory distress. Keywords: Bubble Continuous Positive Airway Pressure; Neonates; Respiratory Distress

Sanitary conditions of few urban slums in New Delhi: a cross-sectional study

Background: Sanitation is essential for a society’s well-being and general health. Water, sanitation, and hygiene standards that are both adequate and safe can prevent numerous infections in the context of the present study, which was conducted with the aim of spreading knowledge regarding water sanitation, disposal, and treatment in the urban slums of southeast Delhi to prevent and control several water-borne diseases. Methods: A cross-sectional study was conducted with 294 participants from 144 households, between May 2022 to April 2023. Data were collected using door-to-door surveys. The sample size was 294 and houses were selected using convenience sampling. The data obtained were analyzed using MS Office (Excel). Results: Based on data collected from 144 households and 294 participants, 44.2% of participants in the Trilokpuri area had an interrupted water supply. There was a significant correlation between the water supply groups in our analysis (p&lt;0.0001). Conclusions: Our research revealed a strong correlation among sociodemographic profile, water supply, water usage, cleaning of water storage utensils, water stagnation, water disposal, treatment of stagnation, type of toilet, and sanitation conditions. According to the study’s key findings, the majority of people in southern Delhi did not have access to clean drinking water. There is obvious evidence of restricted access to contemporary piped water supplies. Thus, since drinking contaminated water can lead to a number of water-borne diseases, our research provides a framework for methodically raising awareness of the issues that need to be resolved to enable fair governance of the water supply

The Global Polio Eradication Initiatives: From Past to Present

The war against infections is one that has been remuneration all through the history of human. In this centuries-long effort the worldwide population has prepared remarkable advancement in stopping infections, therapeutic infections, and enlarging living expectancies. Up till now for all our successes, only once in history 30 years ago, with smallpox made completely eliminate an infection from the earth. Now a days we are on the entrance of eradicating the earth of polio an infection able of crippling and killing many children. The story of polio is both lengthy and hesitant. The arrival of efficient vaccines in the 1950s facilitated polio prevention, and the resultant struggles were victorious wildly, however confronts still continue (Plan, 2011)

Effect of glycemic control on tuberculosis treatment outcomes among patients with tuberculosis and diabetes mellitus:A systematic review and meta-analysis

Introduction: Tuberculosis (TB) and diabetes mellitus comorbidity can lead to poor TB treatment outcomes, particularly with uncontrolled blood glucose levels. Understanding the impact of glycemic control on TB treatment outcomes is essential. Objective: To synthesise evidence on the association between glycemic control and TB treatment outcomes in patients with TB and diabetes mellitus. Methodology: A systematic review was conducted using Medline, Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar for all types of studies published between 1975 and May 2024, including adult TB patients of >18 years of age, with or without diabetes mellitus for whom blood glucose testing along with TB treatment outcome comparison with glucose levels (low/high) was reported were considered for inclusion. A random-effects model was used for meta-analysis, heterogeneity was assessed using I-squared statistics, subgroup and sensitivity analysis was performed followed by publication bias assessment. Results: Of 576 identified studies, 12 met the inclusion criteria, analysing 2320 cases (1572 with uncontrolled high blood glucose [≥7% HbA1c] and 748 with controlled low blood glucose [<7% HbA1c]). Low certainty evidence shows that patients with uncontrolled high glucose had a 1.91 times higher risk of TB treatment failure (risk ratios [RR] = 1.91, 95% confidence interval [CI] 1.81–3.07, p = 0.008), and a 2.97 times higher risk of sputum positivity at 3 months (RR = 2.97, 95% CI 1.10–8.07, p = 0.03). Subgroup and sensitivity analyses showed significant improvement in pooled effects, lowering of heterogeneity and narrower CIs. For overall pooled effect, substantial heterogeneity was observed; therefore, the interpretation and generalisation of results should be done with caution. Conclusion: A low certainty evidence shows that uncontrolled high blood glycemic level significantly impacts TB treatment outcomes, increasing treatment failure and sputum positivity among TB patients with diabetes mellitus

Effectiveness of unani regimen in protecting high risk population from COVID -19: A pilot study

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally. COVID-19 presents varied clinical features. The present study focuses on number of patients turning COVID-19 positive, change in Immune Status Questionnaire (ISQ) and WHO quality of life- Bref (WHO Qol – BREF) scales after taking intervention. This open labelled, double arm, controlled, interventional, clinical trial was conducted on high-risk individuals i.e., those residing with a COVID-19 positive member in the identified quarantine area. This twin armed study was conducted on asymptomatic individuals exposed to COVID -19. The test group were prescribed Unani poly-herbal decoction together with Unani formulations Khamira Marwareed and Tiryaq e Arba whereas the control group was not on any intervention. The duration of intervention was 20 days; follow ups were planned on day 10 and day 20. Of the 81 participants enrolled, none of the patients turned COVID-19 positive. However, 13.58% (n=11) developed COVID like symptoms and 70 patients completed the study. The mean age of the participants was 41.42±16.9 years; however, majority of the participants were 18-28 years male with Damvi (Sanguine) temperament. The quality of life of the intervention group improved significantly however, the immune status in both the groups increased with P &lt;0.001. The Unani prophylactic regimen provides a 62% (relative risk reduction) protection against COVID -19. This pilot study paves for a study on a larger population. No adverse effects were observed during the study. Absence of biochemical investigations were limitations to the study

Establishment of health related physical fitness evaluation system for school adolescents aged 12–16 in Pakistan: a cross-sectional study

BackgroundThe decline in adolescent physical fitness is a significant global public health concern, and Pakistan is no exception. The country’s absence of a health-related physical fitness (HRPF) evaluation system has compounded this issue. To bridge this gap, this study aims to develop a scientifically-based HRPF evaluation system for the adolescent population that meets international standards. The evaluation system identifies at-risk children and improves adolescent health outcomes, including obesity, cardiovascular and musculoskeletal disorders, chronic diseases, and psychological illnesses, through crucial physical fitness evaluation. This study specifically aims to establish an HRPF evaluation system for school adolescents aged 12–16 in Pakistan.MethodsA cross-sectional study was conducted among 2,970 school adolescents aged 12–16 years in the South Punjab, Pakistan. The study used a stratified sampling technique to select participants. The HRPF evaluation system included four components: cardiorespiratory endurance, core muscular endurance, muscular strength, and body composition. Data were collected through standardized tests and anthropometric measurements.ResultsThe study’s results indicated that the HRPF evaluation scoring system was feasible and valid for evaluating the HRPF of school adolescents in the South Punjab region of Pakistan. The results of the evaluation system categorized participants into five groups based on their performance: excellent (6.2%), good (24.9%), medium (50.7%), poor (17%), and very poor (1.2%).ConclusionThe study establishes an HRPF evaluation system for Pakistani school adolescents. This system lays the foundation for implementing effective strategies to improve their physical health. The findings offer valuable insights to policymakers, health professionals, and educators, enabling them to promote fitness and devise impactful interventions for enhancing HRPF in this population

Surface Interactions and Mechanical Properties Shaping Biofilm Dynamics in S. aureus and P. aeruginosa

This study comprehensively investigates biofilm formation, and exploring its various biophysical properties like adhesion, surface roughness, cell stiffness, and cell surface hydrophobicity. The study is focused on five foodborne biofilm-positive strains of Pseudomonas (P) aeruginosa and Staphylococcus (S) aureus. After isolation, antimicrobial susptibility testing and molecular identification of the isolates, biofilm of all the strains was developed, and analyzed using the crystal violet assay. Subsequently, biofilm slides were assessed through Atomic Force Microscopy (AFM) and Scanning Electron Microscopy (SEM) to study the biophysical attributes. AFM findings revealed water reduction during biofilm formation, demonstrating variations in the rate at which water content decreased. Specifically, P. aeruginosa exhibited faster initial force increases on glass surfaces (τ = 4 s) compared to cell-to-cell surfaces (τ = 21 s). Moreover, AFM-based cell stiffness measurements indicated a decreasing trend in P. aeruginosa during biofilm maturation (48 hrs: 0.6 MPa, 96 hrs: 1.3 MPa) with an oscillatory behavior. The S. aureus consistently exhibited a decrease in stiffness over time, with values of 0.9 MPa at 48 hrs and 1.3 MPa at 96 hrs. Additionally, an increase in cell surface hydrophobicity during biofilm stages indicated enhanced water repellency in both species. SEM further revealed distinctive connectivity tubes within P. aeruginosa and S. aureus biofilms, facilitating intercellular communication. This study brings forth new angles for developing targeted, species-specific approaches to address biofilm challenges. Understanding the multifaceted phenomena of biofilm formation and development enables the design of interventions that disrupt key processes, promising more effective biofilm control

Microbial Assessment of Spices Available In Different Markets of Karachi, Pakistan: A Food Quality Index Assessment Approach

Spices are used in almost all types of food preparation, and their microbial contamination can lead to spoilage and pose a risk to public health</jats:p