Distance Aware Relaying Energy-efficient: DARE to Monitor Patients in Multi-hop Body Area Sensor Networks

In recent years, interests in the applications of Wireless Body Area Sensor Network (WBASN) is noticeably developed. WBASN is playing a significant role to get the real time and precise data with reduced level of energy consumption. It comprises of tiny, lightweight and energy restricted sensors, placed in/on the human body, to monitor any ambiguity in body organs and measure various biomedical parameters. In this study, a protocol named Distance Aware Relaying Energy-efficient (DARE) to monitor patients in multi-hop Body Area Sensor Networks (BASNs) is proposed. The protocol operates by investigating the ward of a hospital comprising of eight patients, under different topologies by positioning the sink at different locations or making it static or mobile. Seven sensors are attached to each patient, measuring different parameters of Electrocardiogram (ECG), pulse rate, heart rate, temperature level, glucose level, toxins level and motion. To reduce the energy consumption, these sensors communicate with the sink via an on-body relay, affixed on the chest of each patient. The body relay possesses higher energy resources as compared to the body sensors as, they perform aggregation and relaying of data to the sink node. A comparison is also conducted conducted with another protocol of BAN named, Mobility-supporting Adaptive Threshold-based Thermal-aware Energy-efficient Multi-hop ProTocol (M-ATTEMPT). The simulation results show that, the proposed protocol achieves increased network lifetime and efficiently reduces the energy consumption, in relative to M-ATTEMPT protocol.Comment: IEEE 8th International Conference on Broadband and Wireless Computing, Communication and Applications (BWCCA'13), Compiegne, Franc

Non-Invasive Induction Link Model for Implantable Biomedical Microsystems: Pacemaker to Monitor Arrhythmic Patients in Body Area Networks

In this paper, a non-invasive inductive link model for an Implantable Biomedical Microsystems (IBMs) such as, a pacemaker to monitor Arrhythmic Patients (APs) in Body Area Networks (BANs) is proposed. The model acts as a driving source to keep the batteries charged, inside a device called, pacemaker. The device monitors any drift from natural human heart beats, a condition of arrythmia and also in turn, produces electrical pulses that create forced rhythms that, matches with the original normal heart rhythms. It constantly sends a medical report to the health center to keep the medical personnel aware of the patient's conditions and let them handle any critical condition, before it actually happens. Two equivalent models are compared by carrying the simulations, based on the parameters of voltage gain and link efficiency. Results depict that the series tuned primary and parallel tuned secondary circuit achieves the best results for both the parameters, keeping in view the constraint of coupling co-efficient (k), which should be less than a value \emph{0.45} as, desirable for the safety of body tissues.Comment: IEEE 8th International Conference on Broadband and Wireless Computing, Communication and Applications (BWCCA'13), Compiegne, Franc

Principals Perception Regarding Factors Affecting The Performance Of Teachers

This study investigated the perception of principals on how the factors of subject mastery, teaching methodology, personal characteristics, and attitude toward students affect the performance of teachers at higher secondary level in the Punjab. All principals of higher secondary level in the Punjab were part of the population of the study. From the population, 120 principals were selected as the sample. A questionnaire was developed and validated through pilot testing. The data obtained were tabulated and analyzed by using statistical techniques of mean and standard deviation. The major conclusions of the study were that the factor of subject mastery was perceived to be influencing the performance of teachers maximally, but the factor of attitude toward students was affecting the performance of teachers minimally. The remaining two factors - teaching methodology and personal characteristics - were perceived to be at the intermediary level

Accessibility of antenatal services at primary healthcare facilities in Punjab, Pakistan

Introduction: Almost one-fifth of the world\\u27s population constitutes women of reproductive age who are repeatedly exposed to pregnancy and childbearing. Many are often at high risk of illness and mortality during pregnancy and require maternal healthcare services for early detection of complications. More than 0.5 million women die every year worldwide due to pregnancy-related complications. Almost 0.03 million of them are in Pakistan. Maternal healthcare in Pakistan is poor and results in high rates of morbidity and mortality. This paper evaluates the accessibility of antenatal care (ANC) services in primary healthcare settings in the Punjab province of Pakistan during the period June 2010-August 2011. Methods: The paper uses a cross-sectional study including mix methods (qualitative and quantitative).Nine districts were included in the project; one from each administrative tier or division. Nineteen health facilities, including two rural health centres (RHCs) and 17 basic health units (BHUs) were randomly selected from each district. The total sample was 171 health facilities. The qualitative assessment was carried out through focus-group discussions (FGDs) and in-depth interviews with clients, providers, and health managers. Results: The reasons for the gaps in service accessibility were the distant location of facilities, a lack of transport, and inconvenient facility working hours. The issues of service accessibility were further exacerbated by socio-cultural factors such as low levels of client awareness, a lack of decision-making by clients, and the influence of spiritual healers and quacks. Health managers further pointed out weak co-ordination between vertical programmes and routine integrated health services, and a lack of human resources in distantly located facilities.Conclusion: In order to increase the accessibility of ANC services, facility working hours must be extended and adjusted according to the convenience of clients in primary healthcare (PHC) facilities. The utilisation of ANC services can also be increased through client awareness and gender empowerment for ANC decision-making

Factors Leading To Early Versus Late Presentation In Patients With Neck Masses

Abstract Objective: To compare the factors that lead to early versus late presentation in patients with neck masses Study Design: Group Comparative Study. Study Setting & Duration: Department of Otorhinolaryngology and Head &Neck Surgery at Rawalpindi Teaching Hospital from 01-9-2022 to 01-03-2023. Methods: Approval of the study was obtained from the hospital's ethical committee. A total of 64 patients (32 in each group) were placed in two Groups A &  B. Group A included patients who presented early and Group B included patients who presented late. Both male and female patients were selected. In this study patients suffering from neck masses who have reported for work-up to the Department of ENT, Rawalpindi Teaching Hospital, and fulfil the complete inclusion and exclusion criteria were included. Patients were selected via consecutive nonprobability sampling. The data were analyzed for frequencies by SPSS 24. Results: A total of 64 patients were included in this study. The mean age of these patients was 48.67 ± 9.74 years, ranging from 25 to 70 years. The Frequency distribution of males at 65.63 % was found to be more than that of females at 34.36 %. In the majority of patients, the size of mass more than 1.5 cm (51.56%) revealed malignancy, while only a small percentage of patients (48.44%) had less than 1.5 cm neck mass. The majority of patients (93.75%) with addiction presented late, while just a small number (6.25%) had early presentation. The majority of patients (51.56%) with frequent visits to  Quacks /Hakeem per year were presented late. Regarding socioeconomic status, the majority of patients (28) from upper-class families presented early, compared to (11) patients from middle-class families who presented late, and all (21) patients from lower-class families who presented late. The education level reveals that the majority of patients (31), who were educated, attended a school for more than a year, but only up to ten (matriculate or similar) years, or advanced literacy: got a college- or university-level education, and they displayed early presentation. The 30 uneducated patients, who never attended an educational institution, or attended for less than one year, presented late. 31 patients had frequent visits to health care professionals and were presented early, 30 patients had fewer visits to health care professionals present late with advanced disease.  Conclusion: The majority of patients who were drug and alcohol addicts were presented late with advanced disease. Middle-class families, lower-class families, uneducated patients, and patients who did not see a healthcare provider four or more times per year, make up the majority of visits to Quacks and Hakeem each year and are presented late with advanced disease as compared to the group of patients who belong to upper class, were literate with no history of drug or alcohol addiction and have frequent visits to health care professionals. Both groups were considered to be significant (p=0.00) based on the probability ratio. This study helped to identify the role of various suspected risk factors for late presentation in head and neck cancers in an attempt to reinforce or negate their importance which will help to guide the formation of screening protocols thereby improving morbidity, and mortality and reducing financial costs.

Political Challenges and Security Issues in FATA and its impact on Economic Development

This research paper pertains to an in depth and profound analysis of both political reforms and change extended in FATA and build up systematically, it focuses on the historical background of the tribal areas, which has the centuries old customs and tradition. The system of judiciary, political, social, economic is based on these traditions. Efforts has been made to remain focus on the measures if taken, to integrate the tribal belt in Pakistan’s mainstream and this research paper also focus on the poor level of political administration, human rights, phenomenon and socio economic developments in this deprived and marginalized area of Pakistan. There is dire need of some major steps which must be initiated by the government of Pakistan on war footing to reform the system of education, health judiciary and other services sector. Tribal belt is far behind the rest of the country in all sectors of development. The advantages of modern politicoadministration must also be extended to FATA as in other parts of the country. The areas now forming FATA had seen perhaps more invasion than any other country/area in the world. It hold some of the most chequered and fascinating events of the history

Assessment of Knowledge of Cardiopulmonary Resuscitation among Pharmacy Students of Mirpur, Azad Jammu & Kashmir

Introduction: Cardiopulmonary resuscitation (CPR) is the most important lifesaving technique in several emergency situations such as cardiac arrest. In future, being part of health care professionals, pharmacy students are deemed to possess basic skills and expertise which are required to perform CPR. Objective: To access the knowledge of cardiopulmonary among pharmacy students of Mirpur Azad Jammu & Kashmir. Methods: It was a questionnaire-based, descriptive cross-sectional study, conducted among 4th and 5th year students of two Pharmacy institutes of Mirpur AJ&K from November 2018 to January 2019. A pre-tested questionnaire from previous study was used to collect data. It comprised of 13 dichotomous questions with “Yes/No” options, regarding knowledge of CPR. Descriptive statistics was used to unfold the demographic characteristics. Inferential statistics (Kruskal Wallis and Man Whitney) tests were used for evaluating difference between dependent continuous variables and independent variables and Chi-square was applied to determine difference between grouped variables. P-value of less than 0.05 is considered significant. The data was analyzed using SPSS version 20. Result: Overall, 131 out of 150(response rate= 92%) students participated in current study. Gender distribution among the participants was almost equal with 66 males (50.4%) males and 65 (49.6%) females took part in current study. Participants of the age group 21-23 years (n=88, 67.2%) were dominant. Only few students (n=23, 17.6%) reported to have taken training in CPR previously. Eighty-eight (66.7%) had average knowledge of CPR. No significant differences among male and female, 4th and 5th year students of both the institutes were found. Conclusion: The study revealed that knowledge level of CPR is adequate in most of the students of pharmacy. However, further improvements are required to perform CPR in an efficient manner. Thus, training in CPR should be mandatory in the pharmacy curriculum

Exploiting Layered Multi-Path Routing Protocols to avoid void hole regions for reliable data delivery and efficient energy management for IoT-enabled underwater WSNs

The key concerns to enhance the lifetime of IoT-enabled Underwater Wireless Sensor Networks (IoT-UWSNs) are energy-efficiency and reliable data delivery under constrained resource. Traditional transmission approaches increase the communication overhead, which results in congestion and affect the reliable data delivery. Currently, many routing protocols have been proposed for UWSNs to ensure reliable data delivery and to conserve the node’s battery with minimum communication overhead (by avoiding void holes in the network). In this paper, adaptive energy-efficient routing protocols are proposed to tackle the aforementioned problems using the Shortest Path First (SPF) with least number of active nodes strategy. These novel protocols have been developed by integrating the prominent features of Forward Layered Multi-path Power Control One (FLMPC-One) routing protocol, which uses 2-hop neighbor information, Forward Layered Multi-path Power Control Two (FLMPC-Two) routing protocol, which uses 3-hop neighbor information and ’Dijkstra’ algorithm (for shortest path selection). Different Packet Sizes (PSs) with different Data Rates (DRs) are also taken into consideration to check the dynamicity of the proposed protocols. The achieved outcomes clearly validate the proposed protocols, namely: Shortest Path First using 3-hop neighbors information (SPF-Three) and Breadth First Search with Shortest Path First using 3-hop neighbors information (BFS-SPF-Three). Simulation results show the effectiveness of the proposed protocols in terms of minimum Energy Consumption (EC) and Required Packet Error Rate (RPER) with a minimum number of active nodes at the cost of affordable delay

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation