Sustainability of Urban Regions and Migration in Pakistan: A GIS Analysis

The concept of sustainable migration has emerged recently after realizing the potential of migration in framing and altering the social, economic and environmental structures at destination, especially in the context of sustainable development goals (SDGs). An empirical investigation on the link between regional sustainability and sustainable migration is rare in literature, especially in the context of Pakistan’s urban areas. Present study aims at analysing the relationship between the two by geographic information system (GIS) spatially. This study shows that out of thirteen urban regions, hosting above-average migration along with positive in-migration growth, the migration towards nine regions is unsustainable. Two mega cities namely, Karachi and Lahore are included. This highlights the sustainable growth of regions, specifically and the nation generally. Therefore, in the national policy framework, migration policies should appear as an integral part

Coronary Embolic Phenomena: High-Impact, Low-Frequency Events

Coronary embolic phenomena (CEP) are difficult to diagnose yet carry potentially devastating clinical consequences. The goal of this chapter is to outline key processes and pathophysiologic mechanisms underlying CEP, primarily in the context of acute coronary syndrome (ACS). Not surprisingly, most reported cases of CEP occur in the left coronary circulation, but some right-sided events have been reported. Overall, causes include thrombotic, septic/infectious, neoplastic, valve-related, and iatrogenic mechanisms such as air embolization. Coronary angiography remains the definitive diagnostic and therapeutic approach, with computed tomography being increasingly utilized. Transthoracic echocardiography (TTE) should be part of a routine work up for patients with suspected CEP. Holter/event monitoring for atrial fibrillation may also be indicated in patients with embolic phenomena. Clinical management includes procedural restoration of coronary blood flow, followed by appropriate anticoagulation or antiplatelet therapy, in conjunction with appropriate treatment of any arrhythmias or other associated cardiac manifestations or conditions. Timely diagnosis, based on a high index of suspicion (especially in high-risk population) may be important in improving morbidity and mortality in affected patients. Since CEPs are often underdiagnosed and may be due to a number of heterogeneous causes, the need arises for increasing provider awareness of these important phenomena, as well as for the implementation of appropriate clinical management guidelines

Determination of risk factors for hepatitis B and C in male patients suffering from chronic hepatitis

<p>Abstract</p> <p>Background</p> <p>Hepatitis B and C is common in Pakistan and various risk factors are attributable to its spread.</p> <p>One thousand and fifty consecutive male cases suffering from chronic liver disease (327 HBV and 723 HCV) were selected from the OPD of public sector hospital and a private clinic dealing exclusively with the liver patients. To compare the results 723 age and gender matched controls were selected from the blood transfusion services of the public sector hospital. A standard questionnaire was filled for all patients and controls which included the information on possible risk factors.</p> <p>Findings</p> <p>Family history of liver disease was significantly higher (43% and 34%) in HBV and HCV positive cases as compared to 5% in controls [odds ratio 15.6; 95% Confidence Interval CI: 10.1 -- 24.1, 10.9; 95% Confidence Interval CI: 7.3 -- 16.4] and same trend was seen for death due to liver disease in the family. Majority 74% hepatitis B positive cases had their shaves done at communal barbers but this practice was equally prevalent amongst controls (68%), thus negating it as a possible risk factor, but there is a significant risk with p < 0.05 associated with HCV in male that get their shave in barber. Very strong association of the disease was found with history of dental treatment (38% HCV 36% HBV and 21% controls) [Odd ratio 2.3; 95% CI: 1.8-3.0, Odd ratio 2.1; 95% CI: 1.5-2.8], surgery (23% HCV cases,14% HBV cases and 12% controls), history of blood transfusion was significantly higher in HCV (6%) as compared to controls (2.1%) [Odd ratio 2.9; 95% CI: 1.5-5.5]. History of taking injections for various ailments by the general practitioners (over 90% patients in both hepatitis B and C cases) was significantly higher as compared to 75% in controls [Odds ratio 3.8, 6.9; 95% CI: 2.4-6.1, 4.5-10.4] but hospitalization was not significant in HBV and HCV cases.</p> <p>Conclusion</p> <p>Injections, surgery and dental treatment appear as major risk factors for the transmission of hepatitis B and C in the community. Massive health care awareness drives need to be done for both health care providers and the public to reduce this menace.</p

Impact of Climate Change on International Health Security: An Intersection of Complexity, Interdependence, and Urgency

Climate change (CC) can be defined as a long-term shift in global, continental, and/or local climate patterns. Although many equate CC to the rise in global temperatures, the issue is much more complicated and involves a large number of interconnected factors. Among some of the less discussed considerations of CC are its effects on a broad range of public health issues, including the emergence of novel infectious diseases, the encroachment of infectious disease vectors into previously unaffected geographic distributions, and crop failures resulting in threats of malnutrition and mass migration. This chapter will be devoted to key issues related to CC in the context of international health security (IHS)

Role of copper and alumina for heat transfer in hybrid nanofluid by using Fourier sine transform

The convection, thermal conductivity, and heat transfer of hybrid nanofluid through nanoparticles has become integral part of several natural and industrial processes. In this manuscript, a new fractionalized model based on hybrid nanofluid is proposed and investigated by employing singular verses and non-singular kernels. The mathematical modeling of hybrid nanofluid is handled via modern fractional definitions of differentiations. The combined Laplace and Fourier Sine transforms have been configurated on the governing equations of hybrid nanofluid. The analytical expression of the governing temperature and velocity equations of hybrid nanofluid have been solved via special functions. For the sake of thermal performance, dimensional analysis of governing equations and suitable boundary conditions based on Mittage-Leffler function have been invoked for the first time in literature. The comparative analysis of heat transfer from hybrid nanofluid has been observed through Caputo-Fabrizio and Atangana-Baleanu differential operators. Finally, our results suggest that volume fraction has the decelerated and accelerated trends of temperature distribution and inclined and declined profile of heat transfer is observed copper and alumina nanoparticles

Creating Long-Lasting Clinical Connections: A Trainee-Centered, Leadership-Based Perspective on Provider-Patient Relationship

The nature of provider-patient relationship (PPR) goes far beyond the simplified paradigm of “chief complaints,” “clinical problems” and corresponding “therapeutic solutions.” In order to more comprehensively explore the scope of PPR in the context of leadership-based partnership (LBP), various factors and their contributions were researched in terms of both the success and optimization of health-care interactions. This is especially relevant to graduate medical education (GME) and advanced practice (AP) training programs. There are numerous nuances to PPR, including various communication, behavioral, ethical and leadership considerations. Body language and tone of voice are essential in establishing rapport, beginning with the so-called ‘first impression,’ which serves as a foundation for developing the PPR. Health-care providers (HCPs) with greater ability to empathize with their patients may achieve higher levels of treatment adherence, better clinical outcomes, and ultimately increased patient satisfaction. The inclusion of a patient as a co-leader and an essential member of their health-care team (HCT) should be a natural step and a top priority for GME and AP trainees. Such collaboration requires an open-minded approach by all stakeholders. Finally, recognizing patient well-being in all domains, including physical, emotional and spiritual, is critical to the holistic approach toward maximizing the benefits of an optimal PPR. Same can be said about the HCP. In this chapter, we will explore key aspects of PPR in the context of both the trainee and the patient being co-leaders within the bounds of the LBP framework

Harvesting the crops of ability grouping practice in schools from the field of literature

AbstractStudents of diverse abilities tend to be divided into groups that advocate academic homogeneity. Ability grouping practice is embedded within the contemporary hyper-accountability culture in education that has shifted the focus of the teaching community from promoting academic attainment in pupils to being highly ranked in the market-based education system. To maintain an ascending position and avoid “punitive measures, schools adopt stratification according to the pupils” academic abilities. Ability grouping strategy is commonplace in countries like the United States of America (USA), Canada, New Zealand, United Arab Emirates (UAE) and Australia, but the intensity of this practice is unfavourable. This study aims to visit the scholarly work of the authors of the western world to comprehend the history and the advances in the ability grouping practice. The collected data from several studies endorse that ability grouping leads educational establishments to inculcate diverse educational experiences and opportunities for learners. Thus, dividing learners into academic groups contributes to broadening the socioeconomic gap

Effect of hand arm bimanual intensive therapy (HABIT) on gross motor functions in upper extremity of spastic CP

To review studies that can examine whether there’s effect of hand arm bimanual intensive training(HABIT) and neurodevelopmental treatment on gross motor function in spastic cerebral palsy. Journal articles published between 2011 and 2021 were secured by searching computerized bibliographical databases. High evidence studies as randomized control trials, systematic reviews and &nbsp;cross sectional studies were included. A total of 30 studies were selected. After analyzing the studies, it was seen that; there is effect of HABIT in upper extremity on gross motor function, functional training , manual dexterity and activities of daily living and NDT was also improved gross motor function, spasticity and strength in upper extremity

Techniques to Identify and Test PCB Faults with Proposed Solution

Printed Circuit Boards (PCBs) are getting more complex day by day because of vast and modern technology. Analyzing PCB’s failure and their reason of failing is a challenging task but despite how faulty they may be, they can be diagnosed and repair. Modern PCBs consist of fine pitch components including unidentified, non-testable and customized parts, which make it difficult to troubleshoot and repair. Modern PCBs cannot test and repair using generic Automatic Test Equipments (ATEs), unlike simple ones. Successful repair of such types of PCBs is an art more than science. PCB troubleshooting and fault analysis needs a good theoretical knowledge and analytical thinking. It is not something, which can only study from books, but it can gain through constant troubleshooting and experiencing. Keeping in view above mentioned problems this research focused on exploring diagnosis skills and techniques used to identify faults in such Integrated Circuits (ICs) and components using VI instrument. As a result, reducing equipment downtime and high costs need in PCB repairs