Treatment of Typhoid Fever in Children: Comparison of Efficacy of Ciprofloxacin with Ceftriaxone

Objective: To compare the clinical efficacy of ciprofloxacin vs ceftriaxone in terms of the proportion of children becoming afebrile in 96 hours. Study Design: Randomized controlled design study. Place and Duration of Study: Department of Pediatrics, Holy Family Hospital, Rawalpindi from March 2010 to September 2010. Methodology: 88 children who fulfilled the clinical criteria of having typhoid fever were included in the study. They came to the indoor and outdoor of the department. 44 patients were treated with injectable ciprofloxacin, while 44 were treated with injectable ceftriaxone. Results: The study included 88 patients with febrile illness who were suspected of having typhoid fever. The mean age was 8.3±1.94 years and 41 (46.6%) were males. The mean weight was 24.7±6.3 kg. Only 15 (17%) used boiled water as a routine. 68 (77.3%) children in total became afebrile within 96 hours and 20 (22.7%) failed to become afebrile in 96 hours. In the ciprofloxacin group, 25 (56.8%) patients became afebrile in 96 hours and 19 (43.1%) failed to become afebrile in 96 hours. In the ceftriaxone group, 43 (97.7%) patients became afebrile in 96 hours and 1 (2.3%) failed to become afebrile in 96 hours. The proportion of patients becoming afebrile within 96 hours was significantly higher in the ceftriaxone group as compared to the ciprofloxacin group, p= 0.00. Conclusion: Ceftriaxone is more effective in children with typhoid fever in terms of greater proportion of children becoming afebrile in 96 hours

Under the Radar: Muslims Deported, Detained, and Denied on Unsubstantiated Terrorism Allegations

Through the targeted use of a wide set of immigration and law enforcement policies and actions, the U.S. government has cast Muslims as dangerous threats to national security, leaving Muslim communities across the United States vulnerable to discrimination and discriminatory profiling. This Briefing Paper by the Center for Human Rights and Global Justice (CHRGJ) and the Asian American Legal Defense and Education Fund (AALDEF) documents the U.S. government's deployment of lower evidentiary standards and lack of due process guarantees in the immigration system against Muslims to further marginalize this targeted group in the name of national security and counterterrorism. A number of particular immigration programs and practices -- such as the National Security Entry-Exit Registration System (NSEERS),the Federal Bureau of Investigation (FBI) name-check system in the naturalization process, and racial profiling at U.S. borders have received critical attention for their discriminatory impacts on Muslim communities. This Briefing Paper draws on interviews with immigration and criminal defense attorneys and community-based groups, court documents, and media accounts to identify five key under-documented patterns of government practices that appear to be targeting Muslim communities through the immigration system

Investigation of the Electronic and Optical Properties of the Strained CdTe/ZnTe (001) Superlattices

Semiconductors are distinguished among all materials by having a non-vanishing energy band gaps. They are often used in industry in the form of alloys or heterostructures in order to tailor energy gaps suitable for the desired applications. In general, semiconductor materials have broad applications in industry, ranging from micro-electronic devices, to light emitters and detectors, to laser and solar cells. In the last two decades, particular attention has been given to the II-VI semiconductor heterostructures because of their suitability as photoelectronic devices covering from the infra-red to the ultra-violet spectral ranges. The scope of this thesis belongs to the field of band gap engineering and deals with an investigation of the main parameters directly affecting the electronic band structures and optical properties of the strained CdTe/ZnTe(001) superlattices (SLs). As many other common-anion heterostructures, the valence-band offset (VBO) is also finitely small for these SLs. This fact makes both the biaxial strain and the spin-orbit coupling important parameters in controlling the SL character because they affect the level splitting of the valence-band top states. For this reason, we have used in our computation the Sp3s* tight-binding method with inclusion of strain and spin-orbit effects. We have calculated the band structures, densities of states, and oscillator strengths versus SL layer thicknesses, biaxial strain state, and VBO. Our results show that the electron is always localized within CdTe slabs whereas the hole behavior controls the SL character. Our results are further compared to photoluminescence experiments and shown to be consistent with the strain morphology and structural and optical properties of the experimental samples

Using the Induced Response Function to Measure and Analyze the Impact of Fiscal Policy Shocks on Some Macroeconomic Variables

Purpose: The purpose of this research is to use the induced response function to measure and analyze the reality of the general budget and the trade balance and the impact of the flexible fiscal policy on some macroeconomic variables.   Theoretical framework:  The public finances after 2003 in Iraq were oriented towards consumerism, far from the orientations and objectives of economic policy, through the increase in commercial expenditures at the expense of investment expenditures, in contrast to the increase in the volume of imports of goods and services with the dominance of oil exports over the volume of total exports, and these factors Together, they made the flexible fiscal policy unable to achieve its goals, foremost of which is economic stability.   Design/methodology/approach:  The study starts from the hypothesis. The fiscal policy shocks were deliberately created by the government as part of strategic plans that serve its policy, philosophy, and goals it seeks, or as preventive plans against undesirable events, or may occur within treatment plans in response to certain pressures. To achieve the objectives of the study and to prove or refute the mentioned hypothesis, the research relied on the descriptive analysis method To reach the required results. Depending on the period from 2003 to 2018 (Iraq is a case study).   Findings:  The shock that was occurring in the financial policy tools were fabricated by the decision-makers to meet the needs of the security side, which was reflected in its shadows on the increase in current spending resulting from the wages and salaries system and allocations directed to the security system to achieve stability and control the security situation, in addition to the political repercussions that increased the level of employment or Operation to achieve other goals.   Research, Practical & Social implications:  Future studies can look at measuring and analyzing the impact of fiscal policy shocks on macroeconomic variables or their repercussions on economic, social, and political policies.   Originality/value:  This study contributes to the literature related to fiscal policy by analyzing the results of the impact of financial shocks on some macroeconomic variables, and provides a practical and applied perception of the role played by the fiscal policy methodology in Iraq.

Perceived Stress and Religious Coping among Pakistani-Origin Emerging Muslim Adults Living in Pakistan and the United States: A Cross-Cultural View

This study explored the relationship between Perceived Stress and Religious Coping levels among Muslim emerging adults of Pakistani origin living in Pakistan and Muslim emerging adults of Pakistani origin living in the United States (US). Participants (Pakistani Origin Muslims Living in Pakistan, n= 103; and Pakistani Origin Muslims Living in the US, n=50) were between 18-25 years old. The Perceived Stress Scale (PSS-10) and Brief R-Cope scale were administered using an online format. Results indicated that negative religious coping strategies were associated with higher perceived stress in both groups while positive religious coping strategies showed a weaker association with lower perceived stress levels, and this finding appeared only in the US sample. Marital status was also an important predictor of perceived stress. These findings demonstrate that Muslim emerging adults, irrespective of culture, show moderately similar patterns in their perception of stress and their utilization of religious coping strategies

A Comparative Study Between Convolution and Optimal Backstepping Controller for Single Arm Pneumatic Artificial Muscles

This study was based on the dynamic modeling and parameter characterization of the one-link robot arm driven by pneumatic artificial muscles. This work discusses an up-to-date control design based on the notion of a conventional and optimal backstepping controller for regulating a one-link robot arm with conflicting biceps and triceps positions supplied by pneumatic artificial muscles. The main problems found in systems that utilize pneumatic artificial muscle as actuators are primarily the large uncertainties, non-linearities, and time-varying features that severely impede movement performance in tracking control. In consideration of the uncertainty, high nonlinearity, and external disturbances that can exist during the motion. Lyapunov-based backstepping control technique was utilized to assure the stability of the system with improved dynamic performance. The bat algorithm optimization method is utilized in order to modify the variables used in the design of the controller to enhance the efficiency of the suggested controller. According to the conclusions, a quantitative comparison of the response in the PAM actuated the arm model in the current study and earlier investigations with the Backstepping controlled system revealed fair agreement with a variation of 37.5% from the optimal classical synergetic controller. In addition, computer simulations were utilized in order to compare the effectiveness of the proposed conventional controls and the optimal background. It has been proven that an optimal controller can control the uncertainties and maintain the controlled system’s stability

Problems That Face Genitally Mutilated Immigrant Sudanese Women and Their Awareness of Available Health Services in London: A Case Study

Female genital mutilation (FGM) or female circumcision (FC) is a hazardous practice that negatively affects the health and wellbeing of girls and women. Recently, immigrant women who are victims of the cultural practice of FGM/FC have been facing health complications because health providers in their host countries are largely ignorant of the practice and its implications for women's health. This study is a preliminary investigation into immigrant genitally mutilated Sudanese women residing in London (UK). The study surveyed the problems that face genitally mutilated Sudanese women and their awareness of available health services in London. The study revealed that nearly 50% of genitally mutilated Sudanese women faced complications during delivery in London hospitals. A good number had to deliver their babies by caesarean section although their previous confinements were normal. Also, more than 50% of them faced complications that arose from their mutilation other than those encountered during delivery. These were caused, to a great extent, by the ignorance of most British health providers of FGM/FC health complications. There is only one specialized clinic in London that deals with FGM/FC, and the overwhelming majority of genitally mutilated Sudanese women are unaware of its existence.Since the majority of mutilated Sudanese women live in the Paddington area, the study recommended that a specialized clinic has to be established at St Mary's Hospital in Paddington since its health policy does not presently cater for FGM/FC complications. As great numbers of genitally mutilated women from different countries have immigrated to the UK, it was also recommended that FGM/FC health and other complications are to be included in the curricula of educational institutes at which health providers are trained. In addition, ad hoc training sessions on FGM/FC complications should be offered to all health providers at all levels in the United Kingdom

Response of Manufacturing Sector to Financial Liberalization in Pakistan

It has been believed that financial liberalization can stimulate industrial growth which may be translated into overall growth of the economy by efficient allocation of credit which generates investment opportunities by reducing the cost of investment, deregulations, privatizations and reduced capital controls. This paper aims to examine the impact of financial liberalization on industrial response in manufacturing industry measured as new firm entry. Moreover, moderating effect of external finance dependence on the relationship of financial liberalization and firm entry is estimated. We estimate the model using Generalized methods of moments and found that external finance dependence has a significant negative impact of new firm entry, while financial liberalization has a positive but insignificant impact on firm entry. Nevertheless, a statistically significant positive moderating impact of external finance dependence is documented which implies that the sectors which are more dependent on external finance gain disproportionate benefit from financial liberalization

Use of integrated clinical scenarios in neuroanatomy laboratory sessions a strategy to foster students’ learning

Objective: Combinations of various teaching strategies have been employed to enhance neuroanatomy teaching, to little success. Herein, we describe the use of integrated clinical scenarios in anatomy laboratory sessions as an educational strategy to improve the learning process for students undertaking neuroscience course. Methods: We assessed the perception and performance of students who utilised the integrated clinical resources in the neuroanatomy labs. We also compared the performance of the students on their neuroscience course with the performance of the previous year\u27s students (who did not use the clinical scenarios). Results: A total of (130) 88% of the registered student both male and female participated by filling out a questionnaire. A majority (80%) of students supported introducing clinical cases at this early stage and agreed that cases covered learning objectives well. Students (81%) preferred a decreased faculty participation and 68% strongly agreed that cases were well integrated with other disciplines and assisted critical thinking and conceptual understanding. Most of them (90%) approved using plastic models and pictures as resource-material. The average mark obtained for all block together between the two cohorts did not differ significantly, while student performance was significantly improved in neuroscience block of the cohort which had access to the integrated clinical scenarios. Conclusions: Collectively, or specifically designed neuroanatomy lab sessions provided students with an empowering experience to help them apply critical thinking and use their basic neuroscience knowledge to solve clinical problems

Early provision of maternal colostrum by the oropharyngeal route to preterm infants

Preterm infants are those born before 37 completed weeks of gestation. Worldwide, about one million children die each year due to complications of prematurity and survivors may face lifelong disabilities. Approximately 50% of neonatal deaths and 17% of deaths among children under five are affected by prematurity. Colostrum is the first milk produced by the mother within the early few days after birth. Colostrum is very rich in immunological and growth factors that indicates its primary functions are protective and trophic. Oropharyngeal administration of colostrum (OPC) is a novel route that involves coating the infant’s oropharynx with a small amount of colostrum (0.1 to 0.5 ml) during the early neonatal period. Immune and growth factors in colostrum might interact with the oropharyngeal mucosal-associated lymphoid tissues to modulate the infant’s immune system and promote intestinal growth, potentially reducing infection and necrotising enterocolitis (NEC), improving survival and health outcomes. Ultimately OPC could provide a potential target to prevent mortality and morbidities of preterm and sick infants. This thesis aimed to investigate whether OPC administration during the early neonatal period prevents deaths, improves health outcomes and promotes the growth of preterm infants. To achieve the aim of this thesis; initially, an online survey targeted neonatal professionals was performed to evaluate the current practice and perception of OPC administration in the UK neonatal units. Oropharyngeal colostrum has been introduced into UK neonatal practice despite a lack of high-quality evidence regarding its efficacy and safety. OPC practice was variable, frequently without written guidelines. A Cochrane systematic review was conducted to synthesis and appraise the currently available randomised controlled trials (RCTs), which evaluated if early OPC given within the first 48 hours has a positive impact in preterm infants (< 37 weeks gestation) compared with control. Six RCTs were eligible for inclusion in this systematic review. Meta-analysis showed that early OPC could shorten the time to reach full enteral feeds but did not reduce the incidence of late-onset infection (LOI), NEC and death nor the length of hospital stay. Available evidence is insufficient due to lack of participants and very low quality to demonstrate the benefits effects of OPC for preterm infants. The third study, a matched case-control study evaluated the effects of OPC administration on the short-term health outcomes in preterm (≤ 32 weeks) infants. Eligible infants who were admitted to the Nottingham neonatal units after the implementation of OPC in the care of preterm infants, and received OPC, compared with those who were admitted before the use of OPC in the units. Preterm infants who received OPC within the first 96 hours of life achieved full enteral feeding (150 ml/Kg/day for consecutive 72 hours) earlier than those infants who did not receive OPC. A higher rate of receiving breast milk at discharge to home was also observed. However, the two groups had a similar length of hospital stay, weight Z-score at hospital discharge, and incidences of NEC, LOI and deaths. Finally, a non-randomised observational study evaluated the response of gut hormones to OPC administration in preterm (< 37 weeks of gestation) and ill infants requiring neonatal intensive care (NIC). Preliminary results demonstrated a rising trend in plasma gut hormone concentrations in response to OPC administration in the participant preterm and full-term infants. This study is ongoing, and more infants are required before final conclusions can be elicited. In conclusion, OPC administration is a potentially feasible intervention that shortens time to attain full enteral feeds in preterm infants. Given the high risk for preterm infants and the benefits of maternal colostrum, OPC may have preventive implications for improving the health outcomes of this vulnerable population. This work expands the current knowledge about the use of OPC in the care of preterm and sick newborn infants and could benefit efforts to improve preterm birth outcomes by informing guidelines, clinical decision and future research. Larger, well-designed, high-quality research with sufficient power are needed to assess the efficacy and safety of this intervention