What Gets Measured Gets Treated? A composite Measure of Child Malnutrition and its Determinants

Micronutrient deficiencies in children are a major health problem at a global level. There are various avenues for solving this multidimensional problem, but all require an accurate assessment of the level of the deficiency. In this study, we assessed the prevalence of four essential micronutrients deficiencies using defined cutoff values and determine an aggregate burden of malnutrition named as the Composite Index of Micronutrient Deficiencies (CIMND). We used the National Nutrient Survey 2011 from Pakistan (n = 7,173) to develop this new index. We also built a multinomial logistic regression model to express the probability of an infant falling into a particular category of CIMND as a function of various covariates. Concomitant deficiencies of three micronutrients have the highest percentage (38.6%) among all other levels of malnutrition. Children of rural households are less malnourished.Food security did not prove to be a strong predictor of child malnutrition while demographic and economic dependency showed negative associations with undernourishment.   Keywords: micronutrient deficiency; operationalization; stunting; wasting; underweight

Estimation of Consumption Functions: The Case of Bangladesh, India, Nepal, Pakistan and Sri Lanka

The study uses annual data from 1971 to 2013 and appliesKeynesian Consumption Function (KCF) and the PermanentIncome Hypothesis (PIH) in order to estimate consumption functionsof SAARC countries. The empirical results show that in the shortrun, the difference between KCF and PIH under Marginal Propensityto Consume (MPCs) is quite large. This difference, therefore,indicates that in the short run consumers’ consumption decisionare based on current income. However, another point worth notingis that, in the short run smaller values of MPCs under the PIHindicate that consumers are unable to anticipate their future incomein developing countries, like Bangladesh, India, Nepal, Pakistanand Sri Lanka. Moreover, the study also estimates the MPCs underthe PIH in the long run. The results demonstrate that in the long runthe values of MPCs are higher than the MPCs while using PIH,which indicates that in the long run consumers anticipate theirfuture income and accordingly make consumption decisions on thebasis of permanent income

The Energy-Growth Nexus in Thailand: Does Trade Openness Boost up Energy Consumption?

The nexus between trade openness and energy demand is hot topic of discussion among academicians and researchers, and numerous studies are available in existing literature while investigating the nexus between trade openness and energy demand. This paper explores the relationship between energy consumption, trade openness and economic growth in case of Thailand. In doing so, we have applied Bayer and Hanck cointegration approach to test whether the long run relationship exists between the variables. Our results confirm the presence of cointegration between the variables. Energy consumption stimulates economic growth. Trade openness adds in economic growth. The causality analysis reveals that energy consumption Granger causes economic growth and in resulting, economic growth Granger causes energy consumption. Trade openness and energy consumption are interdependent i.e. trade openness Granger causes energy consumption and in return, energy consumption Granger causes trade openness. This paper openness up new directions for policy making authorities in Thailand to design a comprehensive energy and trade policies to sustain economic growth for long run

Unraveling the South Asian enigma: concurrent manifestations of child anthropometric failures and their determinants in selected South Asian countries

Abstract Malnutrition among children is pervasive in South Asia and there are also reports of overnutrition. To better understand this phenomenon, we need a composite measure. However, the existing measures such as CIAF (Composite Index of Anthropometric Failure) and its revised version have ignored the overnutrition aspect of the phenomenon. This study proposes an extended version of CIAF which also considers overnutrition. This new measure was compared with the existing measures by using data from 1990 to 2018 for three selected South Asian countries including Pakistan, India and Bangladesh. We also examined the effects of socioeconomic and environmental variables on the outcome variable. The results reveal that the new measure (ECIAF) is better at measuring the phenomena. The burden of overall malnutrition has been decreased in the region. However, an increase in the concomitant prevalence of wasting and underweight is observed in both Pakistan and India and stunting and overweight is observed only in India. Besides, political stability, prevalence of undernourishment, anemia in children, mother’s education, household size, dependency ratio, air pollution and unimproved sanitation are significantly correlated with childhood malnutrition. The findings also testified to long-run cointegrating relationship among the variables

Frequency of Modifiable Risk Factors in Ischemic Stroke Patients at a Tertiary Care Hospital in Lahore Pakistan

Objective: The objective was to find out the frequency of modifiable risk factors among patients of ischemic stroke at a tertiary care hospital in Lahore Pakistan. Study type,settings& duration:This observational cross-sectional study was conducted at Medical Department Services Hospital, Services Institute of Medical Sciences, Lahore Pakistan from January 2019 to January 2020. Methodology:After an informed consent 105 patients with ischemic stroke aged between 18-65 years from both sex wasincluded in this study. Patients with trauma, tumor, arteriovenousmalformations, unstable cardiopulmonary condition, psychiatric disease and hemorrhagic stroke were excluded. Demographic information and detailed history with physical examination was noted. Blood pressure and sugar levels were measured for all patients. All bloods test including fasting lipid profile were determined. SPSS version 17.0 was used for data analysis. Results:A total of 105 patients of ischemic stroke were enrolled in the present study. Mean age of the patients was 51.2±8.4 years and 73 (69.5%) were male. Mean BMI was 29.3±2.9 kg/m2. Hyperlipidemia was the most frequent risk factor seen in 53 (50.5%) patients with ischemic stroke followed by obesity in 48 (45.8%) patients, smoking in 43 (40.9%), hypertension in 41 (39.1%) and diabetes mellitus in 41 (39.1%) patients. Conclusion:Hyperlipidemia was the leading risk factor in ischemic stroke patients in the present study followed by obesity, smoking, diabetes mellitus and hypertension respectively

Physioeconomic Poverty Analysis of Grade 1 Employees of Rawalpindi City, Pakistan

Poverty though a universal phenomenon, is the worst challenge in the modern era, which is termed as the age of information and technology. The present study was designed to estimate the incidence of poverty for the grade I employees of Rawalpindi city. Determinants of poverty were explored by using Probit model, which was significant in the determination of the poverty status of the household. Following variables were used in the model; household size, education, experience, working individual, extra income and migration are the variables. For that objective, data from 150 household were collected through questionnaires. The results of the poverty indices showed that about twenty percent households were poor among grade 1 employees of Rawalpindi city. The result of probit models indicated that having large household size, with no extra income and migrants were increasing the probability of being poor while educational attainment and experiences did not had significant effect. On the other hand working individuals and migration were decreasing the probability of being poor

Urban Sprawl, Its Impact and Challenges: A Case Study of Quetta, Pakistan

peer reviewedUrban areas are often developed according to their zoning codes. Each city's zoning is planned considering its character and function. The size of streets, height and size of homes, building sizes, space reserved for pedestrians, and even operating a small food business from home is designed based on the zoning rules. The opinion of residents can be helpful for better planning and management of a city. Unfortunately, in Pakistan, public opinion is not considered in the planning and management of cities. This study focuses on the urban sprawl, its impact, and the urban challenges faced in Quetta, Pakistan. It is based on field surveys, questionnaires, observations, and interviews. The results focus on seven key aspects of urban facilities. The results show that urban sprawl is rapidly growing in Quetta city, and there is an urgent need to address this issue. In the end, the recommendations are made to provide better health and living facilities for the residents of Quetta.11. Sustainable cities and communities6. Clean water and sanitation3. Good health and well-being4. Quality educatio

Use of Apremilast to Achieve Psoriatic Arthritis Treatment Goals and Satisfaction at 1 Year in the Canadian Real-World APPRAISE Study

Abstract Introduction The APPRAISE study was conducted to better understand the 12-month effectiveness, tolerability, and patient satisfaction with apremilast treatment for patients with psoriatic arthritis (PsA) in real-world settings. Methods APPRAISE (NCT03608657), a prospective, multicenter, observational study, enrolled adults with active PsA prescribed apremilast per routine care between July 2018 and March 2020. Patients were followed for 12 months with visits suggested every 4 months. The primary outcome measure was achievement of remission (REM) or low disease activity (LDA), defined as a Clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA) score ≤ 13. Results Of the 102 patients who enrolled, 45 (44.1%) discontinued the study by 12 months. Most patients (75.5%) had moderate or high disease activity, and 24.5% were in REM/LDA at baseline based on cDAPSA score. Achievement of cDAPSA REM/LDA was 63.7%, 67.2%, and 53.8% at months 4, 8, and 12, respectively. In those continuing in the study, significant improvements were seen in swollen and tender joint counts, pain visual analog scale, psoriasis body surface area, and complete dactylitis resolution. Enthesitis reduction was also observed. Improvements in treatment satisfaction and patient-reported outcomes, including Health Assessment Questionnaire-Disability Index and the 36-item Short Form physical and mental component scores, were observed over 12 months. The proportion of patients achieving a Patient-Acceptable Symptom State (PASS) increased significantly from baseline at months 4, 8, and 12 (P < 0.001). Apremilast was well tolerated; the most frequent adverse events (AEs) leading to discontinuation were diarrhea (9/102 [8.8%]), nausea (4/102 [3.9%]), and migraine (4/102 [3.9%]). Conclusion In this real-world study conducted in Canadian rheumatology clinics, apremilast demonstrated clinical effectiveness in patients with active PsA, along with patient satisfaction with treatment. Safety findings were consistent with previously reported clinical data. Trial Registration ClinicalTrials.gov identifier, NCT03608657