Development and validation of sunlight exposure measurement questionnaire (SEM-Q) for use in adult population residing in Pakistan

Background: Vitamin D deficiency has been identified as a major public health problem worldwide. Sunlight is the main source of vitamin D and its measurement using dosimeters is expensive and difficult for use in population-based studies. Hence, the aim of this study was to develop and validate questionnaires to assess sunlight exposure in healthy individuals residing in Karachi, Pakistan. Methods: Two questionnaires with seven important items for sunlight exposure assessment were developed. Fifty four healthy adults were enrolled based on their reported sunlight exposure (high = 17, moderate = 18, low = 19) from Aga Khan University, Karachi. Over four days, study participants were asked to wear a dosimeter between sunrise and sunset and report time spent and activities undertaken in the sun for questionnaire validation. Algorithm for item weightage was created as an average score based on ultraviolet B percentage received. Blood samples were obtained for serum vitamin D. Results: The mean time (minutes) spent in sun over 4 days (±SD) was 69.5 (±32) for low, 83.5 (±29.7) for moderate and 329 (±115) for high exposure group. The correlation between average time (minutes) spent in sun over 4 days and mean change in absorbance of UV dosimeters for 4 days was 0.60 (p \u3c 0.01). Correlation between average score and vitamin D levels was found to be 0.36 (p = 0.01) for short term questionnaire score, 0.43 (p = 0.01) for long term questionnaire score in summers and 0.48 (p = 0.01) in winters. Conclusions: The sunlight exposure measurement questionnaires were valid tools for use in large epidemiological studies to quantify sunlight exposure

Survey on Automated Bugs Triage System

Nowadays IT companies is spending more than 40 percent of their cost in fixing software bugs, traditonally these bugs are fixed by manual assignement to a particular developer , this approach causes too much dependency, the new and alternative approach is the bug triage system which fix the bug automatically , which automatically assign the reported bug to a develop which decreases the time and cost in in manual work, different classification techniques are used to conduct automatic bug triage. In this paper, we propose to apply machine learning techniques to assist in bug triage to predict which developer should be assigned on the bug based on its description by applying text categrorization . We will address the problem of data reduction for bug triage, i.e. How the quality of bug data would be improved

Unusual case of non-resolving necrotizing pneumonia: a last resort measure for cure.

Abstract To our knowledge, this is an unusual case of a community-acquired pneumonia (CAP) with sepsis secondary to Streptococcus pneumoniae that required lung resection for a non-resolving consolidation. A 74 year old previously healthy woman, presented with acute fever, chills and pleuritic chest pain in Emergency Department (ED). A diagnosis of CAP was established with a Pneumonia Severity Index CURB-65 score of 5/5. In the ER, she was promptly and appropriately managed with antibiotics and aggressive supportive therapy. She remained on ten days of intravenous antibiotics. However, 48 hours post antibiotic course, she returned to ER with fever and signs of sepsis. Despite timely and appropriate management, the consolidated lobe remained the focus of sepsis for over four weeks. The patient recovered after the offending lobe was resected. Histopathology of the lung tissue revealed acute and chronic inflammation. However, no malignancy, bacterial infection or broncho-pleural fistula was found. Eighteen months post-surgery, the patient remains well

Ethnic Differences in Ascending Aorta Dimensions and Dilatation Rates: A Systematic Review

Ethnic differences may substantially influence the morphological characteristics of the ascending aorta, with potential implications for clinical assessment and management of aortic dilatation. This systematic review evaluated the impact of ethnicity on ascending aorta diameter and dilatation rates, highlighting the need for more tailored, ethnicity-specific care in cardiovascular practice. We identified 11 studies that measured ascending aorta dimensions using transthoracic echocardiography (TTE), computed tomography (CT), or magnetic resonance imaging (MRI). Most investigations focused on Asian, Caucasian, African American, and Hispanic populations. Data extraction revealed notable variability in baseline aortic diameters across ethnic groups. Some studies found no significant differences between Asian and Caucasian participants, whereas others reported consistently larger diameters in Chinese ethnicities compared to Caucasians and smaller diameters in African American groups. One investigation, for instance, showed that Chinese participants had ascending aorta diameters approximately 1.5 mm larger than their Caucasian counterparts. Dilatation rates also diverged: one study observed that non-White race was linked to earlier or more rapid aortic root dilation in younger populations. At the same time, another reported that Vietnamese individuals had nearly twice the annual growth rate of ascending aorta dilatation when compared to other ethnicities. Available data on prevalence varied, with some studies suggesting ascending aorta dilatation ranged from about 1.2% to 7.5% in Caucasians, 0.9% to 6.4% in African Americans, and 0.8% to 5.9% in Asians. These findings potentiate the role of ethnicity in shaping aortic dimensions, possibly through a combination of genetic predisposition, environmental factors, and lifestyle influences. Incorporating ethnic background into risk stratification may improve the accuracy of clinical assessments and help guide personalized management strategies for ascending aorta dilatation. Future research should address heterogeneity in measurement techniques, more consistently defining ethnic groups, and explore long-term outcomes to clarify whether these observed morphological differences translate into variations in morbidity and mortality

Influence of Near Fault Earthquakes with Forward Directivity and Fling Step on Seismic Response of Steel Box-Girder Bridge

The existing bridge seismic design guidelines that rely on the ground acceleration in the far fault zone, ignore the potential impact of near fault forward directivity and fling-step effects on the bridge structures. In the current study probabilistic seismic damage evaluation of a continuous four-span box girder bridge under the impact of near-fault forward directivity and fling step effect is studied employing the fragility analysis. The incremental dynamic analysis is used to construct the fragility curves which shows a range of damage states from minor to collapse for the different damage metrics and for the considered peak ground acceleration varying between 0.1g and 1.2g. Damage metrics such displacement pier ductility, rotational pier ductility and displacement of girder are used to develop the fragility curves and the probabilistic seismic damage model. To evaluate the bridge vulnerability, a probabilistic seismic damage assessment is performed using an ensemble of forward directivity and an ensemble of fling-step comprising permanent ground offset. The suggested probability-based earthquake damage framework is anticipated to be a well-versed model able to estimate the seismic damages to the continuous box girder bridges while taking into account the variation of near fault earthquakes. The findings show that, even at low PGA values the forward directivity and the fling-step ground motions represent a significant risk to the bridge

STUDY ON PREVALENCE OF ADVERSE DRUG REACTIONS IN PATIENTS SUFFERING FROM TUBERCULOSIS IN A TERTIARY CARE HOSPITAL

Objective: To study the prevalence of ADRs associated with the use of anti-tubercular drugs in patients with tuberculosis in a tertiary care hospital.Methods: A prospective observational and active surveillance study was conducted in the department of pulmonology and DOTS Centre in Owaisi Hospital and Research Centre over a period of 6 mo after the study was approved by IRB. The patients who gave informed consent were included in the study and their information was analysed after being recorded in a data collection form.Results: Descriptive statistical analysis was carried out to generate results, the continuous measurement being presented as mean standard deviation (min-max) and categorical measurement presented in number (%). The results showed the prevalence of ADRs to be 69%. The prevalence of ADRs was more in females (55%) than in males (45%) and 75.9% of them reporting more than 1 ADR. ADR's affecting the skin and appendages were high (23.56%) while ADR's affecting gastrointestinal system (19.28%), the hepatic system (4.28%), the musculoskeletal system (15.7%), Central and peripheral nervous system (7.85%), Vision (0.7%) were comparatively less.Conclusion: The study highlighted the importance of developing strategies to ameliorate ADRs both to improve the quality of patient care and to control TB safely.Â

Peers To Professors: Exploring The Role Of Students And Faculty In Same-Level Reciprocal Peer Assisted Learning In Family Medicine Clerkship

Objective: Peer-assisted learning (PAL) is teaching by the learners to the learners, a teaching strategy globally integrated into curricula. One particular variant is same-year reciprocal PAL, in which peer tutors and tutees are from the same academic year and alternate teaching roles. However, few studies have examined this specific form of PAL, and both student and faculty perspectives on its efficacy remain largely unexplored. To address this gap, we conducted a qualitative study among fourth-year medical students during their Family Medicine clerkship. Methods: Employing content thematic analysis, we gathered data through in-depth interviews and focus group discussions involving both faculty members and students. Students received training to lead small group discussions, and their perceptions were subsequently collected. Coding of the transcripts was carried out by three researchers independently, with themes agreed upon mutually. COREQ guidelines were followed throughout the planning, implementation, and analysis of this study. Results: The finalized themes included "Enhancement of Teaching Skills," "Conducive Educational Environment," "Operational Issues," and "Recommendations for the Future". Conclusion: Our findings suggest that PAL promotes collaboration among students and enhances knowledge, confidence, time management, teamwork and  reflecting skills besides many other. It serves as a valuable supplement to traditional teaching methods, although it cannot replace them entirely. Thorough planning prior to implementation is essential for achieving beneficial long-term outcomes for both students and faculty. Key words: peer groups, medical students, learning, clinical clerkship, teaching methods, undergraduate medical education

Infantile haemangioendothelioma of the parotid gland: Case report and review of literature

Haemangioendotheliomas (HAE), although rare but are the most common parotid gland tumours in children. We report a 4-month-old girl who presented with a progressively enlarging right sided facial swelling overlying the angle of the mandible. An Ultrasound of the lesion and a computed tomography (CT) scan of the head and neck was carried out which revealed a large lesion within the right parotid gland. CT scan further demonstrated a direct communication with the right external carotid artery and external jugular vein. Considering the clinical course and radiological findings, there was sufficient evidence to avoid any invasive testing. Due to the self-limiting nature of the disease, patient was managed expectantly

Cross-Sectional and Longitudinal Associations between Household Food Security and Child Anthropometry at Ages 5 and 8 Years in Ethiopia, India, Peru, and Vietnam

En: Journal of Nutrition, No. 145, pp. 1924-1933. doi:10.3945/jn.115.210229Background: Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. Objectives: We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index–for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. Methods: We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n =1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ;1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). Results: Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, 20.33; India, 20.53; Peru, 20.31; and Vietnam, 20.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, 20.21; India, 20.32; Peru, 20.14; and Vietnam, 20.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8–30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4–19.3%) in other countries. Conclusions: In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam

Reducing anemia prevalence in Afghanistan: socioeconomic correlates and the particular role of agricultural assets

This research aims to examine the socio-economic correlates of anemia in women, and potential sources of iron in household diets in Afghanistan. It also examines whether ownership of agricultural (particularly livestock) assets and their use in food production has a role in alleviating anaemia, especially where local markets may be inadequate. We analyse data from the 2010/11 Afghanistan Multiple Indicator Cluster Survey, estimating a logistic regression to examine how anemia status of women is associated with socio-economic covariates. A key result found is that sheep ownership has a protective effect in reducing anemia (prevalence odds ratio of sheep ownership on anemia of 0.83, 95% confidence interval (CI): 0.73–0.94) after controlling for wealth and other covariates. This association is found to be robust to alternative model specifications. Given the central role of red meat in heme iron provision and absorption of non-heme iron, we hypothesise that sheep ownership promotes mutton consumption from own-production in a setting where market-sourced provision of nutritious food is a challenge. We then use the 2011/12 National Risk and Vulnerability Assessment household data to understand the Afghan diet from the perspective of dietary iron provision, and to understand interactions between own-production, market sourcing and mutton consumption. Sheep ownership is found to increase the likelihood that a household consumed mutton (odds ratio of 1.27, 95% CI: 1.15–1.42), the number of days in the week that mutton was consumed (prevalence rate ratio of 1.24. 95% CI: 1.12–1.37) and the quantity of mutton consumed (7 grams/person/week). In the subsample of mutton consumers, households sourcing mutton mostly from own production consumed mutton 1.5 days more frequently on average than households relying on market purchase, resulting in 100 grams per person per week higher mutton intake. Thus this analysis lends support to the notion that the linkage between sheep ownership and anemia risk is at least partly due to consumption arising from own-production in the presence of market incompleteness