Consanguinity among the risk factors for underweight in children under five: a study from rural Sindh

BACKGROUND: Malnutrition is a common problem, especially in developing countries. Of the 11 million children under 5 who die each year in the developing countries mainly from preventable causes, the death of about 54% are either directly or indirectly attributable to malnutrition. The objectives of this study were to assess the prevalence and associated factors for underweight in rural Sindh.METHODS: A cross-sectional survey was conducted in Jhangara Town, located in District Dadu, Sindh. Eight hundred children under 5 years of age were enrolled. A questionnaire was used to elicit required information and anthropometric measurements were made.RESULTS: The overall prevalence for underweight was 54.3% in the study population, which was higher than the prevalence reported by PDHS 1990-91. In multivariate analysis, various factors for underweight were consanguinity (OR = 1.5, 95% CI = 1.08-2.07), low birth weight (parents\u27 perspective) (OR = 1.6, 95% CI = 1.08-2.16) and lack of breast-feeding (OR = 2.7, 95% CI = 1.19-6.17).CONCLUSION: Effective strategies to discourage consanguineous marriages between first cousins are required. Promoting breast feeding is another factor that should be incorporated while designing control strategies to reduce morbidity and mortality due to malnutrition in children (\u3c 5 years)

Quantum Noise and Polarization Fluctuations in Vertical Cavity Surface Emitting Lasers

We investigate the polarization fluctuations caused by quantum noise in quantum well vertical cavity surface emitting lasers (VCSELs). Langevin equations are derived on the basis of a generalized rate equation model in which the influence of competing gain-loss and frequency anisotropies is included. This reveals how the anisotropies and the quantum well confinement effects shape the correlations and the magnitude of fluctuations in ellipticity and in polarization direction. According to our results all parameters used in the rate equations may be obtained experimentally from precise time resolved measurements of the intensity and polarization fluctuations in the emitted laser light. To clarify the effects of anisotropies and of quantum well confinement on the laser process in VCSELs we therefore propose time resolved measurements of the polarization fluctuations in the laser light. In particular, such measurements allow to distinguish the effects of frequency anisotropy and of gain-loss anisotropy and would provide data on the spin relaxation rate in the quantum well structure during cw operation as well as representing a new way of experimentally determinig the linewidth enhancement factor alpha.Comment: 16 pages and 3 Figures, RevTex, to be published in Phys. Rev.

Muc5ac: a critical component mediating the rejection of enteric nematodes

The mucin Muc5ac is essential for the expulsion of Trichuris muris and other gut-dwelling nematodes

Crystallization of recombinant rat cathepsin B.

A glycosylation-minus mutant of rat cathepsin B expressed in yeast has been purified and crystallized. X-ray diffraction data have been collected and molecular replacement for solving the structure is in progress. The space group for the recombinant rat cathepsin B was determined to be P2(1) with unit cell dimensions alpha = 62.2 A, b = 90.19 A, c = 47.07 A, and beta = 97.43 degrees. A unit cell contains 4 molecules and 2 molecules per asymmetric unit

The implementation of a mobile problem-specific electronic CEX for assessing directly observed student—patient encounters

Background: Facilitating direct observation of medical students' clinical competencies is a pressing need. Methods: We developed an electronic problem-specific Clinical Evaluation Exercise (eCEX) based on a national curriculum. We assessed its feasibility in monitoring and recording students' competencies and the impact of a grading incentive on the frequency of direct observations in an internal medicine clerkship. Students (n=56) at three clinical sites used the eCEX and comparison students (n=56) at three other clinical sites did not. Students in the eCEX group were required to arrange 10 evaluations with faculty preceptors. Students in the second group were required to document a single, faculty observed ‘Full History and Physical’ encounter with a patient. Students and preceptors were surveyed at the end of each rotation. Results: eCEX increased students' and evaluators' understanding of direct-observation objectives and had a positive impact on the evaluators' ability to provide feedback and assessments. The grading incentive increased the number of times a student reported direct observation by a resident preceptor. Conclusions: eCEX appears to be an effective means of enhancing student evaluation

Global Tuberculosis Report 2020 - Reflections on the Global TB burden, treatment and prevention efforts

The October 2020 Global TB report reviews TB control strategies and United Nations (UN) targets set in the political declaration at the September 2018 UN General Assembly high-level meeting on TB held in New York. Progress in TB care and prevention has been very slow. In 2019, TB remained the most common cause of death from a single infectious pathogen. Globally, an estimated 10.0 million people developed TB disease in 2019, and there were an estimated 1.2 million TB deaths among HIV-negative people and an additional 208, 000 deaths among people living with HIV. Adults accounted for 88% and children for 12% of people with TB. The WHO regions of South-East Asia (44%), Africa (25%), and the Western Pacific (18%) had the most people with TB. Eight countries accounted for two thirds of the global total: India (26%), Indonesia (8.5%), China (8.4%), the Philippines (6.0%), Pakistan (5.7%), Nigeria (4.4%), Bangladesh (3.6%) and South Africa (3.6%). Only 30% of the 3.5 million five-year target for children treated for TB was met. Major advances have been development of new all oral regimens for MDRTB and new regimens for preventive therapy. In 2020, the COVID-19 pandemic dislodged TB from the top infectious disease cause of mortality globally. Notably, global TB control efforts were not on track even before the advent of the COVID-19 pandemic. Many challenges remain to improve sub-optimal TB treatment and prevention services. Tuberculosis screening and diagnostic test services need to be ramped up. The major drivers of TB remain undernutrition, poverty, diabetes, tobacco smoking, and household air pollution and these need be addressed to achieve the WHO 2035 TB care and prevention targets. National programs need to include interventions for post-tuberculosis holistic wellbeing. From first detection of COVID-19 global coordination and political will with huge financial investments have led to the development of effective vaccines against SARS-CoV2 infection. The world now needs to similarly focus on development of new vaccines for TB utilizing new technological methods

Giant synovial cell sarcoma of the thorax in a 46-year-old man: a case report

Background:Although synovial cell sarcoma is a common tumor of the extremities, its occurrence in the thorax has been less frequently documented. Case Presentation: A 46-year-old Pakistani man presented with a 2 month history of progressively increasing cough and left lower chest pain. Initial evaluation was done using a chest x-ray, the Patient was found to have a large mass involving the lower portion of the left chest. A computed tomography scan was performed next which showed a large mass involving the left chest wall with invasion into the pericardium and left hemidiaphragm. En bloc surgical resection of the tumor was undertaken. Final pathology showed synovial cell sarcoma of the thorax. At one-year follow-up, the Patient has shown no recurrence of the disease. Conclusions: We have described a rare case of a large synovial cell sarcoma of the thorax. Surgical resection appears an appropriate modus operandi for managing giant synovial cell sarcomas of the thorax. However, there is a need to clearly define post-operative strategies for cases with extensive involvement of surrounding structures