LEFT DOUBLE DISPLACEMENT SEMIGROUP: A FIRST RESULT

In the present article a new type of algebraic structures named as left double displacement semigroup (LDD-semigroup). The structure is enhanced toward its left double displacement group (LDD-group) and discovered some useful results about these structures. The name of the notion is due to double displacement reactions in chemistry because they have same pattern of elements arrangement

SELF-REPORTED MULTI-MORBIDITY WITH TUBERCULOSIS:DATA FROM THE KHYBER PAKHTUNKHWA INTEGRATED POPULATION HEALTH SURVEY (KPIPHS) IN PAKISTAN

Background: With the rise of non-communicable diseases (NCDs) in a country that is already facing high tuberculosis (TB) burden, TB multi-morbidity is likely to pose a significant public health challenge in Pakistan. Data were analysed to determine the prevalence of TB and explore the distribution and determinants of multi-morbidity associated with TB in the population of Khyber Pakhtunkhwa -a province of Pakistan. Methods: This is a secondary analysis of data gathered as part of the KPIPHS survey conducted in 2016-17 in both the rural and urban areas of Khyber Pakhtunkhwa, Pakistan. An interviewer-administered questionnaire was used to collect data, from adults, on demographics, education and socioeconomic status, physical and mental health, reproductive health, child health, health-related quality of life, and self-reported cardiometabolic diseases including Diabetes, hypertension, renal disorders, cardiac failure, angina, and stroke. Results: A total of 20,715 participants were recruited in the survey including 52.8% (n=10,943) males and 47.2% (n=9,772) females with a mean age of 41 (13.1) years. Data on TB status was available for a total of 14452 participants. The prevalence of TB in Khyber Pakhtunkhwa was found to be 0.49% (n=72) including an almost equal number of males and females [48% (n=34) vs 51% (n=36)], respectively. The mean age of the patients with TB was 47.5 (11.6) years. A higher proportion of people with TB had cardiometabolic diseases compared to people without TB (45.9% vs. 30.9%). Amongst the cardiometabolic disorders, self-reported hypertension (OR: 1.81, 95% CI 1.08–3.02, p=0.02), Diabetes (OR: 3.99, 95% CI 1.95-8.18, p=<0.002), and angina (OR: 3.88 95% CI 1.20–12.49, p=0.02) were positively associated with the occurrence of TB. In the adjusted analysis, only self-reported Diabetes was positively associated with the occurrence of TB (OR: 3.33, 95% CI 1.61-6.88, p=0.001). Conclusion: There is a higher burden of self-reported cardiometabolic diseases among people with TB, suggesting that this high-risk group should be screened for cardiometabolic diseases, especially Diabetes

Exploring the reasons for defaulting from childhood immunization: a qualitative study in Pakistan

Abstract Background Childhood vaccination is widely recognized as the most effective means to prevent various diseases. However, a considerable amount of children still miss out on their vaccination schedules. Therefore, this study explores the reasons for defaulting from the expanded program on immunization in district Swat, Pakistan. Methods A qualitative phenomenological approach was used. Data collection took place from March to September 2022. Thirty-six in-depth interviews were conducted with participants who had defaulter children. The collected qualitative data were analysed thematically to identify key patterns and themes related to the reasons for defaulting from childhood vaccination schedules. Results Six themes emerged, i.e., illness of the defaulter child at the scheduled time, perceived side effects of the vaccination, factors related to caregivers, myths and misconceptions, vaccinators attitudes and crowed vaccination centres, as well as poor immunization service arrangements. Four subthemes arose related to caregivers, such as lack of clear understanding about completion of vaccination, least priority for child’s vaccination, cultural restriction on mothers, and the loss of vaccination card. Conclusion According to the study’s findings, caregivers have their own perceptions regarding the non-completion of their children’s vaccination schedule. The childhood immunization defaulting arises from various factors including child illness, Adverse Events Following Immunization (AEFIs) concerns, misconceptions, improper injection techniques, and negative vaccinator attitudes. The vaccination completion rate may be increased if the concerns of the caregivers are appropriately addressed

Korzystanie z pasów bezpieczeństwa i czynniki powiązane wśród kierowców i pasażerów na przednim fotelu w metropolii Peszawar, Pakistan: Badanie przekrojowe

INTRODUCTION: Road traffic accidents is a major public health problem with an estimate to become the ninth leading cause of death worldwide. Pakistan yearly spends around 100 billion rupees on injuries and ranks 5th due to the fatality associated with road traffic accidents. Seat-belt use decreases the fatality amongst drivers and front-seat passengers by around 45–50%. Therefore, the current study was aimed to determine seat belt use among drivers and front passengers and its association of demographic factors. MATERIAL AND METHODS: A cross-sectional study was carried out from October 2016 to March 2017. The city was categorized into five major geographical areas and from each of these areas two roads were randomly selected from the list of the available roads. Data collection was done in the petrol pumps located on these roads and every fifth vehicle interviewed. Data was collected on an adapted tool with information regarding use of seat-belt and socio-demographic factors. Data was analyzed, using STATA version 13.1. RESULTS: A total of 1690 vehicles were interviewed during the time period. Around one third (35.5%) of the drivers were using seat-belt when approached and none of the front passengers. Around three fourth (72.2%) of the drivers reported avoiding fines and penalties as the main reason for using seat-belts. The main reason reported for not wearing seat-belt was embarrassment and was reported by around half of the drivers (45.6%) and front passenger (42.8%). On logistic regression education, type of vehicle and years of experience were independently associated with seat-belt use. Driving experience and education were negatively associated with seat-belt use while the use was less in private cars compared to taxis. CONCLUSIONS: Seat belt use in drivers of the metropolitan city of Peshawar was quite low and ironically was none in the front passengers. Avoiding fines and penalties was the main reason for seat-belt use which was common in taxis. Policy makers and planners should impose regulations and implementation of seat-belt use by all passengers to reduce the morbidity and mortality following road traffic accidents.WSTĘP: Wypadki drogowe to poważny problem zdrowia publicznego, który według szacunków może stać się dziewiątą główną przyczyną zgonów na świecie. Pakistan rocznie wydaje około 100 miliardów rupii na leczenie obrażeń i zajmuje piąte miejsce z powodu śmiertelnych wypadków drogowych. Korzystanie z pasów bezpieczeństwa zmniejsza śmiertelność wśród kierowców i pasażerów siedzących z przodu o około 45–50%. Dlatego obecne badanie miało na celu określenie użycia pasów bezpieczeństwa wśród kierowców i pasażerów na przednim fotelu oraz powiązanie czynników demograficznych. MATERIAŁ I METODY: Badanie przekrojowe przeprowadzono od października 2016 r. do marca 2017 r. Miasto zostało podzielone na pięć głównych obszarów geograficznych i z każdego z tych obszarów losowo wybrano dwie drogi z listy dostępnych dróg. Zbieranie danych odbywało się w stacjach paliwowych znajdujących się przy tych drogach i przeprowadzaono wywiad w co piątym pojeździe. Dane zebrano na dostosowanym narzędziu z informacjami dotyczącymi stosowania pasów bezpieczeństwa i czynników społeczno-demograficznych. Dane zostały przeanalizowane przy użyciu STATA w wersji 13.1. WYNIKI: W czasie badania przeprowadzono wywiad z 1690 użytkownikami pojazdów. Około jedna trzecia (35,5%) kierowców korzystała z pasów bezpieczeństwa, ale żaden z pasażerów na przednim fotelu. Około trzy czwarte (72,2%) kierowców wskazało na unikanie kar jako główny powód używania pasów bezpieczeństwa. Głównym powodem, dla którego zgłaszano brak zapinania pasów bezpieczeństwa, było zażenowanie i zgłosiło je około połowa kierowców (45,6%) i pasażerowie z przodu (42,8%). W edukacji regresji logistycznej rodzaj pojazdu i lata doświadczenia były niezależnie związane z używaniem pasów bezpieczeństwa. Doświadczenie w prowadzeniu pojazdu i edukacja były negatywnie związane z używaniem pasów bezpieczeństwa, podczas gdy korzystanie z nich było mniejsze w samochodach prywatnych w porównaniu do taksówek. WNIOSKI: Używanie pasów bezpieczeństwa przez kierowców metropolii Peszawar było dość niskie i, jak na ironię, żaden z pasażerów nie korzystał z pasów. Unikanie grzywien i kar było głównym powodem używania pasów bezpieczeństwa, który był powszechny w taksówkach. Decydenci i planiści powinni narzucić przepisy i wdrażać stosowanie pasów bezpieczeństwa przez wszystkich pasażerów, aby zmniejszyć zachorowalność i śmiertelność w wyniku wypadków drogowych

Novel mutations in genes of the IL-12/IFN-γ axis cause susceptibility to tuberculosis

Background: The IL-12/23/ISG15-IFN-γ pathway is the main immunological pathway for controlling intra-macrophagic microorganisms such as Mycobacteria, Salmonella, and Leishmania spp. Consequently, upon mutations in genes of the IL-12/23/ISG15-IFN-γ pathway cause increased susceptibility to intra-macrophagic pathogens, particularly to Mycobacteria. Therefore, the purpose of this study was to characterize the mutations in genes of the IL-12/23/ISG15-IFN-γ pathway in severe tuberculosis (TB) patients. Methods: Clinically suspected TB was initially confirmed in four patients (P) (P1, P2, P3, and P4) using the GeneXpert MTB/RIF and culturing techniques. The patients' Peripheral blood mononuclear cells (PBMCs) were then subjected to ELISA to measure Interleukin 12 (IL-12) and interferon gamma (IFN-γ). Flow cytometry was used to detect the surface expressions of IFN-γR1 and IFN-γR2 as well as IL-12Rβ1and IL-12Rβ2 on monocytes and T lymphocytes, respectively.The phosphorylation of signal transducer and activator of transcription 1(STAT1) on monocytes and STAT4 on T lymphocytes were also detected by flow cytometry. Sanger sequencing was used to identify mutations in the IL-12Rβ1, STAT1, NEMO, and CYBB genes. Results: P1's PBMCs exhibited reduced IFN-γ production, while P2's and P3's PBMCs exhibited impaired IL-12 induction. Low IL-12Rβ1 surface expression and reduced STAT4 phosphorylation were demonstrated by P1's T lymphocytes, while impaired STAT1 phosphorylation was detected in P2's monocytes. The impaired IκB-α degradation and abolished H2O2 production in monocytes and neutrophils of P3 and P4 were observed, respectively. Sanger sequencing revealed novel nonsense homozygous mutation: c.191 G>A/p.W64 * in exon 3 of the IL-12Rβ1 gene in P1, novel missense homozygous mutation: c.107 A>T/p.Q36L in exon 3 of the STAT1 gene in P2, missense hemizygous mutation:: c.950 A>C/p.Q317P in exon 8 of the NEMO gene in P3, and nonsense hemizygous mutation: c.868 C>T/p.R290X in exon 8 of CYBB gene in P4. Conclusion: Our findings broaden the clinical and genetic spectra associated with IL-12/23/ISG15-IFN-γ axis anomalies. Additionally, our data suggest that TB patients in Pakistan should be investigated for potential genetic defects due to high prevalence of parental consanguinity and increased incidence of TB in the country