Impact of Prenatal Checkups of Mothers and Immunization of Children on the Health Status of Children (0-3 years) - A Study in Rural areas of Aligarh District, Uttar Pradesh.

Background and objectives: A survey based study on rural areas of Aligarh District was conducted to assess the prenatal checkups pregnant women and its effects on health status of children between the age of (0-3 years), and immunization received by children and its effects on their health status. Methods: Five hundred children from five villages of rural areas of Aligarh District were randomly selected. For the purpose of the study, a self prepared structured interview schedule was used. To get the qualitative information of the study anthropometric measures include height weight were used for assessing growth pattern of the child. The stepwise analysis of two variables height for age and weight for age was done on the basis of Water low’s and Gomez’ classification. To examine the relationship between Health Status of the child and selected variable that affects Health Status of children, Chi-square test was employed. Results: Based on Gomez’ classification out of 88% mothers who did not go for prenatal ups majority 80% of children were underweight, and 80% of children who did not receive immunization majority 60% were underweight. Based on Waterlow’s classification majority 68% of children were stunted whose mother did not go for prenatal checkups and 50% of their children were stunted who did not receive immunization. Conclusion: Majority of children were stunted whose mother did not go for prenatal checkup and the children who did not receive immunization

Prevalence and spectrum of dermatophytes in patients attending a tertiary care hospital Srinagar, Kashmir

Background: Dermatophyte infections are a global health problem but very neglected in Kashmir. India. This work aimed at determining prevalence and spectrum of dermatophytosis isolated from patients attending tertiary care hospital Srinagar. Kashmir.Methods: A total of 510 samples of skin, hair and nail scrapings were collected and processed using standard microscopy (KOH) and cultural methods as per the standard protocol.Results: Out of 510 samples collected, 272 (53.33%) patients were confirmed cases of dermatophytosis (confirmed clinically and on fungal culture). The prevalence of dermatophytosis was significantly associated with age groups of participants with higher infection among those aged 18-32 which accounted for 35.29%, followed by age group 1-17 with 30.14%. Out of 510 samples, 110 ( 21.56%) were both KOH (microscopy) and culture positive, 162 (31.76%) cases were only culture positive and 130 (25.49%) clinical samples were only positive for fungal elements on microscopy. 133 (26.07%) fungal isolates were obtained which included both dermatophyte and non-dermatophytic fungi(excluded in this study). T. mentagrophytes had highest distribution 40.44% among dermatophytes species and T. Unguium 114 (41.96%) accounted for most common site for dermatophytic infections. Poor hygiene was predominant risk factor in 143 cases (52.57%). Patients from lower socioeconomic status were affected more than others (34.92%).Conclusions: In this study we have focused to determine the prevalence, clinical pattern and pathogenic profile of dermatophytosis according to the age, gender, site, and fungal distribution. Improvization of these conditions more accurately can result in decreased incidence of dermatophytosis in this area.

Impact of COVID-19 on the pre and post analytical clinical laboratory testing processes- A performance evaluation study using six sigma

Background: The aim of this study was to determine the impact of COVID-19 pandemic on the total testing process using six sigma metrics based on a comparison of pre and during pandemic periods.Material & methods: The study duration was over 12 months, 6 months before and 6 months after the COVID-19 onset in Pakistan in March 2020 after the recognition of the first case, using quality indicators (QIs). QIs were chosen from a model of QIs recommended by the CAP. Analysis was performed using Six Sigma calculators and QIs were expressed in percentage (%) and Sigma value were computed. Three levels of performance quality i.e. 25th, 50th, and 75th percentile were derived, being best, common and worst performance respectively. Between-group differences were tested using the Mann-Whitney\u27s U test.Results: The median defect percentages of these QIs ranged from 0% to 0.27% for the pre-pandemic period and 0% to 0.13% for the during pandemic period. Meanwhile, sigma values of the majority of the QIs were all above 4.0σ during the pre and the pandemic times. For the pre-analytical phase, sigma scores declined for 1 QI, improved for 3 QIs and remained same for 2. In the post analytical phase, no change in sigma metrics was noted for critical values notification. Considerable increase in defect percentage of inappropriate turnaround times was noted.Conclusion: The emergency preparedness proved to be fruitful as depicted by exceptional performance on the sigma metrics for most Qis both prior to and during the pandemic. The pre-analytical and the post analytical phases, being the most error sensitive requires strict vigilance

Understanding the context of balanced scorecard implementation: a hospital-based case study in pakistan

Background: As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods: Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp\u27s context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation.Results: Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data networks. Conclusion: Variable levels of the BSC implementation were observed in this study. Those intending to apply the BSC in other hospital settings need to ensure a participatory culture, clear institutional mandate, appropriate leadership support, proper reward and recognition system, and sensitization to BSC benefits

Indigenous identity disputes in democratic Bangladesh

Bangladesh is being led by the monolithic nationalism and identity. Though some fundamental political shifts have taken place in the state, and the indigenous identity has been struggling with broken promises. Indigenous peoples are living with denial of their human rights and identity. In fact, diverse issues have been pertaining with this issue. The national policy documents of Bangladesh use different terms to identify the indigenous peoples and the indigenous peoples of Bangladesh have been struggling for the recognition as indigenous peoples or adivasi, yet it has been continuously denied by the state. A dominant assimilationalist approach is revealed by the nationalistic history of Bangladesh. Thus, the monolithic formation of nation state, hegemonic cultural perceptions of national identity and trends to undermining the identity are revealed out in this voyage. But the demand for indigenous identity endorses with translational activism, that has power to penetrate local experiences

THE CHOICE OF WATER SUPPLY SOURCES FOR U.S. CITIES

Municipal governments consider the provision of water supply as an essential service for public health and safety, economic growth, and community well-being. As the demand for water increases with population growth, municipal water sources are approaching their limits and water source expansion is often constrained by the physical and seasonal availability of fresh water, environmental protection policies and other factors. As systems strive to balance supply and demand, it is important to know what choices U. S. cities are making in developing new sources of supply and, in particular, how U.S. environmental policies are influencing the range of water supply alternatives. This research inquiry was constructed based on four hypotheses: 1) development of large surface water impoundments is no longer a preferred choice of a new source, 2) water utilities increasingly are relying on non-conventional sources for augmenting their supplies. 3) environmental statutes act as constraints in developing water sources, and 4) water needs and planning choices vary by geographic region and water system size. Evidence to explore these hypotheses was collected from detailed case studies of the history of source development of ten municipal water systems and an email survey of 189 drinking water systems throughout the U.S. The historical record of these systems was used to identify a pattern of three distinct periods of water source development: i) groundwater regime, ii) surface water regime, and iii) non-conventional regime. Source development before the Great Depression (1930s) was identified as the groundwater regime. The surface water regime began with the addition of large number of reservoirs that were added as part of the public works programs instituted after the Great Depression. Surface water source development slowed after the 1970s due to the enactment of environmental statutes and the non-conventional regime began. The nationwide water utility survey showed that about 88 percent of respondents reduced their per capita water use since the institution of national plumbing standards in the 1990s. The research also found that development of large surface water impoundments is no longer a preferred choice for cities or municipalities and that non-conventional water sources, such as water reclamation and desalination and reclamation began to be employed as alternative sources in 1980s. Environmental statutes such as, National Environmental Policy Act, Clean Water Act (CWA), Safe Drinking Water Act (SDWA), Endangered Species Act (ESA), Rivers and Harbors Act (RHA), and Wild and Scenic Rivers Act (WRSA) have been criticized as constraints to the development of new water sources. However, this research shows that water utilities in general perceive that these statutes are not a constraint. Only 24 percent of respondents perceived them as a constraint and some respondents actually perceived these statutes as an enabler to sustainable water source development. In general, the ESA, CWA 404 permit and NPDES permits were reported to be barriers to water source development, while the SDWA was most reported as an enabler. The research also found that water supply needs and planning choices vary by geographic region. Water systems in the West were more likely to be in need of water source expansion than systems in the East. When considering supply expansions, eastern cities are more likely to pursue conventional sources whereas western cities more likely to pursue a combination of conventional and non-conventional. The water utility survey and case studies showed that while U.S. water systems have employed water demand management techniques to make dramatic reductions in their per capita water use, they nonetheless continue to pursue new water supply sources to meet anticipated future water demands. In spite of this trend toward capacity expansion, virtually all the ten case study water systems currently have surplus water with their current supply exceeding their water demand

Evaluation of antihyperglycemic and antihyperlipidemic potential of Nelumbo nucifera seeds in diabetic rats

The present study was aimed at evaluating antihyperglycemic and antihyperlipidemic activity of nuciferin and norcoclaurine constituents of N. nucifera seeds, a well-known medicinal plant. The alloxan (100 mg/kg b.w) induced diabetic rats (200-250 g) were divided into seven groups (n = 6). Group I; normal control, Group II; diabetic control, Group III; standard, Group lV-VII were fed with methanolic crude extracts (100, 200 mg/kg), nuciferin and norcoclaurine (10 mg/kg b.w.), received for 15 days in dose dependent manner. The study included different parameters; examination of oral glucose, fasting blood glucose, serum lipid profile and checking for body weight changes. In oral glucose examination, within 60 and 80 min of treatment, extracts, nuciferin and norcoclaurine significantly reduced blood glucose (p<0.05) and restored body weight in diabetic rats. Alloxan- induced diabetic rats showed 30-50% reduction of blood glucose level (p<0.05) and recovered 5-20% body weight at day 15 after ingestion of crude extracts (100-200 mg/kg b.w.); and nuciferin and norcoclaurine (each at 10 mg/kg b.w.). It also recovered significantly elevated biochemical parameters such as triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), serum urea and creatinine. Our findings indicated that N. nucifera seeds possess significant antihyperglycemic and antihyperlipidemic activity in diabetic rats

Isolation, Identification and Antimicrobial Susptability of Bacteria from Arpa River, Bilaspur, Chhattisgarh

The isolation and characterization of bacteria from the Arpa River water (Bilaspur, India) could give a better knowledge of their variety, distribution, and possible influence on antibiotic usage. Several species of bacteria were found and their potentiality against antibiotics was determined as a result of this research. Isolation entails collecting sample water and cultivating the microbial culture in a suitable medium. Bacteria were separated from microbial cultures and subjected to biochemical assays, antibiotic susceptibility tests, and microbial evaluation studies. The goal of the research is to determine the types of microorganisms found in the Arpa River as well as to expand our understanding of the river. The potential of microorganisms is assessed in this study. The antibacterial activity of isolated microorganisms was tested using five drugs. The bacterial colony exhibits a zone of inhibition against various antibiotics, including amoxicillin, ofloxacin, streptomycin, and ciprofloxacin, but not against Cefixime &amp; L.A. The antibacterial activity of five different oils and extracts from plants were determined using the well diffusion method

Application of Sigma Metrics for the Assessment of Quality Assurance for Plasma Amino Acid Analysis in Biochemical Genetics Laboratory in Pakistan

Background: Quality is assessed on sigma scale with 3 sigma as the minimum allowable sigma and 6 being world-class quality goal. We aim to present sigma-metrics of plasma amino acids (AA) observed in our Biochemical Genetics Laboratory (BGL). Methods: Internal quality control (IQC) data of AA run in BGL was analyzed from 2013 -2014. Two years mean from IQC and proficiency testing (PT) results were utilized to establish coefficient of variation (CV) and bias respectively. Bias (%): (mean of all laboratories using same instrument-BGL AKU mean)/(mean of all laboratories using same instrument)*100. Sigma metrics were then calculated: ∑(σ)= (total allowable error – bias%)/CV. Results: Overall CV of individual AA ranged from 3.46-11.2%. The laboratory mean and PT target mean showed6. Plasma asparginine, histidine, glutamine and aspartate elicited \u3c 3 on sigma-scale. We achieved sigma metrics of the range 3.1–5.9 for remaining amino acids. Of all the amino acids evaluated the average sigma level was 4.8. Conclusion: Satisfactory sigma metrics were achieved for all AA. The AA below3 sigma must be evaluated with discretion and strict quality control checks. Work Done By Section of Chemical Pathology, Departments of Pathology and Laboratory Medicine and Pediatrics and Child Health*, Aga Khan University Hospital (AKUH