Knowledge, Attitude and Practice (KAP) Survey of Osteoporosis among Students of a Tertiary Institution in Malaysia

Purpose: To evaluate knowledge and perceptions of osteoporosis among university students in Malaysia belonging to different age groups, gender and ethnicity.Methods: Using convenience sampling method, current study was conducted among students of University Sains Malaysia (USM), Pulau Penang, Malaysia. A pre-validated self- administered questionnaire was used to carry out the study.Results: The mean age of the participants was 24.61 ± 5.51 years. A majority, 401 (87 %), identified osteoporosis correctly as a disease that makes bones weak and fragile. Lack of milk and dairy products were identified by majority of participants (74 %) as a risk factor for  osteoporosis while being petite (24 %) and family history (34.5 %) were the least identified risk factors. Female showed statistically higher knowledge score than males (243.89 versus 216.12, p = 0.02). Ethnicity (Malay: 228.32, Chinese: 264.46, Indian: 194.04, Others: 236.94, p = 0.00) and type of education (Hybrid: 225.99, Arts: 182.21, Science: 286.23, p = 0.00) were factors that correlated significantly with knowledge and perceptions of osteoporosis.Conclusion: This study demonstrates an urgent need for the  implementation of educational and awareness programs for university students belonging to various age groups. Such programs should be designed on the basis of the parameters of health belief model.Keywords: Attitude, Bones, Knowledge, Osteoporosis, Practice, University students

Unquenched QCD with Light Quarks

We present recent results in unquenched lattice QCD with two degenerate light sea quarks using the truncated determinant approximation (TDA). In the TDA the infrared modes contributing to the quark determinant are computed exactly up to some cutoff in quark off-shellness (typically 2$\Lambda_{QCD}$). This approach allows simulations to be performed at much lighter quark masses than possible with conventional hybrid MonteCarlo techniques. Results for the static energy and topological charge distributions are presented using a large ensemble generated on very coarse (6$^4$) but physically large lattices. Preliminary results are also reported for the static energy and meson spectrum on 10$^3$x20 lattices (lattice scale $a^{-1}$=1.15 GeV) at quark masses corresponding to pions of mass $\leq$ 200 MeV. Using multiboson simulation to compute the ultraviolet part of the quark determinant the TDA approach becomes an exact with essentially no increase in computational effort. Some preliminary results using this fully unquenched algorithm are presented.Comment: LateX, 39 pages, 16 eps figures, 1 ps figur

Engineering of magnetically separable ZnFe2O4@ TiO2 nanofibers for dye-sensitized solar cells and removal of pollutant from water

Abstract In this study, magnetic Zinc Ferrite (ZnFe2O4)@TiO2 nanofibers were prepared by low cost and nontoxic route; hydrothermal technique followed by electrospinning process. The prepared magnetic ZnFe2O4@TiO2 nanofibers were morphologically and structurally analyzed by X-ray diffractometer (XRD), Fourier transform infrared spectroscopy (FTIR), field emission scanning electron microscope (FESEM), transmission electron microscope (TEM), and thermal gravimetric analysis (TGA). The prepared magnetic ZnFe2O4@TiO2 nanofibers were utilized as photoanode for the fabrication of dye-sensitized solar cells (DSSCs) and presented applicable performance with 4.2% overall conversion efficiency with high short circuit current density (JSC) of 10.16 mA/cm2. The maximum ∼42% incident photo-to-current conversion efficiency (IPCE) value was also recorded at 520 nm. In addition, ZnFe2O4@TiO2 nanofibers were not only possessed the good conversion efficiency, but also shown excellent photocatalytic efficiency with magnetic properties towards the dye remediation. Prepared ZnFe2O4@TiO2 nanofibers can be considered as a promising material for energy conversion and environmental applications

One-Flavour Hybrid Monte Carlo with Wilson Fermions

The Wilson fermion determinant can be written as product of the determinants of two hermitian positive definite matrices. This formulation allows to simulate non-degenerate quark flavors by means of the hybrid Monte Carlo algorithm. A major numerical difficulty is the occurrence of nested inversions. We construct a Uzawa iteration scheme which treats the nested system within one iterative process.Comment: 11 pages, to appear in proceedings of the workshop "Numerical Challenges in Lattice QCD", Springer Verla

Thermodynamics of SU(3) gauge theory on anisotropic lattices

Finite temperature SU(3) gauge theory is studied on anisotropic lattices using the standard plaquette gauge action. The equation of state is calculated on $16^{3} \times 8$, $20^{3} \times 10$ and $24^{3} \times 12$ lattices with the anisotropy $\xi \equiv a_s / a_t = 2$, where $a_s$ and $a_t$ are the spatial and temporal lattice spacings. Unlike the case of the isotropic lattice on which $N_t=4$ data deviate significantly from the leading scaling behavior, the pressure and energy density on an anisotropic lattice are found to satisfy well the leading $1/N_t^2$ scaling from our coarsest lattice, $N_t/\xi=4$. With three data points at $N_t/\xi=4$, 5 and 6, we perform a well controlled continuum extrapolation of the equation of state. Our results in the continuum limit agree with a previous result from isotropic lattices using the same action, but have smaller and more reliable errors.Comment: RevTeX, 21 pages, 17 PS figures. A quantitative test about the benefit of anisotropic lattices added, minor errors corrected. Final version for PR

Effect of a multicomponent intervention on antihypertensive medication intensification in rural South Asia: post-hoc analysis of a cluster RCT

BACKGROUND: Inadequate treatment of hypertension is a widespread problem, especially in South Asian countries where cardiovascular disease mortality rates are high. We aimed to explore the effect of a multicomponent intervention (MCI) on antihypertensive medication intensification among rural South Asians with hypertension. METHODS: A post-hoc analysis of a two-year cluster-randomized controlled trial including 2645 hypertensives aged≥ 40 years from 30 rural communities, 10 each, in Bangladesh, Pakistan, and Sri Lanka. Independent assessors collected information on participants' self-reports and physical inspection of medications. The main outcomes were the changes from baseline to 24 months in the following: 1) the therapeutic intensity score (TIS) for all (and class specific) antihypertensive medications; 2) the number of antihypertensive medications in all trial participants. RESULTS: At 24 months, the mean increase in the TIS score of all antihypertensive medications was 0.11 in the MCI group and 0.03 in the control group, with a between-group difference in the increase of 0.08 (95% CI (0.03, 0.12); P=0.002). In MCI compared to controls, a greater increase in the TIS of renin angiotensin-aldosterone system blockers (0.05; 95% CI (0.02, 0.07); P<0.001) and calcium channel blockers (0.03; 95% CI (0.00, 0.05);p=0.031) , and in the number of antihypertensive medications (0.11, 95% CI (0.02, 0.19);P=0.016) was observed. CONCLUSIONS: In rural communities in Bangladesh, Pakistan, and Sri Lanka, MCI led to a greater increase in antihypertensive medication intensification compared to the usual care among adults with hypertension. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT02657746

On the low fermionic eigenmode dominance in QCD on the lattice

We demonstrate the utility of a spectral approximation to fermion loop operators using low-lying eigenmodes of the hermitian Dirac-Wilson matrix, Q. The investigation is based on a total of 400 full QCD vacuum configurations, with two degenerate flavors of dynamical Wilson fermions at beta =5.6, at two different sea quark masses. The spectral approach is highly competitive for accessing both topological charge and disconnected diagrams, on large lattices and small quark masses. We propose suitable partial summation techniques that provide sufficient saturation for estimating Tr Q^{-1}, which is related to the topological charge. In the effective mass plot of the eta' meson we achieved a consistent early plateau formation, by ground state projecting the connected piece of its propagator.Comment: 15 pages, 25 figures, citations adde

Hemoptysis, a developing world perspective

BACKGROUND: Hemoptysis is a significant clinical presentation in respiratory medicine. Often a life threatening emergency, it mandates prompt assessment and intervention. Various investigations and management protocols are proposed globally, to advocate a standardized approach towards patients presenting with hemoptysis. It is the etiology, however, that has been known to influence clinical outcome and prognosis. With marked contrast in geographical patterns of pulmonary pathologies, etiological agents for hemoptysis vary over the world. Studies in West, usually demonstrate neoplastic and non-granulomatous causes to be the leading agents for hemoptysis. The diagnostic accuracy of various investigations and efficacy of management alternatives has been established there. Developing nations differ in their burden of diseases of lung. Lack of health resources and initiative often prevent quality research in critical areas. DESIGN: This is a retrospective observational study with a cross-sectional design in which charts of all patients admitted with the presentation of haemoptysis in the past ten years will be reviewed, at Aga Khan University Hospital, Karachi, Pakistan. A series of variables, based on previous literature on haemoptysis related to the objectives of present study, will be determined in the study. Demographics, co-morbids and etiology will be determined. Findings of various investigation modalities and their accuracy in localizing the bleeding site will be determined. Efficacy of different management strategies will also be observed. Also observed will be any complications and follow-up. DISCUSSION: Pakistan is a third world nation of over 150 million, established as highly endemic for pulmonary tuberculosis. To date no study has been generated to look into hemoptysis patterns, in this nation. Lack of evidence based medicine poses a major hindrance towards confident decision-making in the approach towards a patient presenting with hemoptysis in this country. This study is devised to obtain the first insight in this direction, from this part of the world. The etiologies, accuracy of various investigations and efficacy of treatment options will be investigated. The results and conclusions will prove to be of value not just for health administrators in this country, but many other regions that share similarities in patterns of pulmonary pathologies

May Measurement Month: results of 12 national blood pressure screening programmes between 2017 and 2019

The first May Measurement Month (MMM) campaign, a global blood pressure (BP) screening programme, began in 2017 as an initiative of the International Society of Hypertension.1 Two subsequent annual campaigns have also been completed in consecutive years2,3 and having had to defer activities due to the COVID-19 pandemic in 2020 the fourth campaign was run in 2021, the results of which are currently in press. Since its initiation in 2017, volunteers from more than 100 countries have participated. The aims of MMM have remained consistent from the start—to raise awareness of the importance of the measurement of BP at the individual and population level and to provide a temporary pragmatic solution to the shortfall in BP screening programmes in countries around the world

Association between electrocardiographic and echocardiographic markers of stage B heart failure and cardiovascular outcome

Aims: The detection of non-ischaemic (mainly hypertension, diabetes, and obesity) stage B heart failure (SBHF) may facilitate the recognition of those at risk of progression to overt HF and HF prevention. We sought the relationship of specific electrocardiographic (ECG) markers of SBHF to echocardiographic features of SBHF and their prognostic value for development of HF. The ECG markers were Cornell product (Cornell-P), P-wave terminal force in lead V1 (PTFV1), ST depression in lead V5 V6 (minSTmV5V6), and increased heart rate. Echocardiographic assessment of SBHF included left ventricular hypertrophy (LVH), impaired global longitudinal strain (GLS), and diastolic dysfunction (DD).Methods and Results: Asymptomatic subjects ≥65 years without prior cardiac history, but with HF risks, were recruited from the local community. At baseline, they underwent clinical assessment, 12-lead ECG, and comprehensive echocardiography. New HF was assessed clinically at mean follow-up of 14 ± 4 months, and echocardiography was repeated in subjects with HF. Of the 447 study subjects (age 71 ± 5, 47% men) with SBHF, 13% had LVH, 32% impaired GLS, and 65% ≥grade I DD (10% ≥grade II DD). Forty were lost to follow-up. Clinical HF developed in 47 of 407, of whom 20% had echocardiographic LVH, 51% abnormal GLS, and 76% DD at baseline. Baseline LVH and abnormal GLS (not grade I DD) were independently associated with outcomes (clinical HF and cardiovascular death). Cornell-P and heart rate (not minSTmV5V6 nor PTFV1) were independently associated with LVH, impaired GLS, and DD. Cornell-P and minSTV5V6 (not heart rate nor PTFV1) were independently associated with outcomes. More ECG abnormalities improved sensitivity, but ECG-markers were not independent of or incremental to echocardiographic markers to predict HF in SBHF.Conclusions: In this elderly study population, ECG markers showed low diagnostic sensitivity for non-ischaemic SBHF and low prognostic value for outcomes. Cornell-P and minSTmV5V6 had predictive value for outcomes in non-ischaemic SBHF independent of age, gender, and common comorbidities but were not incremental to echocardiography