Family physicians understanding about Mantoux test: A survey from a high endemic TB country

<p>Abstract</p> <p>Background</p> <p>Tuberculosis is a global health emergency and is a big challenge to diagnose and manage it. Family physicians being first contact health persons should be well competent to diagnose and manage the patients with tuberculosis.</p> <p>Aims</p> <p>This study was aimed to assess the level of understanding about Mantoux Test amongst Family Physicians in Karachi, Pakistan and to determine the difference of level of understanding by gender and number of tuberculosis patients seen in a month.</p> <p>Methods</p> <p>A cross sectional survey was conducted among 200 Family Physicians working in Karachi; the largest city and economic hub of Pakistan. Family Physicians who attended Continuous Medical Education sessions were approached after taking consent. Pre-tested, self administered questionnaire was filled consisting of: basic demographic characteristics, questions regarding knowledge about Mantoux Test, its application and interpretation. Data of 159 questionnaires was analyzed for percentages, as rest were incomplete. Chi square test was used to calculate the difference of understanding levels between various groups.</p> <p>Results</p> <p>Almost two thirds of respondents were males and above 35 years of age. Majority of Family Physicians were private practitioners and seeing more than five tuberculosis patients per month. Overall, a big gap was identified about the knowledge of Mantoux Test among study participants. Only 18.8% of Family Physicians secured Excellent (≥ 80% correct responses). This poor level of understanding was almost equally distributed in all comparative groups (Male = 20.8% versus Female = 15.9%; p - 0.69) and (Seen < 5 tuberculosis patients per month = 18.6% versus seen ≥ 5 tuberculosis patients per month = 19.3%; p - 0.32). A huge majority of Family Physicians (92%) however, showed keen interest in obtaining further knowledge regarding Mantoux Test and amongst them 72% suggested Continued Medical Education sessions as preferable mode of updating themselves.</p> <p>Conclusion</p> <p>Our study revealed an overall major deficit in understanding and interpretation of Mantoux Test amongst Family Physicians which needs to be addressed. Continues Medical Education sessions for Family Physicians should be organized in regular basis for upgrading their knowledge in this regards.</p

How does the sectoral composition of FDI induce economic growth in developing countries? The key role of business regulations

The prior empirical outcomes on the FDI-growth relationship are vastly conflicting. The key possible reason for these conflicting findings is the use of aggregate FDI, while FDI impacts largely depend on the receiving sectors of the host country. This study empirically estimated the influence of sectoral FDI on the economic growth and the role of business regulations in influencing the FDI-growth connection of 85 developing countries, for the time 1996–2019 and applied 2SLS method. The outcomes indicate the significant contribution of sectoral FDI inflows to economic growth. In contrast, the interaction of regulations with sectoral FDI negatively impacted host countries’ economic growth. Furthermore, in low income countries, only agriculture and industry FDI have growth promoting effect, while manufacturing and services FDI are insignificant. Similarly, FDI inflows to all sectors positively affect middle income countries’ economic growth except services FDI. However, FDI inflows to all sectors enhance high income countries economic growth. The regulations’ interaction with all types of FDI adversely affects the economic growth across all income groups, except agriculture and services FDI in the case of low and high income countries, which are found insignificant. The outcomes are consistent by employing diverse econometric techniques and model specifications

Efficacy of Manual Vacuum Aspiration Vs Conventional Evacuation and Curettage

OBJECTIVES: To evaluate the safety and efficacy of Manual Vacuum Aspiration (MVA) compared to Conventional Evacuation and Curettage (E &amp; C) in managing first-trimester miscarriage. METHODOLOGY: A total of 160 patients were enrolled in this comparative study. Patients were categorized into two groups (Group A undergoing MVA) and (Group B undergoing E&amp;C). Each group had 80 cases randomly selected. Stable patients with miscarriages ­&lt; 12 wks of gestation and no comorbid were included in the study. Data was recorded on pre-designed proforma, and analysis was done by SPSS Software. RESULTS: Efficacy of MVA was 97.5% and 92.5% in E&amp;C, with a 7.5% vs 30% complication rate in MVA and E&amp;C Group, respectively. The mean duration of the procedure was 9 minutes in the MVA group versus 18.8 minutes in the E&amp;C group. The hospital stay was 14.2 hours vs 20.3 hours in MVA and E&amp;C Group. 16.25% vs 46.25% of women in MVA vs E&amp;C Group reported post-op pain. 93.75% of women were satisfied with MVA, whereas only 50% of women were satisfied with E&amp;C. 81.25% 91.25% required Anesthesia/Analgesia in MVA and E&amp;C Group, respectively. CONCLUSION: MVA is a more effective and rapidly performing outpatient procedure with a lower complication rate. In this study efficacy of MVA is 97.5% compared to the E&amp;C group, i.e., 92%. Its safety, cost-effectiveness and efficacy advocate its extended use as an alternative to the conventional surgical method of miscarriag

Abdominal Hysterectomy for Benign Gynecological Diseases

OBJECTIVES This study aims to assess the Pap smear screening method’s accuracy in detecting precancerous lesions. METHODOLOGY After fulfilling the inclusion criteria patients were selected, the patient’s bladder was emptied and put in a dorsal position, and Cusco’s speculum was introduced after lubrication followed by insertion of Ayer’s spatula, applied on the transformational zone, and rotated in 360 degrees. Specimen smeared on glass slides and sent to the laboratory with fulfilled lab pre-requisite form. Patients were requested to follow up with a histopathology report. RESULTS Mean age of the patient was 38.111+9.461 years. Among the 77 patients whose samples were taken 15.4% were asymptomatic, 32.1% with vaginal discharge, 17.9% vaginal discharge,17.0% with intermenstrual bleeding and 16.7% were having lower abdominal pain with p value=0.087. Histopathology reports were interpreted upon follow-up visit among those 1.3% came out to be positive for malignancy, 76.6% negative for malignancy while 22.1% had an inadequate sample. CONCLUSION The most common method for screening for cervical cancer is the Pap smear, but its efficacy in detecting early precancerous lesions is very low, possibly due to laboratory error or false technique to a gynecologist of sample technique in our tertiary care hospital. Other screening methods should be used instead of conventional Pap smear

Natural Resource Rent and Finance: The Moderation Role of Institutions

L

Multivariate analysis and vegetation mapping of a biodiversity hotspot in the Hindu Kush Mountains

To explore and understand the floristic composition of one of the most important biodiversity hotspots in the Hindu Kush region of Pakistan, a multivariate analysis of species was carried out using the DCA and CCA ordination methods. Ordination plots were developed to evaluate interaction between tree-tree, tree-herbaceous plants and plants-environmental variables, using Canoco 4.6 for Windows. Results obtained for the DCA analysis of the tree species only indicate that Taxus baccata has the lowest correlation response with the other species and thus forms no association with the other native trees like Picea smithiana, Cedrus deodara and Abies pindrow. The DCA results for the locations-only data indicate that location 18 (Sulatanr and Rodingar) provides distinct microclimatic conditions for the flora and can be termed as the superior biodiversity hotspots of the area. Results also indicate that all the lowland species have positive correlation response to rock, water bodies, field (Farms) and unpaved paths and are closely associated with each other. Different tree species or group of species were found to support specific sub-flora while species i.e. Pinus roxburghii was found to be ecologically associated with no immediate sub-flora. It was observed that this species of Pine is the favourite plant used for re and afforestation purposes in the area. It is recommended that the species selection for the reforestation efforts should be revisited, and the impact of the climate change should be evaluated on these species if the ultimate aim of these projects is to improve the forest services and biodiversity of the area

Modelling the gender inequality in Pakistan: A macroeconomic perspective

The paper takes up the case of gender build inequality and its potential repercussions on economic growth of Pakistan. Using cointegration and causality analysis, we explore the relationship between gender inequality and its macroeconomic determinants i.e. economic growth, financial development, trade openness and foreign direct investment. For the this purpose, we have applied the Bayer-Hanck combined cointegration approach to test the long-run relationship and Granger causality for causal links amid the variables on the most recent and extended time period data (1972-2013). The cointegration test results validate the long-run association among the underlying variables. We found economic growth and financial development ignite gender driven disparity. Whereas, trade openness and foreign direct investment found to reduce gender gap. The positive bidirectional causal link between economic growth and gender inequality portrays unhealthy socio-economic environment to reduce gender inequality in the country. The feedback effect exists between financial development and gender inequality

Risk Factors Leading to Meconium Aspiration Syndrome in Meconium-Stained Amniotic Fluid

OBJECTIVES This study aimed to find out the risk factors leading to meconium aspiration syndrome in patients having meconium-stained amniotic fluid. METHODOLOGY This comparative study was conducted in the department of Obstetrics and Gynaecology at Hayatabad Medical Complex from January 2022- June 2022. All patients admitted to the labour ward with the diagnosis of meconium-stained liquor (MSL) were included in the study through a convenient sampling technique. Patients were divided into two groups, group 1 having only meconium-stained amniotic fluid (MSAF) without meconium aspiration syndrome while group 2 having babies with the diagnosis of meconium aspiration syndrome (MAS). Both groups were compared for different risk factors for the development of MAS. Differences in the risk factors between the two groups were analyzed using Pearson’s correlation with a p-value of &lt;0.05 considered significant. SPSS vs 20 was used for statistical analysis. RESULTS 84 patients were included in the study, i.e., 61 in group 1 and 23 in group 2. The mean age of the patients was 25± 3.45. The frequency of meconium-stained amniotic fluid was 3.83%. Meconium aspiration syndrome developed in 23 babies out of 84 MSAF deliveries (27.38%). Low APGAR score (&lt; 0.00), patients handled outside the hospital (&lt;0.001) and prolonged second stage (0.003) were significant risk factors for the development of MAS. CONCLUSION In the prolonged second stage, patients handled outside the hospital by unauthorized personnel and low APGAR score at birth were statistically significant risk factors for developing meconium aspiration syndrome

Modelling the gender inequality in Pakistan: A macroeconomic perspective

The paper takes up the case of gender build inequality and its potential repercussions on economic growth of Pakistan. Using cointegration and causality analysis, we explore the relationship between gender inequality and its macroeconomic determinants i.e. economic growth, financial development, trade openness and foreign direct investment. For the this purpose, we have applied the Bayer-Hanck combined cointegration approach to test the long-run relationship and Granger causality for causal links amid the variables on the most recent and extended time period data (1972-2013). The cointegration test results validate the long-run association among the underlying variables. We found economic growth and financial development ignite gender driven disparity. Whereas, trade openness and foreign direct investment found to reduce gender gap. The positive bidirectional causal link between economic growth and gender inequality portrays unhealthy socio-economic environment to reduce gender inequality in the country. The feedback effect exists between financial development and gender inequality

Technological Innovation, Natural Resources, Financial Inclusion, and Environmental Degradation in BRI Economies

This research aimed to examine the relationshipbetween financial inclusion (FNI), technological inno-vation (TIN), and natural resources (NRS) and theirimpact on environmental degradation in the 45‐beltand road initiative (BRI) region from 2001 to 2018. Thestudy utilized advanced econometric techniques,including the generalized method of moments panelvector autoregressive, as well as traditional methodssuch as ordinary least squares and dynamic ordinaryleast squares, to examine the relationship betweenthese factors and environmental degradation, measuredby carbon footprint (CFP) and ecological footprint(EFP). The long‐run estimate confirms that NRS andFNI appear to have led to higher regional CFPs andEFP pressure. Meanwhile, the relationship with TIN,economic governance institutions (government effec-tiveness and regularity quality), and human capital contribute to overcoming environmental degradationand increasing environmental sustainability. The find-ings of this study have important implications forpolicymakers and central authorities in the BRI regionto address environmental degradation and promotesustainable development.Recommendations for Resource Managers•Natural resources (NRS) and financial inclusionincrease the regional carbon footprint (CFP) andecological footprint.•Human capital and technological innovation posi-tively contribute to environmental sustainability.•Belt and road initiative (BRI) economies shouldretain innovative access to financial services,sustainable forest, and biocapacity developmentto meet environmental disasters.•Moreover, BRI economies should not increase NRSused extensively to minimize the regional CFP