CARDIOPULMONARY RESUSCITATION-REVIEW ARTICLE

Introduction: Cardiac arrest is one of the major causes of increased mortality and morbidity worldwide Regarding the occurrence of physiological changes in the vital system of pregnant mothers and reminders, it must be stated that the fact that heart disease in pregnant women can endanger two lives simultaneously, it is clearly indicative of the importance of taking correct remedial and precautionary measures. On the other hand, since the implementation of cardiopulmonary arrest on pregnant women cause incidents, timely and correct remediation is associated with a high percentage of success. Therefore, the purpose of this study was to review the recovery of heart rhythm in pregnant mothers. Methods: In this review article, the databases Medline, Cochrane, Science Direct, and Google Scholar were thoroughly searched to identify the studies investigating Pulmonary cardiopulmonary resuscitation. In this review, the papers published until early January 2017 that were conducted to study the Paget's disease were selected. In searching for the articles, those English papers were selected that had investigated Pulmonary cardiopulmonary resuscitation. Results: . Side effects such as heart rhythm disorders and pulmonary edema usually arise in the context of old heart disease and follow physiological changes in the cardiovascular and pulmonary causes which, unless treated timely and correctly, may lead to cardiac arrest. Conclusion: In case of cardiac arrest, ventilation of pregnant mothers is initially performed by mask and bag valve mask and the oxygen core. If additional ventilation is needed, intubation of the trachea should be done as soon as possible and the ventilation must continue through the tracheal tube and bag valve mask; finally, in case of prolonged cardiac and respiratory difficulty, long-term ventilation can be used. Keywords: Pulmonary, cardiopulmonary, resuscitatio

Autumn food habits of the brown bear Ursus arctos in the Golestan National Park : A pilot study in Iran

Food consumed by brown bears in the Golestan National Park in Iran was analyzed during autumn 2011. We identified 22 food items in 61 scats, with the most important food items being hawthorn fruit, cherry plum fruit and chestnut-leaved oak hard mast, based on importance value (IV) estimates of 26.4%, 18.1% and 12.9%, respectively. The overall bear diet (percent digestible dry matter) was composed of 77.9% soft mast (i.e. fruit), 21.3% hard mast and small proportions of other vegetation (0.3%) or animal matter (0.4%). One anthropogenic food was identified (vine grape) and was of minor importance (IV=0.2%)

A novel, post‐Soviet fire disturbance regime drives bird diversity and abundance on the Eurasian steppe

Many grassland ecosystems and their associated biodiversity depend on the interactions between fire and land-use, both of which are shaped by socioeconomic conditions. The Eurasian steppe biome, much of it situated in Kazakhstan, contains 10% of the world's remaining grasslands. The break-up of the Soviet Union in 1991, widespread land abandonment and massive declines in wild and domestic ungulates led to biomass accumulation over millions of hectares. This rapid fuel increase made the steppes a global fire hotspot, with major changes in vegetation structure. Yet, the response of steppe biodiversity to these changes remains unexplored. We utilized a unique bird abundance dataset covering the entire Kazakh steppe and semi-desert regions together with the MODIS burned area product. We modeled the response of bird species richness and abundance as a function of fire disturbance variables—fire extent, cumulative burned area, fire frequency—at varying grazing intensity. Bird species richness was impacted negatively by large fire extent, cumulative burned area, and high fire frequency in moderately grazed and ungrazed steppe. Similarly, overall bird abundance was impacted negatively by large fire extent, cumulative burned area and higher fire frequency in the moderately grazed steppe, ungrazed steppe, and ungrazed semi-deserts. At the species level, the effect of high fire disturbance was negative for more species than positive. There were considerable fire legacy effects, detectable for at least 8 years. We conclude that the increase in fire disturbance across the post-Soviet Eurasian steppe has led to strong declines in bird abundance and pronounced changes in community assembly. To gain back control over wildfires and prevent further biodiversity loss, restoration of wild herbivore populations and traditional domestic ungulate grazing systems seems much needed.UK Government’s Darwin InitiativeVolkswagen Foundation http://dx.doi.org/10.13039/501100001663University of Göttingen http://dx.doi.org/10.13039/501100003385Peer Reviewe

First record of Poltys nagpurensis (Araneae: Araneidae) from Iran

A female specimen of Poltys (Araneidae) is reported from southern Iran, representing the first record of the genus for the whole Middle East and its westernmost record in the entire Asian region. The specimen was identified as Poltys nagpurensis Tikader, 1982, previously known only from central and western India. Since the Iranian specimen differs in habitus morphology (but not in the epigyne), a brief description and comparison to the holotype with photos of the habitus and copulatory organs are provided.</p

Reducing persecution is more effective for restoring large carnivores than restoring their prey

We gratefully acknowledge funding by the Federal State of Berlin, Germany (Elsa Neumann Scholarship to BB), and the German Research Foundation (GH 149/1-1 and ZU 361/1-1). We further thank all participants of the workshop on the revi- sion of the Strategy for Leopard Conservation in the Caucasus in Tbilisi, Georgia in 2017. We are grateful to J. Buchner, A. Heidelberg, V.C. Radeloff, and H. Yin for fruitful discussions, and F. Poetzschner for help with preparing data. Additionally, we thank two anonymous reviewers for their constructive comments.Peer reviewedPublisher PD

HIV infection predominantly affecting children in Sindh, Pakistan, 2019: a cross-sectional study of an outbreak.

BACKGROUND: In April 2019, an HIV screening camp for all ages was established in response to a report of an unusually large number of paediatric HIV diagnoses in Larkana, Pakistan. We aimed to understand the clinical profile of the children who registered for HIV care. METHODS: In this cross-sectional study, we review the outbreak response from the government, academia, and UN agencies in Larkana, Sindh, Pakistan. We report age-stratified and sex-stratified HIV prevalence estimated among individuals screened. For children who registered for HIV care, clinical history of previous injections and blood transfusions, HIV disease stage, hepatitis B and hepatitis C status, and CD4 count was abstracted from clinical records from Sindh AIDS Control Program HIV Clinic (Shaikh Zayed Childrens Hospital, Larkana, Pakistan) and analysed using percentages, χ2 tests, and weight-for-age Z scores. We also analysed data for parents who were tested for HIV. FINDINGS: Between April 24, and July 15, 2019, 31 239 individuals underwent HIV testing, of whom 930 (3%) tested positive for HIV. Of these, 763 (82%) were younger than 16 years and 604 (79%) of these were aged 5 years and below. Estimated HIV prevalence was 3% overall; 7% (283 of 3803) in children aged 0-2 years, 6% (321 of 5412) in children aged 3-5 years, and 1% (148 of 11 251) in adults aged 16-49 years. Of the 591 children who registered for HIV care, 478 (81%) were 5 years or younger, 379 (64%) were boys, and 315 (53%) of 590 had a weight-for-age Z score of -3·2. Prevalence of hepatitis B surface antigen was 8% (48 of 574) and hepatitis C antibody positivity was 3% (15 of 574). Of children whose mothers tested for HIV, only 39 (11%) of 371 had HIV-positive mothers. Most children (404 [89%] of 453) reported multiple previous injections and 40 (9%) of 453 reported blood transfusions. INTERPRETATION: This HIV outbreak is unprecedented among children in Pakistan: a 54% increase in paediatric HIV diagnoses over the past 13 years. The outbreak was heavily skewed towards young children younger than 5 years, with a predominance of boys. Epidemiological and molecular studies are needed to understand the full extent of the outbreak and its drivers to guide HIV control strategies. FUNDING: None

Community-based asthma assessment in young children:Adaptations for a multicentre longitudinal study in South Asia

BACKGROUND: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan. METHOD: We followed a group of children of age 6–8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the ‘Aetiology of Neonatal Infection in South Asia (ANISA)’ study. We standardised the research methods for the sites, trained field staff for uniform data collection and provided a ‘Child Card’ to the caregiver to record the illness history of the participants. We visited the children on three different occasions to collect data on respiratory-related illnesses. The lung function of the children was assessed in the outreach clinics using portable spirometers before and after 6-minute exercise, and capillary blood was examined under light microscopes to determine eosinophil levels. RESULTS: We enrolled 1512 children, 95.5% (1476/1512) of them completed the follow-up, and 81.5% (1232/1512) participants attended the lung function assessment tests. Pre- and post-exercise spirometry was performed successfully in 88.6% (1091/1232) and 85.7% (1056/1232) of children who attempted these tests. Limited access to health care services, shortage of skilled human resources, and cultural diversity were the main challenges in adopting uniform procedures across all sites. Designing the study implementation plan based on the local contexts and providing extensive training of the healthcare workers helped us to overcome these challenges. CONCLUSION: This study can be seen as a large-scale feasibility assessment of applying spirometry and exercise challenge tests in community settings of LMICs and provides confidence to build capacity to evaluate children’s respiratory outcomes in future translational research studies

Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study

Background Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. Method The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. Results The mean age of participants was 49.38(SD = +/- 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. Conclusion The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers

Mapping disparities in education across low- and middle-income countries

Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations. Educational attainment is an important social determinant of maternal, newborn, and child health(1-3). As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting(4-6). The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness(7,8); however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health(9-11). Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but-to our knowledge-no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries(12-14). By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.Peer reviewe

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations