Stimulating appearance comparison dynamics and their effects on psychological dysfunctions: The moderating role of self-compassion

In recent decades, attitudes towards appearance comparison, and self-disapproval have rapidly increased, and these are attitudes strongly associated with psychological disorders. The present study aims to investigate the underlying patterns of depression, appearance-based stress, dietary constraints, and social and celebrity appearance comparison among young adults. It also examines the role of self-compassion in moderating the relationship between psychological dysfunctions and appearance comparison as well as the criteria and influences contributing to appearance comparison. Data on BMI, the measures of depression, appearance-based stress, eating restraints, appearance comparison, self-compassion, and predictors of peers and celebrity appearance comparison were collected from 434 college students (Age: Mean = 22; SD = 2.36; Male = Female = 217) in Sialkot, Pakistan. The data was analyzed by using the Hierarchical Regression Model. The results revealed that respondents who compared their appearances to peers and celebrities had increased depression and appearance-based stress while eating constraints didn’t affect the appearance-based comparison, stress, and depression. Moreover, self-compassion significantly moderated the relationship between depression, appearance-based stress, and appearance comparison whereas an insignificant moderation effect is observed between eating restraints and self-compassion. Despite psychological distresses such as depression, appearance-based stress, and eating restraints, appearance comparisons are connected to appearance-based victimization, media appearance pressure, social-cultural appearance pressure, appearance conversation, and self-consciousness

Knowledge and attitude towards child marriage practice among women married as children-a qualitative study in urban slums of Lahore, Pakistan

Nasrullah M, Zakar R, Zakria Zakar M, et al. Knowledge and attitude towards child marriage practice among women married as children-a qualitative study in urban slums of Lahore, Pakistan. BMC Public Health. 2014;14(1): 1148.Background Child marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes. Our aim is to describe women’s knowledge and attitude towards child marriage practice who themselves were married as children. Methods Women of reproductive age (15–49 years) who were married prior to 18 years, for at least 5 years and had at least one child birth were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes. Results Nineteen of 20 participants who agreed to participate were married between 11–17 years. Most respondents were uneducated, poor and were working as housemaids. The majority participants were unaware of the negative health outcomes of child marriages. They appeared satisfied by the decision of their parents of marrying them before 18 years, and even condemned banning child marriages in Pakistan. Strong influence of culture and community perceptions, varying interpretation of religion, and protecting family honor are some of the reasons that were narrated by the participants, which seems playing a role in continuation of child marriage practice in Pakistan. Conclusion Raising awareness of the negative health outcomes of child marriage, implementing and enforcing strict laws against child marriage practice, promoting civil, sexual and reproductive health rights for women, can help eliminate child marriages in Pakistan

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Meta-analysis of diabetes mellitus prevalence among tuberculosis patients in Asia and Africa

Objective: To determine the prevalence rate of diabetes mellitus (DM) among active Tuberculosis (TB) patients. To find out the impact of age factor in the prevalence rate. Methodology: This research work is a meta-analysis to determine the prevalence rate of DM among TB patients in Asian and African countries. To conduct this research total 200 studies are reviewed and 15 studies (28,055 patients) are further used for analysis, while 47% and 53% studies of last seven years (2012-2018) have been included from African and Asian countries respectively. The data is analyzed using the Meta excel extension of excel. Results: The results revealed that highest prevalence rate 71% found within Pakistan, while overall pooled prevalence of DM among TB patients is 26% with 95% confidence interval (22.12, 28.47). It also has been determined that age significantly affects the prevalence rate of DM among TB patients with -0.634 to 4.179) confidence interval. Conclusion: It can be concluded that Diabetes Mellitus is widely spreading among people and age also significantly moderate the prevalence rate. Continuous..

Measles – Immunization Status and Outcome

Background: To evaluate the immunization status, complications and clinical outcome in children admitted with measles.Methods : In this descriptive study 150 patients( 8 months to 12 years of age), with clinical diagnosis of Measles i.e. high grade fever, maculopapular rash, coryza, cough and conjunctivitis with its complications were included. Relevant information regarding age, sex immunization status and clinical presentation were also recorded. Immunization status of the patients was checked by examining the EPI card where available or parental enquiry if EPI card was not available. All the relevant investigations like CBC, serum electrolytes, X ray chest were carried out besides history and clinical examination. CSF examination was done where needed. All the patients were observed for complications like encephalitis, pneumonia, diarrhea, otitis media and corneal ulcers. They were managed according to the standard protocol of the hospital.Results: Of the 150 paediatric patients with diagnosis of measles included in the study, eighty nine(59.33%) were males. Mean age of the patients was 25 months. Seventy eight (52%) patients were well-nourished and 72(48%) were undernourished. Out of 150 patients 62% had received measles vaccine. Among vaccinated patients 5.33% patients had received two doses of measles vaccine and 85 had one dose. Majority (88%) developed complications. Pneumonia (43.33%) followed by diarrhea (23.33%) were the commonest. Six patients (4%) expired.Conclusion:There is a need to improve the nutritional status of the children and good coverage for the measles vaccine. The EPI needs to be strengthened

ACOUSTIC BEHAVIOR OF ENGLISH TRIPHTHONGS IN PAKISTANI ENGLISH VARIETY

In this research, the acoustic behavior of English triphthongs has been analyzed in Pakistani English (PakE) variety. A triphthong is a gliding movement of three consecutive vowels. According to Roach (2009), majority of English speakers (with BBC pronunciation) perceived few words as monosyllabic vocabulary by identifying triphthongs. English has five triphthongs which are comprised with the combination of closing diphthongs followed by a short vowel schwa (ə). Contrarily, this condition may not compulsory for PakE due to the language variation phenomenon as we know that two diverse languages have different approaches. If there are some similarities in them than consider them just coincidence nothing else. Presently, it has been proposed that the native language, Urdu affects the acoustic behavior of English triphthongs therefore, two different experimental approaches are adopted. In the first step, the auditory approach has used syllable count technique. While in the second step, the identified segments have been acoustically analyzed in PRAAT. After data analysis, the results have reported that Urdu has influenced and transformed the acoustic features of PakE. Therefore, there is no trace of English triphthongs in PakE variety and they are replaced with a monophthong, diphthong or syllabic division

Clinical Presentations of Coeliac Disease in Children from 2 to 14 Years

Background: To study presentations of childhoodcoeliac disease (CD) in different paediatric age groups .Methods:This descriptive study was conducted on twohundred patients of either sex from two to fourteen yearsof age with suspicion of CD. Anti-endomysial titres(EMA ) were done in all the patients. Those with positiveEMA titres were subjected to endoscopy. Biopsy wastaken for confirmation of CD.Results: Out of two hundred patients seen, fortypatients fulfilled the diagnostic criteria of CD. Mean ageat presentation was eight years. Mean duration ofsymptomatology was 6.5 years. Male to female ratio was1.6:1. Out of forty patients ,32% presented with chronicdiarrhea, 22.5% with short stature. Iron deficiencyanaemia was found in 20% and abdominal pain in 14.5%.Family history was positive in 4.55% patients.Conclusion: Younger children present with intestinalmanifestation of CD like chronic diarrhoea. Olderchildren usually have extra- intestinal manifestations likeshort stature, iron deficiency anemia, abdominal pain andfailure to thrive