HIV MORTALITY DIFFERENCE BETWEEN BLACK AND WHITE WOMEN

OBJECTIVE In the United States, human immunodeficiency virus (HIV) continues to be among the top 10 leading causes of mortality for black women between the ages of 20 and 54¹, but does not rank among the top 10 leading causes of death for white women amongst all age groups². This study describes the HIV mortality difference between black and white women and formulate hypotheses that may reduce or eliminate disparities. METHODS Information was accessed through public data, the US Census, and the US Compressed Mortality File. RESULTS In these descriptive data from 1987 through 2015, including reliable HIV mortality rates of both black and white females aged 25 to 64, the HIV mortality difference in black women is 8.2 times greater than that of their white counterparts. The mortality rate of black: white females is 8.7, a number comparable to that of 1997(13.39) a year after the introduction of highly active antiretroviral therapy (HAART). Although the data indicates a decline in the age adjusted mortality rate in HIV among black females, the current rate for black females is at a greater level than that for white female at any point of the epidemic. CONCLUSION These descriptive data demonstrate a large HIV mortality difference between black and white women. The data also demonstrate a small number of communities with low HIV mortality differences among black/African American women. Their characteristics may provide clinical and public health insights to reduce these higher mortality differences in the black female population of the United States. Analytic epidemiologic studies are necessary to test these hypotheses

Relationship between Social Media Marketing and Consumer Buying Behavior

The social media has become an integral part of our lives with the introduction of 3G, 4G technology in Pakistan it has become possible for people to stay connected from anywhere any time. The purpose of this study is to find out that if any relationship between social media marketing and consumer buying behavior exist if their existence affected each other in any significant way. For this purpose an online survey was conducted and 100 people responded who were active users of social media in the region of Peshawar an unstructured/ structured questionnaire was designed to collect information from the respondents. The research findings and results confirms that there is a positive relationship between social media marketing and consumer buying behavior as well as that social media can be used as an effective marketing tool in region of Peshawar

Higher entropy observed in SARS-CoV-2 genomes from the first COVID-19 wave in Pakistan

Background: We investigated the genome diversity of SARS-CoV-2 associated with the early COVID-19 period to investigate evolution of the virus in Pakistan.Materials and methods: We studied ninety SARS-CoV-2 strains isolated between March and October 2020. Whole genome sequences from our laboratory and available genomes were used to investigate phylogeny, genetic variantion and mutation rates of SARS-CoV-2 strains in Pakistan. Site specific entropy analysis compared mutation rates between strains isolated before and after June 2020.Results: In March, strains belonging to L, S, V and GH clades were observed but by October, only L and GH strains were present. The highest diversity of clades was present in Sindh and Islamabad Capital Territory and the least in Punjab province. Initial introductions of SARS-CoV-2 GH (B.1.255, B.1) and S (A) clades were associated with overseas travelers. Additionally, GH (B.1.255, B.1, B.1.160, B.1.36), L (B, B.6, B.4), V (B.4) and S (A) clades were transmitted locally. SARS-CoV-2 genomes clustered with global strains except for ten which matched Pakistani isolates. RNA substitution rates were estimated at 5.86 x10-4. The most frequent mutations were 5\u27 UTR 241C \u3e T, Spike glycoprotein D614G, RNA dependent RNA polymerase (RdRp) P4715L and Orf3a Q57H. Strains up until June 2020 exhibited an overall higher mean and site-specific entropy as compared with sequences after June. Relative entropy was higher across GH as compared with GR and L clades. More sites were under selection pressure in GH strains but this was not significant for any particular site.Conclusions: The higher entropy and diversity observed in early pandemic as compared with later strains suggests increasing stability of the genomes in subsequent COVID-19 waves. This would likely lead to the selection of site-specific changes that are advantageous to the virus, as has been currently observed through the pandemic

Cytogenetic abnormalities associated with reproductive failure in Pakistani population: experience of a tertiary care hospital

Constitutional chromosomal abnormalities play a significant role in causing reproductive anomalies in individuals of reproductive age. With the rapid advancement of genome engineering techniques, it has now become possible to cure different genetic disorders. However, very limited data is available regarding the prevalence of such aberrations in the Pakistani population. Considering this factor, this retrospective analysis was undertaken to elucidate the type and prevalence rate of such abnormalities in our population. A total of 241 individuals, who were referred to the Liaquat National Hospital, from January 2017 to December 2021, with a history of infertility or miscarriages, were evaluated using the standard GTG banding technique. The results revealed a notably high percentage 44(18.2%) of chromosomal abnormalities in our population. Surprisingly, the frequency of these anomalies was observed to be higher in males than in females. ---Continu

Cost-effectiveness analysis of three different combinations of inhalers for severe and very severe chronic obstructive pulmonary disease patients at a tertiary care teaching hospital of South India

Background: This study aims at simplifying the practical patient management and offers some general indications for pharmacotherapeutic choice by the implementation of (Global Initiative for Chronic Lung Disease) guidelines. This study was designed to evaluate the clinical and economic consequences of salmeterol/fluticasone (SF), formoterol/budesonide (FB), and formoterol/fluticasone (FF) in severe and very severe chronic obstructive pulmonary disease (COPD) patients. Objectives: The aim was to find out the most cost-effective drug combination between the three combinations (SF/FB/FF) in COPD patients. Materials and Methods: A prospective observational comparative study (cost-effectiveness analysis), in which 90 severe (30 ≤ forced expiratory volume in 1 s [FEV 1 ] 30% predicted) COPD patients (outpatients/inpatients) who are prescribed with any one of the following combinations (SF/FB/FF) were selected. In our study, we have divided 90 COPD patients into three groups (Group I, Group II, and Group III) each group consisting of 30 patients. Group I was prescribed with medication SF, Group II with medication FB, and Group III with medication FF. We used five different parameters such as spirometry test (mean FEV 1 initial and final visit), number of symptom-free days (SFDs), number of moderate and severe exacerbations, Number of days of hospitalization and direct, indirect, and total cost to assess the cost-effectiveness of SF/FB/FF. Comparison of cost and effects was done during the period of 6 months of using SF/FB/FF. Results: The average FEV 1 for Group I, Group II, and Group III subjects at initial visit was 33.47%, 33.73%, and 33.20% and was increased to 36.60%, 35.8%, and 33.4%, respectively. A 3% increment in FEV 1 was reported for Group I subjects (SF) and was highly significant statistically (t = −8.833, P = 0.000) at 95% CI. For Group II subjects (FB), a 2% increment in FEV 1 was reported and was highly significant statistically (t = −9.001, P = 0.000) at 95% CI. For Group III (FF) subjects 0.2% increment in FEV 1 . The overall mean total cost for Group I, Group II, and Group III subjects during the 6 months period was found to be Rs. 29,725/-, Rs. 32,602/- and Rs. 37,155/-. Incremental cost-effectiveness of FB versus SF was Rs. 37,781/- per avoided exacerbation and Rs. 661/- per SFD. Conclusion: This study highlights the favorable therapeutic performance of combined inhaled bronchodilators and corticosteroids (SF/FB/FF), thus suggesting that healthcare costs would be also affected positively. Results from our study showed that SF and FB were the most effective strategies in the treatment of COPD, with a slight clinical superiority of SF. The FF strategy was not much effective (i.e. associated with fewer outcomes and higher costs)

Vertical Transfer of Humoral Immunity against Nipah Virus: A Novel Evidence from Bangladesh

A major obstacle to in-depth investigation of the immune response against Nipah virus (NiV) infection is its rapid progression and high mortality rate. This paper described novel information on the vertical transfer of immune properties. In January 2020, a female aged below five years and her mother from Faridpur district of Bangladesh were infected. Both had a history of raw date palm sap consumption and were diagnosed as confirmed NiV cases. The daughter passed away, and the mother survived with significant residual neurological impairment. She conceived one and a half year later and was under thorough antenatal follow-up by the surveillance authority. A healthy male baby was born. As part of routine survivor follow-up, specimens were collected from the newborn and tested for NiV infection at the reference laboratory to exclude vertical transmission. Although testing negative for anti-Nipah IgM and PCR for NiV, a high titre of anti-Nipah IgG was observed. The transfer of humoral immunity against NiV from mother to neonate was confirmed for the first time. The article will serve as a reference for further exploration regarding NiV-specific antibodies that are transferred through the placenta, their potential to protect newborns, and how this may influence vaccine recommendations

EVALUATION OF IMPACT OF EXISTING EXTRA CURRICULAR ACTIVITIES AT UNDERGRADUATE MEDICAL AND DENTAL EDUCATION IN BANGLADESH

With an objective to evaluate the impact of existing extracurricular activities at undergraduate medical and dental education in Bangladesh this descriptive study was designed and collected information conveniently from 515 students and 155 teachers from randomly selected medical and dental colleges of the country. The respondents (100%) supported more than one extracurricular activity for the medical and dental students. More than 65 % were in favor of games, sports and cultural functions. Some students clubs are also popular among the respondents but only 10.8 % respondents supported student politics. The respondents who were against student politics viewed that it hamper educational activities and disciplines in their institutes. About half the respondents (48.8%) were unsatisfied with the present academic activities in their medical colleges. Respondents advised to develop infrastructures, accommodation facilities, teaching aids, libraries, administrative supervisory in the institutes. They also demand more trained teachers, good students-teachers relationship to raise standard of the medical and dental colleges to a satisfactory level