The significance of interfamilial relationships on birth preparedness and complication readiness in Pakistan.

Background: - In the interests of improving maternal health care and survival, the issue of birth preparedness and complication readiness has been much debated and has remained a priority for the international health community. The provision of birth preparedness and complications readiness is determined by a range of different factors. Aim: - The main aim of this study is to identify and measure the influence of husbands and other family relationships on birth preparedness and complications readiness in the Khyber Pakhtunkhwa province of Pakistan. Methods: - This study is a cross-sectional exploratory study. Data was collected through a survey questionnaire. Logistic regression and descriptive analysis was used. Findings: - Analysis indicated that the mother-in-law's role, men's and women's level of education and interfamilial relationships are still the most significant factors influencing birth preparedness and complications readiness. Of the respondents, 86% were receiving antenatal care and 76.5% were planning for the birth to take place in state-run hospitals or private obstetric and gynae clinics. Conclusion: - The tendency to take up antenatal care in Khyber Pakhtunkhwa can mainly be credited to a mutual understanding between husband and wife and a good relationship between the woman and her mother-in-law. Highlighting the significance of these relationships has implications for ensuring birth preparedness and complications readiness

Immature Platelet Fraction in Patients with Chronic Liver Disease, A Marker for Evaluating Cirrhotic Changes.

Objective: To evaluate the role of Immature platelet fraction in patients with chronic liver disease, a marker for evaluating cirrhotic changes. Methodology: This case control study was conducted at department of Pathology, Aziz Fatima Medical and Dental College, Faisalabad, over a period of Seven months from June 2020 to January 2021. A total of 126 participants were included in the study consisting of 63 patients with chronic liver disease in group A and 63 participants without any known disease in group B as control. The IPF master program in combination with XE-2100 multiparameter automatic hematology analyzer was used to measure the immature platelet fraction. Ethylene diamine tetraacetic acid was used to collect the blood sample for IPF measurement and was maintained till analysis on room temperature. Ten repeated analyses, immediately and after 24 hours were done for reproducibility of IPF%. Results: The mean age of liver disease patients was 52.35 ± 13.64 years and in control group the mean age was 51.62 ± 11.27 years. There was no significant (p-value > 0.05) difference between both groups based on age and gender. The hemoglobin level and red cell count was found to be significantly (p-value < 0.05) reduced in cases group. While white blood cells count was comparable in both groups. The mean platelet count was significantly (p-value < 0.05) less in cases group (163.5 ± 90.4 vs 233.4 ± 54.5 (x10*3/µl). The mean value of immature platelet fraction (IPF%) was significantly (p-value < 0.05) raised in cases group (5.62 ± 2.92 vs 3.06 ± 1.87). The multivariate discriminant analysis (MDA) score showed a significant (p-value < 0.05) association with chronic hepatis as compared to other liver related diseases. Conclusions: In chronic liver disease patients, there is an inverse relationship between platelet count and IPF% with decreased platelet count and increased IPF%. The proposed MDA function can be used to identify the cirrhotic changes in liver disease patients

Study on Desiccant and Evaporative Cooling Systems for Livestock Thermal Comfort: Theory and Experiments

The present study considers evaporative cooling and desiccant unit-based air-conditioning (AC) options for livestock AC application. In this regard, proposed systems are investigated by means of experiments and thermodynamic investigations. Air-conditioning requirements for animals are theoretically investigated and temperature-humidity index (THI) is estimated. A lab-scale heat mass exchanger based on the Maisotsenko-cycle evaporative cooling conception (MEC) is set up and its performance is evaluated at different ambient air conditions. In addition, a desiccant-based air-conditioning (DAC) unit is thermodynamically evaluated using a steady-state model available in the literature. The study focuses on the ambient conditions of Multan which is the 5th largest city of Pakistan and is assumed to be a typical hot city of southern Punjab. The study proposed three kinds of AC combination i.e., (i) stand-alone MEC, (ii) stand-alone desiccant AC, and (iii) M-cycle based desiccant AC systems. Wet bulb effectiveness of the stand-alone MEC unit resulted in being from 64% to 78% whereas the coefficient of performance for stand-alone desiccant AC and M-cycle based desiccant AC system was found to be 0.51 and 0.62, respectively. Results showed that the stand-alone MEC and M-cycle based desiccant AC systems can achieve the animals’ thermal comfort for the months of March to June and March to September, respectively, whereas, stand-alone desiccant AC is not found to be feasible in any month. In addition, the ambient situations of winter months (October to February) are already within the range of animal thermal comfort

Estimation of Finite Population Mean by Utilizing the Auxiliary and Square of the Auxiliary Information

This article fundamentally aims at the proposition of new family of estimators using auxiliary information to assist the estimation of finite population mean of the study variable. The objectives are achieved by devising dual use of supplementary information through straightforward manner. The additional information is injected in mean estimating procedure by considering squared values of auxiliary variable. The utility of the proposed scheme is substantiated by providing rigorous comparative account of the newly materialized structure with the well celebrated existing family of Grover and Kaur (2014). The contemporary advents of the new family are documented throughout the article

Antioxidant capacity and antibacterial activity of some phyto-spices against some bacterial isolates of foods origin

Spices that are mostly of plant origin are used in the preparation of almost all processed food to enhance palatability, tastiness, sweetness, and its overall acceptability, without taking into consideration of its medicinal values. The study was conducted to determine the antioxidant capacity and antibacterial activity of the extracts ofAllium sativum,Syzygium aromaticum, andZingiber officinale against some bacterial isolates of foods origin including Bacillus cereus, Escherichia coli,Salmonella typhi,Shigella dysentriae,andStaphylococcus aureus. Bacterial isolates of food origin were collected from the laboratory unit of the Department of Microbiology, Kano University of Science and Technology, Wudil. Antioxidant capacity of the extracts used was determined using 2,2-diphenylpicrylhydrazyl (DPPH) assay while agar disc diffusion techniques were used in the determination of the antibacterial activity. Results show that extracts of the spices exhibited a strong antioxidants capacity that ranges from 89.5% to 97.5% at high concentrations of the extracts with methanol extracts being the most active. Methanolic extracts shows zone of inhibition ranging from 16.45mm to 5.26mm while that of aqueous extracts were 10.32mm to 4.32mm. Meanwhile isolates of E. coli and S. aureus were the most sensitive with 16.45 and 15.32. This study concluded that the antibacterial effect of methanolic extract of Allium sativum extract was stronger in comparison, followed by Syzygium aromaticum and Zingiber officinale against five test bacteria isolated of food origin. Therefore, this study revealed that spices produced using Allium sativum, Syzygium aromaticum and Zingiber officinale have an antibacterial property and can be used for food preservation

Risk Factors of Typhoid Infection in the Indonesian Archipelago.

BACKGROUND: Knowledge of risk factors and their relative importance in different settings is essential to develop effective health education material for the prevention of typhoid. In this study, we examine the effect of household level and individual behavioural risk factors on the risk of typhoid in three Indonesian islands (Sulawesi, Kalimantan and Papua) in the Eastern Indonesian archipelago encompassing rural, peri-urban and urban areas. METHODS: We enrolled 933 patients above 10 years of age in a health facility-based case-control study between June 2010 and June 2011. Individuals suspected of typhoid were tested using the typhoid IgM lateral flow assay for the serodiagnosis of typhoid fever followed by blood culture testing. Cases and controls were defined post-recruitment: cases were individuals with a culture or serology positive result (n = 449); controls were individuals negative to both serology and culture, with or without a diagnosis other than typhoid (n = 484). Logistic regression was used to examine the effect of household level and individual level behavioural risk factors and we calculated the population attributable fraction (PAF) of removing each risk significant independent behavioural risk factor. RESULTS: Washing hands at critical moments of the day and washing hands with soap were strong independent protective factors for typhoid (OR = 0.38 95% CI 0.25 to 0.58 for each unit increase in hand washing frequency score with values between 0 = Never and 3 = Always; OR = 3.16 95% CI = 2.09 to 4.79 comparing washing hands with soap sometimes/never vs. often). These effects were independent of levels of access to water and sanitation. Up to two thirds of cases could be prevented by compliance to these practices (hand washing PAF = 66.8 95% CI 61.4 to 71.5; use of soap PAF = 61.9 95%CI 56.7 to 66.5). Eating food out in food stalls or restaurant was an important risk factor (OR = 6.9 95%CI 4.41 to 10.8 for every unit increase in frequency score). CONCLUSIONS: Major gains could potentially be achieved in reducing the incidence of typhoid by ensuring adherence to adequate hand-washing practices alone. This confirms that there is a pivotal role for 'software' related interventions to encourage behavior change and create demand for goods and services, alongside development of water and sanitation infrastructure

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

Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. FINDINGS: In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30-30·30 million) new cases of TBI and 0·93 million (0·78-1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40-57·62 million) and of SCI was 27·04 million (24·98-30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (-0·2% [-2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (-3·6% [-7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0-10·4 million) YLDs and SCI caused 9·5 million (6·7-12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. INTERPRETATION: TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments