MUNICIPAL SOLID WASTE MANAGEMENT CRISES IN THE DEVELOPING COUNTRIES: A CASE STUDY OF PESHAWAR CITY

Due to the speedy increase in population, the solid waste management issues are becoming a challenge for the developing countries. Unhealthy collection, improper transportation and open dumping of the Municipal Solid Waste (MSW) is causing a serious threat to the environment and the people residing in the surroundings. In Pakistan, unsustainable way of solid waste management, lack of the authorities to deal with effectively with the MSW and least vision of the society towards the emerging issues of the solid waste is depicting the worst situation in the country. To highlight the significant Municipal Solid Waste Management (MSWM) issues in the developing countries of the world, Peshawar city has been selected as a case study. Peshawar city is experiencing serious environmental issues due to speedy urbanization pace, rapid industrialization, deficiency of the authorities to manage the solid waste issues properly and lack of public awareness towards the challenging issue. Open dumping of the MSW on the open lands, utilized as dumping sites are responsible for the environmental problems increasing day by day. The research findings clearly reveal the MSWM crises in the city. Improper MSWM practices are not only creating air, land and water pollution but it also causes the blockage of open drains, smaller canals and ruining the aesthetics of the city

Serious Games in Science Education. A Systematic Literature Review

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MUNICIPAL SOLID WASTE MANAGEMENT CRISES IN THE DEVELOPING COUNTRIES: A CASE STUDY OF PESHAWAR CITY

Due to the speedy increase in population, the solid waste management issues are becoming a challenge for the developing countries. Unhealthy collection, improper transportation and open dumping of the Municipal Solid Waste (MSW) is causing a serious threat to the environment and the people residing in the surroundings. In Pakistan, unsustainable way of solid waste management, lack of the authorities to deal with effectively with the MSW and least vision of the society towards the emerging issues of the solid waste is depicting the worst situation in the country. To highlight the significant Municipal Solid Waste Management (MSWM) issues in the developing countries of the world, Peshawar city has been selected as a case study. Peshawar city is experiencing serious environmental issues due to speedy urbanization pace, rapid industrialization, deficiency of the authorities to manage the solid waste issues properly and lack of public awareness towards the challenging issue. Open dumping of the MSW on the open lands, utilized as dumping sites are responsible for the environmental problems increasing day by day. The research findings clearly reveal the MSWM crises in the city. Improper MSWM practices are not only creating air, land and water pollution but it also causes the blockage of open drains, smaller canals and ruining the aesthetics of the city

Effects of Microwave and Light Emitting Diode as Disinfection Methods on the Dimensional Stability of Polymethyl Methacrylate and Polyamide Denture Base Resin

Objective: To compare the effects of microwave and light emitting diode disinfection on the dimensional stability of two denture base materials; polymethyl methacrylate and polyamide. Study Design: In-vitro study Place and Duration of Study: Peshawar Dental College and Material Research Laboratories, University of Peshawar from 10 June 2021 to 8 December 2021. Materials and Methods: Fifteen specimens each for polymethylmethacrylate and polyamide were divided into three groups, control, microwave & light emitting diode. The specimens for microwave group were irradiated at 1000W for 3 minutes, thrice a week. The specimens for light emitting diode group were disinfected in a device for 30 minutes, thrice a week. The control group specimens were placed in distilled water for 4 weeks. Dimensions were measured before disinfection, and four weeks after the assigned disinfection. The mean and the standard deviation of the differences between three groups were statistically analyzed using one-way ANOVA and after obtaining significant values, through post hoc Tukey HSD. Results: For polymethylmethacrylate highest dimensional difference (-9.02mm) was noted for microwave disinfected group while the control group showed the lowest value (-6.99mm). For polyamide, the highest dimensional changes were recorded for light emitting diode group (8.66mm) and the lowest (-7mm) for the control group. Statistical analysis showed that the differences were significant for both polymethylmethacrylate and polyamide when compared with the control (p0.05) Conclusion: No significant difference in dimensional stability of both the denture base resins was observed after disinfection with microwave and light emitting diode

A multidisciplinary approach to triage patients with breast disease during the COVID-19 pandemic: Experience from a tertiary care center in the developing world

Background: The COVID-19 pandemic has created a need to prioritize care because of limitation of resources. Owing to the heterogeneity and high prevalence of breast cancers, the need to prioritize care in this vulnerable population is essential. While various medical societies have published recommendations to manage breast disease during the COVID-19 pandemic, most are focused on the Western world and do not necessarily address the challenges of a resource-limited setting.Aim: In this article, we describe our institutional approach for prioritizing care for patients presenting with breast disease.Methods and results: The breast disease management guidelines were developed and approved with the expertise of the Multidisciplinary Breast Program Leadership Committee (BPLC) of the Aga Khan University, Karachi, Pakistan. These guidelines were inspired, adapted, and modified keeping in view the needs of our resource-limited healthcare system. These recommendations are also congruent with the ethical guidelines developed by the Center of Biomedical Ethics and Culture (CBEC) at the Sindh Institute of Urology and Transplantation (SIUT), Karachi. Our institutional recommendations outline a framework to triage patients based on the urgency of care, scheduling conflicts, and tumor board recommendations, optimizing healthcare workers\u27 schedules, operating room reallocation, and protocols. We also describe the Virtual Blended Clinics , a resource-friendly means of conducting virtual clinics and a comprehensive plan for transitioning back into the post-COVID routine.Conclusion: Our institutional experience may be considered as a guide during the COVID-19 pandemic, particularly for triaging care in a resource-limited setting; however, these are not meant to be universally applicable, and individual cases must be tailored based on physicians\u27 clinical judgment to provide the best quality care

Progress on the national action plan of Pakistan on antimicrobial resistance (AMR) : a narrative review and the implications

Introduction: The emergence of antimicrobial resistance (AMR) is a threat to public health. In 2015, the World Health Organization (WHO) introduced a global action plan to tackle AMR in the World Health Assembly. Pakistan’s national action plan (NAP) for AMR was released in May 2017 by the Ministry of National Health Services. Based on the NAP, strategies have been initiated on a national and provincial scale in Pakistan. Areas covered: This narrative review of the five components of the Pakistan NAP has been undertaken to discuss some of the challenges in implementation of the NAP for AMR in Pakistan including different opinions and views of key stakeholders, combined with suggestions on potential ways to reduce the burden of the AMR. Expert opinion: Going forward, healthcare authorities should focus on screening and monitoring of all the objectives of the NAP by establishing proper policies as well as promoting antimicrobial stewardship interventions and Infection prevention and control (IPC) practices. Overall, the comprehensive strengthening of the healthcare system is required to adequately implement the NAP, tackle continued inappropriate antimicrobial use and high AMR rates in Pakistan

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI