On FIDEs System by Modified Sumudu Decomposition Method

In this paper, the technique of modified Sumudu decomposition method has been employed to solve a system of Fredholm integro-differential equations with initial conditions. Two examples are discussed to show applicability, reliability and the performance of the modified sumudu decomposition method. This study showed the capability, simplicity and effectiveness of the modified approach. Keywords: Modified Sumudu decomposition method; System of Fredholm integro-differential equations

China, Pakistan, and Afghanistan: Partnership for Regional Peace

This paper examines the prospects of strategic partnership for regional peace between China, Pakistan and Afghanistan through their mutual geopolitical interests. Chinese involvement with Afghanistan serves as a key factor in the successful implementation of its economic outreach through Central and South Asian segments of the Belt and Road Initiative (BRI) as it helps to rebalance China’s economic and political aspirations. The paper also highlights the implications of China’s relations with Pakistan and Afghanistan to counter Indian influence in the region. The trilateral relationship between these countries is of paramount importance for regional peace and security. Afghanistan is the most unstable country in the region; however Chinese constructive engagement with Afghanistan through diplomatic, political, economic and security measures can usher into a new era of peace, progress and development for the entire region

To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy

BACKGROUND: Group B streptococci (GBS) is the usually present in vaginal canal in micro-flora, which usually do not exhibit any symptoms. Instead, in pregnancy, there are certain situations in GBS colonization in vagina, which may lead to several complications. OBJECTIVE: To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy. STUDY DESIGN: Cross sectional survey SETTING: Antenatal clinic, Shalamar Hospital Lahore STUDY DURATION: 6 month i.e. From: 05-09-2014 to 06-03-2015 SUBJECTS & METHODS: 350 Booked Patients attending antenatal clinic at Shalamar hospital at 35-37 weeks of pregnancy for routine antenatal checkup were included. Lower vaginal swabs were taken without speculum using sterilized disposable cotton swab and transported to Amies Agar jell and transported to microbiology lab within 24 hours. Laboratory report was collected and reviewed by researcher regarding positive or negative culture for GBS. Patients with positive GBS culture were given intrapartum antibiotics. RESULTS: In our study, out of 350 cases, with the mean age of 26.92+4.84 years. Frequency of GBS colonization of vagina in women at 35-37 week pregnancy was recorded in 12.29% while remaining 87.71% had no findings of the morbidity. CONCLUSION: It was concluded that the frequency of GBS colonization of vagina in women at 35-37 week pregnancy is not very higher and in accordance with other regions of our country, but routine screening may further decline its incidence. KEYWORDS: Pregnancy, last trimester, Group B Streptococcal colonization of vagin

To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy

BACKGROUND: Group B streptococci (GBS) is the usually present in vaginal canal in micro-flora, which usually do not exhibit any symptoms. Instead, in pregnancy, there are certain situations in GBS colonization in vagina, which may lead to several complications. OBJECTIVE: To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy. STUDY DESIGN: Cross sectional survey SETTING: Antenatal clinic, Shalamar Hospital Lahore STUDY DURATION: 6 month i.e. From: 05-09-2014 to 06-03-2015 SUBJECTS & METHODS: 350 Booked Patients attending antenatal clinic at Shalamar hospital at 35-37 weeks of pregnancy for routine antenatal checkup were included. Lower vaginal swabs were taken without speculum using sterilized disposable cotton swab and transported to Amies Agar jell and transported to microbiology lab within 24 hours. Laboratory report was collected and reviewed by researcher regarding positive or negative culture for GBS. Patients with positive GBS culture were given intrapartum antibiotics. RESULTS: In our study, out of 350 cases, with the mean age of 26.92+4.84 years. Frequency of GBS colonization of vagina in women at 35-37 week pregnancy was recorded in 12.29% while remaining 87.71% had no findings of the morbidity. CONCLUSION: It was concluded that the frequency of GBS colonization of vagina in women at 35-37 week pregnancy is not very higher and in accordance with other regions of our country, but routine screening may further decline its incidence. KEYWORDS: Pregnancy, last trimester, Group B Streptococcal colonization of vagin

Psychological Assessment of Health Care Workers in Intensive Care Units During the COVID-19 Pandemic

ABSTRACT Background Fear and depression are common to any pandemic particularly in healthcare workers as they are in the front line to treat the diseased. Such a state directly affects the performance of the health system and the patients who are seeking care. This study aimed at assessing the psychological effect of COVID-19 among the healthcare workers in the intensive care units of two tertiary care hospitals of Rawalpindi & Islamabad.   Methods It was a descriptive cross-sectional study, conducted over five months i.e., 1st July 2020 to 1st November 2020. Non-probability consecutive sampling technique was used for recruiting health care workers. PHQ-9 tool was used including 9 questions (items) related to the depression due to COVID-19. Other tool Fear of COVID-19 scale was based on 5 points Likert scale as ‘strongly disagree’, ‘disagree’, ‘neutral’, ‘agree’ and ‘strongly agree’. Besides descriptive frequencies, mean and standard deviation, Spearman correlation (r) was applied to check the correlation between fear of COVID-19 with age (years) and professional experience (years).   Results Out of 382 healthcare workers (doctors, nurses & other staff) recruited in the study, around 50% were found to be suffering from severe depression and have developed a fear of the disease. A significant positive correlation was observed between the age of the healthcare worker and the degree of fear of COVID-19 (p<0.05). Similarly, a significant positive correlation was observed between the number of professional experience and the fear of COVID-19 (p<0.05).   Conclusion It is concluded that healthcare workers in ICU are at risk of depression because of fear of COVID-19. The current situation highlights the areas that need attention. Special training or orientation must be arranged for a situation of an outbreak or a pandemic and skills for keeping one’s psychological wellbeing and mental health must be imparted. KEYWORDS: Fear; Depression; Psychological impact; COVID-19, Healthcare workers, Pakista

Evaluation of a Portable Gynecological Examination Table on Increasing Access to Cervical Cancer Screenings

Introduction: Cervical cancer is a preventable disease affecting millions of women worldwide, with higher prevalence and mortality in developing countries. One explanation of this disparity is due to reduced access to screenings, especially in rural communities where mobile health clinics are limited by what medical equipment they can bring. To address these barriers, an engineering team called Project MESA (Making Examinations Safe and Accessible) designed a gynecological examination table that is portable, lightweight, and easily sanitizable. Objective: This study aims to (1) evaluate whether the implementation of this device improves the clinician’s ability to perform pap smears as opposed to alternative surfaces, and (2) investigate the impact on patients’ comfort with cervical cancer screening. Methods: Two gynecological exam tables are being used by a partner organization with clinics in Perú and Nicaragua. Since September of 2022, 42 responses have been recorded. Using clinician and patient questionnaires that were developed based on field observations, the team will perform a mixed methods analysis to compare clinician and patient preferences on the new device versus alternative surfaces. Results: Preliminary data may support greater clinician and patient satisfaction with the new device, but cannot be statistically confirmed yet due to ongoing data collection. Results that can be discussed are dynamic testing on the gynecological table which supported safety through 15,600 uses and positive feedback from many clinicians and international partners. Conclusion: This project provides a construct to address barriers to cervical cancer screenings, with more quantitative results becoming available soon

Synchronization of Monostatic Radar Using a Time-Delayed Chaos-Based FM Waveform

There is no doubt that chaotic systems are still attractive issues in various radar applications and communication systems. In this paper, we present a new 0.3 GHz mono-static microwave chaotic radar. It includes a chaotic system based on a time-delay to generate and process frequency modulated (FM) waveforms. Such a radar is designed to extract high-resolution information from the targets. To generate a continuous FM signal, the chaotic signal is first modulated using the voltage control oscillator (VCO). Next, the correct value for the loop gain (G) is carefully set when utilizing the Phase-Locked Loop (PLL) at the receiver, so that the instantaneous frequency that reflects a chaotic state variable can be reliably recovered. In this system, the PLL synchronization and radar correlation are enough to recover the echo signal and detect the target. The finding indicates that the system can be implemented with no need to use the complete self-synchronization or complex projective synchronization schemes as compared to the existing chaotic radar systems. The simulation results show that the short-time cross-correlation of the transmitted and reconstructed waveforms is good and satisfactory to detect the target under various signal-to-noise ratio (SNR) levels and with less complexity in the design

Body mass index (BMI) of adults: findings of the Malaysian Adult Nutrition Survey (MANS)

The Malaysian Adults Nutrition Survey (MANS) was carried out between October 2002 and July 2003, involving 6,775 men and 3,441 women aged 18 - 59 years. Anthropometric assessment showed that the overall mean body weight and BMI were 62.65 kg (CI: 62.20, 63.09) and 24.37 kg/m2 (CI: 24.21, 24.53) respectively. Based on the WHO (1998) classification of BMI, 12.15% (CI: 11.26, 13.10) were obese (BMI > 30 kg/m2), and 26.71% (CI: 25.50, 27.96) overweight (BMI > 25-29.9 kg/m2). Significantly, more women were obese [14.66% (CI: 13.37, 16.04)] while significantly more men were overweight [28.55% (CI: 26.77, 30.40)]. Ethnicitywise, prevalence of obesity was highest among the Malays [15.28% (CI: 13.91, 16.77)] while overweight was highest for the Indians [31.01% (CI: 26.64, 35.76)]. Both obesity and overweight were highest among those aged 40-49 years. Obesity was highest for those whose household income was between RM1,500-3,500 while overweight was more prevalent for those whose household income exceeded RM3,500. The prevalence of overweight was highest for those with primary education [31.90% (CI: 29.21, 34.72)]. There was no significant urban-rural differential in both obesity and overweight. The study found 9.02% (CI: 8.82, 10.61) with chronic energy deficiency (CED) (BMI < 18.5 kg/m2). The prevalence of CED was relatively higher in the indigenous population (Orang Asli) [14.53% (CI: 5.14, 34.77)], subjects aged 18-19 years [26.24% (CI: 21.12, 32.09)], and with monthly household income of < RM1,500 [10.85% (CI: 9.63, 12.20)]. The prevalence of CED was not significantly different among the geographical zones and educational levels, and between urban/rural areas and sexes. The results call for priority action to address the serious problem of overweight and obesity among Malaysian adults as it poses a grave burden to the country's resources and development

Maternal Mortality Ratio and Universal Access to Reproductive Health Care in the State of Qatar between 1990 and 2012: A PEARL Study Analysis

Study Aim: The Millennium Development Goal (MDG)- 5 mandates a three quarters reduction in Maternal Mortality Ratio (MMR) and provision of universal access to reproductive health by 2015. Our study aims to analyze Qatar’s performance in achieving MDG 5 between 1990 and 2012.Study Design: A National Prospective cohort-studyData Source: Qatar Perinatal Registry (Q-Peri-Reg) for 2011 and 2012 dataMethods: National data on total deliveries, total births (live and stillbirths) and maternal mortality (during pregnancy to day 42 post-delivery) was collected from all public and private maternity units in Qatar (1st January 2011- December, 31st 2012) and compared with historical maternal mortality data (1990-2010) ascertained from the database of maternity and neonatal units of Women’s Hospital, annual reports of Hamad Medical Corporation and international reports. For inter country comparison, country data was extracted from World Health Statistics 2011(WHO).Results: The country wide live births were 20583 during 2011 and 22,225 during 2012 with two maternal deaths duringeach year giving an MMR of 9.85/100,000 and 8.99/100,000 live births respectively which was more than three quarters decline from an MMR of 49/100,000 in 1990. During 2011, 74.22% deliveries were normal vaginal (n 15076) and 25.78% (n 5238) by Caesarean section. 99.45 % of deliveries were attended by a trained birth attendant in a maternity facility while 0.55 % (n = 114) took place out of hospital. 100% of mothers had made at least one antenatal visit and 100% of live births were examined by a pediatrician and entered in national birth register. Qatar’s 2011 and 2012 MMR is significantly lower than the current global MMR of 260/100,000 and Eastern Mediterranean Region MMR of 320/100,000.Conclusion: Qatar has achieved its target MDG 5 well before 2015. Qatar’s 2011 and 2012 MMR is comparable to most high income countries. Qatar’s reproductive health system, with its universal access for all, provides a unique model to study the correlates and associations of maternal survival which can form the basis of global health systems improvement strategies

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