Residual barriers for utilization of maternal and child health services: community perceptions from rural Pakistan.

Low utilization of maternal and child care services in rural areas has constrained Pakistan from meeting targets of Millennium Development Goals (MDGs) 4 and 5. This study explores community barriers in accessing Maternal and Child Health (MCH) services in ten remote rural districts of Pakistan. It further presents how the barriers differ across a range of MCH services, and also whether the presence of Community Health Workers (CHWs) reduces client barriers. Qualitative methods were used involving altogether sixty focus group discussions with mothers, their spouses and community health workers. Low awareness, formidable distances, expense, and poorly functional services were the main barriers reported, while cultural and religious restrictions were lesser reported. For preventive services including antenatal care (ANC), facility deliveries, postnatal care (PNC), childhood immunization and family planning, the main barrier was low awareness. Conversely, formidable distances and poorly functional services were the main reported constraints in the event of maternal complications and acute child illnesses. The study also found that clients residing in areas served by CHWs had better awareness only of ANC and family planning, while other MCH services were overlooked by the health worker program. The paper highlights that traditional policy emphasis on health facility infrastructure expansion is not likely to address poor utilization rates in remote rural areas. Preventive MCH services require concerted attention to building community awareness, task shifting from facility to community for services provision, and re-energization of CHW program. For maternal and child emergencies there is strong community demand to utilize health facilities, but this will require catalytic support for transport networks and functional health care centers

Factors contributing to microfinance addiction among Pakistani microfinance participants

This research is conducted in Bahawalpur, southern Punjab to discover the effect of Microfinance Addiction on Poverty Eradication. One thousand people, half men and half women, both members and non-members of Micro Credit Banks, will make up the sample. The goals of the study are captured in both an online survey and a traditional questionnaire developed with the help of experts. This method is effective in ensuring that all strata of the population are represented equally. Data is collected through cluster sampling. Micro-credit finance has assumed a significant part in changing and further developing the respondents' financial conditions. Data is tested through SPSS and Smart PLS and built up the connection between variables. All parties involved in the microfinance industry can benefit from the study's findings by making more informed decisions. The MFIs providing microfinance for the needy will also benefit from this since it will increase their productivity. The research suggests that the goal of microfinance may be reached more effectively if attention is directed on many sectors, such as agriculture and rural communities. Because of this, we may conclude that both Poverty Eradication and Micro-Finance Addiction are positively related to one another. The research found that the majority of people benefited from MFIs' micro-credit lending programmes. These micro loans helped them increase their economic standing and decrease their vulnerability to poverty. Micro-credit programmes may be improved upon in light of the study's results, which should be of benefit to regulators, policymakers, managers, micro-finance institutions, government authorities, all other stakeholders, and future academics

Risk Factors of Infection in Total Knee Arthroplasty

Background: To determine risk factors of infection in total knee arthroplastyMethods: In this descriptive study all patients undergoing primary total knee arthroplasty were included. Patients were followed post-operatively at 2,4,8,12 and 24 weeks. Signs of inflammation and inflammatory markers such as total leukocyte count (TLC), C-reactive protein (CRP) and ESR were measured. Risk factors like age, body mass index (BMI), ASA, co-morbid conditions were also noted.Results: Out of the 78 patients osteoarthritis (94.87%) was the pre-dominant cause of total knee replacement (TKR). 6.41% cases got infected. In majority of the infected cases (60%), Staphylococcus aureus was the infective organism. Diabetes Mellitus (p=0.01) and Obesity (p=0.02) had a significant relation to post-operative infection.Conclusion: Pre-operative risk evaluation and prevention strategies along with early recognition of infection and control can greatly reduce the risk of joint infection post-TKR which will not only improve the mobility of patient but also its morbidity and mortality as wel

In-vitro experimental analysis and numerical study of temperature in bone drilling

BACKGROUND: Bone drilling is a common practice of surgical treatments in orthopaedics and traumatology. Penetration of a high-speed drill into bone tissue is accompanied by generation of a significant amount of heat. Cooling of the drilling region is necessary to avoid potential risk of thermal damage to bone. OBJECTIVE: The purpose of this study was to measure and predict bone temperature by conducting experiments and numer- ical simulations using cooling by means of irrigation at two different temperatures. METHODS: A series of experiments and numerical studies were performed to investigate the effect of cooling conditions on the rise in bone temperature in drilling. The temperature increase in bone was assessed for different drilling speeds and feed rates in the presence irrigation at 5◦C and 25◦ C. RESULTS: Bone temperature was found to be strongly affected by the drilling parameters and cooling conditions. Irrigation with water at 5◦C kept bone temperature well below the thermal threshold level. CONCLUSION: This study strongly recommends the use of irrigation at lower temperature for safe surgical incision

Burnout, job dissatisfaction, and mental health outcomes among medical students and health care professionals at a tertiary care hospital in pakistan: Protocol for a multi-center cross-sectional study

Burnout, a state of vital exhaustion, has frequently been related to work-related stress and job dissatisfaction. Given the emotionally and physically challenging nature of their work, high rates of burnout have been reported among health care professionals. This may put them at a higher risk for of suffering from adverse mental health outcomes, including depression, anxiety and stress. In our study, we aim to assess the prevalence i of and associations among burnout and job dissatisfaction and adverse mental health outcomes in a developing country, where the challenges faced by the health care system are unique. Facilities are over-burdened and there is a sharp contrast between doctor to patient ratios in developing and developed countries. We plan to conduct a cross sectional study at the largest tertiary care hospital in Pakistan and its peripheral affiliated health centers. A proportionate sampling technique will be employed to include medical and nursing students, interns, residents and consultants. Previously validated questionnaires, including the Maslach Burnout tool, DASS 21, and Job Satisfaction Survey will be disseminated through Survey Monkey. Statistical analysis will be conducted using IBM SPSS Statistics Version 23 to study the association among burnout, job dissatisfaction, adverse health outcomes and demographic and work-related factors This study may begin laying the foundation for prioritizing the novel concept of physician mental health in the developing world. Further research building on to the results of this study will generate evidence to make recommendations about routine screening for mental illness and policy changes in the health care system