Preparation and quality characterization of soy milk based non-dairy ice cream

Soy milk made from soybean has prospective to be used as a substitute of milk due to its health benefits. It is a rich source of iso-flavones, omega-3-fatty acid, dietary fiber, vitamin C, carotenoids, protein and oligosaccharides. The current study was designed to examine the effects of galacto-manan on ice cream by using commercially available (silk) and locally prepared soy milk. Galacto-mannan (guar gum) was used in different concentration (0.3, 0.4, 0.5 and 0.6%) for the preparation of ice cream. Ice cream was analyzed for physico-chemical and sensory characteristics at 0, 30 and 60 days of storage interval. Overrun, meltdown, viscosity, total solids, pH and acidity were affected significantly by ice cream samples as well as storage. While non-significant effects of stabilizer and storage were found on fat, protein, and ash contents of ice cream. On organoleptic evaluation, the highest scores were awarded to the ice cream sample prepared with 0.5% of guar gum. Ice cream manufactured with locally prepared soy milk and guar gum revealed comparable quality with lower cost

Production and use of estimates for monitoring progress in the health sector: the case of Bangladesh

Background: In order to support the progress towards the post-2015 development agenda for the health sector, the importance of high-quality and timely estimates has become evident both globally and at the country level

Usability and acceptability of a mobile app for behavior change and to improve immunization coverage among children in Pakistan: A mixed-methods study

Background: Pakistan\u27s immunization uptake rates are still significantly lower than anticipated despite several initiatives. Lack of awareness, forgetting about vaccination schedule, and vaccine misconception/misinformation are a few of the major drivers that mitigate the rates of immunization. The current COVID-19 pandemic emphasizes the importance of immunization. The significant reductions in regular childhood vaccination during pandemic have increased the risk of outbreaks of vaccine-preventable diseases. Concerns among parents over possibly exposing their children to COVID-19 during child visits may have contributed to the reported declines. Innovative and cost-effective mHealth interventions must be implemented in order to address the problem of inadequate immunization rates. In addition, it is also critical to understand the end user needs in order to reflect on the highly relevant essence of the customized healthcare experience.Objective: The aim of this study was to learn about caregivers\u27 attitudes toward the usability and acceptability of behavior-change smartphone applications (mobile phones) for improving immunization coverage in Pakistan.Methods: A mixed-method design was employed for this study. The study was conducted at Aga Khan University, Hospital. Parents visiting the Community Health Center for 6-week vaccination of their children were recruited. The study was conducted in two stages. Stage 1 consisted of qualitative interviews that grasped the parent\u27s attitudes and challenges to immunization, as well as their acceptability and accessibility of the smartphone-based behavior-change application to increase vaccine uptake. Stage 1 was followed by stage 2, in which data were collected through a questionnaire designed by using data from qualitative interviews.Results: The majority of participants agreed that immunization serves an important role in protecting their child from illnesses that cause morbidity and mortality. Almost all of them emphasized the importance of using a pre-appointment method at vaccination center in order to reduce the waiting time. Furthermore, participants were also interested in AI-based behavior modification applications related to immunization. They also wanted to have applications in their native language for better understanding and communication of related information. In our study, approximately 95.2 percent of participants agreed to accept SMS immunization updates, which was also reasonably high. Lastly, the majority of them identified forgetfulness as a significant contributor to regular immunization.Conclusion: To enhance the uptake of childhood vaccines, overall vaccination rates, and overcome barriers related to vaccination coverage, cost-effective and user-friendly mHealth AI-based smart phone applications are required to raise awareness regarding the continuation of vaccination service and the importance of timely vaccination. Parents\u27 experiences and attitudes must be considered while designing and evaluating the efficacy of mHealth-based interventions

Current challenges of digital health interventions in Pakistan: Mixed methods analysis

Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan.Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan.Methods: This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization\u27s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy.Results: Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations\u27 inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects.Conclusions: We conclude that while digital health has a promising future in Pakistan, it is still in its infancy at the time of this study. However, due to the coronavirus disease 2019 (COVID-19) pandemic, there is an increase in demand for digital health and implementation of health outcomes following global social distancing protocols, especially in LMICs. Hence, there is a need for active involvement by public and private organizations to regulate, mobilize, and expand the digital health sector for the improvement of health care systems in countries

Respiratory syncytial virus-associated mortality among young infants in Karachi, Pakistan: A prospective postmortem surveillance study

Background: Respiratory syncytial virus (RSV) is an important cause of infant morbidity and mortality and a potential target for maternal immunization strategies. However, data on the role of RSV in young infant deaths in developing countries are limited.Methods: We conducted a community-based mortality surveillance from August 2018-March 2020 for infants ≤6 months in Karachi, Pakistan. We tested (reverse transcription-polymerase chain reaction) nasopharyngeal swabs from deceased infants for presence of RSV. We performed verbal autopsies and calculated odds of RSV-associated mortality with 95% CIs and used multivariable logistic regression to evaluate associations.Results: We collected 490 nasopharyngeal specimens from 1280 eligible infant deaths. There were 377/490 (76.9%) live births and 14/377 (3.7%; 95% CI: 1.8-5.6) were RSV positive. Most deaths occurred in neonates (254/377; 67.4%), males (226/377; 59.9%), and respiratory illnesses (206/377; 54.6%). Postneonatal age (10/14, 71.4%; OR: 5.5; 95% CI: 1.7-18.0), respiratory symptoms (12/14, 85.7%; OR: 5.2; 1.2-23.7), and high RSV season (9/14, 64.3%; OR: 4.4; 1.4-13.3) were associated with RSV mortality. In multivariable logistic regression analysis, respiratory symptoms (OR: 6.6; 95% CI: 1.3-32.5), RSV seasonality (6.1; 1.8-20.4), and age (9.2; 2.6-33.1) were significant predictors of RSV-associated mortality.Conclusions: RSV has a significant mortality burden in early infancy in Karachi, Pakistan. Age, RSV seasonality, and respiratory symptoms were significant predictors of RSV-associated mortality. Our findings have implications for clinical management of young infants with cold-like symptoms, policy development, and research regarding maternal immunization against RSV during pregnancy, in resource-constrained, low-income, and vaccine-hesitant populations

Perceptions of women regarding the quality of family planning services in low income urban areas of Karachi : an exploratory study

Quality of care for family planning services is measured primarily at three levels; policy, client and service delivery. However, the definition of quality for health care is diverse; the definition given by The International Conference on Population and Development (ICPD), Program of Action (PoA) defines quality of care (QoC) for reproductive health (RH) as, Ensure universal access for all women to a full range of high-quality and affordable health care, including sexual and reproductive health services . However, the Judith Bruce defines quality of care for family planning (FP) as The way individual couples/clients are treated by the health system provided services . In addition Donna M. defines and links the quality with the health care delivery particularly in relation to family planning. As The extent to which health services for populations increased the likelihood of desired health outcomes and is consistent with current professional knowledge . The slow pace of increase in Contraceptive Prevalence Rate (CPR) and more than half of the population in reproductive age (15-49 years) in Pakistan is indicative of an increase in future population growth. On the other hand, the high rate of discontinuation of FP method (37%), contraceptive switch (12%) , (7% in five proceeding time) resulting in unwanted pregnancies (9%). It is crucial to improve quality of health care for tilling in the gaps related to FP services provision, will address the need of women at local level and will also increase the CPR. This study will identify the gaps for the quality in FP services through the perception of local women who are FP current users and FP past users. Methodology: A qualitative exploratory study design was carried out during July to September 2016, to explore and understand the perceptions of married women of reproductive age who are family planning users and past-users regarding the quality in general, quality in healthcare and quality in family planning. Willows International Foundation was purposely selected because Willows model is based on the Willows International\u27s vision of provision and access to accurate and up-to-date information and high quality services for FP and RH, through providing information, education and referral services so that women\u27s reproductive needs and choices are fulfilled. FGDs were conducted and in depth interviews were conducted with MWRA availing FP services. The aim of this study was to identify the gaps in quality of services from the client\u27s perspective to enable to bring a change in improving the CPR and continuation of FP method. Data were collected using a qualitative study design whereby four Focus Group Discussions (FGDs) were conducted with the married women of reproductive age. Similarly a total of twelve in-depth interviews were conducted with the MWRAs of the study areas. All the FGDs and in-depth interviews were conducted using separate guidelines specifically developed for the purpose. During the FGD pilot testing the guidelines women were unable to understand the concept of quality, we revised our guideline under three themes; i.e. quality in general, healthcare quality, FP quality. Findings: The analysis of FGDs and IDIs with married women of reproductive age revealed three major themes Perception of women about Quality , Quality in Healthcare and Quality of FP . The first theme included five main categories, Physical appearance , cost , durability , role offate , and do not harm . The second theme included four main categories, physical environment , cost , bad behavior , and do not harm . The third theme included six main categories, -physical environment , cost , bad behavior side effects , satisfied and ideal FP and health educator role . All the main categories further included sub categories. Conclusion: MWRA perceive Quality for all the themes as; •Respectful treatment •Personal satisfaction •Complete and true information •Should not harm Majority of the women explained high quality of care as being treated as a human being . From this study finding it is highlighted that service provision quality is poor due to bad behavior of providers, clients have not been provided with enough choices, and clients lack complete information, inadequate time given by the providers, cost variation between public/private sectors, incompetency of staff in terms of providing QoC according to WHO quality dimensions. In this study women expressed their need to use FP birth spacing methods but were not satisfied with the existing methods due to fear of side effects, lack of information on side effects, discomfort involved with provider\u27s attitude, methods and services which they considered as unsafe, inequitable, inefficient, ineffective. Keywords*: Women Perspectives on Quality, Family Planning, and Low Middle income Countrie

Comparison of the robust parameters estimation methods for the two-parameters Lomax distribution

Accurate and precise estimation of parameters in distribution theory is of immense significance. Imprecise and biased estimation of a probability distribution can lead to invalid and erroneous results. In this study, we investigate the Lomax distribution and introduced new four robust point estimation methods such as L-moments, trimmed L-moments, probability weighted moments, and generalized probability weighted moments (GPWM). We compare the efficiency of these methods with traditional method of moments based on performance measures such as bias, root-mean-square error and total deviation criteria using simulation study. We concluded that trimmed L-moments ascertained to be the superior method when the shape parameter is smaller (q < 3) and this assessment is equally valid for larger sample sizes, however, GPWM performs better for higher values of the shape parameter

pH dependent electro-oxidation of arsenite on gold surface: Relative kinetics and sensitivity

A detailed kinetic investigation of As(III) oxidation was performed on gold surface within pH between ∼3.0 and ∼9.0. It was found that the As(III) oxidation on the gold surface follows a purely adsorption-controlled process irrespective of pH. The evaluated adsorption equilibrium constant decreased from 3.21 × 105 to 1.61 × 105 mol L−1 for acidic to basic medium, which implies the strong affinity of the arsenic species in the acidic medium. Besides, the estimation of Gibbs free energy revealed that an acidic medium promotes arsenic oxidation on gold surface. In mechanistic aspect, the oxidation reaction adopts a stepwise pathway for acidic medium and a concerted pathway for neutral and basic medium. From the substantial kinetic evaluation, it is established that a conducive and compatible environment for the oxidation of arsenic was found in an acidic medium rather than a basic or neutral medium on gold surface. Besides, in sensitivity concern, neutral and highly acidic medium is quite favourable for the arsenite oxidation on gold surface

The potential of esculin as a therapeutic modality in diabetes mellitus and its complications

The available medications for diabetes mellitus (DM) are not sufficient to reverse the pathophysiological abnormalities and complications associated with the disease. Considering the undesirable side-effects linked to existing anti-diabetic drugs, there is a paradigm shift towards natural substances for the management and treatment of DM. Plant products such as secondary metabolites or bioactive phytoconstituents are a remarkable source of natural medicines used in ameliorating various diseases, including diabetes. This review article focuses on a natural compound esculin, a coumarin derivative, which possesses multiple biological properties such as anti-inflammatory, anti-oxidative, analgesic, diuretic, anti-coagulative, anti-apoptotic and anti-depressive. It could be a possible candidate as a therapeutic agent in ameliorating diabetes and its complications. Although studies related to the pharmacodynamics of esculin are limited and not fully understood, the anti-diabetic properties of esculin could be exploited as an alternative treatment for type-2 diabetes mellitus (T2DM) either in combination therapy in integrative medicine or as a natural anti-diabetic medicine. However, comprehensive chemical and pharmacological studies are required to validate the available data on esculin from both in vivo and in vitro studies before it can be considered as a potential therapeutic agent in DM