Discoveries of many coal seams at depths by drilling carried by Geological Survey of Pakistan in Sor Range and Harnai Gochina, extended the coal seams at depth which is challenge for mine owners to exploit feasibly. B...Discoveries of many coal seams at depths by drilling carried by Geological Survey of Pakistan in Sor Range and Harnai Gochina, extended the coal seams at depth which is challenge for mine owners to exploit feasibly. Bed to bed gypsum samplings (and their chemical analyses) of huge gypsum deposits from Sulaiman foldbelt is a base for industrialist and also planers to develop cement and gypsum industries to increase export and foreign exchange for the development of area and Pakistan. Low and high grade sedimentary iron deposits, silica sand and uranium host rocks and their extensions in Sulaiman and Kirthar foldbelts are presented. Anomalies of a few base metals arise as a result of geochemical exploration carried at part of Loralai District of Balochistan. Theropod dinosaurs were frequent in India, while Poripuchian titanosaurs (Sauropoda, Dinosauria) were frequent in Pakistan. Besides some ichnotaxa, many bone taxa such as 1 titanosauriform, 14 titanosaurian sauropod (including one new titanosaur), and 3 theropod dinosaurs are established from Pakistan. Among these 12 titanosaur species and 3 theropod species are named in about 10 km<sup>2</sup> area of Vitakri dome and 2 titanosaur species are named in about a few hundred square meter area of Mari Bohri (Kachi Bohri) which is about 10 km westward from Vitakri dome. Pakistan is a unique country which discoverd 14 diversified titanosaurs in a short area and also in a short period (67 - 66 million years ago/Ma). About 400 bones found from a few meter thick upper part of upper shale horizon of latest Maastrichtian Vitakri Formation which is base for titanosaur taxa. Cranial material is in low fraction (but include significant diverse snouts), caudal vertebrae are prominent, the cervicals, dorsals and sacrals have significant numbers, forelimb and hind limb bones have balanced fraction. Humeri, femora and tibiae are most common. To know the position of Pakistani titanosaurs among titanosaurs and sauropods, there is a need to extend list of characters for phylogenetic analyses. This broad feature list should include main characters of titanosaurs from Pakistan and also from global world.展开更多
Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in...Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in developed countries in the West;however,little research has been conducted in low-income countries,especially in Pakistan.The socioeconomic instability and the government's lack of awareness and knowledge have resulted in no regulations being placed to incorporate telehealth in medicine.The healthcare departments must take into consideration the lifechanging impact of telehealth and the barriers that prevent it in becoming known,to reduce the incidence of unsafe abortions and sexual health practices that prove to be a stigma in society.展开更多
BACKGROUND Lipid treatment practices and levels in post-acute myocardial infarction(AMI)patients,which are crucial for secondary prevention.AIM To evaluate the lipid treatment practices and lipid levels in post-myocar...BACKGROUND Lipid treatment practices and levels in post-acute myocardial infarction(AMI)patients,which are crucial for secondary prevention.AIM To evaluate the lipid treatment practices and lipid levels in post-myocardial infarction(MI)patients at a tertiary care hospital in Pakistan.METHODS In this cross-sectional study,we analyzed patients who had experienced their first AMI event in the past 3 years.We assessed fasting and non-fasting lipid profiles,reviewed statin therapy prescriptions,and examined patient compliance.The recommended dose was defined as rosuvastatin≥20 mg or atorvastatin≥40 mg,with target total cholesterol levels set at<160 mg/dL and target low-density lipoprotein cholesterol(LDL-C)at<55 mg/dL.RESULTS Among 195 patients,71.3%were male,and the mean age was 57.1±10.2 years.The median duration since AMI was 36(interquartile range:10-48)months and 60% were diagnosed with ST-segment elevation MI.Only 13.8% of patients were advised to undergo lipid profile testing after AMI,88.7% of patients were on the recommended statin therapy,and 91.8% of patients were compliant with statin therapy.Only 11.5% had LDL-C within the target range and 71.7% had total cholesterol within the target range.Hospital admission in the past 12 months was reported by 14.4%,and the readmission rate was significantly higher among non-compliant patients(37.5%vs 5.6%).Subsequent AMI event rate was also significantly higher among non-compliant patients(43.8%vs 11.7%).CONCLUSION Our study highlights that while most post-AMI patients received the recommended minimum statin therapy dose,the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.展开更多
Electric vehicles (EVs) are the most interesting and innovative technology in the 21st century because of theirenormous advantages, both technically and economically. Their emissions rate compared to fuel-based vehicl...Electric vehicles (EVs) are the most interesting and innovative technology in the 21st century because of theirenormous advantages, both technically and economically. Their emissions rate compared to fuel-based vehicles isnegligible as they do not consume fuel and hence do not emit any harmful gases. However, their bulk production,adoption and lack of charging stations increase the stress of power stations due to modern-day lifestyles. If Electricvehicles demand increases drastically then conventional power stations will not bear their demand and if theygenerate electricity by conventional means it will be very costly and may further add greenhouse gases. Therefore,this research provides the techno-economic assessment of a stand-alone renewable-dependent electric vehiclecharging station, excluding any burden on electrical utility. The proposed study is carried out in Bahria Town,Karachi, a city in Pakistan. In this study, HOMER Pro software was utilized for techno-economic assessment. Ahybrid system comprising solar Photovoltaic/Wind Turbine/Fuel cells and battery storage is included in the model.Solar and wind resources were taken from NASA’s website, where charging stations will be integrated. The overallresults show promising in terms of total Net Present Cost and the Cost of Energy which are 2.72M $ and 0.237 $,respectively. The total system generation is 3,598 Megawatt hours per year, and the total energy consumption is 885Megawatt hours per year.展开更多
Newcastle disease (ND) virus is a leading threat to commercial and domestic poultry in Pakistan. The virus infects and constitutes irreversible impairment to the nervous system, damages the respiratory system, and mar...Newcastle disease (ND) virus is a leading threat to commercial and domestic poultry in Pakistan. The virus infects and constitutes irreversible impairment to the nervous system, damages the respiratory system, and marks severe gastrointestinal lesions leading to heavy mortality in short-living birds and substantial losses in layers and breeders. The continuous emergence and evolution of the virus made it inclined to evade the humoral response and indirectly the circumvention of artificial active immunization. Newcastle disease is caused by the orthoavula genus of the paramyxoviridae family and has shown high genetic diversity even in their genotypes while information regarding enzootic trends of the virus is scanty in Pakistan. A total of 40 tracheal samples of NDV were collected from different commercial broiler farms and 11 isolates of NDV were identified. In the current study, we determined the genetic diversity of the Newcastle disease virus based on the partial sequencing of the fusion protein gene available in the NCBI database. Genetic analysis showed that seven isolates belonged to class I genotype VII and four belonged to class II genotype II. Interestingly, two isolates had epidemiological connections with vaccine-like class II genotype II. Our findings, concerning the recent outbreaks of class I genotype VII and class II genotype II of NDV in vaccinated commercial flocks, suggest possible potential partial mutations in the fusion protein gene. Genetic diversity and formation of the new cleavage site in an important neutralizing protein of wild strain are linked with the potency of artificial active immunization and a major cause of vaccine failure.展开更多
BACKGROUND Peptic ulcer disease(PUD)remains a significant healthcare burden,contributing to morbidity and mortality worldwide.Despite advancements in therapies,its prevalence persists,particularly in regions with wide...BACKGROUND Peptic ulcer disease(PUD)remains a significant healthcare burden,contributing to morbidity and mortality worldwide.Despite advancements in therapies,its prevalence persists,particularly in regions with widespread nonsteroidal antiinflammatory drugs(NSAIDs)use and Helicobacter pylori infection.AIM To comprehensively analyse the risk factors and outcomes of PUD-related upper gastrointestinal(GI)bleeding in Pakistani population.METHODS This retrospective cohort study included 142 patients with peptic ulcer bleeding who underwent upper GI endoscopy from January to December 2022.Data on demographics,symptoms,length of stay,mortality,re-bleed,and Forrest classification was collected.RESULTS The mean age of patients was 53 years,and the majority was men(68.3%).Hematemesis(82.4%)and epigastric pain(75.4%)were the most common presenting symptoms.Most patients(73.2%)were discharged within five days.The mortality rates at one week and one month were 10.6%and 14.8%,respectively.Re-bleed within 24 h and seven days occurred in 14.1%and 18.3%of patients,respectively.Most ulcers were Forrest class(FC)Ⅲ(72.5%).Antiplatelet use was associated with higher mortality at 7 and 30 d,while alternative medications were linked to higher 24-hour re-bleed rates.NSAID use was associated with more FCⅢulcers.Re-bleed at 24 h and 7 d was strongly associated with one-week or one-month mortality.CONCLUSION Antiplatelet use and rebleeding increase the risk of early mortality in PUD-related upper GI bleeding,while alternative medicines are associated with early rebleeding.展开更多
The origin of sandstone in the Rawalpindi group is disputed because of the lesser Himalayas complicated geological structure and ongoing tectonic activity. The goal of the study is to learn more about the petrographic...The origin of sandstone in the Rawalpindi group is disputed because of the lesser Himalayas complicated geological structure and ongoing tectonic activity. The goal of the study is to learn more about the petrographic and geological aspects of the Siwalik molasses deposits, which are formations that belong to the same age group. The Early Miocene Kamlial Formation, the Middle to Late Miocene Chinji Formation, and the Late Miocene Nagri Formation are the stratigraphic units revealed in the project area. The texture of the sandstone found in the Rawalpindi Group and Siwalik is fine to medium-grained. The hue ranges from grey to greenish grey. The sandstone displays thin to medium-bedded layers and exhibits thin lamination throughout. The sandstone of the Kamlial Formation contains load casts, potholes, worm burrows, hematite layers, and filled and unfilled mud cracks in basic structures. Model petrographic research reveals that the Murree Formation primarily consists of light minerals like feldspar, quartzite, and felice, whereas the Kamlial Formation is composed of heavy minerals like garnet and tourmaline. Sandstone from the Rawalpindi group undergoes analysis to ascertain its provenance using the quartz feldspar lithic fragments ternary diagram technique. Each plot in the QFL diagram’s recycled orogeny provenance field is plotted.展开更多
Saraikistan (South Punjab and surrounding) area of Pakistan is located in the central Pakistan. This area represents Triassic-Jurassic to Recent sedimentary marine and terrestrial strata. Most of the Mesozoic and Earl...Saraikistan (South Punjab and surrounding) area of Pakistan is located in the central Pakistan. This area represents Triassic-Jurassic to Recent sedimentary marine and terrestrial strata. Most of the Mesozoic and Early Cenozoic are represented by marine strata with rare terrestrial deposits, while the Late Cenozoic is represented by continental fluvial deposits. This area hosts significant mineral deposits and their development can play a significant role in the development of Saraikistan region and ultimately for Pakistan. The data of recently discovered biotas from Cambrian to Miocene age are tabulated for quick view. Mesozoic biotas show a prominent paleobiogeographic link with Gondwana and Cenozoic show Eurasian. Phylogeny and hypodigm of Poripuchian titanosaurs from India and Pakistan are hinted at here.展开更多
The current study extends the previous literature by exploring the effects of a newly discovered driver,i.e.,import taxes(as a proxy for commercial policies),on the consumption-based carbon emissions(CCO2e)for 1990Q1-...The current study extends the previous literature by exploring the effects of a newly discovered driver,i.e.,import taxes(as a proxy for commercial policies),on the consumption-based carbon emissions(CCO2e)for 1990Q1-2017Q4.For empirical analysis,several tests and methods,including Augmented Dickey–Fuller unit root test,Zivot–Andrews unit root test,asymmetric cointegration bound testing approach,non-linear ARDL,Wald-test,Granger causality test and wavelet quantile correlation(WQC)method are utilized.Furthermore,NARDL technique estimates reveal that contractionary commercial policy enhances the environmental quality by disrupting the detrimental effects of CCO2e.However,expansionary commercial policy escalates the environmental pollution by boosting the carbon emissions.Also,the exports and the renewable energy improve the ecological quality;however,GDP deteriorates the atmospheric quality by increasing the CCO2e.Besides,WQC method and the trivariate Granger causality test are deployed to confirm the robustness of the results.Based on the findings,some crucial policies are also recommended for sustainable and green development in Pakistan.展开更多
Indus basin hosts many significant mineral deposits like gypsum and cement raw materials, gemstones, iron, coal, marble, dimension and construction stones, petroleum and water resources, world class pink salt and othe...Indus basin hosts many significant mineral deposits like gypsum and cement raw materials, gemstones, iron, coal, marble, dimension and construction stones, petroleum and water resources, world class pink salt and other many minerals in different regions which need further exploitation and development. The construction of new water dams in different regions are vital (for availability of cheap electricity), because of available barren and fertile lands and wastage of water as flood. Further the installation of more cement industries in different regions of Indus Basin especially in middle Indus (Sulaiman Range where gypsum, clays and limestones can be available via belt) can increase export to receive more foreign exchange and make local cement cheap for the sustainable development of Pakistan. 31 stratigraphic sequential sections at different sections of Indus basins are presented to know the variation and local stratigraphy. Further here three new titanosaur taxa are being described. Saraikimasoom is based on snout;Gspsaurus, (Maojandino), Nicksaurus and Khanazeem are based on cranial, vertebral and appendicular elements;Balochisaurus, Marisaurus, Pakisaurus, and 3 new genera and species Imrankhanhero zilefatmi, Qaikshaheen masoomniazi and Ikqaumishan smqureshi based on vertebral and appendicular elements;and Sulaimanisaurus and Khetranisaurus based on only caudal vertebrae. Although Pakistani Titanosaurians seem to be proliferated found from one horizon of Vitakri Formation just below the K-Pg boundary they have a wide range of diagnostic features and key elements among titanosaurs which can be used for comparison and phylogenetic analyses with broad updated character data set of titanosaurs.展开更多
This study investigates and analyses empirically the impact of Foreign Direct Investment(FDI)inflows on the exports for a panel series of five large-scale manufacturing industries of Pakistan during the period 2000-20...This study investigates and analyses empirically the impact of Foreign Direct Investment(FDI)inflows on the exports for a panel series of five large-scale manufacturing industries of Pakistan during the period 2000-2020.For this purpose,we establish export production function as based on endogenous growth theory in which role of FDI is considered as additional determinant of export.The Pedroni residual-based co-integration test and Error Correction Model(ECM)are applied for the long and short-run relationships.Pedroni residual based approach highlighted that human capitals,domestic capitals,foreign direct investments,exports,and domestic sales are co-integrated in the long run.According to results of ECM,coefficient of FDI appears to have statistical significant impact on exports and has a positive sign in the long run.Whereas,FDI does not contribute to export growth in the short run but it takes time to influence the growth patterns of the sector.On the basis of theoretical notion of endogenous growth theory,long-run coefficient of FDI may be interpreted as evidence in favour of the hypotheses that FDI has an impact on exports via export development.Thus,it can be concluded that“FDI-based endogenous growth theory”is valid in the case of Pakistan.展开更多
The eastern road section of the ChinaPakistan Economic Corridor(CPEC)traverses the challenging terrain of northern Pakistan,where frequent landslides pose a significant threat to socioeconomic development and infrastr...The eastern road section of the ChinaPakistan Economic Corridor(CPEC)traverses the challenging terrain of northern Pakistan,where frequent landslides pose a significant threat to socioeconomic development and infrastructure.However,the insufficient data on landslide hazards presents a substantial challenge to practical mitigation efforts.Therefore,we conducted an extensive study to gain insight into landslide assessment along the Mansehra-Muzaffarabad-Mirpur and Mangla(MMMM)Expressway.This study involved preparing a landslide inventory,analyzing landslide causative factors,and developing landslide susceptibility models(LSMs)using published data,remote sensing interpretations,field excursions and integrated predictive techniques.We first used Pearson's correlation coefficient(PCC),variable importance factors(VIF),and information gain ratio(IGR)to evaluate multicollinearity among the selected landslide causative factors(LCFs).Then,the topographic roughness index(TRI)with VIF>5 and PCC>0.7 was considered a redundant factor and thus removed before the data modeling.Finally,we adopted multiple machine-learning methods to analyze landslide susceptibility.The results indicate that the landslide inventory contains 1,776 events,of which 674 were classified based on geometrical and lithological configurations.The IGR results show that the rainfall,lithology,PGA,drainage density,slope,and distance to fault are the most effective LCFs.The AUC values for random forest(RF)(0.901),extreme gradient boosting(XGBoost)(0.884),and K-nearest neighbor(KNN)(0.872)remained higher than evidential belief function(EBF)(0.833),weight of evidence(WoE)(0.820),and certainty factor(CF)(0.810),respectively.The RF model outperformed all other models in terms of prediction.However,these models are accurate but newer in the area;thus,susceptible zones were verified with comprehensive field investigations.The northern and central regions accounted for the high and very high susceptibility classes in the final landslide susceptibility mapping(LSM)compared to the southern areas.展开更多
The escalating human immunodeficiency virus(HIV)outbreaks in Pakistan are a matter of concern for both general population and health care settings[1].The first case of HIV was reported in 1987.Since then,0.2 million p...The escalating human immunodeficiency virus(HIV)outbreaks in Pakistan are a matter of concern for both general population and health care settings[1].The first case of HIV was reported in 1987.Since then,0.2 million people are living with HIV,63202 know their positive status,and 40652 patients are acquiring health assistance from 78 anti-retroviral therapy centers[2,3].According to reports,the cases of HIV/AIDS escalated to 75%within a decade since 2013,with merely 4500 in Pakistan[1,2].展开更多
BACKGROUND Behavioral activation therapy(BA)is as effective as cognitive behavior therapy(CBT)in treating depression and can be delivered by practitioners with much less psychological training,making it particularly s...BACKGROUND Behavioral activation therapy(BA)is as effective as cognitive behavior therapy(CBT)in treating depression and can be delivered by practitioners with much less psychological training,making it particularly suitable for low resource settings.BA that is culturally adapted for Muslims(BA-M)is a culturally adapted form of BA that has been found acceptable and feasible for Muslims with depression in the United Kingdom and Turkey;however,this is the first time that its efficacy has been determined through a definitive randomized controlled trial.AIM To compare the effectiveness of BA-M with CBT for Muslim patients with depression in Pakistan.METHODS One hundred and eight patients were randomized 1:1 to treatment arms in a parallel-group randomized controlled trial in hospital or community sites in Lahore,Pakistan.Recruitment followed self-referral or referrals from clinicians,consultants or relevant professionals at each site.Four measures were recorded by blinded assessors:The patient health questionnaire-9(PHQ-9);the BA for depression scale short form(BADS-SF);symptom checklist-revised and the World Health Organization Quality-of-Life Brief Scale.All measures were recorded at baseline and post treatment;PHQ-9 and BADS-SF were also recorded at each session and at three month follow up.The primary analysis was to regress the PHQ-9 score after therapy upon the PHQ-9 score before therapy(baseline)and the type of therapy given,that is,analysis of covariance.In addition,analysis using PHQ-9 scores collected at each therapy session was employed in a 2-level regression model.RESULTS Patients in the BA-M arm experienced greater improvement in PHQ-9 score of 1.95 units compared to the CBT arm after adjusting for baseline values(P=0.006)The key reason behind this improvement was that patients were retained in therapy longer under BA-M,in which patients were retained for an average 0.75 sessions more than CBT patients(P=0.013).Patients also showed significant differences on physical(P<0.001),psychological(P=0.004)and social(P=0.047)domains of Quality of Life(QoL)at post treatment level,indicating an increased QoL in the BA-M group as compared to the treatment as usual group.Some baseline differences were noted in both groups for BA scores and two domains of QoL scale:Physical and environment,which might have influenced the results,though the BA-M group showed more improvement at completion of therapy.CONCLUSION Results proved the efficacy of BA-M in reducing symptoms for depressed patients in Pakistan,indicating BA-M is a promising treatment modality for depression in future,particularly in low resource settings.展开更多
Heritage Impact Assessments(HIAs)are progressively needed to investigate potential impacts and outcomes of development on the Outstanding Universal Value(OUV)of world heritage properties.However,many key stakeholders ...Heritage Impact Assessments(HIAs)are progressively needed to investigate potential impacts and outcomes of development on the Outstanding Universal Value(OUV)of world heritage properties.However,many key stakeholders involved in implementing the World Heritage Convention lack the management system,methodological tools,and guidelines to conduct effective impact assessments in areas without these resources.The paper explores the successful utilization of the Heritage Impact Assessment(HIA)tool to address concerns raised by UNESCO and civil society.This occurred when the Punjab government initiated the Orange Line Metro Train Project(OLMT)near the World Heritage Shalimar Garden and other historic monuments in Lahore.The project aimed to meet the daily transportation needs of around 2.5 million commuters.展开更多
Sustainable income growth and poverty reduction remain critical challenges at the forefront of research in Pakistan,particularly in rural areas.To overcome these challenges,the role of rural transformation(RT)has emer...Sustainable income growth and poverty reduction remain critical challenges at the forefront of research in Pakistan,particularly in rural areas.To overcome these challenges,the role of rural transformation(RT)has emerged and gained importance in recent years.The present study is based on district-level data and covers the period from 1981 to 2019.The study attempts to quantify the role of rural transformation in boosting rural per capita income and alleviating rural poverty in the country.The study also aims to explore the impact of stages of rural transformation on rural per capita income and rural poverty alleviation.The empirical findings reveal that rural transformation(RT_(1)and RT_(2))is essential in enhancing rural per capita income and alleviating rural poverty.The role of the share of high-value crops(RT_(1))is more pronounced than the share of non-farm employment(RT_(2))in boosting rural per capita income and poverty alleviation.The trend of larger contribution of RT_(1)to enhance rural per capita income also continued at 2nd stage of rural transformation.In the case of poverty reduction,at 3rd stage of rural transformation,the role of RT_(2)is dominant.Our results indicate that districts at higher stages of rural transformation(both RT_(1)and RT_(2))tend to correlate positively with increased rural per capita income and reduced poverty rates,suggesting that progress in rural transformation is associated with improved economic conditions.However,it is important to note that this correlation does not necessarily imply a direct causal relationship between rural transformation and these economic outcomes;other factors may have influenced this relationship.In addition,the welfare impacts are more noticeable among the districts where a simultaneous shift from grain crops to cash crops and from farm employment to non-farm employment is observed.The study provides baseline information to learn experiences from fast-growing districts and to replicate the strategies in other districts,which boosts the RT process that may increase rural per capita income and enhance poverty reduction efforts.展开更多
In the last decade,Pakistan has experienced multidemics of HIV in key populations,namely:injecting drug users,male sex with male,female sex workers,transgender sex workers,and transgenders.According to recent reports,...In the last decade,Pakistan has experienced multidemics of HIV in key populations,namely:injecting drug users,male sex with male,female sex workers,transgender sex workers,and transgenders.According to recent reports,in Pakistan,210000 people with HIV accounts for less than 0.2%of the general population.展开更多
Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of ...Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan.Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the study.Data was extracted from electronic data management system.For the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all sites.All the data was analyzed using SPSS version 22.Results:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes available.Of these,384(67.9%)successfully completed their treatment.Out of 368(32%)patients who had their interim results available,all had their 6th month culture negative.Combining new medications was thought to result in serious adverse outcomes such as QT prolongation.However,this study did not record any severe adverse events among patients.Conclusions:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.展开更多
Neonatal mortality is of global concern, it is the death in the first month of life. According to WHO, 2.4 million children died globally in the first month of life2. Globally the neonatal mortality rate declined slow...Neonatal mortality is of global concern, it is the death in the first month of life. According to WHO, 2.4 million children died globally in the first month of life2. Globally the neonatal mortality rate declined slowly from 28/100 live births in 2000 to 17.9/100 live births in 2019. It is a major challenge for the low socioeconomic group of countries. Most neonatal deaths occurred in south Asia and African countries, in 2019 out of 2.4 million death 81% occurred in the Southeast Asia. Objective: To evaluate and improve cord care practices of mothers to reduce the risk of cord related infections. Methodology: The mixed method will be used in this research, questionnaire is used for data collection, total collected sample is 391. Results: 354 (91.0%) of the 394 patients analyzed obtained prenatal care (ANC) in both traditional and nontraditional settings. Among these, 288 (72.3%) got cord care health education, whereas 106 (27.7%) did not. The overall documentation of the instructions for the use of metabolized spirits alone included 116 (48.9%) teaching institutions and 103 (43.5%) private hospitals. the average results show the age of the baby 1 - 7 days, the average age of the mother is 18 - 25 years. The average education of the mothers is primary. Participation of health centers is average. Most of the participants has 1 child. Conclusion: This research concludes the poor umbilical cord practices and knowledge. Those with information used it better. Raise awareness about umbilical cord care and improper behaviors, including using mentholated balms. Before women leave the hospital, they should learn cord care. Mothers must clean wires. Several healthcare organizations don’t provide cord care instruction, and what they provide isn’t research-based.展开更多
Water borne ailments are of serious public health concern in Gilgit Baltistan’s (GB) region of Pakistan. The pollution load on the glacio-fluvial streams and surface water resources of the Chapurson Valley in the Hun...Water borne ailments are of serious public health concern in Gilgit Baltistan’s (GB) region of Pakistan. The pollution load on the glacio-fluvial streams and surface water resources of the Chapurson Valley in the Hunza Nagar area of the GB is increasing as a result of anthropogenic activities and tourism. The present study focuses on the public health quality of drinking water of Chapurson valley. The study addressed the fundamental drinking water quality criteria in order to understand the state of the public health in the valley. To ascertain the current status of physico-chemical, metals, and bacteriological parameters, 25 water samples were collected through deterministic sampling strategy and examined accordingly. The physico-chemical parameters of the water samples collected from the valley were found to meet the World Health Organization (WHO) guidelines of drinking water. The water samples showed a pattern of mean metal concentrations in order of Arsenic (As) > Lead (Pb) > Iron (Fe) > Zinc (Zn) > Copper (Cu) > Magnesium (Mg) > Calcium (Ca). As, Cu, Zn, Ca and Mg concentration were under the WHO guidelines range. However, results showed that Pb and Fe are present at much higher concentrations than recommended WHO guidelines. Similarly, the results of the bacteriological analysis indicate that the water samples are heavily contaminated with the organisms of public health importance (including total coliforms (TCC), total faecal coliforms (TFC) and total fecal streptococci (TFS) are more than 3 MPN/100mL). Three principal components, accounting for 48.44% of the total variance, were revealed using principal component analysis (PCA). Bacteriological parameters were shown to be the main determinants of the water quality as depicted by the PCA analysis. The dendrogram of Cluster analysis using the Ward’s method validated the same traits of the sampling locations that were found to be contaminated during geospatial analysis using the Inverse Distance Weight (IDW) method. Based on these findings, it is most likely that those anthropogenic activities and essentially the tourism results in pollution load from upstream channels. Metals may be released into surface and groundwater from a few underlying sources as a result of weathering and erosion. This study suggests that the valley water resources are more susceptible to bacteriological contamination and as such no water treatment facilities or protective measure have been taken to encounter the pollution load. People are drinking the contaminated water without questioning about the quality. It is recommended that the water resources of the valley should be monitored using standard protocol so as to protect not only the public health but to safe guard sustainable tourism in the valley.展开更多
文摘Discoveries of many coal seams at depths by drilling carried by Geological Survey of Pakistan in Sor Range and Harnai Gochina, extended the coal seams at depth which is challenge for mine owners to exploit feasibly. Bed to bed gypsum samplings (and their chemical analyses) of huge gypsum deposits from Sulaiman foldbelt is a base for industrialist and also planers to develop cement and gypsum industries to increase export and foreign exchange for the development of area and Pakistan. Low and high grade sedimentary iron deposits, silica sand and uranium host rocks and their extensions in Sulaiman and Kirthar foldbelts are presented. Anomalies of a few base metals arise as a result of geochemical exploration carried at part of Loralai District of Balochistan. Theropod dinosaurs were frequent in India, while Poripuchian titanosaurs (Sauropoda, Dinosauria) were frequent in Pakistan. Besides some ichnotaxa, many bone taxa such as 1 titanosauriform, 14 titanosaurian sauropod (including one new titanosaur), and 3 theropod dinosaurs are established from Pakistan. Among these 12 titanosaur species and 3 theropod species are named in about 10 km<sup>2</sup> area of Vitakri dome and 2 titanosaur species are named in about a few hundred square meter area of Mari Bohri (Kachi Bohri) which is about 10 km westward from Vitakri dome. Pakistan is a unique country which discoverd 14 diversified titanosaurs in a short area and also in a short period (67 - 66 million years ago/Ma). About 400 bones found from a few meter thick upper part of upper shale horizon of latest Maastrichtian Vitakri Formation which is base for titanosaur taxa. Cranial material is in low fraction (but include significant diverse snouts), caudal vertebrae are prominent, the cervicals, dorsals and sacrals have significant numbers, forelimb and hind limb bones have balanced fraction. Humeri, femora and tibiae are most common. To know the position of Pakistani titanosaurs among titanosaurs and sauropods, there is a need to extend list of characters for phylogenetic analyses. This broad feature list should include main characters of titanosaurs from Pakistan and also from global world.
文摘Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in developed countries in the West;however,little research has been conducted in low-income countries,especially in Pakistan.The socioeconomic instability and the government's lack of awareness and knowledge have resulted in no regulations being placed to incorporate telehealth in medicine.The healthcare departments must take into consideration the lifechanging impact of telehealth and the barriers that prevent it in becoming known,to reduce the incidence of unsafe abortions and sexual health practices that prove to be a stigma in society.
文摘BACKGROUND Lipid treatment practices and levels in post-acute myocardial infarction(AMI)patients,which are crucial for secondary prevention.AIM To evaluate the lipid treatment practices and lipid levels in post-myocardial infarction(MI)patients at a tertiary care hospital in Pakistan.METHODS In this cross-sectional study,we analyzed patients who had experienced their first AMI event in the past 3 years.We assessed fasting and non-fasting lipid profiles,reviewed statin therapy prescriptions,and examined patient compliance.The recommended dose was defined as rosuvastatin≥20 mg or atorvastatin≥40 mg,with target total cholesterol levels set at<160 mg/dL and target low-density lipoprotein cholesterol(LDL-C)at<55 mg/dL.RESULTS Among 195 patients,71.3%were male,and the mean age was 57.1±10.2 years.The median duration since AMI was 36(interquartile range:10-48)months and 60% were diagnosed with ST-segment elevation MI.Only 13.8% of patients were advised to undergo lipid profile testing after AMI,88.7% of patients were on the recommended statin therapy,and 91.8% of patients were compliant with statin therapy.Only 11.5% had LDL-C within the target range and 71.7% had total cholesterol within the target range.Hospital admission in the past 12 months was reported by 14.4%,and the readmission rate was significantly higher among non-compliant patients(37.5%vs 5.6%).Subsequent AMI event rate was also significantly higher among non-compliant patients(43.8%vs 11.7%).CONCLUSION Our study highlights that while most post-AMI patients received the recommended minimum statin therapy dose,the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.
文摘Electric vehicles (EVs) are the most interesting and innovative technology in the 21st century because of theirenormous advantages, both technically and economically. Their emissions rate compared to fuel-based vehicles isnegligible as they do not consume fuel and hence do not emit any harmful gases. However, their bulk production,adoption and lack of charging stations increase the stress of power stations due to modern-day lifestyles. If Electricvehicles demand increases drastically then conventional power stations will not bear their demand and if theygenerate electricity by conventional means it will be very costly and may further add greenhouse gases. Therefore,this research provides the techno-economic assessment of a stand-alone renewable-dependent electric vehiclecharging station, excluding any burden on electrical utility. The proposed study is carried out in Bahria Town,Karachi, a city in Pakistan. In this study, HOMER Pro software was utilized for techno-economic assessment. Ahybrid system comprising solar Photovoltaic/Wind Turbine/Fuel cells and battery storage is included in the model.Solar and wind resources were taken from NASA’s website, where charging stations will be integrated. The overallresults show promising in terms of total Net Present Cost and the Cost of Energy which are 2.72M $ and 0.237 $,respectively. The total system generation is 3,598 Megawatt hours per year, and the total energy consumption is 885Megawatt hours per year.
文摘Newcastle disease (ND) virus is a leading threat to commercial and domestic poultry in Pakistan. The virus infects and constitutes irreversible impairment to the nervous system, damages the respiratory system, and marks severe gastrointestinal lesions leading to heavy mortality in short-living birds and substantial losses in layers and breeders. The continuous emergence and evolution of the virus made it inclined to evade the humoral response and indirectly the circumvention of artificial active immunization. Newcastle disease is caused by the orthoavula genus of the paramyxoviridae family and has shown high genetic diversity even in their genotypes while information regarding enzootic trends of the virus is scanty in Pakistan. A total of 40 tracheal samples of NDV were collected from different commercial broiler farms and 11 isolates of NDV were identified. In the current study, we determined the genetic diversity of the Newcastle disease virus based on the partial sequencing of the fusion protein gene available in the NCBI database. Genetic analysis showed that seven isolates belonged to class I genotype VII and four belonged to class II genotype II. Interestingly, two isolates had epidemiological connections with vaccine-like class II genotype II. Our findings, concerning the recent outbreaks of class I genotype VII and class II genotype II of NDV in vaccinated commercial flocks, suggest possible potential partial mutations in the fusion protein gene. Genetic diversity and formation of the new cleavage site in an important neutralizing protein of wild strain are linked with the potency of artificial active immunization and a major cause of vaccine failure.
文摘BACKGROUND Peptic ulcer disease(PUD)remains a significant healthcare burden,contributing to morbidity and mortality worldwide.Despite advancements in therapies,its prevalence persists,particularly in regions with widespread nonsteroidal antiinflammatory drugs(NSAIDs)use and Helicobacter pylori infection.AIM To comprehensively analyse the risk factors and outcomes of PUD-related upper gastrointestinal(GI)bleeding in Pakistani population.METHODS This retrospective cohort study included 142 patients with peptic ulcer bleeding who underwent upper GI endoscopy from January to December 2022.Data on demographics,symptoms,length of stay,mortality,re-bleed,and Forrest classification was collected.RESULTS The mean age of patients was 53 years,and the majority was men(68.3%).Hematemesis(82.4%)and epigastric pain(75.4%)were the most common presenting symptoms.Most patients(73.2%)were discharged within five days.The mortality rates at one week and one month were 10.6%and 14.8%,respectively.Re-bleed within 24 h and seven days occurred in 14.1%and 18.3%of patients,respectively.Most ulcers were Forrest class(FC)Ⅲ(72.5%).Antiplatelet use was associated with higher mortality at 7 and 30 d,while alternative medications were linked to higher 24-hour re-bleed rates.NSAID use was associated with more FCⅢulcers.Re-bleed at 24 h and 7 d was strongly associated with one-week or one-month mortality.CONCLUSION Antiplatelet use and rebleeding increase the risk of early mortality in PUD-related upper GI bleeding,while alternative medicines are associated with early rebleeding.
文摘The origin of sandstone in the Rawalpindi group is disputed because of the lesser Himalayas complicated geological structure and ongoing tectonic activity. The goal of the study is to learn more about the petrographic and geological aspects of the Siwalik molasses deposits, which are formations that belong to the same age group. The Early Miocene Kamlial Formation, the Middle to Late Miocene Chinji Formation, and the Late Miocene Nagri Formation are the stratigraphic units revealed in the project area. The texture of the sandstone found in the Rawalpindi Group and Siwalik is fine to medium-grained. The hue ranges from grey to greenish grey. The sandstone displays thin to medium-bedded layers and exhibits thin lamination throughout. The sandstone of the Kamlial Formation contains load casts, potholes, worm burrows, hematite layers, and filled and unfilled mud cracks in basic structures. Model petrographic research reveals that the Murree Formation primarily consists of light minerals like feldspar, quartzite, and felice, whereas the Kamlial Formation is composed of heavy minerals like garnet and tourmaline. Sandstone from the Rawalpindi group undergoes analysis to ascertain its provenance using the quartz feldspar lithic fragments ternary diagram technique. Each plot in the QFL diagram’s recycled orogeny provenance field is plotted.
文摘Saraikistan (South Punjab and surrounding) area of Pakistan is located in the central Pakistan. This area represents Triassic-Jurassic to Recent sedimentary marine and terrestrial strata. Most of the Mesozoic and Early Cenozoic are represented by marine strata with rare terrestrial deposits, while the Late Cenozoic is represented by continental fluvial deposits. This area hosts significant mineral deposits and their development can play a significant role in the development of Saraikistan region and ultimately for Pakistan. The data of recently discovered biotas from Cambrian to Miocene age are tabulated for quick view. Mesozoic biotas show a prominent paleobiogeographic link with Gondwana and Cenozoic show Eurasian. Phylogeny and hypodigm of Poripuchian titanosaurs from India and Pakistan are hinted at here.
文摘The current study extends the previous literature by exploring the effects of a newly discovered driver,i.e.,import taxes(as a proxy for commercial policies),on the consumption-based carbon emissions(CCO2e)for 1990Q1-2017Q4.For empirical analysis,several tests and methods,including Augmented Dickey–Fuller unit root test,Zivot–Andrews unit root test,asymmetric cointegration bound testing approach,non-linear ARDL,Wald-test,Granger causality test and wavelet quantile correlation(WQC)method are utilized.Furthermore,NARDL technique estimates reveal that contractionary commercial policy enhances the environmental quality by disrupting the detrimental effects of CCO2e.However,expansionary commercial policy escalates the environmental pollution by boosting the carbon emissions.Also,the exports and the renewable energy improve the ecological quality;however,GDP deteriorates the atmospheric quality by increasing the CCO2e.Besides,WQC method and the trivariate Granger causality test are deployed to confirm the robustness of the results.Based on the findings,some crucial policies are also recommended for sustainable and green development in Pakistan.
文摘Indus basin hosts many significant mineral deposits like gypsum and cement raw materials, gemstones, iron, coal, marble, dimension and construction stones, petroleum and water resources, world class pink salt and other many minerals in different regions which need further exploitation and development. The construction of new water dams in different regions are vital (for availability of cheap electricity), because of available barren and fertile lands and wastage of water as flood. Further the installation of more cement industries in different regions of Indus Basin especially in middle Indus (Sulaiman Range where gypsum, clays and limestones can be available via belt) can increase export to receive more foreign exchange and make local cement cheap for the sustainable development of Pakistan. 31 stratigraphic sequential sections at different sections of Indus basins are presented to know the variation and local stratigraphy. Further here three new titanosaur taxa are being described. Saraikimasoom is based on snout;Gspsaurus, (Maojandino), Nicksaurus and Khanazeem are based on cranial, vertebral and appendicular elements;Balochisaurus, Marisaurus, Pakisaurus, and 3 new genera and species Imrankhanhero zilefatmi, Qaikshaheen masoomniazi and Ikqaumishan smqureshi based on vertebral and appendicular elements;and Sulaimanisaurus and Khetranisaurus based on only caudal vertebrae. Although Pakistani Titanosaurians seem to be proliferated found from one horizon of Vitakri Formation just below the K-Pg boundary they have a wide range of diagnostic features and key elements among titanosaurs which can be used for comparison and phylogenetic analyses with broad updated character data set of titanosaurs.
文摘This study investigates and analyses empirically the impact of Foreign Direct Investment(FDI)inflows on the exports for a panel series of five large-scale manufacturing industries of Pakistan during the period 2000-2020.For this purpose,we establish export production function as based on endogenous growth theory in which role of FDI is considered as additional determinant of export.The Pedroni residual-based co-integration test and Error Correction Model(ECM)are applied for the long and short-run relationships.Pedroni residual based approach highlighted that human capitals,domestic capitals,foreign direct investments,exports,and domestic sales are co-integrated in the long run.According to results of ECM,coefficient of FDI appears to have statistical significant impact on exports and has a positive sign in the long run.Whereas,FDI does not contribute to export growth in the short run but it takes time to influence the growth patterns of the sector.On the basis of theoretical notion of endogenous growth theory,long-run coefficient of FDI may be interpreted as evidence in favour of the hypotheses that FDI has an impact on exports via export development.Thus,it can be concluded that“FDI-based endogenous growth theory”is valid in the case of Pakistan.
基金supported by the National Natural Science Foundation of China(Grant No.U22A20603)the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDA20030301)。
文摘The eastern road section of the ChinaPakistan Economic Corridor(CPEC)traverses the challenging terrain of northern Pakistan,where frequent landslides pose a significant threat to socioeconomic development and infrastructure.However,the insufficient data on landslide hazards presents a substantial challenge to practical mitigation efforts.Therefore,we conducted an extensive study to gain insight into landslide assessment along the Mansehra-Muzaffarabad-Mirpur and Mangla(MMMM)Expressway.This study involved preparing a landslide inventory,analyzing landslide causative factors,and developing landslide susceptibility models(LSMs)using published data,remote sensing interpretations,field excursions and integrated predictive techniques.We first used Pearson's correlation coefficient(PCC),variable importance factors(VIF),and information gain ratio(IGR)to evaluate multicollinearity among the selected landslide causative factors(LCFs).Then,the topographic roughness index(TRI)with VIF>5 and PCC>0.7 was considered a redundant factor and thus removed before the data modeling.Finally,we adopted multiple machine-learning methods to analyze landslide susceptibility.The results indicate that the landslide inventory contains 1,776 events,of which 674 were classified based on geometrical and lithological configurations.The IGR results show that the rainfall,lithology,PGA,drainage density,slope,and distance to fault are the most effective LCFs.The AUC values for random forest(RF)(0.901),extreme gradient boosting(XGBoost)(0.884),and K-nearest neighbor(KNN)(0.872)remained higher than evidential belief function(EBF)(0.833),weight of evidence(WoE)(0.820),and certainty factor(CF)(0.810),respectively.The RF model outperformed all other models in terms of prediction.However,these models are accurate but newer in the area;thus,susceptible zones were verified with comprehensive field investigations.The northern and central regions accounted for the high and very high susceptibility classes in the final landslide susceptibility mapping(LSM)compared to the southern areas.
文摘The escalating human immunodeficiency virus(HIV)outbreaks in Pakistan are a matter of concern for both general population and health care settings[1].The first case of HIV was reported in 1987.Since then,0.2 million people are living with HIV,63202 know their positive status,and 40652 patients are acquiring health assistance from 78 anti-retroviral therapy centers[2,3].According to reports,the cases of HIV/AIDS escalated to 75%within a decade since 2013,with merely 4500 in Pakistan[1,2].
文摘BACKGROUND Behavioral activation therapy(BA)is as effective as cognitive behavior therapy(CBT)in treating depression and can be delivered by practitioners with much less psychological training,making it particularly suitable for low resource settings.BA that is culturally adapted for Muslims(BA-M)is a culturally adapted form of BA that has been found acceptable and feasible for Muslims with depression in the United Kingdom and Turkey;however,this is the first time that its efficacy has been determined through a definitive randomized controlled trial.AIM To compare the effectiveness of BA-M with CBT for Muslim patients with depression in Pakistan.METHODS One hundred and eight patients were randomized 1:1 to treatment arms in a parallel-group randomized controlled trial in hospital or community sites in Lahore,Pakistan.Recruitment followed self-referral or referrals from clinicians,consultants or relevant professionals at each site.Four measures were recorded by blinded assessors:The patient health questionnaire-9(PHQ-9);the BA for depression scale short form(BADS-SF);symptom checklist-revised and the World Health Organization Quality-of-Life Brief Scale.All measures were recorded at baseline and post treatment;PHQ-9 and BADS-SF were also recorded at each session and at three month follow up.The primary analysis was to regress the PHQ-9 score after therapy upon the PHQ-9 score before therapy(baseline)and the type of therapy given,that is,analysis of covariance.In addition,analysis using PHQ-9 scores collected at each therapy session was employed in a 2-level regression model.RESULTS Patients in the BA-M arm experienced greater improvement in PHQ-9 score of 1.95 units compared to the CBT arm after adjusting for baseline values(P=0.006)The key reason behind this improvement was that patients were retained in therapy longer under BA-M,in which patients were retained for an average 0.75 sessions more than CBT patients(P=0.013).Patients also showed significant differences on physical(P<0.001),psychological(P=0.004)and social(P=0.047)domains of Quality of Life(QoL)at post treatment level,indicating an increased QoL in the BA-M group as compared to the treatment as usual group.Some baseline differences were noted in both groups for BA scores and two domains of QoL scale:Physical and environment,which might have influenced the results,though the BA-M group showed more improvement at completion of therapy.CONCLUSION Results proved the efficacy of BA-M in reducing symptoms for depressed patients in Pakistan,indicating BA-M is a promising treatment modality for depression in future,particularly in low resource settings.
文摘Heritage Impact Assessments(HIAs)are progressively needed to investigate potential impacts and outcomes of development on the Outstanding Universal Value(OUV)of world heritage properties.However,many key stakeholders involved in implementing the World Heritage Convention lack the management system,methodological tools,and guidelines to conduct effective impact assessments in areas without these resources.The paper explores the successful utilization of the Heritage Impact Assessment(HIA)tool to address concerns raised by UNESCO and civil society.This occurred when the Punjab government initiated the Orange Line Metro Train Project(OLMT)near the World Heritage Shalimar Garden and other historic monuments in Lahore.The project aimed to meet the daily transportation needs of around 2.5 million commuters.
基金We highly acknowledge the financial support of the Australian Centre for International Agricultural Research(ACIAR),Australia(ADP/2017/024)。
文摘Sustainable income growth and poverty reduction remain critical challenges at the forefront of research in Pakistan,particularly in rural areas.To overcome these challenges,the role of rural transformation(RT)has emerged and gained importance in recent years.The present study is based on district-level data and covers the period from 1981 to 2019.The study attempts to quantify the role of rural transformation in boosting rural per capita income and alleviating rural poverty in the country.The study also aims to explore the impact of stages of rural transformation on rural per capita income and rural poverty alleviation.The empirical findings reveal that rural transformation(RT_(1)and RT_(2))is essential in enhancing rural per capita income and alleviating rural poverty.The role of the share of high-value crops(RT_(1))is more pronounced than the share of non-farm employment(RT_(2))in boosting rural per capita income and poverty alleviation.The trend of larger contribution of RT_(1)to enhance rural per capita income also continued at 2nd stage of rural transformation.In the case of poverty reduction,at 3rd stage of rural transformation,the role of RT_(2)is dominant.Our results indicate that districts at higher stages of rural transformation(both RT_(1)and RT_(2))tend to correlate positively with increased rural per capita income and reduced poverty rates,suggesting that progress in rural transformation is associated with improved economic conditions.However,it is important to note that this correlation does not necessarily imply a direct causal relationship between rural transformation and these economic outcomes;other factors may have influenced this relationship.In addition,the welfare impacts are more noticeable among the districts where a simultaneous shift from grain crops to cash crops and from farm employment to non-farm employment is observed.The study provides baseline information to learn experiences from fast-growing districts and to replicate the strategies in other districts,which boosts the RT process that may increase rural per capita income and enhance poverty reduction efforts.
文摘In the last decade,Pakistan has experienced multidemics of HIV in key populations,namely:injecting drug users,male sex with male,female sex workers,transgender sex workers,and transgenders.According to recent reports,in Pakistan,210000 people with HIV accounts for less than 0.2%of the general population.
文摘Objective:To assess the effectiveness and adverse drug reactions of all-oral regimens for patients with multidrug-resistant tuberculosis.Methods:This retrospective study was conducted at 10 Programmatic Management of Drug Resistant Tuberculosis sites in Punjab province of Pakistan.Patients receiving treatment for drug resistant tuberculosis from July 2019 to December 2020 with at least interim result i.e.6th month culture conversion or final outcomes(cured,complete,lost to follow-up,failure,death)available,were included in the study.Data was extracted from electronic data management system.For the reporting and management of adverse drug events,active tuberculosis drug safety monitoring and management was implemented across all sites.All the data was analyzed using SPSS version 22.Results:Out of 947 drug resistant tuberculosis patients included in this study,579(68%)of the patients had final outcomes available.Of these,384(67.9%)successfully completed their treatment.Out of 368(32%)patients who had their interim results available,all had their 6th month culture negative.Combining new medications was thought to result in serious adverse outcomes such as QT prolongation.However,this study did not record any severe adverse events among patients.Conclusions:All-oral regimens formulation guided by overall treatment effectiveness resulted in treatment outcomes comparable to those obtained with traditional injectable treatment.
文摘Neonatal mortality is of global concern, it is the death in the first month of life. According to WHO, 2.4 million children died globally in the first month of life2. Globally the neonatal mortality rate declined slowly from 28/100 live births in 2000 to 17.9/100 live births in 2019. It is a major challenge for the low socioeconomic group of countries. Most neonatal deaths occurred in south Asia and African countries, in 2019 out of 2.4 million death 81% occurred in the Southeast Asia. Objective: To evaluate and improve cord care practices of mothers to reduce the risk of cord related infections. Methodology: The mixed method will be used in this research, questionnaire is used for data collection, total collected sample is 391. Results: 354 (91.0%) of the 394 patients analyzed obtained prenatal care (ANC) in both traditional and nontraditional settings. Among these, 288 (72.3%) got cord care health education, whereas 106 (27.7%) did not. The overall documentation of the instructions for the use of metabolized spirits alone included 116 (48.9%) teaching institutions and 103 (43.5%) private hospitals. the average results show the age of the baby 1 - 7 days, the average age of the mother is 18 - 25 years. The average education of the mothers is primary. Participation of health centers is average. Most of the participants has 1 child. Conclusion: This research concludes the poor umbilical cord practices and knowledge. Those with information used it better. Raise awareness about umbilical cord care and improper behaviors, including using mentholated balms. Before women leave the hospital, they should learn cord care. Mothers must clean wires. Several healthcare organizations don’t provide cord care instruction, and what they provide isn’t research-based.
文摘Water borne ailments are of serious public health concern in Gilgit Baltistan’s (GB) region of Pakistan. The pollution load on the glacio-fluvial streams and surface water resources of the Chapurson Valley in the Hunza Nagar area of the GB is increasing as a result of anthropogenic activities and tourism. The present study focuses on the public health quality of drinking water of Chapurson valley. The study addressed the fundamental drinking water quality criteria in order to understand the state of the public health in the valley. To ascertain the current status of physico-chemical, metals, and bacteriological parameters, 25 water samples were collected through deterministic sampling strategy and examined accordingly. The physico-chemical parameters of the water samples collected from the valley were found to meet the World Health Organization (WHO) guidelines of drinking water. The water samples showed a pattern of mean metal concentrations in order of Arsenic (As) > Lead (Pb) > Iron (Fe) > Zinc (Zn) > Copper (Cu) > Magnesium (Mg) > Calcium (Ca). As, Cu, Zn, Ca and Mg concentration were under the WHO guidelines range. However, results showed that Pb and Fe are present at much higher concentrations than recommended WHO guidelines. Similarly, the results of the bacteriological analysis indicate that the water samples are heavily contaminated with the organisms of public health importance (including total coliforms (TCC), total faecal coliforms (TFC) and total fecal streptococci (TFS) are more than 3 MPN/100mL). Three principal components, accounting for 48.44% of the total variance, were revealed using principal component analysis (PCA). Bacteriological parameters were shown to be the main determinants of the water quality as depicted by the PCA analysis. The dendrogram of Cluster analysis using the Ward’s method validated the same traits of the sampling locations that were found to be contaminated during geospatial analysis using the Inverse Distance Weight (IDW) method. Based on these findings, it is most likely that those anthropogenic activities and essentially the tourism results in pollution load from upstream channels. Metals may be released into surface and groundwater from a few underlying sources as a result of weathering and erosion. This study suggests that the valley water resources are more susceptible to bacteriological contamination and as such no water treatment facilities or protective measure have been taken to encounter the pollution load. People are drinking the contaminated water without questioning about the quality. It is recommended that the water resources of the valley should be monitored using standard protocol so as to protect not only the public health but to safe guard sustainable tourism in the valley.