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The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.
Premature ejaculation (PME) is the most prevalent sexual disorder. It affects more than 30% of male population. Thus far SSRI,s clomipramine, local anesthetic along with psychological therapies are the mainstay in the treatment of PME. However, not all the cases are amenable to these treatments. Attempts are underway to find out better remedies for this problem. Gabapentine an anticonvulsant drug is being tested for treatment of PME.
Electronic search was made at database websites, using key words gabapentine, premature ejaculation. It was followed by manual research to find out possible mechanism by which gabapentine could delay orgasm.
Search could not provide concert mode of action which explain inhibitory action on premature ejaculation by gabapentine; except for its anti anxiety effect mediated by gabanergic properties.
Gabanergic action explains its anti anxiety, muscle relaxant and CNS depressant properties which could be beneficial, for premature ejaculation. Gabapentine has anti glutamate properties as well. This action further imparts anti excitatory effect which is helpful for PME. Excellent efficacy on neuralgic pains and neuropathies indicates that gabapentine desensitize the receptors which are oversensitive as are found in erogenous zones of premature ejaculators. Orgasm and partial seizure share many common features. Hence anti antiepileptic properties increase threshold of physiological seizure that is orgasm.
Gabapentine can be considered as medicine which works on PME with a mode of action different from SSRI,s.
To verify the association of various risk factors with Post Traumatic Stress Disorder in adults among Internally Displaced Persons of Bajour and Swat.
Case Control studyPlace and Duration of study: Conducted on adult males and females among internally displaced persons, selected from the IDPs Camp in Peshawer and the IDPs visiting Psychiatric setting at Hayatabad Medical Complex, Peshawer from 1st of May to 15th of June, 2009.
Materials and methods
Cases selected among the respondents through a screening questionnaire, suffering from PTSD. The controls were those respondents which screened out negative from the questionnaire for PTSD but were from the same camp. A total of 208 cases & equal number of controls were enrolled in the study. The statistical analysis was done in a stepwise manner (Uni-variate analysis, bi variate analysis, Logistic regression) using SPSS version 17.
The results show that the factors significantly associated with PTSD were Exposure to Injury (OR = 19.181, 95% CI = 5.740-22.797, p = 0.000), Witnessing Death (OR = 21.113, 95% CI = 5.550-19.826, P = 0.000), Hopelessness (OR = 26.918, 95% CI = 3.403-13.101, p = 0.000), Torture (OR = 5.008, 95% CI = 1.795-3.962, p = 0.009) and Loss of relative (OR = 3.934, 95% CI = 1.077-4.893, p = 0.008).
The Posttraumatic stress disorder is highly prevalent in the vulnerable populations and various determinants are responsible for the morbidity associated with it. The degree that risk factors function to determine both the development and recovery from trauma, it is plausible that targeting risk factors may help both in the treatment of PTSD and in preventing recurrences of PTSD over time.
Ab initio microkinetic modeling was performed to study ethanol conversion to acetaldehyde on Pt-based bimetallic alloys in a non-oxidative environment. Alloying Pt with Au, Ag, Cu, Co, Ni, Zn, Cd, Al, Ga, In, Tl, Ge, Sn, Pb, As, and Sb showed an increase in product turnover by at least an order of magnitude compared with Pt at 423 K. This was correlated to the increased stabilization of CH3CHO species over these alloys. Among the alloy candidates; Pt3Cu, Pt3Zn, Pt3Ga, Pt3Ge, Pt3Sb, and Pt3Pb were found to be more active than Pt.
Introduction: Diabetes mellitus is an increasingly prevalent chronic condition that is usually managed in an outpatient setting. However, the emergency department (ED) plays a crucial role in the management of diabetic patients, particularly for those who are presenting with newly diagnosed diabetes. Little research has been done to characterize the population of patients presenting to the ED with hyperglycemia with no previous diagnosis of diabetes. The objective of this study was to describe the epidemiology, treatment, and outcomes of patients who were newly diagnosed with diabetes in the ED and to compare those with newly diagnosed type I versus type II diabetes. Methods: A one-year health records review of newly diagnosed diabetes patients ≥18 years presenting to one of four tertiary care EDs was conducted. All patients with a discharge diagnosis of hyperglycemia, diabetic ketoacidosis or hyperosmolar hyperglycemic syndrome were screened, but only those who did not have a previous history of diabetes were included. Trained research personnel collected data on patient characteristics, management, disposition, and outcome. Descriptive statistics were used to summarize the data where appropriate. Results: Of 645 patients presenting with hyperglycemia in the study period, 112 (17.4%) were newly diagnosed diabetes patients. Of these patients, 30 (26.8%) were later diagnosed with type I diabetes and 82 (73.2%) were diagnosed with type II diabetes. For the newly diagnosed type I patients the mean (SD) age was 27.6 (9.9) and the mean (SD) age for type II patients was 52.4 (14.1). Of all the new onset patients, 26.8% were diagnosed with diabetic ketoacidosis. The percentage of patients diagnosed with diabetic ketoacidosis was higher in type I than type II (63.3% vs 13.4%; P<0.01). A total of 49 (43.8%) patients were admitted to the hospital, and more patients with type I were admitted compared to those with type II (66.7% vs 35.4 %; P<0.01). Conclusion: Limited research has been done to describe patients newly diagnosed with diabetes in the ED. Patients with type I were found to be more likely to present to the ED with serious symptoms requiring admission to hospital. Our findings demonstrate that the ED may have a strong potential role for improving diabetic care, by providing future opportunities for education and follow-up in the ED to reduce complications, particularly in type I.
We present a family of continuous piecewise linear maps of the unit interval into itself that are all chaotic in the sense of Li and Yorke [‘Period three implies chaos’, Amer. Math. Monthly82 (1975), 985–992] and for which almost every point (in the sense of Lebesgue) in the unit interval is an eventually periodic point of period $p,p\geq 3$, for a member of the family.
Following the intentional dissemination of B.anthracis through the U.S. Postal Service in 2001, use of the term “naturally occurring” to classify some infectious disease outbreaks has become more evident. However, this term is neither a scientific nor an epidemiologic classification that is helpful in describing either the source or the mode of transmission in outbreaks. In this paper, the authors provide examples of how and when the public health community has recognized potentially flawed or misleading taxonomy in the past and taken steps to improve the taxonomy's accuracy and usefulness. We also offer examples of alternative terms for classifying outbreaks since inaccurate descriptions of outbreaks could potentially lead to a flawed or incomplete set of underlying assumptions about the outbreak's causal factors. This, in turn, could lead to implementing a flawed or incomplete intervention or response strategy which could extend the duration of the outbreak, resulting in avoidable morbidity and mortality. (Disaster Med Public Health Preparedness. 2014;0:1–6)
Transmission of hepatitis C (HCV) in Pakistan is a continuing public health problem; 15 years ago it was linked to the practice of reusing therapeutic instruments in healthcare settings. We sought to examine current risk factors for HCV transmission in a hospital population in Karachi, Pakistan. We enrolled 300 laboratory-confirmed HCV-positive participants and 300 laboratory-confirmed HCV-negative participants from clinics at Indus Hospital. Independent and significant risk factors for both men and women were: receiving ⩾12 injections in the past year, blood transfusions, having had dental work performed, and delivery in hospital or transfusion for women. Interestingly, being of Mohajir origin or born in Sindh province were protective. Encouragingly, a strong protective effect was observed for those that reported bringing their own needle for injections (59%). The widespread reuse of therapeutic needles in healthcare settings in Karachi remains a major driver of the HCV epidemic.
The objective of the study was to assess the post-weaning growth response of Sahiwal calves reared on four different pre-weaning dietary regimens. The four diets were: (a) whole cow's milk, starter ration (SR; CP = 20%, total digestible nutrients (TDN) = 72%) and Berseem hay (H; Egyptian clover; CP = 21%, TDN = 63%); (b) whole cow's milk + H; (c) milk replacer (MR; reconstituted to supplier specification; Sprayfo®) + SR + H; and (d) MR + H. The protein and fat percentages of reconstituted MR were 2.22 and 1.84, respectively. Milk or MR were fed at the rate of 10% of the calves’ body weight (BW) until 56 days of age, and then withdrawn gradually until weaned completely by 84 days of age. The average initial BW of calves in groups A, B, C and D were 56.3 ± 1.0, 47.5 ± 1.0, 40.4 ± 1.0 and 30.3 ± 1.0 kg, respectively. Initially, there were 12 calves in each group with six of each sex; however, one male calf died from each of groups B and C and were not replaced. During the post-weaning period, 13 to 24 weeks, the calves were fed a single total mixed ration ad libitum based on maize, canola meal, wheat straw and molasses containing 16% CP and 70% TDN. Daily feed intake and weekly BW gains were recorded. The data were analyzed by MIXED model analysis procedures using the statistical program SAS. The intake of calves as percent of their BW, feed conversion ratio and cost per kg of BW gain were not different (P > 0.05) across treatments. The daily gain at 24 weeks of age for the pre-weaning treatments A, B, C and D were 746 ± 33, 660 ± 33, 654 ± 33 and 527 ± 33 g/day and the final liveweights of calves were 119 ± 4.2, 102 ± 4.2, 95 ± 4.2 and 75 ± 4.2 kg, respectively. Gains were influenced significantly (P < 0.05) by pre-weaning treatments. The calves fed MR and H only during the pre-weaning period were unable to catch up post weaning with calves on other dietary treatments. The calves fed whole milk from birth at the rate of 10% of liveweight together with concentrates had higher weaning weight and superior growth rate post weaning as well. Thus, pre-weaning feeding was important for higher weaning weights and superior growth rates post weaning.
This paper studies the nature of long-run behavior in a two-sector model of optimal growth. Under some restrictions on the parameters of the model, we provide an explicit solution of the optimal policy function generated by the optimal growth model. Fixing the discount factor, we indicate how long-run optimal dynamics changes as a key technological parameter (labor output ratio) changes. For a particular configuration of parameter values, we also provide an explicit solution of the unique absolutely continuous invariant ergodic distribution generated by the optimal policy function.
We analysed the data from the control group in a typhoid vaccine trial in Karachi to assess the differences in individual-, household- and cluster-level characteristics for developing typhoid fever. The annual incidence of typhoid in children aged 2–16 years in the control arm of the vaccine trial was 151/100 000 population. After adjustment, the risk of typhoid was lower with increasing age [risk ratio (RR) 0·89, 95% confidence interval (CI) 0·83–0·95], was higher with an increase in population density (RR 1·13, 95% CI 1·05–1·21) and was lower in the households using a safe drinking-water source (RR 0·63, 95% CI 0·41–0·99). Typhoid fever affects younger children living in areas of high population density and lack of access to safe water in Pakistan. A combination of environmental and biological interventions is required to prevent the continued epidemiological and economic impact of typhoid fever in high-risk areas of Pakistan.
Public exposure to radioactive gas radon and its progeny present in the air results in the largest contribution to total effective dose received by human beings. It is therefore of great concern to monitor radon concentration in energy conserved air tight buildings. Measurements of radon in the Fatima Jinnah Women University (FJWU) have been carried out for investigation and comparison of radon concentration in the new and old buildings of the campus at Rawalpindi, Pakistan. The study was done because according to the international guidelines concerning environmental problems, it is necessary to evaluate and know the radon levels, especially since most of the natural radiation dose to human beings comes from radon gas and its progeny. Solid State Nuclear Track Detectors (SSNTDs) being efficient, therefore, the measurements were carried out by passive, time integrated method, using CR-39 detector in polythene bags. The detectors were exposed for more than six month in various loctations indoors and outdoors. The detectors were etched using NaOH, the tracks were counted manually, and the track density was converted to radon concentration. Radon concentration varied from 31 to 213 Bq.m–3 in old building and from 27 to 143 Bq.m–3 in new buildings, showing slight elevated values in the old buildings. Radon concentration values were found to be less than the values quoted by radiation protection agencies. Radiation dose due to radon varied in the university campus depending on occupancy factor.
To describe the hospital precautions used to isolate a Sabiá virus (arenavirus: Arenaviridae)-infected patient in a US hospital and to protect hospital staff and visitors.
Investigation of a single case of arenavirus laboratory-acquired infection and associated case-contacts.
A 900-bed, tertiary-care, university-affiliated medical center.
Patients or other Participants:
The case-patient became ill with Sabiá virus infection. The case-contacts consisted of healthcare workers, coworkers, friends, and relatives of the case-patient.
Enhanced isolation precautions for treatment of a viral hemorrhagic fever (VHF) patient were implemented in the clinical laboratory and patient-care setting to prevent nosocomial transmission. The enhanced precautions included preventing aerosol spread of the virus from the patient or his clinical specimens. All case-contacts were tested for Sabiá virus antibodies and monitored for signs and symptoms of early disease.
No cases of secondary infection occurred among 142 case-contacts.
With the frequency of worldwide travel, patients with VHF can be admitted to a local hospital at any time in the United States. The use of enhanced isolation precautions for VHF appeared to be effective in preventing secondary cases by limiting the number of contacts and promoting proper handling of laboratory specimens. Patients with VHF can be managed safely in a local hospital setting, provided that appropriate precautions are planned and implemented.
We give a particularly short proof of the symmetrization of Cournot-Nash equilibrium distributions in large anonymous games with countable actions. Our proof relies on the Bollobás-Varopoulos extension of the marriage lemma.
Three patients aged five years, five years four months and 14 years with obstruction of the systemic venous baffle following the Mustard operation were treated with balloon dilation and implantation ofstents. Balloon dilation of the baffle obstruction was performed initially in the first two cases. In the third case, the obstruction was complete and was punctured with atranseptal needle via a 6 French transeptal sheath followed by a balloon dilation. in all three patients, a Palmaz stent (Johnson & Johnson, Summerville, New Jersey, USA) was loaded onto the balloon catheter and delivered into the stenotic area. There was complete relief of obstruction in allcases. The first case developed supraventricular tachycardia at the time ofcatheterization, the morning following implantation of the stent and thentwo weeks after that. There were no complications with catheterization and noshort-term side effects in the other cases. These cases illustrate the use of endovascular stents in the treatment of baffle obstruction.
Most work in the theory of dams has dealt with deterministic withdrawals. Some more recent work, begun by Moran (1969), has been devoted to conditionally deterministic withdrawals which depend on the content of the dam, or in some cases on the last input. We consider in this paper an infinite dam fed by discrete additive inputs, under a totally random withdrawal policy. Explicit expressions are obtained for the time-dependent content distributions. Probabilities of emptiness are computed and stationary results are derived.
We show that Diestel's theorem on weak compactness of subsets of L1,(μ, X) can be derived as a simple corollary of James's theorem. It is a pleasure to acknowledge several stimulating conserversations with Dave Emmons and the remarks of an anonymous referee. Errors are, of course, solely mine.