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Introduction: Family planning includes a wide range of services, such as counseling, contraception, and support to couples. Evidence shows that developing countries have a high degree of inequality in contraception use and prevalence. Reasons for these inequalities include cultural barriers such as traditional preferences and a desire for larger families and lineage, especially in rural areas. The primary objective of this research was to examine the updated contraceptive method preferences of couples in rural and urban regions of Pakistan and how these translate to family planning practices among the different provinces., Methods: A secondary survey analysis using the Pakistan Demographic and Health Survey 2019 survey data was conducted. The dataset included 15 143 women sampled proportionally from the provinces, including Gilgit Baltistan and Azad Jammu and Kashmir. The unit of analysis was 'women' from the individual survey dataset. Age, type of residence (rural, urban), division, education level, and language were used to evaluate access to family planning and contraception services. The c2 test assessed the relationship between dependent and independent variables. Multivariate logistic regression analysis was then performed to see the likelihood of contraceptive use among women., Results: Of the women in the sample, 55% were from rural areas and 50% were without formal education; 51.7% of these women were using or practicing any form of contraception method. The most common method used was condoms (9.2%), followed by injectables (6.2%). Regression analysis showed that women aged 15-19 years were less likely (odds ratio (OR)=0.71, 95% confidence interval (CI)=0.51-1.01) to use contraception when compared to the reference group. The likelihood of contraceptive use was higher in urban areas (OR=1.53, 95%Cl=1.39-1.69). Noticeably, contraceptive use was less likely in uneducated women (OR=0.62, 95%Cl=0.56-070). Punjab province had the highest contraceptive prevalence (34.3%), whereas Baluchistan had the lowest (6.9%). The use of contraception in urban and rural populations was similar in all provinces except Sindh and Gilgit Baltistan. In urban and rural areas, women in the age group 30-35 years who use contraception show a prevalence of 21% and 22% respectively., Conclusion: The study highlights suboptimal use of contraceptives and the existence of high levels of inequalities among the regions. There is a need for the implementation of focused educational initiatives and counseling interventions along with prioritization of accessibility and affordability of contraceptive methods among women in lower socioeconomic regions.

Introduction and Importance: Factor XIII (FXIII) deficiency, a rare coagulation disorder resulting from F13A1 gene mutations, can lead to severe bleeding episodes, especially in infants. The authors' case study featuring a 16-year-old female with a history of this deficiency revealed intracranial hemorrhage necessitating immediate medical intervention. The text emphasizes the importance of understanding the epidemiology and genetics of FXIII deficiency, as well as the challenges in diagnosis and management., Case Presentation: A 16-year-old female with FXIII deficiency presented to the Emergency Department (ER) after a fall, experiencing weakness on her right side, headache, seizures, and altered consciousness. Neurological examination showed weakness and increased tone on the right side of the body. Computed tomography (CT) scan revealed an intracranial subdural hemorrhage overlying the superior parietal lobe. Treatment included IV fluids, sodium valproate, antibiotics, fresh frozen plasma, and mannitol. Serial neurological assessments were normal, and the patient remained stable. MRI later confirmed hemorrhage. Upon discharge, she was prescribed medication and physiotherapy, leading to significant improvement at the 6-month follow-up., Clinical Discussion: The prevalence of FXIII deficiency, a rare disorder, is higher in populations with consanguineous marriages, particularly in regions like Pakistan, India, Tunisia, Finland, and Iran due to specific genetic mutations. Diagnosis involves thorough evaluation and specific lab tests, with varied clinical symptoms including prolonged bleeding, especially in newborns. FXIII deficiency can also develop in association with conditions like hepatic failure and leukemia, complicating diagnosis. Treatment options include blood products and recombinant FXIII, with management of intracranial bleeding requiring a multidisciplinary approach., Conclusion: The case underscores the critical need for early identification and specialized care for individuals with FXIII deficiency to mitigate life-threatening complications like intracranial hemorrhage, promoting tailored treatment approaches and improved patient outcomes., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

The expansion of E-wallet service providers in Indonesia is quite encouraging. In its report, Bank of Indonesia indicated that 48 E-wallet services are lawful. This is consistent with the number of E-wallet transactions, where USD 1.5 billion were recorded in 2018 and this number is expected to increase in 2023. This statistic increases the researcher's motivation to investigate E-wallet acceptability in Indonesia. The intention to use e-wallets among Indonesian adults must be studied in order to comprehend adoption factors, identify user preferences, inform marketing strategies, promote financial inclusion, and inform policy and regulatory decisions. This cross-sectional quantitative study conducted in Indonesia aimed to examine the factors influencing the formation of an intention to use electronic wallets (E-Wallets). It focused on perceived ease of use, perceived trust, perceived risk, perceived usefulness, social influence, compatibility, facilitating conditions, and perception of new technology. While previous studies have explored factors influencing users' intention to adopt electronic wallets, few have explicitly focused on mediating factors in the Indonesian context. This study fills this gap by investigating the mediating factors that affect Indonesian users' intention to adopt electronic wallets. It enhances the understanding of the direct factors influencing users' intention and sheds light on the complex relationships of other factors (mediators) that explain the underlying dynamics of this phenomenon. The study analyzed data from 384 valid participants using partial least squares and structural equation modeling with Smart PLS 4.0. The findings revealed that e-wallet facilitating conditions, perceived usefulness, perceived trust, compatibility, perception of risk, and perception of new technology positively and significantly influenced users' intention to use e-wallets in Indonesia. However, social influence and ease of use did not have a positive impact on e-wallet adoption intention among the Indonesian sample. The implications of this study suggest that e-wallet providers should prioritize balancing ease of use and security in their systems. If an e-wallet system is perceived as too easy to use, it may raise concerns about safety and unauthorized access, negatively affecting users' intention to adopt electronic wallets. Therefore, e-wallet providers should ensure user-friendly systems that address security concerns. Future research should explore other factors related to e-wallet adoption and assess their long-term effects on users' intention to use and adopt e-wallets. Despite its limitations, this study provides valuable insights for e-wallet providers, policymakers, and researchers in understanding electronic wallet adoption in Indonesia. It offers guidance for developing effective strategies and interventions to promote widespread adoption and use of electronic wallets., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Published by Elsevier Ltd.)

Organizations are increasingly adopting green human resource management policies to encourage environmentally friendly behaviors. Research shows that adopting green policies and procedures is beneficial for the hospitality industry. However, limited empirical evidence exists on the association between environmental-specific ethical leadership, psychological green climate, and employees' green behavior. Therefore, this study intends to examine psychological green climate (PGC) as a mediator between the relationship of environmental-specific ethical leadership (ESEL) and employees' green behavior (EGB), specifically in the hotel industry of Pakistan. Data from 224 non-managerial position employees in the understudy sector was collected using a convenient sampling technique. Structural equation modeling (SEM) was utilized to examine the direct and indirect effects among the variables using the Smart PLS 3.3.3 version. This study showed that ESEL is positively related to PGC and EGB. Moreover, PGC is positively associated with EGB, and PGC mediated in the relationship between ESEL and EGB. Thus, current research highlights the significance of environmental-specific ethical leadership behavior, which assists in establishing a green psychological climate, thereby fostering employees' green behavior in the hotel industry of Pakistan., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Khan, Cheng, Yasir, Saufi, Nawi and Bazkiaei.)

In Pakistan, women face economic and social vulnerability, which keeps them underpaid even without social barriers. Government micro and macroeconomic policies are aimed at income generation rather than making women part of the economic mainstream. The cash transfer program is an essential component of social protection policy in the developing world, with one of its key objectives of raising women's financial autonomy. This research investigates the impact of Pakistan's first and largest cash transfer program, named Benazir Income Support Program (BISP), on women's vulnerable employment. BISP was initiated by identifying poor households based on poverty score cutoff, thereby exploiting Regression Discontinuity Design. The findings revealed that this program reduced vulnerable employment in the initial years of its inception. However, it does not impact the later follow-up years. Policymakers should take necessary measures so that women's non-vulnerable employment may improve., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors. Published by Elsevier Ltd.)

The objective of the study is to examine the relationship between environmental indicators and health expenditures in the panel of five selected Asian countries, over the period of 2000-2013. The study used panel cointegration technique for evaluating the nexus between environment and health in the region. The results show that energy demand, forest area, and GDP per unit use of energy have a significant and positive impact on increasing health expenditures in the region. These results have been confirmed by single equation panel cointegration estimators, i.e., fully modified ordinary least squares (FMOLS), dynamic OLS (DOLS), and canonical cointegrating regression (CCR) estimators. In addition, the study used robust least squares regression to confirm the generalizability of the results in Asian context. All these estimators indicate that environmental indicators escalate the health expenditures per capita in a region; therefore, Asian countries should have to upsurge health expenditures for safeguard from environmental evils in a region.

Background/purpose: The aim of this study was to evaluate the anomalous clinical anatomy of congenital pouch colon (CPC) associated with anorectal agenesis in 22 consecutive girls managed over a study period of 7 years., Methods: The 22 patients were categorized into 2 groups. Group A consisted of 10 patients who presented during the neonatal period (n = 9) or as a young infant (n = 1). In these patients, only preliminary assessment results were available. Group B (12 patients) comprised 5 newborns who remained on follow-up and 7 patients who presented after the age of 1 year. These 12 patients were assessed and investigated in more detail., Results: In group A patients, apart from absence of the normal anal opening, the appearance of the external genitalia and perineum was essentially normal. Retraction of the labial folds showed radiation of folds inward from the margins of the vulval vestibule toward the center, at a point of confluence located at a higher level. At laparotomy, the subtypes of CPC were type I (n = 4), type II (n = 5), and type III (n = 1). In 8 patients, uterus didelphys was present. In all group B patients, the appearance of the external genitalia was similar to that in group A patients. However, separate openings of the urethra, septate vagina, and vestibular fistula (if present) were visible in 5 patients, whereas in 3 patients, a single perineal opening was identified. A total of 9/12 patients (75%) had urinary incontinence. Examination under anesthesia and endoscopy revealed a septate vagina in all 12 patients and an open, incompetent bladder neck with reduced bladder capacity in the 9 patients with urinary incontinence. The terminal fistula of the colonic pouch opened just distal to the bladder neck (n = 1), just posterior and cephalad to the urethral opening (n = 2), low in the vestibule (n = 5), and undetermined (n = 4). The subtypes of CPC were type I CPC (n = 2), type II CPC (n = 9), and type III CPC (n = 1). All 12 patients had uterus didelphys., Conclusions: The characteristics in the anomalous clinical anatomy of CPC in girls, as described here, appear to be almost invariable and, especially in regions where CPC is common, should alert the clinician to the presence of this malformation., (Copyright © 2011 Elsevier Inc. All rights reserved.)