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Background Antenatal care (ANC) is essential for ensuring the well-being of pregnant women and their fetuses. This study models the association between achieving adequate ANC and various health and health-seeking indicators across wealth quintiles in low- and middle-income countries (LMICs). Methods and findings We analyzed data from 638,265 women across 47 LMICs using available Demographic and Health Surveys from 2010 to 2022. Via multilevel logistic regression analyses adjusted for a series of confounding variables and country and wealth quintile fixed effects, we estimated the projected impact of achieving adequate ANC utilization and quality on a series of health and health care indicators: facility birth, postnatal care, childhood immunizations, and childhood stunting and wasting. Achieving adequate levels of ANC utilization and quality (defined as at least 4 visits, blood pressure monitoring, and blood and urine testing) was positively associated with health-seeking behavior across the majority of countries. The strongest association was observed for facility birth, followed by postnatal care and child immunization. The strength of the associations varied across countries and wealth quintiles, with more significant ones observed in countries with lower baseline ANC utilization levels and among the lower wealth quintiles. The associations of ANC with childhood stunting and wasting were notably less statistically significant compared to other indicators. Despite rigorous adjustments for potential confounders, a limitation to the methodology is that it is possible that unobserved variables may still impact outcomes. Conclusions Strengthening ANC is associated with improved use of other health care in LMICs. ANC could serve as a critical platform for improving health outcomes for mothers and their children, emphasizing its importance beyond direct impact on maternal and neonatal mortality., Author(s): Boshen Jiao 1, Isabelle Iversen 1, Ryoko Sato 1, Clint Pecenka 2, Sadaf Khan 2, Ranju Baral 2, Margaret E. Kruk 1, Catherine Arsenault 3, Stéphane Verguet 1,* Introduction [...]

The necessity for a shift to alternative forms of energy is highlighted by both approaching consequences of climate change and limited availability of fossil fuels. While a large portion of energy required can be generated by solar and wind, a diverse, sustainable energy generation mix is still necessary to meet our energy needs. By capturing otherwise lost heat energy and turning it into valuable electrical energy, thermoelectric can play a significant part in this. Using the Seebeck effect, thermoelectric generators (TEG) have established their capability to transform thermal energy into electrical energy directly. Furthermore, because they do not include chemical compounds, they are silent in operation and can be built on various substrates, including silicon, polymers, and ceramics. Moreover, thermoelectric generators have a long operational lifetime, are position independent, and may be integrated into bulky, flexible devices. However, the low conversion efficiency of TEG has confined their broad application, hampering them to an academic subject. Until now, recent developments in thermoelectric generators and devices are presuming the technology to catch its place among state-of-the-art energy conversion systems. This review presents the commonly used methods for producing thermoelectric modules (TEMs) and the materials currently studied for TEMs in bulk and printed thermoelectric devices.

Biofilm-associated infections account for a large proportion of chronic diseases and pose a major health challenge. Metal nanoparticles offer a new way to address this problem, by impairing microbial growth and biofilm formation and by causing degradation of existing biofilms. This review of metal nanoparticles with antimicrobial actions included an analysis of 20 years of journal papers and patent applications, highlighting the progress over that time. A network analysis of relevant publications showed a major focus on the eradication of single-species biofilms formed under laboratory conditions, while a bibliometric analysis showed growing interest in combining different types of metal nanoparticles with one another or with antibiotics. The analysis of patent applications showed considerable growth over time, but with relatively few patents progressing to be granted. Overall, this profile shows that intense interest in metal nanoparticles as anti-biofilm agents is progressing beyond the confines of simple laboratory biofilm models and coming closer to clinical application. Looking to the future, metal nanoparticles may provide a sustainable approach to combatting biofilms of drug-resistant bacteria. [ABSTRACT FROM AUTHOR]

This article presents an overview of Aga Khan University's (AKU) pioneering medical education initiatives over the past 40 years, exploring its impact on healthcare in the region and its commitment to advancing medical education and research in the developing world. Established in 1983 as the first private university in Pakistan, AKU has evolved into a global institution with a focus on improving healthcare standards and addressing healthcare needs in the developing world. The article also discusses the undergraduate and postgraduate medical education programs at AKU Medical College, Pakistan, highlighting their unique features and pioneering approaches to medical education. The institution's journey highlights its ability to adapt to the evolving healthcare landscape while maintaining a focus on quality and excellence, offering a model for other institutions striving to meet healthcare needs in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

This paper studies the flexible Lomax distribution's order statistics with graphical and numerical findings. Along with the quantitative measurements, some plots are furnished, including those for the skewness and kurtosis measures. We will dwell on the numerous results that relate to statistics of moments of order. We consider the single and product moment of order statistics from the new distribution. Further, we establish some recurrence relation for single moments of order statistics. We have sought to apply the derived relations to empirically evaluate the moments of smallest (largest) order statistics to establish well-known moments and related measures. For order statistics of a flexible Lomax distribution, exact analytical expressions of entropy, residual entropy, and past latent entropy are determined. [ABSTRACT FROM AUTHOR]

Exploring the debate between Islamic and secular laws from the perspective of Islamists, this article suggests a way of rethinking the relationship between popular sovereignty and God’s sovereignty in the modern world. There has been a conundrum of calls for reform in Islamic law based on democratic principles in the contemporary world. Comparing the role of morality in Islamic and secular legal systems, highlighting their differences in the foundations and principles of morality in both systems, this article primarily argues that morality is essential for law in both systems. However, the examination of the issue of sovereignty, whether it belongs to the people or to God, explains why Islamists reject Westerninspired reforms in Islamic law. The article examines the principles of Islamic law and the concepts of fitrah (innate disposition) and deism to highlight the fundamental differences in sovereignty between the two systems. While the article acknowledges that Islam does not oppose democracy, it reflects on the Islamists’ contention that some modern democratic values are incompatible with Islamic law. It emphasises that arguments on morality should be based on Islamic law (Sharia’h), which is derived from the Qur’an and Sunnah and provides its own criteria for reform. In conclusion, the article stresses on the inherent conflicts between modern democratic values and Islamic law, and the need for independent and internally guided reform within the Islamic legal system which remains faithful to Islamic principles and free from conceptions strange to it. [ABSTRACT FROM AUTHOR]

This document is a correction notice for a paper titled "A new extended gumbel distribution: Properties and application." The correction addresses errors in the funding statement and author contributions. The correct funding statement acknowledges the Deanship Scientific Research (DSR), King Abdulaziz University, Jeddah for their technical and financial support. The correct author contributions are listed, including the roles of each author in the conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, and writing of the paper. The correction is reported by Aisha Fayomi, Sadaf Khan, Muhammad Hussain Tahir, Ali Algarni, Farrukh Jamal, and Reman Abu-Shanab. [Extracted from the article]

Introduction: A major goal in pediatric dentistry is to maintain primary dentition in an intact state until a permanent successor erupts. It should be retained in the oral cavity in a functional state with appropriate treatment. Among various treatment options, pulpotomy is the most widely accepted clinical procedure for treating primary teeth with inflammation of the coronal pulp caused by caries with no involvement of the radicular pulp. Aim and Objective of the Study: The aim and objective of this study were to compare and evaluate the clinical and radiographic success of mineral trioxide aggregate (MTA) pulpotomy versus Turmeric powder and Eggshell powder pulpotomy in primary teeth. Methodology: Thirty primary molars indicated for pulpotomy in children aged between 4 and 8 years were selected for the study and randomly divided into three groups, i.e., MTA, Turmeric powder, and Eggshell powder group. All pulpotomised tooth were restored with stainless steel crown. Follow-up was done after every 3, 6, and 9 months time interval to assess success and failure criteria clinically and radiographically. The data collected for all the groups will be subjected to statistical analysis. Observation: Results are awaited. [ABSTRACT FROM AUTHOR]

There are numerous reasons for underutilization of the public health sector for surgery in Pakistan. This results in patients being diverted to private hospitals or tertiary care centers in urban areas. Diversions overburden the hospitals and significantly increase out-of-pocket costs for the patients. This study aims to determine the barriers to surgical care in first-level hospitals in Pakistan's Sindh province. We conducted a concurrent nested mixed methods study from May to June 2021 in public sector first-level hospitals in the Sindh province. Fifteen hospitals in six districts were surveyed. A consolidated hospital assessment tool adapted from the World Health Organization's Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was used for quantitative data collection. Interview guides were developed for staff interviews. Availability of trained staff was found to be the biggest barrier to the provision of safe surgery. Only eight hospitals had a general surgeon, anesthesiologist, and obstetrician/gynecologist, while the remaining had 1-2 of the three disciplines. Thirteen hospitals had a functioning x-ray machine, while 14 facilities had functioning ultrasound machines with trained personnel to operate them. Only three facilities always had blood available for transfusion. The qualitative component corroborated that the biggest barrier to providing surgical care was the lack of human resources. The lack of human resources is difficult to overcome. We found evidence of task-shifting to medical officers and trainee anesthesiologists, but this is without discrete regulation and monitoring. Building surgical workforce capacity must be addressed in the interest of quality care. [ABSTRACT FROM AUTHOR]

Approximately five billion people do not have access to necessary surgical treatment globally and up to 85% of children in LMICs are affected with conditions requiring surgical care by the age of 15 years. It is crucial to identify common surgical conditions in children in Pakistan to inform healthcare professionals and policymakers for effective resource allocation. This representative cross-sectional household survey conducted on children aged 5-10 years assessed existing surgical diseases and healthcare-seeking behaviors in the two largest provinces (Sindh and Punjab) of Pakistan. The data was collected through a validated cross-sectional survey tool [Surgeons OverSeas Assessment of Surgical Need (SOSAS)]. Caregivers were asked about their child's recent and past surgical conditions in six distinct anatomical regions and pictures were taken of identified conditions after appropriate consent for further diagnosis. Health-seeking behaviors including the kind of treatment sought, the nature of care received, and the reasons for not receiving care were noted. 13.5% of children surveyed reported a surgical condition, with a similar distribution across urban (13.2%) and rural (13.7) areas and the most common cause was trauma. The greatest number of surgical conditions were found to be on the head and neck region (57.7%), while the back accounted for the least number of conditions (1.7%). Our results outline a need for organizing all entities (governmental, non-governmental, and private) involved in child health to ensure efficient resource allocation to cater to existing surgical problems., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Qazi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: To identify early treatment outcomes among patients having undergone ligation of intersphincteric fistula tract for complex fistula-in-ano in a tertiary care setting., Methods: The single-centre retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from January 2016 to January 2021 of adult complex fistula-in-ano patients who underwent ligation of intersphincteric fistula tract procedure. All surgeries were done by a single surgeon. Pre- and post-operative Wexner continence scores were measured, and various factors, including change in continence, complete wound healing, postoperative infection and recurrence, were assessed. Data was analysed using SPSS 23., Results: Of the 20 patients, 15(75%) were females and 5(25.0%) were males. The overall mean age was 38.4±13.8 years. The median duration of surgery was 65 minutes (interquartile range: 57-99 minutes). There were 2(10%) patients who showed a change in continence after surgery to flatus alone. Complete healing was noted in 11(55%) patients. Recurrence was noted in 8(40%) patients; trans-sphincteric fistula-in-ano in 2(10%) patients, and inter-sphincteric fistula in 6(30%). Body mass index had a significant association with the change in continence (p=0.028)., Conclusions: There was a comparable risk of recurrence after ligation of intersphincteric fistula tract surgery, but among those without recurrence, the post-operative outcomes were optimal and no faecal incontinence was noted.