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Abstract Vitamin D deficiency is common in many societies and causes rickets and non-skeletal disorders in children. There are no published data on vitamin D deficiency in Afghanistan. We, therefore, investigated the prevalence and associated factors of vitamin D deficiency in Afghan school children in Kandahar City, Afghanistan. This cross-sectional analytical study was conducted from September 2022 to April 2023 in 510 primary school students aged 6–15 years from six randomly selected schools. Data were analyzed by using descriptive statistics, Chi-square test, and multivariate logistic regression. Of the 510 enrolled children, 54.3% were boys and 91.8% were poor. The mean serum 25(OH)D concentration was 9.3 ng/mL. Vitamin D deficiency (

Abstract Background Undernutrition, which includes stunting, wasting, and underweight, is a global problem, especially among children of low- and middle-income countries. To our knowledge, this study is first of its type from Afghanistan. Its main objectives were to estimate the prevalence and associated risk factors of stunting, wasting/thinness, and underweight among urban primary school children in Kandahar city of Afghanistan. Methods This school-based cross-sectional study was conducted among 1205 primary school children aged 6–12 years during a period of six months (October 2022–March 2023). Anthropometric measurements and other data were collected from all the participants. Data were analyzed by using descriptive statistics, Chi square test (using crude odds ratio or COR), and multivariate logistic regression (using adjusted odds ratio or AOR). Results Among the 1205 enrolled government school students, 47.4%, 19.5%, and 25.6% had stunting, wasting/thinness, and underweight, respectively. Statistically significant factors associated with stunting were age group 6–9 years (AOR 1.3, 95% CI 1.1–1.7), being girl (AOR 2.3, 95% CI 1.8–3.0), poverty (AOR 2.2, 95% CI 1.5–3.2), large family (AOR 3.0, 95% CI 2.4–3.9), illiterate mother (AOR 1.6, 95% CI 1.0–2.6), jobless head of the family (AOR 3.3, 95% CI 2.3–4.8), and skipping breakfasts (AOR 1.7, 95% CI 1.2–2.3). Main factor associated with wasting/thinness were age group 6–9 years (AOR 30.5, 95% CI 11.8–78.7), skipping breakfasts (AOR 22.9, 95% CI 13.9–37.8), and history of sickness during the past two weeks (AOR 17.0, 95% CI 6.6–43.8). Also, main factors associated with underweight were age group 6–9 years (AOR 2.6, 95% CI 1.6–4.1), skipping breakfasts (AOR 2.6, 95% CI 1.8–3.6), and poor sanitation (AOR 1.9, 95% CI 1.1–3.2). Conclusions Stunting, wasting/thinness, and underweight are highly prevalent among primary school children (both girls and boys) in Kandahar city. It is recommended that local government (Afghanistan Ministry of Education and Ministry of Public Health) with the help of international organizations and donor agencies should implement comprehensive school-based feeding programs especially for girls. Health and nutrition education programs should be conducted with emphasis on nutrition of children aged 6–9 years as well as importance of healthy breakfast and good sanitation.

Traditional Shipping ‘Pelra’ as part of the maritime transportation system is expected to support the concept of blue economy `in order to accelerate the national economy. Pelra, with all its limitations, is still the backbone of the maritime populist economy to support inter-island trade in Indonesia, especially the logistics distribution system services for the Disadvantaged, Outermost, Frontier, and Border Areas (“3TP”)’. Traditional Shipping has not implemented a standardized Safety Management System (SMS) as in National shipping, so it often has accidents. The study analyzed the extent of the opportunity to apply SMS on Pelra ships by considering the characteristics of the water area (shipping lanes and wave conditions), as well as the incidence of accidents. It was found that the size of Pelra ships sailing in East Nusa Tenggara waters is dominated by vessels smaller than GT 100, making it possible to apply SMS. Factors that need to be considered in the implementation so that it is more effective are the resources and personnel (HR) factor, the responsibility and authority of the crew, and the responsibility and authority of authority of the company (Corp).

Background Measuring health status by using standardized and validated instrument has become a growing concern over the past few decades throughout the developed and developing countries. The aim of the study was to investigate the overall self-reported health status along with potential inequalities by using EuroQol 5 dimensions (EQ-5D) instrument among low-income people of Bangladesh. Methods A cross-sectional household survey was conducted in Chandpur district of Bangladesh. Bangla version of the EQ-5D questionnaire was employed along with socio-demographic information. EQ-5D questionnaire composed of 2-part measurements: EQ-5D descriptive system and the visual analogue scale (VAS). For measuring health status, UK-based preference weights were applied while higher score indicated better health status. For facilitating the consistency with EQ-5D score, VASs were converted to a scale with scores ranging from 0 to 1. Multiple logistic regression models were also employed to examine differences among EQ-5D dimensions. Results A total of 1433 respondents participated in the study. The mean EQ-5D and VAS score was 0.76 and 0.77, respectively. The females were more likely to report any problem than the males (P < 0.001). Compared to the younger, elderly were more than 2-3 times likely to report any health problem in all EQ-5D dimensions (OR [odds ratio] = 3.17 for mobility, OR = 3.24 for self-care). However, the respondents of the poorest income group were significantly suffered more from every EQ-5D dimension than the richest income quintile. Conclusion Socio-economic and demographic inequalities in health status was observed in the study. Study suggests to do further investigation with country representative sample to measure the inequalities of overall health status. It would be helpful for policy-maker to find a new way aiming to reduce such inequalities.

Left ventricular (LV) dysfunction is a well known complication following ST-segment elevation myocardial infarction (STEMI). Tissue Doppler imaging (TDI) is used as a non-invasive method to assess LV diastolic function. Measurements obtained from TDI augment the prognostic information of clinical risk score. In this study, we are trying to use TDI to predict the development of LV dysfunction (LVEF% 8.0 showed high sensitivity and specificity, 93% and 89%, respectively. Also, a baseline cutoff value of E/e′ ratio at the septal mitral annulus >10.0 had a sensitivity of 79% and specificity of 88%. In conclusion, selected TDI parameters (e′-wave and E/e′ along the septal and lateral mitral annulus) could guide post-STEMI risk stratification, and thus predicting LV dysfunction.

The control and maintenance of inventories is a problem common to all enterprises in any sector of a given economy. Two fundamental question that must be answered in controlling the inventory are when to replenish the inventory and how much to order for replenishment. The (Q,r) inventory models attempt to answer the two question under a variety of circumstances. Studies have shown, (1) that a company that ignores lead-time demand variability may suffer great financial damage, (2) that the gamma distribution provides the most common best fit to lead-time demand for variety of inventories items, (3) that a fixed lead-time demand assumption or a normal approximation to it will often yield significant errors (Namit and Chen, 1998).This research performed an efficient and accurate algorithm for solving (Q,r) inventory model with gamma lead-time demand.