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INTRODUCTION: Anxiety and depression are common mental illnesses among cancer caregivers. Most caregivers often sacrifice a lot of time, energy and their own physical and emotional needs. MATERIALS AND METHOD: A cross sectional study was conducted among 156 caregivers of cancer patients who provided treatment and moral support to cancer patients at the Oncology clinic of Sultan Ismail Hospital (SIH), Johor Bahru, Malaysia. The Hospital Anxiety Depression Scale (HADS) was used to assess the depression and anxiety levels among the respondents. Data was analysed using Statistical Package for Social Sciences version 17.0 software. The P value of less than 0.5 was taken a significant. RESULTS: In general, there was moderate relationship between cancer caregivers and patients in term of emotional, care and patient treatment, but in some circumstances, caregivers were also exposed to risk during care period of cancer patients. There was a significant relationship with moderate correlation between factors of taking care of emotion of patients (p<0.05, r=0.403), their diseases (p<0.05, r=0.456) and treatment (p<0.05, r=0.600) with the level of anxiety. There was a strong correlation between caring and anxiety in the item of lack of attention on patient demand (p<0.05, r=0.91) and not angry to patient (p<0.83). CONCLUSION: The awareness regarding the anxiety and depression among caregivers need to be increased among health professionals such as physicians and nurses. Although the interventions are aimed to help the patients, but this can also cause anxiety and depression to caregivers. [ABSTRACT FROM AUTHOR]

Accurate numerical solution of parabolic and elliptic partial differential equations governing two-dimensional heat transfer is critical for engineering simulations but computationally challenging.This work employs key numerical techniques finite differences, conjugate gradients, and Crank-Nicolson time stepping to solve the heat diffusion equation and analyze method performance.The Poisson equation is discretized using second-order central finite differences and solved with the conjugate gradient approach to determine the steady state solution. The transient heat equation is integrated in time via the Crank-Nicolson implicit scheme, also utilizing conjugate gradients.The methods effectively compute solutions matching analytical and boundary conditions. Convergence and stability are achieved while capturing transient thermal evolution. Insights are gained into discretization and iteration parameter impacts.The numerical framework demonstrates accurate and efficient simulation of two-dimensional conductive heat transfer. It provides a template for extension to more complex geometries and multiphysics phenomena, contributing to advances in computational engineering.

Islamic thought has produced many intellectual and scientific schools, within which many personalities in different scientific fields have emerged. Al-Zamakhshari (d. 538H) is regarded as one of the most influential figures from the Mu’tazila school of thought in the history of Arab and Islamic culture. This study aims to reveal the direction and impact of Mu'tazila thought on the interpretation of verses related to Istiwa through Zamakhshari's book "Al-Kashaf" to expand the definition of the linguistic meanings presented by Al-Zamakhshari and analyze the contexts in which he dealt with this concept. The significance of this article lies in understanding the mechanisms of interpretation upon which Al-Zamakhshari relied in defending his belief by using reasoning and language to disassociate and free the Almighty from being similar or resembling the creature. The research used the descriptive-analytical approach to highlight the aspects used in al-Zamakhshari's interpretation of the concept of Istiwa. The study finds that the interpretations of the verses related to al-Istiwa Zamakhshari are purely linguistic-based interpretations, which he employs and links to the significance and context meaning according to what supports his Mu’tazili doctrine.

لقد أخرج الفكر الإسلامي لنا العديد من المدارس الفكرية والعلمية التي حوت بداخلها العديد من الشخصيات في شتى المجالات العلمية. ويعد السعدي والصابوني من أهم هذه الشخصيات في مجال التفسير، ويعد تفسيرهما موسوعة علمية جديرة بالدراسة والبحث لما فيهما من درر وفوائد علمية. يعمد هذا البحث الكشف عن الدلالة العقلية والاستدلال بها في تفسيري السعدي والصابوني بهدف إبراز مكانة العقل عندهما, وإبراز دور تفسيرهما في توضيح معاني القرآنية، ومدى ارتباط هذا الفن بالعلوم الأخرى ، وذلك من خلال عرض نماذج تقوم بتحليل السياقات التي تناولا فيها هذا المفهوم مع عقد المقارنة بينهما. وقد سار البحث على المنهج الوصفي التحليلي لإبراز الجوانب المعتمدة في الاستدلال بالعقل عند الشيخين المذكورين ، ومن أهم نتائج هذا البحث أن تفسير السعدي مبني على التفسير بالرأي المحمود، بخلاف الصابوني فإنه يعتمد على النصوص الشرعية خصوصا في شرح الآيات،كما يمتاز تفسير السعدي على الصابوني من حيث التركيز على فك المعاني بطريقة سهلة يفهمها كل من عرف العربية أي أنه يعتني بالمعنى أولا، بخلاف الصابوني حيث اعتمد على الظواهر اللغوية والبلاغية، وهذا زاد لتفسير الصابوني روعة على تفسير السعدي.

Immunization of pregnant women against tetanus is a key strategy for reducing tetanus morbidity and mortality while also achieving the goal of maternal and neonatal tetanus elimination. Despite substantial progress in improving newborn protection from tetanus at birth through maternal immunization, umbilical cord practices and sterilized and safe deliveries, inequitable gaps in protection remain. Notably, an infant’s tetanus protection at birth is comprised of immunization received by the mother during and before the pregnancy (e.g., through childhood vaccination, booster doses, mass vaccination campaigns, or during prior pregnancies). In this work, we examine wealth-related inequalities in maternal tetanus toxoid containing vaccination coverage before pregnancy, during pregnancy, and at birth for 72 low- and middle-income countries with a recent Demographic and Health Survey or Multiple Indicator Cluster Survey (between 2013 and 2022). We summarize coverage levels and absolute and relative inequalities at each time point; compare the relative contributions of inequalities before and during pregnancy to inequalities at birth; and examine associations between inequalities and coverage levels. We present the findings for countries individually and on aggregate, by World Bank country income grouping, as well as by maternal and neonatal tetanus elimination status, finding that most of the inequality in tetanus immunization coverage at birth is introduced during pregnancy. Inequalities in coverage during pregnancy are most pronounced in low- and lower-middle-income countries, and even more so in countries which have not achieved maternal and neonatal tetanus elimination. These findings suggest that pregnancy is a key time of opportunity for equity-oriented interventions to improve maternal tetanus immunization coverage.

Abstract Background As of October 2021, 47 (80%) of the 59 countries, identified at highest risk for Maternal and Neonatal Tetanus (MNT), had been validated for elimination. We assessed sustainability of MNT elimination (MNTE) in 28 countries that were validated during 2011‒2020. Methods We assessed the attainment of the following MNTE sustainability indicators: 1) ≥ 90% coverage with three doses of Diphtheria-Tetanus-Pertussis vaccine (DTP3) among infants

Ethnic majority culture (i.e. Malay) has given much influence on the biological and psychosocial aspect of immigrants in Malaysia. This study aims to examine the neuro-culture interaction among immigrants (historical and current immigrant) with regards to their emotional response towards Malay cultural heritage visualization. The Event Related Potential technique was used to explore the neural activity of the mental and emotional processes in response to specific culture-related stimuli. A modified oddball paradigm was applied in the presentation of the visual stimulus that was set-up in the e-prime program. Significant neuro-culture interaction was observed in the temporal area (T6) of the brain which was consistent in P300 and N200 amplitude. Current immigrants indicated significant lower P300 and N200 amplitudes, as compared to majority ethnicity (i.e. Malay). Long- and short-term exposure to cultural environment has an important consequence in the psycho-biological system.

Introduction-Aims: In the modern days, traditional games have been perceived less preferred than universal games. This study examines the emotional reflection of Malaysians and Immigrants in Malaysia towards Malay traditional games and universal games. Malays (ethnic majority), Malaysian minorities (Chinese and Indian) and immigrants responded to the displayed images of Malay traditional games and universal games using a 9-point rating scale for valence domain of Self-Assessment Manikin. The emotional pleasantness towards Malay traditional games are higher in immigrants than Malaysians. There are emotional similarities between Malays and Malaysian minorities. Socio-cultural factors should be examined in future research to further understand this cultural situation.

Objective: To compare the complications and associated risk factors between primary and elective percutaneous coronary intervention (PCI) among patients attending emergency department of a tertiary care hospital, Karachi, Pakistan. Methods: This retrospective cross-sectional study was conducted at Dr. Ziauddin University Hospital, Clifton campus, Karachi, from April 2019 to March 2021. All patients who underwent elective or primary PCI over the age of 18 years were included. The complications such as hypotension, coronary dissection, no-reflow, coronary perforation, arrhythmias, cardiac tamponade, stent thrombosis, and in-hospital death were observed. These complications were followed up till one month after the PCI. Results: Of total 155 patients, the mean age was 60.77 ± 11.15 years. There were 104 (67.1%) males and 51 (32.9%) females. Primary PCI was performed among 103 (66.5%) patients and elective PCI in 52 (33.5%) patients. Complications of PCI was observed in 94 (60.6%) patients. The most common complication presented was no-reflow 31 (32.9%). However, 14 (14.8%) patients presented with hypotension and 10 (10.5%) with hypotension along with no-reflow. Complications were found to be significantly higher in primary PCI 76 (73.8%) as compared to elective PCI 18 (34.6%) (p-value

Substantial progress in maternal and neonatal tetanus elimination has been made in the past 40 years, with dramatic reductions in neonatal tetanus incidence and mortality. However, twelve countries have still not achieved maternal and neonatal tetanus elimination, and many countries that have achieved elimination do not meet key sustainability thresholds to ensure long-lasting elimination. As maternal and neonatal tetanus is a vaccine-preventable disease (with coverage of the infant conferred by maternal immunization during and prior to pregnancy), maternal tetanus immunization coverage is a key metric for monitoring progress towards, equity in, and sustainability of tetanus elimination. In this study, we examine inequalities in tetanus protection at birth, a measure of maternal immunization coverage, across 76 countries and four dimensions of inequality via disaggregated data and summary measures of inequality. We find that substantial inequalities in coverage exist for wealth (with lower coverage among poorer wealth quintiles), maternal age (with lower coverage among younger mothers), maternal education (with lower coverage among less educated mothers), and place of residence (with lower coverage in rural areas). Inequalities existed for all dimensions across low- and lower-middle-income countries, and across maternal education and place of residence across upper-middle-income countries. Though global coverage changed little over the time period 2001–2020, this obscured substantial heterogeneity across countries. Notably, several countries had substantial increases in coverage accompanied by decreases in inequality, highlighting the need for equity considerations in maternal and neonatal tetanus elimination and sustainability efforts.

Summary: This systematic review assessed the progress and barriers towards maternal and neonatal tetanus elimination in the 12 countries that are yet to achieve elimination, globally. Coverage of at least 80% (the coverage level required for elimination) was assessed among women of reproductive age for five factors: (1) at least two doses of tetanus toxoid-containing vaccine, (2) protection at birth, (3) skilled birth attendance, (4) antenatal care visits, and (5) health facility delivery. A scoping review of the literature and data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys provided insights into the barriers to attaining maternal and neonatal tetanus elimination. Findings showed that none of the 12 countries attained at least 80% coverage for women of reproductive age receiving at least two doses of tetanus toxoid-containing vaccine or protection at birth according to the data from Demographic and Health Surveys or Multiple Indicator Cluster Surveys. Barriers to maternal and neonatal tetanus elimination were mostly related to health systems and socioeconomic factors. Modification to existing maternal and neonatal tetanus elimination strategies, including innovations, will be required to accelerate maternal and neonatal tetanus elimination in these countries.

Adapting to the new home settlement has significant implications on psychological dimension. This study aims to examine the emotional expression of the immigrants towards the Malay traditional food - the cultural heritage of the ethnic majority in Malaysia, in comparison to Malaysian Malay and Malaysian non-Malay. Through the visualization approach, participants were asked to respond to a series of Malay traditional food images and self-rated their emotional expression by using the Self-assessment Manikin. Emotional expression was significantly lower in immigrants in comparison to Malaysian Malay and Malaysian non-Malay. Acculturation (tendency towards own cultural heritage) factor explained 6% of the variance of emotional expression of the immigrants. Immigrants are undergoing an emotional adaptation while settling in new home.

Background: Aging results in many changes in health status, body composition, muscle strength, and, ultimately, functional capacity. These changes coincide with significant alterations in the endocrine system, such as insulin-like growth factor-1 (IGF-1) and IGF-binding proteins (IGFBPs), and may be associated with many symptoms of aging. The objectives of this study is to investigate the potential influence of different types of exercise, such as resistance training and aerobic training, on IGF-1 and IGFBP-3 levels in postmenopausal women., Methods: Medline, Scopus, and Google Scholar databases were systematically searched up to November 2023. The Cochrane Collaboration tool was used to assess the risk of bias and the quality of the studies. The random-effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used to estimate the overall effect. Between-study heterogeneity was assessed using the chi-squared and I 2 tests., Results: Seventeen studies were included in the present systematic review and 16 studies were included in the meta-analysis. The pooled results from 16 studies (21 trials) with 1170 participants examining the impact of exercise on IGF-1 concentration showed a significant increase in IGF-1, and the pooled results among six studies (trials) showed a significant decrease in IGFBP-3 concentration (730 participants). In addition, resistance training and aerobic training had a significant effect on increasing IGF-1 concentration post-exercise compared with placebo., Conclusion: Based on this meta-analysis, Women who have completed menopause and followed an exercise routine showed changes in IGF-1 and IGFBP-3 levels that can indirectly be associated with risk of chronic age-related conditions., (© 2024. The Author(s).)

Aims: Long term cardiovascular outcome comparison of multivessel coronary disease among patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is limited. The objective of this study was to compare the long-term cardiovascular outcome PCI vs CABG among DM patients with multivessel disease., Method and Results: Online databases were explored to identify studies that compared cardiovascular outcomes between PCI and CABG among patients with DM. The primary outcome was all-cause mortality. Secondary outcomes included major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction (MI), rate of revascularization, cardiac death, and cerebrovascular accident (CVA). A total of 27 studies with 37,091 (PCI n = 19,838 (53 %) and CABG n = 17,253 (47 %)) patients were included. The mean age was 64 ± 5.9 years for PCI group and 63.8 ± 5.3 years for CABG group; and, predominantly male (71.22 % vs 74.29 %) for PCI and CABG respectively. The most common comorbidity was hypertension (64.35 % vs 62.88 %) in both PCI and CABG respectively. Compared with CABG, PCI group had a higher odds of overall all-cause mortality (OR 1.18, 95 % CI 1.02-1.37, p = 0.03), MACCE (OR 1.52, 95 % CI 1.31-1.75, p = 0.00), MI (OR 1.85, 95 % CI 1.46-2.36, p = 0.00), repeat revascularization (OR 3.08, 95 % CI 2.34-4.05, p = 0.00) and cardiac death (OR 1.27, 95 % 1.02-1.59, p = 0.04), while CVA (0.57, 95 % CI 0.37-0.86, p = 0.01) was higher with CABG., Conclusion: Diabetic patients with multivessel coronary artery disease have worse outcomes undergoing PCI as compared to CABG. However, CVA was significantly higher with CABG. CABG remains the preferred management among eligible patients with multivessel disease and DM., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Although various dietary patterns have been indicated to be associated with the resting metabolic rate [RMR], limited data are available in this field. This study was therefore focused on the association between dietary patterns and resting metabolic rate among participants with overweight and obesity., Methods: This cross-sectional study was conducted on 304 women with overweight or obesity (BMI ≥ 25 kg/m 2 ), aged 18-50. Anthropometric assessments, physical activity and biochemical measurements were assessed. RMR was also measured by means of indirect calorimetry. Dietary intake of participants was evaluated by 147-item semi-quantitative food frequency questionnaire [FFQ]., Results: There was a significant association between higher adherence to the healthy dietary pattern [HDP] and RMR (P = 0.05), intakes of protein (P = 0.003), minerals (P = 0.001) as well as fat free mass [FFM] (P = 0.002), bone mineral content (P = 0.001), skeletal muscle mass (P = 0.001), soft lean mass (P = 0.002) and visceral fat area (P = 0.05). Also, there was a considerable association between higher adherence to the unhealthy dietary pattern [UHDP] and fasting blood sugar [FBS] (P = 0.05). Using multinomial logistic regression has been shown that the medium adherence to the HDP was marginally significant with decreased resting metabolic rate [Dec. RMR] group in crude model (OR: 0.54; 95% CI: 0.28-1.05, P = 0.07). After controlling for various confounders such as age, FFM, physical activity, and energy intake, the association between Dec. RMR group and the lowest quartile of the HDP (OR: 0.36; 95% CI: 0.14-0.91, P = 0.03) became significant as well as the association between Dec. RMR group and medium adherence to the HDP (OR: 0.42; 95% CI: 0.18-0.97, P = 0.04). The medium adherence to the UHDP in crude model was also significant with increased resting metabolic rate [Inc. RMR] group (OR: 2.59; 95% CI: 1.01-6.65, P = 0.04)., Conclusions: Our study showed that there are significant associations between dietary patterns and RMR status., (© 2022. The Author(s).)

Objective: Mental health, sleep quality, and dietary intake are interlinked. Impairment of mental health and low sleep quality may contribute to obesity through the consumption of diets high in energy density. Nevertheless, it is not clear whether dietary energy density (DED) influences mental health. This study aimed to examine the association of DED with mental health indices, including depression, anxiety, stress, and sleep quality in women with overweight/obesity., Results: There was a decreasing trajectory in serum triglyceride across quartiles of DED (from Q1 to Q4) in the crude analysis and also after adjustment for age, BMI, and physical activity After adjustment for age, BMI, and physical activity, subjects in the highest quartile of DED had higher systolic and diastolic blood pressure. DED was significantly associated with increased odds of stress in the crude (OR = 2.15, 95% CI 1.01-4.56, p = 0.04) and adjusted model for age, BMI, and physical activity (OR = 2.56, 95% CI 1.13-5.79, p = 0.02). No significant relationship was observed between DED and depression, anxiety and sleep quality. In conclusion, current study shows preliminary evidence of an association between DED and stress.

Background: Recent studies have shown that depression is inversely correlated with high protein and low fat intake and positively correlated with vitamin D-binding protein (VDBP). Therefore, the aim of this study was to examine the interaction between protein/fat dietary patterns and VDBP genotypes with regard to the risk of depression in apparently healthy adults who have not been diagnosed with any chronic disease., Methods: In this study, 265 individuals (126 males and 139 females) aged 18-55 years were recruited from the communities of central and west Tehran based on convenience sampling. Body composition was measured with a body composition analyzer and depression symptoms were categorized as normal, moderate depression, or severe depression using the Depression Anxiety Stress Scales 21 (DASS-21) questionnaire. Dietary patterns were determined by a semiquantitative food frequency questionnaire to assess typical food intake during the 12-month period. Blood samples were collected from and biochemical measurements performed on all participants. An analysis of two polymorphisms (rs7041 and rs4588) in the GC gene, which encodes VDBP, was performed by polymerase chain reaction-restriction fragment length polymorphism., Results: A statistically significant association was found between depression and diet (p = 0.03) after having categorized the participants into three groups: a high-protein/low-fat (HP/LF) group, a moderate-protein/moderate-fat (MP/MF) group, and a low-protein/high-fat (LP/HF) group. Moreover, the findings demonstrated that depression was related to both the rs7041 and the rs4588 polymorphism (p = 0.05 and p = 0.02, respectively). We next used multinomial logistic modeling to investigate the risk of depression. A significant interaction was observed between HP/LF diet and the rs7041 polymorphism in the moderate- and severe-depression groups (β = -0.30, p = 0.05, and β = -0.48, p = 0.01, respectively)., Conclusion: This study showed that an HP/LF diet interacts with the rs7041 polymorphism, with T allele carriers having a greater prevalence of moderate and severe depression., (© 2018 S. Karger AG, Basel.)