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In this paper, a new robust computational method that applies the geometrical theory of diffraction (GTD) in conjunction with the ray tracing (RT) technique is developed to evaluate the electromagnetic scattering pattern due to a plane wave represented as beam of parallel rays incident on a rough surface of quite arbitrary statistical parameters. The development of the proposed technique is explained in detail taking into consideration the generation of the geometrical model of the rough surface. The Fresnel reflection model is applied under the assumption of arbitrary electrical and optical properties of the rough surface material. Also the polarization of the plane wave primarily incident on the rough surface is taken into consideration. The algorithm developed in the present work accounts for multiple bounces of an incident ray and, hence, it can be considered arbitrary higher-order GTD-RT technique. The accuracy of the obtained results is verified through the comparison with the experimental measurements of the scattering pattern of a light beam incident on rough sheets with specific statistical properties. The numerical results of the present work are concerned with investigating the dependence of the scattering pattern on the surface roughness, refractive index, angle of incidence, and the resolution of the geometric model of the rough surface. Also, it is shown that, for limited resolution of the rough surface model, the accuracy of the calculated scattered field depends on the angle of incidence of the primary beam and the surface roughness.

The study aimed to investigate parental knowledge of tobacco effects on health and parental perceptions on tobacco control measures at households in Dhaka city, Bangladesh. Out of 1436 tobacco-using parents, a total of 400 participants were selected for the cross-sectional survey using a multi-stage probability sampling. Overall knowledge and perceptions of parents were scored. Simple and multiple logistic regressions were performed. There were 19.8% of parents who had good knowledge about health effects of tobacco and 40.8% had positive perception on home initiatives of tobacco control measures respectively. The study revealed that knowledge of overall tobacco effects on health (AOR = 20.92, 95% CI = 2.60-167.83), asthma (AOR = 0.29, 95% CI = 0.17-0.49), infertility (AOR = 0.43, 95% CI = 0.24-0.77) and pre-eclampsia (AOR = 0.36, 95% CI = 0.14-0.90) were significantly increased the odds of parents good knowledge. Whereas, parental perceptions indicate that living in the joint family was positively associated with controlling tobacco use (AOR =3.10, 95% CI = 1.88-5.13). It suggests that health education programs need to be developed to improve parental awareness on the adverse health effects of tobacco-use at households.

The efficacy of renal sympathetic denervation (RSD) in the treatment of uncontrolled hypertension (HTN) remains uncertain. A systematic review of randomized controlled trials was performed to evaluate the efficacy and safety of RSD for resistant HTN. PubMed, EMBASE, MEDLINE, Cochrane, Directory of Open Access Journals, CINAHL, and Google Scholar were searched from January 01, 2001, through July 30, 2020. Randomized controlled trials comparing RSD with the sham procedure for uncontrolled HTN were selected. The primary efficacy outcome was the reduction in ambulatory systolic blood pressure. We used random-effects models. Nine prospective clinical trials met the inclusion criteria. The ReSet and Symplicity HTN-3 Trial showed no significant changes because of discrepancies in complete circumferential ablation during RSD. The Relief study, The Radiance HTN solo, and the SPYRAL HTN OFF medical trials showed a significant reduction in systolic blood pressure in the group that had undergone the intervention compared with the sham group attributed to rigorous trial design. In conclusion, our systematic review suggests that efficacy of RSD seems to be superior to sham-controlled interventions provided circumferential denervation is performed. However, difference in efficacy is marginal.

The novel Coronavirus (COVID-19) pandemic has become a real challenge for healthcare providers around the world. Recently, it has been recorded that among all the health care professionals dentists, dental assistants, and dental hygienists are at high risk as they are in close contact with patients and are exposed to body fluids of patients. To assess the knowledge and create awareness of changes in the practice of emergency and non – emergency dental procedures during COVID-19 among dental interns. A cross-sectional study was conducted among 100dental interns. As the study was conducted during the pandemic time, a web-based survey was created using google form which composed of a set of 12 structured custom- made questions. The answers were collected and subjected to statistics.It was seen that more than 80% of the dental interns were aware of the guidelines issued by various dental associations regarding changes in dental procedures during COVID-19 pandemic situation. Most of the students were also aware of the term ‘Tele dentistry’ and telecommunications for dental care, consultation and education. Adaptations and adjustments in the dental procedures need to be done to avoid the spread of the disease. Hence, it is important and mandatory for dental professionals and students to be aware of the precautions to be taken when performing emergency as well as non-emergency procedures during this pandemic situation.

A Scoping Review was conducted to explore key issues that underpin the experiences of family caregivers of older adults with chronic illness. The review aims to identify the gap in literature and synthesise evidence on this topic. Globally, family caregivers of older adults with chronic illness experience burden. Evidence suggests that family caregivers’ needs are poorly understood and remain largely under recognised by healthcare services. Moreover, little is known about the experience of family caregivers caring for older adults with multiple chronic conditions. Data bases used included: Academic Search Elite, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science Direct, SCOPUS, MEDLINE, and grey literature. 3352 records were identified, 58 full-text articles were assessed for eligibility, and 11 papers included in the literature review. Data are narratively synthesized. This review provides findings that suggest further research.

RATIONALE/AIM Falls can have severe consequences particularly for older patients with cancer undergoing ambulatory care. The aim of the study is to identify the predictors of falls in older patients receiving cancer ambulatory care and evaluate the accuracy of the final multivariable model in detecting older patients with falls. METHOD A retrospective study was conducted on 300 older patients aged 60 years and above that were referred for ambulatory care in three oncology clinics based at hospitals in Tehran, Iran. Participants completed a questionnaire comprising demographic, history of falls, and cancer-related factors. Logistic regression was used to determine risk factors associated with falls. RESULTS A total of 35.3% of the older patients with cancer had experienced a fall in the 6 months following the start of their ambulatory care. The most important predictors of falls include the fourth stage of cancer (odds ratio [OR]: 6.47, 95% confidence interval [CI]: 3.20-13.08, p

Background Indigenous people, although constitute 1.8% of the country’s population, are one of the most deprived communities of Bangladesh in all sectors. This study was conducted to explore the health status and quality of life of indigenous elderly of Bangladesh as there is scarcity of knowledge regarding this. Methods A mixed-method approach was deployed on October,2019 in Sylhet-division of Bangladesh. A cross-sectional survey was conducted among 400 indigenous elderlies from 8 tea-gardens and ten in-depth-interviews were conducted with health-service providers of tea-garden health-facilities. Results Of the indigenous elderly-respondents, majority (79.5%) were suffering from any kind of chronic diseases. Visual difficulty was found predominant (74%) among the chronic conditions, followed by locomotion difficulty (49%) and gastrointestinal problem (41%). Extreme age, being male, living alone and low family income were significantly associated with suffering from chronic conditions. Furthermore, having chronic condition and extreme-age was found to be significantly associated with low quality of life. Health-service providers identified lack of logistical support in health-facilities, economic crisis and lack of awareness as the causes of poor health-status and health-seeking behavior of the indigenous elderly. Conclusions Indigenous older men in extreme old age are more vulnerable to adverse health conditions and poor quality of life. Health literacy and health seeking behaviour is poor among indigenous older adults generally and there is a huge gap in the health services and social supports available to them. Key messages Indigenous, Older population, Bangladesh.

Objectives: This study investigates the prevalence and determinants of undernutrition among children

This study is aimed at evaluating seismic responses of a bridge pier isolated by high damping rubber bearing (HDRBs), subjected to intra-plate and inter-plate earthquake ground motion records. In this regard, a conventional bilinear model and two elasto-visco-plasticity-based rheology models (the original rheology model [36] and an improved rheology model proposed in the current study) of HDRBs have been utilized in this study. In the first part of the paper, the adequacy of the two elasto-visco-plasticity-based rheology models has been checked in predicting the mechanical behaviour of the HDRBs, subjected to sinusoidal loadings. The numerical results of the HDRBs have shown that the improved rheology model can predict the mechanical behaviour of the bearings in a quite better way in comparison to the original rheology model, particularly at higher shear strain levels of the bearings. In the second part, seismic response analysis of a 3-DOF bridge superstructure–pier–foundation (s–p–f) system has been evaluated. In the end, nonlinear dynamic analysis using a standard direct time integration approach has been carried out. The seismic responses of the s–p–f system considered in the current study are the pier and deck displacements, the shear force of the bridge pier, the shear strain of the bearing and the total hysteretic energy of the bearings. The analytical results have shown that the rheology modeling of HDRBs has a significant effect on seismic responses of bridge pier.

IntroductionSevere under-5 child malnutrition (i.e., severe stunting, severe wasting and severe underweight) is high in Bangladesh. The interplay between risk factors needs to be understood to address this complex public health issues. We aim to explore the prevalence and risk factors for severe under-5 child malnutrition in Bangladesh's rural and urban areas using the Composite Index of Severe Anthropometric Failure (CISAF).MethodsWe analysed data from Bangladesh Demographic Health Surveys (BDHSs), 2017-18. Severe malnutrition was defined using the CISAF, and conventional nutritional indicators were aggregated to estimate malnutrition's overall burden. The proportional differences of variables between non-severe malnutrition and severe malnutrition group were assessed using Chi-square test. Risk factors for malnutrition were analysed using regression models to assess the odds ratio (OR) and 95% confidence interval (CI).ResultsThe overall prevalence of severe under-5 child malnutrition was 11% with 12% in rural areas and 10% in urban areas. The key risk factors in rural areas were children born with small birth weight (OR: 2.4, 95% CI: 1.5–3.8), socio-economically poorest households (OR: 2.3, 95% CI: 1.4–3.7) and children aged 36-47 months (OR: 2.1, 95% CI: 1.6–2.8). The key risk factors in urban areas were children born with small birth weight (OR: 5.0, 95% CI: 2.9–8.6), children of mothers with no formal education (OR: 2.0, 95% CI: 1.2–3.6) and children's birth order ≥4 (OR: 1.8, 95% CI: 1.2–2.8). 52% lower risk difference of parents with formal education vs no formal education, and 71% higher risk difference of most affluent vs poorest household for being severely malnourished were estimated in rural areas than in urban areas.ConclusionOne in ten children living in both rural and urban areas experience severe malnutrition. Children of parents with no formal education, children of underweight mothers, those living in socio-economically poorest households and children of small birth weight experienced severe malnutrition regardless of setting. Educational attainments and access to health and nutritional care may not be enough to reduce the burden of severe malnutrition in rural settings. Our study provides helpful guidelines for context-specific interventions to reduce under-5 severe malnutrition.

Introduction Severe undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context. Methods This study extracted the children dataset from the 2017–18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis. Results The overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged Conclusion Severe undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

Background There are currently 1.5 million indigenous people in Bangladesh, constituting 1.8% of the total population and representing one of the country’s most deprived communities. This study explores the health status and quality of life along with their determinants among indigenous older people in Bangladesh in order to fill the knowledge and evidence gap on this topic. Methods A mixed-methods approach was deployed in October 2019 in the Sylhet division of Bangladesh which involved a cross-sectional survey among 400 indigenous older adults (200 males, 200 females) from 8 tea gardens using a pre-tested semi-structured questionnaire. Ten in-depth interviews were also conducted with providers of the tea garden health facilities. Descriptive analysis, multiple logistic and multi-nominal linear regression were performed to explore associated factors around health and quality of life. Results Of the total respondents, the majority (79.5%) had chronic diseases, with visual difficulty being predominant (74%) among the conditions. Almost all (94%) of the respondents experienced delays in receiving treatment and poverty was identified by most (85%) as the primary cause of those delays. Extreme age, being male, living alone and low family income were significantly associated with suffering from chronic conditions. Furthermore, having a chronic condition and extreme age were found to be significantly associated with a low quality of life. Health service providers identified lack of logistical support in the health facilities, the economic crisis and lack of awareness as the major causes of poor health status and poor health seeking behaviour of the indigenous older adults. Conclusion Indigenous older men in extreme old age are more vulnerable to adverse health conditions and poor quality of life. Health literacy and health seeking behaviour is poor among indigenous older adults generally and there is a huge gap in the health services and social supports available to them.

This article aims to examine the National Health Insurance Scheme (NHIS) policy from the perspective of local communities. Qualitative data from 9 key informant interviews and 72 community respondents in 9 focus group discussions were analyzed using a thematic network approach. The focus-group discussions took place in seven different communities in seven regions of Ghana. The findings noted a disconnection between NHIS policy and community life. More so, the findings showed an explicit link between equity and access with its impacts on health outcomes. The qualitative results indicated lack of voice and understanding as the features limiting people from accessing the NHIS facilities. Understanding of equity as a key theme revealed, first, lack of stakeholder engagement and consultation or participation in the NHIS decision-making process. Second, it was established that while the policy indicated a will to include all the core poor for an equitable NHIS, there is lack of willingness to implement this aim fully. Finally, despite being a pro-poor intervention by name, practical management of the NHIS is transmitted down vertical silos from the national level, with the lack of joined-up government at the center undermining local partnerships. Thus, not only are national expectations being dashed locally, local expectations are dashed nationally. This article proposes that community viewpoints should be given higher priority given that NHIS has since its inception been associated with medical treatments and biomedical paradigm. Promoting community participation, understanding, and voices should be recognized to shape the future NHIS policy and practice.

Objective This study examines trends and puts forward projections of under-5 mortality (U5M) in Bangladesh and identifies the effects of maternal high-risk fertility behaviours and use of healthcare services. Methods Data from seven waves of the Bangladesh Demographic and Health Survey (1994–2014) were analyzed for trends and projections of U5M and a Chi-square (χ2) test was used to identify if there was any association with maternal high-risk fertility behaviours and use of healthcare services. A multivariate logistic regression model was used to determine the effects of fertility behaviors and healthcare usage on the occurrence of U5M adjusting with confounders. Results U5M declined from 82.5 to 41.0 per 1000 livebirths during 1994–2014 and is projected to further reduce to 17.6 per 1000 livebirths by 2030. The study identified a noticeable regional variation in U5M with maternal high-risk fertility behaviours including age at birth Conclusion The Sustainable Development Goals require a U5M rate of 25 per 1000 livebirths to be achieved by 2030. This study suggests that with the current trend of reduction, Bangladesh will achieve this target before the deadline. This study also found that maternal high-risk fertility behaviours and non-use of maternal healthcare services are very prevalent in some regions of Bangladesh and have increased the occurrence of U5M in those areas. This suggests therefore, that policies and programmes designed to reduce the pregnancy rates of women that are at risk and to encourage an increase in the use of maternal healthcare services are needed.

The demand for energy in the country has increased with increase in population. The source and methods of energy production have always been insufficient. To meet the energy need, we have been dependent on fossil fuels such as coal, oil and natural gas. While producing and using energy, we have witnessed adverse impacts on environment in general and human health specifically. There is a necessity to abide by the international commitment of stabilizing the increase of temperature by 2 °C as the CO2 level has already crossed 409.8 ppm in 2019. To deal with this, the shift from traditional sources (fossil fuels) to renewable sources of energy that are considered to as clean sources of energy is desirable. The optimum use of renewable sources of energy minimizes the harmful effects on living and non-living components of environment especially human beings. Internationally as well as nationally, regulations and policies have been developing to encourage the people and industrialists to adopt the sustainable renewable techniques to meet the needs of energy especially in untouched rural areas with minimum environment deterioration. This article evaluates all possible options to make the fullest use of renewable sources of energy. The literature related to the reasons behind the need of shift from non-renewable to renewable energy sources has also been summarized. Besides this, the initiatives taken by the Government of India in terms of the availability, current status and policies in bridging the demand–supply gap of energy sources have also been discussed.

BACKGROUND Bangladesh recently experienced a COVID-19 second wave, resulting in the highest number of new cases and deaths in a single day. This study aims to identify the challenges for COVID-19 preventive practices and risk communications and associated factors among Bangladeshi adults. METHODS A cross-sectional survey was conducted between December 2020 and January 2021 involving 1,382 Bangladeshi adults (aged ≥ 18-years) in randomly selected urban and rural areas from all eight divisions in Bangladesh. Descriptive data analysis was conducted to highlight the challenges for preventive practices and risk communications for COVID-19. Multiple logistic regression analysis was used to determine the sociodemographic groups vulnerable to these challenges. RESULTS Lack of availability of protective equipment (44.4%), crowded living situations/workspaces (36.8%), inadequate information on the proper use of protective measures (21.9%), inadequate hand washing and sanitation facilities (17.6%), and negative influences of family/friends (17.4%) were identified as barriers to COVID-19 preventive practices. It was also found that males (OR = 1.3, 95% CI = 1.01,1.7), rural residents (OR = 1.5, 95% CI = 1.2,2), respondents with a low level of education: No schooling vs ≥ higher secondary (OR = 3.5, 95% CI = 2.3,5.2), Primary vs ≥ higher secondary (OR = 2.5, 95%CI = 1.7,3.8), respondents engaged in agricultural (OR = 1.7, 95%CI = 1.2,2.4), laboring (OR = 3.2, 95% CI = 2,5), and domestic (OR = 1.6, 95% CI = 1.07,2.5) works, and people with disabilities (OR = 1.7, 95% CI = 1.1,2.6) were all likely to have difficulty in practicing effective COVID-19 protective behaviors. Respondents’ education and occupation were significant predictors of inadequate understanding of COVID-19 risk communications and was identified as a problem among 17.4% of the respondents. CONCLUSION A substantial percentage of Bangladeshi adults have difficulty practicing COVID-19 protective behaviors and have poor comprehension of risk communications, that is particularly prevalent in rural areas and among those with low education. This research can aid policymakers in developing tailored COVID-19 risk communications and mitigation strategies to help prevent future waves of the pandemic.

Education is the greatest and the most essential asset in this world that any human can attain. But the current education system has lots of unwanted intermediaries, which makes it difficult to deliver the concept to each and every individual. Current system is unable to bring out a particular student’s potential to the fullest and is not able to make them showcase their capabilities and talents. Courses provided in the system lack flexibility and are not updated regularly. This leads to circulation of outdated and inappropriate information. To counter all these problems, our proposed system uses blockchain technology to establish trust between parties like teachers, students, and parents by eliminating intermediaries to provide seamless and up to date info with the power of distributed ledger. Our proposed system fragments the cities into small cells which will be governed by an education director who is responsible for recruiting teachers to tutor the student’s in their cell. These teachers are provided with a web portal which allows them to invoke a smart contract where students can enroll themselves in any courses. Our proposed system provides two ways of attending the course one is the present online video tutorial with improved transparency. The next way provides a traditional classroom where the teacher rents a building or a hall which can hold all the students and provide the essential needs. Students can pay the fees of the course in the beginning or pay a daily fee. The money paid gets locked in the smart contract, and after completion of each class, the rent for that particular day is transferred to the building owner, and the wage for the teacher is also transferred instantaneously. In our proposed system, various new courses can be added in the go and will also abide by the central government's syllabus. Students just need to complete certain mandatory courses for their grade completion in the given period of time along with the topics of their choice.

Rationale, aims and objectives: Much emphasis has been placed on the lack of awareness and understanding of dementia that exist within the ethnic minority groups in the UK. There has been a continual dearth of research, however, among the ethnic minority carers about reducing barriers to accessing services and optimising engagements with religiously tailored interventions. This paper reports findings from a qualitative study that examined the barriers to healthcare service use in Bangladeshi ethnic minority population. \ud Method: This analysis piece draws on findings from a doctoral level research study of understanding dementia among the Bangladeshi community in England. The doctoral research which informed this paper was gathered in two distinct phases: 1) focus group discussions and 2) semi-structured qualitative interviews. All data were audio-recorded and analysed using thematic analysis. The NVivo qualitative software was utilised to simplify the thematic analysis, including transcribing, coding, and interpreting the emergent themes. \ud Results: Some barriers arose out of their religious and cultural beliefs and practices, other barriers related to the complexity of the healthcare system. Gender based caregiving interferes with their religious ideologies while religiously appropriate services are of precise importance when investigating access to services. \ud Conclusion: The findings provide understanding into the development of seeking healthcare services within the mainstream services and it may serve to give a useful direction to future enquiry.

ObjectiveThis study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low birth weight (LBW) in neonates.Study designs and settingsData were drawn and analysed from the Bangladesh Demographic and Health Survey, 2014. Any association between LBW and adverse maternal circumstances were assessed using a Chi-square test with determinants of LBW identified by multivariate logistic regression analysis.ParticipantsThe study is based on 4728 children aged below 5 years and born to women from selected households.ResultsThe rate of LBW was around 19.9% (199 per 1000 live births) with the highest level found in the Sylhet region (26.2%). The rate was even higher in rural areas (20.8%) and among illiterate mothers (26.6%). Several adverse maternal circumstances of the women included in the survey were found to be significant for increasing the likelihood of giving birth to LBW babies. These circumstances included the women being underweight (adjusted odds ratio (AOR) 1.26, 95% CI 1.06 to 1.49); having unwanted births (AOR 1.22, 95% CI 1.03 to 1.44); had previous pregnancies terminated (AOR 1.28, 95% CI 1.05 to 1.57); were victims of intimate partner violence (AOR 1.23, 95% CI 1.05 to 1.45) and taking antenatal care 3 with interval ConclusionThis study finds that adverse maternal circumstances combined with high-risk fertility behaviours are significantly associated with LBW in neonates. This situation could severely impede progress in Bangladesh towards achieving the sustainable development goal concerned with the healthcare of newborns.

Tackling malnutrition is a major global health priority for a developing country like Bangladesh. This paper explores the epidemiological differences between only one form and multiple forms of severe malnutrition among children in Bangladesh aged under-five years. Also, it identifies important factors that are associated with both these forms. Data were extracted from the Bangladesh Demographic Health Surveys of 2007, 2011 and 2014. The outcome measures included only one form and multiple forms of severe malnutrition in children aged under-five years. A Chi-square test was performed to find the association of outcome variables with selected socio-demographic factors and logistic regression models helped identify the risk factors. A total of 19,874 children aged under-five years were included in the current analysis. The overall proportion with one form of severe child malnutrition was approximately 11.53% and with multiple forms was 7.60%. The analysis showed that age, mothers' education, fathers' occupation, mothers' currently working, watching television, source of water, solid waste used in cooking, intimate partner violence (IPV), wealth index, place of residence and birth cohort were significant factors for both one and multiple forms of severe child malnutrition. Those children that had a non-educated mother and came from a poor socioeconomic class were associated with a high risk of severe malnutrition. Where a father had an occupation service, any children were at less risk of multiple forms of severe malnutrition. The proportion of severe malnutrition in children aged under-five years with one form and multiple forms was shown to be high in Bangladesh with the risk identified using selected variables. Prevention of malnutrition in Bangladesh should, therefore, be seen as a significant public health issue and given top priority.

Background: Caesarean section is considered a relatively preferable and safe method of delivery as compared to normal delivery. Since the last decade, its prevalence has increased in both developed and developing countries. In the context of developing countries viz., South Asia (the highest populated region) and South-East Asia (the third-highest populated region), where a significant proportion of home deliveries were reported,however, the preference for, caesarean delivery and its associated factors are not well understood.\ud Objective: To study the caesarean delivery in the South and South-East Asian countries and to determine the factors associated with the preference for caesarean delivery. \ud Methodology: Demographic and Health Survey Data on from ever-married women of nine developing countries of South and South-East Asia viz., Vietnam, India, Maldives, Timor-Leste, Nepal, Indonesia, Pakistan, Bangladesh, and Cambodia have been considered. Both bivariate and binary logistic regression models were used to estimate the propensity of a woman undergoing for caesarean delivery and to assess the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery.\ud Results:Obtained results have shown an inclination of caesarean delivery among urban than rural women and are quite conspicuous, but is found to be underestimated mostly among rural women. Caesarean delivery in general is mostly predisposed among women whose baby sizes are either very large or smaller than average, have a higher level of education and place of delivery is private medical institutions. The logistic regression also revealed the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. Based on nine South and South-East Asian countries an overall C-section prevalence of 13%, but based on institutional births its increase to 19%. The forest plot demonstrated that a significant inclination of C-section among urban than rural regions. In Meta-Analysis, very high and significant heterogeneity among countries is observed, but confirms that in terms of prevalence of C-section all of the countries follow independent pattern.\ud Conclusion: Study of seven urban and four rural regions of nine South and South- East Asian countries showed, a significant inclination towards the caesarean delivery above the more recent outdated WHO recommended an optimal range of 10-15%and are associated maternal socioeconomic characteristics. In order to control unwanted caesarean delivery, the government needs to develop better healthcare infrastructure and along with more antenatal care related schemes to reduce the risks associated with increased caesarean delivery.

A total number of 300 adolescent girls were surveyed. They were divided into two groups ie control (150) and experimental (150). The information regarding socio-economic status, anthropometric measurements and haemoglobin content was collected. The selected subjects were personally interviewed for knowledge, aptitude and practice with the help of questionnaire. Food and nutrient intake of sub sample (70) was collected. The IEC programme was conducted to the experimental group. The nutrition knowledge was imparted through messages, charts, posters, talk and demonstration, etc. After imparting the IEC programme, the haemoglobin content, food and nutrient intake, knowledge aptitude and practice was assessed. The impact of IEC programme was evaluated by appropriate statistical methods. The results indicated that there was a significant increase in the haemoglobin content and nutrient intake of experimental group after IEC programme. Similarly the improvement in the existing knowledge, aptitude and practice was observed. Hence, it was concluded that, respondents require approach regarding nutrition education.

SummaryAlthough young people in South Africa are growing up in an era where their socioeconomic circumstances are seemingly better than those of their parents’ generation, they face greater risks in their trajectory to adulthood. This is mainly because the environment in which they are making sexual decisions is also rapidly evolving. Currently, South Africa has the highest prevalence of HIV and AIDS in the world among young people aged 15–24. This study examined the effect of sexual behaviours initiated in adolescence on enrolment in post-secondary education. The analysis was conducted using data from the longitudinal Cape Area Panel Study (CAPS, Waves 1–5) conducted in 2002–2009, which focused on young people’s sexual behaviours in Cape Town, South Africa. The sample was restricted to 3213 individuals who reported sexual debut during adolescence. Using logistic regression models fitted separately for males and females, the results revealed that several factors acted as either hindrances or protective factors to enrolment in post-secondary education. Early sexual debut (by age 17) was negatively associated with participation in tertiary education. Other variables that had a negative effect included not using contraception at first sex, parenthood, engaging in risky behaviours such as illegal substance use, cigarette smoking and drinking alcohol and neglect of school homework (doing less than an hour a day). Higher levels of parental education (except for paternal education in the female model), urban residence and higher aspirations and analogous behaviours (studying) acted as protective factors and were positively associated with post-secondary education initiation. The paper also points to the relationship between early sexual debut and persistent socioeconomic inequality and provides empirical evidence for re-thinking policy development and implementation around schooling and sex education.

An important parameter in the assessment of quality health care lies on patient satisfaction. Despite concerted efforts to improve health-care services, patient satisfaction coupled with the quality of hospital care at disposal remain a significant challenge in Nigeria. The purpose of the study was to determine the perception on factors associated with prolonged waiting time and patient satisfaction at the outpatient department of Ibrahim Badamasi Babangida Specialist Hospital in Nigeria. A mixed-method research was utilized. Questionnaire was administered on 95 outpatients, and a focus group discussion (FGD) was held with eight participants. Statistical analysis was utilized to determine the association between dependent and independent variables. Data from FGD were analyzed with NVivo 10. The overall hospital satisfaction was found to be 75.8% among the study population. There was a significant inverse relationship between the level of satisfaction with the doctor and employment status and educational level and a significant direct relationship between the level of satisfaction with the doctor and appointment status and type of visits. The results of FGD show that patients were satisfied with the neatness of the hospital, doctor’s professionalism, and patient–doctor relationship. Dissatisfaction was with extended patient waiting time and the small size infrastructure of the hospital, inefficient handling of patient files by nurse aids, and thoroughness of the physicians. The results showed that majority of the patients were dissatisfied with the waiting time for consultation in the hospital. In other words, consultation time positively correlated with the level of patient satisfaction. To improve the overall patient satisfaction, the waiting time for consultation should be reduced significantly.

Post myocardial infarction (MI) short and long term clinical outcome is largely determined by the size of the infarcted area. It is generally assumed that as the lead involvement in electrocardiography (ECG) is less in anteroseptal ST segment elevation myocardial infarction (AS-STEMI), where ST segment elevation (STE) is limited to leads V1 to V3, myocardial damage is likely to be less; and in extensive anterior STEMI (EA-STEMI), as theSTE extends further upto V6, the myocardial damage is likely to be more. This study was intended to compare regional wall motion abnormality (RWMA) between acute anteroseptal STEMI and acute extensive anterior STEMI patients. 90 patients with AS-STEMI and 106 patients with EA-STEMI, admitted in between October 2012 and September 2013, were included. For each patient, a transthoracic echocardiogram (TTE) was performed within 24-48 hours of MI and was interpreted by an independent investigator blinded to the patient's ECG data. No differences were observed between the two groups in baseline characteristics; except AS-STEMI group had more patients with diabetes and EA-STEMI group had more patients with family history of coronary artery disease. Distribution, extent of wall motion abnormalities and mean number of total involved segments were similar between patients with AS-STEMI and those with EA-STEMI (p>0.05). Regarding regional dysfunction, the apical septal (99.1% vs. 92.2%, p

The main aim of the study was to evaluate the effectiveness of the government’s social security cover on support and healthcare and its impact on quality of life of elderly in Brazil. We examine discursively in a qualitative study the State’s political commitment towards ageing issues; ageing seen as a social problem; and the government policies to ensure the quality of life in Brazil. Our main finding was that Brazilian’s elderly protection laws will cease to be a myth when these same elders are aware that they need to participate at all levels of government in the preparation of plans and policies and also to put them into practice. In this way the older person will have mastery over what is management and will be prepared to manage conflicts between individual interests and the policies of the government. O principal objetivo deste estudo foi avaliar a eficácia da cobertura de seguridade social do governo na saúde e na qualidade de vida de idosos no Brasil. Foram examinados, em um estudo qualitativo, os compromissos políticos do Estado em relação às questões do envelhecimento; o envelhecimento visto como um problema social; e as políticas governamentais para garantir a qualidade de vida no Brasil. Concluiu-se que as leis brasileiras de proteção dos idosos deixarão de ser um mito quando esses mesmos idosos estiverem cientes de que precisam participar de todos os níveis do governo na preparação de planos e políticas e também colocá-los em prática. Dessa forma, o idoso terá domínio sobre o que é gestão e estará preparado para gerir os conflitos entre os interesses individuais e as políticas do governo. El principal objetivo de este estudio fue evaluar la eficacia de la cobertura de seguridad social del gobierno en la salud y en la calidad de vida de ancianos en Brasil. En un estudio cualitativo se examinaron los compromisos políticos del Estado con relación a las cuestiones del envejecimiento, el envejecimiento visto como un problema social y las políticas gubernamentales para garantizar la calidad de vida en Brasil. Se concluyó que las leyes brasileñas de protección a los ancianos dejarán de ser un mito cuando esos mismos ancianos tengan conciencia de que precisan participar en todos los niveles del gobierno en la preparación de planes y políticas y también colocarlos en práctica. De esa forma, el anciano, tendrá dominio sobre lo que es gestión y estará preparado para administrar los conflictos entre los intereses individuales y las políticas del gobierno.

The proportion of elderly has been increased gradually over the past years and this has created many causes for concerns particularly in individual’s health status. Relatively little is known about health status of older ethnic group across the world. The study aims to explore the health status of ethnic elderly among Tea Garden workers in Bangladesh. A total of 229 elderly were interviewed from different tea gardens. Prevalence ratio and adjusted prevalence ratio were calculated using simple and multiple Poisson regression analysis. The study revealed that more than 90% of the elderly had suffered from multi-morbidity. Gender, age, family behavior, number of meals in a day, taking milk or milk products and taking sugar were highly associated factor to lead healthy life for elderly. Female and unemployed elderly were in more risk to suffer from multi-morbidity, illiterate were also a risk factor for multi-morbidity but effected by confounding factors. An elderly who rated himself as unhealthy was 1.75 times more risk in compare to healthy elderly. In addition, the ethnic elderly who were suffering from difficulties of seeing, getting up, standing, remembering and others disability were in more risk of suffering from multi-morbidity.

It has long been recognized that health and its determinants are strongly influenced by policies, programs, and projects outside of the health care sector. Few countries have introduced health impact assessments (HIA) to try and ensure that probable impacts on health are considered. An appropriate health impact assessment regime will identify negative and positive impacts of proposed health policies and programs on health, enable the interpretation of health risk and potential health gain, and present the information to assist in decision making. These HIAs are often generic and rapid desk–based appraisals characterized by the use of information and evidence that is already available or easily accessible and generally undertaken by administrators in an organization to gain a snapshot of the health impacts to inform proposal direction. Rapid and generic desk–based assessments require less-intensive effort and resources and draws on existing data sources from scientific peer-reviewed and gray literature to analyze potential health impacts. However, both sources can also be used to determining whether a more detailed review is necessary. The Community HIA model proposed by this work departs from the generic and rapid desk–based appraisals and is intended to provide practical evidence to give higher priority to people’s viewpoints, promote participation, understanding and incorporate community voices to help shape future policy, programs, and practice. A comprehensive review of Ghana’s National Health Insurance Scheme (NHIS) was carried out using the generic desk–based HIA approach. This was followed by a practical qualitative community field work. In this research, we have demonstrated how community HIA is to be conducted through an actual case study in the Ghanaian West African context. The scope of this work is wide and incorporates the consideration of key concepts and possible methods for carrying out HIA at the community level.

The aim of the study is to examine the gender differential outcomes of food habits and physical activities on obesity among school-aged adolescents in Bangladesh. In this study, a nationally representative data extracted from the Global School-based Student Health Survey (GSHS) 2014 was utilized. The information related to physical and mental health was collected from 2989 school-aged adolescents in Bangladesh. To fulfill the aim, an exploratory data analysis and multivariate logistic regression model were employed in this study. The female adolescents’ were at lower risk of overweight/obesity (AOR = 0.573) with a prevalence of 7.4% than males (9.9%) in Bangladesh. The results showed that high consumption of vegetables (both: AOR = 0.454; males: AOR = 0.504; and females: AOR = 0.432), high soft drink consumption (both: AOR=2.357; males: AOR = 2.929; and females: AOR = 1.677), high fast food eating (both: AOR = 2.777; males: AOR = 6.064; and females: AOR = 1.695), sleep disturbance (both: AOR = 0.675; males: AOR = 0.590; and females: AOR = 0.555), and regular walk or bike to school (both: AOR = 0.472; males: AOR = 0.430; and females: AOR = 0.557) was the vital influencing factors of overweight/obesity among adolescents of both sexes in Bangladesh. Besides, fruit eating, vigorous physical activity, physical education attendance, sitting activities were also identified as significant predictors of overweight and obesity for males in Bangladesh. The high practice of fruit and vegetable consumption regularly, avoiding soft drinks and fast food, increasing the vigorous intensity of physical activity, regular attendance in physical education and abating higher sitting activity in leisure time can reduce the risk of overweight/obesity among adolescents of both sexes in Bangladesh.

In Bangladesh, Tuberculosis (TB) is a key public health concern. In this study we assessed knowledge, attitudes, and perceptions (KAP) towards TB among the general population. A cross-sectional mixed-methods study was conducted between March and August 2014, where a total of 400 adults were interviewed at Dhaka city in Bangladesh. The overall knowledge of TB was very limited despite 99.5% of the study respondents having heard of TB. About 99.0% stated correctly that cough was one of the major signs and symptoms of TB. About 39.0% mentioned that through airborne disease someone could get TB. With regard to curability of TB, 362 people replied that TB can be cured. About 77.0% informed that TB could be cured by taking medicines such as antibiotics or others. Sixty five percent of respondents knew someone who had have TB. The mean summary score for TB knowledge was 40 out of 100 (SD 0.5). Regression analysis shows that people with tertiary level of education were connected with higher TB knowledge and people having no income were related with lower TB knowledge. A lack of awareness was associated to delay in seeking treatment because people did not recognize the symptoms of tuberculosis. To improve knowledge of TB among people having no income or even lower income group more emphasis should be given and also more awareness is required to develop the individual’s perception amongst their neighbors in the study area. The alertness campaigns for TB knowledge should be a major concern countrywide in Bangladesh.

Organic–inorganic metal halide perovskite solar cells (PSCs) have been attracted much attention due to their intense broad–band absorption, high charge carrier mobility, low–cost precursor materials and simple solution processing and the impressive upsurge in their solar to electric power conversion efficiency (PCE) over the last few years. An optimized layer structure of PSC with a very thin TiO 2 as electron transport layer has been proposed. The optimized PSC shows the highest efficiency ever reported in this system. Insertion of a very thin TiO 2 beneath the perovskite material enhances efficiency significantly. However, efficiency has been drastically declined while TiO 2 is used on the perovskite material. The role of TiO2 has been studied and the mechanism has also been explained using established formalism. This study has implication to design further efficient and stable PSC to meet energy crisis.

This article aims to examine global population ageing and to evaluate the likely risks and dilemmas of demographic ageing within the context of the health and well-being of individuals.This paper is based on the author's research in the field of social gerontology, demography, and public health. In addition, a literature review has been carried out focused on the objectives of the research.The study has identified potential risks and dilemmas that the older people may face in the globalized world. There are four main aspects that contribute to an unequal distribution of risks in later life: (a) burden of disease in epidemiological transition, (b) financial security in retirement, (c) familial resources for older peoples' care, and (d) availability of workforce for older peoples' care. Whilst population ageing is a global trend, its impact is not equal across the world, and this is highlighted in this research. There are some important dilemmas which are identified in this paper that may also fuel the potential risks and challenges facing ageing societies.It is apparent that older people will face numerous risks in later life and those in developing countries are likely to face more challenges than those in developed countries. The findings may be useful to policymakers for formulating future plans and policy implementation. Further research is required to identify the number of health care workers needed to tackle the challenges of an ageing societies across the globe.

ObjectivesChildren, pregnant women and the elderly at a global level are all being dangerously exposed to tobacco use in the household (HH). However, there is no understanding of the familial and socio-cultural factors that provide barriers to ensuring tobacco-free homes in Bangladesh either in urban or rural areas (U&RAs). This study therefore investigates those barriers to help enable a move towards tobacco-free homes in Bangladesh.DesignComparative cross-sectional study.SettingsData were collected from both urban and rural settings in Bangladesh.ParticipantsA probability proportional sampling procedure was used to select 808 participants in U&RAs out of a total of 3715 tobacco users. Semi-structured interviews through the use of a questionnaire were conducted with the participants followed by a multivariate logistic regression analysis of the data in order to explore the familial and socio-cultural factors associated with tobacco use at home.ResultsThe prevalence of tobacco use at home was 25.7% in urban areas and 47.6% in rural areas. In urban areas: marital status (adjusted OR (AOR)=3.23, 95% CI 1.37 to 6.61), education (AOR=2.14, 95% CI 1.15 to 3.99), the smoking habits of elderly family members (AOR=1.81, 95% CI 0.91 to 2.89), offering tobacco as a traditional form of leisure activity at home (AOR=1.85, 95% CI 0.94 to 2.95) and lack of religious practices (AOR=2.39, 95% CI 1.27 to 4.54) were identified as significant socio-cultural predictors associated with tobacco use at home. In rural areas: age (AOR=5.11, 95% CI 2.03 to 12.83), extended family (AOR=3.08, 95% CI 1.28 to 7.38), lack of religious practices (AOR=4.23, 95% CI 2.32 to 7.72), using children to buy or carry tobacco (AOR=3.33, 95% CI 1.11 to 9.99), lack of family guidance (AOR=4.27, 95% CI 2.45 to 7.42) and offering tobacco as a traditional form of leisure activity at home (AOR=3.81, 95% CI 2.23 to 6.47) were identified as significant determinants for tobacco use at home.ConclusionThis study concludes that socio-cultural traditions and familial norms in Bangladesh provide significant barriers for enabling tobacco-free homes. The identification of these barriers can aid policymakers and programme planners in Bangladesh in devising appropriate measures to mitigate the deadly consequences of tobacco use in the home. The consequences also include the dangers involved in family members being exposed to secondhand smoke.

Previous studies conducted in Japan had revealed an association between social support and life satisfaction among the elderly and the importance of informal support. A plethora of formal social support had been established when the Japanese Government introduced the LTCI (Long-Term Care Instrument) system in 2000. This system enabled elderly people to receive health benefits both mental and physical. The aim of this study was to investigate the relationship between social support and the life satisfaction of elderly people in Japan. The study involved using qualitative analysis on data drawn from recorded and transcribed semi-structured interviews involving five participants living in Town B in Japan. Utilising Interpretative Phenomenological Analysis (IPA) enabled discovery of the past and present lived experiences of participants and also gave insights into their worlds. Three themes emerged from the research: gender difference, transition of role from carer to being cared for, and reciprocity. The research revealed the following key factors that determined social support: gender, past life, resources, physical condition (especially IADL), social role and perception of outcomes. Although the study elicited the key factors that strongly affected the elderly in Japan and the results conformed to previous studies, the research suggested that the perception of the elderly should be the central focus.

An internal combustion (IC) engine has a predominant role in a low power generation and a virtual monopoly in mobile applications today. One of the best methods to improve the engine performance and reduce the exhaust emission in a SI engine is by using introduction of twin spark into the combustion chamber. Two stroke spark ignition engines have high exhaust emissions and low brake thermal efficiency due to the short circuiting losses and incomplete combustion, which occur during idling and at part load operating conditions. Dual spark ignition system has proved their potential in improving the performance of the engines and improved emissive characteristics as compared with the single spark plug ignition system. Experiments were conducted at different load conditions and different types of engines have proved that dual spark plug ignition engines are surely better than a single spark plug engine. To compare, single-spark plug configurations were also considered for other selected spark plug locations. Current paper investigates the effect of multi spark plug to the single spark plug on the basis of the performance of engine and emissive characteristics of engine. The result shown that the considerable improvement in the performance of engine output and considerable reduction in BSFC, HC and Co emission in multi spark plug mode.

Background\ud The outbreak of coronavirus disease, 2019 (COVID-19), which started from Wuhan, China,in late 2019, have spread worldwide. A total of 5,91,971 cases and 2,70,90 deaths were registered till 28th March, 2020. We aimed to predict the impact of duration of exposure to COVID-19 on the mortality rates increment.\ud \ud Methods\ud In the present study, data on COVID-19 infected top seven countries viz., Germany, China, France, United Kingdom, Iran, Italy and Spain, and World as a whole, were used for modeling. The analytical procedure of generalized linear model followed by Gompertz link function was used to predict the impact lethal duration of exposure on the mortality rates.\ud \ud Findings\ud Of the selected countries and World as whole, the projection based on 21st March, 2020 cases, suggest that a total (95% Cl) of 76 (65–151) days of exposure in Germany, mortality rate will increase by 5 times to 1%. In countries like France and United Kingdom, our projection suggests that additional exposure of 48 days and 7 days, respectively, will raise the mortality rates to 10%. Regarding Iran, Italy and Spain, mortality rate will rise to 10% with an additional 3–10 days of exposure. World’s mortality rates will continue increase by 1% in every three weeks. The predicted interval of lethal duration corresponding to each country has found to be consistent with the mortality rates observed on 28th March, 2020.\ud \ud Conclusion\ud The prediction of lethal duration was found to have apparently effective in predicting mortality, and shows concordance with prevailing rates. In absence of any vaccine against COVID-19 infection, the present study adds information about the quantum of the severity and time elapsed to death will help the Government to take necessary and appropriate steps to control this pandemic.

Background Among university students, large numbers are involved with smoking and suffer from many chronic diseases. This study examined tobacco smoking prevalence and potential predictors among university students in Sylhet Division, Bangladesh. Methods A total of 416 students were selected for face-to-face interviews. Logistic regression analysis was used to fulfil the specific objectives of the study. Results It was discovered that the prevalence of smoking among university students in Sylhet Division was 37% and almost half of current male students were smokers. Mother’s occupation and peer smoking status were found to be significant factors. Although data were collected using multistage sampling, the stages (type of university, universities, departments and academic levels) were insignificant with smoking status. There is a 2.1 times greater likelihood of a student becoming a smoker if a close friend is a smoker. The adjusted living expenses (>$100) was a proactive factor, though individually it was a significant factor. Conclusions This study and previous studies found that smoking initiation among female students is negligible, so gender-specific health promotion and intervention is needed in Bangladesh. Tobacco control awareness programs and ‘No smoking’ signage should be displayed within university campuses and sanctioned by university authorities.

Background: Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middleincome countries.\ud Methods: In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE,\ud demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations\ud Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives.\ud Results: The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure,\ud economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related\ud millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and\ud achieving a level of health-related MDGs were found to be the most influential factors.\ud Conclusion: To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

In recent days, people working in agricultural fields are facing lot of problems in cultivating their crops. The solution for such a problem is provided by the solar powered irrigation system. Here with the help of solar panel, submersible pumps, PV cells are used in producing energy. In this system, the moisture sensor and the pH level sensor are powered wirelessly. The sensed data values are transferred to the user mobile via GSM communication method. The aim of this paper is to help the farmers to use water effectively and use solar energy for irrigation purpose.

Financing retirement is an important aspect of later life that is related to overall healthy living and wellbeing. Very little is known about the attitudes of people towards their individual future retirement plans, accrued savings or even finances once they are into old age. There are no comparative studies across geographical regions that may help with understanding the complex behaviour of individuals and social norms. This chapter examines how life in retirement in the UK and Hong Kong is financed while also capturing regional disparities. This study uses data collected from primary sources in both territories. A sample of 800 employed people in the UK and 800 employed people in Hong Kong were sampled during 2013-14. The age ranges were 45 – 65, with most people aged 50 and over. Sampling took place across income groups and professions and included both men and women while the sample profile closely matched that of the UK and Hong Kong populations. Quantitative analysis was carried out in order to answer key research questions. The findings suggest that employees plan to work longer than their actual retirement age and are not prepared for retirement whereas educated and higher income groups generally have savings plans in place to finance their later lives. These findings have significant implications for organisations and policy makers.

The mammalian kidney is a structurally complex organ. The functional unit of the kidney is the nephron, which plays many important roles in maintaining homeostasis in the body. The major functions include excretion of the waste products of metabolism, regulation of body salt and water balance, maintenance of extracellular fluid volume, maintenance of acidbase balance, and elimination of foreign substances such as drugs and chemicals and their breakdown products. Thus, a thorough understanding of its structure and function, including age-related changes, is important to understand the kidney’s response to different types of insults and potential medical interventional strategies. Generally, renal insult is classified as either acute kidney injury (AKI) or chronic kidney disease (CKD). Acute kidney failure is characterized by a rapid fall in the glomerular filtration rate (GFR), occurring within hours to weeks, along with the retention of nitrogenous waste products as a result of reduced renal perfusion (prerenal azotemia), renal parenchymal damage (acute tubular necrosis, acute interstitial nephritis, and glomerulonephritis), or obstruction of the urinary tract (postrenal azotemia). The most common causes for acute tubular necrosis (ATN) are ischemia and exposure to nephrotoxicants. The kidney is particularly susceptible to nephrotoxicity because of the high blood flow to this organ relative to its mass and the unique property of the renal tubular epithelium in concentrating urine and its constituents, including drugs and chemicals. Age-related structural and functional differences in renal blood flow (RBF) and GFR contribute significantly to susceptibility of the aged population to nephrotoxic response compared with neonates, juveniles, and young adults. 5 While the adult kidney receives 20% to 25% of the cardiac output, the human fetal kidney receives only 4%, which increases to 10% by the end of the first postnatal week. Thus, renal function in neonates remains different from that of adults, and GFR and RBF corrected for body size are not comparable to adult values until *1 year of age. GFR gradually increases until adolescence, where it is maintained at adult levels. After age 40 years in humans, there is a progressive decrease in renal function, which is primarily the result of reductions in nephron number. In rats, GFR gradually decreases with age, and by 18 months, the GFR is decreased to approximately twothirds of its rate compared with young adults. In dogs, there is a gradual increase in GFR in the first 3 weeks of life primarily as a result of continuing maturation of nephrons, but progressive nephron loss in older dogs is associated with reductions in GFR, similar to those in rats. Therefore, potential age-related differences in renal mass and function can contribute to the development of ARF, especially secondary to nephrotoxicity, and should be included in the overall assessment of the renal disease and management strategy. CKD is a multifactorial pathophysiologic process resulting in progressive loss of nephrons in both number and function, frequently culminating in end-stage renal disease (ESRD). The clinical manifestations of ESRD result from irreversible loss of endogenous kidney function, leading to the development of life-threatening uremia. Therefore, it is imperative to diagnose renal disease and its underlying etiology at an early stage so that medical interventions can take place prior to the development of ESRD. Important risk factors for the development of CKD and reduced renal function in humans include age, hypertension, and diabetes. Hypertension in particular is the most common cause and also a consequence of CKD in the elderly, in whom underlying renovascular disease and associated local ischemia further contribute to the pathophysiology of CKD. The progression of CKD is characterized by continuously advancing and irreversible morphologic changes in renal parenchyma, including nephron loss and replacement by a selfperpetuating vicious cycle of fibrosis after the initial renal insult. The common pathological themes of CKD include arteriolosclerosis, glomerulosclerosis, and tubulointerstitial fibrosis, suggesting a common pathway in progression of disease. Mechanisms underlying progression of renal pathology are not completely understood, but laboratory investigations suggest potential contributions by systemic and intrarenal

This study explored factors influencing the initiation of smokeless tobacco (SLT) consumption in a low socioeconomic urban community in Bangladesh. The study conducted four focus group discussions among 33 informants involves school teachers, community leaders, women, and betel-nut shops owners. The results were prepared by thematic analysis of the transcripts where informants mean age was 30 ( SD ± 6.8) years with varying level of education. Tradition of hospitality, curiosity, offer from an elderly person, and avoiding nausea during pregnancy and at time of quitting smoking were key factors for the initiation of SLT consumption. The results also revealed most people were aware about the danger of SLT consumption but, in practice, consumed frequently. The research suggested that doctors might advise people not to use any form of SLT while they seeking health services. Furthermore, community-based awareness program could minimize the wider use of SLT among low-income community in Bangladesh.

Health inequalities in health have been observed amongst older people in many developing countries, particularly among those with least social protection and low socio-economic (SES) status. This study attempted to examine effects of SES on the health of older adults, and related gender differences, in two rural sub-districts - Matlab, Bangladesh and Vadu, India. The study utiliszed the WHO SAGE-INDEPTH Wave 1, 2007 Matlab, Bangladesh and Vadu, Pune District, India datasets. Both gender and SES indicators were strongly associated with all health indicators of older adults in the Bangladesh site, whereas in India, education and asset quintiles were not consistently associated with a self-rated health, quality of life and functional ability score but gender was consistently associated with all health indicators except the quality of life score. The SES-health gradient was noticeably higher amongst older adults in Matlab, Bangladesh than in Vadu, India. Education was also found to be an important predictor of health outcome in both sites.

Background: Violence against women is considered as a global problem and the trend for abusing domestically is very much up. This not only violates the human rights and it has got major implications on physical, mental, social and sexual health of a woman. Worldwide there is little research work on how domestic violence has affected women’s health and their decision-making power. This study aimed to explore the relationship between domestic violence on empowerment of women and their health seeking behavior in Pakistan. Methods: This research has used secondary data from Pakistan Demographic and Health Survey data 2012-13. About 3687 ever-married women were selected and interviewed for domestic violence from 248 urban and 252 rural areas of Pakistan. Results: Both chi-square and binary logistic regression analyses were performed. The results show that women with no education have suffered more (43%) from domestic violence. Almost 68% women reported that who have seen their parents beating their mothers have also experiences domestic violence. Logistic regression shown that women from rural areas are highly likely to be victims of domestic violence (OR=1.28, 95% CI 1.07-1.52, p-value

The present study was carried out to understand the seasonal variations in pattern of various diseases in cattle of Pune division of Maharashtra state of India during January 2010 to December 2010. Data of 1538 cattle (both dairy and beef, both male and female), mostly cross-breds, were collected from randomly selected 421 livestock owners by stratified two-stage random sampling design from study area. A log-linear model was used to understand the seasonal variation in incidence of various diseases in cattle. Out of total 1538 cattle, 342 cattle were found affected due to various diseases during study period. The chi-square analysis of data revealed that there was unlike pattern of incidences of various diseases in three seasons. Overall incidence of all diseases was high in winter (41.23%) followed by rainy (39.18%) than that of in summer (19.59%). Overall incidences of reproductive diseases (17.84%) and digestive diseases (11.11%) were major problems in whole study period. A log-linear modelling showed ...

The present study was carried out to analyse morbidity and mortality rate in buffaloes and its associated factors in Pune division of Maharashtra state in India. Stratified two stages random sampling design was adopted & the data of total 564 buffaloes were collected through pre-tested modified schedule from 157 buffalo owners. The data were analysed statistically by SAS 9.3 software for evaluation of Chi-square and Logistic regression analysis. Overall morbidity (28.01%) and mortality (7.98%) rates were recorded in study area. Digestive diseases and respiratory diseases are major cause of the higher morbidity and mortality in buffaloes, respectively. Statistically, there wasn't significant association of overall disease incidence with age or sex. However, the Chi-square analysis of overall mortality rate showed significance (p

Polyethylene glycol-ylation (PEGylation) is a phenomenon of modification of a protein, peptide, or non-peptide molecule by linking of one or more polyethylene glycol chains. These synthetic polymers have received FDA approval for internal use. It is an effective method of delivering therapeutic proteins as it modifies their pharmacokinetic properties. The PEG-drug conjugates have several advantages - prolonged residence in body, decreased degradation by metabolic enzymes and reduction or elimination of protein immunogenicity. The delivery of several classes of protein drugs (including protein scaffolds, enzymes, cytokines and antibodies) is significantly improved by PEG-drug conjugate and they are useful in treating chronic diseases such as hepatitis C, leukemia, acromegaly, severe combined immunodeficiency disease (SCID), chronic gout, rheumatoid arthritis, and Crohn’s disease. This review envisages an overview of PEGylation and its applications in cancer therapeutics. PEGylation technology has proven pharmacological advantages and acceptability and will undoubtedly prove useful for treating many previously difficult-to-treat conditions.