Search

Human communities that inhabit the political borders live a transitional life, which is due to several socio-political and geo-climatic factors. The current cross-cultural ethnomedicinal study was conducted at the highly elevated Pakistan-India borders of the Western Himalayas in order to address the medicinal flora and folk knowledge of Balti and Shina communities. Ethnobotanical field surveys were conducted from May 2021 to September 2022. We used semi-structured interviews in order to collect the ethnomedicinal data. The collected data was analyzed using the relative frequency of the citations, use value, and Venn diagrams. A total of 140 interviews were conducted, which comprised of 90 (64.28%) Baltis and 50 (35.71%) Shinas. The interviews recorded 60 medicinal plant species that belong to 56 genera and 35 families. Asteraceae (5 spp.), Lamiaceae (5 spp.), and Apiaceae (4 spp.) were the families that were the most represented. These medicinally valued plants were being used for 55 health issues that are related to different body systems. Delphinium brunonianum, Thymus linearis, Hymenolaena candollei, Corydalis adiantifolia, and Seriphidium brevifolium were medicinal taxa with maximum RFCs and UV. The Baltis have comparatively more ethnomedicinal knowledge than the Shinas. The Baltis commonly used 22 (36.66%) species, which 34 (56.66%) were exclusive to the Baltis and 4 (6.66%) to the Shinas. Both ethnic groups collectively hold significant ethnobotanical knowledge that demands the preservation of risked folk knowledge, which is due to uncertain border situations, outmigration, and permeating allopathic drugs.

A Smart City is characterized mainly as an efficient, technologically advanced, green, and socially informed city. An intelligent transportation system (ITS) is a subset area of smart cities that enhances the safety and mobility of road vehicles. It essentially makes travel more convenient, time-efficient and improves the citizens’ quality of life. Accurate and real-time traffic prediction enables law enforcement agencies with well-informed about traffic congestion. However, accurate traffic prediction has been considered a challenging issue. Traffic prediction has restrictions on road network topology and the patterns of dynamic change in time-series data. We propose a novel deep learning framework GCST-GRU, called graph convolutional Spatio-temporal gated recurrent unit, to determine the next traffic state from traffic data. The proposed model learns complex topological structures by capturing a) spatial dependencies from data by using the graph convolution operator, and b) temporal dependencies by using the GRU neural network. Experimental results demonstrate that our framework can obtain complex Spatio-temporal correlations efficiently from the traffic network and perform better than state-of-the-art baseline models on a real-world traffic dataset. The graphical visualization by using convolution operation over the neural network shows that the model outperforms the reachability of the 3-hops neighbor effect in the traffic data graph. Additionally, the training time of the proposed framework is better than the existing state-of-the-art deep learning studies.

Background: Different dementia support roles exist but evidence is lacking on which aspects are best, for whom, and in what circumstances, and on their associated costs and benefits. Phase 1 of the Dementia PersonAlised Care Team programme (D-PACT) developed a post-diagnostic primary care-based intervention for people with dementia and their carers and assessed the feasibility of a trial. Aim: Phase 2 of the programme aims to 1) refine the programme theory on how, when, and for whom the intervention works; and 2) evaluate its value and impact. Design & setting: A realist longitudinal mixed-methods evaluation will be conducted in urban, rural, and coastal areas across South West and North West England where low-income or ethnic minority populations (for example, South Asian) are represented. Design was informed by patient, public, and professional stakeholder input and phase 1 findings. Method: High-volume qualitative and quantitative data will be collected longitudinally from people with dementia, carers, and practitioners. Analyses will comprise the following: 1) realist longitudinal case studies; 2) conversation analysis of recorded interactions; 3) statistical analyses of outcome and experience questionnaires; 4a) health economic analysis examining costs of delivery; and 4b) realist economic analysis of high-cost events and ‘near misses’. All findings will be synthesised using a joint display table, evidence appraisal tool, triangulation, and stakeholder co-analysis. Conclusion: The realist evaluation will describe how, why, and for whom the intervention does or does not lead to change over time. It will also demonstrate how a non-randomised design can be more appropriate for complex interventions with similar questions or populations.

Amblyopia is a common developmental disability resulting in reduced visual acuity and gaze stability; it occurs in approximately 5% of the general population. Here, we present the case of an 18-year-old girl diagnosed with amblyopia. Subsequent to her diagnosis of amblyopia, she developed a depressive episode with co-morbid anxiety symptoms. She was treated with low intensity psychological intervention, Problem Management Plus, as home-based intervention. This intervention was associated both subjectively and objectively utilising psychometric measures (i.e. psychiatric interview, depression, anxiety and stress scale, general health questionnaire) with a significant amelioration of her mental state. This case provides preliminary evidence for the effectiveness of Problem Management Plus intervention and suggests that this intervention should be considered for other individuals with similar clinical presentations. Keywords: Disability, amblyopia, low vision, Patient Management Plus.

IntroductionLoneliness has significant impacts on the health of older adults. Social networks help to improve psychosocial and quality of life outcomes among older adults. A fifth of older adults live in rural communities, where geographic isolation poses challenges to health. The dynamics of social networks of older adults in rural communities has not been explored.ObjectiveTo synthesize the literature related to loneliness and social networks of older adults in rural settings.MethodsA mixed-methods systematic review was conducted through searching six bibliographic databases to retrieve peer-reviewed literature with no time limits. We performed a methodological assessment of each study using a mixed method quality assessment tool. Findings are synthesized thematically.ResultsA total of 50 studies (32 quantitative, 15 qualitative, and 3 mixed methods) were included in this review. Studies were conducted in 17 different countries, the majority from China (n = 12), the UK (n = 9), and USA (n = 9). Findings revealed that social networks of older adults consist of family, friends and neighbors and continue to be developed through participation in various physical and social activities such as walking groups and participation in religious events. Social networks offer informational, functional, psychological and social support to older adults. Through their social networks, older adults feel socially connected and cared for. Successful interventions to improve social networks and address loneliness were those developed in groups or one-on-one with the older adults. The key ingredient to the positive impact of these interventions on reducing social isolation and loneliness was the formation of a social connection and regular engagement with the older adults. However, the review did not find any explicitly reported theory or model on which these interventions are based.ConclusionThe prevalence of loneliness among older adults in rural areas needs urgent attention. Social network theory and methods can help in developing interventions to address social isolation and loneliness among older adults in rural communities.

Social entrepreneurship paves the way for both social and economic development of a country. To learn this unique combination, social entrepreneurship education plays a vital role. It positively influences the entrepreneurial intentions of the students. Previously this education was limited to the realm of business studies, but more recently social entrepreneurship education is encompassing students from different disciplinary backgrounds. The present study aims to highlight the learning experiences of the Sociology students during Social Entrepreneurship. Thematic analysis of the textual reflective papers was conducted to highlight different aspects of their learning experiences. The students were motivated to study the course majorly because of their experience with the instructor. Financial motivations were a main driver towards the selection of the course because social entrepreneurship was viewed as a lucrative alternative owing to the rising unemployment in the country. The students highlighted that experiential learning is indispensable to social entrepreneurship education which was severely affected due to the Covid-19 pandemic as the transition towards online education took place. Gender played a significant role in the motivation and inspiration gained from the course as most female students perceived social entrepreneurship education to be a path towards financial independence. Social entrepreneurship education is a growing filed in Pakistan and the higher educational institutes must take into account the learning experiences of students with different disciplinary backgrounds to enhance the overall entrepreneurial capacity of students by overcoming the barriers that they face. The current study presents insights for the growth of social entrepreneurship education in Pakistan.

Disruption of the blood-brain barrier (BBB) causes or contributes to neuronal dysfunction and several central nervous system (CNS) disorders. Wnt/β-catenin signaling is essential for maintaining the integrity of the adult BBB in physiological and pathological conditions, including stroke. However, how the impairment of the endothelial Wnt/β-catenin signaling results in BBB breakdown remains unclear. Furthermore, the individual contributions of different BBB permeability-inducing mechanisms, including intercellular junction damage, endothelial transcytosis, and fenestration, remains unexplored. Here, we induced β-catenin endothelial-specific conditional knockout (ECKO) in adult mice and determined its impact on BBB permeability and the underlying mechanism. β-catenin ECKO reduced the levels of active β-catenin and the mRNA levels of Wnt target genes in mice, indicating downregulation of endothelial Wnt/β-catenin signaling. β-catenin ECKO mice displayed severe and widespread leakage of plasma IgG and albumin into the cerebral cortex, which was absent in wild-type controls. Mechanistically, both the paracellular and transcellular transport routes were disrupted in β-catenin ECKO mice. First, β-catenin ECKO reduced the tight junction protein levels and disrupted the intercellular junction ultrastructure in the brain endothelium. Second, β-catenin ECKO substantially increased the number of endothelial vesicles and caveolae-mediated transcytosis through downregulating Mfsd2a and upregulating caveolin-1 expression. Interestingly, fenestration and upregulated expression of the fenestration marker Plvap were not observed in β-catenin ECKO mice. Overall, our study reveals that endothelial Wnt/β-catenin signaling maintains adult BBB integrity via regulating the paracellular as well as transcellular permeability. These findings may have broad applications in understanding and treatment of CNS disorders involving BBB disruption.

Objective: To elucidate the possible association between suicidal tendencies and psychiatric symptoms associated with anabolic androgenic steroid usage among athletes. Method: The cross-sectional study was conducted from December 2016 to July 2017 in Rawalpini and Wah Canttonment, Pakistan, after approval from the International Islamic University, Islamabad, and comprised male athletes aged >18 years. Those using androgenic anabolic steroid formed group A, while the non-users were in group B. In addition to demographis, data was collected using Beck Scale for Suicidal Ideation and the Symptoms Checklist-90. Data was analysed using SPSS 22. ---Continue

Facilitating citizens with accurate traffic flow prediction increases the quality of life. Roadside sensors and devices are used to capture live streams of huge data and the Internet of Things (IoT) is becoming popular for the deployment of effective Intelligent Transportation Systems (ITS). Traffic flow prediction from the live datastreams require building a data-driven model. This is a challenging task and has attracted researchers for better interpretation of the traffic characteristics. The core problem in traffic prediction is modeling a diversity of traffic trends and unpredictable flow variations with temporal dependencies. Initially, statistical and shallow neural network models were applied to some extent. Recently, deep learning has come up with proven and promising outcomes. Gated Recurrent Unit (GRU) is a variation of recurrent neural networks used effectively for traffic flow prediction. Like other deep networks, GRU uses hyperparameters and a sliding window time-steps mechanism to prepare and tune the model. Better tuning for hyperparameters and search for optimal window size is a tedious process. In this research work, we present an algorithm for hyperparameters tuning along with sliding window steps optimization. Results obtained on a real-time public traffic dataset show a higher capability of the proposed method to reduce the error and an average gain of the optimized model over the untuned network is 4.5%. Furthermore, we apply the optimal hyperparameters obtained in the experiment to other deep learning models and present that our approach improves prediction accuracy and stability.

Purpose: This evaluation study assesses the effectiveness of a creative writing programme for older people. Locations included: care homes, community-based locations, hospital wards and online. Method: Using a mixed-methods approach, the study draws upon: registration documents, facilitators’ diaries, qualitative interviews and satisfaction survey data. Both quantitative and qualitative data were independently analysed. Findings: A total of 190 people engaged with the programme, and 105 workshop sessions were delivered in six venues, with five being delivered online. A total of 653 surveys were returned, 105 facilitators’ diary entries were analysed, and 12 qualitative interviews were conducted. Six themes emerged from the qualitative analysis and these related to finding ways in which creativity can be stimulated and used for health and wellbeing. Originality: In spite of the pandemic and its effects on the planned delivery, the programme of work was very well received by participants. This may well be the only published evaluation of a programme of creative writing for older people that was partially delivered online. Writing groups for older people can be challenging, but they can prove beneficial in terms of self-expression and wellbeing. There is much potential for further development of bespoke online groups for this increasing population of older people.

Introduction: Neonatal sepsis is a clinical syndrome characterized by multiple symptoms and signs of infection during the first month of life. The objective of this study is to determine the frequency of commonly isolated bacteria from patients of neonatal sepsis and their susceptibility patterns in POF hospital at Wah. Methods: This cross-sectional study was carried out in POF Hospital Neonatal intensive care unit and Microbiology laboratory from January 2018 to December 2019. The blood samples of patients suspected with neonatal sepsis were processed as per standard methodology. Results: Out of ninety blood samples, fifty-one (56.7%) yielded the growth of Gram-negative rods and thirty-nine (43.3%) yielded Gram-positive cocci. Among Gram-positive bacteria, coagulase-negative staphylococci were the most common pathogen isolated from 53.8% cases followed by methicillin-resistant Staphylococcus aureus (15.3%). Among Gram-negative bacteria, Klebsiella pneumoniae (54.90%) was the most frequently identified bacteria followed by Serratia marcescens (27.45%). The Gram-positive cocci were the most susceptible to linezolid (100%) followed by vancomycin (87.2%). The Gram-negative rods depict remarkable resistance to ciprofloxacin (92.2%), gentamicin (100%), and meropenem (54.9%). Conclusions: The study concluded a predominance of Gram-negative bacteria as a causative agent of neonatal sepsis in our setup. The bacterial isolates are highly resistant to commonly prescribed oral as well as injectable antibiotics. Implementation of infection control policies is a dire need to combat the grave situation of increasing antibiotic resistance.

Published in August 2021.

The blood–brain barrier (BBB) plays a vital role in maintaining the specialized microenvironment of the neural tissue. It separates the peripheral circulatory system from the brain parenchyma while facilitating communication. Alterations in the distinct physiological properties of the BBB lead to BBB breakdown associated with normal aging and various neurodegenerative diseases. In this review, we first briefly discuss the aging process, then review the phenotypes and mechanisms of BBB breakdown associated with normal aging that further cause neurodegeneration and cognitive impairments. We also summarize dementia such as Alzheimer's disease (AD) and vascular dementia (VaD) and subsequently discuss the phenotypes and mechanisms of BBB disruption in dementia correlated with cognition decline. Overlaps between AD and VaD are also discussed. Techniques that could identify biomarkers associated with BBB breakdown are briefly summarized. Finally, we concluded that BBB breakdown could be used as an emerging biomarker to assist to diagnose cognitive impairment associated with normal aging and dementia.

Vertical growth is viewed as the solution to the problem of urban housing. The present study aims to be multifocal in approaching the phenomenon of apartment living in Lahore, Pakistan. The primary focus of the research was to evaluate the satisfaction with and favorability of vertical living among the dwellers; however, the research was extended to include the in-depth experiences of adolescents regarding privacy because it was observed that this age group was being neglected severely in the distribution of privacy in apartments, as well as in research. The data was first collected from 150 respondents through a survey, and then interviews of 10 adolescents were conducted to explore notion of privacy. The findings highlight that, despite being satisfied with the infrastructural aspects of the building, the residents do not prefer vertical living over horizontal housing. The adolescents in apartments also prefer horizontal housing over vertical living to avoid the feeling of crowdedness that is associated with vertical growth due to shared space and proximity. The utilization of spaces within apartments is associated with certain elements of development of the personality during this age. The findings of the present study can be helpful for sustainable vertical housing policy development and implementation.

Microcephaly (MCPH) is a genetically heterogeneous disorder characterized by non-progressive intellectual disability, small head circumference, and small brain size compared with the age- and sex-matched population. MCPH manifests as an isolated condition or part of another clinical syndrome; so far, 25 genes have been linked with MCPH. Many of these genes are reported in Pakistani population, but due to a high rate of consanguinity, a significant proportion of MCPH cohort is yet to be explored. MCPH5 is the most frequently reported type, accounting for up to 68.75% alone in a genetically constrained population like Pakistan. In the current study, whole exome sequencing (WES) was performed on probands from 10 families sampled from South Waziristan and two families from rural areas of the Pakistani Punjab. Candidate variants were validated through Sanger sequencing in all available family members. Variant filtering and in silico analysis identified three known mutations in ASPM, a MCPH5-associated gene. The founder mutation p.Trp1326* was segregating in 10 families, which further confirmed the evidence that it is the most prominent mutation in Pashtun ethnicity living in Pakistan and Afghanistan. Furthermore, the previously known mutations p.Arg3244* and p.Arg1019* were inherited in two families with Punjab ethnic profile. Collectively, this study added 12 more families to the mutational paradigm of ASPM and expanded the Pakistani MCPH cohort.

To address threats to the natural environment, the government in Pakistan has banned use of plastic bags for shopping. The concept of governmentality presented by Michel Foucault explores the techniques of governance and defines law not just as the manifestation of sovereign power but also as a technique of governance involving a range of organized practices designed to shape mentalities to achieve certain desired ends in subjects which claim to be for the welfare of the population. The present study explores the perceptions of the consumers regarding the rationality of the government behind the ban and also highlights the effectiveness of the use of law as a technique of governance. A qualitative approach was used by conducting fifteen interviews with young consumers selected through convenience sampling. The findings suggest that the rationality of the government behind the ban was received well by the consumers and the ban was viewed as a positive and pro-environmental step. The use of law as a technique of governance also proved to be effective in the said case because the people did not perceive the law as coercive despite the radical change it brought to their shopping practices. The present study contributes to the development of the theoretical understanding of governmentality and its sub-concept of the use of law as a technique of governance.

Background: In 2016, over one-quarter of births in the UK (28.2%) were to foreign-born women. Maternal and perinatal mortality are disproportionately higher among some immigrants depending on country of origin, indicating the presence of deficits in their care pathways and birth outcomes. Objectives: Our objective was to undertake a systematic review and narrative synthesis of empirical research that focused on access and interventions to improve maternity care for immigrant women, including qualitative, quantitative and mixed-methods studies. Review methods: An information scientist designed the literature database search strategies (limited to retrieve literature published from 1990 to 2018). All retrieved citations (45,954) were independently screened by two or more team members using a screening tool. We searched grey literature reported in related databases and websites. We contacted stakeholders with subject expertise. In this review we define an immigrant as a person who relocates to the destination country for a minimum of 1 year, with the goal of permanent residence. Results: We identified 40 studies for inclusion. Immigrant women tended to book and access antenatal care later than the recommended first 10 weeks of pregnancy. Primary factors included limited English-language skills, lack of awareness of availability of the services, lack of understanding of the purpose of antenatal appointments, immigration status and income barriers. Immigrant women had mixed perceptions regarding how health-care professionals (HCPs) had delivered maternity care services. Those with positive perceptions felt that HCPs were caring, confidential and openly communicative. Those with negative views perceived HCPs as rude, discriminatory or insensitive to their cultural and social needs; these women therefore avoided accessing maternity care. We found very few interventions that had focused on improving maternity care for these women and the effectiveness of these interventions has not been rigorously evaluated. Limitations: Our review findings are limited by the available research evidence related to our review questions. There may be many aspects of immigrant women’s experiences that we have not addressed. For example, few studies exist for perinatal mental health in immigrant women from Eastern European countries (in the review period). Many studies included both immigrant and non-immigrant women. Conclusions: Available evidence suggests that the experiences of immigrant women in accessing and using maternity care services in the UK are mixed; however, women largely had poor experiences. Contributing factors included a lack of language support, cultural insensitivity, discrimination and poor relationships between immigrant women and HCPs. Furthermore, a lack of knowledge of legal entitlements and guidelines on the provision of welfare support and maternity care to immigrants compounds this. Future work: Studies are required on the development of interventions and rigorous scientific evaluation of these interventions. Development and evaluation of online antenatal education resources in multiple languages. Development and appraisal of education packages for HCPs focused on the provision of culturally safe practice for the UK’s diverse population. The NHS in the UK has a hugely diverse workforce with a vast untapped linguistic resource; strategies could be developed to harness this resource. Study registration: This study is registered as PROSPERO CRD42015023605. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 14. See the NIHR Journals Library website for further project information.

OBJECTIVES:To conduct a population-wide representative survey to collect multi-dimensional information on the various aspects of individual, household, and population health in the Khyber Pakhtunkhwa (KP) province of Pakistan. METHODS:A multi-stage stratified cluster sampling is used in 24 districts of KP conducted from 2016-2017. Urban-areas are divided into enumeration blocks based on the low-, middle- and high-income groups and rural-areas are divided into mohallas/villages respectively. These are the primary sampling units (PSU’s). Each enumeration block/village/mohallas comrises of 250-300 households (secondary sampling units). Line listing of the selected enumeration blocks for urban and mohallas/villages for rural-areas are done to select 12 household per urban enumeration block and 16 households per rural PSU. The total sample size of the study is 15,724 households (3756 urban areas & 11968 rural areas). Three sets of questionnaires are used: • A household questionnaire (consisting of demographic, and socioeconomic characteristics of all household members) • A questionnaire for ever-married women aged 15-49 years (consisting of infant and maternal mortality, maternal and newborn health, contraception, child vaccination, and nutrition) • A health questionnaire for adults aged ≥18 years (consisting of anthropometry, communicable and non-communicable diseases, stroke, disability, health-related quality of life, physical activity, dietary recall, tobacco use, environmental health, and medicine used). Ethical approval has been taken from the ethical committee of the Khyber Medical University, Peshawar. The data will be entered and analysed in STATA version-14. DISCUSSION:The outcomes of the survey could be used as an evidence to bring reforms in the health and population welfare policies.

There is a debate going on in the present literature that how narcissism predicts several behaviors on social networking sites but the search for potential moderators of that relationship was not given much attention. A survey that assesses narcissism, time spent on TV and self-promoting behavior on Facebook was conducted with 151 undergraduate and post graduate students. Our finding indicates that narcissism and time spent on TV has significant positive relationship with self-promoting behavior on Facebook. The relationship between narcissism and self- promoting behavior is found to be significantly moderated by time spent on TV. The findings are discussed in the context of learning self-enhancing through exposure to TV programs and imitating that behavior for self-regulation by narcissistic individuals through social media.

Castleman's disease is a rare benign lymphoproliferative disorder, characterized by benign growths of the lymph node tissue. It is associated with a number of malignancies, including Kaposi sarcoma, non-Hodgkin's and Hodgkins lymphoma, and POEMS syndrome. This report describes the case of a 38 year old gentleman, presenting with painless hematuria. Initial investigations, including flexible cystoscopy were unremarkable. However, subsequent imaging including CT Urogram and MR pelvis revealed multiple prevesical lesions. Histology obtained from excision biopsy revealed histological features consistent with Castleman's disease. In this report we discuss the nature, presentation and treatment modalities of this rare condition.

In this work, the angular distribution of atmospheric cosmic muons is studied using PYTHIA8 simulations, comparing it to the experimental data. The standalone code in PYTHIA8 consists of an atmosphere of only nitrogen molecules. Here, the standalone code has been augmented adding oxygen molecules with a relative abundance of 78:22 (Nitrogen:Oxygen) to resemble a more realistic atmosphere. The vertical flux intensity (Iμ(θ)) of cosmic muons varies with zenith angle as a function of cosnθ, where θ is the zenith angle and n is the exponent term. The vertical flux intensity of cosmic muons has been characterized as a function of zenith angle (θ), momentum (p) and energy (E). Simulations are compared to the experimental results found in the literature and to the measurements performed at the surface laboratories of SINP (Kolkata) and JUSL (Jadugoda) at two different latitudes and altitudes in May 2024. The integrated vertical muon flux (Iμ(0)) and the exponent term (n) are extracted by fitting each experimental dataset. The simulated vertical flux intensity (Iμ(θ)) as a function of the zenith angle (θ) of cosmic muons shows a good level of agreement with the spectral shape of our experimental data as well as with that from literature. This study highlights the relevance of PYHTIA8 in the context of air-shower simulations, improving its predictive power by incorporating a more realistic atmospheric model. [ABSTRACT FROM AUTHOR]

Undernutrition is a major public health problem in developing countries. Around 40·2 % of children are stunted in Pakistan. This longitudinal study aimed to assess the effectiveness of locally produced ready-to-use supplementary foods in the prevention of stunting by detecting change in of children in intervention v. control arm against the 2006 WHO growth reference. A community-based non-randomised cluster-controlled trial was conducted from January 2018 to December 2020 in the district of Kurram, Khyber Pakhtunkhwa, Pakistan. A total of 80 clusters (each cluster comprising ≈ 250–300 households) were defined in the catchment population of twelve health facilities. Children aged 6–18 months were recruited n 1680. The intervention included a daily ration of 50 g – locally produced ready-to-use-supplementary food (Wawa-Mum). The main outcome of this study was a change in length for age z-score (LAZ) v. WHO growth standards. Comparison between the interventions was by t test and ANOVA. Cox proportional hazard models were used to assess the association between stunting occurrence and the utilisation of locally produced supplement. Out of the total 1680, fifty-one out of the total 1680, 51·1 out of the total 1680 and 51·1 % (n 859) were male. Mean age 13·9 months (sd + 859) were male. Mean age 13·9 months (sd + –4·4). At baseline, 36·9 % (n 618) were stunted. In the intervention group, mean LAZ score significantly increased from −1·13(2·2 sd) at baseline to −0·93(1·8 sd) at 6-month follow-up (P value 0·01) compared with the control group. The incidence rate of stunting in the intervention arm was 1·3 v. 3·4 per person year in the control arm. The control group had a significantly increased likelihood of stunting (Hazard Ratio (HR) 1·7, 95 % CI 1·46, 2·05, P value < 0·001) v. the intervention group. Locally produced ready-to-use supplementary food is an effective intervention for reducing stunting in children below 2 years of age. This can be provided as part of a malnutrition prevention package to overcome the alarming rates of stunting in Pakistan. [ABSTRACT FROM AUTHOR]