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Objective: This study aimed to assess the efficacy of nasal continuous positive airway pressure (CPAP) in term and preterm neonates with respiratory distress by evaluating successful outcomes, identifying factors contributing to treatment failure, and documenting associated complications. Method: A comparative cross-sectional study design was employed. The research was conducted at Combined Military Hospital (CMH) Rawalpindi from November 2022 to July 2023. All consecutive neonates admitted during the specified period with respiratory distress requiring CPAP treatment and meeting inclusion criteria were enrolled. Pre- and post-CPAP respiratory distress levels, relevant biochemical markers, as well as mortality and morbidity rates were documented. Both descriptive and inferential statistical analyses were employed. Results: The mean age of the study cohort was 53.3±85.6 minutes. The average time to initiate CPAP was 82.4 ± 94.7 minutes. Mean gestational age stood at 34.68±2.8 weeks. CPAP was successful in 97% of babies. The low birth weight below 1200grams was the main factor related to failure of CPAP. The mean Downes score decreased from 5.8±1.3 before CPAP to 3.3±1.6 after 12 hours of CPAP and further to 1.85±2 after 24 hours. Significant improvements in Downes score were noted after 24 hours of CPAP usage (p < 0.05) using paired sample T-test. Conclusion: This study affirms the effectiveness of CPAP in addressing neonatal respiratory distress. The utilization of CPAP emerges as a valuable intervention that not only reduces the requirement for invasive ventilation but also exhibits the potential to alleviate morbidity and mortality rates among neonatal populations. [ABSTRACT FROM AUTHOR]

Aim: Despite recurring mumps outbreaks in Pakistan, the virus's genomic diversity remains unavailable. This study explores the mumps genomic diversity in the 2023 Islamabad outbreak. Methods: During January and February 2023, 32 buccal/throat swabs were collected from suspected mumps cases. 15 tested mumps virus (MuV)-positive via RT-PCR. Positive samples underwent partial SH gene sequencing; a subset (n = 10) was whole-genome sequenced using Illumina MiSeq. Results: Phylogenetic analysis identified genotype-G, sharing 95.57–98.73% homology with Japanese/Canadian isolates. Whole-genome-sequencing (n = 2) confirmed genotype-G, 99% similar to Sheffield/Iowa strain. HN region displayed 95.01–95.36% identity with Jeryl Lynn, with genotype G-specific mutations, except T265I. Conclusion: This is the first report of partial and whole-genome sequencing of MuV from Pakistan, highlighting the necessity for genomic surveillance and vaccine integration. This study investigated the different types of mumps virus (MuV) in Islamabad during the 2023 outbreak. Out of 32 people thought to have mumps, 15 were confirmed by lab tests. We found that these 15 people had been infected by the same type of MuV, similar to those that have been investigated in Japan and Canada. Two people had also been infected by a type of MuV that was responsible for an outbreak in the USA in 2006. This is the first study of its kind in Pakistan. It shows how important it is to monitor MuV and to include the MuV vaccine in the national program. This could help to better control mumps infections in the future. [ABSTRACT FROM AUTHOR]

Objective: To compare the typical and atypical celiac patients in terms of different clinical parameters and the impact of late diagnosis. Study Design: A retrospective descriptive comparative study. Place and Duration: Pediatric Outpatient of Federal General Hospital (FGH), Chak Shahzad, Islamabad from 1st January 2018 to 31st December 2019. Methodology: Diagnosed patients with celiac disease were divided into two groups according to typical or atypical symptoms and evaluated for the clinical and biochemical markers and the long term effects of late diagnosis were determined, especially in atypical celiac disease. Results: A total of 50 patients were studied. Mean age at diagnosis was 7.1 years. The younger age was associated with typical symptoms. Most common extra-intestinal manifestations were anemia and short stature, combined or alone. The mean length of late diagnosis was 3.8 years. Urban areas had a high rate of late diagnosis despite having more facilities. The study shows unnecessary investigations and treatment interventions were done especially in atypical celiac disease patients' further delaying diagnosis. Conclusion: Atypical celiac disease is quite common in children and they showed more different aspects of late diagnosis negatively affecting them than the typical ones especially in terms of anemia and short stature. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to measure the impact of Green supply chain management practices(GSCMP) on Economic Performance (EP), Environmental Performance (ENP)and Social Performance (SP)of the frozen food companies. The impact of GSCMP on EP, ENP and SP is measured by using SQM on PLS Smart to test the proposed hypothesis. The data was collected by using a questionnaire through emails and face to face interaction with managers of five major frozen food companies of Pakistan. The results of the research show that there is a direct impact of GSCMP on EP, SP and ENP of the organizations. [ABSTRACT FROM AUTHOR]

Background Globally, infectious diarrhea poses a serious threat to public health, especially in emergency department (ED) settings where timely and efficient treatment is essential. The primary objective of this study was to explore and evaluate the efficacy of a multidisciplinary approach (MDA) in the management of infectious diarrhea within the ED setting. Methodology This prospective cohort study was conducted from January to December 2023 at the Lady Reading Hospital ED in Peshawar, Pakistan. Individuals 18 years of age or older with a confirmed diagnosis of infectious diarrhea were included in the study. Those who refused to participate or had non-infectious reasons were excluded from the study. Through successive sampling, 650 patients comprised the study sample. Using a standardized form, demographic information, clinical presentations, test results, treatment methods, and patient outcomes were collected. Descriptive statistics and logistic regression were used in statistical studies to assess treatment outcomes and complications. Results Of the 650 patients, the majority (203 patients, 31.23%) were between the ages of 30 and 39 years. The gender distribution was about equal (332 men, 51.08%; 318 females, 48.92%). Abdominal pain (383 patients, 58.92%) was the most common presenting complaint. In 310 instances, bacterial pathogens were found, 160 had viral infections, and 110 had parasitic infections. There were notable complications, such as sepsis (37 patients, 5.69%), although the response to treatment effectiveness was notably high (593 patients, 91.08%). Upon follow-up, 590 (90.77%) patients had symptom and sign resolution, while 80 (12.31%) patients had a low recurrence rate. Longer symptom duration (odds ratio (OR) = 1.45, 95% confidence interval (CI) 1.12-1.88, p = 0.005) and specific antibiotics (OR = 1.68, 95% CI = 1.25-2.25, p = 0.001) were found to improve treatment success using logistic regression, whereas the risks of complications increased with age (OR = 1.05, 95% CI = 1.01-1.09, p = 0.012) and severe dehydration (OR = 1.75, 95% CI = 1.32-2.31, p < 0.001). Conclusions The MDA to manage infectious diarrhea in the ED significantly improved patient outcomes and reduced complications., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board of Lady Reading Hospital issued approval NA. The Institutional Review Board of Lady Reading Hospital in Peshawar, Pakistan, granted ethical clearance for this research before data collection started. Prior to their involvement in the study, all participants or their legal guardians provided informed permission, guaranteeing that the ethical standards of patient autonomy, beneficence, and confidentiality were upheld throughout the investigation. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ullah et al.)