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Battery-powered devices face unprecedented technical problems due to limits such as low power density, expensive, and heaviness. Wireless power transfer (WPT) is a revolutionary energization pattern that provides a completely new way for electric-driven devices to acquire energy, reducing their reliance on batteries. This study provides a review of WPT approaches, focusing on their working mechanisms, technical obstacles and traditional applications. This study focuses on WPT systems and highlights current important research areas as well as potential development trends. This unique energy transmission system has important implications for the widespread use of renewable energy in our daily lives.

Studies have indicated that transportation noise is associated with higher cardiovascular mortality, whereas evidence of noise as a risk factor for respiratory and cancer mortality is scarce and inconclusive. Also, knowledge on effects of low-level noise on mortality is very limited. We aimed to investigate associations between road and railway noise and natural-cause and cause-specific mortality in the Danish population. We estimated address-specific road and railway noise at the most (LdenMax) and least (LdenMin) exposed façades for all residential addresses in Denmark from 1990 to 2017 using high-quality exposure models. Using these data, we calculated 10-year time-weighted mean noise exposure for 2.6 million Danes aged >50 years, of whom 600,492 died from natural causes during a mean follow-up of 11.7 years. We analyzed data using Cox proportional hazards models with adjustment for individual and area-level sociodemographic variables and air pollution (PM2.5 and NO2). We found that a 10-year mean exposure to road LdenMax and road LdenMin per 10 dB were associated with hazard ratios (95% confidence intervals) of, respectively, 1.09 (1.09; 1.10) and 1.10 (1.10; 1.11) for natural-cause mortality, 1.09 (1.08; 1.10) and 1.09 (1.08; 1.10) for cardiovascular mortality, 1.13 (1.12; 1.14) and 1.17 (1.16; 1.19) for respiratory mortality and 1.03 (1.02; 1.03) and 1.06 (1.05; 1.07) for cancer mortality. For LdenMax, the associations followed linear exposure-response relationships from 35 dB to 60–

Aim: To estimate the burden of non-communicable diseases and to assess the dietary pattern along with important relevant determinants among adult population of district Kohat & Nowshera Khyber Pukhtunkhwa Pakistan Study Design: A descriptive cross sectional study Place & Duration: This study was conducted in Kohat & Nowshera Districts of Khyber Pukhtunkhwa Pakistan; from June to December 2022. Methodology: A total of n=385 male adults was selected and a structured questionnaire was used to collect relevant information regarding demographic, dietary, behavioral determinants. Finally data was analyzed and presented in form of text and tables. Results: Results showed that 55.71% had age above 37 years; 28.31% were illiterate; 25.71% had monthly income more than 45000/ PKR; 60.78% were married; and 82.08% were employed. Moreover, 30.39% were current tobacco smoking; and 24.68% had positive history of past tobacco smoking. Furthermore, 44.94% prefer high caloric; 40.78% vegetables; 45.19% meat; 63,38% fresh fruits; and 18.70% & 21.30% prefer too much sugar and salt in food respectively. Furthermore; hypertension, malnutrition, eye problems and cancer were found among 22.60%, 59.74%, 7.01% & 2.08% respectively. Conclusions: It was concluded that common non-communicable diseases were present in the studied male adults and showed strong relationship with dietary pattern along with demographic, epidemiological and socio-economical determinants. Moreover, effective and efficient policies and strategies were needed to reduce the double burden of non-communicable disease and its associated complications. Keywords: Prevalence, Determinants, Diet, Vegetables, Overweight, Obesity, Tobacco, Adults

Objective: To assess the knowledge, attitude and practice of food handlers regarding food safety and personnel hygiene practices among the local food handlers of District Kohat Khyber Pakhtunkhwa Pakistan. Methodology: The Department of Community Medicine at the KMU-Institute of Medical Sciences (KIMS), Kohat, conducted a cross-sectional study between December 2021 and May 2022. A cross-sectional study with a sample of n=265 adults was conducted, with a 95% confidence interval and a 5% margin of error. The respondents' food safety knowledge, attitudes, and behaviours were evaluated using a well-designed questionnaire. Data were entered and analysed using SPSS version 26.0. Final results were tabulated and presented. Results: Out of those surveyed, 39.25% were found to have a basic understanding of the written word; 82.648% earned less than 30,000 PKR per month; 58.87% had worked for at least four years; and 67.74% were in the service industry (mostly as cooks and wait staff). In addition, 32.83 percent of those who handled the food had adequate expertise, 90.94 percent had an upbeat mentality, and 47.92 percent followed adequate procedures to ensure the safety and cleanliness of the food they handled. Conclusions: It was concluded that knowledge of food handlers was not up to the standards of food safety and personnel hygiene practices. Moreover, the attitude of food handlers was satisfactory whereas the practice was below the average satisfactory level and thus needs strategies to enhance knowledge, and to improve practices of food handlers regarding food safety to reduce food borne diseases. Keywords: Knowledge, Food Contamination, Practice, Food Handlers, Attitude, Kohat.

Background Colon cancer incidence is rising globally, and factors pertaining to urbanization have been proposed involved in this development. Traffic noise may increase colon cancer risk by causing sleep disturbance and stress, thereby inducing known colon cancer risk-factors, e.g. obesity, diabetes, physical inactivity, and alcohol consumption, but few studies have examined this. Objectives The objective of this study was to investigate the association between traffic noise and colon cancer (all, proximal, distal) in a pooled population of 11 Nordic cohorts, totaling 155,203 persons. Methods We identified residential address history and estimated road, railway, and aircraft noise, as well as air pollution, for all addresses, using similar exposure models across cohorts. Colon cancer cases were identified through national registries. We analyzed data using Cox Proportional Hazards Models, adjusting main models for harmonized sociodemographic and lifestyle data. Results During follow-up (median 18.8 years), 2757 colon cancer cases developed. We found a hazard ratio (HR) of 1.05 (95% confidence interval (CI): 0.99–1.10) per 10-dB higher 5-year mean time-weighted road traffic noise. In sub-type analyses, the association seemed confined to distal colon cancer: HR 1.06 (95% CI: 0.98–1.14). Railway and aircraft noise was not associated with colon cancer, albeit there was some indication in sub-type analyses that railway noise may also be associated with distal colon cancer. In interaction-analyses, the association between road traffic noise and colon cancer was strongest among obese persons and those with high NO2-exposure. Discussion A prominent study strength is the large population with harmonized data across eleven cohorts, and the complete address-history during follow-up. However, each cohort estimated noise independently, and only at the most exposed façade, which may introduce exposure misclassification. Despite this, the results of this pooled study suggest that traffic noise may be a risk factor for colon cancer, especially of distal origin.

Studies suggest a link between PM2.5 and amyotrophic lateral sclerosis (ALS), but critical exposure windows have not been examined. We performed a case-control study on the Danish population spanning 1989 to 2013. Cases selected from the Danish National Patient Registry based on ICD codes. Five controls were randomly selected from the Danish Civil Registry and matched to a case on vital status, age, and sex. PM2.5 concentration was assigned at residential addresses using monthly predictions from a dispersion model. We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusting for confounding. We evaluated exposure to averaged PM2.5 concentrations 12-24 months, 2-6, and 2-11 years pre-ALS diagnosis; annual lagged exposures up to 11 years pre-diagnosis; and cumulative associations in lags 1-5 and 1-10, allowing for varying association estimates by year. We identified 3983 cases and 19,915 controls. Cumulative exposure to PM2.5 in the period 2 to 6 years pre-diagnosis was associated with ALS (OR=1.06, 95% CI: 0.99–1.13). Exposures in the 2nd, 3rd, and 4th year preceding diagnosis were individually associated with higher odds of ALS (e.g., lag-1 OR=1.04, 95% CI: 1.00–1.08). Exposure to PM2.5 within six years before diagnosis may represent a critical exposure window.

Introduction Avascular necrosis of the rib is a rare presentation of sickle cell anemia's vaso-occlusive crisis. This report describes the case of a 45-year-old man known to have sickle cell anemia presenting with rib avascular necrosis complicated by osteomyelitis. The patient came to the outpatient department with left lateral chest wall pain. Antibiotics produced no improvement. A computed tomography scan of the chest revealed a left sixth rib fracture with a thick fluid collection consistent with pus. The patient was taken to surgery and underwent necrotic bone debridement and pus drainage. The patient showed improvement and became afebrile after the surgery. Conclusion The lack of distinct clinical indicators and low occurrence of rib avascular necrosis can lead to misdiagnosis and mismanagement of the disease.

ObjectivesTo investigate the association between occupational noise exposure and stroke incidence in a pooled study of five Scandinavian cohorts (NordSOUND).MethodsWe pooled and harmonised data from five Scandinavian cohorts resulting in 78 389 participants. We obtained job data from national registries or questionnaires and recoded these to match a job-exposure matrix developed in Sweden, which specified the annual average daily noise exposure in five exposure classes (LAeq8h): ResultsExposure to occupational noise at baseline was not associated with overall stroke in the fully adjusted models. For ischaemic stroke, occupational noise was associated with HRs (95% CI) of 1.08 (0.98 to 1.20), 1.09 (0.97 to 1.24) and 1.06 (0.92 to 1.21) in the 75–79, 80–84 and ≥85 dB(A) exposure groups, compared with ConclusionsWe found no association between occupational noise and risk of overall stroke after adjustment for confounders. However, the non-significantly increased risk of ischaemic stroke warrants further investigation.

BACKGROUND: Ambient air pollution exposure has been associated with childhood asthma, but previous studies have primarily focused on prevalence of asthma and asthma-related outcomes and urban traffic-related exposures. OBJECTIVE: We examined nationwide associations between pre-and postnatal exposure to ambient air pollution components and asthma incidence in children age 0–19 y. METHODS: Asthma incidence was identified from hospital admission, emergency room, and outpatient contacts among all live-born singletons born in Denmark between 1998 and 2016. We linked registry data with monthly mean concentrations of particulate matter (PM) with aerodynamic diameter ≤2:5 lm (PM2:5) and PM with aerodynamic diameter ≤10 lm (PM10 ), nitrogen dioxide (NO2), nitrogen oxides, elemental carbon, and organic carbon (OC), sulfur dioxide, ozone, sulfate, nitrate, ammonium, secondary organic aerosols, and sea salt. Associations were estimated with Cox propor-tional hazard models using fixed prenatal exposure means and time-varying postnatal exposures. RESULTS: Of the 1,060,154 children included, 6.1% had asthma during the mean follow-up period of 8.8 y. The risk of asthma increased with increas-ing prenatal exposure to all pollutants except for O3 and sea salt. We also observed increased risk after restriction to asthma after age 4 y, after addi-tional adjustment for area-specific socioeconomic status, and for postnatal exposure to most pollutants. The hazard ratio (HR) associated with an interquartile range increase of 2.4 and 8:7 lg=m3 in prenatal exposure was 1.06 [95% confidence interval (CI): 1.04, 1.08] for PM2:5 and 1.04 (95% CI: 1.02, 1.05) for NO2, respectively. This association with PM2:5 was stable after adjustment for NO2, whereas it attenuated for NO2 to 1.01 (95% CI: 0.99, 1.03) after adjustment for PM2:5. For a 0:5-lg=m3 increase in prenatal OC exposure, for which biomass is an important source, the HR was 1.08 (95% CI: 1.06, 1.10), irrespective of adjustment for PM2:5. DISCUSSION: These findings suggest that early-life exposure to ambient air pollution from multiple sources contributes to asthma development. https:// doi.org/10.1289/EHP11539.

Background: Health status of school children and their school environment plays an important role in the development of physical and mental health, and good personnel behaviors had a significant role in future life of children. Objective: This study was conducted to estimate the frequency of health problems among school children of district Swat, Khyber Pakhtunkhwa Pakistan. Methodology: This study was conducted in district Swat, Khyber Pakhtunkhwa; Pakistan. A total of n=225 school children of age 4-12 years were selected and examined for health problems. A structured questionnaire was used to assess the health status of children regarding health problems. Results: Results showed that 45.56% of children had age < 8 years; 54.44% had age > 8 years; 81.33% of children parents had monthly income < PKR: 45000; 56% children living in mud-made homes; and 46.675 were underweight. Moreover, 15.56% of children had eye discharge; 28.89% backache; 8.44% ear discharge; 16.445 earaches; 47.11% poor oral hygiene status; 60.44% were not using toothbrush; and 22.67% had dental caries. Furthermore, 41.33% had not clean their hair and not took bath within last 48 hours; and 32.89% had poor nail hygiene status for the past one week. Conclusions: It was concluded that school children had several medical health problems and showed relationship with hygiene status of children, tooth-brushing use and its frequency, parents monthly income, and body mass index of children and thus adequate preventive, promotive and behavioral strategies were needed to reduce health problems among school going children. Keywords: School Children, Health Status, Underweight, Eye, Ear, Hygiene, Income, Swat, Kohat.

Background: In both emerging and wealthy nations, the epidemic of overweight and obesity has exploded in the last several decades, becoming a huge public health concern. Objective: To estimate the frequency of overweight and obesity and its important determinants among the adult population of Selected Districts of Khyber Pakhtunkhwa Pakistan Methods: A descriptive cross sectional study was conducted by the Department of Community Medicine, Saidu Medical College, Swat Khyber Pakhtunkhwa Pakistan; from January to April 2022. A total of 410 adults were selected and a structured questionnaire was used to collect relevant information. Results: Results showed that 67.07% had age above 30 years; 72.44% were males, 37.32% were illiterate; 51.95% had monthly income less than 25000/ PKR; 54.39% were married; and 26.34% had family history of overweight and obesity. Moreover, 52.93% had sedentary life; 37.56% watch television; and 15.85% & 17.80% had diabetes mellitus & hypertension respectively. Furthermore, 26.34% prefer carbohydrates; and 44.15$ prefer soft drinks. 63.66% and 58.05% didn’t prefer vegetables and fruits respectively. Conclusions: It was concluded that prevalence of overweight and obesity showed moderate to high frequency among adults, and showed relationship was age, gender, marital status, tobacco smoking, dietary habits, and social habits. Thus effective educational, behavioral and social strategies are needed to prevent and control overweight and obesity in the population. Keywords: Prevalence, Determinants, Developing, Adults, Obesity, Overweight, Pakistan

Objective: To find out the frequency of anemia, agranulocytosis and thrombocytopenia in hyperthyroid patients after the use of propylthiouracil. Study Design: Cross sectional study. Place and Duration of Study: Out Door Patients Department and Pathology Laboratory in Liaquat University Medical & Health Sciences, Hospital Hyderabad/Jamshoro, from May 2016 to Apr 2017. Methodology: Two hundred cases, comprising of adult patients were categorized into five groups, age group 15-30 years 79 (39.5%) patients presenting the highest out of total, age group 31-45 years 68 (34%) patients, age group 46-60 years 36 (18%), age group 61-75 years 14 (7%) patients, age group >75 years 3 (1.5) patients. Complete blood count was analyzed on Sysmex Kx21 and thyroid profiles were analyzed on Elecysis 2010 from the Pathology Department. SPSS version 22 was used for data analysis. Result: Out of total patients, 32 (16%) were males and 168 (84%) were females with mean age of 37.44 ± 14.82 years. Majority of patients 68 (34%) were anemic, while 4 (2%) had agranulocytosis and 11 (5.5%) had thrombocytopenia. Headache was reported in 111 (55.5%), exophthalmos in 106 (53%), sore throat in 172 (86%), fever in 136 (68%) and weight loss in 95 (47.5%) patients. Conclusion: Propylthiouracil causes defective hematopoiesis in hyperthyroid patients because propylthiouracil has adverse suppressive effects on bone marrow.

Background: Agriculture is one of the most dangerous occupations, with high incidence and prevalence of occupational health problems; and farmers are exposed to a too many occupational hazards. Objective: This study was conducted to assess the frequency of occupational health problems among the local farmers of Swat, Peshawar and Kohat Districts Khyber Pakhtunkhwa Pakistan Methodology: After ethical approval; a cross sectional study was conducted among the selected districts of Khyber Pakhtunkhwa; Pakistan. Total of n=325 farmers were assessed regarding the occupational health problems. The famers were selected through convenience sampling technique, based on 95% confidence interval, with 5% precision. A structured open ended questionnaire was used in which farmers were asked regarding the occupational health problems. SPSS version 26.0 was used for data entry and analysis. Finally the result was presented in form of tables. Results: Results showed that 32% were literate; 51.38% had monthly income less than 30000/ PKR; 39.08% had farming for more than 10 years; and 68% were not following personnel protective equipments. Moreover, 38.77% had asthma/COPD; 44.62% had disturbed sleep; 26.77% had hearing loss; 42.15% had eye redness and discharge problems; 64.92% had body ache/ and backache; and 26.77% had history of injuries and falls. Conclusions: It was concluded that farmers revealed a huge list of medical health problems. Moreover, health problems showed relationship with age, educational level, working experience, and compliance of personnel protective equipments and thus occupational education and occupational training strategies were needed to reduce health impacts among farmers. Keywords: Food Contamination, Knowledge, Attitude, Practice, Food Handlers, Kohat

Background: Dental caries is a global public health problem, and affects 60-90% of children; and has relationship with social; dietary; and behavioral factors. The main objective of this study was to assess the frequency and risk factors of dental caries among children of District Nowshera Pakistan. Methods: A descriptive cross sectional study was conducted in District Nowshera, in which a total of n=295 children were examined regarding presence of dental caries, from January to April 2022. A structured questionnaire was used to collect data regarding determinants of dental caries and its risk factors from parents. Data was analyzed by SPSS and results were presented in form of tables. Results: The results showed that 60.68% of children had dental caries. Approximately, 54.92% were male; 64.41% had age < 5 years; 42.03% were working mothers; and 53.56% were form rural setup. Moreover; 46.78% use toothbrush; 26.78% use fluoride toothpaste; 73.56% were breastfed; 20.0% were bottle fed; and 83.39% had night feeding. Furthermore; 29.49% children preferred high caloric food intake; 32.88% prefer sugars in food; and 47.80% added sugar during bottle feeding of their children. Conclusions: It was concluded that dental caries showed moderate to high frequency among children; and showed strong relationship family income, body mass index, parent’s education level; and job status of parents. Moreover, frequency of tooth-brushing, fluoride tooth-paste, and sugar preference showed association with dental caries and thus social, dietary and health promotion strategies were needed to reduce prevalence and complications of dental caries. Keywords: Dental Caries, Toothbrush, Fluoride; Caloric Diet; Bottle Feedings; Nowshera, Pakistan

The objective of this study was to assess the frequency and risk factors of dental caries among adults in District Kohat and Nowshera Khyber Pakhtunkhwa Pakistan. Methods: After taking ethical approval, a descriptive cross sectional study was conducted in District Kohat and Nowshera, in which a total of n=435 adults were assessed and examined for dental caries, from November 2021 to March 2022. A structured questionnaire was used to collect data regarding dental caries and its risk factors. Moreover, relevant tooth brushing, and dietary information was also collected. Data was analyzed by SPSS and results were presented in form of tables. Results: The results showed that 23.68% of adults had dental caries. Approximately, 57.70% of adults are of age between 30-60 years; 25.06% had monthly income less than 25000/PKR per month; 14.02% were illiterate, and 40.92% were overweight and obese. Moreover, 52.64% had compliance to daily tooth-brushing; 49.66% used fluoride tooth paste; 41.15% and 58.85% prefer sugar and sweet beverages respectively. Furthermore, 21.84% had poor oral hygiene; 14.94% had routine dental examinations; and 49.21% & 32.41% prefer vegetables and fruits. Conclusions: Concluded that dental caries showed moderate prevalence among adults and revealed relationship with age; monthly income, body mass index, and literacy level. Moreover, frequency of tooth-brushing, fluoride tooth-paste, oral hygiene status and sweet preference showed association with dental caries and thus comprehensive preventive and health promotion strategies were needed to overcome dental caries among adults. Keywords: Dental Caries, Toothbrush, Fluoride, Monthly Income, Sugar, Sweet beverages, Nowshera

Air pollution is associated with increased risk of myocardial infarction (MI), but it is unresolved to what extent the association is modified by factors such as socioeconomic status, comorbidities, financial stress, residential green space, or road traffic noise. We formed a cohort of all (n = 1,964,702) Danes, aged 50–85 years, with 65,311 cases of MI during the followed-up period 2005–2017. For all participants we established residential five-year running average exposure to particulate matter 2.5), ultrafine particles (UFP, 2). We evaluated risk in population strata, using Aalen additive hazards models to estimate absolute risk and Cox proportional hazards models to estimate relative risk of MI with 95% confidence intervals (CI). PM2.5 and the other pollutant were associated with MI. Lower education and lower income were associated with higher absolute risks of MI from air pollution, whereas no clear effect modification was apparent for relative risk estimates. For example, 5 μg/m3 higher PM2.5 was associated with HR for MI of 1.16 (95% CI: 1.10–1.22) among those with only mandatory education and 1.13 (95% CI: 1.03–1.24) among those with long education. The corresponding rate differences per 100,000 person years were 243 (95% CI: 216–271) and 358 (95% CI: 338–379), respectively. Higher level of comorbidity was consistently across all four pollutants associated with both higher absolute and relative risk of MI. In conclusion, people with comorbid conditions or of lower SES appeared more vulnerable to long-term exposure to air pollution and more cases of MI may be prevented by focused interventions in these groups.

Background: The aetiology of most childhood cancers remains poorly understood. We conducted a nationwide register-based case-control study to assess the association between residential road traffic and railway noise exposure and risk of childhood cancers. Methods: We identified all cases of first cancers diagnosed in children aged 0–19 years in 1985–2013 from the Danish Cancer Registry (N = 3962) and sampled four individually matched (by sex and date of birth) controls per case (N = 14,790) using the Central Population Register. We estimated time-weighted exposure averages of residential road traffic and railway noise at the most (Lden max) and least (Lden min) exposed façades from birth to index-date (for additional analysis: in utero period) based on the individual address history for the respective time windows. We fitted conditional logistic regression models to estimate odds ratios (OR) and their 95% confidence intervals (CI). Results: ORs varied by noise estimate and cancer type, with generally wide CIs mostly including 1.00. We found a tendency of higher ORs with increasing railway and road traffic noise for Hodgkin lymphoma (ORs for railway and road Lden min were 1.63 (95% CI 1.00; 2.66) and 1.14 (95% CI 0.87; 1.48) per 10 dB), as well as a tendency of higher ORs with increasing railway noise for non-Hodgkin lymphoma. For embryonal CNS tumours and astrocytoma and other glioma we observed also some weak suggestions of a positive association. Analysing exposure to traffic noise in utero revealed similar patterns to those of the main analyses. Conclusions: This nationwide study with minimal risk of bias suggests no strong associations between traffic noise and risk of most childhood cancers. We found however some suggestive evidence for a positive association with Hodgkin lymphoma, non-Hodgkin lymphoma and some CNS tumours. Further research is warranted to confirm these associations in other populations and elucidate the underlying biological mechanisms.

Background: Transportation noise increases the risk of ischemic heart disease (IHD), but few studies have investigated subtypes of IHD, such as myocardial infarction (MI), angina pectoris, or heart failure. We aimed to study whether exposure to road, railway and aircraft noise increased risk for ischemic heart disease (IHD), IHD subtypes, and heart failure in the entire adult Danish population, investigating exposures at both maximum exposed and silent façades of each residence. Methods: We modelled road, railway, and aircraft noise at the most and least exposed façades for the period 1995–2017 for all addresses in Denmark and calculated 10-year time-weighted running means for 2.5 million individuals age ≥50 years, of whom 122,523 developed IHD and 79,358 developed heart failure during follow-up (2005–2017). Data were analyzed using Cox proportional hazards models, adjusted for individual and area-level sociodemographic covariates and air pollution. Results: We found road traffic noise at the most exposed façade (Lden) to be associated with higher risk of IHD, myocardial infarction (MI), angina pectoris, and heart failure, with hazard ratios (HRs) (95% confidence intervals (CI)) of 1.052 (1.044–1.059), 1.041 (1.032–1.051), 1.095 (1.071–1.119), and 1.039 (1.033–1.045) per 10 dB higher 10-year mean exposure, respectively. These associations followed a near-linear exposure-response relationship and were robust to adjustment for air pollution with PM2.5. Railway noise at the least exposed façade was associated with heart failure (HR 1.28; 95% CI: 1.004–1.053), but not the other outcomes. Exposure to aircraft noise (>45 dB) seemed associated with increased risk for MI and heart failure. Conclusions: We found road traffic noise and potentially railway and aircraft noise to increase risk of various major cardiovascular outcomes, highlighting the importance of preventive actions towards transportation noise.

Background: Drug stores in Pakistan are run by dispensers with varied knowledge, qualification, and experience. The current study was sought to explore the knowledge, qualification, experience, and dispensing practices among dispensers working in drugstores in South Karachi, Pakistan.Methods: A cross-sectional survey was carried out using a structured questionnaire. Data were collected from medical stores in South Karachi which were then categorized, coded, and analyzed using SPSS version 23. Relationship among different study variables with pharmacist’s availability and personal experience was assessed using statistical non-parametric Chi-square test. A total of 385 samples obtained using a simple random sampling method were included in the study. However, only 210 responses on questionnaire were complete which were then selected for study analysis between October and December 2018.Results: Of the 210 surveyed drugstores, 9% of their staff had studied only till primary school, 5.7% till the eighth grade, 25.2% up to secondary school level, 26.7% till higher secondary school level, 15.7% had non-professional education, and 8.1% were professional graduate. Only 9% of them had a degree in Pharm. D or B. Pharm, while 0.5% had a post-graduation qualification. Furthermore, 44.8% of pharmacies had a valid pharmacy license but the pharmacist was physically absent in 91% of the drugstores. Majority of pharmacies did not maintain appropriate temperature (refrigerator and/or room temperature). Majority of dispensers did not review prescription particulars before dispensing medications and also dispensed medications on older prescriptions as well as without prescription.Conclusion: In conclusion, the overall knowledge and practices of dispensers working in drugstores was poor. However, the presence of pharmacist was associated with good dispensing practices to a certain extent. Keywords: community pharmacy, good dispensing practice, pharmacist, prescription review

High-resolution air quality (AQ) maps based on street-by-street measurements have become possible through large-scale mobile measurement campaigns. Such campaigns have produced data-only maps and have been used to produce empirical models [i.e., land use regression (LUR) models]. Assuming that all road segments are measured, we developed a mixed model framework that predicts concentrations by an LUR model, while allowing road segments to deviate from the LUR prediction based on between-segment variation as a random effect. We used Google Street View cars, equipped with high-quality AQ instruments, and measured the concentration of NO

BACKGROUND: Animal and epidemiologic studies indicate that air pollution may adversely affect fertility. Epidemiologic studies have been restricted largely to couples undergoing fertility treatment or have retrospectively ascertained time-to-pregnancy among pregnant women.OBJECTIVES: We examined the association between residential ambient air pollution and fecundability, the per-cycle probability of conception, in a large preconception cohort of Danish pregnancy planners.METHODS: During 2007-2018, we used the Internet to recruit and follow women who were trying to conceive without the use of fertility treatment. Participants completed an online baseline questionnaire eliciting socio-demographic characteristics, lifestyle factors, and medical and reproductive histories and follow-up questionnaires every 8 weeks to ascertain pregnancy status. We determined concentrations of ambient nitrogen oxides (NOx ), nitrogen dioxide (NO2 ), carbon monoxide (CO), ozone (O3 ), particulate matter RESULTS: During 12 months of follow-up, 73% of participants conceived. Higher concentrations of PM2.5 and PM10 were associated with small reductions in fecundability. For example, the FRs for a one interquartile range (IQR) increase in PM2.5 (IQR = 3.2 µg/m3 ) and PM10 (IQR = 5.3 µg/m3 ) during each menstrual cycle were 0.93 (95% CI: 0.87, 0.99) and 0.91 (95% CI: 0.84, 0.99), respectively. Other air pollutants were not appreciably associated with fecundability.CONCLUSIONS: In this preconception cohort study of Danish women, residential exposures to PM2.5 and PM10 were associated with reduced fecundability.

Background: Some studies have found transportation noise to be associated with higher diabetes risk. This includes studies based on millions of participants, relying entirely on register-based confounder adjustment, which raises concern about residual lifestyle confounding. We aimed to investigate associations between noise and type 2 diabetes (T2D), including investigation of effects of increasing confounder adjustment for register-data and lifestyle. Methods: In a cohort of 286,151 participants randomly selected across Denmark in 2010–2013 and followed up until 2017, we identified 7574 incident T2D cases. Based on residential address-history for all participants linked with exposure assessment of high spatial resolution, we calculated 10-year time-weighted mean road and railway noise at the most (LdenMax) and least (LdenMin) exposed façades and air pollution (PM2.5). We used Cox models to calculate hazard ratios (HR) with increasing adjustment for individual- and area-level register-based sociodemographic covariates, self-reported lifestyle and air pollution. Results: We found that a 10 dB increase in 10-year mean road LdenMin was associated with HRs (95% CI) of 1.06 (1.02–1.10) after adjustment for age, sex and year, 1.08 (1.04–1.13) after further adjustment for register-based sociodemographic covariates, 1.07 (1.03–1.12) after further lifestyle adjustment (e.g. smoking, diet and alcohol) and 1.06 (1.02–1.11) after further PM2.5 adjustment. For road LdenMax, the corresponding HRs were 1.07 (1.04–1.10), 1.05 (1.02–1.08), 1.04 (1.01–1.07) and 1.03 (1.00–1.06). Railway noise was associated with HRs of 1.04 (0.98–1.11) for LdenMax and 1.02 (0.92–1.12) for LdenMin after adjustment for sociodemographic and lifestyle covariates and PM2.5. Conclusions: Long-term exposure to road traffic noise was associated with T2D, which together with previous literature indicates that T2D should be considered when calculating health impacts of noise. After sociodemographic adjustment, further lifestyle adjustment only changed HRs slightly, suggesting that large register-based studies with adjustment for key sociodemographic covariates can produce reliable results.

Background: Epidemiologic studies have linked transportation noise to increased morbidity and mortality, particularly for cardiovascular outcomes. However, studies investigating metabolic outcomes such as diabetes are limited and have focused only on noise exposures estimated for the loudest residential façade. Objectives: We aimed to examine the influence of long-term residential exposure to transportation noise at the loudest and quietest residential façades and the risk for type 2 diabetes. Methods: Road traffic and railway noise exposures (Lden) at the most and least exposed façades were estimated for all dwellings in Denmark during 1990–2017. Aircraft noise was estimated in 5-dB categories. Ten-year time-weighted mean noise exposures were estimated for 3.56 million individuals ≥35 years of age. From 2000 to 2017, 233,912 incident cases of type 2 diabetes were identified using hospital and prescription registries, with a mean follow-up of 12.9 y. We used Cox proportional hazards models adjusting for individual- and area-level covariates and long-term residential air pollution. The population-attributable fraction (PAF) was also computed. Results: Hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes in association with 10-dB increases in 10-y mean road traffic noise at the most and least exposed façades, respectively, were 1.05 (95% CI: 1.04, 1.05) and 1.09 (95% CI: 1.08, 1.10). Following subsequent adjustment for fine particulate matter [particulate matter ≤2.5μm in aerodynamic diameter] (10-y mean), the HRs (CIs) were 1.03 (95% CI: 1.03, 1.04) and 1.08 (95% CI: 1.07, 1.09), respectively. For railway noise, the HRs per 10-dB increase in 10-y mean exposure were 1.03 (95% CI: 1.02, 1.04) and 1.02 (95% CI: 1.01, 1.04) for the most and least exposed façades, respectively. Categorical models supported a linear exposure–outcome relationship for road traffic noise and, to a lesser extent, for railway noise. Aircraft noise >45 dB was associated with a 1–4% higher likelihood of type 2 diabetes compared with those who were unexposed. We found road traffic and railway noise associated with a PAF of 8.5% and 1.4%, respectively, of the diabetes cases. Discussion: Long-term exposure to road, railway, and possibly aircraft traffic noise was associated with an increased risk of type 2 diabetes in a nationwide cohort of Danish adults. Our findings suggest that diabetes should be included when estimating the burden of disease due to transportation noise. https://doi.org/10.1289/EHP9146