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The intersection of community involvement and empowerment in sexual and reproductive health (SRH) initiatives represents a critical area in public health. This scoping review aimed to explore the pathways from community involvement to empowerment within SRH initiatives, providing a comprehensive understanding of how public health strategies engage and build the capacity of communities. The literature from databases such as PubMed, Scopus and Web of Science were reviewed systematically, focusing on studies published between 2000 and 2023. The review identified various public health interventions that initially engage communities through participation, consultation and collaboration. These interventions often serve as the foundation for subsequent empowerment, characterised by capacity building, autonomy and advocacy. Key findings highlight that effective SRH initiatives involve community members in programme activities and foster environments where they can gain the skills, knowledge and confidence needed to take control of their health outcomes. Our analysis revealed that successful pathways from involvement to empowerment are multifaceted, requiring sustained commitment, resources and culturally sensitive approaches. The review underscores the importance of integrating community involvement and empowerment in designing and implementing SRH programmes to ensure sustainable and impactful health outcomes. This scoping review contributes to the existing literature by mapping the relationship between community involvement and empowerment, offering insights for public health practitioners and policymakers aiming to enhance SRH initiatives. Future research should focus on longitudinal studies to better understand the long-term impacts of these pathways on community health and well-being.

Communities across Southeast Asia face challenges posed by natural disasters, including floods, which disproportionately impact vulnerable populations. In light of the growing frequency and severity of extreme weather events attributed to climate change, there is a pressing need to explore and strengthen community flood resilience. Community resilience is pivotal in mitigating flood-related damages and fostering successful recovery efforts. This paper examines the socio-economic and environmental factors shaping community resilience in flood-prone areas of Southeast Asia. Socio-demographic determinants, exposure to floods, social cohesion, communication networks, socio-economic status, and cultural diversity significantly influence resilience capabilities, with disparities exacerbating socio-economic inequality. The interplay of these factors underscores the complexity of community disaster resilience, with some factors acting as moderators, mediators, or confounders in shaping outcomes. The paper highlights that understanding the dynamics of community resilience formation is imperative for informed policy interventions to enhance disaster preparedness and response in flood-prone areas of Southeast Asia. The contributors to flood resilience are interrelated with social determinants of health, underscoring the vital role of broader socio-economic and environmental factors in shaping community well-being. Future research should explore the relationships within these complex dynamics to guide effective resilience-building strategies tailored to local contexts.

This paper introduces a promising ecological approach to classifying infectious diseases based on the reservoir of the causative organism. According to this approach, all infectious diseases are classified as anthroponoses, zoonoses, and sapronoses. Among these three, zoonoses are the most used and known category, including diseases naturally transmitted between vertebrate animals and humans. The principal reservoir of the pathogen is often populations of certain animal species. The term “anthroponoses” denotes diseases where human hosts are central to the pathogen’s life cycle and provide its survival from an evolutionary perspective. These diseases circulate only among humans, and animals are not susceptible to them. Finally, sapronoses is an emerging concept for categorizing diseases where the causative organisms grow saprophytically in the environment and parasitically in vertebrate hosts, including humans. However, the parasitic phase usually plays a secondary role. Recognizing infectious diseases as sapronoses highlights the role of the connection between diseases among humans, animals, and the environment. This ecological approach to classifying infectious diseases is worth exploring, especially in the context of One Health, which emphasizes the interdependence between these three dimensions. Theoretical exploration focusing on the complex dynamics of pathogen-host interactions is needed to develop this classification further.

Studies focusing on the safety and common side effects of vaccines play a crucial role in enhancing public acceptance of vaccination. Research is scarce regarding the usage of COVID-19 vaccines and the side effects experienced by health professions students in India and other countries. This study aimed to document self-reported side effects associated with COVID-19 vaccination among medical and dental students of six medical and dental colleges and teaching hospitals in four states (Tamil Nadu, Madhya Pradesh, Gujarat, and West Bengal) of India. A cross-sectional survey using purposive sampling of medical and dental students was conducted from 26 April to 26 May 2021. Data was collected using a Google Forms questionnaire capturing information regarding receiving COVID-19 vaccines, side effects and symptoms, onset and duration of symptoms, use of treatment to alleviate symptoms, awareness of haematologic risks associated with vaccination, and side effects from previous (non-COVID-19) vaccinations. The majority (94.5%) of participants received both doses of the Covishield/AstraZeneca COVID-19 vaccine. Among participants (n = 492), 45.3% (n = 223) reported one or more side effects. The most frequently reported side effects were soreness of the injected arm (80.3%), tiredness (78.5%), fever (71.3%), headache (64.1%), and hypersomnia (58.7%). The two most common severe symptoms were fever (14.8%) and headache (13%). Most side effects appeared on the day of vaccination: soreness of the injection site (57%), fever (43.1%), and tiredness (42.6%). Most reported symptoms persisted for one to three days–soreness of the injection site (53%), fever (47.1%), and headache (42.6%). Logistic regression showed that women were almost 85% less likely to report side effects. The study’s findings corroborate the safety of the Covishield/AstraZeneca vaccine’s first dose, evidenced by the relatively minor and transient nature of the side effects. However, the study underscores the necessity for ongoing research to assess the long-term impacts of COVID-19 vaccines, especially in the context of booster doses, thereby contributing to the global understanding of vaccine safety and efficacy.

The influence of macro-micro structural design on the mechanical response of structural nanocomposites is substantial. The advancement of additive manufacturing especially three-dimensional (3-D) printing technology offers a promising avenue for the efficient and precise fabrication of multi-functional low-weight and high-strength nanocomposites. In contemporary discourse, there is a notable emphasis on carbon-based nanomaterials as nanofillers for structural composites due to their substantial specific surface area and exceptional load-bearing ability in mechanical structures. Notably, graphene, a distinctive two-dimensional (2-D) nanomaterial, exhibits very large elastic modulus and ultimate strength as well as remarkable plasticity. The utilization of graphene nanoparticles (GNPs) in the field of 3-D printing enables the production of intricate three-dimensional structures of varying sizes and configurations. This is achieved through the macro-assembly process, which facilitates the creation of a well-organized distribution of graphene and the establishment of a comprehensive physical network through precise micro-regulation. This paper presents an overview of multiscale structural composites that are strengthened by the incorporation of graphene and prepared by 3-D printing. The composites discussed in this study encompass graphene-polymer composites, graphene-ceramic composites, and graphene-metal composites. Furthermore, an analysis of the present obstacles and potential future advancements in this rapidly expanding domain is anticipated.

Thalassaemia constitutes an especially prevalent human monogenic illness caused by a lack of synthesis of the α- or β-globin chains. The clinical impact of β-thalassaemia is worse since it consists of the same pair gene configuration, thalassaemia major, causing significant health discouragement and loss of life due to life threateningly insufficient haemoglobin (Hb) levels. Only a few nations have successfully reduced the prevalence of β-thalassaemia major, even though comprehensive screening, group counselling, pre-natal detection and public education can all be used. Since over ½ century ago, the fundamental elements of treatment for thalassaemia major have been iron chelation and hypertransfusion. The globin chain that makes up the adult Hb molecule is missing or synthesised at a reduced rate in β-thalassemia. The aberrant buildup of the α-globin chain and faulty formation of red blood cells (RBCs) leading to RBC haemolysis are the outcomes of this genetic abnormality. Since allogeneic haematopoietic stem cell transplantation (Allo-HSCT) has been a well-established gene replacement therapy for individuals with thalassaemia major for several years, it has had very successful outcomes for patients with access to it. Over the past 20 years, the consequences for more susceptible patients have also steadily improved, leading to 80%–90% longer-term life expectancy amongst this group of patients. However, providing Allo-HSCT as a treatment for these patients globally presents numerous difficulties. Replacing genes in autologous HSCs employing viral vectors has been possible in recent years.

Trichotillomania (TTM) is a less addressed cause of alopecia. Refusal to accept this condition as a psychiatric illness causes marked delay in seeking help. This article aims to evaluate the treatment response of TTM patients. This is a case series study on 5 patients (4 females, 1 male) of TTM, of whom 3 patients took treatment on an outpatient basis (obsessive-compulsive and related disorders clinic) and 2 patients at indoor (orange unit) at the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, from January 2022 to July 2023. Out of 7 cases, 2 patients did not come after the 1st follow-up. Pharmacological management was chosen according to established guidelines. All patients were given basic psychoeducation and relevant psychological intervention. A total of 5 cases were described. The median time to receive effective psychiatric treatment is 8.6 years (4–15 years). The median time to respond after starting therapy is 6 weeks. All patients responded well to selective serotonin reuptake inhibitors. Augmentation with low-dose antipsychotics and the addition of specific pharmacologic agents have been shown to improve outcomes. Psychological management helped patients most in achieving long-term remission. Despite the prolonged treatment gap, patients of TTM showed marked improvement with combined pharmacological and psychological intervention in a short time. Further study involving a more significant number of cases is needed to support the findings.

Background: Fatal neck pressure may arise from hanging, ligature strangulation and manual strangulation. The analysis aimed to evaluate the demographic profiles of deadly neck pressure concerning ligature material, its position on the neck and the pattern of neck injuries with the manner of death in autopsied cases at Universiti Kebangsaan Malaysia Medical Center (UKMMC). Materials and Methods: A 20-year retrospective analysis was conducted at UKMMC, where 287 cases were sampled; out of which 267 cases were suicidal hanging, and four were accidental hanging. Only 11 cases of ligature strangulation and five cases were due to manual strangulation. The details were obtained from the autopsy report and IBM SPSS Statistics 28 analysis. Results: This study showed that 210 (73.2%) males and 77 (26. 8%) females with a ratio of 2.7:1 had died of fatal neck pressure. Male dominance (74.5%) was displayed in suicidal hanging, and there was no sex difference in ligature and/or manual strangulation. Ligature and manual strangulation were common in the younger age group. Accidental strangulation in young adults was most probably due to auto-erotic asphyxia. In this study, the youngest was 1 year, while the oldest was 85 years. The most common ligature used in suicidal hanging and homicidal ligature strangulation was hard material. The most typical pattern of the neck finding was facial congestion (71.1%), followed by petechial haemorrhages, neck muscle contusion, hyoid bone fracture, thyroid cartilage fracture and carotid injury (1.7%). Conclusion: Forensic pathologists' experience and autopsy techniques are fundamental in explaining the injury pattern and its correlation with fatality.

Introduction: Lockdown measures in response to the COVID-19 pandemic had an appreciable impact on the education of all medical, dental and non-medical healthcare professional students. These included the closure of universities necessitating a rapid move to e-learning and a new practical approach to conducting teaching-learning classes. However, initially, there was a lack of knowledge and expertise regarding e-learning approaches and the affordability of internet bundles and equipment. Materials and Methods: We conducted two pilot studies to assess such current challenges, replaced by a two-stage approach including a full investigation involving 32 private and public universities during the early stages of the pandemic, followed by a later study assessing the current environment brought about by the forced tops. Results: The top challenges at the start of the pandemic included a lack of familiarity with the e-learning approaches, the cost of the internet, a lack of IT equipment and the quality of the classes. To address identified challenges, universities offered support to staff and students. Since then, e-learning approaches have widened the possibilities for teaching and learning at convenient times. However, challenges remain. Conclusions: There were considerable challenges at the start of the pandemic. Several key issues have been addressed with hybrid learning here to stay. The remaining challenges include a lack of ICT equipment. However, new innovations will continue.

The measures put in place to contain the rapid spread of COVID-19 infection, such as quarantine, self-isolation, and lockdown, were supportive but have significantly affected the mental wellbeing of individuals. The primary goal of this study was to review the impact of COVID-19 on mental health. An intensive literature search was conducted using PsycINFO, PsyciatryOnline, PubMed, and the China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and June 2022 were retrieved and appraised. Reviews and retrospective studies were excluded. One hundred and twenty-two (122) relevant articles that fulfilled the inclusion criteria were finally selected. A high prevalence of anxiety, depression, insomnia, and post-traumatic stress disorders was reported. Alcohol and substance abuse, domestic violence, stigmatization, and suicidal tendencies have all been identified as direct consequences of lockdown. The eminent risk factors for mental health disorders identified during COVID-19 include fear of infection, history of mental illness, poor financial status, female gender, and alcohol drinking. The protective factors for mental health include higher income levels, public awareness, psychological counseling, social and government support. Overall, the COVID-19 pandemic has caused a number of mental disorders in addition to economic hardship. This strongly suggests the need to monitor the long-term impact of the COVID-19 pandemic on mental health.

Abstract Increased COVID‐19 vaccine hesitancy presents a major hurdle in global efforts to contain the COVID‐19 pandemic. This study was designed to estimate the prevalence of adverse events after the first dose of the Covishield (AstraZeneca) vaccine among physicians in Bangladesh. A cross‐sectional study was conducted using an online questionnaire for physicians (n = 916) in Bangladesh. Physicians who received at least one dose of the COVID‐19 vaccine were included. The study was carried out from April 12 to May 31, 2021. More than 58% of respondents (n = 533) reported one or more adverse events. Soreness of the injected arm (71.9%), tiredness (56.1%), fever (54.4%), soreness of muscles (48.4%), headache (41.5%) and sleeping more than usual (26.8%) were the most commonly reported adverse events. Most vaccine‐related reactogenicities were reported by the younger cohorts (

Prey refuge from predators can play an important role in stabilising an ecological system by reducing interactions between species, while Allee effects can arise from a range of biological phenomena, such as anti-predator vigilance, genetic trends and feeding deficiencies. We develop a predator–prey model that combines these phenomena, considering variable prey refuge with additive Allee effect on the prey species, with a Holling type II response function for the prey growth function. We use the predator and prey nullclines to determine the existence and stability of interior equilibria. We also investigate all possible local and global bifurcations that the system could undergo, showing that prey refuge and a strong Allee effect can lead to saddle-node bifurcations, Hopf bifurcations or Bogdanov–Takens bifurcation. We have investigated the appearance of Hopf bifurcations in a neighborhood of the unique interior equilibrium point of the dynamical system. The rich behaviour of the dynamics suggests that both prey refuge and a strong Allee affect are important factors in ecological complexity.

Objectives Extracranial to intracranial (EC-IC) bypass is an important part of the armamentarium of a neurosurgeon in managing different vascular and neoplastic pathologies. Here, we report our initial experiences of EC-IC bypasses as experiences in the ‘learning curve’, including preparation and training of the surgeon, getting cases, patient selection, imaging, operative skills and microtechniques, complications, follow-up, and outcome. Lessons learned from the ‘learning curve experiences’ can be very useful for young vascular neurosurgeons who are going to start EC-IC bypass or have already started to perform and find themselves in the learning curve. Methods From July 2009 to September 2018, 100 EC-IC bypasses were performed. We looked back to these cases of EC-IC bypass as our initial or ‘learning curve’ experiences. The recorded data of patient management (EC-IC bypass patient) were reviewed retrogradely. Our preparation for EC-IC bypass was described briefly. Case selection, indications, preparation of the patient for operation, techniques and technical experiences, preoperative difficulties and challenges, postoperative follow-up, complications, patency status of the bypass, and ultimate results were reviewed and studied. Result A total of 100 bypasses were performed in 83 patients, of which 43 were male and 40 were female. The age range was from 04 to 72 years old (average 32 years old). Eleven patients were lost to follow-up postoperatively after 3 months and they were not even available for telephone follow-up. The follow-up period ranged from 3 to 120 months (average of18.4 months). Eight bypasses were high flow bypasses, whereas the number of low flow STA-MCA bypasses was 92. Indication of bypass were (in 83 cases):1. Arterial stenosis/occlusion/dissection causing cerebral ischemia (middle cerebral artery [MCA] stenosis/occlusion-05, MCA dissection-04, internal carotid artery [ICA] occlusion-19); 2. Intracranial aneurysm-30; 3. Moya-Moya disease-21; and 4. Direct carotid cavernous fistula [CCF]-04. Common clinical presentation was hemiparesis & dysphasia in ischemic group with history of transient ischemic attack (H/O TIA) (including Moya Moya disease). Features of subarachnoid hemorrhage (SAH) were the presenting symptoms in intracranial aneurysm group. The average ischemic time, due to clamping of recipient artery, was 28 minutes (range: 20–60 minutes). There was no clamp-related infarction. Two anastomoses were found thrombosed intraoperatively. One preoperatively ambulant patient deteriorated neurologically in the postoperative period. She developed hemiplegia but improved later. Here, the cause seemed to be hyperperfusion. Headache resolved in all cases. TIA and seizures were also gone postoperatively. Ophthalmoplegia recovered in all cases in which it was present, except in one CCF, in which abducent nerve palsy persisted. Complete unilateral total blindness developed in one patient postoperatively (due to ophthalmic artery occlusion), where high flow bypass with ICA occlusion were performed. Red eye and proptosis were cured in CCF cases. Motor and sensory dysphasia improved in all cases in which it was present, except for one case in which preoperative global aphasia converted to sensory aphasia in the postoperative period. Three patients died in the postoperative period. The rest of the patients improved postoperatively. All patients were ambulant with static neurostatus and without new stroke/TIA until the last follow-up. All bypasses were patent until the last follow-up. Conclusion The initial experiences of 100 cases of EC-IC bypass revealed even in inexperienced hand mortality and morbidity in properly indicated cases were low and result were impressive according to the pathological group and aim of bypass. Lessons learned from these experiences can be very helpful for new and beginner bypass neurosurgeons

Antimicrobial Resistance (AMR) is significant challenge humanity faces today, with many patients losing their lives every year due to AMR. It is more widespread and has shown a higher prevalence in low- and middle-income countries (LMICs) due to lack of awareness and other associated reasons. WHO has suggested some crucial guidelines and specific strategies such as antimicrobial stewardship programs taken at the institutional level to combat AMR. Creating awareness at the grassroots level can help to reduce the AMR and promote safe and effective use of antimicrobials. Control strategies in curbing AMR also comprise hygiene and sanitation as microbes travel from contaminated surroundings to the human body surface. As resistance to multiple drugs increases, vaccines can play a significant role in curbing the menace of AMR. This article summarizes the current surveillance practices and applied control measures to tackle the hostility in these countries with particular reference to the role of antimicrobial stewardship programs and the responsibilities of regulatory authorities in managing the situation.

Bronchial asthma is a widely prevalent illness that substantially impacts an individual’s health standard worldwide and has a significant financial impact on society. Global guidelines for managing asthma do not recommend the routine use of antimicrobial agents because most episodes of the condition are linked to viral respiratory tract infections (RTI), and bacterial infection appears to have an insignificant impact. However, antibiotics are recommended when there is a high-grade fever, a consolidation on the chest radiograph, and purulent sputum that contains polymorphs rather than eosinophils. Managing acute bronchial asthma with sepsis, specifically the choice of whether or not to initiate antimicrobial treatment, remains difficult since there are currently no practical clinical or radiological markers that allow for a simple distinction between viral and bacterial infections. Researchers found that serum procalcitonin (PCT) values can efficiently and safely minimize antibiotic usage in individuals with severe acute asthma. Again, the clinical manifestations of acute asthma and bacterial RTI are similar, as are frequently used test values, like C-reactive protein (CRP) and white blood cell (WBC) count, making it harder for doctors to differentiate between viral and bacterial infections in asthma patients. The role and scope of each biomarker have not been precisely defined yet, although they have all been established to aid healthcare professionals in their diagnostics and treatment strategies.

The rising caesarean delivery rate is a global concern and is believed by many as a problem in low-income countries exclusively. It has been observed that utilisation of this lifesaving procedure is unusually high in many middle- and high-income countries. Caesarean section (CS) is indicated to save both the mother's and child's life in certain situations. When chosen in the proper indication, it is helpful towards reducing morbidity and mortality in both. There is a vast number of papers evidencing the injudicious use of this necessary procedure. There is an evident disparity in the utilisation of the process too. In some sub-Saharan African countries, women do not have access to or have very minimal access to caesarean delivery due to many factors. On the other hand, certain countries overutilise it. Being a South Asian country, Bangladesh is no different from many other countries, with rising caesarean delivery rates in rural and urban populations. It is of great concern for the Bangladeshi general community and the healthcare workers. There have been claims that it is overutilised injudiciously by the Bangladeshi health force. This review aims to find the facts related to the CSs and compare between the high-, middle- and low-income countries. Being healthcare professionals and medical educators by origin, the authors were explicitly interested in Bangladesh. They conducted the review to contribute to the development of the country's healthcare system.

Introduction: The early approaches to prevent the spread of COVID-19 included lockdown and social distancing measures, leading to university closures. These measures forced unparalleled changes to the delivery of healthcare education. Concerns included the preparedness of faculty and students to e-learning as well as the routine availability and funding of equipment and internet bundles. This needed addressing with fully trained healthcare professionals required given rising inappropriate use of antibiotics in India, growing prevalence of non-communicable diseases as well as an increasing number of patients with joint comorbidities. Consequently, there is a need to ascertain the current impact of the pandemic on healthcare student education across India. Materials and Methods: This was a pilot study among 10 purposely selected healthcare educators in both private and public universities. The questionnaire built on published studies. Results: Identified challenges included a lack of familiarity with online education, no bedside teaching, lack of equipment and affordability of internet bundles, poor internet connectivity and postponed examinations. Ways forward included training faculty on e-learning, providing students with loans and other financial support to purchase equipment and internet bundles, establishing COVID-19 prevention protocols and protective equipment, recording lectures and tutorials to make up for lost time and simulated methods to teach clinical aspects. Conclusion: Despite challenges, there was a rapid move to online learning among surveyed universities. Alongside this, courses to address lack of familiarity with e-learning approaches with hybrid teaching approaches here to stay. The next step will be to undertake a wider study and to use the combined findings to provide future guidance.

Introduction: To date, the focus on COVID-19 among children, especially in low- and middle-income countries, has been to address key issues including poor vaccination rates. However, the focus is changing with new variants and concerns regarding the development of hyperinflammatory syndromes. There have also been concerns with the overuse of antibiotics to treat patients with COVID-19, with the Indian Government developing guidelines, including those for children, to improve patient care. Consequently, a need to document the current management of children with COVID-19 in India and use the findings for future guidance. Materials and Methods: Pilot study assessing the management of children with COVID-19 among five hospitals in India using purposely developed case report forms, which had been piloted in Bangladesh. Results: Low numbers of children in hospital with COVID-19 (11.9% of in-patient beds). The majority were boys (58.3%) and between 11 and 18 years (55.5%). Reasons for admission were in line with previous studies and included respiratory distress/breathing difficulties. 69.4% of children with COVID-19 were prescribed antibiotics empirically, typically those on the Watch list, and administered parenterally, with only limited switching to oral therapy. A minority were prescribed antimalarials, antivirals and anti-parasitic medicines. There was appreciable prescribing of immune boosters and steroids. Conclusion: It was encouraging to see low hospitalisation rates. However, concerns with high empiric use of antibiotics and limited switching to oral formulations need to be addressed potentially, by instigating antimicrobial stewardship programmes. Similarly, other antimicrobials where these are not recommended.

Background: Tuberculosis (TB), better known as TB, is one of the infectious diseases that can cause death and therefore gains major public concerns worldwide. This study attempts to assess the knowledge, attitude and practice (KAP) related to TB among the students in a public university and find the association between the KAP with demographic factors and between the KAP themselves. Materials and Methods: Self-administered questionnaires were distributed to 200 students from the six faculties in the university for the data collection and analysis in this cross-sectional study. The questionnaire was divided into four parts: Demographic characteristics, knowledge, and attitude toward TB, and practices toward the prevention and control of TB. Results: The findings showed that most students had a moderate level of knowledge (obtained 47–92 out of the total 138 marks) and practice (obtained 29–57 out of the total 86 marks) and a good attitude related to TB (obtained 20–28 out of the total 28 marks). There were no significant differences in the level of KAP scores between the different genders, ages and years of study among the participants. However, a significant result was found between the KAP level of the various faculties (P < 0.001,

A new disturbance observer-based control method is presented in this paper to address the attitude tracking problem of rigid-body spacecraft in the presence of external disturbances and parameter uncertainties. Particularly, a sliding mode disturbance observer (SMDO) is designed. The most important feature of this SMDO is the relaxation of the assumption that external disturbances must be constants or changing at a slow rate, which is a typical assumption required in these classes of problems concerning disturbance observer (DO) design but hard to guarantee from the standpoint of practical engineering. In addition, a special adaptive integral sliding mode controller is combined with the SMDO to ensure system state convergence. The proposed control scheme’s primary advantage is the enhanced robustness against system parameter uncertainties and external disturbances. Stringent closed-loop system stability analysis is performed using Lyapunov-based stability theory. Numerical simulations are carried out on nonlinear model of spacecraft to validate the proposed control scheme’s efficiency compared to the existing methods in the literature.

Introduction: This study aimed to evaluate the effect of gender and anthropometric measurement on pulmonary functions (forced vital capacity [FVC], forced expiratory volume in 1st s [FEV1] and peak expiratory flow rate [PEFR]) of undergraduate medical students to emphasise the need for further research on the aetiology and the prevention of respiratory diseases. Materials and Methods: This cross-sectional study was conducted in the Department of Physiology, Chittagong Medical College (CMC), Chattogram, Bangladesh, from July 2017 to June 2018. A total of 100 participants, aged between 18 and 20 years, studying in the 1st year in CMC, were included by a random sampling method. The participants filled out a questionnaire with general information about previous diseases, medication and family history. Fifty male participants were enrolled in the study group according to inclusion and exclusion criteria. Age and body mass index matched another 50 female participants were included. Respiratory parameters such as FVC, FEV1 and PEFR were measured by a digital spirometer (Chestgraph HI-101, Japan). Readings were taken in normal upright sitting posture. The statistical tests utilised were unpaired Student's t-test and the correlation coefficient conducted using SPSS for windows version 23. Results: Female participants showed significantly lower FVC, FEV1 and PEFR than males. This study observed a significant positive correlation between height and weight and FVC, FEV1 and PEFR. Conclusion: The results of this study help assess pulmonary functions among medical students as pulmonary function tests are one of the indicators of the health status of the individuals.

The present review was intended to explore the effectiveness of perinatal services such as antenatal care (ANC) and post-natal care (PNC) on the health indicators such as maternal, child and neonatal mortality. Globally, indicators are considered very important in determining the health status and the overall performance of a country's healthcare system. A literature search was conducted using maternal mortality, child mortality, neonatal mortality, ANC and PNC in the PubMed, Google, Academia, The Lancet and Journal of the American Medical Association databases. Globally, implementing integrated perinatal care services has brought positive changes in the maternal, child and neonatal mortality indices. The United Nations (UN) is committed to improving the overall living conditions in all countries, significantly improving the population's health status. The UN came up with eight Millennium Development Goals in 2000, aiming to eliminate poverty and increase development in member states. The World Health Organization was a partner in implementing these goals. Later, the UN introduced 17-fold Sustainable Development Goals in 2015 as a blueprint for peace and prosperity for all citizens towards a better future by 2030. As a result, many countries have experienced positive changes in most indicator areas, including service utilisation, maternal mortality and child mortality. Some Sub-Saharan African and South Asian countries are progressing, however, slowly.

Background: COVID-19 pandemic led to increased self-medication of antimicrobials, vitamins, and immune boosters among the common people and consuming without prescription can lead to adverse consequences including antimicrobial resistance. Methods: A cross-sectional study was conducted on community pharmacies in Jodhpur, India. They were inquired regarding the prescription and increased sales (75% increase in vitamin C sales. Conclusion: There was an increase in the demand for COVID-19 medications without prescription. This study was unable to detect a significant increase in sales of antimicrobials, which is encouraging.

A recently independent state, Timor-Leste, is progressing towards socioeconomic development, prioritizing women empowerment while its increased fertility rate (4.1) could hinder the growth due to an uncontrolled population. Currently, limited evidence shows that indicators of women's empowerment are associated with fertility preferences and rates. The objective of this study was to assess the association between women empowerment and fertility preferences of married women aged 15 to 49 years in Timor-Leste using nationally representative survey data. The study was conducted using the data of the latest Timor-Leste Demographic and Health Survey 2016. The study included 4040 rural residents and 1810 urban residents of Timor-Leste. Multinomial logistic regression has been performed to assess the strength of association between the exposures indicating women's empowerment and outcome (fertility preference). After adjusting the selected covariates, the findings showed that exposures that indicate women empowerment in DHS, namely, the employment status of women, house and land ownership, ownership of the mobile phone, and independent bank account status, contraceptive use, and the attitude of women towards negotiating sexual relations are significantly associated with fertility preferences. The study shows higher the level of education, the less likely were the women to want more children, and unemployed women were with a higher number of children. Our study also found that the attitude of violence of spouses significantly influenced women's reproductive choice. However, employment had no significant correlation with decision-making opportunities and contraceptive selection due to a lack of substantial data. Also, no meaningful data was available regarding decision-making and fertility preferences. Our findings suggest that women's empowerment governs decision-making in fertility preferences, causing a decline in the fertility rate.

We propose an intraguild predation ecological system consisting of a tri-trophic food web with a fear response for the basal prey and a Lotka–Volterra functional response for predation by both a specialist predator (intraguild prey) and a generalist predator (intraguild predator), which we call the superpredator. We prove the positivity, existence, uniqueness, and boundedness of solutions, determine all equilibrium points, prove global stability, determine local bifurcations, and illustrate our results with numerical simulations. An unexpected outcome of the prey's fear of its specialist predator is the potential eradication of the superpredator.

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus and can lead to patient demise if not immediately treated. From the recent literature, the diabetic ketoacidosis mortality rate, depending on age, is 2–5%. Insulin discontinuation and infection remain the two most common triggers for diabetic ketoacidosis. About 50% of cases of ketoacidosis result from bacterial infections like urinary tract infections and pneumonia. It is also important to diagnose the presence of infection in diabetic ketoacidosis patients to prevent the excessive use of antibiotics, which may lead to antibiotic resistance. Although performing bacterial culture is confirmatory for the presence or absence of bacterial infection, the time required to obtain the result is long. At the same time, emergency treatment needs to be started as early as possible. Methods: This narrative review examines various septic markers to identify the appropriate tools for diagnosis and to distinguish between diabetic ketoacidosis with and without infection. Electronic databases were searched using the Google engine with the keywords “Diabetes Mellitus”, “Diabetic Ketoacidosis”, “Infection with Diabetic Ketoacidosis”, “biomarkers for infection in Diabetic Ketoacidosis”, “Procalcitonin”, “Inflammatory cytokines in DKA”, “Lactic acidosis in DKA”, and “White blood cell in infection in DKA”. Results: This narrative review article presents the options for diagnosis and also aims to create awareness regarding the gravity of diabetic ketoacidosis with infection and emphasizes the importance of early diagnosis for appropriate management. Diabetes mellitus is a clinical condition that may lead to several acute and chronic complications. Acute diabetic ketoacidosis is a life-threatening condition in which an excess production of ketone bodies results in acidosis and hypovolemia. Infection is one of the most common triggers of diabetic ketoacidosis. When bacterial infection is present along with diabetic ketoacidosis, the mortality rate is even higher than for patients with diabetic ketoacidosis without infection. The symptoms and biomarkers of diabetic ketoacidosis are similar to that of infection, like fever, C reactive protein, and white blood cell count, since both create an environment of systemic inflammation. It is also essential to distinguish between the presence and absence of bacterial infection to ensure the appropriate use of antibiotics and prevent antimicrobial resistance. A bacterial culture report is confirmatory for the existence of bacterial infection, but this may take up to 24 h. Diagnosis needs to be performed approximately in the emergency room upon admission since there is a need for immediate management. Therefore, researching the possible diagnostic tools for the presence of infection in diabetic ketoacidosis patients is of great importance. Several of such biomarkers have been discussed in this research work.

Insulin resistance is a critical pathophysiological process in the onset and advancement of type 2 diabetes mellitus. It is well-recognized that alterations in the metabolism of lipids and aberrant fat buildup effectively trigger the development of resistance to insulin. Adjusting one’s eating habits and managing weight appropriately are crucial for treating, controlling, and reducing the risk of T2DM because obesity and a lack of physical exercise are the primary factors responsible for the worldwide rise in T2DM. Omega-3 fatty acid is one of the polyunsaturated fatty acids (PUFA) that include long-chain omega-3 fatty acids such as eicosapentaenoic acid and docosahexaenoic acid, commonly found in fish oils. Omega-3 and omega-6 polyunsaturated fatty acids (PUFAs; 3 and 6 PUFAs) are essential for human health because they serve as metabolic precursors of eicosanoids, a class of signaling molecules that are essential for controlling a body’s inflammation. Since humans are unable to produce any of the omega-3 or omega-6 PUFAs, they both constitute imperative nutritional ingredients. Long-standing concerns about long-chain omega-3 fatty acids’ impact on diabetes management have been supported by experimental investigations that found significant increases in fasting glucose following omega-3 fatty acid supplementation and foods rich in PUFA and omega-3 fatty acid. Cellular explanations to explain the connection between inflammation and IR include mitochondrial dysfunction, endoplasmic reticulum (ER) stress, and oxidative stress. Modifications in the lipid composition of mitochondrial membranes and/or receptor-mediated signaling may be part of the mechanism behind the activation of mitochondrial fusion by fish oil/omega-3 PUFA. The exact molecular processes by which omega-3 PUFAs control mitochondrial activity to defend against IR are still unknown.