Dry desulphurisation of gas streams using KCC-1 mesoporous silica functionalised with deep eutectic solvents.

Sulphur dioxide, a toxic gas pollutant, is mainly generated by the combustion of fossil fuels and the smelting of sulphur-bearing mineral ores. Removal of SO2 gas or desulphurisation can be accomplished in industries using a variety of processes; the most efficient is wet flue gas desulphurisation (FGD). However, wet FGD has challenges, such as the requirement for wastewater treatment, excessive water usage, and the necessity for chloride protective coating. Despite having a lesser adsorption capacity than wet FGD, dry FGD can efficiently remove SO2 from the effluent gas stream and avoid the issues associated with wet FGD, provided that the sorbents are modified and regenerable. An alternative dry desulphurisation strategy by using fibrous mesoporous silica (KCC-1) modified with deep eutectic solvents (DES), choline chloride-glycerol (DES1) and choline chloride-ethylene glycol (DES2) is studied in this paper. KCC-1 modified with DES1 is found to increase SO2 adsorption capacity to 4.83 mg g-1, which is 1.73 times greater than unmodified KCC-1 and twice higher than KCC-1 modified with DES2 attributed to the sorbent's high porosity. Increasing reaction temperature and SO2 concentration reduce the adsorption capacity to 1.73 mg g-1 and 2.73 mg g-1, respectively. The Avrami kinetic model and the Toth isotherm model best reflect SO2 adsorption on the modified KCC-1, indicating that SO2 molecules are adsorbed exothermically in multilayer adsorption on a heterogeneous surface through a combination of physical and chemical processes. The higher SO2 adsorption capacity of the modified KCC-1 suggests that choline chloride-glycerol can provide additional sites for SO2 adsorption in dry FGD technology.

Characteristics of smear-positive pulmonary tuberculosis with normal chest radiographic findings during a tuberculosis outbreak in northeast Malaysia: A cross-sectional study.

Introduction: Tuberculosis (TB) remains a highly prevalent disease in Malaysia. Early identification using cost-effective methods such as chest radiography can reduce the health burden of a TB epidemic. However, normal chest radiographic findings are common. This study aimed to evaluate the characteristics of smear-positive pulmonary TB with normal chest radiographic findings during an outbreak. Methods: A cross-sectional study was conducted by reviewing the medical records of 56 pulmonary TB cases registered at Kodiang Health Clinic from April to October 2022. Smear-negative and extrapulmonary TB cases were excluded. Relevant information was extracted from the medical records and recorded in a case report form for data management and analysis. Results: Approximately 60.7% of the cases had symptoms lasting >2 weeks, and 89.3% showed abnormal findings upon clinical examination. Additionally, 73.2% had sputum acid-fast bacilli counts of ≥1+, and the sputum Mycobacterium tuberculosis culture and sensitivity test findings were positive in 82.1% of the cases. The proportion of smear-positive pulmonary TB with normal chest radiographic findings was 42.9%. The factors associated with smear-positive pulmonary TB with normal chest radiographic findings included being under 18 years old (P=0.021), being a student (P=0.010), being single (P=0.012) and being asymptomatic (P=0.04). Conclusion: Normal chest radiographic findings may lead to a misdiagnosis of smear-positive pulmonary TB, especially during an outbreak. Therefore, active case detection among close contacts with risk factors for normal radiographic findings should consider additional supportive tests.

Development and validation of the intention to use the ICD-11 questionnaire in the Malaysian medical records context.

As health systems transition to ICD-11, it is essential to gauge the readiness and improve existing transition efforts. Assessing the intention to use ICD-11 and factors influencing it is imperative to encourage the use of ICD-11 among the medical record officers (MROs) and assistant medical record officers (AMROs). This study aims to develop and validate a questionnaire on the factors influencing the intention to use ICD-11 among MROs and AMROs in the Ministry of Health, Malaysia. This study comprised a questionnaire development and validation involving 292 participants nationwide from Ministry of Health Malaysia facilities. The questionnaire was developed based on items adapted from the literature. Forward and backward English-Malay translation was done. Then, the questionnaire was examined for content validity, internal consistency reliability, construct validity, face validity, convergent validity, discriminant validity and confirmatory factor analyses. The final version of the questionnaire consists of eleven domains represented by 50 items. The content validity index and modified kappa were excellent for all domains. The Kaiser-Meyer-Olkin sampling adequacy value was appropriate, with a value of 0.790. The questionnaire also demonstrated good internal consistency reliability with Cronbach's alpha values between 0.850 and 0.992. Confirmatory factor analysis showed a reasonable fit for this eleven-factor model. In conclusion, this questionnaire provides a reliable tool for investigating the intention to use ICD-11 among MROs and AMROs. Positive findings from the psychometric properties support the validity of the questionnaire. This instrument can potentially support personnel in charge of ICD codification, guide the ICD-11 transition at various levels and facilitate research on support dynamics among the MROs and AMROs.

ABO Discrepancy in a Patient With Plasma Cell Myeloma.

ABO discrepancies in plasma cell myeloma (PCM) present unique challenges in blood typing tests and transfusion management. We present the case of a 51-year-old male with PCM who exhibited discrepancies between forward and reverse blood grouping. Further investigation revealed that the patient's blood type was a variant of blood group B. While type III discrepancies, typically characterized by elevated globulin levels causing false-positive reactions in both forward and reverse blood grouping, are common in multiple myeloma, our case differed due to the loss of B antigens secondary to the malignant condition. This caused a discrepancy in forward blood grouping. The rarity of ABO discrepancies in multiple myeloma underscores the importance of thorough evaluation. Awareness of potential antigen alterations in such patients is crucial to ensure safe transfusion practices.

Acute and sub-acute Toxicity Profiles of Anchusa strigosa and Zataria Multiflora: Insights from wistar albino rats.

The present study aims to assess the acute and subacute toxicity of the hydro-alcoholic extracts of Anchusa strigosa (leaves) and the aerial parts of Zataria multiflora Boiss in Wistar albino rats. The crude extracts of Anchusa strigosa (leaves) and the aerial parts of Zataria multiflora Boiss were prepared in 70% ethanol. Systematic tests for acute toxicity were performed at varying dosages of 100, 250, and 500 mg/kg, while for subacute toxicity, a dose of 600 mg/kg was orally given to Wistar albino rats. At the end of acute and sub-acute toxicity studies, biochemical parameters, hematological analysis, and histopathological analysis showed no significant difference in the body weight, abnormalities, or organ damage of the rats compared to the untreated rats (control). Also, there were no results of death recorded in rats. These findings indicated that the medium-term oral administration of Anchusa strigosa (leaves) and the aerial parts of Zataria multiflora Boiss after the treatment does not cause toxicity and provides assurance regarding their suitability for potential therapeutic applications in both acute and subacute forms.

Controlled release of vancomycin from PEGylated fibrinogen polyethylene glycol diacrylate hydrogel.

Surgical site infection (SSI) is a common issue post-surgery which often prolongs hospitalization and can lead to serious complications such as sternal wound infection following cardiac surgery via median sternotomy. Controlled release of suitable antibiotics could allow maximizing drug efficacy and safety, and therefore achieving a desired therapeutic response. In this study, we have developed a vancomycin laden PEGylated fibrinogen-polyethylene glycol diacrylate (PF-PEGDA) hydrogel system that can release vancomycin at a controlled and predictable rate to be applied in SSI prevention. Two configurations were developed to study effect of the hydrogel on drug release, namely, vancomycin laden hydrogel and vancomycin solution on top of blank hydrogel. The relationship between the rigidity of the hydrogel and drug diffusion was found to comply with a universal power law, i.e., softer hydrogels result in a greater diffusion coefficient hence faster release rate. Besides, vancomycin laden hydrogels exhibited burst release, whereas the vancomycin solution on top of blank hydrogels exhibited lag release. A mathematical model was developed to simulate vancomycin permeation through the hydrogels. The permeation of vancomycin can be predicted accurately by using the mathematical model, which provided a useful tool to customize drug loading, hydrogel thickness and stiffness for personalized medication to manage SSI. To evaluate the potential of hydrogels for bone healing applications in cardiovascular medicine, we performed a proof-of-concept median sternotomy in rabbits and applied the hydrogels. The hydrogel formulations accelerated the onset of osteo-genetic processes in rabbits, demonstrating its potential to be used in human.

Utilisation of the web-based Home Assessment Tool among patients with COVID-19 in Selangor, Malaysia: An observational study.

Introduction: The COVID-19 pandemic has caused many countries to turn to web-based solutions. The Home Assessment Tool (HAT) is a web-based system using the MySejahtera application developed by the government. It serves as a communication platform for patients with COVID-19 to self-monitor their clinical symptoms and enables authorised healthcare personnel to access and manage collected data for clinical monitoring. Our study aimed to examine the utilisation of this internet-based tool among patients with COVID-19 in Selangor. Methods: This observational study analysed secondary data from the self-reported HAT within MySejahtera. It included all patients who were diagnosed with COVID-19 through molecular assays such as RT-PCR or RTK-Ag on 1-21 February 2021, aged >18 years and residing in Selangor. Patients who had documented their symptoms at least once in the HAT during the prescribed 10-day isolation period were classified as HAT users. Results: A total of 4438 patients were included, of whom 39.4% were HAT users, while 60.6% were non-HAT users. Logistic regression analysis revealed three significant factors associated with low utilisation of the HAT: absence of medical condition (odds ratio [OR]: 9.4; 95% confidence interval [CI]: 7.49-12.01), advanced age (OR: 1.35; 95% CI: 1.20-1.52) and non-Malaysian citizenship (OR: 3.4; 95% CI: 2.50-4.72). Conclusion: The utilisation of the HAT is low, which is associated with advanced age (>65 years), absence of medical conditions and foreign nationality. It is imperative to develop inventive strategies tailored to address the unique needs of these particular demographics.

A review of the discussions on cultivated meat from the Islamic perspective.

Since the introduction of the cultivated meat burger in 2013, numerous discussions have transpired between researchers and consumers, manifesting in various forms such as academic publications, opinions on personal websites and interactions on social platforms. For Muslim consumers, a primary concern revolves around the halal status of cultivated meat, given the pivotal role of adhering to a halal diet as a divine obligation in their lives. Therefore, this article seeks to systematically review the existing literature on cultivated meat from an Islamic perspective as articulated by Muslim scholars, whether these perspectives are issued by an established fatwa organisation or representations of personal views. The sources incorporated into this analysis span from academic publications, newspaper articles, fatwa bodies, personal websites and interviews. Employing thematic analysis, five principal themes were discerned within the discourse among Muslim scholars regarding cultivated meat: (i) the ontological status of cultivated meat, (ii) the status and source of stem cells used in the cultivation process, (iii) the theological implications of cultivated meat production on altering God's creation, (iv) foundational principles for halal cultivated meat production, and (v) the contemporary necessity of cultivated meat from the perspective of al-maqasid al-shariah. It is duly recommended that international fatwa organisations such as the International Islamic Fiqh Academy (IIFA) engage in discussions and deliberations on this matter of growing significance within the food industry. The fatwas and resolutions issued by IIFA are frequently cited as the most recognised authority in many Islamic countries.

Microbial oases in the ice: A state-of-the-art review on cryoconite holes as diversity hotspots and their scientific connotations.

Cryoconite holes, small meltwater pools on the surface of glaciers and ice sheets, represent extremely cold ecosystems teeming with diverse microbial life. Cryoconite holes exhibit greater susceptibility to the impacts of climate change, underlining the imperative nature of investigating microbial communities as an essential module of polar and alpine ecosystem monitoring efforts. Microbes in cryoconite holes play a critical role in nutrient cycling and can produce bioactive compounds, holding promise for industrial and pharmaceutical innovation. Understanding microbial diversity in these delicate ecosystems is essential for effective conservation strategies. Therefore, this review discusses the microbial diversity in these extreme environments, aiming to unveil the complexity of their microbial communities. The current study envisages that cryoconite holes as distinctive ecosystems encompass a multitude of taxonomically diverse and functionally adaptable microorganisms that exhibit a rich microbial diversity and possess intricate ecological functions. By investigating microbial diversity and ecological functions of cryoconite holes, this study aims to contribute valuable insights into the broader field of environmental microbiology and enhance further understanding of these ecosystems. This review seeks to provide a holistic overview regarding the formation, evolution, characterization, and molecular adaptations of cryoconite holes. Furthermore, future research directions and challenges underlining the need for long-term monitoring, and ethical considerations in preserving these pristine environments are also provided. Addressing these challenges and resolutely pursuing future research directions promises to enrich our comprehension of microbial diversity within cryoconite holes, revealing the broader ecological and biogeochemical implications. The inferences derived from the present study will provide researchers, ecologists, and policymakers with a profound understanding of the significance and utility of cryoconite holes in unveiling the microbial diversity and its potential applications.

Early Intervention in Psychosis and Management of First Episode Psychosis in Low- and Lower-Middle-Income Countries: A Systematic Review.

BACKGROUND AND HYPOTHESIS: People with first-episode psychosis (FEP) in low- and lower-middle-income countries (LMIC) experience delays in receiving treatment, resulting in poorer outcomes and higher mortality. There is robust evidence for effective and cost-effective early intervention in psychosis (EIP) services for FEP, but the evidence for EIP in LMIC has not been reviewed. We aim to review the evidence on early intervention for the management of FEP in LMIC. STUDY DESIGN: We searched 4 electronic databases (Medline, Embase, PsycINFO, and CINAHL) to identify studies describing EIP services and interventions to treat FEP in LMIC published from 1980 onward. The bibliography of relevant articles was hand-searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. STUDY RESULTS: The search strategy produced 5074 records; we included 18 studies with 2294 participants from 6 LMIC countries. Thirteen studies (1553 participants) described different approaches for EIP. Pharmacological intervention studies (n = 4; 433 participants) found a high prevalence of metabolic syndrome among FEP receiving antipsychotics (P ≤ .005). One study found a better quality of life in patients using injectables compared to oral antipsychotics (P = .023). Among the non-pharmacological interventions (n = 3; 308 participants), SMS reminders improved treatment engagement (OR = 1.80, CI = 1.02-3.19). The methodological quality of studies evidence was relatively low. CONCLUSIONS: The limited evidence showed that EIP can be provided in LMIC with adaptations for cultural factors and limited resources. Adaptations included collaboration with traditional healers, involving nonspecialist healthcare professionals, using mobile technology, considering the optimum use of long-acting antipsychotics, and monitoring antipsychotic side effects.

Drug Safety Evaluation of Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Comorbid Patients by Review of Systemic Extraglycemic Effects.

Purpose: The aim of this study is to evaluate the safety of this drug in diabetic patients with comorbidities of all systems. Method: In this review, the beneficial effects of this drug and its mechanism on the disorders of every system of humans in relation to diabetes have been studied, and finally, its adverse effects have also been discussed. The search for relevant information is carried out in the PubMed and Google Scholar databases by using the following terms: diabetes mellitus type 2, SGLT, SGLT2 inhibitors, (SGLT2 inhibitors) AND (Pleiotropic effects). All English-published articles from 2016 to 2023 have been used in this study. It should be noted that a small number of articles published before 2016 have been used in the introduction and general informations. Results: Its beneficial effects on improving cardiovascular disease risk factors and reducing adverse events caused by cardiovascular and renal diseases have proven in most large clinical studies that these effects are almost certain. It also has beneficial effects on other human systems such as the respiratory system, the gastrointestinal system, the circulatory system, and the nervous system; more of them are at the level of clinical and pre-clinical trials but have not been proven in large clinical trials or meta-analyses. Conclusion: With the exception of a few adverse effects, this drug is considered a good choice and safe for all diabetic patients with comorbidities of all systems.

Knowledge, Attitude and Practice of Toothbrush Contamination and Disinfection Among Undergraduate Students in Selected Universities in Somalia.

Background: Oral health is crucial for overall well-being and systemic health and Humans are exposed to several bacteria after birth and will causes systemic illnesses like septicemia, respiratory, gastrointestinal, and renal issues. This study aimed to evaluate undergraduate students' knowledge, attitudes, and practices regarding toothbrush contamination and disinfection. Methods: A descriptive cross-sectional study was carried out with undergraduates from seven selected universities, including public and private universities. A closed-ended questionnaire containing 24 items was distributed to A total of 490 undergraduate students. Results: The study showed that (28.6%, n=140) had knowledge about toothbrush cleaning and disinfection. A total of (350, n=71.4%) needed to gain knowledge about toothbrush cleaning and disinfection. Fifty-two percent of the students feel that bacteria are the primary mode of toothbrush contamination. Many of the students had different ways of disinfecting toothbrushes, including, boiling a small pot of normal water (51.4%, n=252), chemical agent (31.8%, n=156), ultraviolet sanitizer (0.2%, n=4), and microwave radiation (0.2%, n=1) does not know (16.1%, n=79). Most students (76.9%, n=377) felt that toothbrush disinfection was necessary. Conclusion: Fewer students have sufficient knowledge about toothbrush contamination and practice disinfection methods, whereas most students need to be made aware of the contamination of toothbrushes and the use of disinfectant methods.

Estimating natural frequency of pipe with various geometries: Improvement of frequency factors.

Piping system is the main structure in many industrial applications, especially for large industry relating with processing and transporting fluids, such as oil and gas industries. The fluid-induced vibration is often the cause of structural fatigue in pipes and therefore piping vibration need to be closely monitored. In case of high piping vibration, knowledge of the natural frequency of a pipe section is crucial for an engineer to propose the right troubleshoot action, either for a temporary or even for a long-term solution for the piping vibration. Therefore, prediction of the pipe natural frequency using a simple formulae is thus of interest, without dealing with complex numerical simulation using a commercial software which consumes cost and time. In this paper, the vibration mode shapes of various possible geometries of pipes in practice were simulated in ANSYS and the simulated natural frequency is related to a natural frequency of an Euler-Bernoulli beam using a correction factor for each corresponding piping geometry. This paper extends the previous work by allowing the boundary conditions of the pipe ends to be simply supported, in addition to the clamped edges. In this way, the frequency factor charts are presented in the range of possible correction factor values to accommodate the real conditions of pipe arrangement in practical application. An experiment from a case study to verify the proposed method is also presented.

Knowledge, attitude and prevalence of ivermectin use as coronavirus disease treatment: A crosssectional study among a Malaysian population.

Introduction: During the coronavirus disease (COVID-19) pandemic, there was a widespread public misconception regarding ivermectin use in managing the disease. There is no approval of ivermectin as COVID-19 treatment by the Food and Drug Administration, and the adverse effects of the drug are alarming. This study aimed to evaluate the knowledge and attitude towards and prevalence of ivermectin use as COVID-19 treatment among the Malaysian population. Methods: This cross-sectional study was conducted among 391 Malaysians aged ≥18 years. A validated online self-administered questionnaire disseminated via Google Forms was used to evaluate the knowledge and attitude towards and prevalence of ivermectin use as COVID-19 treatment. The socio-demographic characteristics and knowledge and attitude towards and prevalence of ivermectin use among the respondents were evaluated through descriptive analysis. The chi-square test was used to identify the association between the variables. Results: The respondents had moderate levels of knowledge and attitude towards ivermectin use, while the prevalence of ivermectin use was 3.58%. The respondents' sex (P=0.014), age (P=0.012) and monthly income (P=0.049) were significantly associated with their level of knowledge. The respondents' sex (P=0.04) was significantly associated with their level of attitude. Conversely, no socio-demographic characteristics were significantly associated with the prevalence of ivermectin use as COVID-19 treatment. Conclusion: The majority of Malaysians have moderate levels of knowledge and attitude towards ivermectin use as COVID-19 treatment, with a low prevalence of actual use.

Enhancing capacitive performance of magnetite-reduced graphene oxide nanocomposites through magnetic field-assisted ion migration.

The transition towards renewable energy sources necessitates efficient energy storage systems to meet growing demands. Electrochemical capacitors, particularly electric double-layer capacitors (EDLCs), show promising performance due to their superior properties. However, the presence of resistance limits their performance. This study explores using an external magnetic field to mitigate ion transfer resistance and enhance capacitance in magnetite-reduced graphene oxide (M-rGO) nanocomposites. M-rGO nanocomposites with varying weight ratios of magnetite were synthesized and comprehensively characterized. Characterization highlighted the difference in certain parameters such as C/O ratio, the Id/Ig ratio, surface area and particle size that contribute towards alteration of M-rGO's capacitive behaviour. Electrochemical studies demonstrated that applying a magnetic field increased specific capacitance by approximately 20% and reduced resistance by 33%. Notably, a maximum specific capacitance of 16.36 F/g (at a scan rate of 0.1 V/s) and 27.24 F/g (at a current density of 0.25 A/g) was achieved. These improvements were attributed to enhanced ion transportation and migration at the electrode/electrolyte interface, lowering overall resistance. However, it was also observed that the aforementioned parameters can also limit the M-rGO's performance, resulting in saturated capacitive state despite a reduced resistance. The integration of magnetic fields enhances energy storage in nanocomposite systems, necessitating further investigation into underlying mechanisms and practical applications.

MOF Derivatives with Gradient Structure Anchored on Carbon Foam for High-Performance Electromagnetic Wave Absorption.

The impedance matching and high loss capabilities of composites with homogeneous distribution are limited owing to high addition and lack of structural design. Developing composites with heterogeneous distribution can achieve strong and wide electromagnetic (EM) wave absorption. However, challenges such as complex design and unclear absorption mechanisms still exist. Herein, a novel composite with a heterogeneous distribution gradient is successfully constructed via MOF derivatives Co@ nitrogen-doped carbon (Co@NC) anchored on carbon foam (CF) matrix (MDCF). Notably, the concentration of MOF can easily control the gradient structure. In particular, the morphologies of MOF derivatives on the surface of CF undergo a transition from the collapse of the inner layer to the integrity of the outer layer, accompanied by a continuous reduction in the size of Co nanoparticles. Correspondingly, enhanced interface polarization from the core-shell of Co@NC and good impedance matching of MDCF can be obtained. The optimized MDCF exhibits the minimum reflection loss of -68.18 dB at 2.01 mm and effective absorption bandwidth covering the entire X-band. Moreover, MDCF exhibits lightweight characteristics, excellent compressive strength, and low radar cross-section reduction. This work highlights the immense potential of composites with heterogeneous distribution for achieving high-performance EM wave absorption.

Three-staged minimally invasive esophagectomy with end-to-end esophago-gastric anastomosis for thoracic esophageal cancers: An experience from a low middle-income country.

BACKGROUND: Esophageal cancer is on a steady rise and carries significant mortality and morbidity. Depending upon the clinical stage at presentation, either chemotherapy, radiotherapy with or without surgical resection is the treatments in practice. Traditionally, open esophagectomy was performed but over time, the importance of minimally invasive esophagectomy has been established. In this study, we aimed to report our data of totally minimally invasive esophagectomies performed for thoracic esophageal cancers in last four years. METHODOLOGY: A prospective cross-sectional study was conducted at the Department of Upper GI Surgery, Dow University of Health Sciences, Karachi. All diagnosed cases of esophageal carcinoma undergoing minimally invasive esophagectomy, from 2019 to 2022 were included in this study. Outcomes measured were operative time, intra operative complications, conversion rate to open, postoperative complications, number of lymph nodes harvested, margin clearance, in-hospital mortality and 90-days mortality. RESULTS: A total of 53 cases were included in the study, the most prevalent histological type was squamous cell carcinoma 42(79.2%) as compared to adenocarcinoma 8(15.1%). Most common tumor site was lower thoracic esophagus (30-38 cm) in 20 (56.6%) cases. Neo-adjuvant chemotherapy was given in all 53(100%) cases, whereas neo-adjuvant radiation therapy was offered to 49(92.5%) patients. There was a significant and favorable patient response to the neo-adjuvant treatment in 37(69.8%) cases, leading to a decrease in tumor size. Laparoscopic McKeown Esophagectomies were performed in 44 (83.0%) and 9(17.0%) were Robot-assisted Minimally Invasive esophagectomy (RAMIE). Intraoperative injuries (i.e., lung parenchymal injury and bleeding) were reported in only 2(3.8%) patients. Post-operative complications were recorded in 12(22.6%) patients. Margin clearance was observed in 53 (100%) of the patients. The 90-day mortality rate was 3(5.7%), one due to bleeding and other two mortalities were due to COVID related respiratory complications. CONCLUSION: Minimally invasive esophagectomy was found to be safe and feasible technique with encouraging results in terms of decreased intraoperative and post operative complications as well as achieving the standard oncological surgery with acceptable lymph node yield and margin clearance and in hospital and 90 days mortality.

Effectiveness of locally produced ready-to-use supplementary foods on the prevention of stunting in children aged 6-23 months: a community-based trial from Pakistan.

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.

Essential Oils in Cervical Cancer: Narrative Review on Current Insights and Future Prospects.

Cervical cancer is a prevalent and often devastating disease affecting women worldwide. Traditional treatment modalities such as surgery, chemotherapy, and radiation therapy have significantly improved survival rates, but they are often accompanied by side effects and challenges that can impact a patient's quality of life. In recent years, the integration of essential oils into the management of cervical cancer has gained attention. This review provides an in-depth exploration of the role of various essential oils in cervical cancer, offering insights into their potential benefits and the existing body of research. The review also delves into future directions and challenges in this emerging field, emphasizing promising research areas and advanced delivery systems. The encapsulation of essential oils with solid lipid nanoparticles, nanoemulsification of essential oils, or the combination of essential oils with conventional treatments showed promising results by increasing the anticancer properties of essential oils. As the use of essential oils in cervical cancer treatment or management evolves, this review aims to provide a comprehensive perspective, balancing the potential of these natural remedies with the challenges and considerations that need to be addressed.