NUTRITIONAL STATUS AND ASSOCIATED FACTORS AMONG CHILDREN LESS THAN FIVE YEARS OF AGE IN TEHSIL ZARGHOON TOWN, DISTRICT QUETTA, BALUCHISTAN.

BACKGROUND: Globally, more than one-third of mortalities in children under five years of age are attributable to malnutrition. The prevalence of malnourished children in Pakistan is inclining. A knowledge gap exists due to availability of limited literature about the nutritional status of children in rural Baluchistan. Therefore, this study assessed the magnitude and factors associated with nutritional status of children of less than five years of age in Tehsil Zarghoon Town of District Quetta. METHODS: A community based cross-sectional study was conducted in two rural union councils of Tehsil Zarghoon Town of District Quetta, selected randomly. An existing questionnaire was modified and three research assistants were hired to collect data from 104 children, selected systematically. Data analysis was done using SPSS-20 and World Health Organization (WHO) Anthro software. RESULTS: Results showed that the proportion of stunting and wasting in children comprising the study population was 48.1% and 9.7% respectively. A significant association was demonstrated between stunting and wasting and socio-demographic characteristics, child health characteristics and maternal health characteristics. CONCLUSION: It was concluded that the nutritional status of children under five years of age in Tehsil Zarghoon Town of district Quetta was unsatisfactory. Thus, community mobilization and incorporation of nutrition related activities in primary health care are recommended.

DIET INTAKE TRENDS AMONG PREGNANT WOMEN IN RURAL AREA OF RAWALPINDI, PAKISTAN.

BACKGROUND: Adequate and healthy diet during pregnancy is essential for the health of both mother and new-born. This study was designed to know the health status of pregnant women and new-born by determining food taking habits of pregnant women. METHODS: A cross sectional study was conducted on pregnant women of 2nd and 3rd trimester in a rural area of district Rawalpindi. Food frequency questionnaire and 24 hours dietary recall methods were used to identify their food consumption practices. Analysis was done by SPSS, while Nutrisurvey software was used to check the presence of Vitamin A, C, and Iron in specific fruits or vegetables. RESULTS: A total of 110 pregnant wome participated in the study. Most of them were illiterate, had low household income, and unemployed. [ntake of meal frequency was according to the standards of Institute of Medicine (IOM), but food grou consumption was not according to the recommendations of the United State Department of Agricultur (USDA). Most participants 102 (93.2%) knew that food is important during pregnancy. However a increase in frequency intake was observed in 63 (57.3%); while, 19 (17.3%) reported no change in food intake practices. About 67 (61%) were taking some sort of dietary supplements. Avoidance of any food 24 (22%), intake of additional food 51 (46%), craving 86 (78%), and aversion to any sort of food 42 (38%) was also identified in the study sample. No significant association was found between food group consumption, food availability and accessibility. Dietary diversity score, calculated according to the Food and Agriculture Organization (FAO) guidelines, indicated that about half study participants were not consuming adequate food. CONCLUSION: Study results show that food intake practices of pregnant women in the study area were not satisfactory. The results suggest that pregnant women need

Diagnostic Accuracy of Right Bronchial Infiltration on Chest X-rays in Diagnosing COVID-19 Patients in the Early Stage of the Disease.

Purpose SARS-CoV-2 has been a diagnostic challenge for healthcare setups worldwide since 2019 due to its proximity to a myriad of pathological processes. Although reverse transcription - polymerase chain reaction (RT-PCR) and high-resolution computed tomography (HRCT) have helped in the diagnosis of the disease, they are not as widely available as chest X-rays. This study aims to investigate the diagnostic accuracy of right bronchial infiltration in chest X-ray in diagnosing COVID-19. Material and methods This was a validation study conducted in a single center in Riyadh, Saudi Arabia. A total of 114 patients were enrolled according to the selection criteria of the study. Consent was waived off on the condition of confidentiality maintenance as per the ethical review board. X-rays of suspected patients were viewed and analyzed by two blinded consultant radiologists. Patients were followed for their RT-PCR reports. Data were entered and analyzed in SPSS Statistics v.23.0 (IBM Corp., Armonk, USA). Results Among the 114 patients, the mean age was 46.2±17.3 years and 85 (74.6%) were males. The total number of COVID-19-positive patients were 82 (71.9%) while the patients presenting with right bronchial infiltration (RBI) were 94 (82.5%). RBI was significantly associated with the presence and absence of COVID-19 on PCR (p<0.001) and the presence of comorbidities (p<0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the sign were 84.04%, 85.00%, 96.34%, 53.12%, and 84.21%, respectively. Conclusions RBI can be used as a diagnostic sign in X-rays for early identification of COVID-19 positive patients. This feature can be used in the triage of patients. This would decrease the spread of disease by providing early time to intervene to isolate patients.

A Viral Crisis: Knowledge, Attitude And Practices Of Undergraduate Medical Students Of The Twin Cities Of Pakistan Towards Covid-19.

BACKGROUND: A novel coronavirus strain, SARS-CoV-2, was identified in December 2019, causing a disease known as coronavirus disease 2019 (COVID-19). WHO declared the COVID-19 emergency as a pandemic in March 2020. Following nationwide lockdowns, it becomes pertinent that the self-quarantined medical students are able to dispense necessary knowledge regarding appropriate prevention practices related to the disease to their respective families and communities, therefore playing a positive role in sharing the economic load of the health system already overburdened by the increasing number of COVID-19 patients. This study aims to investigate the knowledge, attitudes and practices (KAP) of undergraduate medical students of the Twin Cities of Pakistan toward COVID-19, with regards to their observance of precautionary measures against the disease. METHODS: Online data in this descriptive cross- sectional study was collected through self-developed questionnaires from 267 undergraduate medical students of twin cities, by convenient sampling. RESULTS: High level of knowledge (72.7%) regarding Covid-19 infection among undergraduate medical students was consistent with their practices (70.8%) but not with their satisfactory attitude (p<0.01). Being female than male and students of private medical colleges showed more satisfactory attitude (p<0.05) and knowledge (p<0.01) towards Covid-19 infection respectively, while practices were more among the students of public sector medical college (p<0.05). CONCLUSIONS: The Knowledge of the students was satisfactory and consistent with their practices but not with their Satisfactory attitude, indicating a need to improve upon the prevailing attitude regarding infectious diseases such as Covid-19 and their prevention.

Predictors of Prenatal Depression: A Cross-Sectional Study in Rural Pakistan.

Objective: To determine the prevalence and association of prenatal depression with socioeconomic, demographic and personal factors among pregnant women living in Kallar Syedan, Rawalpindi, Pakistan. Methods: Five hundred women in the second and third trimester of pregnancy, living in Kallar Syedan, a rural area of district Rawalpindi Pakistan, were included in the study. Depression was assessed using "Patient health questionnaire" (PHQ9) in Urdu, with a cut-off score of 10. Multi-dimensional scale of perceived social support (MSPSS) was used to assess perceived social support. Life Events and Difficulties Schedule (LEDS) were used to measure stressful life events in past 1 year. Tool to assess intimate partner violence (IPV) was based on WHO Multi Country Study on "Women's Health and Domestic Violence against Women." Results: Prevalence of prenatal depression was found to be 27%. Number of pregnancies was significantly associated with prenatal depression (p < 0.01). Women living in a joint family and those who perceived themselves as moderately satisfied or not satisfied with their life in the next 4 years were found to be depressed (p < 0.01, OR 6.9, CI 1.77-26.73). Depressive symptomatology in women who experienced more than five stressful life events in last 1 year was three times higher (p < 0.001, OR 3.2, CI 1.68-5.98) than in women with 1-2 stressful events. Women who were supported by their significant others or their family members had 0.9 times (p < 0.01, OR 0.9, CI 0.85-0.96) less chance of getting depressed. Pregnant women who were psychologically abused by their partners were 1.5 times more depressed (p < 0.05 CI 1.12-2.51). Odds of having depression was also high in women who had less mean score of MSSI (p < 0.05, OR 1.1, CI 1.01-1.09). Women who had suitable accommodation had 0.5 times less chance of having depression than others (p < 0.05, OR 0.5, CI 0.27-0.92). Conclusion: Over a quarter of the women in the study population reported prenatal depression, which were predicted predominantly by psychosocial variables.

Screen-Based Simulation for Training and Automated Assessment of Teamwork Skills: Comparing 2 Modes With Different Interactivity.

INTRODUCTION: The need for teamwork training is well documented; however, teaching these skills is challenging given the logistics of assembling individual team members together to train in person. We designed 2 modes of screen-based simulation for training teamwork skills to assess whether interactivity with nonplayer characters was necessary for in-game performance gains or for player satisfaction with the experience. METHODS: Mixed, randomized, repeated measures study with licensed healthcare providers block-stratified and randomized to evaluation-participant observes and evaluates the team player in 3 scenarios-and game play-participant is immersed as the leader in the same 3 scenarios. Teamwork construct scores (leadership, communication, situation monitoring, mutual support) from an ontology-based, Bayesian network assessment model were analyzed using mixed randomized repeated measures analyses of variance to compare performance, across scenarios and modes. Learning was measured by pretest and posttest quiz scores. User experience was evaluated using χ2 analyses. RESULTS: Among 166 recruited and randomized participants, 120 enrolled in the study and 109 had complete data for analysis. Mean composite teamwork Bayesian network scores improved for successive scenarios in both modes, with evaluation scores statistically higher than game play for every teamwork construct and scenario (r = 0.73, P = 0.000). Quiz scores improved from pretest to posttest (P = 0.004), but differences between modes were not significant. CONCLUSIONS: For training teamwork skills using screen-based simulation, interactivity of the player with the nonplayer characters is not necessary for in-game performance gains or for player satisfaction with the experience.

Assessment Of Determinants Of Complementary Feeding Practices In Mothers Of Less Than 2 Years Children In Rural Setting Of Islamabad.

BACKGROUND: Complementary feeding plays a significant role in determining child health up to 2 years of age. This study aimed to determine awareness among mothers about the timely initiation, nutritional adequacy and risks associated with early initiation of CF. METHODS: A cross sectional study was conducted on 110 mothers living in Farash town Islamabad.List of women having index child less than 2 years was taken from LHW of that area.Subjects were chosen by simple random sampling.Mothers of children less than 2 years were included and children with any congenital abnormalities and mothers who didn't give consent were excluded. Structured questionnaire was used for data collection. Descriptive statistic was used to categorize the study population. Summary statistics was used for continuous variable. RESULTS: Ninety-six (87.3%) mothers had knowledge about CF and 88.2% practiced it. Thirty-three (30%) of the respondents had knowledge about correct age of CF and 35 (32%) mothers got CF information from the family members. The risks were known by only 46 (41.8%). Forty (36.4%) had introduced CF at 6 months. Sixty-one (55.5%) faced difficulties while introducing CF. Twenty-eight (45.90%) of children only accepted certain solid foods. Twenty-one (35%) children experienced vomiting. Association was seen between age appropriate CF practice with mother's education (p=0.034), type of family (p=0.002), father's profession (p=0.019) and total number of children (p=0.020). CONCLUSIONS: Improper feeding practices and inadequate knowledge regarding initiation of CF among mothers was observed. One third mothers initiated CF to their child at the age of 6 months.Same numbers of mothers were giving their child homemade food.Slightly less than half of the mothers knew about risks associated with early introduction of CF.

Association of Maternal depression with diet: A systematic review.

This review was conducted to explore the bi-directional association of maternal depression with diet. This link is hypothesized because the mental health of pregnant women may adversely affect their nutritional intake; or inversely, that poor nutritional intake during pregnancy may cause mental health issues. Seven electronic databases were searched to retrieve relevant peer-reviewed articles published during 2000-2018. Primary research studies published in English that evaluated the relationship between maternal antenatal and postnatal depression with dietary intake were selected. We screened 1585 articles, of which 13 met the inclusion criteria. These included five cohort studies (including two birth cohorts) and eight cross-sectional studies representing a total of 12,742 participants altogether. Studies were divided into five groups depending on whether they analyzed all nutrients, micronutrients, dietary patterns, dietary behavior or intake of fish and vegetables. The studies exploring the association of depression with dietary patterns found a protective association of "Health Conscious", "Healthy" and "Brazilian" diet patterns with maternal depression. The group of studies which analyzed all nutrients, found an inverse relationship of the "Healthy Eating Index" with maternal depression. Deficiency of calcium, iron, and folate were also associated with maternal depression. Prenatal and early postpartum eating attitudes and BMI were found as predictors of depressive symptoms in the late post-partum period in a diet behavior study. It is important to identify modifiable lifestyle risk factors which may contribute to maternal depression. A limitations of our review is the absence of meta-analysis which was not possible due to heterogeneity of the studies.