The mediating role of stakeholders on green banking practices and bank's performance: The case of a developing nation.

The banking sector serves as a nudge between increased financial investments and reduced environmental impacts in the modern era of sustainability thus, integrating the social, environmental, and economic dimensions. This paper aims to explore the practices and ongoing activities on account of sustainable banking which is being practised in the Pakistani Banking Sector. A mixed methods approach using a survey with a sample size of (n = 250) and in-depth interviews of (n = 25) provides significant evidence for the research. SmartPLS4.0 was used for hypotheses testing and to ascertain the path coefficient association within the constructs. This research fills the gap in existing literature by testing and implying the mediating role of Stakeholders' Influence on the relationship between Green Banking Practices and the Bank's Performance. The results of the quantitative analysis show a positive association between variables, highlighting the role of stakeholders and their need to partake efficiently, in the countrywide execution of green banking. The qualitative analysis portrays that; green banking is currently the partial focus of the banking sector in the developing economy of Pakistan whereas, approaches like financing green projects, investments in renewable energy, in-house greening of the banking sector, and provision of easy lending facilities to encourage and support environmental initiatives are some commonly practised accomplishments of the banking sector.

Smart Resource Allocation in Mobile Cloud Next-Generation Network (NGN) Orchestration with Context-Aware Data and Machine Learning for the Cost Optimization of Microservice Applications.

Mobile cloud computing (MCC) provides resources to users to handle smart mobile applications. In MCC, task scheduling is the solution for mobile users' context-aware computation resource-rich applications. Most existing approaches have achieved a moderate service reliability rate due to a lack of instance-centric resource estimations and task offloading, a statistical NP-hard problem. The current intelligent scheduling process cannot address NP-hard problems due to traditional task offloading approaches. To address this problem, the authors design an efficient context-aware service offloading approach based on instance-centric measurements. The revised machine learning model/algorithm employs task adaptation to make decisions regarding task offloading. The proposed MCVS scheduling algorithm predicts the usage rates of individual microservices for a practical task scheduling scheme, considering mobile device time, cost, network, location, and central processing unit (CPU) power to train data. One notable feature of the microservice software architecture is its capacity to facilitate the scalability, flexibility, and independent deployment of individual components. A series of simulation results show the efficiency of the proposed technique based on offloading, CPU usage, and execution time metrics. The experimental results efficiently show the learning rate in training and testing in comparison with existing approaches, showing efficient training and task offloading phases. The proposed system has lower costs and uses less energy to offload microservices in MCC. Graphical results are presented to define the effectiveness of the proposed model. For a service arrival rate of 80%, the proposed model achieves an average 4.5% service offloading rate and 0.18% CPU usage rate compared with state-of-the-art approaches. The proposed method demonstrates efficiency in terms of cost and energy savings for microservice offloading in mobile cloud computing (MCC).

Examining the factors linking the intention of female entrepreneurial mindset: A study in Pakistan's small and medium-sized enterprises.

In contemporary times, women have gained recognition as accomplished entrepreneurs who make substantial contributions to economic development by virtue of their perseverance, excellence, and expertise. The concept of women's entrepreneurship encompasses the undertaking of creating novel enterprises, with the individual's intention to assume the role of an entrepreneur serving as a pivotal factor in this developmental trajectory. The underperformance of female entrepreneurs is alarming for developing nations. Purposefully, exploring the factors correlating female entrepreneurship intention is highly regarded, and a timely research is needed, thus this study explores the context of Pakistan considered a developing country. Hence, we collected data from listed small and medium enterprises (SMEs) operating in the country by means of structured questionnaires. Using SPSS and Smart-PLS software, we developed a conceptual model and performed analysis. The Theory of Planned Behavior (TPB) constitutes a robust psychological framework applicable to understanding and anticipating various human behaviors, first and foremost, entrepreneurial intention. When applying the TPB to the area of women's entrepreneurial intentions, several crucial factors come into play, including motivation, self-confidence, personality traits, and adaptability. The results indicate that factors such as the will to start a business, willingness, personality traits, adaptability, and background factors, including education and experience, impact entrepreneurial intention. Also, their professional careers make them able to launch a business. Based on our findings, we recommend that the Small and Medium Enterprise Development Authority (SMEDA), policymakers, and practitioners may provide various incentives and support systems related to these factors to encourage their own company launches. Prior research has examined various factors that impact the entrepreneurial mindsets of women. However, our study focuses specifically on closely associated aspects that have received limited attention, particularly in the context of Pakistan. This study makes a valuable contribution to the extant body of literature by providing empirical evidence in the aforementioned domains.

Incidence of aflatoxin M1 in cows' milk in Pakistan, effects on milk quality and evaluation of therapeutic management in dairy animals.

The present study was aimed at measuring the concentration of aflatoxin M1 (AFM1) in the milk of Holstein Friesian cows, its effect on the milk quality and seasonal trends, as well as to investigate the efficacy of a commercial clay-based toxin binder. For this purpose, milk samples from dairy cows (n = 72) were collected and assayed for AFM1 before employing a clay-based toxin binder. The milk samples (n = 72) were collected from selected animals, revealing that 69.4% of the milk samples had AFM1 levels above the United States permissible limit (0.5 µg/kg). The incidence of AFM1 in milk during the winter and summer was 82.5% and 53.1%, respectively. Owing to the presence of AFM1, the level of milk fat, solids-not-fat, and protein were found to be low. Subsequently, the affected animals were divided into two groups, i.e., AFM1 positive control (n = 10) and the experimental group (n = 40). The experimental group of animals were fed the clay-based toxin binder at 25 g/animal/day. A progressive decrease of 19.8% in the AFM1 levels was observed on day 4 and on day 7 (53.6%) in the treatment group. Furthermore, the fat, solids-non-fat and protein increased significantly in the milk. In conclusion, a high level of AFM1 contamination occurs in the milk in Pakistan, affecting the quality of the milk production. Clay-based toxin binders may be used to ensure the milk quality and to protect the animal and consumer health.

Design and Assessment of a Novel In Silico Approach for Developing a Next-Generation Multi-Epitope Universal Vaccine Targeting Coronaviruses.

In the past two decades, there have been three coronavirus outbreaks that have caused significant economic and health crises. Biologists predict that more coronaviruses may emerge in the near future. Therefore, it is crucial to develop preventive vaccines that can effectively combat multiple coronaviruses. In this study, we employed computational approaches to analyze genetically related coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants, focusing on the spike glycoprotein as a potential vaccine candidate. By predicting common epitopes, we identified the top epitopes and combined them to create a multi-epitope candidate vaccine. The overall quality of the candidate vaccine was validated through in silico analyses, confirming its antigenicity, immunogenicity, and stability. In silico docking and simulation studies suggested a stable interaction between the multi-epitope candidate vaccine and human toll-like receptor 2 (TLR2). In silico codon optimization and cloning were used to further explore the successful expression of the designed candidate vaccine in a prokaryotic expression system. Based on computational analysis, the designed candidate vaccine was found to be stable and non-allergenic in the human body. The efficiency of the multi-epitope vaccine in triggering effective cellular and humoral immune responses was assessed through immune stimulation, demonstrating that the designed candidate vaccine can elicit specific immune responses against multiple coronaviruses. Therefore, it holds promise as a potential candidate vaccine against existing and future coronaviruses.

Natural resources, fiscal decentralization, and environmental quality in China: an empirical analysis from QARDL approach.

It is generally believed that fiscal decentralization is an essential way to increase the overall effectiveness and efficiency of the government through the transfer of financial autonomy to the local governments. On the same lines, this study attempts to confabulate the influence of two important economic indicators, (i) fiscal decentralization and (ii) natural resource rent in validation of the environmental Kuznets curve hypothesis. Our current analysis is grounded upon a developing economy - China - and will serve as a stepping stone for the similar economies. The time period for the empirical estimation is from 1990 to 2020. The study applied an advanced econometrics approach, called the quantile autoregressive distributed lag (QARDL), which has many advantages as compared to any conventional approach. The empirical outcomes, after estimations, illustrate that in the long run, FDE is having an unfavorable connotation with CO2 emissions. NRR is another essential factor influencing the CO2 emissions in the long run in the selected economy. The estimated outcomes are revealing the presence of the EKC. Furthermore, the present research elucidates the existence of the bi-directional causality between selected economic indicators, FDE and CO2 emissions, and GDP square and CO2 emissions. But there is a unidirectional causality between GDP and CO2 emissions. Thus, policymakers should encourage the transfer of powers to the lower tiers of government to ameliorate environmental quality in the Chinese economy.

Exploring the intravenous narcotics and controlled drugs wastage and their financial impact: A descriptive single-center study.

Objective: The objectives of this study were to explore the wastage of narcotics and controlled medications and, their financial impact in a tertiary care setting over a one-year period. Methodology: The study period was of one year, i.e., October 2020 - September 2021. The venue of study was a tertiary care hospital. The narcotic medications included Fentanyl, Tramadol, Morphine, and Meperidine. The controlled medications included Midazolam, Phenobarbital, Diazepam, Ketamine and Lorazepam. The annual consumption and wastage of the narcotic and controlled medications were documented using data report generated by narcotics and controlled medication in-charge pharmacist through the hospital's online system. Data was reported using average, minimum and maximum values. Quantities of wastage is expressed in terms of ampoules. Costs per ampoule were calculated and expressed in both Saudi Riyal (SAR) and United States Dollar (USD). The study was approved by an ethics committee. Results: The annual wastage of narcotics was 3.19 % while the same for controlled medications was 21.3 %. An annual wastage of 3.81 % was reported for narcotics and controlled medications combined. The total wastage cost of narcotics and controlled medications was 15,443.1 SAR that was equivalent to USD 4085.5. Fentanyl 500mcg formulations had the highest consumption, i.e., 28,580 ampoules followed by Morphine 10 mg formulations, i.e., 27,122 ampoules. The highest ampoule wastage was observed for Morphine 10 mg formulations, i.e., 1956 ampoules. The highest % wastage was observed for Midazolam formulations, i.e., 29.3 %. Conclusion: The overall wastage was less than 5% of the total consumption, however, midazolam was observed to have the highest wastage. Shifting to prefilled syringes supplied by pharmacies, making protocols, and safely pooling costly drugs could result in significant savings.

Gender classification from anthropometric measurement by boosting decision tree: A novel machine learning approach.

The decision tree used a generating set of rules based on various correlated variables for developing an algorithm from the target variable. Using the training dataset this paper used boosting tree algorithm for gender classification from twenty-five anthropometric measurements and extract twelve significant variables chest diameter, waist girth, biacromial, wrist diameter, ankle diameter, forearm girth, thigh girth, chest depth, bicep girth, shoulder girth, elbow girth and the hip girth with an accuracy rate of 98.42%, by seven decision rule sets serving the purpose of dimension reduction.

Variations in the 24 h temporal patterns and time budgets of grazing, rumination, and idling behaviors in grazing dairy cows in a New Zealand system.

This study investigated the variations in the temporal distributions and the lengths of times utilized for grazing, ruminating, and idling behaviors by grazing dairy cows over 24 h. Spring-calved lactating dairy cows (N = 54) from three breeds, Holstein-Friesian (HFR), Jersey (JE), and KiwiCross (KC) in different lactations (1st, 2nd, 3rd) and with different breeding worth index values (103 < BW > 151) were selected. The cows were managed through a rotational grazing scheme and milked once a day at 0500 hours. The cows grazed mainly pasture and consumed additional feeds (maize silage and turnips) in the summer and autumn seasons. AfiCollar was used to record grazing and rumination behaviors (min/h) in the individual cows throughout the lactation period (~270 d). The time neither utilized for grazing nor rumination was counted as idling behavior (min/h). A repeat measure design with PROC MIXED was performed in SAS considering the effects of breed, lactation, individual cow, the hour of the day, season, day within the season, and supplementary feed within the season to evaluate the difference in grazing, rumination, and idling behaviors. Hour of the day, season, day within season, and supplementary feed had significant effects on grazing, rumination, and idling behaviors. Regardless of the season and supplementary feed, cows spent most of the daytime grazing and most of the nighttime ruminating. Grazing activity remained consistently high throughout the day with two peaks around dawn and dusk and a short peak around midnight. Rumination activity remained high from the late evening until early morning. Grazing and ruminating patterns were similar between different breeds and lactations, however, JE cows grazed slightly longer than HFR and KC, and first-lactation cows grazed slightly longer than those in higher lactations. The onset and cessation of grazing activity by the cows were adjusted according to varying day lengths by season. Cows finished grazing earlier when they consumed additional supplements or silage along with pasture. Cows from different breed groups and lactations spent most of their 24 h grazing followed by ruminating and idling. Season and supplementary feed potentially affected the variations in behavior time budgets. These findings should support improving measures for grazing management to address pasture allocation and additional feed demands, and animal welfare in varying environmental and/or managemental conditions.

This study explored how grazing dairy cows pattern their essential such as including grazing, rumination, and idling, and how they distribute their time for those behaviors over 24 h. We used a group of spring-calved grazing dairy cows affiliated with different breeds, milking ages, and genetic merits and recorded their grazing and rumination behaviors for the whole milking period. An automated device, AfiCollar was used to continuously record minutes within an hour (min/h) utilized for grazing, rumination, and idling. The cows were mainly offered grass with some additional supplementary feeds on various days in summer and autumn and milked once a day at 0500 hours. Regardless of the breed, milking age, season, and supplementary feeds, grazing cows spent most of the daytime (from dawn to dusk) grazing and most of the nighttime ruminating, with a short grazing period around midnight. Cows adopted their grazing patterns according to varying day lengths during different seasons and finished grazing earlier when received supplementary feeds. Grazing cows allocated most of their time over 24 h for grazing followed by ruminating and idling. These findings could have implications to improve the measures for pasture management efficiency and additional feed demand, and animal welfare in varying environmental and/or managemental conditions.

Fabrication, In Vitro, and In Vivo Assessment of Eucalyptol-Loaded Nanoemulgel as a Novel Paradigm for Wound Healing.

Wounds are the most common causes of mortality all over the world. Topical drug delivery systems are more efficient in treating wounds as compared to oral delivery systems because they bypass the disadvantages of the oral route. The aim of the present study was to formulate and evaluate in vitro in vivo nanoemulgels loaded with eucalyptol for wound healing. Nanoemulsions were prepared using the solvent emulsification diffusion method by mixing an aqueous phase and an oil phase, and a nanoemulgel was then fabricated by mixing nanoemulsions with a gelling agent (Carbopol 940) in a 1:1 ratio. The nanoemulgels were evaluated regarding stability, homogeneity, pH, viscosity, Fourier-transform infrared spectroscopy (FTIR), droplet size, zeta potential, polydispersity index (PDI), spreadability, drug content, in vitro drug release, and in vivo study. The optimized formulation, F5, exhibited pH values between 5 and 6, with no significant variations at different temperatures, and acceptable homogeneity and spreadability. F5 had a droplet size of 139 ± 5.8 nm, with a low polydispersity index. FTIR studies showed the compatibility of the drug with the excipients. The drug content of F5 was 94.81%. The percentage of wound contraction of the experimental, standard, and control groups were 100% ± 0.015, 98.170% ± 0.749, and 70.846% ± 0.830, respectively. Statistically, the experimental group showed a significant difference (p < 0.03) from the other two groups. The results suggest that the formulated optimized dosage showed optimum stability, and it can be considered an effective wound healing alternative.

Plant species diversity assessment and monitoring in catchment areas of River Chenab, Punjab, Pakistan.

BACKGROUND: Biodiversity data is crucial for sustainable development and making decisions regarding natural resources and its conservation. The study goal was to use quantitative ecological approaches to determine the species richness and diversity of wild flora and the ultimate impact of environmental factors on vegetation dynamics. METHODS: Quadrats having sizes of 1×1 for herbs, 5×5 for shrubs, and 10×10 m2 for trees were used. Various phytosociological characteristics were investigated in association with a wide variety of environmental variables. Soil analysis based on texture, moisture, pH, electrical conductivity (EC), organic matter (OM), available potassium (K), and phosphorus (P) were examined. The existing state of vegetation along the River Chenab was assessed using SWOT analysis and a future conservation strategy was devised. RESULTS: One hundred twenty different plant speies were divided into 51 families including 92 dicots, 17 monocots, 6 pteridophytes and 1 bryophyte species. Herbs accounted for 89 followed by shrubs (16 species) and trees (15 species). Correlation analysis revealed a highly positive correlation between relative density and relative frequency (0.956**). Shannon and Simpson's diversity indices elaborated that site 3 and 7 with clay loamy soil had non-significant alpha diversity and varies from site to site. Diversity analysis showed that site 10 was most diverse (22.25) in terms of species richness. The principal coordinate analysis expressed that different environmental variables including OM, soil pH, P, K, and EC affect vegetation significantly, therefore, loamy soil showed presence and dispersal of more vegetation as compared to loam, sandy and sandy loam soils. Further, 170 ppm of available potassium had significant affect on plant diversity and distribution. CONCLUSION: Asteraceae family was found dominant as dicot while poaceae among monocot. Adhatoda vasica was one of the unique species and found in Head Maralla site. For evenness, site 3 had maximum value 0.971. Most of the soil represented loamy soil texture where site 2 and 4 possess high soil moisture content. SWOT analysis revealed strengths as people prefered plants for medicine, food and economic purposes. In weakness, agricultural practices, soil erosion and flooding affected the vegetation. In opportunities, Forest and Irrigation Departments were planting plants for the restoration of ecosystem. Threats include anthropogenic activities overgrazing, urbanization and road infrastructure at Head Maralla, habitat fragmentation at Head Khanki, and extensive fish farming at Head Qadirabad. Future conservation efforts should be concentrated on SWOT analysis outcome in terms of stopping illegal consumption of natural resources, restoration of plant biodiversity through reforestation, designating protected areas and multiplying rare species locally.

Assessment of Knowledge Regarding Safety Profile, Use, and Boxed Warnings of Fluoroquinolones Among Healthcare Professionals in Saudi Arabia: A Potential Implication for Drug Regulatory Authorities.

Background: Despite a series of "boxed warnings" (BWs) issued by the US Food and Drug Administration (FDA), fluoroquinolones (FQs) are among the most prescribed antibiotics across the world. Moreover, few studies demonstrated that BW of FQs had less or no impact on prescribing patterns among healthcare professionals (HCPs), which might be attributed to the lack of knowledge toward such warnings. Since FQs contribute to a major proportion of antimicrobial prescriptions in the Kingdom of Saudi Arabia (KSA), this study aimed to ascertain the extent of knowledge toward safety profile, use, and BW of FQs among HCPs working in the KSA. Methods: This cross-sectional study (May-August 2021) was conducted among HCPs working in KSA through a validated questionnaire. The HCPs were requested to identify the indications, adverse effects (AEs), and BW of FQs. The knowledge score (out of 40) was estimated among participants, and its association with demographics was ascertained through the chi-square test, Student's t-test, or Mann-Whitney U-test and one-way ANOVA, or Kruskal-Wallis test, where appropriate. Results: Of the 573 participants (age: 36.1 ± 10.6 years, men: 59.7%), 262 (45.8%) were prescribers reporting frequent use of ciprofloxacin, levofloxacin, and ofloxacin. One-fourth (25.6%) of the prescribers did not recognize nalidixic acid as an agent from FQs class. About 60% of participants correctly identified the mechanism of action of FQs. The average knowledge score was 14.8 ± 6.4, where only 21.5% of respondents scored ≥50%. The average knowledge score for indications, AEs, and BW domains was 5.29 ± 3.05, 6.17 ± 4.05, and 2.3 ± 1.5, respectively. Only 75 (13.1%) participants recognized half of the BW, and 38.6% of participants identified at least one warning. The HCPs aged >40 years (p = 0.043), having non-Saudi's nationality (p < 0.001), working in Riyadh and Eastern regions (p < 0.001), having pharmacy and medicine disciplines (p < 0.001), practicing in public sectors (p = 0.004), and having more than 10 years of experience (p < 0.001) were significantly associated with high knowledge score. Conclusion: This study demonstrates the unsatisfactory knowledge toward safety profile, use, and BW of FQs among HCPs which may put patients at increased risks of AEs. The knowledge score differed among various socio-demographic groups. There is a dire need to initiate the antimicrobial-focused educational campaigns among HCPs regardless of their specialties and methods to improve education and disseminate FDA warnings in practice.

Hydroxyurea- a cost effective treatment in developing countries for Atypical Chronic Myeloid Leukemia (aCML): Case Report of Two Patients.

INTRODUCTION: Atypical chronic myeloid leukaemia (aCML) is a rare chronic myeloproliferative disorder with a poor prognosis. CASE REPORT: This case report presents two cases of male geriatric patients, both referred from primary care in rural areas and received at an urban clinic in a tertiary care hospital on separate instances. The first patient complained of low-grade fever (on/off), generalized body aches, rapid weight loss and shortness of breath for the last 2 months. The second patient arrived pale looking with symptoms of generalized body aches, dizziness and anorexia. Both patients were diagnosed to have aCML according to the World Health organization criteria. MANAGEMENT & OUTCOME: Both the patients were from a low economic bracket and were treated with Hydroxyurea a relatively economic medicine successfully. The follow-up lasted for 12 months in both cases. No progression to acute myeloid leukaemia (AML) or relapse was observed. DISCUSSION: This case report shows the promising results of Hydroxyurea in treating aCML and can be a cost effective alternate to other expensive treatments (allogeneic hematopoietic stem cell transplantation) and expensive medicines in lower and middle-income countries especially for resource-limited patients. These two cases show promising evidence for further studies to evaluate and conduct pharmaco-economic evaluations as well as clinical trials to compare hydroxyurea with other available alternative treatments for an affordable therapeutic option towards prevention of relapse and disease free survival after aCML.

Assessment of cadmium and lead tolerance potential of quinoa (Chenopodium quinoa Willd) and its implications for phytoremediation and human health.

Soil contamination with Cd and Pb is a worldwide problem which not only degrades the environment but also poses a serious threat for human and animal health. Phytoremediation of these contaminated soils using halophytic plants like quinoa presents an opportunity to clean the soils and use them for crop production. The current experiment was performed to evaluate the Cd and Pb tolerance potential of quinoa and subsequently its implications for human health. Three weeks old quinoa seedlings were exposed to Cd (30, 60 and 90 mg kg-1) and Pb (50, 100 and 150 mg kg-1) levels along with a control. The results revealed that plant height decreased at highest levels of soil Cd and Pb. Shoot, root and seed dry weight decreased with increasing levels of soil Cd and Pb. Tissue Cd and Pb concentrations increased with increasing levels of Cd and Pb in soil, the highest Cd was found in roots while the lowest in seeds. The highest Pb concentration was found in shoots at low Pb level, while in roots at high level of Pb. Increasing levels of Cd and Pb stimulated the activities of measured antioxidant enzymes and decreased membrane stability index. The health risk assessments of Cd and Pb revealed that hazard quotient was < 1 for both the metals. However, the results of total hazard quotient showed that value was < 1 for Pb and 1.19 for Cd showing potential carcinogenicity. This study demonstrates that quinoa has good phytoremediation potential for Cd and Pb however, the risk of Cd toxicity is challenging for human health.

In vivo assessment of reversing Cisplatin-Induced nephrotoxicity using Jatropha mollissima crude extract and its potential cytotoxicity.

Jatropha mollissima is one of the ancient plants that known in Africa, Asia and Latin America for its high medicinal value. Previously we showed that the ethanolic leaves extract of J. mollissima was able to reverse the aminoglycoside antibiotics induced nephrotoxicity in only two weeks of administration. Here, we evaluated the phytochemicals, antioxidant and in vivo cytotoxicity of the ethanolic leaves extract in addition to the ability of reversing Cisplatin-induced nephrotoxicity in wistar albino rats. The results of phytochemical analysis showed the presence of flavonoids, phenols, tannins and saponins, with significantly high antioxidant activity. The treated rats did not show any cytotoxic signs; no anatomical, physiological and/or histopathological changes compared with the control group. Kidney, spleen and liver tissues appeared normal after two weeks administration of the maximum dose, with a possible alteration in distal tubules, proximal tubules and glomerulus of the kidney tissues. The results of nephrotoxicity and kidney function suggest promising potential for J. mollissima in kidney damage treatment.

Prevalence and risk factors assessment of mange mites in livestock of Malakand Division, Pakistan.

Mange mites represent a serious problem in livestock farming due to their worse effect on animals health, reducing milk and meat production. The status of mange mites prevalence was unknown from the livestock present in Malakand Division, Pakistan. Hence, the present study was conducted to determine the prevalence and risk factors assessment of mange mites in livestock of Malakand Division, Pakistan. Villages and livestock herds were visited for data collection and sampling for one year from September 2017 to August 2018. The diagnosis of mange infestation was carried out from skin scrapings collected from symptomatic animals. A total of 1437 animals were screened (240 sheep, 658 cows, 340 buffalos, 199 goats) from selected localities of the Malakand Division. The overall prevalence was 2.37%, with the highest prevalence in buffalos (5.0%) and lowest (0.42%) in sheep (p < 0.05). The locality also significantly affect the prevalence of mange mites in livestock, with a higher percentage (8.14%) in the Ouch area. The prevalence was higher in winter (3.78%) than in summer (1.07%). The prevalence was high (p < 0.05) in young animals (≤1 year) (4.7%) as compared to adults (>1 year) (1.15%). Gender was also a significant risk factor for mange infestation. The infestation was higher in females (2.85%) as compared to males (0.64%) (p < 0.05). Herd size of less than ten animals had a significantly high prevalence rate (3.69%) compared to >10 animals (1.89%). Animals having an infection history >15 days infected more than animals having infection history ≤15 days. This study documented for the first-time epidemiology of mange mites in livestock of Malakand Division, Pakistan. Further studies involving molecular characterization of mange mites will increase our understanding on the spread of mange mites in Malakand Division livestock.

Humanistic and socioeconomic burden of COPD patients and their caregivers in Malaysia.

Chronic obstructive pulmonary disease (COPD) is associated with substantial humanistic and socioeconomic burden on patients and their caregivers. COPD is expected to be 7th leading cause of disease burden till 2030. The objective of the current study was to assess the humanistic and socioeconomic burden of COPD patients and their caregivers in Malaysia. The burden includes the cost of management of COPD, QOL of COPD patients and their caregivers, work productivity and activity impairment of COPD patients and their caregivers due to COPD. One hundred and fifty COPD patients and their caregivers from the chest clinic of Penang Hospital were included in the study from August 2018 to August 2019. Caregiving cost was estimated using the replacement cost approach, while humanistic and social burden was assessed with the help of health status questionnaires. Overall, 64.66% and 7.1% of COPD patients reported to depend on informal caregivers and professional caregivers respectively. COPD patients reported dyspnoea score as 2.31 (1.31), EQ-5D-5L utility index 0.57 (0.23), CCI 2.3 (1.4), SGRQ-C 49.23 (18.61), productivity loss 31.87% and activity impairment 17.42%. Caregivers reported dyspnoea score as 0.72 (0.14), EQ-5D-5L utility index 0.57 (0.23), productivity loss 7.19% and social activity limitation as 21.63% due to taking care of COPD patients. In addition to the huge direct cost of management, COPD is also associated with substantial burden on society in terms of compromised quality of life, reduced efficiency at the workplace, activity impairment and caregiver burden.

Assessment of quality of work life (QWL) among healthcare staff of intensive care unit (ICU) and emergency unit during COVID-19 outbreak using WHOQoL-BREF.

OBJECTIVE: The study aimed to document the quality of work life (QWL) among healthcare staff of intensive care units (ICUs) and emergency units during COVID-19 outbreak using the WHOQoL-BREF. METHODS: A multicenter cross-sectional study was conducted for two months (May - June 2020) among healthcare staff working in intensive care units (ICUs) and emergency units of the hospitals under the National Guard Health Authority (NGHA) across five cities of Saudi Arabia. The study used the WHOQoL-BREF instrument to document the QWL through an electronic institutional survey. The data was analyzed through IBM SPSS version 23. The study was approved by an ethics committee. RESULTS: A total of 290 healthcare professionals responded to the survey. The mean overall quality of life score was 3.37 ± 0.97, general health = 3.66 ± 0.88, domains, i.e., physical = 11.67 ± 2.16, psychological = 13.08 ± 2.14, social = 13.22 ± 3.31 and environment = 12.38 ± 2.59. Respondents aged > 40 years, male gender, married status, being a physician and, having a work experience > 15 years and no extra working hours, had higher mean scores for several domains of Quality of life (QoL), overall QoL and general health (p < 0.05). CONCLUSION: The QWL among healthcare staff during COVID-19 pandemic was low. Demographic factors were mainly the determinants for a higher QWL while the variable of extra working hours was a determinant of lower QWL. Despite the pandemic, no COVID-19 related variables affected the work life of healthcare staff.