Analysis and forecasting of road traffic mortalities in Azad Jammu and Kashmir.

OBJECTIVE: To analyse road traffic accident mortalities in a geographical region. Method: The retrospective study was conducted in Azad Jammu and Kashmir based on secondary data from 2004 to 2017 collected from the police department. Duncan's multiple range test was used to assess the trends in road traffic accident fatalities with respect to districts and divisions. Different goodness-of-fit criteria were used to compare the performance of different regression models to analyse road traffic accident mortalities with respect to vehicle ownership. The parsimonious time series model was used to forecast the future trends of road traffic accident mortalities. R 3.6.0 software was used for data analysis. RESULTS: There were 5263 major road traffic accidents during the period studied, causing 2317 deaths and 12963 injuries. The number of mortalities in Mirpur division was 923(39.8%), in Muzaffarabad 794(34.3%), and inss Poonch 600(25.9%). The rates of road traffic accident mortalities per 100,000 population increased up to year 2010 and dropped slowly afterwards (Figure 1C). Some disparities were noted among different districts and divisions with respect to road traffic accident mortalities. Based on different goodness-of-fit criteria, the Smeed's model was found to be the most efficient model to analyse the trends of road traffic accident mortalities with respect to vehicle ownership (Table 1). The forecast for road traffic accident mortalities exhibited some fluctuations in the start and a uniform trend afterwards (Figure 6). CONCLUSIONS: Disparities in road traffic accident fatalities across different districts and divisions of Azad Jammu and Kashmir were observed. Though the rate of road traffic accident mortality was seen to be decreasing since 2010, the situation is for behind compared to the global Sustainable Development Goals.

Healthcare professionals' perspectives on lung cancer screening in the UK: a qualitative study.

BACKGROUND: Lung cancer screening with low-dose computed tomography (LDCT) has been shown to decrease mortality. Low lung cancer survival rates in the UK, driven primarily by late-stage presentation, provide the impetus for implementing screening. Nascent guidance on screening in the UK recommends primary care case-finding. However, the potential impact and acceptability on primary care, and the opportunistic utilisation of other case-finding routes, such as pharmacies, smoking cessation services, and respiratory clinics, have not been fully explored. AIM: To explore healthcare professionals' views and perspectives about lung cancer screening and their preparedness and willingness to be involved in its implementation. DESIGN & SETTING: A qualitative study was carried out with semi-structured interviews conducted with GPs, pharmacists, staff from smoking cessation services within Southwark and Lambeth in London, and staff from respiratory clinics in Guys' and St Thomas' NHS Foundation Trust in London between April 2018 and December 2018. METHOD: Sixteen participants were interviewed and the interview transcripts were analysed thematically. RESULTS: Participants described lung cancer screening as an important diagnostic tool for capturing lung cancer at an earlier stage and in increasing survivorship. However, the majority expressed a lack of awareness and understanding, uncertainty and concerns about the validity of screening, and the potential impact on their patients and workload. CONCLUSION: Study participants had mixed opinions about lung cancer screening and expressed their concerns about its implementation. Addressing these concerns by providing resources and effective and detailed guidelines for their use may lead to greater engagement and willingness to be involved in lung cancer screening.

Healthcare professionals' perspectives on lung cancer screening in the UK: a qualitative study.

BACKGROUND: Lung cancer screening with low-dose CT has been shown to decrease mortality. Low lung cancer survival rates in the UK, driven primarily by late-stage presentation, provide the impetus for implementing screening. Nascent guidance on screening in the UK recommends primary care case-finding. However, the potential impact and acceptability on primary care, and the opportunistic utilisation of other case-finding routes such as pharmacies, smoking cessation services and respiratory clinics, have not been fully explored. AIM: To explore healthcare professionals' views and perspectives about lung cancer screening and their preparedness and willingness to be involved in its implementation. METHOD: A qualitative study was carried out with semi-structured interviews conducted with GPs, pharmacists and staff from smoking cessation services within Southwark and Lambeth and from respiratory clinics in Guy's and St. Thomas' NHS Trust in London in 2018. Sixteen participants were interviewed, and the interview transcripts were analysed thematically. RESULTS: Participants described lung cancer screening as an important diagnostic tool for capturing lung cancer at an earlier stage and in increasing survivorship. However, the majority expressed a lack of awareness and understanding, uncertainty and concerns about the validity of screening, its misuse and the potential impact on their patients and workload. CONCLUSION: Study participants had mixed opinions about lung cancer screening and expressed their concerns about its implementation. Addressing these concerns by providing resources and effective and detailed guidelines for their use may lead to greater engagement and willingness to be involved in lung cancer screening.

Biological activities of Allium sativum and Zingiber officinale extracts on clinically important bacterial pathogens, their phytochemical and FT-IR spectroscopic analysis.

The spread of bacterial infectious diseases is a major public threat. Herbs and spices have offered an excellent, important and useful source of antimicrobial agents against many pathological infections. In the current study, the antimicrobial potency of fresh, naturally and commercial dried Allium sativum and Zingiber officinale extracts had been investigated against seven local clinical bacterial isolates such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Staphylococcus aureus, Streptococcus pyogenes, Staphylococcus epidermidis, and Serratia marcesnces by the agar disc diffusion method. All tested pathogens except P. aeruginosa and E. coli were most susceptible to ethanolic and methanolic extracts of A. sativum. Similarly, chloroform and diethyl ether extracts of Z. officinale showed a greater zone of inhibition of tested pathogens except for P. aeruginosa and E. coli. We found that all extracts of A. sativum and Z. officinale have a strong antibacterial effect compared to recommended standard antibiotics through activity index. All results were evaluated statistically and a significant difference was recorded at P< 0.05. Antioxidant activity of extracts showed that 10 out of 13 extracts have high scavenging potential. Thin layer chromatography profiling of all extracts of A. sativum and Z. officinale proposed the presence of various phytochemicals such as tannins, phenols, alkaloids, steroids and saponins. Retention factor of diverse phytochemicals provides a valuable clue regarding their polarity and the selection of solvents for separation of phytochemicals. Significant inhibition of S. aureus was also observed through TLC-Bioautography. FT-IR Spectrometry was also performed to characterize both natural and commercial extracts of A. sativum and Z. officinale to evaluate bioactive compounds. These findings provide new insights to use A. sativum and Z. officinale as potential plant sources for controlling pathogenic bacteria and potentially considered as cost-effective in the management of diseases and to the threat of drug resistance phenomenon.

Statistical study of the risk factors of myocardial infarction in the patients of district Muzaffarabad capital of Azad Jammu and Kashmir.

Coronary artery disease (CAD) is a leading cause of mortality in the developing countries. The aim of the study was to check the association of Myocardial infarction (MI) with several factors such as smoking & smoking exposure, blood pressure, sugar & cholesterol level, stress, anxiety & lifestyle. A cross sectional community based survey was conducted involving 469 patients having one or more risk factors or having complains regarding MI & already diagnosed MI, was taken using Multistage sampling technique from Sheikh Zaid Hospital & Abbas Institute of Medical Sciences. The Chi-square test was used to check the association of different risk factors with myocardial infarction. The multivariate Logistic regression model was also applied to find out the most significant risk factors of MI. The results revealed that MI was strongly associated with following risk factors family size (p=0.04), profession of respondent (p=0.026), smoking (p=0.028) & smoking exposure (p=0.043). The finding also showed significant association of MI in study population with diastolic blood pressure (p=0.03), cholesterol (p=0.047), blood sugar (p=0.008), stress (p=0.036), anxiety (p=0.044) and lifestyle (p=0.015). The study revealed that family size, family history, smoking & its smoking exposure, cholesterol, blood sugar, diastolic blood pressure, stress and anxiety are the major contributing risk factors of MI in the community, whereas age and gender elucidated minor contributions in the development of MI.

Women's reproductive autonomy and barriers to contraceptive use in Pakistan.

OBJECTIVE: To determine through the log-linear model analysis technique the impact of women's reproductive autonomy, spouses' educational background and other factors on the use of contraception in Pakistan. METHODS: Data from the Pakistan Reproductive Health and Family Planning Survey 2000 were used. In this survey a national sample of married women aged 15-49 years (n = 6579) were interviewed. A number of socio-economic, socio-demographic and women's reproductive autonomy variables were taken for the log-linear model fitting and analysis, in order to examine the impact of women's reproductive autonomy on contraceptive use and the factors affecting this latter. RESULTS: On the basis of partial and marginal association tests, two hierarchical log-linear models were selected. The first one concerned women's reproductive autonomy and contraceptive use, the second one analysed factors affecting contraceptive use. Standardized values of the model's parameter estimates showed that women's reproductive autonomy was significantly associated with husband-wife education attainment when they were using contraception. In the second model, contraceptive use was strongly associated with women's education, husband's desire for more children, sex preference for the next child and number of living children. CONCLUSION: An improved husband-wife educational level results in greater reproductive autonomy of the women and an increased use of contraception. The husband's desire for more children, a preference for the sex of the next child, and the woman's poor education attainment level are the main barriers to contraceptive use.