Estimation of calories intake, iron, zinc, and selenium among children of the underprivileged area in Sindh, Pakistan.

INTRODUCTION: Malnutrition is one of the most serious community health issues in developing countries. This study estimated total energy intake, Iron (Fe), Zinc (Zn), Selenium (Se), Calcium (Ca), and Phosphate (PO4) levels among school-going children (aged 13-17 years) of the underprivileged area in Sindh, Pakistan. METHODS: Children from Mithi City, District Tharparkar, were selected for this cross-sectional investigation. Students from various schools from both genders who fulfilled the selection criteria were selected. A questionnaire was filled, and five ml blood samples were taken to analyze blood parameters. Each participant's estimated nutrient intake (ENI) per day was assessed and matched to the recommended daily allowance (RDA) to determine their micro and macronutrient intake. RESULTS: A total of 300 school-going children [150(50%) boys (mean age 15± 0.8 years) and 150(50%) girls (mean age 14±1.3years)] were included in this study. Total calories (1449±949 Kcal vs. 1245±215 Kcal; p < .001), carbohydrates (138±27 gm vs. 126 ±25 gm; p < .001) protein (47±9.1 gm vs. 44±6 gm; p < .001) was significantly higher among boys compared to girls. In contrast, calcium (1094±105 mg vs. 1144±100; 0.004), phosphate 1050±125 vs. 1148±147; p<0.001), iron (9.2±1.7 mg vs. 10±1.3 mg; p<0.001), and Zinc (7.4±1.8 mg vs. 9.9±1.7 mg; p<0.001) intake was significantly higher among girls than boys. Gender-wise comparison of serum metals in school-going children showed that serum iron was significantly lower among girls than boys (100.86±25.65 µg/dl vs. 78.48±28.66 µg/dl; p<0.001), and no difference was found in serum Zn, Se, and Ca levels. Total proteins were also significantly lower among girls than boys (6.48±1.01g/dl vs. 4.87±1.4301g/dl; p<0.001). Serum iron, Ca, and total proteins were significantly lower among girls with normal ranges compared to boys with normal ranges. Total protein was significantly lower among girls below normal ranges than boys with normal ranges (p < .001). The correlation of carbohydrates, protein, and fat with some serum biochemical parameters in school-going children showed that serum Fe was significantly linked with proteins (r = 0.255; p < .0.05). CONCLUSION: Our findings showed a concurrent shortage of macro and micronutrients. The current study also revealed that total energy intake was lower than the RDA and significant Fe, Zn, and Se deficiencies. The findings highlight the importance of measures aimed at improving children's nutritional status.

Knowledge, attitude, and practice of antibiotics use among primary healthcare physicians, Ministry of Health, Jeddah.

Background: Overuse of antibiotics is considered a major public health problem on a global level and leads to existence and spread of antibiotic-resistant bacterial strains in all settings. Objectives: To explore the knowledge, attitude, and practice of primary healthcare physicians regarding antibiotic use. Methods: A cross-sectional study was conducted at a random sample of primary healthcare centers (PHCCs), belonging to Ministry of Health, in the city of Jeddah, Saudi Arabia. All primary healthcare physicians working at chosen PHCCs were recruited. A self-administered questionnaire was used for data collection. It includes five sections; socio-demographic characteristics of physicians, 11 statements to assess knowledge about antibiotic use, 6 statements to assess attitude toward antibiotic use, 6 statements concerning practice of antibiotic prescription, and 12 statements about factors influencing antibiotic prescription. Results: The study included 163 primary care physicians. The age of 58.9% ranged between 31 and 40 years. Approximately two-thirds of them were females (64.4%), and majority were Saudi nationals (98.8%). History of attending training courses in antibiotic use and resistance was reported by 47.9% of the physicians. The median (Interquartile range) of knowledge score percentage was 63.64 (45.45-81.82). It was abnormally distributed (p-value of Shapiro-Wilk test was 0.001). Physicians who reported previous attendance of courses in antibiotic use and resistance were more knowledgeable regarding antibiotics use and resistance compared to those who did not attend such courses (Mean ranks were 91.04 and 73.70, respectively (p = 0.018)). Most of the physicians agreed that taking antibiotics as prescribed minimize its side effects (81.6%), and taking antibiotics without rationale indication increase its side effects (81%). Male physicians were more likely than females to agree that use of antibiotics in case of viral infection prevents secondary bacterial infection (27.6% versus 10.5%), P < 0.001. Majority of the participants would increase antibiotic prescription in cases of purulent discharge (83.5%) and to prevent complications (71.1%). Conclusion: Knowledge and practice of primary healthcare physicians in Jeddah city regarding antibiotics use and resistance needs improvement. However their attitude toward them was acceptable. Improvement of their knowledge and continuous monitoring of their practice in this regard are warranted.

Bibliometric Analysis and Visualization Mapping of Anthrax Vaccine Publications from 1991 through 2021.

PURPOSE: This study aims to analyze and characterize anthrax vaccine-related research, key developments, global research trends, and mapping of published scientific research articles during the last three decades (1991-2021). METHODS: A bibliometric and visualized study was conducted. The Web of Science Core Collection database (WoSCC) was searched using relevant keywords ("Anthrax" OR "Anthrax bacterium" OR "Bacillus anthracis" OR "Bacteridium anthracis" OR "Bacillus cereus var. Anthracis" (Topic)) AND ("Vaccine" OR "Vaccines" OR "Immunization" OR "Immunisation" OR "Immunizations" OR "Immunisations" (Topic)) with specific restrictions. The data was analyzed and plotted by using different bibliometric software and tools (HistCiteTM software, version 12.3.17, Bibliometrix: An R-tool version 3.2.1, and VOSviewer software, version 1.6.17). RESULTS: The initial search yielded 1750 documents. After screening the titles and abstracts of the published studies, a total of 1090 articles published from 1991 to 2021 were included in the final analysis. These articles were published in 334 journals and were authored by 4567 authors from 64 countries with a collaboration index of 4.32. The annual scientific production growth rate was found to be 9.68%. The analyzed articles were cited 31335 times. The most productive year was 2006 (n = 77, 7.06%), while the most cited year was 2007 (2561 citations). The leading authors and journals in anthrax research were Rakesh Bhatnagar from Jawaharlal Nehru University, India (n = 35, 3.21%), and Vaccine (n = 1830, 16.51%), while the most cited author and journal were Arthur M. Friedlander from the United States Department of Defense (n = 2762), and Vaccine (n = 5696), respectively. The most studied recent research trend topics were lethal, double-blind, epidemiology, B surface antigen, disease, and toxin. The United States of America (USA) was the most dominant country in terms of publications, citations, corresponding author country, and global collaboration in anthrax vaccine research. The USA had the strongest collaboration with the United Kingdom (UK), China, Canada, Germany, and France. CONCLUSION: This is the first bibliometric study that provides a comprehensive historical overview of scientific studies. From 2006 to 2008, more than 20% of the total articles were published; however, a decrease was observed since 2013 in anthrax vaccine research. The developed countries made significant contributions to anthrax vaccine-related research, especially the USA. Among the top 10 leading authors, six authors are from the USA. The majority of the top leading institutions are also from the USA. About 90% of the total studies were funded by the United States Department of Health and Human Services (HHS), National Institutes of Health (NIH), USA, and the National Institute of Allergy and Infectious Diseases (NIAID), USA.