Spatial analysis and modeling of infant mortality rate using conditional autoregressive model- a case study of Punjab, Pakistan

Background: Many Asian countries have persistently high infant mortality because of various biological and social determinants. In particular, infant mortality has increased in Asia in recent decades. The geographic distribution of people having health problems and its relationship to potential risk factors can be of great value for planning cost effective interventions

Objectives: To determine and map the spatial nature of infant mortality in Punjab, at district level and model fit spatial autocorrelation

Materials and Methods: This paper identified and mapped high risk clusters of infant mortality by mapping the infant mortality rate, as well as examines the impact of range of determinants on infant mortality by regressing 15 socio-economic covariates on dependent variable i.e. infant mortality rate by using Multiple Regression model and Conditional Autoregressive Model to quantify spatial risk of infant death

Results: The results showed that the Conditional Autoregressive model yield more reliable results as compared to the multiple regression mode] having lower value of Akaike Information Criterion i.e. 257.8 as compared to multiple regression model i.e. 283.9. The analysis showed that household size, literacy of women, houses having place of hand wash, women having comprehensive knowledge of HIV transmission, households getting benefits from government schemes of social protection and the ownership of assets etc. had low infant mortality rate while adolescent birth rate, underweight live births, unwilling pregnancy, early marriage, infant suspected pneumonia in the last two weeks, people diagnosed with Hepatitis during last one year had high infant mortality rate

Conclusion: Spatial analysis was useful in accessing the determinants of infant mortality rate

Reference intervals for free T[3] and free T[4] in pakistani euthyroid patients: effect of age and gender on thyroid function

To establish reference intervals for Free Triiodothyronine [FT[3]] and Free Thyroxine [FT[4]] in euthyroid subjects and to assess the effect of age and gender on FT[3] and FT[4]. Cross-sectional, analytical study. Institute of Nuclear Medicine and Oncology [INMOL], Lahore, from January 2009 to April 2011. FT[3] and FT[4] were measured in 852 euthyroid patients. Those with previous thyroid surgery, on thyroidrelated medication and severe non-thyroid illness were excluded. There were 215 males and 637 females with mean age of 46 years. The reference intervals, revealed by this study, for FT[3] and FT[4] were 2.80 - 5.39 pmol/L and 11.9 - 22.2 pmol/L respectively. The mean difference between gender groups and age groups was found statistically significant for FT[3] [gender: p < 0.001; age: p < 0.001] but statistically insignificant for FT[4] [gender: p=0.147; age: p=0.201]. There was no effect of gender and age on FT[3] and FT[4]. The age with serum FT[3] and FT[4] significantly negatively correlated but this correlation was stronger for FT[3] as compared to FT[4] levels. Reference intervals of FT[3] and FT[4] for male [2.99 - 5.63 pmol/L, 12.3 - 22.6 pmol/L] and female [2.77 - 5.29 pmol/L, 11.7 - 22.1 pmol/L] respectively are suggested

Oral health-related knowledge, attitude, and practice among school children from rural and urban areas of district Sheikhupura, Pakistan

Good oral health is the major aspect of general health but the practitioners in the field of dental surgery have reported it is one of the most ignored part among general community. Good oral health practices started at earlier age lead to healthy gums and teeth later in life. In present research, the knowledge, attitude and practice of oral health among school children were studied. Descriptive statistics and tests of significance [t-test and F-test] show that oral health Knowledge, Attitude and Practice [KAP] among study participants were poor and needed to be improved. Findings of the present study also showed that utilization of dental service was mainly for pain relief. Significant gender differences were found where girls had scored higher in all the three aspects of KAP. Parent education and income level of the family were also found significant factors. Children from high socioeconomic status had scored higher in all the three dimensions of KAP scores. Similarly, children of educated parents had higher scores. But it is important to note that generally the level of score in KAP was less than 50%, which is not a good indication. Comprehensive oral health educational programs for both children and their parents, especially for less educated and lower socioeconomic group families, are required to improve the prevention and control of oral diseases