Determinants of Diarrhea Among Children Aged 1 to 6 Years in Flood-Affected Areas of Pakistan: A Cross-Sectional Study.

Frequent floods can contribute to the spread of various diseases and complications, some of which may result in diarrhea, especially among children. The current study aimed to find the determinants of diarrhea among children aged 1-6 years in flood-affected areas in Khyber Pakhtunkhwa, Pakistan. A cross-sectional study was conducted in flood-affected districts. Data regarding sociodemographic information related to diarrhea and anthropometric data were collected through a validated questionnaire. Logistic regression was used to find the determinants of diarrhea. In the presence of diarrhea, the prevalences found of stunting, wasting, and being underweight were 75.2%, 76.5%, and 74.1%, respectively, which is higher than those in children without diarrhea (stunting, 24.8%; wasting, 23.5%; and being underweight, 25.9%). In bivariate regression, children aged 2-4 years (odds ratio [OR] = 1.65, P < 0.05), large family size (OR = 7.46, P < 0.01), low income (OR = 2.55, < 0.001), bathing in ponds (OR = 3.05, P < 0.05), drinking of untreated water (OR = 3, P < 0.05), flooding (OR = 1.8, P < 0.05), children living in mud houses (OR = 1.5, P < 0.05), and usage of utensils without lids (OR = 1.96, P < 0.001) were significantly associated with occurrence of diarrhea. In multivariate regression, the identified risk factors (P < 0.05) for diarrhea in flood-affected areas included illiterate mothers, flooding, large family size, households without livestock, poor water quality, untreated water, and lack of toilet facilities. In conclusion, addressing the determinants of diarrhea identified in this study is crucial for mitigating the impact of frequent floods on children in flood-affected areas. Moreover, the higher prevalence of malnutrition underscores the urgent need for comprehensive strategies and proper water, sanitation, and hygiene programs to reduce the occurrence and determinants of diarrhea.

Effect of sorghum and barley-containing bread on plasma total polyphenols, antioxidant status and inflammation in healthy subjects.

The aim of this study was to investigate the effect of bread incorporated with whole-grain red sorghum and barley flours on biomarkers of oxidative stress and inflammation in humans. In a randomized cross-over study, 20 healthy subjects consumed either control bread made of all-purpose wheat flour only or bread containing 40% whole-grain red sorghum and barley flours (20% each), with a washout period of 1-2 week. The test breads were fed at breakfast after 12 h fast. Blood samples were collected at baseline (fasting) and 2 h after intake of breads. Plasma total polyphenols, total antioxidant capacity (T-AOC), superoxide dismutase (SOD) activity, thiobarbituric acid reactive substances (TBARS) and highly sensitive C-reactive protein were assessed. Compared to fasting values, the 2 h postprandial levels of plasma total polyphenols (P = 0.001), T-AOC (P = 0.031) and SOD activity (P = 0.026) were significantly higher following consumption of sorghum and barley-containing bread (SBB). Moreover, net changes in plasma total polyphenols (P = 0.001), T-AOC (P = 0.047) and SOD activity (P = 0.035) were significantly higher following consumption of SBB. In conclusion, bread containing whole-grain red sorghum and barely flours enhanced plasma total polyphenols and antioxidant status and hence its consumption would modulate biomarkers of cardio-metabolic health.

Identification, kinetics and thermodynamic analysis of novel ß-galactosidase from Convolvulus arvensis seeds: An efficient agent for delactosed milk activity.

The ß-galactosidase was extracted and purified from 100 g of C. arvensis seeds using a variety of protein purification procedures such as ammonium sulphate fractionation, gel filtration, and finally chromatography on a cationic ion exchanger. The effects of metal ions, kinetics parameters, and glycoprotein nature were determined, as well as the optimal pH and temperature of the purified enzyme. With a high specific activity (72 units/mg), ß-galactosidase was isolated to a 24-fold apparent electrophoretic homogeneity. The molecular mass of ß-galactosidase was determined as monomeric, which was further confirmed by SDS-PAGE and MALDI-TOF/MS analysis, with a 45 kDa molecular weight. The enzyme has a Km of 0.33 mM and a Vmax of 42 µmol/min Lactose in milk was reduced by 38.5 and 70 % after 4 h of incubation with ß-galactosidase from C. arvensis. The ß-galactosidase thermal inactivation kinetic parameters ΔH°, ΔS°, and ΔG° were calculated, indicating that the enzyme undergoes significant unfolding events during denaturation. Using ß-galactosidase from C. arvensis seeds, lactose hydrolysis in milk up to approx. 50 % was observed. The findings indicate the potential use of C. arvensis seeds for the production of low/delactosed milk for lactose-intolerant population.

Virtual Skills Teaching of Nursing Students during COVID-19: A Problem-Solving Approach.

The COVID-19 pandemic radically affected the whole education system including nursing education. Nursing is a practice-based profession; therefore, it is necessary to transform acquired knowledge into practice. However, in the current situation of the pandemic, the nursing students were unable to learn and practise nursing skills in the skills lab on manikins or simulation. This paper aims to give an overview and practical application of alternative solutions to overcome this situation. Alternatives like virtual skills teaching along with sign-off were sought by using problem-solving approaches to facilitate students' learning and help them to acquire necessary skills timely. Key Words: Virtual skills teaching, Nursing students, Problem-solving approach, COVID-19.

Geo-environmental approach to assess heavy metals around auto-body refinishing shops using bio-monitors.

The vehicular industry is looking for continuous challenges to develop the sustainability of its manufacturing, maintenance processes, and vehicle emissions due to marketability, environmental, economic, and policy concerns. The present study focuses on the impact of these processes on the environment. In Pakistan, most of the auto-body refinishing processes are carried out in an open atmosphere. The shades of Azadirachta indica (Neem Tree) are generally used for the outdoor practice of scrapping, grinding, and painting in auto-body refinishing shops of Pakistan. Azadirachta indica leaves were selected as bio-indicator. For the present work, 26 affected sites and 10 control sites were selected from Karachi city, which is the financial hub and biggest city of Pakistan. Concentrations of different metals (Fe, Co, Cd, Cr, Cu, Mn, Mo, Ni, Pb, and Zn) were determined by atomic absorption spectrophotometer. A geographic information system (GIS) is used to present the variation in concentrations within Karachi city. The only positive correlation was observed in Pb and Mn (0.750). Principal component analysis (PCA) is applied to identify the anthropogenic effect between auto-body refinishing areas and control areas. Almost all analyzed metals show higher concentration at affected sites but Pb (87.14 mg/kg), Mn (46.47 mg/kg) and Fe (146.95 mg/kg) were leading the values, as compared to their concentration at control sites, Pb (48.83 mg/kg), Mn (15.23 mg/kg) and Fe (43.07 mg/kg). All analyzed metals are frequently present in different color pigments, whereas Pb, Mn, and Fe may also come from other sources, like the anti-knocking agent, vehicular exhaust, and scraping of car surface.

Effect of dietary counselling on the nutritional status of end-stage renal disease patients.

OBJECTIVE: To investigate the effect of dietary counselling on the nutritional status of end-stage renal disease patients undergoing maintenance haemodialysis. METHODS: This study was conducted at the Institute of Kidney Diseases, Peshawar, Pakistan, from November to December 2015, and comprised patients of either gender with protein energy wasting. The nutritional status assessment was based on four categories, including biochemical indicators (haemoglobin, serum albumin and cholesterol), measure of body mass index, reduced body fatness, decreased muscle mass and low protein or energy intake. Energy and nutrients intake of patients before and after counselling were estimated by 24-hour dietary recall method. SPSS 20 was used for data analysis. RESULTS: Of the 100 patients, 74(74%) were males and 26(26%) were females. The overall mean age was 41.45±17.44 years. Dietary counselling was significantly effective in increasing the intake of energy (p=0.010), protein (p=0.003) and fats (p=0.002). There was significant improvement in mid-upper arm circumference (p<0.0001) and tricep fat fold (p<0.0001) after counselling. Statistically significant effect was seen in improving serum cholesterol levels (p=0.039). CONCLUSIONS: Dietary counselling was found to be effective in improving the nutritional status and dietary intake of end-stage renal disease patients.