The Interaction Effect of Birth Spacing and Maternal Healthcare Services on Child Mortality in Pakistan.

There is widespread agreement that improved health should be regarded as a means and an end in the context of the development process. The health of the populace and the equitable provision of healthcare are two indicators of a society's level of development. A variety of factors influences child mortality. This study investigated the causes of child death and the interaction effect of birth spacing (B.S.) and maternal health care services (MHCS) on child mortality. Using SPSS version 20, we used the Pakistan Demographic and Health Survey (PDHS) 2017-2018 data set to investigate the associated factors of child mortality and the moderating influence of birth spacing using binary logistic regression. The outcome variable is categorical with two categories. The findings indicated that the risk of infant death decreased with adequate B.S. between two pregnancies and access to maternal health care services. Birth spacing was found to moderate the link between access to maternal health care services (MHCS) and child mortality. Our research leads us to conclude that the amount of time between children's births significantly reduces infant mortality. When the birth spacing is at least 33 months, the relationship between maternal health care services and child mortality becomes more evident and negative.

Reviving the role of mecillinam against extended spectrum beta-lactamase producing enterobacterales.

Background and Objectives: This study was designed to determine the in vitro efficacy of mecillinam against extended spectrum beta lactamse producing Enterobacterales. Materials and Methods: After proper permission from Ethical Review Committee of the Institute, all samples yielding growth of ESBL producing Enterobacterales were part of the study and were processed according to routine microbiological procedures. Routine antibiotic sensitivity testing was done on Muller Hinton Agar by Modified Kirby Bauer Method. All Gram negative isolates were subjected to concomitant detection of ESBL production by double disc synergy method. All ESBL producers were then subjected to the mecillinam Minimum Inhibitory Concentration (MIC) determination by E test. The results were interpreted as per CLSI Guidelines. Results: A total of 120 ESBL producing Enterobacterales isolates were included in the study. The mean age of patients with ESBL infection was 45 ± 18.7 years. There were 44% male and 55% female patients. Majority of the ESBL producing Enterobacterales were isolated from urine samples (56%), followed by pus. Among the isolated organisms, Escherichia coli (45%) was the most frequently isolated organism followed by Klebsiella spp. (22%). Overall 83% of the isolates turned out to be sensitive to mecillinam. MIC50 of mecillinam against ESBL producing Gram negative rods (GNR) turned out to be 1 ug/ml and MIC90 turned out to be 2 ug/ml. Conclusion: Mecillinam shows good in vitro efficacy against ESBL producing Enterobacterales in our study. Further studies with more sample size and from diverse areas across the country should be done to evaluate its efficacy.

Three-Dimensional Multi-Target Tracking Using Dual-Orthogonal Baseline Interferometric Radar.

Multi-target tracking (MTT) generally needs either a Doppler radar network with spatially separated receivers or a single radar equipped with costly phased array antennas. However, Doppler radar networks have high computational complexity, attributed to the multiple receivers in the network. Moreover, array signal processing techniques for phased array radar also increase the computational burden on the processing unit. To resolve this issue, this paper investigates the problem of the detection and tracking of multiple targets in a three-dimensional (3D) Cartesian space based on range and 3D velocity measurements extracted from dual-orthogonal baseline interferometric radar. The contribution of this paper is twofold. First, a nonlinear 3D velocity measurement function, defining the relationship between the state of the target and 3D velocity measurements, is derived. Based on this measurement function, the design of the proposed algorithm includes the global nearest neighbor (GNN) technique for data association, an interacting multiple model estimator with a square-root cubature Kalman filter (IMM-SCKF) for state estimation, and a rule-based M/N logic for track management. Second, Monte Carlo simulation results for different multi-target scenarios are presented to demonstrate the performance of the algorithm in terms of track accuracy, computational complexity, and IMM mean model probabilities.

Molecular detection of blaOXA-23 gene and blaOXA-51 gene in carbapenem resistant strains of Acinetobacter baumannii in patients with ventilator associated pneumonia at tertiary care hospitals.

OBJECTIVE: To evaluate carbapenem resistance and to detect blaOXA-23 and blaOXA-51 genes in carbapenem-resistant Acinetobacter baumanii isolates recovered from patients having pneumonia secondary to ventilation. METHODS: The cross-sectional study was conducted from July 2017 to June 2018 at the Department of Microbiology, University of Health Sciences, Lahore, Pakistan, and comprised endotracheal aspirates / tracheobroncheal lavage samples from patients irrespective of age and gender who developed pneumonia after being on the ventilator for 48 hrs at the Combined Military Hospital, and Jinnah Hospital, Lahore. The samples were inoculated on MacConkey and blood agar and aerobically incubated at a temperature of 370C for 18-24 hours. The isolated organisms were further assessed by standard morphological, cultural and biochemical profile. Antibiotic susceptibility was done by Kirby-Bauer disc diffusion method. Carbapenem-resistant Acinetobacter baumannii were checked for carbapenemase production using Modified Hodge Test. Conventional polymerase chain reaction and agarose gel electrophoresis were performed to detect blaOXA-23 and blaOXA-51 genes. Data was analysed using SPSS 17. RESULTS: Out of 157 samples, 92(58.6%) yielded growth of bacteria, and, among them, 39(42.4%) were identified as Acinetobacter baumannii. All (100%) Acinetobacter baumannii cases showed resistance to carbapenem, were producing carbapenemase enzyme, and were positive for blaOXA-51 gene. The blaOXA-23 gene was amplified in 38(97.4%) isolates. CONCLUSIONS: BlaOXA-23 gene appeared to be the major cause of carbapenem resistance.

Acute effects of different dietary polysaccharides added in milk on food intake, postprandial appetite and glycemic responses in healthy young females.

In the present study we compared the postprandial glycemic and satiety responses of different dietary polysaccharides when added in milk (2% M.F.). The objective of this study was to evaluate different polysaccharides against postprandial glucose, appetite responses and food intake at subsequent meal. In a repeated measures design, 30 females (18-30 years) consumed 250 ml milk 2% M.F. (control), or milk with carrageenan (2.5 g), guar gum (2.5 g) and alginate (2.5 g), followed by an ad libitum pizza meal after 120 min. Alginate and guar gum addition resulted in lower caloric intake at subsequent pizza meal. The post-treatment (0-120 min) glucose and average appetite were suppressed by alginate and guar gum (p < 0.0001), with more pronounced effect of guar gum. However, alginate resulted in lower blood glucose (p < 0.0001) compared with control and carrageenan during post-treatment. Alginate and guar gum added beverages would be beneficial in short-term regulation of postprandial glycemia and satiety.