Frequency and Predictors of Pacifier Use in the Low Socioeconomic Group of Karachi, Pakistan: A Cross-Sectional Study.

Background Pacifier use has been popular for ages. They are prevalent all over the world because of their various perceived benefits. On the other hand, there is a common belief that they do carry health risks as well. Due to these contradicting belief systems, the frequency of their use, and the factors that determine them, need to be thoroughly evaluated. Since Pakistan is a developing country with a low literacy rate, it can be implied that a vast majority of the country's population may lack awareness regarding the advantages and disadvantages of pacifier use, making them incapable of weighing associated risks versus benefits. The data evaluating these factors in this region are however scarce in the published literature. We, therefore, aimed to highlight the frequency and predictors of pacifier use in the low socioeconomic group of Karachi, Pakistan. Materials and methods A descriptive, cross-sectional study was conducted on a sample of 300 mothers visiting a tertiary care hospital in Karachi, Pakistan. We included mothers who had at least one child under the age of two years, and whose child did not have any oro-nasal anomaly that could prevent them from sucking a pacifier. Data were collected using pre-tested questionnaires and analyzed using the Statistical Package for Social Sciences (SPSS version 23.0, IBM Corp., Armonk, NY, US). Frequencies were calculated and presented in the form of tables. The chi-square test was used to determine the significance of all categorical variables. A P-value of <0.05 was considered to be statistically significant. Results Almost half of our respondents (49%) gave pacifiers to their children. A significant number (59%) of these mothers were uneducated. Almost all (97%) of the users had annual household income less than 15,000 Pakistani rupees (PKR); 34% were primiparous and more than two-thirds (71%) had a normal vaginal delivery. Out of all the factors, maternal age less than 20, annual household income less than 15,000 PKR, and primiparity were significantly associated with pacifier use in mothers (P<0.05). Only a half of the users (51%) cleaned the pacifiers by boiling; one-fourth (25%) washed it with water only; while 18% washed it with soap and water. The majority (84%) of the mothers used the pacifier to soothe the baby when upset. Among mothers who did not use a pacifier, about a third (30%) did not do so as they believed it's a bad practice. About one-fourth (27%) believed it was unhygienic. Conclusions Our study highlights the gap in the awareness of mothers regarding pacifier use. Using this data, we can target to disseminate specific information to this population to integrate safe and healthy child care habits in society.

Frequency and Nature of Road Traffic Injuries: Data of More than 10,000 Patients from Ha'il, Saudi Arabia.

Background Road traffic accidents (RTAs) have become a major issue in today's world. They have caused the loss of more than a million lives in the last decade and are substantially increasing every day. Injuries due to RTAs can cause significant morbidity and mortality. These injuries can be sorted by the type, body region, gender, and age group. We aimed to highlight the frequency and nature of road traffic injuries (RTIs) according to these variables in Ha'il, the Kingdom of Saudi Arabia. Methods A retrospective study was conducted in King Khalid Hospital, Ha'il. Data on the cases of RTIs were collected, which presented to the hospital emergency department from January 1, 2016, to December 31, 2017. Data analysis was then performed using IBM Statistical Package for the Social Sciences 17.0 (SPSS, IBM, NY, USA). Frequencies were calculated using descriptive statistics, and graphs were generated. Results A total of 10,855 patients with RTIs were encountered at the hospital emergency department. Out of these, 8035 patients were males (74.02%) while 2820 were females (25.97%). Fractures of one or more sites were the most common type of injury, encountered in 5173 patients (47.66%). Lacerations occurred in 3487 patients (32.12%). Crush injuries were encountered in 1190 patients (10.96%) while penetrating injuries occurred in 844 patients (7.78%). Abdominal and pelvic visceral injuries were present in 103 patients (0.95%) while thoracic visceral injuries were present in 39 patients (0.36%). Amputations occurred in 19 patients (0.18%). Conclusion Our study highlights the frequency and nature of road traffic injuries that present in the emergency department. As suggested by the high frequency of specific types of injuries, special training should be provided to healthcare professionals to address and treat fractures, head and neck injuries, and serious lacerations effectively.

Prevalence and Severity of Depression in a Pakistani Population with at least One Major Chronic Disease.

INTRODUCTION: Diabetes, anaemia, hypertension and asthma are major contributors to morbidity in our society. Depression is the commonest psychological malady diagnosed in hospital settings. There tends to be some overlap between certain chronic systemic illnesses and depressive disorders, this point towards the need to determine relationships between them, if any. AIM: To determine the prevalence and compare the severity of depression among individuals diagnosed with four of the most common chronic diseases in our community. MATERIALS AND METHODS: This cross-sectional study was carried out among patients with chronic diseases visiting a tertiary care hospital in Karachi, Pakistan from August 2015 to August 2016. The Beck Depression Inventory-II*, a 21-item self-report instrument was used to assess the severity of depression. Categorical variables were compared using Chi-square test while intergroup comparisons were performed using one way ANOVA test. Logistic regression was employed to estimate the odds of Category B depression (moderate and severe levels of depression) in chronic diseases. RESULTS: The prevalence of anaemia, hypertension, diabetes and asthma was 90%, 47%, 26% and 23% respectively. Predictors of Category B depression were anaemia (OR=4.21, 95% CI: 1.30-13.56) and diabetes (OR=2.03, 95% CI: 1.09-3.77). Asthma predicted Category B depression in males (OR=1.26, 95% CI: 0.29-5.42) but not in females (OR=0.77, 95% CI: 0.39-1.52). Individuals with hypertension were less likely to report Category B depression than non-hypertensive (OR=0.72, 95% CI 0.43-1.21). Female gender had a greater influence to develop Category B depression than males (OR= 2.96, 95% CI: 1.93-4.55). CONCLUSION: Our study points towards a strong correlation between depression and chronic diseases especially anaemia and diabetes. This cautions medical practitioners against treatment of depressive disorders and chronic diseases as separate, independent entities.

Determination of the mode and efficacy of the cross-linking of guar by borate using MAS 11B NMR of borate cross-linked guar in combination with solution 11B NMR of model systems.

The reaction product of boric acid and the polysaccharide guaran (the major component of guar gum) has been investigated by 11B NMR spectroscopy. By comparison with the 11B NMR of boric acid and phenylboronic acid complexes of 1,2-diols (HOCMe2CMe2OH, cis-C6H10(OH)2, trans-C6H10(OH)2, o-C6H4(OH)2), 1,3-diols (neol-H2), monosaccharides (L-fucose, mannose and galactose) and disaccharides (cellobiose and sucrose) it is found that the guaran polymer is cross-linked via a borate complex of two 1,2-diols both forming chelate 5-membered ring cycles ([B5(2)]), this contrasts with previous proposals. Based upon steric constraints we propose that preferential cross-linking the guaran polymer occurs via the 3,4-diols of the galactose side chain. The DeltaH and DeltaS for complexation of boric acid to cis- and trans-1,2-cyclohexanediol have been determined, from the temperature dependence of the appropriate equilibrium constants, and used in conjunction with ab initio calculations on model compounds, to understand prior conflicting proposals for guaran-boric acid interactions. 11B NMR derived pH dependent equilibrium constants and ab initio calculations have been used to understand the reasons for the inefficiency of boric acid to cross-link guaran (almost 2 borate ions per 3 monosaccharide repeat units are required for a viscous gel suitable as a fracturing fluid): the most reactive sites on the component saccharides (mannose and galactose) are precluded from reaction by the nature of the guar structure; the comparable acidity (pKa) of the remaining guaran alcohol substituents and the water solvent, results in a competition between cross-linking and borate formation; a significant fraction of the boric acid is ineffective in cross-linking guar due to the modest equilibrium (Keq). In contrast to prior work, we present evidence for the reaction of alcohols with boric acid, rather than the borate anion. Based upon the results obtained for phenylboronic acid, alternative cross-linking agents are proposed.

Nanoreinforcement of poly(propylene fumarate)-based networks with surface modified alumoxane nanoparticles for bone tissue engineering.

A novel composite material has been fabricated for bone tissue engineering scaffolds utilizing the biodegradable polymer poly(propylene fumarate)/poly(propylene fumarate)-diacrylate (PPF/PPF-DA) and surface-modified carboxylate alumoxane nanoparticles. Various surface-modified nanoparticles were added to the polymer including a surfactant alumoxane, an activated alumoxane, a mixed alumoxane containing both activated and surfactant groups, and a hybrid alumoxane containing both groups within the same substituent. These nanocomposites, as well as polymer resin and unmodified boehmite composites, underwent flexural and compressive mechanical testing and were examined using electron microscopy. Hybrid alumoxane nanoparticles dispersed in PPF/PPF-DA exhibited over a 3-fold increase in flexural modulus at 1 wt % loading compared to polymer resin alone. No significant loss of flexural or compressive strength was observed with increased loading of hybrid alumoxane nanoparticles. These dramatic improvements in flexural properties may be attributed to the fine dispersion of nanoparticles into the polymer and increased covalent interaction between polymer chains and surface modifications of nanoparticles.