Level of physical activity in undergraduate students in Peshawar, Pakistan

Background: Physical activity is one of the leading health indicators, considered an essential factor in the population's health and quality of life promotion. Physical inactivity is the fourth leading risk factor for global mortality. Physical inactivity has been linked with chronic disease and obesity in most populations. This study aims to compare the prevalence of physical activity and overweight/obesity among students of the university. Methods: A cross-sectional survey was conducted from March to September 2019 on undergraduate students from different departments of Peshawar University. A sample of 377 (male n = 243, female n = 134) was taken through convenience sampling. Those individuals who were physically disabled and not willing to participate were excluded from the study. Those meeting the inclusion criteria were given the International Physical Activity Questionnaire (IPAQ short form). Demographic data included age, weight, and height was self-stated by the participants. The levels of physical activity in each of three domains (leisure, transport, and domestic) were calculated and presented as metabolic equivalent (M.E.T.) hour per week in the form of means, percentage, and frequency in different physical activity domains. Results: The overall sample showed that 13.70% of participants were inactive, 27.76% showed a low level of physical activity, 41.29% showed moderate physical activity level, and 17.24% showed a high level of physical activity. A total of 90.98% of participants were involved in leisure physical activities, 93.10% presented transport-related physical activity, and 74.80% were involved in domestic-related physical activity. Average time spent during sitting was found to be 53.32 hrs/week and 7.61 hrs/ day, with females being more involved in sitting activities as compared to males. A significant difference was found between B.M.I. and sitting domain (p-value 0.002) with a Pearson value of -0.12 showing a negative correlation. Conclusion: The B.M.I. and Physical Activity are found negatively associated with each other. Male students were more physically active than females as females spend their majority of time sitting. It is concluded that students are moderately active, while a minimal percent of students are highly active. There were a few numbers of respondents too who were physically inactive, which shows that there is still unawareness of physical activity on the university level.

Assessment of triage accuracy by Nurses, and delay care of acute myocardial infarction patients admitted to Emergency Department: retrospective analysis from Shifa International Hospital, Pakistan

Background: Coronary vascular disease (CVD) is the premier cause of fatality in the world. In Pakistan, 30 to 40% of all deaths occur due to CVD. The emergency department triage is carried out to prioritize the care of critical patients. Errors during triage may lead to mortality and morbidity of the patient. The current study's objective is to determine the triage process of acute myocardial infarction patients and its associated accuracy and delays during the acute myocardial infarction process of care in the emergency department. Methods: In this descriptive study, data were collected retrospectively from Shifa International Hospital. The consent was taken from participating Registered nurses (RNs) who were involved in the triage process. Nurses with experience of less than 1 year in the emergency department were not part of the study, while only those patients with symptoms indicative of Acute Myocardial Infarction and age of 21 years or older were included in the current study. EMR system was used on a daily basis as a method to capture data for the study. The actual clock time in minutes from arrival until triage and obtain ECG as greater than 10 minutes was identified as a delay. Results: The 8 R.N. participated in the current study with a mean age and experience of 28.11 years and 4.77 years. The patients' age was 22-74 years, which consist of 58.9% male and 41.1% female. Out of 224 patients, 20.53% of patients were smokers, 39.3% were diabetic, 44.6% were CVD, and 78.5% were reported for chest pain. Delay care such as the mean triage and ECG time recorded was 6.75, and 7.30 min, the mean E.R. physician and Cardiology resident assessment was 11 min and 25.19 min, respectively, which were significantly found according to the recommended guidelines of AHA. The triage accuracy in the current study was recorded as 80.35%. Conclusion: In Pakistan, no proper triage system is developed, and no time limits and guidelines are defined for the completion of the triage process. In the current study, the triage level designations, ECG delay, E.R. and cardiology resident assessment delay were found insignificant, and triage designation was found inaccurate with 19.6% of patients, which lead to delay the re-perfusion therapy. In patients with AMI symptoms, triage accuracy and quick ECG helps E.R. physician assessment to take a quick better decision for cardiac care. It helps patients to get re-perfusion therapy on time for acute myocardial infarction.

Perceptions and barriers regarding telemedicine services among Bangladeshi young adults in the COVID-19 pandemic: A qualitative exploration

The present study aimed to explore perceptions and barriers regarding telemedicine services among Bangladeshi young adults. This qualitative study was performed through telephonic interviews where 20 young adults (cases) were taken for in-depth interviews, using a purposive sampling technique from July 1 to July 20, 2020. The verbatim transcriptions was used, and the thematic analysis was performed through manual coding. The findings of this study revealed that the majority of participants perceived telemedicine as it is a system through which we are able to get healthcare services by using the internet, mobile application, or just a phone call from health care providers. Participants had positive attitudes toward telemedicine. Low trustworthiness, difficulties in getting access to emergency diagnostic services, significant anxieties on the use of telemedicine complexity and observability, shortage of network and power supply, as well as financial complexities were acknowledged as significant barriers in terms of receiving telemedicine services during the COVID-19 outbreak. Concerned authorities, including governmental and private organizations, should take effective measures to make telemedicine services available, reliable, and affordable for all across the country.

Sanitation and Diarrheal Morbidity: Evidence from Afghanistan

Background: Lack of sanitation facilities and inadequate water is key to many diseases' outcomes, mainly diarrhea. These factors affect the health status of a country and result in increased mortality and morbidity pattern, particularly among the vulnerable population like children and women. Thus, the study assesses the linkages between diarrheal diseases and sanitation in Afghanistan affected since long by political instability, which has derailed the country's health system. Methods: We used the 2015 Afghanistan Demographic and Health Survey to assess the linkages between sanitation and diarrheal diseases among under-five children. Bivariate and multivariate analyses have been used to carry out the study. The logistic model was used to evaluate the risk factors that lead to diarrheal outcomes. Results: Our findings from the results showed that the prevalence of diarrhea among under-five children in Afghanistan was 29%. Pashai is the most affected, with 36% among ethnicities, whereas eastern Afghanistan is the most affected region with a prevalence of (38%). Open defecated Population (OR: 1.17, p<0.001), Tap water (OR: 1.31, p<0.001), Well water (OR: 1.24, p<0.001), and Sharing toilet (OR: 1.15, p<0.001) are significantly associated with childhood diarrhea. Conclusions: A significant impact has been found with inadequate sanitation, shared toilet facility, clean water, and other elements with childhood diarrhea in Afghanistan. The region-wise difference has also been found to be very high across the regions. Thus, it has been found that a lack of such factors has a more significant impact on children's health and needs a particular focus from a policy purpose.

COVID-19 seroprevalence study of an Indian Diagnostic Laboratory - Report on gender and age analysis

In COVID-19 the extent of the impact on exposure, symptoms, recovery remains minimally explored as the spectrum is challenging to study across geographies. The aim of our study report was to explore seroprevalence in a pan-India cohort of Asian Indians across different age groups. Covid-19 antibodies were tested from a total of 1,36,210 Asian Indians inclusive of 97,124 males and 39,086 females, respectively. Testing for covid-19 antibodies was done by electrochemiluminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA). Analysis for seroprevalence found the frequency to be 19%. The percent positives were higher among females at 21%, compared to males at 19%, and the difference was found to be statistically significant at p < 0.0001. Further, age group-wise analysis found seroprevalence between age groups of 21 - 80 years to be significant at p < 0.0001. Our study found higher seroprevalence among females, which is in line with many small cohort studies published online.

Inappropriate hospital site selection: A case report‎

Introduction: Health centers as one of the main urban services, and one of the key factors in assessing the feasibility of sustainable development in cities have a high sensitivity to location and choice of accommodation. Case Report: Shirvan is the largest city after the capital of the province in North Khorasan of Iran. On the southern edge of the city of Shirvan, there is a seasonal river between the city and Ayatollah Hashemi Rafsanjani Hospital. The need to build a solid bridge is essential for safe access to the hospital, which, unfortunately, has not been achieved. The constructed roundabout passes approximately one meter from the river floor. In the spring of 2019, there was heavy rainfall in most parts of the country, and the area was not poor. The rains blocked access to Ayatollah Hashemi Rafsanjani Hospital as water flowed into the seasonal river. Conclusion: A hospital that should help itself to a crisis was itself a cause of the crisis in a short time.