Background: Stunting is a major public health issue in most of developing countries. Although, its worldwide prevalence is decreasing slowly but the number of stunted children is still rising in Pakistan. Stunting is highly associated with several long-term consequences, including higher rate of mortality and morbidity, deficient cognitive growth, school performance, learning capacity, work capacity and work productivity. To prevent stunting, we proposed Stunting Diagnostic and Education app. This app includes detailed knowledge of stunting and it's all forms, symptoms, causes, video tutorials and guidelines by the Pediatricians and Nutritionists. Methods: A cross-sectional study has been conducted in schools of Multan District, Pakistan for the period of January 2019 to June 2019. Sample data of 1420 children, aged 4 to 18 years using three age groups, were analyzed by using SPSS version 21.0 to assess the prevalence of stunting and to analyze the risk factors associated with it in children under and over 5 age. Chi square test was applied in comparison with rural and urban participants and p-value < 0.05 was considered as significant. This study includes distribution of sociodemographic characteristics, parental education, working status of mothers, dietary patterns of school going children and prevalence of stunting in school going children. After getting study results, Stunting Diagnostic and Education app was developed according to the instructions of child experts and nutritionists. Results: 354 (24.93%) participants were stunted out of 1420, 11.9% children were obese and 63.17% children were normal. Out of 354 stunted children, higher ratio of stunting was found in the age group of 8-11 years children with 51.98 percentage. 37.85% stunted children were found in the age group of 4-7 years and 10.17% stunting was found in the age group of 12-18 years children. It was observed in the study that male children were highly stunted than female with 57.91 and 42.09% respectively. Children living in rural areas were more stunted affected as compared to the children living in urban society with percentage 58.76 and 41.24 respectively.
Objective: To identify echocardiography-based myocardial changes in children with severe acute malnutrition. Method: The prospective study was conducted from January to November 2020 at a territory care paediatric hospital in Multan, Pakistan, and comprised severe acute malnutrition patients of either gender aged 1-60 months and an equal number of matching healthy controls. Malnutrition was categorised using the World Health Organisation criteria. Echocardiographic evaluation was done by expert cardiologists. Values for ejection fraction shortening, left ventricular mass, E/A wave ratio as well as mitral and tricuspid annular plane systolic excursions were noted. Data was analysed using SPSS 21. Result: Of the 150 subjects, 75(50%) each were cases and controls. Age and gender were not significant different between the groups (p>0.05). Left ventricular mass and left ventricular mass index with body surface area were significantly reduced in the cases compared to the controls, and the same was the case with left ventricular ejection fractional shortening (p<0.05). There was no significant difference between the groups in terms of E/A wave ratio as well as mitral and tricuspid annular plane systolic excursions (p>0.05). Among the cases, cardiac evaluation showed 26(34.6%) were kwashiorkor and 49(65.3%) were marasmic patients. Conclusion: Left ventricular parameters in malnourished children were found to be reduced. As such, the assessment of these parameters may appear to be a significant indicator for timely identification of cardiac malfunction in severe acute malnutrition cases. Key Words: Severe acute malnutrition, Myocardial performance index, Ejection fraction, Fractional shortening, Cardiac function.
Cotton is an important cash crop and source of foreign exchange. Nitrogen is a critical nutrient for plant growth throughout the life span of the crop. Wheat straw mulch not only source of nitrogen supply but also improves soil fertility and reduces soil erosion. The current study was performed to investigate the effects of mulches and nitrogen application on cotton productivity and fiber quality at the Central Cotton Research Institute (CCRI), Multan. Two crop residues i.e. wheat straw and non wheat straw were used in main plots while nitrogen levels viz. 0,50, 100 and 150 kg ha-1 were randomized in subplots. The highest seed cotton yield (22.99 t ha-1) was obtained by the combination of nitrogen fertilizer application highest level (150 kg N ha-1) along with the wheat straw (20.27 t ha-1). The fiber quality was also affected by the wheat straw along with nitrogen application 150 kg N ha-1 and gave maximum results. In conclusion, wheat straw along with 150 kg ha-1 of Nitrogen application gave maximum results on cotton production as compared to non straw with low nitrogen application.
Studies investigating the interconnection of health poverty and climatic variability are rare in spatial perspectives. Given the importance of sustainable development goals 3, goal 10, and goal 13, we explored whether the geographic regions with diverse climate structure has a spatial association with health poverty; whether spatial disparities exist across districts of Pakistan. We implied the A-F methodology to estimate the MHP index using the PSLM survey, 2019–20. The climate variables were extracted from the online NASA website. We applied the spatial techniques of Moran’s I, univariate and bivariate LISA, to address the research questions. The findings revealed that the magnitude of MHP differs across districts. Punjab was found to be the better-ff whereas Baluchistan was the highest health poverty-stricken province. The spatial results indicated positive associations of MHP and climate indicators with their values in the neighbors, whereas a negative spatial association was found between the MHP and climate indicators. Also, spatial clusters and outliers of higher MHP were significant in Baluchistan and KP provinces. Government intervention and policymaker’s prioritization are needed towards health and health-related social indicators, mainly in the high poverty-stricken districts, with high temperature and low humidity and precipitation rates, especially in Baluchistan.
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