Background: With Pakistan failing to achieve Millennium Development Goals we have now entered into a new era of Sustainable Development Goals. Decreasing child mortality, improving maternal health and increasing the proportion of births by trained birth attendants, are the areas with unmet goals. As 29.5% of population of Pakistan is below the poverty line, expenditure on maternal health care services is of great importance as it determines the utilization of health care services to a large extent. Objective: To assess maternal health care expenditure and its sociodemographic predictors in rural Khanewal, Punjab, Pakistan. Methodology: In this cross sectional study average cost on delivery (both SVD and Cesarean section) was assessed in both public and private sector of rural

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Half of the world’s population, i.e. women, and one third population of world, i.e. children, are vulnerable in biological sense. Women and children become the most neglected segments of population during natural disasters. This conceptual paper provides an insight about the specific needs and problems of children and women before, during and after a disaster. Social vulnerabilities are more complex and critical to understand, which enhance the intensity of exploitation, vulnerability and risk for women and children. Considering special needs and provision of equal services are main concerns in rehabilitation. Primary emergencies always bring secondary emergencies if they are not properly managed and administered. Effects of disasters can be minimized by enhancing the coping capacities of vulnerable segments and by equipping them with all necessary preparedness and rescue skills and privileges.

During the COVID-19 pandemic, there is an increase in anxiety disorder towards the general population, including those clinical clerkship students who are associated with health care services. There has been limited study conducted regarding to the topic, especially during the COVID-19 pandemic. This study was aimed to know the prevalence of anxiety and insomnia, as well as the correlation between them, in clinical clerkship students during COVID-19 pandemic. An online survey was conducted using a cross-sectional approach to 229 clinical clerkship students batch 2015 at the Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada. This study used the Insomnia Severity Index (ISI) and General Anxiety Disorder-7 (GAD-7), administered using Google Forms. Data were analysed using the Chi-Square test. We collected 101 responses. There were 41.6% of males and 58.4% of females with ages ranging from 21 to 26. The result shows 26.7% (95% CI: 8.1-35.4%) of students undergo anxiety and 44.6% (95% CI: 34.9-54.3%) of students experienced insomnia throughout the COVID-19 pandemic. There is a correlation between anxiety and insomnia on clinical clerkship students during the COVID-19 pandemic. Clinical clerkship students with an anxiety disorder have 2.62 times greater risk of experiencing insomnia (p<0.001). The correlation between insomnia and anxiety during COVID-19 pandemic is vital because clinical clerkship students are directly involved in health care services and could risk the safety of patients. Thus, it is important to conduct the course of actions to reduce the risk of mental health problems during pandemic conditions. Also, further research is needed to have a better understanding of the impact on learning performance.

Breast cancer poses a serious health risk for women throughout the world. Among the Asian population, Pakistani women have the highest risk of developing breast cancer. One out of nine women is diagnosed with breast cancer in Pakistan. The etiology and the risk factor leading to breast cancer are largely unknown. In the current study the risk factors that are most pertinent to the Pakistani population, the etiology, molecular mechanisms of tumor progression, and therapeutic targets of breast cancer are studied. A correlative, cross-sectional, descriptive, and questionnaire-based study was designed to predict the risk factors in breast cancer patients. Invasive Ductal Carcinoma (90%) and grade-II tumor (73.2%) formation are more common in our patient’s data set. Clinical parameters such as mean age of 47.5 years (SD ± 11.17), disturbed menstrual cycle (> 2), cousin marriages (repeated), and lactation period (< 0.5 Y) along with stress, dietary and environmental factors have an essential role in the development of breast cancer. In addition to this in silico analysis was performed to screen the miRNA regulating the TGF-beta pathway using TargetScanHuman, and correlation was depicted through Mindjet Manager. The information thus obtained was observed in breast cancer clinical samples both in peripheral blood mononuclear cells, and biopsy through quantitative real-time PCR. There was a significant dysregulation (**P>0.001) of the TGF-β1 signaling pathway and the miRNAs (miR-29a, miR-140, and miR-148a) in patients’ biopsy in grade and stage specifically, correlated with expression in blood samples. miRNAs (miR-29a and miR-140, miR-148a) can be an effective diagnostic and prognostic marker as they regulate SMAD4 and SMAD2 expression respectively in breast cancer blood and biopsy samples. Therefore, proactive therapeutic strategies can be devised considering negatively regulated cascade genes and amalgamated miRNAs to control breast cancer better.