Risk Of Communicable Diseases Research Articles

On Epidemiological and Actuarial Analyses of Health Insurance Models for Communicable Diseases

This article examines an SIDRS disease model design for insurance contracts, in which the insured population is exposed to the risks of communicable diseases. For the epidemiological models, the population is structured into four demographic groups, namely: susceptibles (S), infected PHs undergoing treatment (I), infected PHs who are diseased (D), and infected PHs who recovered (R) from the disease, with part of the latter thereafter re-entering the group of susceptibles (S) and continuing with the insurer by paying premiums until he or she is infected again. The infective class is a union of the class of those undergoing treatment, deceased policy holders (PHs), and those who have recovered. The number of deceased PHs is counted as part of the insured population because the number PHs who die of the disease must be accounted for and are entitled to claims. The insurance policies are designed for the members of the susceptible group: the latter constantly face the risk of infection and death due to the disease. The probability of PHs remaining susceptible for the SIDRS disease model is formulated. The probability density function (PDF) and cumulative distribution function (CDFs) for the SIDRS disease model for an insurance policy are obtained. For the actuarial part, we used actuarial techniques and principles to determine the financial obligations of the parties and the insurance amounts for the insurer and PHs. The cumulative insurance reserve for an annuity and a lump sum plan are also considered. To ascertain the risk of insolvency, premium adjustment for the PHs is considered. Some numerical computations of the results arising from our model analyses are also considered in this article. This article has practical applications in health insurance schemes. It is also applicable in the determination of insurance premiums payable by PHs who did not have the disease and insurance claims receivable by those who are hospitalized or die of the disease. Our model can also be practically applicable in the determination of health insurance reserves for communicable diseases.

Mental emotional disorder is a predictor of stroke incidence in adults: Ten year results of the Bogor Cohort Study on Non–Communicable Disease Risk Factors in Indonesia

Mental emotional disorder is a predictor of stroke incidence in adults: Ten year results of the Bogor Cohort Study on Non–Communicable Disease Risk Factors in Indonesia

Impact of migrants on communicable diseases in Thailand

BackgroundWhile foreign migrants contribute to economic development, they may impact public health by transmitting communicable diseases to the local population. With its geopolitical position, Thailand has been a primary destination for migrants from neighbouring countries in Southeast Asia and beyond. This positioning makes it a focal point for examining the complexities of migration dynamics and its implications for public health. Through a quantitative analysis, this paper investigates the influence of foreign migrants on physical health issues in Thailand, exploring their impact on various types of communicable diseases. The utilization of provincial-level data from Thailand offers insights into the localized effects of migrant populations on public health within the country. These insights can serve as a valuable resource for researchers and policymakers who conduct comparative analyses, facilitating a deeper understanding of the complex relationship between international migration and public health worldwide.MethodsA spatial panel autoregressive model (SAR) is applied on the provincial level communicable diseases and socio-economic data in Thailand from the period 2016 to 2021.ResultsThe results indicate that the influence of foreign migrants on communicable diseases in Thailand varies depending on the type of disease. While an increase in migrants correlates with a higher prevalence of respiratory and other communicable diseases, it conversely reduces the prevalence of vaccine-preventable diseases. Additionally, we found that migrants do not significantly impact the prevalence of food- and water-borne diseases, insect-borne diseases, animal-borne diseases, or sexually transmitted diseases in Thailand. Additionally, other factors, such as GPP per capita, unemployment, poverty, and technology access, strongly correlate with most types of communicable diseases.ConclusionAs revealed by this study, the increase in migrants leads to a rise in respiratory and other communicable diseases, as well as a decrease in vaccine-preventable diseases, which carries significant policy implications. These results urge policymakers, the Ministry of Labour, and the Ministry of Public Health to implement tailored policies and measures to enhance public health and effectively mitigate the risk of communicable diseases transmitted by migrants in the future.

A retrospective cross-sectional study of risk factors for communicable disease diagnoses among refugees in mainland Greek camps, 2016–2017

Communicable disease risk is high in refugee camps and reception centers. To better understand the risks for communicable disease diagnoses among refugees and asylum seekers, this study assesses individual- and camp-level risk factors among individuals utilizing Médecins du Monde clinics in four large refugee camps—Elliniko, Malakasa, Koutsochero, and Raidestos—on mainland Greece between July 2016 and May 2017. Descriptive statistics are reported for the demographic characteristics of the study population and for communicable disease burdens within the four camps—Elliniko, Malakasa, Raidestos, and Koutsochero. A hierarchical generalized linear model was used to assess risk factors for communicable disease diagnoses while accounting for individual-level clustering. This study shows marginal patterns in risk factors for communicable disease. Males had marginally higher risk of communicable disease diagnosis than females (OR = 1.12; 95% CI 0.97—1.29), and increased age was more protective against communicable disease for females (OR = 0.957; 95% CI 0.953—0.961) than for males (OR = 0.963; 95% CI 0.959—0.967). Communicable disease risk was significantly different between camps, with Elliniko (OR = 1.58; 95% CI 1.40–1.79) and Malakasa (OR = 1.43; 95% CI 1.25–1.63) having higher odds of communicable disease than Raidestos. The demographic and epidemiologic profiles of displaced populations differ across settings, and epidemiologic baselines for displaced populations are fundamental to evidence-informed provision of humanitarian aid. Further, while influences and risks for negative health outcomes in complex emergencies are broadly, the causal mechanisms that underpin these relationships are not as well understood. Both practitioners and researchers should engage with further research to elucidate the mechanisms through which these risks operate among displaced populations, including multilevel analyses.

The relationship between risk and prevention awareness of infectious diseases and health literacy among prisoners

ObjectiveThis study aimed to explore the intricate relationship between the health literacy and the awareness of risks and prevention awareness of infection disease among prisoners. Study designA cross-sectional descriptive study was conducted among 1350 prisoners at an L Type Closed Penal Execution Institution in Turkey, using comprehensive criteria to ensure the inclusion of a diverse participant pool. MethodData was collected via face-to-face interviews using the “personal information form,” “health literacy scale (HLS),” and “communicable diseases risk awareness and protection Scale (CDRAPS).” Both scales exhibited high reliability. Statistical analyses, including Pearson correlation and linear regression, were conducted to evaluate the relationships between the dimensions of these scales. ResultsThe study was completed with 1031 prisoners. The participants' mean age was 38.65 with a majority being single (69.2%) and high school graduates (46.3%). A weak positive correlation (r = 0.448, P = 0.000) was observed between the CDRAPS (mean score 135.98 ± 24.00) and the HLS (mean score 89.85 ± 22.30), indicating health literacy explained a 20% variance in communicable diseases risk awareness and prevention. Furthermore, a significant relationship was established considering multiple variables including age, marital and educational status, family health personnel presence, smoking and alcohol use, and comorbidities, showing a combined effect on disease risk awareness and prevention (R2 = 0.203, β = 0.458, P = 0.000). ConclusionThese findings highlight the importance for governments and policy makers to implement preventive and educational programs that are focused on public health, aiming to increase prisoners' health literacy and awareness of infectious diseases.

The experiences and outcomes of Gypsy, Roma, and Traveller pregnant people in pregnancy: A scoping review.

Within Europe, Roma, Gypsy, and Traveller groups have been marginalized and discriminated against by larger society. Persecution and displacement have resulted in high rates of unemployment, reduced access to education, and poorer health, with significantly increased risk of poverty compared with the general population. In pregnancy, there appears to be a gap in the literature surrounding the experiences and outcomes of pregnant people within these ethnic groups. The aim of this study was therefore to scope published research, specifically questioning "What is the experience of Roma Gypsy and Traveller pregnant people who access maternity care?" and "What are the obstetric outcomes within these groups?" This review followed frameworks proposed by Arksey and O'Malley, Levac, and the Joanna Brigg's Institute. The PRISMA extension for Scoping Reviews (PRISMA-ScR) tool was used. The search strategy and specific terms were chosen using the population-concepts-context framework. Titles and abstracts were reviewed independently by two reviewers. Inclusion and exclusion criteria were defined to set clear guidance for reviewers to identify appropriate studies. Five electronic databases were searched (CINAHL, EMBASE, MEDLINE [OVID] Web of Science and SCOPUS). A charting form was developed to record key characteristics systematically and uniformly from the studies. Five themes were identified: systemic issues, antenatal care, complications of pregnancy, birth experience, and postnatal care. Systemic issues included racism, barriers to care, and adapted antenatal care. Antenatal issues included teenage pregnancy, smoking, risk of venous thrombus embolism, dietary issues, risk of communicable diseases, domestic violence, and mental health concerns. Increased risks of congenital abnormalities, growth restriction, premature labor, and perinatal and early childhood mortality were identified. For Roma women, negative birth experiences were reported, whereas the experiences of Traveller women varied. The findings identified in this study serve to create a framework upon which healthcare providers can tailor the way in which pregnant people from a Roma, Gypsy, or Irish Traveller background are cared for. Using such a framework would hopefully begin to reduce the systematic marginalization and discrimination of these minorities.

Breakfast consumption, saturated fat intake, and body mass index among medical and non-medical students: a cross-sectional analysis

Changes in dietary patterns and body weight have become a focus of research in undergraduate students. This study compared breakfast consumption, intake of foods high in saturated fat, and BMI between medical and non-medical students. A comparative cross-sectional study was conducted in 4,561 Peruvian university students, of whom 1,464 (32.1%) were from the medical field and 3,097 (67.9%) from the non-medical field. We compared the frequency of breakfast consumption (categorized as regular: 6 to 7 days/week; occasional: 3 to 5 days/week; and rarely or never: 0 to 2 days/week) and the frequency of consumption of foods high in saturated fat. We created simple and multiple linear and Poisson regression models with robust variance to evaluate the association of the mentioned variables with academic fields. Non-medical students (Adjusted Prevalence Ratio [PR] = 0.92, 95% CI 0.86–0.99; p = 0.008) were less likely to eat breakfast regularly compared to medical students. Likewise, consumption of foods high in saturated fats was higher in non-medical students (B = 1.47, 95% CI 0.91–2.04; p < 0.001) compared to medical students. Similarly, the mean BMI of these students was significantly higher than that of medical students (B = 0.33, 95% CI 0.12–0.53; p = 0.002). Although medical students reported relatively healthy eating habits and a lower BMI, there is a widespread need to promote improved diet and lifestyle among the entire university population to reduce the risks of communicable diseases and improve quality of life.

Literature Review of “Gesture Navigator: AI Based Virtual Mouse”

Abstract: The mouse is one of the wonderful inventions of Human-Computer Interaction (HCI) technology. Currently, wireless mouse or a Bluetooth mouse still uses devices and is not free of devices completely since it uses a battery for power and a dongle to connect it to the PC. In the proposed AI based virtual mouse system, this limitation can be overcome by employing webcam or a built-in camera for capturing of hand gestures and hand tip detection using computer vision. The algorithm used in the system makes use of the machine learning algorithm. Based on the hand gestures, the computer can be controlled virtually and can perform left click, right click, scrolling functions, and computer cursor function without the use of the physical mouse. The algorithm is based on deep learning for detecting the hands. Hence, the suggested system aims to minimize the risk of communicable diseases like COVID-19 transmission by reducing human contact and eliminating the need for additional devices to control the computer system.

IDF23-0067 Assess the prevalence of non communicable disease risk factors among college students

IDF23-0067 Assess the prevalence of non communicable disease risk factors among college students

Speech detection models for effective communicable disease risk assessment in air travel environments

In environments characterized by elevated noise levels, such as airports or aircraft cabins, travelers often find themselves involuntarily speaking loudly and drawing closer to one another in an effort to enhance communication and speech intelligibility. Unfortunately, this unintentional behaviour increases the risk of respiratory particles dispersion, potentially carrying infectious agents like bacteria which makes the contagion control more challenging. The accurate characterization of the risk associated to speaking, in such a challenging noise environment with multiple overlapping speech sources, is therefore of outmost importance. Among the most advanced signal processing strategies that can be used to accurately determine who spoke when and with whom and for how long but most importantly how loudly, at one location, artificial intelligence-based speaker diarization approaches were considered and adapted for this task. This article details the implementation of speaker diarization algorithms, customized to extract speaker and speech parameters discreetly. Validation and preliminary study results are also provided. The algorithms calculate speech duration and sound pressure level for each sentence and speaker, aiding in assessing viral contaminant spread. The paper focuses on applying these algorithms in noisy environments, particularly in confined spaces with multiple speakers. The findings contribute to proactive measures for containing and managing communicable diseases in air travel settings.

Impact of climate change on environmental health: Challenges and opportunities to improve quality of life

Global climate change has become an urgent and complex issue in this modern era. In addition to its broad impact on the environment, climate change also has significant implications for human health. This article describes the relationship between climate change and environmental health, and identifies challenges and opportunities in addressing its impacts. Research shows that climate change is contributing to increasing global temperatures, extreme weather patterns, and overall environmental change. These impacts can affect air, water and soil quality, and increase the risk of communicable diseases, allergies, respiratory diseases and other chronic diseases. In addition, climate change can also affect food availability, food security, and the distribution of disease vectors such as mosquitoes that carry viruses. This presents new challenges in maintaining public health and dealing with threats related to climate change. However, amidst these challenges, there are also opportunities to improve quality of life and reduce the negative impacts of climate change on environmental health. Implementation of mitigation and adaptation policies that focus on reducing greenhouse gas emissions, developing renewable energy, preventing air pollution, sustainable water management, and disease monitoring and control, are some of the steps that can be taken to protect public health. In addition, public education and awareness about the relationship between climate change and environmental health also needs to be increased. With a better understanding of these impacts, society can engage in collective action to reduce greenhouse gas emissions, adopt sustainable practices, and protect environmental health.

Comparison Of Sewage And Solid Waste Disposal Methods Among Households In Urban And Rural Local Government Areas Of Anambra State

Improper sewage and solid waste disposal lead to environmental pollution and increased risk of communicable diseases. This study compared the sanitation and solid waste disposal facilities utilized in selected rural and urban local government areas of Anambra State, Nigeria. This cross-sectional study was conducted among 1310 households and data was collected from household heads or a designated adult representative using of quantitative (questionnaire) and qualitative (KII) data collection methods. The independent variables in this study are the sociodemographic variables and the geographical location of the respondents while the dependent variables are the toilet facilities and solid waste disposal methods. Data from the questionnaire was analyzed using the SPSS version 23 and the hypotheses were tested with the inferential statistics of Chi square at 0.05 level of significance. Most respondents lie between the age group of 31-50 years. Most of the respondents in both the urban (84.4%) and rural(65.0%) areas had secondary education and above but a higher proportion in the urban compared to rural have tertiary education(41.9% versus 22.1%). The difference in educational status was statistically significant (p = 0.0001). There were more business men (46.6%) and civil servants (38.8%) in the urban area than the rural area. Most rural respondents were farmers(41.5%). Many urban household use toilet with sewer connection 152(11.7%) while pit latrine with slab is the most commonly used toilet facility 242 (18.6%). Burning was more commonly used by the rural households (n = 266, 20.5%). Open dumping of refuse and disposal into gullies and water ways were commonly done by the urban households. The gaps that exist between rural and urban areas of Anambra state may present serious health risk and environmental degradation .This issues can be addressed through health education, building more sanitary infrastructure to include the rural areas and enforcing sanitation laws.&#x0D; &#x0D;

Defining key indicators for migrant health outcomes and health policy: a suite of systematic reviews

Abstract Background 46 million migrants reside in the Middle East and North Africa (MENA) region, a proportion of whom will transit to Europe. Yet little is known about policy and practice in relation to data collection and healthcare provision. We synthesised evidence on health indicators, policies, and provision for migrants in the MENA to inform the development of a new tool to strengthen data collection around key diseases. Methods We did 12 systematic reviews (18 countries) to explore the burden, clinical outcomes, policies, and access for the following disease areas in migrants: TB, HIV and hep B/C, malaria and neglected tropical diseases, non-communicable diseases (NCDs) and mental health, maternal and neonatal health, and vaccine-preventable diseases. We searched electronic databases (PubMed/Embase) from 2000 to April 2023, with no exclusion criteria. Migrants were defined as persons who move away from their place of residence within or across a country. Preliminary results Most studies on migrants in the MENA are descriptive or cross-sectional, focus on disease burden, and few have counterfactual host population groups. We found data on multiple outbreaks of vaccine-preventable diseases in migrant populations, particularly in conflict-stricken areas. Data show that prevalence for TB may be higher among migrants in certain contexts, which is largely due to reactivation of latent TB potentially due to poor living conditions. Diabetes and hypertension are the most common NCDs in migrant populations. There is a paucity of data on clinical outcomes in migrants, and on the coverage and uptake of interventions. Of the studies that do report interventions, majority assess acceptability, perceptions, or knowledge. Conclusions This suite of systematic reviews syntheses evidence from across the MENA to address key evidence gaps. We found there is a need to strengthen data and surveillance around migrant health as an urgent next step to informing policy for disease elimination. Key messages • Migrants in the Middle East and North Africa may be at an increased risk of communicable and non-communicable diseases compared with host populations. • To better inform public health policy, stronger and more comprehensive surveillance on migrant populations and more robust research is needed.

A community developed conceptual model for reducing long-term health problems in children with intellectual disability in India.

Children with intellectual disability (ID) have a higher risk of long-term health problems in adulthood. India has the highest prevalence of ID of any country with 1.6 million under-five children living with the condition. Despite this, compared with other children, this neglected population is excluded from mainstream disease prevention and health promotion programmes. Our objective was to develop an evidence-based conceptual framework for a needs-based inclusive intervention to reduce the risk of communicable and non-communicable diseases among children with ID in India. From April through to July 2020 we undertook community engagement and involvement activities in ten States in India using a community-based participatory approach, guided by the bio-psycho-social model. We adapted the five steps recommended for the design and evaluation of a public participation process for the health sector. Seventy stakeholders from ten States contributed to the project: 44 parents and 26 professionals who work with people with ID. We mapped the outputs from two rounds of stakeholder consultations with evidence from systematic reviews to develop a conceptual framework that underpins an approach to develop a cross-sectoral family-centred needs-based inclusive intervention to improve health outcomes for children with ID. A working Theory of Change model delineates a pathway that reflected the priorities of the target population. We discussed the models during a third round of consultations to identify limitations, relevance of the concepts, structural and social barriers that could influence acceptability and adherence, success criteria, and integration with existing health system and service delivery. There are currently no health promotion programmes focusing on children with ID in India despite the population being at a higher risk of developing comorbid health problems. Therefore, an urgent next step is to test the conceptual model to determine acceptance and effectiveness within the context of socio-economic challenges faced by the children and their families in the country.

Microbiota shaping and bioburden monitoring of indoor antimicrobial surfaces

Indoor residents are constantly exposed to dynamic microbiota that have significant health effects. In addition to hand hygiene, cleaning, and disinfection, antimicrobial coatings (AMCs) can prevent the spread of infectious diseases in public areas. The sustainable use of antimicrobial-coated products requires an assessment of their pros and cons for human health and the environment. The toxicity and resistance risks of AMCs have been considered, but large-scale genetic studies on the microbial community compositions and resistomes of AMCs are scarce. The use of an AMC can reduce the total number of microbes on a surface but poses the risk of dysbiosis, microbial imbalance, such as the polarized growth of metallophilic, metal- and antimicrobial-resistant, and other survivor bacteria, and the overall reduction of microbial diversity. Loss of diversity may lead to the enrichment of harmful bacteria and an increased risk of communicable or immunological non-communicable inflammatory diseases (NCDs). In public buildings, such as kindergartens and nursing homes for the elderly, the use of AMCs is likely to increase due to epidemics and pandemics in recent years. Therefore, comprehensive metagenomic research is needed to monitor the effects of AMCs on indoor microbial community compositions and functions. Although the determination of good indoor microbiota and homeostasis is difficult, microbial communities that have health-protective or harmful effects can and should be identified using a metagenomic sequencing approach before the large-scale implementation of AMCs.

Animal movement and associated infectious disease risk in a metapopulation.

Animal movements among habitat patches or populations are important for maintaining long-term genetic and demographic viability, but connectivity may also facilitate disease spread and persistence. Understanding factors that influence animal movements is critical to understanding potential transmission risk and persistence of communicable disease in spatially structured systems. We evaluated effects of sex, age and Mycoplasma ovipneumoniae infection status at capture on intermountain movements and seasonal movement rates observed in desert bighorn sheep (Ovis canadensis nelsoni) using global positioning system collar data from 135 individuals (27 males, 108 females) in 14 populations between 2013 and 2018, following a pneumonia outbreak linked to the pathogen M. ovipneumoniae in the Mojave Desert, California, USA. Based on logistic regression analysis, intermountain movements were influenced by sex, age and most notably, infection status at capture: males, older animals and uninfected individuals were most likely to make such movements. Based on multiple linear regression analysis, females that tested positive for M. ovipneumoniae at capture also had lower mean daily movement rates that were further influenced by season. Our study provides empirical evidence of a pathogenic infection decreasing an individual's future mobility, presumably limiting that pathogen's ability to spread, and ultimately influencing transmission risk within a spatially structured system.

Physical activities pre- and post-COVID-19 vaccination and its implementations: A narrative review.

Coronavirus disease 2019 is a severe communicable pulmonary medical problem that has been a challenging disease for everyone in the globe, but vaccines development and administration against this severe acute respiratory syndrome-inducing disease (coronavirus disease 2019) are currently yielding fabulous results. The mean duration of the coronavirus disease 2019 pandemic for this study spanned from 2020 until 2022. These manifestations are accompanied by symptoms of respiratory tract illnesses such as non-productive cough, sore throat, and nasal discharge. Relevant reviews on coronavirus disease 2019 manifestations and outcomes, consisting mainly of the infections/outbreaks, experimental information, and pre- and post-serovaccination details that occurred, were described. After a typical vaccination course, the study aims to summarize and understand more about the effectiveness of exercise on the pre-and post-coronavirus disease 2019 vaccination and its implementations. Physical activity is an immunological function adjuvant to decrease communicable disease risk and enhance immunity post-viral infection vaccination. Moderate-intensity resistance exercisesession directly before getting the influenza vaccine decreases vaccine responses in older adults, such as redness, pain, or inflammation at the injection spot or other adverse consequences compared to the inactive circumstance. However, it was reported that exercise after a shot is generally safe as long as vaccinated people feel well enough. Though exercise before or after vaccination has no negative impact on the protection afforded by the vaccine, people can exercise immediately after receiving the vaccine, as any changes in blood flow will not affect the vaccine's response. One episode of light-to-moderate-intensifying exercise after vaccination may improve the antibody reactions to influenza or the coronavirus disease 2019 vaccine. Vaccination administered pre- and post-regular exercise is an effective approach for boosting antibody responses due to its immunostimulant effects. Future research should investigate how different vaccine antibodies respond to low, moderate, and high physical activity levels.

The Role of Teacher-student Relationship in Motivation (A Case Study of Community School of Nepal)

This research paper is focused to analyze how teachers - students' relationship plays a crucial role in students' motivation in learning. This paper is based on the Gardner model of motivation. By adopting a qualitative method approach and a phenomenological research design, the research paper has been prepared. Convenience sampling technique has been used in it. Data were collected by using a questionnaire and unstructured interview via telephone. Four issues were identified between the teachers-student’s relationships throughout the unstructured interview: the importance of teacher-student relationship, teacher expectation, students' motivation, and improvement in academic learning. The delimitation of this researcher was to collect the data from the telephone call due to the high transmission and risk of communicable diseases like corona virus (COVID -19) spreading all over the world. The research found out that, the better contact and mutual relationship between teachers and students resulted higher motivation in learning.

Evaluation of Health, Religious Factors, and Modern Technologies in Public Toilets During Hajj

Hajj pilgrims encounter a great deal of tough physical and mental stress. Overcrowding, extreme temperatures and electrolytes imbalance are common among pilgrims. Approximately more than 2.5 million people from different parts of the world gathered in the holy sites Makka. These factors trigger the increased risk for communicable and non-communicable diseases. This study discusses health and religious factors in an attempt to assess the mandatory health requirements for public toilets in the holy places at Makkah city, that can be translated into toilet design for Hajj pilgrimage at Mecca with the purposes of integration of modern technologies. Articles related to toilet problems faced by the pilgrims published between 2013 to 2018 in some selected data bases were considered in this study. Only 20 studies were included, encompassing 12,000 respondents out of 300 articles. An evaluation requirement checklist was made to evaluate whether the toilet facilities conform to the local and international public toilet standards. Randomly, about 242 toilets were selected and assessed for the availability of essential hygienic items from Mina (54%), followed by Arafat (26%) and Muzdalifah (20%). The proposed conceptual toilets design for Arafat, Muzdalifah, and Mina in the Kingdom of Saudi Arabia is not only applied for Hajj purposes but also as a model to the development of toilet design in all Muslim countries. Sustainable design proposal with safety provisions, accessibility, hygiene, ventilated, lighted and cleaned public toilets during Hajj rituals would more likely protect pilgrims against adverse health effects. However, a definitive conclusion could not be drawn due to lack of existing studies related to this area. The contribution of this study is that the health and religious factors are very crucial in the consideration of toilet design whilst not forgetting modern technologies of the future.

Low Blood Pressure at Presentation and its Adverse Outcomes in Acute Stroke

Introduction: Most patients with acute ischemic stroke (AIS) have elevated blood pressure (BP) at presentation, which often declines spontaneously in the following days. Objectives: The main objective of the study is to find the Low blood pressure at presentation and its adverse outcomes in acute stroke. Material and methods: This cross sectional study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during July 2022 till October 2022. The data was collected with the permission of ethical committee of hospital. The data was collected from those patients who fulfill the inclusion criteria. We collect all the data related to age, sex, history of diseases, risk factors, baseline values and stroke history. All suspected strokes who presented to the ED within 24 h of onset of first symptoms were included in this prospective study Results: In our study total 100 patients were enrolled mean age was 47.7± 10 years with minimum age of 18 years and maximum age of 65 years. Lesser patients belong to younger age group (18 years to 40 years) i.e. 54 while 46 belonged to elder age group i.e. 41 year to 65 years 24.1 % and 75.9% respectively. Out of which 62 were male and 38 were female. Practical implication: Hypotension and hypertension both are inter connected and treated simultaneously. Conclusion: It is concluded that hypotension were the commonest non communicable diseases (cardiovascular) risk factors in known hypertensive patients. Low presenting BP, both SBP and DBP, are associated with poor outcome after acute stroke, even after taking account of these patients. Keywords: Hypotension, Blood pressure, Stroke, Hypertension, Outcomes