Deaths In Pakistan Research Articles

An analysis of the impact of newborn survival policies in Pakistan using a policy triangle framework

IntroductionPakistan has made slow progress towards reducing the newborn mortality burden; as a result, it has the highest burden of newborn mortality worldwide. This article presents an analysis of the current policies, plans, and strategies aimed at reducing the burden of newborn death in Pakistan for the purpose of identifying current policy gaps and contextual barriers towards proposing policy solutions for improved newborn health.MethodsWe begin with a content analysis of federal-level policies that address newborn mortality within the context of health system decentralization over the last 20 years. This is then followed by a case study analysis of policy and programme responses in a predominantly rural province of Pakistan, again within the context of broader health system decentralization. Finally, we review successful policies in comparable countries to identify feasible and effective policy choices that hold promise for implementation in Pakistan, considering the policy constraints we have identified.ResultsThe major health policies aimed at reduction of newborn mortality, following Pakistan’s endorsement of global newborn survival goals and targets, lacked time-bound targets. We found confusion around roles and responsibilities of institutions in the implementation process and accountability for the outcomes, which was exacerbated by an incomplete decentralization of healthcare policy-making and health service delivery, particularly for women around birth, and newborns. Such wide gaps in the areas of target-setting, implementation mechanism, and evaluation could be because the policy-making largely ignored international commitments and lessons of successful policy-making in comparable regional counties.ConclusionsInclusion of clear goals and targets in newborn survival policies and plans, completion of the decentralization process of maternal and child healthcare service delivery, and policy-making and implementation by translating complex evidence and using regional but locally applicable case studies will be essential to any effective policy-making on newborn survival in Pakistan.

Pakistan Oral Cancer Collaborative: analyzing barriers and obstacles to oral cancer diagnosis, treatment, and prevention in Pakistan

Oral cancer is a global health problem with increasing case numbers worldwide and no significant improvement in prognosis over the last few decades. It is one of the most common cancers and a leading cause of death in Pakistan, although the number reported is significantly underreported owing to the lack of a national cancer repository, and the true magnitude of this challenge is not known. Bilateral discussions and workshops funded by the Global Challenges Research Fund brought together a number of like-minded researchers and clinicians from the United Kingdom and Pakistan to analyze the status quo and plan the future course. This article reviews some of these discussions as well as barriers to oral cancer diagnosis in Pakistan and makes recommendations to investigate the magnitude and develop measures that may help tackle this devastating disease.

Analysis of Road Traffic Accident Fatalities in Karachi, Pakistan: An Autopsy-Based Study

BackgroundRoad traffic accident (RTA) fatalities account for a significant number of unnatural deaths in Pakistan. Hence, it is necessary to investigate RTA fatalities in order to implement measures to reduce them. In the present study, we aimed to assess the detailed epidemiological characteristics of RTA fatalities by analyzing the data obtained from medico-legal autopsies performed at the Jinnah Postgraduate Medical Centre (JPMC) in 2019 and 2020. We assessed age- and gender-based variations in the pattern of RTA fatalities and determined the anatomical cause of death and sites of fractures among the fatalities. Moreover, we assessed the monthly distribution of cases in 2019 and 2020 to determine the impact of the coronavirus disease 2019 (COVID-19) on the number of RTA fatalities reported each month.MethodologyIn this retrospective study, data obtained from medico-legal autopsies of all RTA victims in 2019 and 2020 (n = 246) were collected from the Forensic Department of JPMC, Karachi. The data were then entered into Statistical Package for the Social Sciences version 24.0 (IBM Corp., Armonk, NY, USA) for analysis.ResultsThe highest number of fatalities was recorded in the age group of 18-40 years (54.5%), while the lowest number was recorded in the age group of ≥60 years (8.5%). The male:female autopsy ratio was 6.03:1. Most fatalities were recorded from 6:00 am to 11:59 am (41.9%), followed by 12:00 pm to 5:59 pm (37.4%). Moreover, most victims (76.8%) died instantaneously within seconds to minutes of the incident. The number of RTA fatalities reported in 2019 (50.4%) was similar to that reported in 2020 (49.6%). However, the number of RTA fatalities reported in March-July 2020 was 35.6% lower than that reported in the same period in 2019, possibly because of the restrictions (such as lockdowns) that were imposed to control the spread of the COVID-19 pandemic in 2020. There was a statistically significant difference in the number of RTA fatalities reported in March-July 2020 and that reported in the remaining months of 2019 and 2020 (p = 0.006).The cause of death was head injury in 159 (64.6%) cases and multiple traumatic injuries in 65 (26.4%) cases. Injury to the chest, abdomen, and pelvis caused death in 11 (4.5%), nine (3.7%), and two (0.8%) cases, respectively. Assessment of the site of fractures revealed skull fractures to be the most common type of fractures (53%), followed by rib/sternal fractures (19%). Upper limb and lower limb fractures occurred in 10% and 9% of the cases, respectively, while pelvic and neck fractures occurred in 6% and 3% of the cases, respectively.ConclusionsEfforts need to be made at both government and individual levels to reduce RTA fatalities. Strict implementation of traffic laws is necessary. Although we noted a male preponderance, the reluctance to get females autopsied should not be disregarded. The significant decrease in RTA fatalities during March-July 2020 could be attributed to the reduced traffic burden due to the restrictions imposed to control the COVID-19 pandemic and the preventive measures taken, such as staying at home, to avoid contracting the virus.

Monitoring of three-phase variations in the mortality of COVID-19 pandemic using control charts: where does Pakistan stand?

BackgroundAt the end of December 2019, the world in general and Wuhan, the industrial hub of China, in particular, experienced the COVID-19 pandemic. Massive increment of cases and deaths occurred in China and 209 countries in Europe, America, Australia, Asia and Pakistan. Pakistan was first hit by COVID-19 when a case was reported in Karachi on 26 February 2020. Several methods were presented to model the death rate due to the COVID-19 pandemic and to forecast the pinnacle of reported deaths. Still, these methods were not used in identifying the first day when Pakistan enters or exits the early exponential growth phase.ObjectiveThe present study intends to monitor variations in deaths and identify the growth phases such as pre-growth, growth, and post-growth phases in Pakistan due to the COVID-19 pandemic.MethodsNew approaches are needed that display the death patterns and signal an alarming situation so that corrective actions can be taken before the condition worsens. To meet this purpose, secondary data on daily reported deaths in Pakistan due to the COVID-19 pandemic have been considered. The n}{} c and exponentially weighted moving average (EWMA) control charts have been used for monitoring variations.ResultsThe n}{} c-chart shows that Pakistan switches from the pre-growth to the growth phase on 31 March 2020. The EWMA chart demonstrates that Pakistan remains in the growth phase from 31 March 2020 to 17 August 2020, with some indications signaling a decrease in deaths. It is found that Pakistan moved to a post-growth phase for a brief period from 27 July 2020 to 28 July 2020. Pakistan switches to re-growth phase with an alarm on 31/7/2020, right after the short-term post-growth phase. The number of deaths starts decreasing in August in that Pakistan may approach the post-growth phase shortly.ConclusionThis amalgamation of control charts illustrates a systematic implementation of the charts for government leaders and forefront medical teams to facilitate the rapid detection of daily reported deaths due to COVID-19. Besides government and public health officials, it is also the public’s responsibility to follow the enforced standard operating procedures as a temporary remedy of this pandemic in ensuring public safety while awaiting a suitable vaccine to be discovered.

Estimation of serum electrolytes dysfunction in acute MI patients presented at tertiary care hospital in Pakistan

Background and Aims: Myocardial infarction is one of the leading cause of deaths in Pakistan. Electrolytes (Sodium, Potassium and Chloride) are considered to be the major determinants of study, we determined the changing patteren of serum electrolytes levels in acute MI patients by comparing with healthy individuals.

Forecasting COVID-19 in Pakistan.

ObjectivesForecasting epidemics like COVID-19 is of crucial importance, it will not only help the governments but also, the medical practitioners to know the future trajectory of the spread, which might help them with the best possible treatments, precautionary measures and protections. In this study, the popular autoregressive integrated moving average (ARIMA) will be used to forecast the cumulative number of confirmed, recovered cases, and the number of deaths in Pakistan from COVID-19 spanning June 25, 2020 to July 04, 2020 (10 days ahead forecast).MethodsTo meet the desire objectives, data for this study have been taken from the Ministry of National Health Service of Pakistan’s website from February 27, 2020 to June 24, 2020. Two different ARIMA models will be used to obtain the next 10 days ahead point and 95% interval forecast of the cumulative confirmed cases, recovered cases, and deaths. Statistical software, RStudio, with “forecast”, “ggplot2”, “tseries”, and “seasonal” packages have been used for data analysis.ResultsThe forecasted cumulative confirmed cases, recovered, and the number of deaths up to July 04, 2020 are 231239 with a 95% prediction interval of (219648, 242832), 111616 with a prediction interval of (101063, 122168), and 5043 with a 95% prediction interval of (4791, 5295) respectively. Statistical measures i.e. root mean square error (RMSE) and mean absolute error (MAE) are used for model accuracy. It is evident from the analysis results that the ARIMA and seasonal ARIMA model is better than the other time series models in terms of forecasting accuracy and hence recommended to be used for forecasting epidemics like COVID-19.ConclusionIt is concluded from this study that the forecasting accuracy of ARIMA models in terms of RMSE, and MAE are better than the other time series models, and therefore could be considered a good forecasting tool in forecasting the spread, recoveries, and deaths from the current outbreak of COVID-19. Besides, this study can also help the decision-makers in developing short-term strategies with regards to the current number of disease occurrences until an appropriate medication is developed.

Prematurity and Sudden Unexpected Infant Deaths in Pakistan

Prematurity and Sudden Unexpected Infant Deaths in Pakistan

Current Scenario of Covid-19 with Epidemiological and Phylogenetic Analysis of Pakistani Coronavirus: A Review

A novel corona virus named as 2019 n-CoV was identified to be the actual cause of an outbreak of respiratory illness in Wuhan, China beginning in late December 2019. This respiratory disease was named as COVID-19 by WHO. There are many countries affected by COVID-19 including Pakistan. In this review we have provided a brief introduction of COVID-19 and discussed epidemiological and phylogenetic analysis of Pakistani novel corona virus strain. Our epidemiological analysis of data till 16th May 2020 showed rapidly increasing number of new cases, while at the same time a higher recovery rate than number of deaths in Pakistan. Moreover, phylogenetic analysis indicated that 2019-nCoV strain of Pakistan shared 100 % bootstrap value with various countries’ novel corona virus strains. Similarly, phylogenetic analysis was also conducted in comparison with SARS species to confirm our results. In this review, current knowledge of pathogenesis, diagnosis, treatment of COVID-19 and comorbidities which could be helpful in offering novel understanding and possible therapeutic targets for fighting against the COVID-19 infection are discussed.

Knowledge, attitude and practice (KAP) survey of canine rabies in Khyber Pakhtunkhwa and Punjab Province of Pakistan

BackgroundThis study aimed to assess the extent of knowledge and understanding of rabies disease in rural and urban communities of Pakistan. It also identified malpractices after suspected dog bite that might pose a risk for humans contracting rabies.MethodsA cross-sectional study was conducted (n = 1466) on people having different age groups and educational levels in four different geographic regions of Punjab and Khyber Pakhtunkhwa provinces in Pakistan. Knowledge, attitude, and practices of people were assessed using a structured questionnaire. We used a bivariate and multivariate analysis to study the association between rabies related mortalities in near or extended family members and different risk behaviors.ResultsOur results demonstrate that the majority of the juvenile population (less than 18 years of age) were not aware of the clinical signs of rabies in animals. 75% of the total respondents were not vaccinated against rabies, 60% did not seek a doctor’s advice after a suspected animal bite, and 55% had inadequate health care facilities for rabies patients in local hospitals.Respondents that had pets at home had not vaccinated (38%; p < 0.05; odds ratio 1.58) themselves against rabies due to lack of knowledge and awareness of pre-exposure prophylaxis for rabies (51%; p < 0.05; odds ratio 1.25). They also tend to not visit doctor after suspected bite (52%; p < 0.05; odds ratio 1.97), which may had resulted in more deaths (65%; p < 0.05; odds ratio 1.73) of someone in their near or extended family due to rabies.ConclusionsLack of knowledge about the nature of rabies disease and prophylaxis has contributed to increase of rabies related deaths. Inadequate health care facilities and poor attitude of not seeking medical attention after suspected dog bite are the major reasons of rabies related deaths. These findings could help in devising a targeted management strategy and awareness program to control and reduce the incidence of human rabies related deaths in Pakistan.

Intensity and Rate of COVID-19 Infection in Pakistan

Since the WHO has declared the Covid 19 pandemic, number of cases is on rise but not attained peak in Pakistan. Although people are affected by COVID-19 throughout the world but the impact of, the disease is different in various countries, which may be attributed to different factors. Scientifically it is point to ponder that though the official figures are in thousands but there may be many asymptomatic patients in our communities due to closed family living systems in Pakistan. There are more than 12 to 13 people living in single small apartments in Karachi, who are in so close contact with each other and the local transmission cannot be avoided in them. However, the positive thing is that the severity of disease and number of deaths in Pakistan are not as much as in developed countries. There could be a number of reasons, which are needed to be explored by researchers in Pakistan and world over.

Predicting COVID-19 Spread in Pakistan using the SIR Model

Syed Tahir Ali Shah1, Majad Mansoor2, Adeel Feroz Mirza2*, Muhammad Dilshad3, Muhammad Imran Khan4*, Rahat Farwa5, Muhammad Ammar Khan6, Muhammad Bilal7 and Hafiz M.N. Iqbal8Article: 6303 | Pages: 1423-1430 Abstract|Full Text| PDF| XMLhttps://doi.org/10.22207/JPAM.14.2.40

Exploring women's experience of healthcare use during pregnancy and childbirth to understand factors contributing to perinatal deaths in Pakistan: A qualitative study.

Understanding key healthcare system challenges experienced by women during pregnancy and birth is crucial to scale up available interventions and reduce perinatal mortality. A community perspective about preferences and experience of care during this period can be used to improve community-based programs to reduce perinatal mortality. Using a qualitative exploratory approach, we examined women's experience of perinatal loss, aiming to understand the main factors, as perceived and experienced by women, leading to perinatal loss. Qualitative in-depth Interviews were conducted with 25 mothers with a recent perinatal loss, three family members, six healthcare officials, and two focus group discussions with 17 lady health workers. Data were analysed using inductive and deductive coding, by thematic analysis. Our findings revealed three distinct but interrelated themes, which include: 1) poor access to care during pregnancy and birth, 2) unavailability of appropriate healthcare services, and 3) poor quality of care during pregnancy and birth. Women frequently delayed seeking formal care around birth because of delays by themselves, their family members, or the local traditional birth attendants who frequently induced births at women's homes without recognising the dangers to the mothers or their babies. Preference for private care was common, however they often could not bear the cost of care when they needed caesarean section or in-patient care for their sick newborns because these services were absent in public health facilities of the district. Referral to the regional tertiary care hospital was often not officially arranged leading to risky births in small and crowded private clinics. Women's views about negative staff attitudes and the lack of attention given to them in public health facilities highlighted a lack of quality and respectful antenatal care. Improvement in women's access to essential care during pregnancy and around birth, availability of emergency obstetric and newborn care, improving the quality of maternal and newborn care in both public and private health facilities at the district level might reduce perinatal mortality in Pakistan.

A Study on the Case of Kalbushan Jadev from the View of International Law

Kulbushan Yadhav Case is a unique case in which an Indian spy was caught during the operation of security forces in Pakistan in 2016. He was allegedly involved in sponsoring terrorism in the provinces of Baluchistan and Sindh in Pakistan. He confessed all the offenses committed by him which was telecasted on TV channels across the world. Kulbushan Yadhav was serving Commander of Indian Navy that confessed that he funded BLA and BRA named illegal terrorist organizations in the Province of Baluchistan while working for Indian Intelligence Agency RAW. He further confessed that he visited Karachi twice and gathered intelligence pertaining to Pakistan’s Navy. He also admitted that there are many other RAW agents like him working in He was sentenced to death in Pakistan. India denied the confession of Kulbushan Yadhav again and again. India approached International Court of Justice in 2017 which initially stayed the execution of death sentence against Kulbushan Yadhav. In the final verdict of the case the International court of Justice (ICJ) granted consular access to India and ordered review of death sentence of Kulbushan Yadhav in July 2019. India’s plea for the release of Kulbushan Yadhav was rejected. This case was contested by India Legal team headed by Mr. Harish Salve and Pakistan’s Legal Team headed by Mr. Khawar Qureshi. India’s stance was that Pakistan is denying consular access to India which is right of accused under the provisions of Vienna Convention. The proceedings of the case initiated in May 2017 and finally the case got decided in 2019. In this article we have used different spellings of the name of Kulbushan Yadhav (Jadhev) as this name is written both ways in India and Globally. Pakistan and India are neighboring countries located in sub-continent. Both got independence from Great Britain by virtue of Partition Act 1947. India never accepted Pakistan’s independence because of which it made things worse for Pakistan since the independence times. Both countries fought fierce wars against each other in 1948, 1965, 1971 and 1999. Pakistan also lost half of the country which was East Pakistan and later it becomes Bangladesh in 1971 because of the interference of India in the internal affairs of Pakistan. Pakistan came into being on the doctrine of Two Nation Theory which was given by Dr. Allama Muhammad Iqbal at his historic speech at Allahabad India in 1931. He was a renowned poet also known as poet of the east. According to the two nation theory there are two nations living in Indo-Pak Subcontinent which are different in their cultures, religions, morals, language and lifestyles. They cannot live together because of which there is a dire need of separate homeland for Muslims living in India. This two nation theory becomes the basis of division of India and creation of Pakistan in 1947. When Pakistan lost East Pakistan province, the then Primemininster of India Mrs. Indira Gandhi said “Two Nation Theory has been drowned in Bay of Bengal”. India has the same approach of destroying rest of Pakistan because of which it keeps sending its agents in Pakistan to destabilizing it. Kulbushan Yadhav is one of such agents which got arrested after considerable time. He was involved in sponsoring terrorism activities in Pakistan especially in the provinces of Baluchistan and Sindh. Pakistan and India are both Nuclear Armed Nations. Both the countries are well equipped with the state of the art machinery, fighter jets, strong armed forces and capability to destroy each other. There are border disputes also between both countries especially because of disputed territory of Jammu &amp; Kashmir. If agents like Kulbushan Yadhav are not restrained from interfering in the matters of Pakistan, someday this world may become an unsafe place to live. Keywords: - Kulbushan Yadhav Case, Indian Spy Case, Consular Access Latest Judgment, Indian Terrorist Spy Case, Cross Border Terrorism by India, Indian Sponsored Terrorism DOI: 10.7176/JLPG/97-03 Publication date: May 31 st 2020

Derangements of Liver enzymes in Covid-19 positive patients of Pakistan: A retrospective comparative analysis with other populations

Background & Objectives: COVID-19 is a global pandemic, also affecting Pakistan with its first case reported on 26th February 2020. Since then, it has been a total of 217,809 positive cases and 4473 deaths in Pakistan so far. Deranged liver function enzymes levels are prominently detected extra-pulmonary clinical manifestation of COVID-19 reported by at least one-half of the patients. Our study aimed to evaluate these derangements in our population. Methods: A retrospective, observational study was conducted to include all the admitted patients having COVID-19 positive, and evaluated those for derangements of liver function enzymes (n=77). The statistical analysis was conducted to compare those derangements amongst the disease severity, prognostic markers, and death. Results: Out of the 77 patients, 55 were admitted in the ward, 22 were in ICU, 61 of them recovered, while 16 deaths reported. The most deranged liver enzyme was found out to be Gamma-glutamyl transferase (51.94%), followed by Aspartate transferase (41.55%), Alanine transferase (28.57%), and Alkaline phosphatase (14.28%). Total bilirubin was deranged in only 10 patients, however, direct bilirubin was above the normal range in 33 patients, while indirect component in only 4 patients. Increased direct bilirubin, Aspartate aminotransferase, and Gamma-glutamyl transferase were associated with increased mortality, increased ICU admissions, increased neutrophils, lymphocytopenia, leukocytosis, and neutrophil to lymphocyte ratio>3, while Alanine aminotransferase and Alkaline phosphatase were not associated with the above factors. Conclusion: The deranged values of liver function enzymes in COVID-19 are correlated with an increased number of ICU admissions, mortalities as well as prognostic markers.

First COVID-19 related death in Pakistan in a patient with a travel history in Saudi Arabia

Rationale: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been recognized as highly pathogenic. The current pandemic of SARS-CoV-2 has been spread globally and infected more than 200 countries.Patient concerns: We report the first confirmed fatal case of COVID-19 in Pakistan. A 50-year-old man returned from Saudi Arabia on March 09, 2020 and presented with cough, fever, malaise, poor appetite and difficulty in breathing to the Pulmonologist at District Headquarter Hospital Mardan.Diagnosis: The patient was initially diagnosed as COVID-19 suspected case. A oropharyngeal swab sample was positive by realtime RT-PCR tests.Lessons: This report highlights the importance of close coordination between clinicians and public health authorities as well as the importance of early laboratory-based confirmation of COVID-19 cases.

Fast Food, Nutrition Transition and Obesity in Pakistan: Policy and Programs to Address this issue

Pakistan is dealing with nutrition transition, obesity and non-communicable diseases along with children stunting, wasting and other problems of undernutrition. Ischemic Heart disease is the leading cause of death in Pakistan. Fast-Food and processed food industry's market share is increasing. They are using various strategies to exploit this large market. This paper starts with a description of the fast food industry and its rise in Pakistan. Furthermore, it suggests several policy and programs to deal with the problem of nutrition transition and obesity. This paper uses the framework of socio ecological model and social determinants of disease to suggest the intervention for the stated problems

Knowledge, Attitude and Practice Regarding Modifiable Risk Factors of Cardiovascular Diseases Among Adults in Rural Community, Lahore

Background: Cardiovascular diseases (CVD) are group of disorders of heart, blood and vessels. Major risk factors are hypertension, cigarette smoking, high fat, diabetes, obesity and physically inactive. In Pakistan, prevalence data for the Cardiovascular disease is sparse, and literature indicates that there is 30-40% of all deaths in Pakistan due to cardiovascular diseases. Objective: To assess the knowledge, attitude and practice regarding modifiable risk factors of cardiovascular diseases among adults in rural community, Lahore. Methods: This was descriptive cross-sectional study. Convenient sampling was used. Data were collected from adults of rural community Lahore. The sample size was 110. KAP questionnaire was used to collect the data. Ethical permission was obtained and data was analyzed by SPSS version 21. Results: The findings of the research were good knowledge with (67%) high response of correct answer of “Smoking is risk factor of CVD”. The attitudes were negative, (28%) high correct response for “Do exercise for good health”. The practices were very poor regarding the risk-factors of cardiovascular diseases.Conclusion: The knowledge of participants towards the risk factors of cardiovascular diseases was somehow better. The attitude was comparatively negative and practices were poor. No one was following regular exercises, dietary modifications, manage stress and smoking. Rural community people should modify their lifestyle to improve their practices. There is need for health education campaign in the rural community to minimize the risk factors of cardiovascular diseases.Int. J. Soc. Sc. Manage. Vol. 5, Issue-3: 76-82

Under-estimation of maternal and perinatal mortality revealed by an enhanced surveillance system: enumerating all births and deaths in Pakistan

BackgroundReliable and timely data on maternal and neonatal mortality is required to implement health interventions, monitor progress, and evaluate health programs at national and sub-national levels. In most South Asian countries, including Pakistan, vital civil registration and health information systems are inadequate. The aim of this study is to determine accurate maternal and perinatal mortality through enhanced surveillance of births and deaths, compared with prior routinely collected data.MethodsAn enhanced surveillance system was established that measured maternal, perinatal and neonatal mortality rates through more complete enumeration of births and deaths in a rural district of Pakistan. Data were collected over a period of 1 year (2015/16) from augmentation of the existing health information system covering public healthcare facilities (n = 19), and the community through 273 existing Lady Health Workers; and with the addition of private healthcare facilities (n = 10), and 73 additional Community Health Workers to cover a total study population of 368,454 consisting of 51,690 eligible women aged 18 to 49 years with 7580 pregnancies and 7273 live births over 1 year. Maternal, neonatal, perinatal and stillbirth rates and ratios were calculated, with comparisons to routine reporting from the previous period (2014–15).ResultsHigher maternal mortality, perinatal mortality and neonatal mortality rates were observed through enhanced surveillance compared to mortality rates in the previous 1.5 years from the routine monitoring system from increased completeness and coverage. Maternal mortality was 247 compared to 180 per 100, 000 live births (p = 0.36), neonatal mortality 40 compared to 20 per 1, 000 live births (p < 0.001), and perinatal mortality 60 compared to 47 per 1000 live births (p < 0.001). All the mortality rates were higher than provincial and national estimates proffered by international agencies based on successive Pakistan Demographic and Health Surveys and projections.ConclusionExtension of coverage and improvement in completeness through reconciliation of data from health information systems is possible and required to obtain accurate maternal, perinatal and neonatal mortality for assessment of health service interventions at a local level.

ACTIVITY MONITORING AND MEAL TRACKING FOR CARDIAC REHABILITATION PATIENTS

Heart disease has been ranked as the first cause for death in Pakistan along with being the leading cause of death worldwide (https://www.cdc.gov). Recovering heart patients need to monitor their diet and activity routines to mitigate chances of another occurrence (https://www.heart.org). The proposed application aims to provide a platform that would help patients to keep track of their activity, alongside allowing the patients to keep track of their diet; which will act as fitness monitoring for cardiac rehabilitation patients. Further more, activity classification algorithm used only seven features to shows classification into five different classes with accuracy of 98% in real time. Also, meal tracking module is designed to support the cardiac patients with timely feedback and notifications about their dietary routine.

Traumatic brain injury-a leading cause of death in Pakistan. A prospective study

Traumatic brain injury-a leading cause of death in Pakistan. A prospective study