Poor Class Research Articles

Enhancing Cover Management Factor Classification Through Imbalanced Data Resolution

This study addresses the persistent challenge of class imbalance in land use and land cover (LULC) classification within the Shihmen Reservoir watershed in Taiwan, where LULC is used to map the Cover Management factor (C-factor). The dominance of forests in the LULC categories leads to an imbalanced dataset, resulting in poor prediction performance for minority classes when using machine learning techniques. To overcome this limitation, we applied the Synthetic Minority Over-sampling Technique (SMOTE) and the 90-model SMOTE-variants package in Python to balance the dataset. Due to the multi-class nature of the data and memory constraints, 42 models were successfully used to create a balanced dataset, which was then integrated with a Random Forest algorithm for C-factor classification. The results show a marked improvement in model accuracy across most SMOTE variants, with the Selected Synthetic Minority Over-sampling Technique (Selected_SMOTE) emerging as the best-performing method, achieving an overall accuracy of 0.9524 and a sensitivity of 0.6892. Importantly, the previously observed issue of poor minority class prediction was resolved using the balanced dataset. This study provides a robust solution to the class imbalance issue in C-factor classification, demonstrating the effectiveness of SMOTE variants and the Random Forest algorithm in improving model performance and addressing imbalanced class distributions. The success of Selected_SMOTE underscores the potential of balanced datasets in enhancing machine learning outcomes, particularly in datasets dominated by a majority class. Additionally, by addressing imbalance in LULC classification, this research contributes to Sustainable Development Goal 15, which focuses on the protection, restoration, and sustainable use of terrestrial ecosystems.

Buying and selling in the Balkans: the case of Kosovo

The study analyzes from the anthropological viewpoint the transformation of trade relations, trade transactions, the inclusion of men and women of different ages, representatives of various ethnic groups, religions and strata of society in the circulation of goods and services in the territory of Kosovo/Kosovo and Metohija at the turn of the 20th-21st centuries. From a quiet “province” of the Ottoman Empire, royal Yugoslavia and the SFRY, the historical region has turned into the forefront of confrontation between both Balkan elites and international forces. Leaving aside, as far as possible, the multi-vector discussion regarding the status of the territory/region/state, the author focuses on the social and cultural aspects of the type of activity and economic sphere that directly and acutely affect all residents of the region without exception – be they Albanians, Serbs, Turks, Gorans or Roma, Muslims or Christians, rich, poor or middle class – namely, trade. Growing all over the world, both in the business community and among professional researchers studying culture and society, the interest in corporate anthropology is due to the importance of the ethnic factor in the development strategy of individual states and the global economy, and this involves the collection of empirical data and an attempt to assess the risks of conducting business, trade, scientific and other projects that directly affect people’s lives and influence their social “well-being”.

Groundwater geochemistry using modified integrated water quality index (IWQI) and health indices with special emphasis on nitrates and heavy metals in southern parts of Tirupati, South India.

Groundwater is particularly vulnerable to pollution in places with a high population density and extensive human usage of the land, especially in southern parts of Tirupati, India. To assess this, 60 bore-well samples were obtained and assessed for physical specifications, ion chemistry, and heavy metals during the pre- and post-monsoon seasons 2022. The current investigation employed a modified integrated water quality index (IWQI), conventional graphical and human health risk assessment (HHRA) of nitrates and heavy metals to know the groundwater chemistry and its detrimental health effects on humans. The major ions were analyzed using American public health association (APHA)standards, whereas heavy metals were analyzed using inductively coupled plasma optical emission spectrometry(ICP-OES). Additionally, pH Redox Equilibrium and C (PHREEQC),a geochemical model written in C programming language was employed to determine the saturation indices of mineral facies and ArcGIS 10.3.1 was used for spatial distribution patterns of IWQI. Then, the HHRA of nitrates and heavy metals was performed using United States environmental protection agency (USEPA)guidelines. The noteworthy outcomes include elevated levels of Ca2+, Mg2+, Cl-, NO3-, Cu,Fe, Mn, and Pb, demonstrating rock-water interaction, silicate weathering, Ca-Mg-HCO3 followed by mixed water facies, dissolution/precipitation, reverse exchange, and anthropogenic contamination are the major controlling processes in groundwater of southern Tirupati, India. The modified IWQI reveals that most groundwater samples (38%) fall under the bad quality class, with (47%) in the poor quality class and only (15%) classified as medium qualityclass in pre- and post-monsoon seasons. Elevated IWQI were observed in all directions except in the east, which is suitable for drinking. Moreover, the major hazard quotient (HQ) and hazard index (HI)for nitrates (NO3-) and heavy metals like copper(Cu), iron (Fe), manganese (Mn), lead (Pb) and zinc (Zn) are above the critical value of 1, revealing potential risk to humans, especially infants, followed by children and adults, entailing the instantaneous implementation of proper remedial measures and stringent policies to reduce the risk associated with groundwater pollution in the southern parts of Tirupati.

EVALUATION OF ORTHODONTIC TREATMENT NEED AND ITS ASSOCIATION WITH SELF-ESTEEM AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PATIENTS RECEIVING CARE AT SAIDU COLLEGE OF DENTISTRY, SWAT

Orthodontic treatment needs can impact both self-esteem and oral health-related quality of life (OHRQoL). The relationship between these factors, particularly in a developing region, remains underexplored. Objective: To investigate the relationship between orthodontic treatment needs, self-esteem and oral health-related quality of life among patients at Saidu College of Dentistry, Swat. Methods: This cross-sectional study was conducted at Saidu College of Dentistry, Swat and included 115 participants aged 8-30 years. Data were collected using the Index of Orthodontic Treatment Needs (IOTN), Rosenberg Self-esteem Scale and Oral Health Impact Profile (OHIP-14) over a six-month period. Demographic variables such as age, gender and socioeconomic status were also analyzed. Descriptive statistics and statistical tests such as chi-square and t-tests were employed to evaluate associations between variables, with significance set at p < 0.05. Results: Of the 115 participants, 59.1% were male and 40.9% were female. Age groups were distributed as 33% (8-15 years), 39.1% (15-22 years) and 27.8% (22-30 years). Socioeconomic analysis revealed that 25.2% belonged to the upper class, 49.6% to the middle class and 25.2% to the poor class. Severe orthodontic treatment needs were identified in 36.5% of participants. Self-esteem scores were unaffected by gender, age, or socioeconomic status. In contrast, oral health impact scores were notably high, with a mean OHIP-14 score of 19.77±17.7, indicating a significant need for comprehensive oral health care. Conclusion: Despite high orthodontic treatment needs, participants exhibited stable self-esteem levels, suggesting resilience in psychosocial health. The findings emphasize the strong connection between orthodontic needs, OHRQoL and patient demographics, providing important insights for oral health professionals in addressing both clinical and psychological aspects of care.

Evaluation of gold mineralisation potential using AHP systems and weighted overlay analysis

The demand for sustainable development goals and the absence of systematic development and organised exploration for gold has prompted this study to integrate magnetic and radiometric datasets with lithology to evaluate the gold mineralisation potential in the Ilesha schist belt. This study considers 3168.72 km2 of the Ilesha schist belt in southwestern Nigeria, a frontier belt for gold deposits. The high-resolution airborne magnetic and radiometric datasets were processed using enhancement techniques, including the analytical signal, lineament density, and K/Th ratio. CET grid analysis, Euler deconvolution, and analytical signal depth estimation methods were used to aid the interpretation. The spatial integration and interpolation were performed using the Analytical Hierarchy Process (AHP) and weighted overlay analytical tools within the ArcGIS environment. The dominant structural controls for potential mineralisation are ENE–WSW and ESE–WNW trends. The depth of the magnetic sources revealed by the analytical signal ranged from 63.17 to 629.47 m, while depths ranging from 47.32 to 457.22 m were obtained from Euler deconvolution. The delineated highly magnetic edge sources, dense lineaments, radiometrically highlighted alteration zones, and lithological hosts for gold mineralisation were integrated to establish the gold mineralisation potential map. The AHP deductions reveal that 10.52% of the study site is within the high mineralisation potential class, a remarkable 60.39% falls within the moderate class, a significant portion (28.86%) falls within the poor class, and 0.23% is considered unfavourable. The result was optimised by validation using known mines, with 94% (i.e., 15 out of 16 mining sites) plotting within the high mineralisation potential class. This assessment provides invaluable insight for stakeholders and policymakers to embark on gold exploration and exploitation and promote sustainable mineral development.

Preoperative measures of pain at rest and movement-evoked pain in knee arthroplasty: Associations with pain and function outcome trajectories from a prospective multicentre longitudinal cohort study.

The study of pain at rest (PAR) and movement-evoked pain (MEP) in persons with musculoskeletal pain has received substantial attention. Despite strong interest, relatively little attention has been directed to the psychometric development of these constructs. Our purpose was to explore the relationship between PAR and MEP and to examine the prognostic utility of these measures in persons with knee arthroplasty. We used prospectively collected data from persons scheduled for knee arthroplasty who had moderate to high levels of pain catastrophizing. Preoperative latent variables for PAR and MEP were developed and used to determine if they were associated with a binary latent variable of good versus poor pain and function outcome trajectories. Factor correlations were used to determine the extent to which the variance for PAR and MEP was overlapping. PAR and MEP are significant predictors of good versus poor pain and function classes. Odds ratios ranged from 1.21 to 1.64 (p < 0.001) indicating a significant increase in the likelihood of poor outcome. Correlation between PAR and MEP latent variables was high (r = 0.89; 95% CI: 0.86-0.92) indicating substantially overlapping variance. PAR and MEP, as defined in our study, can be used to make prognostic judgements regarding risk of poor postoperative outcome trajectory following knee arthroplasty. However, PAR and MEP showed substantially overlapping variance indicating that measurements of both are not necessary when making prognostic assessments. Preoperative PAR and MEP latent variables, as defined in our study, had prognostic significance for 1 year pain and function outcome trajectories. PAR and MEP latent variables had substantially overlapping variance which suggested that only one is needed to make prognostic judgements. The prognostic significance of PAR and MEP as well as their substantially overlapping variance is new to the field prognostic research in knee arthroplasty.

Representation Strategies of the Rich and Poor Classes in the Squid Game

The Squid Game's high ratings are well documented, and although the Squid Game is a battle royale type of episode, it contains many depictions of class inequality as well as the power of choice. The episodes use stark contrasts of colour and setting to establish situations of identity inequality for the audience. Inequality of identity also means inequality of choice and having to be forced to keep the game going. By analysing the images and plot of the episode, the game is used as a vehicle for the reality of class inequality.

SOSIALISASI HUKUM RIBA TERHADAP PENGGUNA GOPAYLATTER DI DESA BERINGAN KECAMATAN ALALAK KABUPATEN BARITO KUALA

The Islamic ban of usury is an attempt to eradicate economic injustice. This is against Islamic teachings, which emphasize helping the poor and middle class so that the wealthy don't take advantage of them. Reason being that Islamic economics teaches a commitment to social order and humanity, while also rejecting the idea of injustice and the vicious cycle it creates, which in turn leads to poverty. Users of Gopaylartter in Beringin Village, Alalak District, Barito Kuala Regency will be educated on usury legislation and given an overview of Islamic perspectives on debt and credit, which do not include usury. Although there are still obstacles to solve before Islamic banking can be more widely and effectively implemented, there have been good outcomes from socializing usury legislation on GoPayLater users, such as improved knowledge, comprehension, and interest.

AS THE IMPOVERISHED GET EVEN POORER: AN ANALYSIS ON THE IMPACT OF PHILIPPINE TRAIN LAW TO THE MINIMUM WAGE EARNER

In the Philippines, the TRAIN Law or tax reform for acceleration and inclusion legislation was put into effect in 2018. This law sought to significantly alter the nation's tax structure in order to increase money for poverty alleviation, healthcare, and infrastructure. One of the features of the law was to increase the income threshold below which minimum wage earners would not be required to pay income tax. But it also resulted in higher costs for goods and services, which had an effect on Metro Manila's level of living. This qualitative research examines the significant data and information based on the participant's experiences with the TRAIN law. Semi-structured questions were used in the in-depth interview to facilitate deeper clarification and additional discussion. The results show that the majority of the impact of the law on the poor is related to basic needs like food, for which they must cut their budget in order to survive because there are other expenses to consider, such as utility bills and debts. Moreover, it impacts an individual's emotional and overall health, including mental health concerns brought on by financial difficulties. Additionally, it has an impact on their social interaction because they tend to engage with others less frequently because they are preoccupied with the things that need significant financial outlays. Thus, it may be inferred that the poor income class households' standard of living declined with the introduction of TRAIN law. KEYWORDS: tax reform law, poverty alleviation, minimum wage earner

The Student Labor Camp Movement, Postcolonial Development, and the Shaping of Citizens-to-Be in Independent India, 1954–65

The Government of India organized over ten thousand student labor camps for the purposes of village development between 1954 and 1965. This camp movement functions as a key to the novel idealizations of youth in the postcolonial world and the shifting development agendas of independent India. The image of the toiling and vigorous camper committed to serving the newly created nation-state came to be constructed as India's model citizen-to-be, and this figure embodies the emergent forms of postcolonial nationalist politics and ideologies of the 1950s and 1960s. This youthful labor force was depicted in the developmentalist imagination of India as literally building and metaphorically embodying the nation-state and its ideologies of physical fitness, secularism, anti-casteism, and national discipline. This article will argue that camp life negotiated a hierarchy of citizens that made the educated youth the agent of development and the villager the object of development. The running of these camps by volunteer movements such as the National Cadet Corps, the Bharat Scouts and Guides, and the Bharat Sevak Samaj brings to light how the developmental apparatus in India worked or did not work in practice for the students and the poorer classes.

Research on the trajectory and influential factors of poly-victimization: A longitudinal study of Chinese adolescents

BackgroundPoly-victimization is more detrimental to adolescents' physical and mental health than is a single type of victimization. However, there has been limited research on the trajectory of poly-victimization among Chinese adolescents. ObjectiveIdentify the different developmental trajectories of poly-victimization among Chinese adolescents over time and examine the influencing factors of poly-victimization trajectories. MethodsData from four surveys conducted between 2020 and 2022, encompassing a cohort of 319 adolescents who had experienced poly-victimization, were utilized to identify their developmental trajectories via group-based trajectory modeling. Potential influencing factors were screened and compared using ANOVA or chi-square tests, while factors affecting the developmental trajectories of poly-victimization were analyzed through multinomial logistic regression. ResultsWe identified three poly-victimization trajectories among adolescents: increasing poly-victimization (n = 39, 12.2 %), relieved poly-victimization (n = 228, 71.5 %), and fluctuating poly-victimization (n = 52, 16.3 %). Our findings indicate that boys, and those with poor class grade ranking, a lower level of parental education, lower household economy, smoking, drinking, suicide attempts, and suicide ideation, constitute the primary focus for the prevention and treatment of poly-victimization. ConclusionWe identified three poly-victimization trajectories, highlighting a significant heterogeneity in poly-victimization development. Understanding the characteristics of these developmental trajectories is crucial for realizing the dynamics of different poly-victimization subgroups and informing effective interventions.

The Development of Mutual Aid Tontines in Nineteenth Century Ireland

A tontine is a shared fund in which surviving investors benefit financially from the deaths of other members. Since the mid-seventeenth century it has been used variously across Europe as a tool to raise state revenue, as a private investment tool, and as a method to raise capital for building projects. In nineteenth-century Ireland, the tontine developed to include a mutual aid scheme directed at the country's working classes and poor. This form of tontine existed within a wider sphere of microcredit and microfinance instruments – including loan funds, pawnbrokers and Mont de Piété banks - directed at Ireland's poorer classes. These provided services to a section of Irish society neglected by the country's banks and other financial institutions. The mutual aid tontine was therefore very much an indigenous financial instrument developed for the needs of Irish society. Like the Irish themselves it travelled. The scheme also proved to be popular in England during the nineteenth century, predominantly in areas of high Irish immigration. This article argues that this was as a direct result of the transplantation of Irish communities and support structures into England.

Genetics of immune response to Epstein-Barr virus: prospects for multiple sclerosis pathogenesis.

Epstein-Barr virus (EBV) infection has been advocated as a prerequisite for developing multiple sclerosis (MS) and possibly the propagation of the disease. However, the precise mechanisms for such influences are still unclear. A large-scale study investigating the host genetics of EBV serology and related clinical manifestations, such as infectious mononucleosis (IM), may help us better understand the role of EBV in MS pathogenesis. This study evaluates the host genetic factors that influence serological response against EBV and history of IM and cross-evaluates them with MS risk and genetic susceptibility in the Swedish population. Plasma IgG antibody levels against EBV nuclear antigen-1 [EBNA-1, truncated = amino acids (aa) (325-641), peptide = aa(385-420)] and viral capsid antigen p18 (VCAp18) were measured using bead-based multiplex serology for 8744 MS cases and 7229 population-matched control subjects. The MS risk association for high/low EBV antibody levels and history of IM was compared to relevant clinical measures along with sex, age at sampling, and associated HLA allele variants. Genome-wide and HLA allele association analyses were also performed to identify genetic risk factors for EBV antibody response and IM history. Higher antibody levels against VCAp18 [odds ratio (OR) = 1.74, 95% confidence interval (CI) = 1.60-1.88] and EBNA-1, particularly the peptide (OR = 3.13, 95% CI = 2.93-3.35), were associated with an increased risk for MS. The risk increased with higher anti-EBNA-1 IgG levels up to 12× the reference risk. We also identified several independent HLA haplotypes associated with EBV serology overlapping with known MS risk alleles (e.g. DRB1*15:01). Although there were several candidates, no variants outside the HLA region reached genome-wide significance. Cumulative HLA risk for anti-EBNA-1 IgG levels, particularly the peptide fragment, was strongly associated with MS. In contrast, the genetic risk for high anti-VCAp18 IgG levels was not as strongly associated with MS risk. IM history was not associated with class II HLA genes but negatively associated with A*02:01, which is protective against MS. Our findings emphasize that the risk association between anti-EBNA-1 IgG levels and MS may be partly due to overlapping HLA associations. Additionally, the increasing MS risk with increasing anti-EBNA-1 levels would be consistent with a pathogenic role of the EBNA-1 immune response, perhaps through molecular mimicry. Given that high anti-EBNA-1 antibodies may reflect a poorly controlled T-cell defence against the virus, our findings would be consistent with DRB1*15:01 being a poor class II antigen in the immune defence against EBV. Last, the difference in genetic control of IM supports the independent roles of EBNA-1 and IM in MS susceptibility.

Groundwater Potential Assessment in the Rural Loulouni Municipality (Southern Mali): Decision Tree Approach

Groundwater Potential Assessment in the Rural Loulouni Municipality (Southern Mali): Decision Tree Approach

Access to specialized health care services among older Canadians.

Canada is experiencing rapid population aging, which has a wide range of implications, including an increased need for health care services. However, very few studies have examined use of specialized health care services (e.g., visits to medical specialists, non-emergency tests, and surgeries) among older Canadians. Data from the Canadian Health Survey on Seniors - 2019/2020 were used to examine specialized health care service use among older Canadians. Latent class analysis was calibrated using a nationally representative sample of 39,047 Canadians aged 65 years or older to identify distinct patterns of need factors related to health care service use. Multivariable logistic regression, stratified by gender, was used to examine the association of predisposing characteristics, enabling resources, and need factors with specialized health care service use. In 2019/2020, an estimated 2.6 million older Canadians (43.4%) visited medical specialists, 1.4 million (23.2%) got non-emergency tests, and 0.6 million (10.4%) had non-emergency surgeries. Among those, 15.6% reported experiencing difficulties accessing services. Women were less likely than men to have visited medical specialists and have received non-emergency tests. Lower education was consistently associated with lower odds of specialized health care service use. Individuals in the multimorbidity, high stress-multimorbidity-disability, and poor physical and mental health classes were more likely than those in the comparatively healthy class to use specialized health care services and to experience difficulties accessing them. Findings of this study highlight gender differences and the importance of considering multidimensional need factors - ranging from physical health to mental health to psychosocial factors - in examining use of specialized health care services.

Revisiting Equity in Urban Operations Management 50 Years Later: What do City Planners Have to Say?

The persistent inequities in American cities—long recognized and lived by black and Hispanic people and other minorities, the poor and working class, and others disadvantaged by urban systems—have been vaulted into the broader public consciousness over the past decade. Lessening entrenched urban inequalities is now at the top of the national policy agenda, suggesting a need and opportunity for more urban operations management. On what issues and how might this work occur? Operations management was deeply intertwined with urban planning in research and practice from the 1950s through the 1970s, at which point the fields diverged. To build a case for what perspectives and approaches a modern urban operations management agenda might employ to address inequity, I synthesize historical and contemporary planning theory with the debates among reflective operations scholars in the 1950s-1970s over work on cities. Modern operations scholars can look to planning, and especially to recent major shifts in its thinking on race and class, to address urban operations that disadvantage some city residents and overly advantage others. This urban operations agenda should be empirical, equity-oriented, and community-focused in order to best resonate with planners and the city residents they serve. In reengaging with planners to tackle the modern range of urban policy problems, operations analysts have a chance to contribute practical clarity on how cities work and can be made more livable for all residents.

Implementation of K-Nearest Neighbor using the oversampling technique on mixed data for the classification of household welfare status

Welfare is closely related to poverty and the socio-economic disparities in a society. Based on data from the Central Bureau of Statistics, Kulon Progo in Indonesia had the highest poverty rate in the province of the Special Region of Yogyakarta; an increasing trend was observed every year from 2019 to 2021; Kulon Progo also had a low poverty line (after Gunung Kidul) compared to other regencies/cities in this province. This study aimed to classify the household welfare status in Kulon Progo in March 2021 using the K-Nearest Neighbor (KNN) method. Since imbalance was found between the poor and non-poor classes, an oversampling technique was employed. Imbalanced data affect classification, particularly when predicting the results of the classification. The following oversampling techniques were employed in this study: Random Oversampling (RO), the Adaptive Synthetic (ADASYN) and the Synthetic Minority Oversampling Technique (SMOTE). It was found that, of the three techniques, RO was the most efficient with k = 5, which yielded the best performance in terms of sensitivity, specificity, the G-mean, and accuracy reaching 0.643, 0.805, 0.719, and 78.873%, respectively. Therefore, it can be concluded that the classification model performed well enough to classify household welfare status, especially among the poor (minority class).

Design and baseline characteristics of SALT-HF trial: hypertonic saline therapy in ambulatory heart failure.

Hypertonic saline solution (HSS) plus intravenous (IV) loop diuretic appears to enhance the diuretic response in patients hospitalized for heart failure (HF). The efficacy and safety of this therapy in the ambulatory setting have not been evaluated. We aimed to describe the design and baseline characteristics of the SALT-HF trial participants. 'Efficacy of Saline Hypertonic Therapy in Ambulatory Patients with HF' (SALT-HF) trial was a multicenter, double-blinded, and randomized study involving ambulatory patients who experienced worsening heart failure (WHF) without criteria for hospitalization. Enrolled patients had to present at least two signs of volume overload, use ≥ 80mg of oral furosemide daily, and have elevated natriuretic peptides. Patients were randomized 1:1 to treatment with a 1-h infusion of IV furosemide plus HSS (2.6-3.4% NaCl depending on plasmatic sodium levels) versus a 1-h infusion of IV furosemide at the same dose (125-250mg, depending on basal loop diuretic dose). Clinical, laboratory, and imaging parameters were collected at baseline and after 7days, and a telephone visit was planned after 30days. The primary endpoint was 3-h diuresis after treatment started. Secondary endpoints included (a) 7-day changes in congestion data, (b) 7-day changes in kidney function and electrolytes, (c) 30-day clinical events (need of IV diuretic, HF hospitalization, cardiovascular mortality, all-cause mortality or HF-hospitalization). A total of 167 participants [median age, 81years; interquartile range (IQR), 73-87, 30.5% females] were randomized across 13 sites between December 2020 and March 2023. Half of the participants (n=82) had an ejection fraction >50%. Most patients showed a high burden of comorbidities, with a median Charlson index of 3 (IQR: 2-4). Common co-morbidities included diabetes mellitus (41%, n=69), atrial fibrillation (80%, n=134), and chronic kidney disease (64%, n=107). Patients exhibited a poor functional NYHA class (69% presenting NYHA III) and several signs of congestion. The mean composite congestion score was 4.3 (standard deviation: 1.7). Ninety per cent of the patients (n=151) presented oedema and jugular engorgement, and 71% (n=118) showed lung B lines assessed by ultrasound. Median inferior vena cava diameter was 23mm, (IQR: 21-25), and plasmatic levels of N-terminal-pro-B-type natriuretic peptide (NTproBNP) and antigen carbohydrate 125 (CA125) were increased (median NT-proBNP 4969pg/mL, IQR: 2508-9328; median CA125 46U/L, IQR: 20-114). SALT-HF trial randomized 167 ambulatory patients with WHF and will determine whether an infusion of hypertonic saline therapy plus furosemide increases diuresis and improves decongestion compared to equivalent furosemide administration alone.

Less than one in four mothers get quality intrapartum health care services in Ethiopia

Intrapartum care is a platform of comprehensive healthcare for pregnant women that is designed to improve birth outcomes for mother and child. However, complications during the intrapartum period continued to be the leading cause of death for women of reproductive age and newborns. Therefore, the aim of this study was to assess the prevalence of quality of intrapartum care and its associated factors among mothers in Ethiopia. A community based cross sectional study was conducted among 4469 mothers who gave birth in the last 2 years. Quality of intrapartum care was analyzed based on the assessment of health facility delivery, skilled birth attendants and early initiations of breast-feeding. Stata version 14 software was used for data cleaning and analysis. A mixed effect multilevel logistic regression was conducted to determine factors associated with quality of intrapartum care. An adjusted odds ratio with 95% confidence interval and a P value of less than or equal to 0.05 was used for the identification of both individual and community level factors. Overall, the prevalence of quality intrapartum care in Ethiopia was 23.8% (95% CI 22.6, 25.13). Primary education (AOR = 1.46, 95% CI = 1.14, 1.88), rich household class (AOR = 1.48, 95% CI = 1.10, 1.98), history of ANC (AOR = 2.91, 95% CI = 2.18, 3.86), perceived distance to the health facility as not a big issue (AOR = 1.63, 95% CI = 1.30, 2.05), urban residence (AOR = 2.97, 95% CI = 1.93, 5.09), Tigray region (AOR = 5.01, 95% CI = 1.25, 20.59), community level poverty (AOR = 0.63, 95% CI = 0.41, 0.97), and having 2–4 children (AOR = 0.74, 95% CI = 0.56, 0.97) were significantly associated with quality of intrapartum care. The finding conclude that less than one in four mothers received good quality intrapartum care. In order to optimize the quality of intrapartum care, the government should empower women through extensive education. It is also recommended for the Ministry of Health to evaluate the health facilities and community health workers to increase coverage of ANC and provide financial assistance to rural residents and the poor household class.

Bacteriological Study and Antibacterial Susceptibility in Ludwig’s Angina in a Tertiary Level Hospital in Dhaka, Bangladesh

Background: The knowledge of the local pattern of infection and antibacterial sensitivity in Ludwig’s angina is essential to enable efficacious treatment for it. Objective: To find out the pattern of bacteria responsible for developing Ludwig’s angina and their antibacterial susceptibility. Methods: It is a prospective, observational type of study carried out in the Department of Otolaryngology &amp; Head-Neck Surgery, Dhaka Medical College Hospital, Dhaka, and the Department of Clinical Microbiology, ICDDR, B, Dhaka, Bangladesh, between April and September of 2016. A total of 100 patients were included in this study. Results: This study was done among 100 patients. In this study, 42 cases (42%) were in the 31-45 years age group. The male patients were 60 (60%) and females were 40 (40%). Majority of patients 70(70%) came from poor class family with educational level up to HSC (75%), maximum 35(35%) patients use meswak to clean teeth, 70 (70%) patients came from rural area, 70 (70%) patients had dental infection, 25 (25%) patients had diabetes mellitus, all the cases (100%) presented with swelling in the floor of the mouth and neck, pain and tenderness and fever. The major complication was necrotizing fasciitis 8 (8%), 36 (36%) patients were discharged within 1-2 weeks after treatment, Streptococcus 40 (40%) was the most common organism and the most effective antibiotic was Ceftriaxone (65%). Conclusion: The most frequently isolated organism in Ludwig’s angina is Streptococcus and sensitivity results showed a majority of isolates are susceptible to Ceftriaxone. Mugda Med Coll J. 2023; 6(2): 71-76