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Under-five mortality in Pakistan: the role of breastfeeding and immunization

Thesis Info

Author

Memon, Sumaya Falak

Program

MS

Institute

Institute of Business Administration

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2019

Page

29

Subject

Medicine

Language

English

Other

CallNo: 614.47

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676720939819

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Despite huge advancements in medical science and continuous focus on health issues and suggested interventions by local and international agencies, child mortality is still endemic. The world has experienced tremendous declines in under-five mortality since the 1960s but the disparity, however, is so profound and vivid that at the global level, there exist almost 60-fold variation in infant mortality rates between high and low mortality countries (Schell et al., 2007). The world Mortality Report 2017 by the UN explains that part of the reason for these huge disparities lies in the disproportionate progress in health and development, which manifests itself in inequalities in access to safe drinking water, food, sanitation, medical care, and other basic facilities. This research endeavor is an attempt to quantify the role of such policy variables like breastfeeding and immunization in reducing under-five mortality in the context of Pakistan. The study controls various determinants including skilled medical care, maternal factors and like. For this objective, data from the most recent rounds (2012-13 and 2017 18) of Pakistan Demographic and Health Survey (PDHS) is pooled. The sample in this survey is representative of the national and provincial levels. All children under the age of five born five years before each survey are the unit of analysis for this study. The instrumental variable-probit model was used to examine the association of breastfeeding and immunization with under-five mortality on a sample of 26,613 births across two age groups (infants aged 0-11 months and under-five aged 0-59 months). The results indicate that breastfeeding has a strong and highly significant negative impact on both infant and under-five mortality even after controlling for factors such as child characteristics, mother characteristics and household characteristics. This study finds that for every increase in the average number of vaccinations of children under five at the household level the under-five mortality decreases by 1.1 percent and infant mortality by 0.6 percent. Also, every child who is ever breastfed as compared to never breastfed has about a 33 percent lesser probability of succumbing to death. The results of the study signify an important role of these policy variables in reducing under-five mortality and to bringing mortality rates in line with the Sustainable Development Goals targets
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ڈاکٹر شجاعت علی سندیلوی

ڈاکٹر شجاعت علی سندیلوی
دسمبر کے آخری عشرے میں اردو کے ایک بڑے عاشق و مجاہد، اچھے استاد اور صاحب قلم ڈاکٹر شجاعت علی سندیلوی چل بسے۔ وہ ۱۹۱۶؁ء میں اودھ کے مشہور قصبہ سندیلہ کے ایک علمی خانوادے میں پیدا ہوئے، ان کے والد مولوی عنایت علی صدیقی بھی ذی علم شخص تھے۔
شجاعت صاحب کا اصل مشغلہ درس و تدریس تھا۔ ممتاز ڈگری کالج اور لکھنو یونیورسٹی میں اردو کی تدریسی خدمات دے کر سبکدوش ہوئے تو اپنے گھر پر اور اردو اکاومی میں طلبہ کو اردو پڑھاتے رہے۔
انہوں نے ’’حالی بحیثیت شاعر‘‘ کے عنوان سے تحقیقی مقالہ لکھ کر پی۔ایچ۔ڈی کی ڈگری لی، ان کا یہ مقالہ کتابی صورت میں چھپ کر مقبول ہوچکا ہے جو حالی پر مستند اور معیاری کام ہے، اس کے علاوہ بھی متعدد ادبی، تنقیدی اور تحقیقی کتابیں یادگار چھوڑیں۔ اردو اور ہندی کی بعض نصابی کتابیں بھی ترتیب دیں۔ وہ اردو کی مختلف تنظیموں سے وابستہ تھے۔ انجمن ترقی اردو اور اترپردیش انجمن اساتذہ اردو کے سرگرم ممبر تھے۔ ادارہ فروغ اردو سے ان کا گہرا تعلق تھا۔ اس کے ماہانہ رسالہ فروغ اردو کے خاص نمبروں کی ترتیب و تدوین میں ان کا بھی حصہ تھا۔
مرحوم اودھ کی روایتی شرافت، وضع داری، تواضع اور اخلاق کا نمونہ اور بڑی پاکیزہ اور دلکش شخصیت کے حامل تھے، راقم کو ان سے دو ایک بار ہی ملنے کا اتفاق ہوا مگر ان کے خلوص، انکسار، شرافت اور شائستگی کا نقش اب تک دل میں بیٹھا ہوا ہے۔
اردو کے اس بحرانی دور میں اس کے ایسے مخلص اور سراپا عمل خدمت گزار کا اٹھ جانا بڑا حادثہ ہے، اﷲ تعالیٰ ان کی مغفرت فرمائے اور ان کے پس ماندگان خصوصاً چھوٹے بھائی شفاعت علی صدیقی صاحب کو صبر و شکیب عطا فرمائے۔ یہ سطریں تحریر کی جاچکی...

Impact of Military Wars/Conflicts on Pakistan-India Relations

South Asia and Indian subcontinent have historically been regions of geo-strategic importance. They have been the most sought-after territories for every major World Player in each era. As a result of independence from the British in 1947, Pakistan and India emerged as two sovereign states, however, at loggerheads with each other since their very inception. The two countries have fought four deadly wars (1947-48, 1965 & 1971), including one (Kargil) after attaining the status of nuclear powers. One commonality in all these wars has been the unresolved Kashmir Issue, which remains the sorest point in the Pak-India ties to-date. These wars and many others military conflicts have resulted in the breach of peace for the region causing a much-feared nuclear threat, economic losses, disruption of social and cultural ties etc. For greater world peace, Pakistan and India need to resolve their differences/issues through bilateral negotiations, as war is no solution to any problem. For this purpose, political leadership of both the countries will have to intelligently carve out a plan to achieve the objective of peace and tranquility in the region. Both the countries need to realize that neighbours cannot be wished away. Peace in South Asia is synonymous to peace in the world.

Segmentationandclassificationofbraintumormrimages Throughadvancemachinelearning Methods

The main objective of this research work is to develop, test and evaluate an identification support system that is able to provide accurate, fast and reliable diagnosis of brain tumor in MRimages. Keeping in consideration that human decision making skills are mainly dependent on experience and prone to error due to fatigue, Artificial Intelligence (AI) can be utilized as an effective aid in the field of medicinal sciences for tumor diagnosis through image recognition. Therefore, this thesis strives to develop such an intelligent system that can be used for the segmentation and classification of infiltrative brain tumors known as Low Grade and High Grade in MR images. In order to tackle the complex task of brain tumor segmentation in MR images, we present an adaptive algorithm that formulates an energy based stochastic segmentation with a level set methodology. This hybrid technique efficiently matches, segments and determines the anatomic structures within an image by using global and local energies. After evaluating the algorithm on low and high grade images, it was noted that there was an improvement in the resultant similarity between segmented and truth (original) images. Once effective segmentation was achieved we could then work on the next step of tumor identification; classification. In the second part of the process we proposed two classification frameworks, machine learning and deep learning. In machine learning, we first extracted 22 probabilistic features using gray level co-occurrence matrix methodology that served as input features for the classifiers. Then we showed the improvement in classification (through machine learning) accuracy by providing two methodologies in which the first one involved v classification directly after feature extraction whereas in the second we reduced the extracted features using principal component analysis and then applied those reduced features to several classifiers. The second framework that we proposed was the brain tumor classification of segmented MR images through optimized CNN-Deep belief learning model. It scales to various image sizes by distributing the hyper-parameters and weights among all locations in an image. The presented model is translation invariant and is compatible with top-down and bottom-up probabilistic inference. This hierarchical classifier was optimized by regularization, that mitigates the effect of overfitting for small datasets, stochastic gradient decent, which works efficiently by utilizing only a small set of samples from a whole training set to infer the gradient and fine tuning of constraints. A comparative analysis, based on accuracy, error/loss and computation time, was carried out between the pre-processed non-segmented and segmented MR images after classification was completed. The results showed that the accuracy of proposed optimized CNN-deep belief learning classifier with segmented MR images was higher while the loss and execution time were reduced. These methodologies transcend the confines of MR image processing due to their effective modularity allowing them to be suitable for other medical imaging and computer vision tasks.