دریوزہ گری
پابندِ سلاسلِ قسمت ،یہ خاک زاد
فگار سینے کے بل رینگتا ہوا
سڑکوں پراپنی بے پائی گھسیٹتا ہوا
کٹے ہوئے دست و بازو لہراتا ہوا
صدائے سوال بلند کرتا ہے
جس کی غلاظت بھری حریص سوچوں کی تلوار نے
خودی کا سر قلم کر دیا ہے
سڑک کے دوسری طرف سیاہ برقعے میں لپٹی دو خشمگیں نگاہیں
ہر گزرنے والے کو سوالیہ انداز میں دیکھتی ہیں
غربت...
The travel and tours enterprise were badly affected due to pandemics. In the aftermath of high restrictions on human movement, travel-based entrepreneurs were highly impacted due to lockdown. Due to pandemic, highly impacted into earning-saving, lack of supportive working conditions, lower self-capacity, and lack of recovery budget and policies, the travel and tours-based entrepreneurs were highly impacted. The study reflected the impact of pandemics on travel and tours, major constraints, and a possible way forward to sustaining. The research explores what are the major existing practices of sustaining travel and tours entrepreneurs during pandemics, what factors can contribute to building bounce-back capacities of travel and tours entrepreneurs’ sustainability. Above forty-four, snowball-based sampling was done from major travel and tours entrepreneurs, Pokhara-Nepal. A structure-based open-ended questionnaire, key informant interviews, and in-person-based discussion were applied in the method of study. Used the content analysis along with a recap of the research question, undertake bracketing to identify biases, operationalize variables with develop a coding, and code the data with undertaking analysis while qualitative analysis, and multiple regression facilitated on quantitative analysis to finalize the discussion. The study reflects that self-saving, social support, state and financial institutions recovery support, social behavior and change communication, full vaccination practices, and self-accountable tourist behavior are highly expectable conditions to the sustainability of travel and torus entrepreneurship in the learning area. The study concludes that self-saving capacity can contribute to bounce-back capacity for every entrepreneur. Social support and socioeconomic recovery packages were also contributing to sustaining travel and tours in the study area. Self-saving condition and capacity is higher bounce back capacity compared to non-saved entrepreneurs in the study area. Social support, socioeconomic recovery practices, and recovery packages from state and financial institutions were not at the higher level as expected.
Background: Gestational hyperglycaemia is associated with a higher incidence of adverse maternal and fetal outcomes than is seen in normal pregnancy. Untreated gestational diabetes mellitus (GDM) has an increased perinatal morbidity and mortality. Morbidity related to macrosomia includes shoulder dystocia with birth injury and perinatal asphyxia in the fetus. In the mother, macrosomia is a risk factor for genital tract injury, obstructed labour, uterine atony and increased risk of Caesarean section. Long term sequelae in the baby include obesity, development of type 2 diabetes mellitus, intellectual and neurological developmental problems. For the mother, GDM is a very strong risk factor for the development of type 2 diabetes later in life. Published studies show that after GDM, 35-60% of women develop type 2 diabetes within 10 years. Therefore it is prudent that gestational diabetes is diagnosed and appropriate treatment and monitoring instituted. Screening is an important component of the diagnostic process.
Objectives: To compare detection rates of the universal to the selective risk factor-based screening strategy for gestational diabetes mellitus.
Methodology: A prospective cross-sectional study involving 185 participants consecutively recruited at or less than 28 weeks gestation . All participants had their risk factors for gestational diabetes identified and recorded at the beginning of the study then underwent the 50g oral glucose challenge screening test. Detection rates and prevalence of universal and selective strategies were calculated and compared. An exploratory analysis of risk factors was also done.
Results: The Prevalence of an abnormal screening test in the sample with risk factors was 12.0% (95% CI: 6.0%, 17.9%) and in the sample without risk factors it was 19.1% (95% CI: 9.5%, 28.7%).
Conclusion: Overlap of confidence intervals indicates no evidence of a difference between the screening strategies. However despite the non-significant, higher detection rates by the universal strategy, clinical practice safety demands that as many cases of gestational diabetes as possible are detected because of adverse clinical correlates hence justifying universal screening.