Introduction: Physiotherapy exercises administered to preterm infants in the NICU can enhance motor skills and expedite the discharge process for infants born before 30 weeks of gestational age. The research delves into the influence of physiotherapy programs on these preterm infants' activity and participation levels. Methods: The intervention group received a one-month physiotherapy program including massage around the mouth, mobilization and weight-bearing exercises, and massage therapy for the extremities, while the control group did not. The motor skills were evaluated by the Test of Infant Motor Performance (TIMP), Dubowitz Neurological examination, and Preterm Oral Feeding Readiness Scales (POFRAS). Results: There was a significant difference in The TIMP, Dubowitz Optimal Score, Type of Non-Invasive Ventilation, TIMP Range, and POFRAS scores in the physiotherapy group rather than the control group (p<0.05). There were no differences in the length of stay in the NICU, respiration rate, heart rate, body temperature, oxygen saturation, body weight on the evaluation day, body weight at discharge, head circumference at discharge between the groups (p>0.05) Discussion: We conclude that physiotherapy in NICU improves the motor outcomes, activity and participation in preterm infants rather than the body functions and structure like vital signs and infants’ body weight.

Objective: The private healthcare providers (PHCP) are believed to improve access to healthcare services in Public-Private Mix (PPM) projects, as they are considered first point of contact for healthcare. The purpose of this study was to know the satisfaction level of TB patients. Design: A questionnaire-based, cross-sectional study was carried out during November and December 2017 for 572 under-treatment patients registered with PHCPs in the PPM project. Lot quality assurance sampling technique was used to randomly select 19 districts from sample frame of 75 districts. In each selected district, data collector retrieved TB register of 8 months (Jan – Aug 2017) and systematically selected patients by fixed periodic interval. SPSS (version 24.0) was used to analyze the data. Results: Study included 53% (n=301) of males and 47% (n=271) of females, with mean age of 38 years (SD, ±18). Almost half of the participants were illiterate (51%, n=289) and 64% (n=365) were non-earning members of the family. In practice, most of the participants visit private providers (71%, n=407), including private hospital/clinic (44%) and traditional practitioners (27%; n=153). 55% of participants visited the current doctor because of clinic’s proximity to residence. 82% of the participants (n=469) were satisfied with the TB care services and 85% (n=488) said that they would recommend this clinic to others. Conclusion: PHCPs are preferred providers for individuals, which is consistent with findings of other studies. Though they are satisfied with TB care and services, interventions should be introduced to reduce the financial burden on the patient. Partnering PHCP is a way forward to ensure universal health coverage, health system strengthening and better health outcomes of the population.

Abstract: Nonlinear spectrum distortions are caused by the peculiarities of the operation of charge-coupled device elements (CCD), in which the signal exposition time (TINT) is one of the significant parameters. A change of TINT on a CCD leads to a nonlinear distortion of the resulting spectrum. Nonlinear distortion of the spectrum, in its turn, leads to errors in determining the central wavelength of Fiber Bragg Gratings (FBG) and spectrally sensitive sensors, which, in general, negatively affects the accuracy of measuring systems. The paper proposes an algorithm for correcting nonlinear distortions of the spectrum obtained on a spectrum analyzer using CCD as a receiver. It is shown that preliminary calibration of the optical spectrum analyzer with subsequent mathematical processing of the signal makes it possible to make corrections in the resulting spectrum, thereby leveling the errors caused by measurements at different TINT.

Tuberculosis (TB) associated stigma is well-documented phenomenon that may contribute to sub-optimal TB care in Pakistan. The objective of study was to assess TB related knowledge and perceived stigma among community members. This was cross-sectional survey using convenience sample of 183 individuals recruited between October and December 2017. A validated stigma measurement tool developed by Van Rie et al. was adapted. Data was analyzed using SPSS version 20.0. 183 individuals (73% males; n = 134) participated in survey. Eighty-seven percent were aware that TB is curable disease (n = 159) and 91% thought that it could be transmitted by coughing (n = 167). However, respondents also thought that TB was spread through contaminated food (73%; n = 134), sharing meals (55%; n = 100), sharing utensils (53%; n = 96) and by having sexual intercourse with a TB patient (51%; n = 93). Fifty-seven percent (n = 104) associated TB with high levels of stigma. Persons who had less than six years of education (crude OR = 1.2; 95% CI: 0.89, 1.72) and lacked knowledge that TB is curable (crude OR = 3.42; 95% CI: 1.20, 9.70) were more likely to associate TB with stigma. In addition, females (crude OR = 1.33; 95% CI: 0.87, 2.04) and those who were unemployed (crude OR = 1.06; 95% CI: 0.65, 1.74) were also more likely to associate TB with stigma. We found an association between lack of knowledge about TB and perceived stigma. This highlights need for improved education and awareness about TB.

Background Increasingly, healthcare organizations are using technology for the efficient management of data. The aim of this study was to compare the data quality of digital records with the quality of the corresponding paper-based records by using data quality assessment framework. Methodology We conducted a desk review of paper-based and digital records over the study duration from April 2016 to July 2016 at six enrolled TB clinics. We input all data fields of the patient treatment (TB01) card into a spreadsheet-based template to undertake a field-to-field comparison of the shared fields between TB01 and digital data. Findings A total of 117 TB01 cards were prepared at six enrolled sites, whereas just 50% of the records (n=59; 59 out of 117 TB01 cards) were digitized. There were 1,239 comparable data fields, out of which 65% (n=803) were correctly matched between paper based and digital records. However, 35% of the data fields (n=436) had anomalies, either in paper-based records or in digital records. 1.9 data quality issues were calculated per digital patient record, whereas it was 2.1 issues per record for paper-based record. Based on the analysis of valid data quality issues, it was found that there were more data quality issues in paper-based records (n=123) than in digital records (n=110). Conclusion There were fewer data quality issues in digital records as compared to the corresponding paper-based records. Greater use of mobile data capture and continued use of the data quality assessment framework can deliver more meaningful information for decision making.

Control and eradication of brucellosis is an objective for Veterinary and Health Authorities in several countries worldwide. Efficient surveillance programs are crucial for detecting and managing outbreaks, and epidemiological investigations may take advantage from the presence of standardized and efficient molecular typing techniques and analytical tools that enable public health laboratories to identify the origin of an outbreak. The aim of this study was to sequence Brucella spp. strains isolated in Iraq from different ruminant species, to verify whether there was a spatial or temporal clustering and, above all, shedding light on how these Iraqi isolates are positioned in the phylogenetic context of Brucella spp. The isolates under study (N=35) were from abortion, milk, placenta and fetal membrane of sheep, cattle and buffalo. Samples were genotyped using different techniques, namely MLVA-16, Whole Genome Sequencing, MLST and cgMLST. The findings of this study suggests that even relatively small investigations can provide sufficient evidence to justify improvements in existing control strategies. The application of different control measures in different territories, based on molecular epidemiological studies, would increase the chances to maximize public health benefits and minimize the spread of infection to areas free from the disease or with lower prevalence.

The present grievous situation of the tuberculosis disease can be improved by efficient case management and timely follow-up evaluations. With the advent of digital technology this can be achieved by quick summarization of the patient-centric data. The aim of our study was to assess the effectiveness of the ODK Scan paper-to-digital system during testing period of three months. A sequential, explanatory mixed-method research approach was employed to elucidate technology use. Training, smartphones, application and 3G enabled SIMs were provided to the four field workers. At the beginning, baseline measures of the data management aspects were recorded and compared with endline measures to see the impact of ODK Scan. Additionally, at the end, users’ feedback was collected regarding app usability, user interface design and workflow changes. 122 patients’ records were retrieved from the server and analysed for quality. It was found that ODK Scan recognized 99.2% of multiple choice bubble responses and 79.4% of numerical digit responses correctly. However, the overall quality of the digital data was decreased in comparison to manually entered data. Using ODK Scan, a significant time reduction is observed in data aggregation and data transfer activities, however, data verification and form filling activities took more time. Interviews revealed that field workers saw value in using ODK Scan, however, they were more concerned about the time consuming aspects of the use of ODK Scan. Therefore, it is concluded that minimal disturbance in the existing workflow, continuous feedback and value additions are the important considerations for the implementing organization to ensure technology adoption and workflow improvements.