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Objectives To estimate Global, Regional, and National prevalence of Malnutrition, specifically Coexisting forms of malnutrition (CFM) and its various types: Coexistence of underweight with stunting (CUS), Coexistence of underweight with wasting (CUW), Coexistence of underweight with wasting & stunting (CUWS), Coexistence of stunting with overweight/obesity (CSO) among children under five years in low- and middle-income countries (LMICs). Methods This cross-sectional observational study utilized latest nationally representative Demographic and Health Surveys (DHS) datasets of 62 LMICs corresponding to six global regions from 2006 to 2024. Data of 541,707 children aged 0 to 59 months with complete anthropometry were analysed descriptively (prevalence estimates) and inferentially (multivariate logistic regression). Results The global malnutrition prevalence among children was 43.9%, of which CFM was observed among 20.9% children. Among various CFM types, CUS was highly prevalent (11.8%), followed by CUW (4.2%), CUWS (3.2%), and CSO (2.1%). South & Southeast Asian had highest CFM prevalence of 29.6%, while Central Asia and Latin America & Caribbean reported the lowest CFM prevalence of 8.1% and 6.2%, respectively. Among all the LMIC included, Timor-Leste exhibited the highest CFM at 41.8%. In general, children aged between 12 to 35 months had 2-3 times higher odds of various forms of CFM. However, female sex, maternal education, improvement in socioeconomic status, medium to large family size showed significantly lower odds with various forms of CFM. Conclusions This study advances the understanding of CFM’s prevalence, determinants, and regional variations, filling a critical gap in global nutrition research. The findings serve as a reminder to reinvest in efforts to protect children from malnutrition during their early years of life. Governments and other global health sector must invest in a well-established system of nutrition surveillance for addressing CFM, informing targeted interventions to improve child health outcomes in LMICs.

Introduction The mini clinical evaluation exercise (Mini-CEX) is one of the well-known tools of workplace-based assessment (WPBAs) used in medical Education. The effectiveness of this method needs to be determined for undergraduate learning, just as it is already in use for post graduate training. Objective To study the effect of Mini-CEX as formative learning tool for clinical skills in undergraduate medical students in a private medical university in Karachi, Pakistan. Material and methods Setting is Bahria Medical and Dental College with a total duration of one year. This study is a quasi-experimental design with simple random sampling. A total of 143 final-year MBBS students were recruited after obtaining informed written consent. Participants were randomly allocated into four groups, with each group completing a two-month clinical rotation in the Pediatrics Department during the academic year. Randomization was performed using an online random selection generator (Berman H.G., “Random Number Generator”). Students assigned to the Pediatrics rotation were randomized into two control groups and two intervention (case) groups. Weekly, students were further randomized and assigned to different faculty members to minimize instructor-related bias. The random number was generated by producing 146 unique random numbers within the range of 1 to 146, ensuring that no duplicates were included. The Pediatric faculty was trained on how to use Mini-CEX form during daily teaching sessions. One briefing session was followed by personalized hands-on training on how to use the form and also to provide step by step feedback to students. Another questionnaire form sent to the students to ask about their opinion and concerns regarding the effectiveness of this process. The ward test marks evaluated. Analysis done on SPSS version 22. Data collection after approval from IRB. Result Out of 143 students, 76 (53.1%) received Mini-CEX evaluations. Intervention groups achieved higher ward test (72.3 ± 7.5 vs. 65.4 ± 8.2; p  = 0.002; d = 0.65) and OSCE scores (75.6 ± 6.9 vs. 68.1 ± 7.8; p  = 0.001; d = 0.71) than controls. Among 61 respondents (80.3%), 85.2% reported improved clinical skills and confidence, with limited faculty availability noted as a barrier. Conclusion Mini-CEX improved clinical competence, confidence, and assessment scores, confirming effectiveness as a formative tool, though faculty training and time limitations remain notable implementation barriers.

Electronic waste (e-waste) is used for all electronic/electrical devices which are no more used. Conventionally, waste management policies are desfighandle the traditional waste. Although e-waste contains toxic materials, however, its management is rarely focused by policy makers; therefore, its negative impact on the global environment, ecosystem, and human health is aggravated. The review outlines the categories of e-waste materials, major pollutants including ferrous/non-ferrous metals, plastics, glass, printed circuit boards, cement, ceramic, and rubber beside, some valuable metals (such as copper, silver, gold, platinum). Toxic elements from e-waste materials, released in the air, water, and soil, include arsenic, cadmium, chromium, mercury, and lead, causing pollution. Although their roles in biological systems are poorly identified, however, they possess significant toxic and carcinogenic potential. It is therefore critical to monitor footprint and device strategies to address e-waste-linked issues from manufacturing, exportation, to ultimate dumping, including technology transmissions for its recycling. This review traces a plausible link among e-waste condition at a worldwide dimension, as far as settlement procedures to keep it secure and carefully monitored when traded. Their fate in the three spheres of the earth, i.e., water, soil, and air, impacts human health. The strategies and regulation to handle e-waste generation at the global level have been discussed. Graphical abstract .

The presence of major heavy metals including Pb2+, Cu2+, Co2+, Ni2+, Hg2+, Cr6+, Cd2+, and Zn2+ in water is of great concern because they cannot degrade or be destroyed. They are toxic even at very low concentrations. Therefore, it is necessary to remove such toxicants from water. In the current study, polydopamine carbon nanotubes (PD-CNTs) and polysulfone (PS) composite membranes were prepared. The structural and morphological features of the prepared PDCN composite membranes were studied using FTIR, XRD, SEM, and EDS. The potential application of PDCNs for heavy metal removal was studied for the removal of Pb2+, Cr6+, and Cd2+ from wastewater. The maximum removal efficiency of 96.1% was obtained for Cr6+ at 2.6 pH using a composite membrane containing 1.0% PD-CNTs. The removal efficiencies decreased by 64.1 and 73.4, respectively, by enhancing the pressure from 0.50 up to 0.85 MPa. Under the same circumstances, the percentages of Pb+2 removal at 0.49 bar by the PDCNS membranes containing 0.5% and 1.0% PD-CNT were 70 and 90.3, respectively, and decreased to 54.3 and 57.0, respectively, upon increasing the pressure to 0.85 MPa. The results showed that PDCNS membranes have immense potential for the removal of heavy metals from water.

The MQ-8 sensor will be used in this investigation to estimate the maximum hydrogen gas concentration generated during the dry cell generators’ electrolysis procedure. The process of water electrolysis involves breaking down the water molecule H 2 O using direct electric current, into hydrogen gas and oxygen gas. Utilizing DC generators with 4/4 plate electodes (Cu/Al) as the cathodes and NaNO 3 solutions as the electrolytes, hydrogen gas production by electrolysis is achieved. 0.6 amps and 2 volts are employed in this electrolysis procedure for a duration of 1 hour. The ideal conditions for hydrogen gas concentration are NaNO 3 1 M concentration and 60 minutes with a maximum hydrogen concentration of 143.393 ppm generated. The hydrogen gas concentration verification result value is 144 ppm.

Electronic waste (e-waste) is used for all electronic/electrical devices which are no more used. Conventionally, waste management policies are desfig handle the traditional waste. Although e-waste contains toxic materials, however, its management is rarely focused by policy makers; therefore, its negative impact on the global environment, ecosystem, and human health is aggravated. The review outlines the categories of e-waste materials, major pollutants including ferrous/non-ferrous metals, plastics, glass, printed circuit boards, cement, ceramic, and rubber beside, some valuable metals (such as copper, silver, gold, platinum). Toxic elements from e-waste materials, released in the air, water, and soil, include arsenic, cadmium, chromium, mercury, and lead, causing pollution. Although their roles in biological systems are poorly identified, however, they possess significant toxic and carcinogenic potential. It is therefore critical to monitor footprint and device strategies to address e-waste-linked issues from manufacturing, exportation, to ultimate dumping, including technology transmissions for its recycling. This review traces a plausible link among e-waste condition at a worldwide dimension, as far as settlement procedures to keep it secure and carefully monitored when traded. Their fate in the three spheres of the earth, i.e., water, soil, and air, impacts human health. The strategies and regulation to handle e-waste generation at the global level have been discussed. Graphical abstract .

Objective Cutaneous malignant melanoma (CMM) arises from melanocytes, which are pigment-producing cells in the skin. CMM constitutes less than 5% of all cutaneous malignancies worldwide but is associated with the highest mortality rate among all skin cancers. The objective of this study was to examine the profile of clinicopathological factors, survival analyses, recurrence rate, metastatic rates, and the management of CMM at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan. Methodology All patients with a diagnosis of CMM treated at our institute from 2014 to 2017 were included in the study. Demographic variables and clinicopathological characteristics were collected and short-term oncological outcomes were recorded. All data were entered and analyzed in SPSS Statistics version 21 (IBM, Armonk, NY). Results A total of 28 patients were included in the study. The median age of the patients was 46.5 ±15.9 years. There were 16 male and 12 female patients. A family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43 ±9.09 months. The lower limb was the most common site of tumor among all patients, accounting for 46.4% (n=13) of the cases. On histopathological analyses, ulceration was seen in 53.6% (n=15) of the patients. Unclassified tumor type was present in 75% (n=21) of the patients, followed by nodular in 21.4% (n=6), and superficial spreading in 3.5% (n=1). Clark level IV was the most common presentation, constituting 46.4% (n=13) of the cases. Metastasis was seen in 50% (n=14) of the patients. Local recurrence was observed in 60.7% (n=17) of the patients; 64.3% (n=18) of the patients were alive after one year of treatment. Conclusion CMM is a disease with very high fatality rates. Although it is a disease commonly associated with fair-skinned populations, the incidence of CMM is rising in our part of the world as well. Early diagnosis and prompt management of the disease are crucial in its treatment. However, the mortality rate associated with this disease is still not favorable.Objective Cutaneous malignant melanoma (CMM) arises from melanocytes, which are pigment-producing cells in the skin. CMM constitutes less than 5% of all cutaneous malignancies worldwide but is associated with the highest mortality rate among all skin cancers. The objective of this study was to examine the profile of clinicopathological factors, survival analyses, recurrence rate, metastatic rates, and the management of CMM at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan. Methodology All patients with a diagnosis of CMM treated at our institute from 2014 to 2017 were included in the study. Demographic variables and clinicopathological characteristics were collected and short-term oncological outcomes were recorded. All data were entered and analyzed in SPSS Statistics version 21 (IBM, Armonk, NY). Results A total of 28 patients were included in the study. The median age of the patients was 46.5 ±15.9 years. There were 16 male and 12 female patients. A family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43 ±9.09 months. The lower limb was the most common site of tumor among all patients, accounting for 46.4% (n=13) of the cases. On histopathological analyses, ulceration was seen in 53.6% (n=15) of the patients. Unclassified tumor type was present in 75% (n=21) of the patients, followed by nodular in 21.4% (n=6), and superficial spreading in 3.5% (n=1). Clark level IV was the most common presentation, constituting 46.4% (n=13) of the cases. Metastasis was seen in 50% (n=14) of the patients. Local recurrence was observed in 60.7% (n=17) of the patients; 64.3% (n=18) of the patients were alive after one year of treatment. Conclusion CMM is a disease with very high fatality rates. Although it is a disease commonly associated with fair-skinned populations, the incidence of CMM is rising in our part of the world as well. Early diagnosis and prompt management of the disease are crucial in its treatment. However, the mortality rate associated with this disease is still not favorable.

Fax machine is still widely accepted as a legal document and a backup form of rudimentary communication. This acceptance has also left room for improvement/introduction of new communication mediums and techniques. This paper presents a secure fax module that uses GPRS/EDGE as its medium of communication. The system has two tier of encryption/security for securing all forms of data, first at the application layer (AES256) and second at the transport layer with TLS 1.1. The module is built on a customized PCB with a GSM modem; the central processor for the unit is C54x DSP. A secure fax management server with a static-IP processes all the required security information and registers each individual module against its public key, the Client Management System (CSM) connecting modules across the IP cloud. The system is cost effective commercial-off-the-self (COTS) based module and greatly reduces the operational expenditure (OPEX) by removing international termination cost for fax calls. This paper presents the complete SDLC for the secure fax module. [PUBLICATION ABSTRACT]