Seasonality of deaths with respect to age and cause in Chitral District Pakistan

The ethnobotanical heritage of Lotkuh, a high-altitude tribal haven of Chitral, the Eastern Hindu Kush, Pakistan

BACKGROUND

In northwestern Pakistan, Lotkuh is a high-altitude terrain nestled within the eastern Hindu Kush region. Enclaved by towering peaks and harboring a unique culture, the region mirrors the geographical and cultural diversity of Pakistan. In this geographically isolated region, a treasure trove of ethnobotanical knowledge unfolds through generations of interaction between the inhabitants and indigenous plants, resulting in a profound understanding of the plant uses in nutritional, medicinal, cultural, and ritual contexts. Thus, the study seeks to gather, analyze, and document the indigenous knowledge of plant utilization of the distinct tribal culture.

METHODS

Through semi-structured questionnaires, inventory interviews, and participatory workshops, data were collected by engaging a cohort of 120 local respondents. The collected data were then classified into nine distinct use categories, following which quantitative indices were calculated.

RESULTS

The research identified a total of 150 plant species spanning across 59 different families and categorized them into 9 distinct usage groups. Among these, Astragalus oihorensis, Astragalus owirensis, Cicer nuristanicum, Geranium parmiricum, and Rochelia chitralensis stand out as novel species with distinctive applications. Notably, medicinal use garnered 600 reports, while animal feed, veterinary applications, human consumption, and toxicity recorded 500, 450, 425, and 104 reports, respectively. Informant consensus was high ranging between 0.8 and 0.9 with most agreement on human food and animal feed category. Platanus orientalis and Juglans regia, with RFC 0.91, were the most cited. The Family Importance Value (FIV) of Juglandaceae and Platanaceae, each with an FIV of 0.91, and Capparidaceae with an FIV of 0.83 indicate the intricate role the families play.

CONCLUSIONS

In this study, we explore 150 ethnobotanical species, uncovering novel entries within ethnobotanical literature. Among these, several species showcase unique uses previously undocumented in Pakistani literature. Our research sheds light on the intricate interaction between plants and the distinct cultural landscape of the Lotkuh region.

Developing a Cold-Related Mortality Database in Bangladesh

The aim of this study was to develop a database of historical cold-related mortality in Bangladesh using information obtained from online national newspapers and to analyze such data to understand the spatiotemporal distribution, demographic dynamics, and causes of deaths related to cold temperatures in winter. We prepared a comprehensive database containing information relating to the winter months (December to February) of 2009-2021 for the eight administrative divisions of Bangladesh and systematically removed redundant records. We found that 1249 people died in Bangladesh during this period due to cold and cold-related illnesses, with an average of 104.1 deaths per year. The maximum number of cold-related deaths (36.51%) occurred in the Rangpur Division. The numbers were much higher here than in the other divisions because Rangpur has the lowest average monthly air temperature during the winter months and the poorest socioeconomic conditions. The primary peak of cold-related mortality occurred during 21-31 December, when cold fronts from the Himalayas entered Bangladesh through the Rangpur Division in the north. A secondary peak occurred on 11-20 January each year. Our results also showed that most of the cold-related mortality cases occurred when the daily maximum temperature was lower than 21 °C. Demographically, the highest number of deaths was observed in children aged six years and under (50.68%), followed by senior citizens 65 years and above (20.42%). Fewer females died than males, but campfire burns were the primary cause of female deaths. Most mortality in Bangladesh was due to the cold (75.5%), cold-triggered illness (10.65%), and campfire burns (5.8%). The results of this research will assist policymakers in understanding the importance of taking necessary actions that protect vulnerable public health from cold-related hazards in Bangladesh.

Seasonal pattern in elderly hospitalized with acute kidney injury: a retrospective nationwide study in Italy

Purpose

Acute kidney injury (AKI) frequently complicates hospitalization and is associated with in-hospital mortality (IHM). It has been reported a seasonal trend in different clinical conditions. The aim of this study was to evaluate the possible relationship between seasons of the year and IHM in elderly hospitalized patients with AKI.

Methods

We selected all admissions complicated by AKI between 2000 and 2015 recorded in the Italian National Hospital Database. ICD-9-CM code 584.xx identified subjects with age ≥ 65 years and age, sex, comorbidity burden, need of dialysis treatment and IHM were compared in hospitalizations recorded during the four seasons. Moreover, we plotted the AKI observed/expected ratio and percentage of mortality during the study period.

Results

We evaluated 759,720 AKI hospitalizations (mean age 80.5 ± 7.8 years, 52.2% males). Patients hospitalized with AKI during winter months had higher age, prevalence of dialysis-dependent AKI, and number of deceased patients. In whole population IHM was higher in winter and lower in summer, while the AKI observed/expected ratio demonstrated two peaks, one in summer and one in winter. Logistic regression analysis demonstrated that parameters such as age, autumn, winter, comorbidity burden were positively associated with IHM.

Conclusion

We conclude that a seasonality exists in AKI, however, relationship between seasons and AKI could vary depending on the aspects considered. Both autumn and winter months are independent risk factors for IHM in patients with AKI regardless of age, sex and comorbidity burden. On the contrary, summer time reduces the risk of death during hospitalizations with AKI.

Modeling the Impact of High Temperature on Mortality in Pakistan

The objective of this paper is to model and study the impact of high temperature on mortality in Pakistan. For this purpose, we have used mortality and climate data consisting of maximum temperature, variation in monthly temperature, average rainfall, humidity, dewpoint, as well as average air pressure in the country over the period from 2000 to 2019. We have used the Generalized Linear Model with Quasi-Poisson link function to model the number of deaths in the country and to assess the impact of maximum temperature on mortality. We have found that the maximum temperature in the country has a significant impact on mortality. The number of deaths in Pakistan increases as the maximum temperature increases. We found that, as the maximum temperature increase beyond 30 °C, mortality increases significantly. Our results indicate that mortality increases by 27% when the maximum temperature in the country increases from medium category to a very high level. Similarly, the number of deaths in the country increases by 11% when the temperature increases from medium temperature to high level. Furthermore, our study found that when the maximum temperature in the country decreases from a medium level to a low level, the number of deaths in the country decreases by 23%. This study does not consider the impact of other factors on mortality, such as age, medical conditions, gender, geographical location, as well as variability of temperature across the country.