Volume 7 Issue-4 2018

Despite cancer being one of the most common causes of mortality in Pakistan, little authentic data is available regarding the status, incidence and survival of cancer in our population the reason being the non existence of a national cancer registry and major neglect in this area. A cancer registry gathers, and analyses data on individuals with cancer, to formulate directives for control. Several scientific studies are coming up regarding the putative risk factors in relation to chemical, biological and environmental carcinogens associated in cancer pathogenesis. The recent risk factor analysis based on epidemiology, molecular biology and genetics of colon cancer has given a major to its management [1]. However, information regarding these risk factors and cancer burden from our country is not adequate to formulate and implement policies for primary and secondary prevention. This makes the formation of a cancer registry crucial. In addition, standardized data maintained in cancer registries can be used not only for clinical research but also for epidemiological research and to improve quality of care by healthcare planning and monitoring [2]. As cancer registries play a major role in assessing cancer burden and formulating cancer control programs, incorrect data can have detrimental effects on the resources of a developing country like Pakistan. It is therefore of utmost importance that the data collected by cancer registries is reliable and standardized [3].

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ABSTRACT

Background:

Southeast Asian recipes for everyday meals incorporate the use of several spices such as onions, red chillies, turmeric, coriander, cumin, black pepper, garlic and ginger, while cardamom, cinnamon, aniseed, caraway, clove etc are added when preparing festive dishes. The regular use of seasoning spices raises the question of how they may interact and influence the digestive process. The objective of this study was to find out the effect of fourteen seasonal spices on the three intestinal phosphatases: alkaline phosphatase (AlkPase), adenosine triphosphatase (ATPase), and acid phosphatase.

Methods:

The experiment was conducted on rabbits since they are not exposed to spices. A homogenate was made out of the intestines of rabbits. Fourteen commonly used spices were ground, dried, and aqueous and lipid extracts of each spice were prepared. Alk’pase, Acid’pase and ATP’ase were assayed with and without spices using a calorimetric method.

Results:

Spices, in general, decreased the activity of enzymes. Lipid extracts are the active portion of spices, as they produced significant activation and inhibition. Lipid extract of garlic activated all three enzymes. General inhibition of the phosphatases was produced by the extracts of cinnamon, caraway and clove. Lipids of chillies activated Acid’paseand Alk’pase, while their aqueous extract inhibited both. Ginger inhibited Alk’pase and ATP’ase, while cumin, coriander, anise and turmeric inhibited Acid’pase and ATP’ase.

Conclusion:

Generally, spices influence the activity of enzymes by either inhibiting or activating them. However, more focused studies need to be conducted on spices and their influence on physiological process for diagnostic and therapeutic purposes in the future.
KEYWORDS: Spices, Alkaline Phosphatase, Acid Phosphatase, ATP-Ase, Intestinal Enzymes

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ABSTRACT

Background:

Aloe Vera can be used as adjunct to conventional periodontal therapy in patients with chronic periodontitis. The purpose of this study was to investigate the clinical effectiveness of local application of Aloe Vera gel used as an adjunct to scaling and root planing in the treatment of patients with chronic periodontitis.

Methods:

40 patients were examined and treated by alveolar gel in Periodontology department at Altamash Institute of dental medicine. Periodontal evaluation like Gingival index, Plaque index and pocket depth by periodontal probe followed by scaling and root planing was done.

Results:

The mean reduction in gingival index from baseline to 15 and 30 days was (1.98 ± 0.10, 1.6 ± 0.10 and 1.05 ± 0.10, respectively). However, for the control group, there was no significant difference in gingival and plaque indexes between after and before treatment measurements. There was significant reduction in Plaque index before and after treatment with Aloe Vera. The plaque index was significantly reduced from 2.15 ± 0.271 to 1.60 ± 0.34 after 30 days.

Conclusion:

It has been shown that the sites treated with Aloe Vera gel show significant decrease in periodontitis. Also differences between control and test side were statistically significant in clinical parameter.

KEYWORDS:

Aloe Vera, Periodontitis, Gingival Index, Plaque Index, Periodontal pocket.

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ABSTRACT

Background:

Spontaneous bacterial peritoinitis is one of the life threatening complications of Cirrhosis of liver. Mortality and morbidity are high because of sepsis, hepatorenal syndrome and liver failure. International societies recommend the use of 3rd generation Cephalosporin as first line and quinolones and Amox-clav as second line of therapy. Development of resistance among microbials against these antibiotics has been reported during last several years. The purpose of this research is to determine the frequency of micro-organism cultivated in ascitic fluid and pattern of their resistance to antimicrobials at a tertiary care hospital.

Methods:

Ascitic fluid samples were received from both in-patients and out-patients in sterile leak proof containers. All micro-organisms isolated from ascitic fluid samples were included in the study. Ascitic fluid samples were inoculated on sheep blood agar, chocolate agar, MacConkey agar, according to standard microbiological protocol. Antimicrobial susceptibility testing was performed on MHA medium (Oxoid Ltd, England) using modified Kirby Bauer’s disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results:

Out of 356 ascitic fluid samples, 54(15.1%) of samples were culture positive. Esherichia coli (38.9%) was the most prevalent pathogen isolated, followed by Staphylococcus aureus(11.1%) and Acinetobacter species(7.4%). Frequency of strains resistant with Cefotaxime (100%), Ciprofloxacin (68.4%) and Amox-clav (57.1%) were remarkably high. Esherichia coli was mostly responsive with Amikacin, Meropenum, Cefoperazone/Sulbatum and Piperacillin/Tazobactum.

Conclusion:

Gram –ve bacteria has been remained main prevalent infectious organisms causing Spontaneous Bacterial Peritonitis. A high resistance pattern with Cephalosporins and Quinolones is frightening as these drugs have been considered as first line therapy in the management of Spontaneous Bacterial Peritonitis. Resistance profile is better with Amikacin, Meropenem, Cefoperazone/sulbactum and Piperacillin/Tazobactum.

KEYWORDS:

Cultivated Organisms, Antimicrobial Resilience Pattern, Ascites, Liver Cirrhosis

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ABSTRACT

Background: Cervical cancer is regarded as a second most common cancer among women. In developing countries, a disproportionate influence of cervical cancer has accounted approximately 85% of the cases. Identification cytological findings in these women are of utmost importance. Studies reported that proper screening program is not implemented for our population, while the opportunistic contact of women to the doctor can be utilized to screen these females.

Methods:

This cross-sectional study was carried out at Department of Gynecology and Obstetrics, Ziauddin University and Hospitals from April to September 2016.Total of 370 women age 18-65 years, sexually active were included. Pap smear was taken after taking informed consent. Sample was stored; reports were checked and documented on Performa.
Results: The mean age of the patients was 39.54±12.9 years. The mean sexual debut of the patients was 10.02±9.8years. Squamous cell carcinoma and Intraepithelial lesions were observed in none (0%) of the patients. Atypical squamous cell carcinoma-cannot exclude HSIL was observed in 1 (0.3%), low grade squamous intraepithelial lesions in 2 (0.5%), high grade squamous intraepithelial lesions in 1 (0.3%) while atypical glandular cells not otherwise specified was also observed in 1 (0.3%) patients.

Conclusion:

The finding of this study has revealed positive cytological findings in five patients. In particular, low grade squamous intraepithelial lesions were found higher followed by high grade squamous intraepithelial lesions, atypical squamous cell carcinoma-cannot exclude HSIL and atypical glandular cells not specified.

KEYWORDS:

Cervical Cancer, Pap Smear, Squamous Cell Carcinoma

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ABSTRACT

Background:

A lung abscess is characterized by a necrotic lesion with marked cavitation and exudate within the lung parenchyma. The objective of this study was to identify the most common causative agent of lung abscess within our target population.

Methods:

Retrospective data from two consecutive years was obtained from the pulmonology department at Jinnah Postgraduate Medical Centre, one of Pakistan’s largest public hospitals. A total of 41 cases of lung abscess were identified on the bases of clinical, radiological and microbiological evidence. These cases were then analysed to establish a link between the incidence of abscess and key factors such as the most common causative organism, the correlation of age and gender and the location within the lung parenchyma.

Results:

Sputum for routine culture and sensitivity (C/S) showed Pseudomonas Aeruginosa (29.3%) as the most common causative organism. Correlation between abscess and risk factors such as history of smoking (65.9%), poor oral hygiene (56.1%), diabetes (43.9%) and alcoholism (14.6%) have been discussed and compared to previous publications. The frequency of common symptoms such as productive cough (90.2%), fever (82.9%) hemoptysis (58.5%) and clubbing of fingers (46.3%) have been analysed and a contrast is drawn in some instances between our obtained values and pre-existing data. The most common site of involvement is the lower lobe of the right lung (51.2%).

Conclusion:

Pseudomonas Aeruginosa was found to be the most common causative bacteria within the population for lung abscess while smoking was shown to be the most common risk factor.

KEYWORDS:

Lung abscess, Pseudomonas Aeruginosa, Smoking, Hemoptysis

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ABSTRACT

Introduction:

A series of 550 patients with a clinical diagnosis of plantar fascitis. All patients were initially given a conservative trial with anti-inflammatory medications along with resting and icing and rest. 280 patients of planter fascitis got relieved by such conservative management. Only 270 patients received corticosteroid injections and 37 of them were diagnosed with planter fascia rupture post injection. The Diagnosis of the rupture was mostly clinical which was assessed by windlass stretch test by dorsiflexion of the ankle and first toe. In patients who are diabetic the chances of rupture also increases. Treatment following rupture included supportive shoes, orthoses, and time.

Methods:

All patients with clinical diagnosis of PF who came to Dr. Ziauddin Hospital out-patient department from 2012 to 2016 were taken into our study after consent. Only those patients were given CI that reappeared to the Outpatient with similar or worsening of symptoms. 4 out of the 37 patients in whom the clinical assessment was inconclusive MRI were done which showed attenuation of the plantar fascia. From these observations and data, the author concluded that PFR had occurred.

Results:

Out of 270 patients only 37 patients (13.7%) were diagnosed with plantar fascia rupture. With increase in BMI the chances rupture increases. The majority had resolution of their new symptoms, but they often took up to 6 months to reoccur. In the remainder, there were persisting symptoms.

Conclusion:

Corticosteroid injections, although helpful in the treatment of plantar fascitis, appear to predispose to plantar fascia rupture.

KEYWORDS:

CI: Corticosteroid Injections, BMI: Body Mass Index, PF: Plantar Fascitis, PFR: Plantar Fascia Rupture

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ABSTRACT

Background:

The aim of this study was to document the frequency of ABO discrepancies through ABO blood group test performed by the tube technique method. It was conducted on residents of Karachi in Ziauddin hospital, which were then categorized into four groups.

Methods:

Descriptive, cross-sectional type of study was conducted at the Blood Bank of Dr. Ziauddin Hospital, North Nazimabad and Clifton campuses in Karachi Pakistan. A total of 1522 samples were included with the exclusion criteria of neonates and infants of up to the age of 6 months. The time frame was from September 2016 to March 2017. Blood samples were collected from a superficial vein by trained phlebotomists and submitted to the blood bank department in 2 tubes, purple top vacutainer tube containing Di-potassium Ethylene Diamine Tetra Acetic Acid (K2 EDTA) anticoagulant and red top vacutainer tube containing clotted blood. Blood group testing was done by tube technique by a researcher and then redone by the senior technologist of blood bank to control bias.

Results:

1557 hospitalized patients (854 males and 703 females) from various clinical specialties in Ziauddin Hospital, Karachi and other hospitals were included for ABO blood grouping. The male to female ratio was 1.2:1 with the age range from 9 months to 92 years. ABO discrepancies were positive in 18 out of 1557 Patients (1.1%). Male to female ratio among positive ABO discrepancies were 1:5 (11 males and 7 females out of 18 patients). Four groups of ABO discrepancies were formed. The most common one being group I discrepancies which had 12 out of 18 Patients (66.7%). Group II discrepancies had 2 out of 18 Patients (11.1%). Group III discrepancies had 1 out of 18 Patients (5.5%) and Group IV discrepancies consisted of 3 out of 18 Patients (16.7%).

Conclusion:

Forward and reverse groupings are essential to blood group testing for assigning the correct ABO blood group to the individual. Those ABO discrepancies in which forward and reverse grouping are not matched to each other can cause severe transfusion reactions resulting fatal for life. Therefore, it is necessary to ensure that the correct ABO blood product is transfused to save a life. Thus, reverse grouping should be strictly adopted in every blood bank and transfusion services as a routine practice.

KEYWORDS:

Forward and Reverse grouping, ABO discrepancies.

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ABSTRACT

Background:

Thyroid hormone is necessary for metabolism, growth and brain development. Thyroid-stimulating hormone (TSH) secreted by anterior pituitary gland acts on thyroid to release thyroid hormones T3 and T4. Insufficient production of thyroid hormone at birth is known as congenital hypothyroidism (CH). CH leads to intellectual impairment, if not identified. Neonatal hyperthyroidism is relatively uncommon The objective of this study is to determine the frequency of thyroid disorders in neonates born in a tertiary care hospital.

Methods:

This is retrospective cross-sectional, observational study carried out at the tertiary care hospital Karachi, from October 2017 to May 2018. Screening for thyroid disorders is mandatory for newborns born in our hospital. Only data of neonates with thyroid stimulating hormone (TSH) performed was included for this study. TSH levels of these patients were determined by immunoassay on Vitros Enhanced Chemiluminescence technique.

Results:

In this study, 383 neonates were included, who were born in Ziauddin Hospital Clifton and /or were presented in Ziauddin hospital laboratory for TSH testing. The average age of neonates was 4.11+/-4.14 days and average TSH levels were 4.58+/-4.32 µIU/ ml. They were divided into two groups: Group# I from birth to 4days of life, 305 neonates were included in which 278(91.1%) were euthyroid and 27(8.9%) were hyperthyroid. None of neonates found hypothyroid in this age group. Group# II from 5 days to 1 month of life, only 78 neonates were included, 55(70.5%) were euthyroid, 18(23.1%) were hypothyroid and 5(6.4%) were hyperthyroid.

Conclusion:

Neonatal screening for thyroid disorders is very beneficial for patients as well as their families and also gives information regarding these disorder’s epidemiology, pathophysiology, diagnosis and treatment in infantile period.

KEYWORDS:

Thyroid Stimulating Hormone (TSH), Congenital Hypothyroidism (CH), Hyperthyroid.

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ABSTRACT

Background:

Men may also experience bone loss due to declining testosterone levels with aging which might be associated with osteoblastic activity. The objective of the study was to find out the association of osteoporosis with testosterone levels amongst young males.

Methods:

Participants (1000) were enrolled, age +45 years, from free orthopedics camps in different towns of Karachi after an informed consent. Bonemineral density was assessed by heel scan device. Blood samples were taken to assess Testosterone through Elisa. Information on demographics, general and medical history was obtained by an interviewer-administered questionnaire. This cross-sectional study was conducted from February 2014 to April 2015. The study protocol was duly approved by Ziauddin University Ethics Review Committee.Data was analyzed using SPSS version 20. P value less than 0.05 was taken as significant.

Results:

A total of 987 subjects were finalized. Testosterone levels were low in 359(36.4%) subjects and normal in 628(63.6%). 113 had T-score ≥-2.5 on Single x-ray absorptiometry (SXA), and were considered to be osteoporotic according to WHO criteria and rest 874 were taken as controls. Out of 113 subjects, 82(72.6%) had low,whereas,31(27.4%) had normal levels of testosterone. Odds ratio for osteoporosis verses testosterone deficiency came out to be 6.65 (2.70-21.63), p-value was 0.0001 (win pepi version 11.39).When education was seen with the frequency of osteoporosis it was observed that the prevalence was seen higher in those who had attained matriculation or intermediate/ graduation (p-value 0.01).

Conclusion:

Osteoporosis was found associated with testosterone deficiency with an odds ratio of 6.65 (2.70-21.63) and P- value of 0.0001 (win pepi version 11.39).

KEYWORDS:

Osteoporosis; Testosterone; Osteoblasts.

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ABSTRACT

Background:

Burns are associated with morbidity and mortality and have greatly affected mankind. They form the fourth most type of trauma encountered worldwide, preceded by traffic accidents and homicidal violence. In the south Asian region the deaths associated with burns are considered second to accidents.

Objectives:

The objective of this study was to find the epidemiology and distribution of burns in the city of Karachi and to identify the most vulnerable population in this part of country.

Design:

Cross sectional study
Place and Duration: This is a one-year cross-sectional study from January 2016 to December 2016 conducted on patients reported with burn injuries in medico legal section, in a tertiary care hospital, Karachi

Methods:

Total number of cases reported during one year was 453. Data was collected regarding age and divided into various sub categories, gender, causative factor of the burn injury, total surface areas of burns, manner of causation of burns, and time of arrival in medico legal section. The estimation of extent of burn was calculated in terms of total body surface area according to Wallace’s rule of nine and in cases of children Lund and Browder charts were used. Victims were brought dead too that are included in this data. Data was collected and analyzed using SPSS version 20.

Results:

Our sample comprised of n=453 participants with burns. Of total participants majority n=256(56.5%) were males and n=197(43.5%) were females. In nature of burns, n=347(76.6%) were due to dry flame heat, n= 78(17.2%) were due to Scalds (moist burns), n=17(3.8%) were due to electrical burns whereas n=11(2.4%) caused due to chemical burns. Majority of the cases were reported in autumn season and majority of the reporting time n=151(33.3%) were between noon to evening. In patients with < 20% burns majority were n=22(23.7%) children whereas in burns with ≥20% body surface area majority were n=232(64.6%) adults. Children and old age individuals are the most vulnerable population

Conclusion:

In metropolitan city of Karachi burns are suffered in majority by males. The manner of causation of burn is accidental and caused by dry flame burns at work place. There is no association of burns with gas stoves or heating places and majority of cases were reported in autumn between noon and evening time.

KEYWORDS:

Burn, Disability Adjusted Life Years, Surface Area

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Background:

This study investigated the frequency of errors in the construction of multiple- choice questions used for the assessment of para-clinical sciences in medical course at the University of Western Australia.

Methods:

In all there were two hundred and ninety (290) questions reviewed to examine if they adhere to the uniformly accepted guidelines for writing multiple – choice questions. Of these, one hundred and fifty-one questions were already administered in examination so performance of distracters in those questions was also reviewed in addition to the guidelines for the construction of the questions.

Results:

38% of the reviewed questions did not adhere to general guidelines for their construction and 12% had more than one error. A placement bias was also observed in placing correct choices.

Conclusion:

A number of flaws were identified in the review process which raises doubt about the use of objective test items as a true indicator of student learning. This review has led to changes in the assessment policy at Faculty level and Pre-examination reviews have been introduced to identify any flawed items before their administration in the examination. Regular series of workshops on item writing and item analysis have been arranged and a Faculty Teaching and Learning Grant were provided to create online resources on assessment.

KEYWORDS: Educational Assessment, Reliability of Results, Student Performance, Multiple Choice Questions.

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ABSTRACT

Rotavirus is known to be one of the five top most pathogens causing gastroenteritis globally, mostly in children age group of less than 5 years. Almost every child during this age experiences at least one episode of rotavirus gastroenteritis. Amongst the various diseases in children, diarrhea accounts for 10.8% of under-five mortality in Pakistan, making it a leading cause of death in this age group. Furthermore, Pakistan is one of the six countries that accounts for 50% of all rotavirus-related deaths worldwide. About one third of children hospitalized with severe gastroenteritis in urban centers in Pakistan are reported to have rotavirus infections. Although rotavirus diarrhea is endemic throughout the year in this region, however, seasonal peaks are also observed in August and December. There are potentially very effective new vaccines available to control rotavirus infections. Nevertheless, it is utmost important to determine the true burden of disease and the viral type strains prevailing in community before administering the vaccine. This information provides the basis of strategic judgments about the use of rotavirus vaccines.

KEYWORDS:

Rota Virus, Rotavirus Gastroenteritis, Diarrhea, Meningitis, Pneumonia.

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ABSTRACT

Cell cycle progression through each phase is regulated by series of kinase family, the cyclin dependent kinases (CDK). To understand this CDK machinery that controls normal cell cycles, by forming CDK/cyclin complexes thus assisting the identification of molecules or processes altered in tumor cell cycles. So far much has been said that de-regulation of cell-cycle control or inappropriate proliferation due to aberrant CDK activity is a common feature of most of the breast, gastric, Colorectal and testicular carcinomas. Literature shows that depending on the type of cancer, CDKs can be either upregulated or downregulated. One member of CDK family, a CDK10 attracted little attention until it was identified as a major element of resistance after therapy for breast cancer. Therefore, this review will provide an overview of this class CDK10 with a focus on its role in cell cycle and in various cancers.

KEYWORDS:

Cell Cycle, Cyclin Dependent Kinase, CDK10, Cancer

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ABSTRACT

Studies worldwide have observed a link between VDR polymorphism and Diabetes Mellitus. Diabetes is a complex disease characterized by insulin deficiency caused by the alterations in the function of pancreatic β-cells, insulin sensitivity and systemic inflammation. Vitamin D deficiency has been identified as a contributing factor to Diabetes. Vitamin D acting via the nuclear vitamin D receptor (VDR) gene, located on human chromosome 12q12–q14, also acts as a transcription factor and regulates the beta cell secretion of Insulin. Studies have shown that vitamin D deficiency is widespread in those with diabetes but only few have studied the link between the two. Better understanding of the exact biochemical significance of vitamin d receptor polymorphisms and its association with metabolic disorders such as diabetes mellitus is required. To find out the association at the genetic level to combat the rampant prevalence of diabetes linked with VDR polymorphisms research engines employed were PubMed, Medline, etc. and articles selected were up to 2018.

The objective of this review is to provide an overview regarding the Diabetico-protective role of vitamin D and its receptors and to discuss the polymorphism of VDR and the possible mechanism involved in the development of the disease.

KEYWORDS:

Hyperglycemia, Receptors, Calcitriol, Polymorphism, Restriction Fragment Length.

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ABSTRACT

Penile carcinoma, representing less than one percent of all cancers in males, is a condition where diagnosis is frequently delayed, therefore the disease and its treatment results in significant morbidity and mortality in patients. There is no known etiology; however HPV infections are detected in most cases of penile cancer, so possible correlation may exist. Penile cancers usually present as an outgrowth or lesion on the penis with bleeding, itching or discharge. We are presenting an unusual case of a 43-year old circumcised male with penile cancer who had obstructive symptoms and diffuse thickening of penis without any external lesion or growth or known risk factors. The literature review revealed its rarity to best of our knowledge. Till date penile cancer continues to be a devastating disease, and its presentation is compounded by its psychological impact on the patient. Moreover, unusual thickening of penile shaft should be biopsied.

KEYWORDS:

Cancer, Penis, Neoplasms, Penile, Atypical, Carcinoma

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ABSTRACT

Atopic Eczema is a non-contagious skin disease. This study was undertaken to determine the role of home environment allergens in aggravation of atopic eczema by using EASI (Eczema Area And Severity Index) and POEM (Patient Oriented Eczema Measure). Furthermore statistical analysis was conducted to ascertain contribution of indoor environment allergen in exacerbating disease severity among male and female patients in Pakistan. The results revealed that home environment allergens have the potential to increase severity of atopic eczema experienced by the patients. Paints, air quality and fabric coverings were the most eczema deteriorating elements found inside Pakistani homes.

KEYWORDS:

Atopic Eczema, Atopic Dermatitis, Allergens, Environment.

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ABSTRACT

Background:

The importance of medical ethics principles is not emphasized therefore has diminished role in the medical students’ mind. Additionally, practicing in an environment where senior physicians and consultants are not seen prioritizing moral ethical values in their clinical practice, creates an air of indifference. This study was done to assess the awareness of HEC defined objectives for Medical Ethics in the medical curriculum, along with gauging the understanding of key Medical Ethics concepts by way of multiple choice clinical scenarios.

Methods:

This is a cross-sectional study conducted over three months. Response forms were filled at a private and government hospital. The sample size of 243 subjects was finalized according to the number of available House Officers and Postgraduate trainees. The questionnaire was aimed purely at MBBS graduates from Pakistan.
Results: A total of 243 responses were collected, ranging from House Officer level doctors 139(57%) up to Postgraduate level 104(43%). Analysis was done to determine association of awareness of Medical Ethics objectives with their medical school background. Ethical concepts of Confidentiality, Non-malefaience, Informed Consent, Respect for Privacy and Desirable Attitudes in Healthcare Professionals showed significant p-values of 0.006, 0.016, 0.005, 0.013 and 0.045. The number of incorrect responses to the clinical scenarios were: 55(25.3%), 111(51.4%), 87(42%), 119(55.3%), 104(47.9%), 170(78.7%), 50(23.4%). There was no significant difference in response among graduates from different backgrounds or with different years of clinical experience.

Conclusion:

A significant disconnect exists in the application of the knowledge of medical ethics in the clinical setting with several factors affecting physician judgment in ethical dilemmas. Effective teaching and assessment methods, inclusion of postgraduate ethical courses along with a regulatory ethics committee in each hospital is needed to protect both doctors and patients.

KEYWORDS:

Ethics, Medical Ethics, Confidentiality, Informed Consent.

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ABSTRACT

Background:

Men are the leading decision-makers in our society, thus it is prudent to involve them in the reproductive health desires of the families. This study aimed to identify the practices, perceptions and attitude regarding contraception and fertility decision-making among men attended general practice clinics in Karachi, Pakistan.

Methods:

This cross sectional study included 245 married men. Data was collected by a pre-tested questionnaire.

Results:

Overall, number (52%) of study men never used any method of contraception. While those who do not practiced contraception stated the advantages of more children as supportive to their parents in old ages number (80%) and sons inherit to father’s number (50%).
Furthermore, number(71%) participants believed that it’s only the men’s responsibility to make decision about family size and number (59%) it’s only women’s responsibility to use contraceptive method.

Conclusion:

The study concluded that men in general have misconceptions and poor attitude towards contraception and fertility. To improve men’s practices of contraception and encourage them to share contraception responsibility and decision about family size with their wives, public health practitioners can play an important role.

KEYWORDS:

Contraception, Fertility, Men.

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ABSTRACT

Background:

Sugary carbonated drinks might be the risk factor in patients with complaint of sensitivity. Therefore, the aim of the study was to evaluate consumption of fizzy drinks with sensitivity as consumption of fizzy drinks is being considered as a must societal habit.

Methods:

A cross-sectional study was carried out at private tertiary medical university among n=149 study subjects between nineteen to twenty-five years of age. A self-designed close ended structured questionnaire was used to assessed sample’s intake and effects of fizzy drinks on oral cavity. Percentages and frequencies were recorded for qualitative variables. However, means and standard deviation were recorded for quantitative variables. Furthermore, spearman rank correlation test was used to find out the association among intake of fizzy drinks with dental caries and sensitivity. Level of significance was considered as p<0.05.

Results:

Among n=149 study participants, 91.9% (n=137) were consuming fizzy drinks. Tooth ache and sensitivity (of mild degree) was reported in 73.7% of the students. Among those who were consuming fizzy drinks (n=137), 65.7% did not have a history of dental caries in recent past. However, 73.7% (n=101) were experiencing mild degree of sensitivity since the intake of soft drinks. Also, tooth ache was reported in 49.6% of those who were drinking carbonated (fizzy) drinks. A significant correlation was observed between the sensitivity and the duration of intake with a strong positive association r=.830 and a p value of 0.045.

Conclusion:

The dentine hypersensitivity is strongly associated with consumption and time to exposure of carbonated drinks.

KEYWORDS:

Dental Sensitivity, Carbonated Drinks, Oral Health.

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