- Original Article
- Critical Research Periodical
- Review Article
- Kap Study
- Case Reports
- Short Communication
The articles for the PJMD Volume 8 Issue 3 2019 are listed below. The articles are in PDF Format which requires Adobe Acrobat Reader for viewing.
THE STANCE OF CRITICAL RESEARCH PERIODICAL IN MEDICAL JOURNALISM
Medical journalism, a world of aggressively competitive periodicals, may not always be based of valid, reliable or accurate information. A large productivity and wide array of medical research literature makes even the most virtuous scientists unable to gauge and assess through all of them hence a critical and systematic analysis is required to endorse its reliability for best evidence-based practices, which no doubt is the major backbone of medicine. By introducing critical appraisal, we can help the clinicians to avoid reading flawed literature and prevent the incorporation of biased or untrustworthy information into their practice. The world is more than ever competitive now (more than 12,000 new articles added every week to the MEDLINE database) and to stay updated with new ideas, most recent developments, latest results, functional and valuable technical progress with robust scientific evidence is becoming vital.
- Saeeda Baig
- Department of Biochemistry, Ziauddin University, Karachi, Pakistan
katG GENE ASSOCIATION WITH ISONIAZID RESISTANCE IN MULTIPLE DRUG RESISTANT TUBERCULOSIS IN PAKISTAN
The unfolding of multi-drug resistant Mycobacterium Tuberculosis (MDR-MTB) constitutes a grave threat to the currentendeavorsfor controlling the tuberculosis outbreak. During TB treatment, the drug-resistance with 1stline drugs likeRifampicin (RIF) and Isoniazid (INH) has to be re-evaluated. It is assumed that gene mutation is underlying etiology for drug resistance during TB treatment. In Isoniazid resistant MTB, researchers have reported point mutation in katG gene at codon 315. The main objective of this study was to evaluate katG gene association with isoniazid (INH) resistance in our population.
Sputum specimens from suspected TB were inoculated in LJ Medium after proper decontamination. Identification of the organism colonies growth on slopes was done followed by drug sensitivity analysis. Isolates having resistance to Isoniazid (INH) and Rifampicin (RIF) with or without any other drug resistance were categorized as Multi-drug resistant (MDR). Kit method was used for DNA extraction. Then region from base 2714 to 3232 of katG gene was amplified through PCR followed by sequencing with the help of BLAST- alignment software. 24 Multi Drug Resistant MTB specimens were processed.
DNA sequence analysis revealed the reported mutation Ser → Thr in katG codon 315 in five samples (21%). In this study, an authentic molecular analysis (test) was developed and validated for identification of INH resistant strains in Pakistani population.
Our study concludes that mutation of some genes particularly point mutation of katG gene at codon 315 is associated with development of resistance to the drug INH in Multi drug resistant TB.
Isoniazid; Multi-Drug Resistant; Mycobacterium Tuberculosis.
- Farouk Qamar Malik
- Imran Ali Zaidi
- Department of Biochemistry, Fatima Memorial College of Medicine and Dentistry/ NUR International University, Lahore,
- Sana Hafeez
- Department of Zoology, University of the Punjab, Lahore,
- Anila Jaleel
- Department of Biochemistry, Shalamar Medical and Dental College, Lahore,
- Amna Iqtidar
- Department of Pediatric Medicine, Unit-II Services Hospital Lahore,
- Ali Raza Awan
- Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences (UVAS) Lahore.
COMPARISON OF CLINICAL PROFILE AND OUTCOME OF MI IN SMOKERS AND NON-SMOKERS
Myocardial infarction remains a leading cause of global morbidity and mortality. One major risk factor for atherosclerosis and MI is smoking, a highly prevalent habit in South Asian adolescents and healthcare professionals; particularly in Pakistan. This study was conducted to compare clinical presentation and outcome of myocardial infarction (MI) in smokers and non-smokers.
This study included a total of 100 patients who presented to a tertiary care centre for cardiac patients in Karachi. Patients between 18-65 years presenting with MI were included in the study (N=100). They were divided into two groups, based on smoking status. The smoking group included patients who had smoked for 10 years or more. Patients who had smoked for less than 10 years or had quit less than 5 years back were excluded from both samples. Informed consent was taken from each participant.
This study observed that 46% of the non-smokers as compared to 8% smokers present with chest pain (p = 0.001). Arrhythmia was seen in 20% of the smokers compared to 4% of the non-smokers (p = 0.001). Acute heart failure was seen in 24% smokers and only 4% non-smokers (p = 0.004). Of the smoking group, 32% of the patients expired despite treatment as compared to 6% of smokers (p = 0.001).
Specific symptoms of myocardial infarction are more commonly seen in non-smokers, aiding early diagnosis and consequently leading to a good prognosis. Alternatively, fatal complications and death rate is a more likely outcome in smokers.
Smoking; Myocardial infarction; Cigarettes.
- Sumera Batool
- Department of Endocrinology, Aga Khan University
- Ashok Kumar
- Department of Pulmonology and Critical Care, Ziauddin Hospital, Clifton
- Nida Hussain
- Faculty Affairs, Ziauddin University
- Wasfa Farooq
- Department of Biochemistry, Ziauddin University, Clifton
- Muhammad Hamza Syed
- Student, Ziauddin University,
- Nadeem Rizvi6
- Department of Pulmonology, Jinnah Postgraduate Medical Centre, Karachi.
EXPRESSION OF TTF-1, NAPSIN-A, P63 AND P40 IN DIFFERENTIAL DIAGNOSIS OF NON-SMALL CELL LUNG CARCINOMA
Non-small cell lung cancer is classified into different subtypes. It is now mandatory for the histopathologists to classify the NSCLC into its exact classification because of the increase in promising personalized therapy against each of its subtypes. In order to better classify non-small cell lung cancers, the current study evaluates the diagnostic value of p40 and Napsin-A along with the comparison with the conventional markers TTF-1 and P63.
147 blinded diagnosis of NSCLC were included and classified based on histological findings. After histological review, all the specimens were stained with the conventional markers and new markers i.e., p40, p63 for squamous-cell-carcinoma (SQC) and TTF-1, Napsin-A for adenocarcinoma (ADC).
Regarding baseline data, out of 147 NSCLC samples, 106 (72.10%) were males and 41 (27.90%) were females with the mean age of the patient was 57.6 years. The new markers combination reclassified tumors as 60 (40.8%) as ADC, 80 (54.4%) as SQC and 7.0 (4.8%) as Transdifferentiated (TD). The sensitivity and specificity of newly proposed markers, that is, Napsin-A and p40 were better than the conventional markers TTF-1 and p63.
Napsin-A and p40 are better markers than presently used markers (TTF-1and p63). These better markers are suggested to be added or the existing markers (TTF-1 and p63) should be preferred by Napsin-A and p40 in the histopathological diagnostic workup of NSCLC.
Adenocarcinoma; Squamous Cell CarcinomaTTF-1; Napsin-A; p63; p40.
- Nehad Khan
- Department of Pathology, Dow University of Health Sciences, Karachi
- Talat Mirza
- Ziauddin University, Karachi
- Faisal Faiyaz Zuberi
- Dow University of Health Sciences
- Muhammad Furqan Bari
- Dow Diagnostic, Research and Referral Laboratory, Karachi.
EVALUATION OF THE BEST METHOD TO DECONTAMINATE THE TOOTH-RESIN INTERFACE
Contamination is the most common problem of the dental composites when the incremental technique is used to restore a tooth, which results in low bond strengths between the tooth and the resin composite. This study was designed to evaluate the best method to decontaminate the tooth resin interface by analysing the shear bond strength of two bonding agents used to bond a hybrid composite, Herculite XRV to a hydroxyapatite disk with and without contamination and decontamination procedures.
The hydroxyapatite discs were acid-etched, rinsed and air-dried prior to bonding. Specimens were divided into 4 groups, Control group: Normal bonding, Group 1: Contamination, normal bonding Group 2: Contamination, air-blow, normal bonding Group 3: Contamination, rinse, normal bonding. Following bond application, the composite (4mm diameter, 4 mm height) was build-up in 2 X 2 mm increments cured with an LED curing light. Specimens were stored in damp gauze sealed in a bag at 37 °C for 24 hours prior to testing. The shear bond strength was determined and mode of failure assessed using an Optical Microscope.
The three-step etch and rinse adhesive, OptiBond FL, exhibited higher bond strength (43.2 ± 2 MPa) than OptiBond Solo Plus (32.3 ± 2.4 MPa) without contamination. However, OptiBond Solo plus was more resistant to bond failure and responded better to decontamination methods.
Air drying was found the most reliable method for decontamination. However, isolation remains the key factor in protecting the resin-tooth interface by any contamination.
Composite Resin; Decontamination; Isolation; Saliva; Dental restoration failure
- Omair Anjum
- Department of Science of Dental Materials, Lahore Medical and Dental College,
- Omer Yousaf
- Muhammad Qasim
- Department of Operative Dentistry, Lahore Medical and Dental College,
- Behzad Salahuddin
- Department of Oral Pathology, Avicenna Dental College, Lahore,
- Shoaib Khan
- Department of Science of Dental Materials, Ziauddin College of Dentistry, Ziauddin University, Karachi,
- Madiha Pirvani
- Department of Science of Dental Materials, Dow International Dental College, Dow University of Health Science, Karachi.
EUGENOL AMELIORATES RHABDOMYOLYSIS-INDUCED ACUTE KIDNEY INJURY IN MICE
Acute kidney injury (AKI) is a common and dangerous consequence of rhabdomyolysis which occurs in 50% of the cases with 5-10% mortality. In recent studies, eugenol has been reported as anti-fungal, antihyperglycemic, analgesic, anti-bacterial, anti-pyretic, anti-inflammatory and anti-oxidant agent. This study aimed to investigate the protective activity of eugenol on rhabdomyolysis-induced acute kidney injury (AKI) in mice.
Male, 24 BALB/c mice were divided into 4 groups (controls, AKI, eugenol and ascorbic acid as positive control). Controls and AKI were given normal saline, Eugenol (100 mg/kg bw) and ascorbic acid (200mg/kg) were given orally eugenol and ascorbic acid respectively for four days. After water deprivation for 24 hours, all animals, except controls, were injected with glycerol (50% – 10 ml/kg body weight intra-muscularly). After another 24 hours, blood samples were collected and kidneys were dissected out for biochemical investigations (serum urea and creatinine) and histopathological examination.
Serum urea and creatinine levels compared to controls were significantly elevated in AKI group (p < 0.001) and significantly decreased, in eugenol and ascorbic acid groups (p < 0.001) compared to AKI group. Histopathological examination revealed about 44% damage in the AKI group compared to the normal group (p < 0.001). Eugenol and ascorbic acid decreased the damage to 13% and 8% respectively compared to AKI group (p < 0.001). The tested compounds were found to reduce tubular cast formation.
Eugenol has protective effects on rhabdomyolysis-induced AKI in mice. Further studies are required for evaluation of protective role of this compound in AKI.
Rhabdomyolysis; Acute Kidney Injury; Eugenol; Glycerol.
- Nadia Saifullah
- Zahida Memon
- Department of Pharmacology, Ziauddin Medical College, Ziauddin University,
- Rehan Ahmed Siddiqui
- Moazzam Ali Shahid
- Talat Mirza
- Department of Research, Ziauddin University, Karachi.
ASSESSMENT OF HYPOCHONDRIASIS IN MEDICAL AND DENTAL STUDENTS
Anxiety and depression are considered as an important mental health indicators in the community. Medical undergraduates face several emotional, mental and physical stresses during the academic years. Researches indicate that medical students experience a large amount of psychological pressure due to work required in a competitive environment, extreme working hours, examination stress, large amount of information to seek, lack of social life, responsibility of human welfare. Anxiety and depression ranks fourth as the leading cause of disability globally. Several studies suggest high prevalence depression and anxiety among medical students with distress levels consistently higher than general population. The objective was to assess the level of hypochondriasis among the medical and dental student from first year to final year.
A cross sectional survey was conducted amongst the students of medical and dental college at Ziauddin University. The study included total 404 students from both disciplines, a pre-structured questionnaire “The Illness Altitude Scale- IAS” was given to the students after validation. SPSS version 17 was used for data analysis and p value >0.05 was considered significant.
Of the total (n=450) 404 students completed the questionnaire. The average mean age was 22.05±2.6. Of the total (n=164) dental students, 10 students had mild, 83 moderate and 71 had severe hypochondriasis. Among (n=240) medical students, 13 had mild, 153 moderate and 74 had severe hypochondriasis.
These finding confirms the presence of hypochondriasis among the medical and dental undergraduate students, which increases from mild to severe from initial to final years.
Hypochondriasis; Anxiety; Depression; Mental Health; Medical Students; Dental Students
- Mahnoor Moiz Khan
- Khizra Rehman
- Shoaib Khan
- Saima Akram Butt
- Waqas Khan Jadoon
- Ziauddin College of Dentistry, Ziauddin University, Karachi,
- Madiha Pirvani
- Dow International Dental College, Dow University of Health Sciences,
- Sanam Tauheed
- Jinnah Medical and Dental College, Karachi.
ASSOCIATION OF VITAMIN D WITH EARLY ONSET SEPSIS IN TERM NEONATES
Vitamin D deficiency has been associated with increased viral respiratory infections and early-onset sepsis in neonates. Newborns are more susceptible to infections as both innate and adaptive immune systems are not entirely developed. Neonatal sepsis is a frequent and important cause of neonatal morbidity and mortality worldwide. The aim of the study is to determine the association of vitamin D deficiency with early onset of sepsis among term neonates.
This study was conducted at Neonatal Intensive Care Unit, Ziauddin Hospital Karachi. A total of 100 neonates, with early onset sepsis (n=50) and with no sepsis (n=50as controls) were included. Blood was drawn for CBC, CRP and Vitamin D levels with levels <20ng/ml considered as vitamin D deficiency. Descriptive statistics were calculated. Chi square test was applied to see the association of vitamin D deficiency with study groups. Odd ratio >1 was considered as significant.
There were 64% male and 36% female among neonates with sepsis and 54% male and 46% female among controls. Mean time of onset of infection was 2.08±0.82 days among cases. The mean serum vitamin D level was 10.56±5.83 ng/mL and 22.18±4.44 ng/mL among cases and controls respectively. Vitamin D deficiency was observed among 88% patients with early sepsis and among 20% non-sepsis controls and association was found significant with an odds ratio of 29.33.
Vitamin D level in neonates with early sepsis was significantly lower than non-sepsis patients. Hence, it may be a risk factor for early onset of sepsis in term neonates.
Early-Onset Sepsis; Neonates; Vitamin D Deficiency.
- Sameera Saleem
- Muhammad Iqbal
- Department of Pediatric Medicine, Ziauddin University Hospital, Karachi
PREGNANCY CONSEQUENCES IN DIET CONTROLLED MILD GESTATIONAL HYPERGLYCEMIA
The evidence-based screening and management of gestational diabetes mellitus has continued to increase over the past several years. Therefore, our study is aimed to observe fetal and maternal outcomes in diet controlled mild gestational hyperglycemic patients and to compare them with normal controls.
After approval from IRB, 25 healthy females were enrolled as control (GROUP A) from antenatal clinic. While 31 mildly hyperglycemic females were enrolled from diabetic antenatal clinic, with RBS between 126-130 mg/dl or deranged fasting sugar level (GROUP B). They were educated for strict diet controlled nutritional therapy along with 30 minutes of walk thrice weekly. All patients were followed in antenatal clinics until term. Feto-maternal outcomes were tabulated for 25/31 females who completed the study, on SPSS 16.
Patients were equally matching in height and weight in both groups. Fetal weight was significantly more in group B. Though non-significant but numerically more babies were delivered after 37 weeks in group B. At term there was higher FBS and HbA1C with significant number of surgical deliveries in group B than group A. HbA1C was significantly more in group B from enrollment towards term but was still less than 6%.
Mild hyperglycemic females on diet control therapy had significantly higher FBS and HbA1C levels at term, with increased fetal weight and percentage of cesarean deliveries in comparison to normal healthy controls.
Mild Hyperglycemia; Gestational Diabetes; Nutritional Therapy; Fetal Outcomes; Maternal Outcomes; Pregnancy Consequences.
- Rabia Arshad
- Pharmacology Department, Altamash Institute of Dental Medicines, Karachi
- Zahida Sheikh
- Department of Pathology, LUMHS, Jamshoro, Sindh
- Kausar Aamir
- Department of Pharmacology and Therapeutics, Basic Medical Sciences Institute, JPMC, Karachi,
- Nasim Karim
- Pharmacology Department, Bahria University Medical and Dental College,
- Tahira Asaad
- Pharmacology Department, Karachi Institute of Medical Sciences, Karachi.
ASSOCIATION OF LIPID PROFILE WITH BODY FAT PERCENTAGE AND BMI IN SECOND TRIMESTER OF PREGNANCY
Variations in lipid profile are associated with body fat and BMI. In pregnancy, there is an increased demand of nutrients, especially for fats, for fetal development and its growth, which may disturb lipid metabolism. The objective of this study was to find out the associations between maternal body fat percentage (fat%) and BMI with lipid profile during second trimester of pregnancy.
A cross sectional study was designed on pregnant women of second trimester. These patients were recruited from gynae OPD during their antenatal checkup. After an informed consent Fasting blood samples were taken, BMI and body fat was calculated using Omron 308C body fat analyzer. Serum was extracted and lipid profile was analyzed on automated spectrophotometer analyzer at 546nm wavelength.
A total of 84 patients were selected. Cholesterol was highest in younger age (<20). TGs were generally high in all age groups. Patients with low BMI (less than 18), had normal lipid profile, whereas, normal and high BMI patients had high cholesterol, TGs, LDL, HDL and VLDL. Obese had higher values for TGs, HDL, and VLDL with cholesterol on the upper limit. Cholesterol, in obese patients with very high body fat percentage, was not found elevated, but the results were not statistically significant. However, patients with body fat values as low, normal and high, all had high levels of cholesterol TGs, HDL and VLDL, statistically showing no difference.
Lipid profile and BMI were found independent variables having no association with body fat percentage during second trimester of pregnancy.
Pregnancy; Body Fat; Body Mass Index; Dyslipidaemia; Hypertriglyceridaemia; Lipid; Triglycerides.
- Syed Tousif Ahmed
- Hira Attique
- Department of Physiology, Ziauddin University,
- Moazam Shahid
- Research Officer, Ziauddin University
- Leena Hani
- Student, Ziauddin University
- Rehana Rahman
- Department of Health Sciences, Aga Khan University,
- Shahina Ishtiaq
- Department of Obstetrics and Gynaecology, Ziauddin University
CRITICAL RESEARCH PERIODICAL
FUT8: AN EMERGING DRIVER OF METASTASIS
This critical research periodical is mainly based on critical review of research article titled “A Systems Biology Approach Identifies FUT8 as a Driver of Melanoma Metastasis” published in Cancer Cell by Agrawal et al1. Glycosylation is the distinct cell and microenvironment relatedmechanism establishing glycosidic linkages with major nutrients by the action of various enzymes. Meezan et al. described aberrant glycosylation in cancer in 1969 and since then it has been recognized that process of glycosylation is altered during cancer cell transformation and its progression2. The above mentioned research article is also part of continuation of this concept in which Agrawal et al. documented the role of glycosyl transferase FUT8 as a facilitator of metastasis in melanoma. This facilitation opens new avenues for scientists to develop novel therapies making core fucosylation as a target for metastatic tumors.
FUT8; Metastasis; Glycosylation; Melanoma.
- Departmentof Biochemistry, Ziauddin University, Karachi,
- Hussain Shah
- Department of Chemical and Biomolecular Engineering, University of Melbourne, Australia.
MULTIPLE ETIOLOGIES OF TEMPOROMANDIBULAR JOINT DISORDERS – A REVIEW
Temporomandibular joint (TMJ), is a synovial joint, involves two bones particularly mandible and temporal bone. Since TMJ involve muscles of mastication and jaw movement therefore, its disorders damages surrounding tissues and minimizes its function. The etiology of TMJ disorders is complex and multifactorial including genetic, traumatic, inflammatory, degenerative and idiopathic disorders as well as behavioral factors (parafunctional habits). Generally females are more affected because of increased level of estrogen hormone affecting bone and cartilage; moreover, emotional factors (anxiety, stress and depression) are also higher in females compared to males. Genetic disorders of TMJ include many genes, which contribute in bone formation and inflammation mediation.
This article is focused on etiology of temporomandibular joint disorders and involvement of certain genes and other predisposing factors leading to pathophysiology of its development. Information regarding TMJ disorders was retrieved through PubMed, Medline and other authentic search engines available in the University, information was collected through reviews, research, and epidemiological studies published up to 2016.
This review article concludes urgent management is sought in 1-2% young children, 5% teenagers and 5-12% adults. In order to avoid any iatrogenic injury it is mandatory to do prior extensive and detailed physical examination of TMJ.
TMJ Disorders; Genes; Bruxism; Malocclusion; Estrogen.
- Farah Azhar
- Aliya Sani
- Saeeda Baig
- Department of Biochemistry, Ziauddin University, Karachi.
A REVIEW OF TREATMENT STRATEGIES OF SUPRACONDYLAR FRACTURE OF HUMERUS IN CHILDREN
Pediatric supracondylar fracture of distal humerus frequently occurs within 10 years of age with peak at 6-7 years. There is higher incidence of complications such as neurovascular compromise and late cubitusvarus deformity if left untreated at initial stages. This often occur because of important neurovascular structures are crossing the elbow region which hold different anatomic characteristics as well. This article is based on appraisal of the classification, clinical evaluation, and with particular emphasis on the management of each type especially short term complications which may occur with fracture displacement.
Pediatric; Classification; Compartment Syndrome; Fracture Fixation.
- Aqeel Ahmed Memon
- Imtiaz Hashmi
- Sohial Rafi
- Anisuddin Bhatti
- Idress Shah
- Asad Aziz
- Department of Orthopedics and Spine Surgery, Ziauddin University Hospital, Clifton, Karachi.
HIV/AIDS KNOWLEDGE AND SEX RELATED HEALTH SEEKING ATTITUDE AMONG YOUNG ADULTS IN KARACHI, PAKISTAN
The epidemic of acquired immunodeficiency syndrome (AIDS) is considered as a big health problem. Therefore, in the absence of knowledge seeking behavior, issues cannot be handled adequately. Thus, the study is aimed to assess the knowledge about human immunodeficiency virus (HIV/AIDS) and sex-related health seeking attitude among young adults attending family-practice clinics in Karachi, Pakistan.
Across-sectional study was accomplished in family medicine clinics affiliated with a tertiary care private sector teaching hospital in Karachi. Both Male and female gender, 586 subjects were approached by convenient non-probability sampling method. Participants who came to visit family medicine clinics for any reason with age between 18 to 24 years and never married were enrolled for the study. Structured and pretested tool was used to gather the data. Along with socio-economic variables, inquired the level of knowledge about the transmission, cure and prevention of HIV/AIDS. Furthermore, study participants were also asked about the health and education-seeking attitude regarding sexual problems.
Among 586 participants, males were 335 (57.2%) and females 251 (42.8%). Majority of them had knowledge that HIV can be transmitted by blood/blood products (92.7%), un-sterilized needles/syringes (85.3%) and unsafe-sex (93.5%). However, misconceptions were also present such as transmission of HIV by mosquito-bite, public toilets/swimming pools and food/water. Furthermore, 82.9% of study subjects believed that HIV is a vaccine preventable disease and 78.5% stated that AIDS is curable. Over 50% felt that their level of knowledge about HIV/AIDS is insufficient, and 72.7% subjects preferred school as a better source for providing sexual-health education, and the difference of these responses by sex were not significant. However, only 17.9% females preferred electronic media for providing sexual-health education compared to 30.7% males (p<0.01) and 51.4% females stated allopathic doctors as better choice to consult for sexual problems compared to 36.1% males (p<0.01).
The study concluded that the majority of young adults have inadequate knowledge and misconception about HIV/AIDS.
HIV; AIDS; Knowledge; Sexual Health Seeking Attitude; Young Adults.
- Alia Nasir
- Saima Merchant
- College of Nursing, Ziauddin University, Karachi,
- Institute of Nursing, Dow University of Health Sciences, Karachi
DEPRESSION AMONGST PARENTS OF CHILDREN WITH INTELLECTUAL DISABILITY
Parental stress is the major factor that increases a risk of unwillingly placing children with disabilities. The aim of our study is to assess the frequency of depression amongst parents of children with intellectual disability.
This was a cross sectional study conducted for 10 months in various hospitals and rehabilitation centers in Karachi, Pakistan. Participants were inducted using purposive sampling technique. Parents of intellectually challenged children up to 18 years of age were included and a self-administered questionnaire was utilized for data collection both in English and Urdu. PHQ 8 was used to assess the severity of depression amongst parents. For all purposes, p-value of <0.05 was considered statistically significant. Permission was sought from the ethical review board.
High proportion of parents interviewed suffered significantly from moderate to severe depression [223 (66.2%)]. Gender comparison revealed [186 (75.9%)] females had moderate to severe depression compared to [136 (40.3%)] males (p-value=0.000). Some factors associated with the child such as severity of disability also had an impact [197 (69.3%)], parents having children with Cerebral Palsy suffered moderate to severe depression as opposed to [26 (49%)] parents of children with Down’s Syndrome (p-value=0.03). The most common way to relieve stress was praying practiced by [176 (52.2%)] the parents.
Amongst the parents of children with intellectual disability (ID), a significantly high proportion was suffering from depression. From the child’s aspect, age and severity of disability had an impact. Most common strategy identified to overcome depression was praying.
Intellectual Disability; Depression; Cerebral Palsy; Down Syndrome.
- Kashaf Aqeel Zaidi
- Saira Rehman
- Fahad Ahmad
- Syed Hasan Danish
- Farah Ahmad
- Ziauddin Medical College, Ziauddin University, Karachi.
URINOTHORAX PRESENTING AS RESPIRATORY DISTRESS AFTER NEPHROLITHOTOMY
Urinothorax is a rare complication of thoracic cavity often-arising secondary to genitourinary pathology of which the most common is urinary tract obstruction. If urine is accumulated in the pleural space, it is termed as Urinothorax. Here we are reporting two cases presenting with right renal flank pain that underwent Percutaneous Nephrolithotomy and subsequent Double J (DJ) stenting due to right renal calculi. These patients then developed shortness of breath secondary to pleural effusion. At first, they were thought to be suffering from pulmonary embolism and their electrocardiography (ECG) and Chest X-rays were done. ECG showed no acute changes hence further investigations were done. Imaging and biochemical investigations aided in confirmation of the diagnosis of Urinothorax. Treatment of this condition is dependent upon a multidisciplinary approach aiming towards resolution of the underlying cause of this pathology. In this case, report we would like to briefly discuss our experience of management and clinical outcomes of Urinothorax at a tertiary care institute.
Urinothorax; Pleural Effusion; Surgery.
- Syed Mahmood ul Haq
- Imroz Arif Farhan
- Jawed Ahmed Memon
- Mariya Muhammad Salim
- Thoracic Surgery Department, Liaquat National Hospital and Medical College, Karachi.
EXTRADURAL HEMATOMA RESULTING FROM MIGRATION OF SUBGALEAL HEMATOMA
Extradural hematomas are collection of blood between the dura and skull bone. These hematomas are common complication of head injury. Spontaneous resolution of extradural hematoma due to migration into the subgaleal space has been reported. We are reporting an unusual case of a 19-year-old male presenting with an extradural hematoma, which was formed because of migration of a subgaleal hematoma through the skull fracture. Our case emphasized the importance of assessment of patients presenting with subgaleal hematoma to prevent them from any neurological injury.
Subgaleal Hematoma; Extradural Hematoma; Tight Bandage.
- Ateeba Ayesha Khan
- Sidra Saleem
- Dow Medical College, Dow University of Health Sciences, Karachi,
- Talha Ahmed
- Department of Anaesthesiology, National Institute of Cardiovascular Diseases, Karachi,
- Junaid Ashraf
- Department of Neurosurgery, Dow University of Health Sciences, Karachi.
ROTAVIRUS GENOTYPING: A PROMISING DIAGNOSTIC TOOL OF RESEARCH FOR PEDIATRIC GASTROENTERITIS
Every child in his early five years’ age usually suffers at least once with rotavirus diarrhea worldwide. Diagnosis of rotavirus diarrhea is carried out by various methods available worldwide: including electron microscopy, antigen detection, nucleic acid detection and amplification (PCR). However, reverse transcription-polymerase chain reaction (RT-PCR) method for detection of rotavirus and its genotyping is considered as the gold standard diagnostic tool, and commonly used for determining the rotavirus gastroenteritis burden as well prevalence of virus type in children for surveillance and outbreak investigation. RT-PCR genotyping methods are also used as alternatives for rotavirus serotyping. Nested RT-PCRs are usually performed for rotavirus genotyping, in which extracted viral ribonucleic acid (RNA) from infected or suspected pediatric fecal specimens are processed for conserved region of viral genome. The PCR is performed by using consensus primers for the gene 9 and 4, responsible for expression of VP4 and VP7 consecutively. Rotavirus genotyping also helps in taking appropriate decision about the introduction and administration of rotavirus vaccines.
Rotavirus Genotyping; Pediatric Gastroenteritis; Enteric Viruses.
- Tayyab Un Nisa
- Department of Microbiology, University of Karachi, Pakistan.