The Effects Of Simvastatin On Islets Of Langerhans In The Pancreas Of Rats: A Histological And Biochemical Study

Objective: This study explored the effect of simvastatin on the histomorphology of islets of Langerhans, glucose and insulin levels in rats. Study Design: The study was a one-year laboratory-based experimental control trial. Place and duration of study: It was conducted at Army Medical College Rawalpindi, in collaboration with the National Institute of Health Islamabad and Armed Force Institute of Pathology Rawalpindi. Methods: A one-year, laboratory-based, two-group experimental control trial was conducted. Thirty rats were assigned to each group: a control group receiving saline injections, and a simvastatin group receiving a simvastatin 60 mg/kg/day. Histological analysis of pancreatic islets, and measurements of blood glucose and insulin levels were performed. Statistical analysis was conducted using independent sample t-tests, with significance set at p < 0.005. Results: While simvastatin treatment did not affect the number of islets of Langerhans, The area of pancreatic islets of Langerhans was significantly higher in the simvastatin treatment group compared to control (52,664±38,871 μm2 vs 24,643±16,256 μm2, p=0.001). Serum insulin levels were also significantly elevated with simvastatin treatment (21.49±7.03 μIU/ml) compared to control (16.72±5.38 μIU/ml) (p=0.005). There were no significant differences in weekly fasting blood glucose levels at 4 or 12 weeks between groups (p>0.05). These findings suggest potential modulation of pancreatic islet function by simvastatin without affecting glycemic control in this model. Conclusions:  These findings demonstrate that simvastatin treatment significantly impacts the morphology and function of pancreatic islets in rats, increasing insulin secretion without affecting blood glucose levels. Further research is necessary to elucidate the underlying mechanisms and clinical implications of these observations.

An Update on National Consensus Practice Guidelines for the Treatment of Hepatitis C & Literature Review in Epidemiology of Hepatitis C in Pakistan - 2022

Hepatitis C is a global health problem affecting around 58 million people worldwide and killing almost 0.29 million in on one year [1]. The world has united to fight against this lethal disease in 2016 with a moto to eliminate hepatitis by 2030. To achieve this goal WHO’s World Health Assembly has set some targets and individual countries have developed their own strategies to achieve those targets [2].  Pakistan has the 2nd highest prevalence of hepatitis C in the world with 5.8% viremia positive patients [3]. Pakistan is amongst the few countries that have been assisted by the Center for Disease Control and Prevention(CDC) to prevent and control Hepatitis[4].    With the availability of Direct Acting Antivirals(DAAs), the whole paradigm of treatment of hepatitis C has changed not only globally but also in Pakistan. However, the patients in Pakistan are unable to gain access to the latest DAAs at the pace, as they are available globally. International guidelines are being updated on regular basis as per global evidence, recommending such combinations which are not readily available to many parts of the world. Hence there is a dire need to develop national guidelines, keeping in consideration the efficacy of the drugs as well as their availability, in the broader canvas of achieving the targets of eliminating Hepatitis set by WHO.   In this context, our consensus guidelines are an effort to fill the gap created because of upgraded scientific evidence and possible combinations available in our part of the world. Furthermore, quite some good research and evidence has also been shared in the literature from Pakistan during last five years (2016-2021). Hence a literature review has also been carried out to update our own epidemiologic data, risk factors and treatment responses to Hepatitis C in Pakistan

RENAL ARTERY ANEURYSM – A CASE REPORT FROM KP: Renal Artery Aneurysm – A Case Report From KP

Renal artery aneurysm (RAA) is a rare lesion and occurs in less than 1% of the population. There are multiple available treatment options which depend on the type of aneurysm and the timely diagnoses of the condition. Understanding these options is important; endovascular techniques, renal auto-transplantation and nephrectomy maybe indicated.  A case of RAA in the left renal artery which was surgically treated with radical nephrectomy because of the nature of the presentation which was an emergency and was managed swiftly to save the patient’s life

Incidence Of Acute Kidney Injury In Mild, Moderate And Severe Cases Of Coronavirus Disease

Objective: The purpose of this research was to determine the incidence of AKI in COVID-19-affected patients Study Design: Retrospective cohort study Study Setting: This study was conducted at the department of Ziauddin Hospital Clifton Campus between June and December 2020. Methods: Adult patients with AKI or acute-on-chronic kidney disease (ACKD) were included in a retrospective study. Patients infected with SARS-CoV2 and renal involvement were directed towards the ICU/Nephrology departments which have the expertise to perform laboratory analysis, radiography and institution of treatment. Supplemental oxygen use was documented. The research also assessed information about therapy (antivirals, immunomodulators, RRT) and results (renal function recovery or death). Results:  After excluding patients with obstructive AKI, a total of 180 (mean age 50.1 years) of 104 males and 76 females were included in the research. 120 patients were found to have prerenal, and 60 had intrinsic AKI with significant differences between mild, moderate, and severe cases (p=0.004). Acute kidney injury (AKI) survivors had a complete recovery rate of 70%, a partial recovery rate of 22%, and a hemodialysis dependency rate of 8%. Conclusion: Patients with severe COVID-19 infection often develop more severe AKI, and those in the severe or critical stages often exhibit proteinuria and dipstick hematuria. Long-term follow-up for COVID-19 patients should be done to evaluate its influence on renal outcome, and larger samples are required to elucidate the association between COVID-19 and renal damage.

Gender-Based Motivational Factors For Choosing Dentistry As A Career By First Year Dental Students Of College Of Pakistan

Abstract Objective: Dentistry, also known as “Dental Medicine” is opted for various reasons like prestige, socioeconomic status or personal desire. However, some join dentistry just to fulfil the wishes of their parents. Students who choose dentistry by their own choice excel better in this field. Another general impression is that mostly female students prefer it. To have a true picture of these impressions in our society, we planned this study to identify the reasons and motives of undergraduate dental surgeons for joining dentistry. Methods: A cross-sectional study, was conducted on 278 students at Margalla College of Dentistry, from December 2020 to April 2021 after the approval of the Ethical review committee of the institute. - The probability judgmental sampling technique was used. Students who consented were included in the study. A self-administered questionnaire was used to collect data which was analyzed using SPSS 21. Results: In this study, about 48.4% of students selected dentistry as their first choice but out of these only 48.9% did prior career planning. Female students 76 (49.6%) opted for dentistry as compared to male students 12 (30.7%). However, there was an insignificant difference regarding career choice between both genders (p=0.591). Prominent motivating factors were flexible work patterns (63.5%), self-employment (63%), financial security (44.8%) and parents wish (25%). Conclusion: Students chose Dentistry not only due to their interests but also because of flexible work patterns, financial security and self-employment. Both genders have more or less the same inclination towards dentistry.

Exploring Empathy In A Dentist-Patient Relationship. Conclusions From Qualitative Exploratory Research Of Practicing Dentists

Objective: This study explored the factors influencing the development of empathy in a dentist-patient relationship. Design: An exploratory qualitative study. Place and duration of the study: Khyber Medical University KPK, Pakistan October 2019 to April 2020.was conducted during 2019-2020 Methodology: This exploratory qualitative study was conducted during 2019-2020. It was conducted on 12 dental surgeons, recruited from four major dental clinical specialties. A purposive sampling technique was used. In-depth interviews were conducted through a semi-structured format. The interviews were audio recorded, transcribed verbatim and analyzed, using the thematic analysis framework. Results: Three themes were extracted from data. 1) Institutionalization of empathy, indicating a need for incorporating empathy in undergraduate and postgraduate dental curriculum, 2) Barriers in the path of empathetic attitude, including a variety of factors hampering the development of empathy in a dentist-patient relationship and 3) Cultivating a Culture of empathy for better health care provision, indicating a need for changing the collective attitude of all health care professionals, administrative staff, and students. The participants of the study observed that development of empathy in a dentist-patient relationship includes a wide range of factors, ranging from curricular, personal, social, organizational, and cultural. These factors elaborate that empathy is a multidimensional phenomenon with roots deeply entrenched in professional and personal domains

Assessment Of Predictive Value Of Serum Uric Acid Levels For Low Birth Weight In Pre-Eclampsia

OBJECTIVE: To assess the diagnostic accuracy of raised serum uric acid level in females with pre-eclampsia, in predicting low birth weight. SUBJESTS & METHODS: Cross sectional study carried out at Gynecology Department, FGSH Poly Clinic, Islamabad & duration of study was 6 months from July 21, 2021 to Jan 20, 2022. A total of 225 Preeclampsia pregnant female were clinically examined and included in the study. Blood sample were collected for serum uric acid and followed till the birth of the baby. RESULTS: The  study  included  age  ranged  from  18  up  to  40  years.  Average age was 28.69years +5.01SD. Sensitivity & specificity of uric acid level in Serum in diagnosis of low birth weight are 85.71%  and  81.42%  respectively while  it  has  positive  predictive & negative predictive value  of  51.43% &  96.13% respectively.  Diagnostic accuracy of uric acid level in serum was 82.22%. CONCLUSION: Uric acid level in serum is of great diagnostic and prognostic importance in women with pre-eclampsia & helps in predicting low birth weight

Stringent Internal Quality Control Procedures in Chemical Pathology Lead to Better Performance in External Proficiency Testing

Objective: To assess impact of stringent Internal Quality Control (IQC) checks on performance of proficiency testing Material and methods: This was a Prospective study conducted between September 2020 and April 2021 at Chemical pathology lab of Fauji Foundation Hospital Rawalpindi. External quality control data (EQC) from the month of September was evaluated. As part of corrective action plan IQC checks were enforced, internal quality control (IQC) data of the month of September 2020 and April 2022 were assessed. Performance characteristics of routine chemistry analytes coefficient of variance (CV), standard deviations (SD)and Bias were calculated and compared using paired –T- test. Results:  Proficiency testing report (NEQAPP) of cycle 10 round 1 showed 11% External Quality Control (EQC) failure among 18 biochemical parameters. Serum Creatinine and Total Protein failed acceptability criteria with Z-score of greater than 2. As part of corrective action IQC checks were done, which led to improvement in CV (SD) of these parameters. The next EQC lab report for routine chemistry analytes met the acceptability criteria with z-scores of all anaytes being less than 2. Conclusion: Precise & accurate IQC results lead to better performance in EQC result

Perceptions of Medical Teachers Regarding Certification and Master’s in Health Profession Education

Abstract Objective: To find out the perceptions of medical teachers regarding certification and master’s in health profession education. Methods: It’s a mixed method study design. It was done in the department of pathology, Shifa College of Medicine which is a constituent college of Shifa Tameer-e- Millat University, from May 2021 to September 2021. In this study data was collected by means of a survey questionnaire and a Focus group discussion. A total of 41 members participated in this study. Results and Conclusions: The study concluded a high satisfaction of participants with Faculty development programs (FDP). It was suggested that the content of FDP in view of the different roles of medical teachers should include teaching and non-teaching aspects like research, management and leadership which should be equally stressed upon. Although long duration faculty development programs imparted greater depth of knowledge, skills and attitude in health professionals and medical teachers, but if a format of FDP was to be made mandatory for all the medical teaching faculty than a shorter course, highlighting the basics of medical education and having a duration of six-month can be enforced. Key words: Roles of teacher, faculty development program, medical educatio

The Comparison Of Outcome In Engaged Versus Unengaged Fetal Heads In Primigravida

Objective: Our study aimed to compare the outcome of engaged versus unengaged fetal head in primigravida at term. Methods: The study was conducted at the obstetrics & gynaecology unit, FGPC Hospital, Islamabad. The duration of the study was 6 months with a total of 130 women included & divided into two groups. Females were followed till the delivery of the fetus. Results: A total of 130 women were observed & divided into two equal groups. The average age was 28.71 years± 6.80SD with a range of 18-43 years. Mode of delivery was measured and showed that there is a significant association between mode of delivery and unengaged fetal head in primigravida at term with p-value = 0.000. Relative risk shows that C Section was 2.93 times more in unengaged as compared to patients with engaged fetal heads. Conclusions: The frequency of a surgical intervention is significantly higher in cases with unengaged fetal heads among primigravida at term.