Awareness of sleep hygiene in medical students of Kara-chi: A cross sectional study.

Introduction: Sleep, a neurobiological phenomenon, is very essential component for the behaviours of human beings. Sleep Hygiene is essentially a term which is used to understand lifestyle and environmental factors that influence sleep. A stu-dent when get admission in a university, it’s a turning point in his/her life as previ-ous routine is dramatically altered. This is more so if a student enters a medical college or university. While studying medicine the syllabus, timetables, duties, shifts are all manifold and hence it changes the complete environment and lifestyle of nearly all students. This in turn leads to drastic change in the pattern of sleep hygiene.Objective: This study was conducted to assess the awareness of sleep hygiene among medical students.Methodology: This cross-sectional study was conducted from March –August 2019. The approval of study sought from Ethical Review committee of Isra University. A self- administered questionnaire used to collect data after student’s verbal consent and ensuring their anonymity. Using convenient sampling technique 467 medical students were studied including those from 1st year to 5th year students. The data was analyzed using SPSS version 21.0.Results: Showed that 59.5% of the students have not heard about sleep hygiene, 31.5% have heard it and 9% of them were not sure about it.77% of participants use social media, 72% takes shower and 63% of the students wash their face before going to the bed.Conclusion: We concluded that majority of the medical students are unaware of Sleep Hygiene and a large portion of them uses social media before going to bed.Key Words: Sleep Hygiene, medical students, awareness

Forensic Evaluation of the patterns of fatal injuries among pedestrians in road traffic accidents in Hyderabad, Pakistan.

Introduction: Road traffic accidents (RTAs) preventable yet responsible for a large number fatalities among children and adults. It is estimated that RTA causes approximately 1.35 million deaths (27.5 deaths per 100,000 population) through out the world.Objective: To evaluate the patterns of fatal injuries among pedestrians due to road traffic accidents brought in emergency unit of Liaquat University, hospital, Hyderabad.Methodology: This cross-sectional study conducted between Jan 2019 to Dec 2019 and all victims of road traffic accidents brought in the emergency due to fatal injuries belongs to either sex or age-group were included. Data collected includes demographic details; type, site, impact, intensity of inju-ries and different types of vehicles involved in the accidents were recorded from history/ autopsy findings of medico-legal officer. Collected data was entered and analyzed in SPSS ver. 23.Results: Motorcars were more involved (31.0%) in road traffic accidents followed by trucks/loaders (29.0%). Males (87.5%) outnumber female. Head and neck region (26.0%) affected most, while abdomen/pelvis were the least(16.0%) affected. Contusions occurred in predominantly (51.0%) while most (60.5%) pedestrians were found dead when received in the emergen-cy unit. Most common cause of death was head injury induced complica-tions.Conclusion: Injuries to head, neck and facial regions are more common while contusions are the predominant type of injuries occur in the pedestri-ans. Skull bone is most commonly fractured bone among the victimsKeywords: Pattern of injuries, Pedestrians, Road traffic accidents

Cold Abscess mimicking Goiter.

Soon after Tuberculosis is worldwide health problem, especially in south Asia and Africa. It commonly affects lung, but extra-pulmonary Tuberculosis (TB) is also common. Most common extra-pulmonary tuberculosis present as cervical lymphadenopathy (enlarge cervical lymph nodes, mostly matted, various consistency, induration and cold abscess and sinuses). The present case is a very rare presentation of primary tuberculous cervical lymphadenopathy, the young patient present with tuberculous (TB) cold abscess in burns space only, no other lymph nodes enlarge and no other signs and symptoms of TB

Frequency, Management and Outcome of Postpartum Hemorrhage at a tertiary care Hospital.

Introduction: According to WHO, world estimates of 2017, 295 000 maternal deaths were reported all over the world and maternal mortality rate ranged from UI 99 to 243 per 100 000 live births. There has been 35% reduction since year 2000. Similarly, there has been 51% reduction in maternal mortality rate in Pakistan. 94% of all maternal deaths occur in low and lower middle-income countries. The major complications that account for nearly 75% of all maternal deaths are: severe bleeding mostly Post-Partum Hemorrhage (PPH), Postpartum sepsis, pre-eclampsia and eclampsia and other. Objective: To find out the frequency of patients presenting with PPH among all patients delivered during the study period, their management and subsequent morbidity and mortality. Methodology: This retrospective study was conducted between January 2018 to December 2019 at the department of Obstetrics and Gynecology PUMHS Hospital Nawabshah, Benazirabad.  The demography, parity, gestational age, mode of delivery and type of PPH developed as well as treatment for PPH and subsequent morbidity and mortality were all documented. Data analyzed using SPSS version 20. Results: During study period frequency of PPH was 32.73 per 1000 deliveries, prevalence of primary PPH was 90.51%. Among the causes of PPH, Uterine atony was the leading cause 42/137 (30.65%). 56 (40.87%) patients were managed in the ICU for ventilatory &, inotropic support and septic shock, management. Mortality was 7(5%). Conclusion:  Majority of patients are of primary PPH and uterine atony remains the most common cause of PPH which requires prompt and timely management as per guidelines. &nbsp

Major causes of negative and positive impacts on mental health during lock-down due to COVID-19 pandemic.

Introduction: Soon after pandemic of Covid-19; Lockdown across Pakistan led to wide spectrum of problems that includes unemployment, closure of schools & Colleges, shattered economy. Least in focused remained the mental health of the people affected due to different reasons. Objective: To determine the major causes of negative and positive impact on mental health during Covid-19 pandemic. of lock-down on mental health. Methodology: This cross-sectional study was conducted at Dow University of Health Sciences during April-May 2020. Using structured online questionnaire, 362 participants took part in the study. The selection criteria were age above 14 years and resident of Karachi in an area under lock down due to pandemic of COVID-19. Results: Overall, 95.3% participants agreed that lock down is most appropriate strategy to counter the spread of Covid-19. Stress consequent to lock down was attributed as concern for their loved ones and relative by 47% of the participants, social distancing and restrictions by 44.2% and fall in economic situation by 43.4%. When asked for the probable solutions to these problems; provision of grocery items at door steps was stated by 53%, ease on taxes and/or bills by 52.5%; while 51.7% were of the opinion that people should be keep informed about development regarding Covid-19.  The positive impacts on mental health were due to having more time for family (63.5%) and break from busy life (47.5%). Conclusion: Different causes of negative and positive impacts of lock-down were acknowledged with people experiencing almost similar causes of stress and anxiety. Almost all of the problems are solvable if people’s recommendations are taken into account.   Keywords: COVID-19 19, pandemic, Mental health

Clinical Presentation of Alzheimer Disease (ad): a hospital based observational study.

Introduction: Alzheimer's disease (AD) is a neurodegenerative illness that mani-fests itself clinically and pathologically.Objective: To identify the various patterns of Alzheimer’s disease (AD) in adults.Methodology: A hospital based observational study was conducted in the Depart-ment of Neurology Jinnah Postgraduate Medical Centre (JPMC) Karachi, Pakistan from May 2018 to November 2019.Cases with complaint of memory impairment and/or cognitive impairment, with or without behavioral changes were included in the study. Acute delirious state uremia / hepatic encephalopathy hypo / hypergly-cemia and hypo / hypernatremia were excluded diagnosis. The main outcome measures were clinical patterns of AD with age and sex distribution, affective disor-der with cognitive impairment (Pseudo dementia) and affective disorder without cognitive impairment.Results: A sample of 51 cases (36 males and 15 females) with memory impairment was included. Age’s between 25-85years (mean 57years). Out of 51 cases 44 had probable /possible Alzheimer’s disease (AD) 03 had affective disorder with cogni-tive impairment (pseudo dementia), 04 patients had affective disorder without cognitive impairment. Among probable / possible cases of AD 23 (52.27%) had multi infarct dementia (having history of past cerebrovascular disease), same sta-tistics among Parkinson’s patient’s i.e. diagnosis was Parkinson’s disease with memory impairment were 18 (40.90%) followed by alcoholic dementia in 03 (6.8%). There was no definite Alzheimer’s disease case in this study.Conclusion: Vascular dementia not the definite Alzheimer’s disease is the com-monest memory impairment type presentation in our study. Among Parkinson’s disease patient’s dementia was found quite high in our study.Keywords: Alzheimer’s disease (AD), Vascular dementia (MID), Parkinson’s disease (PD), Cognition, Memory

Histomorphometric effects of Raphanus Sativus leaf ex-tract on Carbon Tetrachloride induced hepatotoxicity.

Introduction: Carbon tetrachloride (CCl4) adversely affect the structural/ and or functional properties of the hepatic tissue, leading to grave implica-tions. Currently plant-based compounds have gained sufficient space in the treatment of liver diseases. Among such plants is Raphanus sativus, a cru-ciferous plant also commonly called Radish, which has since long been used in traditional medicine.Objective: To evaluate the protective role of Raphanus sativus in CCl4-induced hepatotoxicity through assessment of liver function and oxidative stress markers in albino Wistar rats.Methodology: This Quasi-experimental study was conducted between Sep-tember 2019 to March 2020 at the Postgraduate Research Laboratory Isra University, Hyderabad. Albino Wistar selected by non-random purposive sampling were divided equally into three different groups: Group A (control group), Group B (CCl4 experimental group), and Group C (CCl4 plus Raphanus sativus group). Blood samples were collected through cardiac puncture followed by hepatic histopathological analysis using light micro-scope. Data was analyzed using SPSS version 24, with ANOVA and Post hoc Tukey’s analysis used for comparison of different study variables.Results: Statistically significant rise relative liver weight of group B rats compared with the group A and C rats (P <0.05). Moreover, statistically sig-nificant (P <0.05) rise in serum markers of hepatic functions was observed after CCl4 administration in Group B. Treatment with Raphanus Sativus ad-ministration significantly reduced serum levels of LFTs (p<0.05). There was a significant decline in the plasma levels of oxidative markers in group B while marked histopathological changes like necrosis, sinusoidal dilatation and congestion observed among animals of group B.Conclusion: Raphanus Sativus exerts an anti-oxidative, and hepato-protective effect against CCl4-induced hepatic tissue damage.Keywords: CCl4, Hepato-protective, Raphanus Sativus

Proton Pump Inhibitors: Pantoprazole is the safe drug as compared to Omeprazole drug during treatment of Dyslipidemia.

Introduction: Proton pump inhibitors (PPIs) are commonly used to manage ret-rosternal burning to peptic ulcer disease. Dyslipidemia is also very common in Asian population.Objective: To evaluate the effects of different groups of PPIs like omeprazole, Pan-toprazole, esomeprazole on lipid profile.Methodology: This animal study conducted at the Department of Pharmacology with collaboration of Diagnostic & Research laboratory of Liaquat University of Medical & Health Sciences Jamshoro from 16 Nov to 30 Nov 2020. 24 male rabbit were divided in 3 equal groups. The sample for lipid profile were taken twice; first sample was collected before start of PPPIs, while another sample was taken after six weeks of the treatment with different groups of PPPIs. The lipid profile was ana-lyzed by Cobass Auto analyzer (C-311) of Hitachi at Diagnostic & Research Labora-tory LUMHS. The Statistical analysis was performed by student ‘t’ test and chi square test by using SPSS version 21.Result: The results found were statistically significant (p=<0.05) for omeprazole and esomeprazole while it was insignificant (p=0.247) for pantoprazole. TG’s was signifi-cantly more in group A and B animals as compare to group C animals. Low density Lipoprotein found raised among all groups but the rise was statistically insignifi-cant.Conclusion: Omeprazole exerts significant effects over all observed parameters of lipid profile, esomeprazole showed effects over few parameters, while pantopra-zole showed insignificant effects over lipid profile.Key words: Proton Pump Inhibitors, Low density Lipoprotein, Cholesterol

Students’ perspective for online teaching program “Survive” during period of Covid-19.

Introduction: During panacea of Covid-19; educational institutes started online teaching program. This was first experience for almost all faculty members and the students. As we all are familiar with face-to-face learning; it is imperative to get feedback from the students regarding their experience of online academic activities. Objective: To document the students’ perspective regarding online teaching program of Muhammad Medical College Mirpurkhas named as “SURVIVE” Methodology: After approval from Research and Ethical Committee of Muhammad Medical College this questionnaire-based study conducted during month of July 2020. This self-constructed questionnaire has 6 components: Organization and Structure, Teaching and learning, Teaching staff and other students, Assessment, Attribute development and Unit performance as a whole. Each component had 3-4 questions and students had to rate their satisfaction level on Likert scale. Results: Each component of the questionnaire was examined. Among participants; female students (n=103) outnumber male students (n=22). The highest number of students were from 4th year MBBS (n= 47; 37.6%) followed by 1st year BDS (n=26;20.8%) and final year MBBS (n=25; 20%). Overall, 106 (86%) students rated Survive as satisfactory. Conclusion: Being first experience, yet survive was found nearly in all aspect as satisfactory way of leaning during pandemic of Covid-19

Diabetes Mellitus Type 2 and role of GINSENG as a Prevention and Control.

Introduction: Diabetes is one of the most challenging diseases of this era. Improper dietary habits and sedentary life style are considered as the foundation stone for metabolic disorders including diabetes. Intake of large amount of animal fat leads to insulin resistance (IR) and oxygen radical formation.IR leads to increase glucose level in blood resulting in diabetes mellitus.Objectives: This experimental study was intended to correlate high fat diet re-sulting in weight gain to diabetes and emphasized the role of ginsenoside in reduc-ing body weight and blood glucose level by both increasing insulin secretion as well as increasing the sensitivity of insulin receptors.Methodology: This is an experiment study on animal model, conducted at DUHS during the year 2017. It comprises of 50 male Albino Wister rats. They were divided into 5 groups for study purpose. Group1 was put on normal balanced diet and serve as control, while other 4 groups were treated with different diet. The ani-mals were sacrificed after 12 weeks; blood sugar was monitored weekly for 12 weeks and finally at the end of experiment, there blood sugar level were estimated. Statistical analysis was done by using SPSS 16, using ANOVA test to evaluate the significance among groups. P-Value < 0.05 was considered as significant.Results: The collected data was interpreted as Mean ± S.D. The results revealed that high fat diet increases blood glucose level, remarkably increase body weight as well as liver weight. By the administration of ginseng root extract significant de-crease in body weight, liver weight and blood glucose levels was observed in dose dependent manner.Conclusion: The results of this study revealed that high fat diet (HFD) is a major cause of metabolic syndrome including diabetes. It can be prevented by changing life style and introducing ginseng as anti-diabetic agent in obese.Key Words: Diabetic mellitus, body weight, Ginsenosid