Major Artery Occlusion: a Rare Complication of Sickle Cell Disease

Sickle cell disease is hereditary hemoglobinopathy which causes haemolytic anemia, vaso-occlusive crisis, ischemic injuries and many other morbidities like cerebral infarction. In this report, we describe a case of a young patient with sickle cell disease presenting with right-sided weakness and slurring of speech with examination confirming right-sided hemiparesis with motor aphasia. On further investigation, she was found to have frontotemporal infarction. On magnetic resonance imaging with angiography, she was found to have absent circulation in left internal carotid artery probably secondary to sickle cell disease. Major vessel occlusion is rare complication of sickle cell disease that one must bear in mind

Burnout among diabetes specialist registrars across the United Kingdom in the post-pandemic era

Introduction: Burnout syndrome is a condition resulting from chronic work-related stress exposure and can be identified by the presence of one or more of the three classic dimensions of burnout, i.e., emotional exhaustion, depersonalization, and lack of personal accomplishment, which negatively impact physician health and productivity. Objective: This study aimed to identify burnout among Diabetes and Endocrinology Specialty Training Registrars (DStRs) across the United Kingdom. Design/setting: It was a Cross-sectional observational study after ethical approval ERSC_2022_1166, utilizing the gold standard Maslach Burnout Inventory to measure burnout syndrome, and to determine self-reported stressors and compare them with the results of our previous survey in 2018. Participants: Over 430 DStRs across the United Kingdom were invited electronically through their deanery representatives and specialty training bodies. Results: Using Google Forms™ to gather data, we were able to collect 104 completed surveys. Results revealed that 62.5% (n = 65) of participants have burnout (5% increase from the previous survey in 2018), 38.6% (n = 40) have high emotional exhaustion, and 44.2% (n = 46) feel a lack of personal accomplishment. “General Internal Medicine specific workload” was the most common self-reported stressor reported by 87.5% (n = 91) of participants, whereas bullying/harassment and discrimination at work were reported by 35.6% (n = 37) and 30.77% (n = 32) of participants, respectively. Using multivariable logistic regression model, personal stress (OR, 4.00; 95% CI, 1.48–10.86; p = 0.006) had significant, while Bullying/harassment (OR, 3.75; 95% CI, 0.93–15.12; p = 0.063) had marginal impact on the presence of burnout. Conclusion: Diabetes and Endocrinology Specialty Training Registrars frequently experience burnout syndrome, which has increased over the last 4 years. However, organizational changes can help identify, prevent, and treat physician burnout. Trial registration: NCT05481021 available at https://ichgcp.net/clinical-trials-registry/NCT05481021

Pakistani Elite Press and Public Agenda: The Case of Women Social Issues

This study attempts to find the correlation between the coverage of social issues of women by Pakistani elite press and the preferences of its readers regarding the coverage. The results show that Pakistani elite press has its own policy to give space and prominence by covering social issues of women in its contents and its readers are not agreed with its policy. The policy adopted by both dailies is different from each other. The News did not give more space and prominence to the issues in its coverage. The issues of murder and rape are on the top in the list of the agenda of The News. On the other hand, The daily Dawn has a policy to highlight the issues by covering them with more space and prominence. The issues of murder and women rights are on the top in the list of the agenda of Dawn. While in perspective of audience characteristics, the readers those higher in age, education, belong to social sciences, female, and married comparatively have more correspondence with the agenda of the dailies. The issues of murder, rape, and women rights have received maximum coverage by Pakistani elite press in overall coverage. Keywords: Elite, Newspapers, Women, Social, Issues, Dawn, New

Effects of bomb blast injury on the ears: The Aga Khan University Hospital experience

Abstract Objective: To evaluate the frequency and effects of blast-related otologic injuries. Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised charts of patients who were victims of bomb explosions between January 2011 and July 2013. Frequency and percentages were reported using cross tabulation with size of bomb, distance of person from blast and the presence of victim in open or closed space. Association of associated variables were also analysed. Results: Of the 100 patients, 81(81%) were men and 19(19%) were women. Besides, 68(68%) patients were aged \u3c30 years. Also, 78(78%) subjects were exposed to \u3c 80kg of explosives and 68(68%) were at a distance of\u3e10m. Furthermore, 61(61%) patients were exposed to explosion in openspace. The prevalence of ear injuries was 21(21%). The odds of experiencing various symptoms of ears was high in those who were exposed to \u3e80 kg of explosives (odds ratio: 3.38; 95% confidence interval, 1.16, 9.91). The odds of hearing loss in those who were within 10m was 8.62 (95% confidence interval: 2.72, 27.28) times than those who were \u3e10 m from the site of explosion. Conclusion: Otologic injuries were frequently associated with large blasts

hepatocellular carcinoma is the most frequent final diagnosis of focal liver lesions identified in a cross sectional evaluation of patients with chronic liver disease in saudi arabia

Background.Hepatocellular carcinoma (HCC) is a frequent diagnosis in patients with chronic liver disease (CLD) and a newly identified liver lesion, although benign diseases may also be responsible for this finding.Objective.To evaluate the characteristics of focal liver lesions in a population of patients with CLD not under surveillance for HCC in the Middle East.Methods.We performed a cross-sectional study evaluating 77 patients with CLD and a focal liver lesion identified during ultrasonography. Patients' characteristics were analyzed on the basis of the final diagnosis (HCC versus benign lesions).Results.The most frequent diagnosis was HCC (64.9%). These patients were older (median age 64 versus 55 years,P=0.003) and cirrhotics (80.0% versus 51.9%,P=0.018), with multinodular lesions (58.0% versus 29.6%,P=0.031) and portal vein thrombosis (24.0% versus 0%,P=0.001) compared to patients with benign lesions. Prevalence of elevated alpha-fetoprotein (>10 ng/mL) was similar in both groups (80.0% versus 88.9%,P=0.198). Cirrhosis (odds ratio: 3.283) and multinodularity (odds ratio: 2.898) were independently associated with HCC.Conclusions.HCC is the most common diagnosis in Middle-Eastern patients with CLD and a liver lesion identified outside HCC surveillance programs, especially in cirrhotic patients. In these patients, elevated alpha-fetoprotein does not differentiate HCC from benign lesions

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Major Artery Occlusion: a Rare Complication of Sickle Cell Disease

<p class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-ansi-language: EN-GB;" lang="EN-GB">Abstract: </span></strong><strong><span style="mso-ansi-language: EN-US;" lang="EN-US">Sickle cell disease is hereditary hemoglobinopathy which causes haemolytic anemia, vaso-occlusive crisis, ischemic injuries and many other morbidities like cerebral infarction.<span style="mso-spacerun: yes;">  </span>In this report, we describe a case of a young patient with sickle cell disease presenting with right-sided weakness and slurring of speech with examination confirming right-sided hemiparesis with motor aphasia. On further investigation, she was found to have frontotemporal infarction.<span style="mso-spacerun: yes;">  </span>On magnetic resonance imaging with angiography, she was found to have absent circulation in left internal carotid artery probably secondary to sickle cell disease.<span style="mso-spacerun: yes;">  </span>Major vessel occlusion is rare complication of sickle cell disease that one must bear in mind.</span></strong></span></span></p&gt