Cross Sectional Survey On Maxillo Facial Injuries In Road Traffic Accidents In Karachi

Background: Injuries due to motorcycle accidents are frequent happenings in developing countries as people utilize it commonly as a mode of transport. In Pakistan 56% of Maxillofacial injuries can be associated to Road traffic accidents (RTA) majority of which are due to involvement of motorbikes. Methods: This cross sectional survey was carried out in public tertiary care setting in the year 2016. Three Hundred and Seventy participants were inducted in the study using Purposive sampling technique. Only those with maxillofacial injuries were included and diagnosed through conventional and panoramic radiographs and computed tomographic scans. Those who consented were included whereas, participants with language barrier or unable to answer were excluded. Data was collected by questionnaire with analysis being performed on SPSS version 21. Descriptive analysis was performed for quantitative variables with association between categorical variables tested through chi square. Bond of error was taken at 5% with 95% confidence interval. Permission was sought from ethical review board. Results: Majority, [267(84.5%)] were young patients with [ 282(89.2%)] patients involved in Motorcycle accidents. Of total participants male gender was [275(87%)] the driver inflicted in most situations [184(58.2%)]. Most patients [285(90.2%)] were without any safety device. Majority [220(69.6%)] had Mandibular fractures whereas, 111(35.1%) had Maxillary fractures. Soft tissue injuries were seen in 212(67.1%) patients. Conclusion: Motorcycle related accidents are common cause for maxillofacial injuries in road traffic accidents. Most patients suffered soft tissue injuries. Most commonly fractured bones were mandible and maxilla. Key Words: Maxillofacial injuries, Motorcycle, Accident

Carotid Artery Stenosis in Diabetic Patients Presenting With Acute Ischemic Stroke

Background: Stroke is the commonest life-threatening neurological disorder. The Abnormal narrowing or stenosis of the Carotid Artery is a major determinant of ischemic stroke in diabetic patients. The main objective of study was to estimate the frequency of carotid artery stenosis in diabetic patients presenting with acute ischemic stroke. Methods: This was a Cross-Sectional study conducted at Medicine wards Jinnah Post-Graduate Medical Centre, Karachi from 5th December 2014 to 5th June 2015. Total 101 patients were included. During the hospitalization, patients were subjected to carotid Doppler ultrasonography to assess carotid artery stenosis. Patients were provided routine medical care during the hospitalization. Data was analyzed using SPSS v23.0. Chi-Square was used to analyze the differences between the categories. The p-value of <0.05 was considered as significance. Results: Total 101 patients were included in the study. There were 71.8% males and 28.2% females. The mean age was 53.7±10.2 years. On analysis of risk factors, it was observed that 59% patients had hypertension, 34.2% patients were obese, 34.2% patients had dyslipidemia, 51.3% patients had history of smoking. On analysis of carotid artery stenosis among the diabetics, it was observed that 20.8% diabetics had carotid artery stenosis. Conclusion: Stenosis of Carotid artery was common in patients suffering from acute ischemic stroke and diabetes mellitus. Among modifiable risk factor in patients with stroke having carotid artery stenosis, Hypertension was most common whereas fasting blood sugar FBS level greater than 100 g/dl lead to increased chances of having carotid artery stenosis

Frequency of HIV in Patients with Central Nervous System Tuberculosis

Background: Tuberculosis (TB) is the most widely recognized reason for death in patients of acquired immune deficiency syndrome (AIDS). Human Immunodeficiency virus (HIV) and AIDS continue to be on an increase in Pakistan. This study aimed to assess the magnitude of HIV among patients with Central nervous system (CNS) tuberculosis as its progression to AIDS significantly influences mortality in these patients. The main objective of the study was to determine the frequency of HIV among patients with CNS tuberculosis. Methods: This Cross-Sectional study was conducted at Medicine Wards of Civil Hospital, Karachi from 7th October 2016 to 7th April 2017. A total of 140 newly diagnosed Central Nervous System tuberculosis patients were included. Blood sample collected for HIV test (ELISA) was interpreted as either: Reactive for HIV or Non-reactive for HIV. HIV infection was considered as HIV positive by using 3 Rapid Diagnostic testing kits according to guidelines of World Health Organization (WHO). All the patient data were collected through a pre-designed proforma. Data were analyzed using SPSS v.23.0. Chi-square test was applied post stratification with p- value≤0.05 taken as statistically significant. Results: Sixteen patients (11.43%) of CNS tuberculosis were found to have HIV positive results. Out of total 140 patients, 50(35.71%) were female and 90(64.29%) were male. The average age of the patients was 39.37±12.8 years. Conclusion: CNS tuberculosis can be the primary clinical manifestation of HIV positive patients. Early recognizable proof of HIV in patients with CNS tuberculosis may warrant early inception of anti-HIV treatment

Role of MicroRNA in Endometrial Carcinoma

Endometrial carcinoma (EC) is a hall mark of gynecological malignancies that usually affects women above the age 50. It is one of the major causes of mortality in females with ever increasing prevalence and the mortality rate is 1.7 to 2.4 per 100000 and each year 10000 death occur due to ECs. MiRNAs regulate the expression of different proto-oncogenes and signaling pathways that are directly or indirectly involved in the development of cancer. Different miRNAs i.e. (miRNA-449, miRNA 370, miRNA-424, and miRNA-152) which gets up or down regulated during endometrial cancer are the potential biomarkers for early diagnosis of EC. Targeting this relationship between the miRNA and signaling pathways may help in the development of new treatment in endometrial cancer. In current study, we reviewed literature from PubMed using miRNA and endometrial cancer as keywords and outlined the synthesis of potent miRNA and role of different miRNAs involved in ECs. The study revealed different sub types of miRNA played crucial role in the development of cancer by up and down regulation of different metabolic pathways. Many evidences have supported that miRNAs play role in control and regulation of different pathways leading to cancer and targeting these pathways may bring changes in the diagnosis as well as in treatment of EC

Mechanistic Insight into the role of Vitamin D and Zinc in Modulating Immunity Against COVID-19: A View from an Immunological Standpoint

The pathophysiology of coronavirus disease-19 (COVID-19) is characterized by worsened inflammation because of weakened immunity, causing the infiltration of immune cells, followed by necrosis. Consequently, these pathophysiological changes may lead to a life-threatening decline in perfusion due to hyperplasia of the lungs, instigating severe pneumonia, and causing fatalities. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause mortality due to viral septic shock, resulting from unrestrained and backfiring immune reactions to the pathogen. Sepsis can cause premature organ failure in COVID-19 patients, as well. Notably, vitamin D and its derivatives and minerals, such as zinc and magnesium, have been reported to improve the immune system against respiratory illnesses. This comprehensive review aims to provide updated mechanistic details of vitamin D and zinc as immunomodulators. Additionally, this review also focuses on their role in respiratory illnesses, while specifically delineating the plausibility of employing them as a preventive and therapeutic agent against current and future pandemics from an immunological perspective. Furthermore, this comprehensive review will attract the attention of health professionals, nutritionists, pharmaceuticals, and scientific communities, as it encourages the use of such micronutrients for therapeutic purposes, as well as promoting their health benefits for a healthy lifestyle and wellbeing

Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan

INTRODUCTION: Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS: DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION: Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION: DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research

Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan.

INTRODUCTION: Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS: DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500 cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION: Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION: DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research

Carotid Artery Stenosis in Diabetic Patients Presenting With Acute Ischemic Stroke

Background: Stroke is the commonest life-threatening neurological disorder. The Abnormal narrowing or stenosis of the Carotid Artery is a major determinant of ischemic stroke in diabetic patients. The main objective of study was to estimate the frequency of carotid artery stenosis in diabetic patients presenting with acute ischemic stroke. Methods: This was a Cross-Sectional study conducted at Medicine wards Jinnah Post-Graduate Medical Centre, Karachi from 5th December 2014 to 5th June 2015. Total 101 patients were included. During the hospitalization, patients were subjected to carotid Doppler ultrasonography to assess carotid artery stenosis. Patients were provided routine medical care during the hospitalization. Data was analyzed using SPSS v23.0. Chi-Square was used to analyze the differences between the categories. The p-value of &lt;0.05 was considered as significance. Results: Total 101 patients were included in the study. There were 71.8% males and 28.2% females. The mean age was 53.7±10.2 years. On analysis of risk factors, it was observed that 59% patients had hypertension, 34.2% patients were obese, 34.2% patients had dyslipidemia, 51.3% patients had history of smoking. On analysis of carotid artery stenosis among the diabetics, it was observed that 20.8% diabetics had carotid artery stenosis. Conclusion: Stenosis of Carotid artery was common in patients suffering from acute ischemic stroke and diabetes mellitus. Among modifiable risk factor in patients with stroke having carotid artery stenosis, Hypertension was most common whereas fasting blood sugar FBS level greater than 100 g/dl lead to increased chances of having carotid artery stenosis.</jats:p

Frequency of HIV in Patients with Central Nervous System Tuberculosis

Background: Tuberculosis (TB) is the most widely recognized reason for death in patients of acquired immune deficiency syndrome (AIDS). Human Immunodeficiency virus (HIV) and AIDS continue to be on an increase in Pakistan. This study aimed to assess the magnitude of HIV among patients with Central nervous system (CNS) tuberculosis as its progression to AIDS significantly influences mortality in these patients. The main objective of the study was to determine the frequency of HIV among patients with CNS tuberculosis. Methods: This Cross-Sectional study was conducted at Medicine Wards of Civil Hospital, Karachi from 7th October 2016 to 7th April 2017. A total of 140 newly diagnosed Central Nervous System tuberculosis patients were included. Blood sample collected for HIV test (ELISA) was interpreted as either: Reactive for HIV or Non-reactive for HIV. HIV infection was considered as HIV positive by using 3 Rapid Diagnostic testing kits according to guidelines of World Health Organization (WHO). All the patient data were collected through a pre-designed proforma. Data were analyzed using SPSS v.23.0. Chi-square test was applied post stratification with p- value≤0.05 taken as statistically significant. Results: Sixteen patients (11.43%) of CNS tuberculosis were found to have HIV positive results. Out of total 140 patients, 50(35.71%) were female and 90(64.29%) were male. The average age of the patients was 39.37±12.8 years. Conclusion: CNS tuberculosis can be the primary clinical manifestation of HIV positive patients. Early recognizable proof of HIV in patients with CNS tuberculosis may warrant early inception of anti-HIV treatment.</jats:p