Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors.

Background: Anxiety and depression contribute to poor disease outcomes among individuals with diabetes. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors including metabolic components among people with type 2 diabetes. Methods: We conducted a cross-sectional, multi-center study in four out-Patient clinics in Karachi, Pakistan. In all, 889 adults with type-2 diabetes were included in this study. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariable analysis using multiple logistic regression was carried out to evaluate the combined effect of various factors associated with anxiety and depression, while adjusting for confounding variables. Results: Overall, 57.9% (95% CI = 54.7%, 61.2%) and 43.5% (95% CI = 40.3%, 46.8%) study participants had anxiety and depression respectively. Factors found to be independently associated with anxiety were physical inactivity, having hypertension and ischemic heart disease. For depression, being female, of older age, having hypertension and ischemic heart disease were significantly associated. Metabolic components found to be independently associated with both anxiety and depression were systolic blood pressure, fasting blood glucose and fasting blood triglycerides. Body mass index was independently associated with depression but not with anxiety. Conclusion: This study identified that a large proportion of adults with diabetes had anxiety and/or depression, and identified factors associated with these entities. These results alert clinicians to identify and treat anxiety and depression as common components of diabetes care. Additional studies are needed to establish the directional nature of this relationship and to test interventions

Navigating Additional Canals in Mandibular Teeth: A Case Series

Morphological variation exists in mandibular teeth. Thus, the clinician should be mindful of all the possibilities of variation. Following case series exhibit the variation of morphology in mandibular teeth within the Pakistani population reported at Operative and Endodontics Department of Islamabad Dental Hospital Keywords: Canine teeth, Endodontics, Mandibular incisor, Premolar, Root canal morphology

Morphometric analysis of soldier cast of Odontotermes obesus (Rambur) and Microtermes obesi (Holmgren) (Blattodea: Termitidae; Macrotermitinae) from three localities of Potohar region, Pakistan

A great diversity of termite species is found all over the world, among these 53 species are identified from Pakistan. The knowledge about morphological features in soldier cast of termites is proved to be a technical tool for taxonomy and identification. In the present studies, the morphometric variations of external morphology in soldier caste of Odontotermes obesus (Rambur) and Microtermes obesi (Holmgren) from three different areas i.e. Gujar Khan (A), Rawalpindi (B) and Islamabad (C) were studied. About 36 characters like body, thorax, abdomen, from head to mandible tip, head, pronotum, postmentum, mandible, antenna (scape, pedicle, flagellum), and legs parts were used for morphometric measurements. The data were statistically analyzed for significant differences in their mean, standard deviation, standard error, 95% confidence interval, coefficient of variability and analysis of variance. “Student t-test” was used for the comparison of mean values using Minitab version 16. The results of the present study revealed no significant differences among the population samples collected from various localities. However little variations were observed in a few characters like antennal segments (pedicle, scape) and legs (trochanter, tibia) among the soldier cast which are adaptive in nature to survive in the environment

Properties and Applications of Biodentine in Restorative Dentistry and Endodontics: A Review

Recently, a new calcium silicate based cement known as “Biodentine” or “dentin in capsule” has been introduced. It is a biocompatible and bioactive material. It consists of tricalcium silicates, dicalcium silicates, calcium carbonate and zirconium oxide. It has many promising characteristics including antibacterial activity, high compressive strength and chemical bonding to tooth structure. Additionally, it also has the ability to initiate reparative dentine formation. These properties allow their use for various restorative and endodontic procedures such as management of deep carious lesions, vital pulp therapies, perforation repair, retrograde fillings, apexogenesis, and apexification.&nbsp

SLC11A1 polymorphisms and host susceptibility to cutaneous leishmaniasis in Pakistan

BACKGROUND: The vector-borne cutaneous leishmaniasis (CL) is endemic in several regions of Pakistan mainly affecting poor populations. Host genetic factors, particularly SLC11A1 (solute carrier transmembrane protein) within macrophages, play a crucial role in disease pathology and susceptibility. Association of SLC11A1 with cutaneous leishmaniasis, a neglected tropical disease, is not well established. Inconsistencies have been observed within different populations worldwide with respect to genetic susceptibility. This study was designed to investigate genetic variation(s) in SLC11A1 and to assess possible association with cutaneous leishmaniasis in Pakistan. RESULTS: Eight polymorphisms (rs2276631, rs3731864, rs2290708, rs2695342, rs201565523, rs17215556, rs17235409, rs17235416) were genotyped across SLC11A1 in 274 patients and 119 healthy controls. Six polymorphisms were studied by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing. Two single nucleotide polymorphisms were analyzed with newly designed semi-nested PCR assays. Case-control analysis showed no association between selected polymorphisms in SLC11A1 and cutaneous leishmaniasis. No significant difference was observed in the distribution of alleles between leishmaniasis patients and healthy individuals. Strong pairwise linkage disequilibrium was observed between rs2276631 and rs2290708 (r (2) = 64); and rs17235409 and rs17235416 (r (2) = 78). CONCLUSIONS: This study shows that genetic variations in the candidate gene SLC11A1 do not affect susceptibility to cutaneous leishmaniasis in the sample population from Pakistan. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13071-016-1934-2) contains supplementary material, which is available to authorized users

Prevalence and determinants of Asthma in adults in Khyber Pakhtunkhwa, Pakistan

Asthma is a chronic inflammatory respiratory disease that is caused by biological and environmental factors. These factors can be in the form of dust, chemicals, smoke, allergens, and viruses. Approximately, 315 million people are affected with asthma worldwide. This study is designed to determine the prevalence of asthma in adults of different ages and its symptoms and main determinants in the Mardan and Peshawar districts of Khyber Pakhtunkhwa. A cross-sectional survey was conducted at Hayatabad Medical Complex Peshawar and Bacha Khan Medical Complex Mardan from May 2020 to March 2021. Data were collected from 1,400 individuals, and the prevalence of asthma was reported to be 22.57% (n=316). Asthma prevalence was reported to be more in men (55.7%) compared to women (44.3%) in Khyber Pakhtunkhwa, Pakistan. Asthma was most common between people aged 18-27 years (31%). The majority of asthma patients were obese (53.8%) compared to non-obese (46.2%) patients. The most common symptoms of asthma were respiratory infections including the common cold, flu and pneumonia (89.87%), followed by chest pain, dyspnea (88.6%) and wheezing (83.54%). %). Risk factors for asthma include allergens exposure to dust mites, pollen, animal dander and cold air, family history of the disease, smoking, consumption of food containing sulphites and preservatives and use of certain medications including beta-blockers and aspirin in the KPK province of Pakistan. The government should conduct awareness campaigns in various cities, where proper lung function tests and other drugs using corticosteroids should be used to control the spread of the disease.  

Cardiovascular Disease-Related Lifestyle Factors among People with Type 2 Diabetes in Pakistan: A Multicentre Study for the Prevalence, Clustering, and Associated Sociodemographic Determinants

Background. We evaluated the prevalence and clustering pattern of cardiovascular disease (CVD) related lifestyle factors and their association with CVD among patients with type 2 diabetes. We also examined the association of these factors with various socio-demographic characteristics. Methods. A total of 1000 patients with type 2 diabetes were interviewed in a cross-sectional, multi-center study in out-patient clinics in Karachi, Pakistan. Results. In this study 30.3% study participants had CVD. Majority of the patients were physically inactive and had adverse psychosocial factors. Forty percent of the study participants were exposed to passive smoking while 12.7% were current smokers. Only 8.8% of study subjects had none of the studied lifestyle factor, 27.5% had one, while 63.7% had two or three factors. CVDs were independently associated with physical inactivity, adverse psychosocial factors, passive smoking and clustering of two or three lifestyle factors. Physical inactivity was more prevalent among females and patients with no/less education. Proportion of adverse psychosocial factors were higher among females, elders and patients with no/less education. Clustering of these lifestyle factors was significantly higher among females, elderly and no/less educated patients. Conclusion. These results suggest the need of comprehensive and integrated interventions to reduce the prevalence of lifestyle factors

Logistical Reasons Causing Return from Retail: A Case of Pharmaceutical Retail Market in Pakistan

The main objective of the study was to identify the factors, especially related to logistics, that contribute the most to product returns from retail pharmacy market back to distributers and manufacturers. From literature search the mostly emphasized three logistical factors namely Customer Service (CS), Inventory and Storage (IS) and Transportation were picked to study their impact on Returns (RE). This study was conducted for the retail pharmacy market of Pakistan. Data was collected through a close ended questionnaire by a small team of enumerators. A total of 161 valid responses from a sample of 370 pharmacies, picked randomly, were received and analyzed through SPSS. The analysis indicated that CS and IS are significant contributors for the return of medicines (RE) from pharmacies to wholesalers or distributors. Role of TR was not very significant in the sample picked for this research

The bacterial profile and antibiotic susceptibility in skin and soft tissue infections at tertiary care hospital of Quetta, Pakistan

Objective: To determine the bacterial profile and antibiotic susceptibility in skin and soft tissue infections among patients in a tertiary care setting. Method: The cross-sectional cohort study was conducted at the Centre for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan, from June 2021 to May 2022, and comprised bacteria-infected skin samples that were collected from the Bolan Medical Complex Hospital, Quetta, and the Sandeman Provincial Hospital, Quetta. The swab samples were immediately cultured, and positive samples were evaluated for biochemical tests, antibiotic susceptibility test and polymerase chain reaction. Data was analysed using SPSS 22. Results: Of the 800 samples, 598(74.7%) tested positive for pathogenic bacteria. Staphylococcus aureus accounted for 316(39.5%) infections, followed by clostridium perfringens 18.96(2.37%), escherichia coli 120(15.12%), pseudomonas aeruginosa 98(12.25%) and klebsiella pneumoniae 44(5.5%). Among all the infected samples, 380(47.5%) belonged to males, 218(27.25%) to patients aged 5-20 years, 448(56%) to the uneducated subjects, and 462(57.87%) to patients having lower socioeconomic status. Pseudomonas aeruginosa showed the highest level of resistance against all antibiotics. Conclusion: Regular surveillance and proper use of antibiotics should be encouraged in hospitals to limit the spread of antibiotic resistance against pathogenic bacteria. Key Words: Antibiotics, Bacteria, Surveillance, Frequency, Skin