Global Citizenship Skills among University Students and its Relationship with their Identity Orientation

Major purpose of the current study was to examine the prevalence of global citizenship skills among university students in Pakistan and its relationship with their identity orientations. Three indicators of global citizenship including social responsibility, global competence and global civic engagement were accepted to execute the research objective. The study followed four aspects of identity orientations including personal, social, collective and relational orientations. 324 students enrolled in selected Pakistani public sector universities participated in the study. Aspects of Identity Questionnaire (AIQ-IV) developed by Cheek and Briggs (2013) and global citizenship scale developed by Morais and Ogden (2011) were adapted as research instruments to collected the required data. Results show the prevalence of global civic engagement and social responsibility is comparatively lesser among the participants than other global citizenship skills. The students supported all four types of identity orientations. The study concludes that the four identity orientations have significant and direct associations with major global citizenship skills

Asymptomatic unilateral cerebellar hypoplasia in an adult patient - A unique presentation.

Unilateral cerebellar hypoplasia is a relatively rare malformation. We report a case of 54 year old female patient who presented with single episode of sudden unconsciousness and slurring of speech. Imaging finding suggests the diagnosis of unilateral cerebellar hypoplasia. The patient recovered with conservative management probably because the symptoms were due to Transient ischemic attack not due to hypoplasia

A rare case of three years disease free survival in a locally advanced parathyroid carcinoma successfully excised by complete surgical resection

Parathyroid carcinoma (PC) is one of the rarest malignancies making approximately 0.005% of all cancers. It may arise sporadically or less commonly, in conjunction with genetic endocrine syndromes. Due to the rarity of the disease, no general consensus or definitive guidelines exist for its pre-operative diagnosis, management, or follow up. Surgical tumor removal is the gold standard treatment to prevent its recurrence. Parathyroid carcinoma has a high recurrence rate ranging from 40 to 60% in recent literature. We report a case of a seventy-year-old elderly female with locally advanced parathyroid carcinoma successfully surgically excised completely with a 3 year disease free survival period without adjuvant chemotherapy or radiotherapy

Quality of reporting of randomised controlled trials of artificial intelligence in healthcare: A systematic review

Objectives: The aim of this study was to evaluate the quality of reporting of randomised controlled trials (RCTs) of artificial intelligence (AI) in healthcare against Consolidated Standards of Reporting Trials-AI (CONSORT-AI) guidelines.Design: Systematic review.Data sources: We searched PubMed and EMBASE databases for studies reported from January 2015 to December 2021.Eligibility criteria: We included RCTs reported in English that used AI as the intervention. Protocols, conference abstracts, studies on robotics and studies related to medical education were excluded.Data extraction: The included studies were graded using the CONSORT-AI checklist, comprising 43 items, by two independent graders. The results were tabulated and descriptive statistics were reported.Results: We screened 1501 potential abstracts, of which 112 full-text articles were reviewed for eligibility. A total of 42 studies were included. The number of participants ranged from 22 to 2352. Only two items of the CONSORT-AI items were fully reported in all studies. Five items were not applicable in more than 85% of the studies. Nineteen per cent (8/42) of the studies did not report more than 50% (21/43) of the CONSORT-AI checklist items.Conclusions: The quality of reporting of RCTs in AI is suboptimal. As reporting is variable in existing RCTs, caution should be exercised in interpreting the findings of some studies

Comparison between the values of intra-ocular pressure measured by Goldmann applanation tonometer and Air-Puff non-contact tonometer and their relationship with central corneal thickness

Objective: Glaucoma is a sight threatening disorder. Measuring the IOP with accuracy plays a pivotal role in diagnosing and monitoring glaucoma. The purpose of this study was to compare the values of non-contact tonometer; air-puff and GAT (Goldmann Applanation Tonometer) along with its correlation to central corneal thickness (CCT), in various IOP (intra-ocular pressure) groups. Methods: Cross-sectional, prospective study. 311 patients were enrolled in this study. IOP was taken in all patients with APT and GAT. CCT was also measured. Data was analyzed and correlated with the help of Bland-Altman, Pearson correlation and intraclass correlation analysis regarding APT, GAT and CCT, using SPSS 24.0 software. Results: The median IOP measured by APT and GAT was 14mmHg (range: 37) and 12mmHg (range: 16) where as the median CCT was 534µ (range: 44), respectively. At low (<10mm of Hg) and normal IOP (10-20mm of Hg) both instruments showed similar results but at higher IOP (21-30mm of Hg) GAT is concluded more accurate (P=<0.001). Conclusion: GAT showed a high agreement with APT over a wide range of IOP. However, at moderate and higher group of IOP, APT revealed overestimation of IOP compared to GAT. CCT also plays a significant role. Continuous..

SARS-CoV-2 induced coagulopathy and potential role of anticoagulation: Scoping review of literature

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can vary on a spectrum of asymptomatic disease to rarer manifestations like hypercoagulability especially among elderly patients admitted in the intensive care unit (ICU) and those with preexisting comorbidities. The exact mechanism behind this phenomenon is still unclear, however studies have shown an association with elevated cytokines and severe inflammatory response which encompasses this disease. Hypercoagulability can be limited to the lungs, or present as systemic manifestations of arterial and venous thrombosis leading to mortal outcomes. Thus, careful evaluation of risk factors should be performed by physicians and treatment with anticoagulants should be modified accordingly. All Coronavirus Disease 2019 (COVID-19) in-patients should receive thromboprophylactic therapy, with increased dosages administered to patients with increased disease severity or those with a high risk. D-dimer levels and sepsis-induced coagulopathy (SIC) score aid in identifying high risk patients and predicting outcome. This article highlights the pathophysiology behind hypercoagulability, its clinical associations and discusses therapeutic modalities to combat this fatal consequence of SARS-CoV-

To assess the aggressiveness of oral squamous cell carcinoma in the young population

Introduction: Squamous cell carcinoma of the oral cavity has a high prevalence not only worldwide but also in Asian countries. It has been estimated that the mortality from the tumor has remained almost 56% and cancer presenting at a younger age tends to be more aggressive and advance at the time of presentation. Objectives: To assess the pattern of recurrence and disease-free survival in two age groups. Materials and methods: This is a retrospective, cohort study of patients diagnosed with oral squamous cell carcinoma admitted between 2008 to 2018. Two groups were made with 40 years as a cut off mean. Various etiological factors, staging, treatment, site of the tumor, and recurrence and mortality were assessed. Results: Patients who underwent treatment for the cancer of which 124 patients were of less than 40 years and 327 were of age above 40 years. The ratio between males to females in Age40 was 3:1 respectively. The most common site of the tumor is cheek in origin. Patients in Age 40 years recurrence of tumor is (n=120, 37%) with CI of 95% (P=0.653) and the overall mortality in Age40 (n=168, 51%) of patients have a mortality with CI of 95% (P=0.811). Conclusion: Overall the study suggests that mortality of the tumor is almost the same with a slight difference in recurrence of the disease. Cheek is the most common site of presentation

Risk factors associated with disease recurrence in patients with T4 staged Squamous Cell Carcinoma of the Oral Cavity treated with surgery and postoperative radiotherapy

Objective: To determine the association of clinical and pathological parameters on recurrence of treated stage T4squamous cell carcinoma of oral cavity patients managed with surgery followed by concomitant chemo and radiation therapy. Method: The retrospective, cohort study was conducted at Patel Hospital, Karachi, and comprised data of patients diagnosed with oral squamous cell carcinoma and admitted between January 1, 2014, and January 30, 2019. Patients of either gender aged 20-80 years who had a minimum follow-up of one year were included. Data was collected using the Head and Neck Cancer registry form and the medical record files. The subjects were also contacted by telephone when needed. The study end-points were disease-free survival and overall survival. Data was analysed using SPSS 21. Results: Out of the 83 patients, 65(78%) were male. The overall median(range) age was 46(20-80) years, and 43(52%) of them were aged 31-50 years. Overall, 15(18%) patients had positive margins and 48(58%) had proven cervical node metastasis on histopathology. Overall survival was 42.2% with the median(range) follow-up time was 14(9-21) months and 5-year disease-free survival was 45.8% with the median (range) follow-up time was 13(7-19). The factor that affected the final outcome was found to be the increasing nodal ratio (p=0.043). Conclusion: Among T4 oral squamous cell carcinoma patients treated with surgery and adjuvant therapy, the rate of disease recurrence was found to be high. Tumors with a high cervical nodal disease burden and/or margin involved were at substantially higher risk of recurrence. Key Words: Squamous cell carcinoma, Oral cancer, Recurrence, Survival

Efficacy and safety profile of 25-gauge pars plana vitrectomy in rhegmatogenous retinal detachment in Pakistan: A multicenter retrospective study

Introduction: This study aims to evaluate the primary anatomical success and visual outcomes of 25-gauge pars plana vitrectomy (25g PPV) in patients with rhegmatogenous retinal detachment (RRD) in Pakistan.Design: This is a five-year retrospective, interventional cohort study conducted at tertiary care hospitals in Pakistan from October 2013 to October 2018.Methods: This is a retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. All surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients who underwent 25g PPV surgery as the treatment for RRD from October 2013 to October 2018 were included. We excluded patients who had a history of previous retinal surgery or did not complete the 4-8 weeks of primary outcome visit. We used the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corporation, Armonk, NY, USA) for statistical analysis. A p-value of \u3c0.05 was considered significant.Results: We identified 452 patients through the coding system of our hospitals who underwent 25g PPV surgery for RRD during the study period. A total of 441 patient files were reviewed for the study, of which 418 patients met the criteria for final analysis. The mean age was 49 ± 15.8 years. There was a higher number of males (n = 284, 67.9%). In our study, 186 (44.4%) patients were phakic at the time of presentation. The macula was detached in 361 (86.4%) patients. At the primary outcome visit (4-8 weeks of follow-up), the primary anatomical success rate was 89.47%. The most common cause of failure was proliferative vitreoretinopathy (PVR) (n = 20), followed by missed breaks (n = 5).Conclusions: The surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population