Level of Psychological Adjustment and Intolerance Uncertainty among Heart Surgery Patients

To perceive the association among psychological adjustment and intolerance uncertainty among heart surgery patients, the present research was conducted. On the basis of purposive sampling method, a sample of 100 was chosen. These patients of BVH, completed the questionnaire forms. From BVH, the sample was purposively selected. By enumerating the percentages, the gathered data was examined and the interpretation was obtained on the base of findings of each type of questionnaire. For examining the data, descriptive statistics, correlation; SPSS was used. On the basis of findings and conclusion, the endorsement was drawn. Among researchers, psychological adjustment is increasingly getting popular as for analyzing behavior, conflicts, obstacles and misrepresenting varied social involvements that pupil go through as executive at workplaces and intolerance uncertainty investigation cogitative, profundity of future uncertainty as intimidating about their disease. Furthermore, there was a pessimistic association among psychological adjustment and intolerance uncertainty

STUDY OF GULZAR'S LEGENDARY STYLE

The short story is an important part of Urdu literature and dealt with a wide range of life dimensions, but most short stories of Gulzar concern the trauma of the partition of the subcontinent in 1947. He critically observed these incidents by himself so the violence generated as a result of this partition leaves a deep impact on him. No doubt he is a live legend and a great writer, his writings gained momentum with the phenomenal narration which is full of expressions, feelings, emotions and questions about the politics and political leaders of that time. Gulzar is a perfect story writer by his charismatic and unique style. This article reveals and examines the artistic aspects of his literary craftsmanship with a special reference to his contribution not only in the field of literature but to history and politics as well

Abdominal Hysterectomy for Benign Gynecological Diseases

OBJECTIVES This study aims to assess the Pap smear screening method’s accuracy in detecting precancerous lesions. METHODOLOGY After fulfilling the inclusion criteria patients were selected, the patient’s bladder was emptied and put in a dorsal position, and Cusco’s speculum was introduced after lubrication followed by insertion of Ayer’s spatula, applied on the transformational zone, and rotated in 360 degrees. Specimen smeared on glass slides and sent to the laboratory with fulfilled lab pre-requisite form. Patients were requested to follow up with a histopathology report. RESULTS Mean age of the patient was 38.111+9.461 years. Among the 77 patients whose samples were taken 15.4% were asymptomatic, 32.1% with vaginal discharge, 17.9% vaginal discharge,17.0% with intermenstrual bleeding and 16.7% were having lower abdominal pain with p value=0.087. Histopathology reports were interpreted upon follow-up visit among those 1.3% came out to be positive for malignancy, 76.6% negative for malignancy while 22.1% had an inadequate sample. CONCLUSION The most common method for screening for cervical cancer is the Pap smear, but its efficacy in detecting early precancerous lesions is very low, possibly due to laboratory error or false technique to a gynecologist of sample technique in our tertiary care hospital. Other screening methods should be used instead of conventional Pap smear

Study of Postdatism with Respect to Fetomaternal Outcome at A Tertiary Care Hospital

OBJECTIVES This study aims to know our setup’s fetomaternal pregnancy complications that extend beyond 40 weeks of gestation. METHODOLOGY This is a prospective cross-sectional study of 390 patients with uncomplicated postdated pregnancies fulfilling the inclusion and exclusion criteria admitted to the department of Obstetrics and Gynecology (both in spontaneous labour and induced patient) at Hayatabad Medical Complex, a tertiary care hospital in Peshawar, KPK from July 2020 to June 2021.RESULTS Out of 390 patients, a majority (72.30 %) were in the age group of 20 – 35 years. Most of them (50.51%) presented at gestation 40+1 – 40+6 weeks. The majority (57.69%) were multigravida, and most (93.07%) were un-booked. Most delivered vaginally (80.51%), and 19.48% had C/section (including both emergency and elective). The most common indication for C/section was fetal distress (44.73%), followed by C/section on demand (18.42%). The majority>90% had Apgar score greater than seven at 5 minutes which was gestation dependent. Overall perinatal mortality was 4.07% which was also gestation dependent ranging from 0.5% at 40+1 – 40+6 weeks to 2.30% at and beyond 42 weeks of gestation. Neonatal morbidity in the form of Birth asphyxia, Meconium Aspiration Syndrome (MAS), Shoulder Dystocia and NICU admission also showed an increasing tendency with increasing gestation beyond 40 weeks. Maternal morbidity in the form of PPH, perineal tears 3°/4° and endometritis also showed a similar increasing trend with increasing gestation beyond 40 weeks. CONCLUSION Pregnancy continuing beyond 40 weeks has a definite risk to the fetus.

“Regenerating” Iα Gene Variants g. -385T>C and g. -243T>G in Type 2 Diabetes

Background: Restoration of the body’s ability to produce insulin by regeneration of β-cells is an essential step toward the management of diabetes. REG Iα is released from damaged β-cell and facilitates their renewal. However, genetic variants of REG Iα and their clinical associations are overlooked areas. This study was designed to identify polymorphisms of REG Iα gene exon 1 and its association with type 2 diabetes. Methods: This was a case-control study conducted on individuals n=51 both diabetics (n=36) (aged, 52±9 years; males 25, females 11) (group II) and age-related controls (n=15) (aged, 50±3 years; males 9, female 6) (group I) recruited from PNS Shifa Hospital, Karachi. The samples were amplified, and the gene was sequenced to identify polymorphisms. Chi-square (γ2) test was used to determine whether each polymorphism obeys Hardy-Weinberg equilibrium (HWE). Odds ratios, 95% confidence interval along with corresponding p values were calculated through logistic regression analysis. p < 0.05 was considered statistically significant.   Results: A set of two single nucleotide polymorphisms (SNPs) were detected in the REG Iα gene exon1 in the subjects under study. SNPs studied were: g.-243T>G [rs 283890], and g.-385T>C [rs10165462]). Both variants g-243T>G, and g-385T>C showed significant association (γ2=12.8, p=0.0003, γ2=13.8, p=0.0002) with smoking. The allele G showed an eight-fold increased risk of disease in smokers while allele C had less chance of the disease in smokers as compared to non-smokers. Conclusion: Among the SNPs detected in exon 1 of the gene for REG Iα, the g. -385T>C and g.  -243T>G variants showed an association with smoking in type 2 diabetes and the SNP -243G (rs 283890) was found to increase the risk of disease in smokers. Keywords: REG Iα gene; Polymorphisms; Type 2 Diabetes; β-cells Regeneration

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

Characterization of Hepatitis C Virus genotype 3a Hypervariable region 1 in patients achieved rapid virological response to alpha interferon and Ribavirin Combination therapy

<p>Abstract</p> <p>Background</p> <p>Hepatitis C virus roots a chronic liver disease. Currently approved treatment strategy includes administration of alpha interferon and ribavirin combined therapy for 24-48 weeks. One of the predictor of sustained virological response is an early virological response to treatment characterized as rapid response. Hyper variable region 1 (HVR1) of E2 protein is responsible for viral entry and acts as a target for neutralizing antibodies. Any mutation in this region would effect virus interaction with target cell and viral persistence.</p> <p>Methods</p> <p>Thirty one clones of six pre-treatment samples subjected to combination therapy were investigated. Three of the patients were rapid responders (R1, R2 and R3) and two were breakthrough responders (BT1 and BT2). Envelope 2 gene was amplified, cloned and sequenced. Amino acid substitution, frequency, composition and antigenic properties of HVR 1 of E2 protein were studied.</p> <p>Results</p> <p>In both rapid responders (R.R) (14 amino acid sites) and breakthrough responders (BT.R) (13 amino acid sites) half of the amino acid sites were either conserved or resistant to any physiochemical change due to amino acid substitution. It also indicated that average composition of hydrophilic and basic amino acids were comparatively lower in rapid responders than other samples affecting probable interaction of virus with target cells. A central non antigenic region was constant among the breakthrough responders but differed in length significantly among rapid responders reflecting the adaptive nature of HVR1 to the immune response.</p> <p>Conclusions</p> <p>We observed that although HVR1is quite variable region in HCV 3a patients responding differently to treatment it still maintains its physiochemical properties for its proper functioning and viability.</p

Mutations in the E2-PePHD region of hepatitis C virus genotype-3a and correlation with response to interferon and ribavirin combination therapy in Pakistani patients

Hepatitis C is a major health problem affecting more than 200 million individuals in the world. Current treatment regimen consisting of interferon alpha and ribavirin does not always succeed in eliminating the virus completely from patient's body. One of the mechanisms by which virus evades the antiviral effect of interferon alpha involves protein kinase (PKR) eukaryotic initiation factor 2 alpha (eIF2a) phosphorylation homology domain (PePHD). This domain in genotype 1 strains is reportedly homologous to PKR and its target eIF2a. By binding to PKR, PePHD inhibits its activity and therefore cause virus to evade antiviral activity of interferon (IFN). Many studies have correlated substitutions in this domain to the treatment response and lead to inconclusive results. Some studies suggested that substitutions favor response while others emphasized that no correlation exists. In the present study we therefore compared sequences of PePHD domain of thirty one variants of six hepatitis C virus patients of genotype 3. Three of our HCV 3a infected patients showed rapid virological response to interferon alpha and ribavirin combination therapy whereas the remaining three had breakthrough to the same combination therapy. It is found that PePHD domain is not entirely conserved and has substitutions in some isolates irrespective of the treatment response. However substitution of glutamine (Q) with Leucine (L) in one of the breakthrough responders made it more identical to HCV genotype 1a. These substitutions in the breakthrough responders also tended to increase average hydrophilic activity thus making binding of PePHD to PKR and inhibition of PKR more favorable

Metformin mitigates SASP secretion and LPS-triggered hyper-inflammation in Doxorubicin-induced senescent endothelial cells

Introduction: Doxorubicin (DOX), a chemotherapeutic drug, induces senescence and increases the secretion of senescence-associated secretory phenotype (SASP) in endothelial cells (ECs), which contributes to DOX-induced inflammaging. Metformin, an anti-diabetic drug, demonstrates senomorphic effects on different models of senescence. However, the effects of metformin on DOX-induced endothelial senescence have not been reported before. Senescent ECs exhibit a hyper-inflammatory response to lipopolysachharide (LPS). Therefore, in our current work, we identified the effects of metformin on DOX-induced endothelial senescence and LPS-induced hyper-inflammation in senescent ECs.Methods: ECs were treated with DOX ± metformin for 24 h followed by 72 h incubation without DOX to establish senescence. Effects of metformin on senescence markers expression, SA-β-gal activity, and SASP secretion were assessed. To delineate the molecular mechanisms, the effects of metformin on major signaling pathways were determined. The effect of LPS ± metformin was determined by stimulating both senescent and non-senescent ECs with LPS for an additional 24 h.Results: Metformin corrected DOX-induced upregulation of senescence markers and decreased the secretion of SASP factors and adhesion molecules. These effects were associated with a significant inhibition of the JNK and NF-κB pathway. A significant hyper-inflammatory response to LPS was observed in DOX-induced senescent ECs compared to non-senescent ECs. Metformin blunted LPS-induced upregulation of pro-inflammatory SASP factors.Conclusion: Our study demonstrates that metformin mitigates DOX-induced endothelial senescence phenotype and ameliorates the hyper-inflammatory response to LPS. These findings suggest that metformin may protect against DOX-induced vascular aging and endothelial dysfunction and ameliorate infection-induced hyper-inflammation in DOX-treated cancer survivors