Pediatric leukemia related depression in Pakistan

The purpose of this letter is to describe the problem facing during and after the treatment of pediatric leukemia. Depression and anxiety are the most leading challenges faced by children and its family. Anti-depressant used to cope this problem but they have many side effects. So, timely proper diagnosis, good healthy behavior of health care professionals and nurses and positive psychological therapy may be useful to reduce the stress level, effectiveness of social stigma, anxiety and hopelessness in Pediatric leukemia survivor children. By implementation of positive psychological therapy in government hospitals of Pakistan rate of better progression recovery after chemotherapy in pediatric leukemic patients towards the stress free life could be possible.Pediatric leukemia is preponderant malignancy in children under age 18 in Punjab, Pakistan. It is most eminent cancer among the children in which body produces abnormal immature lymphoblast which do not form a mature lymphocyte for normal functioning of body [1]. Leukemia is an assemblage of disorders that affect the blood making tissues in spleen and in many other parts such as bone marrow and lymphatic system. The leukemia means “white blood” because it is specifically associated with the white blood cell (leukocytes) proliferation. Production of specified blood cells from stem cells are formed according to requirement of body by hematopoiesis process. In leukemia myeloid or lymphoid cells are defected.According to Punjab Cancer Registry report 2018, 3.5% leukemia frequently reported in all age groups in both genders, 3.4% in adult males and 14.9% acute lymphoblastic leukemia in children age group less than 18 years old. This is a most common cancer among children in 2018 [1]. From 2018 to 2022 the rate of leukemia is increased among all groups such as 3.9% in all age groups including both genders and 25% (acute lymphoblastic leukemia) in childrenPediatric type of cancers such as leukemia are mostly treated by parental expenses and many variables related to family, are strongly associated with the health outcome, morbidity and mortality of children. Its diagnosis and therapies may have confrontational psychological executes on child and his family. Anxiety is first significant problem faced by Leukemic patient and its parents at post diagnosis of disease and depression is continuous mental state during treatment [3]. Cancer survivors have deep fear of loneliness, hopelessness, depression, anxiety and social stigma. Family caregivers are the hidden sufferer of this psychological disorder. Their social, economic and emotional life are strongly disturbed and neurotic [4, 5]. The whole process from duration of treatment of children to their survival after illness is challenging task for both parents and children, physically and psychologically which influenced the family structure and function [6].Mostly people in developing countries like Pakistan has no formal care on this issue, this can lead towards depressed life even after successful treatment. Pharmacological treatments such as antidepressant drugs are used to cure for depression. But due to side effects of anti-depressant, patients are not adhering to this type of cure and prefer to choose non pharmacological treatments to reduce the anxiety. Positive thinking is one of the best psychiatric treatments [7]. Positive psychotherapy relief the patients from stress by encouraging more positive emotions and meetings rather direct targeting the symptoms of depression and anxiety [8].Positive psychological conciliation and healthy behavior of health care professionals is the good contrivance for cultivating positive behavior, emotions and cognition for healthy quality of life in leukemia survival. Psycho educational programs are eloquently escalated hope in child and his family and return towards the healthy happy life after depressed process of treatment [9]. Routine mental screening for anxiety and evaluation of parental functioning are significant methods which is helpful to identify the target patient with family who suffered with high level of depression. Psychological assessment surveys and distress thermometer may be important useful tool can be used by health care professional or nurses during checkup for better evaluation [10]. A significant number of leukemia patients in different hospitals of Pakistan experienced with disturbed depressed psychological mental state. Government of Pakistan should take all these approaches with positive psychological conciliation, practically in hospitals in different phases of cancer such as pediatric leukemia treatment, to help the child to cope with depression and escalating stress-free life expectancy.Keywords: Leukemia; Depression   

Characterization of Halophilic/Halotolerant Bacteria Isolated from the Hypersaline Environment of Khewra, District Jhelum

Background: Khewra salt mine is an extremely saline habitat of Pakistan that provides a suitable environment for salt loving microorganisms, halophiles. Halophiles grow in high salt concentration and are excellent sources of enzymes that perform catalytic reactions competently under extreme conditions.Methods: A total of twenty-five samples (rocks, soil, water, and salt drippings), collected from Khewra salt mine and its vicinity, were checked for growth. Isolates were purified and characterized by Biochemical and Molecular Tests. The isolates were also screened for biotechnological potential.Results: Samples (n=12) did not show growth, while samples (n=13) showed growth on high salt media. Isolates showed growth on 1-29% NaCl concentration, 15oC-40oC temperature and pH 6.5-9.0. Molecular analysis showed that isolate AJS-21y was closely related (98% similarity) to Salinicoccus roseus while isolate AJS-22 belonged to Bacillaceae family and was closely related (99% similarity) to Piscibacillus sp. Both isolates gave extracellular production of amylase.Conclusion: Current study showed the presence of Salinicoccus sp. and Piscibacillus sp. in Khewra salt mine, Pakistan. The ability of isolates AJS-21y and AJS-22 to survive at high salt concentrations and production of extracellular amylase made them highly attractive for industrial applications and synthesizing transgenic crops tolerating high salinity.Keywords: Khewra; Characterization; Halophilic; Halotolerant; Salinicoccus; Piscibacillus   

Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease

Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease Objectives: To determine the outcomes in patients with small-vessel disease (SVD) who underwent percutaneous coronary intervention (PCI) with a drug-coated balloon (DCB) and correlate these adverse outcomes with various risk factors. Methodology: The prospective cohort study was conducted at the Rawalpindi Institute of Cardiology (RIC) from January 2020 to December 2022. After being approved by the Hospital Ethics Committee, fifty-four patients who presented with SVD were enrolled using non-probability consecutive sampling. Written informed consent was obtained from the patients. They were treated with DCB and observed clinically on follow-ups at 15, 30, 60, and 90 days, & later after every 6 months for up to 2 years. Only those patients who presented with symptoms underwent repeat angiography. The outcomes assessed were cardiovascular mortality, myocardial infarction (MI), and target lesion revascularization (TLR). Results: Cardiovascular mortality occurred in 2(3.7%), MI in 3(5.6%) and TLR in 2(3.7%) patients. There was a significant association between cardiovascular mortality, MI, and TLR with diabetes mellitus and BMI. Age was only significantly related to cardiovascular mortality. Conclusion: A drug-coated balloon is an effective and feasible treatment modality for small vessel disease. The incidence of outcomes of cardiovascular mortality, MI, and TLR after DCB is low, making it a safe modality. Advanced age, obesity, and diabetes mellitus alone or with hypertension are the predicting factors of adverse outcomes after DCB in patients with SVD. Keywords: Drug-coated balloon, DCB, Small vessel coronary artery disease, SV

Diagnostic accuracy of Calypte HIV-1 Urine EIA kit in Pakistan

Background: HIV is one of the major public health issues of modern world. The elevation in numbers calls for increased and efficient diagnostic testing protocols. A great number of HIV diagnostic tests have been approved and in use in the developed world but developing countries are still lagging in terms of testing HIV. These reasons are the motives behind this study which is aimed at testing the accuracy and use of Calypte HIV-1 Urine EIA in the Pakistani population.Methods: 516 subjects are included in the study from different HIV centers of Pakistan. The test results of Calypte-HIV-1 Urine EIA were compared with the routinely used 3-kit method.Results: The results exhibited 100% specificity but low sensitivity (74.67%). However, the positive predictive value and negative predictive value were 100% and 52.94%, respectively. Overall accuracy result for this kit was observed to be 81.40% for Calypte HIV-1 Urine EIA in the selected sample.Conclusion: Pakistan has a low population prevalence of HIV and keeping in view of the WHO recommended guidelines for HIV testing, the use of Calypte HIV-1 Urine EIA is not ideal in the current scenario. Even though the test can be of great value in high prevalence populations and can be an excellent means of surveillance procedures, it is not as fit to be used in diagnostic settings in the current situation in developing countries

Exploring Student’s Experiences and Problems in Online Teaching and Learning During Covid-19 and Improvement of Current LMS Through Human-Computer Interaction (HCI) Approaches

This study tried to explore students’ experiences and problems with online teaching and learning during COVID-19 and the improvement of current LMS through Human-Computer Interaction (HCI) approaches. A mixedmethod approach was used in this project. A triangulation design was used in this study. This study was held at the university level and from Baltistan University; researchers took 12 students through a purposive sampling method. After thematic analysis, a survey was conducted. There are 2000 students at Baltistan University. 200 university students were randomly selected as the sample of this study. Semi-structured interviews and self-developed questionnaires were used as research tools. Thematic analysis and descriptive statistics were used to analyse the data. This study concluded that self-learning, family and teacher issues, financial, internet and light issues, IT assistance, and training needs at the students, teachers, and parental level were collectively described as a human-computer interface in the online teaching-learning process during COVID-19. All the students believed that when their family and teachers’ issues; financial, internet, and light issues, information technological assistance, and parents, students, and teachers’ training are improved then improvement of current LMS through Human-Computer Interaction approaches has occurred in Baltistan university.</p

Hyperhomocysteinemia: The independent risk factor of cardiovascular diseases

Hyperhomocysteinemia (Hcy) is an independent risk factor for cardiovascular diseases (CVD) and associated with primary causes of mortality and morbidity throughout the world. Association between Hcy and CVD has been a question for biologists over the last five decades. The circulating levels of Hcy can be increased by defects in enzymes involved in the metabolism of several B and therefore for homocysteine.  Although researchers have yielded conflicting findings on the link between homocysteine and CVD risk, but there is convincing evidence on link between B vitamin deficiencies and increased CVD risk. This review identifies the research conducted on this subject matter and provides a framework for the factors associated with Hcy and CVD.Keywords: Hyperhomocysteinemia; CVD; Methionine; Homocystein

Self-Efficacy and Academic Stressors in University Students

This quantitative study aims to assess the degree to which self-efficacy (the sense of their abilities by students) enables students to overcome their academic stress. A sample of 174 men and women university students (age range of 18-23 and 23-29) of the Islamia University of Bahawalpur participated in the research; data was obtained by convenience sampling technique. The mode of collecting data was online i.e. via emails and social apps like WhatsApp etc. Demographic information such as age, name, gender, socioeconomic status, family system and education was taken, besides, The General Self-Efficacy scale (GSE) (Schwarzer &amp; Jerusalem, 1995) and Opinions of Scholastic Pressure (PAS) scale (Bedewy &amp; Gabriel) were utilized. Study findings suggest that there is a negative correlation between self-efficacy and academic stress which means, if an individual's self-efficacy declines, academic stress will increase and vice versa. The results have also shown that Self-efficacy is a strong predictor of academic stress. Implications were given for future studies on the role of self-efficacy in helping students overcome their stress and improve their academic and other fields of life success

Status of oxidative stress in breast cancer patients in Pakistani population

Background: Breast cancer is a major risk factor to the health of women around the globe and every year more than one million women are diagnosed with it. Pakistan is considered on the highest risk of breast cancer among Asian countries. One of the major reasons associated with higher incidence rate is oxidative stress condition in Pakistani women. The aim of this study was to analyze oxidative stress in patients with breast cancer in local population.Methods: Activity of antioxidant enzymes i.e. superoxide dismutase (SOD) and catalase, level of reduced glutathione (GSH) were measured in the blood samples of breast cancer patients. To emphasize the results and the extent of lipid peroxidation in terms of malonyl dialdehyde (MDA) level were also evaluated. All the activities from cancer patients were compared with those of healthy people taken as control.Results: The levels of GSH and MDA were found higher in the patients as compared to control group. While, activity of SOD and catalase enzymes was low in the diseased group.Conclusion: Our study shows a significant oxidative stress in breast cancer patients in local population

A PROSPECTIVE OBSERVATIONAL STUDY ON MEDICATION USE PATTERN IN PATIENTS WITH RISK FACTORS OF CHRONIC KIDNEY DISEASE

Objectives: The current study was undertaken to review and assess the medication usage pattern in patients with chronic kidney disease (CKD). Methods: A 12-month prospective observational study was carried out at Shadan Teaching and General Hospital, Peerancheru (Hyderabad), involving 384 CKD patients considering the inclusion and exclusion criteria. Medication evaluation for optimization was done using the World Health Organization (WHO) core prescribing indicators. Data collected were entered using Microsoft Excel. Descriptive statistics such as mean, percentage, and standard deviation (SD) were used to present sociodemographic characteristics of the study participants. Results: Out of the total of 384 patients, 249 (65%) were male and 135 (35%) were female with a mean age of 58.28 (SD: 13.12). A total of 384 prescriptions were scrutinized with a total of 3634 drugs, out of which drugs acting on the cardiovascular system were the most prescribed drugs (36.37%). The average number of drugs per prescription was found to be 9.08 considering the total number of prescriptions. The percentage of drugs prescribed by generic name was 15.57%. The percentage of encounters with antibiotics was 25%, whereas the percentage of encounters with injections was 86%. The percentage of drugs prescribed from the Essential Drug List or Formulary was found to be 26.36%. Conclusion: Assessment of medication usage patterns using the WHO core indicators in CKD patients helps to reinforce the current hospital guidelines for the optimal usage of medications. The introduction of a clinical pharmacist along with a multidisciplinary team provides intensive care to the patients and helps to improve the clinical outcome