Impact of Corona Virus Disease in Health Care Professionals in Managing Patients with Positive Disease in Pakistan

ObjectiveThe present was conducted to evaluate psychological impact of COVID-19 infection in health care professionals while treating Corona Virus positive patients.Study and Design Descriptive Observational cross Sectional studyMethods and Materials The Depression, Anxiety and Stress Scale - 21 Items (DASS-21) are a set of three self-report scales designed to measure the emotional states of depression, anxiety and stress. The DASS-21 incorporated in a questionnaire form was distributed among the healthcare professionals that were involved in direct management of COVID-19 patients. 224 consented HCPs participated in this cross sectional study, during MAY 2020, nearing the end of the first wave of this pandemic in Pakistan. Results The results were broken down to scores assigned to: Anxiety (overall mean score 19.01 ± 9.2), with 192 (85.7%) HCPs experiencing moderate to extremely severe anxiety;Depression (overall mean score 18.12 ± 10), with 162 (72.3%) HCPs being moderate to extremely severely depressed;Stress (overall mean score 20.12 ± 12.0), 202 (90.1%) HCPs reporting moderate to extreme stress levels. Conclusions Our study highlights the negative effect of this pandemic, despite the steadfastness to serve, on the psychological well being of our healthcare professionals. As the corona virus pandemic continues, the levels of, anxiety, stress and depression are expected to increase among our major workforce and the main defense against the deadly virus. Hence the mental well being of our doctors and paramedics should be scrutinized often and necessary measures should be taken at a national level to ensure the better functioning of our health care system

Hemorrhagic Stroke May Be the Sequelae of Brain Tumors

Objective:  Hemorrhagic stroke is a common neurosurgical emergency caused by multiple pathological conditions. Brain tumors can also present with acute neurodeficits secondary to hemorrhagic stroke. This study as case series was conducted to report the clinical presentation, radiological findings, causes and management of brain tumors presenting as hemorrhagic stroke. Materials and Methods:  Clinical assessment and radiological investigations were done, including CT brain and MRI brain with contrast. Surgery was done with evacuation of the hematoma and excision of tumor, and the tissue was sent for histopathology. Post operatively patients were shifted to the intensive care unit for monitoring and ventilator support if needed. Adjuvant treatment was guided according to histopathology report. Results:  Total number of patients who were diagnosed to have a bleed in brain tumor were thirteen (n = 13). There were 6 (46%) males and 7 (54%) females. Mean age was 55 years. Among 13 patients, 4 (31%) patients had metastatic brain tumors and 9 (69%) patients had primary brain tumors. Diagnosis was done on CT brain, MRI brain and confirmed on histopathology of tissue obtained during surgery. Out of 13 patients, 5 (38%) patients were asymptomatic prior to hemorrhage and 8 (62%) patients had neurodeficits before and recent episodes of bleeding, which caused deterioration of neurological state. Conclusion:  Malignant primary and metastatic brain tumors can present as acute focal deficits due to brain hemorrhage. Diagnosis is based on clinical presentation, radiological features and histopathology.&nbsp

Albuminuria in diabetic patients with stroke.

Diabetes is a major health burden worldwide. There is a close association between albuminuria and development of stroke in diabetics. This study was conducted to determine the frequency of albuminuria among diabetic patients presenting with strok

Comparative Analysis of Education Policy Reforms of Khyber Pakhtunkhuwa (KP) Pakistan since 2008-18

The aim of this study is to compare the educational reforms of two governments in public sector schools within the Khyber Pakhtunkhwa (KPK) region and finds the difference in educational reforms between the government elected in 2008 and government elected in 2013 in KPK. The study uses quantitative approach and used secondary data which is collected from the Annual statistical Report issued from 2009 to 2015. This research explains relationship between independent variables and dependent variable through linear and multiple regression technique. The analysis shows that three independent variables namely Basic facilities, Number of teachers, Number of institution has great impact on student’s enrollment which shows changes made by present government in the education policy has increased the student’s enrollment in public sector schools. The study focuses only on three independent variables while there are some other factors which can affect the student’s enrollment in public sector school

Antidiabetic activities of alkaloids isolated from medicinal plants

Diabetes mellitus is a metabolic disorder affecting a great part of population around the world. It is the fifth leading death causing disease in the world and its cases are increasing day by day. Traditional medicine is thought to have promising future in the treatment of diabetes mellitus. In contrast to synthetic drugs phytochemicals are considered to be free from side effects. As one of the main class of natural products, alkaloids and their derivatives have been widely used as sources of pharmacological agents against a variety of medical problems. Many studies confirmed the role of alkaloids in the management of diabetes and numerous alkaloids isolated from different medicinal plants were found active against diabetes. Like other natural products, alkaloids regulate glucose metabolism either by inhibiting or inducing multiple candidate proteins including AMP-activated protein kinase, glucose transporters, glycogen synthase kinase-3, sterol regulatory element-binding proteins 1, glucokinase, glucose-6-phosphatase, acetyl-CoA carboxylase among the others. A comprehensive review of alkaloids reported in the literature with anti-diabetic activities and their target enzymes is conducted, with the aim to help in exploring the use of alkaloids as anti-diabetic agents. Future work should focus on rigorous clinical studies of the alkaloids, their development and relevant drug targets

Outcomes of Microsurgical Resection of Low-Grade Cerebral Arteriovenous Malformations: A Descriptive Observational Multicenter Study from a Low-Middle-Income Country

Objective:  To appraise the overall outcomes of microsurgical resection of low-grade arteriovenous malformations (AVMs) in a low-middle-income country. Materials and Methods:  Data was collected from three different neurosurgical centers in Pakistan for this study and it lasted for two years. Patients who had been diagnosed with cerebral AVMs were categorized into three groups, A, B, and C, using the Spetzler-Martin (S-M) grading system. AVMs of grades 1 and 2 were included in Class A. Class B contained grade 3 AVMs, while Class C contained grade 4 and 5 AVMs. All male and female patients in Class A were eligible for this study.  Results:  There were a total of 22 patients. The mean age was 36.41 ± 14.32 SD years. There were 12 (54.5%) male patients and 10 (45.5%) female patients. 13 patients (59.1%) presented with spontaneous intracerebral hemorrhage, while 9 patients (40.9%) presented with seizures. 14 patients (63.6%) had S-M grade 1 and 8 patients (36.4%) had S-M grade 2. All patients underwent microsurgical resection. We discovered 4.5% morbidity in our study. There was no postoperative mortality. According to the Glasgow outcome scale, an excellent functional outcome of 95.5% at 6 months and a 100% cure rate were noted. Conclusion: Regarding morbidity, mortality, and cure rates for low-grade AVMs in our nation, microsurgery is a secure and efficient therapeutic option

Molecular Docking of Isolated Alkaloids for Possible α-Glucosidase Inhibition

Diabetes mellitus, one of the most common endocrine-metabolic disorders, has caused significant morbidity and mortality worldwide. To avoid sugar digestion and postprandial hyperglycemia, it is necessary to inhibit α-glucosidase, a digestive enzyme with an important role in carbohydrate digestion. The criteria for the selection of alkaloids are based on their in vitro and in vivo activities on glucose modulation. The current study assessed the bonding potential of isolated alkaloids with the targeted protein. For this purpose, the 3D structure of the target protein (α-glucosidase) was reproduced using MODELLER 9.20. The modeled 3D structure was then validated and confirmed by using the RAMPAGE, ERRAT, and Verify3D online servers. The molecular docking of 32 alkaloids reported as α-glucosidase inhibitors, along with reference compounds (acarbose and miglitol), was done through MOE-Dock applied in MOE software to predict the binding modes of these drug-like compounds. The results revealed that nummularine-R and vindoline possess striking interactions with active site residues of the target protein, and were analogous to reference ligands. In conclusion, the current study provided a computational background to the α-glucosidase inhibitors tested. This novel information should facilitate the development of new and effective therapeutic compounds for the treatment of diabetes mellitus

Stuttering As a Disability in Pakistan; Policies and Its Implementation

Objective:  Stuttering is a disorder of speech fluency not only includes academic and social consequences but also has emotional/behavioral outcomes. Stuttering leads to negative emotions and feelings i.e., low confidence, frustration, shame, embarrassment, poor self-image, and negative social identity. The present study was aimed at incorporating the definition of disability in Pakistan policy and determining the position of stuttering in it. Materials and Methods:  The nature of the current study is qualitatively conducted on 10 Participants approached through convenient sapling and exploring their responses through Thematic analysis. Participants falling in this category were recruited into the study from SLPs, Lawyers, disability advocates, and CSPs as per inclusion criteria. Common masses were excluded from the study. A Self-Developed Questionnaire/structured interviews were conducted. Questions developed by the Lawshe method. The tool was validated through content validity by 10“experts”. Results:  Thematic analysis was done and the findings of the study indicated an individual’s negative reaction towards association with any kind of disability and communication barriers are also the main source of not fitting disability as a definition. Results also showed that lack of assessment and screening tools are the main barrier, however, Visibility as per data in research publications also consider a barrier towards recognition of it. Conclusion:  The study has practical implications regarding stuttering as a Disability in Pakistan

Anti-Foulant Ultrafiltration Polymer Composite Membranes Incorporated with Composite Activated Carbon/Chitosan and Activated Carbon/Thiolated Chitosan with Enhanced Hydrophilicity

A rapid increase in population worldwide is giving rise to the severe problem of safe drinking water availability, necessitating the search for solutions that are effective and economical. For this purpose, membrane technology has shown a lot of promise but faces the challenge of fouling, leading to a reduction in its lifetime. In this study, ultrafiltration polyethersulfone membranes were synthesized in two different concentrations, 16% wt. and 20% wt., using the phase inversion method. Chitosan and activated carbon were incorporated as individual fillers and then as composites in both the concentrations. A novel thiolated chitosan/activated carbon composite was introduced into a polyethersulfone membrane matrix. The membranes were then analyzed using Attenuated Total Reflection–Fourier-Transform Infrared spectroscopy(ATR-FTIR), Scanning Electron Microscopy (SEM), optical profilometry, gravimetric analysis, water retention, mechanical testing and contact angle. For membranes with the novel thiolated chitosan/activated carbon composite, Scanning Electron Microscopy micrographs showed better channels, indicating a better permeability possibility, reiterated by the flux rate results. The flux rate and bovine serum albumin flux were also assessed, and the results showed an increase from 105 L/m2h to 114 L/m2h for water flux and the antifouling determined by bovine serum albumin flux increased from 23 L/m2h to 51 L/m2h. The increase in values of water uptake from 22.84% to 76.5% and decrease in contact angle from 64.5 to 55.7 showed a significant increase in the hydrophilic character of the membrane