Mucocutaneous Manifestations of Covid-19 in an Isolation Unit of Peshawar, Khyber Pakhtunkhwa

OBJECTIVES This study aimed to determine the frequency of mucocutaneous manifestations in patients with COVID-19. METHODOLOGY This prospective cross-sectional study was conducted in the isolation ward of Hayatabad Medical Complex, Peshawar, for COVID-19-positive patients from 20th June to 30th July 2020. One hundred and twenty COVID-19-positive patients were included in our study. Patients fulfilling the inclusion criteria were subjected to a detailed clinical history and mucocutaneous and systemic examination. Relevant investigations were done. Data was recorded in predesigned proforma and analyzed for various statistical variables. RESULTS Among 120 patients included in our study, 87 were male and 33 female. Most patients belonged to the age group 21-40 years. A total of 17 patients showed mucocutaneous manifestations. Generalized pruritus and petechial rash were the most common, and the maculopapular rash were the least common. Mucosal involvement was seen in 2 patients. CONCLUSION Mucocutaneous manifestations are essential clues in the diagnosis of COVID-19. Early recognition may help in the effective management of patient

IMPACT OF REGIONAL WEALTH DISPARITIES ON CHILD SCHOOLING: A CASE OF PUNJAB, PAKISTAN

Este artigo tem como objetivo explorar o efeito da disparidade de riqueza entre os distritos de Punjab na matrícula escolar de crianças de 3 a 14 anos de idade no período de 2008, 2011, 2014. Este estudo utilizou o modelo probit e também usa o componente principal análise para criar um índice de disparidade de riqueza distrital para examinar como isso influencia a escolarização das crianças nas economias em desenvolvimento. As descobertas expõem que a probabilidade de matrícula escolar é influenciada negativamente pela disparidade de riqueza dos distritos nos três modelos, ou seja, para todas as crianças. Nas variáveis de controle, os domicílios que recebem remessas levam ao aumento da escolaridade das crianças. A educação dos pais aumenta a possibilidade de escolaridade nos três modelos. A educação da mãe afeta mais a matrícula infantil do que a educação da cabeça em todos os modelos. As crianças estavam menos dispostas a estudar no ano de 2007 para todos os três modelos. Os resultados sugerem que a diminuição da disparidade entre os distritos de Punjab deseja uma distribuição equivalente de fundos do governo de Punjab para os distritos. Pode aumentar o bem-estar da família através da matrícula de crianças no ensino médio. Este estudo cria um índice de disparidade de riqueza distrital usando a análise de componentes principais e utiliza uma fórmula diferencial para explicar as disparidades socioeconômicas regionais nos distritos de Punjab, no Paquistão.Este documento tiene como objetivo explorar el efecto de la disparidad de riqueza entre los distritos de Punjab en la inscripción escolar de niños de 3 a 14 años de edad para el período 2008, 2011, 2014. Este estudio ha utilizado el modelo probit y también utiliza el componente principal análisis para crear un índice de disparidad de riqueza del distrito para examinar cómo influye en la escolarización de los niños en las economías en desarrollo. Los resultados exponen que la probabilidad de inscripción escolar está influenciada negativamente por la disparidad de riqueza de los distritos en los tres modelos, es decir, para todos los niños. En las variables de control, los hogares que reciben remesas conducen a aumentar la escolarización de los niños. La educación de los padres plantea la posibilidad de escolarizar en los tres modelos. La educación de la madre afecta más la matrícula infantil en comparación con la educación de la cabeza en todos los modelos. Los niños estaban menos dispuestos a estudiar en el año 2007 para los tres modelos. Los resultados sugieren que la disminución de la disparidad entre los distritos de Punjab desea una distribución equivalente de fondos del gobierno de Punjab a los distritos. Puede aumentar el bienestar del hogar mediante la inscripción de niños en la escuela secundaria. Este estudio crea un índice de disparidad de riqueza en el distrito utilizando el análisis de componentes principales y utiliza una fórmula diferencial para explicar las disparidades socioeconómicas regionales en los distritos de Punjab en Pakistán.This paper aims is to explore the effect of wealth disparity between the districts of Punjab on school enrolment of children 3-14 years age group for the period 2008, 2011, 2014. This study has used the probit model and it also uses the principal component analysis to create an index for district wealth disparity to examine how it influences schooling of children in developing economies. The findings expose that probability of school enrolment is negatively influenced by wealth disparity of the districts in all three models, i.e., for all children. In the control variables, the households getting remittances lead to increase the schooling of children. Parents’ education raises the possibility of schooling in all the three models. The education of mother affects child enrolment more as compared education of head in all models. Children were less willing for schooling in the year 2007 for all the three models. The findings suggest that the sliding down the disparity among the districts of Punjab desires equivalent distribution of funds from government of Punjab to the districts. It may increase the household welfare by high school enrolment of children. This study creates district wealth disparity index by using the principal component analysis and uses differential formula to explain the socioeconomic regional disparities across the districts of Punjab in Pakistan

Maternal and Fetal Outcomes of Triplet Gestation in a Tertiary Hospital in Oman

Objectives: The aim of this study was to describe the fetal and maternal outcomes of triplet gestation and to report on the maternal characteristics of those pregnancies in a tertiary care centre in Oman. Methods: A retrospective study was undertaken of all triplet pregnancies delivered at Sultan Qaboos University Hospital, Muscat, Oman, between January 2009 and December 2011. Results: Over the three-year study period, there were 9,140 deliveries. Of these, there were 18 triplet pregnancies, giving a frequency of 0.2%. The mean gestational age at delivery was 31.0 ± 3.0 weeks, and the mean birth weight was 1,594 ± 460 g. The most common maternal complications were preterm labour in 13 pregnancies (72.2%), gestational diabetes in 7 (39%) and gestational hypertension in 5 (28%). Of the total deliveries, there were 54 neonates. Neonatal complications among these included hyaline membrane disease in 25 neonates (46%), hyperbilirubinaemia in 24 (43%), sepsis in 18 (33%) and anaemia in 8 (15%). The perinatal mortality rate was 55 per 1,000 births. Conclusion: The maternal and neonatal outcomes of triplet pregnancies were similar to those reported in other studies

Decisions to Perform Emergency Caesarean Sections at a University Hospital : Do obstetricians agree?

Objectives: This study was undertaken to assess the degree of agreement amongst obstetricians regarding decisions to perform emergency Caesarean section (CS) procedures at a university hospital. Methods: This retrospective clinical audit was carried out on 50 consecutive emergency CS procedures performed between November 2012 and March 2013 on women with singleton pregnancies at the Sultan Qaboos University Hospital in Muscat, Oman. Data on each procedure were collected from electronic patient records and independently reviewed by six senior obstetricians to determine agreement with the decision. Results: Of the 50 women who underwent CS procedures, the mean age was 28.9 ± 5.1 years and 48% were primigravidae. A total of 65% of the CS procedures were category I. The most common indications for a CS was a non-reassuring fetal heart trace (40%) and dystocia (32%). There was complete agreement on the decision to perform 62% of the CS procedures. Five and four obstetricians agreed on 80% and 95% of the procedures, respectively. The range of disagreement was 4–20%. Disagreement occurred primarily with category II and III procedures compared to category I. Additionally, disagreement occurred in cases where the fetal heart trace pattern was interpreted as an indication for a category II CS. Conclusion: The majority of obstetricians agreed on the decisions to perform 94% of the emergency CS procedures. Obstetric decision-making could be improved with the implementation of fetal scalp pH testingfacilities, fetal heart trace interpretation training and cardiotocography review meetings.

Exploring the efficacy of role-play as a pedagogical strategy to enhance grade VI students` conceptual understanding in selected Science concepts

In the twenty-first century, student-centered learning has emerged as one of the most prominent and crucial educational discourses. In this regard, many efforts have been made to employ student-centered pedagogies for scientific learning. Role-play is one of the student-centered pedagogies that can improve students\u27 learning outcomes and also foster the skills needed to deal with the challenges of the scientific world. However, the effectiveness of role-play in science teaching has not yet been well explored in Pakistan. Therefore, this study employed role-play to investigate the efficacy of role-play to enhance conceptual understanding of selected science concepts in Karachi, Pakistan.A quasi-experimental design (pre-post-test design) was used to explore the effectiveness of role-play as a teaching strategy. The sample consists of 77 students recruited from two intact Grade VI classes from two community-based schools (CBS), who were then assigned to intervention (IG) and control (CG) groups. The IG was taught selected science concepts through role-play methods, whereas the CG was taught the same concepts through traditional methods. The data was collected by using the newly developed and validated Science Achievement Test (SAT), which was administered to both groups at two distinct points, i.e., before the intervention and after the intervention. The two groups were compared on the students’ overall performance on the SAT, performance on SAT content, and cognitive domains on both the pre-test and post-test.The findings of the students’ overall performance on the pre-test revealed that there was no significant difference (p \u3e 0.05) found between the groups. In other words, before the intervention, both groups were matched and had a similar level of understanding of the selected science concepts. Conversely, after the intervention, IG took the lead and demonstrated better performance than the CG. The difference was found to be statistically significant (p \u3c 0.001] with a large magnitude (r = 0.50). Based on the findings, the study reveals that the role-play significantly improved students’ conceptual understanding more than the conventional method. Thus, the study suggests that role-play can be used as an effective pedagogy to enhance students’ conceptual understanding to teach the selected science concepts in the Pakistani context

Phytochemical Analysis and Antioxidant Potential of Ficus Benghalensis L.

Genus Ficus belongs to family Moraceae having 40 genera and over 1000 species worldwide. Different methods have been used for phytochemical screening of medicinal plants like total phenolics content (TPC) and total flavonoids content (TFC) assays to quantify phenolics and flavonoids. The phytochemical analysis exhibited highest total phenolics content in M extract of stem and total flavonoids content in ethyl acetate (EA) extract of leaves i.e. 61.2±1.3 µg GAE/mg extract and 25.1±0.9 µg QE/mg extract respectively. Total reduction power and total antioxidant capacity were maximum in the M extract of stem i.e. 243.89±1.6 µg AAE/mg extract and 127.08±2.7 µg AAE/mg extract respectively

Efficacy of oral fluconazole versus oral terbinafine in the treatment of tinea capitis

Objective: To compare the effectiveness of oral Fluconazole vs oral Terbinafine in the treatment of tinea capitis. Place and Duration: This Randomized control trial was conducted from 6th December, 2019 to 6th June, 2020 in the Department of Dermatology, Hayatabad Medical Complex, Peshawar. Subject and Method: The study was carried out at Department of Dermatology, Hayatabad Medical Complex Peshawar. Through consecutive sampling technique, all patients meeting the diagnostic requirements for inclusion were selected from the OPD. The parents or guardians of the patients provided written informed consent and were advised that the information would be kept confidential because it was all done only for the purpose of the study. To confirm Tinea Capitis in all patients, a thorough history, physical examination, and microscopy were performed. Through the use of a lottery, patients were randomly split into Group A and Group B. For four weeks, patients in Group A received Fluconazole 6–8 mg/kg once weekly. Terbinafine 3-5 mg/kg was given once daily to patients in Group B. Patients were evaluated using the Total Sign and Symptom Score (TSSS) and microscopic inspection at the time of study enrolment, as well as at 4- and 8-week intervals after those times

The association between shift work exposure and cognitive impairment among middle-aged and older adults: Results from the Canadian Longitudinal Study on Aging (CLSA).

BackgroundShift work, especially rotating and night shift work, has been linked to a wide range of detrimental health outcomes. Occupational factors like shift work and their potential impact on cognitive functions have received little attention, and the evidence is inconclusive. The objective of our study is to explore associations between shift work exposure and cognitive impairment indicators based on comparisons with the normative standards from the Canadian population.MethodsCross-sectional analyses were performed using baseline Canadian Longitudinal Study on Aging database, including 47,811 middle-aged and older adults (45-85 years). Three derived shift work variables were utilized: ever exposed to shift work, shift work exposure in longest job, and shift work exposure in current job. Four cognitive function tests were utilized, Rey Auditory Verbal Learning Tests (immediate and delayed) representing memory domain, and Animal Fluency, and Mental Alteration, representing the executive function domain. All cognitive test scores included in study were normalized and adjusted for the participant's age, sex, education and language of test administration (English and French), which were then compared to normative data to create "cognitive impairment' variables. Unadjusted and adjusted multivariable logistic regression models were used to determine associations between shift work variables and cognitive impairment individually (memory and executive function domains), and also for overall cognitive impairment.ResultOverall, one in every five individuals (21%) reported having been exposed to some kind of shift work during their jobs. Exposure to night shift work (both current and longest job) was associated with overall cognitive impairment. In terms of domain-based measures, night shift work (longest job) was associated with memory function impairment, and those exposed to rotating shift work (both current and longest job) showed impairment on executive function measures, when compared to daytime workers.ConclusionThis study suggests disruption to the circadian rhythm, due to shift work has negative impact on cognitive function in middle-aged and older adults and this warrants further investigation

Evaluation of MRSA chrome agar for the detection of methicillin resistant staphylococcus aureus

The aim of this study was to evaluate the efficacy of MRSA Chrome agar to detect methicillin resistant Staphylococcus aureus (MRSA) and compare it with 1µg oxacillin disc diffusion tests and detection of mecA gene by PCR. A total 116 Staphylococcus aureus (S. aureus), isolated from various clinical samples, were obtained from three tertiary care hospitals of Dhaka city. S. aureus was identified by colony characters, Gram stain and standard biochemical procedures. MRSA was detected by susceptibility to 1µg oxacillin disc, growth of denim blue color colonies of S. aureus on the Brilliance MRSA Chrome agar at 24 and 48 hours of incubation. PCR was performed for amplification of mecA gene as a gold standard method. Out of 116 isolated S. aureus, 33 (28.44%) were MRSA by oxacillin disc diffusion test where mecA gene was detected in 28 strains. On MRSA Chrome agar, 29 (25.0%) S. aureus produced denim blue colonies at 24 hours, of which 28 isolates possessed mecA gene. At 48 hours incubation, an additional 4 isolates yielded denim blue colonies from which mecA gene could not be identified. All the strains of S. aureus that produced denim blue colonies at 24 and 48 hours were resistant to oxacillin. The sensitivity, specificity and accuracy of oxacillin disc diffusion test were 100%, 94.31% and 95.68% and Chrome agar at 24 hours were 100%, 98.86% and 99.13% respectively. Thus MRSA Chrome agar could be good choice in clinical microbiology laboratory for rapid and accurate identification of MRSA. Ibrahim Med. Coll. J. 2013; 7(1): 1-

Maternal and Fetal Outcomes of Triplet Gestation in a Tertiary Hospital in Oman

Objectives: The aim of this study was to describe the fetal and maternal outcomes of triplet gestation and to report on the maternal characteristics of those pregnancies in a tertiary care centre in Oman. Methods: A retrospective study was undertaken of all triplet pregnancies delivered at Sultan Qaboos University Hospital, Muscat, Oman, between January 2009 and December 2011. Results: Over the three-year study period, there were 9,140 deliveries. Of these, there were 18 triplet pregnancies, giving a frequency of 0.2%. The mean gestational age at delivery was 31.0 ± 3.0 weeks, and the mean birth weight was 1,594 ± 460 g. The most common maternal complications were preterm labour in 13 pregnancies (72.2%), gestational diabetes in 7 (39%) and gestational hypertension in 5 (28%). Of the total deliveries, there were 54 neonates. Neonatal complications among these included hyaline membrane disease in 25 neonates (46%), hyperbilirubinaemia in 24 (43%), sepsis in 18 (33%) and anaemia in 8 (15%). The perinatal mortality rate was 55 per 1,000 births. Conclusion: The maternal and neonatal outcomes of triplet pregnancies were similar to those reported in other studies