A Bicentric Study of Psychiatric Illness among Pediatric Population Patients with a History of Sexual Abuse

Background:  The present study assessed the psychiatric diseases in victims of childhood sexual abuse from intact and broken families. Methodology:  A cross-sectional study was conducted at the PMC hospital, Nawabshah and Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, GAMBAT between February 2020 to January 2022. 60 (30 in each group) children were included with the ages of 5-16 years,. Non-probability convenience sampling technique was used. Children with reported sexual abuse who fulfilled the inclusion criteria were included in this study. All children included in the study were screened for psychological disturbances through the Urdu version of SDQ. The severity of symptoms was assessed based on ICD-10 criteria. Results:  There was a significant relationship between the identity of the perpetrator with the stability of the family. In victims belonging to the intact family system, the perpetrator was mostly an outsider while, in cases of broken families, oftentimes, the abuser was a relative or known to the victim. 44.44% of individuals belonging to broken families were abused within the confinements of the home. 17.8% of children from unstable families had mixed anxiety and depression disorder, while the rate was lower among children who had intact families. Surprisingly, only five children altogether had post-traumatic stress disorder. Hyperkinetic disorder and conduct disorder was significantly more prevalent in victims belonging to a broken family system. Conclusion:  Childhood sexual abuse and its resultant psychiatric morbidity are equally common in children from intact and broken families. However further research with a greater sample size from multiple centers is needed. Keywords:  Childhood sexual abuse, Psychiatric morbidity, Broken family

Prevalence of ecosapentaenoic acid and docosahexaenoic acid deficiency in pregnant women: a prospective observational study

Background: Docosahexaenoic acid (DHA), ecosapentaenoic acid (EPA) and alpha lineoloic acid (α-LA) are essential fatty acids of the long chain polyunsaturated fatty acid (LC-PUFA) or omega-3 fatty acid. These fatty acids are not synthesized by our body. Diets rich in LC-PUFA reduces the incidence of - preeclampsia, intrauterine growth restriction, preterm delivery, in utero fetal death and placental abruption. Objectives of the study were: to estimate the prevalence of EPA and DHA deficiency in pregnant women by omega-3 index test (O3I), and also to correlate blood levels of EPA and DHA with various socio demographic parameters. Methods: All enrolled subjects were assessed with a pre-defined performa for their demographic and socio-economic characteristics, personal history, obstetric history, body mass index (BMI), education, diet and blood samples were tested for O3I. Results: Result of the study indicated that 98% of pregnant women had EPA and DHA deficiency as indicated by O3I levels. This was regardless of age, parity, BMI, and socio economic status. Women consuming vegetarian diet had statistically significant lower mean and median levels of O3I as compared to the women having a non-vegetarian diet, p value <0.001, 0.004 respectively. In our entire cohort of 150 women, only 2 non-vegetarian women had sufficient O3I. Conclusions: 98% of pregnant women across various socio economic classes had EPA and DHA deficiency as measured by O3I levels. Vegetarians had statistically significant lower levels of O3I as compared to the non-vegetarians

Comparison of hemodynamic changes in ketamine versus fentanyl as co-induction agent with propofol in elective surgical procedures

Objectives: To assess the hemodynamic changes caused by the co-induction of ketamine or fentanyl with propofol. Methodology: This prospective randomized trial included 220 patients that underwent elective surgical procedures under general anesthesia with endotracheal intubation. Random allocation of patients was done into two equal groups and drugs were administered using the double-blinded technique. Group A received propofol and fentanyl while group B received propofol and ketamine given as intravenous bolus doses. Measurement of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) was done before induction and 10 minutes after induction before the surgical stimulus. Independent samples t-test and paired t-test were employed for analysis of the collected data. Results: Both groups had normal hemodynamic parameters before induction; however, there was a significant difference in hemodynamic indices of both groups after 10 minutes of induction (p<0.001). Group A showed a significant decrease in SBP, DBP, and MAP after 10 minutes of induction (p<0.001). The patients in group B showed a significant increase in mean HR from baseline to 10 minutes (p<0.001). Group B demonstrated no change in the systolic, diastolic, and mean arterial pressures; however, group A elucidated a significant decrease in these hemodynamic parameters. Conclusion: The combination of ketamine and propofol provides better hemodynamic stability than fentanyl and propofol. More studies are required to evaluate these changes in patients with cardiovascular comorbidities

The benefits of 24/7 in-house intensivist coverage for prolonged-stay cardiac surgery patients

ObjectiveThe objective of our study was to evaluate the efficacy of 24/7 in-house intensivist care for patients requiring prolonged intensive care unit (ICU) stay following cardiac surgery.MethodsA propensity-matched retrospective before-and-after observational study comparing 2 models of ICU physician staffing was undertaken. Previously, residents (with intensivist backup) provided care for patients after cardiac surgery (surgical ICU cohort). ICU physician staffing was modified with the implementation of 24/7 in-house board-certified intensivist coverage in a cardiac surgery ICU (cardiac surgery ICU cohort) for postoperative care. Patients with a prolonged ICU stay (ie, >48 hours) were identified and their outcomes analyzed for both models of care.ResultsPropensity matching between cohorts was successful for 271 patients (75.7%), with matched patients being used for comparison. There was no difference in ICU or 30-day mortality. There was also no difference in ICU length of stay (LOS); however, the median hospital LOS was significantly shorter in the cardiac surgery ICU cohort (12.3 vs 11.0 days; P < .01). There was a decrease in the proportion of patients receiving transfused red blood cells in the cardiac surgery ICU cohort (80.8% vs 65.7%; P < .001). The cardiac surgery ICU cohort had reduced complications relating to sepsis (4.7% vs 0.7%; P < .01) and renal failure (22.5% vs 12.5%; P < .01); however, the identification of neurologic dysfunction was significantly higher (11.1% vs 20.7%; P < .01).ConclusionsFor patients requiring a prolonged ICU stay, our model of 24/7 in-house intensivist coverage was not associated with changes in ICU LOS, nor ICU and 30-day mortality. However a reduction in blood product use, ICU complications, and total hospital LOS was observed

ROLE OF EXERCISES AND DIETARY INTAKE AS AN INTERVENTION IN WEIGHT REDUCTION

Background: Obesity is now so common within the world’s population that it is beginning to replace under nutrition and infectious disease as the most significant contributor to ill health. Exercise plays significance role with dietary control in weight reduction. The aim of our study is to find out the efficacy of weight reduction interventions and role of exercise. Methods: The study was conducted on 60 participants, subjects or participants were randomly divided. It is an experimental study which was completed in the duration of about six months. The study was based on two groups that are group A (exercise plus dietary) and group B (only dietary) consisting of sixty participants after filling the consent form. Result: Result shows out of these sixty only fifty eight participants completed the study and were observed for four months. Is has been found comparable weight loss relatively fewer in the dietary group Body weight before (80.1±2.7) after (78.1±2.5)and BMI before (32±2) after (30±2) it shows significant results but less significant than group A body weight which was before(78.6±2.6) after(64.0±2.3) and BMI before (33±1) after (39±1). Therefore the results shows that the group A shows more significant outcomes as compare to the other group included in the study. Conclusion: The results shows that (exercise plus dietary) more significant outcomes as compare to the other group included in the study Keywords: Anne Collins, weight reduction, exercises plus dietary, dietary, BMI and body weight

Odds of HIV among incarcerated drug users: a systematic review and meta-analysis of Asian countries

BACKGROUND: HIV makes up a large portion of infectious diseases globally. People injecting drugs in prisons are at high risk for contracting HIV infection. Prisons house ~10.2 million people globally, making them a high-risk setting for HIV transmission. This systematic review summarizes the available data on the odds of developing HIV infection among imprisoned people who inject drugs (PWIDs) in Asian regions. METHODS: The authors electronically assessed published studies from January, 2000 to December, 2022, including studies that investigated the odds of HIV in imprisoned PWIDs. We extensively searched PubMed, ERIC, and Cochrane Central and Google Scholar with no constraints in language or time. All the observational studies evaluating the chances of HIV in Asian prisoners with an exposure group of PWIDs and a control group of non-injecting-drug users were included in our analysis. RESULTS: The databases search yielded 254 potential studies, 10 observational studies of which having a total of 17 333 participants were included. A low or moderate risk of bias was reported in all the studies except one case-control. The pooled analysis showed a significant association between PWIDs and the chances of contracting HIV infection (Odds ratio=6.40; 95% CI=3.89-10.52; P<0.00001; I2=53%). CONCLUSION: This study found a vital correlation between injecting-drug usage during imprisonment and HIV transmission speed. The results of this meta-analysis support the need to prevent HIV and conducting treatment programs in high-risk settings like prisons

Pseudo cardiac tamponade in the setting of excess pericardial fat

Cardiac tamponade is the phenomenon of hemodynamic compromise caused by a pericardial effusion. Following a myocardial infarction, the most common causes of pericardial fluid include early pericarditis, Dressler's syndrome, and hemopericardium secondary to a free wall rupture. On transthoracic echocardiography, pericardial fluid appears as an echo-free space in between the visceral and parietal layers of the pericardium. Pericardial fat has a similar appearance on echocardiography and it may be difficult to discern the two entities. We present a case of a post-MI patient demonstrating pseudo tamponade physiology in the setting of excessive pericardial fat

महिषासुर: मिथक व परंपराएं

इक्कसवीं सदी के दूसरे दशक में भारत में महिषासुर आंदोलन द्विज संस्कृति के लिए चुनौती बनकर उभरा। इसके माध्यम से आदिवासियों, पिछड़ों और दलितों के एक बड़े हिस्से ने अपनी सांस्कृतिक दावेदारी पेश की। लेकिन यह आंदोलन क्या है, इसकी जड़ें समाज में कहां तक फैली हैं, बहुजनों की सांस्कृतिक परंपरा में इसका क्या स्थान है, मौजूदा लोक-जीवन में महिषासुर की उपस्थिति किन-किन रूपों में है, इसके पुरातात्विक साक्ष्य क्या हैं? गीतों-कविताओं व नाटकों में महिषासुर किस रूप में याद किए जा रहे हैं और अकादमिक-बौद्धिक वर्ग को इस आंदोलन ने किस रूप में प्रभावित किया है, उनकी प्रतिक्रियाएं क्या हैं? आदि प्रश्नों पर विमर्श हमें एक ऐसी बौद्धिक यात्रा की ओर ले जाने में सक्षम हैं, जिससे हममें अधिकांश अभी तक अपरिचित रहे हैं। क्या महिषासुर दक्षिण एशिया के अनार्यों के पूर्वज थे, जो बाद में एक मिथकीय चरित्र बन कर बहुजन संस्कृति के प्रतीक पुरुष बन गए? क्या यह बहुत बाद की परिघटना है, जब माकण्डेय पुराण, दुर्गासप्तशती जैसे ग्रंथ रच कर, एक कपोल-कल्पित देवी के हाथों महिषासुर की हत्या की कहानी गढ़ी गई? इस आंदोलन की सैद्धांतिकी क्या है? प्रमोद रंजन द्वारा संपादित किताब “महिषासुर: मिथक व परंपराएं” में लेखकों ने उपरोक्त प्रश्नों पर विचार किया है तथा विलुप्ति के कगार पर खड़े असुर समुदाय का विस्तृत नृवंशशास्त्रीय अध्ययन भी प्रस्तुत किया है। इस पुस्तक में समकालीन भारतीय साहित्य में महिषासुर पर लिखी गई कविताओं व गीतों का प्रतिनिधि संकलन भी है तथा महिषासुर की बहुजन कथा पर आधारित एक नाटक भी प्रकाशित है। समाज-विज्ञान व सांस्कृतिक विमर्श के अध्येताओं, सामाजिक-राजनीतिक कार्यकर्ताओं, साहित्य प्रेमियों के लिए यह एक आवश्यक पुस्तक है

Resident immunity in tissue repair and maintenance: The zebrafish model coming of age

The zebrafish has emerged as an exciting vertebrate model to study different aspects of immune system development, particularly due to its transparent embryonic development, the availability of multiple fluorescent reporter lines, efficient genetic tools and live imaging capabilities. However, the study of immunity in zebrafish has largely been limited to early larval stages due to an incomplete knowledge of the full repertoire of immune cells and their specific markers, in particular, a lack of cell surface antibodies to detect and isolate such cells in living tissues. Here we focus on tissue resident or associated immunity beyond development, in the adult zebrafish. It is our view that, with our increasing knowledge and the development of improved tools and protocols, the adult zebrafish will be increasingly appreciated for offering valuable insights into the role of immunity in tissue repair and maintenance, in both health and disease throughout the lifecourse