Comparison of Combined Nebulization of Salbutamol-Ipratropium Bromide with Salbutamol Alone in Children with Mild and Moderate Acute Asthma

ntroduction: The β2 agonists are potent bronchodilators but their repeated and high doses are related to adrenergic side effects. While ipratropium bromide, an anticholinergic bronchodilator has less adverse effects. Objective: To compare the efficacy of combined nebulization of salbutamol-ipratropium bromide with salbutamol alone in children with mild and moderate acute asthma. Materials and Methods: This randomised control trial was done on 80 children aged 5 to 12 years who presented with mild to moderate acute asthma in the emergency department of Children Hospital of Pakistan Institute of Medical Sciences (PIMS) from July 2014 to June 2016 and randomized into 2 groups. In the experimental group each child received 2 nebulizations of combined salbutamol (5mg) and ipratropium Bromide (0.25mg) at presentation and 20 minutes later. Similarly, each child of the control group received 2 nebulizations of 5mg Salbutamol and 2 ml of Normal saline. Asthma clinical score (ACS) was assessed at baseline and then after every 20 minutes up to one hour after the presentation. Results: In the experimental group, the mean + SD ACS at presentation and 60 minutes were 3.50±1.8 and 3.45±1.7 respectively with mean + SD change in ACS of 0.05 ± 0.1. In the control group, the mean + SD ACS at presentation and 60 minutes were 3.70 ± 1.2 and 3.60 ± 1.9, respectively with mean + SD change in ACS of 0.1 ± 0.7. This difference in mean + SD change in ACS between 2 groups was not statistically significant (P=0.6560). Conclusion: There is no statistically significant benefit of adding ipratropium bromide with salbutamol nebulization as compared to salbutamol alone for the management of children with mild to moderate asthma attacks

Lack of sleep and its association with academic progress of undergraduate students of foundation university medical college, islamabad, Pakistan

The objective of the study,isto compare the relationship between lack of sleep and the academic performance of the undergraduate students of a medical college of Pakistan. METHODS AND MATERIALS: A cross-sectional study was conducted in a medical college of Pakistanin April 2016. Subjects were recruited by non-probability convenient sampling. A total of 140 subjectswereasked questions about sleep by a properly designed questionnaire from 2nd to 5th Year MBBS. Students having a prior diagnosis of sleep disorder were excluded from study.Data was analyzed using SPSS version 18. RESULTS: A total of 101 females and 39 males participated in the study. Duringnon-exam days, 41.14% of the students slept less than seven hours. The figure approached 80% in exam days. Cross tabulation failed to reveal a correlation between hours of sleep and academic performanceSpearman correlation showed a negative academic performance with less sleep in fourth and fifth year students. CONCLUSION: Students sacrifice their sleep during exams particularly girls. However, the association of sleep hours and academic performance was not established in this study. In fact, there was a negative association between academic performance and decrease sleep in fourth and fifth year students

Cleveland Clinic Summer Scholar Program

Program Overview: The program lasts a total of 6 weeks, and you rotate through 3 different departments Dress code: Business professional attire + Cleveland Clinic white coat Every day will be different in terms of activity and length depending on your rotation site, if you have to do rounds, how early your first patient is coming into the clinic, etc. However, an average day will be from 8:30 a.m. - 5:30 p.m

Practical Measures for Disabled’s Empowerment-Time for Economic Growth!

The objective of this article is to advocate for persons with disabilities’ (PWD) rights, to discuss issues solutions, social awareness and to promote diversity and inclusion. The word ‘Disability’ covers a wide range of irreversible permanent impairments including physical and mobility difficulties, hearing, visual impairment, specific learning disabilities including dyslexia, medical conditions and mental health problems that may hinder their full and effective participation in society on an equal basis with others.1 Handicap is the condition of being unable to perform due to physical or mental unfitness

Therapeutic Effects of Bee Venom on Rheumatoid Arthritis

Many beehive products such as propolis, Manuka honey, bee pollen, and royal jelly have been used by people due to their popular known health benefits. A novel bee product, bee venom, has demonstrated effective in treating various debilitating conditions, and thus bee venom therapy has been the subject of scientific studies to quantify its medical efficacy. Although bee venom has been used for millennia in Eastern medicine, modern bee venom therapy (BVT) originated in Europe in the 19th century, but was brought to the U.S. by Dr. Bodog Beck after World War I. The treatment became more widespread in the West as the 20th century progressed (Cooney et al, 2011). There are currently various application methods with the most popular being apipuncture (acupuncture with bee venom where needles are initially dipped into the venom before applied to the patient) and bee venom injections (Mohammadi et al, 2015). The multiple beneficial effects of bee venom include increased blood circulation, stimulation of the pituitary-cortical system, and reduced pain and inflammation (Mohammadi et al, 2015). These responses help treat the symptoms of many diseases and chronic inflammatory conditions. With additional research, the use of bee venom can be included as a means to safely alleviate the symptoms of several autoimmune diseases, especially rheumatoid arthritis (RA)

How the rising cost of living is widening inequality and affecting the most vulnerable

With consumer prices rising above wage increases, broadening gaps for disadvantaged groups in the UK have become increasingly apparent. Mahnoor Murad Khan and Yolanda Blavo look at the impacts of the crisis on specific groups such as gig workers and domestic abuse victims, and write that understanding the needs of disadvantaged groups requires re-examining systems already in place that sustain inequality

Canadian Citizens’ Helping Intentions toward Syrian Refugees

Abstract  Since 2011, over 5 million refugees have fled civil war in Syria (UNHCR, 2018). Canada has responded tothe Syrian refugee crisis by resettling over 50,000 Syrian refugees and encouraging its citizens to supportthe integration process. Previous research has shown that when in-group members take the perspectiveof an out-group it leads to increased helping intentions toward that out-group (Mashuri, Hasanah,Rahmawati, 2013). To replicate and extend these findings in a Canadian context, the current study soughtto answer the question: How does national identity impact the relationship between perspective taking andhelping intentions toward Syrian refugees? The results indicated that when undergraduate participantsengaged in perspective taking, it led to increased financial helping intentions toward Syrian refugees,and this relationship was mediated by empathy. It was also found that individuals with a greater ethnicnational identity had lower levels of political and financial helping intentions toward Syrian refugees.  Keywords: Syrian Refugees, Immigrants, Newcomers, Canada, National Identity, Ethnic National Identity, Perspective Taking, Empathy, Helping Intention

Magnetic resonance imaging of intracranial extramedullary haematopoiesis in β-thalassemia: a case report

We report the Magnetic Resonance Imaging of intracranial extramedullaryhematopoiesis in 21 years old β-thalassemic patient who presented to the Neurology Department of Civil Hospital Karachi with seizures. The MR exam revealed multiple intracranialextra-axial masses;isointense on T1W sequence and hypointenseon T1W, T2W, FLAIR, DWI sequence and ADC (b value= 1000 sec/mm2) with avid post contrast enhancement. Plain CT of the Head documented the presence of multiple hyperdenseextra-axial masses with mean value of 45 HU. Extramedullary hematopoiesis is the formation and development of blood cells in tissues outside of the medulla of the bone. The most common sites of involvement are the liver, spleen, and lymph nodes.Intracranial extra medullary hematopoiesis is a relatively rare manifestation of Thalassemia. There is paucity of literature for MR findings regarding intracranial EMH. It is essential to distinguish it from other central nervous system tumors, because treatment and prognosis are entirely different