Prevalence of stress and depression among University students of Karachi

Stress is an all-time concerned issue in undergraduate students. Stress levels are high due to workload, pressure of academic and extra-curricular activities and unhealthy lifestyle. Though stress can be beneficial for academic growth but increased magnitude can be harmful for physiological, psychological and social aspects

Blended learning: Call of the day for medical education in the global South

Blended learning (BL) is an e-learning approach that combines the strengths of both online and face-to-face learning, creating meaningful interactions between students, teachers, and resources. This paper explores students’ expectations and satisfaction with, and participation in, a basic science course offered through BL approaches in an undergraduate medical education programme in Pakistan. Developmental anatomy (embryology) was redesigned as a BL course and offered to a hundred first-year students. Both online activities and technology-assisted face-to-face interactive discussions were used in each topic. Students’ expectations were gathered at the start of the course and perceptions regarding their satisfaction with the course was collected at the end of the course via questionnaires. A temporal analysis of the website use was conducted to determine any changes in use across the course. The data shows that students were satisfied with their experience in the course. Their expectations regarding technology and pedagogy were met. Online individual learning activities were rated higher than collaborative discussions. Face-to-face discussions received a high rating compared to online learning activities. Students’ access to the website varied throughout the course and declined over time. However, some activity was noted before the exams. Students made extensive use of WhatsApp. In basic science subjects, BL has the potential to offer learners some control over content, learning sequence, and pace and time of learning. Unless made part of an assessment scheme, online discussions and other activities are not likely to be seen as useful learning strategies by students. Teachers’ skills in designing and facilitating BL courses are critical to the success thereof

Prevalence of Polycystic Ovarian Syndrome, Its Associated Conditions And Complications: an Experience from a Low Socio-Economic Population of Sikandrabad, Karachi, Pakistan

OBJECTIVES To study the prevalence of polycystic ovary syndrome, its associated conditions and complications in the low socio-economic population of Sikandrabad, Karachi. METHODOLOGY This cross-sectional study was conducted in a primary health care centre of Ziauddin University, Sikandrabad-Karachi, Pakistan, from January-June 2021. The ethical committee of the university approved this study. All female patients with gynaecological complaints having an age between 18 to 49 years were included. Females with a history of unilateral oophorectomy, uterine abnormality and abnormal karyotype or known malignancies were excluded from the study. A sample size of 118 was calculated using open-epi software. A performed questionnaire was used to collect data from females with gynaecological complaints. PCOS was diagnosed using Rotterdam criteria. Routine examination tests were done at the Primary Health Care Clinic (PHCC) of Ziauddin Hospital, and obesity was labelled through BMI calculation. RESULTSOf 118 females in the reproductive age group screened, 55.93% reported PCOS as a major gynaecological problem, followed by endometriosis at 16.94%, uterine fibroid at 14.46% and urinary tract infections at 9.32% respectively. Patients had infertility as a major complaint, with 54.54% cases followed by menstrual abnormalities at 21.21%, obesity at 16.66% and others at 7.57%. Most patients (38%) were obese, and 34% were overweight. CONCLUSION PCOS is a prevalent complicated endocrine disorder in women in the reproductive age group, and it presents with varying gynaecological complications like infertility, menstrual disturbances, hirsutism, and acne. Obesity, hormonal imbalance and poor dietary intake affect the disease outcomes further. More multi-centred studies are needed to know the exact prevalence and causal relations

TEAM-BASED LEARNING VS LECTURE-BASED LEARNING IN MEDICAL EDUCATION

Objective: The objective of the study is to determine better mode of learning for medical graduates by comparing team-based learning (TBL) and lecture-based learning methods. Study Design: Comparative analytical study. Place and Duration of Study: Surgical Ward 25 of Endocrine and General surgery, Jinnah Postgraduate Medical Center, Karachi, in April 2019. Methodology: This comparative study was based on the principles of TBL; the control program used the traditional lecture-based approach. Both programs were aimed at investigating the knowledge and performance of the two groups. Thirty surgical interns were included in this study. Two groups were made by random selection of surgical interns, 15 in TBL group and other 15 in traditional teaching group. TBL group (Group A) was given the topic of thyroid diseases for self-study followed by 1 h discussion amongst the group members. Lecture-based group (Group B) was given 1 h powerpoint presentation on similar topic. As the main outcome measures, questionnaire containing twenty best choice questions was given to both groups. Performance of the two groups was checked and results calculated as total, average, and standard deviation. Results: Group A participants’ total score (147) was higher than Group B (131) but the p-value was not found to be significant (0.144). Conclusion: Both forms of learning methods are effective and productive in medical education

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Successful engraftment and survival following allogeneic hematopoietic stem cell transplant in a child with familial hemophagocytic lymphohistiocytosis

Hemophagocytic syndrome is a rare disorder mainly affecting children. Symptoms include prolonged fever, hepatosplenomegaly and cytopenias. Allogeneic stem cell transplant appears to provide the best overall cure rate in this disease. The authors report a young boy, the second child of consanguineous parents, diagnosed with familial hemophagocytic lymphohistiocytosis (HLH) who underwent allogeneic stem cell transplant form HLA matched father

Tackling a deadly global phenomenon: Sepsis induced coagulopathy: A narrative review

Sepsis is a potentially fatal illness marked by organ failure and the two main causes of which are shock and disseminated intravascular coagulation. Multi-organ dysfunction in sepsis is mediated by the inflammatory cytokine storm, while sepsis induced coagulopathy is mediated and accelerated by activation of pro-coagulative mechanisms. Regardless of the severity of sepsis, disseminated intravascular coagulation is a potent predictor of mortality in septic patients. Additionally, oxidative stress in sepsis causes renal ischaemia and eventually acute kidney injury. The first and foremost goal is to initiate resuscitation immediately, with treatment mainly focussing on maintaining a balance of coagulants and anticoagulants. A simpler and more universal diagnostic criteria is likely to improve studies on the spectrum associated with sepsis

Morphological changes in the experimental model of polycystic ovary syndrome and effects of vitamin D treatment

Aim: This research was designed to develop an animal model by inducing polycystic ovary syndrome (PCOS) with dehydroepiandrosterone (DHEA) and observe reproductive and morphological changes after treatment with vitamin D.Materials and methods: Thirty pre-pubertal female Sprague-Dawley (SD) dams were recruited. The animals were distributed 10 each in control, PCOS and vitamin D-treated groups. In control group 0.2 ml of sesame oil was given. PCOS group was administered DHEA by the daily dose of 6 mg/kg for 30 days. In vitamin D-treated group, animals were injected 6 mg/kg/day DHEA daily and 120 ng 1, 25(OH) 2D3/100 g subcutaneously once a week. The occurrence of reproductive phenotypic PCOS was evaluated by estrous cycle, morphology and histological changes of ovary, uterus on light microscope.Results: The results of this study showed significant weight gain, obesity, and estrous irregularity in PCOs group as compared to control and vitamin D-treated group.Conclusion: Administration of vitamin D (120 ng 1, 25(OH) 2D3/100) improved the cycle characteristics, reduced body weight and morphological features in PCOS induced animals. The results support the effect of vitamin D treatment for metabolic and reproductive characteristic features in PCOS females