10 research outputs found
A neonate with upper GI bleeding
Bleeding in the newborn is often a serious problem because of cardiovascular effects associated with a loss of blood and/or the damaging effects of bleeding on neonatal tissues, especially the brain. Gastric polyps are described as abnormal lesions that originate in the gastric epithelium or submucosa and protrude into the stomach lumen. Clinical presentation of gastric polyps in children varies widely, from incidental endoscopic finding to massive gastrointestinal bleeding. However, acute gastrointestinal bleeding in association with hyperplastic gastric polyps has been reported very rarely. We report a case of unusual upper gastrointestinal bleeding in newborn baby on 2nd day of life, secondary to gastric polyp, which was diagnosed and resected through endoscopy
Precursor lymphoblastic lymphoma in the extramedullary tissue: A rare manifestation of chronic myeloid leukemia in blast crisis
Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by immature granulocytes in peripheral blood and bone marrow. In 95% of cases, it is always due to the presence of Philadelphia chromosome characterized by the presence of reciprocal translocation between chromosome 9 and 22. However, in 7% -17% of individuals, extramedullary proliferation also occurs, either in skin, lymph nodes, bone or central nervous system (CNS), which could be either myeloid, lymphoid or mixed progenitor in origin. The present case is of a 23-year-old male who presented with lower limb weakness, bowel and urinary incontinence. His complete blood count (CBC) findings showed a raised white blood count (WBC) of 408 X 10E9/L. Peripheral film, bone marrow biopsy and immunohistochemistry showed findings consistent with CML in chronic phase. Bone marrow cytogenetic revealed the presence of Philadelphia chromosome. Simultaneously, magnetic resonance imaging (MRI) was done which revealed extradural mass at L1-L3 level; histopathological and immunohistochemistry findings showed features compatible with precursor B cell lymphoblastic lymphoma. His cerebrospinal fluid (CSF) cytology revealed similar blast cells. This extramedullary presence of lymphoid blast cells in the CNS put the patient in the rare entity of CML in blast crisis. He was started on tablet nilotinib and also received multiple cycles of intrathecal chemotherapy with cytosar, methotrexate and hydrocortisone. He also underwent radiotherapy of extradural mass. His lower limb weakness improved dramatically. However, after receiving the fourth cycle of intrathecal therapy, the patient died consequent to neutropenic sepsis. Extramedullary blast crisis in CML has a poor prognosis. Any patient with CML, presenting with CNS symptoms or lymph node enlargement should be thoroughly investigated for extramedullary blast crisis, as there is a considerable change in management and prognosis from the prototype CML in chronic phase
Deliberate self-harm and attachment: mediating and moderating roles of depression, anxiety, social support and interpersonal problems among Pakistani school going adolescents
Introduction: In Pakistan there is dearth of research on deliberate self-harm (DSH) and
its predictors among adolescents. While the lack of research in Pakistan can be partly
attributed to the sacrilegious status, criminalization and stigmatization attached to DSH, it
is also an attribute of paucity of Urdu versions of the standardized psychological
instruments. Previous research in developed countries has indicated that attachment theory
can be used as a useful framework to understand the development of austere
psychopathologies like DSH, as well as for studying pathways of interaction of
interpersonal and intrapersonal factors of psychopathologies. In this study, standardized
psychological instruments are translated into Urdu language as a first step. These
instruments are then used to study pathways of interaction of interpersonal and
intrapersonal factors of DSH, conceptualized within attachment framework.
Method: The study was conducted in two steps. In step 1, Youth Health Risk Behavior
Survey (YHRB), Inventory of Interpersonal Problems-32 (IIP-32) and Significant Others
Scale (SOS), were translated into Urdu language. Along with these scales, Urdu translated
versions of Hospital Anxiety and Depression Scale (HADS), Adolescent Relationship
Scales Questionnaire (ARSQ), Life Events scale (LES) from CASE questionnaire and
Family Affluence Scale-II (FAS-II) were reviewed for accuracy of translation through
expert judgement and psychometric evaluation. Secondly, a cross sectional survey was
conducted with 1290 adolescents (10 - 19 years age) using the translated Urdu versions of
the instruments and demographic pro forma. Structural equation modelling was used to
study the pathways of associations between predictors of DSH.
Results: The extensive process of translation resulted in establishment of semantic,
content, technical and construct equivalence of the translated instruments with the original
English versions. Multiple imputation was performed to account for missing values in
SPSS 20. Important structural adaptations were made in the scales based on factor analyses
conducted in M plus. After modifications, all scales showed satisfactory CFI (≥ 0.90) and
RMSEA (≤ 0.06). Results of the survey indicated that the prevalence of DSH (with, without
and ambivalent suicidal intentions) was 7%. Two SEM models were constructed involving
both mediation and moderation pathways. Results of Model 1 showed association of
attachment with DSH was double mediated by social support, depression and anxiety.
Model 2 also confirmed association of attachment with DSH with double mediation
through relationship style problems, depression and anxiety. In order to understand the
contextual picture of the concepts studied in this research both SEM models were also
constructed by controlling for demographic factors. This resulted in confirming age,
gender and family affluence as significant contributors but with very small effects.
Discussion and conclusion: In the present study translation of the instruments helped in
building a reservoir for future research. The results of translation and validation of
instruments indicated that cultural differences, language needs and age must be accounted
for while using standardized psychological instruments. Taking into consideration specific
cultural and demographic background of Pakistan, this study also confirms the key role of
attachment in influencing interaction of predictors of DSH. It is suggested that
intrapersonal and interpersonal factors are influential points of intervention for designing
clinical, school and community based awareness and prevention programs for DSH. The
thesis also discusses the implications for policy guidelines along with recommendations
for future research and other applications of the study
Atomic absorption and inductively coupled plasma–optical emission spectroscopic method for determination of micronutrients and toxic metals in Curcuma longa L
Physiochemical, Biochemical, Minerals Content Analysis, and Antioxidant Potential of National and International Honeys in Pakistan
16 honey samples from Pakistan and two other countries were investigated for their physiochemical, biochemical, minerals, and antioxidant potential. Antioxidant activities of all honey samples were performed by using percentage inhibition of DPPH free radical, AEAC, and FRAP. 5-HMF and mineral contents were determined by HPLC and AAS, respectively. The obtained values of respective parameters, namely, pH, EC, TDS, total acidity, moisture, ash, color intensity, sugars, proline, and protein were in compliance with codex standard and recommendation of council directive by European Union. The total phenolics contents in acacia honey from Germany and jujube honey from Pakistan are similar to monofloral honey from Saudi Arabia and Yemen, respectively. The mineral contents in tested honey samples are comparable with honey from Brazil and Romania. Dark color honeys contained higher phenolic contents than light color ones and attributed to higher oxidation potential and have strong positive correlation with DPPH and FRAP