Relationship Between Embitterment and Interpersonal Relation Among Patients with Diabetes

This study focuses on the relationship between embitterment and interpersonal relation among patients with diabetes. It was generally noticed that patients with diabetes would be more embittered if their interpersonal relation would not be healthy. Moreover, gender difference was also observed on both variables. In this study two scales were used for measuring embitterment and interpersonal relation among the diabetic patients. The result showed that there is negative relation between embitterment and interpersonal relation among diabetic patients. In the same way there is significant difference between males and female on embitterment and interpersonal relation among diabetic patients. DOI: 10.7176/JEP/11-1-04 Publication date: January 31st 202

Implementing a Teaching and Learning Enhancement Workshop at Aga Khan University: Reflections onthe implementation and outcomes of an Instructional Skills Workshop in the context of Pakistan

The Teaching and Learning Enhancement Workshop (TLEW) is an indigenous name for the Canadian-based Instructional Skills Workshop (ISW). TLEW is a teaching development workshop aimed at enhancing faculty members’ stances towards student-centred teaching and reflective practice at the higher education level. This short paper discusses the initiation, implementation and institutionalisation of the TLEW at Aga Khan University (AKU) across entities in Asia and Africa. In total, 77 faculty members drawn from different entities of AKU participated in the workshop in 2016-2017. Empirical evidence collected from TLEW graduates through a survey and interviews suggests that the intense episode of planning, teaching and receiving peer feedback during TLEW helped participants in sensitising them to effective planning for teaching in order to engage and enrich students’ learning. Furthermore, the repertoire of pedagogical strategies has permeated graduates’ classrooms. Nevertheless, for sustainability a mechanism needs to be in place for providing faculty with institutional support and recognition for their contribution in teaching and learning. A need is advocated for TLEW to evolve as a mandatory component for all teaching staff at the university to help serve as a fundamental base for initiating and sustaining change through ongoing professional development opportunities and establishing a community of practice

City tumour board Karachi: an innovative step in multidisciplinary consensus meeting and its two years audit.

Management of cancer patients is a team work which usually comprises of surgeons, oncologists, radiologists, pathologists, psychiatrist, nutritionist and a nurse. Any patient who is suffering from any tumour needs a multimodality meeting as cancer treatment is not a single persons job. Most of the time, it is difficult to get the whole team together for a plan discussion due to their busy schedule. This problem was overcome by starting a tumour board meeting early morning of Sunday in Karachi which was named City Tumour Board (CTB) Karachi . Its first meeting was held on Sunday March 28, 2010 and since then it takes place regularly fortnightly. Till March 2012, 44 sessions were conducted and total 264 cases were discussed. Here we present an audit of these two years. On average, in 60% of cases, tumour was up (36%) or down staged (12%) while in 52% of cases the stage remained unchanged. In 70% of cases (inclusive of above 60%), initial treatment plan was changed after discussion in the tumour board. This data signifies the importance of tumour board especially in a Pakistani setup where patient and even referring persons are not well aware of this disease and its outcome. It is advisable that every case should be discussed in tumour board before embarking on any treatment so that the best treatment plan can be given. It is also important that all relevant specialists should be present in the tumour board when planning for any treatment

PRIMARY MALIGNANT MELANOMA UTERINE CERVIX

A 40-year-old premenopausal female presented with foul-smelling per vaginal discharge for 3 months. Diagnostic work revealed a locally advanced primary malignant melanoma of uterine cervix. The patient declined pelvic surgery and was treated with Dacarbazine. Malignant melanoma is a rare tumour of skin and has been ranked in the top ve cancers of Australia and Sweden. It is a tumour of melanocytes which forms melanin pigment in the skin. In men, the most common site is trunk while in females common site is limbs. However, melanoma can arise from mucosal surfaces where the melanocytes are present. Most common mucosal sites are head and neck followed by female genital tract. Key words: Cervix, dacarbazine, malignant melanoma

Utilization and impact of electronic and print media on the patients’ health status: physicians’ perspectives

Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors’ opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients. Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence. Methods and Materials: Physicians’ perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance. Results: In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource. Conclusions: Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media

Quantitative estimation of protein in sprouts of 'vigna radiate' (mung beans), 'lens culinaris' (lentils), and 'cicer arietinum' (chickpeas) by Kjeldahl and Lowry methods

Protein scarcity is the most vital cause of long-lasting diseases and even untimely deaths in some developing nations. The application of protein in food is advantageous from the point of view of non-toxicity, biocompatibility, and dietary benefits. This study aimed to determine the protein contents of the sprouts of Vigna radiates (mung beans), Lens culinaris (lentils), and Cicer arietinum (chickpeas) using the Kjeldahl and Lowry methods. The results obtained from the Kjeldahl method identified protein concentrations of 2.54, 2.63, and 2.19%, whereas the Lowry method results identified protein concentrations of 2.96%, 4.10%, and 1.6% in mung beans, lentils, and chickpeas, respectively. In both the methods, lentils were found to have the highest amount of protein followed by mung beans and chickpeas. Both the Kjeldahl and Lowry methods demonstrated good protein values and low variation in the protein amount in the analyzed samples. Furthermore, the methods had greater sensitivity and comparable experimental variability. The outcomes revealed that assays can be applied for protein analysis in legumes. In the context of a lack of suitable standard procedures for evaluating legumes’ compositions, the present study is suitable for food control laboratories. In addition, the studied samples represent a significant source of protein and can be used to fulfil the daily requirements for protein intake and other food applications

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Visual Outcomes in Children Undergoing Secondary Intraocular LensImplant after Primary Cataract Surgery for Congenital Cataracts

Background: The most frequent surgical approach for cataracts is a micro-incision aspiration with intraocular lens (IOL) implantation. Multiple factors are involved in the long-standing effect of Pediatric cataract surgery. Objective: The purpose of this study was to assess the visual outcomes following secondary implantation of IOL in children who have undergone primary cataract surgery for congenital cataracts. Study type, settings & duration:This was a cross-sectional study performed at the Pediatric section of Al-Ibrahim Eye Hospital, Karachi from January 2018 to December 2019. Methodology:Fifty-seven files were retrieved for data collection. All children who had congenital cataracts and were aged 1-3 years and had undergone primary cataract surgery were included. Children with congenital cataract had undergone a primary surgery at six months to one year after which a secondary IOL implant had been done on them aged 15-36 months. Results:Visual acuity improved to 6/12 in 40.4% patients, 6/9.5 in 33.3% patients, and 6/15 in 10.5% patients. The final visual outcome through log MAR chart revealed that most of the children improved visual acuity. Of the total 19(33.3%) had a 0.2 score that is equivalent to 6/9.5 on the Snellen chart. Likewise, 23(40.4%) had 0.3 score that is equivalent to 6/12 on the Snellen chart, 6(10.5%) had 0.4 on the log MAR chart. Conclusion:The bilateral congenital cataract was more prevalent. Overall an improvement in the visual outcome was seen after secondary Intraocular lens implantation in patients with bilateral congenital cataracts