Risk Factors of Diarrhoea in Malnourished Children Under Age of 5 Years

Background: Acute infectious enteritis remains one of the commonest causes of death among infants and children in developing countries. Acute enteritis is defined as a loss of stool consistency with pasty or liquid stools, and/or an increase in stool frequency to more than three stools in 24 hours with or without fever or vomiting. Human survival depends on the secretion and reabsorption of fluid and electrolytes in the intestinal tract. The objective of the study is to evaluate the risk factors of diarrhoea in children under age of 5 years. Methodology: It was an observational study. Study was completed in about six months. Non-probability purposive sampling technique was used. In this study, 270 samples were taken from Diarrheal ward of The Children Hospital Lahore, Pakistan. Results: In this study, out of 270 patients, 58.52% were males and 41.48% were females. 90.37% patients were vaccinated. 54.81% had weaning history. 91.85% patients had feeding history. 29.26% had blood in stool. 96.67% patients were dehydrated. 95.56% patients had loose watery diarrhoea. 62.96% patients used boiled water. 58.52% patients consumed less than half litre of water, 30.00% patients consumed 1 litre of water and 11.48% patients consumed > 1 litre of water. 49.18% patients had proper hygiene. 38.15% mothers of patients were well educated. 40.37% patients had model household condition. 57.41% patients lived in rural area and 42.59% patients lived in urban area. Conclusion: The variation in the level of diarrheal morbidity was well explained by maternal education, income, personal hygiene, refuse disposal system and the effect of health extension programme

Job Stress among Female Residents during Postgraduate Training at a University Hospital in Karachi, Pakistan

Background: Postgraduate medical training is a stressful experience for both male and female doctors but previous studies have shown that stress might be more prevalent amongst female residents. Since women make up 70-80% of medical graduates in Pakistan we conducted this study to determine the prevalence of stress among female residents during postgraduate training and identify the most common stressors. Methodology: All female residents enrolled in postgraduate training programmes at the Aga Khan University meeting the inclusion criteria were recruited and informed written consent was obtained. Job Stress Inventory (JSI) was used to identify symptoms and sources of job stress. A cut-off value of \u3e25 was used to indicate job stress. Results: A total of 154 female residents met the inclusion criteria. The response rate of the survey was 77%. Sixty one residents scored 26 or more on the JSI, indicating the presence of job stress. The three most common causes cited for job stress were, lack of control, environmental factors and workplace politics. Conclusion: Our study indicates a high prevalence of stress among female residents, independent of the marital status, number of children, the chosen specialty or the level of training. We suggest that programme directors and supervising faculty acknowledge the need for change in the training programmes refraining from favoritism and the need for politics towards constructive feedback based on merit and hard work and allow the residents to have more control over their working environment

Extreme E-Service Learning: Remote Learning for Undergraduate Students and Telehealth Intervention for Children with Autism

Extreme e-service learning courses in higher education, in which all components of the course including the instruction and service is provided online (Waldenr et al., 2012), offer rich educational experience as well as mutual benefits to the students, community and the higher education institutes. Very few studies have examined extreme e-service learning. We examined an undergraduate extreme e-service learning course in psychology; students learned through a virtual class and provided telehealth behavioral intervention services to children with Autism Spectrum Disorder (ASD). Utilizing mixed methods (quantitative and qualitative measures including student observations, assignments, and self-reports) and a mixed design (single subject experimental design and within subject pre-post comparison design), we found improvements across all facets of service learning: knowledge, civic engagement, and personal growth. The positive outcomes suggest the promise of extreme e-service learning courses involving direct service-learning activities

Intraocular Metastasis as the Presenting Symptom of NSCLC and the Role of Bevacizumab: A Case Report

Introduction: Metastasis to the eye is a rare clinical entity accounting for about 2-9% ocular malignancies. Clinical awareness can lead to prompt diagnosis and appropriate management.Case presentation: We here present a case of a 60-year-old patient who visited to several ophthalmologists with the complaint of blurry vision in his left eye. He was diagnosed with anterior uveitis and elevated intraocular pressure. A masquerade syndrome was suspected, and anterior chamber paracentesis was performed, which revealed metastatic non-small cell lung cancer (NSCLC). CT chest revealed a left lung mass with right paratracheal lymphadenopathy. No other evidence of metastatic disease was found on PET/CT scan and MRI of the brain. He received treatment for stage IV lung cancer with carboplatin, paclitaxel, and bevacizumab. The intraocular tumor cell infiltration was treated with intravitreal bevacizumab that resulted in subjective and objective improvement.Conclusion: Metastasis to the eye may present in a masquerade-like fashion as intraocular inflammation. Tumor specific therapy directed locally within the eye may be a component of an overall treatment plan.

Correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at Dr. Ruth K.M. Pfau Civil Hospital Karachi.

Introduction: Cirrhotic patients suddenly or insidiously develop hepatic en-cephalopathy. Approximately three-fourth of the patients usually die within 3 years of onset of their first episode of hepatic encephalopathy. Hypo-natremia, a multifactorial phenomenon in cirrhotic patients may lead to cer-ebral edema and astrocytes swelling.Objective: To determine the correlation of serum sodium with severity of hepatic encephalopathy in liver cirrhosis patients presenting at tertiary care hospital, Karachi.Methodology: This prospective cross-sectional study conducted at Depart-ment of Medicine, Civil Hospital, Karachi between October 31, 2019 till April 4,2020. Data collected from 138 patients after taking written consent; pre-sented as was as mean, standard deviation, frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable taking p-value of ≤0.05 as significant.Results: Among 138 patients 92 (66.7%) were male and 46 (33.3%) were female. Mean age, duration of symptoms, height, weight and serum sodium in our study was 51.14±4.49 years, 12±7.21 hours, 161±6.78 cm, 85.2±8.54 kg and 132.7±6.32 mEq/L. Out of 136 patients, 28 (20.3%), 35 (25.4%), 54 (39.1%) and 21 (15.2%) patients belonged to sodium quartile 1, 2, 3 and 4; while 21 (15.2%), 41 (29.7%), 28 (20.3%) and 48 (34.8%) belonged to hepatic encephalopathy severity grade 1, 2, 3 and 4. Hepatic encephalopathy severi-ty showed correlation with rising sodium levels.Conclusion: Hyponatremia was found with increased frequency in patients with cirrhosis of liver having a correlation with frequency and severity of hepatic encephalopathy.Key words: Encephalopathy, Liver Cirrhosis, Hyponatremia

Development of an Open Source Urdu Screen Reader for Visually Impaired People

Abstract Speech technology has enabled computer accessibility for users with visual impairments but the language barrier poses a great challenge. This project is an effort to overcome the hurdles faced by visually impaired people, in terms of language barrier, by providing them access to digital information through software which can communicate with them in Urdu. A survey was conducted in schools for blind to assess their information and communication needs. The survey helped to deduce the learning abilities, competency level and usability requirements of visually impaired children. An open source screen reader, NVDA was localized and afterwards integrated with Urdu text-to-speech system. The system was deployed in a school of visually impaired children where they participated in training and testing of the system. Results showed that visually impaired children performed equally well and in some cases even better with the localized screen reader as compared to an English screen reader

Students' Feedback of Written Examination: A Public Sector Medical University Experience

Objective: To determine the students’ perceptions regarding the examination in a public sector medical university. Methodology: This cross-sectional study was conducted at Shaheed Zulfiqar Ali Bhutto Medical University Islamabad. An examination feedback proforma was developed to collect the feedback from students appearing for the written exam for MD/MS/MTA during 2015. Multiple variables were assessed and descriptive analysis was done. Results: The feedback proforma was distributed to 98 candidates with response rate was 68.36%. Overall feedback from students about the examination was positive. Majority of the students were satisfied with the process and arrangements of the examination. However a large number of students did not comment on some important issues. Conclusion: Collecting students’ feedback about examination was a good effort to identify our deficiencies and indication for areas of improvement. This study revealed a positive response from students regarding overall management of the examination process

Synthesizing an Agent-Based Heterogeneous Population Model for Epidemic Surveillance

In this paper we propose a probabilistic approach to synthesize an agent-based heterogeneous population interaction model to study the spatio-temporal dynamics of an air-born epidemic, such as influenza, in a metropolitan area. The methodology is generic in nature and can generate a baseline population for cities for which detailed population summary tables are not available. The joint probabilities of population demographics are estimated using the International Public Use Microsimulation Data (IPUMS) sample data set. Agents, are assigned various activities based on several characteristics. The agent-based model for the city of Lahore, Pakistan is synthesized and a rule based disease spread model of influenza is simulated. The simulation results are visualized to analyze the spatio-temporal dynamics of the epidemic. The results show that the proposed model can be used by officials and medical experts to simulate an outbreak