Frequency of urinary incontinence with pelvic organ prolapse and associated factors.

 Introduction : To determine the frequency of common types of urinary incontinence (UI) in women with pelvic organ prolapse (POP) attending Uro-gynaecology clinics at Aga Khan Hospital Karachi. METHODS: A total of 85 women attending the Uro-gynaecology clinics with symptoms of pelvic organ prolapse were included in a cross sectional survey  RESULTS: Out of 85 women presented with pelvic organ prolapse, 61(71.7%) were aged above 50 years and 24(28.4%)  below 50 year of age . The frequency of SUI was reported by 46(54.1%) women, 16(18.8%) women presented with UUI and 23(27.1%) with MUI. Large majority of women were postmenopausal(69%) ,  multiparous(71%), , and obese with a BMI >25 (69.4%). Thirty nine (46%) women had III grade of POP and 46( 54%) had SUI. Grade of POP was significantly associated with UI (SUI). Grade II POP was associated statistically significant  with SUI [Adjusted Odd Ratio (AOR) 0.04; 95% CI: 0.004, 0.418; P value: 0.007].The other factors like age ,parity and BMI were not found to be statistically significant in association with UI.CONCLUSION: Pelvic organ prolapse and urinary and incontinence are significant problems in developing countries .Both of these conditions badly impact quality of life of women .In our study only SUI was found to be significantly associated with increasing grades of POP

Kerr-Newman-Taub-NUT Black Hole Tunnelling Radiation

The tunnelling process always occur nearby the event horizon of the black hole. In this paper, we investigate the tunnelling radiation in the background of the Kerr-Newman-Taub-NUT black hole. The new coordinate system for Kerr-Newman-Taub-NUT is introduced, which helps us to form new line element. This line element helps us to show that new coordinate is exhaustively acted at event horizon. With the help of conservation of angular momentum, self gravitational effect and energy, we will show that Hawking's radiation is not exclusively thermal.Comment: 14 pages, 15 figure

Factors Influencing the Headaches and Their Impact On Daily Life of Medical Students

Background and Objective: Medical students are considered high risk for headaches due to various triggers in their daily routine. The objective of this study was to assess the factors influencing headaches and their impact on the daily life of medical students. Methods: This cross-sectional study utilized a sample of 242 participants who were selected through a convenient method of sampling. Data was collected from medical students of Liaquat National Medical College for a period of six months (January to June 2021). Data was gathered using pre-designed questionnaires that assessed demographic information, lifestyle factors (such as consumption of tea, coffee, and soft drinks), sleep patterns, meal habits, stress levels, and headache characteristics (including frequency, duration, intensity, associated symptoms, aura symptoms, and triggers). An analysis using a chi-square test was conducted to investigate the potential relationships between these factors and the occurrence of headaches. Results: Age and gender were not significant predictors of headaches in this particular sample. Instead, factors such as missed days due to headaches (p=0.020) and problems staying asleep (p=0.044) were more closely linked to headache occurrence. Headaches lead to a minor reduction in the ability to function for a large proportion of individuals (58.1%). A high percentage of participants had a family history of headaches (41%). Conclusion: These findings highlight the importance of addressing sleep quality as a potential avenue for mitigating the burden of headaches in individuals. However, further research is necessary to establish causation and generalizability of these results to broader population

Medical students’ endeavour to make use of their mental capabilities

Objective: To identify and compare awareness of intellectual wellness in male and female medical students of Karachi. Methods: The cross-sectional questionnaire-based survey comprised randomly selected 800 medical students of both gender. It was conducted from January to December 2010 in 8 medical colleges of Karachi. Responses - never, sometimes, mostly and always (numbered 0-4) - were analysed in terms of frequency, proportion and percentages by Predictive Analysis Software version 18. Chi square test was applied for comparison of intellectual wellness in both genders. Results were considered significant at p \u3c0.05. Results: Of the 800 questionnaires distributed, 736 (92%) were received fully completed; 526 (71.5% of them from females. Intellectual wellness was significantly higher in females due to an increasing aptitude towards book reading (p Conclusion: Females were found to be better in terms of intellectual wellness compared to the males. However, males used mentorship support to acquire intellectual wellness

Effectiveness of NA External Fixator with T-clamp in treating Open proximal and Distal Fractures of Tibia

Objective: To compare the outcomes of the open proximal and distal fractures of tibia treated by Nasser Awais External Fixator with T-clamp. Methodology: This cross sectional study was carried out in the department of orthopaedics Nishtar hospital, Multan in one year duration from July 2016 to July 2017. Study was started after ethical approval from hospital ethical board. Collected data of all patients was entered in SPSS software version 23 and analyzed. Mean and SD was calculated for quantitative data like age, frequency and percentages were calculated for qualitative data gender. Chi square was applied to see association of outcome variables with other variables and confounder. P value ≤ 0.05 was considered as significant. Results: Overall, there were 100% (n=180) patients; 50% (n=90) in each of the two groups. Clinical results were excellent in 88.9% (n=80) patients, good in 7.8% (n=7) patients and fair in 3.3% (n=3) patients in group A. While, in group B, the clinical results were excellent in 83.3% (n=75) patients, good in 10% (n=9) patients and fair in 6.7% (n=6) patients. No association was found between clinical results and the groups (χ2= 1.411 DF = 2, P value=0.494). Conclusion: Nasser Awais External Fixator with T-Clamp is a safe and effective technique that enhances the union rate with a low complication rate with less union time in distal tibial fracture compared to proximal fracture. Keywords: NAEF, Tibia, Open proximal, T Clamp, External Fixator.

Intellectual wellness awareness: a neglected area in medical universities of Pakistan

Abstract Objective: To compare the presence of intellectual wellness awareness in students of public and private sector medical colleges in a metropolitan city. Methods: The cross-sectional questionnaire-based survey was conducted from March to November 2011 at Bahria University Medical and Dental College, Karachi, and overall covered five private and 3 public sector medical colleges of the city. The study randomly selected 800 medical students. The responses -- never, sometimes, mostly and always (numbered 0-4) - were analysed in terms of frequency, proportion and percentages using Predictive Analysis Software version 18. Results: Of the 800 forms distributed, 736(92%) completed forms were analysed. Among the respondents, 526 (71.5%) were females. Besides, 450(61%) belonged to private medical colleges and 236(39) were from public medical colleges. The participants of private medical colleges had taken part in intellectual discussions actively compared to those from public colleges (p\u3c0.001). Habit of reading books to acquire knowledge was found in 126(44%) private college students compared to 149(33%) in public colleges (p\u3c0.004). The importance of creative mental activities (p=0.954) and current information about local and international affairs (p\u3c0.564) was deficient in both sets of students. Conclusion: Students of private medical colleges were better in terms of presence of intellectual wellness awareness, took active participation in class discussions, had good reading habits and carefully selected television programmes and movies

Students\u27 perceptions of usefulness of Anatomy demonstrations in traditional and hybrid undergraduate medical education curricula

A cross-sectional study was carried out to study students\u27 perceptions on the usefulness of Anatomy demonstrations (AD) in the undergraduate medical education by comparing the Conventional Medical College (CMC) and problem-based learning as hybrid curriculum (HMC). Purposive sampling technique was used and all students were included. The completed questionnaire responses were returned by 92 CMC and 87 HMC students. CMC cohort understood the structural relationship more than HMC (p=0.03). AD helped 50 students (54%) of CMC to get through the theory examination, however 73 (84%) students of HMC found them useful in preparation for theory examinations (p\u3c0.001). The importance of AD as a major content delivery strategy cannot be overemphasized in the anatomy curriculum and useful teaching strategies from various undergraduate medical curricula, such as the use of the plastic and plastinated models and the session handouts

THE IMPACT OF ANTIHYPERTENSIVE DRUG THERAPY IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

Objective: Hypertension (HTN) is both a cause and an effect of chronic kidney disease (CKD). To adequately control blood pressure (BP) in CKD, choosing antihypertensive strategies with the highest nephro-protective effect is crucial for preventing or reversing end-stage renal disease (ESRD) progression and reducing cardiovascular disease (CVD) risk. The present study was therefore designed to evaluate the impact of clinical use of antihypertensive drug therapy in patients with CKD and ESRD. Methods: It is a prospective observational cohort study. The patients were divided into two cohorts i.e.; non-dialysis dependent (NDD) and dialysis-dependent (DD) CKD. This study was conducted for six months in the Nephrology department, Osmania General Hospital, Hyderabad, India. The data collected and entered into Microsoft Excel (2007) and mean, SD and range were calculated using SPSS version 25. Results: Antihypertensive drugs were prescribed alone or in combination based on the co-morbidities associated with CKD and HTN. Loop diuretics (Furosemide and Torsemide) and calcium channel blocker (Amlodipine, Nifedipine and Cilnidipine) were most commonly prescribed antihypertensive drugs. Triple therapy (44.11%) was prescribed mostly in both the cohorts (NDD = 16.66%+DD = 27.45%) of which calcium channel blockers+loop diuretic+sympatholytic accounts for 19.16% (NDD = 5.88%+DD = 13.73%).  Conclusion: The practice of prescribing antihypertensive drugs for the management of HTN and to achieve BP targets in CKD and ESRD remains uncertain. The development of new and revised guidelines is needed to reduce inappropriate variations in practice and promote better delivery of evidence-based treatment