Acute myeloid leukaemia in children: experience at a tertiary care facility of Pakistan

Objective: To document the demographics and outcome of children with Acute Myeloid Leukemia (AML) treated at a tertiary care facility of Pakistan. Methods: A retrospective study was conducted at Aga Khan University on children (less than 15 years) diagnosed to have AML between January 2000 to May 2007.Total 40 cases were diagnosed out of which 37 charts were available for review. Results: The average age of presentation was 8.5±4.5 years and 75% were males. The most common presenting feature was fever in 83% followed by bleeding in 41% and pallor in 39%. Initial WBC of \u3e 100,000 was seen in 19% of patients. The most common FAB subtype was M4 39%. Twenty three patients underwent treatment out of which 12 patients are alive and in remission. Majority were followed up around 2 years and 6 months. Out of the 11 patients who died three had resistant disease, four relapsed and rest died due to sepsis mostly during induction. Conclusions: The most common sub type in our study is AML M4 although AML M2 is reported as predominant subtype. About a third of the patients could not start or complete therapy due to financial constraints. The overall survival for our patients who completed therapy was 52%

Schiff Bases and Their Metallic Derivatives: Highly Versatile Molecules with Biological and Abiological Perspective

1998 onwards, a span reporting thousands of research articles describes the ever-increasing applicability of Schiff bases and their metallic complexes; this chapter comprehensively examines the literature of the last 20 years. The structural diversity of these molecules made them available for a very wide range of biological and abiological applications. Schiff bases are excellent chelators and due to this unique property have found their place in qualitative and quantitative determination of metals in aqueous media. The structural diversity of metal chelates proved these to be outstanding catalysts and displayed interesting fluorescence effect. Finally, Schiff base moieties have found a unique position during the in vitro and in vivo experiments for drug development against a huge number of biological entities including bacteria, fungi, cancer cells, viruses, parasites, etc

Negative index fishnet with nanopillars formed by direct nano-imprint lithography

In this paper we demonstrate the ability to fabricate fishnets by nanoimprinting directly into a pre-deposited three layer metal–dielectric–metal stack, enabling us to pattern large areas in two minutes. We have designed and fabricated two different fishnet structures of varying dimensions using this method and measured their resonant wavelengths in the near-infrared at 1.45 μm and 1.88 μm. An important by-product of directly imprinting into the metal–dielectric stack, without separation from the substrate, is the formation of rectangular nanopillars that sit within the rectangular apertures between the fishnet slabs. Simulations complement our measurements and suggest a negative refractive index real part with a magnitude of 1.6. Further simulations suggest that if the fishnet were to be detached from the supporting substrate a refractive index real part of 5 and FOM of 2.74 could be obtained

EFFECTIVENESS OF VARIOUS TEACHING METHODOLOGIES IN DEVELOPING CLINICAL REASONING SKILLS IN UNDERGRADUATE FEMALE MEDICAL STUDENTS

ABSTRACT OBJECTIVE: To compare the effectiveness of “summarize, narrow, analyze, probing, management plan, select a topic” (SNAPPS) model, one-minute preceptor (OMP) and traditional clinical teaching in developing clinical reasoning skills of final year undergraduate female medical students in pediatrics clinical setting. METHODS: This randomized control trial was conducted at Department of Pediatrics, Peshawar Medical College from February to July 2016. Students were randomly distributed in three groups i.e. SNAPPS, OMP and traditional teaching with 20 students in each group. All 60 students were exposed to pre-test including 4 Key Feature Problems (KFPs). Students were then taught on pre-identified 4 topics with one topic /week by respective teaching methodology. Each topic was followed by post-test using 4 KFPs. The pre-test and post-test results were recorded and analyzed on SPSS-20. ANOVA was used as test for finding significance. RESULTS: All 60 female students of final year completed the study and none dropped out. The mean marks of pretest of three groups were 12.50±0.15 with minimum number of 4±1 marks and maximum of 23±1. There was no significant difference in pre-test among the groups using ANOVA (p = .984). However, significant difference (p< 0.001) was observed in post-test among groups after intervention. There was statistically significant difference (p<0.001) in favor of SNAPPS as compared to traditional teaching methodology. There was no significant difference between OMP and traditional method. CONCLUSION: SNAPPS is significantly more effective in improving clinical reasoning than OMP and traditional teaching method in female undergraduate medical students in pediatrics clinical setting

Incidence, outcome and risk factors for sepsis- a two year retrospective study at surgical intensive care unit of a teaching hospital in Pakistan

Background: Sepsis is amongst the leading causes of admission to the intensive care units and is associated with a high mortality. However, data from developing countries is scarse. Aim of conducting this study was to determine the incidence, outcome and risk factors for sepsis on admission to surgical intensive care unit (SICU) of a teaching hospital in Pakistan. Methods: Two year retrospective observational study included all consecutive adult admissions to the surgical intensive care unit (SICU) of a University Hospital, from January 2012 to December 2013. Results: Two hundred and twenty-nine patients met the inclusion criteria. Average age of the patients was 46.35±18.23 years (16–85), mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 15.92±8.13 and males were 67.6%. Median length of ICU stay was 4 [IQR 5]. 43% patients fulfilled the criteria of sepsis at the time of admission to the SICU and incidence of severe sepsis/septic shock was 35%. Abdominal sepsis was the most frequent source of infection (57.5%). The overall intensive care unit mortality was 32.31% but the mortality of sepsis-group was 51.15% as compared to 17.7% of the non-sepsis group. Stepwise logistic regression model showed that increasing age, female gender, non-operative admission, admission under general surgery and co-morbidities like ischaemic heart disease and chronic kidney disease were significant predictors of sepsis. Conclusion: The incidence of sepsis and severe sepsis/septic shock, on admission to SICU is high and mortality of the sepsis group is nearly three times the mortality of the non-sepsis group

Death Anxiety among Hospitalized Patients: A Gender Based Comparison

Objectives: Present research purpose is to investigate and compare the level of death anxiety among male and female hospitalized patients in Balochistan. Place and duration: the research was conducted in various hospital of district Quetta and Makuran Division, Balochistan and took 6 months for completion. Sample and methods: Total sample for the study encompassed 50 hospitalized patients that includes male [n= 27, M (SD) = 51.41 (6.541)] and female [n=23, M (SD) = 49.04(6.630)] admitted in various hospitals of Balochistan. Measure:  Informed Consent Form and Death Anxiety Scales (Donald Templer, 1970) was utilized for any level of death anxiety.   Analysis: For assessing and comparing death anxiety among two gender groups. Descriptive analysis and independent sample t- test was conducted. Results:   Results indicate substantial death anxiety among hospitalized patients of Balochistan, but there were non- significant differences among male and female on the levels of death anxiety