MRA-based evaluation of anatomical variation of circle of Willis in adult Pakistanis

Objective: To determine the frequency and patterns of normal anatomical variation of Circle of Willis on magnetic resonance angiogram in adults without cerebrovascular disease.Methods: This descriptive cross-sectional study was conducted at the Radiology Department of Dow University of Health Sciences / Civil Hospital, Karachi, from January to December 2016, and comprised patients referred for magnetic resonance imaging of the brain and magnetic resonance angiogram without any clinical or radiological manifestation of cerebrovascular disease, primarily including those with suspected demyelination, infection, epilepsy or metastases. Three-dimensional time-of-flight magnetic resonance angiography was performed. The Circle of Willis was assessed for its completeness along with anatomical variations of anterior and posterior components of the circle.Results: Of the 135 subjects, 70(51.8%) were males and 65(48.2%) were females with an overall mean age of 49.26±9.2 years. Among all the subjects, 30(22.2%) showed a complete circle, while 82 (60.7%) and 23(17.1%) had partially complete and incomplete circles respectively. The anterior part of the circle was completed in 108 (80%) subjects, showing type \u27a\u27 as the most common variant in 93(68.9%). The posterior part of the circle was completed in 30 (22.2%) subjects with type \u27e\u27 variant in 52(38.5%).Conclusions: There was a wide variability in the anatomy of the Circle of Willis in Pakistani adults asymptomatic for cerebrovascular disease

Postoperative outcome of early appendectomy in patients having appendicular mass by laparoscopic surgery

Objective: To determine the frequency of postoperative outcome of early appendectomy in patients having appendicular mass by laparoscopic surgery.Methodology: It was a descriptive & case series study. Study was conducted in the department of surgery Liaquat University Hospital Jamshoro/Hyderabad, during the time period of Jan 2015 to Dec 2017. Patients were both gender and patients aged between 10-40 years having tender and palpable right iliac fossa mass on clinical examination confirmed on ultrasound abdomen as appendicular mass. Patients with mass in right iliac fossa but with associated features like fixed and immobile mass for more than 1 month, bleeding per rectum, history of weight loss, cardio respiratory diseases like recent myocardial infarction, congestive cardiac failure, chronic obstructive pulmonary disease and renal diseases like glomerulonephritis, nephrotic syndrome and renal failure etc, gynecological and obstetrical diseases in female patients were excluded from the study. The postoperative hospital stay was counted and wound infection was noted.Results: During the study period of one year, total of 73 patients with appendicular mass were included in this study.  The age range 10 to 40 years with mean age ± SD (range) was 25.75±9.2 years. Out of them 46 (63.0%) were male whereas 27(37.0 %) were females During operation we found appendicular abscess in 12(16.43%) cases followed by perforated appendix in   10(13.69%) cases, while during operations we found in adhesions in 15(20.5%) cases and difficulty in localisation of appendix 06 (8.21%) cases. The mean hospital stay + SD (range) was 4.91 +1.65 (3-9 days).  Wound infection was seen in 15(20.5 %) cases.Conclusion: Early appendectomy can be safely performed in appendix mass without any increased risk of mortality and morbidity. The outcome of early surgical management of appendicular lump showed benefits for single hospitalization, shorter hospital stay and lower treatment costs

Multiple system atrophy - The cerebellar type with “hot cross bun sign” on MRI

Multiple system atrophy (MSA) is an adult onset, progressive, idiopathic neurodegenerative disease that clinically manifest as MSA-C with cerebellar signs predominant, MSA-P with Parkinsonian features predominant and MSA-A with autonomic signs and symptoms. MRI has an important role in its diagnosis with a characteristic finding described as hot cross bun sign seen in MSA of cerebellar type (MSA-C). We have seen two cases of MSA-C referred to Radiology Department, Civil Hospital Karachi in February 2017 and March 2017 who presented with difficulty in walking and speech and foecal and urinary incontinence. The MRI showed atrophy of pons, cerebellum and middle cerebellar peduncles with cruciform hyperintense signals in pons (hot cross bun sign). Multiple system atrophy has no specific treatment so the patients were on supportive therapy. We are reporting these interesting cases along with the clinical and radiological findings as well as literature review

The Nexus between Time Management Behaviors and Work-Life Balance of Employees

This research is envisioned to explain the impact of individual time management behaviors on the work-life balance of banking employees. Using the positivist paradigm, a self-administered survey was chosen to collect responses from bank employees across Sindh, Pakistan. The presented hypotheses were supported by quantitative analytical techniques that tested causal links between all constructs. A total of 450 questionnaires were administered, out of which 320 valid responses were analyzed using PLS-SEM. The findings validated that individual time management behaviors do contribute to attaining work-life balance in the banking sector. Results revealed a positive effect of goal setting and priorities, time management mechanics, and organization preference on employees’ work-life balance. Among all, mechanics of time management (MTM) substantially impact achieving work-life balance. This research will aid in the identification of time management practices that are better capable of balancing work and life.JEL Classification: M12How to Cite:Shaikh, S., Khoso, I., & Channa, N. (2023). The Nexus Between Time Management Behaviors and Work-Life Balance of Employees. Etikonomi, 22(1), 119–130. https://doi.org/10.15408/etk.v22i1.22385

Diagnostic accuracy of diffusion weighted MRI in differentiating benign and malignant meningiomas

Objective: To determine the diagnostic accuracy of DWI in differentiating benign and malignant meningiomas keeping histopathology as gold standard.Methods: This was a descriptive analytical study conducted at Radiology Department, DUHS/Dr. Ruth K. M. Pfau Civil Hospital Karachi, from August 2016 to March 2018.It included152 patients clinically suspected of meningioma on conventional neuroimaging. Imaging features of DWI were compared with histopathology findings. The diagnostic accuracy of DWI was calculated in terms of sensitivity, specificity, accuracy, PPV and NPV using histopathology as gold standard.Results: There were 59 male and 93 female patients with mean age of 55.38±9.8 years. Mean duration of sign and symptoms was 5.67±2.57 months. Out of 152 patients, 117(77%) and 35(23%) were differentiated into benign and malignant meningiomas respectively by DWI while 135(88.82%) and17(11.18%) patients were diagnosed respectively on histopathology. The sensitivity, specificity, PPV, NPV and accuracy of DWI of 84.4%, 82.3%, 97.4%, 40%, and 84.2% respectively keeping histopathology as gold standard.Conclusion: DWI features along with calculation of ADC values is a reliable non-invasive technique for differentiating benign and malignant meningiomas. However the low negative predictive value necessitates the use of histopathology

COMPARATIVE STUDY OF ANTI-INFLAMMATORY ACTIVITY OF AQUEOUS AND METHANOLIC EXTRACTS OF HIBISCUS CANNABINUS LEAF (MALVACEAE)

Objective: The present study was undertaken to investigate and compare the anti-inflammatory activity of an aqueous and methanolic extract of Hibiscus cannabinus (Malvaceae) using carrageenan-induced rat paw edema.Methods: Aqueous and methanolic extracts of Hibiscus cannabinus was prepared and tested for anti-inflammatory activity in female spargue dawley rat weighing 150-180 g. The animals were randomly divided into 6 groups of 6 each. First group served as vehicle control, second group served as standard, third and fourth group served as high (400 mg/kg) and low (200 mg/kg) dose of methanolic extract of Hibiscus cannabinus leaves (MHCL) respectively and fifth and sixth group as high (400 mg/kg) and low (200 mg/kg) dose of aqueous extract of Hibiscus cannabinus leaves (AHCL) respectively. The In vivo anti-inflammatory activity was studied using carrageenan induce rat paw edema animal model. The estimation of liver and blood parameters consist of serum glutamic oxalate transaminase (SGOT), serum glutamic pyruvate transaminase (SGPT), lipid peroxidation (LPO), reduced glutathione (GSH) and superoxide dismutase (SOD).Results: Both MHCL and AHCL extracts showed significant (*p<0.05) inhibition of rat paw edema in dose-dependent manner. The maximum percent inhibition in paw edema was found in MHCL at dose of 400 mg/kg was 52.00% and AHCL at dose of 400 mg/kg was 49.93%. Both MHCL and AHCL at dose of 400 mg/kg reduce LPO level as 31.10 nmol/g and 35.23 nmol/g respectively when compared with standard indomethacin.Conclusion: An anti-inflammatory activity was found in both MHCL and AHCL extracts. But the MHCL showed more significant anti-inflammatory activity.Keywords: Hibiscus cannabinus, Anti-inflammatory, Carrageenan, Indomethacin, EdemaÂ

ASSESSMENT OF LIFE SKILLS AMONG COLLEGE UNDERGRADUATE-STUDENTS; IMPLICATION FOR ENHANCING STUDENTS ACADEMICS AND PERSONALITY DEVELOPMENT

The literature indicates that life skills assessment and development is endemic throughout the globe. However, lacking are national studies that have researched life skills assessment at the college level. The present investigation aimed to assess the level of life skills among college undergraduate-students of Khyber Pakhtunkhwa, Pakistan. Besides, the differences based on personal and demographic attributes in respect of life skills were also taken into consideration. A sample of (n=794) 5 % of the total population (15890) was selected and included in the survey. Life Skills Assessment Scale (LSAS) developed by (N.R. Prakash, S. Nirmala Devi, 2014) was used for collecting the required data. The gathered information was processed using (SPSS) version 24. Results of the study indicated that the overall nature of life skills among college students is moderate. The findings of the study indicated that the female-students reported less life skills compared to their counterparts’ male undergraduate-students (p .05). It is hoped that the results of this research will be more helpful for administrators, educators, curriculum designers and other social duties to improve teaching-learning and personality development for learners

IN VITRO AND IN VIVO SCREENING OF ANTI-INFLAMMATORY ACTIVITY OF METHANOLIC AND AQUEOUS EXTRACTS OF ANOGEISSUS LATIFOLIA LEAVES

Objective: To evaluate and compare anti-oxidant and anti-inflammatory activity of methanolic and aqueous extract of Anogeissus latifolia leaves Methods: The in vitro antioxidant activity was investigated using nitric oxide radical inhibition activity assay, hydroxyl radical scavenging activity assay, DPPH free radical scavenging assay, and reducing power assay. The in vitro anti-inflammatory activity was investigated using erythrocyte membrane stabilization, inhibition of protein denaturation, and proteinase inhibitory activity the in vivo anti-inflammatory activity was investigated using carrageenan-induced rat paw edema. The biochemical parameters were evaluated in the blood, which included the determination of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase values and in the liver, which includes the estimation of lipid peroxidation, reduced glutathione, and superoxide dismutase. Results: The methanolic extract caused a significant dose depended on the reduction of inflammation when compared with the aqueous extract of Anogeissus latifolia. The anti-inflammatory activity of all groups was found to be comparable to the standard indomethacin group. The maximum percent inhibition in paw edema was found in methanolic extract of Anogeisuss latifolia at a dose of 500 mg/kg was 53.33%, with significant anti-inflammatory activity p<0.001. Conclusion: The leaf extract of Anogeissus latifolia possesses anti-oxidant and anti-inflammatory activity. The therapeutic effect of Anogeisuss latifolia extracts will encourage its use in the treatment of inflammation

Sex hormones alter the effect of aspirin on bleeding

Background: Interaction of aspirin and sex hormones was investigated through bleeding time.Methods: Bleeding time in 32 males and 105 unmarried females with previous 6 normal menstrual cycles and all aged between 18 to 21 years was found by Duke’s method before and after 2 hours of aspirin administration. Phase of menstrual cycle of each female was determined by present menstrual history.Results: Bleeding time in 32 male was 69.33± 4.94 seconds and in 105 female was 73.03±1.89 seconds which were not statistically different (P>0.05).This time was increased to 107.66±4.76 seconds in males and 113.65±3.73 seconds in females after aspirin administration which were statistically different (P0.05) difference after aspirin administration with a greater effect in Follicular phase probably due to estradiol.Conclusion: Males respond to aspirin more as compared to females which is likely the effect of the drug and testosterone interaction. Similarly females in the follicular phase respond to aspirin more as compared to females in the luteal phase which may be a result of interaction of estrogen and aspirin

Changes in Serum Lipid Profile among Patients Suffering from Chronic Liver Disease Secondary to Hepatitis C

Objective: To find out the changes in lipid metabolism among patients suffering from chronic liver disease secondary to hepatitis C. Study Design: Hospital based observational study. Setting: Medical Unit-I, Ward–5, Jinnah Postgraduate Medical Centre, Karachi. Duration: July 2013 to December 2013. Patients and Methods: About 110 patients admitted in Medical Unit-I with a diagnosis of chronic liver disease were included in the study. Patients suffering from DM, HTN, CKD were excluded from the study. Fasting lipid profile was done in all cases. Results and Observations: There were 44 (40%) male and 66 (60%) female patients. Mean age of the patients was 50.18 (±11.7) years. Total cholesterol was decreased in 76 (69.09%) patients. Normal range was present in 34 (30.91%) patients. None of the patient had hypercholesterolemia. Serum triglyceride levels were low in 14 (12.72%) patients, normal in 82 (74.54%), borderline high in 7 (6.36%) and hypertriglyceridemia was seen in 7 (6.36%). HDL-c was below normal in 26 (23.63%) cases, normal in 78 (70.91%), and high in 6 (5.45%). LDL was near optimal/above optimal in only 5 (4.5%) patients. Mean TC/HDL ratio was 2.53 (±1.02). Mean LDL/HDL ratio was 1.23 (±0.73). Mean TC of HCV +ve patients was 130.5 mg/dl as compared to that of HCV –ve patients which was 82.85 mg/dl (P-value: 0.011). Mean TGs of HCV +ve group was 151.5 mg/dl while that of HCV –ve was 79.9 mg/dl (P-value: 0.025). Mean HDL & LDL levels were 43.67 mg/dl and 39.78 mg/dl in HCV group while 34.83 mg/dl & 64.67 mg/dl in the other group with P-value of 0.026 and 0.081 respectively. Conclusion: When it comes to its relationship with lipid metabolism, HCV is a remarkable virus. Its interaction with lipoproteins and its ability to induce massive steatosis are quite unique and idiosyncratic. Despite of causing hepatic steatosis, chronic HCV infection is associated with a paradoxically favorable lipid profile, although its reason cannot be enlightened precisely. There is a need for very well settled molecular and genetic studies to well understand HCV infection and lipid metabolism