Helicobacter Pylori in Patients with Hepatitis C Virus

Abstract Objective: To determine the frequency and association of Helicobacter Pylori (H. Pylori) infection among patients infected with hepatitis C virus (HCV). Methodology: The study was conducted in Services Institute of Medical Sciences, Lahore. A total of 200 cases fulfilling the inclusion/exclusion criteria were enrolled from Medical OPD Services Institute of Medical Science, Lahore. An informed consent of the patients was taken to include their data in the study. Detailed history for hepatitis C virus was taken. Blood samples were collected and sent to the hospital laboratory for evaluation of presence/absence of H. Pylori in the subjects of HCV. Results: In this study, out of 200 subjects, 32%(n=64) aged 30-50 years while 68%(n=136) aged 51-80 years, and the mean S.D was calculated as 53.99+8.67 years. 54%(n=108) males and 46%(n=92) females were included. The frequency of H. Pylori in subjects with HCV was recorded in 37.5%(n=75) whereas 62.5%(n=125) had no findings of the morbidity. Conclusion: The frequency of H. Pylori is higher in patients of Hepatitis C. &nbsp

Frequency of Autonomic Neuropathy in Type-1 Diabetes Mellitus Patients

Abstract Objectives: To determine the frequency of diabetic autonomic neuropathy in type 1 diabetes mellitus.Methodology: This cross-sectional study was conducted at Medical Unit-IV, Services Institute ofMedical Sciences, Lahore. A total of 236 cases fulfilling the inclusion/exclusion criteria were enrolledfrom Medical OPD Services Institute of Medical Science, Lahore. Informed consent of the patientswas taken to include their data in the study. Detailed history for Diabetes Mellitus was taken. All thepatients were undergoing for evaluation of diabetic autonomic neuropathy. Presence/absence ofDAN was recorded. All this information was recorded.Results: In our study, frequency of diabetic autonomic neuropathy in type 1 diabetes mellitus wasrecorded in 17.80%(n=42) whereas 82.20%(n=194) had no findings of the morbidity.Conclusion: We conclude that the frequency of diabetic autonomic neuropathy in type 1 diabetesmellitus is not very high, but it varies according to diagnostic criteria and population, however,some-other studies in different health centers of our country is required

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

Growing Geo-economic and Geo-strategic Interests of India in Afghanistan: Implications for Pakistan

The tragic event of 9/11 changed not only the global political environment of the world but also altered the security and political environment of South Asian region. A change in Pakistan’s foreign policy towards Afghanistan was witnessed. Since Pakistan’s emergence as a separate independent state, its dispute with Afghanistan on Durand Line has substantially influenced the course of its foreign policy towards Afghanistan. The issues in Afghanistan directly affect Pakistan in the domain of politics, economics and society. The troubled relations between the two states gave a chance to India to win thesympathies of Afghanis after 9/11.India emerged as a strong regional player and established good relations with Afghanistan by helping them. To secure its interests in Afghanistan India also established good relations with Iran. They share some common motives. Both the countries abominate the Taliban regime in Afghanistan and feared of the exportation of militants to their own soil. So far friendly ties between India and Afghanistan always remain as a source of anxiety for Pakistan. India participated in Bonn Conference 2001 which underlined the base of political and constitutional structure for Afghanistan. India is regarded as a positive actor by most of Afghans contrary to Pakistan. The paper examines the strategic interests of India in Afghanistan and its subsequent impacts on Pakistan

Challenges and Barriers of Online Teaching: Perspective of Faculty in a Private Medical College of Lahore

Objective: To identify the challenges and barriers faced during initiation of online teaching by the faculty of a private medical college of Lahore. Methodology: This cross-sectional study was conducted from Sep-Dec, 2021 in FMH College of Medicine and Dentistry, Lahore. List of faculty members was obtained from the Human Resource Department amounting to 140, a sample size of 70 was selected which was the half of total sample. A predesigned, structured questionnaire was used. Approval from IRB committee and consent was obtained. Data was collected online using Google Performa via email, analyzed using SPSS version 20 and Microsoft Excel. Percentages, proportions and means were calculated. Results: The respondents included 23 (32%) Demonstrators, 11 (15.7%) Senior Demonstrators, 22 (31.4%) Assistant Professors, 7 (10%) Associate Professors and 7 (10%) Professors. Year wise distribution of faculty was as follows; 13 (18.5%) were teaching 1st year, 9 (12.8%) 2nd year, 19 (27%) 3rd year, 25 (35 .7%) 4th year, and 4 (5.7%) final year MBBS respectively. Mean age in years was 39±9.8 of the enrolled faculty. Predominance of females 47 (67.1%) to males 23 (32.9%) was observed. Maintaining class decorum and controlling students' plagiarism was a major challenge for 65 participant s(92.9%). Inadequate online teaching resources were recognized by 61 (87.1%) to be a challenge making it difficult to inculcate clinical skills while, 58 (82.9%) accepted effectiveness of lecture was interfered by lack of face to face interaction. Most common barrier 60 (85.7%) was connectivity issues, software failure, power issues and 57(81.40) complained of lack of finances. Conclusion: Lack of face to face interaction, connectivity, software and power failure issues, in addition to finances and time management were major challenges and barriers faced during initiation of online teaching by the faculty