Prevalence of NAFLD in Healthy and Young Male Individuals

Introduction. Nonalcoholic fatty liver disease (NAFLD) is an important cause of liver disease in adults and the most common cause of liver disease in children (Lavine and Schwimmer 2004). The abnormalities include increased liver fat without inflammation (steatosis) and nonalcoholic steatohepatitis (NASH). NASH may lead to fibrosis, cirrhosis, and ultimately liver failure if it is not treated (Matteoni et al. 1999). The objective of the study is to estimate the magnitude of the problem which will help us to formulate strategies in managing the potentially difficult problem. Materials and Methods. We included 1000 individuals between the ages of 30 and 50 years who came for annual checkup. The patients with other comorbidities like diabetes, ischemic heart disease, chronic liver disease, or renal diseases were excluded from the study. History of alcohol ingestion was also taken; any individual with history of alcohol intake was also excluded. All of them underwent investigations including CBC, LFTs, height and weight. The individuals who were found to have increased ALT (50 to 150 u/L) further underwent investigations including ultrasound of abdomen hepatitis b and c serology RA and ANA antibodies. All the individuals who were found to have viral or autoimmune illness were excluded from the study. The individuals having raised ALT levels and ultrasound evidence of fatty liver were taken. Results. 13.5% of the individuals were found to have NAFLD among those selected for the study. Conclusion. Mass campaign regarding physical and dietary measures needs to be undertaken in general masses regarding the gravity and potential prevention of the disease

Development of a stress scale for pregnant women in the South Asian context: the A-Z Stress Scale.

Stress in pregnancy can lead to low-birth-weight and preterm babies and to psychological consequences such as anxiety and depression during pregnancy and the puerperium. Previous scales to measure stress contain items that overlap with the symptoms of pregnancy. A stress scale was developed based on in-depth interviews with pregnant women in Pakistan. Construct validity, test-retest reliability and inter-rater reliability were carried out. Cronbach alpha was 0.82 for the 30 short-listed items, with item-total correlations of 0.2-0.8. Multidimensional scaling determined 2 dimensions: socioenvironmental hassles and chronic illnesses. This was the first scale developed for pregnant women based on stressors in a developing country in South Asia

Mediastinal Synovial Sarcoma.

The mediastinum is an uncommon site of synovial sarcoma which is a rare soft tissue malignancy. An 18 year old boy was admitted for right sided chest pain since one year. Based on the CT scan chest findings, tru-cut biopsy of the mass was performed and histopathology initially reported as neurofibroma. The tumor was excised via posterolateral thoracotomy and excisional biopsy established the diagnosis of primary synovial sarcoma arising from the mediastinum. Patient was started on adjuvant chemotherapy at the oncologist tumor board’s recommendation and he received 6 cycles of adriamycin and ifosfamide. At last follow up he is free of tumor recurrence

Social environment and depression among pregnant women in urban areas of Pakistan: importance of social relations.

Aspects of the social environment, including social conditions (socio-economic status, household situations, chronic illnesses) and social relations (attitude and behaviors of relations) are major determinants of depression among women. This study evaluates the relative power of social relations and social conditions in predicting depression among pregnant women in Pakistan. In the qualitative phase of the study, social environmental determinants were identified through literature search, and experts\u27 opinions from psychologists, psychiatrists, gynecologists, sociologists and researchers. Along with this, 79 in-depth interviews were conducted with pregnant women drawn from six hospitals (public and private) and two communities in Karachi, Pakistan. Identified determinants of depression were grouped into themes of social conditions and social relations and pregnancy-related concerns. In the study\u27s quantitative phase, the relative power of the identified themes and categories, based on their scores for predicting depression (determined by the Center for Epidemiological Studies-Depression Scale (CES-D scale)), was determined through multivariate linear regression. Social environmental determinants of pregnant women were described under the themes and categories of (1) social relations: involving husband, in-laws and children; (2) social conditions: involving the economy, illness, life events, household work, environmental circumstances and social problems; and (3) pregnancy-related concerns i.e. symptoms of pregnancy, changes during pregnancy, dependency and concern for unborn baby. Multivariate analysis found that among these themes, social relations and pregnancy-related concerns were significantly associated with total CES-D scores. Among the categories besides increasing age and less education, husband, in-laws, household work and pregnancy symptoms were significantly associated with total CES-D scores. The study highlights the importance of social relations compared to social conditions for determining depression in pregnant women

Novel Diagnostic Biomarkers in Liver Disease-a Metabolomic Review

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Clinicopathological Profile and Surgical Treatment of Abdominal Tuberculosis: A Single Centre Experience in Northwestern Tanzania.

Abdominal tuberculosis continues to be a major public health problem worldwide and poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. This study was conducted to describe the clinicopathological profile and outcome of surgical treatment of abdominal tuberculosis in our setting and compare with what is described in literature. A prospective descriptive study of patients who presented with abdominal tuberculosis was conducted at Bugando Medical Centre (BMC) in northwestern Tanzania from January 2006 to February 2012. Ethical approval to conduct the study was obtained from relevant authorities. Statistical data analysis was performed using SPSS version 17.0. Out of 256 patients enrolled in the study, males outnumbered females. The median age was 28 years (range = 16-68 years). The majority of patients (77.3%) had primary abdominal tuberculosis. A total of 127 (49.6%) patients presented with intestinal obstruction, 106 (41.4%) with peritonitis, 17 (6.6%) with abdominal masses and 6 (2.3%) patients with multiple fistulae in ano. Forty-eight (18.8%) patients were HIV positive. A total of 212 (82.8%) patients underwent surgical treatment for abdominal tuberculosis. Bands /adhesions (58.5%) were the most common operative findings. Ileo-caecal region was the most common bowel involved in 122 (57.5%) patients. Release of adhesions and bands was the most frequent surgical procedure performed in 58.5% of cases. Complication and mortality rates were 29.7% and 18.8% respectively. The overall median length of hospital stay was 32 days and was significantly longer in patients with complications (p < 0.001). Advanced age (age ≥ 65 years), co-morbid illness, late presentation, HIV positivity and CD4+ count < 200 cells/μl were statistically significantly associated with mortality (p < 0.0001). The follow up of patients were generally poor as only 37.5% of patients were available for follow up at twelve months after discharge. Abdominal tuberculosis constitutes a major public health problem in our environment and presents a diagnostic challenge requiring a high index of clinical suspicion. Early diagnosis, early anti-tuberculous therapy and surgical treatment of the associated complications are essential for survival

Students Anxiety and Its Causes in Mathematics: A Sequential Explanatory Mixed Method Design

From the last few decades, math anxiety has become the major concern of educationists. Students’ academic achievement especially in mathematics has been considered as a crucial factor in determining the future progress of students. But unfortunately, the participation rate of students in mathematics is decreasing day by day. The main objectives of the study were to assess secondary school students’ anxiety in mathematics and to explore the causes of students’ anxiety in mathematics.&nbsp; A sequential explanatory mixed method research design was used. The data was collected through both quantitative and qualitative methods. A five-point rating scale questionnaire was developed for quantitative data collection. The tool was validated through pilot testing. 100 students participated in pilot testing. Internal consistency of the instrument was assessed by Croanbach’s alpha which was 0.7. The targeted population of the study was both male and female secondary school students from the district Bahawalpur, Punjab.&nbsp; Out of the whole population, 726 male and female students were approached via multi-stage sampling technique.&nbsp; After quantitative data collection data was entered in SPSS version 20 and percentage, frequency distribution and mean score was calculated.&nbsp; Based on the quantitative data results it was observed that secondary school students were numerophobic and had moderately a high level of anxiety in mathematics. On the basis of quantitative results, interviews of secondary school teachers were conducted to explore the causes of students’ anxiety in mathematics. 20 teachers were approached via purposive sampling. The qualitative data revealed that major causes of students’ anxiety in mathematics were lack of practice, lack of previous knowledge, communication gap between student and teacher, and lack of interest in mathematics

Response surface optimization in biosurfactant production by using a renewable growth substrate

217-229The present study investigated the use of blackstrap molasses as renewable carbon source by a Pseudomonas aeruginosa strain to produce rhamnolipid surfactant under shake flask conditions. The process factors considered were total sugar concentration, carbon to nitrogen ratio and incubation period, whereas the responses were utilized total sugar, dry cell biomass, rhamnolipid yield, surface tension and certain kinetic parameters. This is the first report on response surface optimization in biosurfactant production by P. aeruginosa strain grown on molasses. Statistical modeling for all the considered responses was done through desirability, which expressed that the percentage of prediction error was much low. This explains that the prediction performance of the models is quite adequate. The highest dry cell biomass (1.63 g/L) and rhamnolipid (1.46 g/L) yields were observed at 5 d of incubation on 2% total sugars-based molasses amended with sodium nitrate (at C:N, 20:1). The surface tension of this culture medium dropped to 28.0 from 50.0 mN/m