Reflection on learning about forces

Force is a basic concept in the physical sciences. It is included in Pakistan’s national curriculum from the primary level through the higher levels. Because of the abstract nature of the concept of force, both students and teachers have alternative frameworks in this area. This was revealed in our classroom discussions on force during the Lower Secondary Science Module of the M.Ed. program at the Aga Khan University Institute for Educational Development (AKU-IED) in Karachi, Pakistan. In-depth discussions and a variety of activities we carried out while teaching about forces challenged our previous concepts and allowed us to think critically about the teaching and learning of forces. In this article, we reflect on our teaching and learning experiences and possible ways, in light of our new learning, to make the concept of force understandable to students

Dementia survey among Attendees of a Dementia Awareness Event in Karachi, Pakistan

There is little information available about peoples\u27knowledgeregarding symptoms of dementia, dementia diagnosis, and care arrangementsfor dementia patients in Pakistan. Aims: We aimed to find out if patients with dementia and their caregivers were aware of diagnosis, the most common and most distressing symptoms, and care arrangement for these patients

Spectrum of Asymetrical Proptosis

Objectives:  To discuss different aspects of unilateral proptosis in our institutions. Study Design:  Observational study. Place and Duration:  Department of Neurosurgery/Head and Neck, PGMI, Govt Lady Reading Hospital, Peshawar. Pakistan from May 2004 – April 2008. All patients presented to outpatient clinic of Neurosurgery and ENT departments along with referred cases to these both departments were included in this study. These patients were analyzed in detail. Apart from local ENT examination and neurological examination, ophthalmological and systemic examination was also carried out. Relevant investigations were carried out to see the effects on anatomy as well as on physiology of globe. Patients with bilateral proptosis, relative proptosis due to crowzen's syndrome, Apart's syndrome and post traumatic proptosis were excluded. All these patients were managed surgically either individually or as team case by combined approach in the department.  Results:  Thirty eight (38) patients with asymmetrical proptosis in this study were analyzed with regard to their sex, age, site of proptosis, origin and extent, surgical approach adapted, per operative and histological diagnosis. There were 22 male and 16 female patients with male and female ratio of 1.4 and 1. The age range was from 8-65 years with median age of 36.5 years. X-ray skull, PNS and CT brain including orbits and fronto nasal sinuses were done in all cases and MRI in 18 cases.  Conclusion:  Variety of causes is responsible for unilateral proptosis which present in clinical practice to both ENT and Neuro surgeons. Team work helps a lot in making proper protocol

Utilization and outcomes with low dose tissue plasminogen activator as intravenous thrombolytic therapy for ischaemic stroke at Aga Khan University Hospital, Karachi: A retrospective analysis

Objective: To determine the utilisation of intravenous tissue plasminogen activator at a certain dose for ischaemic stroke thrombolysis and to compare the outcomes with those of a different dosage mentioned in literature.Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised medical records from January, 2007, to October, 2016, of all patients having received intravenous tissue plasminogen activator for ischaemic stroke thrombolysis. Primary safety outcome variables included symptomatic intracerebral haemorrhage after the start of treatment (0.6mg/kg) and death within three months as per the modified Rankin scale 6. Secondary efficacy outcome variable was functional independence as per modified Rankin scale 0-2 at three months. The outcomes were compared with those mentioned in literature with a dose of 0. 9mg/kg.Results: Of the 79 patients, 52 (66%) were male and 27 (34 %) were female. Median pre-treatment tissue plasminogen activator score was 12 (interquartile range: 8-15). Overall utilisation of t-PA remained at 1.7%. Symptomatic intracerebral haemorrhage was not seen in our cohort while it was seen in 107 (1.7%) patients at the higher dose. Using another definition, it was seen in 3 (3.8%) patients versus 468 (7.3%) patients at the higher dose. Functional independence was seen in 40 (50.6%) patients at three months compared to 3362 (54.8%) patients at the higher dose.Conclusion: Low-dose intravenous thrombolytic therapy for ischaemic stroke patients was found to be safe and efficacious, and yielded comparable results with those obtained at a higher dose

Nasal and hand carriage of bacteria in different groups of persons in a teaching hospital in India

275 persons of different categories were studiedfor nasal and hand carnage of different pathogenic bacteria. Overall carriage rate was 54.5%. Doc­tors and paramedical staff had higher bacterial carriage rate in comparison to other groups. Though Staphylococcus aureus iwu the commonest or­ganism isolated from both nose and skin, earners of Escherichia coli. Pseudomonas and Klebsiella group ofgramnegative bacilli was also observed. Nasal carrier were commonest than dermal carriag

Frequency of Incidental Durotomy during Surgery for Degenerative Lumbar Spine Disease

Objective:  One of the most common treatments performed in a neurosurgical facility for lower back pain and claudication is degenerative lumbar spine surgery. The study aimed to determine the frequency of incidental durotomy during surgery for degenerative lumbar spine diseases. Materials and Methods:  In this study, a total of 95 patients were included from the Department of Neurosurgery, Ayub Teaching Hospital, Abbottabad. After the patient’s selection, their history, examination, and investigations, surgery was carried out by consultant neurosurgeons. Per-operatively unintentional dural tears were identified as rent in dura with or without CSF leak and were either repaired primarily or by applying fibrin glue if the repair was not possible. Results:  The mean age was 38 ± 12.62 years. Fifty-eight percent of patients were male and 42% of patients were females. More than 6% of patients had incidental durotomy while 94% of patients didn’t have incidental durotomy. Recurrent disc prolapse was found in 5% of the cases. One percent of incidental durotomy patients were also recurrent instances, accounting for 6% of the total. Whereas 95% of patients did not require a durotomy, the surgery went smoothly. Conclusion:  The frequency of incidental durotomy was 6% during surgery for degenerative lumbar spine diseases. Keywords:  Incidental durotomy, Degenerative Lumbar Spine, Spinal Stenosis, Spinal Surger

Determinants of vitamin D deficiency among Bangladeshi children: A hospital based case-control study

Background: Risk factors of vitamin D deficiency among children have been identified in many developed countries but not yet in some developing countries like Bangladesh. Therefore, the aim of this study was to identify the determinants of vitamin D deficiency among Bangladeshi children.  Methods: This case-control study was conducted at 2 paediatric hospitals in Dhaka city from January to June 2017. We recruited 198 vitamin D deficient cases and 198 apparently healthy controls. Data were analyzed using IBM SPSS, where quantitative variables were analyzed using descriptive statistics. The association between vitamin D deficiency with different lifestyle and dietary factors were analyzed by using Chi-square test. A 2-tailed p-value less than 0.05 were considered as statistically significant. Univariate and multivariate logistic regression analysis were performed to confirm the association.  Results: The study revealed that not playing outdoor games (OR=3.09; 95% CI 1.46, 6.54), playing video/ TV/mobile games (OR=4.14; 95% CI 1.97-8.67), no sun exposure (OR=2.42; 95% CI 1.25-4.67), no milk consumption (OR=3.01; 95% CI 1.38-6.57), no sea fish consumption (OR=2.20; 95% CI 1.19-4.08) and not exclusively breastfeeding (OR=2.03; 95% CI 1.14-3.63) were significantly associated with vitamin D deficiency.  Conclusion: We concluded that improper lifestyles and nutritional habits are the key determinants of Vitamin D deficiency among Bangladeshi children. Strategy for hypovitaminosis D prevention should be implemented immediately, which includes vitamin D supplementation of breastfed infants and ensuring adequate maternal vitamin D status during pregnancy. Also an awareness program should be initiated to promote a healthy lifestyle and to improve nutritional habits.&nbsp

Isolated tuberculous thyroiditis as solitary thyroid nodule

Isolated involvement of the thyroid by tuberculosis is very rare as reported in literature. We are presenting a case of isolated tuberculous thyroiditis presented as a solitary thyroid nodule. The patient was treated with anti-tuberculous regimen and he responded well with disappearance of the nodule and normalization of the thyroid scan

Case-control study of suicide in Karachi, Pakistan

Background: In recent years suicide has become a major public health problem in Pakistan. Aims: To identify major risk factors associated with suicides in Karachi, Pakistan. Method: A matched case-control psychological autopsy study. interviews were conducted for 100 consecutive suicides, which were matched for age, gender and area of residence with 100 living controls. Results: Both univariate analysis and conditional logistic regression model results indicate that predictors of suicides in Pakistan are psychiatric disorders (especially depression), marital status (being married), unemployment, and negative and stressful life events. only a few individuals were receiving treatment at the time of suicide. None of the victims had been in contact with a health professional in the month before suicide. Conclusions: Suicide in Pakistan is strongly associated with depression, which is under-recognised and under-treated, The absence of an effective primary healthcare system in which mental health could be integrated poses unique challenges for suicide prevention in Pakistan

Profile of dementia patients from a tertiary care center in Karachi, Pakistan

BACKGROUND: According to an estimate currently over 46 million people live with dementia worldwide and 58% reside in developing countries. However like some other developing countries, not much is known about the demographics, characteristics, and associated conditions of those suffering from dementia in Pakistan. OBJECTIVE: To study profile of dementia patients from a tertiary care hospital in Karachi, Pakistan