Pakistan BioMedical Journal

Evaluation of Anticoagulant Effect of Alum in Rats

2024-04-01T12:44:20+00:00

Potassium aluminium sulfate, KAl(SO4)_2, also called Alum, is an acidic white chemical substance. The role of alum in bleeding and clotting is not fully understood. Objective: To determine the effects of alum on clotting time, D-dimer levels, fasting blood glucose level, and lipid profile. Methods: The study was conducted on 24 male Wistar rats, which were randomly divided into six groups. Four groups were given different concentrations of alum solutions. The remaining two groups received warfarin, and distilled water, which are control, and placebo groups, respectively. Blood tests such as fasting blood sugar (FBS), D-dimers, clotting time, and lipid profile were performed. Results: The study found that the administration of alum prolonged the time it took for blood to coagulate. Alum showed a dose dependent increase in clotting time when compared to the warfarin-control group and group 4 (100 mg/kg alum dose) showed the most significant effect. Similarly, in the case of D-dimers, a dose dependent decrease in the level of D-dimers was seen and the most significant effect was found for high concentration. The plasma blood glucose and lipid level of animals treated with alum did not show any significant effect as compared to placebo. Conclusions: The efficacy of alum as an anticoagulant drug was investigated, and it was found to significantly prolong clotting time while simultaneously reducing the level of D-dimers. Furthermore, it was deemed safe and showed no effects on fasting plasma glucose and lipid profile. The safety profile of alum was assessed to be favorable, thus highlighting its potential as an anticoagulant drug of the future

Spectrum of Hemoglobinopathies in Tertiary Care Hospitals of Rawalpindi and Islamabad

2024-04-01T12:44:02+00:00

Hemoglobinopathies, including Thalassemia and sickle-cell syndromes are lifelong diseases with a significant impact on patients, families, and healthcare resources. Despite therapeutic progress, Pakistan, located within the Thalassemia belt, lacks comprehensive data on the epidemiology, clinical course, mortality, complications, and treatment outcomes of Thalassemia. Objective: To determine the frequency of haemoglobinopathies in Tertiary Care Hospital of Rawalpindi and Islamabad. Methods: A retrospective cross-sectional study of 7 months was conducted on the local population of Islamabad and Rawalpindi from January 2020 to July 2020. Total 600 patients referred for Hb electrophoresis were initially selected for study. Data from 300 patients were collected from PIMS Hospital, Islamabad, and 300 from Holy Family Hospital, Rawalpindi. Clinical information for each patient was recorded separately, data were statistically analyzed using Microsoft Excel version 2016 and graphs were made on GraphPad Prism version 08. Results: Out of 600 patients from Rawalpindi and Islamabad 227 (37.84%) patients were found to have hemoglobinopathies. Beta Thalassemia trait was the most common disorder among those with hemoglobinopathies (47.13%), followed by beta Thalassemia major (23.34%), sickle Beta Thalassemia (10.57%), sickle cell disease (6.6%), Hb D trait (5.28%), Hb D/beta Thalassemia (3.96%), Hb E trait (2.2%), and sickle cell trait (0.88%). Conclusions: The study showed a significantly high frequency of hemoglobinopathies in the capital city Islamabad and Rawalpindi. β- Thalassemia trait and β- Thalassemia major were found in high frequency among various hemoglobin disorders.

Academic and Workplace Buoyancy and its Association with Demographic Variables among Health Sciences’ Undergraduates

2024-04-01T12:44:11+00:00

Academic buoyancy is important for influencing students’ ability to face academic challenges. It describes learners’ ability to defeat academic difficulties. It is an important factor on the psycho-educational landscape assisting students experiencing setbacks. Clinical/workplace buoyancy can help health sciences’ students to face the challenges in error-prone learning atmosphere. Objective: To assess the level of academic and workplace buoyancy and its association with demographic variables among health sciences’ undergraduates. Methods: Analytical cross-sectional research with convenient sampling was carried out on 222 undergraduates of Sohail University, Karachi. Ethical approval was taken from the ERC, Sohail University. Data were collected through Academic Buoyancy Scale. By using SPSS Version 25.0, the data were analyzed. Descriptive statistics were calculated and Chi-square was applied to observe the association of buoyancy with demographic variables. Results: In this study, mostly participants (98.6%) belong to the age 22-24 years. Over 50% of the partakers (55.9%) were females. All items of workplace and academic buoyancy had a significant association with study program (p-value 0.000, 0.010,0.002,0.021 respectively) while only 2 items showed significant association with study year (p-value 0.012 and 0.028). There was no significant association of buoyancy with variables like age, gender, religion and marital status. Conclusions: This study’s findings highlighted the buoyancy levels among health sector undergraduates. The association of buoyancy was found significant with study program and some items with CGPA and study year. These findings indicated the need to enhance positive traits like buoyancy among health sector undergraduates.

Prevalence of Neck Pain and Disability in Medical Students of Sialkot

2024-04-01T12:43:35+00:00

Neck pain is a pervasive musculoskeletal disorder and one of the leading causes of disability worldwide. It ranks as the fourth most typical cause of disability. Objectives: To determine the prevalence of neck pain and disability in medical students of Sialkot. Methods: It was cross-sectional study and simple random sampling technique was used. 465 male/female medical student 18–25-year-old were participated. Subjects with other neck pathologies like cervical stenosis were excluded. Data were collected from three different institutes of Sialkot i.e., University of Sialkot, Sialkot College of Physical Therapy and University of Management and Technology. Northwick Park Neck Pain Questionnaire was used to collect data. Study ran from 20 May to 22 September 2021.Statsitical analysis done through SPSS version 20. Histogram, bar charts used to display data. Ethical approval obtained from institute before conducting research. Results: Results were calculated using Northwick Park Neck Pain Questionnaire (NPQ) percentages. 15.9% had no disability, 58.1% had mild disability, and 19.4% had moderate disability while 6.7% were suffering from severe disability. The overall neck pain prevalence was 58.1% and it caused mild disability in medical students. Conclusions: It is concluded that neck pain is quite common among medical students as more than half of participants were suffering from this issue. Lifting heavy objects being in uncomfortable posture during daily activities and reading for extended hours aggravate the pain. Occasional disturbance of sleep was also noted.

Utilization of Antenatal Care Services among Patients Presenting in Ayub Teaching Hospital

2024-04-01T12:44:30+00:00

Regular use of antenatal care services during pregnancy has a positive impact on maternal and fetal health and serves as a tool to reduce maternal morbidity and mortality. Objective: To assess the utilization of antenatal care services among pregnant women at Ayub Teaching Hospital in Abbottabad, Pakistan. Methods: This descriptive study was conducted in Ayub Teaching Hospital in Abbottabad, KPK province, Pakistan. Data were collected on paper-based questionnaires and analyzed using SPSS. A total of 208 patients participated. Results: Key findings from the study indicated that the average age of participants was 28 years. The majority of women came from lower-middle-class backgrounds. The study also revealed a wide range of educational backgrounds among participants. Most women had prior pregnancy experience. The study found that a significant percentage of women initiated antenatal visits during the first trimester with drop in visits during the third trimester. Understanding the reasons for seeking care is crucial, with various medical concerns and routine check-ups cited. Barriers to utilization included lack of awareness, family issues, and geographical distance. Additionally, only 72% of women reported taking recommended supplements during pregnancy. Conclusions: The study identified that women from middle income group with previous experience of pregnancy seek antenatal care in first trimester with various pregnancy problems but visits were not consistent. Major reason for non-utilization of services was unawareness about the services.

Antimicrobial Susceptibility Pattern of Bacterial Pathogens in Our Setup: Ear, Nose and Throat Perspective

2024-04-01T12:43:24+00:00

With a high prevalence of infections involving the ear, nose, and throat, and the occurrence of drug resistance the antimicrobial susceptibility pattern of bacterial pathogens is of immense importance. Objective: To determine the antimicrobial sensitivity profile of pathogenic bacteria isolated from representative infected areas of patients with ear, nose, and throat infections. Methods: This cross-sectional observational study was conducted at Ear, Nose and Throat (ENT) Outpatient Department (OPD), Capital Hospital Islamabad, over two years. The sample included 639 pathogenic bacterial culture specimens, grown from the representative infected ear, nose, or throat of patients who attended ENT outpatients of the hospital. The bacterial cultures were subjected to the standard disc agar diffusion method to know the antimicrobial susceptibility profile. Data collected included the patient’s age, gender, area/ site of infection, bacterial pathogen isolated, and sensitivity to antibiotics. Results: The sample included 49.30% males and 50.70% females and mean age of 30.13±19.24 years. Gram-positive organisms were predominant [n=441, (69.01%)] with Staphylococcus aureus being the commonest isolate (67.92%) followed by Pseudomonas spp. (26.13%). Gram-positive isolates were sensitive to Cefoperazone+Sulbactam, Ceftazidime, Cefoperazone, Amikacin, Pipercillin+Tazobactam, Vancomycin, Gentamycin, Linezolid, Amoxicillin + Clavulanate, and Ceftriaxone with resistance to Cefixime, while the Gram-negative isolates were sensitive to Vancomycin and Meropenum, Ciprofloxacin, Levofloxacin, Ceftriaxone and Ceftazidime and highly resistant to Cefixime, Cefuroxime, Amoxicillin+Clavulanate and Co-trimoxazole. Conclusions: Since ENT infections are predominated by Staphylococcus aureus and Pseudomonas spp. When unavoidable the empirical therapy should cover these pathogens, however culture and sensitivity studies are justified keeping in view the growing resistance to antimicrobials.

Maternal Stress and its Associated Factors among Working Nurses in Public Sector Tertiary Care Teaching Hospitals, Karachi

2024-04-01T12:43:53+00:00

Maternal stress has been identified as an epidemic that has a detrimental effect on work productivity and personal and professional growth. Objectives: To determine maternal stress and its associated factors among working nurses in public sector tertiary care teaching hospitals in Karachi, Sindh. Methods: The analytical cross-sectional study was accomplished at Dr. Ruth K.M Pfau Civil Hospital Karachi and Dow University Hospital Karachi. A total of 131 nurses were approached by a convenient non-probability sampling method. The Parental Stress Scale was used for data collection. Data were entered and analyzed by using SPSS version 24.0. Chi-square test was applied out to find an association between maternal stress and associated factors. Results: Nurses reported 72 (55%) mild parental stress, 58 (44.3%) parental moderate stress, and 1 (1%) severe parental stress. Nurses belonging to the younger age group, widowed or divorced, had mild parental stress, while nurses who lived with their husbands had lesser moderate stress. Female participants with one child of either gender, whose more family members were earning, had less tendency to have mild parental stress. A statistically significant association was found between working nurses' parental stress level and age group (p-value=0.005). Conclusions: It was concluded that nurses reported mild, moderate, and severe maternal stress. Hence, it is increasingly imperative to create facilities like daycare centers and offer them the flexibility to perform their job effectively

Role of Vitamin E And Selenium as an Anti-Stressant in Translocation of Captive Ungulates

2024-04-02T12:43:24+00:00

Wild ungulates especially in captivity face high stress in translocation that may cause even mortality. Chemical immobilization is employed to minimize stress by using sedatives. Vitamin E and Selenium may have impact on reducing stress. Objectives: To estimate the impact of Vitamin E and Selenium treatment in translocation of captive ungulates. Methods: The study was carried out while planned translocation of 40 ungulates from different zoological gardens of four districts of Punjab to Safari Zoo, Lahore, Punjab, Pakistan was performed. The animals were divided into two equal groups i.e., A and B. Both groups were anesthetized with combination of Ketamine and Xylazine while Vitamin E and Selenium was also injected in group B after anesthesia. Blood samples were also drawn for hemato-chemical analysis in both groups. The necropsy of the dead animals was also done for internal organs and skeletal muscles examination. Results: In the group A, two chinkaras and two spotted deer were found dead at the time of release. The pale areas, hemorrhages and clotted blood were observed in necropsy. The values of Hemoglobin, Total Erythrocyte Count and Packed Cell Volume were moderately varied from the normal in both groups. The group A had greater lymphocyte count and lower neutrophils while in group B, lymphocyte count was lower, neutrophils were higher and Aspartate transaminase (AST), Alanine transaminase (ALT), and cortisol levels were quite higher than normal. Conclusions: Vitamin E and Selenium has positive impact to reduce stress level in translocation of captive ungulates.

Screening of Type 2 Diabetes Patients of Khyber Pakhtunkhwa for CDKAL1 Variant (rs10946398)

2024-04-03T12:44:05+00:00

Diabetes Mellitus Type 2 (T2DM) is a metabolic disorder influenced by environmental and genetic factors, with varied genetic predispositions across populations. Research on T2DM's genetic risk factors in the Pakistani community is limited. Objective: To explore the association between the CDKAL1 gene variant (rs10946398) and T2DM in the Khyber Pakhtunkhwa population in Pakistan. Methods: The study involved 100 T2DM patients and 100 controls, matched by age and gender, following specific inclusion and exclusion criteria. Sociodemographic data were collected alongside 3ml of whole blood for DNA extraction. The CDKAL1 gene was analyzed using PCR-based Sequence Restriction Fragment Length Polymorphism (RFLP), and the data were processed with SPSS version 26.0s. Results: Findings showed that 47% of cases were aged 39 to 59, with 94% having a family history of T2DM and 85% leading a sedentary lifestyle. A significant association was observed between the CDKAL1 rs10946398 variant and T2DM. The GC variant was linked to a fourfold increase in risk (OR: 4.833, CI: 1.197-19.509, P=0.027), and the CC variant had a twofold association (OR: 2.788, CI: 1.545-5.033, P=0.001). These associations persisted after adjusting for family history, age, socioeconomic factors, exercise, and diet. Conclusions: The study identified a significant correlation between the CDKAL1 rs10946398 variants and T2DM susceptibility in the Khyber Pakhtunkhwa population, emphasizing the role of genetic factors in the disease's prevalence within this community.

Help-Seeking Behavior among Older Adults with Urinary Incontinence in Intensive Care Unit

2024-04-15T12:47:21+00:00

Urinary incontinence is one of the disabling conditions that may cause discomfort and social avoidance and interfere with daily life, general health, and the overall quality of life. Urinary Incontinence affects people of all ages but is particularly common among older adults. Objective: To find out the tendency of old age people to seek help for Urinary Incontinence and the factors affecting the decision. Methods: A descriptive cross-sectional study was conducted in which 164 participants were selected using non-probability convenience sampling. Older adults of both genders between 60 to 85 years with incontinence and admitted to the intensive care unit were included in the study. Result: Out of 164 patients, N=61(37.20%) of the older adults had sought treatment and N=103 (62.80%) had not sought treatment for urinary incontinence. Conclusion: The frequency of older adults in Pakistan who seek help for Urinary Incontinence in Intensive Care Units is low. The most common reason for not seeking help is a lack of knowledge about the available treatment.

Food Allergy: Current and Future Treatment Approaches

2024-04-01T12:43:44+00:00

Human gut is abundantly populated with different immune cells responsible for protection against antigens entering the host through oral routes. It is perfectly developed to induce immunity against pathogenic antigens by maintaining non-responsiveness or immune tolerance against non-pathogenic antigens. A disruption in immune tolerance resulting in allergic reactions to different food items falls under the term food allergy. It affects different body organs such as gastrointestinal tract, skin, eyes and respiratory system. Food allergy is generally categorized into IgE mediated and non-IgE mediated food allergy. Food allergy is a global health concern affecting about 10% of children worldwide. According to the studies carried out in different western countries, the prevalence of food allergy in children under 5 years age in UK, Denmark and Norway is found to be 4%, 3.6% and 6.8% respectively. The increasing prevalence of food allergy has drawn our attention towards the significance of effective and safe therapeutic strategies for food allergy. Current treatments include gene therapy, probiotics, allergen-specific and non-specific immunotherapy, and anti-IgE therapy. Gene therapy for food sensitization is characterized by adenoviral vector mediated transfer of gene encoding omalizumab to provide lifelong immunity to the allergic reactions caused by food. The idea of using probiotics revolves around promoting the colonization of the gastrointestinal tract with healthy gut bacteria significantly reducing the IgE mediated food sensitization. In allergen specific immunotherapy, patients are frequently exposed to food containing increased doses of allergen causing food desensitization. For this purpose, approaches involving different administrative routes such as oral, sublingual and cutaneous immunotherapy are employed. In contrast, therapies involving anti-IgE, cellular targets, Toll like receptors and cytokines fall under the category of allergen non-specific immunotherapy. Despite the availability of treatment strategies, many challenges regarding the side effects and un-intended immune response associated with immunotherapies, that can pose safety concerns for patients. Due to high cost, not all individuals have the access to such therapies prohibiting them from availing advanced healthcare support. These challenges need to be addressed and require further research along with the collaboration of clinicians, researchers and regulatory authorities so the lifestyle of the individuals affected by food allergies can be improved.