Awareness, treatment, and practices of lifestyle modifications amongst diagnosed hypertensive patients attending the tertiary care hospital of Karachi: A cross-sectional study.

Background: Despite massive research guidelines, high blood pressure remains a major public health concern since barriers to treatment and control are on the rise. Lack of awareness is one of the serious impediments to managing hypertension. Therefore, this study is designed to gauge awareness, beliefs, and practices related to hypertension amongst diagnosed subjects. Methods: A total of 425 hypertensive patients were recruited from the wards and outpatient department of Jinnah Medical College Hospital located in Korangi district, Karachi. Data was obtained regarding socio-demographics, comorbidity, duration of HTN, current BP readings, and BMI. Additionally, awareness, practices, treatment, and control of hypertension were also assessed. Using IBM SPSS version 25.0, a chi-square test was run for categorical variables to analyze the differences in demographic variables, awareness, practices, and treatment between controlled and uncontrolled hypertensive patients. Multivariate regression model was used to identify the risk factors associated with uncontrolled hypertension. A p-value of less than 0.05 was considered significant. Results: 65.6% of the total study population was females, of which, 70.7% had uncontrolled hypertension, with a p-value of 0.007. Majority of the candidates were between the ages of 50 and 59 and there was a significant difference in age groups of controlled and uncontrolled hypertensive patients (p-value = 0.019). Co-morbidities and duration of hypertension yielded no significant results. Awareness, treatment, and practices of lifestyle modifications amongst controlled or uncontrolled hypertension groups were not statistically significant. Age and female gender were the only risk factors significantly linked with uncontrolled hypertension. Conclusion: Overall, there was no significant difference in the statistics of controlled and uncontrolled hypertensive patients. This requires further investigation and evaluation to identify the unknown risk factors and co-morbid contributing to these findings. Most of the patients are on treatment and still not controlled, and this could be considered under treatment. Health professional's advice and counseling skills, social media, internet, and public awareness sessions can play an active role in the management of BP and its associated complications.

Heart on the left, diaphragm on the right: A case of congenital diaphragmatic eventration.

Congenital Diaphragmatic Eventration (DE) requires a prompt diagnosis to avert the potentially life-threatening complications. Herein, a 5-month-old male presented with recurrent respiratory infections due to a right-sided diaphragmatic eventration. Misdiagnosed from previous medical visits, timely surgical intervention by thoracoscopic plication of the diaphragm was crucial for our patient's survival.

Association of Acne with Face Mask in Healthcare Workers Amidst the COVID-19 Outbreak in Karachi, Pakistan.

BACKGROUND: In the wake of coronavirus (COVID-19) global alert, people have begun to practice safety measures in order to reduce the exposure to life-threatening disease. The largest at risk population is undoubtedly the frontline healthcare workers (HCWs) who are using personal protective equipment (PPE), essentially face masks, to battle against this deadly virus. This study was conducted with the prime intention to reveal an association between face mask and acne and measure the prevalence of acne amongst HCWs amidst COVID-19 outbreak in Karachi. Furthermore, this study aimed to identify the type of mask generating acne, locate the common sites, assess the severity and establish an association of mask use with the skin type. METHODS: This cross-sectional study was carried out at Medicare Cardiac and General Hospital, Jinnah Medical College Hospital, Jinnah Postgraduate Medical Centre and Jamal Noor Hospital located in Karachi, Pakistan. A total of 348 HCWs were interviewed, of which only 193 met the inclusion criteria. All information was recorded on a predesigned proforma and analyzed using SPSS 25.0. RESULTS: Among 193 participants, acne was prevalent in 103 (53.4%) participants with maximum cases reported in female HCWs, and in doctors (p<0.05). Out of 73 HCWs using N-95 masks, 46 (44.7%) developed acne, with a p-value of 0.036. Skin type and past history of acne also yielded statistically significant results. Among all the skin types, HCWs with oily skin (64, 62.1%) were prone to face resurgence of acne or new-onset acne. The most common sites of eruption of acne were along the cheeks (45.1%) followed by the nose (40.9%). Majority of the population suffered from mild acne. Moderate and severe acne eruption was particularly observed in those wearing N-95 and surgical masks. CONCLUSION: The use of face masks is associated with high rates of acne eruption. Disseminating the guidelines and indications of World Health Organization (WHO) regarding proper use of mask, encouraging awareness among HCWs and following proper doffing and donning protocol as endorsed by Centers for Disease Control and Prevention (CDC) will possibly minimize the adverse reactions.

Deep Dive Into Familial Mediterranean Fever in a Child Without Fever.

This case report entails the details of a 12-year-old Egyptian boy who had recurrent episodes of shortness of breath, ascites, and pericardial effusions starting at the age of 10, returning with worsening symptoms in April of 2020. The lab findings indicated a critically elevated C-reactive protein (CRP) of 107.2 mg/L; a clinically notable inflammation process was festering. This case was all the more interesting as this boy did not present with a fever, making the diagnosis a difficult one. Nonetheless, genetic Mediterranean fever (MEFv) and polymerase chain reaction (PCR) testing confirmed the diagnosis of familial MEFv. Steroids and colchicine-salicylate decreased the frequency of the attacks and are now on half a dose of colchicine to keep his symptoms at bay. What we see here is the risk-to-benefit ratio of the therapeutic use of colchicine in children outweighs potential side effects such as nausea, vomiting, abdominal pain, diarrhea, kidney or liver failure. However, further research is needed to access better long-term treatment plans. Another key takeaway point that can be highlighted in this case is that the patient does not need to be febrile to diagnose FMF.

Association of quality of life, anxiety, and depression with restless leg syndrome in the hemodialysis patients.

OBJECTIVES: Restless Legs Syndrome (RLS) is commonly known to cause morbidity in patients on hemodialysis, making them prone to chronic mental health illnesses such as depression and anxiety, and also adversely impact quality of life. In this study, we examined the association of quality of life, anxiety, and depression with restless leg syndrome in the hemodialysis patients at Karachi Institute of Kidney Diseases. RESULTS: About 26.7% of the participants reported RLS among the sample size Presence of RLS was not associated with quality of life, depression, and anxiety. However, p-values < 0.05 were significant for body-mass index (BMI), diabetes mellitus as a cause of end-stage renal disease, and serum albumin levels. Majority (82.5%) of the RLS-diagnosed patients had moderate to severe symptoms with 16 (40%) and 17 (42.5%) clients, respectively.

Erectile Dysfunction and Associated Anxiety and Depression in Male Hemodialysis Patients: A Cross-Sectional Study at Karachi Institute of Kidney Diseases.

Objectives Chronic kidney disease (CKD) is one of the most prevailing diseases in the world and is associated with sequelae of depression, anxiety, and sexual dysfunction. The goal of our study is to measure the prevalence of erectile dysfunction, depression, and anxiety among patients suffering from CKD and to establish a correlation between them. Methodology The research was a single-centered, descriptive cross-sectional study. All male patients present at the time of the survey were interviewed, and then based on the inclusion and exclusion criteria, 84 were selected. The questionnaire comprised demographic variables, erectile function scoring using the International Index of Erectile Function (IIEF) scale, and Hospital Anxiety and Depression Scale (HADS) for depression and anxiety. All data were analyzed using SPSS Software 25.0 (IBM Corp., Armonk, USA). Results Out of 84 male patients, 47.6% had erectile dysfunction (ED). 10% of the affected individuals had depression and 3% reported having anxiety. No known external factors had any contribution to erectile malfunction, depression, and/or anxiety. Conclusion We found no correlation of depression and/or anxiety with ED in this population of male subjects undergoing hemodialysis.

Sexual Dysfunction and Associated Anxiety and Depression in Female Hemodialysis Patients: A Cross-Sectional Study at Karachi Institute of Kidney Diseases.

Objectives Hemodialysis patients have to combat certain negative effects such as sexual dysfunction, depression, and anxiety. This study aimed to measure the sexual function and identify the relationship between sexual dysfunction, depression, and anxiety in females undergoing hemodialysis. Methods The descriptive, cross-sectional study was conducted at a dialysis unit in November 2019. Forty-eight females were enrolled in the study. Participants were interviewed for sociodemographic, clinical, and biochemical parameters. Sexual function was assessed through the Female Sexual Function Index (FSFI) while depression and anxiety scores were calculated using the hospital anxiety and depression scale (HADS). Results In this study, the mean age of patients was 44.60 ± 10.27 years. Median sexual function scores were low across all domains. A maximum possible score of 3.4 was calculated for the satisfaction domain while the minimum score calculated was 0 for arousal, lubrication, and orgasm. 14.6% and 45.8% were suffering from borderline abnormal and abnormal depression, respectively. However, 33.3% and 31.3% had borderline abnormal and abnormal anxiety, respectively. Pearson's correlation showed a significant negative correlation between age and desire domain (r = -0.343; p < 0.05) and demonstrated that arousal, lubrication, orgasm, satisfaction, and pain domains were associated with borderline abnormal depression. None of the sexual domains were correlated with anxiety. Conclusions Sexual dysfunction, depression, and anxiety are highly prevalent in hemodialysis patients. In this study, borderline abnormal depression was independently linked to sexual dysfunction excluding sexual desire. Therefore, healthcare teams should keep up with the progress of their patients and evaluate for psychosexual health so that they can be timely managed.