Association of hyperuricemia with metabolic syndrome and its components in an adult population of Faisalabad, Pakistan.

BACKGROUND AND AIMS: The rising prevalence of metabolic syndrome (MetS) is a matter of serious concern worldwide. Hyperuricemia has been observed as an independent risk factor in the development of MetS and each of its individual components in different populations. This study aims to determine the association of hyperuricemia with MetS and its individual components in a Pakistani cohort. METHODS AND RESULTS: A cross-sectional study was performed in a public sector hospital in Faisalabad, Pakistan. Total 204 participants were studied along with their anthropometric measurements and blood sample analysis for clinically important parameters. MetS was defined according to the NCEP-criteria. Independent sample t-test, Binomial logistic regression and Linear regression analyses were used to determine the association between hyperuricemia and metabolic syndrome. The prevalence of MetS and hyperuricemia in our study was 42.6% and 31.9% respectively. As compared to the normo-uricemic group, the hyperuricemic group had a significantly higher systolic blood pressure, BMI and lower HDL-C level (p < 0.05). After adjusting for age, gender, BMI and LDL-C, hyperuricemia was observed to increase the risk of MetS, increased systolic blood pressure and reduce HDL-C respectively by 1.34, 1.23 and 1.20 folds respectively. CONCLUSION: In this study, a significant association between hyperuricemia and metabolic syndrome, systolic hypertension, blood glucose and decreased HDL-C was observed.

Exploring Divergent Careers for Doctors.

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Global digital divide and environmental degradation in Africa.

ICTs and access to Internet use are considered vital for the achievement of sustainable development goals. So, this study explored the effect of the global digital divide, trade openness, renewable energy consumption, and forestation on greenhouse gas (GHG) emissions in 42 high-income countries (HICs) and high-middle-income (HMICs), low-income countries (LICs), and low-middle-income countries (LMICs) of Africa from 1990 to 2018. TheDumitrescu-Hurlin causality results confirmed a unidirectional causality from GHG emissions to the global digital divide (HICs and HMICs), global digital divide to GHG emissions (LICs), and GHG emission to trade openness (LICs and LMICs). Moreover, the long-run results of the autoregressive distributed lag (ARDL) model showed an increase in GHG due to an increase in the global digital divide in all three panels. Further, ARDL results showed reduced GHG emissions due to increased trade openness in LIC and LMICs, renewable energy consumption, and forestation in all three panels. Thus, to encounter pollution from Internet use, the government should start environment-friendly projects through public and private investment in smart and modern environment-friendly technology and reduce the taxes and tariffs on them. Moreover, the governments of African countries should create public awareness through print and electronic media for raising the forestation area.

Association between insomnia and the incidence of myocardial infarction: A systematic review and meta-analysis.

BACKGROUND: Insomnia has been closely associated with cardiovascular disease (CVD) including myocardial infarction (MI). Our study aims to assess the eligibility of insomnia as a potential risk factor for MI. METHODS: PubMed, Scopus, and Web of Science were searched using terms; such as "Insomnia" and "MI." Only observational controlled studies with data on the incidence of MI among insomniacs were included. Revman software version 5.4 was used for the analysis. RESULTS: Our pooled analysis showed a significant association between insomnia and the incidence of MI compared with noninsomniacs (relative risk [RR] = 1.69, 95% confidence interval [CI] = 1.41-2.02, p < .00001). Per sleep duration, we detected the highest association between ≤5 h of sleep, and MI incidence compared to 7-8 h of sleep (RR = 1.56, 95% CI = 1.41-1.73). Disorders of initiating and maintaining sleep were associated with increased MI incidence (RR = 1.13, 95% CI = 1.04-1.23, p = .003). However, subgroup analysis of nonrestorative sleep and daytime dysfunction showed an insignificant association with MI among both groups (RR = 1.06, 95% CI = 0.91-1.23, p = .46). Analysis of age, follow-up duration, sex, and comorbidities showed a significant association in insomniacs. CONCLUSION: Insomnia and ≤5 h of sleep are highly associated with increased incidence of MI; an association comparable to that of other MI risk factors and as such, it should be considered as a risk factor for MI and to be incorporated into MI prevention guidelines.

Introduction of temporal integration in fourth year MBBS curriculum; Students' experience.

Objectives: Rapid innovations in medical science have necessitated the development of an advanced medical curriculum. Taking a step towards this, a temporal integrated system and clinic-pathological conferences themes were introduced in a public sector medical university for fourth year MBBS. This study aims to assess students' perceptions regarding this change. Methods: A cross sectional study was conducted in a public sector medical university from May 2019 to April 2020. A 17 item pre-validated questionnaire was distributed among all students twice, firstly after completion of first module and then again at the end of the academic year. Results were analyzed using SPSS 21. Results: There were 265 and 176 participants in the first and second phase of the study respectively. Majority of the students agreed that it was easier to study a topic when temporally integrated. Most commonly reported advantage was better understanding and concept of the theme under study. Suggestions included revision of the schedule regarding allocation of time for different topics and implementation of this curriculum from first year MBBS. Conclusion: A small step was taken to make improvements in an old traditional method. Students are adapting to this change as they responded positively to various aspects of this methodology. Continuous feedback, evaluation and amendments will help to improve its effectiveness.