Frequency of migraine and its associated triggers and relievers among medical students of Lahore: a cross-sectional study.

Introduction: Headache is a widely prevalent illness that negatively impacts people's lives, leaving them functionally incapable of performing regular everyday tasks. The global burden of headache is 40%, of which migraine accounts for 47%. Objective: This study aims to determine the frequency of migraine among medical students of Lahore and its characteristics, associated triggers, and relievers among medical students. Methodology: A cross-sectional study was conducted in medical colleges after obtaining ethical approval. Migraine was diagnosed using the criteria provided in the International Classification of Headache Disorders, Third Edition (ICHD-3), and data on triggers, relief, and demographics were collected. The information is analyzed using SPSS 22. Result: The data were collected from 522 medical students. The average age of the students was 21.3 ± 2.0 SD (in years). About 146 (28.0%) of the medical students have migraine according to ICHD-3 criteria and were diagnosed initially. Gender was insignificantly associated with migraine (P-value=0.32). Students with psoriasis, hypertension, and polycystic ovarian syndrome were statistically significantly related to migraines with a P-value=0.002. Dehydration is the most frequent aggravator, and adequate sleep is the most frequent reliever of migraine. Conclusion: The findings show a high frequency of migraine. They are similar in both genders, depicting that stressful lifestyles, inadequate sleep patterns, and bizarre dietary habits make them more prone to migraine episodes. So, further, detailed studies should be done on evaluating triggers and relievers of migraine and their interrelations with migraine so we can focus on preventive strategies, diagnosis, and treatment of migraine.

Association of serum digoxin concentration with morbidity and mortality in patients with atrial fibrillation, heart failure and reduced ejection fraction of 45 % or below.

BACKGROUND: Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) are common cardiovascular conditions linked to significant health burdens. This review aims to study the relationship of serum digoxin concentration and mortality and morbidity outcomes in defined population. METHODS: We conducted a thorough search of databases such as PubMed, Google Scholar, and Cochrane Library, from inception until 20th Aug 2023. Studies that explored the relationship between serum digoxin concentration and mortality, morbidity, or other clinical endpoints in AF and HFrEF patients (ejection fraction ≤45 %) were eligible for inclusion. RESULTS: The selected studies exhibited a wide range of designs, patient cohorts, and measured outcomes. The association between serum digoxin concentration, mortality and morbidity endpoints like hospitalization rates and cardiovascular events were assessed in these studies. Despite the methodological diversity, our systematic review uncovered consistent trends across the studies, suggesting that elevated serum digoxin concentrations may correlate with higher mortality and morbidity in AF and HFrEF patients. CONCLUSION: This systematic review emphasizes the need for cautious management of serum digoxin levels in patients with concurrent AF and HFrEF. While digoxin remains a valuable treatment for heart failure, its potential adverse effects on outcomes in this specific patient subgroup call for vigilant monitoring and individualized treatment approaches. Further research is required to elucidate the dose-response relationship and potential confounding factors influencing outcomes associated with serum digoxin concentration in AF and HFrEF patients. Clinicians should consider these findings when making therapeutic decisions to enhance patient care and outcomes.

Lifestyle and Dietary Habits Change Before and During Quarantine and Subsequent Weight Gain.

Background: Pandemics greatly affected human health due to changes in dietary habits and lifestyle. Methods: A multi-centric comparative cross-sectional study was conducted online using a structured questionnaire with 323 respondents from two medical colleges of Lahore, Pakistan. The collected data was analyzed including various variables of dietary habits, lifestyle changes and were compared by using paired sample t-test. Chi-square test was applied to measure the relation of weight gain with lifestyle and dietary habits changes. Result: Out of 323 participants, 64.5% of them observed an increase in their weights and 64.1% of respondents noticed an increase in caloric intake. An increase in chicken, milk, oil, sugar and legumes intake was increased significantly during the quarantine. The lifestyle changes were noted in 91.6% of participants and decreased physical activity, working duration and outdoor games were found significant. Out of 7.4% of students who were smokers, 6.8% of them quit smoking during the quarantine. Conclusion: A significant increase in weight is indicated during quarantine as compared to before quarantine probably due to the changes in dietary habits and lifestyle. If the pandemic prolongs, the problem of weight gain may worsen and lead to obesity and other health problems.

Relationship between musculoskeletal discomfort and cell phone use among young adults: A cross-sectional survey.

BACKGROUND: Cell phone usage is highly prevalent among young adults. They are used for multiple purposes including communication, studies, social networking and entertainment. However, its excessive usage has been associated with adverse health outcomes. OBJECTIVE: The objective was to find the association of cell phone usage with musculoskeletal discomfort (MSD) and its associated factors. METHODS: A cross-sectional study was conducted on young adult students from a low-middle income country over a period of 3 months from December 2018 to February 2019. A structured questionnaire based on the Disabilities of the Arm, Shoulder and Hand (QuickDASH scoring) was used to record the musculoskeletal discomfort. RESULTS: Out of 803 questionnaires, data of 754 (94%) were entered and the remaining questionnaires (n = 49) were discarded due to incomplete answers. The mean age was 20.83 (1.62) years. In our study, there were 194 (25.7%) males and 560 (74.3%) female participants. Neck and shoulder were the most frequently affected regions. A significant difference in QuickDASH score was observed between genders (p-value p ≤ 0.001). Left-handed individuals scored significantly higher on QuickDASH score compared to right-handed individuals (p < 0.05). Increased musculoskeletal discomfort was reported by individuals with daily cell phone use of more than four hours (p < 0.05). A positive significant correlation was found between continuous one hour cell-phone use and higher mean QuickDASH scores (correlation coefficient 0.124, p value 0.001). Shorter eye-to-screen distance was significantly associated with MSD (p < 0.05). CONCLUSION: Musculoskeletal discomfort is associated with the female gender, duration of cell phone use and a small eye-to-screen distance.

Prevalence and Predictors of Contraception Usage in Karachi, Pakistan.

Background Contraception, also known as family planning, refers to methods that intercept unwanted pregnancies. The modalities of contraception have evolved and multiplied over time to facilitate users. Despite enormous benefits, the contraceptive methods remain underutilized in developing countries such as Pakistan. Accordingly, the primary purpose of our study is to determine the prevalence, perception, and attitude of contraceptive usage in Karachi. The study further assesses the knowledge and core determinants of contraception. Methods A cross-sectional study was conducted in Karachi, Pakistan. The sample population comprised currently married males and females residing in Karachi, with females from 16 to 45 years of age and males of 16 years of age and forth. Pregnant females, divorcees, and widowed individuals were excluded. A pre-tested questionnaire was administered to record the demographics, knowledge, and frequency of contraceptive usage, and attitude and perception towards contraception. The data were analyzed using the Statistical Package for the Social Sciences (SPSS( v. 23.0 (IBM Corp. Armonk, NY). Results Results depicted that 93.4% (n=468) had knowledge of contraception while 49.7% (n=249) were currently using contraception. The most frequently employed contraceptive modality emerged as condoms (n=163, 65.5%), followed by withdrawal (n=71, 28.5%) and pills (n=62, 24.9%). The prevalence of contraceptive usage was more inclined towards the educated stratum and higher socioeconomic class. Potential predictors for contraceptive usage came out as the number of children, knowledge regarding contraception, spouse's support for usage, a desire for more children, and family planning counseling (p<0.05). Conclusion There is a drastic increase in the prevalence of contraceptive usage in Pakistan as compared to previous studies. Efforts must be made to further augment the knowledge and awareness regarding contraceptive modalities to increase acceptability and eliminate myths prevalent in society regarding contraception.