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Abstract Introduction Recently, evidence has been accumulating that both smoking and mental health disorders are continuously increasing among adolescents. This systematic review elucidates the research into evidence of the direction of the association and risk factors influencing the relationship between smoking and depression. We also highlight recent studies on the effects of electronic cigarettes and developments on the association between depression and smoking. Methods A literature search was conducted on databases including PubMed, Ovid Medline, EMBASE, and PsycINFO and in relevant neurology and psychiatry journals. Terms used for electronic searches included smoking, tobacco, cigarettes; depression; adolescent, youth; direction. Relevant information was then utilized to synthesize findings on the association between smoking and depression among adolescent population. Results The initial database searches yielded 2,738 related articles. After screening and cross-referencing, duplicate articles, articles published in languages other than English, and studies on animals, social and lifestyle factors, mood disorders, and substance use were excluded. Of these, a total of 122 publications only focusing on smoking and depression in the adolescent population were selected for synthesis in this qualitative systemic review. These include 110 original research articles, eight meta-analyses and reviews, and four reports and websites. Conclusion The relationship between smoking and depression in the literature does not reflect the cause-effect relationship. The lack of evidence on the direction of the association may reflect futile study designs, confounding factors and/or use of indirect measures of depression and quantification of smoking. Future prospective randomized studies should target elucidation of the causal association.
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Context: Age estimation allows the identification of living individuals, dead victims and estimation of age in children using maxillofacial radiographs. Aim: To compare age estimation by mandibular third molar developmental stages using modified Demirjian’s method on OPG with age estimation by mandibular linear dimensions on lateral cephalogram. Setting and Design: A total of 200 randomly selected subjects (100 males and 100 females), with age range from 9 to 20 years, and 200 Digital Orthopantomograms and 200 Digital Lateral Cephalograms were utilized for the study. Methods and Material: Radiographs were taken with Kodak 8000C Digital Panoramic and Cephalometric machine operating at 60–90 kvp, with exposure time of 8–18 s at 2–15 mA, with an inbuilt magnification factor. A flat screen Compaq TFT?LCD monitor was used to view the OPG images. Linear mandibular dimensional measurements were made on each Digital Lateral Cephalogram using Trophy Dicom Software. Statistical Analysis Used: Regression analysis and regression coefficient for establishing gender?specific equation were observed. Evaluation of results and statistical analysis was carried by using Student’s ‘t’ test. For all test, ‘P’ value of 0.05 or less was utilized for measuring the degree of significance. Intra?observer variability was detected using reliability analysis. Results: The accuracy of age estimation by OPG was 93.8% and by lateral cephalogram was 79.7%. Conclusion: The OPG analysis is more reliable than the cephalometric parameters.
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Introduction: Clinical Health Electives are an important part of academic curriculum in medical universities throughout the world. Electives are useful in developing personal and professional growth among students. Hence understanding the importance of electives among medical undergraduates on their academic life is important.Materials and Methods: A cross-sectional based study was conducted among medical undergraduates in Karachi, Pakistan. A total number of 300 students from 3rd, 4thand 5thyear of MBBS were taken as a sample. Consent was taken from the participants and questionnaire was filled from everyone. Study population was selected who did at least one clinical elective in their whole academic period.Results: According to our analysed results, undergraduate students from both private and public sector medical institutes perceived clinical electives as an advantage to themselves. Majority of the students saw their clinical and academic performances to be on a higher level. This shows tha opting for electives regardless of its type (local or international) have proven to be fruitful for the undergraduates’ personal growth and academic career, allowing more scope for understudies to practice and enhance their skills they have only done a limited number of times, which inevitably leads to a steep learning curve.Conclusion: There was a positive influence of clinical electives observed among the students. Overall the academic and clinical performance of theundergraduates enhanced by opting clinical electives and has positive impact on them
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Background: Diarrhoea is the second leading cause of death in children under five years of age, and is responsible for killing around 5,25,000 children every year. A major determinant of child health is the health and knowledge of the mother. So the knowledge, attitude and health practices of the mothers directly reflect on the health and vitality of the child.Methods: A community based cross sectional type of study was conducted among mothers who had children of 0-5 years of age using pre designed, pretested structured questionnaire. Study area was 5 urban slum pockets in Tertiary care hospital of Sangareddy, Telangana. 255 mothers were selected for the study using random sampling technique.Results: Out of the total 255 study populations most of the mothers were literate, living in nuclear families belonging to Hindu religion. About half of the mothers had knowledge regarding diarrhoea and 71.4% of the mothers have given hospital treatment for it. When asked about 78.4% of mothers told that they follow preventive health practices. Majority of mothers had a good knowledge regarding steps to be taken by health care facility during diarrheal attack.Conclusions: On the basis of the present study, there was a significant association of knowledge regarding diarrhoea with maternal literacy and socio economic status. This study brought out the health seeking behaviour of mothers of under five children.
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Background: Vulvovaginitis is a common unavoidable health problem encountered in a woman’s life. Because of its recurrent and persistent symptoms, it leaves a negative impact on the quality of woman’s life and its management poses a challenge. This study is aimed to analyse the clinical profile, clinical symptoms - presentations and various etiological agents in vulvovaginitis.Methods: A study of 125 cases of vulvovaginitis in the age group of 18-50 years was done. This study was based on the data collected like - age, parity, symptoms, clinical presentations and cytological findings. Speculum examination was done with the given consent and high vaginal swabs were taken for cytological study. Based on Amsel’s criteria bacterial vaginosis was confirmed, trichomoniasis by wet mount examination and candidiasis by culture study were confirmed.Results: The present study showed maximum incidence of vaginitis 63.2% among 21-30 years age group, more common in multiparous women 44.8% and vaginal discharge was the commonest symptom 88%. Cytological study showed 53.6% bacterial vaginosis {BV), 27.2% vulvovaginal candidiasis (VVC), 2.4% trichomoniasis and remaining 17% mixed infections like BV + VVC 15.2% and 1.6% BV + VVC + Trichomoniasis.Conclusions: All women of reproductive age should have mandatory regular evaluation for early detection and proper management of vulvovaginitis. Creating awareness among women improves their quality of life.
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Background: Obesity is a newly emerging, global pandemic problem involving developed as well as developing countries. Even in countries like India, which are typically known for high prevalence of under nutrition, significant proportions of overweight and obese now coexist with the undernourished. Overweight and Obesity are the 5th leading risk of global deaths. Rapidly changing diets and lifestyles are increasing the global obesity epidemic. According to recent estimates, there are more than one billion overweight people worldwide, and some 300 million of these are estimated to be obese. Obesity is one of the important risk factors for non communicable disease like CAD, stroke, cancer, depression etc, going to increase burden of non communicable diseases in terms of morbidity and mortality. Aims and objectives were to determine the prevalence of overweight and obesity among women of >20 years and to identify various factors associated with overweight and obesity. Methods: A community based cross sectional study was conducted and 446 women of 20-60 years age were included in the study. A Predesigned questionnaire was used for the study. Anthropometric measurements such as weight, height, waist circumference were measured using standard techniques. Results: In the present study, prevalence of overweight in the study population was 28.2% and obesity 13.6%. Overweight & Obesity were significantly associated with family history, comorbid conditions etc. Conclusions: Prevalence of overweight & obesity is increasing in developing countries like India due to changing life styles, diet patterns and sedentary life style. This observation emphasizes large scale awareness campaign about overweight and obesity
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Introduction: The natural history of diabetic nephropathyhas generally been viewed as a descending path fromnormoalbuminuria to end stage renal disease through anintermediate stage marked by microalbuminuria and overtproteinuria. For this reason, measurement of urine albuminis often used as a sensitive marker and predictor of overtnephropathy in patients with diabetes mellitus. Study aimedto determine the prevalence of microalbuminuria in newlydiagnosed type 2 diabetes mellitus patients and to assess theprobable risk factors associated with microalbuminuria.Material and methods: A total of 155 newly diagnosed Type 2Diabetes mellitus patients were includedin our cross-sectionalstudy. After the history, general physical examination andanthropometry, various biochemical investigations includingkidney function test, plasma blood sugars, lipid profile andHbA1c. The detection of microalbuminuria was done byMicral Test (dipstick, Roche Diagnostic) method in a randomspot urine sample. Microalbuminuria was diagnosed if theurinary albumin excretion was ≥20 mg/L of urine.Results: The overall prevalence of nephropathy was 32.9%(51/155).There was significant association of albuminuriawith the increase in age of the patients, increased BMI, highglycated haemoglobin, high fasting plasma glucose, anddyslipidemia.Conclusion: A relatively high prevalence of microalbuminuriaat the time of diagnosis in our study reconfirms that evaluationfor microalbuminuria must be done at the time of diagnosis inall patients of T2DM
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Background: Pain is an inevitable outcome of any periodontal surgery. Controlling postoperative pain is of utmost importance so as to increase patient compliance. The present study aims to compare the degree of postoperative analgesia with the use of oral diclofenac sodium and transdermal diclofenac patch following periodontal flap surgery in patients with chronic periodontitis. Materials and Methods: A total of 20 patients requiring full mouth flap surgery were selected for this study. Flap surgery was performed quadrant-wise and transdermal diclofenac patch was applied on the right arm following surgery of one of the quadrants and 100 mg oral diclofenac sodium twice daily was prescribed following surgery of the subsequent quadrant. The postoperative pain was recorded on visual analog scale and pain intensity scale 24 h after the surgery. Results: Both the statistical and clinical observation showed that diclofenac sodium administered transdermally has equal efficacy as compared to drug administered orally. Conclusion: The study concludes that the diclofenac administered transdermally has equal potency in relieving postoperative pain as compared to orally administered diclofenac sodium following modified flap surgery. Transdermal patch has an added advantage of better patient compliance as it does not cause gastric disturbance.
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The study is conducted to observe and investigate the effects of oral dosing of methanolic extracts of Cuminum nigrum [L] and Centratherum anthelminticum [L] on neuropharmacological activities of mice. Methanolic extracts of Cuminum nigrum [L] and Centratherum anthelminticum [L] were soluble in Dimethyl sulphoxide [DMSO] i.e. an organic solvent, so it is used in this study. Screening for anxiolytic and antidepressant effects were performed using open field test, head dip test, stationary rod test, cage crossing test, light and dark box and swimming- induced depression test. Thirty animals were divided into three groups of 10 animals each and numbered as 1 [control, on DMSO], 2[on methanolic extract of Cuminum nigrum [L], 3 [on methanolic extract of Centratherum anthelminticum [L]. The extracts and DMSO were administered orally for 60 days. Any possible change in animal behavior was evaluated on day 15, 30 and 60 of dosing. The groups 2 and 3 showed significant increase [p<0.001, p<0.01] in open field activity and light and dark box test respectively, while significantly decreased activity was observed in head dip and cage crossing activity [p<0.01] after 60 days of dosing. Based on above findings, it is suggested that the extracts of Centratherum anthelminticum [L] and Cuminum nigrum [L] have antidepressant and anxiolytic potential with sedative effects
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Aim: The aim of the present study was to compare the efficacy of herbal mouthwash and chlorine dioxide mouthwash in reduction of plaque and gingivitis. Settings and Design: In a randomized clinical trial, forty patients were randomly selected and divided equally into two groups. Materials and Methods: After professional oral prophylaxis, the clinical parameters plaque index, gingival index, and modified sulcular bleeding index were recorded at baseline, 7th day, 14th day, and 21st day. The plaque samples were collected from gingival sulcus with an absorbent sterile paper point and were stored in a thioglycollate broth, then sent for microbiological examination. The microbial colony-forming units were assessed at baseline, 7th day, 14th day, and 21st day for Streptococcus mutans, Tannerella forsythia, and Fusobacterium nucleatum. Results: There was a statistical significant reduction in both clinical and microbiological parameters were observed with use of both the mouthwashes. However, herbal mouthwash was more effective in reducing the plaque and gingivitis than chlorine dioxide mouthwash. Conclusion: Herbal mouthwash was statistically efficacious in controlling plaque and gingivitis with potent antimicrobial activity.
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Objective: To determine the frequency of violent asphyxial deaths in Faisalabad over a span of a decade; and assessing the age and gender vulnerability. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Forensic Medicine and Toxicology, Punjab Medical College, Faisalabad, from January 2007 to December 2016
Methodology: Cases identified as violent asphyxial deaths according to police inquests and findings of the medico-legal examiners were computed. Age, gender, and cause of asphyxia recorded in predesigned proformas and analysed by SPSS version 12.0
Results: Asphyxial deaths accounted for 7.66% [259 / 3,381] of the medico-legal deaths during the 10-year span. Majority [28.57%] victims belonged to the 20-29 year age group, followed by the 10-19 year age group [20.07%]. Male victims [56%] outnumbered the females [44%] by ratio of 1.3:1. Ligature strangulation was the cause of asphyxia in majority of the victims [40.93%], followed by hanging [28.96%]
Conclusion: Young population between 20-29 years were the predominant victims of violent asphyxial deaths. Homicide due to ligature strangulation was the commonest form of violent asphyxial deaths
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Objective: To compare the bichemical and morphological effects of L -Arginine against the changes caused by butter and corn oil supplementation Study design: A prospective experimental study Place: Department of Anatomy BMSI, JPMC Duration: August to October 2008
Methodology: Male Albino rats weighing 200 - 240gm were selected and divided into 5 groups. Group 'CL' received standard laboratory diet. Group 'Bu' received 20% added unsalted butter in diet. Group 'Co' received 20% added corn oil in diet. Group 'BuAr' received 20% Butter with L-Arginine 300mg /kg body weight /day orally .Group'CoAr' received 20%corn oil along with L-Arginine 300mg/kg body weight/day orally. On completion of study period that is 4 weeks, animals were sacrifised. Blood was drawn for hormonal assays. Adrenal glands were removed and fixed in buffered neutral formalin. Right adrenals were processed and sectioned at4 microm thickness to be stained with Mallory trichrome stain to visualize blood vessel. Left adrenalswere sectioned with cryostat in 10 microm sections and stained with Oil red O to visualize fat in cells
Results: Highly significant and moderately significant decrease observed in ACTH [Adrenocorticotrophic hormone]levels in Group BuArand CoAr when compared to Bu and Co respectively; insignificant difference was found between BuAr and CoAr. Moderately significant and significant decrease observed in corticosterone levels in Group BuAr and CoAr when compared to Buand Co respectively. Insignificant difference was found between BuAr and CoAr . Mallory trichrome stained section showed less dilated blood vessels in BuAr and CoAr compared to Bu and Co respectively, while difference among the former two was not remarkable. Oil red O stained sections showed less densely packed fat globules in group BuAr and CoAr compared to Bu and Co respectively. Difference between BuAr and CoAr was not marked
Conclusion: Butter has more stimulatory effect on adrenal cortical cells but the comparison with corn oil is not statistically significant except for ACTH levels. L Arginine seems to be effective in lowering the levels of stress hormones, fat accumulation and vasodilatation when given along with corn oil and butter oil
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Objective: To determine the frequency of HBeAg positivity in chronic hepatitis B infected patients
Methodology: This descriptive cross-sectional study was carried out for one year between June 01, 2014 till May 30, 2015 in a private consulting clinic at Ibrahimi Hospital, Dabgari Gardens, Peshawar - Pakistan. A total of 149 patients were included in the study. All patients of either gender between 15 to 70 years of age, newly diagnosed with HBV infection in the form of positive HBsAg on third generation ELISA were included in the study. In all the patients, HBeAg was checked. Data were analyzed using SPSS version 20.0
Results: Out of the total 149 patients between 20 to 60 years [mean 41 +/-8.7] included in the study, the males 112 [75.2%] outnumbered the females 37 [24.8%]. The prevalence of HbeAg in chronic HBV was 28.2 % [males 16.10 %, females 12.08%] with more patients [22.14%] between 21 and 40 years of age
Conclusion: The frequency of HbeAg was found in a significant number of chronic HBV patients. Its frequency was more in males and in the age group of 21 to 40 years
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Mammary analogue secretory carcinoma [MASC] is a rare salivary gland malignancy that exhibits resemblance with secretory carcinoma of the breast [SC] due to the presence of ETV6-NTRK3 gene fusion, formerly classified as acinic cell carcinoma. It is a slowly growing painless tumor that exhibits wide range of clinical behavior. This tumor typically affects middle aged people. Less than 100 such cases have been reported in the literature so far with only 8 case reports of patients less than 19 years of age. Very little is known about the clinical management of such cases. We hereby report a case of 15-year boy who had been managed for MASC of left parotid gland with exision
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Objective: To compare mean post operative visual acuity of cataractous patients after extracapsular cataract extraction and phacoemulsification with posterior chamber intraocular lens implantation
Methods: 100 patients of more than 50 years of age attending the OPD of Department of ophthalmology, Fatima Jinnah Medical College, Sir Gangs Ram Hospital, Lahore from 1-12-2011 to 30-05-2012, were divided into two equal groups for the study. Group A was operated by phacoemulsification and group B was operated by extracapsular cataract extraction
Results: The visual acuity of operated eye was recorded on first postoperative day which showed improvement in both groups. Mean value of post operative visual acuity was 0.344+0.223 in group A and 0.510+0.287 in group B on log mar scale which is equivalent to 6/12 and 6/18 respectively on snellen chart
Conclusions: it was concluded that there is early post operative visual rehabilitation with phacoemulsification than extra capsular cataract extraction
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Objectives: To determine the frequency of acceptable postoperative astigmatism following phacoemulsification with unsutured 6mm limbal lncision
Methods: 65 cataractous eyes of patients attending the outpatient department and admitted in . . were studied from 7 January 2010 to 16 June 2010 at Department of Ophthalmology, Fatima Jinnah Medical College/ Sir Ganga Ram Hospital Lahore. it was a descriptive case study. All patients under went phacoemulsification with sutureless 6 mm limbal incision and rigid PMMA intra ocular lens implantation. Preoperative and postoperative keratometry reading were taken and difference was presented as acceptable astigmatism if less than +/- 1 D. Acceptable astigmatism [Yes, No] presented as percentages and frequencies
Results: The mean postoperative astigmatism was 0.31D with SD of +/- 0.58 D. it was found to be acceptable astigmatism' In 57 patients [87. 7%] while 8 of patients [12.3%] were out of the range of acceptable astigmatism
Conclusion. Postoperative astigmatism after phacoemulsification with 6 mm sutureless limbal incision is within acceptable range and eliminates significant postoperative refractive error
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Objective: This study was designed to evaluate the protective role of L-arginine on body weight, and absolute and relative kidney weight of Streptozotocin [STZ]-treated albino rats
Methodology: This experimental study was conducted in the department of Anatomy, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi, from February to March, 2010. In this study, 30 male albino rats were divided into 3 groups, containing 10 animals each. Group-A was treated as control. Group-B animals received STZ in a dose of 37 mg/kg intraperitoneally [I/P] only once at the start of experiment. Group-C received L-arginine orally in a dose of 0.3 mg/100 gram [G]body weight/day a week before STZ treatment. Body weight of animals was calculated at start and end of the study period, along with absolute and relative kidney weight and serum glucose level
Results: There was a highly significant increase in serum glucose level in group B animals when compared to the control group A. In group C, the serum glucose levels returned near to control. The final body weight of group B animals decreased significantly when compared to their initial weight, as well as when compared to control. The data also showed that there was a significant decrease in absolute kidney weight whereas, significant increase in relative kidney weight in group B animals when compared to group A animals respectively. There was significant restoration of body weight, and absolute and relative kidney weight in group C animals receiving L-arginine along with STZ
Conclusion: Our findings conclude that L-arginine as a nitric oxide donor and as an antioxidant, plays a significant role in preserving renal morphology in streptozotocin-treated hyperglycemic rats
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A phytochemical study of Alphonsea cylindrica King (unreported) has led to the isolation of six alkaloids. The compounds were identified as kinabaline (1; azafluorenone alkaloid), muniranine (2), O-methylmoschatoline (3; oxoaporphine alkaloid), lysicamine (4), atherospermidine (5) and N-methylouregidione (6; 4, 5-dioxoaporphine alkaloid). The structures of the isolated compounds were determined based on the spectroscopic techniques and by comparison with data reported in the literature. Alkaloid 2 was isolated as a new derivative of azafluorenone while alkaloids 1, 3 - 6 were isolated for the first time from Alphonsea species. In addition, alkaloid 3 and 4 showed inhibition zone against Staphylococcus aureus, Pseudomonas aeruginosa and Bacillus cereus in disc diffusion test. The minimum inhibition concentration (MIC) values of lysicamine (4) against S. aureus, B. cereus and P. aeruginosa were found to be smaller than O-methylmoschatoline (3). Therefore, the reported antibacterial activity showed the potential of this plant as natural antibacterial agent and supported the documented traditional use of Alphonsea sp. in the treatment of diarrhea and fever.