Mediating Role of Psychological Maladjustment in Relation Between Dark Triad, Psychological Distress and Subjective Happiness of Pakistani Emerging Adults.

The transition from adolescence to adulthood is fraught with challenges that might have impacts on later life and personality development. Earlier research investigated Dark Triad traits in connection to emotional problems. The current study, on the other hand, focused on investigating the mediating role of psychological maladjustment in the relation of Dark Triad traits, psychological distress, and subjective happiness in emerging adults. A sample of 546 participants aged 18-25 years (M = 21.2 years) from Pakistan have participated to complete an online survey. Standardized assessment tools were used to measure the targeted variables. Results indicated that Machiavellianism and psychopathy were positively associated with psychological distress, whereas narcissism appeared to be a non-significant predictor. Subjective happiness was positively associated with Machiavellianism and negatively associated with psychopathy. In addition, mediation analysis through Structural Equation Modeling (SEM) indicated that the Dark Triad traits (Machiavellianism and psychopathology), psychological distress, and subjective wellbeing were explained by psychological maladjustment. Implications and limitations are discussed.

Assessing soil properties and chemical quality indices under trees outside forests (TOFs) in temperate Himalayan region.

Trees outside forests (TOFs) have assumed importance in view of its potential to mitigate CO2 under different carbon pools with soil as the prominent pool. The ability of any TOF practice to fix soil organic carbon (SOC) efficiently depends on its SOC build up and soil quality that varies across different strata within TOFs. Soil physico-chemical properties under six TOF practices (boundary plantation, roadside plantation, riverside plantation, horticulture, scattered patches with clumpy plantation (SPCP), and woodlot) in central region of Kashmir valley were investigated to assess SOC content and soil quality. Additive soil quality index (ASQI) approach was used to assess soil quality using "lower or higher is better" criteria. Correlation analysis between soil variables was carried out to assess the relationships. The results showed that TOF soils in the region were sandy clay loam in texture with slightly acidic to alkaline pH and electrical conductivity within normal limits. Lowest bulk density (0.94 g cm-3) was found in SPCP and highest (1.38 g cm-3) in roadside plantation. Highest SOC %, available nitrogen (N), and available phosphorus (P) values were observed in SPCP and lowest in boundary plantation. Average available potassium (K) was observed highest in SPCP (333.04 kg ha-1) and lowest in riverside plantation (244.58 kg ha-1). Soil pH showed significant but negative correlations with SOC and other nutrients (N and P). A significant but perfect positive correlation was observed between SOC and available N. SOC content was found highest in SPCP (60.16 t ha-1) and lowest in boundary plantation (34.56 t ha-1). The hypothesis that all soils under different TOF strata have similar quality and same SOC build up rate was observed otherwise with SPCP exhibiting highest CSQI. SPCP was observed to be more qualitative and dynamic growing system among all strata with an enhanced capacity to fix and conserve SOC to help mitigate climate change. Present study demands plantation of more trees outside the forest areas especially in the pattern of SPCP for enrichment of soil and enhancement of carbon sequestration.

Extra digital glomus tumor: A very rare cause of chronic abdominal wall pain.

INTRODUCTION: Glomus tumors are very rare benign vascular tumors, constituting less than 2% of soft tissue tumors. These tumors originate from the glomus body. 75% of these tumors occur in hand however rarely can be found in any body part. PRESENTATION OF CASE: We here report a case of glomus tumor who presented with abdominal pain (constant and throbbing nature) and small swelling in the left hypochondrium. Pain was mostly spontaneous without any obvious cause, aggravated by cold and palpation. Ultrasonography parietal wall showed 27 × 22 × 21 mm hypoechoic lesion in the parietal wall with increased focal vascularity. Histopathological examination confirmed the diagnosis of glomus tumor. DISCUSSION: These are rare benign vascular tumors arising from the glomus bodies found anywhere in body. However 75% are found in hand mostly subungual region. Glomus tumor may show unusual clinical picture such as extra digital location, large size, deep soft tissue, visceral location, multi-centric or infiltrative growth pattern. These tumor commonly presents with a diagnostic triad of spontaneous pain, hypersensitivity to drop in temperature and pressure tenderness. Clinical diagnostic tests aide in diagnosis, including Love's test, Hildreth's test, Transillumination and the cold test. The clinical differential diagnosis of glomus tumor includes Raynaud's phenomenon, neuroma, gout, infection, peripheral neuropathy and radiculopathy. CONCLUSION: Extra digital glomus tumor occur in any part of the body and should be put in differential diagnosis of abdominal pain when no obvious cause of pain is found. Surgical excision is the curative treatment of choice with rare recurrence.

Rationale use of proton pump inhibitors: Observational study of hospital based prescriptions and role of clinical pharmacist.

The rationale of acid suppressant therapy with PPIs was assessed to measure the treatments conformity in PGHI under clinical guidelines. The irrational use of PPIs was found to induce side effects in patients and increased budgetary constraint. In a 4 phase study, 2 groups of patients (784 and 2804) were selected; Pre intervention retrospective review of the prescriptions was done in phase I. Insightful awareness in clinicians and patients was created in phase II a and II b respectively. The ongoing prescriptions were intervened in phase III. The post-intervention retrospective audit of prescription was completed in phase IV. The data was recorded for chronic disease patients in the hospital, revealed a marked reduction (85%) in the frequency of PPI's prescriptions (784 to 117), Cost of PPI's /year reduced to 19.3% , from US$: 24522/- to US$: 4718/-. The side effects reported in patients' feedback was also reduced such as hypocalcaemia (59%), hypomagnesaemia (52%), anemia (28%), reflux dyspepsia (82%), C. difficile associated diarrhea (15%), pneumonia (5%), and nephritis in patients with CKD (11%). The intervention induced awareness in Clincians (85%), in patients (38%), reduction in PPIs prescription (45%), whereas cost of PPI's prescription in group 2 was reduced from US$ 36481/- to US$:10325/- i.e. (28%).

Formulation of lyophilized single vial kit of N-N-Ethylene-L-Dicysteine (EC) for labeling with 99mTc. II: Radiochemical and clinical evaluation as a renal tubular agent in comparison with 99mTc-MAG3.

A Technetium 99mTc labeled lyophilized single component kit of N-N-ethylene-I-dicysteine (EC) is developed to replace multiple step kit developed by others. The aim of study is to formulate a radionuclide that is easy to prepare, has rapid plasma clearance, produce high quality images and is an affective alternative to radioiodine labeled orthoiodohippurate, which has been remained the physiological 'gold standard' since long time. To achieve this goal, the systematically varied key parameters such as pH, the use of reducing agents, stabilizers and additives are optimized to obtain maximum radiochemical purity and optimum biodistribution in non human and human primates. Various pH levels of EC showed equally good results in animal experiments but only pH 10 was suitable for human use. Dynamic and renal Scintigraphic studies are carried out with 99mTc-EC at pH 8 in 12 volunteers and at pH 10 in 18 volunteers and compared with 99mTc-MAG3, Background ratios, renograms, relative renal function and semi quantitative parameters are available in all studies. The background ratios (mean ± SD) at 30th minute are 0229±0.024 and 0.236±0.018 for 99mTc-EC at pH 10 and 99mTc-MAG3 respectively. The mean ± standard error of mean (SEM) values of TMAX and time to half activity (T12) for 99mTc-EC (pH10) are 3.7±0.6 and 7.3±1.0 respectively while for 99mTc-MAG3, they are 4.0±0.8 and 7.9±1.4 with p values 0.001 and 0.049 respectively. The values of relative renal function (RRF) for 99mTc-EC and 99mTc-MAG3 are 50.8±3.11 and 51.2±3.4 respectively with p value of 0.822. The residual activity at 25th minute (A25 / A MAX) and renal uptake are 0. 209±12.67±2.80 for 99mTc-EC and 0.218±0.035 and 1053±2.98 for 99mTc-MAG3 (p=0.031 an 0.0003) respectively. The correlation coefficient (R2) for TMAX, T1/2, A25/AMAX and renal uptake are 0.96, 0.69, 0.93 and 0.85 respectively.

Formulation and evaluation of a single vial lyophilized preparation of technetium-99m labeled ethylene dicysteine as a renal scintigraphic agent.

(99m)Tc labeled N-N-ethylene-L, L-dicysteine (EC) was introduced in form of multiple-step kit as an alternate renal imaging radiopharmaceutical for commonly used (99m)Tc-MAG3. We developed a single component lyophilized kit of EC ready to be labeled with (99m)Tc. We present the optimization of the components of our formulation, its evaluation in animal models, normal human volunteers and patients of various renal diseases, in comparison with (99m)Tc-MAG3. Efficient labeling of EC was achieved with our preparation at pH 7 to 12. The formulation at pH 8 was used further for bio distribution studies in organs of sacrificed Sprague Dawley rats and a live rhesus monkey using scintigraphy. After satisfactory bio-distribution results, the kit was then evaluated in normal human volunteers through renography. But the renogram parameters of (99m)Tc-EC (pH 8) were statistically inferior to (99m)Tc-MAG3. Surrogate kit at pH 10 was therefore developed and re-evaluated in rats for organ bio distribution. After favorable results the kit was then assessed further in normal volunteers and a group of patients with various renal disorders via scintigraphy. The EC kit developed at pH 10 gave images better than and scintigraphic parameters comparable to (99m)Tc-MAG3. It was concluded that single vial kit we formulated easy to prepare than three-vial kit and can be used as an alternate to (99m)Tc-MAG3.

Primary ovarian lymphoma--a rare entity.

Primary ovarian lymphoma is very rare. Ovarian involvement by non-Hodgkin's lymphoma is usually secondary, occurring as part of a systemic disease. We report a case of primary diffuse large B-cell lymphoma of the ovary manifesting as advanced ovarian cancer. The diagnosis was confirmed on histological and immunohistochemical analysis. The patient was treated with surgery followed by chemotherapy using rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) regimen.

A comparison of single plasma sample methods to estimate renal clearance using 99mTc-ethylenedicysteine and 99mTc-mercaptoacetyltriglycine.

Several single sample methods for determination of (99m)Tc-mercaptoacetyltriglycine (MAG3) clearance are being used clinically. Kabasakal et al. proposed a similar formula for (99m)Tc-ethylenedicysteine (EC). This study was performed to compare his method with Bubeck et al. formula for (99m)Tc-MAG3 already in use. Twenty-eight subjects divided in two groups were registered which included 22 patients with various renal diseases (group-I) and six normal volunteers (group II). All subjects were studied twice using both the radiopharmaceuticals. The images and renogram parameters, that is TMAX and T1/2 of both the agents, were similar in all the subjects. The clearance of the (99m)Tc-EC was however considerably higher than (99m)Tc-MAG3 in both the groups (mean ± SEM =279 ± 14 ml min(-1)/1.73 m(2) versus 177 ± 15 ml min(-1)/1.73 m(2) in group-I and 377 ± 11.90 ml min(-1)/1.73 m(2) versus 238 ± 8.23 ml min(-1)/1.73 m(2) in group II). This difference was more pronounced in cases with reduced renal functions. Among the Effective Renal Plasma Flow (ERPF) values determined from EC and MAG3 clearances in six normal volunteers, four cases only in MAG3 had ERPF below the lower limit. This study has demonstrated superiority of single sample method for (99 m)Tc-EC clearance over its analogous method for (99m)Tc-MAG3.

Triple X syndrome.

Triple X syndrome 47XXX is a sex chromosome abnormality characterized by presence of an extra X chromosome. Most of the girls born with triple X chromosomes have no signs or symptoms at birth. The condition often remains undiagnosed until adulthood when the genetic defect is discovered on investigation for other reasons as in this case of a young girl who presented with primary amenorrhoea. Clinical examination was unremarkable and diagnosis was made on chromosomal analysis. She later started having a spontaneous menstrual cycle but prognosis regarding future fertility is guarded.

Intimate partner violence before and during pregnancy: experiences of postpartum women in Karachi, Pakistan.

OBJECTIVE: To assess the magnitude and determinants of intimate partner violence before and during pregnancy and attitude regarding domestic violence among a cohort of recently delivered women in Karachi, Pakistan. METHODS: A total of 300 women occupying every alternate bed in the postnatal wards of a public tertiary hospital were administered a structured questionnaire. RESULTS: Forty four percent (44%) of women reported lifetime marital physical abuse, 23% during the index pregnancy. Among the 132 women who were ever physically abused, all reported verbal abuse and 36% sexual coercion. The statistically significant risk factors, wife's education, consanguinity, and duration of marriage, were similar for lifetime marital abuse and during pregnancy. Over half (55%) of the women believed that antenatal care clinics were a good time to enquire about domestic violence. CONCLUSION: Annually an estimated one million pregnant Pakistani women are physically abused at least once during pregnancy. Reproductive health stakeholders should be encouraged to advocate for domestic violence screening.

Pelvic tuberculosis mimicking malignant ovarian tumour.

Two cases of pelvic tuberculosis with markedly raised serum CA 125 levels and initially suspected of ovarian carcinoma are presented. Tuberculosis is highly prevalent in developing world and should be considered in the diagnosis of pelvic mass, ascites and elevated serum CA 125 levels.