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BACKGROUND: The benefits of dietary macronutrients for weight management depend on the integrity of gut hormones. The role of food temperature in the release of satiety hormones and satiety needs elucidation. We aimed to determine the impact of different food temperatures with varying macronutrient compositions on satiety-related gut hormones glucagon-like peptide-1 (GLP-1) and cholecystokinin (CCK) and find the correlation of satiety hormones with appetite scores and remainder-day food (energy) intake. MATERIALS AND METHODS: Thirteen healthy participants (eight males and five females) aged 25-35 years with body mass index 18.5-24.9 kg/m2 with no medical illnesses or eating disorders consumed three compositions of meals (high carbohydrate, high fat, and high protein meals) each at three temperatures (cold, warm, and hot) in a randomized, double-blinded, controlled crossover design. Plasma concentrations of peptide hormones were determined at 0, 30, and 240 minutes by enzyme-linked immunosorbent assay, and 24-hours food recall was used for remainder-day food intake (remainder energy). Data were analyzed using SPSS version 27.0. The change in plasma levels of gut hormones with time was assessed using Friedman test; Kruskal-Wallis test was employed to compare GLP-1 and CCK hormonal levels across nine meals. RESULTS: A comparison of the three meals at the three temperatures (total of nine groups), showed that the GLP-1 and CCK plasma concentrations were significantly different (P < 0.001). GLP-1 and CCK responses increased more after hot meals than cold meals. Overall, high-fat meals had more effective gut hormone secretions. The area under the curve was increased for GLP-1 in high-fat meals and for CCK in hot meals. The peptide hormones (GLP-1 and CCK) were positively correlated with satiety scores and inversely with remainder food intake. CONCLUSION: The temperature of food was found to be an effective stimulus for the regulation of CCK and GLP-1 secretion. Hot food temperature increased satiety hormones (CCK and GLP-1), independent of food macronutrient composition.
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Pelvic inflammatory disease (PID) is one of the major public health concerns accounting for 30% of infertility and 50% of ectopic pregnancy cases due to severe inflammation and fibrosis. Punicalagin® are known to exhibit potent anti-inflammatory activity. The aim of this study was to demonstrate the anti-inflammatory and antioxidant effects of Punicalagin®, against pelvic inflammatory disease in rats. Female Sprague Dawley rats (n = 24) were divided into 6 groups (n = 4) as control, PID, prophylactic (low dose and high dose) and therapeutic group (low dose and high dose). PID model was constructed by implanting the rat cervix with mixed microbe (Escherichia Coli and Staphylococcus Aureus) solution. Prophylactic group was gavaged with 3 mg/kg (low dose) and 6 mg/kg (high dose) Punicalagin® daily starting one day before PID induction and therapeutic group was gavaged with 3 mg/kg (low dose) and 6 mg/kg (high dose) Punicalagin® daily starting 1 day after confirmation of PID model. Rats were sacrificed at the end of experiment and samples from upper genital tract were collected for ELISA, antioxidant assay and histopathological examination. According to results, obvious signs of inflammation and oxidative stress including infiltration of neutrophils and significantly raised levels of cytokines, and oxidative stress markers were observed in PID group when compared to control group. Punicalagin® significantly decreased the levels of IL-1ß, catalase and lipid peroxidation in both prophylactic and therapeutic groups when compared to PID group. Punicalagin® also decreased the infiltration of leucocytes in uterus of prophylactic and therapeutic group when compared to PID group, as determined by histological examination. On basis of these results, we concluded that Punicalagin® showed anti-inflammatory and antioxidant potential in rat model of pelvic inflammatory disease and could be used as possible therapeutic agent in treatment of PID.
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Background: Naswar, a smokeless tobacco product, commonly consumed in Pakistan, is associated with a 10-fold increase in the risk of oral cancer. However, little is known about Naswar's underlying toxicity mechanisms. Objective: The current study aimed to investigate the effects of Naswar use on oral health and salivary parameters. Methods: A case-control study was conducted among Naswar users (n=42) and age-matched healthy controls (n=42) in Pakistan in 2019. Participant data were collected using questionnaires. Decayed, missing, and filled teeth (DMFT) scores were computed during clinical examinations. Unstimulated whole saliva was collected to assess salivary flow rate, pH, and salivary total oxidative stress (TOS)/total antioxidant capacity (TAC) using commercially available kits. Participants' oral health parameters were compared between cases and controls using ANOVA. Results: No significant differences were observed between the two groups in terms of age, oral health, and hygiene practices and mean DMFT score. Mean salivary pH and the salivary flow rate was significantly (p<0.001) higher in Naswar users (7.7 and 0.71 mL/minute, respectively) than in non-users (6.95 and 0.52 mL/minute, respectively). Although TOS and TAC were not significantly different between the groups, Naswar users generally had a higher TOS (51.6±42 µmol/L) and lower TAC (0.55±0.18 mmol/L) than non-users (TOS 45.5±38.2 µmol/L and TAC 0.57±0.17 mmol/L). Correlational analysis also revealed a significant positive correlation between DMFT score and Naswar use duration (r=0.796, p<0.001) and the number of dips/units consumed each day (r=0.515; p<0.001). Conclusion: Habitual Naswar use is associated with increased salivary flow rate, pH, and TOS, and reduced TAC levels in Pakistani adults compared to non-users. The pro-oxidant changes may contribute toward deleterious effects of Naswar use including oral cancer.
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Oral lipid-based nutritional supplements (LNS) are designed to ensure dietary adequacy and to improve malnourishment in children. Therefore, this study investigated the effects of 4 weeks of LNS on appetite, energy intake, and lipid profile of moderately underweight children (5-10 years old) with BMI-Z score between -2 and - 3 SDS, recruited in a single-blind randomized control trial. In addition to the regular dietary intake, fasting blood samples, anthropometric measurements, energy intake, and appetite responses were obtained before and after 4 weeks of LNS (535 kcal) or PLACEBO (92 kcal). After 4 weeks of supplementation mean energy intake (kcal) (p < .001), body weight (kg) (p < .001), BMI (kg/m2) (p < .01), mid-upper arm circumference (cm) (p < .01), total cholesterol (mg/dl) (p < .01) and fasting glucose (mg/dl) (p < .01) were raised significantly in the LNS group as compared to the PLACEBO group. No significant changes were detected in appetite responses (p > 0.05). In conclusion, LNS increases the overall energy intake, but does not affect the appetite but may induce hyperglycemia and hyperlipidemia.
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This study aimed to find the molecular basis of Bardet-Biedl syndrome (BBS) in Pakistani consanguineous families. A total of 12 affected families were enrolled. Clinical investigations were performed to access the BBS-associated phenotypes. Whole exome sequencing was conducted on one affected individual from each family. The computational functional analysis predicted the variants' pathogenic effects and modeled the mutated proteins. Whole-exome sequencing revealed 9 pathogenic variants in six genes associated with BBS in 12 families. The BBS6/MKS was the most common BBS causative gene identified in five families (5/12, 41.6%), with one novel (c.1226G>A, p.Gly409Glu) and two reported variants. c.774G>A, Thr259LeuTer21 was the most frequent BBS6/MMKS allele in three families 3/5 (60%). Two variants, c.223C>T, p.Arg75Ter and a novel, c. 252delA, p.Lys85STer39 were detected in the BBS9 gene. A novel 8bp deletion c.387_394delAAATAAAA, p. Asn130GlyfsTer3 was found in BBS3 gene. Three known variants were detected in the BBS1, BBS2, and BBS7 genes. Identification of novel likely pathogenic variants in three genes reaffirms the allelic and genetic heterogeneity of BBS in Pakistani patients. The clinical differences among patients carrying the same pathogenic variant may be due to other factors influencing the phenotype, including variants in other modifier genes.
Subject(s)
Bardet-Biedl Syndrome , Humans , Pedigree , Bardet-Biedl Syndrome/genetics , Pakistan , Phenotype , Alleles , Microtubule-Associated Proteins/geneticsABSTRACT
Substances such as tobacco and cannabis can negatively modulate seminal parameters and sex hormones and lead to fertility problems in males. The present study aimed to determine the effect of cigarettes, dipping tobacco, and cannabis on semen parameters and sex hormones in infertile males. A total of 160 infertile healthy participants (cigarette smokers n = 40, dipping tobacco users n = 40, cannabis users n = 40 and infertile controls n = 40) were included in the study. Fasting blood samples were collected from all the participants using the aseptic technique, and semen samples were collected by masturbation following sexual abstinence of 2-7 days. The levels of serum testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were determined using ELISA. The serum level of FSH was significantly higher in cannabis users relative to the control group (p = 0.043). A mild non-significant decrease in sperm count, serum LH and testosterone levels were observed in all drug users compared to controls. In conclusion, chronic use of tobacco and cannabis mildly modulates semen and hormonal parameters in infertile males.
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Background: Under-nutrition is a major public health problem worldwide. Several studies have documented the effects of vitamin D and calcium supplements in healthy children and in children with bone abnormalities but the effects of multiple micronutrients supplementation in underweight children is limited in literature. Methods: In this randomized controlled trial 38 participants were recruited and divided into two groups of 19 subjects. On the first day of experimental trial, in fasting state 5cc blood samples were collected from all subjects followed by their anthropometric measurements, and serum levels of calcium and vitamin D. All subjects of one group were given Lipid-based nutritional supplement (LNS) and whereas the other group was given the placebo. After one month of compliance the same measurements were repeated and compared. Results: After one month of supplementation mid-upper arm circumference (p=0.005), weight (p<0.001), height (p=0.000), and BMI-Z score (p=0.002) the energy intake (p<0.001), were significantly increased in LNS as compared to Placebo. However, no improvement was observed in the plasma vitamin D (p=0.44) and calcium levels (p=0.46) of underweight children in both groups. Conclusion: Multi micronutrient supplementations are effective in improving anthropometry in the short duration of time. They also improve the energy intake of underweight children. However, no improvement is observed in levels of vitamin D and calcium in LNS group even after a one-month use.
Subject(s)
Calcium , Vitamin D , Child , Humans , Vitamin D/therapeutic use , Thinness , Vitamins/therapeutic use , Energy Intake , Dietary SupplementsABSTRACT
Background Endoscopic third ventriculostomy (ETV) is used to treat patients with obstructive hydrocephalus in infants. This study evaluated the postoperative outcomes of ETV among pediatric patients. Methodology A retrospective study was undertaken at the Mardan Medical Complex between June 2018 and June 2021. All pediatric patients who underwent the procedure of ETV in both the absence and presence of choroid plexus cauterization (CPC) at our center were included in the study. Using medical history data, a comprehensive survey questionnaire was designed. The findings and effects were evaluated either as a success or failure. Results A total of 90 cases were reviewed during the study. The rate of in-hospital mortality was 1.1% while the most commonly identified causes of hydrocephalus were myelomeningocele and aqueductal stenosis. A total of 39 (43.33%) patients had a successful surgery. In patients where hydrocephalus was secondary to aqueductal stenosis, the success rate was the highest, while the success rate was quite low for post-infectious hydrocephalus and intraventricular hemorrhage (p < 0.0001). The postoperative complication rate was 55.56% in our study. The rate of in-hospital mortality was 1.1%. Conclusions We found that the success rate of ETV was dependent upon factors such as the cause of hydrocephalus, type of hydrocephalus, and the age of the patient. Therefore, ETV is not suitable for all patients, and vigilance must be undertaken in selecting patients for the procedure. The rate of postoperative infections in our institution was alarmingly high which is a concerning matter for the institution.
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BACKGROUND AND OBJECTIVES: To determine the seroprevalence of SARS-CoV-2 antibodies and the associated risk factors among healthy blood donors from Peshawar Pakistan, during the second and third waves of the COVID-19 pandemic. METHODS: The study was conducted on 4047 healthy (with no history or symptoms of COVID-19) blood donors attending regional blood center Peshawar between Nov 2020 and June 2021. Demographic data was collected and donors were screened for the presence of anti-SARS-CoV-2 antibodies using electrochemiluminescence immunoassay (ECLIA). RESULTS: The mean age of the participants was 27.27±7.13 and the majority (99%) were males. Overall, 59% (2391/4047) of the blood donors were reactive for SARS-CoV-2 antibodies. An increasing trend in seropositivity was observed from 45.5% to 64.8% corresponding to the second and third wave of the pandemic in Pakistan. Logistic regression analysis revealed significantly higher odds of seropositivity among male donors compared to females. Similarly, in multivariable analysis, the odds ratio for seropositivity among blood types AB, A, and B were, 1.6, 1.4, and 1.3 (CI 95%) times higher compared to blood group O (P-value ≤0.0001). CONCLUSIONS: Seropositivity of SARS-CoV-2 antibodies among blood donors gradually increased during the second and third wave of the pandemic in Pakistan indicating a widespread prevalence of Covid-19 in the general population. Susceptibility to SARS-CoV-2 varies with ABO blood types, with blood group O associated with low risk of infection.
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OBJECTIVES: To determine the effect of moderate-intensity physical activity on glycemic control and antioxidant status in the prediabetic population. METHODS: This experimental study was carried out in the Physiology Department, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan. A total of 50 adult prediabetic subjects having 22 females and 28 males with the age range of 18 to 35 years were included. Diagnosis of prediabetes was made by glycated hemoglobin falling in the range of 5.7-6.4%, and impaired fasting glucose (100-125 mg/dL). Anthropometric measurements and biochemical assays were carried out at pre and post-exercise intervention. The participants performed moderate exercise of 30 min with heart rate max 7% ± 5% for 5 days a week for 8 weeks, monitored with pedometer. Enzyme-linked immunosorbent assay was carried out for individual and total antioxidants. RESULTS: Anthropometric parameters showed a significant decrease at post-exercise analysis. Similar changes were observed for fasting glucose (p<0.001) and glycated hemoglobin (p<0.001). Slight increase in uric acid (p<0.005) and total antioxidant concentration (p<0.001) were found. However, superoxide dismutase, glutathione peroxidase, vitamin C, and nitric oxide decreased (p<0.001). CONCLUSION: Moderate physical activity for 8 weeks significantly reduced the individual antioxidant levels, nominal increase in total antioxidant capacity and uric acid, and there was an explicit decline in the anthropometric and diabetic profile of prediabetic population.
Subject(s)
Antioxidants , Prediabetic State , Adolescent , Adult , Blood Glucose , Exercise , Female , Glycemic Control , Humans , Male , Young AdultABSTRACT
INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder and the main cause of infertility in women of reproductive age. Affected women suffer from insulin resistance and present with an intense stress response. Treatment with insulin sensitizers alone and in combination is used to ameliorate the signs and symptoms associated with the disease. This study was designed to compare the endocrine and metabolic parameters as well as subjective and objective measures of stress in women with PCOS before and after treatment with acetyl-L-carnitine (ALC) and metformin plus pioglitazone. METHODS: A total of 147 women with PCOS were randomly assigned into two groups: the combo group (n = 72) received a combination of metformin, pioglitazone, and ALC (500 mg, 15 mg, and 1500 mg, respectively), twice daily; the Met + Pio group (n = 75) received metformin plus pioglitazone (500 mg, 15 mg, respectively) and placebo (citric acid plus calcium carbonate), twice daily for 12 weeks. Medications were discontinued when pregnancy was confirmed. The Perceived Stress Scale (PSS14) and Profile of Mood States (POMS) were employed as subjective measures of stress. The endocrine and metabolic functions of women with PCOS were assessed by measuring insulin, leutinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and adiponectin levels in fasting blood samples. Insulin resistance was calculated by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). RESULTS: Women at baseline had significantly elevated circulating concentration of insulin and low level of adiponectin. Treatment decreased insulin in both groups; however, the combo group showed a significant decrease (p = 0.001). Serum adiponectin level was raised significantly after treatment in both groups (p < 0.001). HOMA-IR also decreased in both groups (both p < 0.001). Testosterone, FSH, and LH significantly improved in both groups. LH also decreased in both groups; however, the change was significant only in the combo (metformin plus pioglitazone plus ALC) group (p = 0.013). Interestingly, there was a significant improvement in body circumference (p < 0.001) in the combo group. The PSS scores of the patients improved significantly (p < 0.001) in the combo group. Interestingly, regular menstrual cycles were found (97.2%) in the carnitine group, but in only 12.9% of the other group. CONCLUSION: We conclude that addition of ALC therapy is superior to metformin plus pioglitazone in ameliorating insulin resistance, polycystic ovaries, menstrual irregularities, and hypoadiponectinemia in women with PCOS. TRIAL REGISTRATION: Trial registration: clinicalTrial.gov NCT04113889. Registered 3 October, 2019. https://clinicaltrials.gov/ct2/show/NCT04113889 .
Subject(s)
Insulin Resistance , Metformin , Polycystic Ovary Syndrome , Acetylcarnitine/therapeutic use , Female , Humans , Hypoglycemic Agents/therapeutic use , Insulin , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/drug therapy , PregnancyABSTRACT
This study aims to explore the role of conventional beliefs and social stigma on attitude towards access to mental health services. From 50 caregivers data were collected by Perceived Public Stigma Scale and an in-depth semi-structured interview. The majority (86%) of patients having significant symptoms of major mental illness visited traditional healer prior to engagement with the mental health services. However a significant positive finding, related to carers predominantly perceiving that individuals with mental health difficulties were trustworthy, capable of engagement in employment and were comfortable with having them as their friends were identified.
Subject(s)
Caregivers/psychology , Health Services Accessibility , Mental Disorders/epidemiology , Mental Disorders/psychology , Mental Health Services/statistics & numerical data , Social Stigma , Adolescent , Adult , Female , Health Care Surveys , Health Knowledge, Attitudes, Practice , Humans , Interviews as Topic , Male , Pakistan , Qualitative Research , Socioeconomic Factors , Young AdultABSTRACT
BACKGROUND: Spontaneous preterm labour refers to the onset of uterine contractions of sufficient strength and frequency to effect progressive dilatation between 24 and 37 weeks of gestation. The objective of the study was to determine an association between risk factors and spontaneous preterm labour with intact foetal membranes. METHODS: A case control study was designed which was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital, Abbottabad. Sample size of 262 subjects was equally divided into two equal groups (131 cases and control each). Non-probability consecutive sampling was used collection of samples. Pregnant women presenting after 24 weeks of gestation with spontaneous preterm labour with intact membranes were considered as cases. While, pregnant women presenting after 37 complete weeks of gestation with normal pregnancy were considered as controls. The diagnosis of bacterial vaginosis was established by Amsel criteria. Asymptomatic bacteriuria was diagnosed by microscopy. Odds ratios were calculated as measure of association with calculation at 95% confidence interval. Level of 5% (p<0.05) was used to test for significant difference. RESULTS: Mean±SD age of cases was 26.97±7.072. Subjects with young maternal age (<20 years) were 27 (10.3%) from cases and 12 (4.6%) from controls (OR=2.575, 95% CI: 1.242, 5.338). The subjects with advanced maternal age (>35 years) were 26 (9.9%) from cases and 15 (5.7%) from controls (OR=0.522, 95% CI: 0.262, 1.039). 25 (19.1%) cases and 6 (4.6%) controls had bacterial vaginosis (OR=4.914, 95% CI: 1.943, 12.426). Asymptomatic bacteriuria was present in 03 (2.3%) subjects from cases and 2 (1.5%) from controls (OR=1.512, 95% CI: 0.248, 9.199). CONCLUSIONS: The study concluded that risk factors like young maternal age and bacterial vaginosis are significantly associated with spontaneous preterm labour with intact foetal membranes. While, association of other risk factors like advanced maternal age and asymptomatic bacteriuria with spontaneous preterm labour is still debatable.
Subject(s)
Obstetric Labor, Premature/epidemiology , Vaginosis, Bacterial/epidemiology , Adult , Bacteriuria/diagnosis , Bacteriuria/epidemiology , Case-Control Studies , Female , Humans , Pakistan/epidemiology , Pregnancy , Risk Factors , Vaginosis, Bacterial/diagnosisABSTRACT
BACKGROUND: The aim of this study was to investigate whether the learning style preferences of post-graduate medical students change with time when they enter a new learning environment. The learning styles of post-graduate medical students from Pakistan were assessed on Kolb's Learning style inventory and prospectively monitored for any change when the students entered a degree program at the University of Glasgow. METHODS: Medical doctors from Pakistan who joined post graduate program in Evidence Based Medicine and Health Professions Education participated in the study. Kolb's learning style inventory was used to evaluate the learning preferences. Learning styles were evaluated twice in the study, in the first term of the course and then at the end, with a time span of 7 months. RESULTS: The predominant learning style preferences of students were 'Assimilating' type, both at the beginning and at follow up. Some change in the learning style preferences of students was noted as 2/10 students moved to a different learning grid at follow-up. These results were assessed against gender, clinical and teaching experience using linear regression however no significant correlation was found. CONCLUSIONS: There was not enough evidence to suggest that learning style preferences of students change in a meaningful way after coming to a new learning environment. This study however, leads to a suggestion that further large sized longitudinal study should be done with enough statistical power to accept or reject the null hypothesis.
Subject(s)
Education, Medical, Graduate , Learning , Students, Medical/psychology , Adult , Female , Humans , Longitudinal Studies , Male , Pakistan , Scotland , Surveys and QuestionnairesABSTRACT
Infantile and childhood-onset cataracts form a heterogeneous group of disorders; among the many genetic causes, numerous pathogenic variants in additional genes associated with autosomal-recessive infantile cataracts remain to be discovered. We identified three consanguineous families affected by bilateral infantile cataracts. Using exome sequencing, we found homozygous loss-of-function variants in DNMBP: nonsense variant c.811C>T (p.Arg271∗) in large family F385 (nine affected individuals; LOD score = 5.18 at θ = 0), frameshift deletion c.2947_2948del (p.Asp983∗) in family F372 (two affected individuals), and frameshift variant c.2852_2855del (p.Thr951Metfs∗41) in family F3 (one affected individual). The phenotypes of all affected individuals include infantile-onset cataracts. RNAi-mediated knockdown of the Drosophila ortholog still life (sif), enriched in lens-secreting cells, affects the development of these cells as well as the localization of E-cadherin, alters the distribution of septate junctions in adjacent cone cells, and leads to a â¼50% reduction in electroretinography amplitudes in young flies. DNMBP regulates the shape of tight junctions, which correspond to the septate junctions in invertebrates, as well as the assembly pattern of E-cadherin in human epithelial cells. E-cadherin has an important role in lens vesicle separation and lens epithelial cell survival in humans. We therefore conclude that DNMBP loss-of-function variants cause infantile-onset cataracts in humans.
Subject(s)
Cataract/genetics , Cytoskeletal Proteins/genetics , Genetic Predisposition to Disease/genetics , Genetic Variation/genetics , Loss of Heterozygosity/genetics , Adult , Alleles , Animals , Cadherins/genetics , Child , Drosophila/genetics , Epithelial Cells/pathology , Exome/genetics , Female , Homozygote , Humans , Lod Score , Male , Middle Aged , Pedigree , Phenotype , Tight Junctions/pathologyABSTRACT
BACKGROUND: Angiogenesis is involved in many cardiovascular and cancerous diseases, including atherosclerosis and is controlled by a fine balance between angiogenic and angiostatic mediators. Endostatin is one of the main angiostatic mediators, and inhibits angiogenesis and prevents progression of atherosclerosis. The available literature shows a broad range of concentrations in relatively small samples of healthy controls and is calculated by using different techniques. This study was aimed to determine the basal endostatin concentration in plasma of healthy volunteers, to fully understand its physiological role. METHODS: Fifty healthy adult volunteers were recruited to the study. Participants were advised not to participate in any physical activity on the day before the blood sampling. The volunteers' physical activity, height, weight, heart rate and blood pressure were recorded. The samples were analysed for plasma endostatin concentration, using ELISA. The participants were divided by gender and ethnic groups to calculate any difference. RESULTS: Endostatin and other variables were normally distributed. Most of the participants had a moderate level of physical activity with no gender related difference (p=0.370). The mean value for plasma endostatin in all samples was 105±12 ng/ml with range of 81-132 ng/ml. For males, it was 107±13 ng/ml, while for females; 102±12 ng/ml. There were no significant gender or ethnicity related differences in endostatin concentration. Moreover, endostatin was not significantly related with any anthropometric and physical variable. CONCLUSIONS: This study gives endostatin levels in normal healthy people and show no gender and ethnicity related differences in endostatin levels. Endostatin was not related with any anthropometric and physical variable.
Subject(s)
Endostatins/blood , Adult , Enzyme-Linked Immunosorbent Assay , Exercise , Female , Healthy Volunteers , Humans , Male , Reference Values , Young AdultABSTRACT
Despite a large body of research evaluating factors associated with the relapse of psychosis in schizophrenia, no studies in Pakistan have been undertaken to date to identify any such factors, including specific cultural factors pertinent to Pakistan. Semistructured interviews and psychometric measures were undertaken with 60 patients diagnosed with schizophrenia (49 male and 11 female) and their caregivers at four psychiatric hospitals in the Peshawar region in Pakistan. Factors significantly associated with psychotic relapse included treatment non-adherence, comorbid active psychiatric illnesses, poor social support, and high expressed emotion in living environments (P < 0.05). The attribution of symptoms to social and cultural values (97%) and a poor knowledge of psychosis by family members (88%) was also prevalent. In addition to many well-documented factors associated with psychotic relapse, beliefs in social and cultural myths and values were found to be an important, and perhaps treatable, factor associated with relapse of psychosis in Pakistan. The provision of evidence-based psychotherapeutic interventions, such as behaviour and family therapy and cognitive behaviour therapy for psychosis, could potentially ameliorate the relapse rate of psychosis in Pakistan.
Subject(s)
Schizophrenia/etiology , Adult , Antipsychotic Agents/therapeutic use , Culture , Family/psychology , Female , Humans , Interview, Psychological , Male , Medication Adherence/psychology , Pakistan , Recurrence , Risk Factors , Schizophrenia/drug therapy , Young AdultABSTRACT
BACKGROUND: Peer Assisted Learning (PAL) is a well-established approach in learning and is increasingly being utilized in the medical education system. It is a process where active help of peer group members is taken for learning. This study aimed to look at the impact of peer assisted learning on the students at the end of the session. METHODS: Sixteen Postgraduate students attending Evidence Based Medicine (EBM) course spanning over two semesters (6 months each) were recruited. It was a cross sectional study and non-probability convenience sampling technique was used for gathering data. All students enrolled in EBM course conducted an hour-long PAL session during the coursework. At the end of the semester a link to an online questionnaire was sent to all the participants. A set of both open and closed ended questions were included in the questionnaire. RESULTS: Response rate was 87.5%, 14 out of the 16 students completed the questionnaire. The results showed an affirmative change in the behaviour and attitude of the participants' after the workshops. Majority of the respondents were of the opinion that it was a valuable experience and they benefitted through involvement in the process. Most of the postgraduate students suggested that it should be implemented in post graduate studies especially medical education. CONCLUSIONS: PAL is more interactive and informal way of teaching and it helps in the professional development, if peers from different specialties are gathered. However, study with a larger sample size are suggested to prove the generalizability of this assertion.
Subject(s)
Education, Medical, Undergraduate/methods , Evidence-Based Medicine/education , Peer Group , Adult , Cross-Sectional Studies , Female , Humans , Male , Pilot Projects , Surveys and QuestionnairesABSTRACT
This study investigates the magnetohydrodynamic (MHD) flow of ferrofluid along a stretching cylinder. The velocity slip and prescribed surface heat flux boundary conditions are employed on the cylinder surface. Water as conventional base fluid containing nanoparticles of magnetite (Fe3O4) is used. Comparison between magnetic (Fe3O4) and non-magnetic (Al2O3) nanoparticles is also made. The governing non-linear partial differential equations are reduced to non-linear ordinary differential equations and then solved numerically using shooting method. Present results are compared with the available data in the limiting cases. The present results are found to be in an excellent agreement. It is observed that with an increase in the magnetic field strength, the percent difference in the heat transfer rate of magnetic nanoparticles with Al2O3 decreases. Surface shear stress and the heat transfer rate at the surface increase as the curvature parameter increases, i.e curvature helps to enhance the heat transfer.