ABSTRACT
Objective: To determine the role of ghrelin in stimulating leukopoiesis of myelosuppressed rats by stimulating growth hormone release
Study Design: Randomized controlled trial
Place and Duration of Study: It was conducted at Department of Physiology, Foundation University Medical College, in collaboration with National Institute of Health, Islamabad, from February 2013 to June 2014
Material and Methods: Out of 130 Sprague-Dawley rats, 10 were used for baseline sampling and rest was randomly divided into four groups. Group I received ghrelin only while group II and III were administered intraperitoneally with both carboplatin and 5-flurouracil with and without rat ghrelin. Group IV in addition to chemotherapy and ghrelin received growth hormone releasing hormone antagonist [GHRH antagonist]. Total leukocyte count, differential leukocyte count and growth hormone levels were measured on day 7 and 14
Results: The fall in leukocyte count of chemotherapy and ghrelin group on day 7 was less as compared to the chemotherapy-only treated group and chemotherapy, ghrelin and growth hormone releasing hormone antagonist treated group [p<0.05]. Further decreases were also prevented in the chemotherapy and ghrelin group. The serum growth hormone levels in chemotherapy and ghrelin treated group were higher as compared to the chemotherapy and chemotherapy, ghrel in, GHRH antagonist treated group [p< 0.05]
Conclusion: Enhanced leukopoiesis in ghrelin treated myelosuppressed rats as compared to the chemotherapy group [p<0.05] suggest role of ghrelin in enhancing leukopoiesis. While the failure of enhanced leukopoiesis and growth hormone level to rise in chemotherapy, ghrelin and GHRH antagonist treated group suggested the possibility of growth hormone as possible mediator of ghrelin in leucopoiesis
ABSTRACT
Mortality and morbidity rates in patients on haemodialysis vary among different countries widely due to variation in vascular access practices. Documented evidence of patterns and practices of various vascular access modalities in our population is scarce to allow for development of local guidelines or formulating steps to encourage adoption of international guidelines in Pakistani healthcare setup. To assess Vascular Access practices for haemodialysis patients in five dialysis facilities of Northern Pakistan. Cross sectional study. This study was carried out at five dialysis facilities in three cities of Northern Pakistan over a period of one year from March 2011 to March 2012. This cross sectional survey was completed by interviewing 536 end stage renal disease patients between 18 to 70 years of age over a period of one year. Duration of dialysis, types of access, current state and past history of vascular access were recorded and compared with International guidelines. Commonest 'current vascular access' was found to be AV fistula in 317 out of 536 patients [almost 60%] and the most common mode of 'first Vascular Access' [i.e. vascular access first used for haemodialysis] was catheter [83%]. Amongst patients who had dialysis during last eight months, 76.27% were still being dialysed via percutaneous catheters while this figure is less than 34% in Europe. Although the initial mode of dialysis in most cases is a line yet, majority of patients are dialyzed through native fistula. Need for a pre-emptive fistula is required to have superior longevity and fewer complications in haemodialysis patients
Subject(s)
Humans , Female , Male , Vascular Access Devices , Cross-Sectional Studies , Renal Dialysis/adverse effects , Renal Dialysis/mortalityABSTRACT
Prophylaxis of deep vein thrombosis [DVT] is underutilised in Pakistan. This crosssectional survey was designed to evaluate knowledge, attitude and practices of healthcare providers towards DVT prophylaxis in teaching hospitals in and around Rawalpindi. Knowledge, attitude and practices was assessed by a 12-item questionnaire filled-in by healthcare providers in five teaching hospitals. Eleven out of 12 questions were multiple-choice type and one was open ended. One hundred-sixty-nine, out of 200 questionnaires were returned and were analysed. Total 43.2% of the respondents were house-officers. Although 98.8% agreed that DVT prophylaxis is clinically important, but 39.4% actually prescribed it themselves. Out of these, only 10.3% respondents did it routinely. Low molecular weight heparin [LMWH] was the preferred prophylaxis used [36.7%]. Most of the respondents underestimated the prevalence and consequences of DVT in hospitalised patients. Knowledge and practices of healthcare providers about DVT prophylaxis in hospitalised patients is less than ideal. Hospitals need to develop their own guidelines for DVT prophylaxis.
ABSTRACT
Background: Problem based learning [PBL] tutorials are being used in various medical schools world wide. Students' active participation is a must for the success of a teaching program. The objective of this study was to evaluate the effectiveness of PBL Wrap-up sessions in an integrated modular medical curriculum in enhancing the generic skills of medical students. Methodology: This study was conducted on 100 students of 2nd year MBBS who had been taking PBL sessions since 1½ years. Each session concluded with a wrap-up session where students demonstrated their acquired knowledge in the form of PowerPoint presentations, concept maps, skits, models etc. A questionnaire based survey was conducted to find out overall effectiveness of PBL sessions including wrap-up sessions. The questionnaire comprised of 15 questions. Students were asked to rate all those sessions on a likert scale of 1 to 5. Results: Student's responses showed 'Moderate improvement' in 8 out of 15 skills like communication with peers and teachers, presentation skills, self confidence, application of acquired knowledge, using internet and other resources and understanding group dynamics. Improvement in abilities like problem solving, time management, creativity, motivation in studies and self-directed learning was 'Minimal'. In addition students recommended continuation of PBL in the same way for future classes. Conclusion: PBL with wrap-up sessions contributed in bringing moderate enhancement of generic learning skills in students which were not properly addressed in the traditional curriculum and are therefore recommended for future implementation