Effect of gender and physical activity on internet addiction in medical students

Objective: To determine the effect of gender and physical activity on internet addiction in medical students

Methods: In this cross sectional, analytical study Young's internet addiction test questionnaire was distributed to 350 MBBS students of Army Medical College, Rawalpindi. The study was conducted from January to May 2015. A dichotomous response from students regarding physical activity was obtained which was verified from the sports department of the institution. Based upon total score, internet addiction was categorized as no addiction if the score was less than or equal to 49, moderate addiction when the score was 50 to 79 and severe when the score was 80 to 100

Results: Out of 322 respondents 175 [54.3%] were males and 147 [42.7%] females with a mean age of 19.27 +/- 1.01 years. Total internet addiction score and frequency of internet addiction were similar between males and females [37.71 +/- 11.9 vs 38.63 +/- 14.00, p=0.18 and 25 vs 29, p=0.20]. However, total score and frequency of internet addiction were higher in students lacking physical activity as compared to those with regular physical activity [40.37 +/- 15.05 vs 36.38 +/- 11.76, p=0.01 and 30 vs 24, p=0.01]

Conclusion: Internet addiction is unrelated to gender however it is inversely related to physical activity

Index Admission Laparoscopic Cholecystectomy for Gall Stone Pancreatitis.

Background: Timing of Laparoscopic Cholecystectomy (LC) after gallstone pancreatitis varies considerably between surgeons.We examined outcomes at JN Medical College and hospital where most patients underwent LC following initial management of gallstone pancreatitis. Methods: This prospective study is carried out between June2009 to June 2013 in J.N.M.C.H. Patients with signs and symptoms of acute pancreatitis were admitted and evaluated. All patients admitted were provided the standard care. After exclusion of some patients, remaining underwent laparoscopic cholecystectomy irrespective of severity of disease in index admission, although patients with severe biliary pancreatitis were operated after stabilization of general condition. Results: A total of 134 patients with gallstone pancreatitis were identified of whom 90 underwent laparoscopic cholecystectomy (LC) in the index admission.77 patients were of mild pancreatitis while 13 were of severe pancreatitis. Out of 77 patients with mild pancreatitis 8 patients and 6 out of 13 patients with severe pancreatitis had a difficult dissection (p value<0.05).In terms of hospital stay mean duration of stay was 8.7 days in mild pancreatitis group, whereas it is 19.8 days in severe pancreatitis group (p value <0.05). Of these 90 patients79 (88%) underwent LC successfully while 11 (12%) required conversion to open cholecystectomy where 8 were of mild and 3 were of severe pancreatitis. 14 (15%) had a difficult dissection, where 8 were of mild and 6 were of severe pancreatitis There were 6 (6.7%) postoperative complications in form of wound infection and bile leak overall. The difference in terms of variables like conversion rate to open surgery, need of drain placement, bile leak and wound infection was statistically not significant.Conclusion: LC should be used for GSP during the same hospital admission with favorable outcome with complications and conversion rate compared to elective LC. All patients of mild pancreatitis and patients of severe pancreatitis with no local and systemic complications could undergo laparoscopic cholecystectomy in index admission.

Association of magnesium levels with lipid profile and inflammatory markers in thiazide induced hypomagnesemic rats

Objective: To study the effect of Magnesium supplementation on lipid profile [TC, HDL, LDL, TG, VLDL] and inflammatory markers [CRP s-VCAM 1] in thiazide administered rats

Study Design: Randomized control trial

Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College Rawalpindi from Feb 2010 to Feb 2011

Material and Methods: Ninety male Sprague Dawley rats, of age 90 to 120 days, divided into three groups: Control, Hydrochlorothiazide [HCTZ] administered control and Hydrochlorothiazide + Magnesium Oxide [HTCZ + Mg2+], administered experimental groups. Levels of inflammatory markers, Magnesium, lipid profile were measured in blood, after three weeks

Results: Mean values in control group were: Serum TG 104.39 mg/dl,TC151.86 mg/dl, HDL76.91 mg/dl, LDL 52.52 mg/dl, VLDL 19.78mg/dl, CRP 1784.27 mg/L, sVCAM-1 564.33ng/ml and serum Magnesium0.85mmol/l. Mean lipid profile values in HCTZ administered control group were Serum TG 150.04 mg/dl, TC 182.92 mg/dl, HDL 71.77 mg/dl, LDL 76.40 mg/dl,VLDL 32.56 mg/dl, CRP 2923.33 mg/L, sVCAM-1 2003.00 ng/ml and serum Magnesium 0.49 mmol/1. Mean lipid profile values in HCTZ + Magnesium administered experimental group were Serum TG 131.69 mg/dl,TC 157.60 mg/dl, HDL 73.55 mg/dl,LDL 58.2 mg/dl,VLDL 25.05mg/dl, CRP 2149.53 mg/L ,sVCAM-l 1516.60 ng/mland serum Magnesium 0.68mmol/l

Conclusion: Levels of sVCAM-1, CRP, TG, TC, LDL and VLDL are increased in HCTZ administered group, with negative correlation with serum magnesium levels. Levels of these parameters decreased in HTCZ + Mg2+ administered group, showing that magnesium supplementation helped in normalizing derangements [p<0.05]

Arrhythmogenesis in mitral valve prolapse; risk stratification - role of high resolution ECG, Holter monitoring and Mitral leaflet geometry

Mitral valve prolapse is generally considered a benign condition, however, a subset of patients remains at high risk of arrhythmogenesis which may lead to sudden cardiac death. To stratify risk of arrhythmogenesis in patients with mitral valve prolapse on the basis of high resolution ECG, Holter monitoring, resting heart rate and mitral leaflet geometry. Cross sectional comparative study. Armed Forces Institute of Cardiology [AFIC]/National Institute of Heart Diseases, Rawalpindi and Army Medical College, Rawalpindi, Pakistan Mitral leaflet displacement and thickness were measured on echocardiography in 37 patients with mitral valve prolapse. Resting heart rate and time domain indices of heart rate variability of each patient were recorded from 24 hours Holter monitoring. High resolution ECG of all the patients was carried out to record ventricular late potentials. Statistical analysis was performed using SPSS and the alpha value was set at <0.05 for significance. The mean values for resting heart rate, leaflet displacement and leaflet thickness were 77.19 +/- 6.29 per minute, 3.64 +/- 0.92 mm and 4.96 +/- 0.79 mm respectively. Ventricular late potentials were present in 8 [21.62%] whereas heart rate variability was reduced in 5 [13.51%] patients. Leaflet thickness was significantly greater in patients with ventricular late potentials as compared to those without [p-value 0.004]. Patients with reduced heart rate variability had significantly higher resting heart rate as compared to those with normal variability [p-value 0.02]. One patient [2.7%] had ventricular late potentials, reduced heart rate variability, resting heat rate of 88 beats per minute and leaflet thickness over 5 mm. Combined effects of high resolution ECG, holter monitoring and leaflet geometry identified the high risk subset, comprising of 2.7% of the study population

Obesity; effect of high fat diet followed by atorvastatin administration onserum interleukin-6, white blood cell and platelet count in male and female spraguedawley rats

To study the effects of atorvastatin administration on serum IL-6, WBC and platelet count in obese male and female animal models. Randomized control trial [RCT]. The study was conducted at Department of Physiology, Army Medical College, Rawalpindi in collaboration with National Institute of Health [NIH], Islamabad and Centre for Research in Experimental and Applied Medicine [CREAM], Army Medical College, Rawalpindi for funding, blood sampling and biochemical assays respectively. Ninety healthy male and female Sprague Dawley rats were selected and randomly divided into three equal groups. Group I rats were fed normal diet for a period of three weeks. Group II rats were fed high fat diet for a period of three weeks to induce obesity. Group III rats were administered atorvastatin 10 mg/kg/day orally by gavage method for three weeks after obesity induction. Terminal sampling by intra-cardiac puncture was done at the end of study. Whole blood was used to perform blood complete picture by KX 21 Sysmex Hematology Analyzer which includes platelet count and WBC count and serum was used to measure IL-6 levels by Enzyme Linked Immunosorbant Assay [ELISA]. There was a significant decrease [p<0.05] in serum IL-6 levels and WBC count, whereas platelet count was not significantly [p>0.05] affected by atorvastatin administration. Although atorvastatin reduces obesity related inflammation by decreasing serum IL-6 levels and WBC count, it has no effect on platelet count in male and female obese animal models

Dual effect of atorvastatin on endothelium; reduction In LDL And TXA2 levels but unaltered HCY levels In obese hyperlipidemic rats

Objective: The objective of the study was to observe the effect of lipid lowering therapy on homocysteine and TXA[2] concentration in obese hyperlipidemic Sprague Dawley rats

Design: Randomized Control Trial [RCT]

Place and Duration of study: The study was conducted in Department of Physiology and Centre for Research in Experimental and Applied Medicine [CREAM], Army Medical College, Rawalpindi; and National Institute of Health [NIH] Islamabad over a period of 12 months

Methodology: Ninety healthy Sprague Dawley rats divided into three equal groups. Group I [n=30] were healthy controls, group II [n=30] were made obese and group III [n=30] were obese treated [atorvastatin 10 mg/kg/day orally by gavage method for three weeks]. Body weight was recorded thrice weekly, lipid profile was measured by colorimetric method on microlab and homocysteine and TXA2 were measured by Enzyme Linked Immunosorbant Assay

Results: Serum low density lipoproteins and TXA2 decreased after three weeks of atorvastatin administration, elevated HCY concentration in obese hyperlipidemic rats however was not significantly affected

Conclusion: Atorvastatin apart from lowering lipid levels in the body also reduces TXA[2] concentration which is a vasoprotective. Elevated HCY concentration which is deleterious to the endothelium however is not affected

Effect of tocotrienol on aortic atherosclerosis in diabetic mice

To study the hstomorphological effect of tocotrienol on aortic atherosclerosis in diabetic mice having high fat diet. Lab based randomized controlled trial. Army Medical College, Rawalpindi and National Institute of Health, Islamabad from November 2009 to June 2010. Forty five female BALB/c mice were randomly divided into three groups. The diabetic mice model was established by intraperitoneal injection of streptozotocin [STZ] 40 mg/kg body weight. Group A was given normal laboratory diet, group B high fat diet and group C was given tocotrienol along with hgh fat diet for 32 weeks. At the end of experiment the mice were sacrificed. The hearts of animals were dissected out and ascending aortae were taken out. The specimen was fixed in 10% form01 calcium and processed for paraffin embedding. Five micrometer thick sections were made for haematoxylin and eosin, and Verhoeff's staining. After staining, hstomorphologic changes in slides were noted. In contrast to group A, atheroscelrosis developed in groups B and C. Statistically significant atherosclerotic changes were found in the aortae of diabetic mice in group B when compared to group A. On comparison of group A to C, atherosclerotic changes were statistically insigmficant. However when group B was compared with group C, the aortic atherosclerotic changes decreased sigruficantly in group C. In diabetics with high fat diet intake, there is an increase in development of atherosclerosis in aorta which can be reduced by tocotrienol

Diabetic patients; study of inflammatory markers

Inflammation is the one of the major causes for development of type 2 diabetes mellitus and its complications. In this study, association between inflammation and type 2 diabetes mellitus was studied by measuring various inflammatory markers [soluble vascular cell adhesion molecules type - 1, Interleukin - 6 and C- reactive protein] between healthy and diabetic patients. A cross sectional comparative study. The study was conducted at Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi in collaboration with Combined Military Hospital, Rawalpindi and Centre for Research in Experimental and Applied Medicine [CREAM], Army Medical College, Rawalpindi for blood sampling and biochemical assays respectively. The study was performed in 40 human subjects divided into two groups containing 20 subjects each. One group was designated as control while the other was diseased [diabetic] group. Glycemic status was measured to confirm their normal and diabetic state. Inflammatory markers were measured by Enzyme Linked Immunosorbent Assay [ELISA]. Levels of all inflammatory markers [soluble vascular cell adhesion molecules type - 1, Interleukin - 6 and C-reactive protein] were found to be raised in the experimental diabetic groups; 1991.5 +/- 201.97 ng/ml, 24.99 +/- 1.366 pg/ml and 2931 +/- 168.319 respectively compared to the control group; 570.2 +/- 16.526 ng/ml, 6.64 +/- 0.3516 pg/ml and 1806.6 +/- 183.32 respectively. Inflammatory markers were significantly elevated in patients with diabetes mellitus as compared to normal healthy control subjects

effect of olive-pomace oil on different blood parameters in streptozotocin induced diabetic rats

To determine the effects of olive-pomace oil on glycemic status and lipid profile in diabetes. Study Design: Randomized controlled trial. Department of Biochemistry, Army Medical College, Rawalpindi in collaboration with Centre for Research in Experimental and Applied Medicine, Army Medical College, Rawalpindi and National Institute of Health, Islamabad from March 2010 to June 2011. Seventy male albino rats of Sprague-Dawley strain were randomly divided into two groups of 35 rats, each. Rats were rendered diabetic by injecting streptozotocin. Group 1 and group 2 were given normal rodent diet and olive pomace oil supplemented diet respectively for 6 weeks. At the end of the experiment fasting blood glucose and lipid profile were measured for comparison. There was significant increase in high density lipoprotein and significant decrease of blood glucose, total cholesterol and low density lipoprotein of group II rats when compared with group I [control]. Olive pomace oil can significantly improve fasting blood glucose and lipid profile in diabetic rats

Association of allergic rhinitis with gender and asthma

Allergic rhinitis and asthma are chronic inflammatory conditions of airways sharing common pathophysiology. The two disorders have similar cellular responses, with different symptoms based on the differences in the physical structures involved. Studies have shown that allergic rhinitis has a major impact on asthma morbidity and that treating allergic rhinitis may also impact asthma control. The objective of this study was to determine association of allergic rhinitis with gender and asthma. In this cross-sectional study, 100 patients with allergic rhinitis and equal number of patients without allergic rhinitis were included. Patients were excluded if they were smokers or if they had respiratory infection within the month preceding the study. Allergic rhinitis was diagnosed on history, nasal smear and blood complete picture. In both groups, patients having asthma, pre-diagnosed by the physician were isolated and their frequency was calculated. Ninety-two male and 108 female patients with mean age 30.72 +/- 12.58 were included in the study. Odds ratio for allergic rhinitis patients and asthmatics was 5.05 [p<0.05]. Association of allergic rhinitis with gender was also statistically significant [p<0.05]. Multiple regression analysis showed predictability of allergic rhinitis from asthma at p<0.05. Allergic rhinitis is significantly associated with gender and asthma

effect of plasma thiamine deficiency on the antioxidant status of type 2 diabetics having diabetic nephropathy

To see the effects of plasma thiamine on the antioxidant status of the body by measuring plasma thiol levels in type 2 diabetic patients with diabetic nephropathy. Cross sectional comparative study. Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, from January 2009 to December 2010. The study included 80 participants, 20 were control and 60 were known diabetics who were inducted from various diabetic clinics of urban areas of Rawalpindi. The participants were divided into three groups based on their albuminuria status. Group I [n=20] consisted of healthy volunteers having blood glucose level <6 mmol/L, group II [n=20] consisted of normoalbuminurics type 2 diabetics, groups III [n=20] consisted of microalbuminuric type 2 diabetics and group IV [n=20] consisted of macroalbuminuric type 2 diabetics. Fasting blood samples of diabetic and control groups were analyzed for glucose, glycosylated hemoglobin [HbA1c] for the assessment of glycemic status, thiol for antioxidant status, thiamine chloride and thiamine monophosphate for assessment of thiamine status. Twenty four hour urine samples were analyzed for microalbuminuria, thiamine chloride and thiamine monophosphate. Plasma thiol levels were significantly reduced in diabetics as compared to normal controls. Moreover, the thiol levels decreased with increasing urinary albumin excretion, being lowest in the macroalbuminuric group. Furthermore, a significant positive correlation was found between plasma thiamine and plasma thiol levels in all the groups. Thiamine levels are reduced in the diabetic population and this thiamine deficiency is positively correlated with plasma thiol levels in diabetics. Furthermore this progressive decline in the plasma thiol level corresponds to the increase in urinary albumin excretion

Effects of ascorbic acid and alpha tocopherol supplementation on basal testosterone cortisol ratio in male sprague dawley rats

Basal testosterone cortisol ratio is considered very important to maintain homeostasis. Increase in this ratio has various beneficial effects on body. In this study we determined the effects of ascorbic acid and alpha tocopherol supplementation on basal testosterone cortisol ratio in male Sprague Dawley rats. It was quasi experimental study carried out in department of Physiology, Army Medical College Rawalpindi in collaboration with National Institute of Health, Islamabad during October 2006 to September 2007. Forty male Sprague Dawley rats were divided into four groups with ten rats in each group and above mentioned antioxidants supplementation were given along with standard diet for one month. After this, blood samples were taken and analyzed for serum testosterone and cortisol by ELISA and malondialdehyde levels colorimetrically. Data were analysed on SPSS version 13 and p<0.05 was considered significant. There was no significant rise in testosterone cortisol ratio in rats supplemented with single antioxidant; however rats supplemented with combination of ascorbic acid and alpha tocopherol revealed significant rise in testosterone cortisol ratio with a fall in malondialdehyde levels. Synergistic effects of ascorbic acid and alpha tocopherol resulted in a decline in reactive oxygen species induced lipid peroxidation and rise of testosterone cortisol ratio

Effect of variations in insulin on serum leptin levels in pre and post menopausal women

To measure the serum leptin and insulin levels and assess that how insulin affects these levels in pre and post menopausal obese and non-obese women. The experimental work was carried out at the department of Biochemistry and Molecular Biology and Center for Research in Experimental and Applied Medicine-1 [CREAM-1], Army Medical College, Rawalpindi and was spread on a duration of 18 months. The samples for the study were obtained from healthy 80 subjects and divided into premenopausal and postmenopausal groups of 40 each. The groups were further sub-divided into obese and non obese based on the body mass index [cut off BMI value=25 kg/m[2]]. There is significant difference in the mean age [p

Effects of hormonal contraception on serum lipid profile and lipoprotein [LP [a]]

To evaluate the cardiovascular risk factor in Pakistani females, using oral and injectable contraceptives by determining lipid profile and lipoproten [a]. This study was carried out prospectively on 60 women aged between 20-45 years and compared with 30 aged matched controls conducted at Dept of Biochemistry and Molecular Biology, Army Medical College Rawalpindi and various family planning clinics of Rawalpindi and Wah Cantt. Hormonal users were mostly un-educated and controls were taken from different medical colleges and hospitals. They were educated and some of the controls were also from low socioeconomic group and un-educated. Oral contraceptive users [OC; n=30] and injectable users [IC; n=30]. They were using oral tablet lofenienal and injectables depopfovera for more than 1 year. Controls were not using any form of contraceptives. Fasting blood samples were analyzed for serum total cholesterol, triglycerides, HDL-C and LDL-C and Lp [a]. Lipid parameters were estimated by enzymatic colorimetric method and Lp [a] was analyzed by immunoterbidimetric method. The women using OCP shows significant difference in BMI [p<0.01] as compared to control. Similarly injectable users also showed significant difference in DM1 [p<0.001] as compared to control. SBP shows a significant difference in both groups A and B as compared to control [p<0.05] but DBP was higher in injectable users only [p<0.05] and group A was higher than group C but difference was not significant. The level of HDL-C is decreased significantly [P<0.05] in groups A and B as compared to control. Lipoprctein [a] in both groups A and B showed higher levels than control [p<0.0001]. It is suggested therefore that women using hormonal contraceptives are prone to develop atherosclerosis and coronary artery disease earlier as compared to women not using contraceptives

Pulmonary function test in a cohort of older Pakistani population

Pulmonary function test [PFT] depends on a number of factors as height, age, gender and race. Reference equations are used to determine a normal range of spirometry results which in turn are used clinically to determine whether the volumes measured in any individual fall within a range to be expected in a healthy person of the same gender, height and age. The study was conducted in Karachi on 249 healthy, nonsmoking subjects between 35 to 65 years of age were included in the study. The subjects included 149 males and 100 females whose pulmonary volumes and capacities were measured by spirometry. Prediction equation was first derived and the reference values were then calculated for FEV [1] and FVC. The values for both these parameters were found to be lower by about 13% and 18% in females and 10% and 12% in males respectively when compared with those given by researchers for Caucasians. Pulmonary function test reference values and prediction equations for both sexes between the ages of 35-65 years were derived for healthy, nonsmoking, urban Pakistani population. A considerable difference was found between prediction equations and reference values obtained in present study compared with other studies conducted in western countries