Attachment Styles And Death Anxiety Among Pregnant Women In Pakistan

@#The present study was designed to investigate the attachment styles and death anxiety among pregnant women. In order to meet the study objectives sample of (n=62) was recruited from hospitals of Rawalpindi (i.e., Maryam Memorial and Cantonment Hospital) and Islamabad (i.e., Shifa Medicine Hospital and Poly Clinic). Age range of the sample was 18 to 45 years. Attachment styles were assessed by Experience in Close Relationship Revised-Questionnaire (ECR-R) and death anxiety was assessed with Death Anxiety Scale. The findings revealed that there was significant positive correlation between attachment styles and death anxiety (p<0.05) and it was found that pregnant women scored low on secure attachment style. Younger pregnant women were high on preoccupied, fearful and dismissing attachment style as compare to older age pregnant women. Women with first pregnancy scored high on anxious, dismissing, and fearful attachment style as compare to women with second and third pregnancy. Pregnant women had pregnancy loss feel more death anxiety as compare to pregnant women with no history of pregnancy loss. ASEAN Journal of Psychiatry, Vol. 22 (2): March 2021: 1-10.

Hepatitis 'B' and 'C' viral infections in patients with hepatocellular carcinoma

Chronic exposure to Hepatitis B and C viral infections are strongly suspected of causing hepatocellular carcinoma [HCC]. Moreover, in considerable numbers of HCC cases, the patients found positive for Hepatitis infections. The development HCC is related to the integration of viral DNA into the genome of host hepatocytes. It is noted that African and Far East counties, where HCC is common, have high rates of hepatitis carriers, probably with vertical transmission, of viruses from generation to generations. The scope of present study is to evaluate the incidence of HBV or HCV infections in patients with HCC. A brief clinical history of 98 patients [Males; n = 59, Females n = 39] with confirmation of HCC along with base-line value of alpha-fetoprotein [AFP], is taken and cumulated. In all patients, AFP values were found to be elevated ranging from 15 to 1329 ng/ml in males [mean 184.82 +/- 39.26 ng/ml] and 17.00 to 1218 ng/ml in females [mean 179.26 +/- 41.11 ng/ml] with relevant clinical data. It was noted that in most of the confirmed cases of HCC, hepatitis infections of HBV and HCV origin is prevalent. In male HCC patients, 19 were diagnosed with HBV whereas 21 with HCV infection. In females 12 HCC patients were HBV positive and 14 with HCV. Remaining patients were investigated thoroughly for any infection, but found devoid of any. However, cirrhosis of biliary origin, haemochromatosis cystic fibrosis and drug-induced cirrhosis are persistent infections. The results are presented in relation to various risk factors, and clinical and diagnostic characteristic

Diagnostic utility of Amino-terminal pro-B type natriuretic peptide [NT pro BNP] in adult patients with chronic kidney diseases

In recent studies, suggestions were made that the diagnostic utility of Amino-terminal pro-B type natriuretic peptide [NT-proBNP] a known biomarkers of myocardial dysfunction, be extended to chronic kidney disease [CKD] patients that are devoid of any cardiovascular abnormalities or disease, however may develop same in future. The goal of present study was to further evaluate the relationship between CKD and NT-proBNP concentration in patients with varying levels of renal dysfunction including End Stage Renal Disease [ESRD]. Stable adult patients of both gender [n = 76] with CKD were included in the study during January 2007 to September 2008, who had been on hemodialysis [HD]. The patients were divided into two groups depending on Left ventricular ejection fraction [EF]<50%. Other parameters such as mean arterial pressure [MAP], NT proBNP and biochemical parameters were measured using standard procedures. The result strongly presents a correlation between of NT-proBNP levels in CKD patients, who were without a definite onset of LVD. Furthermore, NT pro-BNP significantly correlated with an elevated protein to creatinine ratio and blood urea nitrogen [P < 0.01] suggesting that onset and presence of CKD influenced the concentration of natriuretic peptides. The present study regarding assessment of NT proBNP in CKD patients, provide evidence that renal dysfunction and natriuretic peptides, especially NT-proBNP are correlated with each other. In addition, further prospective studies are underway to validate and better define this relationship

Evaluation of urinary protein to creatinine ratio as a predictor of end-stage renal disease

To evaluate the role of urinary protein to creatinine [P:C] ratio as a predictor of end-stage renal disease [ESRD] in renal failure patients. This study was conducted at Liaquat National Medical College and Hospital, Karachi from Jan-Dec 2006 on 121 patients [77 males, 44 females] with acute renal failure [ARF] and chronic renal failure [CRF]. Clinical history, relevant investigations, renal status, dialysis routine and frequency were recorded. Random Urine samples [single void] were collected and the P:C ratio were calculated. Out of 121 patients, 21 patients developed ESRD including 16 males [12 CRF, 4 ARF] and 5 females [all CRF]. Statistical analyses shows no significant difference between sum of P:C ratio of CRF and ARF patients. However moderate significance [P < 0.05] was noted among P:C ratio of ESRD patients when compared with males CRF and ARF groups. Similarly, female groups also showed non-significant difference, whereas ESRD patients [FCES], depicts moderate [P < 0.05] significance when compared with female CRF and ARF groups. P:C ratio of males and females ESRD groups showed no significance difference. Mean P:C ratio in male CRF end stage category was 4.12 +/- 0.82 [range 2.5 - 9.1] where as in male ARF end stage 3.78 +/- 1.67 [range 1.80- 7.12]. Mean P:C ratio in female CRF end stage category was 3.94 +/- 0.79 [range 1.76 - 5.98]. Patients with > 1.0 of P:C ratio has developed ESRD. Higher the ratio of P:C, the more was risk of deterioration of clinical condition

Assessment of hyperlactatemia and acidosis in patients with cardiac dysfunctions

Background: It has been postulated that hyperlactatemia is not the only cause of acidosis in cardiac dysfunction and there are other factors such as un-measured anions also that significantly participate in its development

Aim: The present study is designed to determine different components of metabolic acidosis in cardiac dysfunctions and cardiac arrest patients in order to assess the degree to which lactate is responsible for the acidosis

Methods and Materials: Forty two patients with out-of-hospital cardiac dysfunctions and cardiac arrest, admitted to the hospital were included in present study. All arterial blood gases and plasma biochemical parameters were estimated by standard methods on automated analyzers. Modified [by Figge and colleagues] form of Stewart's quantitative biophysical methods including formula for apparent strong ion difference AEurooeSIDaAEuro and strong ionic gap AEurooeSIGAEuro were used to evaluate un-measured and measured ions

Results: The mean age of patients were 57.2 years and included 33 [78.6%] males and 9 [21.4%] females. Except for sodium, ionized calcium and SIDa, all variables were significantly different between the two groups. Patients with cardiac dysfunctions and arrest were also hyperkalemic, hypochloremic and hyperlactatemic. The anion gap and SIG were also higher in patients with cardiac arrest. Lactate was the strongest determinant of academia

Conclusion: It was concluded that lactate accounts for only less than 50% of the metabolic acidosis and consequent acidemia seen in such patients and that an increase in unmeasured anions and phosphate also accounts for major portion of acidemia

Prevalence of hepatitis infections in patients with hepatocellular carcinoma

Chronic exposure to Hepatitis B viral infections and in few instances hepatitis C also, are strongly suspected of causing hepatocellular carcinoma [HCC]. Moreover, in considerable numbers of HCC cases, the patients found positive for Hepatitis infections. The development of HCC is related to the integration of viral DNA into the genome of host hepatocytes. It is noted that African and Far East countries, where HCC is common, have high rates of hepatitis carries, probably with vertical transmission, of viruses from generation to generations. The scope of present study is to evaluate the incidence of HBV or HCV in factions in patients with HCC. A brief clinical history of 100 patients [Males; 58%, Females; 42%] with confirmation of HCC along with base-line value of a-fetoprotein [AFP], is taken and cumulated. !nail patients, AFP values were found to be elevated ranging from 13.44 to 610 ng/ml in males [mean 184.82 ng/ml] and 13.00 to 576 ng/ml in females [mean 189.54 ng.ml]. It was noted that in most of the confirmed cases of HCC, hepatitis infections of HBV and HCV origin is prevalent. In malj HCC patients, 24 were diagnosed with HBV whereas 19 with HCV infection. In females 18 HCC patients were HBV positive and 13 with HCV. Remaining patients were investigated thoroughly for any infection, but found devoid of any. However; cirrhosis of biliary origin, haemochromatosis, cystic fibrosis and drug-induced cirrhosis are persistent. It is concluded in present study that HCC patients were discovered with HBV and HCV infections. Nonetheless, these studies neither instate the correlation between presence of hepatitis infections and formation of HCC nor ascertain that hepatitis infection are the causative agents of HCC. The results are presented in relation to various risk factors, and clinical and diagnostic characteristic