Effect of Ramadan fasting on glucose level, lipid profile, HbA1c and uric acid among medical students in Karachi, Pakistan

To assess the effect of Ramadan fasting on blood pressure, fasting glucose, lipid profile, uric acid, HbA1c, body mass index, body adiposity index and visceral adiposity index among fasting medical students, 35 students were recorded before, during and after Ramadan [August] 2011, for their blood pressure, anthropometric measurements, questionnaire response and blood sample. A blood sample was taken at each visit for glucose, lipid profile and HbA1c. Total physical activity, weight-to-height ratio, body adiposity index and visceral adiposity index were calculated for insulin sensitivity. Changes in anthropometric measurements were not statistically significant. However, physical activities increased significantly after Ramadan. Changes in blood pressure, fasting blood sugar, total cholesterol, HbA1c, uric acid and triglyceride were not statistically significant. Mean high density lipoprotein decreased significantly in Ramadan, while low density lipoprotein increased significantly

Calretinin expression in the differential diagnosis of ameloblastoma and keratocystic odontogenic tumour

To determine calretinin expression by immunohistochernistry in ameloblastoma and keratocystic odontogenic tumors [KCOT] and to document the use of calretinin as a differentiating marker between the two lesions. A cross sectional study conducted on previously diagnosed cases of ameloblastoma and Keratocystic odontogenic tumour. Armed forces Institute of Pathology, Rawalpindi Pakistan and duration was one year. [Sep 2009 - Aug 2010]. Twenty cases each of Ameloblastoma and KCOT were retrieved from the record files along with their paraffin embedded blocks. Histological features of all the cases were reviewed on freshly prepared slides and a fresh diagnosis made regardless of the previous diagnosis. The immunohistochemical marker, Calretinin, was applied on both types of cases using the avidin-biotinylated peroxidase complex method.The results were interpreted. In the cases of Ameloblastoma the epithelial tumour nests showed positivity for Calretinin expression. In 85% cases; intense and diffuse staining was observed in more than 80% of the stellate reticulum like cells while 15% cases showed focal and moderate staining patterns. On the other hand KCOT showed contrary results as none of epithelial lining expressed positive staining for Calretinin, [p<0.001]. Calretinin can be used as a useful marker for Ameloblastoma and can be used to differentiate KCOT from Ameloblastoma

Knowledge, attitudes and practices among women towards cervical cancer and prevention: study of a rural community in the suburbs of Rawalpindi

Cervical cancer is a highly prevalent cancer of the reproductive tract with an increasing incidence in Pakistan. This cancer affects the cervix or the neck of the womb and is caused by a persistent infection of Human Papilloma Virus [HPV].Incidents of cervical cancer in Pakistan are on the rise but through screening and vaccination we can successfully fight this deadly disease. This KAP-study was conducted in a rural area of Rawalpindi district to assess the knowledge, attitudes and practices of women of reproductive ages regarding the occurrence, diagnosis and prevention of cervical cancer and to explore any relationship between knowledge and socio-demographic factors. A cross sectional study was conducted from September to November 2011 in two adjacent villages of union council Lodhra, Mohra Amir and Mohra Darogha. The study included 200 women in their reproductive ages [21-65 years]. They were selected by using systematic random sampling technique. Detailed interviews were taken from participants using structured questionnaires. To quantitatively asses the knowledge of the study participants, a scoring system was developed, categorizing the study participants into three groups; poor knowledge, transitional knowledge and good knowledge. The data was entered and analyzed in Statistical Package of Social Sciences software version 16. The study revealed poor level of knowledge regarding cervical cancer in 140[70%] of study participants whereas 53[26.5%] had transitional knowledge, leaving only 7[3.5%] women with good knowledge. Out of a total attainable score of 12, the mean score of our sample was found to be 2.94 [S.D. +2.93] with 57[28.5%] participants scoring straight zero. Majority of participants lacked positive attitude and only 5[2.5%] participants ever had Pap smear test done. The study revealed poor levels of knowledge in majority of the women in their reproductive ages residing in rural areas with lack of positive attitude towards cervical cancer in most of them and reflecting inadequate practices regarding early diagnosis, management and prevention of cervical cancer. Expecting mother and young girls nutrition must be given special attention to ensure delivery of a healthy and a normal child

Oral squamous cell carcinoma: a clinicopathological study of 467 cases at afip Rawalpindi, Pakistan

The purpose of this study was to determine the clinicopathological and demographical characteristics of histologically diagnosed cases of oral SCC. Evaluation is based on age, gender, site of tumor and histological differentiation. Histologically diagnosed cases of oral SCC during a period of 3 years [Jan 2007 - Dec 2009] were retrieved from the tumor records of Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan. Biopsy specimens at the institute are obtained from Armed Forces as well as public and private sector hospitals including the review cases for second opinion. All the cases were subjected to the analysis of age, gender distribution, site of tumor occurrence and grade of histological differentiation. Out of a total of 12611 tumors recorded at AFIP Tumor registry, 467 cases of oral neoplasms were diagnosed as SCC [3.7%]. Among head and neck tumors recorded in the study period, oral SCC comprises 32.9% of the total. The mean age [ +/- standard deviation] of patients was 55.9 +/- 13.3 years [range, 5-90 years] with a male predominance [52.5%], yielding male to female ratio of 1.1:1. Peak incidence is found in 60 years of age. Most common site was buccal mucosa [29.8%] followed by tongue [23.1%] and mandible [13.5%]. Most common histological grade was well differentiated [67.5%] followed by moderately differentiated [26.8%] and poorly differentiated [5.8%] histological subtypes. Oral SCC is the most common malignancy of head and neck region in our community with peak incidence in comparatively older age group. There is an overall male predominance except in younger age group, where it is more common in females. Most common site of tumor is buccal mucosa. The well differentiated grade is the most common histological type of differentiation

Depression, anxiety and their associated factors among medical students

To determine the frequency of anxiety and depression among medical students of Wah Medical College and their associations with sociodemographic and educational characteristics if any. Cross-sectional survey. Wah Medical College, from September 2007 to March 2008. A sample of 279 students was included in the study after excluding first year medical students because they were admitted for less than 6 months. A self administered Encounter Form was administered. Sociodemographic and educational characteristics included age, gender, birth order, number of siblings, monthly income, monthly expenditure on education, academic performance in professional examination, past medical and past psychiatric history, substance abuse and family history of psychiatric illness. Beck depression inventory and beck anxiety inventory were used to assess the level of depression and anxiety. The chi-square test was applied at 5% level of significance to determine associated factors for anxiety and depression respectively. The mean age of students was 21.4 +/- 1.41 years with female preponderance i.e. 202 [72.4%]. Anxiety was present in 133 [47.7%] students and depression in 98 [35.1%] students. Both were found concomitantly in 68 [24.37%] students. Age [p=0.013], gender [p=0.016], examination criteria dissatisfaction [p=0.002] and overburden with test schedule [p=0.002] were significantly associated with depression. Anxiety was significantly associated with gender [p=0.007], birth order [p=0.049], year of study [p=0.001], examination criteria dissatisfaction [p=0.010] and overburden with test schedule [p=0.006]. One third of students were found to have anxiety and depression which was associated with the sociodemographic and educational factors as stated above

Occupational stress and job satisfaction among nurses at a tertiary care hospital

This study was conducted to find the different sources of occupational stress and the level of job satisfaction among nurses working at a tertiary care hospital. Cross sectional study. The study was conducted at Rawalpindi General Hospital from March 2005 to June 2005. The sample comprised of 50 female staff nurses working in different departments in Rawalpindi General Hospital. The sampling technique was stratified random sampling to include nurses working in various departments of hospital. Occupational stress and job satisfaction was assessed by Pressure Management Indicator in terms of Job Satisfaction, Organization, Mental well-being, Physical well-being, a 120 item self-report measure, encompassing many areas of stress evident in the workplace. Majority of the sample [74%] was working on full time whereas 26% were working on contract basis. The mean working hours in a week were 51.16 hrs + 8.98 hrs. On the scale of mental well being, which is comprised of various subscales, the mean score for resilience was 18.78 + 4.32 and for confidence level it was 10.40 + 4.19. These scores were more than the standard score which were 17.66 and 10.37 respectively. Majority of participants [70%] felt secure in their organization. Similarly 74% of participants scored more than the standard on sub scale of job satisfaction [Mean = 24.5 + 3.68]. On the scale for sources of pressure, the mean score on workload was 19.28 + 5.77, on personal responsibility the mean score was 14.04 + 2.99 and on the home/work balance the score was 19.92 + 4.36. The mean scores of participants on all these items were more than the standard scores. It appears that the nurses at a tertiary care hospital have a high index of occupational stress and majority of it generates from the administrative disorganization of the firm and less from the personal or the monitory factors

Relationship between anxiety, depression, psychological well- being and quality of life in diabetic patients having Haemodialysis

To assess the relationship between anxiety, depression, psychological well-being and their association with quality of life in diabetics having haemodilysis due to renal failure and those without haemodilysis.Cross-sectional comparative study. The study was conducted at the inpatient department of Nephrology, Pakistan Institute of Medical Sciences, Islamabad from March 2005 to June 2005.The sample consisted of 60 diabetic patients selected through non-probability convenient sampling technique, whereby 30 patients had haemodilysis and 30 patients were without haemodilysis. Anxiety, depression, quality of life and psychological well being were assessed with General Health Questionnaire 12 [GHQ 12], Hospital Anxiety and Depression Scale [HADS] and WHO Quality of Life Brief [00L BREF] respectively.The mean scores of HADS of diabetic patients with or without haemodilysis on depression dimension were 12.43 [S.D + 3.55] and 8.93 [S.D. + 4.47] respectively where the difference was statistically significant. Mean scores of patients with and without haemodilysis for anxiety were 14.00 [S.D.+ 3.454] and 7.23 [S.D + 2.763] respectively which were again statistically significant. A significant positive correlation existed between anxiety and depression as well as quality of life and psychological well-being whereas depression was inversely correlated to both psychological well-being and quality of life. The diabetic patients with haemodilysis have anxiety, depression and poor quality of life when compared to those without haemodilysis