Collating Spirometry reference values in Asian children and Adolescents; puzzle out the reasons for variations

Lung function tests are essential for the diagnosis and management of different respiratory tract diseases; among them the spirometry is the gold standard technique. The accurate diagnosis, management and monitoring require proper interpretation of the results which depends upon the availability of spirometry reference data for that particular region to differentiate the diseased condition from the normal ones. Multiple studies had been done to find out their own area specific reference ranges but it is still lacking. This need was fulfilled by the Global Lung Function Initiative [GLI] in 2012, which reported the first global spirometry equation for all of the age groups. But some of the studies reported difference among GLI reference range and the measured range for that particular region. So here is the review of the reference ranges among 35,603 Asian children and adolescents from the 32 studies done specifically in Asia. The aim was to compare them with the study done by GLI team, along with these, tried to rule out the causal factor that are responsible for the variations in the reference ranges among the children and adolescents of different population. The literature was searched by using Google scholar and PubMed during the month of March up to July 2017. The review of all the articles published in Asia, specifically accounting for normal reference ranges in children and adolescent exhibit a wide variation among the reference ranges. This also suggest involvement of multiple modifiable and non-modifiable risk factors. So it's necessary to update the reference ranges for spirometry and its prediction equation as well

Medical student syndrome; the affliction in medical students

Objective: The aim of the study is to find out the prevalence of Medical Student Syndrome [MSS] in Pakistan and its association with age, maturity level and the degree of medical knowledge. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The survey was completed in one year, from Jul 2016 to Jul 2017

Material and Methods: A self-designed, self-explanatory questionnaire was used. The link of the questionnaire was disseminated electronically. The data were analyzed by using Statistical Package for Social Sciences [SPSS-22]

Results: Total 129 responses were received from the students of different medical colleges/universities of Pakistan. Mean age of the participants was 21.94 years. Among the respondents 43% were males while 57% were females. Maximum participants were from final year. Majority of the respondents that is about 81% reported they had symptoms of the diseases they study, yet 44% pursued and moved forward. Among them 28% of the respondents said that they investigated their felt symptoms further, of which maximum were from 3rd year. Only 43% of the students knew about the Medical Student Syndrome. Some of the respondents, about 22.8% admitted the fact that they used psychiatric medicines either for relaxing or sleep

Conclusion: It can be concluded that medical students are more vulnerable to conditions like Medical student syndrome so there is a need to counsel medical students about the symptoms of MSS as well as to support the students by discussing different techniques to subsist the stress level

Traumatic events for house officers and their coping strategies

Objective: To determine the major stresses of house officers, causes of these stress and the coping strategies

Study Design: Descriptive cross sectional study

Place and Duration of Study: Study was conducted in 13 different tertiary care hospitals of Karachi in both government and private sectors from Oct to Nov 2017

Material and Methods: A descriptive cross sectional study with multistage random sampling technique was done in which a self-designed and self-explanatory questionnaire was used. Results were analyzed using statistical package for social sciences [SPSS] version 20

Results: About 300 questionnaires were distributed to interns. From the total, 83.9 percent participants were female. The mean age of the participants was 24 years. Out of the total respondents, 9.4 percent participants stated no any significant medical mistake. Issues arising due to lack of knowledge or incompetency leading to mis diagnosis of patients were reported by 20.5 percent respondents. One of the common mistakes reported was wrong drug administration; either route, dosage or incorrect medicine, committed by about 25.3 percent of doctors participated. The most reported reason thought to be the underlying cause of mistakes was work overload that was about 36.3 percent

Conclusion: It can be concluded by the present study that house officers are susceptible to stress which affects their overall work performance and it leads to significant medical mistake due to which patient suffer and because of this pressure it's very hard both physically and mentally for a doctor to cope up

Antidiabetic property of azadirachta indica; a molecular approach

Diabetes mellitus [DM] is a metabolic syndrome, in which there is chronic high blood glucose level. Amongst non-communicable diseases [NCD], type II Diabetes Mellitus is not only the most prevalent disease but its global burden is increasing rapidly. If the blood glucose level is not maintained appropriately, there is a high probability of the development of both macro-vascular as well as microvascular compli-cations. Multiple antidiabetic drugs are in line, but they fail to give long-term control of hyperglycemia, on the other hand these drugs have side effects as well. So there is a need to switch to natural products. The herbal extracts like Azadirachta indica [Neem] is well known for its powerful antioxidant, anti-inflammatory, antipyretic, antimicrobial and antidiabetic properties. It causes hypoglycemia and peroxi-dation of lipid metabolites while increasing the enzymatic activities of glutathione perox-idases, catalases and superoxide dismutases to enhance the antioxidation