Prevalence and diagnostic efficacy of trans-abdominal and trans-vaginal ultrasound for ectopic pregnancies: a longitudinal study

Background: Reducing maternal mortality and morbidity requires an accurate diagnosis of ectopic pregnancy. The fallopian tube is the most frequent location for ectopic pregnancy. Methods: This study was based on a longitudinal analytical design conducted at tertiary care hospitals in Pakistan. Patients in the reproductive age range (20 to 32 years) who underwent clinical examination and investigations and were diagnosed with ectopic pregnancy were included in this study. The ultrasound results of all the patients were evaluated, and data was collected on the existence and positioning of an ectopic pregnancy.Results: In the study, 198 women underwent TVS and TAS. At the time of diagnosis, the age range was 20-32 years old. Our study found that 2.5% of pregnancies resulted in an ectopic pregnancy. 20 women had symptomatic EP that was confirmed. For the initial TVUS, the sensitivity and specificity of ultrasonography were 88.5% and 96.5%, respectively, and with a second rescan, they were 93.1% and 95.7%.Conclusions: Our study showed that an excellent method for identifying ectopic pregnancy is trans-abdominal ultrasonography. Regarding diagnostic accuracy metrics, however, it falls short of trans-vaginal ultrasound. To avoid missing any cases of ectopic pregnancy, early detection can significantly reduce morbidity and mortality. We should employ both ultrasonography modalities sequentially, with TAS being used first.

Psychosocial Burden Among Women With Abnormal Pap Smear And Post Colposcopy In Malaysia

@#Objective: The purpose of this study was to determine the level of psychosocial burden and its associated risk factors among women with abnormal Pap smear and post colposcopy. Methods: A cross-sectional study was conducted employing universal sampling of 218 respondents with abnormal Pap smear and post colposcopy. They fulfilled the specific inclusion and exclusion criteria. Three tertiary hospitals in the East Coast of Malaysia were participated. Self-administration of validated Malay-version Psychosocial Effect of Abnormal Pap smear Questionnaire was used to assess the psychosocial burden. The General Health Questionnaire-12 (GHQ-12) was applied to assess the general health factor. Data was analyzed using IBM-SPSS of version 22. Results: The results showed that respondents with an abnormal Pap smear and post-colposcopy women (43.1%) demonstrated a high level of psychosocial burden. The significant risk factor of psychosocial burden was living in an urban and semi-urban area of residence (p = <0.001) and distress condition (p = <0.001) respectively. Conclusions: A substantial number of women with abnormal Pap smear results were experiencing psychosocial burden. Women with an abnormal Pap-smear who were living in the urban and semi-urban and distressed were more likely to experience a higher psychosocial burden.

Nigella sativa fixed and essential oil improves antioxidant status through modulation of antioxidant enzymes and immunity

The onset of 21[st] century witnessed the awareness among the masses regarding the diet-health linkages. The researchers attempted to explore traditional products/plants were in the domain of pharmacy and nutrition focussing on their health benefits. In the present research intervention, we investigate the role of Nigella sativa fixed oil [NSFO] and essential oil [NSEO] in improving antioxidant status and modulation of enzymes. The National Institute of Health [NIH] provided us 30 Sprague Dawley rats that were equally placed in three groups. The groups were fed on their respective diets [56 days] two experimental diets i.e. D[2] [NSFO @ 4.0%] and D[3] [NSEO @ 0.30%] and control. The indices pertaining to antioxidant status, antioxidant enzymes, and parameters pertaining to immunity were evaluated at 4 weeks interval. The experimental diets [NSFO@ 4.0% and NSEO@ 0.30%] modulated the activities of antioxidant enzymes i.e., catalase [CAT], superoxide dismutase [SOD], glutathione transferase [GST], glutathione reductase [GR] and glutathione peroxidase [GPx], positively. Indices of antioxidant status like tocopherols and glutathione were in linear relationship with that of GPx, GR and GST [P<0.01]. Myeloperoxidase activities were in negative correlation with GST [P<0.01] but positive correlation with some other parameters. In the nutshell, the fixed and essential oil of Nigella sativa are effective in improving the indices pertaining to antioxidant status, however, the immune boosting potential needs further clarification. However, authors are of the view that there is need to explore the molecular targets of Nigella sativa fixed and essential oils. Findings from such studies would be useful to validate this instant study for health promoting potential against diabetes mellitus and cardiovascular disorders

Gratitude and subjective well-being among university teachers

The present study was conducted to investigate the relationship between gratitude and subjective well-being [life satisfaction, positive affect and negative affect] among university teachers. Data was collected from 206 teachers [129 males and 77 females] from GC University, Lahore and University of the Punjab, Lahore. It was hypothesized that gratitude would be positively related to subjective well being and that age, gender and gratitude would be good predictors of subjective well-being. First of all demographic information was obtained from the teachers and then three questionnaires were employed

Prevalence and determinants of diabetic retinopathy in Al Hasa region of Saudi Arabia: primary health care centre based cross-sectional survey, 2007-2009

To evaluate the prevalence of diabetic retinopathy [DR] in the urban and rural areas of Al Hasa region of Saudi Arabia and to determine risk factors related to DR. This study was conducted on patient attending primary health care centers between July 2007 and June 2009. A retrospective chart review was conducted on subjects with diabetes mellitus greater than 18 years old. Ophthalmologists examined DR status through dilated pupils by using direct, indirect, and slit lamp bio-microscopy. Frequencies, percentage, and their 95% confidence intervals [CIs] were calculated. Odd's ratio was used to associate DR with possible risk factors. A P value less than 0.05 was considered statistically significant. The prevalence of DR among 473 diabetic subjects was 30% [95% CI:25.80-34.20]. The odd ratios [ORs] of DR among diabetic residing in an urban area was significantly higher than diabetics residing in rural areas [OR = 1.94 [95% CI of OR 0.82-2.89]]. DR was associated to the duration of diabetes [adjusted OR= 1.70], uncontrolled blood sugar level [adjusted OR=1.96], hyperlipidemia [adjusted OR= 2.04], and hypercholesterolemia [adjusted OR = 2.80]. DR appears to be a public health problem in the Al Hasa district of Saudi Arabia, and a planned approach is required to avoid severe visual impairment in patients with diabetes mellitus. Primary prevention and early detection could be implemented through primary health centers and non-ophthalmologists

Evaluation of resistance to fluoroquinolones in clinical isolates of escherichia coli

The evaluation of resistance to ciprofloxacin [CIP] in Escherichia coli [n=1112] isolated from clinical specimens including urine, pus, high vaginal swabs, etc. was carried out at Rawalpindi General Hospital, Rawalpindi during the years 2002- 2005. The isolates were identified by colonial morphology, gram staining, and biochemical tests like indole, citrate and TSI. The antibiotic susceptibility of these isolates was determined by Kirby-Bauer disk diffusion method according to the standard guidelines of Clinical Laboratory Standards Institute [CLSI]. During the year 2002 resistance to ciprofloxacin was 49.19% [n=187], in the year 2003 it was 47.5% [n=297], in year 2004 was 59.03% [n=332], in year 2005 was 46.28% [n=296]. When resistant isolates from different sources were compared E. coli uropathogens varied between 45.2 to 58.53% during the four year. While pus isolates in 2003 were highly resistant [69% resistance] and isolates from high vaginal swab showed peak resistance in 2004 [66%] Fig. 3 table 4. In the year 2002, four fluoroquinolones [FQs] i.e. ofloxacin [OFX], ciprofloxacin [CIP], enoxacin [ENX] and sparfloxacin [SPX] were included in the study while norfloxacin [NOR] was tested against urinary isolates only. During that year 203 isolates were identified as E. coli; 124 from urine, 45 from pus, 21 from high vaginal swabs, and 13 from other sources. Highest resistance was seen in isolates from urine ranging from 54-68% against these FQs

Antimicrobial prophylaxis in acute appendicitis

It is a case series of 100 [100%] cases of acute appendicitis comprising 52 [52%] males and 48 [48%] females without any antibiotics administration. Median age was noted as 29.5 [std +/- 13.5]. 83% patients belonged to urban and remaining rural areas. 81% were discharged within 72 hours. 93% of the patients recovered uneventfully. In 2 [2%] patients wound infection were seen and in 5 [5%] stitch abscesses were noticed. We observed no significant difference in terms of postoperative wound infection rate when the results were compared with the results of the studies in which routine prophylactic antibiotics were administered