ABSTRACT
Objectives: Our research aimed to examine the characteristics of palliative oncology patients hospitalised through an emergency to look for the symptom profile, characteristics of dyselectrolytemia and blood investigations, and possible associations with mortality. Materials and Methods: After institutional review board approval, a retrospective, observational study of patients hospitalised in our tertiary care specialty oncology hospital was undertaken. Records of hospitalised cancer patients admitted from the emergency department under palliative care from January 2019 to October 2021 were examined. As all admissions during this period were through emergency due to institution COVID-19 protocols, all elective admissions were excluded from the study. Data collected included patient characteristics, blood investigations, and comorbid history of systemic diseases and factors that could be associated with electrolyte imbalance. Results: There were 157 emergency admissions during the study period. A majority were patients with solid tumours (92.4%). Pain was the most frequent cardinal symptom, along with other symptoms (68/157) or in isolation (33/157), followed by reduced oral intake (32/157) and altered sensorium (24/157). sixty-six patients died within the hospitalisation period. On long-term follow-up, only 8 (5.1%) were surviving. Hyponatraemia (43%), Hypoalbuminaemia (66%), and altered renal function (33.1%) were prevalent. We observed a weak positive correlation between sodium levels and outcome (r = 0.199, P = 0.016) and a strong positive correlation between albumin levels and survival outcomes (r = 0.329, P = 0.000). Patients with normal albumin had a higher chance of survival (odds ratio: 33.1225, 95% confidence interval: 3.415-321.20, P = 0.003). Conclusion: Pain-reduced oral intake and altered sensorium are common emergency symptoms in oncology palliative care. Mortality is high in these patients. Hyponatraemia, hypoalbuminaemia, and deranged renal functions were commonly seen. Normal sodium and albumin levels were associated with higher chances of survival, and the association was strong for serum albumin levels. This may have prognostic utility.
ABSTRACT
AIMS AND METHOD: We aimed to examine the burden of mental disorders in Pakistan over the past three decades. We used the crude data of disability-adjusted life-years (DALYs) obtained from the Global Burden of Disease Study database (1990-2019) to represent burden. Data were retrieved on 26 January 2021. Data for adults of reproductive age (aged 15-49 years) were analysed to discuss and interpret the disease burden. An analysis was conducted on total DALYs separately for the genders for ten mental disorders reported in Pakistan. RESULTS: DALYs increased drastically with the onset of reproductive age. Depressive disorder was the most reported mental disorder, contributing 3.13% (95% CI 2.25-4.24) of total DALYs, and varied significantly between genders: females 3.89% (95% CI 2.73-5.29) versus males 2.37% (95% CI 1.62-3.25). CLINICAL IMPLICATIONS: A nationwide high-quality epidemiological surveillance system should be implemented to monitor mental disorders and offer culturally appropriate preventive services.
ABSTRACT
Iodine deficiency in soils and plants is a common problem in the hilly areas and has still been ignored. The aim of the current study is to investigate associated health issues, socio-economic characteristics and people's perception regarding iodine deficiency. Furthermore, a follow-up study was conducted to determine iodine and nutrients concentration in soil and crops at District Diamer, Gilgit-Baltistan, Pakistan. A descriptive and empirical analysis was examined. Most importantly, male was significantly observed as more affected for iodine deficiency than female, as contrary to the literature, socio-economic factors such as households' income and awareness (education) are reported as negative and significant contributor to reduce the iodine deficiency among the people irrespective of the gender. Majority of people (84%) heard about the iodine, but about 51.6% people argue that iodine has no effect on the human body and 56% of the respondents do not know why iodine is necessary for human. It was found that 11.5% of the community was affected from the IDD and majority of them were females. Wheat crops were the principal crop since it supplies 75% of calorific energy in an average Pakistani diet. The concentrations of iodine in soil samples range from 4.21 to 5.45 mg kg-1. The concentration of iodine in wheat crop plant sampled were considerably varied as Boner > Gais > Goher Abad with 1.12, 0.91 and 0.81 mg kg-1. respectively. Likewise, grain iodine concentration was varied as Gais > Boner > Goher Abad with 0.126, 0.102 and 0.078 mg kg-1, respectively. This study exposed that community using the cereal crops could face iodine deficiency in their diet which can cause endemic goiter among the population and control the iodine deficiency by empowering the rural community to raise the income level and providing the awareness to the people.
