ABSTRACT
Introduction Kawasaki disease (KD) is an idiopathic, acute systemic vasculitis typically affecting medium-sized blood vessels with an inclination towards the coronary arteries. There is no specific diagnostic test established for it yet. Hence, our study aims to evaluate serum N-terminal pro-brain natriuretic peptide (NT-proBNP), hydrogen sulfide (H2S), and interleukin-6 (IL-6) levels as potential diagnostic tools in children with KD and determine its relationship with the development of coronary artery lesions (CAL) in the pediatric population visiting a tertiary care hospital in Karachi. Methods A prospective observational study was performed on a sample of 500 children at a tertiary care hospital over a period of two years from June 2017 to June 2019. Blood samples were collected from two groups labeled CAL and non-coronary artery lesion (NCAL), and different biomarkers including NT-proBNP, IL-6, and H2S were compared between them to predict the diagnostic properties of each marker. Results Among the 500 children, 50% were between the age of one to five years. All presented with fever and varying degrees of associated symptoms. On lab investigations, levels of NT-proBNP and IL-6 during the acute phase of the disease were found to be higher in the CAL group than the NCAL and control groups (p<0.001). However, H2S levels during the acute attack were significantly lower in the CAL group when compared to the NCAL or control groups (p<0.001). Conclusion Elevated levels of NT-proBNP and IL-6 can be utilized as potential clinical markers for identifying children at risk of developing CAL as a complication of KD. Reduced H2S levels are also proposed as an indicator of progress towards CAL and should be considered in reaching a diagnosis.
ABSTRACT
Introduction Our study was meant to assess the knowledge, attitude, and barriers towards research in medical students of Pakistan. By assessing the factors, we aim to increase the role of medical students in research, which will eventually help developing countries like Pakistan to achieve self-reliance in health care. Methods Undergraduate and postgraduate students of medicine, dentistry, and pharmacy schools of Dow University of Health Sciences, Karachi, were enrolled from February-March 2018 in a cross-sectional, descriptive study using questionnaires to provide details of the parameters of attitude to the knowledge of and barriers towards research for each individual. All data were coded for each of the parameters. Data analyses were performed by one-way analysis of variance (ANOVA)/Tukey and Student's t-test, Pearson's correlation, and Chi-squared tests. Results A total of 850 questionnaires were received. The overall mean scores of students on attitude, knowledge, and barriers were 69.27 ± 13.44, 70.39 ± 15.67, and 72.46 ± 13.46, respectively; 81.8% of students' scores fell above the middle of the maximum score for knowledge, but 84.5% of attitude scores came in at below the middle of the maximum score. Undergraduate students had a more positive attitude to research than postgraduate students (69.20 ± 11.10 vs 64.23 ± 10.98; p = 0.002). Male students had a better attitude than females (72.97 ± 20.54 vs 67.09 ± 21.56; p = 0.010). Barriers highlighted by students most significantly included a lack of funding support and preference for instruction over research. Conclusion Students showed good knowledge of research, but their attitude was not up to the mark. The barriers highlighted suggest a need for a change in the strategies for research. Attention should be paid to inculcate research as part of the student curriculum and to make available incentives, information, and mentors to solve the problems most students face in the field of research.
