Posterior Reversible Encephalopathy Syndrome (PRES) in a Patient With Primary Myelofibrosis on Ruxolitinib.

Posterior reversible encephalopathy syndrome (PRES) is a reversible neurological syndrome characterized by headache, seizures, altered mental status, and visual abnormalities, in association with the characteristic bilateral white matter abnormalities in the posterior cerebral hemispheres. As the name suggests, it is typically reversible with clinical recovery within a few days, while the magnetic resonance imaging (MRI) abnormalities resolve much more slowly. We present a 78-year-old female with a known diagnosis of primary myelofibrosis (PMF), on ruxolitinib, a Janus kinase (JAK) 1 and 2 inhibitor, presenting with altered mental status. On presentation, she was hypertensive and with possible sepsis, secondary to urinary tract infection (UTI). She was intubated because of her low Glasgow Coma Scale (GCS), to secure her airways. Computed tomography (CT) of the brain did not reveal any acute ischemic changes. MRI of the brain exhibited findings suggestive of PRES. Ruxolitinib was held and the patient was treated with antihypertensives, anticonvulsants, and antibiotics. Within 24 hours of hospitalization, the patient had a complete neurological recovery, which is diagnostic of PRES. She was extubated successfully and was discharged with a resolution of her symptoms. Although several chemotherapeutic and immunosuppressant drugs are reported to be associated with PRES, the association between ruxolitinib and PRES has not been well established. Thus, case reporting is important to highlight the possible association between ruxolitinib and PRES.

Association of body mass index, cardiorespiratory fitness, and their correlates among female physiotherapy students in Nawabshah.

OBJECTIVE: To explore the association of body mass index with cardiorespiratory fitness and other health correlates among physiotherapy students. METHODS: This cross-sectional study was conducted from February to July 2018 at the Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan, comprising female undergraduate physiotherapy students aged 17-25 years. All the eligible participants were assessed using a self-report questionnaire, body mass index, and standardised cardiorespiratory fitness criteria. SPSS 20 was used for data analysis. RESULTS: There were 228 subjects with a mean age of 20.89±1.66 years. Of the total, 77(33.8%) students were overweight/obese and 52(22.8%) were underweight. Overall, 212(93%) reported good quality of life, and 189(82.9%) were satisfied with their general health. Also, 180(79%) subjects had a post-exercise heart rate below average. There was a significant negative correlation for body mass index and maximum oxygen uptake, body mass index and age, and maximum oxygen uptake and subjective quality of life (p<0.05 each). CONCLUSIONS: The frequency of both overweight/obesity and underweight physiotherapy undergraduates was high.

Motivation and factors affecting sports participation: a cross-sectional study on female medical students in Pakistan.

OBJECTIVE: To determine the factors associated with participation of Pakistani female students in organised sports at a university in a rural setting in Pakistan. METHODS: This cross-sectional study was conducted during March and April 2017 at the Peoples University of Medical & Health Sciences for Women, Nawabshah in the Sindh province of Pakistan, and comprised undergraduate female students who got injured during the "Sports Week" organized at the university and visited the on-site physiotherapy camp. Data collection tools included physical activity and leisure motivation scale, sport motivation scale, and athlete fear avoidance questionnaire. SPSS v20 was used for data analysis. RESULTS: Of the 403 students participating in the Sports Week, sports injuries were reported by 127(31.51%) students. Regular physical activity was reported by only 28(22%) participants. Overuse was the most common cause of sports injuries 67(52.8%). Ankle was the main affected site 31(24.4%). The most common injury types were cramps 59(46.5%) and sprains 58(45.7%). Use of improper technique was observed in 61(48%) students. The most common intrinsic motives were 'enjoyment', with a mean value of 21.3±2.71, and 'to know' 21.71±5.2. The most common extrinsic motives were 'physical condition', with a mean value of 21.51±2.81, and 'identified regulation' 21.74±5.6. CONCLUSIONS: Prevalence of sports injuries in female university students was high. The students should be trained about the proper way of sports participation.

Physiotherapy and pharmacy students perception of educational environment in a medical university from Pakistan.

OBJECTIVE: To assess and compare the perceptions of the educational environment between physiotherapy and pharmacy students in a public-sector medical university. METHODS: This cross-sectional study was conducted at the Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan, and comprised undergraduate physiotherapy and pharmacy students. The Dundee Ready Educational Environment Measure questionnaire was used to assess the perceptions of students about their educational environment. Global and subscale scores were computed and compared between the respondents. P<0.05 was considered statistically significant. RESULTS: Of the 300 questionnaires, 281(93.66%) were returned duly filled in. The overall mean global score was 127.2±16.0. For physiotherapy students, the mean global score was 124.9±14.0 while it was 131.7±18.9 for pharmacy students (p=0.16). The domain scores were comparable for both specialties (p>0.05). There was no significance difference in the global and domain scores for preclinical and clinical years in the students (p>0.05). However, in the physiotherapy students, the global and domain scores for Dundee Ready Educational Environment Measure were significantly lower in clinical than preclinical students (p<0.05) except for students' social self-perception (p>0.05). CONCLUSIONS: Students were overall positive about their educational environment.