Trace metal profiling in patients with depression in Pakistani population.

OBJECTIVE: To determine level of trace metals in patients with depression in order to explore any association between the two. METHODS: The case-control study was conducted at the Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology and Armed Forces Institute of Mental Health, Rawalpindi, Pakistan, from January to December 2017, and comprised diagnosed cases of depression with equal number of age- and gender-matched controls. Depression was diagnosed by a consultant psychiatrist as per the International Classification of Diseases version 10 / Diagnostic and Statistical Manual of Mental Disorders -IV criteria and a self-reported depression screening through Siddiqui-Shah Depression Scale. Blood samples were collected from each subject for the measurement of metals like zinc, chromium and copper. Data was analysed using SPSS 24. RESULTS: Of the 370 subjects, there were 185(50%) in each of the two groups. There were 82(44.3%) males and 103(55.7%) females among the cases with an overall mean age of 37.75±11.49 years, and 65(35.1%) males and 120(64.9%) females with an overall mean age of 39.38±12.56 years among the controls. Mean levels of zinc and copper were significantly different between the groups (p<0.05), while the difference was non-significant for chromium (p>0.05). Equivocal prevalence of depression was present between males and females (p=0.04) without any significant age group association (p=1.92). CONCLUSIONS: Blood level of serum zinc and copper were found to be associated with depression.

Pakistani Student Nurses' perceptions of their hospital's health professionals' attitudes and suggested ways to improve patient care - An untainted view.

BACKGROUND & OBJECTIVES: Feedback brings a fresh perspective and improvement in any organization. Health professionals (HPs) lose insight of the gaps in medical care. The views of student nurses can help improve systems. The objective of this study was to assess the views of our student nurses and how they perceive the way the doctors and HPs work in our hospital and comment on training, attitudes, care pathways, teamwork, and what needed to be improved. METHODS: A proforma based qualitative study was carried out at the Nurses' Training Centre of PAF Hospital and Fazaia Medical College, Islamabad, from January to March 2020. After approval, a semi-structured proforma with open and closed ended questions was administered, in English and Urdu. The results were analyzed by comparative numbers and percentages for each question and descriptive responses were grouped in recurring themes and analyzed for content and their constructive value. RESULTS: Out of 85 nursing cadets, the proforma could be administered to 61(M=38(62.3%) and F=23(37.7%). Most were FSc with 26% graduates. Majority of the female students' main reason for joining was to serve humanity, unlike most males. According to gender many responses were interestingly different. Majority of females thought male doctors were better (86%). Only 36% said the doctors were sincere in care of patients. Most thought that we needed to improve patient counseling. Most thought the seniors treated them unfairly, but bullying was negligible. They wanted the senior HPs to improve their attitudes and ensure adequate equipment in the wards. They were worried about personal security from patients and relatives. Dedicated mental health services to deal with stress of witnessing every day misery and death was suggested. CONCLUSIONS: Doctors need to improve their counseling skills and should talk more to the patients and their relatives. They should acknowledge the nursing students and improve teamwork. Belittling them in front of others harms their self-efficacy. Simple corrections like punctuality, ownership of their patients and improvement of equipment and systems can improve patient care.

Hair coil strangulation--an uncommon cause of penile edema.

Penile strangulation by hair coil is an uncommon, under-recognized condition with a spectrum of potential complications including urethral transection and partial or complete penile amputation. Early recognition and treatment can greatly reduce the incidence of these devastating complications. We report a 5-year-old, circumcised boy with penile edema and erosions secondary to a hair wrapped around the coronal sulcus. Prompt diagnosis and removal of the hair led to rapid resolution without surgical repair. We also analyze the possible underlying causes which can lead to strangulation of the penis with a hair.