Objective Our study's motive was to recognize various immune-mediated inflammatory processes involved in the pathogenesis of depression and psoriasis and interlink between them based on inflammatory mediators. Methods A careful and comprehensive literature search was done through various databases like PubMed, Google Scholar, and EBSCO. A total of 56 studies were included in our study after careful screening. Results The immune-mediated inflammatory process was significantly associated with the pathogenesis of both depression and psoriasis. Most of the inflammatory markers involved in Psoriasis (TNF-α, IL-2, IL-6, IL-23, IL-1β, IL-10), and increased serotonin transporters (5-HTT) were also found in the pathogenesis of depression, showing the immune-inflammatory linkage between psoriasis and major depression. Based on immune chemistry, the levels of CD2 + , CD4 + , CD8 + T-lymphocytes were also found to be raised in both depression and psoriasis, validating their relationship. Hyperactivity of HPA-axis was also found another interlink between them along with reduced melatonin amount. Conclusions According to various studies, the neuro-dermatological association between psoriasis and depression is significant. Different immune markers involved in the pathogenesis of depression and psoriasis also show the bidirectional association between them. However, this association between psoriasis and depression is positively correlated, but more work is required to answer why all depressed patients fail to develop psoriasis and why all psoriatic patients fail to develop depression.

<abstract> <p>Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterised by production of autoantibodies against platelet surface antigens. Recent studies have demonstrated a paramount association of ITP and <italic>Helicobacter pylori (H-pylori)</italic> infection with significant rise in platelet count following <italic>H-pylori</italic> eradication therapy. The <italic>H-pylori</italic> infection induced ITP is validated by many proposed mechanisms such as molecular mimicry due to production of autoantibodies against <italic>H-pylori</italic> surface virulent factors (CagA) and cross reactivity of these antibodies with platelet surface antigens (GP IIb/IIIa, GP Ib/IX, and GP Ia/IIa), phagocytic perturbation due to enhanced phagocytic activity of monocytes, enhanced dendritic cell numbers and response, platelets aggregation due to presence of anti- <italic>H-pylori</italic> IgG and von Willebrand factor (vWf) and finally host immune response against <italic>H-pylori</italic> virulent factors CagA and VacA leading to ITP. The effectiveness of <italic>H-pylori</italic> eradication therapy has also been demonstrated with platelet count being used as a predictive factor for assessment of treatment efficacy. Out of 201 patients 118 were responding to the triple therapy and remaining 83 patients were non-responders, showing the response rate of 58.7%. Out of 118 responders 69 patients were showing complete response (CR) and 49 were showing partial response (PR) to the <italic>H-pylori</italic> eradication therapy. However, more studies are required to elucidate this association and treatment efficacy.</p> </abstract>

Objective: Despite remarkable progress in scientific methods and measures against infectious disease transmission, the prevalence of infectious diseases is still on the rise in resource-poor countries. Hand hygiene is considered an effective way of fighting against deadly infectious diseases. Our study aimed to assess knowledge, attitude, and hand hygiene practices among mothers of children presenting for routine paediatric check-up in the department of paediatrics in a tertiary care hospital of Rawalpindi.Materials and Methods: It’s a descriptive cross-sectional study involving 400 mothers from the paediatric department of the Holy family hospital (HFH), Rawalpindi. A convenient sampling technique was used to select the study participants. A semi-structured, pre-tested questionnaire that included demographic details, knowledge, attitude, and practice levels were assessed through validated questionnaires used in previously published studies. Descriptive statistics were used for demographic details and chi-square analysis was used to find an association between handwashing practice with knowledge and attitude. A P<0.05 was taken as significant. Data analysis was done through SPSS.v.23.Results and Discussion: In total, 400 females participated in the study and the mean age (±SD) was 32.4±10.2 years. The mean age of children was 31.2±12.2 months. The level of good handwashing knowledge and attitude was 93% and 60% respectively. However, the level of good handwashing practice was just 40%. The age of mothers, residential area, occupation, socioeconomic status, and the level of knowledge regarding handwashing, showed significant association with handwashing practices.Conclusion: In our study handwashing practice among mothers was relatively low. Age of mothers, residential area, occupation, socioeconomic status, and the level of knowledge regarding handwashing, were significantly associated with handwashing practices.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 418-423

Background: Pelvic organ prolapse (POP) occurs when pelvic organs protrude through the vagina due to displacement from their normal anatomic position, as a result of a weakening of the pelvic muscles. Pessaries have long been used to treat POP, but they may result in rectovaginal fistulas as a rare complication. The Case: We report a rare case of a rectovaginal fistula following vaginal ring pessary use in an 82-year-old G7P7 woman. She had a past medical history of bipolar disorder, and initially presented for nursing care and psychiatric support. A trained psychologist evaluated her, and found no psychological morbidity. A two-day history of a fall, diffuse abdominal pain, and chronic urinary incontinence were rather identified. Gynecological pelvic examination revealed a rectovaginal fistula and impacted stools in the vagina. Conclusion: The use of ring pessaries, though a conservative management option for POP, may lead to a rectovaginal fistula, a rare but severe complication.

COVID-19 is proving to be a double-edged sword for health care professionals. It is not only causing physical malfunctioning but mental suffering among medical undergraduates. This study demonstrates the psychological impact and various predisposing factors causing mental distress. This is a descriptive cross-sectional study involving 157 medical undergraduates of Third, Fourth, and Final year MBBS being trained in tertiary care hospitals of Rawalpindi, Pakistan in September 2020, when the graph of COVID-19 was flattening. Data was collected through a self-designed questionnaire for demographic details and DASS-21. The mean and standard deviation was calculated for depression, anxiety, and stress levels. Frequencies and percentages were calculated for the severity of DASS-21 and predisposing factors. Data analysis was done through SPSS. V. 25. Out of 157 students, there were 80(51%) males and 77 (49%) females. The mean age was 22.52 (SD=1.60). The overall mean score of anxiety was 7.43 ± 4.53, depression was 7.75 ± 4.12, and stress was 8.15 ± 4.53. This study found that the most common reason for stress and anxiety among students attending wards was the fear that they might infect their family members 42 (26.8%), followed by the fear of getting infected themselves 39 (24.8%). This study doesn’t exhibit a significant mental burden of grave concern however, the anxiety level was high among the Third year and depression level was high among Final year students. Fear of infecting family members and contracting the virus themselves were common reasons for distress.