This study examines the association between suicide and bullying among teenagers and adolescents in school besides exploring strategies to prevent acts of bullying. “Bullying” is a risk factor that is linked to suicidal ideation and attempts among school-age children and teenagers. Since youth suicide is an urgent and serious problem, we conducted a systematic review of 28 previous studies conducted in children and adolescents which examined the connection between bullying experiences and suicide. Data Collection: A literature search was carried out using 4 databases, without date description including: PubMed, PsychInfo, Medline and Google Scholar. The search terms contained: bullying, suicide and bullying, suicide in teens, school bullying, and peer victimization. An initial search generated about 97 articles; however, only 28 articles were appropriate for inclusion in the current review. Inclusion criteria was (1) Cross-sectional studies published from 1997-2013. (2) Study based on school bullying and suicidal risk in adolescents and teens 18 years or less (3) Studies had enough information to calculate effect sizes that did include a control group. (4) Studies based on gender discrimination. Papers that focused on specific populations, that did not include quantitative data, that did not use a control group of non-bullied subjects and studies based on cyber bullying, studies with longitudinal design were excluded.The risk of suicide attempts was higher in girls, who were involved in bullying, either as the victim or perpetrator, than in boys. Depression, feelings of hopelessness and loneliness can develop in the child after being bullied for long periods of time; these feelings are indirectly related to suicidal ideation and attempts. Involvement in bullying increases the likelihood of suicidal ideation and attempts in children and teenagers.

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Objective: The purpose of this study is to compare the sufficient accuracy of three different techniques of echocardiography for left ventricular ejection fraction. Study Design: Retrospective study Place and Duration: Saidu Group Of Teaching Hospital, Saidu Sharif, Swat, KPK, From September, 2021 to February, 2022. Methods: Total 90 patients of both genders with age 18-70 years were included. All the patients admitted to hospital with complaint of chest pain. After getting informed written consent detailed demographics of enrolled cases were recorded. All of these techniques (M-mode echocardiography, simpson’s biplane mode and global longitudinal strain) were used to measure the left ventricular ejection fraction of patients within a 3-month period that did not include a myocardial infarction or revascularization. SPSS 23.0 was used to analyze all data. Results: We found that 82 (91.1%) were male patients and 8 (8.9%) were females. Mean age of the patients was 53.6±12.47 years and had mean BMI 25.8±11.44 kg/m2. Hypertension was found in 50 (55.6%) cases, followed by dyslipidemia in 35 (38.9%) patients, diabetes mellitus in 23 (25.6%) cases. Cigarette smokers were 15 (16.7%). We found that accuracy of global longitudinal strain was higher for left ventricular ejection fraction than that M-mode echocardiography and simpson’s biplane mode but the difference was insignificant. Conclusion: We concluded in this study use of these three techniques for LVEF was highly useful to diagnose accuracy but global longitudinal strain was showed better accuracy than that of simpson’s biplane mode and M-mode echocardiography. Keywords: Chest Pain, LVEF, global longitudinal strain, M-mode echocardiography, Simpson’s biplane mode, Accuracy

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Background Atrial fibrillation (AF) is a common concern in patients with heart disease, especially those with acute decompensated heart failure (ADHF). We conducted a cross-sectional study to determine the frequency of AF and associated risk factors among patients with ADHF at a tertiary care hospital in Peshawar, Pakistan. Methods We conducted a cross-sectional analytical study of hospitalized patients with ADHF treated in a tertiary care hospital in Peshawar, Pakistan, from June 5 to October 30, 2021. The study's primary outcome was the proportion of patients with ADHF who had AF, and our secondary outcome was examining the risk factors for AF. The College of Physicians and Surgeons Pakistan provided ethical approval of the study design. Data were analyzed using IBM SPSS Statistics for Windows version 24.0 (IBM Corp., Armonk, NY, USA). We applied the chi-square test to compare the proportion of AF concerning risk factors (i.e., comorbidities). Results One hundred ninety-four patients with ADHF were included in the study; 54.6% were male and 45.4% female. Most (56.7%) were older than 60, and 38.1% were aged 40-60. The prevalence of AF was 38.1%. Diabetes, hypertension, previous stroke, myocardial infarction (MI), and chronic obstructive pulmonary disease (COPD) were the most common comorbidities. All patients with ADHF with AF also had MI and hypertension. Patients of known coronary artery disease (CAD) but without MI, previous percutaneous coronary intervention (PCI), or coronary artery bypass graft (CABG) surgery were less associated with AF than other comorbidities. Conclusions We conducted this study to determine the incidence of AF among patients with ADHF. AF occurs in a significant amount of patients with ADHF, and the risk factors associated with AF in these patients include hypertension, history of MI, diabetes, and COPD. Healthcare professionals should screen patients with ADHF for AF, especially those with common risk factors.