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ObjectivesTo determine the frequency of symptoms of anxiety and depression among the young caregivers of family members with cancer and their correlation with role of gender, age and socio-economic status.ResultsA total of 87.8% of caregivers were between 11 and 16 years of age, with 94.6% reported having support from another caregiver. At least 95% of caregivers reported symptoms of anxiety with a higher predisposition among females. Around 73% of caregivers had low monthly incomes followed by (22.9%) middle and (4.1%) high monthly incomes. Care givers belonging to low income groups were more likely to report anxiety and depressive symptoms (70%). Young adults 17–18 years of age reported fewer symptoms of anxiety (10.9%) than their younger counterparts. Reported symptoms of anxiety and depression decreased when the number of care givers increased—2 (67.5%), 3 (16.2%), 4 (5.4%). Increased hospital stay was associated with increased frequency of symptoms, but not beyond 5 weeks.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3740-8) contains supplementary material, which is available to authorized users.

BackgroundSuicide is a major public health concern and one of the leading causes of mortality worldwide. People with an at‐risk‐mental‐state (ARMS) for psychosis are more vulnerable to psychiatric co‐morbidity and suicide, however, there are limited data from low‐middle‐income countries. The present study aimed to identify the prevalence of depressive symptoms and suicidal ideation along with sociodemographic and clinical correlates of suicidal ideation in individuals with ARMS from Pakistan.MethodParticipants between the age of 16 and 35 years who met the criteria for ARMS based on the Comprehensive Assessment of At‐Risk Mental State (CAARMS), were recruited from the community, general practitioner clinics and psychiatric units across Pakistan (n = 326). Montgomery and Asberg Depression Rating Scale (MADRS) and Social‐Occupational‐Functional‐Assessment‐Scale (SOFAS) were administered to participants.ResultsThe prevalence of depressive symptoms and suicidal thoughts in the sample at baseline were 91.1% (n = 297) and 61.0% (n = 199), respectively. There were significant mean differences between groups (mean difference [95% CI]; p‐value) without suicidal ideation and with suicidal ideation on measures of MADRS (−5.47 [−7.14, −3.81]; p < .001), CAARMS non‐bizarre ideas (−0.29 [−0.47, −0.11]; p = .002) and perceptual abnormalities (−0.23 [−0.41, −0.04]; p = .015).ConclusionThese findings indicate that suicidal ideation and depressive symptoms are highly prevalent in individuals with ARMS in Pakistan. Given the pivotal developmental stages that ARMS presents, and the poor outcomes associated with co‐morbid depression, there is an urgent need to prioritize the development of low‐cost and scalable evidence‐based interventions to address psychiatric comorbidity and suicidality in the ARMS population in Pakistan.

Bullying remains a pervasive problem within the educational institutions of Pakistan. Students, especially the ones with any kind of disability are constant victims of bullying. Among the many forms of bullying, verbal bullying is the most common one. The objectives of the present study are to understand the trends of verbal bullying behavior within Pakistani Universities and to identify practical bullying prevention strategies. The study is delimited to studying only the verbal bullying that relates to the use of language to persecute, oppress or victimize people. The researcher has delimited the study to the undergraduate students of three major universities in Islamabad Pakistan: FAST-NUCES, NUST, and NUML. The present study uses questionnaires as a method of data collection. The study highlights the effects of verbal bullying on the health, well-being and also on educational career of students. This study concluded that bullying culture is common among the universities of Pakistan which is mainly reflected in the language students use. Keeping in mind the findings of the study, better strategies can be suggested to the educational institutions to deal with the bullying culture in their institutes so that students do not suffer at the hands of the bullies.

This paper examines the effect of financial market uncertainty on market returns of different countries of the world. The effect of other macroeconomic like Consumer Price Index (CPI), Real Interest Rates (R.IR), Market Capitalization (MCAP), and Gross Domestic Product per capita growth (GDPPCG).For analyzing this relationship, around 40 countries data including developed and developing countries, over the period of 10 years from 2009-2018. For analysis, Panel Least Square (PLS) was used. Fixed Effect Model (FEM) is used to check the overall strength of the model. Group correlation was also performed on overall variables to check the causal relationship between all the variables and individual regression tests are also conducted country wise to explore that how much this model is applicable, descriptive analysis for market return and uncertainty to check the moments of these variables. The overall results it is concluded that market returns are affected by the financial markets uncertainty in the long run and it is a significant variable in explaining market returns while overall test results proved a positive relationship with market returns but individual testing of this model on each country shows, more than half countries in the study have a negative relationship of financial market uncertainty with market returns. Along this, other macro-economic variables impact is also measured over market returns of the world which shows all variables Consumer Price Index, Real Interest Rates and Market Capitalization except Gross Domestic Product per capita growth have a negative relationship with the Equity Market returns.

Background: Hormonal changes during menopause affect the vestibular system by interfering with homeostasis and by disrupting the enzyme cycles and neurotransmitter function. It has been observed that females have a higher risk of falling and this may increase after menopause. Balance in women is significantly affected by menopause. Objective: To find the prevalence of vestibular dysfunction in menopausal females and to find the risk factors associated with vestibular dysfunction. Methods: The analytical cross-sectional study was conducted from May to October 2021, the data was collected from 385 women in district Jhelum who had menopause after the age of 45 years.  Non-probability convenient sampling was used to collect data. The Berg balance scale, activity-specific balance confidence scale, and a self-made questionnaire for risk factors were used in the study. Results: According to the activity-specific balance confidence scale, 24.4% of the population had high, 60.5% moderate, and 15.1% low physical functioning. A score of less than 67% indicated that 48.1% of patients had a risk for falls in the future. Berg balance scale showed that 6.8% of patients had a high, 22.9% medium, and 60.4% low risk of falling, a score less than 45 demonstrated that 55.8% had a higher fall risk. Diabetes, hypertension, heart disease, and smoking were all statistically significant risk factors for falls (p≤0.001). Conclusion: The current study concludes that there is a significant risk of developing vestibular dysfunction, with an increased risk of falls after menopause in females. Hearing loss is the most common risk factor while obesity also has a great impact on the vestibular system. But there is an increased chance of falls in participants with stroke and hypertension.

Objective: To determine the association between serum CA-125 levels and degree of fibrosis in chronic liver disease with portal hypertension. Methodology: This study was conducted at Mayo Hospital Lahore. A total of 63 patients with liver cirrhosis were enrolled, demographic, clinical and laboratory parameters were documented. Modified FIB-4 index was calculated and value of 3 or more was defined as advanced liver cirrhosis. Receiver Operating Characteristic (ROC) curve was applied to calculate cut off value for CA-125 as 50 IU/L. Pearson correlation and linear regression analysis were applied to determine the association between CA-125 and modified fib -4 index. Results: Sixty three patients were enrolled. Mean age was 52.047±12.78. Female patients were 22(34.9%) and male patients were 41(65.1%). Regarding the clinical features, 8(12.7%) patients had jaundice, 38(60.3%) had ascites , 61(96.8%) had splenomegaly ,58(92.1%) had history of upper gastrointestinal bleed while 12(19%) had history of hepatic encephalopathy. Mean value of Modified fib-4score was 4.75±2.89SD, 43(67.2%) had value above cutoff of 3. Total of 38(60.3%) had CA-125 value above the cutoff level of 50 IU/L. CA-125 value above 50 IU/L has 63% sensitivity and 70% specificity in predicting advanced liver fibrosis and this association was statistically significant. (p value 0.024) . Conclusion: Serum CA-125 level above 50 IU/L is associated with presence of significant liver fibrosis.

This paper examines the effect of financial market uncertainty on market returns of different countries of the world. The effect of other macroeconomic like Consumer Price Index (CPI), Real Interest Rates (R.IR), Market Capitalization (MCAP), and Gross Domestic Product per capita growth (GDPPCG).For analyzing this relationship, around 40 countries data including developed and developing countries, over the period of 10 years from 2009-2018. For analysis, Panel Least Square (PLS) was used. Fixed Effect Model (FEM) is used to check the overall strength of the model. Group correlation was also performed on overall variables to check the causal relationship between all the variables and individual regression tests are also conducted country wise to explore that how much this model is applicable, descriptive analysis for market return and uncertainty to check the moments of these variables. The overall results it is concluded that market returns are affected by the financial markets uncertainty in the long run and it is a significant variable in explaining market returns while overall test results proved a positive relationship with market returns but individual testing of this model on each country shows, more than half countries in the study have a negative relationship of financial market uncertainty with market returns. Along this, other macro-economic variables impact is also measured over market returns of the world which shows all variables Consumer Price Index, Real Interest Rates and Market Capitalization except Gross Domestic Product per capita growth have a negative relationship with the Equity Market returns.