Objective This article systematically reviews current literature on the efficacy and efficiency of selective serotonin reuptake inhibitors (SSRIs) in the treatment of patients with frontotemporal lobar degeneration (FTLD), with a particular focus on behavior and cognitive functions. Methods A search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using CENTRAL, MEDLINE, and Cochrane Library databases. Eleven randomized controlled trials and open-label studies looking at the effects of SSRIs on FTLD patients were included. A random-effects meta-analysis was performed, consisting of 3 randomized and controlled studies that used the neuropsychiatric inventory to assess SSRI intervention. Results The meta-analysis shows a combined mean reduction of 10.17 points (95% confidence interval, 18.14–2.19; P = 0.01) on the neuropsychiatric inventory with SSRI treatment in FTLD patients. The I 2 calculated for this study was 62% (P = 0.07), which represents moderate heterogeneity among the studies. The Egger regression test (P = 0.526) did not show a publication bias. Sensitivity analysis showed no significant change. Conclusions The current meta-analysis supports SSRIs as an intervention for management of behavioral symptoms of FTLD. Marked improvements were seen in disinhibition, irritability, aggression, and aberrant motor activity across studies. However, apathy/loss of empathy did not show similarly promising results. A deteriorative effect on cognition was seen associated with SSRI use.

Background: Brucellosis is the second most widely spread zoonotic disease. There is less literature on this disease in Pakistan, leading to delayed diagnosis, or the patient remains undiagnosed. This study aims to contribute to Pediatric brucellosis literature, epidemiological, clinical features, laboratory findings, and treatment. Case Presentation: We present an 11-year-old child who was admitted to the hospital due to abdominal pain for one month and a fever for 15 days. On abdominal ultrasound, she had hepato-splenomegaly with minimal pleural effusion. A comprehensive diagnostic workup for infectious and immunologic disorders confirmed brucellosis with the antibody tests report. She received doxycycline, rifampin, and trimethoprim-sulfamethoxazole for three months. The treatment was continued with Syrup Doxycycline (50 mg/5 ml), and Syrup Rifampicin (2 g/100 ml) was prescribed for five weeks. Her symptoms were improved by the end of the treatment. Conclusion: Brucella is an intracellular pathogen affecting multi-systems of the human body; thus, the treatment is started with antimicrobials that have penetrative effects on a cell. The treatment can be adjusted based on the age group and the complication of the symptoms.

Background: The house officers face multiple challenging situations at work throughout their internship year leading to House Officer Stress Syndrome. Objectives: The paper addresses the aspects of house officer stress syndrome and its influence on their work. Study Design: Cross sectional study. Setting: Tertiary health care setup of Karachi. Period: October to November 2017. Method: A self-designed and self-explanatory questionnaire was prepared and distributed among house officers during work hours. Verbal consent was taken. Confidentiality of the participants was observed. The data was analyzed using SPSS-20, ANOVA and also via a 5 point Linkert scale. Result: A total of 278 responses were obtained from 13 different hospitals, maximum from Jinnah Postgraduate Medical Centre. Among the respondents, 83.9% were females and 15.8% were males. Mean age was 24. Around 42.6% worked 96 hours weekly while 64% reported to be on call 7-9 times monthly. On call available sleep time was as low as 1-2 hours. Nearly 56.4% found work physically tiring. Conclusion: It can be concluded that house officers are susceptible to stress which affects their overall work performance. Henceforth, a holistic approach must be taken in order to promote a healthy working environment and effective patient care.