Objectives: To determine the frequency of elevated plasma homocysteine (Hcy) levels among type 2 diabetes mellitus (T2DM) patients. Study Design: Cross sectional study. Setting: Department of Medicine, Abbasi Shaheed Hospital, Karachi. Period: From 28 September 2012 to 26 March 2015. Material & Methods: Type 2 Diabetic patients fulfilling inclusion criteria were enrolled. Patients with conditions known to cause altered homocysteine levels were excluded. Patients’ HbA1c and fasting serum homocysteine levels were obtained. Level >15 μmol/L was labeled as elevated.  Data was collected with the help of Performa. Data was analyzed using SPSS version 21. Results: (90) ninety patients were enrolled in this study during study period with mean age of 61.5±7.3 years. Of (90) ninety patients, 45 (50%) were male and 45 (50%) were female with male to female ratio of 1:1. Mean duration of diabetes was 6.9±1.7 years. 40 (44.44%) cases were of controlled diabetes and 43 (47.7%) were on treatment. Of 90 patients 36 (40%) patients had Homocysteinemia. Homocysteine levels were found to be significantly raised in males 51.1% v/s 28.8% (p<0.03), older patients (>60 years of age) 55.5% v/s 16.6% (p<0.001), having diabetes for > 7 years, 59.2% v/s 17%(p<0.00004), in 21% v/s 57.4% cases who were and were not on treatment respectively (p<0.0004), in 22.5% patients with controlled diabetes and 54% patients with uncontrolled diabetes respectively (p<0.002). Conclusion: Hyperhomocystenemia is prevalent (40%) in type 2 diabetics with statistically significant raised levels in males, >60 years of age, non-compliant diabetics, have long duration diabetes, and uncontrolled disease.

Prolonged mechanical ventilation and premature removal from mechanical ventilation (MV) are independent risk factors for morbidity and mortality. Weaning and liberation from MV remain critical stages of a patient's ICU stay. To date, no weaning predictive index has proven to be ideal. Objectives: To determine the frequency of successful extubation in patients on mechanical ventilation after 2 hour of spontaneous breathing trial (SBT). Methods: A total of 100 consecutive patients admitted in Medical ICU, meeting the inclusion criteria was enrolled. Non probability purposive sampling was employed. Patients of both gender and age >18 years, on mechanical ventilator for more than 48hrs were included. Two hours of SBT was performed in a semi seated position. RSBI were measured at 1 min after extubation. Patient who have not developed any feature of SBT intolerance, was continued on SBT up to 120 min. All collected data was entered into Statistical Package for Social Sciences (SPSS) version 24.0 for analysis. Results: Successful extubation was found to be (86%). in patients with RSBImax <105. Among 43 patients with successful extubation, 60.5% were male and 39.5% were female. The average age was 53+ 14.6 yrs and the average days of MV were 7+ 2.3 days. Rate of successful extubation was high with the age < 60 yrs, in male gender and with duration of MV <7 days. Conclusion: It is concluded from the above study that patients with RSBImax <105 were found to have successful extubation

Objective: To determine the coronavirus disease-2019-related risk perception and altruistic response among undergraduate medical students post-lockdown. Method: The analytical cross-sectional study was conducted from October 1, 2020, to March 31, 2021, at the Baqai Medical University, Karachi, and comprised undergraduates aged 16 and above, studying in medical, dental, physiotherapy, pharmacy and Information technology departments. Data was collected using a structured and standardised online questionnaire.  Positive responses led to a perceived risk score ranging 0-9, with a higher score indicating a greater perception of risk. The score was corelated with demographic variables. Data was analysed using SPSS 21. Results: Of the 743 subjects, 472(63.5%) were females. The overall mean age of the sample was 21.34±1.8 years. The mean risk perception score was 3.8±2.5, and it was significantly associated with disease exposure (p<0.001). Altruism had a strong association with the perceived risk score (p<0.001), indicating lower risk perception. Conclusion: The risk perception among the students was low, pointing towards a need of psychological assistance program for the students. Key Words: COVID-19, Risk, Perception, Students, Academics, Institutes.

Objective: This study aims to assess the knowledge and practices towards novel corona virus pandemic (COVID-19) among general patients of a tertiary care hospital in Gadap town, Karachi, Pakistan. Study Design: Cross Sectional study. Setting: At OPD of Fatima Hospital, Baqai Medical University, Karachi. Period: 16th to 21st March 2020. Material & Methods: A total of 267 respondents were included using non-probability convenience sampling. Knowledge and Practices towards COVID-19 were assessed using interview based, open-ended questionnaire. The knowledge questionnaire consists of 11 questions assessing, General information, symptoms, modes of disease spread, methods of disease control and self-isolation techniques. Practice assessment was based on five parameters towards prevention. Mean knowledge and practice scores were calculated. A bivariate Pearson correlation, independent sample T-test and One Way ANOVA were utilized to depict statistical correlations between variables. Post-Hoc Analysis was applied within the demographic groups. Results: The mean age of participants was 37.33+15.1 years, 64.8% were 40 & below age, 64.4% were male, 40.4% belonged to Pushtoon, 43.3% were illiterate, 24.3% were laborer and 27% were housewives. The mean knowledge score was 9.31+5.59 out of 30, depicting an overall 31% rate of knowledge. The mean practice score was 1.33+1.34 out of 5. There is a strong positive (p<0.001) correlation between knowledge and practice scores were found. The knowledge and practice scores were also significantly associated with level of education (p<0.001). Conclusion: The overall knowledge and practices towards COVID-19 were found to be very poor in population of low socioeconomic status with low educational background improvising the public health authorities to design the specialized health education interventions aimed at targeting the specific population.

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Objectives: To discuss the clinically significant endoscopic findings of the upper GI tract and their association with different age groups in a dyspeptic rural population of Gadap town, Sindh. Methods: This was a retrospective secondary data analysis of 806 patients conducted in the medical ward of Fatima Hospital, Baqai Medical University from December 2016 to May 2019. It was approved by the University Ethics Committee. Patients’ demographics and other data related to the procedure were recovered from patients’ records. SPSS version 20 was used for statistical analysis. Results: There were marginally more women suffering from dyspepsia as opposed to men (51.5% vs 48.5% respectively). Majority of the patients were less than 45 years of age, with most procedures being performed as outpatients. Nearly 40% of the patients did not have clinically relevant endoscopic findings. Most common significant finding on endoscopic examination was gastritis followed by hiatal hernia. Conclusion: Normal upper gastrointestinal endoscopy, regardless of age, is a common finding in patients suffering from dyspepsia in our setting. Therefore, in a resource constraint environment like ours, expensive endoscopic procedures should be reserved for those patients who are not responding to medical therapy or those who have alarm symptoms. doi: https://doi.org/10.12669/pjms.38.6.5948 How to cite this:Kamran M, Fawwad A, Rabbani B, Ahmed J. Clinically significant endoscopic findings in a dyspeptic rural population cohort of Sindh, Pakistan: Are we over-investigating? Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5948 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.