Socioeconomic status (SES) is one among important indicators to evaluate the health status and nutritional status of a family. It is a position attained by any individual within a system of hierarchical social structure. Various attempts have been done in past by eminent scholars and medical scientists to formulate a group of composite indexes to determine SES of an individual or a family living in urban or rural areas. The scales have included various composite indexes to take into account details pertaining to an individual or any family. Among all the available SES, the most widely used and popular scale in our country is "Modified Kuppuswamy SES" which is mostly used for urban areas. In this paper, we have aimed at revising and providing an "Updated Modified Kuppuswamy SES" for the year 2021. The scale was initially developed by Kuppuswamy in the year 1976 including index parameters like education, occupation, and total income which was further modified in later years to include head of families educational status, occupational status and overall aggregate income of the whole family, pooled from all sources. The Kuppuswamy SES has included 3 parameters and each parameter is further classified into subgroups and scores have been allotted to each subgroup which have been defined later in this paper. The total score of Kuppuswamy SES ranges from 3-29 and it classifies families into 5 groups, "upper class, upper middle class, lower middle class, upper lower and lower socio-economic class." Due to limitations, the Kuppuswamy SES needs regular update for income levels which is based on changing CPI values which makes the scale vulnerable to fluctuations over time.

Urinary tract stone (Urolithiasis) is a common problem nowadays. Scientists have even found evidence of Urolithiasis in Egyptian mummy several thousand years ago. 1 Frequencies of urolithiasis vary from region to region: 1-5% in Asia, 5-9% in Europe, 13% in North America. 2-3 Urolithiasis is believed to be due to imbalance and crystallisation of minerals inside urine, which act as the focus for more sedimentation and finally the formation of a stone within the urinary tract. 4 The comorbidities associated with urinary stones includes: renal colic, urinary tract infection, ABSTRACT Background: Urinary tract stone (Urolithiasis) is a common problem nowadays. Frequencies of urolithiasis vary from region to region: 1-5% in Asia, 5-9% in Europe, 13% in North America. Urolithiasis is believed to be due to imbalance & crystallisation of minerals inside urine, which act as the focus for more sedimentation and finally the formation of a stone within the urinary tract. The comorbidities associated with urinary stones includes: renal colic, urinary tract infection, hydronephrosis, obstruction of the collecting system, renal parenchymal damage which ultimately leads to renal failure and even death. The aim of this study was to assess the relationship between obesity and the metabolic evaluation of 24 hour urinary analysis of stone formers. Methods: A case-control study was carried out on 70 patients aged ≥20 years with urolithiasis that were without any comorbidities treated between January 2014 to January 2015. We performed 24 hour urinary analysis on urolithiasis patients and classified them as being of low weight (body mass index; BMI: <18.5, 8 men, 5 women), normal weight (BMI: 18.5-24.9, 19 men, 7 women), overweight (BMI: 25-29.9, 30 men, 12 women) or obese (BMI≥30, 12 men, 7 women).140 healthy normal weight sex and age-matched controls were also included in the study in the ratio of 1:2. Results: There was a statistically significant difference in the prevalence of obesity between the urolithiasis group and the control group (p<0.05).The correlation analysis revealed a significant positive relationship between BMI and the serum calcium, uric acid, urinary calcium, uric acid and citrate, and there was an inverse relationship between BMI and urinary pH (p<0.05). The frequency of urinary stone risk factors was increased with BMI (p<0.05). Conclusions: The positive relationship between Obesity and the risk factors for urolithiasis was evident from this study. To understand the mechanism of urolithiasis in obese patient's further research is required.

BackgroundSuicidal thoughts and depression are associated with patients with diabetes, especially patients with low socioeconomic backgrounds and prolonged illness.ObjectiveWe aimed to estimate suicidal thoughts and depression among patients with type 2 diabetes (T2D) in the slums of Karachi.MethodsThis cross-sectional study was conducted across 38 locations in the slums of Karachi to understand depression, suicidal thoughts, and other supporting factors of depression associated with T2D. The three-item Oslo Social Support Scale, the Patient Health Questionnaire-9 (PHQ-9) scale, and the Ask Suicide Screening Questions were used to screen the patients.ResultsA total of 504 study participants were interviewed, with a response rate of 98%. The prevalence of depression among patients with diabetes was 30.83%, and suicidal ideation was 20.39%. In the final multivariate analysis, being socioeconomically poor, physically disabled, and having poor social support were independent predictors of depression.ConclusionDiabetes, low socioeconomic level, a lack of social support, and physical disability were all linked to depression. Therefore, trained health providers should conduct an early depression-focused routine screening for patients with diabetes.

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