Depression is recognized as the most common psychiatric problem in patients with end-stage renal disease. Stress negatively affects the quality of life of not only the patients on hemodialysis but also their caregivers. The objective of this study was to measure and compare the frequency of depression in these patients and their attendants, and to assess the associated risk factors in both groups. A cross-sectional study was conducted at our hemodialysis unit from June to September 2009. A total of 180 patients and 180 caregivers were enrolled and the Beck's Depression Inventory (BDI-II) questionnaire was administered. Of the 360 respondents, 201 (55.8%) were males and 264 (73.3) were married. According to the BDI scoring, 135 (75%) of the patients and 60 (33.4%) of the attendants were found to be moderately to severely depressed. Marriage (OR 1.817), low income status (OR 1.757) and unemployment (OR 4.176) correlated with increased depression grade, while gender and education level did not. Anemia was the only co-morbidity showing positive association with depression scores in the patients' group (P = 0.023). We conclude that the majority of the patients undergoing dialysis were depressed and were twice more likely to be depressed than their caregivers. In both groups, marriage and unemployment were associated with increased depressive symptoms, while household income showed negative association with depression. Gender and education level were not related to the depression scores.
Background: Infertility is becoming global health issue, which affects multiple aspects of human life in both genders . Medical induction of ovulation with clomiphene citrate has been first line of treatment of infertility since 1962 . Discrepancy in ovulation rate and pregnancy rate with clomiphene citrate along with multiple complication in most of the infertile patients raises the question for alternative treatment . Increased risk of (OHSS) ovarian hyperstimulation syndrome is associated with prolonged ovulation induction. Letrozole was found to be an effective alternative ovulogen. Aim: To study the effects on ovarian weight of female albino rat with histological changes after ovulation induction with letrozole and clomiphene citrate . Method: An experimental study was conducted at animal house of PGMI with 84 female Wistar albino rats having weight between 150-250gm.The study was carried out after approved by Ethical Committee of Postgraduate Medical Institute, Lahore. Eighty four rats were equally divided into three groups (one control group A and two experimental groups B & C). Normal saline was given orally to the group A , letrozole(Femara) at dose 5mg/kg and clomiphene citrate at dose 100ug/kg were given orally to B & C groups respectively . Major groups were further subdivided into four subgroups according to duration of treatment (1-4 estrous cycle ). Ovaries of female albino rats were removed after dissection and weight was calculated. Ovarian sections were made and stained with Haematoxylin and Eosin, to study the histology of ovaries. Results: Experimental study showed statistically significant difference in the weight of ovary among control and experimental groups after 1-4 estrous cycles but insignificant difference was observed between letrozole and clomiphene citrate group. This showed that both drugs have enhanced the folliculogenesis as increase in ovarian weight is due to enhanced gonadotropic activity . Normal histological features were observed with letrozole even after 4 estrous cycle. But in clomiphene citrate group after 4 estrous cycles, significant increase in ovarian weight with cystic follicles arrangement at the periphery of ovary showing Practical implication: As ovary is an important reproductive & endocrine organ and plays vital role in female reproductive life , this study showed the hazardous effects of commonly used clomiphene medicine on ovary . Practically letrozole should be used as first line of treatment as it is safe &does not damage the normal histology of ovary . Conclusion: Present study concluded that there is increase in ovarian weight after ovulation induction with Letrozole and clomiphene citrate. But Significant increase in ovarian weight along with cystic changes in ovarian histology with Clomiphene citrate after prolonged use might be hallmark of OHSS (Ovarian hyper stimulation syndrome), still lots of work is required in this regard. Keywords: Ovarian weight, Clomiphene citrate, letrozole, OHSS, Cystic follicles .
Background: The aetiology of polycystic ovarian syndrome (PCOS) is unknown, even though it is the most frequent endocrine disorder in women of reproductive age. Previous community-based studies were unable to directly estimate the prevalence of PCOS in these communities since they did not conduct comprehensive biochemical and clinical screening. Objective: This research focused on polycystic ovaries and associated clinical and biochemical features in young women. Study Design: Cross-sectional study Study Setting: This study was conducted in Department of Biochemistry Central Park Medical College, Lahore from 1st August 2022 1st February 2023. Methodology: During the study period, volunteers were recruited from hospitals and requested their consent. While women were informed specifically that ovaries scan (ultrasound) would be used to detect polycystic ovaries. After the confirmation of polycystic ovaries, they were taken 201 as a case group. To compare the data, we also recruited 233 healthy participants as a control group. After taking consent and filling the questionnaire both cases and controls participants were requested for biochemical and hormonal analysis. SPSS version 20 was used for data analysis. Results: The mean age of control 25.83 ± 4.6 years and 27.12 ± 5.52 years of with significantly increased BMI in the women with PCO as compared to controls (p = 0.001). Insulin and resistance are significantly increased in those women suffering from PCO. LH, oestradiol are significantly increased and FSH is significantly decreased in cases as compared to control. The level of testosterone is not significant in this cohort. SHBG and also free testosterone index are also not significantly different. Practical implication: Even though many women in rural areas experience signs of a disease, they are hesitant to see a gynecologist or endocrinologist for treatment due to a lack of disease awareness, management, and medical therapy that conforms to criteria. Most patients don't get treatment because of this hesitation, which can cause a host of problems down the road. This study was done to better understand the clinical and biochemical characteristics of polycystic ovary syndrome in young women. Conclusion: Most women with infertility in Pakistan's leading medical centers have polycystic ovaries. Women with polycystic ovaries may not always experience the symptoms of polycystic ovarian syndrome. However, 26 percent of women in this research had PCOS. Women with polycystic ovaries often have hyperinsulinemia and high levels of insulin resistance. While LH and FSH are both considerably higher in cases than in controls, they are unrelated. The results of this investigation showed that although testosterone levels did not influence PCO, a negative correlation between insulin levels and SHBG hormone was seen in individuals with elevated insulin. Hence, the management of insulin can reduce the risk of PCO. Keywords: PCO, PCOS, LH, FSH, oestradiole, hyperinsulinemia, HOMA-IR
Background: Delaying acute appendicitis diagnosis may cause appendix perforation and abscess or peritonitis. Appendectomy is one of the most common surgeries in Pakistan, however little is known about vermiform appendix variation architecture. Hence, appendix anatomy may improve prognosis, this research identified appendix anatomical locations, length, and age and sex relationships. Objective: This study aimed to identify the anatomical sites of the appendix, the length of the appendix and to examine the associations between these factors and age and sex. Study Design: Retrospective cross-sectional study Study Setting: This study was conducted in anatomy department of Islamic International Medical College, Rawalpindi from August 2022 to January 2023. Methodology: This retrospective cross-sectional research was completed in the (department and hospital name) between (year). This study was approved from Ethical review committee with IRB (no). The patients reports were taken for the completion of the study. The CT scan of both gender from 8 to 60 years with the help radiologist suggestions were included in this study. Together with a radiologist, we analyzed CT axial images, a coronal of 1.5 mm thickness, and a sagittal reconstruction to assess the anatomical findings of the vermiform appendix retrospectively. Results: There were 300 total participants in this research, 165 (55%) were female and 135 (45%) were male between 8years to 60 years of age. In both sexes, the following sites were found Pelvic, Post ileal, Pre ileal, Retro caecal, Retro colic, Retro Para colic, and Sub caecel. Appendix length and site was shown to be significantly different in gender and age (p<0.001). Children less than 10 years old were more likely to have an incomplete mesoappendix. According to our findings, males have a longer appendix than females do. On the other hand, we discovered that the appendix tends to become longer with age. Practical implication: The location of the appendix reportedly varies among ethnic and geographical groups. Preoperative planning requires knowledge of these variations. Although appendectomy is one of the most common operations in Pakistan, very little is known about vermiform appendix variation anatomy in the country. Conclusion: This study's findings showed that the vermiform appendix is most often seen in the pelvic position on CT in the Karachi-based population. In conclusion, the high prevalence of anterior location and full mesoappendix in our group suggests that acute appendicitis may be more easily and quickly diagnosed in our demographic, with fewer instances of sequelae including perforation and gangrene. Keywords: Vermiform Appendix, Pelvic, Post ileal, Pre ileal, Retro caecal, Retro colic, Retro Para colic, and Sub caecel
Lead (Pb) is an abundant and one of the most lethal metals found in the earth’s crust. Its use by humans dates back to thousands of year. Even the low doses of lead are responsible for the production of reactive oxygen species which leads to oxidative load. This oxidative stress mitigates production of malondialdehyde (MDA) and down regulates antioxidant enzyme superoxide dismutase (SOD). Study Design: Quasi experimental Study. Place and duration of study: Department of Biochemistry, ANMCH, Islamabad, Pakistan in collaboration with NIH, Islamabad from November, 2018 to April, 2019. Methodology: A total of 40 BALB/c mice were divided into two groups of 20 mice each. Group was given normal standard diet. Group was given lead acetate in drinking water with normal diet without any supplementation. Levels of malondialdehyde were measured by using Thiobarbituric acid reactive substances (TBARS) and Superoxide Dismutase (SOD) was estimated by xanthine oxidase method at the end of study. Results: The results of our study showed increase in MDA and decrease in SOD in lead treated group when compared with the control group. Pearson correlation was applied to assess the degree of association between two parameters, it showed significant negative correlation with value of r = -0.96 and p-value of 0.001 Conclusion: It was concluded from our study that increase in MDA leads to decrease in SOD indicating strong negative correlation in lead poisoned mice. Key words: Lead poisoning, Malondialdehyde, Oxidative Stress, Superoxide Dismutase
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