Objective: To determine the effects of cognition improvement strategies on academic performance, stress and sleep quality of medical students. Method: The cross-sectional study was conducted att he Dow University of Health Sciences, Karachi, from March 2019 to March 2020, and comprised medical students regardless of gender and academic year. Academic performance was assessed through grade point average, while stress and sleep were assessed using the Perceived Stress Scale and Pittsburgh Sleep Quality Index. Data was analysed using SPSS 25. Result: Of the 770 subjects, 748(97%) formed the final sample with mean age 20.32±1.49 years; 619(82.7%) females and 129(17.2%) males. Overall, there were 655(87.6%) consumers of cognitive enhancers and 93(12.4%) non-cunsumers. The mean Pittsburgh Sleep Quality Index score of consumers was 6.05±3.306, while that of non-consumers was 5.80±3.701. The respective mean Perceived Stress Scale scores were 21.18±6.09 and 20.5±6.8. There was no significant association of consumption of cognitive enhancers with academic performance and stress levels (p>0.05), but it was significant with sleep quality (p<0.05). Conclusion: Majority of the students were found to be consuming cognitive enhancers, but no significant association of the stimulants was found with either academic performance or stress.
Introduction: This study aimed at determining the frequency and association of stress levels with modes of transportation and was likely to reveal the contributing transportation-related factors for stress in medical students. Methods: This was a questionnaire-based, cross-sectional study that included undergraduate medical students of a public sector medical university in Karachi, Pakistan. A total of 573 students participated voluntarily, of which 300 were provided a manual questionnaire and 273 filled it online. The reliability of the questionnaire was assessed using Cronbach’s alpha at 0.791. The collected data were analysed using IBM SPSS Statistics for Windows, version 21.0. Results: Out of 573 participants, 99.3% (n = 298) of students filled the questionnaire manually, whereas 100% of students filled the questionnaire online. Almost two-thirds of students used university transport; more than 90% lived more than 5 km from the university and 56% had a traveling time of more than an hour. Approximately 15.4% of students reported physical trauma and some form of harassment. Sheldon Cohen’s stress scale surprisingly revealed 90% of students to be within the moderate-to-high stress category. Risk factors were associated with stress levels and significant associations were observed with noise exposure (P = 0.023) and sleep quality (P = 0.001). The most common reported stressors associated with commuting included overcrowding, long travel, and air and noise pollution. Noise pollution was the main predictor of stress among commuters. Conclusion: Poor transportation has adverse effects on health and academic performance. Administration in their respective jurisdictions is needed to investigate this matter to make commuting a routine rather than a hassle.
Objectives: To quantify the depiction of violence and vulgarity in television programmes for children, and to assess the perception and practices of parents and children about television programmes meant for children. Methods: We conducted this mixed-methods cross-sectional study in Karachi, Pakistan in the months of August-September 2018, after approval from the ethics review board of Dow University of Health Sciences, Karachi. First, a content analysis of over 102 hours of various television programmes meant for children was performed in the light of the guidelines set out by the World Health Organisation, the United States Federal Communication Commission and the Pakistan Electronic Media Regulatory Authority. Seven trained researchers sampled the children prime time throughout a week, including the weekends, using a structured tally sheet. Subsequently, interviews were conducted with dyad of parent-children from the employees’ list of a public-sector university. A questionnaire was also administered to assess the practices and perceptions of the parents-children dyad about the programmes. Data was analysed using SPSS 24. Results: Of the 173 subjects, 84(48.6%) were parents and 89(51.4%) were children. The mean age of the children was 89 children 9.8±3.7 years. Content analysis comprised 6130 minutes, of which 5442(88.8%) had depictions of violence and vulgarity. Depiction of violence and vulgarity was prevalent on television channels that were watched the most, but there was no significant difference in this regard (p=0.238). Of the parents, 68(81%) expressed concern over the effect of screen time and content on the mental health of their children.
Background: Hypospadias repair requires an appropriate wound dressing to prevent complications, but there is a lack of studies comparing the efficacy of different dressings. Aim: To compare the clinical outcomes of occlusive hydrocolloid dressing and petroleum-impregnated gauze with zinc oxide adhesive plaster, and recommend an appropriate dressing based on efficacy, availability, and cost-effectiveness. Methods: We performed a retrospective cohort study on paediatric patients who had undergone hypospadias repair between August 2017 and November 2020 at Dr. Ruth K. M. Pfau Civil Hospital Karachi, Pakistan. All the patients receiving one of the two wound dressings, occlusive hydrocolloid dressing (group A) or petroleum-impregnated gauze with zinc oxide adhesive plaster (group B) during primary or secondary hypospadias repair, operated by the same paediatric surgeon were included in this study. Patients with missing data were excluded. There was only one patient lost to follow up in this study. Results: A total of 64 male hypospadias patients with a mean age of 6.0 ± 3.4 years were included in this study. Group A patients (n=37) received a thick 10 x 10 cm occlusive hydrocolloid dressing whereas, in Group B patients (n=27), a 2.5 x 10 cm petroleum-impregnated gauze with zinc oxide adhesive plaster was applied over the wound. In group A, five patients (13.5%) suffered post-operative fistula and wound dehiscence. Whereas, in group B, the post-operative fistula was seen in three patients (11.1%). This study provides evidence-based information to clinicians and healthcare providers regarding the use of wound dressings for hypospadias repair. By demonstrating the efficacy of a cheaper and more accessible dressing, this study could help improve access to care and reduce costs for patients, especially in resource-limited settings. Conclusion: Occlusive hydrocolloid dressing and petroleum-impregnated gauze are equally effective in the healing of hypospadias repair wounds. The simpler and cheaper petroleum-impregnated gauze may be preferable in resource-limited settings. Keywords: Hydrocolloid dressing; Petroleum impregnated gauze; Paraffin gauze; Hypospadias
Objectives: Cardiovascular disease (CVDs) is the leading cause of deaths globally. Apart from traditional risks, multiple indigenous factors are implicated to impact disease courses. Lifestyle factors distinct to South Asians may predispose to disease or serve a protective effect. Our study objective was to determine the Relationship of lifestyle and dietary habits of South-east Asian (Pakistani) population with cardiovascular diseases. Methodology: A case-control study was conducted from April to October 2021 in a two-thousand bedded university teaching hospital in Karachi, Pakistan. Out of 400 participants, 189 were cases with a documented cardiovascular event and 211 were controls. Participants >18 years were included whereas pregnant females and patients with congenital heart defects were excluded. A structured questionnaire was designed and implemented, and anthropometrics were recorded. Chi-square test, independent sample t-test and multivariate analysis were utilized via SPSSv23. P-value <0.05 was considered significant. Results: From 400 participants, 189 cases and 211 controls were identified. 53.4% of the people consuming open spices had CVDs while 46.6% did not. While only 37% of people using home cooked spices had CVDs with an OR= 0.51(0.3-0.84, 95% CI, p=0.08). Our results showed an inverse or no relationship of high BMI with CVDs. No statistically significant results were observed of diabetes and hypertension with CVDs. Conclusion: Based on our results, home grounded condiments have a protective effects on CVD than open spices. With reference to CVD, poor lifestyle habits and anthropometric profiles of our controls indicate a need for urgent preventive measures at population level.
Objective: To determine the role of low-dose aspirin in preventing preeclampsia for previously hypertensive pregnant women. Method: The meta-analysis was conducted from February to May 2021 and comprised search on PubMed and Cochrane Library databases for randomised controlled trials consisting of previously hypertensive women aged 18-55 years, aspirin dosage range 60-100mg, and a comparison between aspirin and placebo groups. Duration of intervention till the end of gestation, the dosage of aspirin given, risk ratios or odds ratio with the confidence intervals, and preeclampsia were the main variables recorded. Data was analysed using RevMan 5.4. Result: Of the 144 articles found, 4(%) were included, having 2238 participants. Pooled estimates revealed that aspirin, compared to placebo, did not significantly reduce the manifestation of preeclampsia (p=0.06). Besides, heterogeneity between the different trials was moderate at 59%. Conclusion: Aspirin was not found to substantially diminish the risk of incidence of preeclampsia, but it did show some beneficial effects. Key Words: Preeclampsia, Low-dose aspirin, Hypertensive pregnant women.
According to the World Bank forecast COVID19 economic consequences have been estimated as the deepest recession since the Second World War. To date COVID19 has claimed 1.4 million lives, leaving millions in varying levels of morbidity and emerges as a bigger problem in the high income than in the low middle income countries. The only hope to put a stop to this monster and go back to the normal is the man's old friend, the vaccines. Extraordinary circumstances require extraordinary measures and we have seen that the development of vaccines which was usually thought as a years of business is being prepared and ready to be rolled out under ten months of concentric efforts. A certain percentage of adverse effects are expected from any medication and the same is true for vaccines. However even within the expected numbers of any untoward effects from vaccines, the same are highlighted and become under media limelight for no scientific reason. In this regard manageing mthe mass media is imperative. In the recent history of infections and vaccines, the world has seen both causal and spurious adverse relationships claimed to be associated with vaccines. Whatever the truth was, news of vaccines causing adverse reactions can not only affect the uptake of the very vaccine itself, but can also avert people to go for other routine vaccinations. In the low and middle income countries of the world this could prove as an impending community health disaster. In a country like the UK the Wakefield reports caused decline in the vaccine uptake and a surge in the infections, so what worse we can be expected in other parts of the world. Considering the tight rope of a newly developed vaccine administration in the first stage, ‘the first few thousands’ in the population would be a make or break situation, specially in the low middle income countries where rumors spread faster than anything. In the second stage, targeting a bigger population for vaccine delivery, diligent planning at both macro and micro levels would be required to avoid problems related to vaccine storage, safe delivery, administration and follow up of the vaccine receivers. This pandemic provided us with an opportunity to uncover our potential in a time constraint Global health crisis. The precious achievements of scientists and vaccine manufacturers in this regard must be capitalized upon and be secured from mishaps and mismanagement. Continuous...
By this letter we aim to highlight the neglected issue of excessive viewing of pornography and its impact on the person and the society as a whole. An authority on this topic devised a “triple-A engine” effect criteria: accessibility, affordability and anonymity, to explain the pervasiveness of Internet addiction including Pornography(1). Pornography is a Compulsive Sexual Behaviour Disorder which has been classified under impulse control disorder in ICD-11 (2). Whereas, here, in Pakistan the prevailing erotica has not yet been perceived as a problematic condition even though several disturbing incidents have been reported. In 2015, the largest ever child abuse scandal in Hussain Khanwala Village of Pakistan was brought to light. Over 280 children were compelled to have sex while being videotaped and more than a thousand copies were trafficked (3). This case of child pornography alerted the victims’ families but the root cause was not determined nor were strict laws against the persecutors enforced. Hence, to form counter strategies for such incidences in future, this issue and its ramifications should be highlighted through researches. Gathering statistical evidences can help in making laws and deriving measures as to when and how they should be implemented. Many surveys and researches have concluded that excessive pornography usage has led to negative impacts on relationships as sexual desires in the participants were found to be significantly diminished and the porn addicts showed heightened expectations from their partners. Poor performance at work and negligence was also observed in some users due to being preoccupied in their obscene thoughts and repetitive viewing. (4) Research has shown pornography can provoke men to seek pleasure by unlawful means like rape considering the fact that it displays aggressive sex. It can incorporate violence in men and inability to distinguish between agony and love. This leads to men thinking that violent sex or sex without the consent of women is allowed and enjoyed by the women (5) which is a misperception that leads to crime. Last year a rising trend was demonstrated amongst the viewers which has been attributed to the enforcement of lockdown due to COVID-19. Lack of work and outgoing activities caused people to spend more time on the screen which also increased porn viewing. (6) ---Continue
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