Assessment of eating habits, lifestyle and physical activity among medical and dental students of Faisalabad Medical University

Objective

To assess the eating habits, lifestyle and physical activity and their impact on health of students of Faisalabad Medical University (FMU) Faisalabad Pakistan.

Methods

A descriptive cross-sectional study was prepared on 328 medical and dental students at Faisalabad Medical University from June, 2022 to October, 2022. Three Factor Eating Questionnaire Revised 21 (TFEQ-R21) was used to assess the eating habits among medical students and physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short version. A self-constructed questionnaire was used to assess lifestyle patterns.

Results

According to the study, 191(58.2%) students out of 328 practiced unrestricted eating. While 229(69.8%) students demonstrated cognitive restraint and 128(39%) students indulged in emotional eating. Less than half of the students, 52(15.9%) lead unhealthy lifestyles compared to 276(84.1%) who had healthy habits. Out of 328 students, 104 (31.7%) engaged in low, 137(41.8%) in moderate, and 87(26.5%) in high levels of physical activity. Whereas a higher proportion of female students engaged in low to moderate physical activity (61.5% and 52.6%, respectively), while a higher proportion of male students (63.2%) were involved in intense physical activity.

Conclusions

A large proportion of medical students exhibited poor dietary habits with low physical activity. Obesity and other metabolic diseases are more likely to strike medical students who engage in these unhealthy eating habits. As future health providers, health interventions must be implemented to avert future harm.

A rare case of arthrogryposis multiplex congenita in a 2-year-old boy case report

Arthrogryposis multiplex congenita (AMC) is an uncommon condition present from birth that is marked by a combination of weakened muscles and multiple joint contractures. We present a case of a 2-year-old boy with AMC, who was born to consanguineous parents in Saudi Arabia. He presented with musculoskeletal abnormalities of all four limbs, including symmetric contractures in multiple joints of the body, bilateral developmental dysplasia of the hip, and vertical talus. Dysmorphic features included low-set ears, chin recession, triangular face, and nevus flammeus on the face. The child also had lactose intolerance, gastritis, inguinal hernia, and right-sided undescended testis. Surgical interventions were planned after a multidisciplinary team discussion. This case report highlights the good prognosis of AMC with all four-limb involvement and the importance of a thorough physical examination and a multidisciplinary approach to the diagnosis and management of AMC.

Managing Kartagener's Syndrome With Type II Respiratory Failure and Left-Sided Pneumothorax During the COVID-19 Pandemic: A Case Report

Kartagener's syndrome is an autosomal recessive disorder with symptoms varying from chronic sinusitis to bronchiectasis and situs inversus (a congenital condition in which the visceral organs are located in an opposite location). We describe a rare and complicated case of a 40-year-old female patient who presented to the emergency room with significant chest congestion and Kartagener's syndrome. This case demonstrates the value of individualized and proactive care as well as the challenge of managing this illness, particularly when it coexists with type II respiratory failure related to pneumothorax.

The prevalence, angiographic profile and clinical features, management, and outcomes of coronary artery perforation secondary to percutaneous coronary interventions in Pakistan: a retrospective cohort study

Coronary artery perforation (CAP) is a rare entity that is often fatal. The mortality rates reported as high as up to 21% hence prompt diagnosis, intervention, and treatment are paramount to survival for such patients. Several factors may predispose a patient to coronary artery intervention including chronic total occlusion, severe calcification and tortuosity, aggressive use of oversized balloons and stents, and use of athero-ablative devices. Therefore, it is significant to have an insight related to it as despite being rare, it is one of the most feared complications of percutaneous coronary intervention (PCI).

Method

We conducted a retrospective study of the patients who have undergone PCI at our institution from January 2015 to December 2021. During this duration, all the patients who had developed CAP based on angiographic review during the PCI were selected. The demographic, clinical, angiographic, procedure-related features, management of the CAP, and in-hospital and follow-up outcomes were gathered.

Result

Thirty-five thousand fifty-nine patients underwent PCI among which, only 93 (0.26%) patients were complicated with (CAP. Fifty-eight (62.4%) patients were in the 50-70 years age range. The most common vessel involved was the left anterior descending (36.5%) followed by the right coronary artery (32.3%). The angiographic calcification was present in 51.6% of patients, significant tortuosity greater than 90° was seen in 48.4% of patients, chronic total occlusion was observed in 42% of patients and In-stent restenosis was found in 8.6% patients. The highest mortality of four patients was seen in the CAP involving the right coronary artery.

Conclusion

Mostly the CAP involves large vessel perforations however both, the distal and large vessel perforations are related to the increased incidence of adverse clinical results which indicates the significance of the prevention and early identification and treatment of the perforation.

Concurrent Obsessive-Compulsive Symptoms in Patients With Schizophrenia: A Retrospective Study From a Tertiary Care Centre in Sindh, Pakistan

INTRODUCTION

The present study aimed to evaluate the proportion of concurrent symptoms of obsessive-compulsive symptoms (OCSs) among patients with schizophrenia.

METHODS

A retrospective study was undertaken at the Department of Psychiatry, Jinnah Postgraduate Medical Center, Sindh, Pakistan between 1st March 2019 and 1st April 2020. All cases with diagnosed schizophrenia irrespective of gender, age, or ethnicity were eligible for the study. We excluded patients with acute psychosis due to isolated substance use disorder or any organic brain disease. The medical records for each patient were retrieved from the departmental database. Sociodemographic factors including age, gender, ethnicity, and presence of OCSs and other psychiatric comorbidities were recorded in a predefined pro forma. The presence of OCSs was noted by the attending psychiatrist during history taking as positive or negative.

RESULTS

A total of 139 patients were included. A predominance of the male gender was noted. There were 63 (45.3%) patients with concurrent OCSs. Out of the total patients, 42 (66.67%) males and 21 (33.33%) females had OCSs. A total of 28 (44.44%) patients between 31 and 45 years of age had OCSs. Out of the 63 patients with OCSs, 36 (57.14%) had a history of substance abuse (p = 0.471). In the study, 17 (26.98%) Balochi and 19 (30.16%) Pashtuns had OCSs. However, the difference was statistically insignificant.

CONCLUSION

In conclusion, OCSs were frequent in patients with schizophrenia, according to the current study. We discovered that males, individuals between the ages of 18 and 30 years, Balochis, Pashtuns, and those with a history of substance abuse were more likely to have OCSs. However, the difference was not statistically significant.

Relationship between Renal Function and Bone Mineral Density in Postmenopausal Women

Renal insufficiency is a risk factor for osteoporosis and can increase risk of fracture. It may be a result of an age-related decline in renal function or chronic kidney disease. In patients with CKD, accurate diagnosis of osteoporosis or CKD-MBD is important for determining the most appropriate treatment. This was a cross sectional study was done at Institute of nuclear medicine and Allied Sciences, BSMMU, Dhaka from 1st January 2014 to 31st December 2014. Study population was total 69 postmenopausal women age over 50 years. Women with Bilateral hip replacement or bilateral hip pins or screws, metallic rods in spine, Carrying out BMD scan within the week after other radiological investigation using contrast media e.g. Barium meals or enema, IVPs were excluded from study. Clinical variables were- age (years), height (cm), weight (kg), BMI. Laboratory variables were- serum creatinine and BMD (Dexa). Estimated GFR was determined by using the serum Creatinine by MDRD formula. Renal function test and Bone mineral density (BMD) were done in all of these patients. Majority (43.4%) of the patients were in 6th decade. The mean weight was found 57.4±11.2kg. Majority 41(59.4%) patients belonged to T score at hip (-1 to -2.5) and their mean T score at hip was found (-1.1±1.1). Osteopenia and osteoporosis were found in 59.4% and 4.3% respectively according to BMD. High serum creatinine level was found in 10.1% cases. Renal function impairment was found in 79.6% of patient. Majority (50.7%) patients had mild decrease of eGFR (60-89 ml/min/1.73m²), There was Pearson's correlation (r=0.156; p=0.200) but not significant was found between age with T score at hip of the patients. Positive Pearson's correlation (r=0.112; p=0.361) was found but not significant between age and serum creatinine level. A significant negative Pearson's correlation (r= -0.274; p=0.023) was found between T score at hip and serum creatinine level of the patients. A significant negative Spearman correlation (r=-0.278; p=0.021) was found between BMD and serum creatinine of the patients. A significant positive Spearman correlation (r=0.580; p=0.001) was found between BMD and estimated GFR of the patients. This study was undertaken to evaluate the relationship between renal function and bone mineral density in postmenopausal women. Majority of the postmenopausal women were in 6th decade and most of them were overweight and obese. Renal function impairment was found in 79.6% of patient. Osteoporosis was found in 04.3% and 20.3% cases according to T score at hip and T score at lumber spine respectively. Significant negative Pearson's correlation was found between T score at hip and serum creatinine level of the patients. Significant negative Spearman correlation was found between BMD and serum creatinine of the patients. Significant positive Spearman correlation was found between BMD and estimated GFR of the patients.

An Urdu speech corpus for emotion recognition

Emotion recognition from acoustic signals plays a vital role in the field of audio and speech processing. Speech interfaces offer humans an informal and comfortable means to communicate with machines. Emotion recognition from speech signals has a variety of applications in the area of human computer interaction (HCI) and human behavior analysis. In this work, we develop the first emotional speech database of the Urdu language. We also develop the system to classify five different emotions: sadness, happiness, neutral, disgust, and anger using different machine learning algorithms. The Mel Frequency Cepstrum Coefficient (MFCC), Linear Prediction Coefficient (LPC), energy, spectral flux, spectral centroid, spectral roll-off, and zero-crossing were used as speech descriptors. The classification tests were performed on the emotional speech corpus collected from 20 different subjects. To evaluate the quality of speech emotions, subjective listing tests were conducted. The recognition of correctly classified emotions in the complete Urdu emotional speech corpus was 66.5% with K-nearest neighbors. It was found that the disgust emotion has a lower recognition rate as compared to the other emotions. Removing the disgust emotion significantly improves the performance of the classifier to 76.5%.

Verrucous Squamous Cell Cancer of the Esophagus: A Case Report

Verrucous Cancer of the esophagus is basically a type of squamous cell carcinoma and is associated with a chronic inflammatory process in the lower esophagus usually secondary to gastro-esophageal reflux disease (GERD). Mostly it is a local disease process but sometimes it can invade distant structures also. We report a case is a 62-year-old female patient who presented with marked weight loss, anorexia, and difficulty to take solid food. On Upper GI endoscopy there was a warty appearing irregular mass at the mid to distal esophagus. Superficial multiple biopsies were taken but turned negative for malignancy and re-endoscopy after a few days with deep multiple biopsies revealed the diagnosis of verrucous carcinoma on histopathology. The patient was having multiple co-morbid conditions like hypertension, diabetes mellitus, and early nephropathy along with infiltration of malignancy in surrounding structures on CT scan chest. Therefore a decision was taken to place an esophageal stent by upper GI endoscopy followed by chemotherapy and radiotherapy by the oncology department. Patient symptoms were much relieved after 4 months of chemotherapy and radiotherapy and the patient is still on regular follow-up in medical OPD. Chronic inflammation due to gastritis and esophagitis is the main risk factor for verrucous carcinoma of the esophagus. Although surgery is the treatment of the choice for the local and early disease but as in our case disease was already spread palliative stenting followed by chemo-radiation is the best possible option that can be offered.

Assessment and Comparative Study of Biofilm Formation with Frequency of Multi Drug Resistance in Strains of Staphylococcus aureus

Background: The study was conducted to identify the role of biofilms in the antibiotic susceptibility in the strains of Staphylococcus aureus. A total of 19 non-repeated pus/wound swab samples from different anatomic locations and 17 samples that were previously identified as Staphylococcus aureus and preserved in the labs were included in the study. The Staphylococcus aureus was identified based on colony morphology, Gram’s stain, biochemical tests (catalase and coagulase tests) and molecular identification through PCR amplification. Methodology: A total of 26 samples were recovered out of the 31 samples. Kirby-Bauer disk diffusion susceptibility test was used to determine the sensitivity or resistance of Staphylococcus aureus to methicillin. Out of the 26 strains, 4 were highly resistant, 10 were moderately resistant and 12 strains were sensitive. Three different protocols (Tube Method, Congo Red Agar Method and Tissue Culture plate method) were used for the detection of biofilm formation for both resistant and sensitive strains. Result: Comparative analysis of the antibiotic susceptibility and biofilm formation by different protocols showed that 70% strains that are resistant to antibiotic methicillin produced moderate-strong biofilms. 50% have produced the moderate-strong biofilms in all 3 protocols. In case of sensitive, 50% strains had produced none-weak biofilms in all 3 protocols. Decisions: The strains that had zone of inhibition of close to resistance produced weak-strong biofilms but they all produced weak biofilms in CRA method. It can be concluded that the strains of Staphylococcus aureus that have the ability to produce biofilms become methicillin resistant.

Induction of secondary metabolites on nanoparticles stress in callus culture of Artemisia annua L

Nanoparticles are known bio elicitors in plant biotechnology. Different concentrations of ZnO, CuO and CoO nanoparticles were used for the enhanced accumulation of secondary metabolites and antioxidant activities in the callus derived from root, shoot and leaf of Artemisia annua L. Biomass of callus was somehow affected on high concentrations of Nps. Phenolic content was observed maximum (60µg) in shoot callus at 0.1mg/l of CuONps. Total antioxidant activity was observed maximum (33µg) in root callus at 0.1mg/l of ZnOnps. Total reducing power maximum (33µg) was observed in root callus at concentration of 0.05 mg/l of CoONps. Maximum radical scavenging activity was observed in shoot callus at 0.05mg/l of ZnONps. Rutin gallic acid and caffic acid were also determined in most of the samples by HPLC. The study concludes that different Nps have positive effect on the induction of secondary metabolites in A.annua plant.

Microbial Patterns and Antibiotic Susceptibility in Blood Culture Isolates of Septicemia Suspected Children in the Pediatrics Ward of a Tertiary Care Hospital

Objectives  This study aims to determine microbial patterns and antibiotic susceptibility to alert clinicians to the emerging pathogens that may pose a threat to the community, especially children.

Materials and Methods  This retrospective cross-sectional study was conducted in the Department of Pathology, Holy Family Hospital, Rawalpindi, Pakistan, from July 2019 to December 2019. Two samples were taken from two different sites of each patient at the time of fever (> 100° F) to avoid chances of contamination. A blood sample of 5 to 10 mL was drawn from each site. In a 50 mL brain heart infusion broth (BHIB), 5 to 10% blood was injected in two different bottles and incubated for 48 hours at 37°C. After 48 hours, subculture was done by streaking the drops of blood samples taken from BHIB on blood and MacConkey agar. Cultures were incubated in aerobic conditions at 37°C for 24 to 48 hours. For testing antibiotic susceptibility, criteria defined by the Clinical and Laboratory Standards Institute (CLSI) were followed. Microbes were identified under a microscope by observing their morphological characteristics after gram staining and applying biochemical tests. Antibiotic sensitivity test was performed using standard aseptic methods.

Statistical Analysis  Bacterial isolates and their susceptibility patterns were represented using frequencies and percentage charts.

Results  Out of 423 blood cultures, growth was recorded in 92 (21.75%) of the cultures with female to male ratio 2.1:1. The gram-positive bacteria accounted for 43.48% ( n = 40), whereas gram-negative bacteria covered the majority 54.36% ( n = 50). Among isolates, Staphylococcus aureus (42.39%) was the most common, followed by Acinetobacter spp. (17.39%) and Pseudomonas aeruginosa (14.13%). Acinetobacter spp. showed 0% susceptibility to amikacin and cefotaxime. All the isolates were 100% resistant to amoxicillin-clavulanic acid. S. aureus showed lower sensitivity for ceftazidime (0%), clindamycin (66.67%), ciprofloxacin (0%), clarithromycin (11.76%), and ceftriaxone (0%). Tigecycline showed 100% sensitivity for all isolates tested.

Conclusion  Gram-negative bacteria form the majority of isolates in our setup, with Acinetobacter as the most common species among them. The resistance against cephalosporins, penicillin, and fluoroquinolones shown by Acinetobacter , Pseudomonas , Salmonella, and Klebsiella is of grave concern. Among gram-positive bacteria, S. aureus has established resistance against multiple drugs. Limited and objective use of antibiotic therapy is a much-needed strategy under new guidelines.

A comparison of characteristics and outcomes of patients with community-acquired and hospital-acquired COVID-19 in the United Kingdom: An observational study

BACKGROUND AND OBJECTIVES

Reports comparing the characteristics of patients and their clinical outcomes between community-acquired (CA) and hospital-acquired (HA) COVID-19 have not yet been reported in the literature. We aimed to characterise and compare clinical, biochemical and haematological features, in addition to clinical outcomes, between these patients.

METHODS

This multi-centre, retrospective, observational study enrolled 488 SARS-CoV-2 positive patients - 339 with CA infection and 149 with HA infection. All patients were admitted to a hospital within the University Hospitals of Morecambe Bay NHS Foundation Trust between March 7th and May 18th^, 2020.

RESULTS

The CA cohort comprised of a significantly younger population, median age 75 years, versus 80 years in the HA cohort (P = 0·0002). Significantly less patients in the HA group experienced fever (P = 0·03) and breathlessness (P < 0·0001). Furthermore, significantly more patients had anaemia and hypoalbuminaemia in the HA group, compared to the CA group (P < 0·0001 for both). Hypertension and a lower median BMI were also significantly more pronounced in the HA cohort (P = 0·03 and P = 0·0001, respectively). The mortality rate was not significantly different between the two cohorts (34% in the CA group and 32% in the HA group, P = 0·64). However, the CA group required significantly greater ICU care (10% versus 3% in the HA group, P = 0·009).

CONCLUSION

Hospital-acquired and community-acquired COVID-19 display similar rates of mortality despite significant differences in baseline characteristics of the respective patient populations. Delineation of community- and hospital-acquired COVID-19 in future studies on COVID-19 may allow for more accurate interpretation of results.

The Influence of Tomographic Corneal Characteristics on Epithelial Thickness Profile

Purpose

To understand the influence of tomographic corneal characteristics on the epithelium of normal eyes.

Methods

We scanned a total of 98 eyes of 98 individuals using anterior segment tomography and a spectral-domain optical coherence tomography (OCT) epithelial mapping tool. Only eyes with no previous pathology were included, with a refractive range of +5 diopters (D) to -6 D, intraocular pressure of < 22 mmHg, and no evidence of dry eye (Schirmer’s test 2 value > 5 mm). Corneal curvature metrics were statistically correlated with regional epithelial thickness parameters.

Results

The anterior and posterior corneal surface flat and steep axis, the maximum and minimum curvature, corneal topographic astigmatism, astigmatism polar values, and corneal volume had no statistically significant correlation (p>0.05) with the epithelial thickness. Similarly, anterior corneal surface asphericity had no significant correlation. Posterior surface asphericity had a statistically significant moderate correlation with the epithelium in all areas. Similar results were seen in the multivariate analysis.

Conclusions

None of the front or back surface parameters had any influence on the corneal epithelium except for the posterior surface asphericity. This statistically significant yet clinically insignificant correlation may be enhanced in diseased populations like keratoconus and could indicate epithelial remodeling with early posterior corneal changes.

Prevalence of virulent Candida spp. in complicated urinary tract infection of nephrolithiatic patients from surgical units of tertiary care hospitals Islamabad

Candida species are the commensal organisms of human mucosa and opportunistically cause the diseases in susceptible persons. This study aimed to determine the prevalence and virulence of different Candida spp. among nephrolithiatic patients and their association with complicated UTI (cUTI). A total of 164 urine samples were collected from surgical units of two tertiary care hospitals (Poly Clinic and Pakistan Institute of Medical Sciences Hospital, Islamabad). From 74 kidney stone patients, 77 isolates of Candida spp. were confirmed through standard microbiological and molecular characterization. C. albicans was the predominant species with 51 isolates (66.2%) followed by 26 (33.8%) of C. non-albicans. The nephrolithiatic patients suffering from cUTI were more prone to be infected with Candida (P=0.047). Among all isolates, 83% (64) of the Candida isolates were biofilm formers, 80% (60) showed the esterase production and 64.9% (50) showed phospholipase production. Candida isolates positive for various virulence factors were more prevalently isolated from both catheterized and recurrent UTI patients. Among Candida spp., 16.9% (13) isolates showed resistance to fluconazole and 19.5% (15) against voriconazole and 11 isolates were resistant for both tested antifungals. Candida isolated from cUTI cases showed comparatively enhanced virulence attributes and antifungal resistance, suggesting that these factors might have role in development of cUTI in nephrolithiatic patients. Hence, this work highlights the high prevalence of both C. albicans and non albicans spp. in nephrolithiatic patients. So, there is need to administer evidence based antifungal therapy rather than empirical therapy to reduce the cUTI in nephrolithiatic patients.

Incidence of Hyperuricemia in Patients with Acute Myocardial Infarction – A Case-Control Study

Introduction

Various researches have stated the correlation between serum uric acid (sUA) and cardiovascular disease (CVD); however, no local studies are available. In this study, we will determine the prevalence of hyperuricemia in patients with acute myocardial infarction and compare with the control group.

Methods

This case-control study was conducted from March to November 2019 in the tertiary care hospital in Pakistan. In all, 119 patients with acute myocardial infarction were enrolled in this study, and 119 controls were identified from the outpatient department. Their sUA levels were measured within 24 hours of acute myocardial infarction.

Results

The mean sUA levels were significantly higher in patients with acute myocardial infarction (AMI) in comparison to the control group (6.17 ± 2.12 vs. 5.51 ± 1.89, p-value; 0.01). Overall, there were more patients with hyperuricemia in the case group compared to the control group (47.89% vs. 33.6%, p-value = 0.04)

Conclusion

In this study, after adjustment of other known factors, hyperuricemia is associated with AMI. Efforts should be made to include screening for hyperuricemia in patients with a high risk of myocardial infarction.

Comparison of Lipid Profile in Patients With and Without Acute Myocardial Infarction

Introduction

There is ample data available to determine the impact of deranged lipid values of acute myocardial infarction (AMI); however, there is a paucity of data from low-income countries like Pakistan. In this study, we aim to determine the correlation of lipid values with AMI.

Materials and methods

This case-control study was conducted from 1 February 2019 to 30 October 2019 in a tertiary care hospital in Sukkur, Pakistan. There were a total of 421 participants divided into two groups; Case Group (patients with AMI, n=212) and Control Group (patients without AMI, n=209).

Results

Total cholesterol and low-density lipoprotein (LDL) were significantly higher in patients with AMI and HDL was lower. There was no significant difference between triglycerides in both groups.

Conclusion

Dyslipidemia is an important risk factor for AMI. There is a need for more large scale multi-center studies to further understand the role of lipid profile in AMI and the various factors that influence it.

Risk of Abdominal Aortic Calcifications among End Stage Renal Disease Patients under Maintenance Haemodialysis

Calcification of soft tissue and blood vessel wall occurs more frequently in dialyzed patients. The purpose of the present study was to estimate the risk of abdominal aortic calcification among end stage renal disease patients under maintenance haemodialysis. This case-control study was carried out in the Department of Nephrology at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka and National Institute of Cardiovascular Disease and Hospital (NICVD), Dhaka, Bangladesh from January 2013 to December 2014 for a period of two (02) years. Chronic kidney disease in stage 5 {CKD-5(D)} patients older than 18 years on maintenance haemodialysis (MHD) for more than 3 months were selected as case group. And same age and sex non CKD patients were considered as control group. Serum calcium, serum albumin, serum phosphate and iPTH were estimated by semi-automated biochemistry analyzer from the Department of Biochemistry of NIKDU, Dhaka and NICVD, Dhaka. Plain X-ray abdomen in lateral view was performed for all patients. Total 100 patients were enrolled for this study of which 50 patients were in end stage renal disease (ESRD) group and the rest 50 patients were in non-CKD group. Abdominal aortic calcification on X ray was present in 22(44%) patients of ESRD group and 6(12%) patients of non CKD group of population. Mean±SD serum calcium (corrected) level was significantly high (p<0.001) in ESRD patients (9.79±0.87) compared to non CKD group of population (9.13±0.70). Mean±SD of serum phosphate level was significantly higher (p<0.001) in ESRD patients (5.71±0.96) compared to non CKD group of population (4.20±0.59). However, mean±SD iPTH level showed no significant difference between ESRD (25.33±51.98) and non CKD group of population (38.53±19.52), though iPTH level remain below the target level in ESRD group. Abdominal aortic calcification is significantly higher among ESRD subjects.

Nuclear spatial and spectral features based evolutionary method for meningioma subtypes classification in histopathology

Meningioma subtypes classification is a real-world multiclass problem from the realm of neuropathology. The major challenge in solving this problem is the inherent complexity due to high intra-class variability and low inter-class variation in tissue samples. The development of computational methods to assist pathologists in characterization of these tissue samples would have great diagnostic and prognostic value. In this article, we proposed an optimized evolutionary framework for the classification of benign meningioma into four subtypes. This framework investigates the imperative role of RGB color channels for discrimination of tumor subtypes and compute structural, statistical and spectral phenotypes. An evolutionary technique, Genetic Algorithm, in combination with Support Vector Machine is applied to tune classifier parameters and to select the best possible combination of extracted phenotypes that improved the classification accuracy (94.88%) on meningioma histology dataset, provided by the Institute of Neuropathology, Bielefeld. These statistics show that computational framework can robustly discriminate four subtypes of benign meningioma and may aid pathologists in the diagnosis and classification of these lesions.

Plant species affect colonization patterns and metabolic activity of associated endophytes during phytoremediation of crude oil-contaminated soil

Plants coupled with endophytic bacteria hold great potential for the remediation of polluted environment. The colonization patterns and activity of inoculated endophytes in rhizosphere and endosphere of host plant are among the primary factors that may influence the phytoremediation process. However, these colonization patterns and metabolic activity of the inoculated endophytes are in turn controlled by none other than the host plant itself. The present study aims to determine such an interaction specifically for plant-endophyte systems remediating crude oil-contaminated soil. A consortium (AP) of two oil-degrading endophytic bacteria (Acinetobacter sp. strain BRSI56 and Pseudomonas aeruginosa strain BRRI54) was inoculated to two grasses, Brachiaria mutica and Leptochloa fusca, vegetated in crude oil-contaminated soil. Colonization patterns and metabolic activity of the endophytes were monitored in the rhizosphere and endosphere of the plants. Bacterial augmentation enhanced plant growth and crude oil degradation. Maximum crude oil degradation (78%) was achieved with B. mutica plants inoculated with AP consortium. This degradation was significantly higher than those treatments, where plants and bacteria were used individually or L. fusca and endophytes were used in combination. Moreover, colonization and metabolic activity of the endophytes were higher in the rhizosphere and endosphere of B. mutica than L. fusca. The plant species affected not only colonization pattern and biofilm formation of the inoculated bacteria in the rhizosphere and endosphere of the host plant but also affected the expression of alkane hydroxylase gene, alkB. Hence, the investigation revealed that plant species can affect colonization patterns and metabolic activity of inoculated endophytic bacteria and ultimately the phytoremediation process.

Dietary habits and life style among the students of a private medical university Karachi

OBJECTIVES

To determine the dietary habits and life style of the students of a private medical university in Karachi.

METHODOLOGY

A cross-sectional study was conducted at Baqai Medical University, from August 2005 to September 2005. A total of 384 medical students from the batches of 2002 to 2005 participated in this study. A pre-tested semi structured questionnaire was self administered to the students after taking their consent. The data included sociodemographic characteristics, life style, exercise, dietary habits and family history of diabetes mellitus. The collected data was analyzed by statistical program SPSS version 11.

RESULTS

Out of the total participants, 53.4% were male and 46.6% were female students. The mean age was 20 +/- 1.58 years. The average income of the household of students was 50,000 Pakistani rupees per month. Only 7% students were tobacco users. About 33% students had a history of diabetes mellitus among their parents. Nearly ninety-seven percent reported consumption of junk food while 60% reported use of whole grain food in their diet. Seventy percent students walked 30 minutes and 47% exercised daily. According to the body mass index, 58.3% students were of normal weight and 41.7% were overweight. No significant difference was found among male and female students when dietary habits and life style were compared by sex. Junk food and soft-drink consumption was associated with being overweight. Eating whole grain food and doing exercise showed a protective association against overweight.

CONCLUSION

Unhealthy lifestyle and poor dietary habits were highly prevalent in the overweight study population. Type-2 diabetes mellitus was common among parents and grandparents of the students making them prone to this disorder. Our study concluded that dietary and exercise counselling is necessary as a preventive strategy.

Dietary habits and life style among the students of a private medical university Karachi

OBJECTIVES

To determine the dietary habits and life style of the students of a private medical university in Karachi.

METHODOLOGY

A cross-sectional study was conducted at Baqai Medical University, from August 2005 to September 2005. A total of 384 medical students from the batches of 2002 to 2005 participated in this study. A pre-tested semi structured questionnaire was self administered to the students after taking their consent. The data included socio-demographic characteristics, life style, exercise, dietary habits and family history of diabetes mellitus. The collected data was analyzed by statistical program SPSS version 11.

RESULTS

Out of the total participants, 53.4% were male and 46.6% were female students. The mean age was 20 +/- 1.58 years. The average income of the household of students was 50,000 Pakistani rupees per month. Only 7% students were tobacco users. About 33% students had a history of diabetes mellitus among their parents. Nearly 97% reported consumption of junk food while 60% reported use of whole grain food in their diet. Seventy percent students walked 30 minutes and 47% exercised daily. According to the body mass index, 58.3% students were of normal weight and 41.7% were overweight. No significant difference was found among male and female students when dietary habits and life style were compared by sex. Junk food and soft-drink consumption was associated with being overweight. Eating whole grain food and doing exercise showed a protective association against overweight.

CONCLUSION

Unhealthy lifestyle and poor dietary habits were highly prevalent in the overweight study population. Type-2 diabetes mellitus was common among parents and grandparents of the students making them prone to this disorder. Our study concluded that dietary and exercise counselling is necessary as a preventive strategy.

Patients' satisfaction and opinions of their experiences during admission in a tertiary care hospital in Pakistan - a cross sectional study

Background

It is often felt that developing countries need to improve their quality of healthcare provision. This study hopes to generate data that can help managers and doctors to improve the standard of care they provide in line with the wishes of the patients.

Methods

It was a cross sectional study carried out at a major tertiary care hospital of Karachi. Patients between the ages of 18 and 80 years admitted to the hospital for at least one day were included. Patients in the maternity, psychiatry and chemotherapy wards and those in the ICU/CCU were excluded. A pretested, peer reviewed translation of a validated patient satisfaction scale developed by the Picker Institute of Europe was administered.

Results

A total of 173 patients (response rate: 78.6 %) filled the questionnaire. Patient satisfaction was at levels comparable to European surveys for most aspects of hospital care. However, nearly half the patients (48%) felt they had to wait too long to get a bed in the hospital after presenting to the ER. 68.6% of the patients said that they were never asked for views on the quality of care provided. 20% of the patients did not find anyone in the staff to talk to about their worries and fears while 27.6% felt that they were given emotional support to only some extent. Up to one third of the patients said they were not provided enough information regarding their operative procedures beforehand.

Conclusion

Although several components of patient care equal the quality levels of the west, many sections require considerable improvement in order to improve health care provision. The healthcare team needs to get more involved with the patients, providing them greater support and keeping them informed and involved with their medical treatment. Efforts should be made to get regular feedback from the patients.

Relationship of HLA antigens and cryoglobulinaemia in hepatitis C virus infected patients

OBJECTIVE

To find the relationship between human leukocyte antigens (HLA) and cryoglobulin positivity in hepatitis C virus (HCV) infected individuals.

METHODS

Eligible individuals selected from pre and post renal transplant settings were divided into three groups. Group A (n = 301) consisted of normal controls, while group B (n = 200) comprised of pathological controls that were HCV antibody (anti-HCV) positive but negative for cryoglobulins. Group C comprised of 56 anti-HCV positive, cryoglobulin positive patients. HLA-A, -B and -DRB1 loci were typed by polymerase chain reaction (PCR) method and relationship between HLA antigens, anti-HCV status and cryoglobulinaemia was analyzed.

RESULTS

HLA-A*02, -B*57 and -DRB1*03 were more frequently found among group C members as compared to groups A and B. Only HLA-B* 57 occurrence reached statistical significance (14.3% versus 6% and 4%, corrected P-value = 0.045 and 0.012 and OR = 2.6 and 4 respectively) No differences in the distribution of HLA antigens were seen among healthy and pathological controls.

CONCLUSION

The presence of HLA-B*57 confers susceptibility to cryoglobulinaemia in HCV infected patients in our population. HCV positive renal transplant recipients with these alleles should be monitored for cryoglobulin formation).

A community based study about knowledge and practices regarding tobacco consumption and passive smoking in Gadap Town, Karachi

OBJECTIVE

To determine the proportion of people consuming tobacco in various forms, level of knowledge and practices regarding various harmful effects of tobacco and passive smoking.

METHODS

A cross-sectional study was conducted at Ghulam Mohammad Jokhio Goth, a small semi urban community of Gadap Town Karachi, which comprises of a population approximate 2225. About 157 people were interviewed regarding their tobacco consumption practices through a semi structured pre-tested questionnaire from June to August 2005. There were 314 households in the community and every alternate household was selected with a random start. The study subject was selected among all the adult members of 18 years age and above present at the time of interview in the household by lottery method and the questionnaire was administerd to those who were resident of GM Goth after taking consent.

RESULTS

In our study 110 (70%) people were tobacco consumers, 47% were knowledgeable about hazards of smoking, 22% were aware about passive smoking, and 90% started consuming tobacco below 20 years of age. The most popular form of tobacco was pan 40%, cigarette 39% and hookah 19%. Eighty four percent were regular smokers. Only 13.6% took counseling, 26.3% tried to quit smoking but none of them succeeded. About 23.5% smokers suffered from cough and headache due to smoking. When age, sex, marital status, income of the household, education and knowledge about hazards of smoking was compared, age and knowledge showed significant association while other variables did not show any significant association.

CONCLUSION

Our study concluded that high proportion of people including men and women consume tobacco. Most of them were unaware about tobacco consumption hazards, and passive smoking.

Amino Acid analysis of intellan, a herbal product used in enhancing brain function

Analysis of the drug "INTELLAN" and two reputed plants i.e. Centella asiatica and Herpestis monniera used in the preparation of the drug reveals that glutamic and aspartic acids are present in high concentration in the drug and are also required by brain in high concentration to keep itself in higher gears. Both these amino acids are used as neurotransmitters and also in stabilizing and stimulating the activities of brain, thus resulting in better performance.

Ventilatory functions in pregnancy

The apparatus used was a dry bellows spirometer and a Wright's peak flow meter. Statistical analysis using the student's t test showed a significant reduction in peak expiratory flow rate, forced vital capacity and first second forced expiratory volume in the third trimester compared to controls. Besides, mid-expiratory flow rates were significantly lower in the first trimester. Spirometric performance was reduced in all three trimesters when compared to controls, although values were within physiological limits. This reduction may assume importance in patients with associated diseases or those requiring surgery.

Studies on the Alkaloids of Rhazya stricta

A new strychnos-type alkaloid, bharhingine ( 1), has been isolated from the leaves of RHAZYA STRICTA. Its structure has been assigned on the basis of spectral studies including 2D-NMR measurements. The structure and stereochemistry of another Aspidosperma-type alkaloid, strictanol ( 2) has been investigated by extensive NMR studies including hetero-COSY experiments and NOE difference measurements. Isolation of another strychnos-type alkaloid, vincanicine ( 3), not previously reported from this plant, is also described.