Spontaneous Abortions and Gestational Diabetes Mellitus- A Study from Pakistan

Background: Gestational diabetes mellitus leads to adverse pregnancy outcomes. Objectives: The objective of the study was to explore the relationship of spontaneous abortions with gestational diabetes mellitus in pregnant women from rural and urban Lahore. Methods: This cross-sectional study was conducted at University of Health Sciences, Lahore in 2019. Among 60 pregnant women sampled, 30 had gestational diabetes mellitus (GDM) and 30 were normal pregnant controls. Pregnant women were sampled from different hospitals of rural and urban areas of Lahore. Independent sample t-test was applied for analyzing the data. Chi- square test was used to analyze the categorical variables. Association of fasting blood glucose (FBG) and abortions was checked. Odd ratio and relative risk were calculated. Results: Mean fasting blood sugar levels were significantly higher in GDM group (105 mg/dL) as compared to non-GDM group (80.50 mg/dL) at p<0.001. The proportions of the women with increased number of abortions had significantly higher blood glucose levels (OR 5.091, 95% CI, RR 1.27). Conclusions: Gestational diabetes mellitus is associated with an increased risk of spontaneous abortions.

Mass Media and Health Communication During the Pandemic

Importance of specialized health communication has been demonstrated fully during the recent COVID 19 pandemic. New variants of the virus continue to emerge, the larger portion of the country’s population remains unvaccinated, and booster doses are becoming essential. Therefore, the need for sustained interest in health communication through mass media is far from over. Health communication helps public understand the threat and make informed choices about the preventive measures and treatment. Done effectively, it can produce behaviour change, prevent panic and ensure the participation of populations in governments’ public health measures. Healthcare sector possesses the necessary knowledge to impart this information to the media industry which is largely unstructured and learning from experiences. Therefore, the healthcare sector needs to communicate effectively with the mass media representatives in order to influence the population in adopting and continuing healthy behaviour to fight the pandemic.

Effect of Apium Graveolens (Celery) Seed Extract on Serum Uric Acid Level of Hyperuricemic Rats and its Comparison with Allopurinol

Background: Plant derived medicines are widely used in traditional culture all over the world. Objectives: To determine the effect of Celery Seed Extract (CSE) on uric acid levels in hyperuricemic rats and to compare the effect of allopurinol and CSE. Methods: It was an animal experimental research study. Group A served as negative control whereas Group B served as positive control. CSE was given orally to three groups of rats (C, D, and E). One hour prior to administration of CSE; potassium oxonate was injected intraperitoneally in all groups except negative control to induce hyperuricemia. Similarly, group F was given allopurinol one hour after injection of potassium oxonate. Blood samples were collected for uric acid estimation. Results: It was found that administration of both CSE (group C, D, E) and allopurinol (group F) significantly lowered serum uric acid levels (p<0.001) as compared to positive control (group B). Serum uric acid lowering effect of both drugs CSE and allopurinol was found to be statistically significant on day 3rd and day 7th and was almost comparable. Conclusions: Celery seed extract significantly reduces serum uric acid levels in potassium oxonate-induced hyperuricemic rats and its uric acid lowering effect was comparable with that of allopurinol.

Advancing Age as a Risk Factor for Acute Myocardial Infarction

Background: Acute myocardial infarction (AMI) is one of the leading causes of death in developed and developing countries. Age is an important non-modifiable risk factor for acute myocardial infarction. Objectives: The objective of the study was to explore the relationship of advancing age with the risk of acute myocardial infarction. Methods: It was a cross-sectional study conducted in 2019 after getting approval from Institutional Review board of University of Health Sciences, Lahore. Written informed consent and thorough history was taken from the study participants. Group 1 included 45 AMI patients aged 20-60 years. Group 2 included 45 healthy individuals aged 20-60 years. Independent sample t test and chi-square tests were applied for analysis of data. Results: Mean age was significantly higher in AMI patients (50.52±7.31) as compared to healthy controls (30.67±7.20). The risk of AMI increases with advancing age (p<0.001, OR= 2.78). Conclusions: Advancing age is an important risk factor for acute myocardial infarction.

Awareness about Workplace Harassment among Female Nursing Students and Nursing Staff of a Teaching Hospital in Lahore

Background: Harassment of working women is a common social and human rights problem and healthcare settings are no exception. This unacceptable situation has many avoidable determinants that need preventive measures to ensure, safe and secure working environment for nurses. Objectives: To assess the knowledge and understanding among female nursing students and nursing staff about workplace harassment in a tertiary healthcare facility. Methods: It was a cross-sectional study conducted at Tertiary care hospital Lahore from July to September 2018. Convenient sampling technique was used to collect data. Verbal informed consent of voluntary participants was taken. Anonymity and confidentiality was assured. SPSS version 21 was used for data analysis. The participants (n=80) comprised of senior female nurses students (62.5%) and senior nursing staff (37.5%), aged 18 to 46 years. Results: Awareness about common harassment forms was adequate (81.3%). Adverse effects included mental health problems (83.8%) and low self-esteem (72.5%). A large percentage of nurses (62.5%) intended to report such personal incident to institutional head and 72.5% were willing to accompany victims for such reporting. 77.5% desired arranging informative sessions and holding counseling for victims (78.8%) at workplace. Only 22.5% had vague idea about official protective legal frameworks. Conclusions: Workplace harassment of female workers is quite prevalent but under-reported phenomena in Pakistan. All organizations and institutions must have a harassment policy to protect the females.

Booster Dose of COVID 19 and Ethical Issues

COVID 19 is a recent and global pandemic. Preventive medicine is not very popular in Pakistan. With the limited resources, an average Pakistani would spend on a medical treatment rather than on a preventive drug. In Pakistan, booster shots are recently made available only to those who can pay for the cost of the vaccine. A Utilitarian approach has been adopted at various levels since the pandemic emerged by health care organizations and the government. The purpose was to maximize the benefits and minimize the risk of harm. It is the need of the hour to think about health equity and justice in a pluralistic way and refrain from initiating booster shots for elite of a resource-poor country. This pandemic will never end if a maximum number of people are not vaccinated in each country. This is only possible if there is an equitable distribution of vaccines.

Association of Serum Ferritin with Risk of Anemia in Non-Diabetic Adolescents with Family History of Type 2 Diabetes Mellitus

Background: Controversy occurs in the relationship between serum ferritin levels, insulin resistance and risk of developing anemia in adolescents with family history of diabetes. Aims & Objectives: This study was designed to find out the association between serum ferritin levels with risk of developing anemia in non-diabetic adolescents with family history of type 2 diabetes mellitus (T2DM). Materials & Methods: A descriptive cross-sectional was conducted in a local medical institute of Lahore. Study included 50 non-diabetic, non-obese male / female adolescent with family history of type 2 diabetes mellitus and 50 healthy male/female non-obese adolescents without family history of T2DM considered as controls. Level of serum ferritin and serum insulin was estimated by Enzyme Linked Immunosorbent Assay. Blood glucose was estimated by auto-analyzer. Insulin resistance was calculated by HOMA-IR index and beta cell function was assessed by HOMA- beta index. Results: Levels of fasting blood sugar, insulin resistance were found to be increased with decreased level of serum ferritin and decrease beta cell function in both male as well as female cases as compared to controls. Negative correlation was found between serum ferritin and insulin resistance while a positive correlation was found between serum ferritin and beta cell function. Conclusions: Low level of serum ferritin is associated with reduced beta cell function and increased insulin resistance. This may increase the risk of developing iron deficiency anemia that can affect both immune system as well as increase susceptibility to infections.

Difference in the Characteristics of Imposter Syndrome in Dental Students of Preclinical and Clinical Phase

Background: People suffering from imposter syndrome despite being competent consider themselves less skillful and incapable. Such individuals are also more prone to regret their choice of career with consequent early drop out, experience burnout, more prone to medical errors, absenteeism and low job satisfaction. The current study aims to determine the difference in the characteristics of imposter syndrome in dental students of preclinical and clinical phase and its gender predisposition. Objectives: 1. To find out the frequency and characteristics of imposter syndrome among dental students. 2. To evaluate the differences in the characteristics of imposter syndrome among dental students of preclinical and clinical year. 3. To determine gender predisposition of imposter syndrome among dental students. Methods: The cross-sectional study was conducted on 138 dental students of CMH Lahore Medical and Dental College. A validated questionnaire (Clance IP Scale) containing 20 items with 5-point Likert scale was used to collect data by convenient sampling technique. The characteristics of IP were determined by adding the scores of all items. Descriptive statistics were done, chi-square applied, p-value <0.05 was considered significant. Results: One hundred and thirty-eight students filled the IP Scale. The frequency of imposter syndrome is found to be 52.1% among Dental Students. Majority (72) of the dental students have frequent to intense imposter feelings. There is non-significant difference in the IP characteristics of male and female students. No significant difference in the characteristics of imposter syndrome is found between dental students of preclinical and clinical year. Conclusions: There frequency of imposter syndrome is high among Dental students. Non-significant difference in the IP characteristics is found between male and female students as well as students of preclinical and clinical year.

COVID-19 Vaccine Uptake in Pakistan: No Time to Err

COVID 19 pandemic has had a significant impact on social, physical, mental and financial aspects of human life. Among the sickness and despair experienced for last more than a year, COVID vaccination is a ray of hope. The uptake of COVID vaccines has remained low. The government, institutions as well healthcare professionals should take this responsibility of promoting vaccination. A strong will and simple nudges are what it takes to fight the menace of the COVID pandemic.