Journal of Rawalpindi Medical College
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Mental Health And Eating Patterns: Relationship Between Body Mass Index, Generalised Anxiety Disorder And Three-Factor Eating Scores Among University Students In Lahore
No full textObjective: To investigate the relationship between Body Mass Index (BMI) and eating behaviours, specifically cognitive restraint, uncontrolled eating, and emotional eating among university students in Lahore, Pakistan.
Methods: A cross-sectional study was conducted among 385 university students aged 18–24 years using random sampling. Anthropometric data were collected to calculate BMI, and validated questionnaires, including the Three-Factor Eating Questionnaire-R18 (TFEQ-R18) and Generalised Anxiety Disorder-7 (GAD-7), were administered. Data were analysed using IBM SPSS v21. Descriptive statistics and chi-square tests were used; p-values <0.05 were considered significant.
Results: Of the participants, 48.05% had normal BMI, 40.78% were overweight, and 6.23% were obese. A statistically significant association was found between BMI and emotional eating (p = 0.018), with higher scores in overweight and obese individuals. No significant relationship was observed between BMI and either cognitive restraint (p = 0.985) or uncontrolled eating (p = 0.443). Most participants (68.57%) exhibited minimal anxiety levels.
Conclusion: The study highlights a significant link between BMI and emotional eating among university students, suggesting emotional regulation as a potential target for obesity prevention strategies. Integrative interventions focusing on mental health and healthy eating behaviours are warranted in academic settings
Skin-To-Stone Distance On Computed Tomography KUB: An Independent Predictor Of Stone-Free Status After Shock Wave Lithotripsy
No full textObjective: To evaluate SSD and other factors related to the characteristics of the patient and renal stone to predict the ESWL outcomes in patients with renal stones.
Methods: A cross-sectional study was conducted on 90 patients undergoing ESWL for renal calculi. Pre-procedural CT scans were used to measure SSD, stone size, and CT attenuation values. Patients were followed post-ESWL by ultrasound and X-ray KUB to assess stone-free status. Correlation analysis, independent samples t-tests, chi-square tests, and binary logistic regression were used to assess associations between variables and treatment outcomes.
Results: The mean value of SSD in our cases was 10 ± 0.72 cm, and 57.8% of patients had SSD ≤10 cm. A statistically significant difference in mean SSD was found between the group that was stone-free vs. the group with residual stones (p < 0.0001). Logistic regression confirmed SSD as an independent predictor of ESWL success (p < 0.00001), with increasing SSD significantly reducing the odds of being stone-free. Stratified analysis showed that 90% of patients with SSD ≤10 cm achieved stone-free status versus only 37.5% with SSD >10 cm (p < 0.0001).
Conclusion: SSD is a statistically and clinically significant predictor of ESWL success. An SSD ≤10 cm is strongly associated with favorable outcomes. Given its simplicity, non-invasiveness, and predictive value, SSD should be incorporated into routine pre-ESWL evaluation to guide treatment planning and improve patient selection
Assessing The Physical And Psychological Well-Being Of Palestinian Medical Students Arriving At Rawalpindi Medical University
No full textObjective: To assess the physical and psychological well-being of Palestinian medical students carried out at Rawalpindi Medical University.
Methods: A cross-sectional descriptive survey was carried out to analyse the physical and psychological health of Palestinian medical students who arrived at Rawalpindi Medical University in a desperate scenario. Apart from measuring vitals, Ophthalmic and ENT examinations of medical students were also done. Their comorbidities were also inquired, and influenza and typhoid vaccines were administered. Depression among students was categorised by using the Patient Health Questionnaire (PHQ-9) scale. Data was analysed by using Microsoft Excel 2016 software. Descriptive statistics were applied.
Results: Of the 36 Palestinian medical students reaching RMU for continuation of medical education, 19 were males. The mean age of the students was 22.4 ± 1.45 years. Around 29 students were subjected to a physical and psychological health assessment. They were physically fit and healthy. 11 students were mildly depressed, and female students were comparatively more depressed than males.
Conclusion: The medical students of Gaza were physically fit but depressed due to the disaster in their homelan
Genetic Study In a Pakistani Family Reveals Autosomal Recessive Type of Artemis Deficiency
Full text linkObjective: To perform clinical and genetic investigations in two patients suffering from Artemis deficiency with total deficiency of T-B- lymphocytes.
Methods: We enrolled a Pakistani family with one male patient suffering from Severe Combined Immune Deficiency (SCID). Immunological investigations including lymphocyte subset analysis, and serum immunoglobulin levels were performed. Genetic analysis was performed on patients and available parents. Polymerase Chain Reaction (PCR) based amplification and electrophoresis in patients, parents and control was performed.
Results: A detailed clinical investigation revealed mild fever, lower respiratory tract infections, watery diarrhoea, and oral moniliasis from the age of one month. Lymphocyte subset analysis showed T-/B- and NK+ type SCID. Genetic analysis revealed two exon deletions in the Artemis encoding gene (DCLRE1C, OMIM 602450).
Conclusion: This study reveals a novel mega deletion mutation in the gene DCLRE1C, (two exon deletions) confirmed through PCR-based electrophoresis. The mutation leads to Artemis deficiency T-/B-/NK+ type of SCID.
Keywords: CNV repeats, SCID, Artemis deficiency, Lymphocyte subset analysis, Immunoglobulins
Evaluating the effect of tonsillectomy on anti-streptolysin O titre levels in the pediatric population.
Full text linkObjective:
To evaluate the effect of tonsillectomy on anti-streptolysin O (ASO) titre levels in children.
Methodology:
48 patients 5 -15 years of age with ASO titre > 200IU/ml undergoing elective tonsillectomy were included in the study.ASO titre was measured at 1 month, 2 months and 3 months after tonsillectomy. Data analysis was done at SPSS 21. P-value of < 0.05 was taken as significant.
Results:
After tonsillectomy reduction of ASO titre to less than 200IU/ml occurred in 3 (6%), 27 (56%) and 46 (96%) patients at 1st, 2nd and 3rd monthly follow up respectively.
Conclusion:
Tonsillectomy significantly reduces ASO titre levels in pediatric patients with recurrent tonsillitis. This reduction suggests that tonsillectomy can effectively mitigate the immune response to streptococcal infections.
Pentoxifylline: A promising solution for reducing proteinuria in type 2 diabetes patients
Full text linkObjective:
To determine the effects of pentoxifylline on reducing proteinuria in diabetic patients.Methods:
A randomized placebo-controlled trial was conducted at the Nephrology department of Akbar Niazi Teaching Hospital, Islamabad and the Medicine department of Pakistan Ordnance Factory (POF) Hospital, Wah Cantt, Pakistan from January to June 2024. A total of 170 patients with type 2 diabetes on ACE inhibitors and ARBs but still having proteinuria over 500 mg/24 hours were enrolled in the study. 85 patients and placebo-treated volunteers formed the control group. Patients received 400 milligrams of oral pentoxifylline thrice daily. Proteinuria was measured for 24 hours at the onset of the experiment and during the initial quarter and half a year after pentoxifylline administration. In the other group, 85 healthy participants received a placebo.Results:
The mean age of the patients was 59.2±10.2 years (ranging; from 18 to 70 years), with 56.5% (n=96) male and 43.5% (n=74) female. Patients who consumed oral pentoxifylline decreased proteinuria significantly (p ≤ 0.05). Proteinuria decreased over the initial three months were significant (p ≤ 0.05).Conclusion:
According to trial data, pentoxifylline three times a day reduces proteinuria and prevents renal failure. The dosage does not affect the kidneys
Frequency of Hepatitis B Infection in Vaccinated Children with β-Thalassemia Major Receiving Multiple Transfusions
No full textObjective: To determine the frequency of hepatitis B infection in vaccinated children with beta thalassemia major receiving multiple blood transfusions.
Methods: This was a cross-sectional study with a non-probability consecutive sampling technique conducted at the Department of Pediatrics, Cantonment General Hospital & Holy Family Hospital, Rawalpindi, from January 26, 2022, to July 26, 2022. A total of 245 children diagnosed with beta thalassemia major and receiving regular transfusion therapy were enrolled. Venous blood samples were collected and tested for hepatitis B surface antigen (HBsAg) using an enzyme-linked immunosorbent assay (ELISA). Demographic and clinical data were recorded, including age, gender, and number of transfusions. Quantitative variables, such as age and transfusion frequency, were expressed as mean ± standard deviation (SD), while qualitative variables, including gender and hepatitis B positivity, were expressed as frequencies and percentages.
Results: The mean age of patients was 9.56±4.3 years. Of the total, 170 (69.4%) were male and 75 (30.6%) were female. Children receiving fewer than eight transfusions annually were 136 (55.6%), while those receiving eight or more were 109 (44.4%). Hepatitis B infection was detected in 20 children (8.2%).
Conclusion: Hepatitis B infection is still prevalent in vaccinated children with transfusion-dependent beta thalassemia major and is more frequent in those receiving a higher number of blood transfusions. Strengthening blood donor screening programs and considering booster vaccination strategies may help reduce this burden.
Keywords: Beta thalassemia major, Blood transfusion, Child, Hepatitis B, Vaccinatio
Comparative Efficacy Of Dapagliflozin And Empagliflozin For Blood Pressure Control In Type 2 Diabetes Mellitus With Hypertension
No full textObjective: To find out the efficacy of empagliflozin and dapagliflozin for blood pressure control in patients having type 2 diabetes mellitus with hypertension.
Methods: A Quasi-experimental study was performed at the Medicine department of Tertiary Care Hospital, Rawalpindi, from March 2024 to September 2024. All patients were categorised into two groups, with group A receiving Empagliflozin (10 mg), while group B received Dapagliflozin (10 mg). Initial measurements were taken from both groups and repeated after three and six months of treatment to evaluate changes in HbA1c levels and blood pressure. SPSS-24.0 was used for all the above-mentioned analyses. Differences between groups at baseline and 3 months were analysed using independent samples t-tests. Within-group differences measured at baseline and 3 months were analysed using paired-sample t-tests, with p ≤ 0.05 considered statistically significant.
Results: A total of 128 patients were included in this study, out of which 64 received 10 mg of dapagliflozin, while the other 64 received 10 mg of empagliflozin. HbA1c was decreased by 2.35% and 3% after 3 months and 6 months, respectively, by using 10mg dapagliflozin. In the empagliflozin group, this level was reduced by 2.70% and 3.40% after treatment of 3 and 6 months, respectively. Blood pressure was also decreased significantly in both groups, with a value of p<0.001.
Conclusion: In conclusion, both empagliflozin and dapagliflozin have similar effects on significantly reducing the HbA1c level and blood pressure in patients with T2DM and hypertension.
Keywords: Empagliflozin, Dapagliflozin, Hypertension, Type 2 Diabetes Mellitu
Endoscopic Dacryocystorhinostomy With And Without Silicone Intubation: A Retrospective Study On Surgical Outcomes
No full textObjective: To evaluate the effects of silicon stent intubation versus no intubation in endoscopic dacryocystorhinostomy (EnDCR).
Methods: A Comparative Study Design was conducted in the ENT Department, Tertiary care hospital, Abbottabad, January 2022–August 2023. The study included 56 patients (28 in each group). Endoscopic DCR was done in one group with silicone stent intubation and other group without silicone intubation. Pre-operative and post-operative variables were evaluated for surgical outcomes using Munk scoring criteria. The absence of epiphora, a clear orifice, and the end of dacryocystitis episodes were considered signs of functional success. ANOVA tests were applied for comparisons.
Results: Among the total 56 patients, 25(44.6%) were females and 31(55.4%) were male patients with a mean age of 36.8±11.9 years. Success rate after 18 months (Munk 0) is 67.9% in the non-stent group and 57.1% in the stent group. The success rate of both groups is nearly the same, which shows that the silicon intubation is not associated with the success rate of EnDCR.
Conclusion: Given the comparable outcomes, non-intubated EnDCR should be considered the initial surgical option due to cost-effectiveness, reduced discomfort, and ease of postoperative care. However, this recommendation may not apply universally. Non-intubation is a reasonable first-line option but should be tailored to patient anatomy and risk factors. This study’s small sample size is a limitation, and larger randomised trials are needed.
Keywords: Dacryocystorhinostomy, Epiphora, Endoscopy, Lacrimal Duct Obstructio
Serum Homocysteine Levels in Patients with Ischemic Heart Disease and Normal Individuals: A Comparative Study
Full text linkObjective: To compare the serum homocysteine levels of patients with ischemic heart disease (IHD) with those of normal individuals (those without ischemic heart disease) in our population.
Methods: This is a case-control study, carried out at CMH Rawalpindi during the course of 6 months from June 2024 to Dec 2024. This study included 200 individuals, among whom 130 were patients with ischemic heart disease (angiographically diagnosed coronary artery disease), within the last 3 months, and 70 normal individuals (those without ischemic heart disease), with the closest matching of baseline characteristics with the cases, which comprised the control group. Individuals having other diseases or medications that could raise serum homocysteine levels were excluded from the study. Fasting serum homocysteine levels were measured in both groups and compared.
Results: Mean serum homocysteine levels in patients with ischemic heart disease were higher (23.12 ± 7.16 μmol/L) as compared to normal individuals (9.60 ± 3.17 μmol/L). This difference was statistically significant, with a p-value less than 0.05.
Conclusion: This study demonstrates that patients with ischemic heart disease have higher serum homocysteine levels as compared to normal individuals, suggesting a potential role of homocysteine in the pathogenesis of ischemic heart disease. These findings highlight the importance of serum homocysteine measurement in the risk assessment and management of ischemic heart disease patients.
Keywords: Coronary artery disease, Homocysteine, Risk facto