Year 2023, Volume 39 - Issue 4

Prof. Dr.Tania was the epitome of perseverance, patience, and resilience. She was a dedicated educator, inspiring and influencing not only the basic science students, but also engaging clinicians with research collaborations. Her wisdom and passion for research and teaching fostered a spirit of curiosity and critical thinking in all those whom she met and taught. She was well known as a kind and humble soul, a cherished colleague, a supportive friend, and a loving mother. Her compassion left everyone in awe, and the warmth of her genuine companionship touched the lives of those who had the honor of knowing her. She will be remembered for all her scientific achievements, and for her strong spirit, her dedication, her kindness and unwavering strength. Her death has left a void in the Physiology community which can never be filled, but her work and her trainees will stand as a testament to the enduring impact she had on all.

The dawn of globalization has produced the need for doctors who are prepared to facilitate communities regardless of their ethical constraints. Medical ethics is an integral component of undergraduate training and has gradually affirmed that different ethical issues are encountered by doctors within rural settings and urban areas. There is a strong need to acknowledge that ethics varies as we move not only from urban or rural settings, but also as we move across different regions, countries, and continents. There have been various studies conducted in different regions of the world to highlight the presence of different ethical issues arising in various settings. This review aims to highlight common ethical issues faced by general practitioners in rural settings as various regions have different customs which influence their decision-making skills and the patients’ relationship with their practitioner. This gives rise to the necessary task of providing training for doctors so that they are better equipped to handle these challenging scenarios in primary health care domains in order to facilitate optimal health care for patients from diverse backgrounds in different settings ethically and professionally.

Fibroadenomas (FAs) are the most common benign tumors of the breast in young females. Most of the time, it presents as a well-circumscribed, painless, firm to hard, mobile, and slow-growing unilateral or bilateral breast lump. The median age of its presentation is 25 years with rare occurrence after menopause. The exact etiology of FA is still unclear. Unopposed estrogen in the growing breasts of young females is considered as a main factor in its pathogenesis. Family history and development of FA in identical twins are suggestive of genetic contribution to the pathogenesis of these tumors.

This is a case report of young twin sisters who presented at a tertiary care hospital in Lahore with a complaint of a synchronously developed unilateral breast lump. Fine needle aspiration cytology was planned after taking a detailed history and clinical examination of both patients. Diagnosis of FA was confirmed radiologically and through cytological examination. To the best of the authors’ knowledge, this is the first case of its kind reported from Pakistan.

ABSTRACT

Background and Objective: Statins can induce myopathy; however, the impact on muscle regeneration remains unclear. β2-agonists may mitigate statin myotoxicity. This study investigated the effects of simvastatin and formoterol on skeletal muscle regeneration and injury using a rat model.
Methods: Adult Sprague-Dawley rats (n = 90) were divided into three groups: control (A), simvastatin treatment (B), and simvastatin plus formoterol treatment (C). The rats were kept at room temperature for 3 months where an animal house diet was available ad libitum. Simvastatin was administered orally once a day, by oral gavage for 12 weeks; formoterol was concurrently administered to one group. Extensor digitorum longus muscles were analyzed for the myogenic differentiation factor (MyoD) by immunohistochemistry. Serum lactate dehydrogenase (LDH) levels were quantified as a marker of muscle damage.
Results: MyoD-positive myonuclei were significantly increased in the C group (simvastatin plus formoterol group) compared to the A and B Groups (control and simvastatin-only groups) (p < 0.05). Serum LDH levels were significantly lower in group C than in groups A and B (p < 0.05).
Conclusion: Formoterol alleviates statin-associated muscle injury in a rat model as evidenced by increased MyoD expression and decreased LDH levels. The activation of dormant satellite cells and increased expression of MyoD indicate the potential of formoterol to promote muscle regeneration.

ABSTRACT

Background and Objective: Replacing lost dentin with an appropriate substitute has been challenging in recent years. Biodentine and conventional glass ionomers are used as dentin replacement materials. This study aimed to compare the Vickers microhardness (VHN), diametral tensile strength (DTS), and setting time of Biodentine and glass ionomer cement (GIC).
Methods: This experimental study was conducted in the Department of Science of Dental Materials at Fatima Memorial College of Dentistry, Lahore, in collaboration with the Interdisciplinary Research Centre of Biomedical Materials, COMSATS Lahore from December 2022 to March 2023. A total of fifty disc-shaped samples (4 × 2 mm) of Biodentine and GIC Gold Label 2 were fabricated to assess the VHN, DTS, and setting time after immersion in distilled water for 1 hour and after 3 days. Data were analyzed by applying the paired and independent t-tests using Statistical Package for Social Sciences 26.0.
Results: The mean VHN value of Biodentine and GIC Gold Label 2 cement was 23.4 ± 1.5 and 17.5 ± 1.27 after 1 hour and 31.9 ± 1.66 and 29.6 ± 1.58 after 3 days, respectively. DTS of Biodentine [7.0 ± 0.91 mega pascal (MPa)] was significantly greater than GIC Gold label 2 (5.5 ± 0.68 MPa) after 1 hour (p < 0.05). However, after 3 days, there was a slight increase in the DTS of Biodentine (9.3 ± 1.53 MPa) while compared to GIC Gold label 2 (8.2 ± 1.0 MPa) and this difference was not statistically significant (p > 0.05). Biodentine had a higher setting time than GIC Gold label 2, with an initial setting time of 6.7 minutes compared to 2.9 minutes.
Conclusion: GIC Gold label 2 has a shorter setting time than the but Biodentine which, however, showed higher Vicker’s microhardness and DTS. Therefore, Biodentine may be a more suitable substitute for dentine replacement than the GIC Gold label 2.

Background and objective: Severely ill patients are at a higher risk of carrying nosocomial infections especially when admitted to the intensive care units (ICUs). Therefore, it is the professional obligation of all health workers to adhere to the scientifically accepted criteria for infection control in clinical settings. This study was conducted to assess intensive care nurses’ adherence to standard precautions (SPs) and to assess the practices of SPs in intensive care.

Methods: This cross-sectional study was carried out at ICUs of two public sector hospitals in Lahore, Pakistan, from March to September, 2022. A total of 150 nurses were selected for the study who worked in the medical-surgical, general, and specialized ICUs. The extent to which the behavior of a worker coincides with the prescribed standard (Adherence) and performing work repeatedly till it becomes a routine competency (Practice) was assessed using a structured questionnaire. The chi-square test was used to determine the link between adherence to SPs and the practice carried out by nurses. Data were analyzed and a p-value ≤ 0.05 was taken as significant.

Results: A total of 84.7% of nurses showed adherence while practice was demonstrated by 52.7% of nurses. No significant correlation (p-value:0.95) was however found between the practice and adherence to the SPs, despite the fact that a notable gap was observed between the practice and adherence to SPs among ICU nurses.

Conclusion: It is concluded that a compromised adherence to SPs of infection control in ICUs of public sector hospitals in Lahore is exhibited by the nurses.

ABSTRACT

Background and Objective: Root canal treatment is hampered by the presence of resilient bacteria within the canals of teeth which leads to the need for incorporation of intra-canal medication. This study aimed to assess the effectiveness of mustard gel against the highly resistant Enterococcus faecalis (E. faecalis) bacteria in comparison with calcium hydroxide (Ca(OH)2) paste as an intra-canal medicament.

Methods: This experimental study comprised forty extracted single-rooted teeth which were equally divided into two groups. In group 1, Ca(OH)2 paste was applied whereas in group 2, mustard gel was used. After disinfection, each tooth was sectioned horizontally into three equal parts. The standardized middle section was inoculated with a controlled strain of E. faecalis followed by the application of intra-canal medicaments for a week in both groups. The bacterial colonies were counted as colony-forming units (CFU/ml). Data were entered and analyzed by using Statistical Package for Social Sciences version 25.0.

Results: Microscopically, E. faecalis appeared as cocci-round shaped in chains or pairs. The median bacterial count was 1,550 (775-2,500) for group 1 (Ca(OH)2 paste) as compared to only 400 (200-775) in group 2 (mustard gel) (p < 0.001).

Conclusion: Mustard gel can be used as a cost-effective, readily available, and safe herbal alternative to Ca(OH)2 paste for root canal treatments.

Background and Objective: In the undergraduate medical curriculum, various subjects synergize throughout the years, culminating in the completion of the MBBS course. Histology, a branch of Anatomy, specifically deals with microscopic anatomy. Concurrently, Histopathology, an extension of histology, is a vital facet of Pathology. Proficiency in comprehending the normal histological structure of the human body is imperative, enabling a comprehensive understanding of the microscopic foundations and the diagnosis of diseases during one's medical education. This study was designed to compare and contrast the MBBS students’ exam performance in Histology with that of Histopathology through a longitudinal follow up.

Methods: A study sample comprised of MBBS students of College of Medicine, Northern Border University, Arar, KSA who had completed final exams for both subjects between the academic years 2016 to 2021; excluding the academic year affected by Covid-19. Mean scores for the two subjects were computed, and statistical analysis, including the calculation of p-values, was performed using SPSS.

Results: The mean scores for Histology and Pathology for the sample students were 75.6% and 77.26% respectively, exhibited a striking similarity and, indicated a robust correlation (p<0.001) between the averages of the two subjects.

Conclusion: The study suggests that, under typical circumstances, a solid grasp of histology enhances comprehension in histopathology. Students with a thorough understanding of normal human tissue are better equipped to predict changes or disruptions in pathological samples with increased accuracy

Background and Objective: The vaccines Sinopharm and Pfizer account for more than 7.3 billion vaccinations across the globe. Study data shows that the protection offered by these vaccines wanes with time, which is why the third dose of a different or same vaccine may become necessary. The objective of this study was to compare the levels of IgG in the post-vaccination phase, with two different vaccines, Sinopharm and Pfizer.  

Methodology: A cross sectional study was conducted at CMH Lahore Medical College and Institute of Dentistry, after approval by the Ethical committee. A total of 100 participants, who were completely vaccinated, with either Sinopharm or Pfizer, at least six weeks before, were included in the study. Participants with concurrent infection, incomplete vaccination or any known disease, were excluded from the study. Written consent was obtained from all the participants. A predesigned questionnaire, adapted from similar studies, was used for data collection. Afterwards, blood samples were collected and IgG antibody levels were estimated using RD-RatioDiagnostics SARS-COV-2 virus IgG ELISA kit (E-COG-K105). The collected data was analyzed with SPSS software. Results with p value < 0.05 were taken as significant.

Results: Mean age of the participants was 20.18±1.29 years. Mean antibody titers, six weeks post-vaccination, were 5453.73±609.15 U/ml and 10786.86±1525.49 U/ml in Sinopharm and Pfizer groups, respectively. The difference was statistically significant (p=0.0004).

Conclusion: Antibody response is considerably higher in Pfizer-vaccinated individuals, in comparison to Sinopharm.

ABSTRACT

Background & Objectives: People with pre-hypertension (PHTN) is more likely to developed hypertension (HTN) and having higher risk of cardiovascular (CVD) and renal diseases. This study aims to determines the prevalence of pre-hypertension among the adult population of the XYZ institute

Methods: A descriptive cross-sectional study was conducted no the adult population of a teaching institute Peshawar. This study included sample of 176 adults. A close ended questionnaire, containing some demographic and medical information’s was design to fulfil the aim of our study.  Blood pressure measurement was taken from all subjects and data were analyzed by using SPSS version22.

Results: The prevalence of PHTN and HTN was 50.57% (n=89) and 18.19% respectively.  statistically significant association was found of gender with PHTN (P=0.036). PHTN was slightly more prevalent among male gender i.e.39.8% comparative to female gender i.e. 10.8%.  

Conclusion: More than our half study population was to have PHTN. Its incidence was found statistically significant with male gender and is at higher risk developed HTN.