Notes

Three-dimensional bioprinted cancer designs: A robust platform for checking out tunneling nanotube-like mobile or portable constructions inside sophisticated microenvironments.
Polycystic ovary syndrome (PCOS) is an oligogenic condition characterised by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. Previously, European and Han Chinese populations identified different susceptibility loci, of which ERBB4 (rs1351592) was strongly associated with PCOS. Our study aimed to investigate the association of ERBB4 Single Nucleotide Polymorphism (SNP), rs1351592 with PCOS in Pakistani women of Hazara region. Fifty PCOS patients and 14 healthy women were recruited and SNP was replicated using ARMS-PCR and sequencing. The study showed that Luteinising Hormone (LH), Follicle Stimulating Hormone (FSH), and Testosterone (T) were significantly elevated in patients compared to controls (P less then 0.05). Overall, the frequency of G allele was higher than C allele and the SNP lacked significant association with PCOS. This is the first study demonstrating the association of ERBB4 SNP, rs1351592 with PCOS in Pakistani population. Further research using larger population size will help to estimate the role of ERBB4 SNP as potential biomarker for disease diagnosis.Beta thalassemia in Pakistan is a serious health concern with an estimated 5-8% carrier frequency and birth of 5000 major children every year in the country. The treatment of beta thalassemia major patients poses a great economic burden; hence, the ideal approach towards this disease should encompass effective prevention services. At present only one government funded project "Punjab Thalassemia Prevention Programme" existed in Punjab province, and providing free of cost services for beta thalassemia screening and prenatal diagnosis. Complete blood count and haemoglobin electrophoresis remains the preliminary test for screening, while chorionic villi sampling and amplification refractory mutation system method have been most widely used for molecular diagnosis of beta thalassemia. Modern molecular techniques, non-invasive prenatal diagnosis, and pre-implantation diagnosis are in trial phases. In this review we have discussed the available diagnostic facilities and status of prevention programmes for beta thalassemia in Pakistan as well as future perspectives.Palliative care has gained considerable attention during last few decades. Increasing demands by the society owing to increased number of elderly and people with chronic illnesses require increased number of health care professionals with competence in providing palliative care. The current review provides a summary of the published literature pertaining to palliative care education in surgical residency programmes internationally and locally. Most surgical residency programmes provide limited, if any, formal education in knowledge and skills related to palliative and end of life care. The situation is alarming in Pakistan where the discipline is in infancy and resources are limited while the demand for palliative care is increasing. Surgery can learn lessons from other disciplines. Development and integration of palliative medicine into most of the existing postgraduate curricula continues to be a challenge for the accreditation bodies and medical educationists. Collaborative measures need to be taken urgently at all levels.Gliomas are one of the most annihilating types of brain tumours having a high rate of annual incidence worldwide. Notch signaling is an evolutionary conserved pathway that regulates differentiation and development. Aberrations in Notch signalling pathways lead to severe pathological state such as the Gliomas. MicroRNAs (miRNAs) are the tiny molecules less than 200 bps in length and regulate a myriad of cellular processes. Categorically, miRNAs are divided in to oncogenic and tumours suppressor miRNAs. Protein Tyrosine Kinase inhibitor Accumulating data have identified miRNAs, which positively or negatively regulate Notch signaling in Gliomas. Here, we have assessed status of our understanding of the interplay between miRNA-base regulation of Notch signaling in gliomas, interaction between Notch signaling and other signaling cascades and have also discussed use of natural compounds that will help us get closer to personalized medicine for gliomas.
To develop a valid and reliable scale for measuring psychosocial issues of hearing-impaired school children.

The cross-sectional study with four stage model of scale development was conducted at Multan, Muzafargarh, and Dera Ghazi Khan Pakistan from August 2018 to January 2019. The four stages were item generation, expert validation, conversion of scale into sign language and psychometric study. The sample comprised hearing-impaired school children aged 18-23 years who were studying Special Education schools in Multan, Pakistan.

Of the 230 subjects, there were 110(47.8%) boys and 120(52.2%) girls. The overall mean age was 19.90±2.46 years. Exploratory factor analysis with varimax rotation revealed 26 items in 'Depressive Affect', 'Social Isolation' and 'Feeling of Anger' sub-scales with high internal consistency (r=0.85) and validity (r=-0.32).

The internalised nature of psychosocial issues of children with hearing impairment needs timely identification and intervention so that silent suffering can be prevented to improve psychosocial functioning of such children.
The internalised nature of psychosocial issues of children with hearing impairment needs timely identification and intervention so that silent suffering can be prevented to improve psychosocial functioning of such children.
This experimental study on 24 stroke patients aimed at evaluating and comparing the effects of bilateral arm training on upper extremity (UE) motor function between right and left hemispheric chronic stroke patients.

Both groups received the same intervention involving 5 functional tasks for 1 hour, 3 days per week, for a total of 6 weeks. Fugl-Meyer Assessment-Upper Extremity and Wolf-Motor Function Test were applied as outcome measures at baseline and after 6 weeks of training to assess the recovery of function in the affected area.

Intra-group analysis showed no significant improvement in the wrist and hand function in the left hemispheric stroke (LHS) (p>0.05), while right hemispheric stroke (RHS) patients did not improve significantly in the coordination/speed domain (p>0.05). Inter-group analysis showed no significant difference between right and left hemispheric stroke patients (p>0.05).

Bilateral arm training showed beneficial effects in improving UE function in both RHS and LHS patients. Distal UE function in LHS and coordination and speed of movement in RHS patients did not show any significant improvement.
Bilateral arm training showed beneficial effects in improving UE function in both RHS and LHS patients. Distal UE function in LHS and coordination and speed of movement in RHS patients did not show any significant improvement.
To evaluate the knowledge and awareness of students at a medical university regarding possible risk factors and screening modalities of breast cancer.

The cross-sectional study was conducted from January to April 2019 at the People's University of Medical and Health Sciences for Women, Nawabshah, Pakistan, and comprised young female students from first year to final year at the Institute of Pharmaceutical Sciences and the Institute of Physiotherapy and Rehabilitation Sciences of the university. Data was collected using a predesigned questionnaire, and was analysed using SPSS 21.

Of the 450 students approached, 375(84%) completed the questionnaire. The mean age of the participants was 21.06±1.164 years (range 18-26 years). Overall, 225(60%) students said contraceptive pills could increase the risk of breast cancer, 267(71.2%) agreed that breast-feeding could reduce cancer risk, while 361 (96.27%) students had good mammography and clinical breast examination knowledge. Also, 308(82.13%) respondents knew about breast self-examination, but were not aware of its procedure.

Majority of the subjects had knowledge and awareness about breast cancer, its risk factors, diagnostic parameters and possible treatment options, but they did not have knowledge regarding the procedures of breast self-examination.
Majority of the subjects had knowledge and awareness about breast cancer, its risk factors, diagnostic parameters and possible treatment options, but they did not have knowledge regarding the procedures of breast self-examination.
To compare the knowledge, attitude and practice regarding diabetes mellitus among diabetics and non-diabetics.

The cross-sectional study was conducted at the Government College University, Faisalabad, Pakistan, from December 2017 to April 2018, and comprised subjects recruited randomly from different cities of Punjab, Pakistan. Data was collected using a predesigned structured questionnaire regarding socio-demographic characteristics, general knowledge about diabetes, perception regarding indication, risk factors, diagnosis, and complications, and practices followed for treatment and management of diabetes.

Of the 2,000 subjects, 972(48.6%) had family history of diabetes, 1338(66.9%) were living in urban areas, 1068(53.4%) were university graduates, 804(40.2%) were employed and 1152(57.6%) belonged to socio-economically balanced families. Composite knowledge score was significantly associated with age and socio-economic status (p<0.05). A highly significant association was observed regarding family history (p<0.001), level of education (p<0.0001) and occupation (p<0.001) with composite knowledge score.

The knowledge level about diabetes was seen to be average.
The knowledge level about diabetes was seen to be average.
To assess the effects of antidepressant use on pregnancy outcomes.

The cross-sectional study was conducted at the Department of Pharmacology, Manisa Celal Bayar University, Manisa, Turkey, and comprised pregnant women who were admitted to the Department of Gynaecology between 2008 and 2017 who had been prescribed antidepressant drugs before pregnancy and continued to use them during any week of their respective pregnancies. The women were contacted by telephone after delivery to obtain information about the pregnancy outcomes. Data was analysed using SPSS 23.

There were 183 women with a mean age of 31.3 ± 5.3 years (range 18-44 years). There were congenital defects in the newborn in 11(7.65%) cases. The most commonly used antidepressant group was selective serotonin reuptake inhibitor 138(75.4%), and escitalopram was the most frequently used drug 46(25.1%). Spontaneous abortion rate was higher with escitalopram than the other antidepressants (p=0.062). Induced abortion rate was significantly higher in multidrug users compared to those on a single drug (p<0.05).

Selective serotonin reuptake inhibitor was found to be the most used class of antidepressants during pregnancy due to the low side effects and teratogenic effects. When antidepressant treatment is necessary during pregnancy, a single drug can be more suitable.
Selective serotonin reuptake inhibitor was found to be the most used class of antidepressants during pregnancy due to the low side effects and teratogenic effects. When antidepressant treatment is necessary during pregnancy, a single drug can be more suitable.
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