Notes

Repetitive Immune-Mediated Noninfectious Endocarditis Requiring Five Mitral Control device Alternatives.
Among these centres, 82(79.6%) were private, 18(17.5%) university hospitals and 3(2.9%) were state hospitals. CONCLUSIONS A massive majority of websites related to in-vitro fertilisation centres did not follow standardised guidelines for advertising.Objective To assess the nutritional status of mothers of severely malnourished children, and to evaluate the factors associated with inadequate caloric intake of children with severe acute malnutrition versus sufficient caloric intake by mothers. METHODS The cross-sectional descriptive study was conducted from January to June 2016 at Children Hospital and Institute of Child Health, Multan, Pakistan, and comprised mothers of severely malnourished children admitted for treatment. Data was collected using a questionnaire administered through interviews. Elements noted included body mass index, 24-hour recall, dietary restriction during pregnancy, lactation and complimentary feeding patterns of the children. The mothers were also examined for clinical signs of iron deficiency anaemia. RESULTS Of the 100 women, 20(20%) were malnourished, 42(42%) were of normal weight, and 38(38%) were either overweight, pre-obese or obese. The caloric intake of 26(26%) mothers was less than 1500 kcal per day, while 42(42%) were taking between 2000-2500 kcal per day and 32(32%) were taking >2500 kcal daily. Also, 67(67%) women were suffering from anaemia and 80(80%) women had some myths related with dietary restrictions during pregnancy, lactation and complimentary feeding of children. Overall, 23(23%) women breastfed their babies.OBJECTIVE To explore the effectiveness of peer debriefing in practical sessions of undergraduate medical students in Pakistan. METHODS The cross-sectional quasi-experimental study was conducted from November 2016 to October 2018 at Shifa College of Medicine, Islamabad, Pakistan, and comprised second year medical students who were randomly divided into two groups. Group A was delivered skill sessions of Nutrition and Metabolism module through facilitator-led demonstration, while Group B was delivered skill sessions through peer debriefing using Pendleton's method. All the students were assessed in formative integrated practical exam. A focus group discussion followed by interviews was subsequently arranged for recording the perception of students regarding the effectiveness of peer debriefing as an instructional tool for skill sessions. Data was analysed using SPSS 21. RESULTS Of the 84 subjects, 39(46.4%) were in Group A and 45(53.6%) were in Group B. Group B results were statistically significant for total cumulative scores and scores for the station of calculating body mass index (p0.05). Thematic analysis showed that students found the process of peer debriefing as fun, more interactive, time-consuming yet organized and less stressful. Students considered peer debriefing as an effective tool for learning skill sessions. CONCLUSIONS Peer debriefing approach can be a useful instructional strategy to deliver skill sessions. It increases students' participation and thus effectively promotes learning.OBJECTIVE To evaluate probable association of dietary risk factors with childhood leukaemia. METHODS The case-control study was conducted at the Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from January to December 2017, and comprised children of either gender aged 2-12 years with recently diagnosed acute lymphocytic or acute myelocytic leukaemia An age and gender matched equal group of healthy children was taken as controls. Dietary-intake data was collected for six food groups, namely raw vegetables, fresh fruits, packed fruit juices, caffeinated drinks, junk foods, and processed/precooked food items. Frequency of the selected food group consumption was summarised in six categories rarely/never, 1-3 days/week, 4-6 days/week, once daily, twice daily and thrice daily. Data was collected through interviews with the mothers using a pre-designed questionnaire, and was analysed using SPSS 21. RESULTS Of the 90 subjects, 45(50%) were in each of the two groups. There were no differences in baseline characteristics between the two groups (p>0.05). Consumption of caffeinated drinks and junk food was significantly higher in cases (p=0.001) while controls showed significantly higher consumption of fresh fruits (p=0.0012). No significant difference was noted for consumption of vegetables, packed fruit juices and processed food between the groups (p> 0. 05 ). CONCLUSIONS Higher consumption of caffeinated drinks and junk food was observed in cases compared to controls.Objectives To compare the effectiveness of manual therapy to the cervical spine with and without manual therapy to the upper thoracic spine in the management of non-specific neck pain. METHODS The randomized controlled trial was conducted at 3 different hospitals in Peshawar, Pakistan, from October 2016 to January 2017, and comprised patients suffering from non-specific neck pain aged 25-60 years. The control group received cervical manual therapy alone while the experimental group received cervical along with thoracic manual therapy for 2 weeks. Selleckchem CC-115 Data was analysed using SPSS 20. RESULTS Of the 37 subjects, 20(54%) were cases and 17(46%) were controls.The overall mean age was 35.9±9.6 years. There was no significant difference between the groups at baseline in terms of the levels of pain (p=0.125) and disability (p=0.392). The experimental group showed greater reduction in pain (p=0.02) and disability (p=0.03) compared to the control group. CONCLUSIONS Cervical along with thoracic manual therapy reduced neck pain and associated neck disability more effectively than cervical manual therapy alone.OBJECTIVE To compare the effects of eccentric muscle energy technique versus static stretching exercises combined with cervical segmental mobilisation in the management of upper cross syndrome in patients having neck pain. METHODS The randomised controlled trial was conducted at the Khan Kinetic Treatment Canada Orthopaedic and Rehabilitation Centre, Rawalpindi, Pakistan, from August 2017 to January 2018, and comprised patients of upper cross syndrome who were randomized into two equal groups using lottery method. Patients in Group-A were treated with eccentric muscle energy technique with cervical segmental mobilisation, while those in Group-B received static stretching exercises with cervical segmental mobilisation. Two sessions per week for 3 weeks were given to each patient who were analysed by measuring tragus-to-wall distance, visual analogue scale and neck disability index. Cervical passive range of motion was measured using inclinometer. Data was recorded at baseline and after 3 weeks of treatment. Data was analysed using SPSS 21.
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