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Objective: To compare the clinical effectiveness of Paracetamol with Ibuprofen as an antipyretic, fever relief and linked discomfort in children. Study Design: Comparative cross-sectional study. Place and Duration of Study: Combined Military Hospital, Abbottabad Pakistan from Apr to Nov 2019. Methodology: Children aged six months to five years, who reported fever between 38-41°C were included. Two temperature groups were developed, i.e., 37.8--38.9ºC and 39-41ºC with baseline temperatures of 38.60±0.56 for Paracetamol-Group and 38.58± 0.56ºC for Ibuprofen-Group. The prescriptions were given over to the parents with clarification about the dose of the medication. The medication had active and placebo forms. Information was gathered until saturation was done. Results: A total of 104 children were taken in the study. Of these, 77(74.08%) were females, and 27(24.96) were males. Comparing Ibuprofen-treated children with Paracetamol-Group, the final result showed that the extent of children's temperature management was greater in the Ibuprofen-Group 37(71%) than in the Paracetamol-Group 34(65%). Conclusion: Doctors, attendants and guardians wishing to use medications to treat children suffering from fever should be encouraged to use Ibuprofen first and to consider the relative risks and advantages of using Ibuprofen in addition to Paracetamol for fever. Comparatively, Ibuprofen is more effective than Paracetamol. [ABSTRACT FROM AUTHOR]

Abstract Background The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become an important tool for healthcare professionals training but the data on its use by medical students in developing countries is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the pattern of internet access and utilization by medical students in Pakistan. Methods A structured pre-tested questionnaire was administered to a group of 750 medical students in clinical years studying at various public and private medical colleges in Lahore. The questions were related to patterns of internet access, purpose of use and self reported confidence in performing various internet related tasks, use of health related websites to supplement learning and the problems faced by students in using internet at the institution. Results A total of 532 medical students (70.9%) returned the questionnaire. The mean age of study participants was 21.04 years (SD 1.96 years). Majority of the respondents (84.0%) reported experience with internet use. About half of the students (42.1%) were using internet occasionally with 23.1%, 20.9% and 13.9% doing so frequently, regularly and rarely respectively. About two third of the students (61.0%) stated that they use internet for both academic and professional activities. Most of the participants preferred to use internet at home (70.5%). Self reported ability to search for required article from PubMed and PakMedinet was reported by only 34.0% of the entire sample. Students were moderately confident in performing various internet related tasks including downloading medical books from internet, searching internet for classification of diseases and downloading full text article. Health related websites were being accessed by 55.1% students to supplement their learning process. Lack of time, inadequate number of available computers and lack of support from staff were cited as the most common problems faced by students while accessing internet in the institution premises. There were significant differences among male and female students with respect to the place of internet use (p = 0.001) and the ability to search online databases for required articles (p = 0.014). Conclusions Majority of the medical students in this study had access to internet and were using it for both academic and personal reasons. Nevertheless, it was seen that there is under utilization of the potential of internet resources to augment learning. Increase in awareness, availability of requisite facilities and training in computing skills are required to enable better utilization of digital resources of digital resources by medical students.

Abstract Background There is a growing body of literature on the relationship of Hepatitis C virus infection (HCV) and type 2 diabetes mellitus (T2DM). However, there are certain gaps in literature and the data is inconclusive. This study was, therefore, carried out to determine the prevalence of HCV infection in diabetic patients and to elucidate the presence of any possible relationship between HCV and T2DM in this region. Methods Serologic testing for anti-HCV antibody was done on a sample of 3000 individuals with T2DM visiting Diabetes Clinic of Nishtar Medical College Hospital, Multan and 10,000 volunteer blood donors visiting blood bank of the same hospital during the study period using Accurate rapid immunochromatographic kits which was later confirmed by using Chemelex S.A third generation ELISA kit for positive cases. Data about various variables was collected from diabetic patients using a structured questionnaire after taking informed consent. Results Prevalence rate of 13.7% for HCV infection was recorded among subjects having T2DM with seropositivity rate of 4.9% among the control group of volunteer blood donors without diabetes. The patients with T2DM were more likely to have HCV infection as compared to the control group (OR = 3.03, 95%CI = 2.64-3.48, p = 0.001). Diabetic patients with age above 55 years had higher prevalence rate as compared to younger individuals. Male patients had significantly high seropositivity as compared to female patients (15.3% vs. 12.4%, p = 0.02). Those with duration of diabetes 11 years and above and the ones with good glycemic control had higher seroprevalence rates of 18.2% and 18.7% respectively. There was no statistically significant difference among subjects when the distribution of HCV was studied on the basis of marital status, locality, or family history of diabetes. Conclusions The results show that there is a strong association between HCV and T2DM in the region as evident from significantly higher prevalence of HCV infection in diabetics as compared to the control group in the present study.

Abstract Background The prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients. Methods This cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS) was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group). Results The mean age of cancer patients was 40.85 years (SD = 16.46) and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74). Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7%) had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001). Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal malignancies, chest tumors and breast cancer. Conclusions This study highlights high prevalence rates of depression and anxiety in cancer patients. Younger age was associated with a higher likelihood of meeting criteria for psychological morbidity. The findings support screening patients for symptoms of depression and anxiety as part of standard cancer care and referring those at a higher risk of developing psychological morbidity for appropriate care.

This paper addresses the chaos control and synchronization problems of a hyperchaotic system. It is assumed that the parameters of the hyperchaotic system are unknown and the system is perturbed by the external disturbance. Based on the Lyapunov stability theory and the adaptive control theory, suitable nonlinear controllers are designed for the asymptotic stability of the closed-loop system both for stabilization of hyperchaos at the origin and complete synchronization of two identical hyperchaotic systems. Accordingly, suitable update laws are proposed to estimate the fully uncertain parameters. All simulation results are carried out to validate the effectiveness of the theoretical findings. The effect of external disturbance is under our discussion. [ABSTRACT FROM AUTHOR]

This study aimed to explore the influences of overcrowded classroom on the academic achievement of students at secondary school level in Khyber Pakhtunkhwa. Objective of the study was to explore the effect of overcrowded classroom on the academic achievement of students. Mixed method approach was applied for this research study. Sample of the study consisted of 600 10th grade students, 143 secondary school teachers and 30 principals selected through multistage cluster and simple random sampling technique. Quantitative data collected for the last five years result(2013-17) of 10th grade students from the Gazette book and also through self-developed questionnaires. Items of the questionnaire were developed on the basis of the problems of overcrowded classrooms with five point's Likert type rating scale. Qualitative data collected from the principals through interview. The results showed that there was a very weak correlation between the 10th grade students enrolled and their pass percentage in the SSC(A) exams for the years 2013-17. The study showed that there was much agreement between the views of teachers, students and principals on the issue. It was concluded from the current study that an overcrowded classroom can influences the student's academic achievement. The study confirmed that all the sampled secondary schools were lacking enough classrooms, teaching staffs and mostly the classrooms were overcrowded. It was recommended that class size may be of 35 students, shortage of teaching staffs and additional classrooms may be constructed to overcome the problem of overcrowded classroom. [ABSTRACT FROM AUTHOR]