Pakistan Institute Research Articles

Prevalence, Severity of Anemia and Meal Skipping Behaviour among Undergraduate Students: A Cross Sectional Study

Background: Iron Deficiency Anemia (IDA) is a significant global health challenge, particularly affecting women and students in developing countries. Despite its prevalence, IDA often remains underdiagnosed and overlooked, especially in regions with limited resources. The World Health Organization identifies iron deficiency as one of the leading risk factors contributing to global mortality. Objective: This study aimed to evaluate the prevalence and severity of anemia and to assess dietary habits among undergraduate nursing students in a private sector institution in Pakistan, with a focus on understanding the gender differences in anemia prevalence. Methods: A cross-sectional study was conducted involving 105 first- and second-year nursing students (47 females, 58 males) at a private nursing institution in Karachi, from August to December 2022. Data collection included demographic information, dietary habits, and a 3-milliliter venous blood sample for hematological analysis. Anemia was classified based on hemoglobin levels, with thresholds set at <12 g/dl for females and <13 g/dl for males. Results: The prevalence of anemia was found to be significantly higher in females (53.2%) compared to males (15.5%). Among the anemic participants, 55.8% had mild anemia, 41.2% moderate anemia, and 2.9% severe anemia. The severity of anemia was predominantly higher among females, with 29.8% experiencing moderate and 2.1% severe anemia. Additionally, 60.9% of the students reported skipping breakfast, with a higher tendency observed among anemic females (51.0%). Conclusion: The study highlights a considerable prevalence of anemia among female nursing students, with moderate anemia being more common. The association between anemia and dietary habits, particularly skipping breakfast, was evident. These findings underscore the need for targeted nutritional interventions and regular health monitoring in this demographic.

Diabetes and its associated factors: A Retrospective cohort analysis of a large database at Indus Hospital Health Network.

This is a retrospective cohort analysis of diabetes and its associated factors from Electronic Medical Record (EMR) of 2020-2022 of Indus Hospital Health Network (IHHN), Korangi campus Karachi. Retrospective cohort study was conducted at Indus Hospital & Health Network (IHHN), Korangi Karachi. Out-patient records of adult patients of 2020-2022 were extracted from EMR of IHHN in March 2023. Descriptive statistics were presented as median (IQR) and frequency and percentage. Chi-square test determined association of risk-factors with diabetes and Wilcoxon-sign-rank test compared change in HbA1C from baseline. Data of 460,799 adult patients were extracted and analyzed. Median age of patients was 38.71 (27.87-52) years. Female preponderance was observed in our study. Out of 460,799, HbA1C was seen in 42,638 (9.25%) patients. Among these 29,596 (69.4%) had a HbA1C ≥ 6.5% while 13,042 (30.6%) had a HbA1C in the pre-diabetes range. Significant association was found between age, baseline creatinine, LDL and diabetes with no association depicted between gender, BMI, blood pressure, triglycerides, HDL and diabetes status. Patients in general had higher HbA1C at baseline as compared to last visit (p-value<0.001). High blood pressure, obesity, increased creatinine, micro albuminurea, high LDL and Triglycerides were important risk factors for diabetes. This study reports a snap shot of the status of diabetes and associated risk-factors in the Pakistani population. This was the first time that a large data was extracted and analyzed from a healthcare institution in Pakistan, which would guide physicians and public health practitioners to take evidence-based decisions for prevention and management of diabetes.

Comparative Study of Topical Steroids Vs Non steroidal Anti-Inflammatory Drugs to Control Post-Cataract Surgery Macular Edema

Purpose: To compare the efficacy of topical steroids with non-steroidal anti-inflammatory drugs in controlling post-cataract surgery macular edema. Study Design: Quasi experimental study. Place and Duration of Study: “Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan” from 1st July 2022 to 31st December 2022. Methods: Forty patients who had undergone cataract surgery were selected for this study by convenient sampling. After informed consent, patients were divided into two groups: Group S (n = 20) was given 1% prednisone eye drops for 14 days while group N (n = 20) was given 0.1% nepafenac acid eye drops for 14 days. 30 days after surgery, central macular thickness (CMT), using OCT, was assessed and documented in both groups. Data was analyzed by SPSS 21. Results: Mean age of patients was 44.02 ± 6.08 years. There were 60% (24) males and 40% females. Mean pre-operative CMT difference between two groups was statistically insignificant. Post-operative CMT was significantly lower in group N as compared to group S [243.00 ± 21.71 µm vs 223.90 ± 17.52 µm; p = 0.004]. Frequency of post-operative ME was lower in group N as compared to group S [35% (7) vs 15% (3); p = 0.144]. Conclusion: Topical eye drops containing NSAIDs and steroids are useful to control post-cataract surgery macular edema but NSAIDs drops have better efficacy in controlling post-cataract surgery macular edema.

Correlation of HbA1c with red cell width distribution and other red cell indices in Type II diabetic females.

Objective: To assess the correlation of HbA1c with hemoglobin concentration, RWD, and other red cell indices in Type II diabetes mellitus female patients. Study Design: Cross-sectional study. Setting: Department of Physiology, Al Nafees Medical College, and Pakistan Institute of Medical Sciences, Islamabad. Period: January 2019 to December 2020. Material &amp; Methods: The study included 70 adult female diabetic patients, adhering to International Diabetes Federation guidelines. Exclusion criteria encompassed uncontrolled diabetes, pregnancy, renal issues, cardiac failure, and hemoglobinopathies. Laboratory tests, such as Complete Blood Count and HbA1c measurements, were conducted. SPSS version 23 was used for statistical analysis, employing mean, standard deviation, and Pearson's correlation to assess relationships among HbA1c, hemoglobin, Red Cell Distribution Width (RDW), and other red cell parameters. Results: A total of 70 female patients with diagnosed Type II diabetes mellitus were included in our study with a mean age of 40.45±12.70 years. The Mean±SD of study variables like HbA1c, hemoglobin, MCV, MCHC, RDW, and FBS of the patients was 5.91±0.89%, 11.23±1.59 gm/dl, 76.32±9.50fl, 31.02±3.39mg/dl, 12.78±1.51 and 100.53±15.52mg/dl respectively. A significant correlation between HbA1c and RDW was found and showed that both variables were positively correlated with each other. (r= 320, p=0.001). Conclusion: RDW correlates with HbA1C in female Type II diabetes patients, suggesting CBC, including RDW, as a cost-effective diagnostic marker alongside HbA1c for glycemic status assessment.

Educators’ relationships and its impacts on students’ educational outcomes in higher educational institutions of Pakistan

Educators’ relationships and its impacts on students’ educational outcomes in higher educational institutions of Pakistan

Impact Of Organizational Justice On Organizational Citizenship Behavior: Role Of Transformational Leadership

The purpose of this research study was to investigate how organizational justice influences organizational citizenship behavior (OCB), taking into account the moderating effect of transformational leadership. Organizational justice was assessed through distributive justice, procedural justice, and interactional justice, while organizational citizenship behavior was evaluated based on altruism, civic virtue, conscientiousness, courtesy, and sportsmanship. Data was collected from randomly chosen universities in Punjab using a questionnaire survey, and [1]120 responses were obtained over a three-month period. The findings revealed a significant and positive relationship between organizational justice and organizational citizenship behavior (OCB). Additionally, it was observed that transformational leadership plays a significant moderating role in the association between organizational justice and organizational citizenship behavior (OCB). Furthermore, this research provides important understanding for the administration of educational organizations, indicating that enhancing beliefs of fairness and equity among teachers and scholars can enhance the overall efficiency of their institutions in Pakistan.

Frequency of Complications after Paediatric Ventriculoperitoneal Shunt Surgery for Management of Hydrocephalus: An Observational Cohort Study

Objectives: To determine the frequency of complications after paediatric ventriculoperitoneal shunt surgery for management of hydrocephalus.&#x0D; Materials and Methods: An Observational Cohort Study was conducted from 19th March, 2020 to 18th September, 2021 at Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Total 150 patients of both genders, aged between 1-18 years diagnosed with hydrocephalus were selected. Shunted patients operated for other pathologies of brain and spine and those with more than 3 shunt revisions were excluded. Based on the clinical findings and investigations, a final diagnosis was made and the treatment in individual cases was planned accordingly. Post-operatively all the patients were followed up till 6 months and any complication which occurred was documented.&#x0D; Results: Age range in this study was from 1 to 18 years with mean age of 7.50 ± 4.22 years. Majority of the patients 74.0% were between 1 to 10 years of age. Out of these 150 patients, 85 (56.67%) were males and 65 (43.33%) were females with male to female ratio of 1.3:1. Shunt blockade was seen in 36 (24.0%), Shunt malfunction in 21 (14.0%), Shunt infection in 48 (32.0%) and Shunt migration in 23 (15.33%) patients.&#x0D; Conclusion: This study concluded that ventriculoperitoneal shunt in children with hydrocephalus is not free of complications and should be monitored and managed properly to reduce the complications.

Evaluating and Designing Active Citizenship Education for Youth Resilience to Preventing Violent Extremism at Public Sector General Universities of Sindh, Pakistan

Higher Education Institutes (HEIs) in Pakistan have experienced unprecedented on-campus violent extremism. Large-scale research led approach is needed to prevent homegrown violent extremism through transformative active citizenship education at HEIs in Pakistan taking into account that youth under the age of 30 constitutes 63% of the total population of Pakistan. As recognized repeatedly by the UN Security Council, violent extremism poses a significant threat to global peace and stability, with tremendous impact on social cohesion, eroding development progress and hindering future gains. This paper assesses the current state of citizenship education at Higher Education Institutes in Sindh province. The problem, however, is that many countries, including Pakistan, do not give citizenship education the importance it deserves, nor use approaches appropriate to the development of informed and participatory citizenship. (Dean, 2000; Kerr, McCarthy, and Smith 2002; Torney-Purta and Amadeo 1999). Citizenship active citizenship in youth is a social leadership program that promotes intercultural dialogue and social responsibility as key leadership competencies in the 21st century and results in community resilience. For this purpose, institutionalizing active citizenship for developing youth resilience to violent extremism warrants a massive radical reform of the education system to develop critical analysis skills among youth enabling them challenge violent extremist narratives. This is a preventive and initiative-taking strategy to develop active citizenship to be capitalized as glue for social inclusivity, integration and national cohesiveness in Pakistan. Active citizenship encompassing volunteering, democratic engagement, environmental sustainability, community development and reflective thinking is most likely to prevent vulnerability to recruitment of violent extremist organizations.

CLIENT SATISFACTION AND WAITING TIME IN MCH EMERGENCY

The emergency departments are often a source of complaints. Due to the COVID-19 pandemic, we are facing an increase in the number of patients in MCH ER. The patients are referred from all over the country, which increases the burden on the facility compared to the available resources. The department has to face the burden of non-booked patients secondary to the COVID-19 pandemic presenting to the MCH ER, leading to increased complaints about client dissatisfaction regarding the Emergency department. Hence, we decided to audit our current ER and plan interventions to improve our practices. We propose to formulate recommendations for other facilities facing similar challenges. This study aimed to determine the waiting time and total length of stay in the mother and child health care emergency of the Pakistan Institute of Medical Sciences to plan interventions to reduce client dissatisfaction. An audit study was conducted from 1st September 2021 to 30th September 2021, and then a re-audit with interventions was carried out from 1st April 2022 to 30th April 2022 at the Emergency of Mother and Child Health and Care Center of Pakistan Institute of Medical Sciences. The Study had the active participation of duty doctors, nurses, paramedics, statisticians, computer operators, personnel from HMIS, workers, and patients. This study was conducted to determine our practices in an emergency. The data was collected from maintained existing paper-based doctors' and staff nurses’ registers. The duty doctor manually enlisted patient’s data on worksheets, this data was then shared in the "MCH ER WhatsApp group" and compiled. The data was entered on SPSS 25 and analyzed. Primary Outcome measures were waiting time for assessment, primary (registration to triage time), secondary assessment (triage to decision time), and total length of stay in ER (Door to deposition time). Secondary outcome measures included client dissatisfaction rate. A total of 1447 patients were included, of which 46 % were from Islamabad and 38% were from Rawalpindi. The first assessment by a duty ER doctor within 5 minutes (registration to triage time) was 16.4%, which increased to 25.5%, and 59.2% at 30 minutes, which increased to 70.7% in the re-audit. The second assessment by senior (doctor to decision time) within 30 minutes was 59% and increased to 69% in re-audit. Admissions were offered to 33.6%, 1.1% left against medical advice (LAMA), and 38 % were lost to follow-up. The total length of stay in MCH ER (Door to deposition time) was 3 hours mean (195 min) in 60% of the patients (37.9% of patients were admitted, 22.1% were discharged). In the re-audit, 69.6% were admitted after interventions, 27.6% were discharged (97% door to deposition time within 3 hours with a (mean time of 180 min ), 1.8% LAMA and only 1% were lost to follow-up. Both study cycles had no significant change in CTGs, ultrasounds, or baseline investigation frequency. Complaints can be curtailed by taking measures such as adding another duty doctor in emergency for immediate triage, early second assessment by seniors to shorten the triage to decision time, and avoiding unnecessary ultrasounds and baseline investigations. The most significant determinant of client satisfaction in the ER is the short length of Stay in the ER that is, arrival to deposition time.

Experimental and numerical study of an innovative twined tube HX design

An innovative twined tube heat exchanger (HX) design is proposed, which is simple, robust, and efficient for use in advanced nuclear reactors. The heat exchanger is designed with two tubes twined around each other. Multiple modules can be assembled within a shell to meet the necessary heat load. Thermal-hydraulic investigations of the novel design are performed through experiments and numerical simulation. The experimental investigations of the twined tube HX are carried out on a laboratory-scale thermal–hydraulic rig commissioned at the Pakistan Institute of Engineering & Applied Sciences (PIEAS). The primary loop contains water at a high temperature and a pressure of 4.0 bar pressure, while the secondary loop operates at atmospheric pressure. Single-phase forced convection heat transfer characteristics of the twined tube HX are investigated experimentally. Pressure drop is measured for mass fluxes ranging from 350 kg/m2s to 1376 kg/m2s. A correlation for the estimation of friction factor is developed based on the experimental studies. Heat transfer measurements are carried out for mass fluxes ranging from 244 kg/m2s to 419 kg/m2s. Based on these experiments, the Nusselt number is evaluated for the mass flux range mentioned above. The numerical simulations of a twined tube HX are performed on a full-scale STAR-CCM + model. The model is validated against the experimental results. The performance factor of the twined tube HX is higher than that of straight tube HX, with a maximum performance enhancement of 60%. The thermal–hydraulic performance of the twined tube HX is comparable with helical coil HX designs. However, the proposed HX design is easier to fabricate and maintain than the helical coiled HX. Overall, the study provides valuable insights into the thermal–hydraulic performance of the twined tube HX, which could be useful in the design of compact and efficient heat exchangers for small modular reactors.

ANTIMICROBIAL SENSITIVITY PATTERN OF PEDIATRIC CYSTIC FIBROSIS PATIENTS IN PAKISTAN

Cystic fibrosis (CF) is a complex genetic disorder affecting the respiratory and digestive systems, causing recurrent infections. This study aimed to evaluate the microbiological cultures and identify the patterns of antimicrobial sensitivity among young CF patients in Pakistan. This prospective observational study was conducted at the Pakistan Institute of Medical Sciences (PIMS) from December 2021 to November 2022, involving comprehensive assessments, interviews, clinical tests, MTs, CBCs, CXRs, sputum cultures, RBS measurements, microbiological analysis of sputum and oropharyngeal swabs, antimicrobial susceptibility testing, and statistical analyses (p ≤ 0.05) using SPSS for both continuous and categorized data. Pseudomonas Aeruginosa was the most common respiratory pathogen (n=21; 36%), and most CF-afflicted children (n=46; 77.96%) had infections with a single microorganism. Significant associations (p &lt; 0.05) were observed between Streptococcus pneumoniae, Klebsiella Pneumoniae, Staphylococcus Aureus, and Acinetobacter with their antibiotic sensitivity patterns. In contrast, Pseudomonas Aeruginosa and Escherichia Coli showed no statistically significant associations. Ciprofloxacin demonstrated high sensitivity, followed by Levofloxacin, while several first-generation antibiotics, including rifampicin, erythromycin, and amoxicillin, exhibited nearly complete resistance against bacteria collected from children with CF. Ciprofloxacin and Levofloxacin emerge as the foremost effective therapeutic agents for CF patients, advocating the perpetual promotion of active surveillance to monitor resistance patterns.

Knowledge of Human Monkeypox Infection among Final Year Medical, Pharmacy, and Nursing Students: A Multicenter, Cross-Sectional Analysis from Pakistan.

The World Health Organization (WHO) declared the monkeypox outbreak a public health emergency in June 2022. In Pakistan, positive cases of monkeypox were reported in April 2023. Healthcare workers (HCWs) are considered as a front-line force to combat such outbreaks. A questionnaire-based cross-sectional study was conducted among 11 public sector educational institutions in Punjab, Pakistan, during May and June 2023 among final year medical, pharmacy, and nursing students concerning their knowledge of monkeypox. This included the signs/symptoms of monkeypox. Healthcare students were chosen as they are the HCWs of tomorrow. A total of 389 healthcare students participated in the study, with a mean age of 23.17 ± 1.72 years, and the majority were female. The mean knowledge score was 17.69 ± 4.55 (95% CI 17.24-18.14) out of a maximum total knowledge score of 26 (each correct answer was given a score of 1). The proportion of students with good, moderate, and poor knowledge was 21.6%, 43.2%, and 35.2%, respectively. Age (p = 0.017), gender (p < 0.001), and education (p < 0.001) had a significant impact on the knowledge score. In the multivariate linear regression model, education was the only significant factor linked to knowledge scores. Overall, the majority of future HCWs had moderate knowledge of monkeypox. Consequently, educational activities are needed to improve monkeypox-related knowledge among future HCWs. Furthermore, emerging infectious diseases should be routinely incorporated into HCW curricula.

Conflicting interests, institutional fragmentation and opportunity structures: an analysis of political institutions and the health taxes regime in Pakistan

Pakistan is the world’s fifth most populous country, with large segments of its population at risk from non-communicable diseases caused by consumption of harmful products, including tobacco and sugar-sweetened beverages....

Exploring Heads’ Perspective on Social Justice for Students in Higher Education Institutions in Pakistan

Equal opportunity does not imply equal treatment: rather it means fair treatment (Ghosh, 2012). Fair treatment and providing equal opportunities to enhance individual’s capability, irrespective of any personal or societal differences, can contribute in providing excellence in education that leads to social justice. The objective of the study was to explore heads’ perspectives of students’ equitable access to educational resources, equitable participation and equitable outcomes in higher education. The study had also explored heads’ perspectives on students’ personal barriers to social justice and equity. To explore the perspective of heads on social justice for students in universities, data had been collected from 17 leaders working in higher education, by using multistage sampling technique. An interview protocol was developed to explore the perspective on social justice connected to leaders for bringing improvements in education so that all students get equal opportunities to excel in education. The results presented less positive situation of social justice and equity in public sector higher education. The study recommends that the education system needs to consider social justice and equity to ensure heads’ commitment to social justice and equity principles, leading to equal opportunities for making students’ capability better in higher education institutions in Pakistan.

Political Skills and Perceived Employability: Exploring the Mediating Role of Career Self-efficacy

This research study aims to explore the impact of political skills on perceived employability, focusing on the mediating effect of career self-efficacy among faculty of higher education institutes in Pakistan. By examining the employability issues faced by faculty in Pakistan’s higher education institutes, this study shed light on the challenges and opportunities for professional development in this domain. The survey was conducted using an administered questionnaire. A sample of N= 340 was selected through convenience sampling technique, ensuring representation from various higher education institutes of Pakistan. Data was collected from respondents through online Google forms. The questionnaires determine three variables: perceived employability, career self-efficacy, and political skills. The results indicated that career self-efficacy has a mediating role between political skills and perceived employability. Regression analysis also confirmed that political skills are positively correlated with perceived employability. Faculty members in higher education institutions should prioritize Self-managed career behaviors, such as developing career goals and implementing career tactics, as a means of enhancing their employability. In addition, management should launch formal and informal training programs for employees to strengthen feeling of success and career development. Providing employees with sufficient support and resources can help them improve their career self-efficacy and ensure their future employability.

Workplace dynamics and individual outcomes: Role of workplace ostracism in shaping inner resignation

This study aims to examine the influence of workplace ostracism on horizontal workplace violence, occupational self-efficacy, and inner resignation in the faculty members working in higher education institutions of Pakistan. In this study, a survey was held for native Urdu speakers. The back-to-back method was used for the translation of the questionnaire. The translated questionnaire was pilot tested with a small group to ensure clarity. The total of 321 responses were collected by using self-administered questionnaires and online platform. The SPSS and Smart PLS4 software were utilized for hypothesis testing. The results of the study show that respondents have low workplace ostracism, horizontal workplace violence, and inner resignation, whereas they exhibit high occupational self-efficacy. The results also indicate that workplace ostracism has the strong and positive relation with horizontal workplace violence while negative relation with occupational self-efficacy. The findings of the study show that interrelationship between workplace ostracism and inner resignation is not an isolated one but is significantly influenced by horizontal workplace violence and occupational self-efficacy.

Assessment of Physician Knowledge, Attitude and Safety Practice Towards Radiation Safety

Background: Radiations plays an important role in various diagnostic and therapeutic procedures within health facilities, but its use poses inherent risks to both healthcare professionals and patients. Understanding the knowledge, attitude, and safety practices of physicians in relation to radiation safety is paramount for ensuring the well-being of all stakeholders involved. Physicians, as key decision-makers in medical procedures involving radiation, need to be well-informed about the associated risks and safety measures. Objective: To determine the physician knowledge, attitude and safety practice towards radiation safety. Study Design: Cross-sectional study. Settings: Pakistan Institute of Medical Sciences, Islamabad Pakistan. Duration: March 2020 to February 2021. Methods: All the physician relevant to exposure to ionizing radiation, such as radiology, nuclear medicine, interventional cardiology, and oncology, having minimum one year or more experience in radiological field of either age and gender were included. Data collection was carried out through a structured questionnaire, specifically designed to evaluate participants' understanding of radiation safety principles, their attitudes towards adherence to safety protocols, and their day-to-day practices in radiological procedures. The collected data was analyzed using appropriate statistical methods SPSS version 26. Results: Majority of participants experience medical radiation exposure less than once per week (42.1%), with a significant portion having exposure more than three times per week (40.8%). 90.8% of participants have never undergone a radiation protection course, despite 73.7% expressing willingness to participate in such a course if provided by their institution. 52.7% strongly disagreed that radiation significantly affects childbearing, while 39.5% believe they are safe within 1 meter of radiation exposure. On a positive note, 86.8% of participants correctly identified the ALARA principle for radiation protection. Regarding the implementation of safety protocols, only 28.9% were more likely to wear a lead apron, and 22.4% never wore it. Conclusion: Health care professionals lacks adequate knowledge, training and attitude regarding radiation safety protocols. Lack of adequate knowledge and training leads to poor utilization of radiation safety equipment and it is a source of health hazard for both medical professionals and the patients.

Intention to use technology for micro-credential programs: evidence from technology acceptance and self-determination model

PurposeThe study aims to investigate students' attitudes toward using technology for micro-credential programs (MCPs) and their behavioral intention toward using MCPs for learning and enhancing their skills. The study also intends to investigate the moderating influence of labor market conditions (LMC).Design/methodology/approachA closed-ended questionnaire is employed to collect data from 474 participants through a convenience sample, from the university students in Karachi. Two theoretical frameworks are used in the study: technology acceptance model (TAM) and self-determination theory (SDT). The partial least squares structural equation modeling (PLS-SEM) technique is used to analyze data.FindingsFindings reveal significant and positive relationships between all variables, except controlled motivation (CM) and perceived challenges. Moreover, the moderation results ascertain that the labor market does not moderate the relationship between attitude toward using technology for MCPs and students' behavioral intention toward using MCPs for learning.Originality/valueThe study seeks to understand students' attitudes and behavioral intentions toward using technology for MCPs. Also, the moderating effect of LMC is highlighted in understanding the impact of the attitude to use technology (AT) for MCPs and behavioral intentions in higher educational institutions (HEIs) in Pakistan. The study highlights intuitive practical implications for students of HEIs, universities and digital credential program providers.

The Validity Of 75gms OGTT For Detection Of GDM Keeping 100gms OGTT As Gold Standard

Objective: To determine the validity of 75gms (Oral Glucose Tolerance Test) OGTT for the detection of GDM keeping 100gms OGTT as the gold standard. Methodology: This was a Cross-sectional validation study done at the Mother and Child Health Centre, Pakistan Institute of Medical Sciences, Islamabad. The duration of the study was Six months from the approval of the synopsis. Data was collected from March 2019 to September 2019. Informed consent for participating in the study was taken from all 205 patients. The patients' bio data along with the hospital registration number was entered pro forma. The patients were assessed initially by History taking and examination. All pregnant women underwent a 75g oral glucose test in the 2nd trimester at 24-28 weeks of gestation. For this, the patients were sent to the MCH laboratory with overnight fasting where FBS was taken and they were given a 75 g glucose drink. Their blood sample was taken at 1-hour and 2-hour interval. Two or more elevated values out of the 3 blood samples were sufficient to diagnose GDM. Laboratory reports were reviewed and data was entered in the performa (attached) by the researcher. All the diagnosed patients were further evaluated for a 100g OGTT dose at the MCH laboratory with overnight fasting. Their FBS was studied and women were given a 100 g glucose drink and blood samples were drawn at an interval of 1, 2 and 3 hours respectively. Out of the 4 blood samples, two or more elevated values were sufficient to diagnose GDM. Lab reports were entered in the Performa. Results: From a total of 205 patients, the sensitivity and specificity of OGTT-75 g for diagnosing GDM were 83.02% and 82.83%. However, positive predictive and negative predictive value for OGTT-75 g was 83.81% and 82% respectively. However, the overall diagnostic accuracy of OGTT-75 g was 82.93%. Conclusion: Results of this study showed that 75 gms OGTT is highly sensitive (83.02%) and specific (82.83%) for the detection/diagnosis of gestational DM. Advanced screening and diagnosis of gestational DM, and its effective treatment not only inhibit adverse perinatal and maternal outcomes but also save the lives of both child and mother from diabetes in future.

Social Media Addiction in The Young Community: Elucidation of The Development of Behavioral Responses

Background: University students have been using social media in an uncontrolled manner without knowledge of the negative impacts on their cognitive functionality. Therefore, an assessment of the alterations in the behavior pattern of the university students is required to associate the linkage between social media use and subsequent aggressiveness. Contribution: Current work has for the first time conducted a socio-behavioral study on the younger university students for gaining an insight into their inclination towards using different social media platforms and changes in their behavioral patterns. Method: University students (73 total; 35 males and 38 females) were chosen who had history of using social media for the last three to five years. These students were affiliated with higher education institutions in Pakistan and the time of analysis was September 2022 – January 2023. An open-ended questionnaire was filled and statistically analyzed for significance using Origin software and SPSS software Results: This work has identified significant relationship between the social media utilization and alterations in the behavior of university students. Different determinants worked upon in this research are the impacts of the social media on cognitive occupation, emotive functions, relapse, conflict, anger, and hostility. Conclusion: The study has associated and evaluated such behavioral factors as determinants of aggression in the younger generation. Also, the study has compared and contrasted the appearance of aggression as a pattern taking in consideration different gender roles to comprehend the role of gender in perceiving and adopting social media trends.