Riphah International University Research Articles

Smoking has detrimental effects on voice related Quality of Life of University Teachers.

To compare voice related quality of life of smoker and non-smoker university teachers. This Cross-Sectional descriptive study was conducted at Riphah International University over a period of six months January to June, 2022. A sample of N=352 University teachers of both genders, aged 25 to 65 years, who were faculty members and working at least 8 hours per day in teaching positions with at least one-year experience were included in the study. Demographic sheet, Voice Related Quality of Life (VRQOL) and Voice Handicap Index (VHI) were used for data collection and analysis conducted on SPSS Version 21. Mean scores of VRQOL and VHI for smokers and non-smokers were compared using Mann Whitney U Test. & Spearman's correlation was utilized to determine any association between the tool scores. P<0.01 was considered significant. Results reveal that the mean score of Voice related quality of life scale was significantly (p=0.000) higher in smokers compared to non-smokers indicating worse voice quality in smokers. Similarly, voice handicap index scores were much higher in smokers (p=0.000) indicating more handicap in the smokers. The study concludes that smoking has a detrimental effect on voice and voice related quality of life of university teachers and voice related quality of life as determined by VRQOL scale is significantly better in non-smokers.

Post-Laparotomy Pulmonary Complications in Blow Bottle versus Interdigital Breathing Technique: A Quasi-Experimental Study

Objective: To analyze the impact of interdigital versus blow-bottle breathing exercises on spirometry, pulse oximetry and respiratory rate in post-laparotomy patients. Study Design: Quasi-experimental study. Place and Duration of Study: Riphah College of Rehabilitation Sciences, Riphah International University and Capital Hospital, Islamabad, Pakistan, from Apr to Aug 2018. Methodology: This quasi experimental study recruited 27 post laparotomy patients, male and female, aged between 25-45 years. Along with conventional treatment for both groups, Group-A (n=14) received interdigital breathing exercises and Group-B (n=13) was given blow-bottle breathing therapy. Effect on spirometry, pulse oximetry tests and respiratory rate on Day 1, 3 and 6 were recorded. Results: On 6th Day post-laparotomy, interdigital group (Group A) showed significantly higher median and mean ranks for oxygen saturation (OS) (p&lt;0.001), rate of peek expiratory flow (p=0.000), forced expiratory volume (1 second) (p=0.018), forced vital capacity (p&lt;0.001) and lower respiratory rate (p&lt;0.001). Blow bottle breathing therapy revealed significantly higher mean for forced vital capacity (p=0.017), but was lower for Oxygen saturation (p&lt;0.001) and respiratory rate (p&lt;0.001). Conclusion: Our findings lead us to conclude that interdigital technique provides more benefit to post-laparotomy patient compared to blow bottle technique in effective management of pulmonary complications.

Medical Student’s Attitudes towards Implementation of National Licensing Exam (NLE) – A Qualitative Exploratory Study

The introduction of the post-qualification National Licensing Examination (NLE) in Pakistan has been met with resistance from the medical students. They are the main stakeholders of medical colleges. Objective: To explore the opinions of medical students regarding the feasibility of NLE. Methods: An exploratory, qualitative study was conducted at Riphah International University, Islamic international medical college, Rawalpindi and Gomal Medical College, D.I. Khan, KP using in-depth interviews. A sample of 12 medical students from different medical colleges in Pakistan was included. The recorded interviews transcribed verbatim. Thematic analysis was then conducted using NVivo V2 and coded into nodes and daughter nodes, of which 5 themes and 17 subthemes emerged. Results: A total of five themes and 17 themes were created. NLE was deemed as a good standardization tool for assessing the competence of medical graduates. Students believed that current MBBS assessment lacks in clinical skills assessment and did not prepare to treat patients upon graduation. However, they did not want to take another exam after the professional exams especially when no incentives are offered to graduates upon clearing. They suggested NLE should be used as a means of constructive feedback for institutions and students to allow them to work on weak areas. Conclusions: There were mixed opinions regarding the acceptance of the exam. If medical institutions across the country focus their curricula on developing clinical skills and incentives are provided to the doctors upon clearing, the students would readily accept the exam

Common practices of Speech and language pathologists about partner oriented training to treat aphasia

Objective: To find the common practices among speech language pathologists regarding partner-oriented training for aphasic patients. Method: The exploratory, qualitative study was conducted at Riphah International University, Lahore, Pakistan, from March 1 to May 31, 2021, and comprised speech language pathologists working with aphasiac patients for at least 5 years in Lahore, Karachi and Islamabad. Data was collected using a structured interview guide that were conducted online. The recorded interviews were transcribed, and the data was subjected to thematic analysis. Result: Of the 10 subjects, 6(60%) were females and 4(40%) were males. Overall, 6(60%) subjects had professional experience of &gt;10 years. Thematic analysis showed that most of the speech language pathologists used traditional approaches for aphasia treatment, and counselling of patient’s caregiver was done. However, there was no formal tool in Urdu language to provide basic communication strategies for the patient’s caregivers or their communication partners. The participants recommended efforts to develop such a tool. Conclusion: There was found a dire need of communication partner training (CPT) programme for aphasia patients and their significant others with appropriate linguistic and cultural norms to facilitate them with the aim of improving their quality of life. Key Words: Aphasia, Quality of life, Speech therapies, Acquired communication disorder, Partner communication.

Social intelligence in health professions educationists: how it helps to deal with challenges at the workplace? a mixed-method study

Objective: To identify the social intelligence of medical educationists, and the coping strategies used to deal with workplace challenges. Method: The mixed-method study with an explanatory sequential design was conducted from March 15 to July 30, 2021, after approval from the ethics review committee of Riphah International University, Rawalpindi, Pakistan, and comprised medical educationists working in medical and dental colleges and institutions across the country. Data was collected using Tromso social intelligence scale in the quantitative phase. The socially intelligent educationists were identified, and were interviewed. Qualitative data was subjected to thematic analysis to identify predominant themes explaining the coping strategies used. Results: In the quantitative phase, there were 80 participants; 51(63.7%) females and 29(36.3%) males, with 24(30%) having &gt;10 years of professional experience. Of them, 11(13.8%) scored low, 54(67.5%) moderate and 15(18.8%) high on the social intelligence scale. In the qualitative phase, there were 13 subjects; 9(69.2%) females and 4(30.8%) males. There were 4 themes identified as coping strategies; inspire respect and trust, bringing readiness before a change, a collaborative and inclusive approach, and soft skills. Conclusion: Variation was seen in the levels of social intelligence among medical educationists working in academic institutions. Those with high levels of social intelligence used their non-cognitive soft skills to manage workplace challenges. Key Words: Social intelligence, Medical education, Workplace, Coping strategies, Coping skills.

Effect of Dynamic Balance Training on Physical Function and Proprioception in Individuals with Knee Osteoarthritis

Background: Osteoarthritis (OA) is a prevalent joint disorder affecting synovial joints, particularly the knee. It leads to degeneration of cartilage, causing pain and reduced physical function. Effective treatment strategies are essential for managing symptoms and improving quality of life. Objective: To determine the effect of dynamic balance training on physical function and proprioception in individuals with knee osteoarthritis. Methods: This quasi-experimental trial was conducted at Riphah International University Lahore, Aziz Medical Clinic, and Ali Hospital, Mughal Pura Lahore. A total of 48 patients with anterior knee pain were recruited and divided into two groups: one receiving dynamic balance training and the other receiving conventional physical therapy (control). Non-probability convenience sampling was used. Outcomes were measured using NPRS, a goniometer, the Community Balance and Mobility Scale (CB&amp;M), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Knee proprioception was assessed by joint position sense using a universal goniometer, with the average of three angles taken for the final reading. Data were analyzed using SPSS version 25. Results: Significant differences were observed in joint proprioception between weight-bearing (WB) and non-weight-bearing (NWB) procedures. The mean difference for WB was -3.07 compared to -2.18 for NWB, with a higher relative error in WB (p &lt; 0.05). Dynamic balance training resulted in greater reductions in NPRS scores and improvements in WOMAC scores compared to conventional physical therapy (p &lt; 0.05). Conclusion: Dynamic balance training was more effective than conventional physical therapy in improving physical function and proprioception in individuals with knee osteoarthritis.

Sequential mediation analysis of physical activity, healthy diet, BMI, and academic burnout in the Pakistani educational landscape

Research has indicated a negative impact of physical activity on academic burnout among students, however, there is a paucity of evidence about the underlying mechanism of this association in Pakistani students. The present research seeks to investigate the relationship between physical activity and academic burnout by investigating the potential mediating effects of adherence to the Mediterranean diet (MD) and body mass index (BMI). A sample of 596 students using a cross-sectional survey design was gathered from two public universities (Riphah International University and Mohammed Ali Jinnah University) in Rawalpindi, Pakistan from June to July 2022. The study participants were asked to fill out the Physical Activity Rating Scale-3, the Learning Burnout Scale, and the Test of Adherence to MD questionnaires. The study employed descriptive, bivariate, and path analysis through regression utilizing the SPSS software version 27. The findings demonstrated a negative correlation between academic burnout and BMI, physical activity, and adherence to the MD. The relationship between physical activity and academic burnout was mediated by BMI. Physical activity and academic burnout were inversely correlated, with adherence to the MD and BMI interacting as sequential mediators. The outcomes of this research have expanded our knowledge of the association between physical activity and academic burnout and have suggested crucial and appropriate strategies for addressing student academic burnout.

Association between Parenting Style and Language Development in Children

Parenting style plays important role in the development of the children from birth to five years of age including language development as well. Hence, parents can play important role in the development of their children because their quality of time matters. Objective: To determine the association between parenting style and language development and to identify the type of parenting style mostly use by the parents. Methods: This cross-sectional study, with a sample of n=384 parents, was conducted at Riphah International University, Islamabad from 1st August, 2022 to 31st January, 2023. Parents of typical children of both genders, aged birth to 36 months were included. Basic demographical sheet, Parenting style questionnaire and Receptive Expressive Emergent Language (REEL)3rd edition were used for data collection. SPSS version 21.0 was used for data analysis. Point-Biserial Correlation was used to determine correlation between the parenting style and language development and p&lt;0.05 was considered significant. Results: Results indicate significant (p&lt;0.001) relationship between parenting style and language development of children. The correlation of parenting style was low with receptive language but high with expressive language. The results also indicate that parents used different parenting styles with majority 225(58.6%) using authoritative parenting style and least 12(3.1%) used permissive parenting style. Conclusions: Study concludes that parenting styles have great impact on language development of children. Different types of parenting style are being used among which authoritative parenting style is the most and permissive being the least common.

Role Of A Teacher In A Blended Learning MHPE Program: A Qualitative Analysis

Background: During the last two years, the pandemic has taken a toll on education. However, E learning tools and other innovative computer software technologies are being widely adopted to deliver educational elements of different courses to students who are placed in far off areas from the university campus. However, Teaching is demanding and complex task and the key limitations in total e-learning format included limited interactions with peer and teachers, communication problems, and insufficient sense of bonding between the teacher and student. To address these issues concept of “blended learning” was adopted. Blended learning escalates the chances of student engagement, enhance critical-thinking development and improve learning processes in the presence of a valued teacher. However, whenever innovative techniques are introduced, it becomes essential to ensure that there is no impact on instructional integrity. Thus, the response of students who are amongst the main stakeholders is absolutely vital to confirm an effective implementation of any teaching and learning approach. Objective: This study provides help to the faculty who newly incorporate BLA (blended learning approach), also it provides guidance for educators and curriculum planners to effectively plan their modules while incorporating a BL approach in medical education. Study Design: Qualitative study (Phenomenology). Settings: Three universities, Riphah International University Islamabad, University of Lahore, Lahore and Khyber Medical University, Peshawar in Pakistan. Duration: Six months from February to August 2017 Methods: Sampling was done by purposive (homogenous) sampling. Study population included MHPE students from three different universities of Pakistan. Population size was 10 MHPE students who completed their course work, and data was collected through one on one semi structured interviews. All interviews were audio recorded, transcribed and analyzed manually as well as by importing in NVivo software version 11. Results: By a thematic analysis a total of six major areas were identified that influences the student learning in blended programs. Out of these the major influencing factor came out to be the role of teachers’ both in online and face to face sessions. This blended course design helped them to become more self-regulated, self-directed, lifelong and active learners, and they were also able to transfer these learning skills to their students as well. Conclusion: Students hold a positive perception of the BLA being offered in this MHPE program. Research findings suggests that a BL course design can be successfully used in postgraduate education as well as undergraduate studies it helped to impart new learning approaches in them. The main factors which were appreciated in these courses were flexible or hybrid course design, role of a teacher as facilitators who reinforced learning strategies towards learners’ professional needs.

Comparison of General Exercises, Motor Control Exercises and Spinal Manipulation in Chronic Low Back Pain Patients

Objective: To compare the effects of motor control exercises, general exercises and spinal manipulative therapy on pain, functional status and disability in chronic low back pain patients. Study Design: Randomized Clinical Trial (IRCT:20200511047391N1) Place and Duration of Study: Riphah International University, Islamabad Pakistan, from Jun to Nov 2020. Methodology: Study was conducted on 36 chronic low back pain patients aged 18-50 years. All were randomly allocated to three groups: general exercises group, motor control group, and manipulative therapy; all were treated with eight sessions in four weeks. Numerical pain rating scale, Patient-specific functional scale and Oswestry disability index were used. Results: Findings revealed that differences between the three groups were statistically significant (p&lt;0.05) concerning pain score, patient-specific functional scale, and Disability index. Conclusion: It was concluded that motor control exercises are most effective in treating chronic low backache. The results of our study showed that there is a significant difference in pain, function and disability in all the groups.

Magnetic Resonance Spectroscopy Outperforms Conventional MRI in Diagnosing Brain Tumors: A Comparative Analysis

Background: Despite several revolutionary advances in imaging technology, physicians are still unable to obtain findings that are 100 percent reliable. A number of limitations have been noted for imaging approaches. Objective: The aim of this study was to compare the diagnostic accuracy of magnetic resonance spectroscopy with conventional magnetic resonance imaging for brain tumors. Study Design: A Comparative study Place and duration of study. The Department Of Medical Imaging Technology Riphah International University Faislabad Campus From 05-June 2023 To 05-Dec-2023 Methodology This study was carried out at the department of Department of Medical imaging technology Riphah International university Faislabad campus from 05-June 2023 To 05-Dec-2023 following receiving permission from the institute's ethics committee. The study comprised 154 people, both male and female, who had a clinical suspicion of having a brain tumor. Patients between the ages of 20 and 65 who had symptoms and signs suggestive of brain tumors or had nonspecific results from CT and MRI scans were the participants in this study. The technique used was MR spectroscopy. The collected data were entered into SPSS v23.0, and frequency and percentage were reported for gender, positive MRI and MRS results, and histology, along with a 95% confidence interval. Results; A total of 154 individuals were studied. The most prevalent age group was 50 years or above 78(50.6%) . Histopathology of 52 (33.7%) negative and 102 (66.2%) patients were tested positive for MR Spectroscopy. The findings of MR Spectroscopy were compared to conventional MRI alone, and with histology maintained as the gold standard, it was discovered that the sensitivity was 90.0% &amp; specificity of 97.0% were at a higher diagnostic level. The results of the MRI accuracy comparison with the conventional histopathological results were 75% sensitivity, 83% specificity The MRS method has 90.0% and sensitivity 97%. Conclusion Thus, the study found that all of the diagnostics measures with p-values &lt;0.001, MRS considerably enhances brain tumor characterization when compared to conventional MRI Keywords: Diagnostic accuracy,Magnetic resonance spectroscopy,Conventional MRI,Brain tumors

Effects of dry needling on pain, range of motion and function in patients with upper cross syndrome

Background: In upper cross syndrome, upper trapezius, levator scapulae, sub occipital, sternocleidomastoid, pectoralis major and minor become tight. Whereas, the phasic muscle including lower and middle trapezius, deep neck flexor and serratus anterior muscle weaken. Objectives: To determine the effects of dry needling on pain, range of motion and function in upper cross syndrome. Methods: This randomized clinical trial was conducted at Sheikh Zaid Hospital Rahim yar khan. Ethical approval REC/RCRS/20/1049 was obtained from Riphah International University Lahore. Group A was treated with dry needling along with conventional therapy and group B was treated with conventional therapy and 34 subjects were allocated in both groups. The duration of study was of 2 weeks with 1 session per week. The pre and post intervention scores were taken for Visual analogue scale, Neck disability index and neck range of motion. The data was analyzed using SPSS 25. Results: There was no significant difference (p&lt;0.05) between groups based on demographic data at baseline. The BMI in group A was 24.38(1.14) and in group B 23.19(2.59). The mean difference of VAS in group A was 2.89(1.68) with CI [1.98, 3.76] (p&lt;0.05) and in group B was 2.87(1.03) with CI [2.33,3.42] (p&lt;0.05). The mean difference for NDI in group A was 21.25(10.85) with CI [15.46, 27.03] (p&lt;0.05) and in Group B was 14.68(8.42) with CI [10.20,19.17] (p&lt;0.05). In VAS and NDI between group analysis did not show significant result (p&gt;0.05). Conclusion: Dry needling along with conventional therapy only improves range of motion but in term of pain and functionality, dry needling and conventional therapy are equally effective. Clinical Trial Number: NCT04674904

The Effectiveness of SLR Stretching and Pelvic Tilt Control Stretching on SLR Range Among Asymptomatic Females with Hamstring Tightness

Background: Hamstring muscle tightness is a significant factor that impedes performance in daily and sports activities, necessitating the need for effective stretching techniques to enhance hamstring flexibility. This is particularly important for an active, physically fit lifestyle, as hamstring tightness is linked to various musculoskeletal issues and injuries. Objective: This study aimed to evaluate and compare the effectiveness of Passive Straight Leg Raise (SLR) stretching and Pelvic Tilt Control Stretching in improving hamstring flexibility among asymptomatic young females with hamstring tightness. Methods: In a quasi-experimental trial conducted at the Arif Memorial Teaching Hospital and Riphah International University, Lahore, 50 female participants aged 20-40 years with unilateral hamstring tightness were randomly assigned to either the Passive SLR stretching group or the Pelvic Tilt Control Stretching group. The efficacy of the stretching techniques was assessed using the active knee extension test, measured with a goniometer, both pre- and post-treatment. Results: The Pelvic Tilt Control Stretching group showed a significant improvement in hamstring flexibility, with the mean post-treatment active knee extension significantly increasing from the pre-treatment measurement (p-value = 0.000). In contrast, the Passive SLR group showed no significant change in flexibility (p-value = 0.872). The study also highlighted the prevalence of a sedentary lifestyle among participants and its potential contribution to reduced hamstring flexibility. Conclusion: The study concludes that Pelvic Tilt Control Stretching is an effective method for improving hamstring flexibility in young, asymptomatic females, suggesting its incorporation into physical therapy practices. This finding is particularly relevant for populations prone to hamstring tightness due to sedentary lifestyles. Keywords: Hamstring Flexibility, Pelvic Tilt Control Stretching, Passive Straight Leg Raise, Young Females, Muscle Tightness, Physical Therapy, Sedentary Lifestyle.

Prevalence of Lower Back Pain in Undergraduate Physiotherapy Students in Lahore

Background: Lower Back Pain (LBP) is a prevalent condition among various populations, including students in physically demanding disciplines such as physiotherapy. Understanding the prevalence and associated factors of LBP in this group is crucial for developing effective prevention and intervention strategies. Objective: This study aimed to determine the prevalence of LBP among undergraduate physiotherapy students in Lahore, assess the relationship between LBP and factors like gender, BMI, pain intensity, and its impact on activities of daily living (ADL). Methods: A cross-sectional survey was conducted at four prominent universities in Lahore: The University of Management and Technology Lahore (UMT), Riphah International University Lahore, the University of Lahore Campus (UOL), and the University of South Asia (USA). The study included 390 undergraduate physiotherapy students, aged 18-25, with a gender distribution of 162 males and 228 females. Data on LBP prevalence, pain intensity, BMI, and its impact on ADL were collected through questionnaires and analyzed using descriptive and inferential statistics. Results: Out of the 390 students, 176 (45.1%) reported experiencing LBP. The prevalence was higher among females (67.0%) than males (33.0%). Students with a BMI in the 25-29.9 range exhibited the highest prevalence of backache. Pain intensity varied, with a higher incidence of moderate to severe pain among females. The University of Lahore reported the highest percentage of LBP (27.8%), while the University of South Asia had the lowest (22.2%). Conclusion: The study indicates a significant prevalence of LBP among undergraduate physiotherapy students in Lahore, with a notable gender disparity and a correlation with BMI. These findings emphasize the need for targeted preventive measures and health promotion programs in academic settings to address LBP and its impact on students' well-being and academic performance.

Investigating the Efficacy of Neurolinguistics Programming Techniques in Enhancing Vocabulary Learning of BS English Students

This study aims to explore the effectiveness of Neurolinguistic Programming (NLP) techniques in improving vocabulary learning among BS English students at Riphah international University, Pakistan. Employing a mix method research approach, the study adopts a between-subject experimental design with an experimental group n=30 receiving NLP interventions and a control group n=30 without NLP intervention. The participants are native Urdu speakers learning English as a foreign language. The NLP techniques applied include word anchoring, reframing, mind mapping, modeling, and language pattern mirroring. Data collection involves pretest and posttest evaluations of vocabulary skills using a standardized vocabulary test. The purpose of this study is to clarify the possible advantages of NLP methods for improving vocabulary learning in the context of Riphah International University's BS English students. A pretest was used to ensure that both groups were homogeneous and functioning at the same level. The control group's pre-test resulted in mean, mode, and SD. This demonstrated that the two groups are on same level. Visual representations of the Vocabulary results include charts and statistical analysis. A posttest was created following a four-week NLP training session that included the use of mind mapping, anchoring, metamodeling, mirroring, matching, framing, and pattern disruption. The Experimental group performed better this time, which led to some somewhat unexpected findings. Because NLP operates at the fundamental level of the brain and inspires students to take responsibility for their performance, the results demonstrated how NLP approaches impacted the performance of the BS English students. This result indicates students were empowered by NLP techniques to gain self-assurance, discover untapped mental ability, become more aware of their hidden talents, and do well on the vocabulary exam.

Distinguishing Iron Deficiency Anemia from Anemia of Chronic Disease Using Hematological Measures

Anemia is a serious public health concern in today’s world which is particularly affecting young children, pregnant women, menstruating adolescent girls and women. The two most common causes of anemia are iron deficiency anemia (IDA) and anemia of chronic disease (ACD), often known as anemia of inflammation. This study aim was to assess the levels of certain hematological parameters, including Hemoglobin Estimation, Mean Corpuscular Volume (MCV), Serum Ferritin, Serum TIBC, Erythrocyte Sedimentation Rate and C - reactive protein to clearly differentiate between iron deficiency anemia and anemia of chronic disease. The study was conducted in Department of Medical Lab Technology, Riphah International University, Islamabad from September 01, 2023 to January 01, 2024. A total of 109 samples with 59 of iron deficiency anemia patients and 50 patients of Anemia of chronic disease were assessed for differentiation be these two diseases. The significant level was selected with p-value less than 0.05. Hemoglobin estimation, TIBC, and ESR were significant in our investigation as their p-values were less than 0.05. Hence, it concluded that Hemoglobin estimation, total Iron Binding Capacity and Erythrocyte Sedimentation Rate were Hematological parameters that distinguished between Iron Deficiency Anemia and Anemia of Chronic Disease.

Association of vascular endothelial growth factor a gene (VEGFA) polymorphisms, rs699947 and rs1570360, with diabetic retinopathy and altered VEGF secretion in the Pakistani patients with type 2 diabetes mellitus: a case-control study

Objective: To investigate the association of vascular endothelial growth factor A gene polymorphisms 2578C/A (rs699947) and 1154G/A (rs1570360) with type 2 diabetes mellitus, diabetic retinopathy and serum vascular endothelial growth factor levels in Pakistani patients. Method: The case-control study was conducted from Jan 2017 to Dec 2018 after approval from the ethics review board of Riphah International University, Islamabad, Pakistan, and comprised type 2 diabetes mellitus patients of either gender with diabetic retinopathy in group A, and without diabetic retinopathy in group B. Non-diabetic healthy individuals were enrolled in control group C. Genotyping was done by amplification refractory mutation system-polymerase chain reaction and serum vascular endothelial growth factor levels were measured using enzyme-linked immunosorbent assay. Data was analysed using SPSS 22. Results: Of the 450 subjects, 150(33.3%) were in each of the 3 groups. The mean age in group A was 58.16±9.42, in group B 56.25±8.5 years and in group C it was 55.90±10.90. The proportion of Punjabi ethnicity was significantly high in group B compared to other groups (p&lt;0.05). There was no significant association of rs699947 and rs1570360 genotypic and allelic frequencies in group B compared to group A. Further, rs699947 AA genotype was significantly associated with proliferative diabetic retinopathy compared to group A (p&lt;0.05). Minor allele A showed significant association in groups A and B compared to group C (p&lt;0.05). Significantly raised serum vascular endothelial growth factor levels were found in group B compared to group A (p&lt;0.05), and were associated with rs699947 and rs1570360 heterozygosity in group A (p&lt;0.05). Also, rs699947 genotype showed significant association with groups A and B in Punjabi and Pathan ethnicities (p&lt;0.05) and with Kashmiri ethnicity in group B (p&lt;0.05). Conclusion: There was a strong association of vascular endothelial growth factor 2578C/A (rs699947) gene polymorphism with proliferative diabetic retinopathy in type 2 diabetic Pakistani patients, suggesting its role in the pathogenesis of this condition. Key Words: Diabetic retinopathy, Polymorphisms, Type 2 diabetes mellitus, Vascular endothelial growth factor A gene.

Imatinib resistance in CML and its association with age &amp; gender.

Objective: To evaluate the association of gender and age with the resistance shown to Imatinib in CML with evaluation of WBCC in different age groups. Study Design: Cross Sectional Analytical study. Setting: Islamic International Medical College, Riphah International University, Islamabad, Pakistan. Patients were enrolled from the CML clinic in Holy Family Hospital, Rawalpindi. Period: January 2019 to December 2021. Material &amp; Methods: Sampling technique was non probability consecutive sampling. We included 75 newly diagnosed CML patients, who were taking Imatinib 400 mg. Blood samples of all these patients were analysed at the start of treatment and also after 3 months to determine the complete haematological response (CHR) and patients were labelled as resistant who failed to achieve complete haematological response at this stage according to the Leukemia Net guidelines. Results: Our study demonstrates that 54.7% of the patients were Imatinib responders while 45.3 % patients were Imatinib resistant. Patients who were labelled as responders have shown complete haematological remission at 3 months of treatment. (Platelet Count &lt; 450 x 10 9/L - WBCC &lt; 10 x 10 9/L - Differential without Immature Granulocytes (MC, PMC, MB) and With Less Than 5% Basophils - Non-Palpable Spleen) A chi square test of independence was performed to examine the relation between gender and response and between age groups and response. The relationship between age groups and response is significant with p value of 0.003. While the relationship when determined between gender and response, it was found to be non-significant with p value of 0.08. It was also found out that WBC count in responders is at lowest in second age group and also highest in second age group in case of resistant patients that is age between 31-40 years. Conclusion: Imatinib resistance is common while treating patients with chronic myeloid leukemia. There is significant association with the different age groups and non-significant association with the gender in terms of response to the treatment of Imatinib. It was also found that age also effects the WBC count with Imatinib though it was not significant.

Cases of spinal cord injury: correlation among resilience, social support and psychological well-being

Background: Spinal injuries are highly prevalent and are a major cause of disability. Studying resilience, perceived social support, and psychological well-being in persons with spinal cord injury is important for better-managing patients with spinal cord injuries. Objectives: To analyze the correlation among resilience, perceived social support, and psychological well-being in persons with spinal cord injury. Methods: This cross-sectional correlational study was conducted at Riphah International University, Lahore Pakistan from September 2019 to February 2020. The study utilized a sample of 100 patients with spinal cord injury using purposive sampling. The sample included paraplegic patients 6 months following SCI, of both genders above 18 years of age who were active wheelchair users. A demographic sheet, scale of psychological well-being, resilience scale, and multi-dimensional scale of perceived social support (MSPSS) were used for data collection. SPSS Version 22 was utilized for data analysis &amp; correlation was analyzed using bivariate statistics with p&lt; 0.05 was considered statistically significant. Results: The study revealed a positive correlation (γ=0.57, p&lt;0.001) between Resilience with Perceived Social Support; Resilience and Psychological well-being (γ=0.55, p&lt;0.001); and Perceived Social Support and Psychological Well-being (γ =0.57, p&lt;0.001). Conclusion: There is a positive relationship between resilience perceived social support and psychological well-being. Keywords: perceived social support; psychological wellbeing; resilience; spinal cord injury

SERUM ACTIVIN A &amp; INHIBIN A: POSSIBLE BIOCHEMICAL MARKERS OF PREECLAMPSIA &amp; PREGNANCY INDUCED HYPERTENSION

Objective: The objective of this study was to compare the levels of Serum Activin A and Inhibin A in Pregnancy induced hypertension, Preeclampsia &amp; Normal Pregnancy Material and Methods: An analytical, cross-sectional study conducted at Chemical Pathology Laboratory Collaborating with Gynae/Obstetric Department of Pakistan Railway Teaching Hospital, Rawalpindi over the period of one year (18 Sep 2019 to 18 March 2020). The study started after the approval of Ethical Review Committee, Riphah International University Islamabad. The sample size was calculated using WHO sample size calculator. Taking Prevalence of PIH and PE is 8%.3 Non probability convenient sampling technique was used. An overall 100 pregnant women with gestation of 20 – 25 weeks, were included. Patients of UTI, Carcinomas, Diabetes Mellitus and other chronic disorders were not included. The subjects were divided into three groups. Group I PIH: This group included 30 pregnant women of PIH; 20 - 25 weeks of gestation, BP: ≥140/90 mmHg on two separate occasions without proteinuria. Group II PE: This group included 20 pregnant women of preeclampsia; 20 - 25 weeks of gestation, BP: ≥140/90 mmHg on two separate occasions with proteinuria (&gt;0.3 g protein/24 hours Urine). Group III Control Group: This group included 50 pregnant women with gestational age of 20 – 25 weeks without any complication as healthy controls. Results: It was determined that Serum Activin A and Serum Inhibin A levels were significantly increased in PIH and PE groups as compared to healthy group. Mean of Serum Activin A in PIH, PE and Control group was (251.53+200.23 pg/ml), (466.95 + 237.40 pg/ml) and (43.35 + 85.22 pg/ml) respectively. Similarly Mean and Standard Deviation of Serum Inhibin A levels in PIH, PE and Control group was (194.78 + 173.00 pg/ml), (349.20 + 190.30 pg/ml) and (17.27 + 44.33 pg/ml) respectively. One-way ANOVA and post-hoc Tukey analysis was conducted to compare the mean of Serum Activin A and Serum Inhibin A levels among three different groups i.e Group 1(PIH and PE), Group 2(PIH and Control) and Group 3 (PE and Control). p-value&lt; 0.05 was considered as statistically significant. Conclusion: It can be concluded that Serum Activin A and Serum Inhibin A can be used as biochemical markers of PIH and PE. Estimation of Serum Activin A and Inhibin A at an early stage can detect PIH and PE early and further prevents their complications such as Eclampsia and HELLP syndrome. Keywords: Pregnancy induced hypertension (PIH), Pre-eclampsia (PE), HELLP syndrome (H – Hemolysis, EL- Elevated Liver Enzymes, LP – Low platelets count), Serum activin A, Serum inhibin A.