Objective Our study's motive was to recognize various immune-mediated inflammatory processes involved in the pathogenesis of depression and psoriasis and interlink between them based on inflammatory mediators. Methods A careful and comprehensive literature search was done through various databases like PubMed, Google Scholar, and EBSCO. A total of 56 studies were included in our study after careful screening. Results The immune-mediated inflammatory process was significantly associated with the pathogenesis of both depression and psoriasis. Most of the inflammatory markers involved in Psoriasis (TNF-α, IL-2, IL-6, IL-23, IL-1β, IL-10), and increased serotonin transporters (5-HTT) were also found in the pathogenesis of depression, showing the immune-inflammatory linkage between psoriasis and major depression. Based on immune chemistry, the levels of CD2+, CD4+, CD8+ T-lymphocytes were also found to be raised in both depression and psoriasis, validating their relationship. Hyperactivity of HPA-axis was also found another interlink between them along with reduced melatonin amount. Conclusions According to various studies, the neuro-dermatological association between psoriasis and depression is significant. Different immune markers involved in the pathogenesis of depression and psoriasis also show the bidirectional association between them. However, this association between psoriasis and depression is positively correlated, but more work is required to answer why all depressed patients fail to develop psoriasis and why all psoriatic patients fail to develop depression.
Engraftment syndrome (ES) is a non-infectious complication seen both in autologous and allogeneic hematopoietic stem cell transplants and is characterized by the presence of non-infectious fever, diarrhea, skin rash, pulmonary infiltration, pulmonary edema, and deranged renal and liver function tests This review will be delineating the incidence of ES, important differential diagnoses to be considered and management options. The literature search was done through various databases like PubMed, Google scholar, Cochrane library, and EMBASE. The incidence of engraftment syndrome was ranging from 8 to 50% in patients undergoing Autologous stem cell transplantation while the incidence was 10–77% in patients undergoing Allogeneic stem cell transplantation. Fever was the most commonly observed symptom of ES in both Autologous and Allogeneic stem cell transplantation while the second most frequently reported symptom was non-infectious diarrhea in patients undergoing autologous stem cell transplantation and Skin rash in patients with Allogeneic stem cell transplantation. Pro-inflammatory cytokines and immune response dysregulation were highlighted as the mechanism behind ES development. The significant difference between ES and aGVHD was observed based on cytokines, with IL-12, IL-1β, IL-6, TNF-α, and IFN-γ levels in plasma being higher in patients with ES as compared to patients with aGVHD. Intravenous methylprednisolone was used as the treatment of choice in the majority of the studies. Overall the incidence of ES was high in patients undergoing allogeneic hematopoietic stem cells transplantation. The survival in patients developing ES was less compared to those who did not develop ES. Engraftment syndrome is one of the complications following hematopoietic stem cell transplantation that need early identification, differentiation from infectious complications, and aGVHD and timely initiation of corticosteroids therapy.
Since the emergence of coronavirus diseases 2019 (COVID-19) not only have social and the economical dimension of life been disturbed but it has also shattered educational activities as well. Due to fear of disease spread educational institutes are forced to implement online educational systems to teach their pupils. This study aims to explore the student's perceptions related to E-learning and their positive and negative outcome among medical students in Pakistan and Iran. ology: This cross-sectional questionnaire-based study was conducted at Rawalpindi Medical University, Rawalpindi, Pakistan, and Islamic Azad University of Medical Sciences Tehran, Iran. This study involved 402 medical students of Rawalpindi Medical University, Rawalpindi, Pakistan (n = 202), and Islamic Azad University of Medical Sciences Tehran, Iran (n = 200) who were actively involved in the online mode of education. A self-administered validated questionnaire was used for data collection. Descriptive statistics and chi-square analysis was used and analysis was done through SPSS V.23. A P-value of 0.05 was taken as significant. A total of 402 students were enrolled, 202 from Pakistan and 200 from Iran. About 68.2% of the students were acquainted with moderate levels of IT skills. About 75.8% of the students were not showing any previous experience with E-learning. The most common advantage of E-learning was the ability to stay at home. The technical problem was the most common disadvantage in our study. Finally, face-to-face learning in terms of increasing knowledge, skill, and social competence was considered the best mode of learning both by Pakistani and Irani students. Country-wise effectiveness of face-to-face learning in terms of increasing knowledge is statistically significant (p-value = 0.019). Acceptance of E-learning is statistically associated with the country of learning (p-value = 0.020). E-learning was rated as enjoyable by 51.5% of the students. E-learning has its associated advantages and disadvantages as perceived by medical students but still face-to-face learning is considered the most effective form of learning as responded by medical students.
Hepatitis is a major public health issue in Pakistan, with an estimated 11.55% prevalence of HCV infection in the adult population. The country ranks second globally in terms of hepatitis C virus (HCV) infections, with approximately one in every 20 Pakistanis already infected. The mortality rates due to HBV and HCV stand at 563,000 and 366,000 annually, respectively. However, the absence of a national registry or database system and the lack of coordination among provinces pose significant obstacles in combating this disease effectively. To address this issue, the establishment of a centralized national database registry is crucial, allowing comprehensive analysis, tracking of hepatitis prevalence, and identification of high-risk areas for targeted interventions. By fostering collaboration among provinces, the government, and non-governmental organizations, the registry would facilitate joint decision-making, minimize duplication of efforts, and address inconsistencies in diagnosis and treatment. Collaborating with student-run organizations and leveraging enhanced laboratory capacities post-COVID era can strengthen the hepatitis control program. The centralized approach and unified efforts are necessary to achieve the goal of a hepatitis-free Pakistan, where a healthier future can be realized.
1 October 2024 in European Archives of Oto-Rhino-Laryngology
Antimicrobial resistance (AMR) has been declared one of utmost matters of importance in global health by WHO. Awareness of AMR is essential in controlling