Randomized Clinical Trial on the Efficacy of Triple Therapy Versus Sequential Therapy in Helicobacter pylori Eradication.

Introduction: () colonization is prevalent all over the world, and it is associated with low socioeconomic status, poor hygiene, and overcrowding. Its eradication is important since it is an etiologic agent for gastritis, peptic ulcer, gastric carcinoma, and mucosa-associated lymphoid tissue lymphoma. Different regimens are available for the eradication of and include triple therapy and sequential therapy.

Double Peptic Ulcer Perforation due to Cumulative Effects of Post-surgery Stress and NSAIDs: A Rare Event in Surgical Practice.

Peptic ulcer disease affects a large number of people around the world. Complications occur in 10-20% of patients and perforation develops in 2-14% of the cases. It can either be in the pyloric part of the stomach or in the first part of duodenum.

Stroke-like Symptoms as Presenting Signs of Varicella Zoster Meningitis in an Immunocompetent Adult.

Varicella zoster is one of the common causes of aseptic meningitis, typically seen in immunosuppressed individuals and rarely in the immunocompetent. The varicella zoster virus (VZV) infection is normally associated with a dermatomal rash in the abdomen with spread to the back. The small prevalence of VZV in immunocompetent individuals may be due to lack of recognition; thus, it is always important to keep it in mind when meningitis is in the differential.

Risk Factors Associated With Birth Asphyxia in Term Newborns at a Tertiary Care Hospital of Multan, Pakistan.

Background Perinatal asphyxia is one of the main causes of death in term newborns. During the past two decades, no significant progress has been made in reducing neonatal deaths in developing countries. This study was aimed to determine various factors associated with birth asphyxia in term newborns at a tertiary care hospital of Multan, Pakistan.

Acute Non-Traumatic Sub-Arachnoid Hemorrhage in a Young Female With Diabetic Ketoacidosis.

Diabetic ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in patients with type 1 DM. Due to severe acidosis, ketonemia and electrolyte disturbances it can lead to various complications in the body, which can be fatal in some cases. Neurological complications related to DKA include cerebral edema, cerebral infarction, brain herniation, cortical venous thrombosis.

Impact of COVID-19 on the Mental Health of Healthcare Workers: A Cross-Sectional Study From Pakistan.

The novel coronavirus (COVID-19) pandemic has significantly increased the rate of mortality and morbidity worldwide due to its rapid transmission rate. The mental health status of individuals could have a negative impact attributed to this global situation. Therefore, this study was intended to explore the symptoms of depression and anxiety among healthcare workers (HCWs) of Pakistan during the ongoing COVID-19 pandemic.

Qualities of a Teacher: A Trainee's Perspective.

Objective: To determine the qualities of a good medical teacher from a trainee's perspective, to evaluate the best teaching method, and to explore the association of specialty and level of training with teaching methods and qualities of a medical teacher.

Methods: The questionnaire-based cross-sectional survey was conducted in two tertiary care teaching hospitals in Lahore, Pakistan, from July 2019 to December 2020, and comprised all house officers and postgraduate residents. Data was collected using a self-administered questionnaire that had three sections: demographics, best method of teaching, and the characteristics of a good medical teacher.

Auto-Brewery Syndrome: A Clinical Dilemma.

Auto-brewery syndrome (ABS), also known as gut fermentation syndrome, is a very rare disorder. It is characterized by the endogenous production of alcohol. It typically presents with the signs of alcohol intoxication, such as staggering gait, slurred speech, gastrointestinal distress, and state of confusion.

Factors associated with disease severity and mortality among patients with COVID-19: A systematic review and meta-analysis.

Background: Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID-19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19.

Methods: We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020.

Chylous Ascites: A Rare Initial Presentation of Pancreatic Carcinoma.

Chylous ascites as first manifestation of pancreatic carcinoma is very rare. Usual presentations of pancreatic malignancy are abdominal discomfort, back pain, obstructive jaundice and duodenal obstruction. Development of chylous ascites during the course of the disease signifies poor prognosis.

Frequency of autoimmune thyroiditis in children with Celiac disease and effect of gluten free diet.

Objective: To determine the frequency of autoimmune thyroiditis in children with Celiac disease and the effect of gluten free diet on autoimmune thyroiditis.

Methods: We enrolled 100 patients, age 1-12 years of either gender diagnosed as Celiac disease (CD) in this prospective observational study in the Department of Pediatric Medicine, from 1 January 2018 to 30 June 2019. Diagnosis of autoimmune thyroiditis was made if anti-thyroperoxidase >35 iu/ml or anti-thyroglobulin >20 iu/ml at diagnosis of CD and then at one year on gluten free diet (GFD) in all cases.

Maternal and Fetal Outcome of Pregnant Patients Having Preexisting Cardiovascular Disease.

Introduction Cardiovascular disease is common in woman of all age, including child bearing age. In this study, we aim to compare maternal and fetal outcome in pregnant woman with and without preexisting cardiovascular disease. Methods This case control single center study was conducted by Obstetrics & Gynecology department and Cardiology department Shaikh Zayed Medical College/Hospital Rahimyar Khan from 1 March 2020 to 30 June 2020.

COVID-19 Pneumonia: An Emerging Cause of Syndrome of Inappropriate Antidiuretic Hormone.

Syndrome of inappropriate antidiuretic hormone (SIADH) is the leading cause of hyponatremia. We, herein, report a case of a patient with coronavirus disease-2019 (COVID-19) who developed sudden exertional dyspnea and hypoxia and was found to be hyponatremic. A diagnosis of SIADH was made due to COVID-19 pneumonia.

Parotid Gland Venolymphatic Malformation Presentation As Macroglossia.

Venolymphatic malformations (VLM) are the rare congenital disorders but the parotid gland VLMs are the rarest. Most of the parotid lesions present with unilateral swellings. Aetiology is unknown.

Cost-effectiveness and diagnostic accuracy of telemedicine in macular disease and diabetic retinopathy: A systematic review and meta-analysis.

Objective: To determine cost-effectiveness and the diagnostic accuracy of teleophthalmology (TO) in the detection of macular edema (ME) and various grades of diabetic retinopathy (DR).

Methods: MEDLINE, EMBASE, and Cochrane databases were searched for TO, ME, and DR on May 25, 2016. The search was updated on April 2, 2019.

Late-onset Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like Episodes (MELAS) Syndrome in a 63-year-old Patient.

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) usually manifests in early life. Clinical hallmarks of the disease are mitochondrial myopathies, encephalopathy with stroke-like episodes, seizures, and lactic acidosis. It rarely manifests in late adulthood.

Molecular characterization of SLC24A5 variants and evaluation of Nitisinone treatment efficacy in a zebrafish model of OCA6.

Skin pigmentation is a highly heterogeneous trait with diverse consequences worldwide. SLC24A5, encoding a potent K -dependent Na /Ca exchanger, is among the known color-coding genes that participate in melanogenesis by maintaining pH in melanosomes. Deficient SLC24A5 activity results in oculocutaneous albinism (OCA) type 6 in humans.

Role of Prophylactic Antibiotics in Critical Care of Stroke Patients - A Preventive Approach to Post-stroke Infections?

Post-stroke complications are very common worldwide and the most common complication is infection. This contributes the most to the mortality rate in stroke patients. Among the infections, pneumonia and urinary tract infections are most common.

The Neuroprotective Effects of Exercise on Cognitive Decline: A Preventive Approach to Alzheimer Disease.

Alzheimer's disease (AD) is a progressive disorder that causes brain cells to slowly degenerate and die. This leads to a continuous decline in thinking, behavioral and social skills that disrupts a person's ability to function independently. AD is the most common cause of dementia globally.

Rare novel CYP2U1 and ZFYVE26 variants identified in two Pakistani families with spastic paraplegia.

Bakground: Hereditary Spastic paraplegias (HSPs) are a clinically and genetically heterogeneous group of degenerative disorders characterized by progressive spasticity and weakness of the lower limbs. This study aimed to identify causative gene variants in two unrelated consanguineous Pakistani families presented with 2 different forms of HSP.

Methods: Whole exome sequencing (WES) was performed in the two families and variants were validated by Sanger sequencing and segregation analysis.