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Objective: To determine serum levels of brain-derived neurotrophic factor and its polymorphism rs12291063 in schizophrenic patients. Method: The case-control study was conducted from January 1, 2020, to May 15, 2021, at Dr Abdul Qadeer Khan Institute of Behavioural Sciences, Dow University of Health Sciences, Karachi, and comprised schizophrenia cases aged 14-60 years who were diagnosed using Diagnostic and Statistical Manual of Mental Disorders-V criteria, and healthy controls without any psychiatric illness. Positive and negative syndrome scale score was used to assess disease severity. The genomic deoxyribonucleic acid of the subjects was isolated from peripheral blood, followed by polymerase chain reaction, gel electrophoresis and sequencing of the amplicons. The sequences were analysed using MEGA X software for genotyping. Serum brain-derived neurotrophic factor levels were assessed using enzyme-linked immunosorbent assay. Data was analysed using SPSS 21. Results: Of the 100 subjects, 50(50%) were cases; 36(72%) males and 14(28%) females (pC substitution. Serum brain-derived neurotrophic factor levels were significantly higher in cases compared to controls (pC was found with schizophrenia. Key Words: Brain derived neurotrphic factor, genotyping, Schizophrenia, Mental Disorders.

Abstract Objective Diabetes distress typically causes depressive symptoms; common comorbidity of diabetes unpleasantly affects patients’ medical and psychological functions. Psychotherapeutic interventions are effective treatments to treat depressive symptoms and to improve the quality of life in many chronic diseases including diabetes. The present study investigated the efficacy of cognitive behavior therapy (CBT) to treat depressive symptoms in patients with type 2 diabetes mellitus (T2DM) using experimental and waitlist control conditions. Materials and Methods A total of 130 diagnosed patients with T2DM were taken from outdoor patients services of different hospitals in Faisalabad. Ninety patients met the eligibility criteria and were randomly assigned to experimental (n = 45) and waitlist control (n = 45) conditions. All the patients completed clinical interviews and assessment measures at pre-and post-assessment stages (16 weeks intervals). Medical consultants at the respective hospitals diagnosed the patients on the base of their medical reports and then referred those patients to us. Then we used different scales to assess primary and secondary outcomes: Diabetes Distress Scale (DDS) and Patient Health Questionnaire (PHQ) to assess primary outcomes, and a Short Health Anxiety Inventory (SHAI), a Revised Version of the Diabetes Quality of Life Questionnaire (DQLQ), and a General Medication Adherence Scale (GMAS) were used to investigate secondary outcomes. Repeated measure ANOVA was used to analyze the results. Results The findings indicated that patients who received CBT got a significant reduction in their diabetes distress F(1,60) = 222.710, P

Low levels of triiodothyronine (T3) in the brain lead to increased dopamine receptor sensitivity, potentially resulting in schizophrenia. Iodothyronine deiodinase 2 (DIO2) is the only enzyme which converts tetraiodothyronine (T4) to T3 in the brain. DIO2 polymorphism of rs225014 results in the expression of non-functioning DIO2. Therefore, this study aimed to investigate the association of rs255014 with schizophrenia and its impact on thyroid hormone levels. This study included 150 schizophrenia cases and 150 controls. DNA was extracted from blood and subjected to PCR and amplicon sequencing. Serum thyroid profiles were determined using chemiluminescent magnetic microparticle immunoassay. Statistical analyses involved independent sample t-tests, Chi-square, and Pearson’s correlation tests. The results revealed a higher frequency of the reference genotype (TT) in controls compared to cases (p < 0.05). However, rs225014 did not influence serum thyroid levels or the severity of schizophrenia (p > 0.05). Interestingly, control subjects exhibited significantly higher T3 levels (p < 0.001) than cases. Regardless of the genotype (TT or CC), the control group had higher mean T3 levels than the corresponding case group (p < 0.05). In conclusion, rs225014 is associated with schizophrenia and has no effect on serum thyroid hormone levels.

OBJECTIVE: To determine the factors associated with suicidal ideation among college students in Pakistan. METHODOLOGY: This was a cross sectional study, sample was selected randomly from public and private colleges located in different areas of Karachi, Pakistan. Data was collected from Sep 2014 to Feb 2015. 545 adolescents, aged 16 years to 19 years were selected by random sampling. Positive and negative suicide ideation Inventory, Personal Information Form, Beck hopelessness Scale, and Aga Khan Anxiety and Depression Scale were administered. Adolescents with any physical disability, chronic physical illness and any diagnosed psychiatric disease were excluded. Statistical analysis was done by using SPSS 14. RESULTS: Descriptive statistics and Binary Logistic Regression analysis were used to analyse the collected data. The analysis revealed that gender, living in nuclear family setup, suicide attempt in past, a suicide attempt by family members, suicide attempt by friends, illness in family members, and the severity of hopelessness and symptoms of anxiety were found significantly correlated with the suicidal Ideation. CONCLUSION: Findings of the study evidenced that certain socio-demographic and psychological associated risk factors should be consider to design and implement strategies for intervention and prevention of suicidal behaviours. Limitations and implications of the present study have also been recommended.

Objective: To measure treatment readiness in patients with opioid use in the form of problem reorganization, desire for help and taking steps. Methodology: This was a descriptive and cross-sectional study, conducted at the Institute of Behavioral Sciences (IBS), Dow University of Health Sciences (DUHS), Karachi, Pakistan. The duration of the study was from 1st January 2018 to 1st June 2018. Those patients who fulfilled the criteria of the dependent on opioids as per the International Classification of Diseases version 10 (ICD-10) were enrolled in the study. Those who were using substances other than opioids such as Cannabis or having organic brain disorder such as dementia were excluded from the study. Treatment readiness was measured by The Stages of Change Readiness and Treatment Eagerness scale (SOCRATE). The collected data were analyzed by Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Of the 120 participants, 96 (80%) were males while 24 (20%) were females. Mean age of the patients was 31.57 ± 8.71 years. Among all 48 (40%) were married. Majority of patients 54 (52.9%) were employed. Almost two-thirds were in favour of the strongly agree option as per the Stages of Change Readiness and Treatment Eagerness Scale. While talking about ambivalence 54% strongly agreed that they were ambivalent about their addiction. Twenty-one per cent strongly agreed that they have taken steps to quit. Statistically age group, gender, marital status, educational status and occupational status were not significant. Conclusion: As the Stages of Change Readiness and Treatment Eagerness scale, mostly opioids users strongly agree for treatment as well as recognition of their problems and desire for change.

Low levels of triiodothyronine (T3) in the brain lead to increased dopamine receptor sensitivity, potentially resulting in schizophrenia. Iodothyronine deiodinase 2 (DIO2) is the only enzyme which converts tetraiodothyronine (T4) to T3 in the brain. DIO2 polymorphism of rs225014 results in the expression of non-functioning DIO2. Therefore, this study aimed to investigate the association of rs255014 with schizophrenia and its impact on thyroid hormone levels. This study included 150 schizophrenia cases and 150 controls. DNA was extracted from blood and subjected to PCR and amplicon sequencing. Serum thyroid profiles were determined using chemiluminescent magnetic microparticle immunoassay. Statistical analyses involved independent sample t-tests, Chi-square, and Pearson's correlation tests. The results revealed a higher frequency of the reference genotype (TT) in controls compared to cases (p < 0.05). However, rs225014 did not influence serum thyroid levels or the severity of schizophrenia (p > 0.05). Interestingly, control subjects exhibited significantly higher T3 levels (p < 0.001) than cases. Regardless of the genotype (TT or CC), the control group had higher mean T3 levels than the corresponding case group (p < 0.05). In conclusion, rs225014 is associated with schizophrenia and has no effect on serum thyroid hormone levels. [ABSTRACT FROM AUTHOR]

Objective: To determine prevalence of depression in mothers of children with mental retardation using the ICD-10 criteria for depression. Material & Method: This cross-sectional study was conducted at Psychiatry outpatient Department, Civil Hospital Karachi. Three hundred twenty-three mothers were included in the study and interviewed between the periods of October 2014 to April 2015. Mothers of children with mental retardation were assessed for depressive disorder using ICD-10criteria for depression. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 16. P value less than 0.05 was considered significant. Results: Number of depressed mothers who have mentally retarded child was more as compared to non-depressed mothers. The association of depression to their marital status was found to be significant (p-value 0.009) revealing that single parenting mothers were more vulnerable to depression as compared to children living with both parents. Most of the depressed mothers were more educated (p-value 0.00) and were mostly graduates, and had their child in the older age group that is 9 to 12 years (p-value 0.03) and had a female child. (Table 2) effected (p-value 0.00). The association of maternal age and socioeconomic status with depression was found to be insignificant (p-value 0.43 and 0.37 respectively. Conclusion: This study reveals a high prevalence of depression in mothers of mentally retarded children and highlights the need for help. Strategy should be reinforced in the clinical settings to screen such mothers for Depression.

OBJECTIVE: To determine the factors associated with suicidal ideation among college students in Pakistan. METHODOLOGY: This was a cross sectional study, sample was selected randomly from public and private colleges located in different areas of Karachi, Pakistan. Data was collected from Sep 2014 to Feb 2015. 545 adolescents, aged 16 years to 19 years were selected by random sampling. Positive and negative suicide ideation Inventory, Personal Information Form, Beck hopelessness Scale, and Aga Khan Anxiety and Depression Scale were administered. Adolescents with any physical disability, chronic physical illness and any diagnosed psychiatric disease were excluded. Statistical analysis was done by using SPSS 14. RESULTS: Descriptive statistics and Binary Logistic Regression analysis were used to analyse the collected data. The analysis revealed that gender, living in nuclear family setup, suicide attempt in past, a suicide attempt by family members, suicide attempt by friends, illness in family members, and the severity of hopelessness and symptoms of anxiety were found significantly correlated with the suicidal Ideation. CONCLUSION: Findings of the study evidenced that certain socio-demographic and psychological associated risk factors should be consider to design and implement strategies for intervention and prevention of suicidal behaviours. Limitations and implications of the present study have also been recommended. [ABSTRACT FROM AUTHOR]

Aim: Variations of dopamine receptor type 2 (DRD2) are among the key factors involved in the pathology of schizophrenia. Presence of certain SNPs in DRD2 gene also amend patients' response to antipsychotics. Keeping in view the genetic diversity among populations and important role of DRD2 polymorphisms in schizophrenia, we aimed to study two of its SNPs rs1801028 and rs6277 in patients with schizophrenia from Pakistan.Methods: A total of 100 schizophrenia cases and 100 healthy controls were recruited. DNA was extracted from whole blood followed by PCR, Sanger sequencing and genotyping of two SNPs, that is, rs1801028 and rs6277.Results: No association of rs1801028 and rs6277 was found with schizophrenia in Pakistani population (P > .05). Highlight of our study is the association of polymorphism rs201256011 with schizophrenia (P = .001), which is being reported for the first time. Significant association of rs201256011 was also found with Positive and Negative Syndrome Scale negative, cognitive and total score (P < .05).Conclusion: In conclusion, genetic variants rs1801028 and rs6277 of DRD2 are not associated with schizophrenia in Pakistani population. While, previously unreported polymorphism rs201256011 have shown significant association with schizophrenia and its severity. A large scale multicentre replication study is required to confirm the association of this SNP with schizophrenia. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of high burden of care on family members of patients with Schizophrenia. Study Design: Descriptive, Cross-sectional study. Place and Duration: Department of Psychiatry, Civil Hospital Karachi for Six months from 15th September, 2014 till 15th March, 2015. Methodology: Caregivers fulfilling the selection criteria were enrolled. "Zarit Burden Interview" (ZBI) was used for assessment of high burden over caregivers of schizophrenic patients. Different demographic factors like gender, age, education and employment status were also assessed. Results: Out of 150 caregivers, majority 83.3% were married followed by 9% being single and 9% being widow. In this study 58% caregivers had high burden as measured on ZBI. Out of those having high burden 52.8% were males while 47.2% were females. While gender distribution in caregivers having no burden 65% was males and 35% were females. Conclusion: This study reveals a high burden among caregivers living with patients of Schizophrenia. [ABSTRACT FROM AUTHOR]

Objective To determine the frequency and pattern of substance use during COVID-19 Study Design A descriptive cross-sectional study. Place and Duration Department of Psychiatry, Dow Medical College, Dr. Ruth KM Pfau Civil Hospital, Karachi and Model Addiction Treatment and Rehabilitation Centre (MATRC) Anti Narcotic Force, Karachi from December 16th 2020 to 15th April 2021. Methods Male patients of substance use disorders visiting on an out-patient basis were enrolled, and their status of COVID-19 was assessed and effect of COVID-19 disease on their substance use behaviour was recorded. Sample size was of 250 patients and non-probability consecutive type sampling was done. Ethical approval was sought before commencement of the study. Results The mean age of 250 participants was 28.2 +- 8.25 years. Out of total, 24 (9.6%) came out PCR positive as Covid-19, while 226 (90.4%) were negative for covid-19. When they were asked regarding the effect of COVID-19 on their substance taking behaviour, 138 (55.2%) were in the favour that the pandemic had increased their substance using habit while 112 (44.8%) replied that their substance using behaviour remained as usual and COVID-19 had not affected it. Statistically, COVID-19 status whether positive or negative was significantly related with type of substance use, as well as mode of substance use having a p-value of less than 0.05. While the effect of COVID-19 over the substance using behaviour was also significantly associated with having a pvalue of less than 0.05. Conclusion The Substance Use behavior was increased during COVID-19 in terms of usage, amount and mode of taking substance. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the proportion of women suffering from antenatal depression and anxiety visiting a tertiary care hospital for routine antenatal visits to evaluate the psychosocial factors associated with their depression and anxiety. STUDY DESIGN A descriptive cross-sectional study PLACE AND DURATION Department of Gynaecology & Obstetrics Ward 9B, Jinnah Postgraduate Medical Center (JPMC), Karachi from January 2024 to May 2024. METHODS The study was conducted with 249 pregnant women via non-probability, consecutive sampling. The Urdu validated version of Hospital Anxiety and Depression scale was used to assess anxiety and depression. Psychosocial stressors were also recorded. The data was entered and analyzed using SPSS for Windows version 23.0. RESULTS The study showed that 20% of women in their 2nd and 3rd trimesters of pregnancies were anxious and 5% were depressed. Critical psychosocial factors included low education, marital stressors such as low social support from husband and/or in-laws, living separately from husband, and intimate partner violence, financial stressors such as husband unemployment and pregnancy-related factors such as unplanned pregnancy and narrow birth spacing. CONCLUSION The study provides a significant burden of antenatal mental health issues in our region and their specific associated psychosocial factors. The study emphasizes upon the need for Biopsychosocial support systems as well as interventional measures to mitigate any risk of developing antenatal depression and to optimize the maternal health, both mental and physical, during this crucial period. [ABSTRACT FROM AUTHOR]

Being the primary target of antipsychotic therapy, dopamine receptor type 2 (DRD2) remains a point of interest in schizophrenia pathology. Polymorphisms in DRD2 have been shown to alter patients' response to antipsychotics. DRD2 SNP rs6275 (C>T) have found to be associated with schizophrenia in different populations; however, data remains inconsistent. Keeping in view the genetic diversity the present study was aimed to explore association of rs6275 with schizophrenia in population from Pakistan. Using Diagnostic and statistical Manual 5 (DSM 5) criteria, 100 schizophrenia cases and 100 controls (individuals without any psychiatric illness) were enrolled in the study. Severity of illness was determined using PANSS score. Genotyping was done via Sanger sequencing. MEGA-X was used to align the sequences, Expasy translate tool was used to translate nucleotide sequences. Difference in genotype and allele frequencies between cases and controls was determined using χ2 test. No significant difference in genotype or allele frequencies of rs6275 (p >0.0.5) was found between cases and controls. Interestingly, a novel SNP (C>A, Pro297Thr) was spotted during electropherogram analysis at position chr11:113412805. Significant difference was found in genotype and allele frequency of this novel SNP among schizophrenia cases and controls (p = 0.003). No association of rs6275 was observed with schizophrenia in Pakistani population. However, the study found significant association of a novel missense SNP of DRD2 at chr11:113412805 (C>T) with schizophrenia in Pakistani population. A large-scale multicenter study will be required to confirm the association of this novel SNP with schizophrenia. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of depression and anxiety (PDA) among undergraduate medical students including both males and females studying in a public university and to see whether an association exists between the academic year of study and the PDA. Methodology: A cross-sectional study, using a self-administered, structured, validated questionnaire, was conducted on a total of 325 medical students selected through convenience sampling technique at Dow Medical College. An english version of the AGA KHAN UNIVERSITY ANXIETY AND DEPRESSION SCALE (AKUADS) was used for evaluating the prevalence of depression and anxiety with inclusion of basic personal information of the students. Results: With a 100% response rate and a cutoff score of 20, 36.3% (118 out of 325) of the sampled population was found to be at risk of anxiety and depression. There was no significant association of depression and anxiety with gender and academic year of study but there was a significant association of depression and anxiety with positive family history. Conclusion: Medical students in university of Karachi are at risk of depression and anxiety with positive family history acting as an add-on factor. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To understand the reasons behind medical professionals' resistance to the COVID-19 vaccine and the negative effects, the vaccination has. STUDY DESIGN: Cross-sectional study design. PLACE AND DURATION OF STUDY: Dow University of Health Sciences, Ojha Campus Karachi, Pakistan from March 2021 till May 2021. SUBJECTS AND METHODS: Altogether, 260 samples were recruited and analysed to investigate the reason(s)of unwillingness for vaccination in healthcare workers and approaches for treating COVID-19. Data were analysed via IBM SPSS Statistics version 25.0 and the results were expressed in frequencies and percentages. RESULTS: Altogether, 41.8% of vaccinated participants developed postvaccination symptoms including fever, flu, body ache, headache and allergic reactions. Despite experiencing postvaccination symptoms, a large group of people (65.6%) did not take any medication to ease the symptoms. CONCLUSION: The study's subjects reportedly expressed reluctance to receive the COVID-19 vaccination. Social media played a key role in spreading the misconceptions regarding vaccination. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine frequency of depressive disorder among spouses of stroke patients at follow-up in tertiary care public hospital. STUDY DESIGN Descriptive cross-sectional study. PLACE AND DURATION OF THE STUDY Out-patient department of Medicine and Neurology Departments, JPMC Karachi, Pakistan, for the period of six months i.e. 1st April 2016 to 30th Sep 2016. SUBJECTS AND METHODS Total of 145 spouses of diagnosed stroke patients were included in the study. Criteria to include were spouses of the patients who were brought for follow-up at concerned OPD, at least after two weeks of diagnosis of stroke both ischemic and hemorrhagic, having ages between 18 to 60 years, both male and female spouses, Diagnosis of depressive disorder was based on applying patient health quesstionnare-09, (PHQ-9). RESULTS A total of 145 spouses of diagnosed cases of stroke were recruited in the study with 65 (44.8%) males and 80 (55.2%) females. According to PHQ-9, Out of 145 spouses, 73 (50.3%) had minimal or no depressive disorder while 26 (17.9%) had major depressive disorder or very severe depression, 46 (31.6%) had other depressive disorder as per PHQ-9 that includes mild, moderate and moderately severe depressive disorder, so totally 72 (49.7%) had depressive disorder. CONCLUSION In developing country like Pakistan where emotional health of an individual is often neglected, even during stressful situations like persistent disability of spouse which can be a turmoil in anyone's life, therefore the issues related to emotional wellbeing are poorly addressed and this study reveals high prevalence of depression among spouses of stroke patients. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of anxiety and depression in chronic hepatitis C patients. Methodology: In this cross sectional study conducted at a private medical college hospital, adult subjects of either sex with positive antibodies to hepatitis C of more than 6 months' duration were enrolled after taking informed consent. After implementation of inclusion and exclusion criteria subjects were interviewed for the presence and severity of anxiety and depression by Beck anxiety inventory and Beck depression inventory questionnaires respectively. Results: The mean age of 264 naïve hepatitis C subjects was 39.826 ±10.6121 (ranging from 17 to 71) years. Among those, 127 (48.1%) were males while 137 (51.9%) were female. Mean duration of hepatitis C was 3.665 ±2.445 (range 0.1 to 12) years. Anxiety was found in 177 (67%) subjects and males had higher frequency as compared to females (70.9% versus 63.5%). Depression was found in 191 (72.3%) subjects, In contrast to anxiety, depression was more prevalent in females 106 (77.4%) as compared to males 85 (66.9%). Conclusion: Anxiety and depression were found in a significantly high number of naïve hepatitis C patients. [ABSTRACT FROM AUTHOR]

Objectives: To determine serum levels of brain-derived neurotrophic factor and its polymorphism rs12291063 in schizophrenic patients., Methods: The case-control study was conducted from January1, 2020, to May 15, 2021, at Dr Abdul Qadeer Khan Institute of Behavioural Sciences, Dow University of Health Sciences, Karachi, and comprised schizophrenia cases aged 14-60 years who were diagnosed using Diagnostic and Statistical Manual of Mental Disorders-V criteria, and healthy controls without any psychiatric illness. Positive and negative syndrome scale score was used to assess disease severity. The genomic deoxyribonucleic acid of the subjects was isolated from peripheral blood, followed by polymerase chain reaction, gel electrophoresis and sequencing of the amplicons. The sequences were analysed using MEGA X software for genotyping. Serum brain-derived neurotrophic factor levels were assessed using enzyme-linked immunosorbent assay. Data was analysed using SPSS 21., Results: Of the 100 subjects, 50(50%) were cases; 36(72%) males and 14(28%) females (p<0.05) with mean age 34.34±10.32 years. There were 50(50%) controls; 32(64%) males and 18(36%) females (p=0.391) with mean age 30.886±8.88 years. Among the cases, the mean age at schizophrenia diagnosis was 25.14±9.54 years, and there was a significant association with positive family history for psychiatric disorders (p<0.05). Sequencing revealed no T>C substitution. Serum brain-derived neurotrophic factor levels were significantly higher in cases compared to controls (p<0.001). There was a weak negative correlation between brain-derived neurotrophic factor levels and positive and negative syndrome scale score (p<0.05)., Conclusions: Higher brain-derived neurotrophic factor levels were found to be associated with schizophrenia, while no association of rs12291063 T>C was found with schizophrenia.