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The Ewing sarcoma family of tumors (ESFT) stands for a group of rare and aggressive malignancies consisting of high grade poorly differentiated small round blue cells. In our case report, we aim to describe the clinical presentation, diagnosis and the treatment plan for our patient. A 16-year-old girl presented to the ENT outpatient department of the Mayo Hospital Lahore with the complaints of right nasal obstruction, epistaxis from right nose, swelling on the right cheek and headaches. Examination revealed a soft, tender swelling on her right cheek below the right eye. Imaging revealed a heterogeneous opacity in the right nose and right maxillary sinus with erosion of the sinus walls.Very few such cases have been reported in international literature. Being a rare case, our article will add insights to the literature regarding complex clinical presentation, diagnostic evaluation and treatment of the sinonasal Ewing sarcoma.

Objective: To determine test anxiety in medical students and to assess the measures used by them to reduce it., Methods: The cross-sectional study was conducted in August 2009 at the Dow University of Health Sciences, Karachi, and involved 388 medical students who were voluntary participants. The 10-item Westside Test Anxiety Scale, was used to measure anxiety and the pre-designed questionnaire asked the students about the frequent measures used by them to overcome anxiety during exams and their past Grade Point Average. All data was coded and analysed using SPSS version 16 with a prior set alpha level of 0.05., Results: Of the 450 students who were initially considered for the study, 388 fulfilled the inclusion criteria. Among them, 101 (25.3%) were male students with a mean anxiety level of 2.55 +/- 1.27, and 287 (71.8%) were females with a mean anxiety level of 3.07 +/- 1.43 (p<0.05). Prayers and self-motivation (28.3%), sleep and relaxation (11%), television and music (10%), calling friends (8.5%) and revision (6.7%) were the frequent measures used by the medical students to overcome exam anxiety. Students in their fourth and final years of studies showed a higher level of anxiety compared to those in the 2nd and 3rd years., Conclusion: The study indicated high levels of exam anxiety among the medical students, showing that there is a need for anxiety-reduction programmes in medical colleges.

Objectives: To evaluate the awareness of hypertension among medical students and junior doctors in Karachi, Pakistan., Methods: This cross-sectional study was conducted using a structured questionnaire consisting of eleven multiple choice questions, encompassing major aspects of hypertension such as the definition, diagnosis, treatment, complications and risk factors. This survey was conducted from June to August 2010 on final year medical students of Dow University of Health Sciences and interns and residents working at four tertiary care hospitals., Results: Analysis of 475 participants showed that only 127 (26.74%) participants were acquainted with the basic definitions including the cut-off levels for blood pressure among the general population, in diabetics, in those with chronic kidney disease and pre-hypertension. We further inquired about the drugs to be used as first-line of treatment in uncomplicated hypertension, in those with diabetic nephropathy and drugs that worsen blood-pressure and renal dysfunction. Only 40 (8.42%) participants correctly responded to all the three questions. While 97 (20.42%) answered all the three questions incorrectly. No participant correctly answered all of the 11 questions. Only 1 participant could answer 10 questions, correctly, whereas, 14 participants answered 9 correctly and 18 did 8. Majority of the participants (442) correctly answered 7 or less questions. Mean number of correct answers given by the final year students was 5.2 +/- 1.6, by interns 4.4 +/- 1.6 and those given by residents was 5.04 +/- 2.0. Statistically significant difference was noted between the number of correct answers by medical students, interns and residents., Conclusion: This study highlights obvious deficiencies in the knowledge of both junior and future doctors of Pakistan regarding hypertension which should be dealt seriously.