No abstract

Depression is one of the most frequently diagnosed psychiatric illnesses, which remains a big cause of mortality and morbidity among all groups of population. 1 Things are not different in our part of the world as depression remains a common mental health illness in our population. 2 If untreated, it may lead to serious consequences including severe depression with psychotic illness, physical problems and even suicide. [3][4][5] Transgender is a broad term which includes the people with all types of gender identity disorder. ICD-11 coins a new term for this group of people, i.e. gender incongruence. In United States of America, 390/100,000 individuals are believed to be transgenders. 6 Census of 2017 has shown that more than 10,000 transgender subjects exist in Pakistan. They suffer from various health issues including the HIV, drug dependence, and various mental health problems. 7,8 Previous research highlights the presence of depression and suicide ideation among the transgender population. Depression, suicide and other mental health indices are very high among the transgender population as compared to controls even in a developed country like USA. 9 Another study showed suicide attempt rate as 32-50% among the transgender population of our neighboring country India. This was also coupled with increased rate of depression among the target population. 10 Oswalt et al. concluded in a large study that all mental health illnesses including schizophrenia are found more among the transgender as compared to heterosexual controls. 11 Depression and suicidal ideation, if remain unaddressed for long, may result in poor life quality and even leading to death. 12 Suicidality and depression have some common biological pathways, which explain one of the bases of their comorbidity. Role of genetics, alteration in the hypothalamic-pituitary-adrenal (HPA) axis, dysregulation of serotonin metabolism and receptors and neuroimmunological basis are some of the factors which contribute in development of both depression and suicidality. 13 In addition to the biological factors, depression also leads to suicidal ideation and suicidality by psychological and social pathways. 14 Ideas of self harm are also part of diagnostic criteria for depression in

This study showed that there is a knowledge gap among trainees in medicine regarding the meaning and usage of common medical abbreviations. We therefore recommend proper education of trainees in medicine to ensure they understand the meaning of abbreviations and are aware of the list of 'do not use' abbreviations.

Opinions of university students about euthanasia were studied in 4 cities in Pakistan using convenience sampling. A total of 836 students (316 males and 520 females) completed a questionnaire in which euthanasia was defined as deliberate administration of an overdose of a drug by a doctor to relieve pain and suffering of a dying patient at his/her explicit request to end his/her life. Only 25.6% of students agreed that euthanasia should be legalized in Pakistan. The most common reason cited for legalization of euthanasia was to relieve patient's suffering but only when a committee of physicians agreed to recommend it. Students who opposed legalization (74.4%) cited impediments to future medical research as the most common reason, followed by the risk of misuse by physicians or family members. Only 8.9% of students cited religious beliefs as a reason against legalization. There is a need in Pakistan for more debate about euthanasia.

Seventeen pairs of published primer sets were compared for their relative sensitivity to detect malaria DNA extracted from blood samples, which were obtained from Pakistani patients suffering from malaria. The primer sets investigated consisted of: (i) 9 pairs of direct primers and 3 sets of nested primers for detecting Plasmodium falciparum, (ii) 2 pairs of direct primers and 2 sets of nested primers for detecting P. vivax, and (iii) 1 set of multiplex primers for detecting both P. falciparum and P. vivax, simultaneously. After a miniscreen of 9 DNA-extracted blood samples using the 17 primer sets stated above, 5 primer sets were short-listed (based on their superior sensitivity) and used for a maxi-screen of DNA extracted from 126 microscopy-positive blood samples from Pakistan, with the following results. (i) For the detection of P. falciparum, the direct primer pair 'PF1 + PF2' gave a sensitivity of 95% and the nested primer set 'RIT405 + RIT406/RIT371 + RIT372' gave a sensitivity of 97%. (ii) For the detection of P. vivax, the direct primer pair 'Forward + Reverse' and the nested primer set 'PLF + UNR/PLF + VIR' both gave a sensitivity of 94%. (iii) The nested multiplex primer set 'rPLU5 + rPLU6/rFAL1 + rFAL2 + rVIV1 + rVIV2' gave a sensitivity of 97% and 96% for P. falciparum and P. vivax, respectively. It was concluded that the nested multiplex primer set was the most optimal primer set to use for the detection of malaria DNA extracted from blood samples. Furthermore, the nested multiplex primer set has the advantage of simultaneously detecting and differentiating between P. vivax and P. falciparum.