The aim of the present was to assess and compare the mental health of male and female healthcare students in a Health University of Karachi, Pakistan. A cross-sectional study was conducted for which questionnaire was designed along the standard scoring scales of depression (PHQ-9), anxiety (GAD-7) and phobia (IAPT) completed by 300 enrolled students. Females (52%) of the medical institute suffered from mild to moderately-severe depression in contrast to the males (33%). Females were found to be affected by mild anxiety and phobia (42.7 and 26% respectively) exceeding the male population (27.3 and 15.3% respectively). However, severe depression or anxiety was not observed in either gender groups significantly, suggesting a healthy mental picture of these medical students. It can be concluded that health care students in modern upgraded education systems, in contrast to evidence from literature, have been able to adopt better coping mechanisms for maintaining their mental health.

Background: This meta-analysis aimed to pool all the available data to provide a well-powered assessment of the role of maternal Vitamin D levels in developing gestational diabetes mellitus (GDM) because already published studies evaluating this association are small in sample size and yielded conflicting findings. Material and Methods: A systematic review and meta-analysis of observational studies was performed. We searched electronic databases (PubMed and Cochrane Central) from inception to April 2021 for published and unpublished observational studies that determined the association between the reduction of Vitamin D levels and the risk of developing GDM in pregnant women. Results from studies were pooled as mean ± standard deviation (SD) and odds ratios (OR) using the random-effects model. Results: Forty-four studies, consisting of 37,838 pregnant women were included in this meta-analysis. Dichotomous studies showed a significant association between maternal Vitamin D deficiency and increased risk of GDM (OR = 1.38; 95% confidence interval [CI] = 1.21-1.57; P < 0.00001). Studies with continuous data also showed a significant association between maternal Vitamin D deficiency and the risk of developing GDM (weighted mean difference (WMD): –5.14 nmol/L, 95% CI = –6.28 to -4.00; P < 0.00001). Moderate heterogeneity was also detected. Conclusion: In conclusion, all studies demonstrated that lower levels of maternal serum Vitamin D were associated with a higher risk of developing GDM in pregnancy.

Objective: To determine the prevalence of A1 and A2 subgroups of blood group A in healthy blood donors of northern Pakistan. Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Transfusion, Rawalpindi Pakistan, from Sep to Dec 2017. Methodology: The blood samples of donors reported during the study period at Armed Forces Institute of Transfusion were collected. ABO typing was performed and those in group A and AB were further subtyped using anti-A1 lectin and thus the individuals were labelled as A1 (and A1B) or A2 (and A2B). The serum of individuals with groups A2 and A2B was tested for anti-A1 based on the reaction with A1 red cells. Results: Out of total 4485 donors, 1116 (24.88%) were of blood group A and 422 (9.41%) individuals were of AB group. Out of 146 (13.08%) individuals among 1116 blood group A donors were of subgroup A2. While out of 422 of blood group AB, 80 (18.95%) were A2B. 21 (14.38%) out of 146 individuals of A2 blood group, had anti-A1 antibody while among 80 individuals with A2B blood group only 2 (2.50%) had anti-A1 antibody in their serum. Conclusion: Blood group A2 is quite prevalent in our population. Although anti-A1 is present in significant fraction of A2 blood group individuals, the routine testing is not needed to identify the A2 group and cross match compatibility is the only requirement as anti-A1 is rarely active at 37° C.

Hydralazine-induced pauci-immune glomerulonephritis is a rare cause of glomerulonephritis. It is an antineutrophil cytoplasmic antibody (ANCA) associated vasculitis that can be rapidly progressive and potentially life-threatening. However, most cases are found to be asymptomatic, and patients often present with acute renal failure and painless hematuria. It has been confused with lupus nephritis but treatment differs, thus, necessitating the need for differentiation.A case report of an 80-year-old African American woman with a history of hypertension, diabetes mellitus type 2, and hypothyroidism, who presented with generalized weakness and weight loss of 30-40 lbs. The patient had been treated with hydralazine for months for hypertension. She presented to the hospital with acute renal failure that worsened over the course of several months eventually requiring hemodialysis.The patient was found to have drug-induced ANCA vasculitis from hydralazine. This etiology was confirmed with pauci-immune glomerulonephritis seen on renal biopsy. This presentation has the potential of being confused with lupus nephritis. Despite the initial serology being suggestive of lupus, this type of nephritis does not have positive immunofluorescence.The treatment of nephritis in this patient was generally supportive. However, it was important to identify the underlying cause of renal failure. Equally important to initiating immunosuppressive therapy, it was imperative to discontinue the offending drug in a timely manner to prevent rapid organ failure. The causative agent, hydralazine, may have otherwise gone unnoticed without a thorough investigation into other causes of renal failure. Thus, it is important to consider this as a diagnosis with a patient who presents with rapidly progressive renal failure on hydralazine and may mimic lupus nephritis.