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Objective: Medical students have considerably higher prevalence rates of depression and suicidal thoughts as compared to their age-fellows from the general population. Only a limited number of studies have previously investigated the suicidal thinking/planning in Pakistani medical students. The aim of this study was to assess the prevalence rates of suicidal thoughts and planning in medical students studying at a private medical college in Lahore, Pakistan. Place and duration: Fourth year and final year medical students at Azra Naheed Medical College, Lahore were invited to voluntarily take part in this study. The study was conducted from 15th of June to the 15th of July 2022. Study design: Cross-sectional descriptive study Methodology: Suicide behavior questionnaire revised (SBQ-R) was used as the study instrument. Data collection was anonymous and the study was approved by the local institutional review board. The study was approved by the Institutional review board of Azra Naheed Medical College, Lahore. Descriptive statitstics were employed to report the findings and SPSS version 26 was used to store and analyze the data. Results: A total of 248 medical students (51.5% female) participated in the study. The prevalence of suicidal thoughts/plans in the past was 36.3% and the prevalence of suicidal thoughts in the past year was 31%. More than 16% of students communicated their intent to commit suicide to someone else in the past and 7% of the students reported that it was likely, rather likely or very likely that they will attempt suicide in the future. Conclusions: The prevalence of suicidal thoughts/ planning in medical students is worryingly high. Medical teachers should routinely assess their students for the presence of depressive symptoms/suicidal thoughts and offer support for students who screen positive for these. Key words: Suicide, Medical students, Prevalence

Background: Background: Medical education is a dynamic and lifelong process directly linked with human life. The profession is supposed to minimize the human sufferings, prevent diseases and promote the healthy practices at individual and community level. Burnout in undergraduate medical education can influence the academics and overall well-being of the learners in a negative way, which will ultimately affect the process of learning. Objective: The current study was conducted to assess the magnitude of Burnout syndrome among the students of a private medical college. Study Design: Descriptive, cross sectional study design. Place & Duration: The study was conducted during the period of six months from September 2019 to March 2020 at Azra Naheed Medical College Lahore. Methodology: Non probability convenient sampling technique was used and all the students of 3rd and 4th year MBBS were invited for the study. Burnout was evaluated by using the Maslach Burnout Inventory-Student Survey (MBI-SS). Approval of institutional ethical review committee and informed consent from the participants were obtained. The collected data was organized, entered in the version 21 of SPSS and analyzed by the use of statistical tools. Results: Out of total 200 participants, 43.5% were females and 56.5 % were males, 55.5% were from 3rd year and 44.5% were from 4th year of MBBS class. The prevalence of high Burnout was found to be 45(22.5%). Gender and residence-based prevalence was studied and calculated P value of (0.87) and (0.41), showed no association. However, a statistically significant association of burnout, (P value 0.003) was found between the 3rd and 4th year MBBS classes. Conclusion: The study concludes that a substantial number of undergraduate medical students suffers from the Burnout syndrome which may influence the health, well-being and academic progress of students in a negative way. Preventive measures including counselling, early diagnosis and clinical management should be opted by the medical institutes. Key Words: Burnout, Medical Education, Emotional Exhaustion, Depersonalization

Background: Basil and Chia seeds contain higher nutritive values like vitamin, carbohydrates, Omega-3 oil and other dietary fibers. With all these rich dietary benefits these seeds regulate necessary health conditions and maintain body weight. Ocimum basilicum (Basil) plant have been known to contain properties of weight loss, better digestion and other health benefits. Objective: The aim of this research was to check the Basil seed against hyperlipidemia in mice with Chia seeds. Methodology: In this research, the effect of both seeds extract on body weight and plasma lipid profile were estimated in Albino mice after raising their cholesterol levels by high fatty diet. The experiments were performed in different groups like normal control, standard control, hyperlipidemia group and four groups of diet supplemented chia or basil seeds with two different doses. Results: The biochemical analysis revealed that the supplementation of Basil seeds (400mg/kg/day) significantly lowered the levels of total plasma cholesterol, lipoproteins and triacylglycerol. Moreover, histopathological analysis of vital organs like kidneys, heart reported no toxicity. Conclusion: Extracts of Chia and Basil seeds have shown controlling effects over the given parameters in the blood and weights of the animals and these may have potential to control high fat diet-induced hyperlipidemia when taken as dietary supplements. Keywords: Cholesterol, Hyperlipidemia, Ocimum basilicum, Salvia hispanica

Background: Basil and Chia seeds contain higher nutritive values like vitamin, carbohydrates, Omega-3 oil and other dietary fibers. With all these rich dietary benefits these seeds regulate necessary health conditions and maintain body weight. Ocimumbasilicum (Basil) plant have been known to contain properties of weight loss, better digestion and other health benefits. Aim: To check the Basil seed against hyperlipidemia in mice with Chia seeds. Methodology: In this research, the effect of both seeds extract on body weight and plasma lipid profile were estimated in Albino mice after raising their cholesterol levels by high fatty diet. The experiments were performed in different groups like normal control, standard control, hyperlipidemia group and four groups of diet supplemented chia or basil seeds with two different doses. Results: The biochemical analysis revealed that the supplementation of Basil seeds (400mg/kg/day) significantly lowered the levels of total plasma cholesterol, lipoproteins and triacylglycerol. Moreover, histopathological analysis of vital organs like kidneys, heart reported no toxicity. Conclusion: Extracts of Chia and Basil seeds have shown controlling effects over the given parameters in the blood and weights of the animals and these may have potential to control high fat diet-induced hyperlipidemia when taken as dietary supplements. Keywords: Cholesterol, Hyperlipidemia, Ocimumbasilicum, Salvia hispanica

Objective: The objective of this study is to determine the frequency of asymptomatic left ventricular systolic dysfunction in high risk patients. Study Design: Cross sectional survey Setting: The study was conducted in the Department of Cardiology, Gulab Devi Hospital, Lahore. Methodology: 150 patients aged more than 50, who do not have signs and symptoms of heart failure like dyspnea on exertion, orthopnea and PND and having any 2 or more of these risk factors, Diabetes mellitus,Hypertension, IHD and Obesity were selected for this study. Each patient was asked about age, sex, diabetes mellitus, hypertension and symptoms of heart failure. Height and weight was checked and BMI was calculated in every patient. 6 minute walk test was done in every patient to rule out dyspnea on exertion. Echocardiography was performed in OPD of cardiology department. Left ventricular (LV) ejection fraction (EF) less than 50% was taken as LV systolic dysfunction. Results: The mean age of the patients was 57.5±7.04years.There were 24 (16%) patients who had ejection fraction less than 50% and they were labeled as having left ventricular systolic dysfunction. Among these, 09 (06%) patients had ejection fraction less than 40%. Only 32 patients had ischemic heart disease, 16 of these (50%) had ALVSD. This is the highest frequency of ALVSD amongst the different risk factor groups. Conclusion: In view of our results, we conclude that ischemic heart disease, diabetes mellitus, hypertension and obesity are important risk factors for the development of ALVSD. The frequency of ALVSD rises proportionately with increasing number of risk factors. Multiple risk factors have cumulative effect in the causing left ventricular systolic dysfunction Keywords: Asymptomatic, Ejection fraction, High risk, Preventive Medicine, Public Health, Systolic dysfunction

Introduction: Acute myocardial infarction causes significant mortality and morbidity. Timely conclusion permits clinicians to risk stratify their patients and select suitable treatment. Biomarkers have been utilized to help with timely decision, whereas an expanding number of novel markers have been recognized to predict result taking after an acute myocardial infarction or acute coronary disorder. This may encourage tailoring of appropriate treatment to high-risk patients. This survey focuses on an assortment of promising biomarkers which give symptomatic and prognostic data. Objective: To compare the early demonstrative efficiency of the cardiac troponin I (cTn-I) level with that of the cardiac troponin T (cTn-T) level, as well as the creatine kinase (CK), CK-MB, and myoglobin levels, for acute myocardial infarction (AMI) in patients without an initially diagnostic ECG presenting to the Emergency department within 24 hours of the onset of their symptoms. Material and Methods Study design: Prospective Observational Cohort Settings: Punjab Institute of Cardiology Duration: Six months i.e. 1st January 2020 to 30th June 2020 Data Collection procedure: A planned, observational, cohort study was performed including chest pain patients admitted to territory care hospital. Members were sequential consenting through Emergency department with chest pain and age more than 30 years. Exclusion included having symptoms >24 hours, failure to total information collection, receipt of CPR, and ST-segment elevation on the starting ECG. Estimations included levels of Trop-I, Trop- T, CK, CK-MB, and myoglobin at the time of introduction and 1, 2, 6, and 12-24 hours after presentation as well as showing ECG and clinical follow-up. The collected data was analyzed by using SPSS version 23. Results: 140 included for study out of the 200 patients, 21 (14%) were analyzed as having acute myocardial infarction after diagnostic ECG testing. The sensitivities of all 5 biochemical markers for acute myocardial infarction were poor at the time of emergency department induction. The sensitivity of Trop-T was essentially superior to that of Trop-I over the starting 2 hours (3.2-33.1), but both markers' sensitivities were low (

Introduction: Statins or 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors are one of the foremost commonly endorsed medications in cardiac patients. A bit like any other lesson of drugs, they have the potential to cause liver harm over time indeed with reasonable utilize. This drug induced liver harm (DILI) can be either coordinate (hepatocellular) or peculiar. As with multiple other hepatic pathologies, DILI may be asymptomatic or clinically quiet. Subsequently, it is judicious to carry out liver work tests (LFTs) from time to time. LFTs are an inexpensive, noninvasive, and fast first-line examination to monitor liver status. Be that as it may, the design of liver damage with statin utilize isn't particular and a relationship over time may not be clear. Objectives: To assess the derangements in Liver function test with regard to statin utilization and decide if there is any correlation exists. Method: Retrospective Observational study conducted in Punjab Institute of Cardiology, Lahore, from 31st July 2020 to 30 June 2021. Data Collection Procedure: This study is conducted at Punjab Institute of cardiology, Lahore, a total of 100 patients admitted from 1st July 2020 to 30 June 2021 with ischemic heart diseases were considered for inclusion as this was retrospective observational cohort study. The patients already taken statin were included in this study. LFTs were noted before the start of statin in their records then during the use of statin at 3rd and 6th month with great care. The collected data was analyzed by using SPSS version 23. Results: A total number of 100 patients were included in this study after inclusion exclusion criteria. The ratio male to female is 3:2.Patients using two types of statin i.e. Atorvastatin 20mg and Rosuvastatin 10mg were included. LFTs elevation was seen in the study. Conclusion: The use of statins clinically proved insignificant elevation of LFTs and hence it is safe to prescribe. Keywords: (HMG-CoA) reductase, Liver finction tests, Statin, LFTs

Background: Most institutions in the Pakistan face many educational troubles that innovation can offer assistance to overcome. A digital source, such as Zoom, LMS and Moodle e-learning stage has been actualized at national level in Pakistan. These learning makes a difference to supply e-content and to appear distinctive conceivable results for executing a synchronous e learning modules This paper appears highlighted the elearning increments which motivate the undergrad for online learning. Objectives: To evaluate the minimum inhibitory concentration of Oenothera biennis seed extract against staphylococcus aureus by using different concentrations. Study Design: Descriptive, cross sectional study design. Settings and Duration: The study was conducted during the period of six months from March 2020 to August 2020 at Mohi-ud-Din Islamic Medical College Mirpur Azad Kashmir. Methodology: Non probability convenient sampling technique was used and all the students of 1st and 2nd year MBBS were invited for the study. Approval of institutional ethical review committee and informed consent from the participants were obtained. The collected data was organized, entered on SPSS version 21 to analyze by the use of statistical tools. Results: Total 200 study participants, 43.5% were females and 56.5 % were males, 50% were from 1st year and 50% were from 2nd year of MBBS class. The majority of participants (63%) were from urban area. Father’s occupation of participants was businessman (35%), professionals including doctor, teachers and engineers (25%), landlord and farmers (15%), other Government employees (25%). Education level of fathers was bachelor degree or above in (75%) and among mother of the participants it was found as (54.5%). Conclusion: This review highlighted several important discoveries in the near-online learning mode, disproved others, and made a number of predictions about long-term online innovation for instructional purposes. Key words: e-learning, higher education, inspiration, web-based instruction

Objective: To find outthe frequency of cardiogenic shock in patients with ACS Study design: Cross sectional study Methodology:A calculated sample of 240 patients presented with acute coronary syndrome confirmed clinically and/or on the basis of ECG and cardiac markers was taken. In addition to collecting basic demographic details patients were inquired about the presence of risk factors (smoking status, diabetesand hypertension).The collected data was entered and analyzed by using SPSS version 16. Quantitative variable were presented in the form of mean, range and standard deviation. Results:Out of 240 patients, 33 patients (13.8%) were having cardiogenic shock and 207 patients (86.2%) were not. In the patients presented with cardiogenic shock, there were 21 (8.8%) with STEMI, 10 (4.2%) with NSTEMI and 2 (0.8%) with unstable angina. In STEMI there were 14 patients (5.8%) with anterior wall MI, 4 patients (1.7%) with inferior wall MI and 3 patients (1.2%) with lateral wall MI. Conclusion:Frequency of cardiogenic shock in patients presented with ACS was 13.8%. It was more commonin patients presented with ST-segment elevation MI as compared to unstable angina and NSTEMI. In STEMI, anterior wall was more involvement was more predominant. Keywords: ACS, Cardiogenic shock, Unstable angina, NSTEMI, STEMI

Objective: To determine the impact of diabetes on adverse outcomes amongst patients presenting for the first time with acute coronary syndrome. Study design: Cohort Study Methodology: A total of 340 patients were enrolled in this study. At presentation patients were divided in two equal age and gender matched groups with 170 patients in Group-A having diabetes and another 170 being non-diabetics in Group-B. Patients were followed up for period of index hospitalization and all adverse outcomes were noted in both groups as per operational definition. Results: Mean age in Group-A with diabetes was 54±12.7 years whereas in non diabetics it was56±13.12 years. In both groups there was male predominance with approximately 60% males and 40% females. In diabetic group, 38% patients had typical chest pain, 62% patients had dyspnea, 20% patients had cardiogenic shock while in non diabetic group, 20% patients had typical chest pain, 40% patients had dyspnea, 10% patients had cardiogenic shock. In diabetic group, 38% patients had heart failure, 10% patients died while in non diabetics 20% had heart failure and 5% patients died. Conclusion: This study concluded that in hospital adverse outcomes after first episode of acute coronary syndrome were more frequent in diabetic patients as compare to non diabetic patients. Keywords: Acute coronary syndrome, Adverse outcomes, First attack

Aim: To find the frequency of recently poor glycemic control as assessed by HbA1c in diabetic patients with acute coronary syndrome Study design & Setting: Observational study. Methods: The study included 60 diabetic patients presented with acute coronary syndrome. Diagnosis of acute coronary syndrome was based on patient’s symptoms, ECG changes and cardiac enzyme results. HBA1c level report was collected for all patients from their hospital record. SPSS 21 version was used to analyze the collected data. The qualitative data was presented in the form of graphs while the quantitative data was presented by simple descriptive statistics in the form of mean, range and standard deviation. Results: Out of sixty patients enrolled in this study 2(45%) were females and 33(55%) were males. 28(46.67%) patients presented with ST-elevation MI (STEMI) whereas 25(41.66%) patients presented with non ST-elevation MI. 7(11.66%) had unstable angina. Out of sixty patients 21(35%) patients were having poor glycemic control (HBA1C >7%) whereas 39(65%) patients had fair glycemic control (HBA1C< 7%). Fifty eight (96%) patients were using oral anti diabetic tablets whereas 2(3.33%) patients were using insulin before hospital admission. Conclusion: This study shows that amongst patients admitted with acute coronary syndrome a significant proportion of patients (35%) had poor glycemic control over past three months as assessed by HBA1C implying that recent poor glycemic control is a significant risk factor for acute coronary events in diabetic patients. Keywords: Acute coronary syndrome, Glycemic control, Diabetes mellitus.