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Objective: The purpose of this study was to assess the prevalence and factors associated with the use of psychoactive drugs amongst medical undergraduate and postgraduate students. Study Design: A cross-sectional study was conducted using a self-administered questionnaire to obtain information on the consumption patterns of psychoactive substances. Study Place and Duration: The study was carried out at Department of Psychiatry, Khyber Teaching Hospital Peshawar, Khyber Pakhtunkhwa, over a period of twelve months from January, 2022 to December, 2022. Methods: A total of 2,500 medical students, comprising 1,800 undergraduates and 700 postgraduates, were randomly selected from the participating institution. The questionnaire collected data on demographics, academic performance, substance use, and factors contributing to the consumption of psychoactive drugs. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression models. Results: The overall prevalence of psychoactive drug use among the medical students was found to be 35.8%, with a higher rate among postgraduate students (42.1%) compared to undergraduates (32.6%). The most commonly used substances were stimulants, followed by opioids and sedatives. Factors significantly associated with psychoactive drug use included high levels of stress, academic pressure, and peer influence. Students who reported using psychoactive drugs had a higher incidence of poor academic performance and mental health issues. Gender differences were also observed, with male students showing a higher prevalence of substance use than female students. Conclusion: The study highlights the alarming prevalence of psychoactive drug use among medical undergraduate and postgraduate students, which can adversely impact their academic performance, mental health, and future professional lives. It is imperative for educational institutions and policymakers to implement targeted interventions to address the underlying factors contributing to substance use, such as stress management and peer support programs. Furthermore, fostering a culture of open dialogue and increasing awareness about the consequences of psychoactive drug use can help mitigate this growing public health concern. Keywords: psychoactive drugs, medical students, undergraduate, postgraduate, prevalence, substance use, academic performance, stress, mental health.

Objective: To compare the efficacy of Copal varnish versus dentin bonding agent for the prevention of postoperative sensitivity in amalgam restorations with the help of Visual auditory score (VAS). Study Design: Comparative clinical study. Place and Duration: A randomized control trial was conducted in the Department of Operative Dentistry after approval from the Institutional Review Board (IRB) of Fatima Memorial Hospital (FMH-03-2020-IRB-752-M). Methodology: A randomized control trial was conducted in which sample size of 60 was calculated, 30 in group. A (copal varnish) and 30 in group B (dentin bonding agent) with 95% confidence level and 80% power of test, 5 % level of significance. Non-probability consecutive sampling was used using lottery method. Inclusion criteria included both male and female patients with age range 18-40 years and no significant signs and symptoms of pain prior to treatment. Teeth which were previously restored and deep cavities with less than 2mm of remaining dentin thickness on periapical radiograph, with reference to GV Black’s class I were excluded from the study. Results: The study subjects were 60 patients requiring restorations for class I cavities. Each treatment group had 30 patients. A single operator evaluated all the patients at baseline and performed the procedure. The patients were recalled at 24 hours and 7th day, for postoperative evaluation. No significant difference was found in the mean sensitivity score of both the classes. Chi-square test was analyzed to find out the frequency of postoperative sensitivity and efficacy among males and females. No significant difference was found among both males and females. Practical implication: Current study can help dentists choose the right materials for restorative procedures, reducing postoperative discomfort. It also highlights the importance of regular dental check-ups and early intervention to prevent invasive procedures and promote oral health for the community. Conclusion: Copal varnish and dentin bonding agents are equally good in terms of their efficacy and reduction of postoperative sensitivity, in class I amalgam restorations. The effect of cavity depth and amount of tooth reduction greatly affect the result of postoperative sensitivity in class I lesions confined to outer 1/3rd of dentin. Keywords: Copal varnish, dentin bonding agents, Amalgam, dentinal tubules

Introduction: Over the past few years, the population of Pakistan has become much aware of the need of weight loss and healthy lifestyle. We evaluated the cholesterol profiles to observe how keto diet and low-calorie diet influence the basic lipid profile of females. Aims: The aim of this study was to compare the cholesterol and triglyceride levels in adult non pregnant females taking ketogenic versus low calorie diet for a one month Methodology: The design of this study was a cross sectional study design. This study was conducted in lady reading hospital Peshawar and the duration of this study was from January 2022 to February 2022. 60 non pregnant females of age between 35-45 years with BMI ranging between 30-34.9 were included in the study. 30 were on low calorie diet, 30 were on keto diet. The serum cholesterol and triglyceride levels were calculated on day 1 and day 30 of the study. Results: The serum chloesterol levels were significantly reduced in individuals taking low calorie diet as compared to keto diet over a period of thirty days. After few weeks, anthropometric and body composition measurements revealed a significant reduction significant decrease in glucose and insulin blood levels were observed, together with a significant improvement of body weight. There was a significant, slightly decrease of LBM. A significant decrease of triglycerides, total cholesterol and LDL were observed along with a rise in HDL levels. The LH/FSH ratio, LH total and free testosterone, and DHEAS blood levels were also significantly reduced. Estradiol, progesterone and SHBG increased. The Ferriman Gallwey Score was slightly, although not significantly, reduced. Practical Implication: to determine the effects of a ketogenic diet (KD) in women age with a diagnosis of PCOS. We hypothesized that a modified KD (KEMEPHY diet) would lead to an improvement in body weight, plasma cholesterol, triglycerides, hyperinsulinemia, and hormonal outcomes Conclusion: Low calorie diet was significantly better than ketogenic diet in reducing serum cholesterol and triglyceride levels in individuals on a 30-day diet plan of respective type. Our results suggest that a ketogenic diet may be considered as a valuable nonpharmacological treatment for Polycystic ovary syndrome. Longer treatment periods should be tested to verify the effect of a ketogenic diet on the dermatological aspects of Polycystic ovary syndrome. Keywords: Cholesterol, Ketogenic Diet, Serum, Lifestyle, Low Calorie, Nutritionist

Background: The COVID-19 (Coronavirus Disease of 2019) virus has affected millions of people around the world, and it is likely to induce mental health issues in those who have never had one before, as well as worsen the condition of those who already have. Objective: To determine the effect of COVID-19 on mental health and quality of life. Methodology: The non-probability convenient sampling strategy was utilized in this cross-sectional research. A sample of 300 Males and Female with age above 30 who have gone through COVID-19 and recovered before one month or more are included in the study. All patients who already had cognitive issues even before COVID-19 were excluded from the study. The study variables were measured using the MMSE (mental health) and WHOQOL-BREF (quality of life). Results: The results revealed that 128 participants (43%) of the respondents were male and 172 participants (57%) were female. The findings showed that 32 people were with normal mental health, 100 were with mild and 36 were with moderate mental health between the ages of 30-39. 52 people were with normal mental health, 24 were with mild and no one was with moderate mental health between the ages of 40-49. 4 people were with normal mental health, 4 were with mild and 24 were moderate mental health between the ages of 50-59. 12 people were with normal mental health with, 4 were with mild and no one was with moderate mental health between the ages of 60-69. The results also showed that there was a significant association between mental health and quality of life. chi-square test of independence showed significant association between mental health and quality of life with ꭓ2 (N = 300) = 600.0, p = .000. The findings showed that people with normal mental health had very good quality of life, people with mild mental health have poor quality of life and people with moderate mental health have very poor quality of life. Conclusion: It was concluded from the study that COVID-19 has badly effected mental health and quality of life of the patients suffered from coronavirus. Keywords: COVID-19, Mental Health, Quality of Life, Mental State Examination, Chi-Square

Background: Sudden cardiac arrest has become a serious pandemic and a substantial public health burden. Significant morbidity and death are linked to it. Hemodialysis is considerably a heavy burden on cardiac patients. A sudden cardiac arrest is sometimes a disastrous event that happens without warning and is regrettably a significant cardiac disease manifestation in individuals surviving on kidney dialysis. Aim: To determine Serum Hemoglobin and potassium levels in sudden cardiac death patients admitted in hemodialysis center of Aziz Bhatti Shaheed Teaching Hospital Gujrat. Study Design: Cross-Sectional Study Methodology: This research study was conducted at the hemodialysis center of Aziz Bhatti Shaheed Teaching Hospital Gujrat. The Ethics Committee approved to conduct of this descriptive cross-sectional study on 40 (20 males and 20 females) sudden cardiac patients. All information and the goal of the research project were explained to patients or their relatives before the collection of blood serum. Prescription drug lists, smoking histories, and medication or dialysis report data were randomly evaluated. Laboratory results from recent month were collected, together with dialysis run sheets and cardiac arrest data forms. Results: Results of this result study showed that the mean value of age was 50 years with a mean standard deviation of 15.1 (p= 4.0mmole/L) showed that there was a significant change in the estimated values i.e. estimated glomerular filtration rate (mL/min per 1.73 mm2) was 0.67 (95% CI of 0.54-0.58) (p=

Background: Pre-labour rupture of membrane (PROM) at term is one of the most common demonstration for labour induction. PROM is the fissure of membrane before the arrival of orderly uterine shrinkage at term gestation. About 8% of the pregnant women have influence of this condition. PROM also occur when the amniotic sac ehich surround the fetus fissure before the onset of labour leading to the risk of maternal and fetal infection. Study design: It is a randomized and controlled study conducted at Obs and Gynae Department, Civil Hospital, LUMHS, Jamshoro and Divisional Headquarters Teaching Hospital Mirpur Azad Kashmir for the duration of six months from February 2022 to July 2022. Material and Methods: The study comprised of two groups. Each group had 30 patients. The patients that were not fulfilling the inclusion criteria were excluded from the study. The average age of patients in group 1 that is oxytocin induced was 25.4±5.4 years. Patients with prostaglandin E2 induction were included in group2 with average age as 24.7±4.5 years. Group1 had 35.9±4.2 while the average value for group 2 was 36.7±5.3. Results: The induction active labor interval was 5.9±2.1 for Oxytocin induction group while for Prostaglandin E2 induction group the value was 6.3±2.2. Whereas the induction delivery was 14.3±1.9 for Oxytocin induction group and 15.1±2.1 for Prostaglandin E2 induction group. Conclusion: It is concluded that oxytocin is a better drug for labor pain induction as compared to the prostaglandin in case of Pre-labour rupture of membrane at term. To route oxytocin via an intravenous pathway leads to a shorter delivery time and reduced rate of different infections in the mother. Keywords: PROM at term, Intravenous oxytocin and vaginal prostaglandin.

Objective: The aim of this study is to review the current guidelines regarding the management of HMB, including screening for anemia, Iron studies and iron-based and non-iron-based treatment of ID/IDA. Methods: The literature searched for this article included the latest Guidelines for HMB. The data was collected from authentic websites such as pubmed and well-known clinical guidelines from professional societies. Results: More than 50 guidelines throughout the world were searched and studied for this review. Among them 22 were selected for this review. 16 of these guidelines focused on screening of women with HMB for anemia. There were some inconsistencies concerning screening for ID with eleven of the 22 guidelines providing no recommendation for screening of Iron levels and four even strictly advising against screening for iron levels initially. Almost one third of the selected guidelines provided guidance for oral iron therapy as first line in ID, 4 guidelines provided guidance for use of IV iron replacement in severe anemia, non-responders to oral treatment and prior to surgery. 3 of the guidelines had HB threshold for selecting between oral and IV route while further 4 guidelines were of the view of transfusion in case of severe anemia. Conclusion: Although many of the guidelines are of the view to treat anemia due to HMB, there is lack of consensus regarding screening for ID and treatment with iron supplements, due to this most of the IDA related with HMB goes undiagnosed. Therefore, a proper guidance is required that addresses all the aspects of ID/IDA including screening, relevant tests and treatment in patient with HMB in order to optimize the health outcome of these patients. Keywords: Anemia, Blood, Menstrual Cycle, Surgery

Aim: To compare the efficacy of modified bass technique and charters technique in plaque removal among orthodontic patients. Study design: Single Blind Randomized control trial Place and duration of study: Department of Periodontology, Sardar Begum Dental College Peshawar from 1st July 2022 to 31st December 2022. Methodology: Forty six patients undergoing orthodontic treatment were enrolled. Patients were divided into two equal groups using lottery method. Group A used Modified Bass technique and Group B used Charter’s brushing technique. Plaque scores were measured by principal investigator and were recorded onthe Online Periodontal Chart of University of Berlin. Plaque score was recorded on all sides of the tooth in relation to bracket (mesial, distal, gingival, occlusal) using dental explorer after disclosing plaque by plaque disclosing tablet. Results: There were 24 (52.2%) females and 22 (47.8%) males. The mean plaque score for Group A was 25.76 and for Group B was 27.64, with no statistical difference after the test was applied. Conclusion: The modified Bass and Charters brushing techniques showed similar results in plaque removal efficacy. Scrubbing is the simplest and most often used cleaning procedure. Keywords: Plaque, Fixed appliances, Brushing techniques, Efficacy

Introduction: Dental anxiety is a common phenomenon among patients of all ages, but the issue becomes particularly relevant for older adults who may have more complex dental needs or medical conditions that could impact their dental health. Objectives: The main objective of the study is to assess the tooth extraction anxiety and depression in older adults. Material and methods: The research article aimed to investigate the prevalence of tooth extraction anxiety and depression among older adults receiving dental care at the Oral and Maxillofacial Surgery Department of Liaquat University of Medical and Health Sciences in Jamshoro. The study was conducted over a period of 12 months, from January 2019 to December 2019, and included a sample of 150 patients aged 65 years and above. Results: The majority of the participants were male (60%), and the mean age of the sample was 71.6 years (SD= 5.8 years). The educational level of the participants was relatively low, with 71% of the sample having less than a high school education. The most common medical comorbidities reported by the participants were hypertension (62%), diabetes (32%), and heart disease (14%). Conclusion: In conclusion, tooth extraction anxiety and depression are common in older adults, with nearly half of the participants in this study reporting symptoms following the procedure. Female participants in the 60+ age group were found to be more likely to report anxiety and depression, as were those with pre-existing medical conditions. Keywords: Dental, Anxiety, Depression, Adults, Patients

Objective: The purpose of this study is to compare the prevalence of pre-eclampsia in obese primigravida compared to those who are not obese. Study Design: Prospective cohort study Place and Duration of Study: The research was conducted at the Gynecology and Obstetrics Department at the bahawal Victoria hospital Bahawalpur from 01 June 2021 to 31 December 2021. Materials and Methods: The study consisted of sixty (60) patients, selected using a non-probability consecutive sampling technique. All primigravida between the ages of 20 and 35, with singleton pregnancies of >26 weeks and with a BMI>30kg/m2 in the obese group and BMI

Introduction: Identification whether of living person or of dead bodies have always been an uphill task for forensic experts. Traditional ways of identification are used commonly due to limited resources and lack of trained personals in the relevant field. Identification becomes very important when victim or assailant is unknown. To establish identification, methods commonly used are finger prints, foot prints, DNA technology. Lip prints a relatively neglected field of identification can be used to establish identification and sex determination producing almost same results as other methods of identification. Objectives: To determine whether lip prints can be used from their configuration to determine the gender identification. Material and Method: 75 medical college students with equal gender distribution, 35 male and 35 females were included in the study. Students were aged between 18 to 25 years. Inclusion criteria: Students with no lip abnormality were included in the study. Exclusion criteria: Students with any abnormality of lips or who have some lip surgery were excluded from the study. Results: The uniqueness of the lips was established by the facts that no two lips matched with each other. Females revealed type I, I’ most abundant, whereas type IV was abundantly observed among males. From the current study, with inexperienced observers it was revealed that from sample of 20 lip patterns from each gender, 18 females and 17 males were easily identified. Conclusion: Identification of a person whether living or dead is a challenging task for forensic experts around the globe. Lip prints are among the cheapest and easily available methods of identification producing almost same results as finger prints. It is a rather neglected area which needs to be focused more as it is cheap and can be equally effective in producing almost same results as other related methods used for identification and sex determination in particular unknown cases. Keywords: Sex determination, Lip prints, Medicolegal importance.

Objective: To determine the frequency of different category of Dermatology Life Quality Index (DLQI) in patients with Acne Vulgaris visiting to tertiary care hospital. Study Design: Descriptive Cross-Sectional Study. Place and Duration: This study was conducted at the Department of Dermatology, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan during the period from August 23, 2019 to February 22, 2020. Materials and Methods: All patients who fulfilled the inclusion criteria and visited to SMBBMU, Larkana were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, patients with acne vulgaris were diagnosed on the basis of relevant clinical history and examination. Patients were asked to fill the DLQI questionnaire themselves to assess the DLQI. All the collected data were entered into the proforma attached at the end and used electronically for research purpose. Results: Mean ± SD of age was 25.4±5.2 years. Out of 343 patients, 157 (45.8%) were male and 186 (54.2%) were female. In frequency of different category of dermatology life quality index (DLQI) 44 (12.8%) patients had no effect, 105 (30.6%) had mild, 74 (21.6%) moderate effect, 86 (25.1%) had very large while 34 (9.9%) patients had extreme larger effect. Conclusion: It is to be concluded that his study showed significant impairment of QoL in acne patients. Assurance and counseling along with early treatment of acne vulgaris are important to reduce disease-related psychosocial sequelae. Keywords: Dermatology Life Quality Index, Acne Vulgaris, Influencing Factors, Quality of Life, Psychosocial, Cosmetological Treatments

Background: Cutaneous warts are common dermatological viral infection caused condition which causes cosmetic problems besides it primary morbidity like pain and discomfort. Intralesional vitamin D3 derivatives therapy is recent and effective modality for treatment of cutaneous warts. Objective: To determine the efficacy of intralesional vitamin D3 injection in cutaneous warts in local patients. Methods and patients: A descriptive case series study conducted from June to December 24, 2019 at Dermatology OPD, SMBBMU- Larkana.A sample of 65 patients with cutaneous warts, either gender, age 20-50 years, 3 months to 6 months history were included after taking a valid informed/ written consent. Pregnant and lactating women, patients on immunosuppersive therapy, signs of any systemic or local inflammation or infection, history of pasthma allergic skin disorders meningitis or convulsions, history of hypersensitivity to Vitamin D3 were excluded. The injections of vitamin D3 (vials containing 6,00,000 IU of cholecalciferol in 1 ml = 15 mg)were given at 2 weekly intervals for a maximum of four injections.A standard questionnaire was used to collect demographic and study related data. Data analysis was performed through SPSS Version-21. Descriptive and inferential statistics were calculated. Stratification was done and post stratification chi square test was applied. P-value ≤0.05 was considered as significant. Results: The mean age of patients was 27.9±5.1 with C.I (26.63-29.16) years. The Mean ± SD of duration was 4.4±1.9 with C.I (3.92-4.87) months. The Mean ± SD of number of warts was 14.3±4.2 with C.I (13.25-15.34). Out of 65 patients, 35 (53.8%) were malewhile 25 (38.5%) patients were belong to urban areas. Primary outcome of this study i-e; the efficacy was n=54 (83.1%). Stratified analysis revealed that younger age (20 – 30 years), male gender, urban residence, 3-5 mm size, 2-3 months duration (p value = 0.009) were associated with more efficacy of intralesional vitamin D3 injection in cutaneous warts. Conclusion:This study clearly demonstrates that recalcitrant plantar warts can be treated successfully with intralesional vitamin D3 injection. The immunotherapy of injection vitamin D3 has better patient compliance, good therapeutic response without cosmetic disfigurement and capable of preventing recurrences. Keywords: Efficacy, Intralesional Vitamin D3, Cutaneous Warts, Treatment,Immunotherapy

Introduction:One million children die each year from injuries around the world, with poisoning being the fourth most common cause.Children below five years are at an increased risk because of their exploratory nature and hand to mouth activity, accounting for 15% of accidental poisoning related deaths in this age group.A community oriented study that studiedthe national health survey of Pakistan reported that the incidence of accidental poisoning was 4.3% among children below five years. Objectives: To determine the socio-demographic factors affecting accidental toxic ingestion in children younger than five years at Aga Khan University Hospital, Karachi. Materials & Methods:A descriptive cross-sectional study was carried out at the emergency Deptof the Aga Khan University Hospital in Karachi, Pakistanbetween August 2016 to July 2017. Children with a history of accidental ingestion were included in the study. Descriptive statistics and Chi-square association was used employed using SPSS version 23. Results: A total of 97 children between the age group of 6 months – 5 years were enrolled, amongst 61 (62.88%) male. 74 (76.29%) children had unsafe storage of hazardous chemicals, 34 (35.05%) had large family size, 5 (5.15%), 3 (3.09%), and 3 (3.09%) of participants had lower socioeconomic status, uneducated, and rural residents respectively. Practical implication Conclusion: Awareness to parents regarding child protective strategies and usage of safe packaging in medicines may avoid accidental toxic ingestion. Keywords: Accidental poisoning, Socioeconomic Status, Education.

Objective: To determine the factors of maxillary arch dimension of students aged 18–25 years in the prosthetic department at Bhittai Dental and Medical College Methods: This cross-sectional study was done at the prosthetic department at Bhittai Dental and Medical College, MirpurKhas. All the students having Class I canine and molar relationships; well-aligned upper and lower dental arches; mixed dentition; good facial symmetry; and no previous orthodontic treatment. Dental arch dimensions of width, length, and depth were taken by one examiner using the Korkhaus’ compass and a digital pachymeter. All the data was collected by the study proforma and SPSS version 26 was used for the purpose of analysis. Results: A total of 50 students were studied. Their mean age was 22.68+3.32 years. According to the arch width, the mean inter canine distance was 35.28+1.98 mm, the mean inter pre molar distance was 42.92+2.36 mm, the mean inter first molar distance was 52.48+4.03 mm, and the mean inter 2nd molar distance was 59.52+3.61mm. According to the maxillary arch length, the anterior arch length was 8.32+1.34mm, molar ventricle distance was 29.72+2.52 mm and the total arch length was 43.2+2.1mm. In the arch width and length, the mean inter 2nd molar distance and anterior arch length were statistically insignificant according to age and gender (p

Objective: To inquire the oral cancer awareness among general medical and general dental professionalsand their knowledge of early detection and prevention of oral squamous cell carcinoma. Study design: cross sectional study Place and duration of study: Oral and maxillofacial surgery Department King Edward Medical University from 5th November 2019 to 5th February 2020. Methodology: A questionnaire was given to dental and medical practitioners and their responses were included in the results. This study was done in three months’ period from 5th November 2019 to 5th February 2020 after ethical approval from institutional review board. Results:The questions were given back by 57 general medical practitioners and by 40 general dental practitioners, producing return rates of 38% GMPs and 26.66% GDPs respectively. The questions were answered by 93 GMPs and by 110 GDPs producing rates of 62% GMPs and 73.33% GDPs respectively. Conclusion: Patients suffering from oral pathologies often go to their general medical practitioner and dental practitioners. The number of patientsof squamous cell carcinoma of oral cavity are rising in the Pakistan, hence general medical and general dental practitioners need to play significant role. This study talks mainly about the on the need for improvement in awareness about oral squamous cell carcinoma. Keywords: oral cancer, awareness, risk factors

Aim: Diabetes is considered as the major disease which is increasing day by day in world wide. Research shown that it should be properly treated and routine visits to doctors are needed to overcome this issue, otherwise it will lead to major cause and severe health issues. Methods: To check out the actual results, they collect different samples from different clinics of Lahore. They were trying to check out the self-check from patients. Interviews has taken by face to collect certain data. Results: After taking interviews, they collect results as the ages of people suffering from diabetes was between 55-65 years. Patients suffering with type 2 diabetes were about 390 and people who suffers with type 1 diabetes was 80. Glucose in the blood was about 9.03 moll/l. Conclusion: If patients are suffering from type 2 diabetes, they should have proper self-awareness, effectiveness of their treatment, self-efficiency etc. Keywords: Diabetes mellitus, self efficiency, effectiveness, DSM, Type 2 diabetes.

Aim: To investigate the correlation between capillary blood oxygen saturation and Computerized tomography (CT) severity index in patients with Covid-19 pneumonia. Study design: A cross sectional study design Setting & duration: Ibne-sina hospital Multan Medical & Dental College Multan, from 1st June 2020 to 1st June 2021 Methods: A cross-sectional analytical study was conducted at the COVID-19 ward of Ibne-sina hospital Multan Medical & Dental College Multan for 1 year. At the time of admission, all capillary oxygen saturation of all the included patients was measured. Pulmonary CT scans were then performed on these patients and CT severity index was calculated. SPSS was used for data analysis. Results: A total of 170 Covid-19 infected patients were included in the study. At the time of admission, the mean oxygen saturation was found to be 88.9%±6.53%. Whereas, the mean severity index was15.01±7.79. 22 patients had hypoxia when presented in hospital and a significantly high iCT severity index was found in these patients (p=0.001). Chronic obstructive pulmonary disease (COPD), hypertension, and diabetes were significantly related to reduced blood oxygen saturation (p

Antibiotics have played a crucial role in the treatment of bacterial infections. Past few decades are marked with advancement of multidrug resistant (MDR) pathogens, which have endangered antibiotic’s therapeutic efficacy. Scientific world is now struggling with the crisis of MDR pathogens. This supreme matter demands careful attention or otherwise it would jeopardize clinical management of infectious diseases. Implication of alternative approaches can pave a new way in the treatment of these troublesome bacteria. Tea leaves are known to pose antibacterial activity against many pathogenic microorganisms. This review has summarized the antibacterial potential of tea leave’s extracts against resistant bacterial pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa, Helicobacter pylori, Escherichia coli, Klebsiella pneumonia, Salmonella typhi, Acenitobacter spp, Campylobacter spp. Consumption of natural products such as tea may very well replace, minimize or obliterate this complicated situation. Keywords: Anti-bacterial, Tea, Camellia sinensis, Drug resistant bacteria, Antibiotic resistant bacteria, Synergism, Polyphenols.

Quality refers to the extent of superiority or excellence of something when compared with other things of similar characteristics1. During this era of quality enhancement, more and more emphasis is now being given to raise the standards of providing quality services in health care1. One possible way of ascertaining high quality service provision is by “measuring” the quality of services being provided, as this will help to identify either good or bad providers of services that is the health care practitioners2. This has gained much importance globally and a lot of work has been done by the researchers and stakeholders to measure and to standardize the quality of health care services2.

Background: According to World health organization anemia is most common among females during pregnancy and child birth. Maternal and fetal morbidity and mortality is high due to anemia in pregnancy as it is a contributing factor in poor pregnancy outcome. It is the main cause of maternal death, almost 29% of women die due to anemia in pregnancy. Half of the maternal mortality causes are related to anemia in pregnancy either directly or indirectly. What so ever is the cause of anemia in pregnancy, its management is important for mother and child health. The consequences of anemia have serious health implications especially among pregnant females. Methodology: The cross-sectional study was conducted to find prevalence of anemia during first, second and third trimester of pregnancy and factors related to cause of anemia. A total of 340 pregnant females of government and private hospitals of Lahore city during the period from February 2017 to August 2018 were included in study after sample size calculation through convenient sampling. Sociodemographic, economic status, education level, number of children born to females and gestational period were the factors that were studied among anemic pregnant females. Data analysis was done and frequencies of continuous variables and descriptive analysis for categorical variables were determined. Prevalence of anemia was determined by multinomial logistic regression. Results: Our study showed females were with mean age 27.9 (±SD=5.4) and in age group 31-39 years (53.8%) were more anemic during pregnancy as compared to females 3. Sociodemographic factors, education level, number of children born to female, economic status all were significantly associated with moderate anemia during pregnancy (p=0.00). Conclusion: Our study showed that although the prevalence of anemia is more among pregnant females but the severe anemia was less. So, it is a preventable health problem which can be controlled by different public health approaches to reduce the burden of disease on the health system. The strategies to control anemia in reproductive age women is important to prevent it among pregnant women. the early diagnosis and immediate correction of anemia is important to reduce the complications of pregnancy and its poor outcome. Early identification of factors is significantly important in managing the problem. Keywords: anemia, pregnancy, prevalence of anemia, gestational period.

Objective: To determine the soft tissue lip profile with Steiner (S) and Ricketts (E) lip analysis in patients with skeletal and dental class i occlusion at LUMHS Methodology: This descriptive study was done at department of Orthodontic, Liaquat University of medical and health sciences Jamshoro/Hyderabad, from august 2014 to august 2015. Individuals having age range of 18–30 years with dental and skeletal occlusion class I, competent lips involving facial profile, without history of preceding orthodontic treatment, mal and crowded aligned teeth and either of gender were included. To evaluate hard soft and tissue lip profile, the cephalometric analysis was done using radiographs, traced manually on matte acetate sheets with thicknesses of 0.003, measurements of 8x10 under direct inspection on an illuminator. SPSS version 26 was used for data analyzed. Results: A total of 100 patients were enrolled in the study their average age was 22±1.2 years. Males were 41% and females were 59%. The overall average of SNA angle was 81.866±1.199 and average of SNB angle was 80.667 ±1.27. Average of ANB angle, S line to upper lip, S line to the lower lip and E line to upper lip were 1.167 ±1.028, 1.067 ±1.006 mm, 1.917±1.369 mm, and 3.2±1.96 mm, respectively, while average of lower lip was 2.80+2.83. Conclusion: In terms of soft tissue lip profile with Ricketts (E) and Steiner (S) lip analysis among patients with dental and skeletal occlusion class I, the Antero-posterior position of lower and upper lip regarding E-line was 2.80 +2.83mm and 3.2+1.96 mm, respectively, and Antero-posterior position of lower and upper lip regarding S-line was 2.16+1.34mm and 1.30+1.019 mm, respectively. According to gender, there was statistically no significant variance. Keywords: Lip profile, skeletal, dental, occlusion class I

Aim: To investigate the etiology, gender distribution and presenting complaints associated with zygomatic fractures Method: This cross sectional study was done in Oral and Maxillofacial Surgery Department of King Edward Medical University from April to D3ecember 2019. Patient data was collected from OPD and analysed with SPSS. Results: We analyzed the data of 162 patients with zygomatic bone fracture. Out of this 148 were male and 14 were females. There were bilateral cases, more affecting right side of face and affecting left side of face. The most common etiology was road traffic accident followed by interpersonal violence and occupational injuries. When we consider presenting complaints 87 patients came with difficulty in chewing, 45 with limited mouth opening, 23 with depressed malar eminence and only 7 patients with nerve paraesthesia. Conclusion: Considering the geographic and cultural indices of the evaluated population, it can be concluded that the patients gender and trauma causes significantly affect the prevalence of zygomatic bone fracture Keywords: Zygomatic bone, nerve paraesthesia, limited mouth opening

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.

Objective: The purpose of this research is to see how coronavirus affects people with cirrhosis, a type of chronic liver disease. Study Design: Retrospective/observational Place and Duration: Conducted at Khyber Teaching Hospital Peshawar, during from April 2021 to Oct 2021. Methodology: This study included 100 covid-19 individuals of both genders with or without chronic liver disease. There were two groups of patients. Group I (50 patients with cirrhosis) and Group II (without cirrhosis 50 patients). The mortality outcomes of the two groups were compared. SPSS 25.0 was used to analyze all of the data. Results: There were 31 (62%) males and 19 (38%) were females with mean age 43.31±=7.61 years in group I while in group II 32 (64%) and 18 (36%) patients were males and females with mean age 46.01±5.23 years. Patients with cirrhosis died at a higher rate than those without it, with a p-value of 0.0001 (34 percent vs. 10%). Conclusion: Patients with cirrhosis who also had coronavirus illness had a higher incidence of poor outcomes. Keywords: Mortality, Corvid-19, Chronic Liver Disease

Aim: To evaluate the association of hepatitis with the hepatocellular carcinoma. Hepatitis is known as the inflammation of the liver. Methods: Hepatitis C and B may lead to HCC (hepatocellular carcinoma), such as Hepatitis B may cause 50% and hepatitis C is responsible for 70 to 80 % of cases of HCC. Obesity, alcohol and type 2 diabetes are also a predisposing factor for HCC. HCC is the malignant tumor, and have a low survival rate due to reoccurrence. Results: Eighty two patients were selected with hepatitis and HCC. This cross-sectional study was conducted at Allied Hospital Faisalabad. Ultrasound machine of Toshiba was used with a transducer of frequency 3-6MHz for the liver scanning. 82 patients with hepatitis B, C, and HCC were included in this study. Out of 82 patients, 55 were male and 27 were female. The mean age was 55yrs. Group A 45 (54%) patients were infected with hepatitis C and Group B 35(42%) patients were infected with hepatitis B. Hepatitis C is the most common cause of HCC as compared to hepatitis B. Conclusion: In this study, it is concluded that there is a positive association between hepatitis and Hepatocellular Carcinoma. The patient infected with hepatitis C is more prone to develop HCC than those infected with hepatitis B. Keywords: HCC (hepatocellular carcinoma), Hepatitis B, C, lesion.

Aim: The goal of this study is to find out how common vitamin D deficiency is in patients with corona virus disease and what the consequences are. Study Design: Observational /Prospective Place and Duration: Institute of Basic medical sciences, Khyber Medical University (KMU), Jan 2021-Oct 2021. Materials & Methods: This study included 120 patients of both genders who had been diagnosed with covid-19. Patients ranged in age from 15 to 75 years. After receiving written agreement, demographically detailed such as age, sex, and BMI were recorded. All of the patients had a 5 mL blood sample obtained to check their vitamin D levels. 25(OH)D < 25 nmol/L (10 ng/dL) was considered severe Vitamin D insufficiency. The prevalence of vitamin D insufficiency as well as negative effects were investigated. SPSS 23.0 was used to analyse the data. Results: The mean age of the 120 patients was 40.11±8.64 years, with 68 (56.7%) males and 52 (43.3%) females. There were 52 patients (43.3%) with severe vitamin D insufficiency. There were 17 deaths of the total number of patients in the study. Vitamin D deficiency was associated with a higher mortality rate in patients with covid-19 disease than in those who had normal levels of vitamin D, a finding that was statistically significant at the 0.05 level. Conclusion: It was found that severe deficiency of vitamin D and death in individuals with covid-19 illness had a strong association. Keywords: Mortality, Vitamin D Deficiency, Covid-19