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The increasing occurrence of maternal hydronephrosis is causing concern across the world. Hydronephrosis during pregnancy is graded by using sonographic techniques. Objective: On ultrasonography, determine the consistency of maternal hydronephrosis during the second and third trimesters of pregnancy. Methods: A descriptive study was done at the Gilani Ultrasound center. There were following variables; trimesters, a baby's weight and three grades of hydronephrosis (Mild, Moderate and Severe). The data was collected based on these variables (Right, left). Pregnant women with kidney disease and without kidney disease were preferred. Pregnant women of all ages who are in their second and third trimesters of pregnancy are included in this study. Pregnant women in their first trimester and people with kidney problems were not included in the study. Toshiba and XARIO ultrasound machines and convex probe were used. SPSS version 21.0 was used to analyze the data. Results: With the standard deviation of 4.26, minimum 18.00, maximum 41.00 and mean of 6.85 out of 139 pregnant females were included according to age in this study.68 (48.9%) out of 139 were without hydronephrosis and 71 (51.1%) were with hydronephrosis.  Out        of        139 pregnant females 18 (25.4%) had moderate hydronephrosis, 53 (74.6%) had mild hydronephrosis. According to laterality 2 (2.8%) pregnant   females had bilateral hydronephrosis 20 (28.2%) had left  sided hydronephrosis and 48 (67.6%) had right sided hydronephrosis. During 3rd trimester 44 (62.0%) and during 2nd trimester 27 (38.0%). According to fetal lie 11 (15.5%) were transverse and 60(84.5%) were longitudinal. According to fetal position 46 (64.8%) were cephalic and 25 (35.2%) were breech. Conclusion: According to the findings, hydronephrosis is more common in the third trimester than in the second trimester. Mild hydronephrosis is more common t

Diabetic and hypertensive patients are at increased risk of vascular complications. Carotid Doppler ultrasonography serves as a non-invasive gold standard technique/tool to access and monitor carotids hemodynamics and morphology. There is a need to predict difference in carotid artery hemodynamics among hypertensive and diabetic patients.Aim: Aim of this study is to find out the hemodynamics of carotid artery in diabetic and hypertensive patients. Method: Cross sectional study conducted at University Ultrasound Clinic Green Town. All patients were investigated with Toshiba Xario XG with 5-7.5MHz linear probe. Study included diabetic and hypertensive individuals, whereas patients with history of carotid endarterectomy, carotid stenting and co-morbidity were excluded. Total 200 participants were recruited, 41 were diabetic and hypertensive, while 159 were normal subjects. Statistical analysis was performed using SPSS version 21. Results: From 200 participants were recruited, out of them 41 patients with 20.5% were positive with diabetes and hypertension and 159 patients with 79.5% were negative with diabetes and hypertension. Right common carotid artery intima media thickness (IMT) mean ± S.D was 0.659±0.114mm with p-value (0.022). Left common carotid end diastolic velocity mean ± S.D was 16.719±6.303cm/s with p-value (0.002). Conclusion: The study highlighted that common carotid artery intima media thickness (IMT) and common carotid artery end diastolic velocity were significantly correlated with hypertension and diabetes. Our findings revealed that common carotid artery IMT and EDV were significant in hypertensive and diabetic patients. Indeed, hypertension and diabetes are mainly associated with vascular complications.

Pharmaceutical care related services provided by pharmacists in the community are mainly taking patients' medication history, informing patients about use of medications, informing patients about medication storage, and provide information about drug and/or food interaction. Objective: Toevaluate the knowledge about evidence based pharmaceutical care in medical and non-medicalpopulation of Lahore, Pakistan.Methods: A sample of 100 participants was drawn by using non-convenient sampling in this cross-sectional survey. Survey was conducted within the duration of 6 months from 2nd June, 2020 to 15th December, 2020. Data was collected from participants of different universities, societies and hospitals, having age between 25-40 years, both genders without discrimination of profession. Data was analyzed using SPSS version 21.0. Qualitative data was calculated using frequencies and percentages. Results: In this study 63% medical and 37% non-medical participants respond to questionnaire. About 34% of the population had knowledge about pharmaceutical care. Almost 23%had lack of knowledge about pharmaceutical care while 43%participants did not respond.Conclusions:The knowledge about pharmaceutical care in general community is very vital and pharmacist shouldprovide knowledge and pharmaceutical care services to the patients.

Hospital waste management (HWM) is extremely important and it is very different kind of waste that has high potential of spreading infection and diseases. There should be proper management of this waste, otherwise it can be hazardous Objective: The objective of the study is to evaluate the waste management practices at DHQ Hospital, Sheikhupura Methods: It was cross-sectional hospital-based study. The study was carried out at DHQ Hospital Sheikhupura. The sample size of the study was 169 including 94 waste handlers, 45 nurses and 30 doctors were included. Data was collected through questionnaire using non-probability convenient sampling technique, which was entered and statistically analyzed using SPSS 20.0. Results: Among 94 waste handlers, 30.8% were 21-30 years old, 64.9% males and 45.7% had up to 5 years’ work experience. 67.0% had been vaccinated, 87.2% confirmed that waste is segregated at source and100.0% waste handlers were provided with color bags for various types of hospital wastes. 92.6% stated that pre-treatment procedure is carried out before hospital waste disposal and 75.5% waste handlers were provided with protective gears. Among 45 nurses, 55.6% were 31-40 years old and 64.4% had up to five years’ work experience. 100.0% nurses ensured internal collection of waste bags & containers and their transportation to the central storage facility of hospital on the daily basis. 82.2% coordinated and monitored all the operations related to waste management and for this purpose regularly met with hospital waste management committee. 100.0% nurses recorded the waste quantities generated by the department on weekly basis. Among 30 doctors, 73.3% organized training activities for HWM staff on safe waste management procedures.

Acute Respiratory Distress Syndrome (ARDS) is an acute respiratory disease in which the respiratory activity of the lungs is compromised due to secretion of fluid in the alveoli of lungs and thus depriving the blood stream with optimal oxygen supply. Objective: To determine the effects of ankle pumping exercises on limb edema in critically ill patients with acute respiratory distress syndrome Methods: A sample of 67 patients was selected by using non-probability convenient sampling from different hospital settings. Ventilated patients or those having endotracheal tube, age between 40-65 years, and either gender were included in the study. Results:   The effect of Range of Motion (ROM) on ARDS patients was as high as 91 %. There were 61(91.0) responders who experienced edema reduced by ankle pumping 54(80.6) found prone position and 13(19.4) found supine position effective 53(79.1) having resonant sound and 14(20.9) with hyper stony dullness 24(35.8) person having added sound and 43(64.2) crepitus sound in this study. In this study, 20 out of 67 patients who were admitted to the intensive care unit (ICU) developed acute onset of severe dyspnea, hypoxemia, and cyanosis and decreased respiratory system compliance, despite supplemental oxygen and mechanical ventilation. Edema had been reduced by ankle pumping in 61 subjects. Conclusions:  Patients with ARDS report improvement in symptoms with physiotherapy treatment, ROM exercises had remarkable effects on such patients.

Musculoskeletal lower extremity pain constitutes one of the main professional hazards among construction workers. Because laborers require heavy lifting, repetitive bending, twisting, prolong standing and sitting in awkward position.Objective: To find out the prevalence of work related musculoskeletal disorders of lower extremity among construction workers. Method: A self administered questionnaire was undertaken to detect the occurrence of work related musculoskeletal disorders of lower extremity among 151 construction workers. Data was analyzed statistically by SPSS version 21.0.  Results:  Mean age of respondents was 31.13 years with only males. Hip pain prevalence was found to be 20 (13.2%), knee pain 25(16.6%) and ankle/foot pain 29(19.9%).There was significant association of lower extremity pain with age, type of occupation and p-value was less than (0.05). Conclusion: This study concluded that lower extremity musculoskeletal pain is very common among construction workers due to their nature of work.

Mechanicalneckpainisalsoreferredasnon-specificneckpain.Itmaydefineaspainwhich is aggravated by movement, relived by rest and that is not associated with serious underlying pathology.Among drivers, complaintsconcerningthemusculoskeletalsystemaremostfrequentlyreportedfromtheneck,shoulderand lower back. The driving sitting position is featured by non-neutral spinal postures, generally a reduction in neutrallumbarlordosisandanincreasedordecreasedneckflexion. Objective: To find out the association of neck pain and scapular position among auto drivers.Methods:  It was a cross sectional study. Data was collected by 160 auto drivers on basis of inclusion and exclusion criteria. VAS was used for pain intensity and distance between scapula and spinous process was measured by Vernier caliper. Data was entered and analyzed using IBM SPSS version 21.0. Descriptive statistics was given in form of mean and standard deviation.Result:  The results of current study showed that the mean value of scapular protraction of right side when hands at rest was 6.96, when hands on hip was 7.56 and when 90 degree glenohumeral abduction with internal rotation was 7.19. For visual analog scale scoring for right side when hands at rest the mean score was 5.84 and when hands on hip it was 6.84, and when 90o degree abduction the score was 6.44. When we discuss about the scapular protraction for the left side when hands were at rest the mean value was 6.87 and when hands on hip it was 7.53 and 90o glenohumeral abduction with internal rotation was 7.5. Similarly, VAS scoring for left side hands at rest is 5.61, for hands on hip was 6.65 and 90pglenohumeral abduction.Conclusions:This study explains that there is significant difference on hand in different of three positions in drivers who worked for long hours in abnormal posture. Scapular protraction is high when hand placed at hip, also a VAS for neck pain is high in both right and left side