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Drought stress adversely affects crop growth and yield. Water availability at critical crop growth stages reduces water losses and improves water use efficiency and yield of a crop. Potassium is a major plant nutrient required in large quantity by crops and has a significant role in increasing crop growth and yield by reducing the adverse effects of drought stress. Although a large quantity of potassium can be found in soil but is mostly in an unavailable form. A field experiment was, therefore established at Agronomy Research Farm the University of Agriculture Peshawar-KP to evaluate the response of maize toward different K levels under varied irrigation frequencies, during Autumn, 2015. Randomized complete block design with split plot arrangement was used with a subplot size of 3m × 2m. Treatments consisted of six irrigation frequencies; I0 (no irrigation), I1 (irrigation at V1 stage), I2 (two irrigations; each at V1 and V7 stage), I3 (three irrigations; each at V1, V7 and VT stage), I4 (four irrigations; each at V1, V7, RT and R2 stage) and I5 (five irrigations; each at V1, V7, RT, R2 and R4 stage) allocated to main plot and five levels of potassium (0, 25, 50, 75 and 100 kg ha-1) assigned to subplots. Results exhibited significant effects of irrigation frequencies and K levels on crop growth, yield and yield components. Increasing irrigation numbers substantially increased yield of maize crop and taller plants with higher number of grains ear-1, 1000-grain weight, biological and grain yield, and harvest index were observed in plots irrigated five times. Likewise, 75 kg K ha-1 application resulted in higher biological (plant height and biological yield) and grain yield (grains ear-1, thousand grains weight, grain yield and harvest index) components of maize. Increase in K levels beyond 75kg ha-1 showed a slight decrease in yield. It is concluded that water stress at each critical crop growth stage can drastically reduce crop yield, therefore, five times irrigation each at (mentioned) crop growth stage along with 75 kg ha-1 K is recommended for higher maize production. [ABSTRACT FROM AUTHOR]

Organic manures if properly incorporated in soil with suitable tillage implement might better enhance grain yield and soil fertility. To investigate the influence of tillage systems and nitrogen (N) sources incorporation on soil physical properties, total N and maize productivity, a field experiment was conducted at Agronomy Research Farm, The University of Agriculture Peshawar during summer 2016. The design used was randomized complete block design with split plot arrangement having four replications. Tillage implements (mould board plough, rotavator, disk harrow and cultivator) were used as main plot factor and N sources (control, cattle manure, poultry manure, sheep manure, mushroom spent, mungbean residue and urea) as subplot. The results exhibited that, improved bulk density, grain yield, harvest index and soil total N (STN) were observed when N incorporated with MB plough. In case of N sources poultry manure, sheep manure and mushroom spent gave at par yield with urea. However, STN and other soil physical properties were significantly higher in organic fertilizer applied plots compared to urea treatments. Conclusively, urea incorporated with cultivator gives higher yield but organic sources incorporated with MB plough could be better alternate for urea to improve maize productivity on sustainable basis. [ABSTRACT FROM AUTHOR]

Objective: To find out the diagnostic accuracy of levels of plasma lactate in neonatal birth asphyxia by taking pH as gold standard. Study Design: Cross sectional validation study. Place and Duration of Study: The study was conducted at Paediatrics Department, Pak Emirates Military Hospital Rawalpindi, from May to Nov 2013. Material and Methods: Two Hundred and forty neonates were selected through non-probability purposive sampling after informed consent from parents by inclusion and exclusion criteria. The sample size was calculated by WHO calculator. The plasma lactate and pH of the neonates were taken within first six hours of delivery of child. The samples were sent in heparinized containers along with ice packs and were stored at 0°C to -2°C. Results: Gestational age of 52.5% (n=126) neonates was between 34-37 weeks while 47.5% (n=114) was between 38-40 weeks with a mean of 37.75 ± 2.91 weeks. Gender distribution among neonates showed that 58.75% (n=141) male and 41.25% (n=99) females. The diagnostic accuracy of plasma lactate in neonatal birth asphyxia by taking pH as gold standard showed 194 (80.83%) true positive, 7 (2.92%) false positive, 31 (12.92%) true negative and 8 (3.33%) were false negative. The test has sensitivity = 96.04%, specificity = 81.58%, positive predictive value= 96.52%, negative predictive value = 81.58% and accuracy of 93.75%. Conclusion: There was a higher diagnostic accuracy of plasma lactate by taking pH as gold standard for the diagnosis of neonatal birth asphyxia. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of hyperuricemia in patients with thyroid dysfunction. Study Design: Cross-sectional descriptive study. Place and Duration of Study: Department of Chemical Pathology, Army Medical College Rawalpindi, National University of Sciences & Technology (NUST) Islamabad and Military Hospital (MH) Rawalpindi, from Apr 2013 to Jun 2014. Material and Methods: Fifty five individuals with thyroid dysfunction were included in this study. Detailed history was recorded on a questionnaire, blood samples were collected and serum total tri-iodothyronine (T3), free thyroxine (T4), thyroid stimulating hormone (TSH) and uric acid levels were measured. Results: Among the fifty five participants, 16 (29.1%) were male while 39 (70.9%) were females. Mean age of the subjects was 45.49 ± 16.7 years in this study. Hyperuricemia was observed in seventeen (30.9%) individuals with thyroid dysfunction. Mean serum uric acid level was found to be 418.3 ± 147 μmol/l in participants. Conclusion: High frequency of hyperuricemia occurs in patients with thyroid dysfunction. Therefore in patients presenting with thyroid dysfunction, evaluation of underlying hyperuricemia should be considered by the clinicians. [ABSTRACT FROM AUTHOR]

Objective: To determine the status of thyroid functions in patients of β Thalassemia Major, reporting to OPD of Military Hospital, Rawalpindi. Study Design: Descriptive cross sectional study. Place and Duration of Study: Paediatric Outpatients Department of Military Hospital, Rawalpindi from 1st Jan to 30th Jun 2012. Material and Methods: After taking informed consent from the parents of all the children fulfilling the inclusion criteria, detailed history was taken and blood samples were drawn by strict aseptic means. Samples taken from these patients included complete blood and thyroid profile (serum thyroxine T4, triiodothyronine T3 and thyroid stimulating hormone TSH). These blood samples were labeled and sent to Armed Forces Institute of Pathology (AFIP), Rawalpindi for analysis by enzyme-linked immunosorbent assay (ELISA). Primary hypothyroidism was defined by TSH levels >4IU/ml. Statistical analysis was done at the end of study using SPSS version 10. Significance for association was calculated using student t-test. Results: Sixty patients fulfilled the inclusion criteria out of these sixty four patients lost the follow up while 56 patients completed the study. Out of 56 patients, 21 (37.5%) had biochemical evidence of hypothyroidism. Mean Ferritin level was 3924 ± 1247ng/ml in hypothyroid and 3136 ± 1387ng/ml in euthyroid patients indicating a significant difference in mean serum ferritin levels between hypothyroid patients and others. Conclusion: The study demonstrates hypothyroidism in a significant number of hyper transfused β-thalassemic patients, emphasizing the importance of monitoring thyroid functions in thalassemic patients, particularly in those receiving suboptimal chelation. [ABSTRACT FROM AUTHOR]

Objective: To describe the perceptions & behaviors of undergraduate medical students regarding the use of internet. Study design: Cross-sectional descriptive study. Place and Duration of Study: Army Medical College, National University of Medical Sciences (NUMS) Rawalpindi, from January 2014 to June 2014. Methodology: Data had been obtained from volunteer undergraduate medical students who were computer literate and were using the internet facility in their daily routine. Students, who did not have the computer and internet using skills and were not using the internet services, were excluded from this study. A structured questionnaire was used which included following items: duration and frequency of internet use, impact of internet use on academic grades, influence of internet usage on relationships with friends and family, effect of overuse on sleep cycle and having the self-knowledge of being internet addicted. Results: Two hundred and twelve students gave consent to participate in this study. Different perceptions of undergraduate medical students regarding the internet use were observed: 64 (30.2%) students spent about two hours daily in internet surfing and 79 (37.3%) participants in our study utilized internet facility for social networking while 67 (31.6%) used it for educational and learning purposes. A total of 147 (69.3%) participants reported that internet use enhanced their learning and had a positive effect on their academic grades. Conclusion: Our study concludes that internet-using skill is a very powerful tool in today's world with regards to academic learning. With appropriate guidance and support, students can get maximum benefit from this facility and can enhance their learning capabilities. Institutes should play their role by making every student computer literate and also by making on-campus advisory services available to figure out internet abuse related issues of the students. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of place of birth, mode of transport and medical skills of the accompanying person on mortality of neonates. Study Design: A descriptive study. Place and Duration of Study: Military Hospital (MH), Rawalpindi from October 2011 to March 2012. Patients and Method: One thousand two hundred and ninety three neonates of either gender under the age of 28 days admitted to NICU either as indoor or outdoor were entered in the study. Data included high risk obstetric factors, gestational age, birth weight, APGAR score, gender, need for resuscitation, diagnosis, complications, place of delivery, mode of delivery and outcome. The associations between the place of delivery, mode of delivery and medical skills of the accompanying person with the neonatal mortality were associated using the Pearson Chi-Square method. Results: A total of 1293 neonates were included in the study and their data regarding place of delivery and mode of transport was evaluated. Four hundred and two (402/1293) cases died in our NICU and the mortality rate of the neonates admitted in our setup was 31.1%. The breakup of neonatal deaths was further subdivided into the patients born in health care with NICU facility (25%), those born in health care without NICU facility (33.60%) and those born in the community setting (40.54%). The aforementioned percentages were calculated out of the total live births in that particular setup and do not represent mere breakup of total mortality. A total of 50.32 % neonates brought to hospital in an unequipped vehicle expired versus 2.28% mortality of neonates that were brought in a medically equipped vehicle. The neonatal mortality rate in patients accompanied by unskilled personnel was 40% versus skilled personnel which was 1.62%. Statistically significant associations using Pearson Chi-Square method were seen between the place of delivery, mode of transport, the skills of the person accompanying the patient in the transport and neonatal mortality (p value = 0.001 each). Conclusion: Results of this study prove that the quality of birth services and patient transport mechanisms directly affect the neonatal survival and babies who are born in community setting, transported in unequipped vehicle without a skilled medical attendant are at a higher risk for mortality than the patients born in NICU facility, transported in an equipped vehicle and accompanied by skilled medical attendant. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to identify the quality of statistical procedures used, the accuracy of study design, sampling and relevant statistical analysis Study Design: Retrospective Survey study. Place and Duration of Study: Army Medical College from June 2014 to Jan 2015. Methodology: Three hundred and forty two original research articles published in Pakistan Armed Forces Medical Journal were reviewed. The selected research articles were all original articles. Case series and case reports were excluded. Results: Among 342 articles, the major error was that the objectives, results and conclusion were not in accordance with each other in 115 (33.6%) articles. In 48 (14%) articles study design was incorrect and does not matched with the objectives. In 26 (7.6%) articles sample size was not appropriate as per the guidelines of journal. In 12 (3.5%) articles sampling technique used for sample selection was not mentioned. In 62 (18.1%) articles type of variables was incorrectly defined. In 6 (1.8%) articles descriptive statistics were not given at all. In 13 (3.8%) articles inferential statistics were not given articles. In 60 (17.5%) articles figures and tables were either not given or if given were incorrect. The pattern of statistical errors was almost similar in different years with a little bit difference but that difference could not attained any statistical significance (p = 0.460). Conclusion: In order to maintain the standards of the medical writing in research with authentication the teaching of statistical methods should be enhanced. [ABSTRACT FROM AUTHOR]

Objectives: To assess the post graduate students' perception of various aspects of the learning and educational environment at Army Medical College, Rawalpindi. Study Design: A descriptive study. Place and Duration of Study: Army Medical College, Rawalpindi from May 2014-July 2014. Participants and Methods: The modified Postgraduate Hospital Educational Environment Measure (PHEEM) a scored 34 item questionnaire was administered to evaluate various aspects of the learning environment. Three domains of the learning environment were covered with the help of PHEEM scores: perceptions of autonomy; perceptions of teaching; and perceptions of social support. Total and subscale scores were calculated according to Likert scale. Descriptive statistics were used to calculate mean SD. Analysis of variance (ANOVA) was used to compare scores between different departments. Results: Total 39 postgraduate trainees were included in the study. Average of total score came out to be 107, whereas for perception of teaching it was 45.57 (SD = 5.22, range: 43 -- 48), for social support it was 24.76 (SD = 3.76, range: 21 -- 27) and for perception of autonomy it was 36.84 (SD = 4.09, range: 33 - 39). The overall and subscale scores were also compared between post graduates of the different departments of the public sector medical colleges. The education climate was rated as more positive than negative determined by overall PHEEM scores. Conclusion: Army Medical College as an institution has a positive education environment. [ABSTRACT FROM AUTHOR]

Objective: To study the frequency of Helicobacter Pylori (HP) infection among children with recurrent abdominal pain (RAP) Study Design: Cross-sectional comparative study. Place and Duration of Study: Military Hospital (MH), Rawalpindi from December 2011 to February 2012. Patients and Methods: One hundred children of either gender aged 2 to 12 years presenting with RAP were tested for HP at Paediatric OPD MH, Rawalpindi who consented to participate in the study. Those children who tested positive for Helicobacter Pylori Stool Antigen Test (HPSAT) were labeled as those having Hp infection. The stool assay was performed using the HpSAT kit and the socio-demographic and clinical profiles of children were associated. Results: Out of 100 children included in the study HpSAT was positive in 38% children. Frequency of Hp infection was significantly associated with source of drinking water (p = 0.014), socioeconomic status (p = 0.001) and positive family history of dyspepsia (p= 0.023). While age and gender have no significant association with HP infection. Conclusion: Hp infection is very common in children presenting with RAP in our Paediatric OPD. Children with family history of dyspepsia, from low socioeconomic class and those drinking filtered water are at greater risk for HP infection. It is recommended that children from other populations in our country should also be tested in their medical health facilities in order to have a wider analysis of this problem in our setup. [ABSTRACT FROM AUTHOR]

Diphtheria is caused by Corynebacterium diphtheriae primarily affecting mucous membrane of upper airways. Global incidence of diphtheria has reduced due to worldwide immunization programs. Yet cases of diphtheria are reported across the world because of poor vaccine coverage, large population and low socio economic status. We report here a case of diphtheria in an 11-year-old girl who presented with fever, sore throat, difficulty in swallowing and hoarseness of voice for 3 days. Hematological analysis showed neutrophil leukocytosis with normal lymphocytes, CRP was raised, cardiac profile, renal function test, hepatic functions and chest x-ray were normal. Microscopy of throat swab revealed rods containing metachromatic granules on Albert stain. Intramuscular penicillin was started and diphtheria antioxin was administered. The child recovered uneventfully and was kept on follow up. [ABSTRACT FROM AUTHOR]

Objective: To document the undergraduate medical students' perceptions regarding the structured viva as an assessment tool. Study Design: Cross sectional. Place and Duration of Study: Army Medical College, National University of Sciences & Technology (NUST), Islamabad from April 2013 to April 2014. Subjects and Methods: Data was collected from fourth year students of a public sector medical college. A structured questionnaire was used to evaluate student's perception regarding relevancy of viva questions to syllabus, level of comfort while being assessed and provision of adequate time to answer, bias or harassment by the mentors, freedom to answer in their own learning styles. Results: One hundred seventy one, fourth year students gave consent to participate in this study. Almost all of the students were satisfied after being assessed in oral structured viva exam. The results obtained were: relevancy of questions to course: 169 (98%); comfortable environment of viva room: 165 (97%); appropriate time to answer the questions: 162 (94.7%), structured viva: 132 (94.7%); welcomed upon arrival for viva: 147(86%); encouraged by examiner: 144 (84%); facilitated to answer in their own learning style: 137(80%); covered all the topics: 120 (70%); demotivated during viva: 11(6.4%) and bias during viva: 14 (8.1%) Conclusion: There is substantial need of introducing innovations in the conventional exam strategies being practiced in our medical colleges. Introducing structured viva examination, making the exam environment comfortable and adapting an appreciative inquiry approach while assessing students can greatly help them to overcome exam stress. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequencies of comorbidities (dyslipidemias, diabetes mellitus, and hypertension) in patients with spinal cord injury (SCI) of duration > 1 year. Study Design: Case control. Place and Duration of Study: Spinal Cord Injury Department, Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi and Department of Chemical Pathology, Army Medical College, National University of Sciences and Technology (NUST), from October 2013 to March 2014. Patients and Methods: Thirty six patients with complete spinal cord injury (SCI), level C5 to T12 were included by non-probability, convenience sampling. Control group consisted of age and sex matched healthy individuals. A detailed medical history was obtained. Anthropometric measurements and blood pressure were recorded. Fasting blood samples were obtained and analyzed for plasma glucose and serum lipid profile. Results: Out of thirty six patients, 31 (86.1%) were male and 5 (13.9%) were females; their mean age was 36.6 ± 11 years. Mean duration of injury was 6.04 ± 3.35 years. Among cases, dyslipidemias were detected in 25 (69.4%) patients while 7 (19.4%) patients had diabetes mellitus. Whereas in control group, frequency of dyslipidemias and diabetes mellitus were significantly lower than cases i.e 13.8% and 5.5% respectively. Also no significant difference was found between blood pressures of study group when compared with control group. Conclusion: Individuals with chronic SCI had more frequent associated co-morbid conditions like dyslipidemias and diabetes mellitus than normal individuals. Early screening is recommended in patients having SCI >6 months for better patient care and reduction in long term comorbidities in such patients. [ABSTRACT FROM AUTHOR]

Objective: To document the perception of participants and the impact of faculty development and related educational workshops arranged in a public sector medical education setting. Place and Duration of Study: The departments of Medical Education (DME); Army Medical College and Armed Forces Post Graduate Medical Institute, Rawalpindi, Pakistan from 2013 to 2014. Study Design: A descriptive study. Subject and Methods: During 2013 to 2014, nine faculty educational workshops were arranged by the faculty members of the departments of Medical Education (DME), Army Medical College and Armed Forces Post Graduate Medical Institute, Rawalpindi, Pakistan. Both clinical and pre-clinical teaching faculty members attended the workshops. Proper consent was taken from each participant to document their perceptions for this study. Results: Two hundred and forty of the teaching faculty members of the Army Medical Corps participated in different proportion for the workshop arranged during a period of one year. At the end of each workshop a questionnaire was completed by each participant. The study addressed the perceptions of the participants regarding impact of workshop, the facilitator's knowledge about the workshop topic and his/her communication skills. The responses of the participants were documented for each question and the percentages were calculated. Conclusion: The planning efforts of professional development workshops by the departments of medical education at Army Medical College and Armed Forces Postgraduate Medical Institute resulted in a satisfactory implementation of the set objectives for faculty development. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of various etiologies of painless lower gastrointestinal bleeding (LGIB) in pediatric patients using colonoscopy. Study Design: Cross sectional descriptive study. Place and Duration of Study: This study was carried out at the department of Pediatrics, Military Hospital, Rawalpindi, from June 2010 to February 2012. Patients and Methods: A total of 80 patients (2-18 years of age) presenting with painless lower gastrointestinal bleeding were subjected to fiber-optic colonoscopy and findings were recorded. Data was analyzed with the help of SPSS version 10. Descriptive statistics were used to determine the mean ± SD of numerical data, e.g., for age. Categorical data like gender and colonoscopic findings were analyzed by their frequencies and percentages. Results: The study included 80 children out of which 53 were boys and 27 girls (male: female ratio was 1.96: 1). The majority of children, n=54 (67.5%) were between two and six years of age. The most common colonoscopic findings were polyps. In 47 (58.75%) patients, polyps were found in the colon and were resected. In 9 (11.25%) patients, gross appearance of colon was normal. Evidence of colitis was found in 17 (21.25%) patients. Patients with hemangiomas were 2 (2.5%). A total of 5 (6.25%) patients had non specific ulcerative lesions. Conclusion: Polyps of the colorectal area are the most common cause of rectal bleeding in children in our set up. Thorough physical examination which includes a digital rectal examination and colonoscopy leads to rapid and accurate diagnosis and appropriate therapeutic measures. [ABSTRACT FROM AUTHOR]

Objective: To determine the serum lipid profile in patients with traumatic spinal cord injury (SCI) of duration >1 year and to compare the serum HDL-c levels of SCI patients undergoing regular physiotherapy for >60 minutes daily with those who did not undergo physiotherapy. Study Design: Cross-sectional, comparative study. Place and Duration of Study: Spinal Cord Injury Department, AFIRM Rawalpindi and Department of Chemical Pathology, Army Medical College, Rawalpindi, from January 2013 to June 2013. Patients and Methods: Forty six patients suffering from traumatic spinal cord injury (SCI) were included. After recording the detailed medical history, fasting blood samples were obtained and analyzed for serum lipid profile. Dyslipidemias were assessed using guidelines from the National Cholesterol Education Project Adult Treatment Panel III (ATP III). Serum high-density lipoprotein cholesterol (HDL-c) < 0.9 mmol/l (40 mg/dl) was considered as low HDL-c level. Results: Out of total 46 patients, 33 (71.7%) were male and 13 (28.3%) were females with mean age of 34.9 ± 9.55 years. Low levels of serum HDL-c were found in 21 (45.7%) SCI patients (mean serum HDL-c levels: 0.97 ± 0.23). SCI patients were further categorized in two groups depending upon the status of regular physiotherapy. Statistically significant difference was found in mean serum HDL-c levels of 22 (47.82%) SCI patients undergoing regular physiotherapy as compared to 24 (52.18%) SCI patients who did not underwent physiotherapy (p < 0.05). Conclusion: Patients with SCI have decreased levels of serum HDL-c, imparting an increased risk of cardiovascular disease (CVD) in these disabled persons. SCI individuals following regular physiotherapy, have better serum HDL-c levels as compared to bed-ridden SCI patients, suggesting the physical activity as an important factor to elevate the serum HDL-c in such patients. Knowledge of relative risk of CVD in persons with SCI is important for appropriate interventional strategies, including planned physical activities or exercises and therapeutic intervention. [ABSTRACT FROM AUTHOR]

Objective: To determine the immunization status of children between 1-3 years of age, reported at children OPD; Military Hospital, Rawalpindi. Study Design: Descriptive cross sectional study. Place and Duration of Study: Paediatric outpatients department of Military Hospital, Rawalpindi from January to June 2010. Material and Methods: Vaccination data of 2200 children of 1-3 years of age coming to outpatients department, regarding seven EPI target diseases was collected using a standard proforma. Statistical analysis was done at the end of study using SPSS version 14.0. Results: Out of 2200 children, 1256 (57.1%) were completely immunized, 740 (33.6%) were partially immunized and 204 (9.3%) were unimmunized. Conclusions: This study concludes that immunization indicators have not met the expected benchmarks and achievements are inadequate as compared to the regional and global immunization level. [ABSTRACT FROM AUTHOR]

Objective: To document the perceptions and views of undergraduate medical students on why did they fail in their annual examinations. Study Design: Cross-sectional descriptive study. Place and Duration of Study: Army Medical College, National University of Sciences & Technology (NUST) Islamabad, Pakistan from March 2013 to March 2014. Participants and Methods: Data had been obtained from undergraduate students who failed at least once during their MBBS course and volunteered to participate in this study. Students who did not come across any academic failure during their MBBS course were excluded. A structured questionnaire was used which included following items: knowledge overload of failed or other subjects, poor time management for their studies, their own ineffective communication and expression skills (oral/ written), poor teaching skills of teachers/facilitators and boarding problems. Results: One hundred and seventy nine students gave consent to participate in this study. Factors leading to their failure and identified by students were: poor time management with regards to their studies: 81.6%, lack of revision time due to co-curricular activities: 73.7%, poor output in written assignments/assessments: 62.6%, knowledge overload of the failed-in subject: 47.5%, poor motivation to make serious efforts to understand and learn the subject: 57%. Conclusion: The reflections of medical students signify a variety of causes. It would be pertinent to organize strategies to rectify and address the basis of these expressed specific causes, especially those that had the highest impact towards the failure of these students. Such measures will help to rescue majority of these medical students and prevent them from failing in their examinations. Remedial steps when in place, shall also equip them with required skills to work on their weaknesses and turn them into strengths for their academic successes. [ABSTRACT FROM AUTHOR]

Objective: This study aims to determine the educational impact of premenstrual syndrome (PMS) on various academic activities of undergraduate female medical students. Study Design: Cross sectional study. Place and Duration of Study: Army Medical College, National University of Sciences & Technology (NUST), Islamabad, Pakistan from June 2013 to November 2013 Material and Methods: This cross sectional study was conducted at Army Medical College, National University of Sciences & Technology (NUST) Islamabad. Data were collected from 224 undergraduate female medical students of all professional years. PMS was diagnosed according to WHO's ICD-10 criteria. Impact of premenstrual syndrome on academic activities of female medical students was assessed using a 22-itemed, structured questionnaire. Results: Two hundred and twenty four female undergraduate medical students gave their written consent to participate in this study. PMS was present among 207 (92.4%) female students. Major PMS symptoms experienced by the female students were: backache (87.5%), fatigue (80.2%), depressed mood (78.2%), anxiety (76.8%), hypersomnia (71%) and poor emotional control (64.3%). The frequency of various PMS symptoms interfered with their academic activities (76.3%), with large group discussion sessions (79.2%), with small group discussion sessions (72.9%), written assessment (66.6%) and oral assessment (70.0%). Conclusion: The study findings affirm the fact that premenstrual syndrome profoundly affects the academic activities of young female medical students. In the light of these pertinent findings we recommend that health education and counselling services are essential to be provided at medical college campuses for female undergraduates. This will not only help them alleviate the negative effects of PMS but also develop an understanding about their problems, enhancing their academic output and performance in early medical carrier. [ABSTRACT FROM AUTHOR]

The article presents a case study on the diagnosis of aplasia cutis congenital (ACC), a skin disease characterized by the congenital absence of skin, in twin girls who had lesions on the vertex of their scalps. It mentions the causes of the skin disease such as ectodermal fusion failure and mutation of BMS1. It also mentions the treatment techniques which could be followed for the management of the skin disease.

The author reflects on β-thalassemia major, an autosomal recessive haemoglobinopathy that is one of common genetic disorders worldwide and is one of the major challenge in Pakistan. He says that β-thalassemia major is one of the major pediatric health challenge as children are dependent upon regular blood transfusion and chelation for survival. He discusses the developments in treatment for β-thalassemia major, such as the introduction of bone marrow transplantation (BMT).

A letter to the editor is presented in response to the column regarding the representation of College of Physicians and Surgeons Pakistan (CPSP) in the National Bioethics Committee, published in the January 15, 2014 issue.

A letter to the editor is presented in response to the interest group discussion held at the AEME conference hosted by the Fauji Foundation Medical College on March 7, 2015 which allowed the faculty and the panel members to identify the issues related to assessment in medical education.