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Background: Acute food bolus impaction is an emergency causing absolute dysphagia and is managed surgically by endoscopic removal. However certain conservative measures have been reported to serve the purpose and relieve the impaction. Objective: To assess the efficacy of conservative (non pharmacological/pharmacological) management of acute esophageal food bolus impaction before proceeding to definitive endoscopic treatment. Study design: Hospital based cross sectional Place and duration of study: Departments of Otorhinolaryngology Nishtar Medical University, Multan and Bahawal Victoria Hospital, Bahawalpur, from 1st January, 2022 to 30th June, 2022. Material and Methods: A total of 45 patients with confirmed food bolus impaction were included in the study after informed verbal consent of the participants. Conservative management was initiated before endoscopy. Endoscopy was performed in all the patients who were fit for general anesthesia. Age, gender, effects of non-pharmacological (carbonated beverages), pharmacological (calcium channel blockers, nitrates) agents and endoscopic procedure with associated pathology were documented. Data was put in SPSS 23 and analyzed. Mean, standard deviation and range were calculated for age. Percentages were calculated for gender, pharmacological and non-pharmacological agents, endoscopic procedure and underlying pathology. Results: Carbonated beverages (Cola drink), Calcium channel blocker (Nifedipine) and nitrate (Isosorbide dinitrate) could be given to 37.8%, 17.8%, 20% patients respectively with success rate in 35.2% (12) patients. With endoscopy food bolus was pulled with polypectomy snares, dormia basket, retrieval forceps and roth net in 18.1% (6), 24.2% (8), 27.2% (9), 9% (3) patients respectively. Food bolus was pushed intact into the stomach in 6% (2) patients and pushed after the fragmentation in 15.1% (5) patients. Schatzki ring, esophageal stricture, achalasia and hiatal hernia were present in 8.9% (4), 28.9% (13), 15.5% (7) and 20% (9) patients respectively. Conclusion: Acute food bolus impaction can be treated conservatively with non pharmacological/pharmacological agents in certain cases before doing definitive endoscopic relieve of the obstruction. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of the information seminar on breast cancer awareness among the medical and nursing students of CMH institute of Medical Sciences (CIMS) Multan Pakistan. Study Design: Prospective Comparative Study. Place and Duration of Study: One-day seminar at CMH Institute of Medical Sciences (CIMS) Multan Pakistan. Methodology: A one-day seminar on breast cancer awareness was arranged at CMH Institute of Medical Sciences Multan Pakistan for 3rd and 4th-year MBBS and 3rd-year BSc Nursing students. A total of 137 participants were recruited. Participants were selected by non-probability consecutive sampling. A validated 13-question questionnaire was designed to assess participants' basic knowledge of breast cancer and breast self-examination (BSE). Results: The mean age of participants was 21.27±0.99 years. 30(21.9%) were males and 107(78.1%) were female students. Before the seminar, approximately half of the students were correct about the demographics and presentation of breast cancer which increased to more than 80% in all avenues post-seminar (p<0.001). The most significant improvement was the correct responses regarding the age at which BSE should begin. Its frequency and correct technique pre-seminar were 75(54.7%), 51(37.2%) and 23(16.8%), which in post-seminar were 98(71.5%), 106(77.4%) and 75(54.7%) respectively (p<0.001). Conclusion: This one-day educational seminar played a significant role in increasing awareness among medical and nursing students. [ABSTRACT FROM AUTHOR]

Climate change is a severe threat for productivity of sugarcane crop. Crop models have potential to quantify the climate change impacts, and management practices effects on development and productivity of sugarcane crop. These models provide simulations as a result of interaction between genotype, management, and environment. The current study was conducted with the objectives to (1) calibration, evaluation and application of CSM-CANEGRO-Sugarcane model (2) climate change assessment and make adaptation strategies for industrial (spring and autumn crops) and non-industrial (summer crop) sugarcane. Two field experiments regarding industrial sugarcane were carried out at Multan during 2013–2014 and 2014–2015 and two field experiments regarding ponda chewing sugarcane (non-industrial, thick, soft and juicier sugarcane) at Vehari during 2017 and 2018. Calibration and evaluation of CSM-CANEGRO-Sugarcane model showed that all model statistical parameters were obtained under acceptable range. Model sensitivity was also evaluated against Carbon, Temperature and Water analysis for both sites. Results revealed that average temperature is increased almost 0.94 °C during baseline weather data (1980–2018), while according to different climate projections by Global Climate Models (GCMs), average temperature 3–5 °C can be increase during mid-century. So, without adaptation strategies, fresh cane yield will be decreased ranging from 15.31 to 22.57% at different GCMs during mid-century (2039–2069). Adaptation strategies; like 18–25 days earlier planting, increasing 15% N application quantity and increasing frequency of irrigation and growing heat tolerant and more growing degree days requiring varieties can compensate the negative impact of climate change in future scenario. [ABSTRACT FROM AUTHOR]

Objective: To identify the stage of Hepatocellular Carcinoma (HCC) at the time of presentation. Methods: This cross sectional observational prospective study was carried out at Gastro Department of Combined Military Hospital (CMH) Multan from August 2017 to December 2018. Patients were diagnosed on the basis of alpha fetoprotein, abdominal ultrasound, triphasic contrast enhanced computerized tomography (CECT). They were evaluated for etiology including Hepatitis B, C and non B & C. The patients were inquired about the previous treatment and when they came to know about the HCC. Staging of the tumor was done on the basis BCLC (Barcelona cancer liver clinic) and Melan's criteria. Performance status (PS) of the patient was checked by Eastern Cooperative Oncology Group (ECOG) criteria. Severity of cirrhosis was assessed by CTP (Child Turcotte Pugh) and Model for end stage liver disease (MELD) score. The data was analyzed in IBM SPSS version 22. Results: Out of 135 patients 78% were males and 22% females. Age Mean SD was 58.81± 9.366. Frequency of hepatitis C, B, combined B, C and non-B non-C was 80%, 11%, 2.8% and 6.2% respectively. 96(73.8%) never got the treatment before for Hepatitis. 81(62.3%) came to know first time on this index admission. Maximum numbers of patients were in BCLC stage B i.e. 82(55.2%) with ECOG grade of one i.e.57 (39.3%), at the time of presentation. Mean MELD and CTP score were 12.24, 7.34 (class B) respectively. Conclusion: HCV was the most common in HCC, never treated before, presented for the first time in advance stage of the disease where very limited treatment options left behind. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of the information seminar on breast cancer awareness among the medical and nursing students of CMH institute of Medical Sciences (CIMS) Multan Pakistan. Study Design: Prospective Comparative Study. Place and Duration of Study: One-day seminar at CMH Institute of Medical Sciences (CIMS) Multan Pakistan. Methodology: A one-day seminar on breast cancer awareness was arranged at CMH Institute of Medical Sciences Multan Pakistan for 3rd and 4th-year MBBS and 3rd-year BSc Nursing students. A total of 137 participants were recruited. Participants were selected by non-probability consecutive sampling. A validated 13-question questionnaire was designed to assess participants' basic knowledge of breast cancer and breast self-examination (BSE). Results: The mean age of participants was 21.27±0.99 years. 30(21.9%) were males and 107(78.1%) were female students. Before the seminar, approximately half of the students were correct about the demographics and presentation of breast cancer which increased to more than 80% in all avenues post-seminar (p<0.001). The most significant improvement was the correct responses regarding the age at which BSE should begin. Its frequency and correct technique pre-seminar were 75(54.7%), 51(37.2%) and 23(16.8%), which in post-seminar were 98(71.5%), 106(77.4%) and 75(54.7%) respectively (p<0.001). Conclusion: This one-day educational seminar played a significant role in increasing awareness among medical and nursing students. [ABSTRACT FROM AUTHOR]

This study aims to explore the historical background and current state of affairs regarding all aspects of "Public Library Bagh-Langey Khan, Multan". This library was started as a reading room by the Multan Book Society in 1850 to provide reading space for to the general public in 1886. Name of this reading room was changed into "Public Library Bagh-Langey Khan" and got registered under Public societies' act 1860. The library possesses a rich collection of 55,000 titles including more than 200 manuscripts and a number of rare books. It is a symbol of educational and cultural heritage of ancient city of Multan. For the purpose of collecting the data the interview technique was utilized in order to explore the issues, problems, challenges and opportunities for future development. On the basis of SWOT (strength, weakness, opportunities, threats) analysis the study attempted to identify the problems, challenges and prospects and provides the suggestions to promote the usage and to improve its image in the community. It is hoped that would help in creating awareness about the need of reviving the role of public libraries in accordance with the requirements of 21st century. [ABSTRACT FROM AUTHOR]