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Chlorpyrifos is an endocrine disruptor pesticide that induces breast cancer cell proliferation through Estrogen receptor alpha pathway in humans. It also has toxic effects on some beneficial insects like bees, wasps, and arthropods, even low levels of CP can kill fish in water. Thus, it is important to efficiently remove this compound from wastewaters to get rid of its hazardous effects. Al2O3 supported ZnO.MoO3 composite was prepared as an efficient material for photo‐degradation of chlorpyrifos under UV irradiation and characterized by SEM‐EDX, XRD and TG techniques. The XRD analysis showed the orthorhombic structures with band gap of 2.86 eV for ZnO.MoO3/Al2O3 which was 2.96 eV for MoO3/Al2O3. The kinetics of degradation depicted that ZnO.MoO3/Al2O3 afforded a complete degradation of chlorpyrifos with half life of only 3 minutes which otherwise was 24 minutes in the presence of MoO3/Al2O3. The complete mineralization of chlorpyrifos was confirmed by GC/MS analysis, where no peaks of intermediates were recorded. The prepared material also exhibited good recyclability without any leaching of Zn and Mo metals. Thus, ZnO.MoO3/Al2O3 is an efficient and cost effective material for removal of chlorpyrifos. Its potential may also be explored for the removal of other hazardous organic pollutants. [ABSTRACT FROM AUTHOR]

BACKGROUND & OBJECTIVE: The world is facing a COVID-19 pandemic. The cure for the disease is yet to be established. This situation has created a severe stress-producing challenge for humankind. It has been reported in few studies that human health and adaptability are dependent on and are related to hope level. How this connection could help humanity to face the COVID-19 challenge was the main focus of the present work. METHODOLOGY: A library research was conducted to explore the individual potential to increase 'hope' and to evolve specialized instructions (tips) that could help to improve pandemic stress coping: It was convincing that increase in level of hope with due watchfulness is possible, that could contribute towards improving coping in the prevailing challenging, stressful situation. RESULTS: To exercise 'tips' to improve hope was found psychologically possible. It was also convincing that 'tips' by improving the 'hope' level would add to the surviving spirit and subsequent coping. CONCLUSION: Exercising'tips' would improve pandemic stress coping. [ABSTRACT FROM AUTHOR]

Objective To determine the efficacy of lactic acid peeling in the treatment of melasma. Methods This quasi- experimental study was carried out at department of Dermatology, Sir Ganga Ram Hospital, Lahore. A total number of 40 patients, with age ranging from 20-50 years were included in the study. All patients were female except 2. All patients underwent lactic acid peeling sessions at 3 weekly intervals for a total 6 sessions. The severity of melasma was assessed by MASI score. Efficacy was based on mean decrease in MASI score at baseline and MASI score three weeks after the completion of treatment. Results Mean of MASI scores of all these subjects at baseline was 12.62, and the mean MASI score recorded at the final follow-up was 6.30. Mean decrease in MASI scores was 6.32. Conclusion Lactic acid peeling is effective in the treatment of epidermal type of facial melasma in Asian skin. [ABSTRACT FROM AUTHOR]

Infectious diseases of the breast can demonstrate a wide variety of clinical presentations and imaging appearances. Breast abscesses are often a complication of infectious mastitis of the breast. Puerperal mastitis is the most common cause of breast abscess, typically affecting postpartum females. Often diagnosed clinically, it is usually treated with antibiotics without need for imaging. Non‐puerperal mastitis is relatively uncommon and typically subareolar in location. Patients can present with asymmetric breast thickening, a palpable lump, nipple discharge, or axillary adenopathy. These presentations can mimic malignancy. Herein, this pictorial review demonstrates imaging findings of common and uncommon infectious processes of the breast and clinically important mimickers of breast infection. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of present study is to investigate and explore the relationship between Perceived Stress and suicidal ideation of drug adcits MATERIAL AND METHOD: Sample of the study consisted of n=100 male addicts, aged 12-50 drawn from Department of Psychiatry and Behavioral Science, Madinah Teaching Hospital, Faisalabad. STUDY DESIGN: Co- sectional study design. PLACE AND DURATION OF STUDY: The sample was taken from MTH of Faisalabad. The duration of study was from 01-6-2015 to 31-10-2015. Inclusion and Exclusion criteria were followed to gather data for this study. Female drug addicts were excluding because female drug addicts were very rare in our society. Perceived stress scale and Suicide Probability Scale (SPS) were used for quantities analysis in the study. After getting data, result was tabulated and analyzed using SPSS version 20. The study result that is based on small sample can be generalized on large population which can build positive approach in people toward their future life RESULTS: In this study descriptive statistical tools were used to analyze the data. Results showed that Suicide probability scale and Perceived stress scale has significantly associated. CONCLUSION: Thus, it can be concluded from the above discussion that is positive relationship between Drug addiction and stress and stress and suicidal rick and stress. It also concludes that age, employment, education, marital status and no of children were strong factors that increase stress and suicidal risk due to addiction. [ABSTRACT FROM AUTHOR]

Kuwait Group aquifers and Dammam Formation are the two prominent aquifers, the wells tapping Dammam Formation and Dual completion wells are used for groundwater production. The current study investigates the spatiotemporal evolution of hydrochemical characteristics of the Shagaya water field utilizing long-term (1975–2019) hydrochemical data from 116 water wells. The Shagaya water well field has been differentiated into A to F sub-Fields. Mann-Kendall and Sen's Slope method along with spatial interpolation of change in TDS with time identified a significant decrease in TDS with time in the major portions of the Shagaya B, C, D, and E Fields. The study infers that 82% of wells extracting water from the Dammam Formation and 42% of Dual completion wells show a decrease in TDS concentration. The most plausible explanation for this phenomenon was the inflow of better-quality water from the up gradient parts of the Kuwait Group and the Dammam Formation aquifers due to the fall in the potentiometric head with high volume production in the well field. The results of ionic ratios (Na/Cl, Ca/Mg, Ca/SO 4 , Ca + Mg/SO 4 +HCO 3), isotopes (34S, 87Sr/86Sr), relationships between 2H and 18O, and Ne/He and 3He/4He ratios identified that salinization was due to the result of rock-water interaction, ion exchange, mixing between groundwater of Kuwait Group and Dammam Formation and with groundwater from deeper parts of the aquifer. The long-term analysis of the data shows a notable variation of chemistry in a few locations and thus the study helps to manage, sustain groundwater resources, and protection of host aquifers. [Display omitted] • Decrease in TDS of groundwater was noted in few well of the same field. • Saturation carbonate and Silicate and minerals were observed. • Evaporative recharge and witnessed by stable isotopes. • Evaporate dissolution, precipitation, ion exchange and mixing were main processes. • Recharge and Upward movement of deeper groundwater has resulted in freshening. [ABSTRACT FROM AUTHOR]

Mixed connective-tissue disease (MCTD) is an autoimmune disorder with overlapping clinical features of systemic lupus erythematosus (SLE), scleroderma, and myositis, with the presence of antiU1-ribonucleoprotein (RNP) antibody. We report a case of a male p atient with unusual clinical presentation of the condition . [ABSTRACT FROM AUTHOR]

To assess the feasibility of recovering water from the unsaturated zone, the soil data from this zone at three sites in an agricultural research station in Kuwait and the meteorological data from the station at the nearby location were analysed to investigate the variation of soil properties with depth and any relationship that might exist between these and some of the meteorological parameters. Automatic sensors were set at several depths within the three boreholes installed at the sites, to record the soil water content, temperature, and electrical conductivity (EC) at one-hour intervals. The results of the grain size analysis of the drill cuttings from different depths of these boreholes were used to determine the lithology of the sediment sequence penetrated. The extracts from the drill cuttings were chemically analysed. Graphical and statistical methods were used for the analysis of these data. It was concluded that down to the depth investigated (25 m), the depth and meteorology did not have much influence on the quantity and quality of the soil water content. A continuous increase in the soil water content with time was, however, observed over the monitoring period that was surmised to be related to the infiltration of winter rain and the irrigation water that might lead to water mounding. It was further concluded that there would be sufficient quantity and quality of soil water in the unsaturated zone of the study area that could be profitably recovered. [ABSTRACT FROM AUTHOR]

• Late P-H climatic variations are observed and recharge locations identified. • Two prominent vapour sources for rainfall had prevailed since Late Pleistocene. • Impact of shift in ITCZ is observed from 7.8Ky to 4.9Ky. • Shift of ITCZ is influenced by Holocene volcanism. • Late Holocene recharge indicates initial wetness followed by aridity. The study attempts to determine paleo recharge sources for two major aquifer units of Kuwait, namely, Kuwait Group Aquifer (KGA), and Dammam Formation (DFm) were collected and analyzed for major ions and isotopes. The obtained results of 14C ages indicated that the groundwater samples ranged from 31.9 Ky to 3.9 Ky in DFm and 23.3 Ky to 0.8 Ky in KGA. The variations in δ18O signatures with respect to age reflected that there were two major sources of rainwater such as enriched southern Indian Ocean monsoon and the depleted northwesterly (Mediterranean) vapor source. The samples found to show variations during the three marine isotopic stages (MIS 1–3), Heinrich events, Bolling-Allerod, and Dryas time periods in both aquifers. A shift in the Intertropical convergence zone (ITCZ) was witnessed in the groundwater of both aquifers from 7.8 Ky to 4.9 Ky. The variation in the Holocene climate is mainly due to the influence of tropospheric easterly jet governed by the swing in ITCZ , as a result of Holocene volcanism. The mean δ18O values of DFm samples (-3.81‰) reflect depletion than KGA samples (-2.31‰), and the d-excess values were −0.95‰ and 2.05‰ respectively. Thus it could be inferred that the DFm was predominantly recharged during Late Pleistocene period and it was in a relatively cooler climate than recharge environment of KGA. The study infers that KGA was recharged between 26oN and 26.8oN latitudes, and that of the DFm was noted to be recharged (south west of Kuwait) in two different patches between 25.8oN and 26.2oN and 26.7oN-27.4oN latitudes during Late Pleistocene. The KGA was concluded to be recharged between 25.5oN and 27.5oN latitudes, south of Kuwait, during Holocene. [ABSTRACT FROM AUTHOR]

Background Lichen planus is one of the chronic autoimmune inflammatory mucocutaneous disorders that affects stratified squamous epithelium. It affects skin, oral and genital mucous membranes, and nails and scalp. Oral Lichen planus is more common than cutaneous forms and is resistant to treatment. It presents as reticular, erosive and atrophic lesions. One of the serious complications of oral form of Lichen planus is the development of squamous cell carcinoma. We want to ascertain different clinical patterns of oral lichen planus in our population. Objective To find out the frequency of different clinical patterns of oral Lichen planus in population presenting in a tertiary care hospital. Methods It was a Cross sectional study that was carried out in Department of Dermatology, Sir Ganga Ram Hospital, on 100 patients meeting the inclusion criteria. Patients were explained the details of study, written informed consent was taken. Patients were examined clinically and their age, gender, duration of disease and the clinical type of oral lichen planus and the site of lesions were recorded in the predesigned proforma. Results Out of 100 patients, 38 were men and 62 were women. The mean age of the patients was 40±10 years. The mean duration of disease was 5.4±6 years. Among the various clinical patterns, the isolated reticular pattern was found in 65% of patients, the erosive pattern was seen in 28% of patients, the atrophic pattern was seen in 7% of patients. 42% of patients had no concomitant skin lesions while 58% had skin lesions along with the oral lesions. The buccal mucosa was most frequently involved, seen in 61% of patients with the most common pattern i-e isolated reticular pattern. When stratified oral LP was highest among the age group of 41 to 50years and among those with duration between 1 to 5 years. There was a remarkable relationship among duration of disease (p=<0.001) and age (p=0.04) of patient with the pattern of disease, however there was no remarkable relationship among gender (p=0.63) and disease pattern. Erosive oral LP showed longest duration. Conclusion The most frequent clinical pattern of oral lichen planus identified in this study was reticular pattern and the most frequent site of involvement was buccal mucosa. The second most common pattern was erosive pattern and atrophic pattern was the least common pattern observed. Erosive LP showed the longest duration. [ABSTRACT FROM AUTHOR]

Background Lichen planus (LP) is a chronic inflammatory disorder that affects skin and/or mucous membranes. It is a T-cell-mediated inflammatory disorder which causes lipid metabolic aberrations and is associated with increased risk of cardiovascular diseases. Objective To assess the prevalence of dyslipidemia in patients of lichen planus which presents to the Dermatology Department at a tertiary care setting. Methods In this cross sectional survey, 80 cases of lichen planus were included after clinical and histopathological confirmation. Presence or absence of dyslipidemia was confirmed by fasting lipid profile. Patients taking lipid lowering drugs, patients of diabetes, hypothyroidism (TSH >4.2mIU/ml), hypertension or ischemic heart disease, patients with BMI more than 30 kg/m², patients with family history of dyslipidemia and early cardiac death, were excluded. Stratification of dyslipidemia with regards to age, gender and area of involvement was carried out. Results There were 47 (58.8%) males and 33 (41.2%) females. Mean age of the patients was 39.00±11.76 years. Cutaneous lichen planus was seen in 32 (40%) patients, mucosal in 28 (35%) patients and both (cutaneous and mucosal) in 20 (25%) patients. Dyslipidemia was present in 48 (60%) patients. Stratification of dyslipidemia with regard to age and gender was not significant but with regard to mucosal and cutaneous involvement was significant. Conclusion Lichen planus is significantly related to dyslipidemia according to this study. Therefore meticulous screening for dyslipidemia is needed in patients of LP. [ABSTRACT FROM AUTHOR]

Objective To determine the percentage reduction in modified MASI score with combination of microneedling and tranexamic acid in patients of melasma. Methods This descriptive case series involved 66 patients of both genders aged 18-40 years having moderate to severe melasma. These patients were treated by microneedling with tranexamic acid at 0, 4 and 8 weeks. Baseline modified MASI scores at 0 weeks was calculated and outcome was evaluated after 12 weeks in the form of percentage reduction in the initial modified MASI scores, both clinically and photographically. Response was graded as excellent (>75% reduction), very good (50-74%), good (25-49%) and fair (<25%). Results A total of 66 patients with moderate to severe melasma were enrolled. Majority of the patients (53%) showed very good response, 41% had good response, 4.5% had excellent response while only 1.5% patients showed fair response. No serious side effects were noted. Conclusion Microneedling in conjunction with tranexamic acid showed very good response (50-74% improvement) in majority of the patients. [ABSTRACT FROM AUTHOR]

Objective To determine the efficacy of intralesional vitamin D3 in treatment of plantar warts. Methods Total 65 participants, of either gender, with clinical diagnosis of plantar warts were enrolled in the study after taking informed written consent. In each session, selected wart was first injected with 0.2ml (20mg/ml) lignocaine and then 0.6 ml of intralesional vitamin D3 injection (2,00000 IU) was injected with 27-gauge insulin syringe at the base of selected wart. Total 4 sessions were performed every 2 weeks. All patients were clinically assessed for change in size of wart before the first session, every two weeks for the next four sessions, and then at the follow-up period of two weeks after the last session. The treatment was considered effective if there was complete resolution of wart on inspection and palpation at the end of 10 weeks, as final assessment was done 2 weeks after last injection. Results The patients' average age was 26.69±4.63 years. Out of 65 patients, 57.7% (n=57) were between the ages of 18-30; and 8.3% (n=8) were between the ages of 31-45. There were 26.2 percent females (n=17) and 73.8 percent were males (n=48). Treatment was considered effective on complete clearance of wart. In a total of 65 patients, procedure was found to be effective in fortysix patients (70.8%). Conclusion In our study intralesional vitamin D3was effective in 70.8% patients. [ABSTRACT FROM AUTHOR]

Objective To determine the efficacy of topical 5% tranexamic acid cream in patients of melasma. Methods Total 100 patients of either gender with clinical diagnosis of melasma were enrolled in the study after taking informed written consent. The demographic data was collected on a predesigned proforma. Baseline modified MASI score was calculated and pictures were taken of all patients at baseline. The patients were advised to apply 5% topical tranexamic acid cream at night along with sunscreen during day time for 12 weeks daily. All patients were evaluated for improvement of melasma using percentage reduction in MASI score at the end of 12 weeks and pictures were also taken again. Results The patients' average age was 29.23 6.58 years. With a male to female ratio of 0.2:1, there were 100 patients, 81 of whom were female, and 19 who were male. At the conclusion of 12 weeks, the modified MASI score had decreased by a mean of 41.4314.56. After 12 weeks, the modified MASI score was reduced by less than 50% in 63% of patients whereas it was reduced by more than 50% in 37% of patients. In our study, 37 (37%) patients experienced efficacy. Conclusion This study concluded that the topical 5% tranexamic acid cream was effective in 37% of melasma patients in our study population (>50% reduction in baseline Modified MASI score) after 12 weeks. [ABSTRACT FROM AUTHOR]

The energy-dependent neutron flux incident on surveillance capsule assemblies (SCAs) installed at the outer surface of the core barrel in two pressurized water reactors—Chashma Nuclear Power Plants Units 1 and 2 was evaluated. This safety study was made for the reactor pressure vessel surveillance program to determine the fast-neutron-induced radiation embrittlement of vessel materials in sections facing the core side and the upper weld positions. A total of 68 radiometric sensors were irradiated in each SCA of these two reactors, and dosimetry data were measured from radiometric sensors. Fast neutron flux ( $E> 1$ MeV) was best estimated using the least-squares method by employing LSL-M2 package. Measured results were compared with the fast neutron flux calculated using MCNP5 at the base and weld metal sections of SCA. The results agreed within ±20% of each other in both reactors, which satisfy the regulatory acceptance criteria. Therefore, these results can be used in life assessment of reactors. [ABSTRACT FROM PUBLISHER]

Necrolytic acral erythema (NAE) is a rare but distinct clinical entity. It is one of the necrolytic erythemas that presents with itchy well-defined, dusky, erythematous to violaceous papules and plaques on acral areas. We report a case of a 50-year-old woman with 8-year history of itchy hyperpigmented papules and plaques on dorsum of both feet. Later, she developed similar lesions on both hands along with hemorrhagic blisters and purpura. She was found to be a hepatitis C virus (HCV) positive case. Histopathological findings were consistent with necrolytic acral erythema. She was treated with topical tacrolimus, oral zinc and cetirizine, and referred to medical outpatient department for treatment of HCV infection i.e. interferon and ribavirin. [ABSTRACT FROM AUTHOR]

Reports on Groundwater level variations and quality changes have been a critical issue, especially in arid regions. An attempt has been made in this study to determine the surface manifestations of groundwater variations through processing imageries for determining the changes in land use, Normalized Differential Building Index (NDBI), Normalized Difference Vegetation Index (NDVI), Land Surface Temperature (LST), along with Groundwater level (GWL) and Electrical conductivity (EC). Decadal variation between these parameters for 2013 and 2023 shows that the average water level had increased by 1.03amsl, while the EC values of groundwater decreased by 418 μS/cm. The decrease in EC values indicates freshwater recharge, promoting natural vegetation, thus reducing the LST values by 3.28 °C. In addition, urban landscaping and relatively lesser emissivity from built-up surfaces than the sandy desert have further reduced the LST. The interrelationship of the parameters indicates that an increase in LST correlates with an increase in NDBI and with less significant changes in NDVI. The lowering of the LST along the coastal regions was inferred to be due to the influence of Sea breeze, adjacent moisture from the ocean, shallow water level, and the shadow effect of the buildings. Further, the increase in water level was mainly attributed to the recent increase in rainfall and the extreme event in 2018. The higher EC in the lesser NDBI regions is attributed to the anthropogenic contamination from agriculture and landfill leachates. Though there was an increase in NDBI, the LST of the region was inferred to be reduced mainly due to the increase in water level and reduction of emission from desert sand by recent urban developments. [Display omitted] • Decadal changes in LULC, NDBI, NDVI and LST show relation to GWL, and EC variations. • LST exhibit good correlation to NDBI than NDVI. • Anthropogenic impact increased EC in the regions with lesser NDBI values. • Freshwater recharge is indicated by rise in WL and decrease in EC during 2023. • Decrease in sand cover increase in WL reduced LST during 2023. [ABSTRACT FROM AUTHOR]

Chlorella sp., was isolated from wild water and purified on agar plates. Chlorella culture was further extended in Erlenmeyer's flasks on pure nutrient media (reagent grade chemicals) and then maximized in aspirators. Chlorella was then cultured on mass scale in polyethylene bags and 1000 L fiber glass tanks on commercial fertilizers (urea, nutri-calcium, ammonium sulfate, phosphorus plus (P+), potash-plus (K+), nitro-20 and di-ammonium phosphate (DAP) instead of pure nutrient media as practiced in flasks and aspirators. Various combinations of N, P and K were prepared empirically from aforementioned fertilizers and added to polythene bags and fiber glass tanks in fixed ratios for propagation of Chlorella vulgaris. Combined applications of urea, P+ and K+ (N:P:K; 16:4:6) produced the highest cell number (34.05×106 cells mL-1) and were far higher (p<0.05) than control group (8.5×106 cells mL-1). Duration of the log phase of Chlorella varied among containers. The polythene bags showed the best average (200%) and median (178%) growth rates of natural increase at exponential phase. Growth rate per day (244%), density (34.05×106 cell ) and division's day-1 (2.9) were also highest in polythene bags. Fiberglass tanks were second in production and average algal growth, median growth, maximum growth rate day-1, maximum cell density, divisions day-1, generation time day-1 h-1 were 1.13 (113%), 1.19 (119%), 1.19 (119%), 23.15×106 cells mL-1, 1.63, 0.57 and 14.7, respectively. Chlorella in aspirators exhibited the poorest growth. The average and median growth rates were 34.95% and 39.93%, respectively. Growth rate day-1 was 57.64%, and maximum cell density did not exceed 8.5×106 cells mL-1 and divisions day-1 were only 0.504. Strong positive correlation was observed between number of cells and number of days. It was the highest in polythene bags (R2=0.9724) and the lowest in aspirators (R2=0.7539), while correlation values for fiberglass tanks fell in between these two extremes (R2=0.8355). Ciliates, major algae consumers were successfully controlled by the application of quinine sulfate @ 80 mg L-1 of water after 3 h of administration with no effect on algal cells. [ABSTRACT FROM AUTHOR]

Background: Leprosy disease in the community is usually mistaken as a cursed disease. Leprosy disease is a chronic granulomatous infection caused by Mycobacterium leprae. Quality of life in leprosy patients with neuropathic pain in every region is varied. Objective: To determine the quality of life in leprosy patients with neuropathic pain by using the SALSA Scale and VAS. Methods: The research used analytic observational, a cross-sectional design and an interview technic. 37 subjects of 19 to 59 years age had leprosy with neuropathic pain at Donorojo Hospital. Results: SALSA score explains that 62.2% of the research subject has limitation of activity and has a correlation with leprosy disease with p 0.012. There is no correlation between VAS score and leprosy disease with p 0.034. SALSA score and VAS score in this research explain there is no correlation with p 0.458. The number of other medical conditions with limitation activity has a correlation score of 0.870 which has a very good correlation power. The number of used tools with limitation activity has a correlation score of 0.716 which has a good correlation power. Conclusion: There is activity limitation in leprosy patients with neuropathic pain at Donorojo Hospital Jepara District. The other aspect that affect activity limitation is the number of other medical conditions. Multibacillary type has more limitation than a Paucibacillary type. [ABSTRACT FROM AUTHOR]

Assessment of fluid status can play a critical role in the diagnosis and management of emergent conditions such as trauma, shock, decompensated heart failure, syncope, and hypertension. Unfortunately, common methods are all qualitative and/or indirect, and often inaccurate. With the recent introduction of a modernized method of nuclear medicine blood volume analysis (NM-BVA), offering results in 90 min or less as well as improved precision and ease of performance, this decade-old technique is for the first time a viable tool in the emergent setting. In this review, we discuss the history of NM-BVA, the modern method, and our institution's experience implementing this method. [ABSTRACT FROM AUTHOR]

Recreational water use (RWU) injuries span from superficial lacerations to even death. Given the global popularity of RWU, radiologists should be aware of the common mechanisms and key imaging findings related to injuries in this setting. The goal of this article is to depict common RWU injuries and their emergent radiographic findings, which may have both important surgical and management implications. We present a broad review with case illustrations of these injuries seen at our level 1 trauma center showing the breadth of injury that can occur, general mechanisms and sample imaging findings. [ABSTRACT FROM AUTHOR]

Objective To study the outcome of microneedling combined with 35% focal trichloroacetic acid peeling in post acne atrophic scars. Methods This study was conducted in department of dermatology, unit 1, Jinnah hospital, Lahore. A total of 90 patients with Goodman Baron grade 2, 3 & 4 post acne atrophic scars were included in the study. All patients were treated with microneedling alternating with trichloroacetic acid focal peel via CROSS technique at 2 weekly intervals. Results Combination therapy with microneedling followed by trichloroacetic acid peeling resulted in improvement of 1 grade in 93.3% patients with grade 3 and 4 post acne atrophic scars regardless of the age, gender, duration and type of scar and the baseline grade of scarring. There was statistically no significant difference in the frequencies of improvement across various subgroups of patients based on patient's age (p-value=0.731), gender (p-value=0.461), duration of disease (pvalue= 0.777), type of scar (p-value=0.899) and baseline Goodman and Baron Grade (pvalue= 0.821). Conclusion Combination therapy of microneedling followed by trichloroacetic acid peeling resulted in improvement of 1 grade in 93.3% patients with grade 3 and 4 post acne atrophic scars. [ABSTRACT FROM AUTHOR]

Objective To determine the degree of agreement between clinical and dermoscopic diagnosis in patients of scabies. Methods A total of 210 patients with clinical suspicion of scabies were enrolled in the study. Patients were evaluated in a well lit room and those patients who met the definition of clinical diagnosis were recorded as having scabies. All patients were then subjected to dermoscopic examination of the suspicious areas e.g. interdigital clefts of hands, abdomen and groin. Findings were recorded on a predesigned proforma. Outcome variable was a positive or negative dermoscopic examination. Results Mean age of patients was 16±8.5 years with a range of 1 month to 87 yrs. Among 210 patients 116 (55.2%) were males and 94 (44.7 %) were females. Total of 112 patients (53.3%) were clinically diagnosed as scabies and 98 patients (46.7%) were not. Positive dermoscopic examination was recorded in 104 patients (49.5%) of whom 99 (95.2%) were also positive on clinical examination. Mite head was the most frequently visualized part, in 94.1% of the 104 cases. Negative dermoscopic examination was seen in 106 patients (50.5%) of whom 93 (87.7%) were also negative clinically. Hence 99 patients were true positives and 93 were true negatives. Kappa test was used to assess the difference between the two (K=0.829, P < 0.05). Conclusion The results of this study suggest that there is almost a perfect agreement between the clinical diagnoses and dermoscopy for scabies (K=0.829). [ABSTRACT FROM AUTHOR]

Objective To determine the clinical spectrum of pediatric dermatoses at a tertiary care unit. Methods Three hundred and fifty cases aged up to 12 years, presenting to dermatology unit I, Jinnah Hospital, Lahore with skin diseases were enrolled over a period of 6 months. Detailed history and physical examination were done to diagnose the skin lesions. All the information was collected on a specially designed proforma. Results A total of 350 children with skin diseases, 186 (53.1%) males and 164 (46.9%) females were seen. The mean age of patients in the study was 4.18±2.97 years. Infections and infestations were the common dermatoses seen in 158 (45.1%) and 105 (30%) children, respectively. Eczema was present in 79 (22.6%) patients and diseases of sweat gland in 8 (2.3%). Conclusion Infection and infestations were seen as the most common pediatric dermatoses. [ABSTRACT FROM AUTHOR]

Objective To assess the frequency of steroid-induced hyperglycemia in patients taking systemic steroids (30mg or more of prednisolone or equivalent) for dermatological disorders. Methods We included 150 patients of either sex and with ages between 12 and 70 years in this cross-sectional study, carried out in the department of dermatology, Jinnah Hospital, Lahore for a duration of 6 months. Their baseline fasting blood glucose level prior to the start of steroid treatment was recorded. Patients taking 30mg or more of prednisolone (or equivalent) were followed up after one week of treatment and their random blood sugar levels were checked by the same laboratory on venous blood, to see whether they developed hyperglycemia or not after treatment with steroids. Results Mean age of the patients was 41.83±16.42 years. Ninety-four (62.7%) patients were male while 56 (37.3%) were female. Hyperglycemia was found in 28 out of 150 (18.7%) patients. Conclusion Steroid induce hyperglycemia occurred in 18.7% of the study population. [ABSTRACT FROM AUTHOR]

We present the reversible Diels–Alder functionalization of metal organic frameworks (MOFs). Cyclopentadiene (Cp) functional MOFs are ligated with dienophiles to fabricate functional MOFs with a reprogrammable chemical nature. Our strategy thus constitutes an unprecedented concept for chemically dynamic MOFs able to be recoded. [ABSTRACT FROM AUTHOR]

Bullous pyoderma gangrenosum is an atypical variety of pyoderma gangrenosum characterized by rapidly evolving vesicles or bullae that later rupture to form ulcers, commonly associated with underlying hematological malignancy. Various therapeutic options are available, including corticosteroids and other immunosuppressive agents. We present an eight-year-old boy having recalcitrant bullous pyoderma gangrenosum treated successfully with thalidomide. [ABSTRACT FROM AUTHOR]

Objective: To determine the spectrum and frequency of skin diseases on the basis of histopathology. Methods: 152 skin biopsy specimens were received during a period of one year. They were processed routinely and findings recorded. Relevant demographic data as well as clinical findings were also noted. After diagnosis, the cases were divided into seven groups, viz, eczema-dermatitis, papulosquamous disorders, infectious disorders, blistering disorders, neoplastic lesions, degenerative diseases and miscellaneous lesions. Results: were analyzed using percentage frequencies, Fischer's exact test and student's t test as appropriate. Results: The age range of patients was 5-81 years with mean being 37.59±17 years. Majority of biopsies were from male patients (55.3%). Papulosquamous disorders were the most common group with a frequency of 46.7%. Second most frequent skin disease groups were eczema - dermatitis and blistering disorders, each accounting for 12.5 % of all biopsies. Neoplastic lesions constituted 10.5% of the lesions, with benign and malignant lesions presenting at the average ages of 47 and 43 years respectively. Conclusion: The average age at presentation was close to that reported by other researchers from this region. The greater number of male patients is at variance from most other reported studies. The difference was statistically highly significant (p=0.0031). The frequency of different diagnostic groups was unique in some respects and conformed to other studies in others. The most striking was the statistically significant difference in age of presentation of patients with malignant neoplasms. This highlights the need to raise awareness in public about the possible precautionary measures that need to be taken, in this region with high levels of exposure to sunlight. [ABSTRACT FROM AUTHOR]

Toxic epidermal necrolysis (TEN) is an acute, life-threatening cutaneous drug reaction that predominantly involves the skin and mucous membranes. It is a rare disorder and treated as a medical emergency, due to its fatal outcome. The principles of management include immediate removal of culprit drug(s), supportive management and specific drug therapies or procedures, of which plasmapheresis is one treatment modality. We report two patients of TEN, being successfully treated with plasmapheresis, proving it to be a life saving treatment modality. [ABSTRACT FROM AUTHOR]

Background: To assess factors affecting career choices of newly admitted and graduating medical students. Methods: A cross sectional study was carried out in four private medical colleges of Islamabad. Two hundred students of first and final year were selected for this study. Data was collected by using self-developed questionnaire after extensive literature review by the researchers. Questionnaire was pilot tested. Data was analyzed by using SPSS v. 16.0. Results: Study results indicated mean age 21.13 years (± 2.48), 101 (53.72%) males and 87 (46.28%) female. Majority (96.80%) were unmarried., 51.10% (96) MBBS first year and 48.90% (92) in final year students. Although medical specialties remain of overall highest preference of all medical students but male students preferred surgical specialty as first choice as compared to female students. Study results revealed that interest and motivation to help others were main factors to affect choice of a particular specialty. Students of both gender and years agreed with the influence from a mentor/teacher, however male students thought expected income (51) and good working atmosphere (74) are main factors affecting careers. Among social factors parent's choice or wish, having doctor in the family and personal interest were highly associated with career choice (p-value less than 0.05). Conclusion: Factors affecting on career choice should be identified and managed timely. [ABSTRACT FROM AUTHOR]

Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology.Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology.Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology.Objective To determine the learning resources and procedures used for dermatology postgraduate training in Pakistan. Methods Trainees from different centers accredited for dermatology postgraduate training in Pakistan were approached. A pre-designed proforma was filled by 100 dermatology trainees of FCPS, MCPS and MD programs . Results Hundred percent trainees followed Rook’s Textbook of Dermatology as a major learning resource. The most commonly read journal was Journal of American Academy of Dermatology. Scientific conferences had been attended by less than 50% students. Most of the students were participating in clinical case discussions, while clinical slide sessions and histopathology sessions were not being attended by all. Most commonly learnt diagnostic procedure was fungal scraping (92%), least common was immunofluorescence (16%). Out of various therapeutic procedures, electrocautery was being performed by 100% students while dermal fillers and botox injections by none. Conclusion There is a wide variation in exposure of dermatology residents to various learning resources and procedural skills across different teaching units of the country. The most lacking part of training highlighted in this study is the aesthetic or cosmetic aspects of dermatology. [ABSTRACT FROM AUTHOR]

Background: To determine the role of ultrasound as an adjunct modality to mammography in diagnosing breast cancer. Methods: Total 100 patients of breast cancer were recruited in this comparative study. These cases were subjected to mammography. Ultrasound was then performed as an adjunct modality while clinical and mammographic results were available to the radiologist evaluating the ultrasound scans. Patients with positive findings were then followed for histopathology findings obtained from excisional biopsy or mastectomy specimen. The results of histopathology were taken as gold standard. Sensitivity and specificity of mammography and adjunctive ultrasound was calculated by constructing a 2 x 2 table taking histopathology as gold standard. Statistical measures of accuracy, sensitivity, specificity, positive predictive (PPV) and negative predictive values (NPV) were calculated. Results: Age distribution revealed, 68 patients (68.0%) were < 40 years of age. Mean age of the patients was 44.9 ±5.2 years. Distribution of cases by presenting symptoms was as follows: breast lump 93 (93.0%), and breast pain 7 (7.0%) with nipple discharge 10 (10.0%) and nipple retraction 8 (8.0%). Family history of breast cancer was present in 37.0%. Combined sensitivity of mammography and adjunctive ultrasound was 94.67%, specificity 77.78%, diagnostic accuracy 85.54%, positive predictive value 89.87%, negative predictive value 63.63% comparatively better than these modalities alone. Conclusion: Ultrasound can be considered as a primary screening tool in younger population and as an adjunct to mammography in elder women to minimize the chances of missing diagnosis of breast cancers. [ABSTRACT FROM AUTHOR]

Examines the suitability of the European standard series of patch test allergens in Pakistani patients. Most common allergens; Percentage of patients who were positive on patch testing; Demographics of male and female dermatitis patients.

This study was conducted from First August 2010 to 31th July 2011 at G.B. Pant children hospital which is tertiary care hospital and is associated hospital of Government Medical College Srinagar India in which all the patients of suspected malignancies underwent detailed history, through physical examination and relevant laboratory and imaging investigations followed by histological or cytological examination to confirm diagnosis. A Total of 63 patients under 15 year of age were diagnosed as childhood malignancies 40 were males (63.4) and 23 were females (38.3) giving male to female ratio of 1.73:1 . Leukemia was the most common type of cancer constituting 38 % of all cases followed by lymphoma (23.8%) and sacrococcygeal teratoma was rarest one. This data suggests that Leukemia and Lymphoma were the most common childhood tumors in our geographic area. Malignancies were 1.65 times more common in boys than girls in this series. Most of patients were from rural areas than urban areas. [ABSTRACT FROM AUTHOR]

Background Eczema is a pruritic skin disorder of exogenous or endogenous nature. Allergic contact dermatitis is of exogenous nature and can be caused by many allergens including plants. Patients and methods In this quasi-experimental study, 50 patients presenting with extensive eczematous eruption were enrolled. They were patch tested with fresh crushed extract of flowers of Parthenium hysterophorus. Three patch test readings were taken at 48 hours, 72 hours and 120 hours. Patch test readings were read according to ICDRG criteria. Results Forty four (88 %) out of 50 enrolled patients were male while 6 (12%) were female with male to female ratio of 7.3:1. Average age of the patients was 56.8 years with S.D ±12.6 years. Fifty four percent of enrolled patients showed positive patch test reactions to fresh crushed extract of flowers of P. hysterophorus with a male to female ratio of 5.7:1. Conclusion P. hysterophorus is a leading cause of extensive eczematous eruption of exogenous type in a specific group of patients [ABSTRACT FROM AUTHOR]