2026-04-19T05:52:30Z https://pakistanbmj.com/journal/index.php/pbmj/oai

oai:ojs2.pakistanbmj.com:article/1 2021-09-09T18:34:57Z pbmj:G.Edt driver

Obesity and Healthy Eating Habits Khalid, Sidra Obesity is a growing problem, most prevalent in the developed countries, especially US. Children and adolescents are gaining weight at a fast pace as compared to their parents.Although, it is very complicated to exactly know the cause of obesity, its risk factors, its prevention in different populations,yet, it has been observed that changes in life style and particularly in eating habits has contributed to an increased obesity incidence globally. These habits include eating junk food, synthetic and bakery products, increased hoteling, increased consumption of meat and unstaturated fats. If we compare the urban and rural regions at a global scale, we may come to know that Obesity and gastrointestinal problems are more prevalent in urban areas. It also indicates that these disorders are mostly attributed to bad eating habits and wrong choices of food which lack nutritional value but cause various disorders. Atleast 2 decades ago, when there was less digitalization and technological advancements, if people consumed high cholesterol diet or meat, they could digest it as they were physically very active. But in these days, there is less physical activity and our digestive systems cannot digest such food. Moreover, junk food may contribute to obesity. No doubt genetics may also has some role which cannot be denied but the modifiable risk factors can be controlled, monitored and may prevent such disorders. However, global investigations in this regard are direly needed to know the dietary habits and patterns worldwide, their effects in different populations, so that policies may be devised and implemented. Parents are also not aware of a proper healthy pattern that meets the requirements of their children. Knowledge, Attitude and Practice (KAP) Surveys and then awareness campaigns may play a positive role in this regard. Teaching healthy dietary patterns for different age groups at school level may also serve the purpose. CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/1 10.52229/pbmj.v3i1.1 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/1/1 10.52229/pbmj.v3i1.1.g1 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/2 2021-09-09T18:34:57Z pbmj:Edt driver

Are we geared for the upcoming challenges by nCoV-19 or is it still grim news….? Zuhair Yusuf, Muhammad Ahmed, Naseer The novel Corona Virus (nCoV-2019), clouded the entire world during the year 2020; with its emergence in December 2019 from Wuhan, China. The nCoV-19 is a novel variant of the Coronavirus family, with its predecessors been implicated for the pandemics of Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV); that caused flu-like condition and respiratory distress symptoms [1-6]. The viral strain also intrudes on extra-pulmonary relevance; being involved with deranging immunity as evidenced by lymphopenia and a prolonged prothrombin time; it impacts cardiomyocytes and pancreatic tissue directly [7-11]. These implications of nCoV-19 does suggest a long-term relevance of the disease profile. The emergenceof nCoV-2019 was quick to gain a pandemic status worldwide. An immense shift in the influx of the type of patients was observed, that imparted a false impression of a reduction in cardiovascular and metabolic patient presentation; formerly that had been the majority engaging the worlds’ healthcare facility. But as the world prepares itself for a possible second wave of the n-CoV-19, a prudent approach would be to remind us of the history lessons from the previous corona-led pandemic, such as MERS and SARS. This editorial will emphasize on channeling our focus to nCoV-19 implications on cardiovascular and metabolic disorders. The pandemics of SARS-CoV during 2002-2003 and MERS-CoV in 2012 highlight the long term relevance of coronavirus to cardiac and metabolic disease pathologies, both during and in the aftermath of these pandemics [3]. The SARS-CoV had demonstrated an increase of cardiovascular problems by 44%, hyperlipidemia by 68% and diabetes mellitus by 60%, in people who had recovered from the viral attack [12, 13]. Likewise, MERS-CoV had also embarked an increase of cardiac disorders by 30% and hypertension by 50% and diabetes mellitus by 50% [3, 8, 9]. Published research on nCoV-19 has hinted for a similar rising trend of cardiovascular and metabolic complexities. An increase in cardiac troponin level is observed with increased cases of myocarditis and heart failure [14]. A 20% increase in the incidence of diabetes and a 40 % rise in cardiovascular and cerebrovascular diseases is observed with nCoV-19 [8, 9]. Little do we comprehend that the involvement of angiotensin converting enzyme 2 (ACE2) receptors could play havoc on endothelium, kidney, intestine, liver and any other organ [15]. The nCoV-19 has thrown a curveball to the realm of the worldwide health and financial setting. Even with the current economic predicament it does seems prudent to be prepared in advance for the long term consequences of this pandemic. The bigger question would be to, not just direct our efforts at countering the possible second wave of nCoV-19 but also for the possible chaos of cardiovascular and metabolic disease outfall, impacting the world health system. CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/2 10.52229/pbmj.v3i1.2 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/2/2 10.52229/pbmj.v3i1.2.g2 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/3 2021-09-09T18:34:57Z pbmj:O.A driver

Effect of storage on PHYSIO-CHEMICAL EVALUATION OF PEANUT YOGURT: Effect of storage on peanut yogurt Abbas, Naukhaiz Sharmeen, Zainab Bashir, Shahid Khalid, Sidra Arshad, Misbah Mazhar, Zargham ABSTRACT: Peanuts may be consumed in a variety of processed forms like roasted, raw and processed etc. and represent as a multimillion dollar crop worldwide with many potential dietary benefits as it contains high protein and health effective oils. Objective: The present investigation was planned to evaluate thephysio-chemical properties of peanut milk yogurt by the addition of different concentration of peanut milk (0 %, 10 %, 20 % and 30 %), skimmed milk liquid (60 %, 70 %, 80 %, and 90 %), skimmed milk powder (9 %) and sugar (1 %). Methods:The physico-chemical tests (pH, acidity, moisture, ash, fat, protein, syneresis, and viscosity) were examined after every 5 days of interval for a period of 15 days at 4 ºC. Results:The results of physico-chemical analysis revealed that pH, ash, fat, protein and viscosity decrease during storage period where as acidity, moisture and rate of syneresis increased during storage. Treatment T1 (10 % peanut milk) was comparatively best for manufacturing of peanut milk yogurt followed by T2 (20 % peanut milk + 70 % skimmed milk liquid + 9 % skimmed milk powder + 1 % sugar) while peanut milk yogurt from (30 % peanut milk + 60 % skimmed milk liquid + 9 % skimmed milk powder + 1 % sugar) had the lowest degree of firmness. Conclusions:It was noticed that correlation among fat, total solids and protein contents in peanut milk affect the extent of serum separation and pH of yogurt.The storage had significant effects on all physico-chemical parameters. Treatments had significant effect on all physico-chemical parameters CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/3 10.52229/pbmj.v3i1.3 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/3/3 10.52229/pbmj.v3i1.3.g3 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/4 2021-09-09T18:34:57Z pbmj:O.A driver

Detection of Metalo-Beta-Lactamase Gene in Carbapenem Resistant Pseudomonas Aeruginosa Isolated From Lahore, Pakistan: Detection of Metalo-Beta-Lactamase Gene in Pseudomonas Aeruginosa Kausar, Humera Hussain, Shabbir Muhammad Akram, Afia Pseudomonas aeruginosa is a widespread organism, caused severe nosocomial infection in human and associated with multiple drug resistance (MDR)Objective:The present study was carried out to observe current antimicrobial resistant pattern of Pseudomonas aeruginosa in Lahore and to detect the Metallo-beta-lactamase (MBL) gene in carbapenem resistantPseudomonas aeruginosaMethods:By screening 360 samples total 123 Pseudomonas aeruginosa was identified by standard microbiology techniques such as microscopy and biochemical testing. The isolated Pseudomonas aeruginosa was evaluated for drug resistance by disc diffusion method and polymerase chain reaction(PCR) was used to identify the carbapenem resistance causing gene (bla-VIM and bla-IMP) Results:Following antibiotic resistant pattern was observed,Gentamycin (59.00%), Ceftazidime(58.7%), Ceftriaxone (58.00%), Cefotazime (57.0%) and Ciprofloxacin (55.00%). Resistance rates to carbapenem group of antibiotics is Doripenem (30.5%) Meropenem(31.0%) and Imipenem (28.0%). Out of 123 samples of Pseudomonas aeruginosa, 28 isolates were found resistant to carbapenem group of antibiotic which was supposed to be highly sensitive for this bacterium. Molecular based identification of resistance genes showed that bla-IMP gene was present in 32.1% (09) and bla-VIM was found positive in 17.8% (04) samples. Metallo-beta-lactamasesproducing genes (bla-VIM and bla-IMP), amongcarbapenem resistant Pseudomonas aeruginosa were detectedin 28.1% of samples. If other carbapenem resistant gene were also included this number might be higherConclusions:PCRbased test should be included in routine laboratory examination for quick detection of the resistancecausing genes. CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/4 10.52229/pbmj.v3i1.4 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/4/4 10.52229/pbmj.v3i1.4.g4 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/5 2021-09-09T18:34:57Z pbmj:O.A driver

Isolation of Plant Growth Promoting Bacteria from the Rhizosphere of Different Plants and Assessment of Their Plant Growth Promotion Potential: Isolation of Bacteria and their Assessment for Plant Growth Promotion Potential Yousaf, Anam Khan, Hassan Ahmed Younas, Tayyaba Plant are benefitted in different aspects by symbiotic bacteria. Environmental conditions, Plant conditions and type of pathogens determine these important services for plants Objective: The research was conducted to assess the plant growth enhancing effects of wheat and cabbage rhizobacteria on the growth of wheat plantMethods:For this purpose, total 49 bacteria were isolated and characterized from the rhizosphere of wheat and cabbage plants. The isolates were assessed for plant growth promoting properties such as: indole acetic acid production, phosphate solubilization, antibacterial activity and heavy metal resistance. Indole acetic acid was found to be produced by 7 isolates and phosphate solubilization was shown by 20 isolates. Antibacterial activity was determined against four clinical isolates like Staphylococcus aureus, Klebsiella sp., Escherichia coli and Pseudomonas aeruginosaResults:Antibacterial activity against Staphylococcus aureus was shown by 38 isolates, 12 isolates showed antibacterial activity against Escherichia coli and Klebsiella sp., whereas no isolate was found to bepositive against Pseudomonas aeruginosa. Another plant growth enhancing trait (heavy metal resistance) was shown by 28 rhizobacteria. In order to evaluate the capability of isolates to enhance the plant growth, bio-inoculation assay was performed using wheat seedsConclusions:Rhizobacterial inoculation increased the number of roots, shoots, leaves and roots and shoot length of wheat plantlets as compared to un-inoculated control.   CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/5 10.52229/pbmj.v3i1.5 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/5/5 10.52229/pbmj.v3i1.5.g5 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/6 2021-09-09T18:34:57Z pbmj:O.A driver

Determinants of Peptic Ulcer: Determinants of Peptic Ulcer Khan, Mehmoona Hafeez Kamran, Hafsa Naveed, Maryam Ali, Mahrukh Khan, Anam Hafeez Globally, peptic ulcer is a disease that is very common in an adult population with 10% prevalence. Patients with H.pylori infection has 3 to 4 folds higher risk of getting peptic ulcer. Objective: To find out the determinants of Peptic ulcer among the patients visiting Services Hospital LahoreMethods:A Cross sectional study was carried out. Patients were selected through non-probability convenient sampling technique from Services Hospital, Lahore. Patients were assessed through pre-tested questionnaire. SPSS version 21.0 was used for analysis of data.The study was carried out at Medical departments of Services Hospitals, Lahore during Dec-2017 to March-2018Results: The prevalence of peptic ulcer was higher in males i.e. 68%. 41% patients were 36-45 years of age, 63% patients were from urban areas, 40% of patients were overweight, 32% patients were secondary educated and 75% patients were having no knowledge about peptic ulcer. There was significant association of gender with consumption of fried food items and smokingConclusions: Study concluded that, male gender, low educational status, work pressure, smoking, addiction of pain killers and intake of fried food items were the risk factors of peptic ulcer. CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/6 10.52229/pbmj.v3i1.6 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/6/6 10.52229/pbmj.v3i1.6.g6 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/7 2021-09-09T18:34:57Z pbmj:O.A driver

Assessment of Blood Glucose and Calcium Concentrations Among healthy female volunteers: Blood glucose & calcium in females Ashraf, Kiran Jamsheed, Iraj Zaidi, Farheen Al Mostafa, Morad Yaser Abstract: Hypoglycemia and Hyperglycemia are associated with a number of complications including kidney damage, neurological damage, cardiovascular damage, damage to the retina or damage to feet and legs, lethargy, impaired mental functioning and irritability. The most abundant mineral in the body is calcium. Its abnormal levels also associated with multiple disorders. Objectives: The aim of this study was to assess the blood glucose and calcium levels in healthy female volunteersMethods: A cross sectional study was conducted at the Sir Ganga Ram Hospital, Lahore, over a period of 6 months, after obtaining the ethical approval from the The University of Lahore. A total number of 60 females were enrolled through consecutive sampling technique. Females of all age groups were included. All of the females had gone through routine history taking and lab investigations for the assessment of blood glucose an calcium concentrations. Results: In this study out 60 female participants, 33.3% were between ages of 15-30 years, 33.3% were between age of 31-50 years and remaining 33.3% were above 50 years old. All females of age group 15-30 years had normal glucose levels while single case of age group 15-30 years had abnormal calcium level. The results indicated that females of above age 50 years had low calcium and high glucose levels due to poor nutrition and less physical activity.Conclusions:The results of the current study showed that females with increasing age should intake food enriched in calcium and low glucose and adopt a physically active life style to manage normal blood glucose levels. CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/7 10.52229/pbmj.v3i1.7 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/7/7 10.52229/pbmj.v3i1.7.g7 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/8 2021-09-09T18:34:57Z pbmj:Rew.Art driver

Novel Bioactive Compound Production by Microbial Biota: Potential Antimicrobials: Potential antimicrobials produced by microbial biota Hayee, Sara Man is always trying to make his life easier and accomplished. He has faced mass destruction in history due to epidemics like small pox, malaria and plague. In order to combat diseases, exploration of man led him to search for causative agents and their control. A time reached when it was found that microbes are themselves a source of potent metabolites which have proved to be effective as drugs and medicines showing great antibiotic activity. It is necessary to find out new sources for potential new antimicrobial compounds. Several hundred important compounds have been isolated which have antibiotic activities and diverse chemical nature. But these compounds should have minimum toxicity to be useful clinically. Because of the increasing resistance of pathogens, there was a never ending desire and need to search for more. Bioactive Compounds have been extracted from microbes which are produced as secondary metabolites. Day by day, new compounds are being discovered giving a hope of golden future of drug industry. The current article emphasizes the importance and need to search for new bioactive compoundsto overcome infections caused by multiple drug resistant (MDR) and biofilm forming pathogens irrespective of the previously present knowledge.  CrossLinks International Publishers 2020-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/8 10.52229/pbmj.v3i1.8 Pakistan BioMedical Journal; Vol. 3 No. 1: Volume 3 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v3i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/8/8 10.52229/pbmj.v3i1.8.g8 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/9 2021-09-09T18:35:47Z pbmj:Edt driver

Mental Health Disorders and Challenges faced by developing countries Mehboob, Riffat Mental disorders are common and contribute to the highest burden of disease across the globe.Depression and anxiety has become the most frequent disorder in these times. However, it is notconsidered a disease mostly and there are no proper policies and treatment all over the world but thedeveloping countries are affected the most. Mental health care services are lacking and inaccessible tomost of the patients worldwide. Apart from this fact, the stigma associated with this ailment is a majorhindrance in the way of treatment. Lack of human resource and their proper training is also lacking. Thereis a dire need to enhance research capacity to actually estimate the burden and magnitude of the problem,preparing a policy and above all, its implementation to bring a change in the treatment of mental healthproblems. Low and middle income countries are suffering the most due to these disorders and ironicallyit is not considered a disease thereMostly, the uneducated people attribute such mental health issues to supernatural phenomenonsuch as ghosts or magic etc. Additionally, for the treatment of these so-called “supernatural phenomenon”and to get rid of ghosts, they tend to go to “peers” or “baba” who are illiterate people, pretending to havecure for these patients. But infact, such malpractices and misconceptions among masses lead to adisastrous situation. It causes worsening of the condition of patient by not getting the proper medical andpsychiatric treatment, secondly, they are caught up by wrong people who extort huge amount of money.These are the challenges that developing countries are facing for the treatment of mental health issues.Evidence-based interventions and practice by trained personals in community and primary health carefacilities can improve the understanding and treatment of these ailments. Exercise, healthy life style,healthy dietary+ patterns and physical activities may also work wonders in these conditions. CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/9 10.52229/pbmj.v3i2.9 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/9/9 10.52229/pbmj.v3i2.9.g9 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/10 2021-09-09T18:35:47Z pbmj:G.Edt driver

Impact of Covid-19 on people and Work from Home Hassan, Sana This pandemic has affected family life around the world.As a result of lockdown individuals are already experiencing significant revenue and job losses.The ability to ‘Work from Home’ (WFH) can help damp down the impact of the situation, undoubtedly. Overall, the effects of WFH arrangements rely a lot on the job status of parents and presence of dependents (children & elderly), and this current situation is likely to intensify these differences.It does not necessarily mean, however, that the effect of the crisis should inevitably be gender neutral. Working women have been particularly affected. It seems to be very fascinating to work from home, while sitting on a comfortable couch, casually dressed, even sometimes in sleep suits, without stepping out in scorching heat and wasting time in traveling, but this may not be a preferred situation for everybody, especially women.The most significant impact on working women during the crisis will be trying to balance household demands, childcare needs and work demands. The group most likely to be hardest hit then would be lower income families with young children, and single mothers in particular. Generally women are in charge of planning, organizing and recalling of everything that needs to be remembered. The mental stress and load that comes with such work has risen exponentially in present circumstances. Even though many countries are relied on lockdown to control widespread of COVID-19 pandemic, the mental problems such as depression, anxiety, insomnia, suicidal thoughts and other psychological trauma are most common in case of normal individual and extensive in case of people who are psychologically ill.Females are more prone to psychological distress. The main concern is to manage and provide opportunities for regulation of stress caused due to anxiety and lack of peer contact. Another main threat is an increased risk of parents to develop mental illness, women may also suffer from domestic violence and consequently it results child maltreatment.The current scenario may be particularly challenging especially for children and adolescents with special needs or disadvantages, such as disabilities, also if someone has prior trauma experiences, undiagnosed mental health problems, background of migration and low socioeconomic status. CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/10 10.52229/pbmj.v3i2.10 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/10/10 10.52229/pbmj.v3i2.10.g10 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/11 2021-09-09T18:35:47Z pbmj:O.A driver

Demographic Profile Associated With Malnutrition: Demographic Profile Associated With Malnutrition Khalil, Adnan Bashir, Shahid Al Mostafa, Morad Yaser Worldwide, malnutrition is the severemost health problem leading to the highest rate of disease and mortality among children less than 5 years of age.Objective:To find out the association between malnutrition and demographic profile.Methods:350 malnourished children were chosen by non-probability convenient sampling technique from Sir Ganga Ram Hospital, Lahore. Children were assessed through pre-tested questionnaire.Data were analyzed by SPSS version 21.0.Results:45% malnourished children were 1-3 years of age, majority of the children were females (52%), 89% children were from rural areas, 82.6% children were from low socioeconomic status, 54.6% mothers were uneducated,50% malnourished children were not having their own house, 115 malnourished children were having 3 or more siblings and 89 mothers were having less than one year of pregnancy gap.Conclusions:Low socioeconomic status, illiteracy of mothers, rural area, gap between pregnancy and female gender has been found to be linked with malnutrition in children below 5 years of age. CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/11 10.52229/pbmj.v3i2.11 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/11/11 10.52229/pbmj.v3i2.11.g11 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/12 2021-09-09T18:35:47Z pbmj:O.A driver

Biological activity of Citrus paradisi peel: Biological activity of Citrus paradisi peel Khalid, Amna Hayee, Sara Nasir, Nouman ., Habibullah Citrus paradisi (Grapefruit) peel oil has medicinal properties which shows beneficial effects against plant pathogenic fungi Objective: The aim of this research was to investigate the antifungal potential of Citrus paradisi peel oil against different plant pathogenic fungal strainsMethods: The essential oil of Grapefruit peel was provided in different concentrations 0.25 to 0.75ml per 100 ml of media to 3 different plant pathogenic fungal strains i.e, Fusarium oxysporum, Fusarium solani and Dreschlera tetramera and its effect on the growth of fungi was recorded Results: The studies provided the results compared with the controlled media, which showed the fungal growth was almost completely inhibited at 0.75ml concentration of oil, even the lower concentration was sufficient to retard the growth Conclusions: The study provided the blue print for fungicidal spray to cure serious diseases in plants, such as, rice blast, papaya fruit rot, seedling collar rot and wilt diseases. CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/12 10.52229/pbmj.v3i2.12 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/12/12 10.52229/pbmj.v3i2.12.g12 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/13 2021-09-09T18:35:47Z pbmj:O.A driver

The Impact of Hearing Aids on Quality of Life of Hearing Impaired Individuals: Impact of hearing aids on QoL Zafar, Fatima Usama Basheer, Hafiz Muhammad The regular use of hearing aids (more than 8 hours a day) benefits people in hearing for better communication than those who are less-likely to use hearing aids Objective: The objective of the study was to assess the impact of hearing aids on the quality of life of hearing impaired individuals Methods: In this cross-sectional study total 50 participants were recruited by convenient sampling technique from Lahore, Pakistan. 50 patients who were diagnosed with hearing loss and were recommended with hearing aids of both genders were included in the study.The International Outcome Inventory for Hearing Aids (IOI-HA), questionnaire was used for data collection. Data were analyzed through Statistical Package for Social Sciences (SPSS) version 23.0 Results:In this research 50 hearing impaired individuals who were hearing aid users, participated. The mean age of participants was 64.10+15.88 years. Among which 25 (50%) were males and 25(50%) were females. The average time of hearing aid use was 3.88 hours, majority of patients responded that hearing aid helped quite a lot in the daily routine (mean score of IOI-HA,3.62), have moderate difficulty in residual activity (mean score of IOI-HA,3.26), moderately satisfied with their hearing aid (mean score of IOI-HA,3.28), moderately affect the participation restriction (mean score of IOI-HA,3.20), impact of their hearing loss bothered moderately (mean score of IOI-HA,3.14) and quality of life (QOL) was very much better (3.90). There was insignificant association between the QOL of males and females (p-value>0.05) Conclusions: It was concluded from the study that the hearing aids have a greater impact on the quality of life and socio-economic aspects of hearing impaired individuals. Hearing loss is such a problem, which separates certain community of hearing impaired individuals from the normal population. Individuals with hearing impairment not only have to face personal communication problems but also it affects their health, independency and quality of life in their daily routine. CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/13 10.52229/pbmj.v3i2.13 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/13/13 10.52229/pbmj.v3i2.13.g13 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/14 2021-09-09T18:35:47Z pbmj:O.A driver

Gender based Differences in COVID-19 patients: Gender based Differences in COVID-19 patients Mumtaz, Sami Ullah Iqtadar, Somia Abaidullah, Sajid Gondal, Khalid Masood Hassan, Amber Khan, Asad Aslam Akram, Javed Coronaviruses are a huge family of viruses that originate disease extending from the common cold to further fatal maladies.Objective:The study was conducted to determine the gender based differences in COVID-19 patients.Methods:Study included total 150 participants visiting Department of Medicine, Mayo Hospital, Lahore, Pakistan.Data were collected through self-structured questionnaire using non-probability convenient sampling. Prior written informed consents were taken from the participants. Ethical approval was taken fromThe University of Lahore, Lahore. Data were analyzed through SPSS version 25.0.Results:Results showed that among the comorbidities hypertension was most common in COVID-19 patients followed by diabetes mellitus, especially in females. Whereas renal disorders and asthma were most reported in males.Analysis revealed that there was a significant association (p=0.001) between disease severity and gender.Conclusion:Study concluded that there was significant association between gender and disease severity. CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/14 10.52229/pbmj.v3i2.14 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/14/14 10.52229/pbmj.v3i2.14.g14 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/15 2021-09-09T18:35:47Z pbmj:Rew.Art driver

Intake of Anti-Epileptic Drugs and their Influences on Sexual Dysfunctions: Anti-epileptic Drugs in Sexual Dysfunctions Yasmeen, Roheela Mobeen, Nida Khan, Muhammad Amjad Aslam, Irfan Chaudhry, Samia Epilepsy which is also called seizures disorder is an uncontrolled action of the central nervous system. It is not a single disease but a set of neurological disorders. Actually in this situation, the brain does not receive a precise signal and as a result an abnormal condition is produced that is usually involuntary in action. In this review, we aimed to focus on the relationship of anti-epileptic drugs with sexual dysfunction and adaptation of better remedies that improve a patient’s family life. Sexual dysfunction is a common comorbidity in people with epilepsy which badly affects their quality of life. Sexual dysfunction is caused by different factors like psychiatric problems, anti-epileptic drugs (AEDs) and social factors etc. Sexual dysfunctions include ejaculatory failure, lessen libido, penile erection in men and irregular menstrual cycle in women. Common drugs such as Topiramate, Gabapentin (GBP), Valproate (VA), Carbamazepine (CBZ), Olanzapine (OL) and Risperidone (RTG) that are in practice to treat epilepsy usually produced adverse effect on sexual dysfunction. Even though a lot of studies have been carried out to control sexual dysfunction in epilepsy’s patient, but still research is going on. Medicine such as Cyproheptadine, Mianserin, Buspirone, Yohimbine were found better to treat epilepsy with minimum side effects of sexual dysfunction. Moreover, it is also seen that certain vasodilators, folate , and vitamin supplements are effective in improving the quality of life. CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/15 10.52229/pbmj.v3i2.15 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/15/16 10.52229/pbmj.v3i2.15.g16 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/16 2021-09-09T18:35:47Z pbmj:O.A driver

Phase-dependent expression profiling and quantification of several growth factors in liver regeneration after partial hepatectomy: Growth factors in liver regeneration Hussain, Adeela Ali, Gibran Afzal, Muhammad Awais Tayyeb, Asima Akram, Shehla J Akram, Javed Growth factors are the potential operational members which control different phases of liver regeneration. Different growth factors have expression regulation in the whole process relating to different phases of liver regeneration. Objective: To assess the expression regulation of different growth factors and cytokines involved in liver regeneration in a phase-dependent manner. Methods: Blood and liver samples were collected and analyzed on 1st, 3rd, 5th, 7th and 14th postoperative days after 50% Partia hepatectomy (PHx). Results: Steady increase of liver regeneration rate was recorded from 90.8% (1st day) to 97.9% (7th day). Liver function tests further confirmed the steady liver recovery in PHx mice. Several growth factors such as HGF and VEGF exhibited an up-regulation till 5th day and later gradual decrease till 14th day compared to control mice. Albumin, CK18 and CK19 showed sequential expression increase from 1st to 14th day compared to AFP and HNF-4α upregulated until 5th and 1st day, respectively. Quantification of these growth factors further confirm our results. Conclusions: Conclusively, these results highlight a phase-dependent regulation and role of growth factors in liver regeneration and recovery CrossLinks International Publishers 2020-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/16 10.52229/pbmj.v3i2.16 Pakistan BioMedical Journal; Vol. 3 No. 2: Volume 3 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v3i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/16/17 10.52229/pbmj.v3i2.16.g17 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/17 2021-09-09T18:34:25Z pbmj:O.A driver

Assessment of Dietary Behavior of Children Aged between 3-12 Years Suffering from Thalassemia Visiting Tertiary Care Hospitals, Lahore: Dietary behavior of Thalassemia children Shehryar, Mehvish Aslam, Maria Sohail, Namrah Qadeer, Saman Tariq, Tooba Thalassemia is a hereditary blood disorder passed down through families in which the body makes hemoglobin in an abnormal form. Nutritional deficiencies in thalassemia children results in anemia and other medical complications. Objective:To assess dietary behavior of children aged between 3-12 years suffering from thalassemia.Methods:A cross-sectional study was carried out in the outdoor patient department of thalassemia at Sir Ganga Ram Hospital, Lahore for 4 months.100 patients were selected through non probability sampling technique. Data was tabulated and analyzed by SPSS version 21.0.Results: Thalassemia was more prevalent in the age group of 8-12 years. Nutritional deficiencies in thalassemia patients caused anemia as it was evident from results that 74% of thalassemic children had pale skin. As far as dietary intake was concerned only 4% of thalassemia children were consuming meat and meat products.58% of thalassemia children consumed milk on daily basis.Only 8% took green leafy vegetables on daily basis as it contains high amount of iron.Micro nutrient deficiencies as vitamin A, C were common among thalassemia patients as only 30% were consuming fruits on daily basis.Conclusions:Most of the thalassemiacchildren were found to be malnourished due to inadequate dietary intake. The caregivers and parents should be counseled to create awareness CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/17 10.52229/pbmj.v2i2.17 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/17/18 10.52229/pbmj.v2i2.17.g18 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/18 2021-09-09T18:34:25Z pbmj:O.A driver

Correlation between Onset of Renal Disease with Diabetes: onset of renal disease in diabetics Arshad, Misbah Ashfaq, Mamoona Mazhar, Zargham Sharmeen, Zainab Diabetes is associated with number of vascular and nonvascular complications, and the vascular complications which include Cardiovascular Disease (CVD), peripheral vascular disease (PVD), stroke, retinopathy, neuropathy, and Diabetic Kidney Diseases (DKD are responsible for most of the morbidity and mortality attributable to diabetes. Objective: The aim of this study was to determine the correlation of onset of any renal disease with diabetes in Pakistani population. Methods: A cross sectional study was conducted at Medicine and Nephrology Departments of the Sir Ganga Ram Hospital, Lahore, over a period of 3 months, after obtaining the ethical approval from the The University of Lahore. A total number of 100 Diabetic patients were selected through non probability convenient sampling technique. Patients of both sexes and all age groups were included. Results: In this study 60% were male and 40% were female. Most of the patients belonged to lower socioeconomic status. Frequency of onset of diabetes with age showed that patients between age of 41-50 years (33%) were more susceptible to diabetes and its complications whereas onset of diabetes was relatively higher in males as compared to females. Frequency distribution of CVD among diabetic patients was 19%. Conclusions: Results of current findings showed that diabetes mellitus also leads toward further microvascular complications and co-exist with different diseases.  CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/18 10.52229/pbmj.v2i2.18 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/18/19 10.52229/pbmj.v2i2.18.g19 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/19 2021-09-09T18:34:25Z pbmj:O.A driver

Patterns of Deranged Lipid Profiles in Patients of Chronic Hepatitis C: Deranged lipid profile in hepatitis C patients Masud, Mohsin Bangash, Lala Rukh Mumtaz, Sami Ullah Iqtadar, Somia Komal, Tayyeba Abaidullah, Sajid Mehboob, Khurram Liver plays an important role in lipid metabolism and any acute or chronic malfunction of the liver due to viral hepatitis or liver cirrhosis may induce lipid derangements Objective: To determine the patterns of deranged lipid profiles in patients of chronic hepatitis C Methods: It is a prospective, observational study, conducted at Medicine Department, Mayo Hospital Lahore for 6 months i.e.1stJanuary to 30th June 2018.After the ethical approval, 160 diagnosed cases of chronic hepatitis C of ages 18-70 years of either gender were selected by non-probability purposive sampling. Informed written consent was taken. Demographic information such as name, age and gender were recorded. Venous blood samples from patients after 10 to 14 hours of fasting were drawn for lipid profiles and sent to pathology laboratory. All results were expressed as mg/dl. Data were analyzed in SPSS version 22 Results: Out of 160 patients in this study, there were 94 males and 66 females. Total cholesterol was lower in 62.5% patients, normal in 33.75% patients and higher in 3.75% patients. Triglycerides levels were low in 66.25%, normal in 33.125%, and high in 0.625% patients. Low density lipoprotein (LDL) levels were low in 82.5% patients, normal in 10% and raised in 7.5% patients. High density lipoprotein (HDL) levels were low in 95%,normal in 4.375% & high in 0.625% patients Conclusions: Low levels of serum lipids including total cholesterol, triglycerides, LDL and HDL are seen in population suffering from chronic HCV infection. CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/19 10.52229/pbmj.v2i2.19 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/19/20 10.52229/pbmj.v2i2.19.g20 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/20 2021-09-09T18:34:25Z pbmj:O.A driver

Epidemiology of Squamous Cell Carcinoma in Response to Different Hazardous Chewing Causes in Lahore, Pakistan-a Unicenter study: epidemiology of oral carcinoma in Lahore, Pakistan Siddiqui, Maria Fareed Yaqoob, Umair Oral squamous cell carcinoma (OSCC)being the world’s most prevailing and frightening cancerous disorder lacks the sufficient data in Pakistan despite of its higher magnitude and prevalence. Objective:This study was specifically designed and conducted with the aim to identify the frequency of this disorder along with causative factors in past three years in a tertiary care hospital of Lahore, Pakistan.Methods:Epidemiological study was conducted using retrospective randomized method and all pre-requisites were filled.The clinical profiles of patients were collected from Maxillofacial and Oral Surgery Departmentof Pathology, Mayo Hospital Lahore. Patients who had undergone treatment for OSCC were contacted and interviewed for information about demographic regions, previous history of malignancy, disease onset, chewing habits, exposure to pesticides, industrial exposure to metals etc. and all particulars were not and compiled on questionnaire. Results:A total of 54 patients from different districts of Punjab participated in the study.Percentages for each possible causative chewing habit were calculated and 87.50 % of population was found addicted to different habits. Genetic factor might have contributed in remaining for development of OSCC.Conclusions:Informative data provided in this study will be helpful to be used by the government and private health agencies while designing and planning management of oral health problems and allocating health budgets in focusing this issue CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/20 10.52229/pbmj.v2i2.20 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/20/21 10.52229/pbmj.v2i2.20.g21 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/21 2021-09-09T18:34:25Z pbmj:Edt driver

A Welcome Note from the Editor Shabbir, Ayisha We are delighted and proud to welcome you to the second issue of Volume 2. Each article received and accepted is an important contribution to the already existing knowledge in the field of Biomedical Sciences. All the editorial team is excited about the progress of PBMJ as an international journal. As editors, we would like to express our heartiest congratulation to the team and welcome to the authors and readers.We are also grateful to the advisory board and managing editors. We hope that PBMJ can promote the academic and applicable research and improve the research activities and collaborations. We are aware of the bumps along the way, but we are determined to keep pursuing the research goals to meet the high quality standards and move forward with great courage. If you have any suggestions to improve, you may write to us as a reader. In the age of technology, we can actively conversate with the readers and get their feedback to improve the quality with their valuable input. PBMJ will continue to serve the Biomedical Sciences as an outlet for high-quality research. This is an exciting time for the journal and we look forward to working with authors, the Editorial board and the team to make PBMJ as a leading source for work in the space. CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/21 10.52229/pbmj.v2i2.21 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/21/22 10.52229/pbmj.v2i2.21.g22 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/22 2021-09-09T18:34:25Z pbmj:G.Edt driver

Momentum of Ajwa Dates towards Cardiovascular Diseases: Momentum of Ajwa Dates towards Cardiovascular Diseases Bibi, Huzaima Tabassum, Sobia Ahmed, Naseer Cardiovascular diseases (CVDs) are the top most cause of morality around the world.  It is predicted that the number casualties from CVDs will increase to more than 24 million till 2030 people.Medicinal plants provide the major raw materials for medicine preparations. They are gaining high consideration due to their effectiveness and increasing cost of modern medicines.Many successful drugs are plant based, including aspirin from the willow bark, morphine from opium poppy, quinine from the cinchona bark, and digoxin from the foxglove. According to World Health Organization (WTO), ~70% to 80% of people around the world rely on herbal sources for the treatment of their disease.Plant sources are endorsed due to the fact that they contain an optimal amount of  antioxidants and phytochemicals that help to avoid and treat many diseases. Phoenix dactylifera L. particularly Ajwa variety, is the most rich in phytonutrientsthat can benefit to control many cardiovascular diseases.It contains6 vitamins (vitamin A, C, B1, B2, B3 &riboflavin), high amount of fibers, Potassium, Magnesium and 23 amino acids which play a healthy role towards hypertension, muscular contractions, and blood pressure control. It has been studied that Niacin (B3) helps to control cholesterol and low density lipoprotein levels (LDL), as high cholesterol is the one of the main cause of cardiovascular diseases so, Ajwa could be a vital regulatory source. According to the findings of Sabbah M. et al., Ajwa extracts significantly improved the DNA integrity and also reduced the cardiomyocytes congestion, edema and the cellular stress wielded on cardiac muscles resulting the restoration of cardiomyocytes architecture in Doxorubicin (DOX) induced cardiotoxicity in rats. Research done by Alqarni et al., proves that Ajwa extracts has successfully decreased the LDL‐C, VLDL‐C, and triglycerides concentration. Additionally, treatment with ajwa pulp also improved the HDL‐C level and antioxidant enzymes activity. In another invivo study, Ajwa preparation has successfullydecreased the diclofenac-induced pulmonary and hepatic instabilities. Vitamin-K play important role in blood coagulation, and in case of anticoagulant therapy, activity of vitamin-K controlled by drugs (warfarin) that sometimes causes serious side effects. According to the reported data, Salicylic acid is the vitamin-K antagonist and has capability to block the action of vitamin K during the coagulation pathway. Dates contain ~3.75 to 4.50 mg/100 g of salicylic acid. Thus, providing anticoagulation effect too.So, the limelight of the reported data provides an enough reason that plants can be used as primary source of drug designing for the cardiovascular disease. They hold true momentum to address the increasing healthdiseases, which cannot be lost to distraction or apathy. Fight against the burden of CDVs, is affecting all countries and specially, under developing and the poor countries. CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/22 10.52229/pbmj.v2i2.22 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/22/23 10.52229/pbmj.v2i2.22.g23 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/23 2021-09-09T18:34:25Z pbmj:Rew.Art driver

Immunological memory as the fundamentals of vaccines: Immunological memory and vaccines Haider, Fatima Sultan, Amir Khan, Hassan Ahmed The immune system also called as the defense system involves many different cells that work as soldiers in an individual. These immune cells provide protection against various pathogens. For better protection of an individual the immune systems has the ability to memorize or remember the pathogen. This ability is known as immunological memory. With the help of immunological memory the immune memory cells remember the antigen and are prepared if there is an encounter with the antigen in future. The immunological memory can be developed against certain strains with the help of different types of vaccines. Such types of vaccines that are currently being used to save lives are, Live attenuated vaccines, Toxoid vaccines, Subunit vaccines, Glyco-conjugated vaccines, and Killed/Inactivated vaccines. These vaccine show different efficiency. Hence, the immunological memory generated after a single vaccination may wear off with time. Multiple numbers of shots are required for the development of long term memory. All these types of vaccines vary from each other in their manufacturing and also in their mechanism of providing long term immunological memory. They show many pros and cons but their advantages are greater than their disadvantages. Thus, are preferred to be used for the betterment of mankind.    CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/23 10.52229/pbmj.v2i2.23 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/23/24 10.52229/pbmj.v2i2.23.g24 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/24 2021-09-09T18:34:02Z pbmj:Edt driver

A Welcome Message from The Editor Khalid, Sidra It is with profound pleasure that we write this editorial to welcome you to the new journal, “Pakistan Biomedical Journal” (PBMJ), an interdisciplinary international journal. PBMJ has successfully completed its first volume and now its the second volume. We greatly appreciate the response of scientists who have contributed previously and are still contributing to this new journal. The subject of the journal is interesting and we try to address the health related concerns of public and improve the understandingof scientific phenomenons by researchers. Research discoveries are happening at a fast pace, in all the fields and PBMJ provides an ideal forum for exchange of scientific knowledge in terms of full length papers, surveys, reviews, case studies, letters to editor and systematic analysis. PBMJ is committed to publishing all manuscripts receiving a high recommendation from reviewers. The intention of PBMJ is to create space for generation of new knowledge, debate, collaborations among national and international scientists. Our vision is to promote research that will be helpful for knowledge sharing, new discoveries, development of critical thinking among the upcoming scholars, guidance for policy makers, awareness among the concerned community and ultimately benefitting the general population in improving health and fitness at large. It is a matter of pride for us to haveexcellent editorial board members from renowned institutes. We aim to have the best standards of quality of the published manuscripts. With every issue, we are continuously trying to improve the standards. We look forward for more exciting researches and scientific studies from all over the world. We would like to extend a very warm welcome to the readers of PBMJ and hope you will join us as authors, reviewers and editors in future. CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/24 10.52229/pbmj.v2i1.24 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/24/25 10.52229/pbmj.v2i1.24.g25 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/25 2021-09-09T18:34:02Z pbmj:G.Edt driver

Dengue Fever: A Continuous Threat Hayee, Sara Rehman, Amna Dengue fever is a vector borne disease and is caused by DEN Virus. This virus has four different serotypes. The vectors are two mosquitoes known as Aedesaegypti (the yellow fever mosquito) and Aedesalbopictus(the Asian tiger mosquito).  First case of dengue fever was reported back in 1994 in Karachi. A complete outbreak of this epidemic shook the whole nation in 2012.Uptill now, Lahore a city full of culture, witnessed about 16,580 confirmed cases and 257 deaths. About 5000 confirmed cases with 60 deaths were reported from the rest of the provinces. Under guidelines of WHO, Government has made efforts to combat this epidemic. Although the overall efforts have minimized the outbreak on controllable levels but dengue fever is a continuous threat. Since no permanent cure is available, the transmission of DEN virus is controlled indirectly. So the prime focus is to control mosquito population and decrease the possible hot spots i.e. mosquito breeding sites in human habitations. Every year, the country witnesses monsoon season which brings vast areas full of clear standing waters providing breeding sites for mosquitoes which ultimately leads to increased number of patients suffering from dengue fever. Efforts have been made to fight against dengue including formation of dengue wards in hospitals, vector surveillance, community education, reactive vector control etc. A study has shown prevalence of four mosquito genera in Pakistan including Aedes, Culex, Armigeresand Anopheles. All of the above mentioned genera are associated with disease transmissions as they are the vectors of different viruses and parasites. It is the need of hour to do a collaborative effort stressing the community mobilization and management in war against dengue. CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/25 10.52229/pbmj.v2i1.25 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/25/26 10.52229/pbmj.v2i1.25.g26 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/26 2021-09-09T18:34:02Z pbmj:Rew.Art driver

Thermostable Vaccines: Past, Present and Future Perspectives: Thermostable Vaccines Farooqui, Misbah Sultan, Amir Khan, Hassan Ahmed Vaccines stability has a major role in the success of immunization programs and saves millions of lives every year. To stabilize vaccines cold chains are developed for storage and transport, as efficiency of vaccines is hampered if they are not kept under proper temperature. Aluminum is used for making vaccine thermostable. The development of vaccine formulation is a critical part of overall development cycle of approving, testing and producing new vaccines. However, Liquid vaccine formulation is still preferred over dry formulation because of ease in using, packaging and manufacturing. Other approaches have been used to make vaccine thermostable. This study demonstrates those processes, used to develop thermo-sensitive vaccines into thermostable vaccine and also describes vaccine formulation designing and use of heat shock protein including mHSP70 and mHSP65 to generate innate and adaptive immune response. CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/26 10.52229/pbmj.v2i1.26 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/26/28 10.52229/pbmj.v2i1.26.g28 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/27 2021-09-09T18:34:02Z pbmj:O.A driver

Association of consanguineous marriages with congenital anomalies: Cousin marriages and birth defects Naveed, Maryam Nadeem, Sajeeha Hassan, Amber Tanvir, Imrana Congenital anomalies are a major health problem all over the world; especially it is important cause of deaths and birth defects, chronic illness and disability in infants. The major cause of this is consanguineous marriages. Generation of cousin marriages have significant association with congenital anomalies Objective: To find out the association of consanguineous marriages with congenital anomaliespresent at the time of birthMethods:A cross sectional study was conducted at District Head Quarter Hospital, Okarafrom May to August, 2018. 100 adult individuals aged between 19 to 55 years, with and without cousin marriage of both genders were consecutively enrolled. Participants were assessed through pre-tested questionnaire, with prior written informed consent. Unwilling married individuals and individuals from other hospitals were not selected Results:According to resultsthere was a significant association between generation of cousin marriages with congenital anomalies present at the time of birth , as p value was 0.002Conclusions:Study concluded that the generation of cousin marriages has significant association with congenital anomalies present at the time of birth and due to cousin marriage 59% of the couples had congenital abnormalities in their children and 85% had genetic disorders. CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/27 10.52229/pbmj.v2i1.27 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/27/29 10.52229/pbmj.v2i1.27.g29 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/28 2021-09-09T18:34:02Z pbmj:O.A driver

Efficacy of Atorvastatin Plus Pegylated Interferon and Ribavirin Versus Pegylated Interferon and Ribavirin Alone in Chronic Hepatitis C Patients with Genotype-3a: Atorvastatin for the treatment of chronic HCV with Genotype-3a Gulzar, Waqas Niaz, Zafar Mumtaz, Sami Ullah Iqtadar, Somia Komal, Tayyeba Abaidullah, Sajid Background:Chronic hepatitis C infection has created a huge burden of disease causing serious health effects. The combination therapy used to treat hepatitis C virus (HCV) infection includes Pegylated interferon and Ribavirin. As cholesterol biosynthesis plays a pivotal role in HCV replication, the use of various statins has been associated with higher sustained viral response Objective: To compare the efficacy of atorvastatin plus pegylated interferon and ribavirin versus pegylated interferon and ribavirin alone in patients of chronic hepatitis C with genotype-3a Methods:This Randomized controlled trial was conducted at outpatient department, Mayo Hospital Lahore for six months i.e. May to November 2017. After ethical approval, 60patients of ages 25 to 55 years of either gender with chronic hepatitis C with genotype 3a were included in the study. Informed consent was taken from all patients.Then patients were randomly allocated into two groups “A” and “B” using random number table. Patients in Group A received standard of care treatment for chronic hepatitis C i.e. pegylated interferon and ribavirin while the patients in Group B also received tab atorvastatin along with the standard treatment. Patients were follow up for 4 week. Blood samples were collected and HCV RNA detection. All this information were entered in proformaResults: In standard therapy group, the mean age of patients was 39.50±8.39years. In atorvastatin plus standard therapy group, the mean age of patients was 34.30±6.78years. In standard therapy group, there were 25 (83.3%) males and 5 (16.7%) females. In atorvastatin plus standard therapy group, there were 16 (53.3%) males and 14 (46.7%) females. After 4 weeks, Rapid VirologicalResponse (RVR) was achieved in 4 (13.3%) patients in standard therapy group while in 14 (46.7%) in atorvastatin plus standard therapy group. The difference was significant (p<0.05) Conclusions: Atorvastatin in combination with Pegylated interferon and ribavirin have better efficacy as compared toPegylated interferon & ribavirin alone in chronic hepatitis C-3a. CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/28 10.52229/pbmj.v2i1.28 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/28/30 10.52229/pbmj.v2i1.28.g30 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/29 2021-09-09T18:34:02Z pbmj:O.A driver

Frequency of Renal Diseases in Diabetic Patients: Renal diseases in diabetic patients Arshad, Misbah Ashfaq, Mamoona Sharmeen, Zainab Mazhar, Zargham Ehsan, Kashifa Diabetic nephropathy, also known as diabetic kidney disease is the chronic loss of kidney function occurring in those with diabetes mellitus. Diabetic nephropathy is one of the leading causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) globally. Protein loss in the urine due to damage to the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) and result in the nephrotic syndrome. Objective: The aim of this study was to determine the frequency of renal disease in diabetic patients and its complications in Pakistan. Methods: A cross sectional study was conducted at Renal and Diabetic Departments of the Sir Ganga Ram Hospital, Lahore, over a period of 3 months, after obtaining the ethical approval from the The University of Lahore. A total number of 100 Diabetic patients were selected through non probability convenient sampling technique. Patients of both sexes and all age groups were included. Results: In this study 60% were male and 40% were female. About 41% diabetic patients were 1-6 month of age, 42% were 1-5 years old and 1% of 18-23 years old who had renal diseases while 9% patients were without any renal disease. whereas the prevalence of diabetes is more in infants than others which is 35%. But there was not significant association between onset of renal diseases with the onset of diabetes mellitus with p-value 0.24. Conclusions: Results of current study showed that diabetes mellitus effecting individuals of all ages equally but there was not significant association between diabetes and renal diseases.  CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/29 10.52229/pbmj.v2i1.29 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/29/31 10.52229/pbmj.v2i1.29.g31 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/30 2021-09-09T18:34:02Z pbmj:O.A driver

Frequency and Psychosocial Determinants of Gender Discrimination Regarding Food Distribution among Families: Gender discrimination regarding food distribution among families Mumtaz, Sami Ullah Iqtadar, Somia Akther, Muhammad Kalim Niaz, Zafar Komal, Tayyeba AbaidUllah, Sajid Due to male dominance in society as well as in households, the rights of females are ignored. Hence, there exists gender discrimination while giving food to family members which in turn results in poor health status for females. Therefore, it is important to explore the causes of this unequal distribution of food among family members Objective: To determine psychosocial factors causing gender discrimination regarding food distribution among families Methods: Data collected from fifty females aged 15-80 years, selected from the urban community using non-probability consecutive sampling, were used for analysis. Females with malnutrition, psychological disorders, with laparotomy and major surgery were excluded. Gender discrimination was assessed as males or male children were preferred for better and more food items like fresh food, meat, fruits, milk, dairy products and multivariate logistic regression analysis was done to see the impact selected factors on gender discrimination Results: The large family size (> 6 members) showed significantly higher odds of discrimination (OR=3.89; 95% CI= 1.03-15.26) than smaller families. The odds of food discrimination were 4 times more for the families, with males being earning hand (OR=4.57; 95% CI= 1.19-18.31). Similarly, there exist higher odds of gender discrimination in low-income families (OR=5.10; 95% CI= 1.18-23.87). While maternal education reduces the chances of food discrimination (OR=0.10; 95% CI= 0.02-0.42)  Conclusions: Psychosocial factors such as large family size, low monthly income, males being earning hand and maternal education were found to be associated with gender discrimination regarding food distribution among family members. CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/30 10.52229/pbmj.v2i1.30 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/30/32 10.52229/pbmj.v2i1.30.g32 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/31 2021-09-09T18:34:02Z pbmj:O.A driver

Diversity Analysis of Rotifers from Temporary Spring Pools of Jallo Park, Lahore, Pakistan: Diversity Analysis of Rotifers from Jallo Park, Lahore, Pakistan Hayee, Sara Arshad, Sayrah Sundas, Rabiia Akhter, Naveed Khan Sulehria, Abdul Qayyum Temporary pools are relatively small water bodies with limited resources and are seasonally available. These freshwater bodies are rich source of microbial and planktonic lifeObjective:This survey was conducted to find out the presence of rotifers in temporary pools formed inJallo Park established in 1978 and explore their density and diversityMethods:Sample collection was done from ten pools with the help of a planktonic mesh. The counting was performed with a Sedgwick- Rafter chamber. Diversity indices like Shannon Weaver index etc. were applied Results: In present study 27 rotifer species belonging to 14 genera were identified. The highest diversity and density was shown by Brachionus and Lecane. There was even distribution in each pool. Results of ANOVA showed statistically significant difference in population density and diversityConclusions:This study has presented a guideline to find out rotifer diversity which could be present in any water reservoir like temporary pool. CrossLinks International Publishers 2019-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/31 10.52229/pbmj.v2i1.31 Pakistan BioMedical Journal; Vol. 2 No. 1: Volume 2 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v2i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/31/34 10.52229/pbmj.v2i1.31.g34 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/32 2021-09-09T18:34:25Z pbmj:O.A driver

Arrhythmias after Implantation of the Left Ventricular Assisted Device: Arrhythmias after Implantation of the Left Ventricular Assisted Device Albkhoor, Bashar Alnawaisheh, Khalid Anzeh, Razi Abo Alfawaeer, Zyad Alrawashdeh, Hanan Cardiac arrhythmias has been frequently reported after left ventricular assist devices implantation but currently literature shows no sufficient information on cardiac arrhythmias. Objective: The aim of this study was to assess the frequency and other features of ventricular and supra ventricular ectopic beats ((SVEB), atrial fibrillation (AF)/flutter (AFL) post device implantation. Methods:This is a retrospective study conducted in Department of Cardiac-Surgery, University of Verona Medical School, Verona, Italy from June 2014-September 2016. Rhythm monitoring and registration were collected from 16 patients (13 males; 45±13years) during the first five (05) days after implantation. To assess late post-operative rhythm, patient’s hospital electronic records were used as well asfunctional hemodynamic parameters including mean arterial pressure(MAP), right atrial pressure(RAP), heart rate(HR) and ST-deviation(d-ST). Results: Ventricular arrhythmia (n=9), atrial fibrillation (n=5) or atrial flutter (n=2) episodes were preoperatively present in 11 patients. Postoperatively, 5 patients developed either VT (n=2), AF (n=1) or both VT/AF (n=2) during a follow-up of 18±14 months. Prior to postoperative VT (POVT) episodes (n=123), MAP decreased, HR, d-ST increased and RAP remained unaltered. POVT were initiated either by single VEBS (28%), V-couplets (15%), V-run (46%) or occurred suddenly (11%).Conclusions: Ventricular and supraventricular arrhythmias are common after device implantation. The frequency of sustained VTA was less at early phase as compared to late postoperative phase. CrossLinks International Publishers 2019-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/32 10.52229/pbmj.v2i2.32 Pakistan BioMedical Journal; Vol. 2 No. 2: Volume 2 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v2i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/32/35 10.52229/pbmj.v2i2.32.g35 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/33 2021-09-09T18:32:48Z pbmj:Edt driver

Welcome to the inaugural Issue of Pakistan BioMedical Journal Mehboob, Prof. Dr. Riffat Firstly, I would like to welcome all the readers, authors, editorial team and management of Pakistan Biomedical Journal (PBMJ) to this new journal in Biomedical Sciences.It is an intenational peer-reviewed, open-access journal that merges the basic and clinical research for the better outcome in terms of diagnosis and therapeutics. This approach will update and upgrade the existing knowledge among the researchers and clinicians, regarding the patient care and practice as well as understanding of underlying mechanisms of diseases. The ultimate beneficiary is patient and community as a whole. PBMJ is led by an outstanding Editorial Board comprising of national and international members with multidisciplinary research background. Our goal is to promote the basic and clinical research, health and disease perspectives. We receive original studies, review articles, case reports, systemetic reviews on medical, biomedical, basic and therapeutic research. We welcome scientific contributions from all over the world. It is the need and demand of the recent world scenario to focus on biomedical research. In the current world, basic and medical science cannot be considered as two separate and independent entities. There should be coherent efforts to unveil the basic understandings of pathologies at physiological, cellular and molecular level. Furthermore, the therapeutic strategies should also be explored on regional and global levels, by keeping in mind the different genetic makeups and considering the individual identities. It leads to the field of ‘personalized medicine’. There are many other recent therapeutic regimens such as regenerative medicine, exosomes, gene silencing and gene editing technologies. The world has also advanced in diagnostic modalities. Much focus has been emphasized on rapidness, accuracy and cost-effectiveness of these techniques. Imaging, scanning, histopathological, biochemical and hematological techniques have been much advanced than before. World has been changing rapidly in medical profession. Hence, it is important to be aware of these advancements worldwide and also to share the health related researches at local level. We hope this new journal will be a good addition in this perspective of sharing the recent knowledge, advancements and create awareness among masses. CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/33 10.52229/pbmj.v1i1.33 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1; 01 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/33/36 10.52229/pbmj.v1i1.33.g36 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/34 2021-09-09T18:32:48Z pbmj:G.Edt driver

Revival of Complementary and Alternative Herbal Medicines Fareed Siddiqui, Maria Herbal medicines, complementary or alternative medicines is a wide term for the therapies that are not part of standard care but it has many theories regarding efficacy based on personal experiences, history and common knowledge. It has long been used since ancient times since the beginning of human civilization. Its use had caught much attention in the early 1800s, with the development in the science of chemistry, a new era in pharmacotherapeutics and the use of active chemical ingredients in plants which were known to produce favorable therapeutic effects, were explored, active compounds were extracted, purified and their structure was revealed. This advancement paved the way towards modern pharmaceutical therapy. The modern drugs are based on these herbal medicines, after extracting the active and pure chemical compounds. Pharmacokinetics and physicochemical properties of the active ingredients was explored. It lead to the better understanding of efficacy and safety profile of these drugs and first choice for treatment of various diseases. At the same time, the herbal medicines were considered as secondarily important. After approximately two centuries, the use of herbal medicines have seen a revival globally both in developing as well as developed countries. In the past few years, the practice of using herbal medicines as an alternative and complementary health medicine has gained more importance.Herbal medicines are common for treatment of various ailments including cancer, digestive disorders, pain related disorders, neuropathic ailments and cardiac arrhythmias etc. Even it has been used by pregnant females and mostly perceived as safe. Its use has gained more attraction due to its ‘natural’ approach and lesser side effects. Their use if often overlooked but physicians should pay attention to these medicines. There is lack of familiarity, standardization of the drug components, unproven therapeutic effects in various diseases, unexplored toxicology, pharmacokinetics, drug-drug interactions, and compatibility in patients with varying medical, genetic and demographic history. There are serious concerns regarding the safety, efficacy and quality of herbal products and nutraceuticals. Accidental contamination and deliberate adulteration are assumed to be the main cause of the side effects. Much of the herbal medical knowledge is scattered in different regions of the world and mostly available at family, community and local level and mostly in any native languages. There is need of coherent sources, knowledge, and exploration of these medicines across the world. The herbal medicine has varying diversity in different geological regions and they should be investigated. There should be a regional or national body to control and approve the herbal medicines. Proper documentations on these medicines and food supplements should also be done. CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/34 10.52229/pbmj.v1i1.34 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1; 02 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/34/37 10.52229/pbmj.v1i1.34.g37 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/35 2021-09-09T18:32:48Z pbmj:O.A driver

Prognostic Significance of Cellular Iron Metabolism in Breast Cancer Khan, Rizwan Ullah Hassan, Amber Tanvir, Imrana Ehsan, Kashifa Breast carcinoma is among the most common malignancy in women. Objective:Aim of the present study was to evaluate the prognostic significance of iron expression in the biopsies of patients with breast cancer. Methods: 24 breast biopsies were studied. 19 cases were poorly differentiated, 5 cases were moderately differentiated and there was no well differentiated case. Iron, Estrogen receptor (ER), Progesterone receptor (PR), HER2 and Ki-67 immunohistochemical staining was performed for all these cases. Results: Among the 5 moderately differentiated cases, 3 (60%) were positive for iron staining and among 19 poorly differentiated cases, 11 cases (57.89%) were positive. More iron positive cases (7 out of 14) were triple positive belonging to Luminal B class. Out of 14 iron positive cases, 11 were positive for HER2, 10 for ER, 9 for PR and all positive for Ki-67. Conclusions:Iron deficiency in premenopausal and overload in post-menopausal women can contribute to the development of breast carcinoma. So, iron can be considered as a cheap and effective marker for the prognosis of breast cancer.Association between a risein iron levels and HER2 expression may providenewstrategy for breast cancer treatment. CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/35 10.52229/pbmj.v1i1.35 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1; 14-20 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/35/38 10.52229/pbmj.v1i1.35.g38 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/36 2021-09-09T18:32:48Z pbmj:O.A driver

Comparative Effect Of Tetrapack Juices And Fresh Fruit Juices On Blood Glucose Level Among Healthy Individuals: Comparative Effect of Juices on Blood Glucose Level Manzoor, Junaid Kamran, Hafsa Shakeel, Anum Uses of tetra pack juices enhances the risk of diabetes and obesity. People were unaware of impact of fresh fruit juices on health.Objective:To compare the effect of tetra pack juices and fresh fruit juices on blood glucoselevels among healthy individuals Methods:10 participants were selected using an internationalstandard Glycemic Index (GI) test protocol. After getting their fasting blood sample theywereinstructed to consume all the juice served in a period of 5 min. Further blood samples were takenat different intervals of time that is 0, 30, 60, 90, 120 and 150 minutes after consumption. Participants wereremained sedentaryduring each session. Blood was obtained by finger-prick and tested by the glucometer.Results:The glycemic index of Apple juice Nestle has the glycemic index of 95.87, Orangejuice Nestle has the GI value 93.78, Apple juice fresh has the GI value of 92.17 and Orangejuice fresh has the glycemic index value of 99.07, respectively Conclusions:Detailed study of glycemic index of tetrapack juices (Nestle Apple and Orangejuice) and fresh fruit juices (Apple and Orange juice) showed similar impact on the blood glucose level of healthy individual. In the study, both types of juices were found to be equally hyperglycemic (GI 70+) causing a fast rise in blood-sugarlevels, hence should not be given to diabetic patients CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/36 10.52229/pbmj.v1i1.36 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/36/39 10.52229/pbmj.v1i1.36.g39 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/37 2021-09-09T18:32:48Z pbmj:Rew.Art driver

Human Papilloma Virus Related Head and Neck Squamous Cell Carcinoma-an updated review Kaur, Jaspreet Human papilloma virus (HPV) related head and neck squamous cell cancer (HNSCC) has varying etiology, genetic as well as environmental factors involved and differential clinicicopathological features. HNSCC came in the limelight recently due to increased incidence rate and insufficient diagnostic methods. This review will comprehensively focus on the characteristics of HPV associated HNSCC.  It will provide an updated review of our understanding of HPV role in Oral squamous cell carcinoma (OSCC) known to date. Curruntly, three vaccines are available (Gardasil, Gardasil 9 and Cervarix). These vaccines prevent infections with HPV types 16 and 18 HPV-16 is most common type associated with HNSCC. HPV related HNSCC has better prognosis, does not mutate  but inactivatestumor suppressor genes and therefore has comparatively better treatment options. However, there is still a need to improve our methods of sampling, HPV molecular assay and type of specimen to be used. CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/37 10.52229/pbmj.v1i1.37 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/37/40 10.52229/pbmj.v1i1.37.g40 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/38 2021-09-09T18:32:48Z pbmj:O.A driver

Multivariate Analysis of Rotifers Community from Safari Zoo Lake Lahore, Pakistan Hayee, Sare Akhter, Naveed Khan Sulehriya, Abdul Qayyum Rotifers are zooplanktons that react more sharply to the environmental changes. Objective:To better understand the community composition of rotifers in Safari Zoo Lake, Lahore, PakistanMethods: wecollected 16 water samples on monthly basis, dividing lake into four major sites: northern, southern, eastern, and western sites. Each of these was further subdivided into four locations, for a total of 16 sampling sites. A total 23 rotifer species were recorded from the lake with Brachionus calyciflorus having maximum abundance. A species abundance curve was plotted between months and number of species of rotifers indicating their lowest and highest abundance through the study period. Results:A Cluster Analysis yielded three main groups of closely related species including species like Brachionus quadridentatus, Synchaeta stylata and Brachionus calyciflorusetc. We used a Principal Component Analysis (I and II) to study variation in the rotifer community on a seasonal basis and among sampling sites. A biplot of Principal Component Analysis (PCA I) reflected the relationship of rotifers with the months. Some of the species showed a positive positive relationship, while others showed negative one. PCA II was plotted between months and physico-chemical parameters showing their negative and positive relations. Conclusions:We conclude that a lesser replacement of fresh water, increased density of waterfowl, reptilia and solid waste left overduring boating has resulted in eutrophication of lake leading to overall low diversity of rotifers observed CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/38 10.52229/pbmj.v1i1.38 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1; 33-37 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/38/41 10.52229/pbmj.v1i1.38.g41 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/39 2021-09-09T18:33:23Z pbmj:Edt driver

Welcome Note from Editor-in-Chief Lavezzi, Prof. Dr. Anna Maria It is with great pleasure that I write this editorial to welcome you to the first issue of this new International journal, “Pakistan Biomedical Journal” (PBMJ).The topics covered by the journal are certainly broad and interesting. Biomedical science is a collection of applied sciences that help us understand, research, and innovate within the field of healthcare. It includes disciplines like molecular biology, clinical virology, bioinformatics, and biomedical engineering, among others. It's designed to apply the biological sciences to advance not only individual health but also the area of public health. Biomedical Research can help health professions better understand things like the human body and cell biology, making advances in our understanding of epidemics, health initiatives, and human health in the age of longer life expectancy. It aids our understanding of infectious disease and provides research opportunities into some of our most troubling health issues. The journal will continue to publish high quality clinical and biomedical research in health and disease later in life. Peer review will remain a vital component of our assessment of submitted articles.I am very happy to have a team of excellent editors and editorial board members from the top international league covering in depth the related topics. They will ensure the highest standards of quality for the published manuscripts and, at the same time, keep the process time as short as possible.We hope to bring best researches in the field of biomedical sciences that may serve as a guideline in health awareness, understanding the mechanisms and its management in future.   We definitely look forward to receiving your excellent studies to making PBMJ synonymous with high quality in the biomedical science domain. CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/39 10.52229/pbmj.v1i2.39 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/39/42 10.52229/pbmj.v1i2.39.g42 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/40 2021-09-09T18:33:23Z pbmj:G.Edt driver

Physical activity in prevention of cancer and better prognosis Yousafzai, Muhammad Sulaiman Cancer is a multifactorial disease with genetic and environmental risk factors. Environmental factors may also be termed as modifiable risk factors and these contribute towards 35% of cancer related mortalities as reported by World Health Organization. Obesity is the leading risk factor in this regard, causing not only deaths due to cancer but also to many other diseases. Among different factors causing obesity, a major contributor is lack of physical activity. In this era of modern technology and digitalization, sedentary mode of life has become a part of life and is mostly unavoidable. At the same time, there is a rise in the incidence of cancer. In the olden times, people used to do all manual work, a lot of walk, exercise and had healthy life style. Such healthy life style may have prevented them from various diseases.             Physical activity as a therapy on daily basis, is associated with a reduction in incidence of various carcinomas. It may improve overall wellbeing of healthy people as well as diseases persons from various ailments. As it is a common proverb that, “prevention is better than cure”, physical activity serves as a preventive measure for various diseases and also for fitness of normal healthy people. Although it is a known fact, yet planned population studies are required to provide evidence. Instead of unorganized physical activities, a structured physical activity may help in improvement of condition of cancer patients, prevention of cancer, cancer related deaths as well we quality of life. Healthcare providers should guide the patients in this regard.             There is lack of awareness among physicians and mostly they don’t refer them to physical therapists. There is also lack of information regarding the implementation of the programs and regimens of physical exercises for different diseases and cancers. Physical therapists may guide the patients in terms of frequency, intensity, duration of exercises which may serve as a betterment of their condition. CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/40 10.52229/pbmj.v1i2.40 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/40/43 10.52229/pbmj.v1i2.40.g43 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/41 2021-09-09T18:33:23Z pbmj:Rew.Art driver

Dietary Options in Irritable Bowel Syndrome: Irritable Bowel Syndrome & Die1 Shabbir, Tayyaba Aslam, Maria Liaqat, Mishal Khan, Rija Saleem, Maham Irritable bowel syndrome (IBS) is thedisease condition in which our gastrointestinal(GI) tract is affected and cause abdominal pain and discomfort that is associated with change in the stools form and frequency. In this condition one may suffer from diarrhea, constipation or both at the same time. This disorder is very common now days because of unhealthy eating habits mostly in females. Manyfactors are responsible for IBS like food, environment, genetic and psychological factors.IBS can be overcomed by improving our eating habits and lifestyle and also by following different diets like FODMAP and GLUTEN FREE diet.Probiotics and herbs are also very beneficial in curing IBS. CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/41 10.52229/pbmj.v1i2.41 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/41/44 10.52229/pbmj.v1i2.41.g44 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/42 2021-09-09T18:33:23Z pbmj:O.A driver

Assessment of Quality of Life in Chronic Renal Disease Patients Undergoing Hemodialysis at Public Hospital, Lahore: QoL in Hemodialysis patients Ali, Mahrukh Naveed, Maryam khan, Mehmoona khan, Muhammad Arif Quality of life of chronic renal disease patients is affected by several factors, depending on stage of disease, type of treatment and sociodemographic factors Objective:To assess the quality of life undergoing hemodialysis patients Methods:A cross-sectional study was carried out at Sir Ganga Ram Hospital, Lahore during February to May-2019. Patients suffering from chronic renal disease were included in the study and uncooperative patients were excluded in the study. Total 100 samples of chronic renal disease patients were selected through non-probability convenient sampling technique. Patients were assessed through pre-tested questionnaire. SPSS version 21.0 was used for data analysis Results:According to results 39% patients reported that they were suffering from depression,47% patients of chronic renal disease were unemployed, 28% patients were malnourished and 98% patients were having 3 or more dialysis sessions per week. Also only 26% patients thought that quality of life of older patients is better while 74% considered it poor. Only 77% patients thought that quality of life of middle aged patients is better while 23% patients considered that quality of life of middle aged patients was poor.42% patients thought that quality of life of young aged patients is better while 58%considered it poor Conclusions:Malnutrition, unemployment and hypertensionare the factors affecting the quality of life in patients undergoinghemodialysis in this study. The quality of life of middle aged patients was comparatively better. CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/42 10.52229/pbmj.v1i2.42 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/42/45 10.52229/pbmj.v1i2.42.g45 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/43 2021-09-09T18:33:23Z pbmj:O.A driver

Cytotoxic Assessment of Quinoline Based Derivatives on Liver Cancer Cell Line : Quinoline compounds and their Cytotoxicity Fareed, Maria Qazi, MH Ahmed, Sarfaraz Awan, Sana Qazi, Aamer Current scenario of newer diseases with multiple causes has drawn the attention of the researchers in the field of therapeutics and they are now inclined to identify molecules effective for targeted therapy. Objective: Quinoline (1-azanaphthalene); belongs to heterocyclic aromatic nitrogen compound. Some quinoline-based derivatives are also known for their anti-tumor activity. The study was planned to evaluate the cytotoxic potential of quinoline derivatives. Methods: Berberine; a quinoline compound was made part of study to make structural analogs which were docked against potential target proteins. Cytotoxic profiling of all derivatives was done using MTT cytotoxicity assay. Results: The pharmacoinformatic and structure activity relationship studies of analogs were done. The cytotoxic profiles were elucidated by comparing viability rates of analogs treated hepatic cancerous cell line with untreated hepatic cells and untreated mesenchymal stem cells as standards.  Marked cytotoxicity was seen in all molecules at low doses than reported in past studies with relevance to parent compound. Conclusions: The results will be further confirmed through various other cell culture assays targeting different marker proteins, pharmacoinformatics tools and structure activity relationship studies CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/43 10.52229/pbmj.v1i2.43 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/43/46 10.52229/pbmj.v1i2.43.g46 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/44 2021-09-09T18:33:23Z pbmj:O.A driver

Antibacterial effect of Tradescantia pallida purpurea against fish (Labeo rohita) pathogens: Antibacterial effects of Tradescantia pallida purpurea against fish pathogens Bokhari, Syeda Shazia Yasmeen, Roheela Manzoor, Rimsha Rafi, Uzma Qureshi, Aisha Waheed Diseases are recognized as one of the major restrictions to sustainable animal production which can cause significant economic loss in aquaculture. Even though there are various chemotherapeutic agents such as antibiotics and disinfectants in practice from centuries. Antibiotics have the potential to cause unwanted side effects as well as microbes get resistant against them. Now there is also a lot of research going to see the potential of natural products against pathogens. Tradescantia pallida purpurea plant has various bioactive compounds such as alkaloids, flavonoids, tannis and phenolic compounds Objective:The present study was conducted to testefficacy of Tradescantia pallida purpurea in chloroform extract against fish pathogens and also a comparison in methods (well diffusion and disc diffusion) was made Methods:Four fish pathogens (NP1, NP4, SCC4 and TS1) were isolated after morphological and biochemical tests. Erythromycin was used as control. 10 µg/ml chloroform leaf extract was used by well diffusion and disc diffusion Results:It was noticed that well-diffusion assay was better to inhibit growth of fish isolates as compared to disc diffusion method. It was noticed that Tradescantia pallidahaspotential to inhibit growth of pathogens. Conclusions:So, there is a need to plan a comprehensive study to recommend the maximum dose that is helpful to control fish pathogens. CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/44 10.52229/pbmj.v1i2.44 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/44/47 10.52229/pbmj.v1i2.44.g47 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/45 2021-09-09T18:33:23Z pbmj:O.A driver

Density and Diversity of Rotifers from Shore of a Flood Plain, Balloki Head Works: Density & Diversity of Rotifers in Balloki Head Works Hayee, Sara Zahid, Leena Sundas, Rabiia Akhter, Naveed Khan Sulehria, Abdul Qayyum The present research work is an investigation of Rotifers from flood plains of Balloki Head Works using diversity indices.Objective: To study the density and diversity of rotifers of flood plain. Methods:collection of rotifers was done from the shore of flood plains from September to July. In total, 15 different species were identified. Rotifers were extracted from soil sample by a customized Baermann Funnel method. A moderate diversity of rotifers was explored by Shannon – Weaver. Simpson index of dominance supported this result. Analysis of variance (ANOVA) showed that there was no significant difference in population density of rotifers among months as the p-value was greater than 5% (α= 0.05). Population density of rotifers was negatively correlated with water temperature and pH whereas a positive correlation was observed with electrical conductivityResults:Overall a moderate diversity was observed. Rotifer density and distribution was under the influence of physico-chemical parameters. CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/45 10.52229/pbmj.v1i2.45 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/45/48 10.52229/pbmj.v1i2.45.g48 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/46 2021-09-09T18:33:23Z pbmj:O.A driver

Frequency of Hypothyroidism in Chronic Hepatitis C patients treated with Standard Interferon Therapy: Hypothroidism in HCV patients on Interferon Therapy Farooq, Muhammad Mumtaz, Sami Ullah Akhtar, Hina Ashraf, Kanza Komal, Tayyeba Qureshi, Irshad Hussain Chronic hepatitis C is a major health problem associated with high mortality and morbidity. It is the most common chronic blood borne infection leading to chronic liver disease and hepatocellular carcinoma. One of the treatment used for hepatitis C is interferon therapy which can lead to thyroid dysfunction i.e. hyperthyroidism and hypothyroidism. OBJECTIVE: “To assess the frequency of hypothyroidism in chronic hepatitis C patients treated with standard interferon therapy”. METHODS:Thisdescriptive case series study was carried out at Outpatient Department of Medicine, King Edward Medical University/ Mayo Hospital Lahore for 06 months from July to December 2014.After ethical approval of the study, 200 patients of ages 15 to 65 years with both genders having chronic hepatitis C on Polymerase chain reaction (PCR)& normal thyroid functionstest were taken by Non-probability, purposive sampling technique. Informed written consent was taken from all the patients. Serum thyroid stimulating hormone level (TSH) was sent of all patients to Centre for Nuclear Medicine (CENUM), Mayo Hospital Lahore before and after the completion of three months of interferontherapy and hypothyroidism was considered as TSH>4.0 mIU/L (normal range: 0.2-4.0 mIU/L). RESULTS: The mean age of the patients was 36.29 + 8.5 years. Out of total 200 patients, 123 (61.5%) were male and 77 (38.5%) were female. At baselines mean TSH of the patients was 3.16 + 2.57 mIU/L. After 3 months of therapy 163 patients (81.5%) were euthyroid and 37 patients (18.5%) were having thyroid dysfunction. Among patients with thyroid dysfunction 29 (14.5% of total patients) were hypothyroid. Among hypothyroid patients, according to gender distribution 8 (27.6%) patients were male and 21 (72.4%) patients were female. The difference was statistically significant (P=0.0003). CONCLUSION: It is concluded from this study that there is significant frequency of hypothyroidism in patients of chronic hepatitis C treated with standard interferon therapy and females are at more risk of developing thyroid dysfunction particularly hypothyroidism after standard interferon therapy. CrossLinks International Publishers 2018-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/46 10.52229/pbmj.v1i2.46 Pakistan BioMedical Journal; Vol. 1 No. 2: Volume 1 Issue 2 2709-2798 2709-278X 10.52229/pbmj.v1i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/46/49 10.52229/pbmj.v1i2.46.g49 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/47 2021-09-09T18:32:48Z pbmj:O.A driver

Significance of Philadelphia Chromosome in Chronic Myeloid Leukemia Patients of Anmol Hospital, Lahore, Pakistan Rashid, Kanwal Hassan , Amber Tanvir, Imrana Ehsan, Kashifa Background:Chronic myelogenous Leukemia is a form of cancer that was firstly recognizes to associate strongly with the chromosomal abnormality [t (9; 22) translocation] called Philadelphia chromosome. Objective:Philadelphia chromosome is a characteristic chromosomal marker that is associated with chronic myelogenous leukemia. Methods:More than one hundred patients of either sex were selected for the experiment.RNA was isolated from whole blood of patients so can use exclusively in RT-PCR.Results:Philadelphia chromosome in blood samples of patients with suspected diagnosis of CML was detected in 63% of patients. During our experimental studies on CML patients we do not encounter any complex translocation involving chromosome 8, 9 and 22.  Conclusions:Philadelphia chromosome is a precise cytogenetic marker the detection of which is significant for differential diagnosis and clinical organization of patients with clinical diagnosis of CML. It is of significant that Ph chromosome occurs in pre-leukemic stage and has great diagnostic significance. CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/47 10.52229/pbmj.v1i1.47 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1; 28-32 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/47/50 10.52229/pbmj.v1i1.47.g50 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/48 2021-09-09T18:32:48Z pbmj:O.A driver

Hematological, Biochemical and Etiological factors of Chronic Liver Disease in a tertiary care Hospital of Lahore Mumtaz, Sami Ullah Akbar, Amna Waseem, Humaira Komal, Tayyeba Iqtadar, Somia Abaidullah, Sajid Chronic Liver Disease (CLD) progresses from hepatocyte inflammation to fibrosis, regeneration, cirrhosis and in some cases to Hepatocellular Carcinoma (HCC). In general, the main etiologies of Liver Cirrhosis (LC) are viral infections (hepatitis C and B viruses), chronic alcohol abuse and Non-Alcoholic Fatty Liver Disease (NAFLD), including Non-Alcoholic SteatoHepatitis (NASH). Major complications of CLD are ascites, upper gastrointestinal bleeding, jaundice (acute or chronic) and hepatic encephalopathy. Objectives:This study assesses the etiological factors and complications of CLDin a tertiary care hospital of Lahore,Pakistan. Study Design: Cross-sectional. Methods: Study was carried out in indoor and Accident & Emergency Departments of Mayo Hospital Lahore. 100 clinically diagnosed CLD cases were chosen through “Convenient Sampling” technique during 3 months. Observations:Most common complications of CLD were upper GI variceal Bleeding (48%) & hepatic encephalopathy (34%) and acute or chronic hepatitis (AVH) (33%). Other less common complications observed were hepatorenal syndrome (10%), Spontaneous bacterial peritonitis (15%), Ascites (5%) and HCC (10%).Conclusions:Hepatitis C was found as main etiological factor of CLD. Bleeding andhepatic encephalopathy are the common complications.Awareness programmes regarding CLD and its complications are mandatory in our society to improve human health. CrossLinks International Publishers 2018-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/48 10.52229/pbmj.v1i1.48 Pakistan BioMedical Journal; Vol. 1 No. 1: Volume 1 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v1i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/48/51 10.52229/pbmj.v1i1.48.g51 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/49 2021-09-09T18:36:12Z pbmj:G.Edt driver

Second Wave of COVID-19 in Pakistan: Our Responsibilities and Challenges as A Nation Mumtaz, Sami Ullah The Corona virus (SARS-CoV2) pandemic initiated in late December 2019 in Wuhan city of Hubei, China, which has rapidly progressedinvolving more than 215 countries of the world.It was caused by novel SARS-COV2 coronavirus with Huanan seafood wholesale market as the possible point of origin. In past two decades, coronaviruses epidemic of Middle East Respiratory Syndrome (MERS-COV) had 37% mortality rate and Severe Acute Respiratory Syndrome (SARS-COV) had 10% affecting more than 10,000 population together.World Health Organization (WHO) declared it as the sixth Public Health Emergency of International Concern (PHEIC) on January 30, 2020 and later on March 11, 2020, the WHO labeledit as a pandemic.The first case of COVID-19 from Pakistan was reported on 26th February, 2020 and has affected over 354,000 people with a mortality of over 7000 patients. Many countries of the world have seen second wave of this pandemic. Government ofPakistan has also declared a second waveon October 28, 2020, after the rise in cases from 500 to 750 per day.Now it has crossed 2000 cases.The data released by the National Command and Operation Centre (NCOC) shows that the current percent positivity rate is close to 3 compared to the previous figure of lesser than 2 making it a bigger challenge than first wave in Pakistan. The patients now presenting in hospitals are all in critical condition. Lack of a specific vaccine or antiviral drug and non-compliance to the standard preventive measures is the major reason of initiation of a second wave of this viral infection in Pakistan. Being a nation we need to be responsible. Our country may go into economic crisis & our health facilities may choke.We have to understand how to live with this virus till the availability of vaccine or Curative antiviral drug.TheGovernment of Pakistan is creating awareness in the public for the second wave as the situation of pandemic is getting worse. Smart lock downs are being implementedbut people are not following preventive measures that are leading to infection spread at a very alarming speed. At the moment preventive measures are the only way to stop the spread of disease. Preventive measures should be adopted to contain this deadly disease. Wearing masks,using hand sanitizers, washing hands with soap for 20 sec,keeping social distance of 6 feet are mandatory preventive strategies. Social, political, business, recreationaland religious gatherings, should be avoided. Educational institutesshould follow strict standard operating procedures. Most of the people in Pakistan are not considering this disease as a matter of serious concern due to unawareness, poverty, beliefs and lack of resources. People should ignore such disbeliefs and should start considering it as a great health concern. They should follow the preventive measures in true sense.. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/49 10.52229/pbmj.v4i1.49 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/49/52 10.52229/pbmj.v4i1.49.g52 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/50 2021-09-09T18:36:12Z pbmj:O.A driver

Knowledge about evidence based pharmaceutical care in medical and non-medical population of Lahore, Pakistan: Evidence Based Pharmaceutical Care Sohail, Sundas Shoukat, Filza Mukhtar, Aisha Shoukat, Halima Fatima, Arooj Sharif, Faiza Ahmad, Ashfaq Gilani, Syed Amir 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. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/50 10.52229/pbmj.v4i1.50 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/50/53 10.52229/pbmj.v4i1.50.g53 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/51 2021-09-09T18:36:12Z pbmj:O.A driver

Frequency of Cardiovascular Complications in Coronavirus-19 infected Patients during the second wave in a tertiary care Hospital of Lahore, Pakistan: Cardiovascular Complications in COVID-19 patients Tariq, Ayesha Jamshed, Aneeza Shabbir, Muhammad Saad Aslam, Muhammad Arsalan Sajjad, Ali Aslam, Wajeeha Khan, Amna Komal Coronavirus 2019 (COVID-19) affects the cardiorespiratory systems by causing inflammation of the circulatory systems, hence, causing more cardiac complications in COVID-19 patients Objective: To observe the frequency of cardiac complications in COVID-19 patients during the second wave Methods: 235 COVID-19 patients presenting with cardiac complication to the Cardiology Department of Mayo Hospital, Lahore during 6 month periods of second wave of COVID-19 were included. Data regarding the medical history, age, gender was taken and the observed cardiac complication were noted Results: There were 76.6% male patients and 23.4% female patients. 56.2 % patients were already hypertensive, 37.9% were diabetic, 18.3% had familial history of cardiac diseases. The cardiovascular manifestations observed were, myocardial infarction (57.82%), 7.3% had angina, 21.3% had acute coronary syndrome and 12.3% had non ST elevation myocardial infarction. Conclusions: Our study suggests that there is a prevalence of cardiovascular diseases in COVID-patients which is a major concern as they are at increased risk for severe infection. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/51 10.52229/pbmj.v4i1.51 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/51/75 10.52229/pbmj.v4i1.51.g75 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/52 2021-09-09T18:36:12Z pbmj:O.A driver

Effect of Microwave Power and Time on Total Phenolic Contents and Antioxidant Characteristics of Microwave Assisted Extracts of Watermelon Rind Powder: Microwave Assisted Extracts of Watermelon Rind Powder Shahid, Tanzeel Khan, Ammar Ahmad Khalil, Anees Ahmed Batool, Madiha Khan, Sundus Aslam, Ayesha Watermelon is gaining importance as a functional food due to its therapeutic effect. The therapeutic effect of watermelon has been reported and has been attributed to antioxidant constitutes.The major component in watermelon rind is citrulline that has a strong antioxidant effect which protect body from free-radical damage.Objective:This study was conducted to investigate the effect of microwave powers (150 W, 300 W & 450 W) and time intervals (1,3 & 5 minutes) on total phenolic content (TPC) and total flavonoid content (TFC) and antioxidant characteristics i.e. DPPH and ferric reducing antioxidant potential (FRAP) of microwave assisted extracts of watermelon rind powder.Methods:The extracts collected after Microwave assisted extraction (MAE) of watermelon rind wereanalyzed for their antioxidant potential through different tests including total phenolic contents (TPC), total flavonoid content (TFC), DPPH assayand FRAP.Results:Microwave assisted extraction by using ethanol as a solvent at different microwave powers and various time intervals showed that total antioxidant potential was significantly higher at low microwave power such as TPC ranges obtained at 150W for 1, 3 & 5 minutes of time intervals show ranges (159.84, 160.04 & 169.71 mg GAE/100 g). While TFC ranges at 150W for time 1, 3 & 5 minutes were (21.31, 24.15 & 42.20 mg CEQ/100g) whereas DPPH ranges at 150W for time 1, 3 & 5 minutes were (53.14, 54.87 & 68.17 % ascorbic acid inhibition) and FRAP values at 150W for time 1, 3 & 5 minutes were (201.71, 221.50 & 326.43 mg FE/100g). While high microwave power 450W can result in disruption of some antioxidants at various time intervals.Conclusions:Watermelon rind is a rich source of many antioxidants andmicrowave assisted extraction technique should be implemented in the food and nutraceutical industries and microwave assisted extracts of watermelon rind should be utilize for the development of new functional food to combat many health related problems CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/52 10.52229/pbmj.v4i1.52 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/52/81 10.52229/pbmj.v4i1.52.g81 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/53 2021-09-09T18:36:12Z pbmj:O.A driver

Iron deficiency and risk of oral squamous cell carcinoma: Iron expression in oral carcinoma Tanvir, Imrana Khan, RizwanUllah Hassan, Amber Mumtaz, SamiUllah Oral squamous cell carcinoma (OSCC) is a subset of head and neck squamous cell carcinoma caused by excessive substance abuse like alcohol, tobacco etc.  Objectives:Aim of the present study was to evaluate the iron expression in different grades of OSCC and potential of iron staining as a prognostic marker and its importance as an essential nutrient in diet.Methods and Patients:It was a cross sectional study.A total of 40 oral biopsies were evaluated and the mean age of patients was 53.5 years with age range 23-80 years. 14 cases were well differentiated, 14 moderately differentiated and there were 12 poorly differentiated case. Iron staining was performed for all these cases. Results:Iron positivity was observed in 11 (27.5%) of OSCC patients with maximum iron positivity in well differentiated group (64.28%) of age range 20-40 years (70%). More patients had tongue as site of cancer. There was no genderwise difference in iron expression. Iron deficiency was associated with poor prognosis indicating iron as an important nutrient which can prevent OSCC if adequately present in our routine diet. Conclusions:Prevalence of iron positivity in young patients and initial stage of OSCC, indicates the protective effect of iron against oral squamous cell carcinoma CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/53 10.52229/pbmj.v4i1.53 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/53/54 10.52229/pbmj.v4i1.53.g54 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/54 2021-09-09T18:36:12Z pbmj:O.A driver

Varietal Comparison of Proximate Composition and Mineral Profiling of Pakistan Native Barberry Powder: Proximate Composition and Mineral Profiling of Barberry Powder Batool, Madiha ., Aurangzeb Khursheed, Tara Shahid, Tanzeel ., Sadaf Al Mostafa, Morad Yaser Berberis Vulgaris fruit (barberry)also commonly known as “zereshk” is one of the world’s renowned medicinal plant with highly nutritious and therapeutic values, world widely. It is an elongated, 8-10mm long, bright red colored, fruit. Berberidaceae family; B. vulgaris fruit is very useful tonic for liver, heart, pancreas, gallbladder and kidneys. It prevents chronic bleeding disorders, purifies blood, lowersblood cholesterol level, blood pressure and most importantly it help to treat diabetes. In addition it is effective in treatment of parasitic liver, kidney stones, gout, colon cancer, prostate inflammation, fever, asthma and malaria. Objective:This study is aimed to check the mineral and chemical profiling of Pakistan native barberry fruit.Methods:Proximate analysis of three different varieties (BVF01, BVF02, and BVF03) of B. vulgaris fruitfrom different three regions Azad Kashmir, Chitral and Gilgit Baltistandemonstrated a nutritional composition in range of 77.43, 70.08, 73.12%for moisture,0.98,0.76, 0.89% for crude ash,0.42, 0.33, 0.39% for crude fat,1.53,1.32, 1.44% for crude protein, 2.76, 2.64, 2.75% for crude fiber,16.88, 24.87, 21.41% for Nitrogen free extract (NFE).The different varieties of barberry contained the ranges of minerals such ascalcium2724.70,2584.13, 2693.59ppm, magnesium 998.46,944.06, 986.32ppm, potassium12189.75, 11,114.21, 12021.19ppm, sodium 1402.16, 872.38, 1269.44ppm, iron 449.67, 334.58, 396.90ppm, zinc8.42,13.78,29.5ppm, copper 15.11, 5.45, 11.63ppm, manganese 32.5, 25.86, 28.91ppm(mg/L), respectively. Conclusions: The type of barberry cultivated in Azad Kashmir is the best having good proximate composition and highest minerals amount as compared to Chitral and Gilgit Baltistan cultivated barberry CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/54 10.52229/pbmj.v4i1.54 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/54/55 10.52229/pbmj.v4i1.54.g55 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/55 2021-09-09T18:36:12Z pbmj:O.A driver

Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute: Endoscopic versus open radial artery harvesting used in coronary artery Albkhoor, Bashar Hyasat, Bahi Altaani, Haitham Alnawaiseh, Khaled Altarbsheh, Salah Alshwabkeh, Ziad Anzeh, RaziAbu Alfawares, Safwan Alqaisi, Abdallah Alnaser, Mohammad Yanal Jaber, Said Coronary artery stenosis bypass by using radial artery is good techniques which have longer outcomes. In coronary artery bypass grafting (CABG) the radial artery has several advantages. The radial artery has a thick muscular wall which is more susceptibleto contraction from the competitive flow. As compared to the open harvesting technique endoscopic harvest of the radial artery has long lasting cosmetic results it also reduces the post-operative complications. The purpose of the study is to compare the two harvesting techniques and compare the short term and long term results related to intra-operative and post-operative outcomes Methods: This is retrospective study (In Queen Alia Heart Institute, Amman ,Jordan) to compare endoscopic radial artery technique versus open technique by reviewing patients files through a period between June 2013 and June 2018. Total 50 patients of CABG surgery was selected they were divided into two groups. Group A includes endoscopic radial harvest (n= 10) and Group B includes open harvest (n=40).Data was collected on predesigned Performa. Data were entered and analyze through IBM SPSS 22.0 Results: There was insignificant dissimilarity between the pre-operative outcomes between groups. The Post-operative outcomes were almost same in both groups except hand numbness (P-value<0.005).The comparison of intraoperative outcomes like harvest time between both groups indicate that the mean harvest time in group A was shorter than group B (39.20 + 3.73 Vs 51.90 + 2.09, P-value=0.000). The operative time in group A was higher than the group B (306.0 + 11.6 Vs 278 + 4.25 p-value=0.00). The hospital stays in both groups were insignificantly different (p = 0.09) Conclusions: Endoscopic radial artery harvest is best suited technique for CABG surgery as it significantly decreases the harvest time as well as hospital stay. It is also proven that it is safer, less painful and better wound appearance technique with exceptional outcomes based on positive surgical experience. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/55 10.52229/pbmj.v4i1.55 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/55/56 10.52229/pbmj.v4i1.55.g56 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/56 2021-09-09T18:36:12Z pbmj:O.A driver

Frequency of depression and anxiety among heart failure patients in a tertiary care hospital of Faisalabad, Pakistan: Depression & anxiety among cardiac patients Niaz, Naila Faridi, Tallat Anwar Azad, Naseem Hanif, Asif Tanvir, Imrana Hassan, Bilal Heart failure (HF) is a chronic illness with high prevalence and mortality, leading toeconomic burden ofhealth due to prolonged hospital stay and re-admissions.Failure to comprehend the importance of identifying mental illnesses could lead to explanations that why the morbidity and mortality of heart failure patients endure to be very high.Objective:To determine the frequency of anxiety and depression in heart failure patients.Methods:It is a descriptive cross sectional study including 323 CHF patients admitted to the Faisalabad Institute of Cardiology hospital, 250 were males and 73 were females, mean age was 54.1 ± 9.2 years having 70 years as maximum and 25 years as minimum.  Data was collected with the help of HADS questionnaire. Patients were interviewed for assessment of anxiety and depression. Data was analyzed using SPSS version 24. Mean and standard deviation was calculated for quantitative data and for qualitative data frequency and percentageswas calculated. To measure the association of anxiety and depression with age categories and gender, chi square test was used. P values less than and equal to 0.05 were taken as significant.Results:The results showed that 43% subjects had <11 score indicating no anxiety, 57% had >11score indicating anxiety. 45% subjects had<11 score indicating no depression, 55% had >11score indicating depression.Conclusions: The study concluded that frequency of depression and anxiety is high in congestive heart failure patients. Strategies are required to assess and diagnose these mental illnesses to establish early treatment which may foster multidisciplinary health care team approach and interventions that address the psychological burden. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/56 10.52229/pbmj.v4i1.56 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/56/57 10.52229/pbmj.v4i1.56.g57 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/57 2021-09-09T18:36:12Z pbmj:O.A driver

Impact of abolishment of PMDC on Basic Medical & Dental Sciences Faculty Career Path of a Federally Chartered Public Sector Medical University- A Questionnaire Validation Study: PMDC abolishment & Faculty career Iqbal, Muhammad Abid Ashfaq, Mehvish Riaz, Bushra Khan, Danish Hassan Ahmed, Nouman Shahid, Saleha Ascertain validity of a questionnaire which measures the impact of abolishment of PM&DC on Basic Medical & Dental Sciences Faculty Career Path of a Federally Chartered Public Sector Medical University. Cross sectional study conducted on a pre-defined population at a given point in time. Study setting was Army Medical College, Rawalpindi over a period of 2 months. Target population for pilot testing was basic sciences faculty of Army Medical College, Rawalpindi. 12 items questionnaire was designed using Likert scale with 5 options response set. Content validity was assured by expert opinion.Results: Inter item correlation represented by Cronbach’s alpha was p=0.839.Conclusions: The 12 item questionnaire appropriately measures the attitudes and beliefs of basic sciences faculty regarding their career path after abolishment of PM&DC CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/57 10.52229/pbmj.v4i1.57 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/57/58 10.52229/pbmj.v4i1.57.g58 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/58 2021-09-09T18:36:12Z pbmj:Rew.Art driver

Congenital Heart Disease: Causes and Risk Factors: Congenital Heart Disease: Causes and Risk Factors Siddiqui, Maria Fareed Farooq, Sehar Khan, Amna Komal Kausar, Humera Congenital Heart Defect (CHD) is a multifactorial disorder based on both genetic and environmental factors involved in development. The basic problem lies in the structure of heart leading to CHD that occurs in walls, valves, arteries and veins of heart. During cell cycle, the gene that controls this process may mutate, causing disturbance in any portion of heart leading to disturbed blood flow, blood flow in wrong direction or complete blockage. Defect may range from simple with no manifestations to complex with severe symptoms. Simple defects need no treatment while some babies with complex birth defects during birth require special care, vaccination, medication or otherwise treated with surgery. The incidence of CHD has declined from 80 to 20% due to progress in heart surgery techniques, medical treatment and interventional cardiology. Various genetic and non-genetic increase the susceptibility for CHD. The diagnosis and treatment of CHD has greatly improved in recent years. Almost all the children with CHD survive to adulthood and spend healthy and active lives after being treated. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/58 10.52229/pbmj.v4i1.58 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/58/78 10.52229/pbmj.v4i1.58.g78 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/59 2021-09-09T18:36:12Z pbmj:L.E driver

Immunization Crisis may Develop due to Economic Crisis During COVID-19 pandemic: Immunization Crisis Develop due to Economic Crisis During COVID-19 Kabir, Mahvish COVID-19 pandemic is a global health crisis with 61, 149,391 confirmed cases and 370,478 deaths till 29May, 2020 [1]. This pandemic has shattered many economies with an estimated loss of $5.8 trillion to $8.8 trillion globally. This economic loss can result in reduction in funds to World Health Organization. Unfortunately, United States of America (USA) has announced termination of any further funding to WHO which can lead to another global health crisis[2]. As WHO is a voluntary funding based organization its main donor are America, China, Japan, Germany and United Kingdom. Among these USA is the main donor with a contribution of $115.8million alone followed by China $57.4 million, Japan $41million, Germany $29.1 million and UK $21.9 million [3].  America’s termination of funding can put WHO and child health programs in serious crisis. Among many programs run by WHO one of the most important program is immunization of children. Immunization coverage programs  save 2-3 million livesper year causing decline in measles related deaths, eradication of polio, surveillance of rotavirus, BCG and DTaP vaccination in children[4].It is estimated that during MillenniumDevelopment Goal (MDG) there is overall decline in child related mortalities due to malaria, measles, diarrhea, AIDS and meningitis [5]. Remarkable results are achieved with measles are diarrhea immunization programs causing a decline in death rate by 73% and 80% respectively. According to a study with current success rate diarrhea related deaths can be virtually eliminated by 2030. Another successful program is “End Polio” program which eradicated polio from world except from Pakistan and Afghanistan [4][6].This termination of funds to WHO can waste all previous efforts in developing countries. On the other hand despite of all efforts still 19.4 million children did not received prescribed dose of vaccines. Data analysis revealed among these  60% of children belong to 10 developing countries namelyAngola, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines and Viet Nam [4]. These countries mainly rely on foreign funding and Non-Government Organization (NGOs) for child health care programs. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/59 10.52229/pbmj.v4i1.59 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/59/77 10.52229/pbmj.v4i1.59.g77 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/60 2021-09-09T18:36:12Z pbmj:C.R driver

A Case Report of Non-Atherosclerotic Driven Myocardial Infarction in a Patient Presenting with Coronary Artery Spasm: Non-atherosclerotic driven myocardial infarction Tariq, Ayisha Akhtar, Bilqees Sharif, Asma Yaqub, Furqan Ahmad, Bilal Ahmad, Jawad Tanvir, Amna Background: Non-atherosclerotic processes are regarded as equally important contributors to a substantial number of coronary problems mainly myocardial infarction. This includes coronary spasm which has been considered as one of the coronary syndromes leading to myocardial infarction. These non-atherosclerotic events ensuing in major averse cardiac events (MACE) not only require various diagnostic and therapeutic strategies but also there is a need to delineate the underlying etiology for their effective treatment and management. Case Summary: We report a case of anterior wall myocardial infarction (AWMI) driven by a non-atherosclerotic event i.e. coronary spasm. Concomitant marked ST-segment elevation recorded on ECG revealed a diffuse mid distal disease in our patient. We report here the initial presentation, coronary care & intervention and throughout the clinical course of our patient. Conclusion: Myocardial infarctionsinvolving non-atherosclerotic causes in young individuals as in our study should be reported by medical practitioners and given equal importance as they might indicate the underlying root cause of such events. Effective treatment of such future cases can be done by taking management strategies, diagnostic findings and prognostic data into consideration. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/60 10.52229/pbmj.v4i1.60 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/60/74 10.52229/pbmj.v4i1.60.g74 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/61 2021-09-09T18:36:12Z pbmj:C.R driver

The Lung Mass and Nodule: A Case Series: The Lung Mass and Nodule Jan, Azam Ahmed, Naseer Awan, Nabil Iftikhar Khan, Bahauddin Ul-Islam, Mujahid Ahmed, Imtiaz Shabbir, Ahsan Mohammad, Amir Shah, Hussain Lung mass is an abnormal region of 3 cm or more in size present in the lungs mainly due to underlying pulmonary caner. It is usually round, opaque and poorly differentiated on X-ray. Common etiological key players are smoking, exposure to asbestos, radon, however, familial history may also play a role. We presented retrospectively7 cases of lung mass and nodule encountered during our clinical practice. We have discussed their clinical presentation, manifestation, medical history, radiological findings and differential diagnosis. In this case series, most of the patients were young, only 2 cases were older patients. There was one infant one month old, one female child 12 years old, one female 25 years, 2 males, 22 and 21 years, one male of 50 years and another male of 60 years age. Correct diagnosis on the basis of clinical profile, radiological findings and histology may help in proper management and hence, timely treatment of the patient CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/61 10.52229/pbmj.v4i1.61 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/61/62 10.52229/pbmj.v4i1.61.g62 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/62 2021-09-09T18:36:12Z pbmj:Edt driver

Association of COVID-19 with obesity: Association of COVID-19 with obesity Khalid, Sidra COVID-19 is a disease that cause respiratory illness due to novel corona virus. It was reported to WHO on December 31,2019 for the first time. The outbreak of this disease started from Wuhan city, China. Now COVID-19 pandemic is spreading worldwide mostly in Europe and North America, these regions have high prevalence of obesity. In the pathogenesis of COVID-19 disease, obesity assumes a significant job. Theinsusceptible framework, which is official in the pathogenesis of COVID19, assumes asignificant job in weight instigated fat tissue aggravation. In the fat tissue the irritationbrings about metabolic brokenness conceivably prompting dyslipidemia, type 2diabetes mellitus, insulin obstruction, hypertension and cardiovascular sickness.Obesity has been expanded the vulnerability to contaminations. In this pandemic, a large number of obese individual with Covid-19 are reported. Infection rate in obese is greater due to poor immunity, comorbidity and inadequate nutritional needs. Statistical analysis showed that about 41.7% patients reported in New York city were obese. Whereas 40% obese have been reported in United State of America with Covid-19. A report from UK indicated that 38% obese were admitted in ICU with Covid-19. According to Chinese researchers, obese individuals are 3-timesmore prone toward the development of Covid-19. So recent analysis indicated that obesity is the major risk factor of Covid-19. In COVID-19, overweight and obese patients have high danger of metabolic difficultiesand eternal infections that stoutness works. More nutrition care is required for such patients. As nutrition is a key factor for keeping up human wellbeing, for example, denseimpervious framework and satisfactory admission of supplements and dietaryenhancements. Tolerant with COVID-19 create contamination from slight to seriousindications bound to the dietary status. Consequently, assessing wholesome status ofindividuals with contamination turns out to be increasingly significant. Through dietaryhelp, we can bring down the danger of oxidative pressure, infection contamination andexpands invulnerability framework among obese people especially. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/62 10.52229/pbmj.v4i1.62 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/62/63 10.52229/pbmj.v4i1.62.g63 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/63 2021-12-13T20:18:45Z pbmj:O.A driver

A study of Microorganisms causing wound infections after Elective laparotomy: Microorganisms causing wound infections after Elective laparotomy Noor, Sofia Faridi, Tallat Anwar John, Akash Hassan, Taimoor Noor , Asya Noor, Amna Iqbal, Neelam Any purulent discharge from a closed surgical incision, after surgery, together with signs of inflammation of the surrounding tissue should be considered as Post operative (post-op) wound infection. There are two types of wounds in elective laparotomy: clean and contaminated wound Objective:  To find out most causative microorganism involved in post-op wound infection in elective laparotomy cases at the Children Hospital and The Institute of Child Health Sciences, Lahore Pakistan. Methods: It was a prospective observational study conducted on patients who developed wound infection after elective laparotomy. This study was conducted in the surgical Units I and II of Children Hospital Lahore, Lahore, Pakistan. The duration of the study was 11 months from January 2019 to November 2019. 150 patients were included in this study. Data was collected by convenient sampling technique. It was a hospital-based study in which patients from both genders were included. Data was obtained by a questionnaire. Patients were asked for wound condition and surgery details were taken to find out the reasons of wound infection. The data selected was analyzed using SPSS version 21.0. Results: Out of total 150 patients who underwent elective laparotomy, 40% patients were identified with Escherichia Coli, 13.3% patients identified with Pseudomonas species, 13.3% patients had klebsiella, 6.7% patients had Pseudomonas Florescence, 6.7% people had Acinetobacter, 6.7% had Staphylococcus aureus, 13.3% did not show any growth. Conclusions: It was concluded that most abundant microorganism isolated from patients who underwent elective laparotomy was Escherichia coli. The most common reasons for wound infection were increase in number of surgeons and increase in duration of illness. CrossLinks International Publishers 2021-10-17 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/63 10.54393/pbmj.v4i2.63 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 53-58 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/63/89 10.54393/pbmj.v4i2.63.g89 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/64 2021-12-13T20:18:45Z pbmj:L.E driver

Third wave of COVID -19 in Pakistan: New Variants with new travelers? Third wave of COVID -19 in Pakistan: New Variants with new travelers? Akhtar, Naveed Hayee, Sara Nawaz, Faheem Idnan, Muhammad In Wuhan City, China, Corona or COVID-19‘s first case was reported in late December 2019 [1]. It is caused by SARS-CoV-2 also called as corona virus. This disease has now spread in in all countries and territories of the world including Pakistan. According to World Health Organization (WHO), 125,425,270 confirmed cases with 2,756,679 deaths have been reported till date with highest positive cases encountered in USA followed by Brazil and India [2]. Pakistan, a developing country in the Asia, faces a big challenge with COVID-19.Ministry of Health in Karachi, Sindh Pakistan, reported first case of corona on February 26, 2020 [3]. The positive cases reported from Pakistan had travel history from Iran, London and Syria. The rapid rise of the positive cases of COVID-19 in first wave in Pakistan is attributed to mishandling of the pilgrims coming from Iran through Taftan, one of Pakistan’s border crossings with Iran. Also, the students in China were returning back to Pakistan especially from the Wuhan, which is the site of the origin of the COVID-19 CrossLinks International Publishers 2021-08-13 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/64 10.52229/pbmj.v4i2.64 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 4-6 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/64/87 10.54393/pbmj.v4i2.64.g87 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/65 2021-09-09T18:36:12Z pbmj:Rew.Art driver

Comprehensive overview on Bacillus subtilis antibacterial metabolites production: Bacillus Subtilis Antibacterial Metabolites Production Umar, Jahanara Mazhar, Sumaira Over the last 70 years, Food processors and the plant protection sector have both benefited from Bacillus subtilis. Their capacity to manufacture endospores for survival, as well as a multitude of antimicrobial substances has piqued industrial interest in areas such as food preservation, medicinal agents, and biopesticides. In light of the growing trend of food healing and the protection of bacterial plants, this review suggests a holistic approach to visualizing the antimicrobial screen described in Group B. This review aims to make easy and updated classification of antimicrobial metabolites in group B. subtilis, its complex phylogeny that tends to perpetuate development. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/65 10.52229/pbmj.v4i1.65 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/65/79 10.52229/pbmj.v4i1.65.g79 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/66 2021-12-13T20:18:45Z pbmj:G.Edt driver

Virtual Classrooms during the Covid-19 pandemic Hassan, Sana In order to contain the virus, lockdown was imposed and as a consequence, education delivery methods have changed drastically, with e-learning progressively identifiable, and teaching being carried out with the help of digital platforms.Teachers are struggling with Zoom and Google classrooms to teach students. The conventional style of lectures is deemed incompetent and has been criticized for its inadequacy in involving students, now the focus has been diverted on more innovative pedagogical methods, such as group training, peer interaction and integrated or 'flipped' learning. These practices can continue on-line and can help to develop and expand the interest of students. Multiple IT tools can now be incorporated as a teaching strategy so that Professors and teachers, rather than emphasizing on the classical lecture format, can bring innovation and interactivity to their teaching. One of a very basic and interesting tool is Interactive Video. It allows teachers to enable students to practice questions and discussions while watching videos, by marking signs at specific moments during that video. Mostly the topics are previously taught so it`s easy for a student to understand the lesson. Students can even return back and watch the same video again, in order to develop thorough understanding of a topic. The performance of each student can be evaluated and this approach keeps track of their problems and the topics which are harder to understand. The students stay motivated as the feedback is instant and timely. May educators take Quizzes as standard in classrooms, This learning format develops variety of discussion and suggestions.Apps like Kahoot, Socrative, Quizlet can result in effective classroom engagement. These apps when assigned, allow teachers to test understanding of students simultaneously. Quizzes may be in the form of open-ended short questionnaires, short answer question, true-false, or multiple choice questions. When the quiz iscreated by the educator and displayed, students can either use their laptops, computers or phones to respond. This is a synchronous type of interaction, where the teachers screen is displaying the questions,and students have to reply through their own devices. It is difficult to engage students during online classes and this issue need to be resolved. If such an approach is adoptedwhich highlight students perspective into consideration rather than trying to accomplish a fake on-campus experience online. Novel methods to teach using digital technologycompliments the teaching system and adds creativity. The concept of virtual classroom is potentially off-putting and unfamiliar for new students, studying online for the first time. There are multiple factors influencingthe engagement and involvement of students in online system of teaching: it includes family of students due to which students are distracted and focus less during online sessions, additionally, there may be lack of proper technical facilities i.e they may either have no digital facility or older and slower versions which make it difficult for students to understand during the online classes. Therefore, teachers must keep all these issues in mind in order to impart proper knowledge to students and address the difficulties these students are facing. A proper and clear communication is the key to succeed in online teaching sessions. CrossLinks International Publishers 2021-08-11 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/66 10.52229/pbmj.v4i2.66 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 2-3 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/66/86 10.54393/pbmj.v4i2.66.g86 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/67 2021-09-09T18:36:12Z pbmj:O.A driver

Knowledge, Attitude and Practices towards Menstrual Hygiene among Government and Private School Girls: KAP towards menstrual hygiene in school girls Mubashra, Aniqa Faridi, Tallat Anwar Rana, Muhammad Saleem Parveen, Ishrat Zahid, Muhammad Talha John, Akash Khan, Salsabeel Menstruation is a normal physiological process unique to females. Pre-menarche is characterized by physiological, cognitive, and psychological transitions which may be initiated from the midst of their second decade. The onset of puberty/ menstruation in girls tends to change their role in society. Overall inadequate awareness levels accompanied by socio-cultural taboos and prevailing myths and misconceptions about menarche and menstruation have played havoc on human society. Objective:To diagnose and compare the prevailing level ofknowledge, attitude, and practices of adolescent girls studying in government and private schoolstowards menstrual hygiene and management. Methods: This Analytical and cross-sectional study was conducted at Government Jouhar Girls High School and Shiblee Grammar School System, Gulberg Branch (private) Faisalabad. A self-administered survey-based questionnaire was developed. Prior formal written approval from school authorities was followed by the pre-planned scheduled visits, explaining the purpose of the study, assuring confidentiality of acquired information, and self-administration of survey-based questionnaires. Results:The results indicated that the mean age at menarches of the girls was 13.69±0.95 years. A relatively more percentage of government (59.6%) school respondents followed by private school respondents (57.1%) had satisfactory knowledge about their age of first menarche (p = 0.806). Motivated by the socio-cultural taboos and /or fear or shame a majority of government (59.6%) and private school respondents (57.1%) had satisfactory knowledge about their age of first menarche (p = 0.806). A strong prevalence of Urinary Tract Infection (UTI) was found in private school girls 87(49.2%) and 21(11.9%), followed by respective percentages of 78(43.8%), 16(9.0%) amongst the government school respondents who recorded their responses as agreed and strongly agreed about the development of reproductive tract infection in the post-menstruation period. As far as the adoption of hygienic practices is concerned a relatively high percentage of government school 28(15.7%) followed by private school 14(7.9%) girls strongly disagreed about changing their absorbent material on daily basis. The development of skin abrasions like rashes, itching, and urinary tract infection was found in a relatively high proportion amongst the government school girls 30(16.9%) followed by private school respondents 18(10.2%) in the post-menstruation period. A most common and alarming unhygienic practice prevalent amongst the government and private school girls was the reuse of absorbent cloth,  who responded as agreed and strongly agreed in respective terms as 43(24.2%),  22(12.4%), and 69(39%) and 28(15.8%).  Conclusions: The study concluded that the persistent myths, misconceptions, socio-cultural taboos, and unhygienic practices i.e.use of old clothes as absorbent, reuse of absorbent material, and delaying tendency of changing absorbent,  amongst the adolescent school girls of government and private institutes which may pose direct adverse health and life quality concerns for the female Pakistani community. The current situation calls for active participatory contributions from education communities to initiate various communication and awareness campaigns regarding pre-menarche knowledge and menstruation management which may aid to strengthen and transform their role as a significant representative of society.  CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/67 10.52229/pbmj.v4i1.67 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/67/66 10.52229/pbmj.v4i1.67.g66 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/68 2021-09-09T18:36:12Z pbmj:O.A driver

Psychological morbidity in medical students after entering into clinical training: Psychological morbidity among medical students Chaudhry , Samia Yasmeen, Roheela Psychological morbidity is emerging as animportant issue for medical students after entering clinical training due to extensiveworking hours. Students find themselves unable to balance competing demands on their time and cannot allocate appropriate time to family, spouses and even to themselves;this leads to complaints about exhaustion and lack of efficiency in their profession. Objective: To assess Psychological morbidity in interns, medical officers and residents Methods:a cross sectional study was conducted. A google form was designed with questions adopting from the three scales of the Maslach Burnout Inventory-General Survey (MBI-GS). Question from all three categories of MBI-GS such as emotional exhaustion, depersonalization and personal accomplishment were considered. The form was distributed via email and Whatsapp to 87 house officers, medical officers and residents of six public healthcare facilities in Lahore. Responses were captured from 73 participants who completed the General Health questionnaire.Seven of these forms were filled by nurses, so in the present study only the response ofthose 66 participants who conformed to the study cross-section were considered.The results were analyzedusing SPSS version 22 for descriptive statistics and chi-square association. Results:A significant association was found between long working hours and emotional exhaustion, depersonalization and personal accomplishment questions in particular. The findings suggests long working hours ruin the mental health of medical professionals, which ultimately produce psychological health impacts. Conclusions: It was concluded that these factors should be considered to reduce psychological morbidity in health professionals.   CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/68 10.52229/pbmj.v4i1.68 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/68/67 10.52229/pbmj.v4i1.68.g67 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/69 2021-09-09T18:36:12Z pbmj:O.A driver

Frequency of Conjunctivitis among Farmers of District Vehari, Punjab, Pakistan: Conjuntivitis among farmers of Vehari Abideen, Zain Ul Sohail, Ahmed Perveen, Ishrat Faridi, Tallat Anwar Ayyub, Hafsa Conjunctivitis is a globally prevalent ocular and/eye infection. The basic motivation of the current study may be traced back to the association of conjunctivitis with unhygienic situations and sunlight exposure. The daily routine of farmers, overwhelming poverty, and illiteracy ratio may have further enhanced the incidence ratio of conjunctivitis. The ocular infection and/or conjunctivitis is caused by various pathogens, if not managed properly and appropriately may lead to corneal perforation or blindness. Objective: The study has been designed to find out the prevalence of various pathogenic and allergic conjunctivitis among farmers in the district Vehari, Punjab, Pakistan. Methods: It was a community-based and cross-sectional descriptive studyfrom October- November 2019. The study involved the quantitative analytical method.Anterior segments of eyes followed by posterior segments were examined by using an ophthalmoscope and torchlight for the diagnosisof conjunctivitis. Data on pathogenic and allergic conjunctiva was collected. Result: Our study indicated that 33(16.5%) farmers were found with the symptoms ascertained with conjunctivitis. Among the studied subjects, 29(14.5%) and 4(2%) farmers were found with bacterial and viral conjunctivitis, respectively. As far as the tendency of seeking medical help and ophthalmic consultation is concerned, 31(15.5%) and 19(9.5%) patients preferred to get examined by an eye specialist and traditional treatment, respectively. However, 150(75%) patients neglected to seek any medical aid. It was found 27 (13.5%), and 55 (27.5%) farmers were using glasses and traditional eye protective measures, respectively. However, almost sixty percent 118(59%) of farmers were not using any type of eye-protective measures. It was found that 59%, 30%, and 11% farmer population was exposed to sunlight for almost six, four, and two hours, respectively on daily basis. Conclusions:The use of prevalent traditional protective measures and lack of treatment or medical aid seeking trendby farmers has been found responsible for the high incidence of bacterial conjunctivitis. Moreover, long working hours and sunlight exposure alongwith the predominant unhygienic conditions may further quadruple the frequency of viral and bacterial conjunctivitis.The high prevalence ratio of conjunctivitis, eye infections, and ocular injuries highlight the need of observing universal eye safety and precautionary measures.Keeping in view the downtrodden economic conditions of the farmers and agriculturalists in the country and the financial repercussions associated with the infection, a state-ownedmedical awareness and relief process must be ensured and encouraged for the Pakistani community. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/69 10.52229/pbmj.v4i1.69 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/69/68 10.52229/pbmj.v4i1.69.g68 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/70 2021-12-13T20:18:45Z pbmj:O.A driver

Strong risk factors for depression and anxiety in heart failure patients: Risk factors for depression & anxiety in heart failure patients Niaz, Naila Faraz Ali, Syed Muhammad Younas, Attaullah Faridi, Tallat Anwar Hanif, Asif Despite advancing medical technology, Heart Failure (HF) is still a prevalent disease with high mortality and high health expenditure.To improve patient outcome and prognosis, it is important to identify the association of risk factors which leads to the co-morbid depression and anxiety in heart failure patients.Objectives: To determine the association of depression and/or anxiety with age, gender and ejection fraction in heart failure patients.Methods:It is ananalytical cross sectional study including 323 CHF patients who visited the to the Faisalabad Institute of Cardiology hospital Out-Patient Department, 250 were males and 73 were females, mean age was 54.1 ± 9.2 years having 70 years as maximum and 25 years as minimum.  Data collection was done using Hospital Anxiety and Depression Scale (HADS) questionnaire to assess depression and anxiety. Data was analyzed using SPSS version 24. For quantitative data, mean and standard deviation was calculated and for qualitative data frequency and percentages was calculated. To measure the association of anxiety and depression with age categories, ejection fraction and gender, chi square test was used. P values less than and equal to 0.05 were taken as significant.Results: No association of depression and anxiety with gender and Left Ventricular Ejection Fraction (LVEF) was observed. However, depression and anxiety were found to be significantly associated with age.Conclusions: The study concluded that age is a strong risk factor of depression and anxiety in congestive heart failure patients. Multidisciplinary health care team approach and interventions are required to cater chronic heart failure (CHF) patients to address the psychological burden. CrossLinks International Publishers 2021-07-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/70 10.52229/pbmj.v4i2.70 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 48-52 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/70/88 10.54393/pbmj.v4i2.70.g88 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/71 2021-09-09T18:36:12Z pbmj:O.A driver

Frequency of Osteopenia and its association with Socio Economic Status among general female population aged 18-60 years : Osteopenia and Socio Economic Status Zahid, Sana Faridi, Tallat Anwar Hanif, Asif Masood, Zahid John, Akash Noor, Sofia Noor, Aasia Noor, Amina Osteopenia is regarded as the Bone Mineral Density (BMD) which is lower than that of the average value but not as low as Osteoporosis. In Pakistan, Osteoporosis and Osteopenia among women have become one of the most common problems of recent times. Objectives: To find the frequency of osteopenia among females in Faisalabad and its association with SES (Socio Economic Status). Methodology: It was an analytical and cross-sectional study which was conducted at Niaz Medicare Clinic in Faisalabad. The study was completed in 9 months from 18 October 2019 to 18 July 2020. Non probability purposive sampling was done and 323 females were taken for the study. Results: The results demonstrated that 56.3% of the population had Osteopenia. Socio Economic Status had as statistically significant association with Osteopenia (p= 0.041). The results also revealed that the females belonging to middle class and lower class had a higher prevalence of Osteopenia than the females of upper Socio Economic Status. Conclusion: the frequency of Osteopenia was fairly high among females specifically the age group 18-29 years. There was an association found between Osteopenia and Socio Economic status (p =0.041). CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/71 10.52229/pbmj.v4i1.71 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/71/80 10.52229/pbmj.v4i1.71.g80 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/72 2021-12-13T20:18:45Z pbmj:Rew.Art driver

Virus induced hepatocellular carcinoma (HCC) and protein biomarkers: Virus induced hepatocellular carcinoma (HCC) and protein biomarkers Jaffari, Hamza Abbas Mazhar, Sumaira Hepatocellular carcinoma (HCC) is a standout amongst the most widely recognized cancers around the world, and just as the alcoholic liver disease it is also progressed by extreme viral hepatitis B or C. At the early stage of the disease, numerous patients are asymptomatic consequently late diagnosis of HCC occurs resulting in expensive surgical resection or transplantation. On the basis of the alpha fetoprotein (AFP) estimation, combined with the ultrasound and other sensitive imaging techniques used, the non-invasive detection systems are available. For early disease diagnosis and its use in the effective treatment of HCC patients, the identification of HCC biomarkers has provided a breakthrough utilizing the molecular genetics and proteomics. In the current article, most recent reports on the protein biomarkers of HBV or HCV-related HCC and their co-evolutionary association with liver cancer are reviewed. CrossLinks International Publishers 2021-07-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/72 10.52229/pbmj.v4i2.72 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 7-13 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/72/92 10.54393/pbmj.v4i2.72.g92 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/73 2021-09-09T18:36:12Z pbmj:O.A driver

Effects of Carica Papaya and Psidium Guajava Extracts on Hepato-Renal Performance of Streptozotocin- Induced Diabetic Male Albino Rats: Carica Papaya and Psidium Guajava Extracts & Diabetic rats Arshad, Sofia Azeem, Muhammad Ahmed Muzahir, Jawaria Mehreen, Arifa Khan, Muhammad Anwar The growing number of diabetes coupled with the harsh side effects of some synthetic drugs has led to the increasing search for alternative medicine which are relatively cheap with minimum side effects. Objective: To investigate the anti-diabetic effect of ethanolic extract of Carica papaya and Psidiumguajava extracts separately and in combination, and the effect of treatment on hepato-renal performance. Methods:Papaya and guava leaves were macerated in 98% ethanol for extraction. Results:The result showed that ethanolic leaf extract of P. guajava and C. papaya significantly (P< 0.05) reduced blood glucose level, Total Cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and significant increase in high density lipoprotein (HDL) as compared to diabetic control group. Serum activities of liver enzymes such as aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alanine aminotransferase (ALT) was slightly elevated that indicate hepatotoxic nature of plant extracts. The level of gamma-glutamyl transferase (GGT), bilirubin and HbA1C level were restored to normal range. A slight reduction in body weight (P>0.05) of treated groups was observed. Serum urea and creatinine concentration was restored to normal level in treated rats with regeneration of kidney function. Conclusions:The study concluded that individual and combined plant extract show anti-hyperglycemic effect but the combined remedy at this dose show hepatotoxicity CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/73 10.52229/pbmj.v4i1.73 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/73/71 10.52229/pbmj.v4i1.73.g71 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/74 2021-12-13T20:18:45Z pbmj:O.A driver

Relation between different grades of pterygium and amount of induced corneal astigmatism: Different grades of pterygium Khan, Bilal Sohail, Ahmed Faridi, Tallat Anwar Jan, Ubaidullah Zahid, Fatima Parveen, Ishrat Pterygium and Astigmatism, Grades of pterygium, Amount of astigmatism Pterygium is more prevalent among people exposed to ultraviolet (UV) light. It occurs more often in people who live in warm climates and spend a lot of time outdoors in sunny or windy environments Objective: To determine and the relation of different grade of pterygium with amount of induced corneal astigmatism Methodology: This observational study was done in The Layton Rahmatulla Benevolent Trust (LRBT) hospital Multan road Lahore. A self-designed Performa was filled after clinically examining the patients. Frequency distribution/percentages of data were described, simple frequency tables and cross tables were formed to calculate the statistical results Results: A total patients 50 with grades of pterygium and induce amount of astigmatism.  There 31(62.0%) were male and 19(38.0%) were female and the mean age of the patient is 2.5. 21(42.0%) patients were grade 1 pterygium and 21(42.0%) patients were grade 2 and 8(16.0%) patents have grade 3 pterygium.  The amount of astigmatism in grade 1 from 0.00 to 1.00 DC is 17(34.0%) patients, from 1.00 to 2.00 DC are 2(4.0%) patients and from 2.00 to 4.00 DC are 2 (4.0%). In grade 2 from 1.00 to 2.00 DC are 10(20.0%) patients, from 2.00 to 4.00 DC are 10(20.0%) patients and from greater than 4.00 DC 1(2.0%). In grade 3 from 1.00 to 2.00 DC are 2(4.0%) patients, from 2.00 to 4.00 DC are 4(8.0%) patients and from greater than 4.00 DC are 2(4.0%) patients Conclusions: Result show that the present study verifies that as the pterygium reaches more than 1.00mm in size from the limbus it induce with the rule astigmatism and pterygium size increases, the amount of induced astigmatism also increases with direct proportion. CrossLinks International Publishers 2021-10-14 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/74 10.54393/pbmj.v4i2.74 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 59-63 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/74/90 10.54393/pbmj.v4i2.74.g90 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/75 2021-09-09T18:36:12Z pbmj:O.A driver

Determinants of Lack of Family Planning in Grand Multiparous Women: Lack of Family Planning in Grand Multiparous Women Noor, Sofia Rana, Muhammad Saleem Hanif, Asif John, Akash Noor, Aasia Noor, Amina Zahid, Sana Hassan, Taimoor Faridi, Tallat Anwar Iqbal, Neelam Multiparity is a matter of great concern regarding the health of women as well as child. At the same time it has different determinants and socioeconomic backgrounds.Objective: To determine the determinants of lack of family planning in grand multiparous women.Methods: It is a descriptive cross sectional study including 271 GMP patients from DHQ Hospital Okara city. Mean age was 35 ± 10 years. Data was collected with the help of questionnaire and evaluated and analyzed using SPSS version 24. Mean and standard deviation was calculated for quantitative data and frequency and percentages for qualitative data. To measure the determinants of lack of family planning, chi square test was used. P values less than and equal to 0.05 were taken as significant.Results:Most of women belong to rural area 172(63.47%) and areMuslims 259(95.5%). Most of the families lie under upper lower 149 (54.8%) and lower middle group of income 71(26.1%). The reason of last pregnancy was desire for baby boy 66(24.4%), then husband’s wish 45(16.6%)and so on.There is a good association of socioeconomic status and residence of head of family as p < 0.05, (Results are 325.272a, df = 10, p=0 .000). There is an association of Gravida and socioeconomic status of head of family as p<0.05. (27.294, df= 20, p=.05). There is a good association between reasons of last pregnancy and gravida as p<0.05, (41.920, df = 24, p=0 .001).Conclusions:The grand multiparty is still very common in Okara Pakistan district, considering the easy availability of modern contraceptive methods but very few women are aware of it. The most popular explanation given for present pregnancy by grand multiparous women was an urge for baby boy followed by husband wish. Most of women are Muslims. Rural Women are more socio-economically down and they have grandermultiparty. CrossLinks International Publishers 2021-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/75 10.52229/pbmj.v4i1.75 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/75/72 10.52229/pbmj.v4i1.75.g72 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/76 2021-12-13T20:18:45Z pbmj:O.A driver

Significance of Ectopic Beats in Post Aortic Valve Replacement Arrhythmia Patients: Ectopic Beats in Post Aortic Valve Replacement Rawashdeh, Bashar Al-Bkoor, Tareq Emad Hawash Tahir, Adnan Mehmood, Malik Irfan The incidence of new onset arrhythmia after conventional aortic valve replacement (AVR) is relatively high whereby atrial fibrillation (AF) in particular (30-40%). Arrhythmias increase postoperative morbidity, mortality and consequently health costs. The need for a reliable method for early detection and discrimination between low and high risk patients is therefore indispensable. For this reason this study examined the possible correlation between electrophysiological abnormalities on continuous ECG recordings and the initiation of arrhythmia directly after surgery. Methods and Results: Both ECG and clinical data was collected from the hospitals filing system for all patient (n=107) who underwent surgical Aortic Valve Replacement (AVR) for non-rheumatic aortic valve stenosis or insufficiency for the period from January 2010 to December 2018.  Continuous ECG data was converted into ISHNE-format and analyzed by using Synescope™ software. Data showed that one minute prior to arrhythmia, AF in particular, an increase of both supraventricular premature beats (SVPB) and missed beats (MB) was detected (n=33; P<0,05). However there was no correlation between arrhythmia and the overall SVPB incidence (n=33). Twenty-one out of 33 AVR patients developed a de novo intraventricular conductance delay directly after cardioplegic arrest, which persisted in 7 cases. Conclusions: Although there is an increase of both SVPB and MB prior to arrhythmia startup, it is still questionable what is the true predictive value of these findings are. Additionally it appeared that a temporarily intraventricular conduction delay (IVCD) is a common finding after AVR. CrossLinks International Publishers 2021-10-17 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/76 10.54393/pbmj.v4i2.76 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 64-74 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/76/91 10.54393/pbmj.v4i2.76.g91 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/78 2021-12-13T20:18:45Z pbmj:O.A driver

Maternal Serum Copeptin As a Biomarker For Intrauterine Growth Restriction: Serum Copeptin As a Biomarker For IUGR Hassan, Amber Nasief , Hisham In obstetrical world, Intrauterine Growth Restriction (IUGR) occupies second slot as a cause of small for gestation neonates, first being premature birth, both of which result in potential neonatal morbidities and mortalities. IUGR is defined as an estimated fetal weight at one point in time at or below 10th percentile for gestational age. Annually about thirty million babies suffer from IUGR and out of these about 75% are Asians. IUGR has been found to be associated with increased levels of Copeptin. As copeptin is a marker of endogenous stress, so increased copeptin levels can indicate fetal and maternal stress in IUGR Objectives: The objectives of this study were to the compare maternal serum copeptin levels in pregnancies with IUGR and pregnancies with adequate for gestational age fetuses and to establish the significance of copeptin as a biomarker for IUGR. Methodology: It was a cross-sectional comparative study in which maternal serum copeptin levels were measured and compared in 60 patients divided in two groups, pregnancies with IUGR and normal pregnancies with adequate for gestation age fetuses between 28-35 weeks of gestation Results: Maternal serum copeptin levels were raised in pregnant women with IUGR as compared to that in pregnant women with adequate for gestational age fetuses. Mean ± SD maternal serum copeptin levels were 97.5 ± 6 pg/ml in pregnant women with AGA fetuses and 121 ± 7.8 pg/ml in pregnant women with IUGR.  Conclusions: Maternal serum copeptin levels are raised in pregnancies with IUGR as compared to pregnancies with adequate for age fetuses which can represent as a possible clinical biomarker for identification of IUGR. CrossLinks International Publishers 2021-11-21 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/78 10.54393/pbmj.v4i2.78 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 75-80 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/78/97 10.54393/pbmj.v4i2.78.g97 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/80 2021-12-13T20:18:45Z pbmj:O.A driver

Effect Of Storage Time And Temperature On Platelet Indices Of EDTA Samples: Effect of storage on platelet indices Naveed, Muhammad Asif Nawab, Kashifa Hamid, Ambareen Ashraf, Sobia Junaid, Nada Saleem, Umera This study was conducted to find effect of storage time and temperature on platelet indices of samples taken in EDTA. Methods:In this study 100 samples without the specification of gender were included. CBC samples were taken in two EDTA vials from each patient. All the samples were separated in two groups. One sample group was stored at room temperature(RT) and other at 2-6°C. CBC was run on CBC analyzer Sysmex XN-1000 at 0 hours, 4 hours, 12 hours and 24 hours. Results: There was significantly increasing trend for MPV, PDW and P-LCRat RT and decreasing trend at 4°C when compared with 0 hours. PCT showed significant decreasing trend at 4°C with respect to 0 hours. Significant decrease in platelet count was observed after storage at room temperature as well as at 4°C. Conclusion:Although 4°C consider as optimal temperature to transport specimen for CBC but Platelet Indices values varies significantly in comparison to baseline when stored at 4oC and at room temperature. It seems prudent to conclude that if platelet pathology is the major drive for CBC test performance then specimen should be run without delay. CrossLinks International Publishers 2021-12-06 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/80 10.54393/pbmj.v4i2.80 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 81-86 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/80/100 10.54393/pbmj.v4i2.80.g100 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/81 2021-12-13T20:18:45Z pbmj:O.A driver

Role of Multi Detector Computed Tomography in the Evaluation of Hepatic Masses: Multi Detector CT to evaluate Hepatic Masses Rehman, Ishtiaq ur rehman Farooq, Syed Muhammad Yousaf Ashraf, Adnan Khan, Muhammad Zakir Gilani, Hafiz Syed Arslan Faisal, Muhammad Arslan Ahmad, Faizan Afzal, Muhammad Aqib This research is about 7 hepatic masses. The liver is at risk of various diseases which include benign and malignant. The rich blood supply by hepatic artery and portal vein. Objective: To find the role of multi detector computed tomography in the evaluation of hepatic masses.  Methods: It was cross-sectional analytical study. It involves 162 patients suffering from liver masses visiting Shalimar hospital, Lahore. Consecutive sampling method was used. Analyses by using SPSS version 21.0. Results: In this study, 162 patients visited radiological department because all the patients were suffering from different hepatic masses. Out of 162 patients, 116 patients were males and 46 patients were females. In these 162 patients, 112 patients (69.9%) were suffering from HCC, 55 patients (34%) were suffering from abscess, 42 patients (26.9%) were suffering from multiple cysts, 12 patients (8%)were suffering from FNH, 9 patients (7.4%) were suffering from hemangioma, 4 (2.5%)patients were suffering from hydatid cyst and 2 patients (1.2%) were suffering from lymphoma. Conclusion: Triple phases CT helps in better diagnosis of different types of hepatic masses and our study concludes that the prevalence of HCC is higher than other masses. It also provide information about enhancement of liver lesion with the help of images. CT also helps in diagnosis of different liver lesions in arterial, venous and delayed phase.     CrossLinks International Publishers 2021-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/81 10.54393/pbmj.v4i2.81 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 92-96 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/81/174 10.54393/pbmj.v4i2.81.g174 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/82 2021-11-23T20:59:28Z pbmj:O.A driver

A Prospective Cohort Study on Suspected COVID-19 Patients undergoing Nasopharyngeal Swab PCR and HRCT: Nasopharyngeal Swab PCR and HRCT in COVID-19 Patients John, Akash Faridi, Tallat Anwar Samreen, Kubra Gill, Anil Noor, Sofia Iqbal, Neelam John, Nayab Objective:To Determine the Specificity, Accuracy and Sensitivity of HRCT in Diagnosis of Covi-19. Methods: Prospective cohort study was done with 181 participants who were suspected for COVID-19 infection and were followed to evaluate PCR and HRCT reporting in patients with clinical symptoms. Results: 86.8% of patients had a dry cough, followed most commonly with shortness of breath. 65 (35.9%) of patients had ground-glass opacities of haze on HRCT followed by 47 (26 %). who had consolidations present. 147 (81.2)patients had a positive PCR whereas 34 (18.7%) was negative had an HRCT that was suggestive of having COVID-19 pneumonia. Conclusion:In conclusion clinical symptomatology, HRCT findings and PCR all should be used in a triple examination. It is concluded that a positive PCR test is very specific and used to make diagnosis for Covid-19. CT has a higher sensitivity but a lower specificity, thus helping with disease diagnosis and therapy. CrossLinks International Publishers 2021-06-25 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/82 10.54393/pbmj.v4i1.82 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/82/96 10.54393/pbmj.v4i1.82.g96 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/83 2021-11-23T21:04:11Z pbmj:O.A driver

A Survey to Assess Knowledge of Antenatal Care among Rural Women of Gujrat, Pakistan: Knowledge of Antenatal Care among Rural Women John, Akash Faridi, Tallat Anwar Noor, Sofia Iqbal, Neelam Muhammad, Aasia Noor John, Nayab Introduction:Antenatal care is the daily health management of healthy pregnant women with few symptoms, orderly diagnosis of diseases or difficulties connected to obstetrics, and contributing to lifestyle, pregnancy, antenatal care, and safe delivery of child. Objective:To assess the knowledgeof antenatal Care among Pregnant women of Rural Population Material and Methods:The study was conducted at rural areas of Gujrat city for the periodof 6 months, fromJanuary 2021 to June 2021. The data was collected through Questionnaire which was piloted tested and validated by Cronbach. A sample of 100 was taken following inclusion criteria of pregnant women to assess knowledge from rural under developed areas of Gujrat, Pakistan. Results:A total of 100 participants were included in which common agegroups were 26-32 having 37%. The Profession and literacy status was evaluated and found 73% Housewives and 59% Illiterate. Results also shows the Responses about their knowledge clearly showing that 59% pregnant women do not visit and unaware of number of visits in Maternity Clinics. 40 % of the women were unaware about Blood Pressure maintenance in Antenatal care.52% women did not know about blood and urine tests performed during pregnancy. Pregnant women who was unaware of vaccination during antenatal care was 54% and 59% do not acknowledge about using of Multi vitamins during this period of pregnancy. Conclusion:In conclusion rural population had little of Antenatal care, maternal issues, nutritional supplements, investigation tests, and vaccinations practices. The primary reason for this was lack of awareness about proper health care services in rural areas. The secondary reason was family/husband restraints and impediments for not seeking antenatal care. CrossLinks International Publishers 2021-06-28 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/83 10.54393/pbmj.v4i1.83 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/83/109 10.54393/pbmj.v4i1.83.g109 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/84 2021-11-23T21:05:53Z pbmj:O.A driver

Knowledge, Attitudes and Practices of Male Transgenders in Transmission of Human Immunodeficiency Virus in Lahore, Pakistan: Male Transgenders in Transmission of HIV John, Akash Rana, Muhammad Saleem Hanif, Asif Faridi, Tallat Anwar Noor, Sofia Zahid, Sana Taj, Serena Human immunodeficiency virus (HIV) is a subgroup of retrovirus causing HIV infection which if prolongs turns into a progressive failure of the immune system called as acquired immunodeficiency syndrome. It is commonly prevalent in Male Transgenders who are born male and disobeys the cultural defined social norms and identify themselves as a female. The objective was to assess knowledge, Attitudes and Practices of Transgender Community regarding Transmission of Human Immunodeficiency Virus in Lahore, Pakistan. A Descriptive Cross-sectional Survey was conducted in Nine Towns of Lahore. A sample size of 79 was calculated and data was collected in duration of 9 months. A self-administered survey-based questionnaire was developed using WHO and National AIDS control Programme guidelines followed and pilot tested. Data was collected after Informed consent.The mean age of Respondents was 29.56 ± 8.27 years with minimum and maximum age as 19 and 50. In this study the mean knowledge score of the transgender about HIV Transmission was 2.804±0.32, the mean score of attitudes of transgender were 3.25±0.19 and the mean practice score was 2.931±0.28.Majority of the transgender have insufficient knowledge, and bad attitude towards their health. They have unsafe sexual practice and Drug Interventions playing a significant role in HIV epidemic. Majority of them are uneducated, unemployed and found sex selling and dancing an easiest way of earning. Their knowledge about HIV screening, transmission, and antiretroviral therapy is low. CrossLinks International Publishers 2021-06-25 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/84 10.54393/pbmj.v4i1.84 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/84/108 10.54393/pbmj.v4i1.84.g108 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/85 2021-11-23T21:10:55Z pbmj:O.A driver

A Cross Sectional Study to Evaluate Adverse Outcomes of Vitamin D Deficiency in Females of Lahore, Pakistan: Adverse Outcomes of Vitamin D Deficiency in Females Faridi, Tallat Anwar John, Akash Iqbal, Neelam Ahmed, Arsalan Hussain , Muhammad Bakir Vitamin D is a group of fat-soluble sec steroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and multiple other biological effects. The most important compounds in human are vitamin D₃ and vitamin D₂. Vitamin D is essential for strong bones, because it helps the body use calcium from the diet. Vitamin D deficiency has been associated with rickets, a disease in which the bone tissue doesn't properly mineralize, leading to soft bones and skeletal deformities. A cross sectional study was conducted from 30th January 2021  to 30th June 2021 to evaluate adverse outcomes of Vitamin D level among 370 females of aged 20-60 years were recruited through non-probability convenient sampling technique from students and Faculty ofColleges and Universities in Lahore, Pakistan. The data was collected through a Semi-Structured Questionnaire.A total 370 participantswere included age groups of female ranging from 20-60. Comparing age and level of Vitamin D was more common in reproductive age of females with more association in young females of 20 to 30 years. 81.9 % participants had general awareness regarding deficiency of vitamin D. 80% People eat Vitamin D Rich Diet While only 20% use vitamin D supplements and only 41.9 % females drinks a Cup of Cow Milk. 73.8% participants had suffered weakness and general body aches and 82.2% females reported musculoskeletal pain.This studyevaluated thatMost of Educated People are unaware of Vitamin D knowledge and intake. They take insufficient amount of Vitamin D and experience discomfort in Muscoskeletal system. CrossLinks International Publishers 2021-06-29 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/85 10.54393/pbmj.v4i2.85 Pakistan BioMedical Journal; Vol. 4 No. 1: Volume 4 Issue 1 2709-2798 2709-278X 10.52229/pbmj.v4i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/85/107 10.54393/pbmj.v4i1.85.g107 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/86 2021-12-13T20:18:45Z pbmj:Cmntry driver

Pharmacovigilance in Pakistan: A Peek into the Future Prospects: Pharmacovigilance in Pakistan Jahan, Sarwat Zahid, Shumaila Ahmed, Naseer The dire need for drug monitoring and surveillance principles are practices governing the safety profiles of the medicines arose following the 1960’s Thalidomide disaster that resulted in phocomelia in thousands of new born babies [1]. Since then Pharmacovigilance centers have been established in the member countries, which report all the untoward drug reactions to Uppsala Monitoring Centre (UMC) that is designated to perform further investigations and global dissemination of the necessary information [2]. Currently 134 countries that are collaborating with UMC of which 96% are developed while 27% are developing countries which are lagging behind as per the unavailability of infrastructure and resources [3]. Pakistan National Pharmacovigilance Centre (PNPC) Ministry of health initiated pharmacovigilance activities in Pakistan in 1994; however a stable system could not be established owing to the unavailability of human resources as well as the infrastructure [4]. Later the suggestion for the establishment of Pakistan National Pharmacovigilance center (PNPC) was mentioned by the national drug policy in 2003 [5], however, the launch of the centre took place in 2012 following the tragic death of around 200 cardiac patients in Lahore as a result of an accidental mixing of Isosorbide mononitrate with Pyrimethamine that resulted in severe deficiency of folic acid, destroying the platelets and causing profuse internal bleeding [6,7]. In the view of the gravity of the situation, an independent authority for drug regulation (Drug regulatory authority of Pakistan – DRAP) was founded under the orders of the Pakistan Supreme Court in 2018. This authority was established for ensuring availability and safety of the medications. In order to devise an infrastructure for the post-marketing drug surveillance, DRAP in collaboration with the Pharmacopoeia of US established PNPC in the year 2017 and by 2018 Pakistan was included as a member in the UMC [8]. The centre has laid down protocols and practices for the international and national coordination and has added Pakistan 134th on the drug monitoring WHO program. Currently the PNPC is being governed by the 2012 Act of DRAP for developing, promoting and regulating the pharmacovigilance system in the country and coordination with provincial sectors to empower the hospitals to establish their own pharmacovigilance centers [9]. Future Perspectives of PNPC PNPC has come a long way still being in infancy and is setting up future goals towards development. Proper guidelines have been formed and an organized system was established by PNPC till 2018 for reporting Adverse Drug Reactions (ADRs) online. Training workshops for the members are regularly carried out to keep the work force ready and updated about the regulatory and management aspects. A regional centre of PNPC was announced to be established in Islamabad in November, 2019 [10]. PNPC has also upgraded its recording, monitoring and reporting system for ADRs via affiliation with the VigiFlow database of the country permitting maximum control locally effectively managing and analyzing the country-wide data [11]. The provincial, market authority and public health stakeholders are called for regular meetings. PNPC has composed comprehensive guidelines and legislation regarding pharmacovigilance protocols that are meant to provide legal surveillance of the activities. In the long run, the PNPC is planning for the establishment of provincial pharmacovigilance centers in each province, and the sub-regional centers and integrating them into the national database. Good practices of pharmacovigilance will utilize the obtained data to bring about safety protocols. However, a number of hurdles are still in the way. There are constraints related to logistics and legal matters as well as finances. There is a requirement of a collaborated effort by all the stake holders in the country. Healthcare professionals have a limited awareness about PNPC protocols and a reluctance to report the adverse events. The main issue is getting the healthcare workers and public normalized and used to with the reporting and surveillance system in order to cope up with the reluctance to report and awareness about the protocols. The success of this system is actually two way and it depends on the response from the reporting stake holders as much as it does on the system of the organization itself. The public health programs, hospitals and healthcare units need to be encouraged to participate in the PNPC system for proper reporting and detection of serious ADRs. Training and awareness sessions need to be conducted to form and normalize a reporting culture among heath care workers in Pakistan. Methods for assessment of severity, detection of cause and preventability of the reported ADRs, need further standardization. Furthermore, the international collaboration is still deficient as the WHO data bank does not have any adverse effect reported data from Pakistan; therefore, the gap needs to be filled as a priority. Although a lot still needs to be don e, a clear  progress has been noted in the past couple of years. With the introduction of new guidelines and strategies; route to further progress is clearly marked but the effort has to involve all the stake holders which will start by the realization and understanding of the significance and need for a properly functional pharmacovigilance system in the country. CrossLinks International Publishers 2021-11-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/86 10.54393/pbmj.v4i2.86 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 272-273 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/86/103 10.54393/pbmj.v4i2.86.g103 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/88 2021-12-13T20:18:45Z pbmj:O.A driver

Analysing the Positive Impact of COVID-19 Lockdown on Educators in Higher Education Institutions of Pakistan: AN Exploratory Research: Analysing The Impact Of Covid-19 Tabassum, Farhana Rizwan, Bahisht mehak Sherazi, Syeda Rida Shah Rashid, Sabrina Bashir, Fareeha Waheed, Kainat Mehak Sherazi, Syeda Warda Shah Latif, Rabia Keywords: Educators, Positive impact, Negative impact, Lockdown, Online courses, and business Lockdowns have been implemented worldwide to halt the development of the COVID-19 pandemic, owing to the virus's potential threat and infectious nature. The coronavirus outbreak has wreaked havoc on the world and poses a serious hazard due to the virus's infectious natureObjective:To examine the positive and negative impacts of COVID-19 on educators (250) teaching at various public and private higher educational institutions in Pakistan during the lockdownMethods:A Google form was used to conduct an online cross-sectional survey. The questionnaire included questions about the following topics: demographic information. demographic details, physical exercise, health consciousness, relationship with family members, social relationship, Information and technology (IT) skills, digital courses, research activities, work from home, time spent on social media, expenditures, and lockdown activities. The sample was collected from 1st January 2021 to 12th May 2021 and 250 responses were recorded from the educators working from homethrough the snowball sampling technique. The data were analyzed through SPSS version 25. Results: The findings revealed an overall reduction in expenditures, preference for healthy and homemade food, adequate intake of supplements, enhancement of professional grooming (E-courses and IT skills), quality time with family, improvement in social relationships with family, friends, and colleagues. Conversely, the study also brought to the light negative impact of COVID-19 lockdown, for instance, overindulgence in social media, sedentary lifestyle, hard time-saving money, inadequate training for online classes, increased workload, strict schedule, incessant fear of downsizing, and pay cuts.Conclusions:The study recommends that educatorsengage themselves in yoga, meditation, physical exercise, and eat a healthy diet. Furthermore, they should continue upskilling the professional development through E-courses and technology-based skills. CrossLinks International Publishers 2021-12-06 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/88 10.54393/pbmj.v4i2.88 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 87-91 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/88/169 10.54393/pbmj.v4i2.88.g169 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/91 2021-12-13T20:18:45Z pbmj:O.A driver

Prices, Availability And Affordability Of Essential Medicines For Non-Communicable Diseases: A Facility Based Survey In District Abbotabad: Availability And Affordability Of Essential Medicines For Non-Communicable Diseases Mir, Khizran Ayyub, Hafsa Background: Non communicable diseases (NCDs) are spreading like an epidemic worldwide. Essential medicines are crucial for prevention and control of NCDs. World Health Organization (WHO) has set a benchmark of 80% availability of essential medicines in public and private facilities. Availability being a predictor of access to medicines is low in Low and Middle income countries (LMICs). The objective of this study is to determine price, availability and affordability of essential medicines for NCDs in District Abbottabad. Methods: This study was based on the standardized protocol provided by WHO and Health Action International (HAI) for determination of availability, prices and affordability of medicines. A total of 50 medicines for NCDs that were enlisted in Essential Medicine List of district Khyber Pakhtun Khawa were selected for the study. Twenty seven medicine dispensing facilities belonging to public, private and other basic health units (BHUs) (managed by PPHI) sectors were surveyed in the district. Simple random sampling was employed to select facilities. Results: The mean overall percentage availability of essential medicines for NCDs was 0.1% for original brand and 1.9% for low price generic in public sector. Overall availability was better in private and other sectors (32.9% for OB and 13.8% for LPGs and 5.3% for OB and 11.1% for LPG respectively). The prices in public procurement sector were competitive. The median price ratio (MPR) in public procurement sector was 0.56. Prices were higher comparatively in private sector with MPR 2.83. Most of the medicines require less than a day wage to buy 30 days treatment. Conclusions: The availability of essential medicines for NCDs was poor in District Abbottabad. None of the sectors reached the benchmark of 80% with regard to availability of medicines. LPGs were not frequently available in the private sector. However, prices were reasonable in public sector and acceptable in private sector. Medicines were found to be affordable but affordability may differ for people living below poverty line of US $1. CrossLinks International Publishers 2021-12-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/91 10.54393/pbmj.v4i2.91 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 97-102 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/91/115 10.54393/pbmj.v4i2.91.g115 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/92 2021-12-13T20:18:45Z pbmj:O.A driver

Platelets and D-dimer as the Biomarkers for COVID-19: Platelets and D-dimers as Biomarkers for COVID-19 Rashid, Sabrina Zulfiqar, Aqsa Abdul Sattar, Ayesha Rizwan, Muhammad Ali, Waqar Ilyas, Arham COVID-19, a highly contagious and rapidly spreading viral infection caused by the new corona virus SARS-COV-2, was first identified in China. On March11th, 2020 World Health Organization announced it a pandemic. The novel infection which is still being studied has a wide range of severity, ranging from no symptoms to severe pneumonia that can lead to death Objective: To find correlation between D-Dimer and platelets count with the severity of the disease Methods: It was a cross sectional study. The duration of the study was 6 months from November, 2020 to May 2021. The study was conducted in University Institute of Medical Laboratory Technology (UIMLT), University of Lahore. Data of 101 COVID-19 positive patients was taken from Shaukat Khanum Hospital, Farooq Hospital & University of Lahore Teaching Hospital (UOL), Lahore. Hematological and biochemical parameters such as Complete blood count (CBC), D-Dimer, Lactate Dehydrogenase (LDH), Platelet count (PLT) and Ferritin levels were observed. The data was analyzed using Statistical Package for Social Sciences (SPSS) Version 21.0. P-value less than and equal to 0.05 was taken as significant Results: Platelet count was decreased in severe patients of COVID-19 and was statisticallysignificant (P-value = 0.004) LDH, D-dimer, and Ferritin were increased with severity of disease and they were also statistically significant (P-value 0.005, 0.000. 0.027) respectively Conclusions:The platelet count, D-Dimer, LDH and Ferritin levels could act as the biomarker to determine the severity in COVID-19 infection   CrossLinks International Publishers 2021-12-06 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/92 10.54393/pbmj.v4i2.92 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 103-106 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/92/131 10.54393/pbmj.v4i2.92.g131 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/93 2021-12-19T21:37:25Z pbmj:O.A driver

Effects of Chlorpyrifos on biochemical characteristics of Labeorohitafish during acute and chronic exposure: Effects ofChlorpyrifos on biochemical characteristics of Labeorohita Syed, Adeeba Mazhar, Sumaira Rafi, Uzma Hussain, Dilawar Hayee, Sara The aim of present study was to examine the biochemical characteristics of Labeorohita fish during acute and chronic exposure of pesticide, chlorpyrifos (CPF). Methods:During acute exposure, fish were exposed to different concentrations of CPF ranging from 0, 0.005, 0.006, 0.007, 0.008, 0.009, 0.01, 0.02, 0.03, 0.04 and 0.05 mg/L for 96 hrs in glass aquaria. The 96 hrs LC50 value of CPF for Labeorohita was found to be 0.01 mg/L. During chronic exposure fish were subjected to 1/3rd, 1/5th, 1/7th and 1/9th of LC50 for 30 days. At the end of the trial, samples were collected for biochemical (Blood cells, haemoglobin, plasma glucose and plasma protein) and sent to related laboratories. Results:The present study showed the RBCs, haemoglobin and Plasma Glucose level decreases as the concentration of CPF increases. On the other hand, platelets, WBCs and Plasma glucose level increases as the concentration of CPF increases. Decrease in RBCs count and haemoglobin indicates that CPF can cause anaemia to the fish. Conclusions: It is therefore concluded that Chlorpyrifos adversely affects the major organs of the fish Labeorohita. CrossLinks International Publishers 2021-12-20 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/93 10.54393/pbmj.v4i2.93 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 107-112 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/93/99 10.54393/pbmj.v4i2.93.g99 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/94 2021-12-13T20:18:45Z pbmj:O.A driver

Evaluation OF Novel Hormone Asprosin And Its Role In Insulin Resistance In Neonatal Cord Blood Of Preeclamptic And Healthy Pregnant Mothers: Novel Hormone Asprosin And Its Role In Insulin Resistance In Neonatal Cord Blood Shafi, Nida Mushtaq , Rehana Bano, Farhat Preeclampsia, insulin resistance, asprosin, insulin, HOMA-IR, Agouti-related protein (AgRP) Asprosin, a novel glucogenic adipokine, plays a complex role in central nervous tissue, peripheral tissues and other organs. It is involved in glucose metabolism, appetite, insulin resistance, cell apoptosis etc. This study aimed to find relationship between asprosin and other insulin resistance related-hormones in neonates of preeclamptic mothers. A comparative cross-sectional study was conducted on 42 neonates of preeclamptic pregnant mothers and 42 neonates of healthy pregnant mothers. Samples were taken from placentas at the time of delivery and were processed for estimation of asprosin, insulin, C-peptide and glucose hormones. Data was analysed using SPSS 21. Normality of the data was checked and Independent t-test was applied. A p-value of ≤0.05 was considered significant. P-values of asprosin, insulin, C-peptide, glucose and HOMA-IR index were 0.020, 0.550, 0.360, 0.310 and 0.740, respectively when compared between neonates of preeclamptic pregnant mothers and healthy pregnant mothers. CrossLinks International Publishers 2021-12-22 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/94 10.54393/pbmj.v4i2.94 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 175-180 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/94/142 10.54393/pbmj.v4i2.94.g142 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/95 2021-12-13T20:18:45Z pbmj:O.A driver

Evaluating the efficacy of High-energy Extracorporeal Shockwave Therapy Aimed at Treating Calcified Shoulder (ESWT-CS): a study protocol for a randomized controlled trial : Efficacy of high-energy extracorporeal shockwave therapy in patients with calcified shoulder Fatima, Arooj Sohail, Sundus Shoukat, Filza Nasir, Iqbal Kazmi, Shiza Extracorporeal shockwave therapy, Calcified shoulder, Study protocol Shockwave therapy is a solid scientifically based medical tool used to manage calcified shoulder. This therapy, along with its pros and cons, is paving its way among armamentarium of interventions for musculoskeletal disorders. Objective: To determine efficacy of extracorporeal shockwave therapy on subjective and objective measures in patients with calcified shoulder. Methods: Single-blinded, parallel-group, randomized trial will be conducted on sample of 48 participants recruited through convenient sampling. Patients with calcified shoulder tendinopathy, aged between 30-55 years and both gender will be included. Outcome measures will be numeric pain rating scale, Constant and Murley score, Western Ontario rotator cuff index, shoulder ROM and radiological outcomes. Current study has been initiated in June 2020 till enrollment in December 2020.The quantitative data would present in the form of mean and standard deviation. After fulfilling the parametric assumptions, data will be analyzed using independent sample t-test/Mann Whitney test. Repeated measure ANOVA/Friedman test for pair-wise comparisons for follow-ups will be used to determine the effects of treatment within the groups at baseline, in 6th week and 12th week after commencement of treatment. Discussion: Evidence reported related to shockwave therapy for tendinopathy shows less quality and less number of randomized trials done, with no comparable groups and methodological deficiencies of studies. Trial registration: Approval was obtained from Institutional Review Board Committee (ref: IRB-UOL-FAHS/693/2020). The study was registered on 28th March 2020 in Iranian Registry of Clinical trials (IRCT), its registration reference number is IRCT20200204046373N1 https://irct.ir/trial/45657. CrossLinks International Publishers 2021-12-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/95 10.54393/pbmj.v4i2.95 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 170-174 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/95/138 10.54393/pbmj.v4i2.95.g138 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/96 2021-12-13T20:18:45Z pbmj:O.A driver

Comparing The Validity Of Electronic Color Vision Test With Conventional Ishihara Pseudoisochromatic Plate Test: Validity Of Electronic Color Vision Test Rashid, Bisma Zahid, Fatima Sohail , Ahmed Nadeem, Hakim Anjum Faridi, Tallat Anwar Jan, Ubaidullah zafar, Shahab Hameed, Sajid Many ocular diseases can affect color vision of a patient which will ultimately reduce many daily based activities. Measuring color vision of a patient can help deciding any management plan for that patient. Objectives:To compare the validity of electronic color vision test with conventional pseudoisochromaticishihara plates and to find out easiest and appropriate method of color vision testing.Methods: This was a cross-sectional study involving the use of structured proforma and questionnaire to evaluate the validity of electronic color vision test and conventional ishihara plate test. A sample size of 80 individuals with normal and mild degree of refractive error was examined and results were recorded in self-designed proforma. Results: Eighty individuals were enlisted; 35 were males (43.8%) and 45 (56.3) were female; age ranged from 14 to 56 (average 34.2+ 12.2) years. By conventional ishihara testing 68 patients gave 100% results (n = 68; 85%) and 12 gave 75% (n = 12; 15%) results. In electronic color vision test 69 individuals gave 100% ( n = 69; 86.3%) results and 11 gave 75% (n = 11; 13.7%) results. 45% peoples are satisfied with their electronic color vision test, 20% satisfied with both methods however 35% are satisfied with conventional method. Prevalence of color vision defect is higher in males as compared to females. Conclusions: This study found that the sensitivity and specificity of electronic color vision test and conventional ishihara test is nearly similar (p< 0.05). Electronic Ishihara color vision test is also a way of self assesment and also has the advantage of reducing the cost through decreasing resources and the time to analyze the results. CrossLinks International Publishers 2021-12-13 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/96 10.54393/pbmj.v4i2.96 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 156-159 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/96/149 10.54393/pbmj.v4i2.96.g149 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/97 2021-12-13T20:18:45Z pbmj:O.A driver

Need Assessment for Faculty Development in Wah Medical College: Need Assessment for Faculty Development Khan, Khola Ramzan, Musarat Ahmed, Saleh Nadeem, Sadia needs assessment faculty development medical colleges Introduction: Faculty development (FD) is defined broadly as the range of activities that institutions use to assist faculty in their roles and fields including teaching, research and administration. And faculty is now expected to be more effective and creative in their teaching methods. Objectives: To determine the needs assessment for faculty development. Study Design: Cross sectional study. Place and duration of study: Wah Medical College, January- June 2019.  Methodology: A questionnaire was prepared after the review of literature. It had two parts; demographic profile and responses of the faculty on various aspects regarding needs assessment. Questionnaires were distributed to all the faculty members of college. Data was analyzed by SPSS and frequencies were calculated. T-test was used with p value of 0.05. Result: 90 faculty members responded back. Out of these 90, 34(37.8%) were in favor of 1 workshop per year. 59(65.6%)wanted half day workshop. 75(83.3%) members wanted workshops to be on weeks days. 66(73.3%) favored one-day workshops. 71(78.9%), 47(52.2%), 38(42.2%) don’t attend workshops due to lack of time, institutional support, trained facilitators respectively. Conclusion: We concluded that the Wah medical college faculty is in need of faculty development programs that should be conducted by the medical education department with in the college. The college should facilitate the faculty in the best possible way especially considering the limitations and responsibilities of the female faculty.  CrossLinks International Publishers 2021-12-14 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/97 10.54393/pbmj.v4i2.97 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 130-133 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/97/112 10.54393/pbmj.v4i2.97.g112 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/98 2021-12-13T20:18:45Z pbmj:O.A driver

Effect of depression and anxiety on quality of life among cardiovascular patients visiting Tertiary Care hospital Lahore: Effect of depression and anxiety on QoL among cardiovascular patients Shakoor, Andleeb Kamran, Hafsa Shakoor, Maryam Khalid, Sidra Shakoor, Sughra Aslam, Maria Shakoor, Hina Cardiovascular disease patients, anxiety, depression, quality of life. Cardiovascular diseases (CVD) are the leading cause of death worldwide. Mental disorders like anxiety and depression are common among cardiovascular patients. These mental disorders have adverse effect on quality of life (QoL) among these patients which further increases mortality and morbidity among them Objective: The propose of this study was to assess the effect of anxiety and depression on quality of life among cardiovascular patients Methods: A cross sectional study was performed at Sir Ganga Ram Hospital Lahore. 100 patients of CVD were selected by non-probability sampling technique. All patients of both genders aged above 18 years with diagnosed CVD were included. In order to measure the anxiety and depression among cardiovascular patients, Hospital Anxiety and Depression Scale (HADS) and WHOQOL was used to assess the QoL of patients Results: Out of total 100 patients, there were 47 females and 53 males. Patients mean age was 54.87 ± 16.66. Among CVD patients, 52 were borderline cases and 33 were abnormal cases of anxiety. 56 cases were borderline and 28 were abnormal cases of depression. Anxiety and depression had adverse effect on QoL among CVD patients. Low scores were found for physical, psychological and environmental domains of WHOQOL. A significant association was found between social relationships domain of  WHOQOL with anxiety and depression and the level of significance was p-values 0.016 and 0.043 respectively. There was significant association between psychological domain of QoL with depression (P=0.039) and monthly income (P=0.016). There was insignificant association between educational level, sex, age with QoL, anxiety and depression Conclusions: Study concluded that anxiety and depression have negative impact on QoL and are risk factors for health-related QoL among CVD patients. Persons attending medical care are usually not being assessed for anxiety due to lack of facilities, lack of understanding of disease and over burden of patients. They are responsible for greater mortality and morbidity in CVDs. The depression and Anxiety are the mediating factors and it must be taken into consideration in clinical practices when QoL is considered as a clinical prerequisite CrossLinks International Publishers 2021-12-13 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/98 10.54393/pbmj.v4i2.98 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 124-129 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/98/113 10.54393/pbmj.v4i2.98.g113 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/99 2021-12-13T20:18:45Z pbmj:O.A driver

Effects OF Mulligan’s Mobilization With Movement On First Rib To Reduce Pain And Improve Cervical Rotation In Mechanical Neck Dysfunction: Mulligan’s Mobilization In Mechanical Neck Dysfunction Ahmad , Irfan Riaz , Saima Faiz, Uzma Sulaman, Muhammad Zeeshan , Muhammad Manzoor , Tabassum Neck pain, range of motion, mechanical, cervical rotation Mechanical Neck Pain(MNP)  is  a  term  used  to  describe  pain  that results from stress or strain on  the structures of the vertebral  column. Factors such       as alteration in the anatomical structures, sprain or strain of the muscles or ligaments, and adaptation to a faulty posture can result in First rib dysfunction has been identified as a potential cause for faulty dynamic,  static,  traumatic  or  congenital  factors, may contribute to the development of elevated first rib dysfunction. Objective: Was to determine the effects of Mulligan’s mobilization with movement on first rib to reduce pain and improve cervical rotation in mechanical neck dysfunction. Material and methods: This study Quasi-experimental trial was done at PT CARE MM Alam road Lahore. The study was completed within the time duration of six months (July-Dec 2019) after the approval of synopsis. A total of 26 cases (13 in each group) were divided into 2 groups. Group A and Group B were treated with conventional exercise program and with Mulligan’s mobilization with movement on first rib and conventional exercise program only respectively. Bubble inclinometer and NPRS tools were used to measure cervical rotation and Pain respectively. Data analysis was done by SPSS 21.Results: The mean change in NPRS was statistically higher in group-B (5.46 ± 0.78) as compared to group-A (2.62 ± 0.87), p-value < 0.001. The mean change in cervical rotation (ROM) was statistically higher in group-B (17.46 ± 5.19) as compared to group-A (31.23 ± 4), p-value < 0.001. Conclusion: It is concluded that Mulligan’s mobilization with movement on first rib and conventional exercise program had statistically significant change in reduction of pain and had higher improvement in cervical rotation (ROM) right and left. Hence, by combining conventional treatment and Mulligan’s mobilization , maximum clinical benefits to reduce pain and improve cervical rotation can be attained in mechanical neck dysfunction CrossLinks International Publishers 2021-12-21 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/99 10.54393/pbmj.v4i2.99 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 150-155 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/99/133 10.54393/pbmj.v4i2.99.g133 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/100 2021-12-13T20:18:45Z pbmj:Sys.Rvw driver

Nutraceutical Intervention of Seeds in the Treatment of Poly Cystic Ovarian Syndrome; A Systematic Review: Nutraceutical Intervention; Seed Cycling Aslam, Maria Shauket, Rameesha Yousaf, Zoha Tehzeeb, Kinza Poly cystic ovary syndrome, seed therapy, holistic medicine, flaxseed, sesame seed, pumpkin seed and sunflower seed In poly cystic ovary syndrome multiple cysts formation occurs in female ovaries. It is highly prevalent in developing countries like Pakistan and India. Its symptoms include irregular menstrual cycle, abnormal hair growth pattern, acne and mood swings. This disease is also associated with imbalance in androgen levels (which include testosterone and estrogen) and high insulin levels also called hyperinsulinemia. It also contributes in the development of type 2 diabetes, heart disease and cancers. Seed cycling is a modern method used in alternate medicine of treating PCOS by using different seeds in the different stages of menstrual cycle. In this review article we will find out how seed cycling is effective in the treatment of PCOS. Flax, sesame, pumpkin and sunflower seed combinations are being used at different stages of female menstrual cycle. Flaxseeds contain lignans, omega 3 fatty acids and fibre which help in relieving the symptoms of polycystic ovaries. Sesame and sunflower seeds contain high number of fatty acids and lignans which helps in balancing hormonal disturbances in female. Losing weight by having diet rich in fibre improve the level of cholesterol and it is also beneficial decreasing the level of insulin resistance, which if not treated can progressed into type 2 diabetes mellitus and its complications. Herbal medicine in Ayurveda has shown promising effects in relieving pre- menstrual symptoms, hormonal fluctuations and the co-morbidities.  CrossLinks International Publishers 2021-12-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/100 10.54393/pbmj.v4i2.100 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 281-286 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/100/179 10.54393/pbmj.v4i2.100.g179 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/101 2021-12-13T20:18:45Z pbmj:O.A driver

Effects Of Remote Myofascial Release Of Sub-Occipital Region In Asymptomatic Individuals With Hamstrings Tightness: Remote Myofascial Release Of Sub-Occipital Region Ahmad, Irfan Manzoor, Tabassum Riaz, Saima Zeeshan, Muhammad Ali, Mehboob Faiz, Uzma The purpose of this study was to research the effect of performing Remote myofascial release of sub occipital region in asymptomatic individual with hamstring tightness. Keeping these muscles loose is important. If muscles have tightened up then muscles are working at less than 100 % of capacity and performance will be down as a result. Objective: The objective of this study was to find out the effect of performing Remote myofascial release of sub occipital region in asymptomatic individual with hamstring tightness. Methods: The study was a Quasi experimental trial and was conducted in Physiotherapy center for arthritis. 64participant in this research & divided into 2 Groups. (Group A was   treated with static Stretching exercises of hamstrings and Group B was treated with remote Myofascial release of sub occipital region and static Stretching exercises). For analysis we were used Knee Extension angle and Sit to reach test at baseline and after 2 weeks of treatment in both groups. Data analysis was done by SPSS. Results: p value of within the group comparison for  knee extension angle and Sit to reach test score was significant i.e. <0.001.Mayofascial Release of sub occipital region and static stretch give us best result.IN group A Pre-treatment knee extension angle was 14.68 & post treatment 10.87 with mean difference 3.81 P <0.01.In Group B pre-treatment knee extension angle 14.78.& post-treatment   knee extension angle 13.75 with mean difference 11.03 & p<0.001 which concludes that remote myofascial release of sub-occipital region improve the flexibility of hamstring tightness. Conclusion: The current study concludes that myofascial release of sub occipital region along with static stretching and static stretching alone, both are effective in improving flexibility in patients with hamstring tightness. However, myofascial release of sub occipital region along with static stretching is more effective than static stretching alone. CrossLinks International Publishers 2021-12-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/101 10.54393/pbmj.v4i2.101 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 113-118 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/101/102 10.54393/pbmj.v4i2.101.g102 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/102 2021-12-13T20:18:45Z pbmj:O.A driver

Effect of Zinc Supplement on Severity of Acute Diarrhea Among Children Under Five Years of Age: Zinc Supplement on Severity of Acute Diarrhea among Children Jabeen, Shaista Shafique, Tanzeel Basharat, Shahnai Khalil, Anees Ahmed Ali, Muhammad Saeed, Mudasir choohan, Numan Diarrhea, Zinc, Children, Dehydration, Pakistan. According to World Health Organization (WHO) approximately four million children less than 5 years of age in Asia, Africa, and Latin America die annually from diarrhea; and 80% of these deaths occur in the first year of life. Objective: To see how a zinc supplement influences the severity of acute diarrhea in children under the age of five. Methods: In current study, we analyze the effect of zinc on diarrheal patients. Zinc was randomly assigned to diarrheal patients in different concentration 5 mg, 10 mg, 15 mg and 20 mg. There were two groups in our study, treatment and control group. Results: The results are presented in the form of descriptive and inferential statistics. In T1 (Treatment Group) number of Diarrhea patients < 1 Year of age were 16, 2-4 years of age were 45, 4-5 years of age and maximum no of patients in T1 < 2 year of age were 57. Number of male patients were 84 while female patients were 67 in T1.In T2 (Control Group) number of male patients were 92 while female patients were In T1 number of patients residing in urban area were 51 while rural were 100. In T2 number of urban were 69 while rural were 82.Number of patients stay in the hospital for one day were 67 ,15 for Four days and only 1 for seven days in T1. In T2 number of patients stay in the hospital for one day were 29, 17 for four days and only 6 for seven days. In T1 number of Patients with watery diarrhea were 87, Mucoid consistency of stool were 31,soft consistency of stool were 23 and formed consistency of stool were 9.In T2 watery diarrhea were 92,Mucoid consistency of stool were 25,soft consistency of stool were 31 and formed consistency of stool were 4. Frequency of stool significantly reduced (P<0.005) at 7th day of zinc treatment while consistency of stool was significantly improved (P<0.005) at day 3 and day 5 of zinc treatment. Children who received zinc supplements showed a marked improvement in all outcome measures, suggesting that this deficiency is amenable to correction by replacement. CrossLinks International Publishers 2021-12-15 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/102 10.54393/pbmj.v4i2.102 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 143-149 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/102/132 10.54393/pbmj.v4i2.102.g132 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/103 2021-12-13T20:18:45Z pbmj:O.A driver

Impact Of Population Screening Programs On The Knowledge, Attitudes And Practices Regarding Prevention Of Thalassemia Tariq, Rija Mahmud, Talha Bashir, Shabnam Akhtar, Samia Israr, Muhammad Beta Thalassemia is the most common genetic disorder in Pakistan. This study was conducted to assess the knowledge, attitudes and practices of parents of children suffering from Thalassemia with regards to disease prevention. It also determined the degree of social and religious opposition faced by these parents during implementation of preventive practices Methods: A descriptive cross-sectional survey was conducted in the 36 districts of Punjab via nine regional centers of Punjab Thalassemia Prevention Project. 248 parents of Beta Thalassemia Major and Intermedia were interviewed using a pre-designed pre-tested structured questionnaire. All statistical analyses were conducted using Statistical Package for Social Sciences (IBM SPSS 23.0) Results: 83.5% of the respondents had adequate knowledge and 98.4% had positive attitudes. Knowledge and attitude were positively correlated (p=0.00). 93% opted for prenatal diagnosis and 91% opted for termination of affected fetus. Among these individuals 12% faced opposition from their family members when they went for diagnostic testing and this opposition rose to 20% when they had to opt for termination. The local religious clerics opposed prenatal diagnosis in 3% of the cases and termination in 7% of the cases Conclusion: When compared to previous studies the knowledge, attitudes and practices of our study population was better. Thus, population screening programs have a positive impact on knowledge, attitudes and practices of caregivers of Thalassemia patients. However, social and religious opposition needs to be countered for further implementation of effective preventive practices. CrossLinks International Publishers 2021-12-15 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/103 10.54393/pbmj.v4i2.103 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 209-214 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/103/157 10.54393/pbmj.v4i2.103.g157 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/104 2022-04-30T10:35:05Z pbmj:L.E driver

COVID-19 future challenges; ease in lockdown, fragile health sector Kabir, Mahvish Javed, Bilal COVID-19 cases in Pakistan are increasing exponentially since last couple of days with over 50,000 infected individuals and over 1000 deaths [1]. Furthermore government has eased the lock down as Pakistan is facing serious economic crisis. A 4% GDP loss is predicted in economy due to disruptions in business activities. Government has also announced a reduction in budget goals for financial year 2020 and 2021. This ease in lockdown is a desperate effort to support collapsing economy and reducing unemployment.Government statistics are predicting many deaths due to hunger if lockdown prolongs CrossLinks International Publishers 2022-01-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/104 10.54393/pbmj.v5i1.104 Pakistan BioMedical Journal; 2022: Volume 5 Issue 1 (January Issue); 3-4 2709-2798 2709-278X 10.54393/pbmj.v5i1 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/104/185 10.54393/pbmj.v5i1.104.g185 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0

oai:ojs2.pakistanbmj.com:article/107 2021-12-13T20:18:45Z pbmj:O.A driver

In Vitro study of Thrombolytic activity from the different parts of Carica papaya plant on COVID-19 patients.: Thrombolytic activity of Carica papaya in COVID-19 patients Afzal, Ayesha Zahid, Aasia Akbar, Asma Jamal, Zunaira Habib, Huma Awais, Hina Javaid, Shehla Carica papaya plant has been used for medicinal purpose throughout the world because it have anti-inflammatory, anti-oxidant, antiviral, anti-cancer and wound healing like properties. Objective: To evaluate the thrombolytic activity of Carica papaya plant in normal healthy individuals and COVID-19 patients to determine either parts of the plant (roots, seeds and leaves) exhibit more activity in normal persons or in COVID-19 patients. Methods: For this study, total 20 blood samples were taken, 10 for normal individuals and 10 for positive COVID-19 patients. We used two different solvents i.e. autoclaved distilled water and concentrated methanol to prepare the 10% root, seed and leaf extracts of Carica papaya plant. For the thrombolytic activity of these plant extracts, samples were arranged as a triplicate for the accuracy of results percentage. Results: Our results evaluated that in normal individuals, distilled water root extract and methanolic seed extract exhibits maximum thrombolytic activity. The mean value with distilled water (root extract) and methanol (seed extract) is 36.9% and 32.9% respectively. While in covid-19 patients, distilled water leaf extract and methanolic leaf extract reveal maximum thrombolytic activity. In patients, the mean value with distilled water and methanol (leaf extract) is 21.8% and 23% respectively. Conclusions: In our study, we have observed that normal persons showed highly significant results as compared to COVID-19 patients. Because in COVID-19 disease, plasminogen activator inhibitor 1 (PAI-1), thrombin activatable fibrinolysis inhibitor and tissue plasminogen activator (tPA) factors elevate which results in hypo-fibrinolysis. CrossLinks International Publishers 2021-12-16 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://pakistanbmj.com/journal/index.php/pbmj/article/view/107 10.54393/pbmj.v4i2.107 Pakistan BioMedical Journal; Vol. 4 No. 2: Volume 4 Issue 2; 134-138 2709-2798 2709-278X 10.52229/pbmj.v4i2 eng https://pakistanbmj.com/journal/index.php/pbmj/article/view/107/121 10.54393/pbmj.v4i2.107.g121 Copyright (c) 2021 Pakistan BioMedical Journal https://creativecommons.org/licenses/by/4.0 2744ffe4f6bb37cffffcd32e22cfbf92