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Objective: The objective of study was to determine the pattern of dyslipidemias in patients with end-stage renal disease on conventional hemodialysis in three months duration. Material and Methods: This study was conducted in the Department of Medicine and Dialysis Unit, Sargodha Medical College, District Headquarter Teaching Hospital, Sargodha. We conducted conventional hemodialysis (2cycles/week) for at least three hours and measured fasting lipid profile of 115 subjects with end-stage renal disease. Results: Our study included 115 subjects with end-stage renal disease. The mean age was 51.03 ±10.73 years. Out of 115 subjects, 69 (60%) were male and 46 (40%) were female. From study population, 39 (33.9%) patients were smokers and 76 (66.1%) patients were non-smokers. The mean baseline HDL cholesterol was 45.19±4.9 mg/dl, which after the end of study period was 41.07±8.57mg/dl. The difference was statistically significant as indicated by the p-value <0.001. The mean baseline triglyceride was significantly increased before and after the study. Almost all of our sample population exhibited elevated serum triglycerides and decreased HDL. Conclusion: The current study findings strongly support the notion that dyslipidemias are more prevalent in patients with end-stage renal disease. It could be an independent causative factor for cardiovascular deaths in end-stage renal disease. Additional large-scale case-control studies are needed to further strengthen the above statement. Key Words: End-Stage Renal Disease, Lipid Profile, Conventional Hemodialysis

Abstract Objective: To study the antifungal activities of aqueous and organic extracts of Prosopis cineraria against selected fungal strains including Aspergillus niger and Candida albicans. Material and Methods: Prosopis cineraria extracts were prepared using different solvents including water, methanol, ethyl acetate and n-hexane. Disc diffusion method was used to study the antifungal activities of prepared extracts. The extracts were tested for antifungal activities at different concentrations i.e., 75, 50, 25, 12.6, 6.5, 2.9 and 1.8 µg/mL. Inhibition zones of tested concentrations of extracts were compared with fluconazole (standard drug) for their antifungal activities. Results: Significant antifungal activity of Ethyl acetate extract was seen against the Candida albicans at the minimum inhibitory concentration (MIC) 2.9 µg/mL, for methanolic extract MIC was 12.6 µg/mL. For the n-hexane and aqueous extracts no MIC was seen against Candida albicans. P. cineraria didn’t show any significant activity against the Aspergillus niger strain. Conclusion: P. cineraria expressed promising antifungal activity against Candida albicans. Further phytochemical analysis is required to identify the biologically active constituents which may lead towards the development of new novel antifungal drugs. Key Words: Prosopis cineraria, Candida albicans, Aspergillus niger, Antifungal activity

Objective: To study an alternative and cheap way for the waste water treatment to remove the dyes. Material and Methods: Three adsorbents i.e. banana bark, rice straw and wheat straw were used without any treatment, having a particle size less than 841 micron to remove disperse blue 106 dye and reactive red 195 (C.R) dye from their aqueous solution. Experiments were performed in the batch method. All the experiments performed for various variables such as dose of the bio-adsorbent, shaking time, dye concentration, pH and nature of the bio-adsorbent under both shaking and static conditions. Percent (%) removal of each of the bio-adsorbent was estimated after every six hours for shaking condition and 24 hours for the static condition with the help of U.V visible spectrophotometer. Results: Banana bark proved to be the best adsorbent for Reactive red 195 dye and wheat straw for Disperse blue 106 dye. Banana bark showed best efficiency (50%-100%) for red dye as compared to the other two adsorbents and wheat straw proved to be the best adsorbent for blue dye having % removal of 40%-100% depending upon dye concentration in aqueous solution. Conclusion: Biosorbents are the hope for developing countries to protect the underground water and ecosystem from toxic effects of industrial effluents. Key Words: Biosorbent, industrial effluents, pollution, dye removal, health improvement

Abstract Osteoporosis (low bone mineral density) and sarcopenia (muscle loss) are collectively known as Osteosarcopenia. Osteoporosis and sarcopenia appear to affect the patient's fat content as the level of physical activity decreases, resulting in obesity. These three terms are named as “Osteosarcopenic obesity.” Osteoporosis and obesity have increased health care costs tremendously over the years. Nutritional modifications like sufficient magnesium, calcium, protein, vitamin D, and omega-3 and some pertinent exercises help patients dealing with this syndrome. This syndrome could be overcome by modifying dietary patterns and increasing physical activity as lifestyle choices greatly influence its prevalence. This article will help to understand the relationship between Osteosarcopenia and obesity and their associated risks. Keywords: Osteoporosis, Sarcopenia, Obesity, Nutritional modifications

Objective: To study the antimicrobial activity of the purified peptides/proteins isolated from the seeds extract of Nigella sativa (Kalongi). Material and Methods: Peptides/proteins isolates of Nigella sativa was screened for their antimicrobial activity against the bacterial strains including Staphylococcus aureus, Escherichia coli, Bacillus subtilis and Pasturella multocida and fungal strains including Aspergillus niger, Alterneria alternata, Aspergillus flavis and Rhizopus solani. Purification was carried out by dialysis, ammonium sulphate ((NH4)2SO4) precipitation, gel filtration chromatography using Sephadex G-100 gel and ion exchange by using DEAE-Sephadex A-50, fractions eluted using the gradient buffered NaCl (0.2-1 M). Results: Nigella sativa showed good antibacterial activity against S. aureus and E. coli while minimum zones of inhibition were noted against fungal strain A. niger and poor antifungal activity against Rhizopus solani. SDS-polyacrylamide gel electrophoresis revealed that the purified protein was a monomer with molecular mass of 14 kDa which possesses a strong and broad spectrum antimicrobial activity. Conclusion: Peptides/proteins contained by the N. sativa showed good antimicrobial activities. Keyword: N. sativa, antimicribial, peptides, proteins

Objective: To investigate the risk of hypertension among male university students in relation to dietary habits, lifestyle and obesity. Material and Methods: The cross-sectional study was performed at the Rawalpindi Medical University during September-December 2018. Participants were healthy male students aged 18-25 (medical & allied health students) selected via simple random sampling. Closed ended questionnaire was used to document life style and eating habits of participants. Blood pressure of all participants was recorded at two different occasions. BMI was calculated. The participants were selected by simple random sampling. Results: Of the 370 participants, 38(10.27%) were obese, 88(23.78) were overweight and 244 (65.95%) were with normal BMI. Out of the 370, 8(2.16%) were hypertensive whereas 68(18.38%) were pre-hypertensive and 294(79.46%) had normal blood pressure. Overall, out of 8 hypertensive participants 6(80%) were obese, 2 (20%) were overweight. Out of 68 Pre-hypertensive participants 24 (35.29%) were obese and 42(61.76%) were overweight and 2 (2.94%) were normal. These participants were taking at least two fast food meals weekly. Also, 318 (79.5%) responders were consuming soft/energy drinks more than once/day. Interestingly, 318(85.95%) respondents were spending 2-3 hours/day watching TV, playing video games or browsing on internet Conclusion: All of the hypertensive and Pre-hypertensive participants were either obese or over weight with sedentary lifestyle and unhealthy eating habits. Key Words: Hypertension, Sedentary lifestyle, Obesity, Dietary habits

Objective: The objective of this study was to determine the prevalence of anaemia in pregnant patients attending antenatal outpatient department (OPD) and to assess the cause and severity of anaemia. Material and Methods: Study design: Non-probability convenience sampling technique. Place and Duration of study: Antenatal outpatient department (OPD) Obstetrics and Gynaecology, Moula Bakhsh Hospital, District Head Quarters Teaching Hospital Sargodha from February 2017 to February 2018. Haemoglobin concentration of all the study patients was measured photometrically. Then, the patients have been classified according to the types of anaemia, its prevalence in pregnancy and the socioeconomic status of patients. Results: 75.2% of pregnant women were found anaemic. Anaemia was more common in patients with increasing parity, low socioeconomic status, and in patients who presented late in their pregnancy. Amongst anaemic patients, iron deficient anamia was found in 73% of the patients. Conclusion: Anaemia is highly prevalent in our population so effective measures must be envisaged to diagnose and prevent it early in pregnancy. Key Words: Anaemia, hemoglobin, pregnancy

Objective: To determine frequency of women presenting for IUD removal due to abdominal pain after immediate post-partum insertion. Material and Methods: This is a descriptive case series conducted at Department of Obstetrics & Gynecology, Nishtar Hospital, Multan from 15th January 2016 to 15th July 2016. Pregnant women age 25-34 years old were included with Parity ≥3 having gestational age of 36-40 weeks on ultrasound. Sample size was 148. Results: Age range in this study was from 25 to 35 years with mean age of 32.067±1.64 years, mean gestational age 38.040±1.08 weeks, mean BMI was 28.033±1.94Kg/m2 and VAS score was 6.662±1.16. Majority of the patients were from 31-35 years (86.5%). 3-4 parity was seen in 82.4% patients. Vaginal delivery was seen in 55.4% patients. IUD removal due to pain was seen in 17(11.5%) patients. Conclusion: This study demonstrated that the insertion of immediate post-partum intrauterine device is a suitable, feasible and safe way for contraception. The insertion of IUD at post-partum time is safe, has more advantages due high motivation of the patient and ease of insertion. It is highly convenient for both the patient and the doctor. Key Words: Gestational Age, BMI, Parity, IUD, Contraception.

Objective: Anemia during pregnancy is a frequent medical problem that contributes to increased maternal and fetal morbidity. Current work was planned to investigate the iron deficiency anemia associated with pregnancy. Material and Methods: A total of 150 pregnant females with different trimester and different history of gravida were selected from different rural areas of Sargodha District Punjab-Pakistan. A questionnaire was completed and blood samples were collected from all subjects to determine the concentration of Hemoglobin, serum Iron and Total iron binding capacity. Results: Study results revealed that prevalence of iron deficiency anemia is more significant (p<0.05) during second trimester with Hemoglobin concentration (9.1±1.7 g/dL), iron (29±5.1 µg/dL) and TIBC (367±91 µg/dL) as compared to first and third trimester. Furthermore, the results showed that prevalence of iron deficiency anemia is 89% with hemoglobin < 11.0 g/dL; of which mild anemia was 47 % (Hb 9-11 g/dL), moderate anemia 33% (Hb 7-8.9g/dL), severe anemia 08% (Hb <7 g/dL) and only 11 % pregnant female have hemoglobin > 11 g/dL. Conclusion: It could be concluded that iron deficiency anemia is significantly associated with progression of gestational period which is more prevalent in rural areas of Sargodha. Further, this condition could be controlled by improving the socioeconomic status of local population as well as with iron supplementation. Key Word: Anemia, iron deficiency, pregnancy, rural areas

Objective: Chronic obstructive pulmonary disease is an inflammatory disease with airway obstruction that can affect breathing pattern and consequently posture. The objective of the study was to measure the effects of chronic obstructive pulmonary disease on cervical and lumbar spinal mobility. Material and Methods: This was analytical cross-sectional study, consists of 75 patients with COPD. An inclinometer was used to assess a range of motion, and the Dutch Musculoskeletal Questionnaire (DMQ) was used to assess pain. Analysis of data done by using SPSSv20. Percentage and frequency were used for categorical variables, age, and gender. Results: Majority of participants had limited lumber ranges and mild limitation in cervical ranges. Patients felt much trouble in moving heavy load and little trouble when working in an uncomfortable posture. Conclusion: The findings of this study indicate that majority of patients had limited lumber ranges, and they felt trouble in doing activities. Key Words: COPD, Posture, Inclinometer, Range of motion

A comprehensive body of evidence now exists concerning the protective effect of healthy eating habits and food choices against a number of chronic diseases particularly diabetes, cancer and stress. In the main body of the review, the factors that affect food choice decisions of university students in relation to healthy eating habits are studied. Determinants covered included; socio- demographic, breakfast skipping, availability of food, media advertisings, fast-food consumption, family choices, stress and poor meal patterns. The content of review showed that poor food choices are leading towards chronic diseases. The purpose of this review is to highlight the determinants affecting food choices and eating patterns of students by showing the association with chronic diseases and poor health status. Key Words: Food Choices, Meal Patterns, Diabetes, Cancer, Psychological Stress, Breakfast Consumption

Abstract Objective: Cardiovascular disease (CVD) is a major and growing contributor to morbidity and mortality in Asian countries including Pakistan. This study is planned to examine the variations in various hematological indicators in cardiac patients from Faisalabad, Pakistan. Material and Methods: The study population consists of fifty subjects including healthy individuals as control group (n=20) and cardiac patients as test group (n=30). The blood samples taken from subjects were investigated for hematological indices using an Automated Hematology Analyzer Sysmex KX-21. Results: Significant variations in hematological indices were observed between the control group and test group individuals. Results showed that mean corpuscular volume, total white blood cells, packed cell volume and platelets count were increased significantly (p<0.05) in test-group individuals than in control-group. Erythrocyte sedimentation rate (ESR) was also increased in test group individuals. It was also found that hemoglobin concentration and percent neutrophil count were decreased significantly (p<0.05) in test-group as compared to control-group. Conclusion: This study concluded that investigating hematological indices is a useful indicator for evaluating the health status of cardiac patients along with other specific markers for cardiovascular diseases. Key Words: Cardiovascular disease, Hemoglobin, White Blood Cells Count, ESR

Objective: The objective of this study is to determine the frequency of most common bacteria from bacterial isolates and their antimicrobial sensitivity pattern in neonatal sepsis. Material and Methods: A total of 200 neonates of both genders aged under 28 days of life who presented with neonatal sepsis were included in the study. Blood culture and sensitivity reported were obtained, and frequency of common bacterial isolates and their antibiotic sensitivity pattern were recorded. Results: The age of the patients ranged from 2 days to 27 days with a mean of 8.25±5.99 days. Majority (n=172, 86.0%) of the patients were aged under 2 weeks. The weight of the patients ranged from 1.6 Kg to 4.0 Kg with a mean of 2.53±0.56 Kg. Body weight was between 1.6-2.8 Kg in 150 (75.0%) patients while the remaining 50 (25.0%) patients had body weight in the range of 2.9-4.0 Kg. There were 124 (62.0%) male and 76 (38.0%) female patients (with male to female ratio of 1.6:1). E. Coli was the most frequent bacteria found in 78 (39.0%) cases while Ciprofloxacin (49.0%) and Meropenem (43.0%) were least resistant antibiotics. Conclusion: E coli were the most frequent bacteria followed by S. aureus, Klebsiella spp., Pseudomonas spp. and S. epidermidis in patients with neonatal sepsis. Ampicillin was found to be the most frequent resistant antibiotic and meropenem was least resistant drug. Key Words: Neonatal Sepsis, Bacterial Isolate, Antibiotic Sensitivity Pattern

Objective: Lung cancer (LC) is one of the leading causes of cancer related deaths worldwide. Among other reasons, one cause of LC deaths is the lack of early diagnosis. Serum biomarkers might be helpful in early detection of this cancer but there is no up to date specific biomarker reported to diagnose LC. Aim of the present study was to predict the tumor associated proteins as potential biomarkers for the early detection of Lung Cancer (LC). Material and Methods: 50 serum samples from LC patients were tested and SDS-PAGE profiling was performed. The visualization of detected protein bands the gels were stained by Coomassie blue staining method. Results: Two bands were differentially expressed by LC patients comparing control sera. A 41 kDa band was stained in 21% testing sera while 110 kDa band was stained with 17% testing sera of patients. Conclusion: These protein bands might serve as candidate potential biomarkers for early LC diagnosis after mass spectrometry confirmation with large scale testing sera. Keywords: Sera, Diagnostic biomarker, Lung cancer

Objective: This study was designed to profile differently expressed proteins (by SDS-PAGE) from sera of patients of thyroid cancer, and to analyze using bioinformatics tools. Material and Methods: 30 serum samples were collected from thyroid cancer patients. The protein extract was resolved by SDS-PAGE for protein separation to profile the proteins differentially expressed in sera of patients. These proteins were analyzed using bioinformatics tools to predict the peptides produced by cutting the proteins, their physiochemical properties and the transmembrane domains using ExPASy server (www.expasy.org/tools/). Results: Seven protein bands were differentially stained in sera of thyroid cancer patients comparing sera of healthy subjects. The protein bands of 15 kDa, 32 kDa, 37.5 kDa, 38 kDa, 49 kDa, 82 kDa and 90 kDa were observed which might correspond to Gal3, CK19, TPO, Ki67, Calcitonin, Thyrotropin receptor and E cadherin. Physiochemical properties were predicted using ProtParam and putative transmembrane domains were predicted by ProtScale bioinformatics tool. The transmembrane domains were found more in thyrotropin receptor, few or less in Gal3, Ki67 and E cadherin, moderate in CK19 and TPO while null in calcitonin. Conclusion: The present study provides potential predictions on physiochemical properties, transmembrane domains and secondary structure of proteins differentially expressed in the sera of thyroid cancer patients which might be helpful in the discovery of prospective biomarkers for thyroid cancer diagnosis. Key Words: Thyroid Cancer, SDS-PAGE, ExPASy, Bioinformatics tools

Objective: The objective of the study was to compare the efficacy of Kinesio Tapping and conventional physical therapy for the treatment of subacromial impingement syndrome. Material and Methods: A comparative study was conducted. A total of 54 patients were randomly allocated to the experimental group (n=27, Kinesio taping plus conventional therapy) and control group (n=27, conventional physical therapy). Patients were treated for four weeks. Shoulder pain disability index (SPADI) and numerical pain rating scale (NPRS) were used for the outcome measure before and after the treatment protocols. Results: Total of 54 patients with shoulder impingement participated in this study with age ranges from 40 to 60, where the mean and SD for age was 48.91±6.26. In 54 patients, 34(63%) were male, while 20(37%) were female. After treatment, the mean scores ±SD for Visual analogue scale in the experimental group was 3.05 ± .51 While Conventional therapy VAS was 4.97± 2.02, showing that patients significantly improved in the treatment group. The mean scores ±SD for SPADI in the Tapping group was 50.37 ± 20.27 While Conventional therapy SPADI was 75.67± 11.15, showing that patients significantly improved in the treatment group. P-value of <0.05 was considered statistically significant. Conclusion: This study suggests the effectiveness of KT and conventional PT on pain reduction and disability in patients with SIS as compared to conventional physical therapy alone for the treatment of SIS. Keyword: Physical Therapy, Exercise, Kinesio Tape, Shoulder, Shoulder Impingement Syndrome

Objective: The objective of the study was to determine the risk factors and pregnancy outcome in patients having placenta previa along with placenta accreta. Material and Methods: A cross sectional study was carried out at Obstetrics & Gynecology Department, Sir Ganga Ram Hospital Lahore. Total 50 pregnant women with singleton pregnancy and >24 weeks gestation. Patients having placenta previa on trans abdominal ultrasound and during caesarean section were included in the study. Placenta previa-accreta was clinically diagnosed while doing caesarean section. Results: The age of patients was from 20 to 50 years, with 42.0% >36 years. Majority of the patients were multipara while primipara with placenta previa were only 3.6%. All patients with placenta previa gave the history of cesarean section. Age, parity and previous history of cesarean section has significant relation with placenta previa. 12(24.0%) and 15(30.0%) of patients showed grade-III and grade-IV placenta previa respectively. 36(72.0%) had anterior previa and 14(28.0%) had posterior previa. 16 patients underwent caesarean hysterectomy. 11(22.0%) patients were diagnosed as having placenta accreta along with placenta previa. Conclusion: Risk of placenta previa along with accreta rises with previous cesarean sections, age and parity. Sonographic detection of abnormal placenta should be carried out for diagnosis to avoid massive maternal hemorrhage to reduce the morbidity linked with placenta previa. Key Words: Placenta Previa, Maternal Outcomes, placenta accreta

Smoking is leading cause of lung cancer accounting for about 85% lung cancer cases. Even, illness associated with smoking caused about 5 million deaths globally every year. It is alarming that about one-third of adults globally are considered to be smokers and this rate is significantly increasing in female. It is worrisome that estimated deaths attributed to tobacco smoking will rise up to 10 million by 2025. A number of researches reported strong association between cigarettes smoking and lung cancer and cigarette smoking related deaths accounts about one-third of all adult deaths. A constant smoker has 20-40 times higher risk for the development of lung cancer as compared to non-smokers. About sixty carcinogens have been identified in cigarette in laboratory settings which are proven to induce carcinoma. This review article described the linkage of lung cancer and smoking with some etiologies for the development of cancer in tobacco consumers. Key Words: Smoking, DNA adducts, carcinogenic metabolites, pulmonary cancer

Objective: The objective of study was to identify the results of task-oriented strength-training on lying and rolling in children having cerebral palsy Material and Methods: This study is a quasi-experimental study design to check the effects of task-oriented strength training in improving rolling and lying in children with cerebral palsy with age 5 to 15. The total of thirty-two Cerebral Palsy (CP) patients having either type spastic or athetoid CP were included. Gross Motor Function Measure (GMFM) scoring system was used for analysis of the patients. Intervention used in this study was set of exercises in lying position. Duration of intervention was five days in week for six months. Results: Results showed mean Pre-lying and rolling score was 90.68 ± 11.87 and post mean score in lying and rolling domain was 94.72 ± 6.74. Paired sample T test was used for comparing pre and post GMFM score which indicate significant difference. Conclusion: The conclusion was that task-oriented strength training have significant role in improving in lying and rolling in children having cerebral palsy. Key Words: Cerebral palsy, motor strength, task-oriented strength training

Objective: To examine the impact of sports activities on stress among medical and undergraduate’s students. Material and Methods: It’s a descriptive cross-sectional study undertaken in four private sectors teaching institutions situated in Faisalabad. Sample consisted of 150 students. 75(50%) students were selected form medical and 75(50%) students (20 to 30 years) were having undergraduate level of education. Data was collected through self-administered structured questionnaire. Results confirmed that the internal consistency (reliability analysis) of all questionnaires in this study are in adequate values of Cronbach’s alpha (.83 to .94). Results: Out of 150 study participants, there were 86 male and 64 female participants. Mean age of participants was 22.75 years+1.14. The study showed deep insights on the relationship between stress of adults and physical activity. The result displays that rational sports activity is positive significant (p < .01) correlate with stress (r = -.43). While, depend sports activity is also positive significant (p < .01) correlate with stress (r = .26). It means if rational sport activity will increase then stress will decrease. Additionally, rational sports activity has significant negative impact on stress, while depend sports activity has significant positive impact on stress. Conclusion: It is concluded that sports activity has significant impact on stress among medical and undergraduate students. Counselling sessions should be offered to student to reduce their stress and engage in sport activities. Key Words: Stress, Sports Activities, Medical students, Undergraduates Students

Objective: Purpose of the study is to study the effects of Kinesio Taping on individuals with non-specific neck pain. Material and Methods: The methodology comprises of 40 Individuals who were selected for the study. The individuals were selected form Karachi University and NED University, as the complaint of mechanical neck pain is common among students. SPSS (statistical package of social sciences version 23 were used to analyzed data. Descriptive statistics was used to analyses the frequency and percentages and pre and post outcomes. Results: Finding revealed before the treatment the pain score was 6.50 standard deviation 1.53, while after the treatment it was 2.10 standard deviation 1.11. The mean decrease in both the pains was on average 4.40 units with significant p value less than 0.01. Conclusion: It has been concluded from the study that the neck pain was reduced when kinesio-taping was applied on the neck. Furthermore, study showed that the disability of the neck was widely effected and reduced because of taping. Key Words: Neck pain, Neck disability, Taping, Kinesio-taping.

Objective: The study aimed to determine the prevalence of painful diabetic peripheral neuropathy (PDPN) in uncontrolled type 2 diabetes patients. Material and Methods: A simple random sampling technique was used to collect data from 120 patients in four months; data collection was carried out via a questionnaire. Statistical package for the social scientists SPSS version 23 was used to analyze data statistically. Results: This study revealed that out of 120 individuals, thirty-seven percent were males, and sixty-three percent were females. All were suffering from Type-2 Diabetes Mellitus. Among them, seventy-one percent of subjects were suffering from diabetic peripheral neuropathy (DPN), and fifty-three percent were suffering from painful diabetic peripheral neuropathy (PDPN). Conclusion: This study concluded that painful diabetic peripheral neuropathy (PDPN) is highly prevalent in type 2 diabetes i.e. 52.9%, in Pakistan. Key Words: Diabetes mellitus, Diabetic peripheral neuropathy (DPN), Painful diabetic peripheral neuropathy , Prevalence, Burning sensation, Muscle cramps.

Objective: To find out balance problems after mild traumatic brain injury among young adults in Lahore, Pakistan. Material and Methods: The descriptive case series was conducted at Lahore General Hospital 20 patients were recruited who completed the inclusion criteria. In the study, the data was collected by conducting interviews and balance test. The static and dynamic balance of the patients was assessed by Berg Balance Scale. Results: In the study population, the mean age of the patients was 26.40, with a range of (18-35years). Out of them, 75 % of the patients were male and 25 % were female. In the study (N=20), it was found that 30% patients were at high risk of falling, whereas 55% patients were at medium and 15% patients were at low risk of fall respectively according to the Berg Balance Scale. Conclusion: Mild traumatic brain injury significantly influences the balance of the individuals resulting in marked limitation in physical activities and increases the risk of falling and related consequences. Key Words: Mild traumatic brain injury, young adult, postural balance

Objective: Constraint-induced movement therapy is a form of rehabilitation therapy that improves function of involved extremity in patients of stroke and other patients with damage to brain by selectively increasing the use of their affected upper limb. The basic purpose of current study was to access the functional abilities of upper limb among older adults having constraint induce movement therapy post 6-9 months of ischemic stroke. Material and Methods: A descriptive study was conducted on 43 stroke patients who had undergone constraint induced movement therapy. Data was collected from patients with stroke coming to physical therapy department of multi-setting Hospitals. Data collection was performance based and patients were evaluated by help of Wolf Motor Function Test that is standardize tool and involves 15 items and two strength items. Validity of WMFT is 0.92. Results: The mean age of patients was 62.44 whereas standard deviation 7.95. Mean and Standard deviation of functional ability was 3.3488 with a Standard Deviation 0.9228 and a P value of 0.001. Conclusion: Use of CIMT therapy during sub-acute stage rehabilitation period of post stroke patients facilitates functional improvement of a pelagic upper limb. Key Words: Constraint Induced Therapy, Functional Ability, Stroke, Manual coordination.

Objective: Asthma is a chronic inflammatory disease and its prevalence is increasing with each passing day. This research work was aimed to study the impact of a pharmaceutical care program on asthmatic patients. Material and Methods: Prospective study was performed on sixty patients in Gulab Devi chest hospital Lahore by questionnaire evaluation. Two methods were used for data collection including the use of pharmaceutical care model instrument to collect participant’s baseline data, peak expiratory flow rates, adverse reaction of asthma medication and triggering factors. A seven-point scale score method was used for technique of using inhaler in proper way Results & Conclusion: Majority of study participants were female 58% under 35-45years of age and 75% of patients had family history of asthma. The average peak expiratory flow rate was 280±7.7 and a significant difference (p<0.05) was found between pre and post intervention group. Most of the study participants had a maximum of primary school education 46.5%. The daily symptoms occurrence was 13.9% and the night-times awakenings was 14.2% more than once in a week, 61.7 % patients showed adherence to preventive medication. Itching, sweating, cough and headache were the most frequently reported adverse effects perceived to be associated with asthma medicine. Results showed that only 17% and 12% of participants were metered dose inhalers and dry powder inhalers, respectively. The average score of metered dose inhaler (MDI) and dry powder inhaler (DPI) were 3.5±3.1 and 2.14 ±1.3, respectively. Conclusion: To achieve proper outcomes and to ensure better quality of life to patients, pharmacist should counsel patients about the proper use of medications as well as inhaler use especially meter dose inhaler and also about the avoidance of triggers of disease. Keyword: Asthma, pharmaceutical care, patient education, inhaler technique, avoidance of triggers.

Objective: The objective of the study was to compare the effects of McKenzie Extension Exercises versus Mulligan Sustained Natural Apophyseal Glides on Pain and Functional outcomes in patients with Acute Non-Specific Low Back Pain. Material and Methods: Study design was experimental. 84 Patients were selected randomly through computer balloting and were allocated into group A and B. The questionnaire was based on two primary outcome measures i.e. Visual Analogue Scale for pain and Back performance scale for functional abilities. Patients were assessed by a research assessor at pre-treatment i.e. t0, mid treatment i.e. t1 and after treatment i.e. t2. Results: Mean age for patients in group A was found to be 41.97±8.16 and 45.02±7.29 for patients in group B. 45.24% were males and 54.76% were females. Pain score according to VAS was recorded to be 8 which significantly dropped to 4.02±0.80 and 4.12±0.76 (p=0.56 i.e. non-significant) in patients of group A and B respectively at mid treatment level. Moreover, pain was recorded to be 1.45± 0.50 and 1.43 ± 0.50 (p=0.81 i.e. non-significant) in group A and B respectively. Functional abilities measured by Back Performance Scale was found to be 5.02 ± 2.05 and 6.78 ± 3.3 at post treatment level (p=0.00). Back Performance Scale results at 8th week follow up for both groups were significant (p-value of 0.03) with values of 2.15 ± 1.64 and 3.16± 2.43 respectively. Conclusion: The present study concluded that McKenzie exercises and SNAGs both were equally effective in improving pain whereas McKenzie exercises improved Functional abilities better than SNAGs. Key Words: Nonspecific Low back pain, McKenzie extension exercises, Mulligan SNAGs.

Objective: Restless leg Syndrome has adverse effects on sleep quality. The study intended to find out the incidence of Restless Leg Syndrome (RLS) in Type-2 diabetic patients and its relationship with Quality of Sleep. Material and Methods: The population under study consisted of 203 patients attending three major hospitals in the city of Lahore, Pakistan. RLS was diagnosed by consulting the criteria defined by the “International Restless Legs Syndrome”. The Pittsburgh Sleep Quality Index scale assessed the quality of sleep. Subjects were interviewed using these questionnaires to determine the presence, frequency & severity of RLS symptoms and their effect on the quality of their sleep. Results: Out of 203 patients, 66 were males, 137 were females. Present results revealed that RLS was present in 65% of patients. The Pittsburgh Sleep Quality Index (PSQI) showed that 155 out of 203 participants were poor sleepers, and 48 were good sleepers. The disturbances in the sleep were found more among the patients with RLS than non-RLS (86.36% Vs 57.7%). A positive association was found between RLS and sleep quality. Conclusion: The findings of this study demonstrated that the occurrence of RLS was very high among diabetic patients, and RLS is strongly associated with poor quality of sleep. Key Words: RLS, Diabetes, Sleep quality, Pittsburgh Sleep Quality Index

Objective: This Experimental study was organized to investigate the ameliorating effect of Renadyl on some hematological and biochemical changes in young male rats after gentamicin induced nephrotoxicity. Material and Methods: Total eighteen (18) rats were used and divided into a control group (n=6) and treated groups (n=12). Gentamicin was given through the intraperitoneal route for 8 days. After 8 days half (n=6) rats were sacrificed from the treated group. Renadyl was administered orally to the remaining rats (n=6) for a further 10 days. After this rats were decapitated for investigation. Results: Data were analyzed by one way ANOVA. A significant difference (p≤0.05) was found in mean corpuscular hemoglobin, creatinine, urea, HDL, LDL, glucose, TAC, TOS, kidney, and liver weight in Renadyl treated group as compared to Gentamicin treated group. The results indicated that Renadyl has the potential to reduce toxicity level induced by gentamicin by using creatinine and other toxic agents as their food ingredients and also remove enteric toxins which further provoke kidney damage. Conclusion: Renadyl possesses a nephroprotective approach against Gentamicin induced nephrotoxicity. Key Words: Gentamicin, Nephrotoxicity, Renadyl, nephroprotective

DOI: https://doi.org/10.52587/njhms.v4i1.37 Objective: Hemostasis is the natural process causing the blood to stop flowing out from damaged blood vessel following an injury. This involves the coagulation process activating the coagulation mechanism to form fibrin clot. Cytotoxicity is the ability of an agent to destroy the living cells. The current work was aimed to study the thrombolytic and cytoprotective potential of Moringa oleifera leaves extract through in vitro assays. Material and Methods: M. oleifera leaves extract was tested for thrombolytic activity against human blood clots through clot lysis assay using streptokinase as standard thrombolytic agent. For evaluation of cytoprotective potential of the aqueous leaves extract, hemolytic assay was performed using washed human erythrocytes. Distilled water and Triton X-100 was used as negative and positive controls, respectively. Results: Current study results showed significant (p<0.05) clot lysis activity against blood clots but the percent clot lysis by M. oleifera extract (42.74±1.8%) was lower than that of standard streptokinase (79.4±2.6%). No significant (p>0.05) hemolysis was observed in M. oleifera leaves extract (6.58±1.02%) treated red cells and distilled water (2.84±0.78%) while remarkably significant (p<0.05) hemolysis of washed red cells incubated with triton X-100 (86.04 ± 4.87 %) was observed. Conclusion: The study indicated that M. oleifera leaves have therapeutic potential against blood clots with less cytotoxic effect on human erythrocytes. Hence, this plant might be used as cardioprotective and membrane stabilizing agents in pharmaceutical preparations after proper screening and analysis of bioactives present in aqueous extract of this plant. Keywords: Thrombolytic, streptokinase, cardioprotective, cytotoxicity

DOI: https://doi.org/10.52587/njmhs.v4i1.32 Objective: This study aims to compare the compare the treatment response of azithromycin against ciprofloxacin while treating salmonella infection in children. Material and Methods: The study was conducted in Yaseen Memorial Hospital, Faisalabad Pakistan. Informed written consent was taken from parents or guardians of patients. The sample size of the study was 200 children. The Patients that are included in the study after fulfillment of the criteria were included in study and were randomly divided into Azithro-group and Cipro-group. Cipro-group was treated with oral ciprofloxacin 15mg/kg/dose twice a day for 7 days. Azithro-group was treated with oral azithromycin 10mg/kg/dose Once/day for 7 days. Patients were closely monitored during the whole study period. Results: Out of 200 patients, 125 patients fall between 3- to 8-year age group. Out of these, 71 were in Cipro-group and 54 were in Azithro-group. Rest of the 75 patients fall between the 9- to 14-year age group. Out of these, 29 were in Cipro-group whereas 46 in Azithro-group. The Comparative efficacy of the oral azithromycin vs oral ciprofloxacin in children with typhoid infection demonstrates that 89% patient in Azithro-group and 68% patient in Cipro-group met the criteria of effectiveness. While 32% in Cipro-group and 11% in Azithro group did not meet the criteria of effectiveness despite the same treatment. Differences were considered statistically significant if p<0.05. Conclusion: Clinical treatment response with azithromycin is significantly higher both age groups of children in comparison to ciprofloxacin for treating typhoid fever. Keywords: Children, Typhoid fever, treatment response, azithromycin, ciprofloxacin

DOI: https://doi.org/10.52587/njmhs.v4i1.15 Objective: Tuberculosis mainly affects lunges and other organs of human body such as brain bones and intestine may be involved. Tuberculosis treatment causes significant hematological and biochemical changes during treatment. Material and Methods: Positive new TB patient which was enrolled in treatment are selected. This descriptive study was carried out on pulmonary TB patients who were treated with standard regimen before treatment and during treatment five-month data was collected at FJCH Quetta Baluchistan. Indicator of hepatocellular function enzyme included ALT, AST, changes have been observed almost in all patients. The Hematological changes Include drug induced aplastic Anemia, changes in RBC and WBC counts have been observed with tuberculosis treatment. Results: The level of blood continent is significantly affected. The mean among RBC count in TB patient before treatment (4.89±51) and after five-month treatment it was (4.84±54) and it was slightly lower. The average total no of WBC of TB patient before treatment (7.29±.19) after completion of five-month treatment it was (7.21±15.2) slightly increases in number. The mean among thrombocyte count in TB patient before treatment was (244.98±) and after five-month treatment it was (244±28) and it was slightly lower in number. The total ALK-P of TB patient using anti TB drugs before treatment (111.10 ±12.9) and after completion of five-month treatment (127.80±7.2) it was slightly increases. The mean among ALT in TB patient before treatment (39.56±1.37) and after five-month treatment it was (43.56±4.16) and it was slightly higher. The average Globulin level in TB patient before treatment was (3.50±.45) and after completion of five-month treatment (5.03±63) it was slightly increases. Conclusion: The level of blood chemistry is significantly lowered after completion of five-month treatment. It shows significant variation before initiation and after completion hematological abnormalities in TB patient should be checked during tuberculosis treatment. LFT including ALKP and ALT biomarkers are slightly increases. And should be monitored during and after intensive phase of treatment. Keywords: Biochemical assessment, anti TB drugs. Liver enzyme, Hematological indices

DOI: https://doi.org/10.52587/njmhs.v4i1.29 Objective: The objective of study was to find out the prevalence of flat foot in the female adults of university and to find out the association of flat foot with obesity and footwear. Material and Methods: A cross sectional study conducted in the female students with sample size of 714 who meet our inclusion and exclusion criteria. Duration of study was six months. Study was conducted at department of Allied Health Sciences, University of Faisalabad. Sample was selected by convenient sampling and then measure the primary outcomes of our study i.e., body mass index (BMI) and footwear. The clinical tests i.e., single limb heel rise test and Supple Pes Planus test were performed and the Clarke’s angle of foot prints is measured. Results: The prevalence of flat foot in the female students of the University of Faisalabad was 9.64% in which 4.00% were unilateral flat foot and 5.64% were bilateral flat foot. The 72.55% females had negative ligamentous test and 27.45% had positive ligamentous test. The 20.18% females had positive Single limb heel rise test and 79.82% females had negative test. There is no association of flat foot with BMI, type of shoes and type of heels, p=0.465, p=0.783 and p=0.209 respectively. Conclusion: The prevalence of pes planus was 9.64% in which 7.45% had mild flat foot and 2.18% had moderate flat foot and 4.00% were unilateral and 5.64% were bilateral. The bilateral flat foot was more than unilateral flat foot. There was no association of obesity and footwear with Clark’s Angle in the flat foot individuals. Keywords: Supple pes Planus, Single Limb Heel Rise, Clarke angle, BMI, Footwear, Flat foot.

DOI: https://doi.org/10.52587/njmhs.v4i1.31 Objective: Kidney stones have both genetic and environmental factors for its formation. The objective of this study was to find the affected lab parameters in urolithiasis patients and to find the association between dietary habits and kidney stone formation in confirmed urolithiasis patients at Jinnah hospital, General hospital, and Sheikh Zaid hospital Lahore. Material and Methods: About 140 confirmed urolithiasis patients were included in the study from Urology wards of above-mentioned hospitals with due permission of competent authorities. Related data was collected by using pre-certified questionnaire. Data was analyzed by using SPSS version 26.0. Results: Selective blood parameters like Urea, Creatinine, Lymphocytes, and granulocytes were found significantly (p<0.05) high in the participants. MPV and RDW were also raised in these patients. Results also showed that dietary factors including green leafy vegetables (Spinach, mustard greens, curly leaves and cabbage), meat (red meat, fish meat and organ meat), lentils and lack of water intake were found significantly (p<0.05) major dietary factors which might be associated with kidney stones development in these urolithiasis patients. Conclusion: Kidney stone formation can influence lab markers such as urea, Creatinine, lymphocytes, MPV, granulocytes, and RDW, which might prove helpful in early detection of the disease. Dietary factors like certain vegetables, meat (Red meat and organ meat), cereals and lack of water intake might have some association with kidney stones development in urolithiasis, that warrants further studies to get clear association. Keywords: Renal stones, prevalence, risk factors, hot weather, dietary habits, renal parameter

Objective: The study is conducted to access the effectiveness of Isometric Handgrip (IHG) Exercise in pre-eclamptic females. Material and Methods: Fifty-six diagnosed females with history of pre-eclampsia were randomly allocated into two groups: A with 28 subjects and B with 28 subjects. Participants with group A received isometric handgrip exercise along with medicines while Group B was treated only with medicines. Each patient was treated three times a week for a period of 4 weeks. Pre-treatment, 2nd week and 4th week measurements of blood pressure was taken by a sphygmomanometer, reading was taken according to American Heart Association. Results: While comparing the values of both experimental and control group, both groups show statistically significant changes in the results after treatment, but experimental group shows more improvement than control group. Conclusion: In the study, it has been demonstrated that reduction in SBP and DBP was seen after 4 weeks of isometric handgrip exercise. It is also concluded that IHG training may be an easy, simple, cost-effective, efficacious, and non-pharmacological therapy in clinical management for reduction of blood pressure in pregnancy. Keywords: Hypertension, Diastolic blood pressure, Isometric handgrip exercise, IHG Training, Pre-eclampsia, Systolic blood pressure

DOI:https://doi.org/10.52587/njmhs.v4i2.35 Abstract Objective: Breech presentation is a common complication during pregnancy that increases the risk of fetal morbidity and mortality during vaginal delivery compared to caesarean section. To reduce the number of caesarean sections and associated complications, external cephalic version (ECV) is recommended. The objective of this cross-sectional study was to determine the success rate of ECV in uncomplicated singleton breech presentation at term. Material and Methods: The study was conducted on 85 patients at Gynae-unit I, SPH/ Bolan Medical Complex Hospital, Quetta, Pakistan. The success rate of ECV was found to be 42.4%, while the failure rate was 57.6%. Multigravida had a higher success rate (80.6%). Complications such as fetal distress, ruptured membranes, placental abruption, and emergency cesarean section occurred in a small percentage of cases. Results: According to study, the success rate was 42.4% and failure rate was 57.6%. Multigravida shows higher success rate (80.6%). In one patient (1.2%) emergency cesarean section was done due to abruption placenta, that occur in (1.2%) after the successive version, and in 4.7% cases fetal bradycardia was seen, which was transient, that resolved spontaneously. No complication seen after failed ECV. Conclusion: The study concludes that ECV is an effective and safe procedure in reducing the incidence of breech presentation at term with a low risk of complications. Maternal age and multiparity are associated with a higher success rate, and the procedure is simple to learn and perform. Properly counseled women are satisfied with the procedure, and well-equipped obstetrics units should routinely offer the procedure in selected cases during term pregnancies. Keywords: Abruption placenta, Breech presentation, External cephalic version, Term pregnancy

DOI:https://doi.org/10.52587/njmhs.v4i2.40 Objective: The study was planned to measure markers of myocardial injury in experimental model of acute myocardial infarction. Material and Methods: This was a randomized experimental study. In the study, 40 male rabbits were included and distributed equally into five groups. During first 14 days, G-1 and G-2 (control group and Iso-control group) animals got 1ml normal saline, while G-3, G-4 and G-5 animals got citric acid at the dose of 250 mg/kg, 500 mg/kg and 750 mg/kg body weight respectively. Isoproterenol (85mg/kg body weight) was injected subcutaneously for induction of acute myocardial infarction in experimental model except for G-1. Markers of myocardial injury like serum- CK-MB, LDH., SGOT and SGPT were analyzed in the study. Results: The data in the study shows that there was significant rise in myocardial injury markers such as CK-MB, LDH, SGOT and SGPT as compared to control-group indicating severe infarction and myocardial cell death. On the other hand, citric acid treated groups showed significant restoration of CK-MB, LDH, SGOT and SGPT as compared to Iso-control group. Conclusion: It is clear from this study that citric acid possesses cardio protective potential. It reduces the impact of ischemic injury to myocardium during acute attack of myocardial infarction, evident by reduced cardiac enzymes levels. Keywords: Acute myocardial infarction, Cardio protection, Isoproterenol, Cardiac Enzymes, CK-MB, LDH, Citric acid.

DOI:https://doi.org/10.52587/njmhs.v4i2.41 Objective: The aim of this study was to assess the effectiveness of proprioceptive and therapeutic exercises on pain among patients with knee osteoarthritis. Material and Methods: In this study, fifty-four patients having knee osteoarthritis were arbitrarily assigned into two groups: Group-A with 27 patients and Group-B with 27 patients. Both groups were given local heat for 20 minutes. Group A received proprioceptive exercises while Group B was treated with therapeutic exercises. Each patient was treated four times a week for a period of 4 weeks. Pre-treatment, 2nd week and 4th week intensity of pain, stiffness and physical difficulties were evaluated by using Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Results: After the fourth week of exercises, both Groups A and B's mean values on WOMAC scores significantly decreased (P<0.001). However, it was found that the Group A having proprioceptive exercises performed better than Group B with therapeutic exercises. Conclusion: The special effects of proprioceptive exercises on the pain are more effective than therapeutic exercises among the patients of knee osteoarthritis. Further studies are needed to explore the better strategies to manage knee osteoarthritis with the help of proprioceptive exercises. Keywords: Knee Osteoarthritis, Proprioceptive Exercises, Therapeutic Exercises, Pain intensity.