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Introduction: Iron deficiency anemia is one of the major global public health issue causes many serious diseases mostly found in the women and children of developing world. Objective: To evaluate and assess the occurrence and disorder related to iron deficiency in the population of district Dir (Lower). Materials and Methods: From all volunteers blood samples were collected from Vein through syringe and kept it in the EDTA tubes. Hemoglobin concentration was determined by the help of Hematology Analyzer. Following the guidelines of WHO, the value of a hemoglobin (Hb) was

Career guidance had been a strong variable for consideration in democratic societies at global level. Individual autonomy and choice making is imperative for indulging in better market economy. Career guidance programs, if introduced at university level are very helpful for students in overcoming hesitation in career choices and selecting desirable study paths. The study compared career guidance needs among students at higher education level in Pakistan with reference to gender. Mix method design was adopted to extract data from graduating students enrolled in Management Sciences through questionnaire and semi structured interviews (male=100, female=100). Findings illuminated that male students (μ=4.1) have a clear idea about career guidance through internship programs whereas female students (μ=3.1) differed in their views about it. Male students suggested that career planning strategies, if implemented in their course may help designing lifelong careers whereas female students’ focus was towards development of effective career skills only. It is suggested that career guidance is on the brink of coming a national reality at all of the educational levels, so it may be included as a vital part in curriculum. Furthermore, as female students in our society are given less projection so they may be provided with more chances of exposure towards their future careers. Keywords: Perceptions, career guidance, career skills, career planning

Aim: We aimed to evaluate the role of selected single nucleotide polymorphisms of DNA damage response pathway genes in breast cancer (BC). Materials & methods: In present study, 500 BC patients and 500 controls was used to estimate the frequency of single nucleotide polymorphisms of DNA damage response pathway genes. Tetra-amplification refractory mutation system-PCR technique was used for screening of the six selected polymorphisms. Results: Logistic regression analysis showed that heterozygous mutant genotype of rs1800057 (p < 0.0001) and homozygous mutant genotype of rs1801516 (p < 0.0001) was associated with significant increased risk of BC. In the ATR gene, heterozygous mutant genotype of rs2227931 (p < 0.0001) was associated with significant increased risk of BC. However, significant decreased risk of BC was found associated with heterozygous mutant genotype of rs2227928 (p < 0.0002) and homozygous mutant genotype of rs2229032 (p < 0.0001) in patients compared with controls. Conclusion: The present results showed that alteration in DNA damage response pathway gene ( ATM & ATR) results in increased BC risk.

Purpose: This study was planned to examine the effects of Src and Yes1 single nucleotide polymorphism (SNPs) on the risk of thyroid cancer in 499 patients and 500 controls. Materials & methods: Three SNPs of Src gene and three SNPs of Yes1 gene were analyzed using Tetra-primer ARMS-PCR followed by sequencing. Results: rs121913314 of Src gene genotype TT showed 32-fold increased risk of thyroid cancer and rs2305994 of Yes1 genotypes TT and CT showed 2.7-fold and 16-fold increased risk in thyroid cancer (p < 0.0001). Haplotype analysis revealed that CATGCC, CATGCT, CATGTC, CATGTT, TATGCC and TATGTTA haplotypes are associated with thyroid cancer risk. Conclusion: Results showed that genotypes and allele distribution of Src and Yes1 genes are significantly linked with increased risk of thyroid cancer.

Acinetobacter is an important nosocomial pathogen to cause infections such as pneumonia, bloodstream infections, meningitis, wound and surgical site infections including flesh eating bacterium necrotizing fasciitis and urinary tract Infections. A. baumannii can be spread through direct contact with surfaces, objects and the skin of contaminated persons. Acinetobactter has acquired resistance to most of the antibiotics and can play havoc in hospital environment due to its ability to survive desiccation and in moist environment in the presence of disinfectants. Currently, there are 32 genospecies of Acinetobacter known. Among these, A. baumannii is the most important in the clinical context, since it is the most frequently isolated in nosocomial infections and the one associated with the highest mortality rate. Objective To find out the frequency of A. baumannii causing surgical site infections after cardiac surgery and best antibiotic options for its treatment in patients admitted in Rawalpindi Institute of Cardiology. Materials and Methods A retrospective study was carried out to find out bacterial cultures in admitted patients at Rawalpindi Institute of Cardiology with surgical site infections from July 2017 to August 2018. A total of 405 pus specimens collected from patients with suspected surgical site infections were tested for bacterial culture and antimicrobial susceptibility test. Patient profile was noted from centralized hospital data. Results Out of total 405 specimens 13 were culture positive for A. baumannii (3.2%). Ten isolates were Pan Drug Resistant (PDR). Conclusion A. baumannii infection although infrequent in our set up is mostly pan resistant. Infection control practices & surveillance are important to avoid its spread in hospitalized patients.

Aim: In this study, we evaluated the effect of selected polymorphisms of mitochondrial unfolded protein response (UPRmt) pathway in 500 head and neck cancer (HNC) patients and 500 healthy controls from Pakistan. Materials & methods: The experiments were conducted using tetra-ARMS PCR followed by DNA sequencing. Results: Multivariate analysis showed that AA genotype of rs3782116 showed fivefold, GG genotype of rs6598072 approximately twofold and CC genotype of rs4946936 and TT genotype of rs12212067 showed twofold increased risk of HNC. Furthermore, haplotype analysis showed that certain haplotypes of UPRmt pathway single nucleotide polymorphisms have significant association with increased HNC risk. Conclusion: These results show that genetic aberrations in UPRmt pathway genes have association with increased HNC risk and can be an indicator of advance clinical outcome especially invasion and metastasis.

Graphical abstract, Introduction Researchers worldwide with great endeavor searching and repurpose drugs might be potentially useful in fighting newly emerged coronavirus. These drugs show inhibition but also show side effects and complications too. On December 27, 2020, 80,926,235 cases have been reported worldwide. Specifically, in Pakistan, 471,335 has been reported with inconsiderable deaths. Problem statement Identification of COVID-19 drugs pathway through drug-gene and gene−gene interaction to find out the most important genes involved in the pathway to deal with the actual cause of side effects beyond the beneficent effects of the drugs. Methodology The medicines used to treat COVID-19 are retrieved from the Drug Bank. The drug-gene interaction was performed using the Drug Gene Interaction Database to check the relation between the genes and the drugs. The networks of genes are developed by Gene MANIA, while Cytoscape is used to check the active functional association of the targeted gene. The developed systems cross-validated using the EnrichNet tool and identify drug genes' concerned pathways using Reactome and STRING. Results Five drugs Azithromycin, Bevacizumab, CQ, HCQ, and Lopinavir, are retrieved. The drug-gene interaction shows several genes that are targeted by the drug. Gene MANIA interaction network shows the functional association of the genes like co-expression, physical interaction, predicted, genetic interaction, co-localization, and shared protein domains. Conclusion Our study suggests the pathways for each drug in which targeted genes and medicines play a crucial role, which will help experts in-vitro overcome and deal with the side effects of these drugs, as we find out the in-silico gene analysis for the COVID-19 drugs.

Salmonella enterica serovar Typhi (S. Typhi) is one of the typhoidal Salmonellae that causes typhoid fever. We report the first case of an XDR S. Typhi in a suspected case of Endocarditis with Aortic Valve Replacement and deranged INR. The identification was carried out by an automated system. The antibiogram was performed according to CLSI recommendations. The XDR S. Typhi isolates were found resistant to Azithromycin. Although XDR S. Typhi has been reported in our country and elsewhere, however, till to date no complete resistant isolate of S. Typhi to Azithromycin has been reported in Pakistan. The patient had a smooth recovery on intravenous meropenem. The case highlights the importance of the acquisition of resistance to the last line antibiotics in S. Typhi in our country and is of concern to infectious disease specialists to ensure infection control to avoid its spread. J Microbiol Infect Dis 2021; 11(1):32-35.

Objective To investigate the clinical and angiographic characteristics of coronary artery ectasia (CAE) and its relation with the inflammatory marker, HsCRP. Study design An observational study. Place and duration of study Rawalpindi Institute of Cardiology, Rawalpindi, from April 2015 till November 2016. Methodology Eighty-one patients with CAE and 57 age matched patients with stenotic coronary artery disease (CAD), but without CAE, were included in the study. Clinical, angiographic, and laboratory data were documented. Chi-square test was used to compare coronary risk factors between two groups. T test was used to compare means between the groups. Analysis of variance was used to analyse HsCRP levels among various types of ectasia. Correlation analysis was used to study association of ectasia with different risk factors. Results Males were predominant in both with & without CAE. Hypertension, smoking and obesity were significantly more common among CAE patients than those without (60.5% vs. 52.6%, 56.8% vs. 43.9% and 80.2% vs. 14%, respectively). Diabetes was much less in CAE group (32.1% vs. 42.1%). HsCRP was higher in patients with CAE than those without and was significantly higher in patients with more extensive ectasia. Majority (65.4%) of CAE patients had significant CAD; whereas, only 7.4% had isolated CAE. Most common artery involved was RCA (70.4% of total) and most common pattern was single ectatic vessel. Conclusion Obesity and smoking predispose to CAE, along with male sex and hypertension. While diabetes is negatively associated with CAE. HsCRP levels tend to be higher in ectasia patients, especially those with severe forms. Finally, CAE has a predilection for RCA.

Introduction: Perinatal asphyxia is one of the most common causes of neonatalmorbidity and mortality in most countries of the world. The objective of my study was to assessthe correlation of clinical findings of perinatal asphyxia with cranial sonography in full termbabies. Study Design: Retrospective study. Setting: Neonatal Intensive Care Unit of Children’sHospital Multan. Period: January 2016 to October 2016. Material and Methods: 100 fullterm babies having history of delayed cry were scanned within three days of birth in NeonatalIntensive Care Unit of Children’s Hospital Multan. Clinically findings including full term babies,birth weight, grunting, cyanosis history of mode delivery, resuscitation history, delayed cry andhypoxic ischemic encephalopathy (HIE) grades were taken from baby’s hospital file record andstandard images including coronal and sagittal plans were taken by Ultrasound machine probeof frequency 3-5 MHz. Findings were recorded on data collection sheets and spread on EXELsheets. Correlation was found by using SPSS software. Result: Out of 100 neonates 63 weremale and 37 were female with birth weight (2.4-3.6) having mean ± SD 3.08 ± 0.53. HIE grades(mild, moderate and severe) were found in 12, 83, 5 babies respectively and ultrasound grades0 (normal/ mild echogenic), grade 1 (moderate echogenic) and grade 2 (severe/generalizedechogenic) were found in 32, 52, 16 neonates respectively with r= 0.37 and P-value < 0.05showing moderate positive correlation. Conclusion: Cranial ultrasound is a good screeningtool to evaluate asphyxiated neonatal brain. It has a moderate positive correlation with clinicalfindings.

Objectives: The objective was to determine accuracy of ultrasound in thediagnosis of ureteric calculi confirmed on non-contrast Computed Tomography amongpatients with acute ureteric colic. Study Design: Cross-sectional study. Setting: EmergencyDepartment of Nishtar Hospital, Multan. Period: 11-07-2012 to 10-01-2013. Materials andMethods: 100 consecutive patients presenting with acute severe ureteric colic and fulfillingthe inclusion and exclusion criteria were enrolled for the study from the emergency departmentof Nishtar Hospital Multan. Ultrasonography was done in all patients and USG findings wererecorded for the presence or absence of hyperechoic shadows in the ureteric. All the patientsunderwent CT scan to confirm or refute the findings of Ultrasonography. Result: Mean age ofthe patients was 37.85 + 12.60 years. Males were 53 (53%) while females were 47 (47%). Meanduration of pain before presentation was 14.81 + 6.20 hours. Mean severity of pain on visualanalogue scale was 9.40 + 0.8. Overall 79 patients were diagnosed as having ureteric calculi.Ultrasonography detected the ureteric stone in 75 patients and was all found to have stoneon CT scan and represented true positives. Among 25 patients in whom ultrasound did notdemonstrate any stone, 4 were found to have ureteric stone on CT scan thus representing falsenegative whereas 21 (84%) were confirmed on CT scan not to have any stone, thus representingTrue negatives. The sensitivity of USG for detection of ureteric stone was found to be 94.9%,the specificity was 100%, and positive predictive value was 100% while negative predictivevalue was 84% .There was no significant effect of age or gender on the accuracy of ultrasound.Conclusion: Ultrasonography is a readily available, non-invasive and reliable investigation inpatients presenting with acute flank pain to diagnose ureteric stones with a specificity of 100%and a sensitivity approaching 95%. Thus it is recommended that it should be used routinely forthe evaluation of patients presenting with acute flank pain.

Background: Paravalvular leak (PVL) can complicate mitral and aortic valves replacement. Most PVLs are often clinically insignificant. However, large leaks can lead to heart failure and infective endocarditis. Intravascular hemolytic anemia is common in small PVLs. Reoperation for closure of PVL is associated with high mortality. Transcatheter closure is less invasive and can be used in high-risk patients. Case summary: We present a case of a 38-year-old man with a history of Aortic Valve replacement (AVR) and Mitral valve replacement (MVR) who developed hemolytic anemia and haemoglobinurea. The patient was managed initially conservatively but later underwent redo valve surgery after exclusion of other causes of hemolytic anemia. Postoperatively, haemoglobinurea disappeared dramatically whereas anemia resolved gradually after surgery. Discussion: Significant intravascular hemolysis is a rare but serious complication of PVL that poses diagnostic problem to cardiac surgeons, but also for cardiologists and internal medicine professionals especially when the prosthetic valve function is considered adequate. PVL is the flow of blood through a track between the native cardiac tissue and the implanted valve due to any compromise in closure between the two. PVL is also more frequently seen after mitral (up to 20%) valve replacement than aortic prosthetic valves. PVLs are more frequently diagnosed by Transesophageal echocardiography (TEE) than Transthoracic echocardiography (TTE) due to its ability to detect minute jets of regurgitated blood. Conclusion: Either repair or re-replacement of prosthetic valves with PVLs is needed in about 1% to 5% of patients. The case study is presented to highlight PVL as a rare cause of haemoglobinurea and hemolytic anemia.

Hepatitis C Virus (HCV) infection is a major health concern worldwide. The presence of both HCV viral RNA and NS5A proteins in peripheral blood mononuclear cells (PBMCs) indicate the efficacy of the treatment during sustained virological response (SVR) and end of treatment response (ETR). The main objective of this study was to detect the absence or presence of HCV RNA and NS5A proteins in PBMCs. Blood samples were taken from selected patients (Islamabad, Pakistan) before treatment, at ETR, and during SVR. Two hundred HCV responders to pegylated IFN-α-2a plus ribavirin were selected. HCV RNA was extracted from the patients to determine the viral load by reverse transcription (RT)-polymerase chain reaction before treatment. Out of 200 patients, 152 (76%) and 48 (24%) achieved positive and negative ETR, respectively. Among ETR patients, 134 (88.2%) showed SVR, whereas 18 (11.8%) displayed relapse. The male to female ratio was 92:108 with mean age of 37.4 years. Among 152 ETR-positive patients, 29 (19%) patients' PBMCs were positive for HCV RNA and 27 (17.8%) were positive for NS55A proteins. Patients having HCV RNA in PBMCs showed higher relapse frequency compared with patients lacking it. Similarly, patients having NS5A protein showed significantly higher relapse frequency compared with patients lacking it. All PBMC-positive samples were of genotype 3a. In addition, patients with positive NS5A in their PBMCs showed greater risk of relapse compared with patients having HCV RNA. We conclude that the absence of both viral HCV and proteins can be used as an indicator for diagnosis of SVR in the future.

Dengue is one of the greatest important mosquito-borne viral sicknesses touching people; with over portion of the total populace living in regions at hazard initially, dengue infection contaminations happened for the most part as pestilences in tropical and subtropical nations There are four distinctive dengue infection (DENV) serotypes that share antigenic affiliations (DENV-1, DENV- 2, DENV-3, and DENV-4) Doctors/Scientists are confronting trouble in the characterization of dengue Virus (DV) through wet labs and accessible programming’s are not particular for this reason. Dengue infection has turned into a noteworthy general medical issue in Pakistan Through the computational approach, noteworthiness of ID in order for genome grouping of DV will turn out to be more productive in clinical and test ways. By methods for calculations it has been viewed as that rate of precision and factual control turn out to be more advantageous for genotyping of dengue Virus. On the premise of results we build up a Tool for the Classification of dengue Virus, the computational approach, importance of recognizable proof in arrangement for genome grouping of DV will turn out to be more effective in clinical and test ways.

Background: Colorectal cancer is a varied illness with an expected heritability of 25–30%. Many CRC disorders occur because of solid family history, a high penetrance of the infection, and developing various tumors at an early age. A few novel genes are recognized that shows associations with CRC, such as AURKA, BCAS1, GNAS and MLH1. Material and methods: In this research work FDA rejected Alpidem and Propoxyphene were selected. Drugs were changed on the basis of side effects; modified drugs were docked with AURKA, BCAS1, GNAS and MLH1 proteins and QSAR analysis was performed. Results: Docked and QSAR results demonstrated the better interaction of both modified Alpidem and Propoxyphene along with proteins of CRC causing genes. The toxicity value and side-effects of modified Alpidem and modified Propoxyphene are less than original drugs. Conclusion: The fewer side effects and docking results of both modified Alpidem and Propoxyphene suggest that both the drugs can be used to cure mutations of genes in colorectal cancer as both modified drugs have fewer side-effects and toxicity, as compared to original drugs, both drugs have demonstrated greater interactions with the amino acid residues lying in the pockets of mutated proteins that demonstrates their stability and soundness.

Aim of Study: Increased expression of human epidermal growth factor receptor type 2 (HER2) is significantly associated with poor prognosis in breast cancer patients. However, data on HER2 at transcript levels in Pakistani mammary tumor affected females is still limited. In the current study, HER2 transcripts were explored in breast cancer cohort and correlated with various clinical parameters. Materials and Methods: Freshly excised tumors along with adjacent normal background tissues of 94 patients were collected at the time of surgery and immediately stored in RNAlater ® solution. Clinical data for these samples (disease stage, grade, age, and menopausal status) was also retrieved after a subsequent follow-up. Isolation of RNA and cDNA synthesis was done using an already established protocol. HER2 expression was evaluated using the quantitative real-time polymerase chain reaction (qRT-PCR) technique while β-actin was used as an internal control. Results: In the given cohort, 31 (33%) patients were found positive for HER2. These tumors showed a pronounced increase in HER2 as compared to controls (P = 0.0004). Interestingly, the significant relevance of high HER2 mRNA among moderately differentiated tumor tissues in comparison to controls was also observed (P = 0.02). A significant association of HER2 levels with premenopausal status was also reported. Conclusion: Based on these findings, early screening of HER2 using qRT-PCR should be incorporated for breast cancer patients of Pakistani population diagnosis.

Present study was conducted to study seasonal abundance and distribution of dragonflies in upper Siran valley district Mansehra Pakistan. To collect data, eleven localities were visited for three consecutive years (2016-2018). Results come up with a sum of 300 specimens identified under three families, eight genera and twenty species. Highest seasonal abundance recorded during summer and spring were 80.67% and 13.33% respectively while minimum 6.00% was recorded during early autumn. Dominant species observed were, Orthetrum chrysis (14.00%), followed by O. gluacum (12.00%), Palpoleura sexmaculata sexmaculata (11.33%) and O. cancellatum cancellatum (8.00%). However the highest population of dragonflies was found in Munda Gucha with a percentage of 11.33 followed by Jabbar (11.00%) and Sachan (9.67%). The lowest populations were recorded in Suham (6.00%), Dadar (7.67%) and Jabori (7.67%). The surveyed valley showed diverse Anisopterous fauna and thus further extensive surveys are recommended that can come up with more important species from the area. Resumo O presente estudo foi realizado para verificar a abundância sazonal e a distribuição de libélulas no vale superior de Siran, distrito de Mansehra, Paquistão. Para a coleta de dados, 11 localidades foram visitadas por três anos consecutivos (2016-2018). Os resultados apresentaram uma soma de 300 espécimes identificados em três famílias, 8 gêneros e 20 espécies. A maior abundância sazonal registrada durante o verão e a primavera foi de 80,67% e 13,33%, respectivamente, enquanto o mínimo de 6% foi registrado no início do outono. As espécies dominantes observadas foram Orthetrum chrysis (14%), seguido por O. gluacum (12%), Palpoleura sexmaculata sexmaculata (11,33%) e O. cancellatum cancellatum (8%). No entanto, a maior população de libélulas foi encontrada em Munda Gucha (11,33%), seguida por Jabbar (11%) e Sachan (9,67%). As populações mais baixas foram registradas em Suham (6%), Dadar (7,67%) e Jabori (7,67%). O vale pesquisado mostrou fauna Anisopterous diversificada, e, portanto, recomenda-se a realização de mais pesquisas que possam apresentar mais espécies importantes da área.