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The aim of the present study was to assess the drinking water quality in the selected urban areas of Lahore and to comprehend the public health status by addressing the basic drinking water quality parameters. Total 50 tap water samples were collected from groundwater in the two selected areas of district Lahore i.e., Gulshan-e-Ravi (site 1) and Samanabad (site 2). Water samples were analyzed in the laboratory to elucidate physico-chemical parameters including pH, turbidity, temperature, total dissolved solids (TDS), electrical conductivity (EC), dissolved oxygen (DO), total hardness, magnesium hardness, and calcium hardness. These physico-chemical parameters were used to examine the Water Quality Index (WQI) and Synthetic Pollution Index (SPI) in order to characterize the water quality. Results of th selected physico-chemical parameters were compared with World Health Organization (WHO) guidelines to determine the quality of drinking water. A GIS-based approach was used for mapping water quality, WQI, and SPI. Results of the present study revealed that the average value of temperature, pH, and DO of both study sites were within the WHO guidelines of 23.5 °C, 7.7, and 6.9 mg/L, respectively. The TDS level of site 1 was 192.56 mg/L (within WHO guidelines) and whereas, in site 2 it was found 612.84 mg/L (higher than WHO guidelines), respectively. Calcium hardness of site 1 and site 2 was observed within the range from 25.04 to 65.732 mg/L but, magnesium hardness values were higher than WHO guidelines. The major reason for poor water quality is old, worn-out water supply pipelines and improper waste disposal in the selected areas. The average WQI was found as 59.66 for site 1 and 77.30 for site 2. Results showed that the quality of the water was classified as "poor" for site 1 and "very poor " for site 2. There is a need to address the problem of poor water quality and also raise the public awareness about the quality of drinking water and its associated health impacts. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the effect of the Growth Mindset on the prospective teachers' Self-Efficacy, Psychological Well-being and Academic Achievement. There were 400 Prospective teachers selected with Cluster sampling from four universities based in Lahore. Their Growth Mindset has been measured with Growth Mindset Scale developed by Chen et al. (2023) and their Self-Efficacy has been measured with the Academic Self-Efficacy developed by Kunnathodi (2016). Similarly, their Psychological Wellbeing has been measured with the Psychological Wellbeing Scale by (Ryff et al., 2018) whereas their academic achievement has been measured while taking scores of their semester. Pearson's r and Regression Analysis indicated a positive and moderate effect of Growth Mindset on prospective teachers' Self-Efficacy, Psychological Wellbeing and Academic Achievement. Therefore, it is recommended that the Growth Mindset should be developed in the Prospective Teachers so that their Psychological Wellbeing, Self-Efficacy and Academic Achievement could be effected positively. [ABSTRACT FROM AUTHOR]

This study aims to measure the impact of workplace bullying on work engagement in terms of employee silence and knowledge sharing. It also helps to explain how psychological contract breach moderates the bullying-silence relationship. For this study, data is collected from 384 early-career employees having experience up to three years from seven banks of Lahore, Pakistan. Findings of this study reveals that workplace bullying has a positive relationship with employee silence and negative relationship with work engagement. Results of all moderation and mediated variables are significantly related to each other. However, the results explain that a psychological contract breach slightly moderates the bullying-silence relationship. Survey-based questionnaire, cross-sectional research design, and convenience-based sampling technique are some of the limitations of this study. This is the first study that tried to investigate the bullying-engagement relationship among early-career employees in the banking sector of Lahore, Pakistan. This study may help practitioners and policymakers to develop anti-bullying laws that can support the management in overcoming the negative workplace environment. This study aims to promote an equal opportunity for all employees where they can raise their voices about misconduct. This is the first study that investigated the victimization of bullying behavior among early-career employees in a Pakistani cultural context. [ABSTRACT FROM AUTHOR]

Objective: To compare the level of awareness of type 2 Diabetes Mellitus control among urban and rural patients. Materials & Methods: A Comparative Cross-sectional study was conducted at Ganga Ram, Sheikh Zayed, and PSRD Hospital, Lahore by using a non-probability purposive sampling technique. The data from 362 participants were gathered and analyzed from November 2021 to April 2022. Participants who had type 2 Diabetes Mellitus for 10 years, aged 34-68 years, and Body Mass Index (BMI) of 18.5 to 34.9kg/m2 were included and those with micro and macrovascular complications were excluded from this study. Ethical approval was taken from the Institutional Review Board of PSRD College of Rehabilitation (Ref#PSRD/CRS/IAJ/REC/Letter-002). Semi-structured questionnaires that comprised pharmacological, diet, and exercise components were used for data collection after getting informed consent from participants. Results: Results of this study show Mean±SD of age in urban and rural 49.7011±7.38161, 48.3457±7.09693 years, BMI 27.6858±4.27858, 27.6551±4.27986kg/m2 respectively. The Mean±SD of pharmacological awareness in urban and rural 4.4483±0.44174, 4.3085±0.55392, and exercise awareness was 1.4415±.49789, 1.4368±.49742 showed no significant difference while diet awareness to control diabetes was 3.8391±1.10043, 2.7553±1.44922, with significant difference(p-value< 0.05). Conclusion: This study concludes that there is no significant difference between urban and rural patients for pharmacological and exercise awareness and a significant difference in diet management in diabetes control. [ABSTRACT FROM AUTHOR]

Objective To determine the frequency of nail changes in patients of psoriasis to Dermatology Department of Services Hospital, Lahore. Methods It was a cross-sectional survey conducted in the Department of Dermatology, SIMS/Services Hospital, from September 2022 to March 2023. 80 patients of psoriasis were enrolled. Detailed history and examination for psoriasis was done. All patients underwent evaluation for nail changes (as per operational definition). The presence/absence of nail changes was recorded on a pre-designed proforma (annexure). Results In this study, mean age of patients was 27.24±4.57 years, 59 (73.8%) were male whereas 21 (26.3%) were females, 55 (68.8%), moderate in 17 (21.3%) and severe in 8 (10%) of the cases. Descriptive statistics of nail changes of patients in psoriasis shows 72 (90%) had pitting, 64 (80%) had Onycholysis, 24 (30%) had Splinter Haemorrhage, Oil Drop Discoloration in 71 (88.8%) and Subungual hyperkeratosis in 64 (80%) of the cases. Conclusion We found pitting as the leading nail change in psoriatic disease followed by Oil Drop Discoloration and Onycholysis. Psoriasis can significantly impair a patient's quality of life. Nail changes can significantly affect cosmetic concerns of the patients and need to be addressed adequately and timely. [ABSTRACT FROM AUTHOR]

Allergy is an abnormally extended and evolved sensitivity to specific substances, whereas asthma is constriction of the airways of the lungs due to swelling of internal walls of the airways. Dietary consumption of omega-3 and omega-6 supplementation may help in the prevention of allergies and asthma. The objective of this investigation was to assess the effectiveness of omega 3 and 6 supplementation on patients who were suffering from asthma or any allergy. A cross-sectional study on 100 patients with asthma and different types of allergies was conducted at different hospitals in Lahore. They were given a questionnaire to accumulate input about their dietary practices, understanding, and awareness. Data was analyzed by using SPSS 22.0. Results showed that 40% of patients had mild improvement in symptoms, 28% exhibited good responses, and 32% had no progress in their symptoms at all. About 27% of patients took omega 3 and 6 supplementations weekly, while 36% used to take them daily, and 37% never took the supplementation. It was concluded that most of those patients who took the omega-3 and omega-6 fatty acids supplementations showed mild improvement as compared to those who were not taking supplements. People taking omega 3 and 6 food sources such as fish, nuts, legumes, and meat faced fewer symptoms. [ABSTRACT FROM AUTHOR]

The present study was conducted to evaluate the quality of drinking water and assess the potential health hazards due to water contaminants in selected urban areas of Lahore, Pakistan. Water samples were collected from ten sites and analyzed for different physico-chemical parameters including turbidity, color, pH, total dissolved solids (TDS), nitrates, fluoride, residual chlorine, and total hardness. Additionally, heavy metal (arsenic) and microbial parameters (E. coli) were also determined in the water samples. Drinking water quality evaluation indices, including the water quality index (WQI) for physico-chemical and biological parameters and human health risk assessment (HHRA) for heavy metal were estimated using the analytical results of the target parameters. It was found in most of the areas that the levels of arsenic, fluoride, TDS, and residual chlorine were higher than those recommended by the National Environmental Quality Standard (NEQS) and World Health Organization (WHO) guidelines. In addition to the physico-chemical parameters, microbial content (E. coli) was also found in the drinking water samples of the selected areas. Statistical analysis of the results indicated that levels of target parameters in drinking water samples are significantly different between sampling sites. The WQI for all physico-chemical and microbial parameters indicated that drinking water in most of the areas was unfit and unsuitable (WQI > 100) for drinking purposes except for the water of Bhatti Gate and Chota Gaon Shahdara with a WQI of 87 and 91, respectively. Drinking water in these areas had a very poor WQI rating. According to HHRA, drinking water from the selected sites was found to be of high risk to children and adults. The carcinogenic risk of arsenic indicated that all samples were of high risk to both adults and children (4.60 and 4.37 × 10−3, respectively). Regular monitoring of drinking water quality is essential, and proactive measures must be implemented to ensure the treatment and availability of safe drinking water in urban areas. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy of platelet rich plasma in patients of androgenic alopecia attending the dermatology department of a tertiary care hospital in Lahore. Methods This descriptive case series was conducted at the Department of Dermatology, Services Hospital, Lahore over six months. 77 patients of both genders, aged between 18-45 years who presented with androgenic alopecia were enrolled and treated with injection of platelet rich plasma. Outcome was assessed in terms of improvement in hair quality and thickness by patient selfassessment questionnaire on a linear analogue 2 scale of 5-26 scores. Treatment was labelled effective if the score was less than 12, four weeks after the completion of all 4 sessions. A written informed consent was taken from each patient. Data was entered and analyzed using SPSS version 21. Results The mean age of patients was 29.2±9.2 years. Majority (n=51, 66.2%) of the patients were aged under 30 years. There were 52 (67.5%) male and 25 (32.5%) female patients with a male to female ratio of 2.1:1. 31 (40.3%) patients had Grade-II while 38 (49.4%) patients had Grade-III alopecia. Only 8 (10.3%) patients had Grade-IV alopecia. Platelet-rich plasma treatment was effective in 65 (84.4%) patients as per operational definition. There was no statistically significant difference in the frequency of efficacy across various age (p-value=0.972) and gender (pvalue= 0.944) groups. However, it decreased insignificantly with increasing grade of alopecia; Grade-II vs. Grade-III vs. Grade-IV (87.1% vs. 84.2% vs. 75.0%; p-value=0.701). Conclusion Platelet-rich plasma therapy was found extremely effective in patients of mild to moderate androgenic alopecia which along with cost-effectiveness, simplicity and safety of procedure advocate its preferred use in future practice. [ABSTRACT FROM AUTHOR]

The aim of the work was to determine the role of bacteria to mitigate the effect of fluoride on the growth, gas exchange characteristics, and productivity of the two wheat varieties (Galaxy-13, Chakwal-50). Experiment was conducted in the Botanical Garden (University of the Punjab, Lahore Pakistan) according to the Design Expert software 11. Four concentrations of NaF (0 ppm, 150 ppm, 250 ppm, and 350 ppm) and three bacterial strains (ss5a, ss5b, and ss10a) were used. Growth parameters, gas exchange characteristics, fresh and dry weight of root and shoot, and productivity were measured. The results observed were less harmful in case of plants treated in combination with NaF+bacteria as compared to plants treated with NaF alone. Fluoride affected various parameters, chlorosis, leaf tip burn, leaf necrosis, growth, and productivity of the wheat plants. Galaxy-13 was least influenced by F compared to the Chakwal-50 variety. It was concluded that growth was increased with the application of beneficial fluoride resistant bacteria and proved helpful in minimizing the harmful effects of fluoride salt on wheat varieties. [ABSTRACT FROM AUTHOR]

Background: Dengue is a mosquito-borne viral disease that is mainly spread by Aedes aegypti. It is prevalent on five continents, predominantly in tropical and sub-tropical zones across the world. Wolbachia bacteria have been extensively used in vector control strategies worldwide. The focus of the current study was to obtain a natural population of Ae. aegypti harbouring Wolbachia and to determine the impact of this bacteria on the new host in a semi-field environment. Methods: Wolbachia-infected Aedes albopictus was collected from the city of Lahore, Punjab, Pakistan, and Wolbachia were successfully introduced into laboratory-reared Ae. aegypti via embryonic microinjection. The stable vertical transmission of wAlbB in the host population was observed for eight generations, and the impact of Wolbachia on the general fitness of the host was evaluated in semi-field conditions. Results: In the laboratory and semi-field experiments, wAlbB Wolbachia presented a strong cytoplasmic incompatibility (CI) effect, evidenced as zero egg hatching, in crosses between Wolbachia-infected males and wild (uninfected) females of Ae. aegypti. Wolbachia infection had no noticeable impact on the general fitness (P > 0.05), fecundity, body size (females and males) and mating competitiveness of the new host, Ae. aegypti. However, there was a significant decrease in female fertility (egg hatch) (P < 0.001). In addition, under starvation conditions, there was a remarkable decrease (P < 0.0001) in the life span of Wolbachia-infected females compared to uninfected females (4 vs. > 5 days, respectively). Conclusions: Wolbachia strain wAlbB has a great potential to control the dengue vector in Ae. aegypti populations by producing 100% CI with a limited burden on its host in natural field conditions. This strain can be used as a biological tool against vector-borne diseases. [ABSTRACT FROM AUTHOR]

Microplastics (MPs) pollution is an emerging global environmental concern. Considering the high fraction of time people spend indoors, the human population can be directly exposed to this contamination through indoor dust. This preliminary study evaluates MPs' abundance and human health risk assessment in the deposited indoor dust. A total of forty dust samples (n = 20) were collected from homes in two different cities (Pakistan) in steel mesh pouches using the vacuum cleaner. The identification and quantification of MPs were conducted with a stereo microscope, whereas the qualitative assessment was performed with Fourier transform infrared spectroscopy (FTIR). The US EPA parameters to calculate the human health risk assessment were used to determine MPs' risk per-day/month/year. Overall, microfibers were the dominant category, followed by microfilms, micro-fragments, and nurdles. The chemical categorization of MPs was revealed as polyester, polyethylene, copolymers of polypropylene, and polyurethane. In Lahore, an average abundance of 241.45 (items/m2) MPs were observed compared to Sahiwal, with 162.1 (items/m2). More than 90% of the identified MPs were microfibers, with higher detection frequency and abundance in Lahore than Sahiwal. The human health risk assessment revealed high exposure risk because of indoor MPs. Moreover, toddlers were more vulnerable as compared to adults at both low and high exposure risk scenarios. There is an imminent need to conduct in-depth risk assessment focusing on the respirable fraction of MPs. [ABSTRACT FROM AUTHOR]

Objective: To determine the demographics, clinical characteristics and treatment outcomes of nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) patients treated at our hospital. Study Design: Retrospective longitudinal study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan from 1996 to 2016. Methodology: We collected clinical data of all the cases of HL diagnosed over twenty years (between 1996 and 2016) from our electronic hospital information system (HIS). A total of 3426 HL patients were identified, out of whom the pathologically confirmed diagnosis of nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) was identified. Results: In this study, eighty-four patients were studied. The majority of the patients were male (80%). B symptoms were present in 35%. There were 24% patients in stage-I (n=20/84), 33% in stage-II (n=28/84), 12% in stage III (n=10/84) and 31% in stage IV (n=26/84). Hence, early-stage was seen in 57% (n=48/84) and advanced stage was 43% (n=36/84) respectively. The Median follows up time was 30 months (range: 1-60 months). Patients were treated with chemotherapy in most cases (48%), radiotherapy alone in 14% cases, and combined modality (chemotherapy and radiotherapy) was used in 38% patients. The estimated 5-year disease-free survival was 73% and overall survival was 86%. Autologous stem cell transplant was done in only one patient whose disease had transformed from NLPHL to T-rich cell B cell lymphoma. Conclusion: This study confirmed the divergent features of NLPHL with a comparatively good long-term prognosis. Most patients achieved an excellent response to first-line therapy. There was a tendency towards multiple relapses but improved outcomes. [ABSTRACT FROM AUTHOR]

Considering that antimicrobial resistance (AMR) is a global challenge, there is a dire need to assess the knowledge, attitude, and practice (KAP) of clinicians in AMR endemic countries. The current multicenter, cross-sectional study aimed at highlighting gaps in antimicrobial (AM) stewardship and AMR among practicing doctors working in public tertiary care teaching hospitals of Lahore, Pakistan. A KAP survey, based on a self-administered questionnaire containing 45 questions, was distributed among 336 clinicians in 6 randomly selected hospitals. Overall, 92% of the clinicians considered AMR as a worldwide problem but only 66% disagreed that cold and flu symptoms require antibiotics. Moreover, around 68% of the doctors felt confident about their practice in AM but still, 96% felt the need to get more knowledge about AM drugs. The need for refresher courses on rational antibiotic use was expressed by 84% of the participants. The main contributing factors considered for AMR by the doctors included excessive AM usage in the medical profession (87.1%) and multiple antibiotics per prescription (76.4%). Pharmacologically, AM spectrum was accurately chosen by 1.4% for Ampicillin, 0.003% for Erythromycin and 0% for Levofloxacin. Clinically, more than 50% of the clinicians used miscellaneous AM for empirical therapy of respiratory tract infection and cholecystitis. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 25. It is concluded that the knowledge of clinicians is relatively poor for AM spectrum and drugs of choice for certain infections. However, the clinicians are aware of their shortcomings and desire for improvement. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) caused by the novel coronavirus-infected millions globally. Despite a wide range of advised options for the treatment of COVID-19, a single strategy to tackle this pandemic remains elusive, thus far. That is why we are conducting a clinical trial to find out the efficacy of iodine complex to clear a viral load of severe respiratory syndrome coronavirus-2 (SARS-CoV-2) along with a reduction in time taken to alleviate symptoms.Method: The proposed study is a placebo-controlled, add-on, randomized trial using parallel group designs. This is a closed-label and adaptive with sample size reassessment, multi-centered design with a 1:1:1:1 allocation ratio and superiority framework. It will be conducted in Shaikh Zayed Post-Graduate Medical Complex, Ali Clinic, and Doctors Lounge, Lahore, Pakistan. This study will have three arms of mild to moderately symptomatic COVID-19 patients (50 patients in each) which will receive ionic-iodine polymer complex with 200 mg of elemental iodine: interventional arm A will have encapsulated, arm B will receive suspension syrup form, arm C will get throat spray, while arm X will be standard care with placebo. Data will be collected on self-constructed, close-ended questionnaires after obtaining written consent. Data will be analyzed using SAS version 9.4. COVID-19 patients will be monitored by RT-PCR and HRCT (high-resolution computed tomography) chest. In addition to these, the duration of the symptomatic phase and mortality benefits will be analyzed in both groups.Discussion: The study is designed to measure the superior efficacy of the iodine complex as an add-on in treating COVID-19-positive patients with mild to moderate symptoms. This combination is hypothesized to improve various parameters like rapid viral load reduction, clinical and radiological improvement, lower mortality, and reduction in hospitalization. The trial will aid in devising a better strategy to cope with COVID-19 in a relatively inexpensive and accessible way. The implications are global, and this could prove itself to be the most manageable intervention against COVID-19 especially for patients from limited-resource countries with deprived socioeconomic status.Trial Registration: ClinicalTrials.gov NCT04473261 . Registered on July 16, 2020. [ABSTRACT FROM AUTHOR]

Aims: Antibiotic resistance is a major problem in Salmonella enterica serovar Typhi. The objective of this study was to evaluate the prevalence of XDR Salmonella among local population of Lahore and genotyping of isolates for antibiotic‐resistant genes. Methods and Results: A total of 200 blood samples from suspected typhoid fever patients were collected. One hundred and fifty‐seven bacterial samples were confirmed as Salmonella Typhi and 23 samples were confirmed as Salmonella Paratyphi after biochemical, serological and PCR based molecular characterization. Antibiogram analysis classified 121 (67·2%) Salmonella isolates as MDR and 62 isolates (34·4%) as XDR. The predominant resistance gene was ampC with 47·7% prevalence, followed by gyrA, catA1, tet(A), aac (3)‐la, qnrS, blaNDM‐1 and blaCTX‐M‐15 genes in 45·5, 40, 21·6, 18·3, 11·6, 2·2 and 0·5% isolates respectively. Sequence analysis showed the presence of sul1 and dfrA7 gene cassette arrays in 12 class 1 integron integrase positive isolates. Conclusion: Large number of clinical XDR S. Typhi‐resistant against third generation cephalosporins have been reported. Significance and Impact of the Study: The current study highlights the possible emergence of clinical XDR S. Typhi cases in Lahore, Pakistan. Potential attribution of phenotypic and genotypic XDR cases may help to contribute targeted therapy. [ABSTRACT FROM AUTHOR]

Vitiligo is a condition where loss of colored cells develop on the skin and cause white lesions (Morrone, 2004). The present study was designed to examine sociodemographic and clinical factors of perceived quality of life (QoL) in individuals with Vitiligo. A cross-sectional correlational research design with purposive sampling strategy was used. The sample consisted of people with Vitiligo (N=120) from skin department of different government and private hospitals in Lahore. Self-constructed demographic information sheet, clinical information sheet and Dermatology Life Quality Index (Finlay & Khan, 1994) used to gather data on QoL. Findings revealed that the majority of people with Vitiligo tend to report poor perceptions about QoL. Men perceived QoL better when contrasted with women. Individuals with both types of Vitiligo (white patches on exposed and unexposed regions) tend to report poorer perceptions about their QoL. No demographic factor significantly correlated with QoL. Interestingly, only one clinical factor which was percentage of Vitiligo spreading on body significantly negatively correlated with QoL. It was found that Vitiligo greatly affected person's psychosocial functioning rather than physiological complications. This study identify psychosocial aspects of Vitiligo that could help in organizing therapeutic interventions for patients whose psychosocial functioning are disturbed due to their skin condition. [ABSTRACT FROM AUTHOR]

Objective: To find out correlation of body measurements and exercise with blood pressure among medical students in Lahore, Pakistan. Study Design: Correlational study. Place and Duration of Study: Akhtar Saeed Medical and Dental College, Lahore, from May to Jul 2018. Methodology: A sample of 332 students was recruited through simple random sampling technique. Resting blood pressure in sitting position along with body mass index of respondents were taken after informed consent. Results: Mean age of respondents was 21.06 ± 1.53 years. Mean sitting systolic blood pressure was 117.5 ± 8.24mm Hg, Mean sitting diastolic blood pressure was 77.9 ± 7.05mm Hg. Significant association was found between weight and both Systolic (r=1, p≤0.00) and Diastolic (r=0.01, p=0.05) blood pressure. Height was negatively correlated with systolic blood pressure (r=-0.004) and diastolic blood pressure (r=-0.07). Body mass index was also significantly associated with systolic blood pressure (r=1, p≤0.00) and diastolic blood pressures (r=0.14, p=0.00). Significant association is found between systolic blood pressure and exercise with number of days (r=-0.15, p=0.05) and diastolic blood pressure (r=-0.11, p=0.00) and duration of exercise with systolic blood pressure (r=-0.13, p=0.01) and diastolic blood pressure (r=-0.16, p=0.04). Conclusion: Weight and Body mass index are positively correlated with systolic and diastolic blood pressure. [ABSTRACT FROM AUTHOR]

This study is the pioneer assessment of the PCBs in indoor dust particles (from air conditioners) of an urbanized megacity from South Asian. The ∑35 PCB concentration ranged from 0.27 to 152.9 ng/g (mean: 24.84 ± 22.10 ng/g). The tri‐ and tetra‐PCBs were dominant homologues, contributing 57.36% of the total PCB concentrations. The mean levels of Σ8‐dioxin‐like (DL), Σ6‐indicator PCBs and WHO2005‐TEQ for DL‐PCBs were 2.22 ± 2.55 ng/g, 9.49 ± 8.04 ng/g and 4.77 ± 4.89 pg/g, respectively. The multiple linear regression indicated a significant correlation of dusting frequency (p = 1.06 × 10–04) and age of the house (p = 1.02 × 10–06) with PCB concentrations in indoor environment. The spatial variation of PCB profile revealed relatively higher concentrations from sites near to illegal waste burning spots, electrical locomotive workshops, and grid stations. Human health risk assessment of PCBs for adults and toddlers through all three exposure routes (ie, inhalation, ingestion, and dermal contact) demonstrated that toddlers were vulnerable to high cancer risk (4.32 × 10−04), while adults were susceptible from low to moderate levels of risk (3.16 × 10−05). Therefore, comprehensive investigations for PCBs in the indoor settings, focusing particularly on the sensitive populations with relationship to the electronic devices, transformers, and illegal waste burning sites, are recommended. [ABSTRACT FROM AUTHOR]

This study was carried out to analyze the phytochemical profile of Euphorbia prostrata Aiton through GC-MS and identification of possible antifungal, antibacterial and other pesticidal compounds through literature survey. Whole plant material of the weed was collected from Lahore, Pakistan and shade dried followed by two-week extraction in ethyl acetate. The filtrates were analyzed by GC-MS that showed the presence of 19 compounds. The major compound in the extract was 9,19-cyclolanost-24-en-3-ol, (3β)- (24.62%) followed by 9,19-cyclolanostan-3-ol, 24-methylene-, (3β)- (19.51%) and γ-sitosterol (12.51%). Other compounds were phytol (8.11%), n-hexadecanoic acid (6.15%), 9,12,15-octadecatrienoic acid, (Z,Z,Z)- (4.90%), neophytadiene (4.88%), cyclohexane, 1,3,5-triphenyl- (3.71%), hexadecanoic acid, ethyl ester (3.04%), phenol, 2,2'-methylenebis[6-(1,1-dimethylethyl)-4-methyl- (2.42%), octadecanoic acid, ethyl ester (2.24%), octacosane (2.11%), 1-heptacosanol (1.71%), stigmasta-5,24(28)-dien-3-ol, (3β,24Z)- (1.71%), 9,12,15-octadecatrienoic acid, ethyl ester, (Z,Z,Z)- (1.29%), oxirane, hexadecyl- (1.21), 9,12- octadecadienoic acid (Z,Z)- (1.05%), Z-8-methyl-9-tetradecenoic acid (1.01%), and 9-octadecyne (0.76%). Literature survey revealed that eight compounds possess antibacterial, antifungal, nematicidal and/or insecticidal properties. Most of the pesticidal compounds were antibacterial in nature. [ABSTRACT FROM AUTHOR]

This preliminary investigation highlights the occurrence of organochlorine pesticides (OCPs) in the indoor environment of a megacity, Lahore, Pakistan using the dust ensnared by air‐conditioner filters. The Σ16OCPs concentration ranged from 7.53 to 1272.87 ng/g with the highest percent contribution by ΣDDT (dichlorodiphenyltrichloroethane; 87.21%) and aldrin (6.58%). The spatial variation of OCPs profile revealed relatively higher concentration from homes near to agricultural and abandoned DDT manufacturing sites. Calculated isomer ratios revealed historic sources of hexachlorocyclohexanes (HCHs) and the fresh input of technical DDT and chlordane by the dwellers. The air conditioner dust was helpful to better understand the health risk in the indoor environment. So far a high lifetime cancer risk (10−3) was predicted for toddlers via accidental ingestion, inhalation, and dermal exposure. Similarly, the non‐carcinogenic risk‐based hazard quotient was found to be high for toddlers (6.94) and within the permissible limit (<1) for adults. [ABSTRACT FROM AUTHOR]

The present study was designed to examine psychosocial predictors of quality of life (QoL) such as body image, selfesteem, impact of Vitiligo (psychologically and socially), and perceived stigmatization in patients with Vitiligo. The sample (N =120) comprised of individuals with Vitiligo recruited from dermatology units of different hospitals in Lahore. Body Image State Scale (Cash, Fleming, Alindogan, Steadman, & Whitehead 2002), Rosenberg Self-Esteem Scale (Rosenberg, 1965), Vitiligo Impact Scale (Rammam, Khaitan, Mehta, Sreenivas, & Gupta, 2014), Perceived Stigmatization Questionnaire (Lawrence, Fauerbach, Heinberg, & Thomas, 2006) and Dermatology Life Quality Index (Finlay & Khan, 1994) were used as assessment measures. Results revealed that most of the individuals with Vitiligo reported poorer perception of QoL; while, men with Vitiligo expressed better perceived QoL as compared to women. Individuals with both types of Vitiligo (lesions on exposed/unexposed regions) expressed poor body image, negative impact of Vitiligo on their psycho-social functioning, and higher levels of perceived stigmatization. Individuals with exposed Vitiligo affected regions exhibited lower self-esteem. In addition, body image, impact of Vitiligo (psychologically and socially), and perceived stigmatization (absence of friendly behavior) significantly predicted QoL. It was concluded that Vitiligo had a greater impact on individual's psychological health and social functioning rather than physiological complications. [ABSTRACT FROM AUTHOR]

Objectives: To sonographically assess uterine leiomyoma among pregnant women. Study Design: Cross-sectional Descriptive study. Setting: Gilani Ultrasound Center, Ferozepur Road Lahore. Period: Sep to Dec 2019. Material & Methods: The sample size was all the pregnant women with fibroid. Ultrasound machine Honda 2000 HS and Toshiba xerio x4 were used. Results: Out of 73 patients, 47(64.4%) had fibroid at the anterior wall of the uterus, 14(19.2%) patients had fibroid at the posterior wall of the uterus, 5(6.8%) patients had submucosal fibroid, 2(2.7%) patients had fibroid in the lateral wall of the uterus, 2(2.7%) patients had fibroid at fundal region of the uterus and 1(1.4%) of each had fibroid in cervix, lower uterine segment and subserosal. Conclusion: The findings of this study concluded that the anterior wall of the uterus is more favorable for leiomyoma in pregnant women. [ABSTRACT FROM AUTHOR]

BACKGROUND & OBJECTIVE: Obstructive sleep apnea (OSA) leads to multiple complications which may be life-threatening. In this study we determined the frequency of obese individuals at high risk for developing (OSA). METHODOLOGY: It was a cross-sectional survey. The study was conducted in the Medicine department of Services hospital, Lahore from February 6, 2016 to August 5, 2016. A sample size of 2 300 healthy obese individuals (BMI ≥ 30kg/m ) aged between 18-60 years who were accompanying a patient or visiting someone admitted, were enrolled in our study. Informed Verbal consent was obtained before administering a structured, validated questionnaire to the significant obese population; Survey was translated into Urdu for ease. The data were stratified for age, gender and BMI of the patients to control the effect modifiers. Post-stratification Chi-square test was used. A p-value ≤ 0.05 was taken as significant. RESULTS: A total of 300 subjects were enrolled. Mean age was calculated as 41.81±11.98 years, while 161(53.7%) individuals were females and 139(46.3%) were males. The frequency of risk of OSA was low in 241(80.3%) and high in 59(19.7%) of the population. The relationships of OSA with age groups and BMI were insignificant with p-value being 0.867 and 0.790 respectively. CONCLUSION: In this study, a significant population of male obese individuals was found to be at high risk for obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Syzygium cumini L. (Jamun), member of family "Myrtaceae" is a well-known medicinal plant. It is also known for its anthelmintic activity by which it can paralyze the worms leading to their death. Current study was conducted to evaluate anthelmintic activity of methanolic extract of S. cumini L. leaves against earthworms (Lumbricus terestris), Tape worms (Monnizia expansa) and Red worms (Haemonchus contortus). Research was conducted at Department of Botany, Lahore College for Women University, Lahore. The experiment was repeated for three times for accuracy and then average data was statistically analyzed using Ducan's Multiple Range Test. Various concentrations of each extract (100, 50, 25, 12.5 and 6.25%), Albendazole (10%) and saline solution (10%) were used as treatments. All the tested concentrations were significant to kill the worms used in experiment. Maximum activity of methanolic extract of S. cumini leaves was 8 minutes as time of paralysis, 15 minutes as time of death at dose of 100 mg/ml. Saline solution used as control, there was no paralysis and death of worms in this case. The result of current study indicated that all tested extract of S. cumini L. show anthelmintic activity in a dose depended inhibition. The effectiveness of test sample was found to be reversible to time of paralysis and death time of worms. Albendazole (10 mg/ml) was used as reference. All the concentration of S. cumini L. extract possessed good anthelmintic activity as compared to Albendazole. Thus, the study concluded that the methanolic extracts of S.cumini L. have good anthelmintic activity against all the worms used in study. [ABSTRACT FROM AUTHOR]

Objective: Genetic variation analysis of rare autosomal recessive Niemann-Pick disease (NPD) Pakistani patients. Methods: We sequenced the SMPD1 gene including its all coding and flanking regions in seven unrelated sporadic patients suffering from Niemann-Pick disease through targeted exome sequencing. Genetic variants mapping and their protein predictions were evaluated using different bioinformatics tools and clinical phenotypes were correlated. The study was conducted from January 2018 to March 2019 at The Children's Hospital Lahore. Results: We have mapped five different mutations in SMPD1 gene of enrolled patients with a novel homozygous missense variant (c.1718G>C) (p.Trp573Ser) in one patient. A missense mutation (c.1267C>T) (p.His423Tyr) has been identified in three unrelated patients. A nonsense mutation (c.1327C>T) (p.Arg443Term) and one missense mutation (c.1493G>A) (p.Arg498His) mapped in one patient each. A compound heterozygous mutation has been mapped in one patient (c.740G>A) (p.Gly247Asp); (c.1493G>A) (p.Arg498His). Pathogenic effect of novel variant has been predicted through in-silico analysis and has not been reported in general overall population in the globe. Conclusion: This is the first report of genetic demographic assessment of Niemann-Pick disease in Pakistan. The mapped mutations would be helpful to build a disease variants algorithm of Pakistani population. This will be used for determining disease clinical magnitude along with provision of genetic screening services in affected families. [ABSTRACT FROM AUTHOR]

Objectives: Considering the therapeutic potential of honey and Nigella sativa (HNS) in coronavirus disease 2019 (COVID-19) patients, the objective of the study is defined to evaluate the prophylactic role of HNS.Trial Design: The study is a randomized, placebo-controlled, adaptive clinical trial with parallel group design, superiority framework with an allocation ratio of 1:1 among experimental (HNS) and placebo group. An interim analysis will be done when half of the patients have been recruited to evaluate the need to adapt sample size, efficacy, and futility of the trial.Participants: All asymptomatic patients with hospital or community based COVID-19 exposure will be screened if they have had 4 days exposure to a confirmed case. Non-pregnant adults with significant exposure level will be enrolled in the study High-risk exposure (<6 feet distance for >10min without face protection) Moderate exposure (<6 feet distance for >10min with face protection) Subjects with acute or chronic infection, COVID-19 vaccinated, and allergy to HNS will be excluded from the study. Recruitment will be done at Shaikh Zayed Post-Graduate Medical Institute, Ali Clinic and Doctors Lounge in Lahore (Pakistan).Intervention and Comparator: In this clinical study, patients will receive either raw natural honey (0.5 g) and encapsulated organic Nigella sativa seeds (40 mg) per kg body weight per day or empty capsule with and 30 ml of 5% dextrose water as a placebo for 14 days. Both the natural products will be certified for standardization by Government College University (Botany department). Furthermore, each patient will be given standard care therapy according to version 3.0 of the COVID-19 clinical management guidelines by the Ministry of National Health Services of Pakistan.Main Outcomes: Primary outcome will be Incidence of COVID-19 cases within 14 days of randomisation. Secondary endpoints include incidence of COVID-19-related symptoms, hospitalizations, and deaths along with the severity of COVID-19-related symptoms till 14th day of randomization.Randomisation: Participants will be randomized into experimental and control groups (1:1 allocation ratio) via the lottery method. There will be stratification based on high risk and moderate risk exposure.Blinding (masking): Quadruple blinding will be ensured for the participants, care providers and outcome accessors. Data analysts will also be blinded to avoid conflict of interest. Site principal investigator will be responsible for ensuring masking.Numbers To Be Randomised (sample Size): 1000 participants will be enrolled in the study with 1:1 allocation.Trial Status: The final protocol version 1.4 was approved by institutional review board of Shaikh Zayed Post-Graduate Medical Complex on February 15, 2021. The trial recruitment was started on March 05, 2021, with a trial completion date of February 15, 2022.Trial Registration: Clinical trial was registered on February 23, 2021, www.clinicaltrials.gov with registration ID NCT04767087 .Full Protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). With the intention of expediting dissemination of this trial, the conventional formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines. [ABSTRACT FROM AUTHOR]

Background: Irrational drug use is markedly a reason for morbidity and mortality in paeds. To analyze the pattern of drug use in pediatrics outpatient department of tertiary care hospitals by using WHO core drug use indicators, was the main objective of this evaluation process. Methods: A descriptive cross-sectional study was designed to review total 2000 prescriptions from the pediatrics outpatient department (OPD) of two tertiary care centers of Lahore, Pakistan during 1st April 2019 to 31st September 2019. The data was collected on standard core drug use indicator forms for evaluating WHO prescribing, patient care and health facility indicators. WHO's declared ideal standards were used against each of the indicators and SPSS software was used for statistical analysis. Results: The statistics obtained for prescribing indicators depicted the average number of drugs per prescription were 3.26, generic prescribing was missing completely, the experiences with anti-microbial were 76.4%, injections prescribed up to 8.25% and 97.8% of the drugs were prescribed from the Essential Drugs List (EDL). The patient-care indicators revealed the average consultation time and dispensing time of 1.75 min and 21.25 seconds respectively, 93.65% drugs were actually dispensed; prescription labeling was followed all the way. For the facility-specific indicators, both facilities owned a duplicate of the EDL and 92.5% of Essential drugs were at hand in inventory. Conclusion: Majority of WHO core drug use indicators were found non-conforming in the tertiary care hospitals. The result urges the implementation of WHO recommended interventions and education of physicians, pharmacists and patients to stimulate rational drug use. [ABSTRACT FROM AUTHOR]

Objective: To determine the level of stress among the academic side in Doctor of Physical Therapy teachers and also to identify the age and gender specific patterns of stress in the target population. Material and Methods: Data was collected from different Physical Therapy institutes of Lahore, Pakistan. The study period was from February 2016 to August 2016. The results were calculated from 61 participants as per response rate of teachers. The study time period was seven months. The age range was 22 to 50 years including 20 male and 41 female teachers. Stress questionnaire of NUT (National Union of Teachers) was used for this study with demographic data. The qualitative variables were demonstrated through frequency tables and graphs where needed. Results: The results showed that out of 61 respondents who were willing to participate in this study 78.7% (n=48) had moderate level of stress at their job, while 21.3% (n=13) had low level of stress at their university/college. Conclusion: A large number of Doctor of Physical Therapy teachers have moderate level of stress. With the increasing age the stress related to teaching increased and there was no strong correlation between the gender and stress. [ABSTRACT FROM AUTHOR]

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The twinkling artifact is a color Doppler artifact, but it could be used in the confirmation of urinary stones. Conventionally, gray-scale criteria (echogenic foci with acoustic shadowing) is used in the diagnosis of urinary stones, but unfortunately, its reliability is very low. If the color Doppler twinkling artifact is applied in conjunction with other provocative measures, then its overall reliability exceeds 95%. To determine the clinical significance of twinkling artifact in the diagnosis of urinary stones, this cross-sectional observational study was conducted at Gilani Ultrasound Center, Lahore, Pakistan. For the determination of clinical significance, 1350 patients were recruited for this study. All the patients had renal stones of variable size and location. All the patients were evaluated with gray-scale sonographic criteria, and then color Doppler was applied to look for the twinkling artifact. The findings were confirmed with other imaging modalities (i.e., plain X-ray, computed tomography scan, etc., or during patient follow up). Sensitivity and specificity of the gray-scale ultrasound criteria in the detection of urinary stones was 96.1% and 57.9%, respectively, while the sensitivity and specificity of the color Doppler twinkling artifact in the detection of urinary stones was 100.0% and 97.4%, respectively. It was concluded that the application of twinkling artifact is useful in the confirmation of urinary stones, but specifically, it is of great diagnostic value in the small (less than 5 mm) renal stones and stones adjacent to a strong reflector (i.e., ureteric stones or stones in the prostatic urethra). [ABSTRACT FROM AUTHOR]

Objective: To determine the correlation between portal vein diameter and spleen size (craniocaudal). Methodology: The study was conducted at the University Ultrasound Clinic, The University of Lahore, Lahore Pakistan from 1st January to 1st July 2013. All the individuals who referred for abdominal sonographic examination, including male, female, older and younger were conveniently included in the study, voluntarily, irrespective of the disease state. Ultrasonographic measurements of the caudocranial length of the spleen and portal vein were carried out on all of the one thousand subjects. The subject position for spleen was supine or right posterior oblique during suspended inspiration and right anterior oblique position for portal vein diameter with quiet respiration. The correlation between the splenic length and portal vein diameter was evaluated. Result: A total of 1000 subjects; 36.9% females and 63.1% males aged from 4 to 79 years. The mean splenic length was 10.29 ± 1.89 cm. The mean portal vein diameter was 10.27 ± 1.78 mm. A statistically significant correlation was found between the spleen size and portal vein diameter; the Pearson correlation was significant at the 0.01 level. Conclusion: Portal vein diameter is directly correlated to splenic caudocranial length. A regression formula was developed to measure the splenic length from the calculation of portal vein diameter. [ABSTRACT FROM AUTHOR]

Public sector organizations have been accused of being inefficient in most parts of the world in the recent past. This paper is specially focused on the influence of political liberalism on efficiency of public sector (a case of NADRA). A qualitative research methodology is adopted for the collection of data. Results of the study show that though after adoption of reforms under the rubric of political liberalism the efficiency of NADRA apparently increased in short run, it proved costly (inefficient) in the long run when employees left their job due to job insecurity and low wage-rates and organization had to bear costs in hiring and training processes. [ABSTRACT FROM AUTHOR]

Objective: Study aimed to assess complications during pregnancy and its management Materials and methods: A cross-sectional study design was adopted using convenience sampling technique. A total of 311 pregnant women with age 18 years and above, and those having complications lead to early delivery were included. Data was collected from different hospitals of Lahore Pakistan during the period from December-2018 to February-2019. Results: Results showed that gestational periodhas significant relation with the complication present (P<0.001),morning sickness (P=0.037), vaginal bleeding (P<0.001), anemia (P<0.001) and miscarriage (P<0.001), while qualification has significant relation with urinary tract infections (P=0.014). Conclusion: It was concluded that presence of complications is related to gestational age and patient qualification. [ABSTRACT FROM AUTHOR]

Objective: To examine the frequency and cause sof periprocedural myocardial infarction (PMI) in complex coronary interventions. Methodology: This cross sectional study was conducted at catheterization laboratory of Gulab Devi Chest Hospital, Lahore in 6 months duration from June 2016 to January 2017. Patients aged between 30 to 80 years undergoing complex coronary interventions were included. Blood samples for creatine kinase-MB evaluation were drawn at three different times i.e. Once before procedure, 8-10 and 24 hours after the procedure. CKMB level >3× ULN was considered as PMI. Association of different factors with PMI was also observed. Results: A total of 72 consecutive patients were included in the study. Mean age of patients was 53.65+11.84 years. There were 56(77.78%) males. PMI was detected in 14 (19.44%)patients, with 3-5× ULN in 13.88% and >5× ULN in 5.55% of patients. Statistics of study showed that revascularization of left main stem lesion (1.38 % vs 0 %, p=0.04), in-stent restenosis (2.77 % vs 1.38 %, p=0.03) and procedural complications such as side branch occlusion (1.38%vs0%, p=0.04) and slow/no reflow (4.16 % vs 1.38 %, p=0.004)were significantly associated with CKMB elevation following complex coronary intervention. Conclusion: PMI is common in patients undergoing complex coronary interventions. [ABSTRACT FROM AUTHOR]

OBJECTIVE To investigate the relationship of social rejection and psychopathology among adolescents. STUDY DESIGN Correlational research design. PLACE AND DURATION OF STUDY The study was conducted in Higher Education Commission recognized institutions of Lahore during 2015-2016. SUBJECTS AND METHODS 200 adolescents (both male and female) with age range from 13 to 19 years participated in the study. The respondents had education level from middle level to intermediate level. Purposive sampling was used to collect the data. For data collection child rejection sensitivity questionnaire and strength and difficulties questionnaire were utilized. For mean differences t-test and for finding relationship among the variables Pearson correlation and multiple regression analysis were run. RESULTS Findings revealed positive significant relationship between social rejection and psychopathology among adolescents. Results indicated that social rejection scores significantly correlated with psychopathology (r=.46, p<.001). Further, it was found that overall female adolescents (M=22.67, SD=5.83) had higher score on general health as compared with males (M=21.31, SD=5.90). CONCLUSION The social rejection impaired mental health of adolescents. Viewing the results it can be concluded that social rejection is a predictor of psychopathology. [ABSTRACT FROM AUTHOR]

Introduction. Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor-patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor-patient relationship. Methods. A descriptive, cross-sectional study design with convenience (nonprobability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or "HOs'' (recent graduates doing their 1 year long internship) and postgraduate trainees or "PGRs'' (residents for 4-5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor-patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results. A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P >0:05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson's burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion. Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor-patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced. [ABSTRACT FROM AUTHOR]

The present study was conducted in different areas of Lahore city with objective of assessing the quality of ambient air. Samples were collected from selected locations of Lahore and were analyzed for particulate matter (fine and course). Air monitoring equipment was used for measurement of other gaseous pollutants. For data analysis, statistical means were estimated and compared with Punjab Environmental Quality Standards (PEQS). Results showed that gaseous and particulate pollutants in ambient air were higher than PEQS in all study sites. Highest levels of target pollutants were found as CO 17.53 mg/m3 (railway station), NO 45.87 ug/m3 (Thokar Niaz Baig), NO2 88.56 ug/m3 (Lahore Fort), SO2 129.31 ug/m3 (Thokar Niaz Baig), PM10 156.17 ug/m3 (Lahore Fort), PM2.5 45.85 ug/m3 (Railway Station) and O3 133.41 ug/m3 (Thokar Niaz Baig). Levels of air pollutants were higher because of industrial and vehicular emissions. This study can be useful to improve environmental conditions of industrial estate by reducing level of particulate matter and controlling methods for industrial pollution. There is need to raise environmental awareness regarding ambient air health effects among people. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To assess the frequency of shoulder pain in policemen due to gun hanging in Lahore, Pakistan. Study Design: Cross-Sectional Study. Place and Duration: Police Stations in Lahore, including Johar town, Model Town, Faisal Town and Khyaban e Amin. Lahore Pakistan from Nov 2019 to May 2020. Methodology: The data were collected from the policemen of different police stations in Lahore. Inclusion criteria were workrelated shoulder pain and no fracture or dislocation, and with no history of trauma or injury, and the age limit is 25 to 40 years of policemen. Data was collected using "Shortened disabilities of the arm, shoulder and hand questionnaire (Quick DASH)". Results: There were 100 study participants. The mean age of the participants was 32.48±4.49 years. Results of this study showed that 43% had no shoulder pain, and 57% had shoulder pain due to gun hanging. In addition, results showed that 21% participants had no difficulty, 18% had mild difficulty, 27% had moderate difficulty, 22% had severe difficulty, and 12% were unable to open the jar. Conclusion: The shoulder pain due to gun hanging is high among policemen Daily life activities such as sleeping patterns and recreational and social life activities were also disturbed due to shoulder pain. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study is to measure the efficacy of ionic-iodine polymer complex [1] for clinical and radiological improvement in coronavirus disease 2019 (COVID-19) patients.Trial Design: The trial will be closed label, randomized and placebo-controlled with a 1:1:1:1 allocation ratio and superiority framework.Participants: All PCR confirmed COVID-19 adult patients including non-pregnant females, with mild to moderate disease, will be enrolled from Shaikh Zayed Post-Graduate Medical Complex, Ali Clinic and Doctors Lounge in Lahore (Pakistan). Patients with any pre-existing chronic illness will be excluded from the study.Intervention and Comparator: In this multi-armed study ionic-iodine polymer complex with 200 mg of elemental iodine will be given using three formulations to evaluate efficacy. Patients will be receiving either encapsulated iodine complex of 200 mg (arm A), iodine complex syrup form 40 ml (arm B), iodine complex throat spray of 2 puffs (arm C) or empty capsule (arm D) as placebo; all three times a day. All the 4 arms will be receiving standard care as per version 3.0 of the clinical management guidelines for COVID-19 established by the Ministry of National Health Services of Pakistan.Main Outcomes: Primary outcomes will be viral clearance with radiological and clinical improvement. SARS-CoV-2 RT-PCR and HRCT chest scans will be done on the admission day and then after every fourth day for 12 days or till the symptoms are resolved. RT-PCR will only be shown as positive or negative while HRCT chest scoring will be done depending on the area and severity of lung involvement [2]. Time taken for the alleviation of symptoms will be calculated by the number of days the patient remained symptomatic. 30-day mortality will be considered as a secondary outcome.Randomisation: Stratification for initial COVID-19 status (or days from initial symptoms as a proxy), age groups, gender, baseline severity of symptoms and co-morbidities will be used to ensure that the study arms remain balanced in size for the 1:1:1:1 allocation ratio. Randomization will be done using the lottery method. As patients are being admitted at different times, they will be recruited after obtaining their voluntary written informed consent following all standard protocols of the infection, control and disinfection.Blinding (masking): This is a quadruple (participants, care providers, investigators and outcomes assessors) blinded study where only the study's Primary Investigator will have information about the arms and their interventions.Numbers To Be Randomised (sample Size): 200 patients will be randomized into four groups with three experimental and one placebo arm.Trial Status: Protocol Version Number is 2.3 and it is approved from IRB Shaikh Zayed Hospital with ID SZMC/IRB/Internal0056/2020 on July 14th, 2020. The recruitment is in progress. It was started on July 30, 2020, and the estimated end date for the trial is August 15, 2021.Trial Registration: Clinical Trial has been retrospectively registered on www.clinicaltrials.gov with registration ID NCT04473261 dated July 16, 2020.Full Protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). With the intention of expediting dissemination of this trial, the conventional formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Objectives: Work-related musculoskeletal disorders are increasing due to poor posture adaptation. Increasing the use of technologies in the office settings is one of the main reasons behind muscle and soft tissue strains. The objective of the study was to determine the pattern of posture-related musculoskeletal pain in office workers. Methods: This observational study was conducted from 15th May, to 25th June, 2021. Data were collected by convenient sampling. The Nordic Musculoskeletal questionnaire on body postural habits was filled by 150 office workers from different universities of Lahore. Statistical Package for the Social Sciences software version 25 was used for statistical analysis. Results: There were 79 (52.7%) male and 71 (43.7%) female participants, with a mean age of 35.7 ± 5.14 years. Majority (51.3%) of the subjects reported sitting tilted forward, while a few used backrests and footrests for support. Prolonged crossed legs and twisted spine posture were also adopted by many subjects. Neck, lower back, and shoulder were the most affected regions, with increased musculoskeletal pain reported over the last 12 months. Due to recurrent pain in the neck, shoulder, and upper back, difficulty in carrying out routine jobs, housework, and hobbies was reported by 38.7%, 34.7%, and 30% of the subjects, respectively. Conclusion: Failure to adopt a good ergonomic approach leads to frequent musculoskeletal pain and difficulty in carrying out routine office and household work. [ABSTRACT FROM AUTHOR]

In this article Muhammad Danish ali at University of the Punjab Lahore was missing from the author list. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to find out types of technologies being used in institutions working for children with mental retardation and explore perceptions of speech language therapists about the integration of technology into speech and language therapy of children with mental retardation. The population of study included all speech therapists working in seventeen institutions for children with mental retardation at Lahore, Pakistan. The sample of study comprised 20 speech therapists. A validated questionnaire (Cronbach Alpha 0.85) consisting of two parts, one about different types of technologies being used in different institutions and second part including 13 questions about the integration of technology was developed by the researchers. The respondents were required to respond on two point criteria (Yes and No).The collected data were analyzed and tabulated by using descriptive statistical techniques. The results indicated that communication books and computer soft wares were technologies largely integrated into speech and language therapy of children with mental retardation. It was also investigated that majority of speech language therapists were of the view that integration of technology proved helpful in developing speech and language of children with mental retardation [ABSTRACT FROM AUTHOR]

Forensic Odontology is a significant outgrowth of Forensic Medicinal Sciences. It plays a pivotal role in identifying the individual. But awareness regarding Forensic Odontology is less among Dental Professionals. It was a cross sectional, questionnaire-based study. Four Dental Institutes of Lahore were selected for the survey. Ethical approval for this study was obtained from the ethical review committee of the University of Lahore. Participants included an assortment of house surgeons, demonstrators and postgraduate trainees of private dental teaching hospitals. A questionnaire consisting of 15 questions was used as a study tool. There were 40 (16.7%) demonstrators, 55 (22.9%) postgraduate residents and 145 (60.4%) house officers. One hundred seventy nine (74.6%) candidates knew about forensic odontology, 189 (78.9%) thought that forensic odontology is an important part of dentistry, but only 25 (10.3%) learned about forensic dentistry in their institution. 66 (27.6%) knew about cases solved by forensic odontologists, 175 (72.8%) maintained the patient record at the hospital, 121 (50.4%) knew the significance of bite mark pattern of teeth, 177 (73.7%) knew that teeth can serve as a source of DNA. Most of the dental professionals were aware of forensic odontology and its importance but were unaware whether this sulyed is being laugh or not in dental colleges. Moreover, Institutions were not providing enough information regarding Forensic Odontology. [ABSTRACT FROM AUTHOR]

The present study explored the potential moderating role of intrinsic religiosity between problem-focused coping and suicide risk among patients with renal failure. The purposive sampling technique was used to collect the data from 250 individuals with renal failure; men (n = 165) and women (n = 85) with (M = 45.39, SD 13.80) taken from hospitals in Rawalpindi, Islamabad, and Lahore. Results indicated that intrinsic religiosity moderates the relationship between problem-focused coping and suicidal risk by adding a 6% variance. Furthermore, men used more problem-focused coping as compared to women based on the group of education. This was specifically noted in individuals with low education levels. This study will provide guidelines for mental health professionals to identify the possible suicide risk among patients with renal failure. Treatment adherence can be improved when their coping styles are congruent with their treatment demands. Therefore, it is necessary to plan proper interventions for renal failure patients. [ABSTRACT FROM AUTHOR]