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Purpose: Pilonidal sinus incidence is increasing in surgical departments all over the world. Pilonidal sinus is under the influence of several factors. These factors are studied well in various parts of the world; however, these factors are understudied in Pakistan. This study aimed to find out the risk factors of pilonidal sinus among the patients diagnosed with pilonidal sinus. Methodology: This descriptive cross-sectional study was conducted among one hundred and eight patients with pilonidal sinus at Benazir Bhutto Hospital Rawalpindi, for one year from January 2021 to January 2022. Ethical approval and informed consent were obtained before the start of study. Patients’ enrollment was done according to a developed inclusion and exclusion criteria. Convenient sampling technique was also applied for recruitment of participants. Data was collected through a self-designed questionnaire. Descriptive statistics were utilized for the data analysis. Data analysis was performed by SPSS version 25.0 (IBM Corp., Armonk, NY). Findings: Pilonidal sinus frequency was high among the patients who had age group of 11 to 30 years (68.52%), male gender (62.96%), driving profession (37.96%), family history of pilonidal sinus (64.82%), high body mass index(60.18%), daily sitting for more than 6 hours (79.62%), sitting on hard surfaces (63.88%), hairy skin (55.55%), excessive sweating (68.52%), poor hygiene of sacrococcygeal region (77.78%), number of baths less than three times per week (61.11%), and light colored skin (62.04%). Recommendations: This study recommends that health authorities should make people educated regarding the risk factors that lead to pilonidal sinus. The study also recommends that people should reduce their body weight, sit over soft places and should avoid continuous sitting for long periods. People should take care of hygiene, especially of sacrococcygeal regions by shaving hair, drying moisture, and taking frequent baths.

Purpose: Stroke incidence is high all over in the world. It has a list of specific warning signs and risk factors. Awareness of people about those warning signs and risk factors is low especially in third world countries. This study aimed to identify the awareness of people about the warning signs and risk factors of stroke. Methodology: This descriptive cross-sectional study was performed in a tertiary care hospital, Rawalpindi, among one hundred for one year from June 2021 to June 2022. Ethical approval and informed consent were waived before the start of study. Patients’ selection was made via a well-defined inclusion and exclusion criteria. Convenient sampling technique was also used for enrollment of participants. Data was collected by using a self-designed questionnaire. Descriptive statistics were put into action for the data analysis. Data analysis was carried out by SPSS version 25.0 (IBM Corp., Armonk, NY). Findings: The warning sign of the stroke about which most of the people were aware was sudden body weakness or numbness (74%) while warning sign about which people were least aware was sudden difficulty in seeing objects by one or both eyes (29%). The most common identified risk factor in people was hypertension (70%) for stroke while least common identified risk factor was family history of stroke (36%). In short, this study indicates people awareness about the warning signs and risk factors of stroke was not up to the mark in study population. Recommendation: There is need to increase the awareness level of people about the warning signs and risk factors of the stroke. This could lead to timely and effective management of stroke and its prevention as well.

Purpose: Rickets is one of the most common diseases of childhood and is more prevalent in the developing countries. It affects the rapid growth phase of the children. Rickets is affected by different factors which are understudied in Pakistan. This study aimed to identify the risk factors that lead to rickets in children under five years of age among diagnosed cases of the nutritional rickets. This may cause reduction in the incidence of the rickets by prevention of the factors that lead to rickets in the children. Methodology: This descriptive cross-sectional study was performed in the pediatric outpatients department of the Holy Family Hospital, Rawalpindi, Pakistan for 1 year from June 2021 to June 2022 on 132 diagnosed cases of the nutritional rickets. Patients were enrolled via non- probability convenient sampling technique and a set developed inclusion and exclusion criteria. Data was collected through self-structured questionnaire after taking informed consent. Data analysis was done through SPSS version 25. Findings: Nutritional rickets was more common among children who had, age range from 1 to 3 years group (64.39%), male gender (68.94%), lower socioeconomic status (55.30%), exclusive breastfeeding (70.45%), cow’s milk use (71.96%), no sunlight exposure (66.67%), shorter duration of sunlight exposure (57.58%) fully dressed during sunlight exposure (40.90%), no oil massage during sunlight exposure (63.30%), poor nutritional status (72.73%), and mothers with poor nutritional status (69.70%). In short, age group with range 1 to 3 years, male gender, lower socioeconomic status, exclusive breastfeeding, cow’s milk use, no sunlight exposure, shorter duration of sunlight exposure, fully dressed during sunlight exposure, no oil massage during sunlight exposure, child poor nutritional status, and mothers with poor nutritional status, all raise the of the nutritional rickets in children of under five years age. Recommendations: Supplements should be added in the diet of children during breastfeeding. Also, there should be adequate sunlight exposure of children. Finally, malnutrition of both children and mothers should be treated.

Background: Urinary tract infection (UTI) is common health issue all over the world and several factors predispose the people to urinary tract infection. Objective: The study aimed at determining the incidence of Urinary tract infection and factors associated with it. Material and Methods: This cross-sectional study was performed among 205 patients in a tertiary care hospital of Rawalpindi, Pakistan. Simple convenient sampling and an established inclusion and exclusion criteria was applied to select the participants. After obtaining the informed consent from all participants, data was acquired via a self-designed proforma. Data analysis was carried out through SPSS version 25. Chi square test was applied to check the association between urinary tract infection and predisposing factors. The p-value less than 0.05 was taken as statistically significant. Results: The incidence of urinary tract infection was 12.68%. Urinary tract infection was significantly associated age group (p=0.003), gender (p=0.001), marital status (p=0.004), educational status (p=0.0001), socioeconomic status (p=0.005), previous history of UTI (p=0.0002), family history of UTI (p=0.0004), history of stone in urinary tract (p=0.003), history of recent use of antibiotics (p=0.04), history of catheterization (p=0.001), hygienic condition of external genitalia (p=0.0005), frequency of intercourse (p=0.04), history of diabetes mellitus (p=0.002), and hydration status (p=0.0007), whereas, association of urinary tract infection with holding urine was insignificant (p=0.05). Conclusion: The incidence of urinary tract infection was high among research population. Risk factors that could lead to UTI were young age, female gender, married marital status, lower educational status, lower socioeconomic status, previous history of UTI, family history of UTI, history of stone in urinary tract, history of recent use of antibiotics, history of catheterization, poor hygienic condition of external genitalia, high frequency of intercourse, history of diabetes mellitus, and dehydration. Recommendations: People should be educated about the UTI and its causes and prevention. People should also take special care when they are on antibiotics or when they are diabetics, to prevent UTI. People should maintain hygiene when they are catheterized and during intercourse. People should stay hydrated.

Background: Bed sore (BS) is very common among hospital admitted patients. Bed sore is a localized injury to skin and underlying tissues due to pressure or friction and its incidence is affected by multiple factors. Objective: This study was aimed to determine the incidence of bed sore and its potential risk factors among hospital admitted patients. Material and Methods: This cross-sectional study was conducted among 108 hospital admitted patients in a tertiary care hospital of Lahore, Pakistan. Simple convenient sampling was used to enroll patients. After taking the informed consent from all patients, data was collected through a self-structured proforma. Data analysis was done via SPSS version 25. Chi square test was utilized to assess the association between bed sores and potential risk factors. Results: The incidence of bed sore among study population was 14 (12.96%). Bed sores incidence was significantly associated with age group (p=0.002), educational status (p=0.03), socioeconomic status (p=0.002), awareness about bed sores (p=0.001), hospital stay length (p=0.002), limitation in movement (p=0.0001), diabetes mellitus (p=0.03), chronic kidney disease (p=0.04), obesity (p=0.001), history of hypertension (p=0.002), history of stroke (p=0.02), and history of heart disease (p=0.04), whereas, bed sores were not associated with gender significantly (p=0.40). Conclusion: In a nutshell, the incidence of bed sores was significantly high among study population. Predisposing factors to the bed sores were advanced age, lower educational status, lower socioeconomic status, lower awareness about bed sores, longer hospital stay, limitation in movement, diabetes mellitus, obesity, history of hypertension, history of stroke, and history of heart disease. Recommendations: This research recommends that people should make aware about the predisposing factors of bed sores and how to avoid these factors at every level and especially in hospitalized patients. Patients should change their position periodically. Obese patients should reduce weight. All patients, especially diabetic patients, should take care of skin.

Hypertension is a common health issue all over the world. It has been suggested that hypertension leads to diseases of vital organs like, heart, brain, and kidney. Although, hypertension is under the influence of many factors like age, gender, marital status, genetic, social class, educational status, diabetes, lifestyle, and tobacco and alcohol consumption, even so, obesity is considered as a very critical factor. Thus, our study was established with the objective to determine interrelation between hypertension and obesity. This study with cross-sectional design was accomplished among general and regional population of Pak Arab society, Lahore in about 2months from March 2021 to the end of April 2021. People were called up in our study via established criteria. Data was collected by self-designed proforma and WHO classification was applied to classify participants into four WHO classes of weight status. Data analysis was done by applying SPSS version 25. Diverse statistical tests like Chi-square test, independent sample t-test, and One-Way-ANOVA test. were used to evaluate study variables. This study shows overall high prevalence of both hypertension (45.1%) and obesity (30.70%) among study population. Mean values of both blood pressures systolic and diastolic were higher among men (systolic blood pressure = 142.34 mmHg with SD of ±18.03, diastolic blood pressure = 89.93 mmHg with SD of ±1.26), than women (systolic blood pressure = 136.64 mmHg with SD of ±19.95, diastolic blood pressure = 89.65 mmHg with SD of ±8.67) however, these differences were not significant statistically with p-values 0.75 and 0.851 respectively. BMI mean values were higher among women (25.95 with SD of ±3.67) than men (25.76 with SD of ±4.10)), and difference was insignificant statistically (p=0.779). Variation in mean BMI values across four weight statuses (For Underweight BMI mean value = 17.86 with SD of ±0.38, for normal weight BMI mean value=21.18 with SD of ±1.36, for overweight BMI mean value =25.48 with SD of ±1.10, for obese BMI mean value= 30.47 with SD of ±0.77) was significant(p=0.0003). Difference in BMI mean values was also significant between hypertensive (BMI=27.68 with SD of ±3.28) and normotensive people (BMI= 24.39 with SD of ±3.62) with p-value of 0.0001. Variations in mean values of both systolic (underweight=127.57mmHg with SD of ±10.67, normal weight=126.89mmHg with SD of ±9.63, over weight=135.52mmHg with SD of ±17.46, obese=152.6mmHg with SD of ±19.74) and diastolic blood (underweight= 81.71mmHg with SD of ±7.29, normal weight=83.21mmHg with SD of ±4.68, over weight=89.39 mmHg with SD of ±7.57 , obese = 95.40 mmHg with SD of ±9.75) pressures across four statuses were significant with p values 0.004 and 0.0001 respectively. Gender was associated with weight status significantly (p=0.040); however, gender was not associated with hypertension (p=0.072) Most importantly, obesity and hypertension were associated significantly(p=0.0003) In summary, our study shows high prevalence of hypertension and obesity among enrolled population. Hypertension incidence goes up with increase in the weight. Hypertension incidence was higher among men than women whereas, obesity was higher among women than men. Thus, we can by controlling obesity we would be able to manage hypertension.

Background: Acute otitis media (AOM) is the second most common disease of childhood. Many factors play role in the causation of AOM. However, the research-based data on risk factors for AOM in infants is still inadequate. Objective were this study aimed to determine the risk factors for AOM in infants with AOM.Methods: This descriptive cross-sectional study was conducted among 189 infant patients with AOM in the otorhinolaryngology outpatient department of allied hospital of Rawalpindi medical university, Rawalpindi. Established inclusion and exclusion criteria and non-probability convenience sampling technique were utilized for the selection of patients. After taking informed consent, data were collected through a self-adapted questionnaire. Descriptive analysis was accomplished through SPSS version 25.Results: AOM was more common among patients who had, an age group with a range of 9-12 months (41.28%), male gender (55.02%), lower birth order (49.73%), mothers with illiterate educational status (53.96%), mothers with the job (57.14%), lower socioeconomic status (59.25%), used bottle-feeding (46.56%), supine position during feeding (61.37%), used a pacifier (67.73%), poor feeding hygiene (58.21%), unvaccinated pneumococcal status (57.15%), and large family (63.50%). In the case of family ear infection and passive smoking, AOM incidence was more frequent among infants whose family had no history of ear infection (69.85%) and no smoking exposure (53.44%).Conclusions: In short, the age group with a range of 9-12 months, male gender, low birth order, illiterate mothers, mothers with the job, lower socioeconomic status, bottle-feeding, supine feeding position, pacifier use, poor feeding hygiene, unvaccinated pneumococcal status, and large family size, all raise the risk of AOM incidence in infants.

Stress is a common health problem among medical students. Higher stress among students leads to change in food preference. This study was aimed to assess the relationship between perceived stress and food pattern among final-year MBBS student of Rawalpindi Medical University. This cross descriptive cross-sectional study was conducted among final-year MBBS students of Rawalpindi Medical University in January 2020.Data was collected through Perceived stress scale and self-structured questionnaire about demographic details and dietary habit details. Students with irregular dietary habits were excluded. Because of non-parametric nature of data, non-parametric statistical tests including Mann–Whitney test, Kruskal–Wallis test and Multinomial logistic regression were applied to assess the variables. Statistically significant differences of perceived stress were observed across gender (p=0.000) and boarding status (p=0.004). Significant differences of perceived stress were also found across intake three frequency levels of sweet foods(p=0.000), snack foods(p=0.001) and ready to eat foods(p=0.012) while differences were non- significant across three intake frequency levels of fast foods(p=0.067) and fruits and vegetables(p=0.175).Multinomial logistic regression proposed increase intake of sweet foods, snack foods, ready to eat foods and fast foods with the increase in perceived stress while decease intake of fruits and vegetables with the increase in perceived stress. Our study shows that perceived stress changes dietary patterns and with the increase in perceived stress consumption of unhealthy foods increases while consumption of healthy foods decreases. So, by applying suitable interventions for alleviation of stress we can improve dietary habits and consequently physical health.

Acute otitis media (AOM) is the commonest disease of childhood. High incidence of AOM might be due to immature Eustachian Tube and immaturity of immune system. Exclusive breast feeding is protective against acute otitis media, however, improper breastfeeding position can increase AOM occurrence in infants. This study aims to assess the association of improper breastfeeding position with occurrence of Acute otitis media in infants and to assess association of Maternal educational levels with feeding positions. 220 breastfed infants satisfying inclusion criteria with diagnosed AOM were enrolled. Study was conducted over a period of 6 months from August 2019 to January 2020. Demographic details and Detailed history regarding feeding positions and maternal educational levels were obtained through a Self-structured proforma from parents. Data analysis was done through descriptive statistics and chi square test and p value less than 0.5 was set significant. Out of 220 infants, 123(55.90%) were male and 97(44.10%) were females. AOM was more common in male infants than female infants, however it was not statistically significant(p=0.169). The mean age for enrolled infants(1-12months) was 6.90(±3.413). Statistically significant association between increase incidence of AOM and breastfeeding position was found(p=0.032). We also found a statistically significant association between maternal educational levels and breastfeeding position (p= 0.000). In this study, we have noted that Breastfeeding in supine position is associated significantly with increase in incidence of AOM. Feeding positions are statistically associated with Maternal Educational levels.

Auxetic materials are under great attention of researchers due to their excellent mechanical response under certain conditions. Previous works have been carried out in knitted or uni-stretch woven fabrics. In the present study, three-dimensional (3D) woven structures were produced and the effect of float length of ground weave and binding yarn on auxeticity of the fabric was investigated. Eight different 3D orthogonal woven structures/reinforcements were produced on rapier dobby loom by changing the float length in ground weave and binding yarns. Hand layup technique was used for composite fabrication, while green epoxy resin was used as a matrix. For investigating the auxeticity, 3D reinforcement samples were subjected to tensile loading and change in their thickness was measured. The results showed that 3D woven reinforcements with equal and maximum float length of ground weave and binding yarn showed greater auxetic behavior, because both weaves support each other and room for opening of structure increases. As the difference between the float length of ground weave and binding yarns increases, the auxeticity of reinforcement decreases because the ground weave and binding yarn cancel out the effect of each other. Moreover, the impact energy absorption of the developed composites was found to increase with the increase in float length, justifying that the structures are auxetic in nature.