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Aim: To determine the distribution of gender, age and clinical presentations along with histological type of colorectal cancer in patients presented to Shaikh Zayed Hospital Lahore. Study design: This is a case series study Methodology: This retrospective study on colorectal cancer was conducted in Shaikh Zayed Hospital Lahore. Forty-four 44 patients from Jan 2018 to Jan 2021 were included of colorectal carcinoma. Data were collected and analyzed using SPSS v 23 retrospectively from hospital record. Results: 15.9% of the patients were below the age of 30 years, 31.8% were below 40 years. Male were 65.9%. Commonest presenting symptom was altered bowel habits, rectal bleeding along with weight loss and the dominating tumor grade was moderately differentiated adenocarcinoma. Conclusion: In this study colorectal carcinoma among young age groups were more commonly present at the fourth and sixth decade. Keywords: Colorectal carcinoma, Adenocarcinoma, Tertiary care hospital.

ObjectivesConsidering 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 designThe 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.ParticipantsAll 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 (10min without face protection) ● Moderate exposure (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 comparatorIn 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 outcomesPrimary 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. RandomisationParticipants 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 StatusThe 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 registrationClinical trial was registered on February 23, 2021, www.clinicaltrials.gov with registration ID NCT04767087.

Introduction: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist, caused by impaired gliding of the abductor pollicis longus and extensor pollicis brevis tendons. Aims and objectives: The basic aim of the study is to find the role of corticosteroid injections in the treatment of De Quervain’s Tenosynovitis. Methodology of the study: This cross sectional study was done in Shalamar hospital Lahore during June 2019 to November 2019. A total of 40 patients were registered in the study. All patients previously had a mean of 6 weeks (range 4-8 weeks) of treatment of the condition with oral and local NSAIDs and had shown no response and were therefore not satisfied with treatment. Results: Out of a total of 40 patients, 24(30%) were men and 26(70%) were women. The age ranged between 20 to 40 years. (Mean age 29.32 Years SD ±6.099). The right hand was affected in 48 (60%) and left in 32 (40%) patients. The mean duration from the onset of symptoms to enrolment for this study was 5.87 weeks (range 4 weeks to 8 weeks SD ±0.527). Conclusion: It is concluded that one or two local steroid injections in the first dorsal compartment leads to early improvement in patients with de Quervain's tenosynovitis.

Introduction: Non-communicable diseases (NCDs) are a major and increasing global health issue. According to the Global Burden of Diseases (GDB) 2015 report, there are between 39.8 and 40.5 million deaths per year from the four main categories of NCDs, namely cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases (CRDs), representing 63% of all global deaths. Aims and objectives: The basic aim of the study is to analyze the epidemiology of non-communicable respiratory diseases in Pakistan. Methodology of the study: This cross sectional study was conducted at Ghurki Trust and Teaching Hospital Lahore in 2019 with the permission of ethical committee of hospital. There were 100 patients who was suffering from different kind of respiratory diseases, selected for this study. Patients of both genders were included in this research analysis. For this purpose we collect the socio-demographic data of selected participants. Results: The data was collected from 100 selected patients. There was significant association between presence of metabolic syndrome and BMI with p-value = 0.000. Significant association was found between the presence of metabolic syndrome and duration of COPD with p-value = 0.000. There was significant association between presence of metabolic syndrome and smoking with p-value = 0.000. Conclusion: It is concluded that there is, however, limited epidemiological evidence currently representing an important gap in the evidence base and need for further research. Asthma and COPD are likely to be under-estimated, under-diagnosed, under-treated as well as inadequately prevented.

Aim: Clinical planning specialists are a difficult task for postgraduate programs throughout Pakistan. The reason for this study was whether a single specialist who had entered the practice sufficiently developed by contrasting the type and volume of the surgeries that have been performed over the last 3 years with that in the principal year of clinical practice. Methods: I have logged both approaches over the last 3 years of the planning of a surgical treatment. The British Columbia Medical Services Plan (MSP) records all methodologies in realistic terms. I ordered the methods I used during my first year of training using MSP settlement studies. Our current research conducted at Mayo Hospital, Lahore from March 2019 to February 2020. I have introduced and listed the quantity of techniques in (general, colorectal, laparoscopic, endoscopic, hepatobiliary, oncologic, pediatric, thoracic, vascular and other). I contrast residency training and network experience at that stage. Results: Over the last three years I have logged a total of 1170 methodologies. 452 of these were carried out during pivots of the network. 382 generals, 19 colorectal, 245 laparoscopes, 103 endoscopes, 85 hepatobiliary, 142 oncologic, 1 pediatric, 78 thoracic, 94 vascular tubes and 18 more may be divided in residency approaches. In the primary training year, I played a total of 1440 methods. 399 generals, 15 colorectal, 101 laparoscopic, 654 endoscopic, 2 hepatobiliary, 78 oncologic, 10 pediatric, 0 thorax, 70 vascular and 115 different were included in the separate. Conclusion: In general, residency gave amazing planning to clinical practice dependent on my experience. Regions of potential improvement included endoscopy, pediatric medical procedure and "other," which involved generally hand a medical procedure. Keywords: surgeon, type and volume of surgical procedures performed in Pakistan.

Background: Increasing number of youth is indulging in smoking practices each day despite of the public health efforts for its eradication. Objective: To identify perceived reasons for smoking in youngsters and adults visiting khokha shops in Lahore. Methods: A cross-sectional study was conducted on a sample of 350 visitors of khokha shops in Lahore. Two union councils 110 and 117 were selected. Total 76 khokha/ cigarette shops in both UCs were included but for convenience 25 shops were randomly selected. Almost 1 hour was spent by researchers on each shop during a day and all eligible visitors were interviewed after taking verbal consent. Data was analyzed using SPSSv23.0. Results: Preliminary analysis revealed tension reduction as the most important factor contributing 66.9% in smoking. Peer pressure ranked second as 37.7%. Mood elevation ranked third as 36.6%. Young participants of age group 15-19years gave higher ratings to peer pressure, cigarette availability at shops, to be gentle man and to impress the girls. Middle age group 24-35years gave higher ratings to reduce tension, excessive work load and addiction. 46.8% participants were found to have begun smoking at young age (15-24years). Nearly 37.4 % respondents smoke 6-10 cigarettes per day. Conclusions: It is concluded that tension reduction/stress relieve is the most prevalent perceived reason of smoking in youngsters and adults. Peer pressure ranked second. Students show indulgence in smoking due to social evils. The employees smoked “to reduce tiredness” and for “mood elevation”. Laborer mostly smoke to “reduce tension" and as an “addiction" Keywords: khokha/cigarette shops, Smoking, tension/stress relieving, Peer pressure and addiction.