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This work aimed to synthesize the aluminium oxide nanoparticles using Ixoro coccinea leaf extract. Furthermore, the synthesized Ixoro coccinea aluminium oxide nanoparticles (I–Al2O3-NPs) and nanocomposites (I–Al2O3-NC), including them as the fillers in a chitosan matrix were characterized, and I–Al2O3-NC was applied to remove the toxic metals (TMs) including Cd, Ni, and Pb from water. Optimization of different batch experimental adsorption parameters (pH, concentration of TMs, dose of I–Al2O3-NC, temperature, and time of contact) was done to check the feasibility of I–Al2O3-NC for maximum removal of TMs from water. The extreme adsorption capacities using nanocomposites for Cd, Ni, and Pb were 66.0, 60.0, and 66.4 mg g−1, respectively. The I–Al2O3-NC followed the Freundlich isotherm model for removing Cd and Ni while showing the monolayer surface coverage for the removal of Pb. For this process, the best-fitted kinetic model was the pseudo-second-order equation. The enthalpy, entropy, and free energy of metal ion adsorption, among other parameters of thermodynamics, were estimated. The process was found to be exothermic, advantageous, and spontaneous. Kinetic studies show that intra-particle diffusion is essential for eliminating TMs. In addition, I–Al2O3-NC was applied for the adsorption of TMs from surface water and determined to be effective in removing these contaminants up to an acceptable drinking water standard. Regeneration of adsorbent suggested that green synthesized I–Al2O3-NC may be an active tool for removing Cd, Ni, and Pb ions from contaminated water. © 2023 Elsevier Ltd and Techna Group S.r.l.

Cerebral palsy (CP) is a chronic, non-progressive, and incurable disorder that affects mobility and posture. Objective: To assess the Knowledge and Care among mothers having Children with Cerebral Palsy at Nishter hospital Multan. Methods: A cross sectional study designed was used. A sample of n=85 participants was recruited from Nishtar Hospital Multan Pakistan, through purposive sampling. The knowledge and care questionnaire were used for measurement of knowledge and care among mothers having children with cerebral palsy (CP). Filled questionnaires were entered and analyzed through SPSS version 21. Results: Findings revealed that 71.8% participants had poor knowledge regarding CP, 21.2% had fair knowledge and only 7% of participants had good knowledge regarding CP. Similarly, it was revealed that 50.6% participants had poor care, 41.2% had satisfactory care and only 8.2% were having good care for cerebral palsy children. Conclusions: Majority of the mothers of children with cerebral palsy in this study are unaware of the condition and show no concern for it. Support groups may be developed further to increase care giving' awareness of and concern with CP, which may aid them in finding the most suitable and timely interventions for their charges.

The current investigation takes up Ernest Hemingway’s The Old Man and the Sea and provides a corpus-based analysis by selecting monologues as data for this study. The focal point of this corpus analysis is to highlight and identify textual features in the construction of the character of Santiago. This study goes for a corpus stylistic analysis of the selected text and unravels textual features which were previously unnoticed. Only monologues are selected as corpus data and AntConc 3.5.8 (Anthony, 2010) is utilized as a tool for corpus analysis. The study displays the significant role of corpus-based approaches for a better understanding of a literary text. It is clear after this analysis, corpus-based approaches in studying Hemingway's monologues highlight linguistic features of monologues and provide new avenues and perspectives, thus enhancing the value of literary corpus stylistics.

This research deals with the ups and downs in the socio-economic development of Pakistan in light of the economic theory of IbnKhaldun (1332-1406 AD). He evaluated dynamics and multidisciplinary approach that how the interconnected relationship of social and economic factors leads to ascend and descend the nations. His opinion, immorality, injustice and many other social evils are the indicators of unstable development, which caused fall of society. Like opinion of Khaldun, the researcher analysed number of factors which are responsible for rising and falling the socio-economic situations of Pakistan. Further, the consequences of the slow growth, poverty, lack of good governance, sectarianism and poor law and order situation have also pointed out. This paper focusses on those social, political and economic indicators which are directly or indirectly influence the rise and fall of socio-economic development in Pakistan. If Khaldun’s theory of economic development of nations applied, it will lead to the rise of society, because social and political stability is a good omen for development. This paper analysed the Khaldun’s economic model and compare it with socio-economic situation of Pakistan.

In contrast to previous approaches to chiral α-aryl carboxylic acids that based on reactions using hazardous gases, pressurized setup and mostly noble metal catalysts, in this work, a nickel-catalyzed general, efficient and highly enantioselective carboxylation reaction of racemic benzylic (pseudo)halides under mild conditions using atmospheric CO

Objective: The purpose of this analysis was to do the comparison of the effect of general anesthesia and spinal anesthesia on neonatal Apgar score in patients enduring elective cesarean section. Study design: A Randomized control trial. Place and duration: In the department of Anesthesia, pain and intensive care Divisional Headquarters teaching Hospital Mirpur Hospital for six-months duration from July 2021 to December 2021. Methods: In this study, 120 patients in the cesarean section operating room list were alienated into 2 equal groups. Group I (n = 60) were given spinal anesthesia and in group II (n = 60), general anesthesia was given. There was no significant difference in height, weight and age of patients. Patient information is recorded on the designed performa. Comparisons were made between groups I and II. Apgar scores were assessed 1 and 5 minutes after birth and recorded as proforma. Results: The patients mean age of the group-I was 30.04 ± 4.9 years and 29.81± 5.84 years in the group-II. The mean change between the groups was not statistically substantial (p = 0.66). The patients mean weight in the first group was 70.95 ± 10.31 kg and in the second group it was 73.50 ±11.28 kg. Infants born to women who received spinal anesthesia had a higher Apgar score at 1 minute and 5 minutes compared to females who were given general anesthesia (P

The current study aimed to synthesize and characterize the Duranta erecta leaves extract-based iron oxide nanoparticles (D-Fe3O4-NPs) and chitosan biopolymer-based nanocomposites (D-Fe3O4-NC). The synthesized D-Fe3O4-NC was applied for the adsorptive removal of cadmium (Cd), chromium (Cr), and lead (Pb) from water. The nanostructure, porous, rough, crystalline structure, and different functional groups of chitosan and D-Fe3O4-NPs in D-Fe3O4-NC showed that the D-Fe3O4-NC is feasible for suitable adsorbents for quantitative removal of Cd, Cr, and Pb. Based on the batch experiments, the influences of pH, adsorption time, contents of Cd, Cr, and Pb in solution, and temperature were successfully optimized. The adsorption capacities of D-Fe3O4-NC for Cd, Cr, and Pb were observed at 74.4, 76.0, and 75.2 mg g−1, respectively. The adsorption isotherms fitted the Freundlich Model equation well, and the adsorption kinetics followed pseudo-second-order kinetics for the adsorption of these toxic metals. D-Fe3O4-NC showed an excellent recyclable efficiency up to multiple analyses (n = 20). The D-Fe3O4-NC was an excellent adsorbent for removing toxic metals from municipal and hand pump water samples (% removal >93%). Therefore, the proposed D-Fe3O4-NC is the most efficient and selective adsorbent for removing Cd, Cr, and Pb from drinking water up to recommended permissible limit. © 2023 Elsevier B.V.

The first nickel-catalyzed highly enantioselective reductive Ullmann coupling of ortho-chlorinated aryl aldehyde was achieved under mild reaction conditions with a chiral 2,2'-bipyridine ligand (+)-DTB-SBpy, thus providing axially chiral biphenyl or binaphthyl dials with up to 99 % yield and 99.5:0.5 er. The versatility of the products as common synthetic intermediates for diverse axially chiral ligands, catalysts, and functional molecules was demonstrated by short-step transformations. This protocol also allowed the concise and highly enantioselective formal total synthesis of biologically active natural products (+)-kotanin, (-)-isoschizandrin and (+)-gossypol.

Catalytic carbene-transfer reactions constitute a class of highly useful transformations in organic synthesis. Although catalysts based on a range of transition-metals have been reported, the readily accessible nickel(II)-based complexes have been rarely used. Herein, an air-stable nickel(II)-carborane complex is reported as a well-defined, versatile and recyclable catalyst for selective carbene transfer reactions with low catalyst loading under mild conditions. This catalyst is effective for several types of reactions including diastereoselective cyclopropanation, epoxidation, selective X-H insertions (X = C, N, O, S, Si), particularly for the unprotected substrates. This represents a rare example of carborane ligands in base metal catalysis.

The present study investigated the relationship between gaming addiction and aggression among young adults. 160 participants (80 males and 80 females) were approached by purposive sampling. Cross-sectional, correlational research design was employed. The data were collected using two questionnaires: Gaming Addiction Inventory for Adults and The Aggression Questionnaire. The data was analyzed through Statistical Package for the Social Sciences, version 21. Results revealed that gaming addiction has significant but negative relationship with aggression, anger, and physical aggression, however, verbal aggression and hostility were not significantly related. Analysis of gender difference indicated males as more addicted to games than females, while aggression and its variants were not found to be significantly different. The study concluded that video game playing may become a source for releasing aggression, hence, lowering the physiological arousals and reducing aggression in life. The inverse relationship of gaming addiction and aggression implies the positive consideration of games for dealing with aggression among young adults. The study has certain limitations as forthcoming researches should examine the particular types of games with aggression or comparing different age groups will further enlighten the relationship of game playing and aggression.

A new class of chiral 2,2'-bipyridine ligands, SBpy, featuring minimized short-range steric hindrance and structural tunability was rationally designed and developed, and the effectiveness was demonstrated in the first highly enantioselective Ni-catalyzed addition of aryl halides to aldehydes. In comparison with known approaches using preformed aryl metallic reagents, this reaction is more step-economical and functional group tolerant. The reaction mechanism and a model of stereocontrol were proposed based on experimental and computational results.

Objective: To estimate the incidence of hypocalcemia in women suffering from preeclampsia. Study Design: Cross sectional study. Place and Duration of Study: Department of Obstetrics & Gynaecology, Pakistan Railway Hospital Rawalpindi from 1st July 2020 30th June 2021. Methodology: One hundred women with preeclampsia were suffering from high blood pressure and amenorrhea 32 weeks’ pregnant women with parity between 0-5 were enrolled. They were divided in two groups. Group A consisted of normal pregnant women while Group B consisted of pre-eclamptic pregnant women. Blood pressure was taken at three various times using a mercury based sphignomometer. Urine analysis was initially performed as a confirmation of preeclampsia. Serum Calcium levels were determined through calorimetric method using Human Diagnostic kits (Germany). Results: The study highlighted the fact that majority of the pre-eclamptic women such as 54% were educated. There was a significant difference in primigravida of group A and Group B with p value

Objectives: The aim of our study is to see the maternal and fetal outcome of pregnancies with previous one lower segment cesarean section. Study Design: Prospective study. Setting: Department of obstetrics and gynecology at DHQ Teaching Hospital Rawalpindi. Period: 1st July 2018 to 31st June 2018. Material and Methods: All pregnant women with previous one LSCS and at the gestation of more than 34 week are included after taking consent. Results: 258 patients were included. 132(51.2%) had elective LSCS, 106(41%) had emergency LSCS. 77(29.8%) patients actually took trial of scar, 20(25.9%) patients delivered vaginally. 179 (69.8%) patients had no maternal morbidity. 3(1.2%) patients had peripartum hysterectomy secondary to PPH due to placenta previa. The most common indication for emergency LSCS was fetal distress. The second commonest indication was failure to progress in first stage of labour. 248 (96.1%) of our neonates had good APGAR score(>7 at one minute).We had very low rate for NICU admission, only 10(3.9%) neonates were admitted to NICU. 4 neonates were premature, 5 neonates were admitted due to low birth weight and one with fetal hypoxia. Conclusion: Rate of repeat LSCS is increasing on maternal demand and fetal distress, by careful selection of the patients for VBAC, proper counseling and advanced facilities for monitoring of fetus, repeat LSCS rate can be decreased with associated decrease in maternal and perinatal morbidity and mortality. Comfortable environment and tender loving care during first delivery can decrease the number of patients with refused trial of labour.

BACKGROUND: Perinatal outcome is related to the onset and duration of glucose intolerance. Theobjective of the study is to determine the effect of HbAlc on mode of delivery in Obs/Gynea departmentof Saidu Teaching Hospital, Swat.MATERIAL AND METHODS: This observational & descriptive study was carried out in theDepartment of Obstetrics and Gynecology at Saidu Teaching Hospital, Swat, from 1st March 2015 to29th Feb 2016. Total 313 pregnant women were included in the study, who had Gestational Diabetes orEstablished Diabetes.Detail history was taken regarding maternal age in years, gestational age in weeks.Abdominal examination was done for lie and presenting part of the fetus, and vaginal examination wereperformed. These patients were followed till the end of labour and their mode of delivery i-e; normalvaginal delivery, instrumental delivery or cesarean section was recorded. Maternal HbAlc level wasdone at the time of delivery and was categorized as Mild (< 6.5), Moderate (6.5-9) and severe (>9).Maternal HbAlc was measured in hospital laboratory. The numerical variables of mean HbAlc,maternal age in years and gestational age in weeks were analyzed by mean ± SD (range). Categoricalvariables like; grades of severity of HbAlc levels and frequency of modes of delivery were analyzed byfrequency (number) and relative frequency (percentages). SPSS 20 (SPSS Inc. Chicago, Illnios, USA)was used to analyze the data.RESULTS:The total number of patients was 313. Mean age of the study population was 27.85 ± 6.37(43 - 15) (95% Cl 28.39 - 27.30). The mean age of gestational amenorrhea, at which most of thepatients presented was 38.31 ± 3.02, ranging from 41 to 29, (95%CI 38.57 - 38.5). The meanglycosylated Hemoglobin (HbAlc) was 6.9 ± 1.69 (95% Cl 6.17 - 5.88). Majority of the patients hadpoorly controlled diabetes, i-e: 64%. In different levels of HbAlc levels, normal vaginal delivery wasthe pre dominant mode of delivery.CONCLUSION:^ patients with uncontrolled diabetes the rate of complications increased and so doesthe rate of macrosomia and fetal distress, leading to higher rate of cesarean section and instrumentaldelivery, so by strict control of the blood sugar levels in a diabetic patient one can reduce the risk ofoperative deliveries and complications.KEY WORDS:Hbalc levels, Mode of delivery, cesarean section

… Zygomatic fractures are the most common facial fractures or second in frequencyafter the nasal fractures. The high incidence of zygomatic fractures probably relates to itsprominent position in the facial skeleton hence it is frequently exposed to fractures. This casereport presents an isolated bilateral zygomatic arch fracture that was been reduced by Gille’stemporal approach and stabilized using foley’s balloon catheter. This study highlights theimportance of early diagnosis and timely treatment to reduce the morbities

Foetal Neuro-Protection-Role of Magnesium Sulphate

Organocatalyzed asymmetric Friedel–Craft reactions have enabled the rapid construction of chiral molecules with highly enantioselectivity enriching the toolbox of chemists for producing complex substances. Here, we report N-heterocyclic carbene-catalyzed asymmetric indole Friedel–Crafts alkylation-annulation with α,β-unsaturated acyl azolium as the key intermediate, affording a large variety of indole-fused polycyclic alkaloids with excellent diastereo- and enantioselectivities. The reaction mechanism is also investigated, and the reaction products can be easily converted to highly functionalized indole frameworks with different core structures. Indole-fused polycyclic alkaloids are present in numerous bioactive natural products. Here an enantioselective N-heterocyclic carbene-catalysed Friedel–Crafts alkylation/annulation cascade using acyl azolium salts as the electrophile provides access to these products with high stereoselectivity.

Increasing effort has been made towards the asymmetric total synthesis of rotenoid natural products owing to their impressive biological and pharmaceutical activities. Here we report the modular asymmetric total synthesis of rotenoid natural products. The concise construction of the cis-fused tetrahydrochromeno[3,4-b]chromene core structure of rotenoids through N-heterocyclic carbene-catalyzed dynamic kinetic resolution is achieved, and a series of annulation products containing rotenoid key structures are rapidly assembled using this method. More importantly, the protocol enables the modular synthesis of a variety of rotenoid natural products in a highly convergent fashion, and the concise asymmetric total synthesis of tephrosin, the first asymmetric total synthesis of 12a-hydroxymunduserone, milletosin, and 12a-hydroxyrotenone, and the formal synthesis of deguelin are accomplished. Rotenoid natural products have attracted interest as synthetic targets. Here N-heterocyclic carbene-catalysed dynamic kinetic resolution is used to rapidly and enantioselectively assemble the rotenoid core, enabling the modular asymmetric total synthesis of several rotenoid natural products

Objectives: To compare Un-enhanced Helical Computed Tomography (UHCT),Ultrasonography (US) + Plain X-Ray and Intravenous Urography (IVU) in the evaluation ofpatients with suspected renal colic. Subjects: In 70 patients with renal colic US, plain X-ray,IVU and UHCT were performed to demonstrate urinary stones and other relevant pathologies.Patients were then followed-up to stone passage or removal, and the course of clinicalsymptoms were noted. Results: 57 patients had ureteral stones based on stone passageor removal. 13 patients did not have ureteral stones based on failure to recover a stone,disappearance of symptoms, and diagnosis unrelated to stone disease. Un-enhanced helicalcomputed tomography was found to be the most useful method in the demonstration of ureteralstones with a sensitivity of 97%. Reformatted images clearly depicted the intraureteral locationof stones in most cases. Spiral UHCT showed renal calculi in 15 patients, USG + KUB in 12 andIVU in 9 patients. Conclusions: Non-contrast axial and reformatted spiral CT (UHCT) imageswere found superior to USG + KUB and IVU in the depiction of ureteral and renal calculi.Reformatted images offer a good alternative to IVU in problematic cases.

The highly stereoselective intermolecular all-carbon [4+2] annulation between in situ generated acyclic dienolates and α,β-unsaturated acyl azoliums is disclosed. The identification of 2-acyloxy-3-butenones as suitable diene precursors is the key to the success of this transformation. The corresponding highly functionalized cyclohexene products, which are inaccessible from Diels–Alder reactions, were delivered with high levels of diastereo- and enantioselectivities. A series of further transformations based on the product showed the potential of this reaction.

Controlling the population growth is one of the most feasible solutions to reduce burden on the country and it can be achieved by effective use of contraception. This study was designed to analyze the trends of utilization of different family planning methods in relation with socio-demographic factors at divisional headquarter hospital in a year time. A retrospective study was performed by analyzing one year records from family planning clinic at divisional headquarter hospital. At family planning centers, a total of 920 individuals attended the Reproductive Health Services from April 2015 to March 2016. Among them, 92% individual utilized temporary methods and only 8% utilized permanent methods. Regarding temporary solutions, a total of 299 (33%) selected intrauterine device, 233 (25%) had used injectable, 191 (21%) adapted oral contraception pills and 121 (13%) selected Barrier methods (condoms). Among permanent solutions, atotal of 76 (8%) had bilateral tubal ligation and no vasectomy. Investigations highlighted that males were not convinced to adapt male sterilization owing to social pressure of family. Findings of this study showed that the majority of the individuals are comfortable with the use of intrauterine contraception devices; howeverneed of the hour is to introduce awareness compaigns to educate general public for better use of contraception especially male partner as it is less invasive compared to female partner.

1,2-Dihydronaphthalenes are important molecules in both medicinal and synthetic chemistry, but methods for the catalytic asymmetric construction of this class of molecules are limited. The diastereo- and enantioselective N-heterocyclic carbene-catalyzed cascade annulation reactions using benzodiketones and enals under oxidative conditions, which afford a variety of 1,2-dihydronaphthalenes with two adjacent stereocenters in up to 99% yield, with >20:1 dr, and up to 99% ee, are reported. Furthermore, the product can be easily transformed to a series of useful compounds such as alcohol, amide, and epoxide.

Objective: To observe the effect of abnormal Cardiotocography to delivery interval on perinatal outcome in terms of Apgar score. Study design: Descriptive case series study. Place and duration of study: Baqai Medical University department of obstetrics and gynecology Fatima Hospital Karachi from Jan 2011 to July 2011. Material and method: One hundred patients were registered who had pathological Cardiotocography. Bishop’s score was noted and decision to deliver the patient was made according to the abnormality, and bishop’s score. If bishop’s score was good and vaginal delivery was imminent, then her second stage was shortened by operative vaginal delivery. Fetal distress was managed by left lateral position, O2 inhalation and hydration. If delivery was not imminent then decision of urgent LSCS was made, meanwhile fetal distress was managed. Decision – delivery interval was recorded, and fetal outcome was noted in terms of Apgar score and resuscitation needed. Results: During this period one hundred pregnant women at term had pathological CTG for which they were delivered urgently. Among them 12% of parturients were delivered within 30 min ,68% delivered within 30-60 min , 12% delivered in 60-90 min and only 8% were delivered in 90-120 min. Seventy four (74%) of parturients were delivered by emergency lower segment caesarean section and 26% of parturients were delivered by instrumental vaginal delivery. Fetal outcome in terms of 1 min Apgar score ,38% of neonates had Apgar score of 7 and 16% had Apgar score of

Objective: To audit indications and outcome of hysterectomies in Fatima HospitalBaqai Medical University Karachi so as to improve the quality of care provided to patients. StudyDesign: Descriptive observational study. Place and Duration of Study: Department ofObstetrics and Gynaecology, Fatima hospital, Baqai Medical University Karachi from November2009 to November 2011. Patients and Methods: All patients undergoing hysterectomy forgynaecological conditions from 2009 to 2011were included in the study. Results:Hysterectomies for gynaecological conditions accounted for184 cases during the study period.Mean age of patient was 49 (range 30-60 years). Mean parity was 6 (range 0-11). The mostcommon indication for hysterectomy was fibroid uterus56(30.4%) cases, dysfunctional uterinebleeding 38 (20.6%) cases, and uterovaginal prolapse 10 (5.4%) cases. Abdominal hysterectomyaccounted for 174(96.6%) and vaginal hysterectomy accounted for 10 (5.4%) cases. Twenty six(14%) patients were found to be suffering from hypertension,6(3.3%)patients were suffering fromdiabetes mellitus. Wound infection occurred in 11 (6%) cases. No mortality was associated withhysterectomy during the study period. The duration of hospital stay was less in vaginal route ascompared to abdominal. Conclusions: An audit should be carried out every year to improve thelevel of care of patients and also the expertise of surgeon should be checked. The study hasshown that hysterectomy is a safe procedure but the high morbidity associated with thisprocedure is bothersome. The other options like endometrial ablation, intrauterine hormonaldevice like mirenaetc should also be considered. More efforts should be made on vaginalhysterectomies as it is economical and morbidity is less with it.

Objective: To study frequency of Scarred Uterus in placenta praevia. Design: Descriptive observational study. Place andDuration Of Study: December 2008-December 2009 Holy family Hospital Rawalpindi. Patients and Methods: 50 patients with placentapraevia presented to Holy Family Hospital Gynae and Obs unit II during this period. All patients either admitted through emergency or Gynaeoutpatient department were included. Results: The mean age of patients with placenta Praevia was 29.04 year with (SD =5.11).The meangestational age was 34.6 weeks and (SD = 2.7). Fourteen (28%) patients were gravida 2 and 13(26%) were primigravida. Fifteen (30%) patientswere para 1 & 14 (28%) were para 0. Painless vaginal bleeding was the presenting complaint in 38(76%) patients, whereas 12(24%) patientswere diagnosed on routine ultrasonography. Nine (18%) cases underwent spontanouse vertex delivery and 41 (82%) cases were delivered bycaesarean section. Placenta Praevia type 1 in 7 (14%) cases. Placenta Praevia type 2 in 20 (40%) cases, type 3 in 14 (28%) cases, type 4 in 9(18%) cases . Previous history of scarred uterus was found in 16 (32%) cases .Post partum haemorrhage occurred in 13 (26%) cases.caesarean hysterectomy in 5 (10%) cases. Conclusions: A scarred uterus leads to increase frequency of Placenta Praevia, scarring of uteruscan be reduced by keeping the caesarean section rate within reasonable limits and instead of doing surgical evacuation of retained products ofconception, suction and evacuation by suction canula.

It is known that most cases of Ovarian Hyperstimulation Syndrome (OHSS) areassociated with the therapies for ovulation induction. However, OHSS may rarely be associatedwith a spontaneous ovulatory cycle, usually in the case of multiple gestations, hypothyroidism orpolycystic ovarian syndrome. We report a case of moderate OHSS in spontaneously conceivedtwin pregnancy in a 24 years old woman. The clinical picture showed amenorrhea,nausea,vomiting, abdominal pain and moderate ascites. After examinations, imaging and laboratoryinvestigations, the diagnosis was established. The patient was managed expectantly with nocomplications. Although spontaneous ovarian hyperstimulation is a rare entity, it is important thatthe physician recognizes this condition. Prompt diagnosis and successful management is likelyto avoid serious complications, which may develop rapidly.

A 12 years old girl was presented with bilateral swellings on angle and body of mandible. On general physical examination, there were polydactyly and papular lesions on arm. Histopathology of mandibular lesions revealed odontogenic keratocysts. Marsupialization of the cysts followed by enucleation was done. The patient was reviewed every six months and there was no recurrence at the end of two years.

Background: Microdeletions of the azoospermia factor locus of the long arm of Y chromosome are an etiological factor of severe oligozoospermia or azoospermia. Objective: The aim of this study was to investigate the prevalence of Y-chromosome microdeletions in AZF region and their role in infertility in Pakistani population. Materials and Methods: The type of deletions in AZF locus were detected in infertile men (n=113) and the association of Y chromosome microdeletions with male infertility was assessed by including men (50) with normal karyotype and having children. Y chromosome microdeletions were detected by multiplex PCR using 10 sequence tagged sites namely sY81, sY130, sY141, sY142, sY155, sY157, sY160, sY182, sY231, and sY202 that covered all three regions of AZF. Results: Individuals with severe oligozoospermia showed 2.86% deletion frequency in AZFc region as compared to azoospermic males (5.5%). Conclusion: The results of our study showed that deletions in Y chromosome are not playing major part in male infertility. Moreover, multiplex-PCR strategy might preferably be employed for the detection of Y chromosome microdeletions allied to male infertility.

BACKGROUND: Premenstrual syndrome refers distressing somatic and psychological symptoms, inthe absence of organic or underlying psychiatric diseases, which regularly occurs in the luteal phase ofmenstrual (ovarian) cycle and which disappears or significantly regresses by the end of menstruation.OBJECTIVE: To find out the frequency of psychological, social and physical symptoms in relation tobody mass index, in patients with premenstrual syndrome.MATERIAL & METHODS: It was a cross sectional, prospective, observational study conducted fromMay 2010 to April 2011, in Out Patient Department of Obstetrics and Gynecology, Post GraduateMedical Institute, Lady Reading Hospital, Peshawar. By purposive non-probability sampling technique,150 subjects were selected among attendants of regular patients, after fulfilling inclusion criterion ofreproductive age women, in age group of 15-40years. Body Mass Index (kg/m2) was recorded andcategorized, as low (30).Premenstrual symptoms were recorded through Quantification of severity of psychological, social andphysical symptoms, for two consecutive symptomatic cycles. SPSS 16.0 was used to analyze the data.Mean±SD, frequency and percentages were used for numerical and categorical variables, respectively.Chi-Square test was used to compare the proportion of premenstrual syndrome at different BMIs. Pvalue < 0.05 was taken as significant between pairs of variables.RESULTS: A total of 150 female patients were included in the study. Mean age was 26±6.2 years (15-45). About 61% (n=91) were unmarried, 38% (n=57) were married, and one case each of widow anddivorced. Mean body mass index was 24.5±3.6 kg/m . About 10% (n=15) subjects had low BMI, 52%(n=79) had normal BMI, while 30% (n=45) were overweight and 7% (n= l 1) were obese. Psychologicalsymptoms were present in 45% (n=68) of patients, followed by 42% (n=64) and 59% (n=89), of patientshaving social and physical symptoms, respectively. There was a general trend of more psychologicalsymptoms in overweight and obese group, with no statistically significant difference. Those patientswith low to normal BMI has less chances of having social symptoms. Physical symptoms were morefrequently observed in obese group, with no statistically significant difference.CONCLUSION: There was no statistically significant difference in the frequency of symptomatologyof premenstrual syndrome among the studied categories of Body Mass Index.KEY WORDS: Premenstural syndrome, Body Mass Index