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This cross-sectional study aimed to explore the relationship between perceived social support and psychological well-being in patients with epilepsy. The study was conducted, from January to December 2019, after ethical approval from the research ethical committee of FMU (Faisalabad Medical University, Faisalabad). A sample of 90 patients, attending free epilepsy camp in Mujahid Hospital Madina Town Faisalabad and psychiatry OPD of government General hospital G.M. Abad Faisalabad, was collected by using the Multidimensional Scale of Perceived Social Support (Urdu version). Moreover, Psychological well-being was assessed by Ryff Scale. Statistical analysis was done through data Correlation and T-test SPSS version 21. A positive correlation between psychological well-being and perceived social support in epileptic patients was established (p

Objective: To find out common organism causing nosocomial sepsis in neonatal intensive care unit (NICU) and their sensitivity to frequently used antibiotics. Study Design: Cross Sectional study. Setting: NICU Pediatric Department of Nishtar Hospital Multan. Period: May 2018 to April 2019. Material & Methods: A total of 111 neonates of either gender admitted with blood culture proven sepsis were included in the study. For culture, blood samples were taken, ensuring standard antiseptic measures, either from a peripheral vein or an artery. Any growth of bacteria after incubation of 24 to 48 hours with only BACTEC and VITEK-2 technique were included, and their drug sensitivity recorded. Demographic data along with causative microorganisms, sensitivity and resistant patterns to frequently used drugs were recorded. Results: Out of 111 patients, 61 (55%) were male. Early onset sepsis (EOS) was present in 37 (33%) patients and 74 (66%) had late onset sepsis (LOS). Serratia species 33 (29.7%) and Staphylococcus epidermidis 31 (27.9%) were the commonest causative bacteria responsible for neonatal sepsis. Commonly involved microorganisms were highly resistant to frequently used antibiotics like ampicillin /amoxicillin, cefixime, ceftazidime. Conclusion: Nosocomial sepsis is a major health issue in NICU while and resistance of pathogens to commonly used antibiotics is alarming.

Objective Preeclampsia is a hypertensive disorder of pregnancy marked by an excessive inflammatory response. The anti-inflammatory effect of pyridostigmine (PYR) was previously reported; however, its role in hypertensive pregnancies remains unclear. We hypothesized that PYR could attenuate increased blood pressure and other pathological features in preeclampsia models. Methods The expression of tumour necrosis factor (TNF)-α was evaluated in normal and preeclampsia pregnant women. PYR (20 mg/kg) was administered daily to reduced uterine perfusion pressure (RUPP) and TNF-α (150 ng/day) infused rats from gestation day 14 to GD19. In a cell culture experiment, the effect of acetylcholine (ACh) on TNF-α-stimulated primary human umbilical endothelial cells (HUVEC) was assessed. Results Preeclampsia women had higher placental TNF-α expression than normal pregnant women. Mean arterial pressure (MAP) in the RUPP group was higher than in the Sham group. PYR inhibited serum and placental acetylcholinesterase activity in rats, and reduced MAP, placental oxidative stress, apoptosis and inflammation in the RUPP group but not in the Sham group. In addition, PYR significantly attenuated the TNF-α-induced increase in MAP, placental oxidative stress and apoptosis. Moreover, TNF-α decreased cell viability and increased the number of TUNEL-positive nuclei of HUVEC, which could largely be abolished by ACh treatment. Conclusion Collectively, PYR ameliorated hypertension and other preeclampsia-like symptoms in rat models of preeclampsia not only by inhibiting the synthesis of TNF-α but also by acting against TNF-α-induced detrimental effects directly, which is worthy of further investigation and may be used as a potential agent for preeclampsia management.

Objectives: To analyze the clinical profile, etiologies and outcome of seriously ill patients admitted in Pediatric Intensive Care Unit (PICU). Study Design: Cross Sectional study. Setting: PICU of Nishtar Medical Hospital, Multan, Pakistan. Period: January 2018 to December 2018. Material & Methods: During the study period, a total of 150 children, aged 1 to 12 years, with better prognosis and post-surgical cases requiring intensive care were registered. Age, gender, cause for hospitalization (clinical, surgical or emergency), length of PICU stay, diagnosis and outcome were recorded for all patients. Results: During the year of the study, 83 (55.3%) children were noted to be male. The mean age was 56.9+12.5 months. Mechanical ventilation was done in 62 (41.3%) patients. Major indications for admission to the PICU were respiratory disorders (21.5%), followed by sepsis (11.4%) and meningitis (8.1%). Majority, 80 (53.3%) patients improved and were shifted to ward and later discharged while 27 (18.0%) expired. Conclusion: Most of the children admitted in the PICU were male, aged below 5 years. Most common indication for admission in the PICU were respiratory disorders followed by sepsis and meningitis.

Three new constituents: 1,5

Increased number of newly-born neurons produced at latent stage after status epilepticus (SE) contribute to aberrant rewiring of hippocampus and are hypothesized to promote epileptogenesis. Although physical training (PT) was reported to cause further increase in neurogenesis after SE, how PT affect their integration pattern is still elusive, whether they integrate into normal circuits or increase aberrant integrations is yet to be determined. To understand this basic mechanism by which PT effects SE and to elaborate the possible role of neuronal integrations in prognosis of SE, we evaluated the effect of 4 weeks of treadmill PT in adult male mice after pilocarpine-induced SE on behavioral and aberrant integrations' parameters. Changes in BDNF gene methylation and its protein level in hippocampus was also measured at latent stage (2-weeks) to explore underlying pathways involved in increasing neurogenesis. Our results demonstrated that although PT increased proliferation and maturation of neurons in dentate gyrus, they showed reduced aberrant integrations into hippocampal circuitry assessed through a decrease in the number of ectopic granular cells, hilar basal dendrites and mossy fiber sprouting as compared to non-exercised SE mice. While SE decreased the percentage methylation of specific CpGs of BDNF gene's promoter, PT did not yield any significant difference in methylation of BDNF CpGs as compared to non-exercised SE mice. In conclusion, PT increases hippocampal neurogenesis through increasing BDNF levels by some pathways other than demethylating BDNF CpGs and causes post SE newly-born neurons to integrate into normal circuits thus resulting in decreased spontaneous recurrent seizures and enhanced spatial memory.

A series of (perfluorophenyl)hydrazone derivatives 1–27 were synthesized by the condensation reaction of (perfluorophenyl)hydrazine with a variety of benzaldehydes. Compounds were structurally characterized by various spectroscopic techniques. All compounds were screened for their urease inhibitory activity which revealed that most of the analogs exhibited significant urease inhibitory activity in the range of IC50 = 14.09 ± 0.23–78.69 ± 1.56 µM as compare to the standard thiourea (IC50 = 21.10 ± 0.31 µM). Amongst active compounds, derivatives 2 (IC50 = 14.23 ± 0.21 µM), 5 (IC50 = 16.78 ± 0.33 µM), 7 (IC50 = 15.59 ± 0.60 µM), 9 (IC50 = 20.18 ± 0.78 µM), 10 (IC50 = 16.13 ± 0.93 µM), and 11 (IC50 = 14.09 ± 0.23 µM) showed potent inhibitory activity better than the standard thiourea. A limited structure-activity relationship (SAR) was established by rationalized the effect of different groups on the inhibitory potential. Molecular docking study was performed to understand the binding modes of active analogs into the active site of urease enzyme.

Biogas is a valuable renewable energy source and a secondary energy carrier provided by anaerobic digestion of biodegradable organic materials. It can be used as a fuel in a number of ways. Methane (CH4) and carbon dioxide (CO2) are the main components of biogas, with other pollutants such as ammonia (NH3), water vapour (H2O), hydrogen sulphide (H2S), methyl siloxanes, nitrogen (N2), oxygen (O2), halogenated volatile organic compounds (VOCs), carbon monoxide (CO), and hydrocarbons present in varying amounts. H2S is a toxic and odorous compound formed by the anaerobic digestion of bio-solids and other organic materials, and it is also one of the pollutants in biogas. Hydrogen sulphide must be eliminated because it is toxic to human health, poisonous to process catalysts, and corrosive to machinery. Desulfurization, or the removal of hydrogen sulphide, is an integral part of biogas utilization efficiency. The conventional desulfurization technologies for biogas that are currently available were reviewed in this paper., https://www.ijtsrd.com/other-scientific-research-area/enviormental-science/39996/a-retrospection-of-hydrogen-sulphide-removal-technologies-in-biogas-purification/srinivas-kasulla

Ethnopharmacological relevance Different orchids are important in traditional medicine, and species belonging to the genus Bletilla are important. Bletilla species have been used for thousands of years in Traditional Chinese Medicine (TCM) for the treatment of several health disorders, such as gastrointestinal disorders, peptic ulcer, lung disorders, and traumatic bleeding etc. Aim of this review This review aims to provide a systematic overview and objective analysis of Bletilla species and to find the probable relationship between their traditional use, chemical constituents, and pharmacological activities, while assessing their therapeutic potential in treatment of different human diseases. Materials and methods Relevant literatures on Bletilla species have been collected using the keywords “Bletilla”, “phytochemistry”, and “pharmacology” in scientific databases, such as “PubMed”, “Scifinder”, “The Plant List”, “Elsevier”, “China Knowledge Resource Integrated databases (CNKI)”, “Google Scholar”, “Baidu Scholar”, and other literature sources, etc. Results This review indicates the isolation and identification of over 261 compounds from this genus, till December 2020. These chemical isolates belong to the stilbenes (bibenzyls and phenanthrenes), flavonoids, triterpenoids, steroids, simple phenolics, and glucosyloxybenzyl 2-isobutylmalates classes of compounds. These compounds have been reported to be characteristically distributed in Bletilla striata (Thunb.) Rchb. f. (BS), Bletilla ochracea Schltr. (BO), and Bletilla formosana (Hayata) Schltr. (BF). The crude extracts and pure compounds derived from the three Bletilla species have reportedly exhibited a wide spectrum of in vitro and in vivo pharmacological effects, such as hemostatic, anti-inflammatory, anti-tumor, and anti-microbial activities. As a Traditional Chinese Medicine (TCM), Bletilla species or preparations containing Bletilla species have been used for the treatment of epistaxis, gastrointestinal bleeding, cough and hemoptysis, gastric and duodenal ulcer, and traumatic injuries. Thus, Bletilla species have proven potential both in traditional uses and scientific studies. Conclusions Pharmacological studies have validated the use of Bletilla species in the traditional medicine, especially hemorrhagic diseases. Polysaccharides and stilbenes are the major bioactive chemical constituents of Bletilla genus according to the literatures. However, the mechanism of action of these molecules is yet to be studied. In addition, a detailed comparative analysis of the phytochemistry and biological activities of the three Bletilla species (BS, BO and BF) is highly recommended for understanding their ethnopharmacological uses and applications in clinics. Clinical toxicity tests on BS have been found to be negative, but it can't be used with Aconitum carmichaeli in traditional uses. Furthermore, not many reports are present in the literature regarding the conservation of Bletilla species.

Objective: To test and evaluate the accuracy and safety of an automatic biopsy gun for collecting kidney tissue samples in children. Design: prospective study in a hospital. Place and duration: Pediatric Medicine Unit, Bahawal Victoria Hospital, Bahawalpur for one-year duration from June 2019 to June 2020. Methodology: Fifty children diagnosed with nephrotic syndrome (steroid-dependent, steroid-resistant and frequently relapsing) underwent percutaneous ultrasound-guided kidney biopsy with an automatic biopsy gun (needle size 16G or 18G) under local anesthesia in 1-3 trials in each patient, followed by observation after biopsy for 24 hours. Results: With a majority of 38 men (76%), the age ranged from 2 to 14 years with a mean ± SD (7.20 ± 3.41) years. A suitable kidney tissue sample was obtained in 48 (96%) cases, while 2 (4%) tissue samples were inadequate. The core length of the tissue sample was mean ± SD (1.04 ± 0.37) and the number of glomeruli per tissue sample remained mean ± SD (13.07 ± 3.62). Five patients developed a small perirenal hematoma Conclusion: Percutaneous ultrasound-guided kidney biopsy in children is a fairly accurate and safe procedure. Observation for 24 hours allows you to identify any complications. Keywords: Kidney biopsy in children, automatic biopsy gun, safety, complications

Aim: The purpose of this study was to evaluate the efficacy and safety of this sedation protocol and to emphasize that pediatric patients need an MRI kit with general anesthesia equipment. Place and Duration: In the Pediatrics and radiology department of Jinnah Hospital Lahore for one-year duration from June 2019 to June 2020. Patients and Methods: Nine hundred and twenty-five patients underwent Magnetic Resonance Imaging. Oral sedation was to be administered to children up to 5 years of age. Oral sedation consisted of oral administration of 90 mg / kg of lymphatic hydrate. All MRI orders for unsuccessful oral sedation and those referred for general anesthesia were reviewed by an anesthetist consultant, who then assigned patients to surgery under general anesthesia or intravenous sedation. Intravenous sedation consisted of either propofol 0.5 mg / kg bolus followed by infusion or midazolam 0.2-0.5 mg / kg. General anesthesia was performed with sevoflurane, and intravenous propofol was introduced. Results: Five hundred and fifteen patients (57.15%) scans were done without sedation. On the other hand, 46 scans were performed during sessions supervised by a consultant anesthesiologist. Oral sedation was unsuccessful in 25 of 364 patients (6.9%). Eighty-seven percent of children 5 years of age and under required sedation compared with 4.5% of children aged 10 and over. Conclusion: This study concluded the structured sedation protocol for MRI scanning as it is both effective and safe. Keywords: measurement techniques, magnetic resonance imaging, anesthesia, pediatric sedation.

Three new constituents: 1,5R-dihydroxy-3,8S-dimethoxy-5,6,7,8-tetrahydroxanthone (1), (3S,4R,16S,17R)-3,16,23-trihydroxyoleana-11,13(18)-dien-28-aldehyde-3-O-β-D-glucopyranoside (2), and new natural product (S)-gentiandiol (3), along with 41 known compounds were isolated from Tujia ethnomedicine Shuihuanglian, namely, the whole plant of Swertia punicea. Structures of all these compounds were established through extensive spectroscopic techniques, namely 1D, 2D-NMR spectroscopy, HRESIMS analysis, and the absolute configuration of the new compounds was discerned by circular dichroism (CD) spectroscopy. Antioxidative effects of these compounds were evaluated by using the DPPH radical scavenging method, compounds 7, 9 and 14 showed antioxidant activities with IC50 values of 68.9, 50.8 and 48.2 μM, respectively.

Aim: To determine the diagnostic performance of specific ultrasound features in discriminating endometriomas from other adnexal masses. Study design: A retrospective study was conducted in the Department of Obstetrics & Gynecology, Sir Ganga Ram Hospital, Lahore for one-year duration from August 2019 to August 2020. Methods: Patients> 25 years of age were included in the study, infertile women with endometriomas who underwent laparotomy or laparoscopy, while patients with pelvic inflammation and ectopic pregnancy were excluded. All patients were prospectively assessed by a transvaginal study. The ultrasound criteria for the diagnosis of endometrioma are: round shaped, cystic structure in adnexa, diffuse low-level internal echoes, multilocularity, hyperechoic wall foci and wall thickness were noted. Results: Histopathological findings of adnexal mass were endometrioma (n=40), dermoid cyst (n=3), hemorrhagic cyst (n=6), malignancy (n=2) and benign cyst (n=2). Among benign cyst cases of ovarian torsion n=1, broad ligament hematoma n=1, para-tubal cyst n=1, hydrosalpinx n=1 and single functional cyst n=7. The results were analyzed statistically it was found that sensitivity of TVS for diagnosing endometrioma was 86% specificity 90%; the positive predictive value 91% and negative predictive value 98%. Conclusion: An adnexal mass with diffuse low-level internal echoes and absence of particular neoplastic feature is highly suggestive of endometrioma if multilocularity/hyper echoic wall foci present. Keywords: TVS, endometrioma, adnexal mass.

Objective: To evaluate the percentage of various early postoperative complications. Material and method: This is descriptive type of study with a purposive, non-probability sampling technique. We included all patients who underwent open splenectomy due to injury or other medical conditions. Place and Duration: In the Surgical Unit-II of Sir Ganga Ram Hospital, Lahore for one-year duration from March 2019 to March 2020. Results: A total of 30 patients were enrolled in the study. we examined 30 patients. Of these 30 patients, 18 were admitted to the emergency department after an injury, and the remaining 12 patients were elective for medical conditions. Among these patients, the greatest number of patients undergoing splenectomy was in the age group of 21-30 years, and then in the group of 31-40 years. There were 20 men (67%) and 10 women (33%). Key words: splenectomy, complications, postoperative

Background: Coronary artery disease (CAD) is the most common form of heart disease with multifactorial etiology and atherosclerosis. Recently it is considered that ALT associated with endothelial dysfunction and carotid atherosclerosis. The predictive value of ALT for coronary events seems independent of traditional risk factors and the features of the metabolic syndrome. Aim: To find out association of elevated ALT with coronary artery disease Methods: This cross sectional study was carried out on 100 patients presented with clinically suspected CAD. Serum ALT was measured. Patients underwent angiography and images of coronary arteries were obtained and presence of CAD was noted. Relative risk was calculated to measure association between raised ALT and CAD. Results: The mean age range of patients was 49.16±10.15 years. There were 78 male and 22 female patients. The male to female ratio was 3.54:1. The mean ALT was 41.58±16.18U/L. Coronary angiography findings showed that 29% patients had normal coronaries, 4% had mild CAD, 49% had moderate CAD and 18% had severe CAD. There were 1.8 times high risk of CAD in patients with raised ALT. Conclusion: It is concluded that although difference in CAD and raised ALT is insignificant but the risk of CAD is 1.8 times high in patients with raised ALT. Keywords: Coronary Artery Diseases, Serum Alanine Transaminase.

Introduction and purpose: With high level of demands in academics and psychosocial pressure, medical students during their course of training tend to become depressed, leading to problems later in professional life and compromising patient care. This study was held to determine the prevalence of depression in male and female students and related factors amongst medical undergraduates. Study Design: A Cross-sectional study. Place and Duration: In the Department of Psychiatry in Mayo Hospital Lahore for Six months duration from September 2019 to February 2020. Material and method: out of 330 students from 3rd year to 5th year, 285 students were selected using stratified random sampling method and were assessed by investigators using Beck Depression Inventory. Associations between class of studying and depression, social factors like family problems, substance use, family history of depression and residing away from family were scrutinized by univariate analysis. Results: 78% was the overall depression prevalence among medical students. Most people had mild to moderate depression observed among 80%. This study revealed that among women depression was noted in 74.81% (101) and among males 48.6%. 30(10%) students were found normal (0-9), mild depression was noted in 86 (28.7%) (10-18), moderate in 86 (28.7%) (19-29), severe in 21 (7.0%) (30-40) according to cut-off scores) and very severe depression was noted in 19 (6.3%) with > 40 cut-off score. Among 3rd and 4th year medical students; the depression prevalence was relatively low and the variance between the year of study and grade of depression was significant (χ2 = 122, p Conclusion: Depression is very common amongst medical students. Female students reported more cases of depression than their male counterparts. Our conclusions point to the significance of broad screening and psychiatric counseling of this susceptible population. Keywords: Medical students, Depression, Beck Depression Inventory.

Objective: The aim of this study was to compare postoperative outcome with diclofenac rectal suppositories versus intramuscular diclofenac in patients undergoing laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial. Settings: General surgery Department, Khawaja Muhammad Safdar Medical College Sialkot & Allied Hospital Faisalabad Pakistan. Duration: 2 year from May 2017 to April 2019. Methodology: After informed consent, 200 patients scheduled for laparoscopic cholecystectomy were randomized into two groups. Group-A got diclofenac sodium rectal suppository at time of induction of anesthesia and Group-B were given IM Diclofenac for postoperative pain relief. Assessment of pain was done using Visual Analogue Scale (VAS) by an observer which will be graded ruler ranging from 0-10 showing the minimal and maximum pain score respectively. The score was assessed post operatively at recovery time 6, 12 and 24 hours. Activity score was checked at 8, 12 & 24 hours postoperatively. Data was collected for pain & mobility through specially designed Performa. Results: Demographic characteristics, intraoperative and postoperative hemodynamics of the patients were similar between groups. Postoperative VAS were lower at all-time points in Group -A. Mean VAS was 6.41(SD 0.89), 4.03 (SD 0.92), 2.16 (SD 0.84) in group A as compared to 7.78 (SD 0.83), 5.86 (SD 0.92), 4.4 (SD 1.33) in group B after 6hr, 12 hr. & 24 hr. respectively. Mean activity score was 3.28 (SD 0.61), 1.8(SD 0.79), 1.1(SD 0.36) in group A and 4.35 (SD 0.63), 3.31 (SD 0.83), 2.85 (SD) in group B after 8 hr., 12 hr. and 24 hr. respectively. Conclusion: In patients undergoing laparoscopic cholecystectomy, application of diclofenac sodium rectal suppository at time of induction of anesthesia is more effective than IM diclofenac sodium and can be preferred in postoperative pain treatment.

Muriolide (

Ranunculus muricatus L., an important member of family Ranunculaceae upon submission to phytochemical studies, led to the isolation of a novel natural hydrazine derivative, muricazine (1). Chemical structure of the compound was established with the aid of advanced spectroscopic techniques. It was evaluated for in vitro antioxidant, lipoxygenase, and urease (jack-bean) inhibitory activities. Results suggested that compound 1 could scavenge the DPPH free radical (42.1 ± 0.12 μM) to a great extent as compared to the standard (40.6 ± 0.91 μM). However, it showed moderate inhibitory potential against lipoxygenase (65.2 ± 0.45 μM) and urease (54.8 ± 0.23 μM) enzymes.

Muriolide (1), a new aromatic lactone, has been isolated from the ethyl acetate fraction of Ranunculus muricatus. The compound was structurally characterized with the help of UV, IR, mass, 1D- and 2D-NMR data. It was tested in vitro for antioxidant and lipoxygenase inhibitory potential. Compound 1 showed good DPPH radical scavenging activity (IC50=56.9 μM), however it was moderately active against lipoxygenase enzyme (IC50=68.3 μM).

Lonicerae flos, a widely used traditional Chinese medicine (TCM), has been used for several thousand years in China. As a famous traditional Chinese herbal medicine, it was used as heat-clearing drug and alexipharmic agent and was widely cultivated in Hunan province. L. flos mainly contains biologically active compounds such as caffeic acid derivatives, essential oil, flavonoids, iridoid glycosides and terpenoids. A range of biological activities has been reported from plant extracts including anti-inflammatory, antitumor, antioxidant, antiallergy, immunomodulating and antibacterial activity. In this study, the author investigated ancient books of TCM and nowadays reports, summarized the chemical constituents, biological activity of L. flos to provide a comprehensive systematic review. Keywords: Caprifoliaceae, Lonicerae flos, Chemical constituents, Biological activity, Lonicera macranthoides, Lonicera cofusa

Iron plays a pivotal role in human physiology, while its deficiency may prove fatal in severe cases. Analytical methods for the quantitative determination of iron are thus very important. Herein, we report the estimation of iron in iron Polysaccharide complex (IPSC) using raw material and formulations, through a spectrophotometric analytical method. IPSC capsules were formulated and their stability was studied by developing a simple and validated analytical method. The process is based on the acid hydrolysis of IPSC and the development of chromogen by reacting ammonium thiocyanate with IPSC, maximum absorption at 474 nm was observed. Beerand#39;s Lambert law (linearity response) was found in the range of 10-20 μg/ml with excellent correlation coefficient of determination (R = 0.998). The quantification and detection limits were established to be 0.45 mcg/ml and 0.14 mcg/ml correspondingly. The recovery of IPSC analysis was 99.25 to 102.28 %. Percentage assay of IPSC capsules showed results around 102.34 %. The formulated IPSC capsule was stable under accelerated conditions for 6 months (% assay andgt; 91.69). The dissolution profile over 60 minutes showed a better dissolution (94%) compared with the internationally marketed IPSC capsule (92%).

As the world is moving towards autonomous technology and every aspect of human lives is influenced by technology so does the academics andacademic institutions, learning management systems work in academic institutes across the globe, this paper gives a comparison between differentlearning management systems and their comparative analysis, it will help any individual who wants to compare and choose the best learning managementsystem with respect to the requirements of their institute.

Objectives: To determine the frequency of renal dysfunction in patients withacute coronary syndrome at a tertiary care hospital. Study design: Descriptive Cross-sectionalstudy. Setting: Department of Cardiology, Nishtar Hospital Multan. Duration of study: Sixmonths from November 2016 to May 2017. Subjects and Methods: Consecutive 285 patientswho met inclusion criteria of our study were enrolled from department of Cardiology, NishtarHospital Multan. History was taken and relevant investigations were done. Computer basedformula for MDRD eGFR was used to calculate eGFR in our patients. All these findings wereentered in pre-designed, pre – tested study questionnaire. Data was entered and analyzed usingcomputer based software SPSS version 20. All the quantitative variables of the study (suchas age, serum creatinine level, GFR value) were calculated for mean and standard deviation.Frequencies and percentages were calculated for categorical variables like gender, residentialarea, socioeconomic status, level of education, H/O diabetes, H/O hypertension, H/O smokingand family history of IHD etc. Results: We studied 285 patients of acute coronary syndromeadmitted in Cardiology department of Nishtar Hospital Multan, 210 (73.7%) were male and 75(26.3%) female. One hundred eighty (63.2%) were from rural area and 105 (36.8%) were urban.One hundred thirty two (46.3%) were from low income group, 144 (50.5%) from middle incomeand 9 (3.2%) were from high income group. Two hundred four (71.6%) patients presented withchest pain and 72 (25.3%) presented with chest pain and shortness of breath. One hundredeight (37.9%) were hypertensive, 63 (32.6%) were diabetic, 135 (47.4%) were smokers andfamily history of IHD was present in 102 (35.8%) of the cases. eGFR was calculated by MDRDeGFR formula. eGFR was less than 30 ml/min/1.73 m2 in 30 (10.5%) of the cases, 31-60 ml/min/1.73 m2 in 66 (23.2%) cases and eGFR was more than 60 ml/min/1.73 m2 in 189 (66.3%) ofthe cases. Conclusion: The present study reveals that the substantial proportion of our studypatients have underlying renal dysfunction. So eGFR estimation in ACS patients should begiven due consideration. This will help in the management of these patients and may improveshort and long term disease outcome. Further follow up studies especially in terms of morbidityand mortality in this sub-group of patients are suggested.

Purpose To conduct a systematic review and meta-analysis of studies testing exercise in animal models of pilocarpine induced status epilepticus (SE) and to compare the efficacy of different training strategies used in those studies. Methods We searched 2 online databases (Pubmed and Web of Science) for studies analyzing the efficacy of different trainings in pilocarpine-induced SE models. Training was categorized into forced physical training (PT), voluntary PT and resistance PT. Two reviewers independently extracted data on study quality, behavioral seizures, and histological, chemical and cognitive outcomes. Data were pooled by means of a meta-analysis. Results Among 17 selected studies; 174 animals from 8 studies with 10 comparison groups showed that exercise intervention after induction of SE significantly decreased spontaneous recurrent seizures with [mean difference (MD) = − 1.80, 95% confidence interval (CI): − 3.22, − 0.37, p = 0.02] and 60 animals showed statistically significant decrease in latency in Morris water maze (standardized mean difference (SMD) = − 2.57, 95% CI: − 4.06, − 1.08, p = 0.0007). Although not statistically significant, still a remarkable increase in number of CA1 neurons and hippocampal BDNF level (MD = 2.27, [95% CI: − 1.20, 5.73], p = 0.19, SMD = 1.07, [95% CI: − 0.36, 2.51], p = 0.14 respectively) and a decrease in mossy fibers sprouting (SMD = − 1.03, [95% CI: − 3.06, 1.00], p = 0.32) were observed. PT interventions in 72 animals before induction of SE showed favorable increase in latency to develop SE (MD = 8.34, [95% CI: − 3.10, 19.78], p = 0.15) but no remarkable improvements in latency for the first motor sign and motor signs intensity. Conclusions PT after SE reduces the recurrent seizures and improves the morphological, biochemical and cognitive profiles of pilocarpine epileptic models. Resistance PT was identified as particularly effective in reducing behavioral seizures. The efficacy of training was also dependent upon duration.