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OBJECTIVE: To study the frequency and antifungal susceptibility of the Candida albicans and non-albican species in diabetic foot infections from samples collected in a tertiary care hospital of district Peshawar. METHODOLOGY: This cross-sectional study was conducted from March 2020 to February 2021 in Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar. Specimen for culture swabs or tissue from diabetic foot ulcers was taken using aseptic methods. If pus was absent in the wound, ulcer scraping was collected. One tissue sample was soaked in 10% KOH for microscopy, while the second sample was used for fungal culture and sensitivity using Sabouraud dextrose agar. RESULTS: Of the 600 samples, 200 patients had diabetic foot ulcers with positive fungal culture from Males 102(51%) and Females 98(49%). The age range was 40-78 years. The frequency of C. albicans, C. dubliniensis, C. famata, C. glabrata, C. parapsilosis, and C. lusitaniae was 23(11.5%), 27(13.5%), 19(9.5%), 19(9.5%), 88(44%) and 24(12%). C. albicans was the most common fungal species. Antifungal susceptibility testing was done, and resistance to drugs like Amphotericin, Caspofungin, Fluconazole, Flucytosine, Itraconazole, Micafungin, Voriconazole which was 6.5%, 16%, 25.5%, 5.5%, 3%, 22.5%, 21% respectively. Resistance to Fluconazole, Micafungin and Voriconazole was the highest among all commonly used antifungal drugs. CONCLUSION: Fungal infection in diabetic foot ulcers usually does not respond to antibiotics. Candia albicans and non-albicans spp are also associated with diabetic foot ulcer infection and inflammation, and these fungi have the highest resistance to commonly used antifungal agents.

Objective: Iron deficiency anemia (IDA) is the most prevalent hematological disorder in women of child-bearing age. IDA poses a threat to feto-maternal wellbeing. It is the leading cause of morbidity and mortality in pregnancy. IDA in young females can coexist with other nutritional deficiencies such as vitamin B12 (Vit B12). An undetected Vit B12 deficiency carries a greater likelihood of development of maternal neuropsychiatric disorders and neural tube defects in the fetus. Materials and methods: Venous blood samples of non-pregnant female population (N=133) from Fauji Foundation Hospital, Rawalpindi were collected and analyzed for complete blood count (CBC), Vit B12 and serum Ferritin. Population was further subdivided into two groups. Group A, included females with low serum Ferritin and low MCV, group B restricted to normal serum Ferritin and low MCV, whereas control group had females with normal serum Ferritin and MCV levels. Results: Demographic data suggested that only height was slightly lower in IDA patients other than reduced serum Ferritin levels. Group A also showed reduced levels of Vit B12 as compared to group B and control group. CBC analysis indicated marked reduction in all hematological parameters except platelet count in group A. Conclusion: Our findings suggest that IDA and Vit B12 deficiency may coexist in young females. Monitoring Vit B12 along with iron deficiency parameters is essential to treat anemia and prevent gynecological complications. Paucity of information on their coexistence in females of childbearing age require further investigation. Keywords: Vitamin B12, Iron deficiency anemia, Microcytosis, Serum Ferritin.

Introduction: Dengue is an epidemic in Pakistan. Proper monitoring of dengue cases is necessary for its early diagnosis and prevention, especially in developing countries with limited resources. Our study aims to use some hematological parameters as Early Diagnostic Indicators in Acute Dengue Infection which can help reduce mortality and morbidity. Materials and Methods: Dengue NS1 Antigen test was used to identify 119 Dengue Patients over August-October, 2019. Hematological data from such patients was collected and analysed. Results: In our study thrombocytopenia was prominent with sensitivity based on gender distribution being 86% for males and 76% for females. According to age, distribution thrombocytopenia had a sensitivity of up to 81% in the younger age group and 80% in the older age group. The other prominent findings in younger age groups were lymphopenia, neutropenia, and monocytopenia with a sensitivity of 55%, 43%, and 24% respectively. Lymphopenia and neutropenia had similar sensitivity across the two genders, whereas monocytopenia had higher sensitivity among females of 27% as opposed to males of 12%. Eosinopenia did not differ as much among the two age groups i.e. 18% in young and 19% in older patients and across the two genders i.e. 56% in males and 60% in females. The sensitivity of lymphocytosis in older patients is 21% which was also significant. Conclusions: The Differential Leukocyte Count and Platelets Count can help as an early indicator of acute dengue infection in resource-limited areas. This can help in early diagnosis and prompt treatment thus reducing complications.

Introduction: The massive number of cases with SARS-Cov-2 has put a tremendous pressure on healthcare systems all over the world. Most of the countries have declared health emergency. In these highly challenging times and also to reduce the risk of morbidity early warning signs may be helpful.6 Objective: To correlate lymphocyte count with serum ferritin levels in patients with COVID-19 admitted in the intensive care unit of a tertiary care hospital. Material and Methods: This cross-sectional study was carried out at Fauji Foundation Hospital Rawalpindi from July 2020-December 2020. A positive COVID-19 patient was the one who had a positive real time polymerase chain reaction (PCR) for SARS-CoV-2 by sampling through nasopharyngeal swabs. 3 ml of blood is taken for Blood CP in ethylene diamine tetra acetic acid containing vacutainers and was run on Sysmex-XN series. For serum ferritin 4 ml clotted blood was collected in plain test tube. Serum ferritin was performed on AXSYM system by immunoassay using AXSYM Ferritin reagent kit pack. Covid -19 disease severity classification proposed by WHO was used to categorise the patients. (WHO COVID 19 interim guidelines). 11 Results: A total of 91 patients diagnosed with covid-19 by RT-PCR testing admitted in intensive care units (severe and critical disease) were included in the study. Out of these 91 patients ;41 were males and 50 patients were females. Mean age of the patients was 61+/- 9 years. The age range was (28-75) years. The median nadir lymphocyte count was 0.2 X 10 9/L. Mean lymphocyte count was 1.1 +/- 0.2 SD. Mean Ferritin value was 1148.5 +/- 60 SD. The Pearson correlation coefficient showed an r value of -0.60 which shows a moderate negative correlation. Conclusion: There is a significant negative correlation between lymphocyte count and serum ferritin levels

Objective: To evaluate the clinical and morphological features in advanced phase chronic myeloid leukaemia. Methods: This descriptive observational study was conducted at the Pathology Unit of Fauji Foundation Hospital, Rawalpindi from June 2012 till June 2016. Diagnosed patients of chronic myeloid leukaemia in accelerated and blast phase of the disease were included in the study. History was taken, physical examination, complete blood counts, peripheral blood film examination, and bone marrow biopsy was done. Results: Mean age in the advanced phase was 47 years. Female to male ratio was 5:1. 19 patients were in blast phase ; 14( 74%) in myeloid transformation, 4(21%) patients in lymphoblastic transformation and 1(05%) patient transformed into acute biphenotypic leukaemia showing both lymphoid and myeloid markers. Forty six patients were in accelerated phase. Conclusion: There is usually not a single criterion for transition into accelerated phase but certain variables coexist at the same time.

Introduction:At the end of December 2019, the novel coronavirus began to spread in central China and soon became a pandemic. Unfortunately,all elective dental treatments including orthodontic visits were postponed and patients could not be counselled on how to manage orthodontic emergencies that they could encounter at home. Teledentistry can play a major role in providing instructionsto patients during quarantine. Objective:The study aimedto assess the awareness of orthodontic patients regarding the management of orthodontic emergencies and their psychosocial well-being during the novel coronavirus pandemic through Tele-dentistry. Materials and Methods:A questionnaire-based study was conducted on two groups during the lockdown period in which their anxiety, psychological status,and their ability to manage orthodontic emergencies at home during the COVID-19 pandemic lockdown wereassessed through teledentistry. Results:A total of 170 patients participated in our study, Independent sample t-test was used to compare the means ofthe group's control and experimental. Statistically,a significant difference was determined between the two groups regarding their psychosocial well-being (social media embarrassment p=0.049, awareness ofhow to manage orthodontic emergencies p=0.00). The participants displayed a better understanding of how to deal with orthodontic emergencies at home after having instructions. 48.2% of the patients selected voice call as a preferred mode of instruction for managing orthodontic emergencies at home. Conclusion:Experimental group of patients wasmore aware ofhow to manage orthodontic emergencies and they were less anxious. Teledentistry has proven to be an important tool for providing instructions to anxious patients as well as reducing the spread of coronavirus due to lack of contact. Voice call was the preferred mode of instruction. Keywords:Anxiety, COVID-19, Orthodontic emergencies, Tele-dentistry.