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Objective: To determine the diagnostic accuracy of Ultrasound BI-RADS classification in diagnosing breast lesions utilizing the core needle biopsy method keeping histopathology as a gold standard. Materials and Methods: A cross-sectional study was conducted in the Radiology department of CMH Peshawar incorporating 51 patients having breast lesions as presenting complaints. After performing ultrasonography, lesions were categorized as benign and malignant according to BI-RADS scoring. A core needle Biopsy of lesions was done and histopathology reports were collected. Diagnostic accuracy, Sensitivity, Specificity, Positive predictive value, and Negative predictive value of “BI-RADS classification were calculated by analyzing data. Results: The mean age was calculated as 45.63+ 16.83 years. According to the BI-RADS score, 17 cases (33.3%) were categorized as benign and 35 cases (66.7%) as malignant while Histopathology reported 20 cases (39.2%) as benign while 31 cases (60.8%) as malignant. Diagnostic accuracy, Sensitivity, Specificity, Positive predictive value, and Negative predictive value for ultrasound BI-RADS turned out to be 90.19%, 96.77 %, 80.00%, 88.23%, and 94.11% and respectively. Conclusion: Ultrasound BI-RADS classification has high diagnostic accuracy in differentiating benign from malignant lesions. Universal application of ultrasound BI-RADS guidelines will help in the early diagnosis of malignant breast lesions while avoiding unnecessary biopsies in benign lesions. Keywords: Breast imaging, Core needle biopsy, Diagnostic accuracy

Background: Taking into account, the adverse effects of chemotherapy on male fertility, Chemotherapy has been a major area ofconcern for physicians. Chemotherapeutic agent Doxorubicin (DOX) profoundly affect the morphometric of testes that is indicativeof damage to this important reproductive organ. Antioxidants being free radical scavenger could be used in order to ameliorate theUndesirable effect of anti-cancer agentsObjective: To demonstrate change in weight of testes and thickness of germinal epithelium after consumption of Doxorubicin andto observe the effect of ascorbic acid on these changesMaterial and Methods: Experimental study was conducted on mice which were divided in 3 groups A, B and C. They receivedsaline intraperitoneally (IP), DOX IP and DOX + Ascorbic acid per oral respectively. On completion sacrificed animals weredissected and testes were weighed and later sections were selected for morphometric measurement of germinal epithelium andwere observed in H&E stained slides under 40x objective and 10x ocular lenses of light microscopeResult: Ascorbic acid seems to be significantly affecting the declined weight of the organ and on disturbed morphometry ofgerminal epithelium in mice induced with chemotherapeutic agent DOXConclusion: Ascorbic acid seems to be significantly affecting the declined weight of the organ and on disturbed morphometry ofgerminal epithelium in mice induced with chemotherapeutic agent DOXKeyword: Chemotherapy, antioxidant, weight, germinal epithelium, mice.

Objective: To compare the conventional ways of teaching to new teaching methodologies thus finding their efficacy. It also highlights the significance of incorporating technology into teaching thereby creating a rich learning experience for students. Study Design: Cross-sectional Survey. Setting: Different Medical and Nursing Colleges and Universities of Punjab, Pakistan; Faisalabad Medical University Faisalabad, University Medical and Dental College Faisalabad, Ameer-ud-din Medical College Lahore, Nishtar Medical and Dental College Multan, Shareef Medical and Dental College, Continental Medical College Lahore. Period: June 2020 to August 2020. Material & Methods: Was conducted amongst 1600 medical, dental and nursing students from various medical and dental colleges across Pakistan. A questionnaire was circulated among students after briefing them about the objective of the study. Result: Out of 1600, 816 were MBBS students, 715 were BDS and 69 were nursing students. About various teaching methods, 53% in MBBS, 56.78% in BDS and 30.43% of nursing students were aware about new teaching methodologies. Tutorials were least known by MBBS students, online classes for BDS students whereas both methods of teaching were least popular amongst nursing students. A significant percentage of students were more in favor of group discussion as an effective method of teaching. Conclusion: This study concluded that student-centered learning should be focused on and new technologies should be incorporated in order to make medical education more interactive and interesting.

Objective: To ascertain the vaginal birth rate following the trial of uterine scar and its outcomes. Study Design: Cross-sectional Observational study. Setting: Department of Gynecology Bakhtawar Amin Trust Teaching Hospital Multan. Period: 6th August 2020 to 6th August 2021. Material & Methods: After passing through selection criteria, all enrolled women underwent serial ultrasound including pelvis ultrasound to access scar thickness up to thirty-six gestation weeks. All women were evaluated for baseline investigations, clinical history, and underwent cardiotocography (CTG) which was then followed by a trial of labor (TOL). Women who experienced spontaneous labor after TOL were observed through partogram and intrapartum CTG. All maternal and fetal outcomes were observed. Results: Out of these 80 women, 51 (63.7%) had successfully given birth through the vaginal route while 29 (36.2%) underwent emergency CS following TOL. The majority of enrolled women, 62 (77.5%) had age less than 35 years, 45 (56.2%) had parity 1-4, and 74 (92.5%) had gestation age >36 weeks. 3 (5.8%) women had a history of VBAC and all had parity >4. Among the women with successful VBAC, the majority were younger than 35 years (88.2%), parity less than 4 (62.7%), and all were positive for previous successful VBAC. Postpartum hemorrhage was the most reported maternal complication (3.9%). Three (4.4%) experienced intra-uterine deaths which were the major fetal complications. Conclusion: Trial of vaginal birth following cesarean section could be a preferable option given its association with low fetal and maternal complications and considerable success rate.

Objective: To study anatomical variations of facial nerve encountered during parotid gland surgery. Study Design: Observational Study. Setting: Anatomy Department with the Collaboration of General Surgery Department at Dow University of Health Sciences and Dow Hospital (Ojha Campus Karachi). Period: December 2020 to May 2021. Material & Methods: Dissection of parotid gland was done in 50 cases including 10 cadavers (20 parotid glands) in anatomy department and 40 patients (40 parotid glands) admitted in general surgery ward undergoing parotid gland surgery for any pathology of the gland. Total 60 parotid glands were studied. Mean age of the cases was 31.6 ± 2.14 years with age range of 20-60 years. There were 10 female and 40 male cases. Results: In this study 60 parotid glands were dissected in 50 cases and facial nerve configuration was studied. In 46(92%) cases facial nerve pattern could be classified into main five types of the nerve pattern but in 04(08%) cases facial nerve pattern did not fit into any category of the classification. Type-III pattern of facial nerve distribution was commonly seen in 21(35%) glands. Conclusion: It is very important to keep knowledge of anatomical variations in facial nerve branching pattern in parotid gland to avoid its Injury during surgery.

Objective: To evaluate the frequency of semen parameters in male partners of in sub-fertile couples. Study Design: Cross-sectional study. Setting: Department of Gynaecology, Bakhtawar Ameen Hospital, Multan. Period: July 2019 to July 2020. Material & Methods: Infertile couples from at least 12 months were selected for study. A team of Gynaecologist, andrologist and endocrinologist assessed the couples. In male partner, general physical examination, endocrine factor, genetic assessment, accessory gland infection and testicular dysfunction were evaluated. Semen sample was sent to laboratory for semen analysis. Results: In a total of 169 sub-fertile couples, the mean age of male and female partner were 37.98±4.54 years and 32.51±3.78 years respectively. Mean duration since marriage was 5.17±4.51 years. Abnormal semen parameters such as azoospermia, oilgo-azoospermia, asthenozoospermia, teratozoospermia and aspermia were noted 21 (12.4%), 26 (15.4%), 48 (28.4%), 18 (10.7%) and 10 (5.9%) subjects respectively. There were 46 (27.2%) subjects with normal semen parameters. Conclusion: Most of the male sub-fertile subjects had asthenozoospermia. More than one fourth of the subjects had normal semen parameters.

Background: COVID19 has been a disastrous pandemic infecting millions across the globe. Health care providers are the one who at an increased risk of contracting this infection due to their immense exposure. Our study aims to access the knowledge and mental status of HCPs after being through three months of this pandemic as they have witnessed the morbidities, mortalities and sufferings during this period. Method: A cross-sectional survey-based study was conducted including 309 Health Care Professional. They filled the self administered questionnaire which accessed the knowledge and mental health status. Categorical socio-demographic variables were measured by frequencies and percentages of occurrence while Numerical variables were measured as mean and standard deviations. Mean Knowledge and Mental health scores were calculated. Inferential statistics including Chi-square tests and T test which were applied to find the difference in responses by demographic characteristics. Correlation analysis was performed to determine the relationship between different variables. Results: Over all mean score for Knowledge was 10.18±1.7and Mean Mental health score were 12.4±3.89. Doctors had a higher mean Knowledge score (10.7±1.63) as compared to nurses (9.7±1.72 ) and paramedics(9.8±1.83). Among the Doctors, 84.9% had Good knowledge scores as compared to 60% and 61% of the nurses and paramedics respectively. Doctors had a lower mean Mental health score (11.51± 4.14) as compared to nurses (13.58±3.250) and paramedics (12.58±3.814) respectively. Females had a higher Mean Mental Health score as compared to males. (12.97±3.750 vs 11.81±3.967) Pearson Correlation analysis showed weak negative correlation between Knowledge and Mental health scores (r=-0.032, P value=0.57). Conclusion: Although it has been more than three months since COVID19 emerged to become a pandemic, there still remains a need to educate our health care professionals especially nurses and paramedics. Measures should be taken to alleviate the stress and depression of HCPs. Key Words: Health care professional, Knowledge scores, Mental health scores