Background: The co-occurrence of diabetes mellitus (DM) and tuberculosis (TB) is largely associated with high frequency of morbidity. Objective: To determine the prevalence of DM among TB patients and describe the socio-demographic and behavioral factors associated with TB-DM co-occurrence . Methods: We enrolled 500 TB patients from September, 2014 to August 2015 at four major public sector hospitals of Lahore, Pakistan. A questionnaire was used to collect information regarding associated socio-demographic and behavioral factors of the patients. We monitored the fasting blood sugar of each patient by using a semi automated clinical chemistry analyzer followed by an HbA1c level check of all hyperglycemic patients. Results: The prevalence of TB-DM co-occurrence was 14.8%. The prevalence of TB-DM was higher (62.2%) among males. The >57 year age group had the highest proportion of patients (35.1%), with co-existent TB-DM. Most were illiterate (73.0%) and unemployed (48%). Moreover, among the 74 patients positive for TB-DM had a history of smoking. Age and education level were significantly associated with DM-TB while gender, occupation and smoking were not associated. Conclusion:The study revealed a 14.8% prevalence of DM among TB patients. This was associated with several socio-demographic factors, including age, unemployment, literacy and polluted environment. Thus, poor and unhealthy lifestyles were the factors associated with DM among immunologically compromised individuals due to TB. Keywords: Tuberculosis (TB), diabetes mellitus (DM), socio-demographic and behavioral factors.

Objectives:To determine the prevalence and risk factors of hepatitis C virus among injecting drugs users, furthermore different genotypes of HCV infection and their effect on viral load were also found and subsequently most prevalent subtype was predicted.Methods:All samples were processed for Anti-HCV antibody detection through ELISA by using third generation ELISA Kit. The Anti-HCV positive serum samples were stored for RT-PCR to estimate the viral load and genotypes of HCV for study. Injecting drug users selected from in and around Lahore Metropolitan from July 2012 to August 2013 was included. The data analysis was completed by using SPSS version 16. A p-value of < 0.05 was considered to be significant.Results:A total of 241 Injecting drug users were enrolled and screened for Anti HCV in the study. Prevalence of HCV infection in IDUs from Lahore was found to be 36.09%. Education (p=0.000), low socioeconomic status (p=0.011), Blood transfusion (0.003), any tattoo on the body (p=0.002), use of injectable drugs with reused syringes (p=0.000) and sharing of syringes (p=0.001) in groups was significantly associated with HCV infection. Some utensils were also significantly associated with HCV status. The most common subtype of HCV genotype was 3a (n=65) followed by 2a (n=15) and 1a (n=6).Conclusion:The study reveals that IDUs with reused syringes status and sharing of syringes in group had more chances to get HCV infection. The viral load in IDUs infected with different subtypes of genotype was significantly associated.

Tuberculosis (TB) remains as one of the deadliest diseases after HIV globally with 95 % of deaths confined to low-and-middle income countries. Pakistan is fifth among the 22 high-burden TB countries with the incidence rate of 230/100,000 persons, however, studies related to prevalent Mycobacterium tuberculosis strains and their spread, drug resistance pattern and evolutionary genetics are inadequate. The present study was undertaken to highlight the circulation of M. tuberculosis strains causing drug resistant TB in our community by targeting the molecular marker IS6110 and then characterization of these strains as Beijing and Non-Beijing genotypes. Sputum samples from 102 MDR TB suspects from different cities of Punjab were collected and their record was stored in a database. Sputum samples were evaluated by Ziehl Neelson staining and cultured on Lownstein Jensen medium by Modified Petroff’s method. DST was performed for first-line anti-mycobacterial drugs by indirect proportion method. Mycobacterium tuberculosis isolates were investigated for the presence of IS6110 and further identification as Beijing, Non-Beijing or mixed genotype. Percentage of male and female patients was found to be 58.8 and 41.2 % respectively. DST showed resistance of 93 % of isolates to isoniazid and rifampicin. All of the isolates showed positive results for IS6110 amplification. Based on PCR amplification of Beijing and non-Beijing primer sets 4.9 % of the patients showed infection with pure Beijing isolates, 14.7 % with both Beijing and non-Beijing isolates and 80.3 % with pure non-Beijing isolates. Analysis of IS6110 and Beijing sequences showed the presence of putative transposase conserved domain while non-Beijing sequences were epitomized with RAMP_I_III superfamily domain (CRISPR-associated protein family). TB in Pakistan is predominantly caused by Non-Beijing genotypes, but Beijing strains showed incessant circulation in our community as both single and mixed (co-infecting Non-Beijing and Beijing) strains.

IntroductionThe process of learning begins in childhood and accurate vision can greatly affects a child's learning capacity. It is documented that visual impairment in children can have a significant impact on their performance at school as well as their social interaction and development.ObjectiveThis research aimed to study the impact of refractive corrections on the academic performance of high school children in Lahore.MethodologyA total of 2,000 students with equal distribution of gender, public, private school, and locality were included in the study. All students were screened for defective vision. The academic performance before and after corrections was recorded on the prescribed proforma.ResultsThe prevalence of refractive error was high among the public high schools 244 (59.2%) as compared to the private schools 168 (40.8%). The area-based prevalence was higher among the students in urban settings 255 (62%) while in rural it was 157 (38%). It was found that in the public sector, the average score of academic results before the intervention was 56.39 ± 13.24 which was increased to 60.27 ± 14.94 after the intervention while in the private sector, before the intervention, the average score was 63.53 ± 17.50 which was improved to 67.12 ± 18.48. It was found to be statistically significant at p-value &lt; 0.05.ConclusionA significant impact was observed in the average academic scores of the results after refractive corrections.

Introduction: Pakistan, a country with a 27 high burden countries of multidrug resistance tuberculosis. To predict the associated risk factors and proportion of loss to follow up among MDR-TB patients treated at PMDT sites of Punjab from 2017 to 2019. Methodology: This case control study based on the standardized reporting and recording case record forms called as Electronic Nominal Review System (ENRS) of National TB Control Program, Pakistan. A logistic regression model was used to assess risk factors of lost to follow up MDR-TB patients. Results: A total of 539 patients with MDR-TB were included in the final analysis. Among them, 207 patients (7.5%) had lost to follow up outcome at the end of the study. MDR-TB lost to follow up patients were more likely to report older age (AOR: 1.40, CI: 1.14-1.71, p=0.000), history of lost to follow up from first line drugs treatment (AOR: 0.39, CI: 0.28-0.56, p=0.000), co-morbid (AOR:1.54, CI: 1.24-1.91, p=0.000), adverse reaction of second line drugs (AOR: 0.45, CI: 0.37-0.56, p=0.000), long distance between patient’s home and PMDT site (AOR: 0.68, CI: 0.52-0.89, p=0.001). Conclusion: The history of lost to follow up from first line drugs treatment, co-morbid, older age and long distance were independent risk factors of MDR-TB. Proper training for PMDT sites staff, friendly follow up services and psychological counseling may help to reduce lost to follow up.

Objective: Uni-variate time series data analysis has been reported in medicalliterature for prediction the patients volume, emergency overcrowding, stay length in hospitalon surgical procedure and bed occupancy in hospital wards, patients influx or patients arrival,moreover to estimate the cost of hospital stay or any medical or surgical procedure. Design:The present study was designed to fit an appropriate uni-variate ARIMA model (Box-Jenkinmethodology) to forecast the patient’s incoming at OPML, Mayo Hospital, Lahore. Setting:Mayo Hospital Lahore, Period: September 2009 to December 2013 were used for fitting thebest model. Method: Time series data of male, female and peads patients coming/reportingin OPML, OPD. Result & conclusion: The appropriate model for male and female data wasfound as ARIMA (1, 0, 1) and for peads as ARIMA (1, 1, 1) after residuals diagnostic checks. Theestimated number of male patients for Month of January2014 is 632 whereas the actual incomingof male patients in the month of January, 2014 was 649, which shows that the estimated modelhas ability to forecast the number of incoming patients accurately. It is now concluded that thefitted ARIMA model can be used to forecast the patients incoming to OPD Medical Laboratoryfor future planning and management.

Objectives: The aim of the current study was to estimate the seroprevalence andrisk factors investigation associated with hepatitis C virus (HCV) infection in general patientsattending various public and private hospitals of Lahore metropolitan. Study Design: Crosssectional study. Setting: Out Patient Departments (OPDs) of public hospitals, comprising ofMayo Hospital, Sir Ganga Ram Hospital, Services Hospital, Jinnah Hospital and Lahore GeneralHospital of Lahore. Period: 2012. Material and Methods: A total of 904 patients from outpatientdepartments of five public and two private hospitals were enrolled during 2012. Bloodsamples were collected to evaluate their anti-HCV status using 3rd generation ELISA. To findout the risk factors associated with HCV infection, the data was collected on a pretested andvalidated questionnaire. Results: The seroprevalence was estimated to be 14.6%. Mean ageof reactive and non-reactive general patients was significantly associated (P=0.012) with anti-HCV status. Marital status (OR=2.042), socioeconomic status, blood donation (OR=2.15),prescription by doctor or non-doctor (OR=2.664), route of drug administration, relatives havinghepatitis and towel sharing (OR=1.987) were significantly associated (P<0.05) risk factors forHCV infection. Conclusion: The study reveals a higher prevalence of HCV infection in generalpatients of Lahore due to poor socioeconomic status, treatment by quacks, excessive use ofinjectable drugs, house hold contacts with hepatitis patients and lack of awareness about theHCV transmission.

The aim of the current study was to estimate the seroprevalence and risk factors investigation associated with hepatitis C virus (HCV) infection in general patients attending various public and private hospitals of Lahore metropolitan. Study Design: Cross sectional study. Setting: Out Patient Departments (OPDs) of public hospitals, comprising of