Objective: The study's objective was to evaluate the effectiveness and safety of low-dose isotretinoin vs the standard-dose regimen for the treatment of acne vulgaris. Study Design: Randomized controlled trial Place and Duration: This study was conducted at Department of Dermatology, Bannu Medical College and Federal Government Polyclinic Hospital Islamabad in the period from March, 2022 to August, 2022. Methods: Randomization was used to split the total of 190 patients with acne vulgaris who participated in the study into two groups of 95 sample size each. Patients of both sexes were affected with acne vulgaris. Isotretinoin was administered orally to patients in group I at a dose of 20 milligrammes per day for 12 weeks, whereas patients in group II received conventional dosing regimen 80 milligrammes per day. After a total of 12 weeks of therapy, both groups had a final assessment of their effectiveness. SPSS 23.0 was used to analyze all data. Results: In all 190 cases, majority of the cases 110 (57.9%) were females and 80 (42.1%) were male patients. Mena age of the patients in group I was 24.16±10.52 years and in group II mean age was 25.8±9.87 years. We found that efficacy of conventional dosing regimen was higher in 73 (76.8%) as compared to low doze isotretinoin in 50 (52.6%) with p value <0.005. Post-treatment frequency of complication were higher in group II 46 (48.4%) as compared to group I 28 (29.5%). Dry eyes and headache were the common complications in all cases. Conclusion: As a result of this research, we came to the conclusion that the typical dosing regimen for the treatment of acne vulgaris is more effective but poses a greater risk of side effects than the low dose of isotretinoin. Keywords: Efficacy, Safety, Acne vulgaris, low dose isotretinoin

Aim: To determine the efficacy of lactulose as prophylaxis on hepatic encephalopathy among cirrhotic patients of acute upper gastrointestinal bleeding. Material and methods: We carried out this randomized control trial in multi centers including Mian Rashid Hussain Shaheed Memorial Hospital Pabbi Nowshera. KPK and Isra University Hospital, Hyderabad from February 2022 to July 2022 (06 months) with total no of 80 patients. Group A patients received lactulose while group B patients received sweet syrup placebo. Both groups were assessed for Hepatic encephalopathy as primary outcome. Chi Square test was used for assessment of outcomes between both groups keeping P value < 0.05 as statistically significant. Results: Eighty patients were divided into two groups equally using lottery method. Group A patients received lactulose treatment while group B patients received placebo. The mean age in group A was 44.36±15.37 years while the mean age in group B was 38.71±18.56 years. Hepatic encephalopathy was observed in 2.5% patients in group A while in group B 10% patients had HE, the difference was statistically significant. Diarrhea, abdominal pain and mortality between both groups were no statistically significant. Conclusion: Lactulose is effective in preventing hepatic encephalopathy in patients with cirrhosis and an acute upper gastrointestinal bleeding. Keywords: Lactulose, hepatic encephalopathy, cirrhosis, acute upper gastrointestinal bleeding

Aim: To compare the efficacy of intravenous dexamethasone and methylprednisolone on the treatment of hospitalized patients with covid-19. Methods: Between January 2022 and September 2022, 46 COVID-19 positive patients from the medical ward of ABWA Hospital and Research Centre participated in a randomized controlled trial. Patients in group A were given dexamethasone, whereas those in group B were given methylprednisolone. Hyperglycemia, hypokalemia, duration of oxygen therapy, death, intensive care unit hospitalization, and other outcomes were measured in both groups. For qualitative variables, Chi Square test was used, while for quantitative variables, T-Test was used. A significance level of less than 0.05 was used. Results: In Group A, the average duration of hospitalization was 7.13±2.26days, but in Group B, it was 9.61±2.33 days (P = 0.0001). Group A had considerably shorter O2 therapy duration than Group B (5.78±1.16 days vs. 8.48±1.90 days; P = 0.0001). Group A had a considerably reduced incidence of hyperglycemia and hypokalemia compared to Group B (34.8% vs 73.9%, P = 0.008) (13% vs 43.5, P = 0.02). Conclusion: We conclude that 8mg/day dexamethasone is better than 30mg methylprednisolone twice a day in treatment of COVID-19. Keywords: Efficacy, Covid-19, Dexamethasone, Methylprednisolone

A severe onset of COVID-19 leads to death due to respiratory failure and ARDS is the common finding of lung histopathology in different people with different comorbidities. It can invade the nervous system leading to the manifestation of neurological symptoms and brain damage including encephalitis and stroke. Genetic polymorphism, comorbidities, and gender differences is playing a pivotal role in conferring resistance and susceptibility to COVID-19. Despite almost the same ACE2 expression profile in males and females, males have shown a high mortality rate due to higher expression of TMPRSS2 (pivotal for S protein binding) as these genes are androgen responsive. While women have shown higher expression of ADAM17, ADAM10 genes are associated with the shedding of ACE2 receptors and are estrogen-responsive, leading to low levels of membrane-bound ACE2 which is indispensable for SARS-Cov2 entry into the cell. People with blood Groups A, and AB are comparatively more susceptible to COVID-19 than people with blood group O, the reason for the O group is attributed to the presence of Anti A antibodies.

Background: H Pylori infection is associated with multiple conditions of gastroenterology like gastritis, mucosal ulcer and dyspepsia. Due to emergence of resistance against conventional therapeutic agents, new treatment regimens have been introduced and are superior to the older one. Objective; Compare P-CAB dependent dual therapy vs PPI dependent triple therapy against H. Pylori infection Methodology: Sample size was 400 patients, segregated into P-CAB -group and PPI-group randomly. P-CAB -group was treated with 1gm amoxicillin 8 hourly and Vonoprazole 20-mg 12 hourly daily for 4 weeks. PPI-group was treated with 1-gm amoxicillin, 500-mg clarithromycin and 20-mg Lansoprazole 12 hourly daily for 4 weeks. After four weeks of therapy, stool antigen test for H Pylori was performed to confirm H Pylori eradication. Patient with negative stool antigen test for H Pylori was labeled recovered and vice versa. Collected data was analyzed using window application SPSS (statistical package of social Sciences software). p value under 0.05 was considered significant. Results: Among P-CAB -group, 89 % patients become free from H.Pylori, while 11% patients could not recover from H.Pylori infection in spite of the same treatment. Similarly 69.5% patients of PPI-group recovered and 30.5% patients could not get rid of H.Pylori infection. Conclusion: It is concluded that P-CAB dependent dual therapy is more effective than PPIs dependent triple therapy against H.Pylori infection. Keywords: Lansoprazole, Proton Pump inhibitor, Potassium-competitive acid blocker, Vonoprazan, H. Pylori infection.