Background: Obesity is a major epidemic of developed world that is now extending to developing countries and is the risk factor of pre-eclampsia which is the major contributor to maternal and foetal morbidity & mortality. Objective: To determine the frequency of preeclampsia in obese primigravida women visiting the Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan. Methodology: This cross-sectional descriptive study was conducted in Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan from January 2018 to December 2018. All the Primigravida women with singleton pregnancy of gestational age ≥ 26 weeks assessed by ultrasound between 20-35 years of age were included in the study by non-probability consecutive method. After obtaining ethical approval from hospital ethical committee and informed written consent from all the study subjects, relevant data were documented in a predefined data sheet and body mass index (BMI) was calculated by using the formula: Weight (kg) / Height2 (m). Women having blood pressure (BP) of 140/90 mmHg or above in third trimester of gestation measured on at least two occasions, 6 hours or more apart accompanied by proteinuria of 300 mg per 24 hours or above in previously normotensive were labelled as preeclampsia and first-time pregnant women having BMI ≥ 30 were taken as obese. Statistical analysis was performed by using computer-based software, Statistical Package for Social Science (SPSS) for windows version 17.0. Mean and standard deviation was calculated for numerical data like age. Frequencies and percentages were calculated for categorical variables. Chi-square test was performed to find the statistical difference regarding preeclampsia distribution between groups and ‘p’ value <0.05 was considered as a lowest level of significance. Results: Mean age of the respondents in the study was 27.08±3.59 years. Majority of the women were between the ages of 26-30 years (53.30%). The mean gestational age of the respondents was 34.50±4.33 weeks and most of the women had gestational age ≥ 36 weeks (46.70%). Frequency of obesity in pregnancy was 15.4% and frequency of preeclampsia in obese primigravida was 55.3%. Conclusion: It is concluded that frequency of preeclampsia is higher in obese primigravida compared to non-obese primigravida.

Objective: Surveying public awareness of antibiotic use and antibiotics can identify factors relevant to the design of effective educational campaigns. The aim of this study was to evaluate the knowledge, attitudes, and practices related to antibiotic use and multidrug-resistant pathogens in the general population in Pakistan.Research Design and Methods: Cross-sectional survey was conducted, using a 60 itemed structured questionnaire and recruited individuals by convenient sampling from the general population in the four provinces of the country. Descriptive statistics were used to evaluate the responses and the chi squared statistic was used to assess differences between groups.Results: The response rate was 87.6% (6,684 out of 7,631 individuals). Half of the respondents had received at least one prescription of antibiotics in the 6 months preceding the survey. Knowledge about antibiotic use, (39.8%) individuals scored above the mean (≥3) showed good knowledge about antibiotic use. Urban residents and male showed significant higher knowledge (p &lt; 0.001) about antibiotic use. Approximately 50% of the respondents correctly answered the question about antibiotic resistance. Of the 3,611 received antibiotics, 855 (23.7%) were indicated for cough, 497 (13.8%) for a sore throat, 335 (9.3%) for ear ache, 665 (18.4%) for a burning sensation during urination, 667 (18.4%) for wounds or soft tissue inflammation. MDR pathogen was perceived as an important topic by (4,010) 60.1% of respondents.Conclusion: Participants were aware of the problem of multidrug-resistant pathogens and understood the responsibility of each individual to avoid the spread of these infectious agents.

Background Pneumatosis intestinalis is an abnormal presence of free air outside the lumen of the intestines in many shapes. It is classified based on its etiology to primary or secondary, it affects adults as well as infants and can involve any part of the GI tract. Case presentation We report a case of a 55-year-old man with a past medical history of a surgically repaired perforated duodenal ulcer who presented with an acute abdominal pain, Flatulence and constipation. On examination of the abdomen; severe distension, tenderness and tympanicity on percussion were noted. An erect CXR was performed and showed bilateral sub-diaphragmatic air levels. We performed an abdominal Paracentesis under the right subcostal margin which led to evacuation of large amounts of air. Next, an investigational laparotomy showed that the reason was a gastric volvulus associated with an anterior and posterior gastric wall lacerations. The suitable surgical repair approach was taken, but another lesion was detected incidentally. A pneumatosis cystoides intestinalis (PCI) was extended along large length of the intestines in many shapes and without any symptoms or signs. Conclusions Pneumatosis cystoides intestinalis has been reported continuously in relation to peptic ulcer disease (PUD). We aim to report a new association of a gastric volvulus and PCI secondary to pyloric stenosis caused by a duodenal ulcer; which we believe can aid in the diagnosing of dangerous complications, of a rare disease.

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Aim: To find the characteristics and frequency of hepatitis C among children with β-Thalassemia. Methodology: It was a cross sectional type of study conducted in tertiary care hospital of Bahawalpur for a period of 6 months from from January 2021 to June 2021. Sample size was 51 patients. Patients suffering from β-Thalassemia and were undergoing blood transfusions in large amounts were included. Results: β-Thalassemia is more common in Males (67%) than females (33%) with most of the cases detected in the patients who were living in rural areas (61%). Moreover, with the increase in number of transfusions the threat of HCV increases. Conclusion: Blood transfusion is a lifesaving intervention. There is a need to pay an immediate attention towards the bio safety practice in both the public and private sector blood banks. There must be strict rules and regulations for safe blood transfusions in Pakistan. Keywords: Thalassemia; HCV; Blood transfusion; HB electrophoresis

Background and Objective: The rise in incidence and prevalence of cases of Human immunodeficiency virus (HIV) has made it a disease of public health concern especially in under-developed countries. Timely diagnosis and initiation of treatment, the only effective strategy to break the chain of transmission in the community, is a caveat in the measures taken for its prevention. The objective of this study was to determine frequency and the reasons behind delay in initiating treatment after being diagnosed with HIV among patients presenting to a public sector hospital. Methods: This cross-sectional study was conducted in the HIV center of Aziz Bhatti Hospital, Gujrat for six months after approval from ERB. About 200 diagnosed HIV patients fulfilling the selection criteria were included in the study after an informed consent. Data were collected by personal interviews and information regarding their timing of initiation of therapy and reasons behind delay in treatment were noted in a questionnaire. Data entry and analysis was done using SPSS version 23.0 and cross tabulation was done keeping p-value <0.05 as significant. Results: Among 200 study participants, mean age was 26.5 ± 5.68 years including 126 (63%) males and 74 (27%) females. About 34 (17%) of patients were found to have a delay in initiation of treatment for more than 6 months. Patients reported multiple reasons behind the delay in initiation of treatment the most frequent was being in denial in which they did not believe the test results 32 (94%) followed by difficulty in accessing health care 28 (82.3%). Age was found to be significantly related with delay (p= <0.001) while relationship of gender with delay in treatment was found to be insignificant. Conclusion: It can be concluded that a considerable proportion of patients diagnosed with HIV delay their treatment because of lack of acceptance of results or access to health care. Proper educational session of these patients along with increasing the accessibility to health care facilities can result in timely management and better outcomes in these patients.

ABSTRACT:OBJECTIVE: The single most important factor that has long-lasting impact on lives of women is education. The study was conducted to determine the effect of women and partner's education on utilization of antenatal services in the urban slums.STUDY DESIGN AND SUBJECTS: This descriptive cross sectional study was conducted in urban slums of Bahawalpur City from January 2018 to December 2018 after taking ethical approval from hospital ethical committee. Women of reproductive age n=377, between 15 to 49 years, having at least one alive child less than one year of age and irrespective of current pregnancy were included in the study. Out of selected slum area sample was drawn by non-probability consecutive method. The preformed, pretested questionnaire with the help of lady health workers of the areas was used for collection of data. RESULTS: Mean age of the respondents was 28.26 ± 6.03 years. The age distribution showed that 31.1% respondents belonged to 30-34 years age group followed by 29.7% in 25-29 years, 19.1% in 20-24 years. The utilization of antenatal services was poor in 41.1% (n=155), fair in 24.9% (n=94) and good in 34.0% (n=128) women. The utilization of antenatal services was significantly higher in literate group (p <0.001). Regarding husband's educational status the wives of educated husbands had better utilization (p <0.001). The use of antenatal services among wives of uneducated and primary educated husbands was 67.8% and 61.5% respectively. The 52.1% women having graduate and above educational level of husband had good antenatal care use. CONCLUSION: Educational status significantly affect the utilization of antenatal services.

Aim: Medical student’s outlook about implementation of E-Learning in Covid-19 Methodology: A cross-sectional study was at Quiad-e-Azam Medical College, Bahawalpur on undergraduate medical students from March 2021 to August 2021. Self-administered online questionnaire was used to obtain the perception of medical students about E-learning, effects of this pandemic on medical education and implementation problems of E-learning in Pakistan. E mail and other electronic social media including Face Book, WhatsApp and Instragram were availed to broadcast the questionnaire. Results: Out of 218 respondents, the majority (71.9%) agreed the closure decision of college to prevent the lives from rapid spread of pandemic. 64% students considered E-Learning best available solution during lockdown. E-Learning initiative has a close connection with the residence and opinion regarding this program. Students faced limited connection and bandwidth, new and unfamiliar process of learning, limited technical help, inflexible time despite problems in connection during online examination and unavailable advantage of face to face learning facilities. Conclusion: Majority of students took E-learning positively. But it becomes challenging due to unavailability of essential required electric technology for students. Key words: E learing, medical students, covid-19