This study reports microwave assisted physically cross-linked sodium alginate and pectin film and their testing in combination with modified chitosan-curcumin nanoparticles for skin tissue regeneration following 2nd degree burn wound. Film was formulated by solution casting method and physically cross-linked using microwave irradiation at frequency of 2450 MHz, power 750 Watt for different time intervals for optimization. The optimized formulation was analyzed for various physiochemical attributes. Afterwards, the optimized film and optimized modified chitosan-curcumin nanoparticles were tested in combination for skin regeneration potential following burn wound in vivo and skin samples extracted and tested for different attributes. The results indicated that the optimized film formulation (5 min microwave treatment) physicochemical attributes significantly enhanced addressing the properties required of a wound healing platform. The vibrational analysis indicated that the optimized film experienced significant rigidification of hydrophilic domains while the hydrophobic domains underwent significant fluidization which also resulted in significant increase in the transition temperatures and system enthalpies of both polymer moieties with microwave treatment. The combined film and nanoparticles application significantly increased protein content in the wounds which were evident from higher absorbance ratios of amide-I and amide-II (2.15 ± 0.001), significantly higher melting transition temperature and enthalpy (∆T = 167.2 ± 15.4 °C, ∆H = 510.7 ± 20.1 J/g) and higher tensile strength (14.65 ± 0.8 MPa) with significantly enhanced percent re-epithelization (99.9934 ± 2.56) in comparison to other treatments. The combined application of film and nanoparticles may prove to be a new novel treatment strategy for 2nd degree burn wound healing.

Objective The present study aimed to assess the psychological and clinical determinants of coronavirus disease 2019 (COVID-19) and their association with the disease severity and outcomes. Methods This prospective study was conducted at Hayatabad Medical Complex, Peshawar-Pakistan. Admitted patients were screened for COVID-19 with reverse transcription-polymerase chain reaction (RT-PCR) and subsequently, 250 COVID positive patients were included in the final analysis. Data were obtained from the patient's medical chart; demographic and clinical characteristics were recorded using a structured questionnaire. Psychological determinants, including anxiety and depression, were measured using the Hospital Anxiety and Depression Scale (HADS). The predictors of disease severity and outcomes (recovery vs. mortality) were also studied. Results A total of 250 patients were included in this study; out of which, 193 patients recovered from this deadly virus and 57 died. Based on psychological assessment, 58.4% of the enrolled COVID-19 patients had poor HADS scores. Most of the patients who died (70.2%) had severe symptoms (poor HADS scores). Similarly, 49.6% of the total cases were observed with poor HADS, and 50.9% of those who died had severe depression. Conclusion It is concluded from the study results that psychological distress is frequent in COVID-19 patients. Age, hypertension, fatigue, abnormal respiratory rate, oxygen saturation, ferritin, and poor HADS sore were determined as the significant predictors of COVID-19 severity and outcomes.

Objective: To find out the frequency of plasma leak as evident by pleural effusion and ascites in the patients of dengue fever. Study Design: Cross-sectional study. Place and Duration: Medical unit of Hayatabad Medical Complex, Peshawar Pakistan from April 2021 to September 2021. Methodology: Patients diagnosed as having dengue fever based on positive dengue antigen (NS 1) test or antibodies serology on enzyme linked immunosorbent assay (ELISA) were evaluated. Plasma leak was defined as having ascites or pleural effusion evident on ultrasound or X ray chest of the patients with active dengue fever. Hematocrit of >50% in female and 55% in male was considered as indirect indicator of plasma leak. Results: In a total of 154 patients, 89 (57.8%) were male and 65 (42.2%) female with age ranging between 14 to 75 years while mean age was 40.6±15.54 years. The over all frequency of plasma leak as evident by ascites or pleural effusion was 44.2% (n=68. The minimum duration in which plasma leak was noted, remained 4 days while the maximum was 8 days after the start of illness. The duration of patient’s hospital stay was 5 to 17 days (mean 9.53±3.43 days). Practical implications: The frequency of plasma leak was higher in complicated dengue fever patients as compared to patients with less or no complications. Conclusion: Plasma leak is an important and frequent feature of dengue fever. X ray chest and ultrasound can detect majority of plasma leak in patients with hemoconcentration. Keywords: dengue fever, plasma leak, dengue NS1, dengue shock, dengue hemorrhage

Background: Dengue fever is becoming endemic in Pakistan as shown by its increasing prevalence in the summer seasons foralmost the last decade. Elevation of liver enzymes indicating underlying liver damage, is a common phenomenon and may beassociated with other complications.Objective: To find out the frequency of hepatocellular damage in the patients presenting with dengue fever as evident by elevatedliver enzymes.Material and Methods: This was a descriptive study performed in the medical unit of Hayatabad Medical Complex PeshawarPakistan. Patients were consecutively collected from the wards, outpatients, and emergency department. The patient's collectionwas from the year 2022 epidemic from 10th Jul to 23rd Oct. Patients with consistent clinical features, were diagnosed on the bases ofdengue NS1 test and antibodies titers. Liver enzymes, complete blood counts and ultrasound were performed to find out anyevidence of liver damage and plasma leaks as evident by pleural effusion or ascites. Alanine aminotransferase (ALT) of more than50 U/L was considered as elevated in our study. Patients with elevated liver enzymes due to expected reasons other than denguefever as per clinical records, were excluded from the study. The patient's data was noted on a preformed Performa for furtheranalysis.Results: We consecutively collected 500 patients for the study. The number of male patients was 59% (n=295) while femalepatients were 41% (n=205). The age range was 15 to 75 years (mean 45, SD 21.32). The overall frequency of elevated (ALT) was68.2% (n=341). Stratification of patients according to the ALT level shows that only 13.68% were having anALT level of more than300 U/L. The frequency was 45.45% in patients without complications, 91.60% in patients with warning signs, 85.71% insevere dengue and 100% with acute liver failure. Patients with an alanine aminotransferase (ALT) of =>300U/L werehaving a hospital stay of 5 to 12 days (mean 8.81, SD 2.6) days verses 4 to 9 days (mean 5.8, SD 1.9) in the patients having<300U/LConclusion: Most of the patients with dengue fever have elevated alanine aminotransferase level indicative of underlyinghepatocellular damage. Such patients usually recover without any serious consequences except those having elevation of 300U/lor more whose hospital stay was prolonged, and a smaller percentage was associated with acute liver failure.Keywords: dengue fever, dengue NS1, hepatocellular damage, liver enzymes, hospital stay.

Background: Haematological disorders are quite common in children. Bone marrow examination is a very important investigation for the diagnosis of many haematological and non haematological diseases. Objective: To determine the frequency of common hematological diseases in paediatric patients presenting with clinical features underling on biopsy. Material and Methods: This is a descriptive cross sectional study carried out at Hematology Department Hayatabad Medical Complex Peshawar from 19th Feb to 19th Aug 2018. A thorough relevant history was collected, and a clinical examination was performed. All haematological parameters were documented. Blood counts were carried out using an automated haematology analyzer. May – Grunwald Geimsa and Sudan Black B were used to stain peripheral blood and bone marrow smears, while haematoxylin and eosin was used to stain trephine biopsies. Exclusion criteria were used to compensate for confounding variables and bias. Results: A total of 290 patients were enrolled in this study. The range of age was between 2 months -15 years, with an average age of 8 years. Among 290 patients 211 (72.75%) male and 79 (27.24%) were female. 154 (53.10%) patients were in 2-8 years age group whereas 136 (46.89%) patients in 9-15 years age group. As per common hematological diseases, 72 (24.82%) patients were having megaloblatic anemia, 42 (14.48%) patients were having aplastic anemia, and 74 (25.51%) patients were having leukemia. Stratification of common hematological diseases with respect to age, gender and duration of disease are recorded. Conclusions: Leukemia is the commonest haematological disorder followed by megaloblastic anemia and aplastic anemia. Keywords: Bone marrow Examination, Leukemia, Megaloblastic anemia, Aplastic Anemia

With obesity there is an increase in relative risk of type 2 diabetes, hypertension, and cardiovascular diseases. These can induce a vicious circle of a downward spiral of morbidity and mortality. Obesity is also associated with disability and health costs. In the US alone, it is $192.2 billion. This would be a formidable worldwide cost if interpolated globally. Obesity is also associated with sleep disturbance, respiratory difficulties, joint and mobility disorders, as well as social stigma. Treatments are varied and multifaceted and one shoe does not fit all. The different treatments are a low caloric diet (600 calories/day—this is quite debatable in the elderly); motivational and behavior approaches to sustain changes in eating and activity, these too need a lot of dedicated workforce; and drug treatment should be regarded as a therapeutic trial. Drugs should be stopped if there is no weight loss in two months' time. All drugs have side effects.