Introduction: Cancer is a major public health problem. Worldwide, colorectal cancer (CRC) is a leading cause of deaths due to cancer in both men and women. Among, Saudi men, CRC is the most common malignancy while it is the third most common among Saudi women. Over, two decades the incidence and deaths due to CRC have been steadily increasing in Saudi Arabia. Regular and timely screening has the potential in reducing the incidence and deaths due to colorectal cancer. The present study is conducted to evaluate the knowledge and awareness about colorectal cancer and its screening among the doctors. Objectives:To measure the frequency of knowledge and awareness about colorectal cancer and its screening guidelines among doctors in Al-Ahssa. Methods:A questionnaire based survey of the doctors (Specialists & residents), working in different hospitals and primary health centers under the Ministry of Health in Al Ahssa region, Eastern province, KSA. Knowledge and awareness about colorectal cancer and its screening among the doctors is evaluated.Results: Over 80% of the doctors knew, screening reduces deaths due to CRC. Only 60% were aware about the risk factors and less than 50% knew the clinical features of CRC. About 60% doctors agreed Colonoscopy is gold standard screening test. While, less than 60% knew the ideal age to initiate screening and the actual interval of screening tests in the standard risk and high-risk population. Fewer than 25% doctors were aware about the American cancer society recommended screening guidelines. Majority of the doctors expressed keen interest to know and receive information about CRC and its screening guidelines.Conclusions: Regular and timely screening reduces deaths due to CRC. There is a need for improving knowledge and awareness of doctors about CRC and its screening. Awareness among the doctors improves uptake of screening by the general and high-risk population.

Objective: The aim of this study is to determine the requirement of intravenous fluid and insulin in the treatment of diabetic ketoacidosis to overcome the crisis. Study Design: Cross-sectional Place and Duration:Study was conducted at Medicine department of King Abdullah Teaching Hospital Mansehra and Nishtar Medical University Hospital Multan for six months duration from15thDecember, 2020 to 15thJune, 2020. Methods: Total seventy patients of both genders were presented in this study. Patients were aged between 18-65 years. Patients details demographics age, sex and body mass index were recorded after taking written consent. Patients had diabetic ketoacidosis were presented in this study. Frequency of intravenous fluid and insulin were assessed to overcome the crisis of diabetic ketoacidosis by using portland protocol. Complete data was analyzed by SPSS 22.0 version. Results: Mean age of the patients was 30.51±7.41 years with mean BMI 25.18±3.48 kg/m2. 38(54.3%) cases were females and 32 (45.7%) patients were males. 42 (60%) cases had previous history of diabetes and the rest28 (40%) were newly diagnosed.Prevalence of DKA was more common in low socio-economic status found in 39 (55.7%) cases. Vomiting was the most common symptom found in 35 (50%) cases, followed by infection of insulin doses 18 (25.7%) cases, abdominal pain found in 15 (21.43%) patients. 32 (45.7%) patients who had increased diuresis received 11L of fluid in the treatment of DKA, 91-100 units of insulin were given to 18 (25.71%) cases, and for management of acidosis 24 (34.3%) patients took 2-days. There was no any mortality found in this study. Conclusion:We concluded in this study that early diagnosed of diabetic ketoacidosis is necessary for treatment. Removal of adequate fluid was necessary to avoid mortality. Keywords:Intravenous fluid, Insulin, Diabetic ketoacidosis, Diabetes

Objectives: To determine the frequency of HBV and HCV among blood donorscoming voluntarily at the blood bank of Ibne- Siena hospital and research centre, Multan,Pakistan, to ascertain the disease burden in the community for their future prevention andcontrol. Study Design: It was a descriptive, cross- sectional study on blood units donated byhealthy individuals coming voluntarily for blood donation, and willing to get their blood testedfor HBV, HCV. Setting: Community medicine department of Multan medical and dental collegeMultan, and blood bank of affiliated tertiary hospital, Ibn-e- Siena hospital Multan. Period: Sixmonths period from Jan 2016 to June 2016. Materials and Methods: Data of the blood donorswas collected. Present study was based on previous well maintained records of hospital bloodbank. During the reported period, a total of 1195 blood donors attended the blood bank, andthey all were screened for HBsAg and anti-HCV. SPSS- 16 was used to analyze the data, fordetermination of frequencies of Hepatitis- B, and C according to the age and gender. Results:Total numbers of blood donors were 1195. 1191 were males, and 4 were females. All thefemales were negative for both HBV, and HCV. Males positive for HBV were 18 (1.5 %), andthose Positive for HCV were 27 (3.2%).

Siena hospital and research centre, Multan, Pakistan, to ascertain the disease burden in the community for their future prevention and control. Study Design: It was a descriptive, cross-sectional study on blood units donated by healthy individuals coming voluntarily for blood donation, and willing to get their blood tested for HBV, HCV. Setting: Community medicine department of Multan medical and dental college Multan, and blood bank of affiliated tertiary hospital, Ibn-e-Siena hospital Multan. Period: Six months period from Jan 2016 to June 2016. Materials and Methods: Data of the blood donors was collected. Present study was based on previous well maintained records of hospital blood bank. During the reported period, a total of 1195 blood donors attended the blood bank, and they all were screened for HBsAg and anti-HCV. SPSS-16 was used to analyze the data, for determination of frequencies of Hepatitis-B, and C according to the age and gender. Results: Total numbers of blood donors were 1195. 1191 were males, and 4 were females. All the females were negative for both HBV, and HCV. Males positive for HBV were 18 (1.5 %), and those Positive for HCV were 27 (3.2%).

Background and Aims: Rheumatologic disorders (RDs) can manifest as gastrointestinal (GI) symptoms. Patients with systemic sclerosis (SSc) frequently experience upper GI symptoms due to a lack of esophageal contractility (AC). GORD (gastro oesophageal reflux disease) is a common comorbidity in rheumatoid arthritis patients (RA).The aim of the present study was to evaluate the correlation between manifestation of rheumatoid arthritis and gastrooesophageal reflux disease. Materials and Methods: This cross-sectional study was carried out on 845 gastro-oesophageal reflux disease patients who presented to department of medicine, Qazi Hussain Ahmad Medical Complex Nowshera and Lady Reading Hospital (LRH), Peshawar for period of six months i.e from January 2020 to June 2020. Consecutive patients with were premeditated subsequently taking written informed consent. Patients with prior history of Oesophageal surgery were excluded. The demographics characteristics such as age, BMI, gender, previous history, gastrointestinal symptoms severity, analgesics, and medication usage were recorded on a pre-designed questionnaire. Inflammatory marker’s results were taken in the forms of C - reactive protein (CRP), and Erythrocyte Sedimentation Rate (ESR). Ethical approval was taken from the respective institutional review board. SPSS version 20 was used for data analysis. Results: Out of 845 GORD patients, 110 (13%) had Rheumatologic disorders (mean age 49.5± 2.6 years, 71% females). The prevalence of rheumatoid arthritis (RA), systemic lupus erythematous (SLE), and the most common systemic sclerosis (SSc) were 39 (36%), 24 (21.8%), and 47 (42.2%) respectively. Regurgitation, dysphagia, heartburn, and nausea were the most severe symptoms of gastrointestinal patients having rheumatoid disorder. The GI symptoms had no significant association with SLE, RA, and SSc severity. Upper GI symptom severity did not differentiate between RDs. Conclusion: Our study concluded that subsequent rheumatoid arthritis has a significant association with gastro-oesophageal reflux disease. Keywords: Gastro-oesophagealReflux Disease, Rheumatoid arthritis, Systemic sclerosis

Background: Hypomagnesaemia is related with diabetes mellitus (DM) and its complications and insulin resistance. On the other hand, the patients of Diabetes mellitus have decreased levels of magnesium. This analysis was planned to assess levels of serum magnesium in patients with newly diagnosedimpaired glucose intolerance and the severity of intolerance e.g., DM or impaired glucose tolerance, impaired fasting glucoseand compare the serum levels of magnesiumwith sex and age matched healthy individuals. Methods: This case-control study was carried out in the Outpatient department of Diabetes Hospital Peshawar and CMH Multan Institute of Medical Science Multanfor six months duration from February 2020 to July 2020. New patients of glucose intolerance (IGT 2, DM 54) were matched with same number of sex and age matched healthy subjects (n=56). All participants in the study done with the level of serum magnesium and comparisons were made between the case and the healthy subjects. Results: This study evaluated 56 patients (studied group) and 56 healthy volunteers of similar gender and age (control group) with glucose intolerance.There was no substantial difference between the control group in terms of sex, body mass index (p = 0.39) and age (p = 0.88). The level of serum magnesium was according to standard in 30 patients and 39 healthy subjects, and decrease in 26 patients and 17 normal subjects. The mean concentration of serum magnesium was lower in the experimental group (0.69±0.16m. Mol / L) than in the control group (0.84±0.17 m. Mol / L), though the variance was not substantial (p = 0.37). Conclusions: The levels of Serum magnesium were lesser in individuals with IGT and DM compared to healthy volunteers of the same sex and age and levels of serum magnesium were related to blood glucose levels. Key words: Serum magnesium, Diabetes mellitus, Glucose intolerance, Impaired glucose tolerance, Impaired fasting glucose.