Background Ankylosing spondylitis (AS) is a chronic rheumatological condition affecting sacroiliac joint and spine and occurs more often in younger patients than in the elderly population. Objective The purpose of the study was to determine the association of the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) with the disease activity of AS.

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Background and objective Juvenile idiopathic arthritis (JIA) is an idiopathic autoimmune rheumatic disorder in children. JIA has been associated with depression and has a negative psychological impact on patients' quality of life. The aim of the study is to determine the prevalence of depression in patients with JIA presenting at a tertiary care hospital in Islamabad, Pakistan.

Background: Infectious diseases are caused by various multidrug-resistant pathogenic bacteria and in recent scenarios nanoparticles are used as innovative antimicrobial agents. Aim: Current research aimed to evaluate the bactericidal effect of chitosan-coated green synthesized silver nanoparticles using aqueous extract of Mentha spicata (MSaqu) against bacterial pathogens i.e. Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, and Streptococcus pyogenes. Methods: Synthesis and characterization of silver nanoparticles (MSAgNPs) were carried out via atomic absorption spectrometer and Fourier-transform infrared spectroscopy. Agar well and agar disc diffusion methods were used to assess the antibacterial and synergistic effect of chitosan-mediated biogenic silver nanoparticles and standard antibiotics. Three types of interactions i.e antagonistic (↓), synergistic (↑), and additive (¥) were observed. Results: Synergistic effect was recorded against Pseudomonas aeruginosa (8.5±0.25 mm↑), Serratia marcescens (19.0±1.0 mm↑), and Klebsiela pneumonia (8.5±0.25 mm↑), an additive effect was shown by Escherichia coli (9.0±0.0 mm¥), Streptococcus pyogenes (10.0±0.0 mm¥), and Staphylococcus aureus (7.5±0.25 mm↓) showed antagonistic effects when chitosan-coated silver nanoparticles (CLMSAgNPs) were applied compared to chitosan, MSaqu, and MSAgNPs. Interesting antibacterial results were recorded when chitosan-coated Mentha spicata extract and silver nanoparticles were applied along with antibiotics. The synergistic effects of Chitosan coated silver nanoparticles (CLMSAgNPs) + K was recorded against E. coli (14.5±0.25 mm). The synergistic effects of Chitosan coated silver nanoparticles (CLMSAgNPs) + AML was recorded against E. coli (5.5±0.0 mm), S. pyogenes (10.0±0.0 mm), K. pneumonia (5.5±0.0 mm), and S. aureus (4.0±0.0 mm). The synergistic effects of chitosan-coated silver nanoparticles (CLMSAgNPs) + NOR were recorded against E. coli (16.0±0.0 mm), P. aeruginosa (19.0±0.0 mm), S. marcescens (19.5±0.25 mm), S. pyogenes (11.5.0±0.25 mm), K. pneumonia (23.0±0.0 mm), and S. aureus (8.5±0.25 mm). Conclusions: Current findings concluded that chitosan-coated biogenic silver nanoparticles have potential bactericidal effects against infectious pathogens and could be used as forthcoming antibacterial agents.

Background: Hypoxic Ischemic Encephalopathy is a frequently encountered occurrence in a pediatric setting and more prevalent in the low middle income countries. Magnetic resonance imaging (MRI) is considered a reliable source of investigation. Our study determined the imaging findings and cause of Hypoxic ischemic encephalopathy in children referred for MR Imaging to our radiology department. Study design: A prospective cross-sectional study. Place and duration of study: Our prospective cross-sectional study was conducted at a pediatric tertiarycare hospital, of Karachi Pakistan from 1st November 2021 to 30th October 2022. Methods: Our study included children from newborns to 16 years of age who either had a history of fits, abnormal APGAR score, delayed cry or delayed milestones. The brain MRI was performed on 1.5 tesla scanner with a standard protocol and interpreted by Experienced Radiologists Findings were recorded on anExcel Sheet and data was analyzed on SPSS version 26. Our study included children from newborns to 16 years of age who were at risk of hypoxic insult and were born to mothers who had hypertension, diabetes milletus, history of maternal substance abuse and maternal history of fits history of fits and children who had a history of fits, abnormal APGAR score, delayed cry and/or delayed milestones. Children who were born via instrumental delivery were excluded from our study. Result: A total number of 187 patients were included in our study with 98 males and 89 females. The most common age group involved was from age >1 year to 5 years (50.3%). The most common presenting complaints included delayed milestones (63.6%) and fits (59.9%), delayed cry (52.4). On examination 42.2% had microcephaly. One-third of the patients had a positive maternal history for diabetes mellitus, hypertension and anemia. APGAR score was checked at 1 minute and 5 minute which showed the most common APGAR score of 3-6 which was seen in 81.8% of the patients. On MR Imaging 54.5% had periventricular leukomalacia, 35.3% had deep gray matter involvement, 3.7% had germinal matrix hemorrhage, and only 1.6% had watershed infarcts. A statically significant association was seen between gestation at birth and periventricular leukomalacia (P=<0.5). Conclusion: Hypoxic Ischemic Encephalopathy is a common occurrence in our society and MRI is the recommended modality due to its sensitivity and superior soft-tissue resolution. In developing countries due to a lack of proper facilities and awareness, there is an increased incidence of HIE which leads to increased morbidity therefore increasing awareness and early diagnosis is of utmost importance. Keywords: Hypoxic ischemic encephalopathy, Magnetic Resonance Imaging, Pediatric population

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