Human infertility is a worldwide health issue and is the inability to conceive following twelve months of unprotected sexual intercourse. Consistent studies reiterated tobacco abuse to be an important risk factor which adversely effects male fertility.This study aims to determine the correlation of kisspeptin and total testosterone levels in smokeless tobacco, smoking tobacco users and healthy controls. A total of 180 subjects were selected using random sampling technique. Non-fasting blood samples (5 ml) were drawn, and ELISA technique was used for the evaluation of plasma levels of kisspeptin and total testosterone. Total testosterone was found to be significantly high in smokers and smokeless tobacco users, while the level of kisspeptin was found to be significantly high in smokeless tobacco users only as compared to control group. Furthermore, the level of cholesterol was found to be significantly low, whereas HDL and triglycerides were found to be significantly high in smokeless tobacco users relative to control subjects. Findings of this study suggest that tobacco use has impact on HPG axis by affecting kisspeptin level. The increase in kisspeptin level can affect hypothalamic function leading to pituitary and gonadal dysfunction along with impairment of reproduction. The finding that smokeless tobacco significantly raises kisspeptin strengthens the idea that smokeless tobacco use has more potent effects centrally compared to smoking. K E Y W O R D SHPG axis, infertility, kisspeptin, smokeless tobacco, smoking tobacco, testosterone

Aim: To determine the frequency of different types of cleft lip and palate and to investigate the possible relation of some risk factors to cleft lip and palate. Study design: Descriptive study. Place and duration of study: Peshawar Dental College, Peshawar Pakistan from 1st August 2017 to 31st January 2019. Methodology: One hundred and seven patients with congenital cleft lip and cleft palate deformities, either gender and age ranged from 1 day to 720 days were enrolled. Cleft types were categorized as bilateral cleft lip and palate (BCLP), left cleft lip and palate (LCLP), right cleft lip and palate (RCLP), cleft alveolus (CLA) and bilateral incomplete cleft (BICLP). Results: There were 73(68.2%) males and 34(31.8%) females. The highest number of patients from Peshawar 30(28%) followed by Swat 21(19.8%) and Charssada by 11(10.3%). Forty two (39.3%) patients’ parents had consanguineous marriages. There were 89(83.2%) of mother haven't used folic acid during their pregnancy. Forty 40(37.4%) cases had a positive family history of cleft deformities. Most common systemic disease was anemia 25(23.2). Eighty five (79.4%) of cleft lip and palate patients were belonging to poor class family. Conclusion: The households of cleft lip and palate children demonstrated low socioeconomic status. The incidence of cleft lip and palate should be reduced to enhance the conditions of women during pregnancy by maintaining a balanced diet and giving them folic acid. Keywords: Epidemiology, Children, Cleft lip, Palate, Risk factors

OBJECTIVES: To determine the frequency of emergencies in patients with fixed and removable orthodontic appliances at tertiary care dental hospital. METHODOLOGY: A questionnaire was designed for this descriptive cross-sectional study to be filled by the clinician (L3/L4 FCPS resident) at the end of addressing every orthodontic emergency. Sampling was done under consecutive non-probability protocols. Descriptive statistics were applied to determine the frequency of different orthodontic emergencies, and Pearson’s chi-square test was applied to determine association of emergencies with gender and etiology of emergency (patient related vs operator related). Data was analyzed on SPSS version 20. RESULTS: A total of 175 patients reported with orthodontic emergencies. The sample comprised 38.3% males and 61.7% females. Most frequent orthodontic emergency reported was deboned brackets in fixed appliances, while the most common emergency in removable appliances was traumatic PNAM. A statistically significant association (Pearson’s Chi Square=4.74, Cramer’s V=0.165, p=0.029) was seen for removable and fixed appliance emergencies with males and females. CONCLUSION: Most frequent fixed appliance orthodontic emergencies were deboned brackets while for removable appliance emergencies were trauma due to PNAM. Emergencies with removable appliances were mostly due to the operator related factors, while in fixed appliances patient related factors were dominating.