Objective: Objective of this study was to determine internet addiction and its impact on mental health and academic performance in medical students. Methodology: One hundred medical students (male: 50, female: 50) aged 18–21 years were selected by convenience sampling in this cross-sectional study in Mahi-ud-din Islamic Medical college Mirpur AJK. A questionnaire of Young’s internet addiction test was used to identify the prevalence of Internet addiction, the purposes of Internet use, and their priority levels. Frequencies and level of mental health was measured using Mental health Battery by Singh and Gupta. Chi square test was applied and p value <0.05 was considered significant. Results: Out of 100 students, 46 (male: 28, female: 18) were found to be slightly addicted, 53 students were average online users and only 01 male was severely addicted. There was no significant difference between male and female students in addiction level. However, males were more addicted than females. The major use of Internet was to communicate with friends and family and to watch songs and movies. 51 students used the Internet to assess information for their educational and learning activities. Some students with overuse of the Internet lead to insufficient sleep and affected their concentration levels in the class. Conclusion: Medical students experiencing problems due to Internet overuse and experiencing poor academic progress and lack of concentration while studying. The main use of the Internet was to communicate with friends and family and for entertainment.

Objectives: To compare the effect of active and secondhand smoke to unexposed smoke and to renal functions in young healthy Medical Students. Study Design: Cross sectional study comparative. Setting: Mohi-ud-din Islamic-Medical-College Mirpur AJ&K. Period: Fanuary-2018 to February-2019. Material & Methods: 350 healthy medical students aged 17-19 years were divided into active, secondhand and unexposed to smoke on basis of serum cotinine levels. The estimated GFR was measured by Modification of Diet in Renal Disease equation, albuminuria by albumin to urinary creatinine ratio, BMI by body weight (kg) to height (m2) and blood pressure by mercury manometer. The chronic kidney disease was classified into low, moderate and high risk according to Kidney Disease: Improving-Global Outcomes-2012-guidelines. Results: Out of 350 participants, 49 were active and 126 were of secondhand smoke. Most were male, overweight or obese, have high systolic and diastolic pressure and decreased eGFR. The CKD prevalence was 8.2%, eGFR <60ml/min/1.73 m² noticed in 19% and albuminuria in 26.4% of the participants. The proteinuria in active smokers in comparison with unexposed showed a high OR-5.67-(95%CI-17.17-40.49), cotinine levels >10 ng/mL; OR-5.520-(95%CI-3.67-3.91), systolic BP >140 mmHg; OR-2.50-(95%CI- 0.142-4.968); moderate to severely decreased eGFR, OR-2.478-(95%CI-0.124-4.391) and with high creatinine levels OR-4.300-(95%CI 2.432–7.603). The decreased eGFR showed Odds for obese OR-1.113(95%CI-2.391-5.197), active smokers OR-0.145(95%CI-0.029-0.721) and for systolic blood pressure >140 mmHg OR-6.892-(95%CI-1.414-2.235). Conclusion: Tobacco smoke exposure was associated with proteinuria and decreased eGFR effecting kidney functions in adolescents.

Objective: The aim of the study was to evaluate maternal and fetal outcomes among patients of placenta previa (PP) with and without placenta accreta (PA). Methodology: All patients who underwent cesarean section for PP and PA were analyzed retrospectively at a tertiary care Combined Military Hospital Kharian, Pakistan, from February 2015 to March 2018. Maternal and neonatal data were obtained from medical records and the hospital database system. Results: PA was found in 37 patients from 111 patients of PP and 74 were without PA with the rate of approximately 2/1000 and 4/1000 respectively were included in the study. The mean age was 31.16±2.65 (range 22–37) years, mean gravidity of 3.69 ±1.40 (range 1 - 9), mean parity 2.57±1.01 (range 1–5), mean number of cesarean sections 2.10±0.66, (range 1-3) and a mean gestational age at the time of cesarean section was 35.65±2.46 (range 28–41) weeks. The maternal risk factors revealed marked differences between placenta previa with accreta and without accrete. The mean intraoperative blood loss in PA was 3,000ml, with a loss of 2,000ml occurring in 60%, and 3,000 ml in 21% of the PA cases. The mean pRBC transfusion was 4 units, while 17% received 6 units. Fetal growth restriction was not seen. A total of 12 neonates were admitted in NICU, with 03 neonatal deaths. There was no maternal death. Neonates born to women with placenta accreta had significantly lower birth weight, Apgar scores at 1 min and 12% required admission to NICU with 3 neonatal deaths. Conclusion: The advanced maternal age, past cesarean or uterine surgery, high parity as well as multiple gravidity were the risk factors for adverse fetal and maternal outcomes.

In chronic stress, release of catecholamines, adrenocorticoids and pituitary hormones result impaired release of neuromodulator - neuropeptide Y. The deregulated neuropeptide Y results imbalanced redox homeostasis reduced endogenous superoxide dismutase and raised malondialdehyde. Objectives: To find the effect of chronic stress on plasma neuropeptide Y, superoxide dismutase, and malondialdehyde levels. Study Design: Quasi-experimental. Setting: Al-Nafees Medical College & Hospital in collaboration with National Institute of Health, Islamabad. Period: January 2016 to December 2016. Material & Methods: After approval from institutional review board, thirty healthy male Sprague Dawley rats were included in the study and were divided equally into group I (control) and group II (restraint stress). The animals were housed in stainless steel cages, at humidity (40-60%), temperature (22 ± 2°C) and a 12-h light-dark cycle with lights on at 0700 am. After adaptation, group II was exposed to restraint stress of 6 hours daily for 28 days. The blood sampling for plasma neuropeptide Y, serum superoxide dismutase and malondialdehyde levels were taken. Results: There was significant decline in neuropeptide Y plasma and superoxide dismutase serum levels while an increase in malondialdehyde levels serum levels was noticed in restraint stress group. Conclusions: Chronic stress induces decrease in plasma NPY with subsequent increase in serum malondialdehyde and decrease in superoxide dismutase levels.

Objective: To determine the frequency of Dengue fever in children presenting with Hepatomegaly and elevated SGPT level. Study Design: Cross sectional study. Duration of Study: March 2016 to August 2016. Setting: Department of Pediatric Medicine Unit-1, Allied Hospital, Faisalabad. Methodology: Over 6 months, 91 children meeting the inclusion criteria were selected from OPD and ward after parental informed consent. Laboratory investigations included Complete Blood Count with peripheral film for Malarial Parasite, SGPT level, IgM and IgG typhoid antibodies, Hepatitis A by ELISA, Hepatitis B and C. Patients were thoroughly evaluated by detailed history and clinical examination. Ultrasonography of the patients was performed to confirm the presence of hepatomegaly. After 5 days 2cc blood for IgM and IgG dengue antibodies were sent to pathology laboratory. Finally, the data were analyzed to determine the mean and standard deviation for quantitative variable like age of child, duration of fever and SGPT level. Qualitative variable like sex and presence of Dengue Fever were presented as frequency and percentage. Results: Age distribution of the patients was done which shows that 59.34% were between 1-7 years and 40.66% were between 8-14 years of age, mean+SD was calculated as 7.02+4.05 years. Mean SGPT levels were recorded as 58.32+6.43. Frequency of dengue fever in children presenting with hepatomegaly and elevated SGPT level was recorded in 72.53%. Conclusion: We concluded that the frequency of Dengue fever in children is high among patients presenting with hepatomegaly with elevated SGPT levels. Therefore, it is recommended that every child who presents with hepatomegaly and elevated SGPT levels might also be elevated for Dengue fever in dengue endemic areas.