Background: Nutritional rickets resulting from different causes continue to be a major pediatric concern in many developing countries. It's the most frequent non-communicable disease among children globally. Even developed countries have not been exempted from this disease. Aim: To determine the predisposing factors for nutritional rickets in children, presenting in Shaikh Zayed Hospital Lahore Study design: Cross sectional study Place and duration of study: Department of Pediatric Medicine, Sh. Zayed Hospital, Lahore from 01-01-2019 to 31-07-2019. Methodology: One hundred and thirty children of nutritional rickets were enrolled. Children of both genders and age 9 months to 2 years were included. All children on anti-convulsant therapy and chronic liver diseases were excluded. Results: There were 83(63.85%) between 9-18 months, 47(36.15%) were between 19-24 months of age with mean age was 17.36±3.92 months. Seventy four (56.92%) males and 56(43.08%) were females. Predisposing factors reveal 89(68.46%) exclusive breast feeding, 68(52.31%) low nutritious status of mother, 93(71.54%) had cow’s milk, 87(66.92%) had lack of sunlight exposure and 63(48.46%) had malnutrition. Conclusion: Exclusive breast feeding, low nutritious status of mother, cow’s milk, lack of1sunlight exposure and malnutrition are the significant predisposing factors for nutritional rickets in children. Keywords: Nutritional rickets in children, Predisposing factors, Exclusive breast feeding, Low nutritious status of mother

Aim: To assess the diagnostic performance of ultrasound in predicting the extension of disease in advanced ovarian cancer. Study design: Prospective observational study. Place and duration of study: Department of Obstetrics & Gynaecology, Islam Teaching Hospital, Sialkot from 1st July 2020 to 30th June 2021. Methodology: Fifty-nine patients were enrolled and each patient underwent ultrasonography preoperatively and was assigned a six Fagotti-score. Surgical removal of ovarian mass was done through laparotomy. Midline incision was given. Peritoneal washings were taken for cytology. Omental biopsies were taken from various sites. Total abdominal hysterectomy was performed with bilateral oophorectomy. The ultrasound results and intraoperative extent of the ovarian malignancy spread were compared. The Cohen’s Kappa results were interpreted. Results: The mean age was 51.5±5.2 years. The range of Cohens Kappa was 0.7 in cases of carcinomatosis presented on the smaller/larger bowel. The predictive agreement value between the ultrasound and surgical cases for Cohens Kappa was 0.75 and 0.73 with mean as 0.74. Conclusion: The ultrasonography can be used as an important tool in identifying the advancement extent of ovarian cancer. Keywords: Ovarian cancer, Ultrasound, Cohen’s Kappa

Background: Anaemia is nutritional deficiency disorder which is very commonin developed countries and related with inauspicious maternal and perinatal outcome. Itsprevalence in pregnancy is about 50-80% in Pakistan. It is a risk element for low iron stores inbabies, preterm delivery, foetal anaemia, low birth weight as well as stillbirth. Objectives: Todetermine the frequency of low iron store in babies born to iron deficient mothers and effectof maternal anaemia on newborn weight and cord haemoglobin. Study Design: Prospectiveobservational study. Setting: Government Sardar Begum Hospital Sialkot. Period: 1st January2017 to 30th June 2017. Materials and Methods: 160 pregnant women delivering for antenataland haemoglobin as well as weight of newborn babies, which was entered in computer softwareSPSS version 20. Results: Out of 160 mothers, 143 (89.37%) were anaemic. Out of 160 babies,127 (79.37%) of babies had anaemia. The mean haemoglobin among babies was 12.9±2.01 g/dL. Conclusion: A notable positive correlation with maternal haemoglobin and newborn weightand cord haemoglobin.

Introduction: This study attempts to highlight the relation of various types ofcancers to abnormalities in liver and renal function tests. Objectives: Correlation of derangedrenal and liver function tests to different types of cancers in industrial workers who are exposed toindustrial chemicals and carcinogens. Patients and Methods: This non-interventional studyincluded 100 hundred confirmed cases of cancer were selected and studied from July 2011 toDecember 2011. The study was conducted at Fatima Memorial Hospital/College of Medicine &Dentistry, Lahore . Results: Out of these 100 patients, 21 had CA lung, 19 had lymphoma, 14 hadsarcoma, 13 had CA breast, 6 had CA prostate, 4 had CA liver, 3 had CA colon, 3 had CA ovary, 3had CA testis, 2 had leukemia, 2 had multiple myeloma, 2 had CA gall bladder, 2 had CA stomach,1 had CA esophagus, 1had CA tongue, 1had CA parotid, 1 had CA rectum, 1 had CA cervix and 1had CA larynx. Among lymphoma, non-Hodgkin lymphoma was more than Hodgkin lymphoma(out of 19 patients, 13 had non-Hodgkin and 6 had Hodgkin lymphoma). Out of 14 patients ofsarcomas, 5 had Ewing sarcoma, 4 had chondrosarcoma, 3 had fibrosarcoma and 2 hadliposarcoma. Similarly the serum bilirubin levels in liver cancer, ovarian cancer, multiplemyeloma, stomach and gall bladder cancer were 1.50±0.31, 1.17±0.10, 1.46±0.15 and1.40±0.50 mg% were 32.38±18.81, 37.73±4.35, 34.43±4.35, 45.00±46.17, 31.33±44.70,65.25±31.14, 33.67±80.90, 99.00±73.08, 50.00±98.49, 33.50±75.0, 36.50±85.0 and49.0±11.0 μ/l respectively which were statistically significantly higher (p<0.05) then controlindividuals. respectively which were significantly higher (p<0.05) than the control individualsSimilarly the ALT levels in lung cancer, lymphoma, sarcoma, breast cancer , prostate cancer, livercancer, leukemia, ovarian cancer, cancer of colon, multiple myeloma, cancer of testis andstomach. The mean serum creatinine levels in lung cancer, liver cancer and cancer of colon were0.89±0.05, 0.90±0.16 mg% respectively which were significantly higher than the controlindividuals (p<0.05). Conclusions: The renal and liver function tests should be frequentlymonitored in cancer patients from industrial back grounds.

… Background: Anaemia is nutritional deficiency disorder which is very common in developed countries and related with inauspicious maternal and perinatal outcome. Its prevalence in pregnancy is about 50-80% in Pakistan. It is a risk element for low iron stores in babies, preterm delivery, foetal anaemia, low birth weight as well as stillbirth. Objectives: To determine the frequency of low iron store in babies born to iron deficient mothers and effect of maternal anaemia on newborn weight and cord haemoglobin. Study Design: Prospective observational study. Setting: Government Sardar Begum Hospital Sialkot. Period: 1 st January 2017 to 30 th June 2017. Materials and Methods: 160 pregnant women delivering for antenatal and haemoglobin as well as weight of newborn babies, which was entered in computer software SPSS version 20. Results: Out of 160 mothers, 143 (89.37%) were anaemic. Out of 160 babies, 127 (79.37%) of babies had anaemia. The mean haemoglobin among babies was 12.9±2.01 g/ dL. Conclusion: A notable positive correlation with maternal haemoglobin and newborn weight and cord haemoglobin.