Aim: To find out the reasons behind prolonged hospital stay among children. Study Design: Descriptive cross-sectional Place and Duration of Study: Study was conducted at the People university of medical and health sciences hospital during the period of November 2020 to April 2021. Methodology: All the children between the age group of 1 year to 12 years, who were admitted in pediatric ward of the hospital for any reason, were included in the study. Prolonged hospital stay was labelled when it exceeded above 7 days. A self-designed proforma was made which consisted of demographic data, total duration of stay and the most probable cause of stay. Data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20. p-value less than 0.05 was considered as significant Results: The mean age of the study participants with standard deviation was 6.8 ± 2.3 years. Half of the participants (50.9%) admitted in hospital for prolonged duration were from the age group of ≤ 5 years. About 55.7% of the participants were female and majority were from the lower socioeconomic class (53.8%) Mean and standard deviation of duration of hospital stay was 11.85 ± 2.29. In majority of cases (n=80) there was delay in consulting a physician which was followed by resistant to the therapy and acquiring nosocomial infection while very few of the cases were having some invasive procedure done so increased duration of stay. Conclusion: It can be concluded that the younger age group that is less than 5 years is the most significant risk factor while the most common reason is the delayed consultation to the physician.

Background: Lamotrigine is a member of antiepileptic drugs, it belongs to the sodium channel blocking agent’s class and it is pregnancy category C drug. While its teratogenic effects are not hidden by the doctors but it is the preferred drug being prescribed in pregnancy. The current study aims to investigate the effects of fetus resorption and histologic changes in cranium of fetus of albino mice and to compare their weight changes due to lamotrigine therapy. Methodology: It was an experimental animal study conducted in collaboration of anatomy and surgery department at animal house of University of Lahore in 2019. The duration of study was 25 days, twenty-four albino mice (12 males and 12 females) were placed in conventional cages in pairs for mating purpose. Female mice Group A, controls in which normal saline was administered intraperitoneally on 10th day of gestation and Group B, in which lamotrigine was given intraperitoneally on the 10th day at the dose of 10 mg/kg. Maternal health was monitored daily during the intervention. Body weight, food and water consumption, and changes in general health, behavior, activity and any sign of toxicity were checked daily. After 18th day the pregnant mice were sacrificed under euthanasia and fetuses were removed and histologic assessment was carried out. Results: Weight of mice treated with lamotrigine decreased significantly (p-value=0.03) and fetus resorptions were also more (p-value=0.013) in Group B. Histologic assessment reveled that there were cleft of lip and palate in group B. Conclusion: Lamotrigine increased the fetal resorption and decrease the weight and seemed to be responsible for inducing cleft of lip and palate at 10mg/kg dose in albino mice.

Background and Aim: The clinical tuberculosis infection risk increases with rheumatoid arthritis and its medication. Chronic systemic inflammation caused by rheumatoid arthritis is an autoimmune disease may affect various organs and tissues. The present study was aimed to assess the frequency of smear positive pulmonary tuberculosis in rheumatoid arthritis patients taking DMARDS at Khairpur Medical College/ Hospital Khairpur. Methodology: This cross-sectional study was conducted on 249 smear positive pulmonary tuberculosis in rheumatoid arthritis patients at the Department of Internal Medicine of Khairpur Medical College/Hospital Khairpur from March 2019 to July 2021. All the patients with cough for >3 weeks were enrolled by taking three sputum sample and risk assessment questionnaire. The Mycobacterium tuberculosis bacilli presence was identified based on acid fast staining technique. Tuberculosis incidence, medical records, and clinical manifestation were explored. SPSS version 24 was used for data analysis. Results: Of the total 249 patients, 226 (90.8%) were male and 23 (9.2%) were females. The overall mean age was 65.73±7.53 years. The incidence of tuberculosis with rheumatoid arthritis was 4-fold. The prevalence of pulmonary tuberculosis and disseminated tuberculosis was 59 (72.8%) and 22 (27.2%) respectively in rheumatoid disease patients. The incidence of tuberculosis with rheumatoid arthritis reduced from 47.6 to 28 per 100 000 with p<0.001. Conclusion: Our study found that pulmonary tuberculosis was more prevalent (72.7%) among adult tuberculosis patients with rheumatoid arthritis. Compared to general population, the tuberculosis incidence among rheumatoid arthritis patients was 4-fold. Keywords: Smear positive pulmonary tuberculosis, Rheumatoid arthritis, DMARDS

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis and red meat consumption. Study Design: Cross-sectional Place and Duration: Medicine Department of Liaquat University Medical Hospital Jamshoro and Civil Hospital Khairpur Mir's for six months duration from December 2019 to November 2020. Methodology: Total 120 patients of both genders with chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (red meat consumption >60 gm/day) and group B (red meat consumption <60gm/day). Outcomes in term of mortality between both groups were examined. All the data was analyzed by SPSS 27.0. Results: There were 36 (60%) males and 24 (40%) were females with mean age 48.14±7.58 years in group A while in group B 39 (65%) and 21 (35%) patients were males and females with mean age 49.08±8.33 years. Cirrhotic patients with red meat consumption >60 gm/day had high mortality rate as compared to patients with red meat consumption <60 gm/day (10% Vs 3.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients and red meat consumption. Keywords: Chronic Liver Disease, Red Meat Consumption, Mortality