Background: Polycystic ovarian syndrome (PCOS), the far most common endocrine disorder among sexually active women. The disease is typically characterized by irregular menstrual cycles and appears to be influenced by associated thyroid dysfunction. Aim: The goal of this research was to assess and compare the effects of Metformin and its combination with Probiotic on monthly cycle irregularity and TSH levels in PCOS women. Methodology: This was a single-center study conducted at Karachi's Gynecological Outpatient department from January 2019 to September 2019. A total of 52 PCOS patients aged 18 to 40 years were included in this trial, which followed Rotterdam criteria. After providing written and consent form, individuals were randomized into one of the two groups and received Metformin 500 mg TD (n = 26) or Metformin Combination (n = 26). Results: After three months of treatment, both groups improved in terms of menstrual cycle irregularity and TSH levels, but the combination treatment improved the most. Conclusion: Probiotics may be considered in conjunction with Metformin for improving TSH levels to achieve better results.

Aim: To find out the prevalence of needle stick injury, its reporting system and the reasons behind it. Study design: Descriptive cross-sectional Place and duration of study: Study was conducted at Jinnah post-graduate medical center (JPMC) Karachi during the period of March to September 2019 Methodology: A self-designed, self-explanatory questionnaire was used, consisting of two parts, the first part was about demographic information while second part is for information related to needle stick injury like probable cause, frequency, response after injury, post-exposure prophylaxis and about reporting of the incident. Questionnaire was validated by calculating the Cronbach’s alpha which was 0.78. data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20. Results: Majority of the study participants were female (67.2%) and about 50% were postgraduate students. Out of total 134 doctors about 64.2% of the doctors had needle stick injury during their career. Finding out the most probable cause of needle stick injury during the survey it was found out that increased work load and prolonged working hours were the main reasons. Majority of the cases occurred in emergency department (41.9%). About 95.5% of the doctors didn’t get any post-exposure prophylaxis. Majority of the participants (96.3%) did not report to any authority because of the lack of knowledge about the reporting policy, it was noted that about 38.8% were confused either the reporting system exist or not. Most of the injuries occur during the procedure of suturing followed by recapping syringes. Conclusion: It has been concluded that majority of the doctors had faced needle stick injury during their career and a very negligible number of them got any post-exposure prophylaxis. Majority of them did not report to any authority. So there is a need of implication of safety measures and reporting policies for early detection and treatment of infections after needle stick injury.

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: The menstrual cycle describes the healthy reproductive system of the women which is controlled by different hormones. Aim: The goal of the study is to evaluate the prevalence of irregular menstruation in different endocrine changes and to identify their association with the age of women in reproductive life. Methodology: It was a cross-sectional study conducted on women attending the gynecological clinic of Karachi from March 2019 to June 2019. Of the 165 women with different hormonal changes 100 presented with menstrual cycle abnormality. Results: Among the women with menstrual irregularities 51% women presented with insulin resistance, 23% with hyperandrogenism, 19% with hypothyroidism and 7% hyperprolactinemia. Age-related association was observed in menstrual irregularities women with insulin resistant and hyperandrogenism. Conclusion: Menstrual cycle is a physiological process, any irregularities in cycle can be caused by  even  minimal  hormonal  imbalance.  As  a  result,  it  is  critical  to  address  endocrine abnormalities in order to improve women's reproductive health.

Aim: To highlight the frequency of non-motor clinical features in patients of Parkinson’s disease in Pakistan. Study Design: Descriptive cross-sectional study Place and Duration of Study: Study was conducted at the neurology ward of Jinnah postgraduate medical center, Karachi during August 2019 to February 2020. Methodology:  The study participants were having age >50 years but <70 years and were diagnosed case of Parkinson's disease. Demographic data including; age, gender, residence, and duration of symptoms were collected on the preformed proforma. Depression was diagnosed by using ICD-10 while anxiety and sleep disturbance were diagnosed by using BAI and DSM-IV respectively. Data was entered into SPSS version 20. Results: The mean ± SD of age of patients was 59.26 ± 5.95 years. The mean ± SD duration of symptoms among these patients was 2.67 ± 2.04 months while mean ± SD of MMSE (mini mental status examination) score was 24.29 ± 1.59. About two thirds (62.86%) of patients were of age 50-60 years. Male to female ratio was 1.69: 1. The main outcome variable of this study was frequency of non-motor clinical features of Parkinsonism, it was noted that depression was more prevalent with frequency of 54.3%, anxiety was 41.4% and insomnia was present in 32.9% patients of Parkinson’s disease. Conclusion: There is a high frequency of non-motor clinical symptoms particularly depression, anxiety and insomnia among patients of Parkinson’s disease with frequency of 54.3%, 41.4% and 32.9% respectively.