Background: Tuberculosis (TB) is fatal and life threatening infectious disease. The transmission rate of tuberculosis is very high. Various drugs are used as treatment for TB. Recently it has been observed that one of the most important factor for fast TB spread is development of anti-TB drug resistant mycobacterium tuberculosis (MTB). Various combination of drugs like isoniazid (INH), rifampicin (RIF), Streptomycin(SM), pyrazinamide (PZA) or ethambutol (EMB) are in global use for TB treatment. Improper usage of these drugs makes the person prone to develop anti-TB drug resistant tuberculosis. Aim: To evaluate association of embB gene with ethambutol resistance in Mycobacterium Tuberculosis. Methods: 104 Specimens of sputum from suspected tuberculosis patients were processed for inoculation in Lowenstein J Medium after it has been decontaminated properly. Kit method by using QIAamp DNA Mini kit was utilized for extraction of DNA. Then region from base 6953 to 10249 of embB gene was amplified through PCR and then followed by sequencing with the aid of softwares blast2seq and ClustalW2. Three primer sets were utilized to amplify embB gene. Ethambutol (EMB) Resistant MTB specimens were processed to study mutation in embB gene. Results: Out of the total 104 sputum specimens, 14 samples were found to have ethambutol resistance. These 14 samples were then processed for mutational analysis. DNA sequence analysis of these 14 samples confirmed embB gene mutation in 10 samples. Mutational analysis revealed that 08 samples showed mutation at codon 306 and two samples showed mutation at 319 codon. The reported mutation Methionine →Isoleucine was seen in 07 samples with ATG codon replaced by ATA codon at codon position 306. One sample showed mutation as Methionine →Isoleucine with ATG codon replaced by ATC codon at codon position 306. Two samples showed mutation as Tyrosine →Serine with TAT codon replaced by TCT at 319 codon position in embB gene. Conclusion: This study concludes that mutation of certain genes particularly point mutation of embB gene at codon 306 and 319 is associated with drug resistance of ethambutol in ethambutol resistant mycobacterium tuberculosis patients. Keywords: Ethambutol, embB gene, Mycobacterium tuberculosis.

Background: Myocardial ischemia is considered as one of most common cause of mortality worldwide. Several Risk factors are linked to an increased incidence of Myocardial Ischemia. The most common risk factors are hypertension, hypercholesterolemia, diabetes mellitus, high BMI, physical inactivity, smoking, age and gender predisposition and socioeconomic status. Aim: To inspect and compare incidence of myocardial ischemia in cases with hyperlipidemia and elevated BMI. Methods: 102 patients were selected for our research study and cases were split up into 2 groups of 51 patients each. Group A comprised cases with standard normal lipid profile and BMI with suspected myocardial ischemia. Group B contained 51 patients with hyperlipidemia and high BMI with suspected myocardial ischemia. The study data was then analyzed by SPSS 21st version. The Probability Value (P- Value) of ≤0.05 was coined as statistically convincing value. Results: The serum Cholesterol levels were 148 ± 11 in first group A and 268 ± 41 in other group B. The triglycerides serum values were 129± 13 in A group and 220± 13 in B group. The serum Low density Lipoproteins values were 109±10 in A group and 179±22 in B group. The serum HDL values were 39±10 in A group and 20±08 in B group. An independent/unpaired samples T- statistical test was used Using a two-tailed 0.05 criterion, the test indicated a statistically convincing difference among the two research groups (p value was <0.05) in relation to cholesterol, triglycerides, HDL, LDL and BMI. Conclusion: Hyperlipidemia and High BMI contribute significantly to development of acute myocardial ischemia Keywords: Myocardial Ischemia, Hyperlipidemia, Body Mass index

Background: Hypercoagulation is hallmark complication of Diabetes mellitus where increased coagulability of blood manifests in the form of more clot formation. Type 2 Diabetes Mellitus is a longstanding metabolic abnormality indicated by elevated sugar values in blood and insulin resistance. Aim: To evaluate role and association of serum triglycerides levels in onset and progression of diabetic nephropathy. Materials: 120 patients are included in our study and cases are managed into 02 groups(60 patients each group). A Group: included diabetic cases without nephropathy B Group: included 60 diabetes patients with nephropathy The study data was then analyzed by software SPSS 21 number version. The Probability (P statistical Value) value of < 0.05 was decided as convincing number statistically. Results. The serum triglycerides levels were 159± 13 in A group and 210± 13 in the B group. The unpaired(independent) samples T- statistical test was utilized Using a two-tailed 0.05 criterion, the test showed remarkable difference between the two groups statistically (p value was < 0.05) in relation to serum triglycerides. Based on the inferences of the unpaired (independent sample) t- statistical test (p value was less than 0.05), we repudiated the null statistical hypothesis. Conclusion: Hypertriglyceridemia plays significant part in onset, development and progression of nephro-pathy in diabetic patients. Keywords: Hypertriglyceridemia, Diabetic Nephropathy, Diabetes Mellitus

Early onset neonatal sepsis is invariably very common and serious problem worldwide, especially it is one of the important etiological factor for deaths of neonates in Pakistan. Acute renal failure is frequently seen in neonates with sepsis. Objectives: The aim of present study was to determine the correlation of renal function tests (Blood Urea and creatinine) with early onset neonatal sepsis. Study Design: Descriptive study. Setting: Department of Paediatric Medicine Sir Ganga Ram hospital, Lahore. Period: Six months from 20th March to 20th September 2018. Material & Methods: Total 300 cases of neonatal sepsis with acute renal failure were included in this study after taking informed consent from the parents. Cases selection was done with help of a predefined inclusion and exclusion criteria. Daily blood urea and serum creatinine were calculated from birth to first 7 days of life. If any of blood urea or serum creatinine was deranged, the neonate was labelled as having acute renal failure. Data was entered and analysed using SPSS software version 21. Results: Mean age of all cases was 2.82±1.56 days. The minimum and maximum age limits of the neonates were 1 and 7 days respectively. Gender distribution of neonate showed that 57% of the neonates were male and 43% were females. At the 2nd day of life, mean serum creatinine level was 1.12±0.39, at 3rd day 1.19±0.51, at 4th day 1.41±0.38, at 5th day 1.33±0.39, at 6th day 1.19±0.39, and at 7th day mean serum creatinine level was 1.09±0.31 respectively. At 2nd day of birth mean blood urea was 54.82±34.77, at 3rd day59.50±28.22 at 4th day 74.94±30.37, at 5th day 67.09±26.94, at 6th day 56.09±25.76, at 7th day mean blood urea level was 47.66±22.47 respectively. Frequency of acute renal failure was observed in 28.3% of the neonates while the remaining 71.7% of neonates did not suffer from acute renal failure. Conclusion: Early onset neonatal sepsis contributes significantly to development of acute renal failure in neonates.

Background: White phosphorus cause injuries and bereavement by burning human body, by being inhaled the smoke or body exposed to burning material. Aim: To find out the Human Suffering caused by bomb containing White Phosphorus: Health effects Methodology: An Exploratory Surveys (case control study) was carried out on people who exposed to bomb blasts (white phosphorous) and shooting happened in a market of Lahore. Data was collected from 100 consented victims residing in the terrorism-affected area. The detail of personal data and health effects was recorded in a Proforma. A chi-squared test showed the differences in complains of victims on exposure. Results: Of the one hundred patients majority was male with age < 30 years and were exposed to explosion in open air space.The highest odds of feeling generalized weakness, susceptibility to fatigue was observed followed by psychological trauma, Insomnia in initial days, scared to dark and scared to close door was noted. Other complains of victims wereear drum rupture, with highest odds and it was followed by head injuries, brain injuries, head injuries causes blindness and hair loss due to shelling. Conclusion: In populated placed heavy explosive weaponries increase the risk of personal and emotional harm to general people. Key Words: Bomb Blast, psychological and respiratory problem, ear drum rupture.