Objective: To determine the frequency of successful cannulation of ultrasound assisted inline oblique transducer approach for internal jugular venous cannulation. Study Design: Descriptive Case Series. Setting: Department of Anesthesia and Intensive Care, Hameed Latif Hospital, Lahore. Period: 22-02-2017 to 22-08-2017. Material & Methods: In this study the cases were included of both gender and age between 18 to 65 years. Jugular vein was visualized ultrasonographically in an oblique axis and the needle was inserted in the same plane, aligned with the longitudinal axis of the transducer. Success rate was noted. Results: The mean age of patients was 49.94±10.90 years, male to female ratio of the patients was 1.9:1. In this study the successful cannulation was observed in 145/155 (93.55%) patients. Conclusion: It has been observed in this study that the ultrasound assisted inline oblique transducer approach is successful technique for IJV cannulation.

Background: Previous findings have shown that the body mass index (BMI) is related positively to bone mineral density (BMD). In patients with low BMI (<18.5 kg/m2), the levels of BMD have usually been decreased and the T-values have been low. The goal of the study is to assess weight-BMI-BMD relationships among743 healthy people from the Karachi Gulshan district.Methodology: The research comprised a population of 743 people classified into four BMI classes. The BMD measurement in all the study participants was done by using a Sonost 3000 (Ultrasound Bone Densiometer) from Osteosys CO. Ltd. Korea.Results: The findings of BMI and BMD correlation indicated that osteopenia was occur more in underweight individuals than the overweight and obese, while osteoporosis occurred more in those who were obese in the comparison under & overweight individuals.Conclusion: The study of the associations between BMI and BMD in both male and female participants revealed a strong positive association showed by Pearson's correlation analysis.

Background: The ninth month of the Islamic calendar is Ramadan, during which Muslims fast from dawn till sunset. This extended fasting period may affect the management of diabetes in diabetic people. This study aimed to compare the number of visitors to the diabetic Emergency Room (ER) of a private tertiary care hospital in FB Area, Karachi, Pakistan, throughout Ramadan and other lunar months, with diabetes emergencies. Methodology: A retrospective cross-sectional study was conducted utilizing an electronic medical record review of patients with diabetes emergency who visited the ER of a tertiary care hospital between the ninth and eleventh lunar months during the previous two years. Patients with diabetes who visited the ER and were more than 18 years old were included. It established the frequency of ER visits, sociodemographic parameters, and clinical features. The relationships between variables were evaluated using the SPSS Software. Results: During the selected study period, the ER reported a total of 32,134 admissions. There were just 0.61 % of diabetes emergency visits. According to the inclusion criteria, 123 participants were included in the study (64.2% men and 35.7% women). The majority (51.2%) took oral hypoglycemic agents, and more than half (60.97%) had type 2 diabetes. There was a substantial variation in the prevalence of diabetes emergency visits between Shaban, Ramadan, and Shawal, 0.55, 0.32, and 0.27 %, respectively. However, the peak incidence did not occur during Ramadan. Despite identifying specific associations, the study showed no significant differences between the frequency of ER visits during Ramadan and the prior and subsequent lunar months regarding demographic and clinical variables and diabetes profile. Practical Implication: The following investigation will help in designing a plan with suitable diet and antidiabetic agents that will help in balancing the blood sugar levels as well as the glycemic index. Conclusion: In contrast to earlier studies, a decreasing prevalence trend was observed from Shaban to Ramadan to Shawal. This demonstrated that fasting throughout Ramadan has no negative effect on the occurrence of diabetes emergencies compared to other months. During the three-month study period, type 2 diabetes and insulin-treated patients with hyperglycemia were the leading cause of diabetic emergency room visits, with no significant variations across the months. These findings underscore the necessity for primary care physicians to thoroughly evaluate type 2 and insulin-treated individuals and provide comprehensive health education and counseling. Keywords: Ramadan, Diabetes, Fasting, Emergency visit, Antidiabetic agents, Diabetic Ketoacidosis, Hypoglycemia

Diabetes mellitus has high global prevalence and occurrence and is considered to bean endocrinological and/or metabolic disorder. Conventional drug treatment is costly and has toxic side effects, although it is successful in treating diabetes mellitus. If effective and less toxic, herbal medicine will thus include alternative therapy. This research has been designed to investigate the role of Grewia asiatica extract in the control of diabetes in male albino rats with Streptozotocin mediated type 2 diabetes. Grewia asiatica fruit extract at a dose of 200mg/kg was given to Streptozotocin mediated type II DM Rats. A known anti-diabetic drug, Glibenclamide has been used as a standard drug. The method of the research was to monitor the effect of Grewia asiatica on the blood glucose level of Rats. In this study, Rats were split into four categories i.e. Control, Streptozotocin treated, Streptozotocin + Glibenclamide treated and Streptozotocin +Grewia asiatica extract-treated group.  Grewia asiatica fruit extract significantly improve the blood glucose levels as compared to the standard drug Glibenclamide in Streptozotocin mediated diabetic group. Conclusion: It was concluded that Grewia asiatica may be used in the treatment of diabetes or decreasing the elevated level of blood sugar.

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