Objective: Medical students have considerably higher prevalence rates of depression and suicidal thoughts as compared to their age-fellows from the general population. Only a limited number of studies have previously investigated the suicidal thinking/planning in Pakistani medical students. The aim of this study was to assess the prevalence rates of suicidal thoughts and planning in medical students studying at a private medical college in Lahore, Pakistan. Place and duration: Fourth year and final year medical students at Azra Naheed Medical College, Lahore were invited to voluntarily take part in this study. The study was conducted from 15th of June to the 15th of July 2022. Study design: Cross-sectional descriptive study Methodology: Suicide behavior questionnaire revised (SBQ-R) was used as the study instrument. Data collection was anonymous and the study was approved by the local institutional review board. The study was approved by the Institutional review board of Azra Naheed Medical College, Lahore. Descriptive statitstics were employed to report the findings and SPSS version 26 was used to store and analyze the data. Results: A total of 248 medical students (51.5% female) participated in the study. The prevalence of suicidal thoughts/plans in the past was 36.3% and the prevalence of suicidal thoughts in the past year was 31%. More than 16% of students communicated their intent to commit suicide to someone else in the past and 7% of the students reported that it was likely, rather likely or very likely that they will attempt suicide in the future. Conclusions: The prevalence of suicidal thoughts/ planning in medical students is worryingly high. Medical teachers should routinely assess their students for the presence of depressive symptoms/suicidal thoughts and offer support for students who screen positive for these. Key words: Suicide, Medical students, Prevalence

Objective and background: Previous studies have reported a high prevalence of depressive and anxiety disorders in medical students. The aim of the current study was to investigate the prevalence of PTSD symptoms among 1st to 3rd year MBBS students. Place and duration: The study was conducted at Azra Naheed Medical College, Superior University, Lahore, Pakistan from 15th of August o 15th of September 2022. Methodology: A Google form was developed by authors of the study that comprised demographic questions as well as items of post-traumatic stress disorder checklist-Civilian version (PCL-C). The form was posted in the official WhatsApp group of each class and the rationale and purpose of the study were communicated to students. Confidentiality of the data was ensured and anonymity of the participants maintained at all stages. The study was formally approved by the Institutional review board of Azra Naheed Medical College, Lahore. Descriptive statistics, independent samples T-test and the ANOVA test were employed to analyze and report the findings. SPSS version 26 was used for reporting and analyzing the data. Results: A total of 223 medical students (45.4% males) participated in the study. Nearly three quarters of medical students (73.4%) had either moderate, (29.1%) or severe (44.3%) PTSD symptoms. No significant difference was found between the students with regards to gender, age group and year of study. Students who belonged to a mixed rural/urban background had significantly higher PTSD symptoms as compared to students from a predominantly rural or urban background. Practical Implication Medical students should be routinely assessed for the presence of anxiety/depressive disorders, as successful treatment of these disorders may improve the quality of life as well as the academic performance of the students. Conclusions: The prevalence of PTSD symptoms in medical students participating in this study is very high. Future studies should investigate the reasons as well as the risk factors associated with PTSD in medical students. Keywords: Post Traumatic stress disorder, Medical students, Anxiety

Background: Chronic liver disease is a highly prevalent illness globally and in Pakistan as well. The current study was designed to investigate the prevalence of anxiety and depression in patients with chronic liver disease (CLD) in hospitalized patients. Methods and materials: Agha khan University anxiety and depression scale (AKUADS), a questionnaire developed natively in Urdu language, was the instrument used for the study. Admitted patients with the diagnosis of chronic liver disease at a tertiary care hospital in Lahore were invited to take part in the study. A total of 107 patients volunteered to take part in the study (29.9% females) from February 2018 to November 2018. Descriptive statistics was employed to report the prevalence of anxiety and depressive disorders in the study population and independent samples T-test was used to analyze the gender difference between the participants. Results: All study participants scored above the cut-off score of 20 on AKUADS. No significant gender difference was seen among the study participants on mean AKUADS scores. Conclusions: The prevalence of depressive and anxiety disorders is very high in patients with CLD. These patients should be assessed for the presence of depressive and anxiety symptoms on a frequent and routine basis. Recognition and treatment of depressive and anxiety symptoms at an early stage may lead to avoidance of many adverse outcomes related to CLD. Keywords: Depression, Anxiety, Chronic liver disease

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Background & Objective: After the Spanish Flu world has seen epidemics of SARS and MERS; however, these epidemics have no comparison to the magnitude of devastation caused by COVID-19. This virus originated from Wuhan, China and spread to every nook and corner of the world within weeks. In three months World Health Organization had labeled it as a pandemic. This novel deadly virus shows no discrimination of race or age. Everyone is equally at risk of developing the infection; however, clinical severity is thought to be influenced by age and the presence of comorbids. Furthermore, an increased rate of intensive care admissions, length of stay, need for mechanical ventilation, and mortality have been reported in patients with COVID-19 infections having comorbids.The objective of this study was to evaluate the Factors responsible for clinical severity of COVID 19 infection in patients presenting to tertiary care hospitals in Lahore. Methods: This Descriptive observational study was conducted simultaneously at three tertiary care hospitals in Lahore. A total of 200 confirmed patients with COVID-19 infection by RT PCR were included in the study. The case records of all the inpatients in the General Corona ward, Isolation wards, HDUs and ICUs were analyzed. Data analysis was performed in SPSS 20. Age, gender, and comorbid including Diabetes, hypertension, ischemic heart disease were recorded and their relationship with the severity of COVID 19 infection was studied by applying the Spearman's rank correlation and Fisher's exact test. Results: Out of the total 200 patients 54.5% were male and 45.5% were female, with a mean age of 58.29 ± 15.20 years. Critical and severe disease was seen in 33% and 63% of patients respectively. Most frequent comorbids reported were Hypertension (HTN), Diabetes (DM), ischemic heart disease (IHD), and lung diseases. A statistically significant positive association was observed between the severity of COVID 19 infection and increased age, diabetes. Hypertension was most frequently reported comorbid but association was not statistically significant. However, patients who had HTN along with ischemic heart disease had a statistically significant positive association with the severity of the disease . Conclusion: Advanced age, diabetes Mellitus and hypertension when present in patients with ischemic heart disease have a statistically significant association with clinical severity of patients suffering from COVID 19 infection.