Background: In Pakistan, almost 30% population is between 15 to 29 years of age, with university enrollment rates of 10–15%. Although there is a growing concern on mental health of university students across the globe, studies from low and middle income countries such as Pakistan are scarce. We conducted a systematic review and meta-analysis of prevalence of depressive symptoms among Pakistani university students.Methods: PubMed, Web of Science, PsycInfo and Google Scholar were searched between 15 to 30th January 2020. Cross-sectional and longitudinal studies, published till 31st December 2019 were included. Data on study characteristics and prevalence of depressive symptoms were extracted. Meta-analysis was conducted using random effects models. To estimate subgroup difference based on study characteristics, meta-regression and sub-group analyses were conducted.Results: In total, 26 studies involving 7,652 participants were included in review. Overall prevalence of depressive symptoms was 42.66% (95% CI: 34.82% to 50.89%), with significant heterogeneity among studies. Subgroup analyses revealed a significant difference in prevalence estimates based on depression screening instrument and study major. Statistically significant differences were observed among studies employing different psychometric scales (test for subgroup differences, Q = 21.92, p < 0.05) and between students from different study majors (test for subgroup differences, Q = 3.76, p = 0.05).Conclusion: Our study found that overall prevalence of depressive symptoms among university students in Pakistan was 42.66%, however, findings should be interpreted with caution. Large scale epidemiological surveys using valid and reliable tools are needed to better estimate prevalence of depression among Pakistani university students.

Background: Pilonidal sinus is a common chronic disease of thesacrococcygeal region. The treatment for a pilonidal sinus varies according to the clinical presentation of the disease.Although many surgical methods have been suggested, an ideal method is still lacking because of high recurrencerates. Setting: Surgical Unit-II, Allied Hospital, PMC, Faisalabad. Material and Methods: This prospective studyincludes 30 patients who were treated with the use of a rhomboid excision and Limberg flap closure for chronic andrecurrent sacrococcygeal pilonidal sinus. The follow-up period ranged from 04 to 08 months. Results: The meanhospital stay was 03 days (range, 03-08 days) and the mean time to return to work was 15 days (range, 12-26 days).Early wound complications were encountered in 03 patients. No recurrence was noted on maximum of 08 months offollow-up. Nine patients had numbness at the operation site and 10% were not pleased with cosmetic appearance ofthe scars. Conclusions: The results favor rhomboid excision and Limberg flap closure in the treatment ofsacrococcygeal pilonidal sinus, especially in recurrent cases and in patients with extensive involvement. Low recurrencerates, shorter hospital stay, and time off from work may outweigh the disadvantages related to unfavorable cosmeticappearance.

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