Sarcoptes scabiei (S. scabiei), a parasite mite which causes scabies disease resulting in serious public health concern. The long-term scabies disease can lead to complications such as septicemia, acute post-streptococcal glomerulonephritis, heart disease, and secondary infections. Timely treatment to the affected patients is required to control the disease and get rid of the causative agent. Delayed diagnosis and inappropriate treatment can lead to serious consequences. The most common treatment strategy is the use of allopathic medicines which can immediately relieve the patient but have the drawback of side effects. The safe and cost-effective alternative treatment strategy is the use of medicinal plants which have beneficial therapeutic potential against variety of diseases due to the presence of many bioactive phytoconstituents with no or minimal side effects. For the present review, the published articles describing scabies disease and its phytotherapeutic modalities were searched through different data bases including Google Scholar, PubMed, Medline, and ScienceDirect using the keywords like S. scabiei, prevalence of scabies disease, and phytotherapy of scabies. A large number of medicinal plants, such as Melaleuca alternifolia, Curcuma longa, Azadirachta indica, Rosmarinus officinalis, Capsicum annuum, Cinnamomum camphor, Solanum nigrum, and Eupatorium perfoliatum, have been reviewed for the promising future treatments of scabies. All the studied plants have many bioactive compounds with potential therapeutic effects against scabies and can be utilized for therapeutic purposes for this disease. This literature study has limitations because of the lack of sufficient data due to limited pre-clinical trials in this particular area. This review provides a baseline to explore the therapeutic potential of these medicinal plants against skin diseases. However, extensive studies are required to identify, authenticate, and characterize the bioactive compounds present in these plants which may lead to value addition in pharmaceutical industries providing the cost-effective way of treatment with minimal side effects. K E Y W O R D S

Aim: To study the prevalence and response to needle-stick injuries in a tertiary care hospital. Study design: Cross-sectional study Place and duration of study: Dept. of Gen. Surgery, Hayatabad Medical Complex Peshawar from 01-06-2020 to 30-06-2022. Methodology: One hundred and ninety three healthcare workers were recruited, including doctors, medical students, nurses, student nurses and paramedics. Results: There were 60(31.1%) healthcare workers reported needle stick injury. Majority of the injuries 51(85%) occurred during contact with patients who were assessed as not high-risk and 9(15%) when exposed to high-risk patients. Most of responders 49(81.7%) reported that the injury was self-inflicted and 11(18.3%) reported that it was caused by someone else. About 45(75%) injuries were caused by hollow bore needle and 15(25%) by a solid needle. Most of the needle stick injuries occurred at the bedside 50(83.4%), 8(13.4%) in the operating theatre and 2(3.4%) were at other locations. Conclusion: Needle stick injury is a significant cause of physical and psychological morbidity among healthcare personnel. Proper training and strict protocol for following the standard precaution can minimize its incidence. To improve its reporting the procedures of reporting a needle stick injury could be simplified. Keywords: Needle, injury, health care professional

Background: Fetal buttocks or feet positioned at the pelvic inlet are referred to as breech presentation. Both vaginal delivery and Caesarean section are options for them. Everyone agrees that breech deliveries are better handled by caesarian section than by vaginal delivery. Risk factors for breech presentation include uterine abnormalities, prematurity, foetal abnormalities, and repeated pregnancies. This research sought to ascertain the foetal fate in multigravida individuals undergoing breech vaginal birth. Methods: This descriptive case series investigation was carried out at the Khyber Teaching Hospital in Peshawar, in the department of obstetrics and gynaecology. The study was conducted from October 2018 to April 2019, seven (07) months. Patients had thorough clinical examinations and lengthy history interviews. The selected patients were instructed to have normal labour under careful foetal and maternal monitoring supervision. All of the patients that experienced a regular delivery had their specific information entered into the database along with the intrapartum occurrences and immediate foetal outcomes. At five minutes, an apgar score was obtained. Brachial plexus damage, low birth weight, low apgar score, foetal distress, and stillbirth were among the foetal outcomes that were reported. Results: As per fetal outcomes, 35 (16.21%) patients were recorded with low apgar score, 37 (17.05%) patients were registered with low birth weight, 69 (31.79%) patients were recorded with birth asphyxia, 27 (12.44%) patients were recorded with brachial plexus injury, 26 (11.98%) patients were registered with fetal distress and 23 (10.59%) patients were recorded with still birth. Conclusion: This research shown that foetal morbidity comes from vaginal breech deliveries (VBD) of singleton term pregnancies. To prevent these difficulties in our local Khyber Pukhtunkhwa population, we thus highlight the necessity for special safeguards, including close monitoring of labour and enough preparedness for newborn resuscitation. This study may be useful in breech delivery decision-making by helping to personalise each choice by understanding the risks involved. Based on the findings, the technique of delivery in breech presentation should be determined. Keywords: Breech, Vaginal Delivery, Singleton Term Pregnancies, Fetal Morbidity, Multi- Gravida.

Introduction: Toxoplasma gondii (TG), Rubella virus (RV), Cytomegalovirus (CMV), and Herpes simplex virus (HSV) 1 and 2, globally most neonatal and infant deaths are reported due to this group of infections. Purpose: The objective of this research study is to estimate the Prevalence of TORCH infections. Methods: This research study was carried out at the Hi-Tech clinical laboratory Shewa Adda Swabi KPK Pakistan for a duration of 4 months from April 2022 to July 2022. Data statistics looking at the clinical characteristics of Toxoplasma gondii, CMV, RV, and HSV were filled from n=371. All samples were qualitative and quantitative tested by using Immune chromatographic (ICT) and Chemiluminescence Microparticle Immunoassay (CMIA) techniques. Results: Out of n=317 pregnant women, n=131 (35 %) women were found positive while n=240 (65 %) women were found negative. Prevalence of Toxoplasma gondi 32 %, RV 28 %, CMV 27 %, and HSV 13 % in Swabi, KPK, and Pakistan. Among them, a high-frequency fraction of co-infection was detected for CMV and Rubella 17 (58 %), followed by CMV, Herpes, Rubella virus, and Toxoplasma gondii combined 7(25 %). The highest number of infected individuals 37 % we found in the age-group 21-25 years, followed by the 15-20 years age group 23 %, 26-30 years age group 17 %, 31-35 years age group 23 % while the lowest number of positive individuals found in >36 age group. Conclusion: In brief context, TORCH pathogens have potentially shocking clinical manifestations. Hence, screening before pregnancy, and timely diagnosis of TORCH can reduce disease and death in both kid, and the mother. Moreover, knowing the epidemiology survey is a significant aspect to develop strategies and implementation for the prevention of disease. Keywords: Pregnancy, Prevalence, TORCH, Swabi, Infections.

Background: All disturbed pattern of bleeding which arises due to different reasons such as anovulation, pregnancy, uterine abnormalities and coagulopathies is termed as abnormal uterine bleeding (AUB). Abnormal uterine bleeding is present in many forms such as heavy bleeding, short menstrual cycle, excessive and heavy menstruation, uterine bleeding at irregular period, excessive and prolonged uterine bleeding. Abnormal uterine bleeding is mostly caused by benign findings such as endometrial hyperplasia or atrophy or benign polyps. Around 5–12% of Abnormal uterine bleeding results from Endometrial Cancer. Objective: Uterine artery Doppler indices in various causes of abnormal uterine bleeding confirmed with histopathology. Methodology: A Cross-sectional Analytical study was conducted at Shireen Ultrasound Clinic Peshawar, Pakistan. This study enrolled a purposive sample of 162 patients presenting with abnormal uterine bleeding with the age between 18 to 80 years. The examination was performed with Toshiba Nemio 20(Xario Prime with TVS Probe frequency range 7-14MHz) .The Resistive index(RI), Pulsatility index(PI), mean and standard deviation were calculated for the continuous variables. Results: A total of 162 patients were enrolled in our study. The mean age of patients was recorded 38±5 years. In this study, the histopathological findings were as follow, 8.6% adenomyosis,12.3% endometrial hyperplasia, 43.3% leiomyoma’s, 17.3% polyp, 2.5% endometrial carcinoma and 16% non-specific findings so the most common cause of abnormal uterine bleeding was leiomyoma’s with mean of Right Uterine artery (U-A) PI and RI was 3.33±1.23 and 0.83±0.03 respectively and left U-A PI and RI was 2.95±1.17 and 0.84±0.03 respectively while the least common cause was endometrial carcinoma with mean of Right U-A PI and RI was 2.54±1.08 and 0.52±0.01 respectively and of Left U-A PI and RI was 1.62±0.00 and 0.52±0.00 respectively. Conclusion: From our study we concluded that the uterine artery RI in endometrial carcinoma causing abnormal uterine bleeding is low and in benign condition like polyp, hyperplasia and fibroids is high. Keywords: Uterine bleeding, Carcinoma, Fibroids, Hyperplasia, Trans-vaginal ultrasound