Background: Melasma is hyper-pigmentation of skin, usually seen in young female adults, and previous studies have established substantial psychosocial burden associated with this disease. Aim: To measure the frequency of depression in melasma patients and its correlation with severity of melasma Study Design: Descriptive cross-sectional study. Place and duration of study: Dermatology OPD, HIT Hospital Taxila from 1st January 2021 to 31st August 2021 Methods: One hundred consecutive patients of melasma diagnosed by a skin specialist were enrolled. Elderly patients aged >60 years, those with previous psychiatric disease or chronic illnesses and on long term streroids were not included. After getting written informed consent, enrolled patients were screened for depression using Patient Health Questionnaire 9 (PHQ-9) Results: There were 17 males and 83 females. The mean age was 41.5±8.14 years. On MASI scale for assessing severity of melasma, 38 patients scored mild, 51 scored moderate and 11 scored severe. Using Patient Health Questionnaire 9 (PHQ-9) in patients with melasma, 18 patients didn’t have depression, 38 had mild depression, 31 had moderate depression, 6 had moderately severe depression and 7 had severe depression. Conclusion: The frequency of depression is quite high in patients suffering from melasma. It indicates a need for prompt diagnosis, appropriate intervention at correct time to ensure patient’s compliance to therapy to improve his disease outcome. Keywords: Depression, Melasma, Frequency

Background: Despite of our strong want, the datum is that the Covid-19 pandemic is still not over. Its physical and mental sufferings are well known. Mass vaccination is the true hope to eradicate this virus. Despite of large scale efforts, vaccination including boosters still needs optimization Aim: To see the effect of vaccination against covid-19 on general and covid-19 related anxiety so to endorse the continuation of vaccination until the virus is completely eradicated. Study Design: Observational, cross-sectional study Place and Duration of Study: Shifa International Hospital Islamabad from 1st October 2021 to 31st March 2022. Methodology: Three hundred and thirteen subjects with recent history of Covid-19 vaccination were enrolled and 281 subjects completed the survey, asked to fill out CAS (covid-19 anxiety scale) and GAD-7 (general anxiety disorder) scale based on the recall of their feelings before vaccination and then about after vaccination. Results:. Majority were females (61.1%), had education graduation and above (71.2%), belonged to non-medical profession (71.4%). 47.3% had Covid-19 cases in family while 13.2% had covid-19 related deaths in family. Means of CAS were higher than the means of GAD-7 (p<0.001). Drop in anxiety level was statistically significant for both Covid related anxiety and general anxiety after vaccination (p<0.05). Conclusion: Vaccination against covid-19 is crucial to manage Covid related and general anxieties because, future covid waves hence the anxiety waves are still expected. Bereaved families need further psychiatric support beyond vaccination to deal with their anxieties. Keywords: Anxiety in covid, Vaccination and anxiety, Mental health in covid, Covid related anxiety

This study is designed to determine the cognitive impairments in individuals with Down syndrome. This study was conducted in September to November 2014. Sample of 30 patients was taken by using purposive sampling technique within three months. Observational and Cross-sectional study design was used. This was a hospitalbased study in which patients with Down's syndrome between the age range of 5-18 and both genders were included. A structured questionnaire was developed that was based on Piaget's theory of cognitive development to assess the cognitive abilities by assessing tasks related to developmental ages. Out of those 30 patients 15(50٪) were male and 15(50٪) were females. Most of the patients were found in age range of 5-10 years according to frequency 16 (53.3٪) followed by 10 (33.3٪) patients in 10-15 years and 4 (13.3٪) in 15-20 years. The preoperational stage of cognitive development showed that the girls were more impaired. Pretend-play (boys (50%), girls(46.7%)),Centration(boys(40.%), girls(33.3%) and irreversibility boys (50%) girls(40.%) are the aspects in which boys were tending to show better than boys. In concrete operational stage and in formal operational stage both genders were tending to show equal impairments in their cognitive aspects. In the children with Down syndrome it is observed that there is high frequency of cognitive impairment and girls are more cognitively impaired than boys. While the tasks which require more accuracy and intelligence such as reasoning, meta-cognition, inductive and deductive reasoning are rarely present in both genders.

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