One of the common dilemma and the most important cause of child death below the age of 5 years in developing countries is acute gastroenteritis. Aim: To check the frequency of inflammatory diarrhoea (faecal leukocyte count ≥ 5/ml or faecal calprotetctin positive) in young patients presenting with acute gastroenteritis in hospital. Study design: Descriptive cross sectional study. Methodology: Patients (n=366) within the age range of 1 day to 6 years presenting to the OPD with the complaints of symptoms associated with acute gastroenteritis (diarrhoea with or without abdominal pain, vomiting and nausea) were included into the study. Patients demographic data were collected. Stool samples from the patients were obtained in sterile bottles and sent for Stool RE and CS examination. All this information was recorded on Performa. Data was analyzed using SPSS version 26. Results were presented as frequency and percentage. Age was presented as mean± SD. Results: Out of total 366 patients 178 (48.6%) were male and 188(51.4%) were female. Mean age of the patients presenting to the OPD/MRC was 826 days (2.2 years) ± 618 days, with a range 13 days to 2187 days (5.9 years). Frequency of inflammatory diarrhea was 193(52.7%) among patients presenting with acute gastroenteritis as compared to non inflammatory diarrhoea. Conclusion: It was concluded that frequency of inflammatory diarrhoea in young patients presenting with acute gastroenteritis is alarmingly high in our region. Various programs for the identification and eradication of causative factors and organisms should be carried out along with education of masses about this fatal condition. Keywords: Acute Gastroenteritis, Diarrhoea, Infectious Diarrhoea, Inflammatory Diarrhoea and Non-Inflammatory Diarrhoea,

Objective: To compare the effectiveness of intraarticular injections of hyaluronic acid and corticosteroids in the treatment of patients with knee osteoarthritis symptoms.Study Design: Prospective comparative study.Place and Duration of Study: Rheumatology/General Medicine department, Pak Emirates Military Hospital Rawalpindi, from May 2019 to Jun 2020.Methodology: Patient of knee osteoarthritis with active symptoms of pain and stiffness who fulfilled American college of rheumatology criteria of 1997 were included in the study. They were randomly divided into two groups with group A receiving intraarticular hyaluronic acid. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was administered before and three months after the management to assess the efficacy of treatment in both the groups. Student ttest was applied to ascertain that the difference in the WOMAC scores before and after the management has been statistically significantly different in both groups. Results: A total of 150 patients of osteoarthritis of knee joint were included in the study. Mean age of the study participants was 58.439 ± 7.35. 85 (56.7%) patients were female while 65 (43.3%) were male. 81 (54%) received the intraarticular hyaluronic Acid while 69 (46%) received the intraarticular steroids. Mean difference before and after the management in WOMAC score in corticosteroids group was 9.295 ± 1.24 while in hyaluronic Acid group was 5.41 ± 4.556 (p-value <0.01). Conclusion: Both hyaluronic Acid and corticosteroids were effective to reduce the symptoms of osteoarthritis knee in our target population, but intraarticular steroids emerged as the better option from the two in terms of.......

Background: One of the leading cancers worldwide is the hepatocellular carcinoma, ranked as the 6th most common cancers. Aim: To evaluate the co-relation between BCLC staging of HCC and alpha fetoprotein levels. Study design: Cross-sectional study. Methodology: Patients (n=90) of either gender irrespective of age who were diagnosed with hepatocellular carcinoma were included into the study. Clinical examination was performed and findings were noted. Eastern cooperative oncology group ECOG scoring system was used to identify the functional performance status of the patients. Hepatocellular carcinoma staging was done using the BCLC scoring system. Complete blood counts, Liver function tests (LFTS), INR, alpha fetoprotein levels, viral serology for hepatits and ultrasonography of abdomen were performed for all the patients. Data was analyzed using SPSS version 26. Results were presented as frequency and percentage. Age was presented as mean± SD. Results: Mean AFP levels were 400.7±305.4 IU/ml with a range of 8.50- 1015 IU/ml. 3(3.3%) patients were in BCLC stage 0, 23(25.6%) were in stage A, 33(36.7%) in stage B, 15(16.7%) in stage C and 16 (17.8%) in stage D. Results showed significant positive correlation between BCLC staging and AFP levels (r=o.834, p=0.001). Conclusion: It was concluded that Hep C followed by Hep B was the main cause of HCC. AFP has a significant diagnostic and prognostic value with positive co-relation with HCC. Keywords: Alpha-Fetoprotein, BCLC Staging, HCC and Liver Disease.

Objective: To determine the efficacy of Methotrexate versus Leflunomide versus combination of both among patients managed at Pak Emirates Military Hospital with active rheumatoid arthritis. Study Design: Prospective comparative study. Place and Duration of Study: Rheumatology/General Medicine Department, Pak Emirates Military Hospital Rawalpindi, from May 2019 to June 2020. Methodology: Patient of active rheumatoid arthritis who fulfilled American college of rheumatology criteria of 1997 were included in the study. They were randomly divided into three groups with group A receiving Methotrexate, group B receiving Leflunomide while group C received the combination of both Methotrexate and Leflunomide. Disease activity was assessed by using the Disease Activity Score-28 in all the three groups after three months of treatment. Results: Mean age of the study participants was 36.919 ± 6.85 years. One hundred and fifty (83.3%) patients were female while 30 (16.7%) were male. Out of 160 (88.9%) patients achieved remission according to Disease Activity Score-28 score at the end of three months while 20 (11.1%) did not achieve remission. Pearson chi-square test revealed that none of the factors studied including the treatment option had any statistically significant relationship with presence of remission among the target population (p-value 0.386, 0.815, 0.194 and 0.145 for age, gender, duration of symptoms and type of treatment respectively). Conclusion: Remission rate among the rheumatoid arthritis patients in response to treatment was overall good in the study. In terms of efficacy for symptoms of rheumatoid arthritis and achieving remission, after three months of treatment all the three options..................