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Objective: To compare the effectiveness of intradermal platelet-rich plasma with 30% Trichloroacetic acid in treating atrophic acne scars. Study Design: Quasi-experimental study. Place and Duration of Study: Tertiary Care Hospital of Multan Pakistan, from Aug 2019 to Sep 2020. Methodology: A total of 76 patients (38 in each group), were enrolled in the study. Platelet-rich plasma treatment was given to Group-A, and 30% Trichloroacetic acid treatment was given to Group-B patients. Platelet-rich plasma was injected in the dermis with an insulin syringe while 30%Trichloracetic acid was applied with a cotton tip applicator. The effectiveness of treatment was measured by Goodman and Baron quantitative acne scar scale. Results: A total of 76 patients with atrophic acne scars were included in the study. The mean age of patients in Plate rich plasma Group was 29.63±5.08 years and 29.92±5.85 years in the 30% Trichloroacetic acid Group. Platelet Rich Plasma was an effective treatment of atrophic acne scar (p= 0.030) with post-procedure improvement in the Goodman and Baron quantitative acne scar scale. Conclusion: Atrophic acne scar treatment with intradermal Plate-rich plasma is more effective than 30% Trichloroacetic acid.

ABSTRACT… Objectives: Diabetes Mellitus being a major issue faced by developing countries like Pakistan. Non-adherence is a major issue in achieving a desired therapeutic goal. This study aims at determining relation with the drug non-adherence associated with the treatment regime, treatment satisfaction and educational status of the person. Study Design: This was a cross sectional study. Place and Duration: This study was done at the Diabetes clinic, Nishtar hospital, Multan. Total 242 diabetic patients were studied over a period of 10 months. Methodology: The inclusion criteria was set as patients who have been diagnosed with Diabetes Type II and had been on oral hypoglycemic medications for about last 5 months or more. Those patients who were diagnosed with Type I diabetes and Type II diabetes less than 5 months were not included in the study. Also those patients who were on Insulin therapy were also excluded. Socio-demographic data was obtained along with therapy type and educational status. Drug adherence level was studied with the 8-item Morisky (MMAS-8). Treatment satisfaction was studied with the help of treatment satisfaction questionnaire for medication. The data was analyzed on the SPSS version 23 with significant p-value <0.05. Results: Among 242 patients 152(62.81%) were females and 90(37.19%) were males. Mean age of the patients were 47.68±15.13 years. Patients on combination therapy were (n=134, 55.3%) and on monotherapy were (n=108, 44.6%). Mean adherence score was 5.4±1.1.The mean for four domains of Treatment Satisfaction Questionnaire for Medication(TSQM) were: effectiveness= 66.93±15.27, side effects=32.09±26.91, convenience =62.59±14.49 and satisfaction= 65.49±16.13.Non-adherence was found to be associated with age, illiteracy, side-effects, satisfaction and convenience (p<0.05). Conclusion: Non-adherence must be overcome in patients to achieve appropriate glucose levels. Significant factors affecting the adherence levels were Illiteracy, Side effects, convenience and satisfaction of the patient. Public awareness campaigns and regular clinic visits should be encouraged. Drugs having lower sideeffects, higher satisfaction levels and combined generics for once daily dosing having greater convenience should be used.

Objectives: Diabetes Mellitus being a major issue faced by developingcountries like Pakistan. Non-adherence is a major issue in achieving a desired therapeuticgoal. This study aims at determining relation with the drug non-adherence associated with thetreatment regime, treatment satisfaction and educational status of the person. Study Design:This was a cross sectional study. Place and Duration: This study was done at the Diabetesclinic, Nishtar hospital, Multan. Total 242 diabetic patients were studied over a period of 10months. Methodology: The inclusion criteria was set as patients who have been diagnosedwith Diabetes Type II and had been on oral hypoglycemic medications for about last 5 monthsor more. Those patients who were diagnosed with Type I diabetes and Type II diabetesless than 5 months were not included in the study. Also those patients who were on Insulintherapy were also excluded. Socio-demographic data was obtained along with therapy typeand educational status. Drug adherence level was studied with the 8-item Morisky (MMAS-8). Treatment satisfaction was studied with the help of treatment satisfaction questionnaire formedication. The data was analyzed on the SPSS version 23 with significant p-value <0.05.Results: Among 242 patients 152(62.81%) were females and 90(37.19%) were males. Meanage of the patients were 47.68±15.13 years. Patients on combination therapy were (n=134,55.3%) and on monotherapy were (n=108, 44.6%). Mean adherence score was 5.4±1.1.Themean for four domains of Treatment Satisfaction Questionnaire for Medication(TSQM) were:effectiveness= 66.93±15.27, side effects=32.09±26.91, convenience =62.59±14.49 andsatisfaction= 65.49±16.13.Non-adherence was found to be associated with age, illiteracy,side-effects, satisfaction and convenience (p<0.05). Conclusion: Non-adherence must beovercome in patients to achieve appropriate glucose levels. Significant factors affecting theadherence levels were Illiteracy, Side effects, convenience and satisfaction of the patient. Publicawareness campaigns and regular clinic visits should be encouraged. Drugs having lower sideeffects,higher satisfaction levels and combined generics for once daily dosing having greaterconvenience should be used.

Objective: Liver cirrhosis is one of the most widespread diseases in underdeveloped countries. Study Design: Cross Sectional Study. Setting: Nishtar Hospital Multan. Period: January 2020 to March 2020. Material & Methods: Three hundred and ninety seven of admitted patients were included and patients falling in class C of child Turcotte Pugh classification of liver cirrhosis were determined. Prevalence of hepatocellular carcinoma and cause of cirrhosis in these patients was also determined. Statistical Package for Social Sciences (SPSS 23.0) was used for analysis. Results: Out of 397 patients included in the study 25.4 % or 101 had class C cirrhosis, out of these 5.94% or 6 also had hepatocellular carcinoma. With respect to age of initial diagnosis of the illness 25.7% or 26 were in age interval 31-40yrs, 24.8% or 25 in interval 41-50yrs, 20.8% or 21 in interval 51-60 yrs. Hepatitis C (67.3%) comes out to be the commonest of all causes of chronic liver disease, followed by other causes (18.8%), then both hepatitis C and B (7.9%) and hepatitis B alone (5.9%). Conclusion: Our study concluded that approximately 1 in every 4 patients admitted in medical wards of a tertiary care hospital have severe liver cirrhosis caused most commonly by hepatitis C with most common age of presentation being 30-60 years. Approximately 6 out of 100 of these patients also had hepatocellular carcinoma.