Objectives: To determine the frequency of slow/no flow in primary percutaneous coronary intervention, to know the clinical and angiographical predictors of the phenomenon, and to investigate the immediate impact of slow/no flow on hemodynamics. Method: The cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from June 2018 to July 2019, and comprised patients presenting with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention. Demographic and clinical details of the patients were recorded. The antegrade flow was assessed and determined using the thrombolysis in myocardial infarction criterion. Patients were assessed for the occurrence, predictors and impact of slow/no flow. Data was analysed using SPSS 21. Results: Of the 559 patients, 441(78.9%) were males. The overall mean age of the sample was 55.86±11.07 years. Angiographical slow/no flow during the procedure occurred in 53 (9.5%) patients, while normal flow was achieved in 506(90.5%). The thrombolysis in myocardial infarction grade in the affected patients was 0 in 10(1.8%), 1 in 15(2.7%), and 2 in 28(5%) patients. Smoking status, Continuous...

Background and Aim: Most women who experience diffuse hair loss suffer from female-pattern hair loss (FPHL). Several mechanisms other than androgen have been suggested as contributing to the process. Serum 25-hydroxy vitamin D [25-(OH) D] has been associated with other hair disorders. The present study aimed to assess the female-pattern hair loss possible association with variation in serum 25-hydroxyvitamin D levels. Patients and Methods: This case-control study was conducted on 72 FPHL diagnosed female patients attending dermatology department of Tertiary Care Hospitals in Jamshoro and Karachi from November 2021 to October 2022. Females aged 18-40 years with skin prototypes III and IV were enrolled. About 72 healthy females were considered as control group. Study protocol was approved by the institutional research and ethical committee. Careful history, socioeconomic status, FPHL family history, menstrual history, and drug intake were recorded from cases and control. Patients were classified as having stage I, II, or III FPHL based on a clinical evaluation of the pattern of hair loss using Ludwig's scale. 25-OHD levels over a period of 4 months were measured to minimize seasonal bias. Females with 25-OHD levels <20 ng/ml were deficient, insufficient 21–29 ng/ml, sufficient >30 ng/ml, and intoxication >150 ng/ml. SPSS version 26 was used for data analysis. Results: The overall mean age was 28.6±2.4 years. Age-wise distribution of patients were as follows: 9 (12.5%) in 18-25 years, 24 (33.3%) in 26-30 years, 21 (29.2%) in 31-35 years, and 18 (25%) 36-40 years. Serum 25-(OH) D levels in FPHL patients were significantly lower (15.4 ± 8.25 ng/ml) than in controls (46.42 ± 19.92 ng/ml). The mean vitamin D level did not differ significantly between patients with and without family history (14.46 ± 8.62 and 13.9 ± 8.24 ng/ml, respectively. The mean vitamin D level differed significantly between the three Ludwig's degrees (13.15 ± 8.49, 14.23 ± 6.74, and 24.9 ± 6.42 ng/ml, respectively): between degrees I and III, as well as between degrees II and III. Conclusion: The present study showed that hair loss varied significantly across all age groups. Premenopausal women with vitamin D deficiency have higher rates of hair loss, which is most profound in the age groups 26-30, followed by 25-30. Furthermore, changes in serum 25-(OH) D levels, whether deficient or sufficient, may play a role in the etiology of FPHL. Keywords: Female Pattern Hair Loss (FPHL), Vitamin D, Serum 25-hydroxy vitamin D

Objective: To determine the Effectiveness of topical application of 15℅ salicyclic acid and 0.1℅ Diphencyprone combined in an ointment form for treatment of plantar warts. Place and Duration: This Descriptive, case series was held in Dermatology outpatient department, Abbasi Shaheed Hospital Karachi. Method: A sample size of 80 patients with plantar warts were included as calculated by exact 95% confidence interval. Results: Total 80 patients of plantar warts were enrolled. 40 (50%) were females and 40 (50%) were males, with mean age of 31 yrs. 65 patients (81.25%) showed positive response to treatment with combined DPCP and salicyclic acid, while remaining 15 (18.75%) had some mild adverse reactions. Conclusion: As Plantar wart is a common problem in all populations therefore more randomized trials should be done on combined chemical treatments for better outcomes.

Objective: To determine the frequency of prevailing microorganism, treatment approach, different treatment complexities and rationalize the approach for treating Infective Endocarditis (IE) patient. Material and Methods: The retrospective study was conducted from 01st January 2015 to 31st October 2019. Data was collected and after applying exclusion criterion 40 patients were selected and their available record was evaluated. To obtain the conclusive results, frequency and percentages were calculated. Results: The mean age of patient in studied group was 34.02 years with standard deviation (S.D) 13.02 years, and 65% of patients included were male and 35% were female. Staphylococcus aureus (S.aureus) was the prevalent microorganism found in most cases i.e; 60%. Mitral valve was mostly affected; Rheumatic heart disease was the leading factor of IE in patients. Most of the patients complained of shortness of breath and high-grade fever. Benzylpenicillin and aminoglycosides were most commonly prescribed for patients. The medication health care cost was on the higher side at about 1038 PKR/day considering all healthcare facilities provided free by the government. Conclusion: In most of the younger population active infective endocarditis remains the most prevalent disease. Rheumatic heart disease remains to be the most common underlying factor for heart disease. Overall treatment cost of therapy was found to be high due to vigorous antibiotic therapy. Keywords: Infective endocarditis, Microorganism, Rheumatic heart disease, Medication treatment, Vegetation, Staphylococcus aureus

Background: Rheumatoid arthritis is an autoimmune debilitating disease involving multiple joints and organs. Many treatment options are available but all are associated with frequent side effects. Phytochemical screening of Torilis leptophylla has shown the presence of anti-inflammatory compounds like flavonoids, phenols and anthraquinones. This study was designed to evaluate its effect on joints inflammation (rheumatoid arthritis). Indomethacin is one of the oldest and most commonly used drugs for arthritis. It was used as a standard drug to compare with indomethacin. Methods: This experimental study was carried out in Pharmacology Department, University of Health Sciences, Lahore. Thirty six male albino Wistar rats were randomly divided into six groups (group I-control, group II-positive control, group III-10 mg indomethacin, group IV,V,VI--100mg, 200mg, 300mg Torilis leptophylla extract (TLE) administered (orally) respectively). Arthritis was induced by sub plantar injection of 0.1 ml Freund’s complete adjuvant (FCA) to all groups except the control group. Body weight (weekly) and ankle joint diameter (every 4th day) were measured. At day 29 blood was collected and all animals were killed by overdose of ether. Acid phosphatase and alkaline phosphatase levels were determined by chemistry analyzer (RX MONZA, RANDOX, Republic of Ireland). Statistical analysis was performed using SPSS 20. One way ANOVA and Post hoc -Tukey tests were applied. A p-value of ≤0.05 was considered statistically significant. Results: Treatment with indomethacin caused significant (p≤0.001) reduction in all the inflammatory parameters. Torilis leptophylla extract also significantly (p≤0.05) reduced all the inflammatory parameters. Anti-inflammatory effect was comparable to indomethacin. Conclusion: Torilis leptophylla has significant anti-arthritic activity as it modified the parameters of joint inflammation and destruction.