Aim To determine the efficacy of neutrophil/lymphocyte ratio (NLR) as a marker of the severity of COVID‐19 pneumonia in the South‐Asian population. Methods This was a prospective, cross‐sectional, analytic study conducted at HDU/ICU of District Headquarter Hospital, Faisalabad, Pakistan, from May through July 2020. Sixty‐three eligible patients, admitted to the HDU/ICU, were prospectively enrolled in the study. Their NLR, C‐reactive protein, serum albumin and serum fibrinogen were measured. Patients’ demographic characteristics, comorbidities, clinical manifestations of COVID‐19 infection, medication use and history of lung malignancy were retrieved from their medical history. Patients were categorised into either a general group (with mild COVID‐19) or a heavy group (with moderate to severe COVID‐19). Results There were significant differences between the two groups in diabetes prevalence, NLR, C‐reactive protein and serum albumin. NLR and C‐reactive protein were positively correlated (P < .001, P = .04, respectively) whereas serum albumin was negatively correlated (P = .009) with severe COVID‐19. NLR was found to be an independent risk factor for severe COVID‐19 pneumonia in the heavy group (OR = 1.264, 95% CI: 1.046~1.526, P = .015). The calculated AUC using ROC for NLR was 0.831, with an optimal limit of 4.795, sensitivity of 0.83 and specificity of 0.75, which is highly suggestive of NLR being a marker for the early detection of deteriorating severe COVID‐19 infection. Conclusion NLR can be used as an early warning signal for deteriorating severe COVID‐19 infection and can provide an objective basis for early identification and management of severe COVID‐19 pneumonia.

Objective: To determine the effectiveness of routine physical therapy with and without Instrument Assisted soft Tissue Mobilization on pain intensity, range of motion in patients with neck pain due to upper crossed syndrome. Methods: It was Randomized clinical trial. The data was collected from Physiotherapy Clinics, The Agile Institute of rehabilitation Sciences (AIRS) and National Orthopedic Hospital Bahawalpur. The study was completed from 28 August 2019 to29 February 2020 after the approval .60 patients of upper crossed syndrome diagnosed patients complaining neck pain with forwarded head posture in age range of 18-40 years were included based on following Inclusion and exclusion criteria. The subjects were divided into two equal groups of 30 each using non-probability purposive sampling technique. Outcome tool used were Inclinometer to assess range of motion and Pain by Numeric pain Rating Scale. The Data was analysed by using SPSS version 22. Criteria of significance i.e. p-value<0.05 was taken as significant at 95% Confidence Interval. Results: Pain rating at base line in experimental compared to routine physical therapy show significant improvement as P value was 0.01.The results of Neck Flexion P=0.03, Neck Right Bending P=.00, Neck Left Bending P=0.00. The results for Neck extension 0.25 show that both techniques were equally effective. Conclusion: The study concluded that addition that Instrument soft tissue mobilization with combination of stretching exercise is more effective in management of symptoms of upper crossed syndrome. Clinical Trial Number: [IRCT20190912044754N1] Keywords: IASTM, Neck Pain, Upper Crossed Syndrome, Neck Range of Motion Continuous...

Tapeworms of zoonotic importance have been described as a leading public health problem. Current research was aim to assess the prevalence of tapeworms among 5-12years school children residing in district Lower Dir, Pakistan from January 2019-December 2019. The wet mount preparation in saline/iodine/methods were used for stool examination. Data was analyzed using appropriate descriptive, static methods. Of the 400 children studied 71.7% were infected with one or more species of intestinal parasites. Single infection of cestode species was found in 69 individuals with 17.2% prevalence and multiple parasitic infections were identified in 19.7% (n=79/400) individuals. The multiple infection were comprised as 10% (n=40) double, 6.75% (n=27) triple and 3% (n=12) quadruple. A total of 9 species of helminths and one species of protozoan infection. Among the helminths Ascaris lumbricoides was the most prevalent 33.1% (n=95), Taenia saginata 22.6% (n=65), hookworm 19.8% (n=57), Hymenolepis nana 18.8% (n=54), Enterobius vermicularis and Hymenolepis diminuta 1.39% (n=4each), Trichuris trichura 1.04% (n=3), Toxocara spp 0.69% (n=2) and Schistosoma japonicum 0.34% (n=1) were reported. One protozoan species was Cryptosporidium spp 0.69% (n=2) in current study. In case of A.lumbricoides, hookworm, E.vermicularis, T.trichura, T.saginata, H.nana and H.diminuta the male children of below 8 years of age were highly infected. Other infections are reported in the same prevalence with slight difference if any. We conclude that there is a need for mass scale campaigns to create awareness regarding health and hygiene in children and the need for development of effective poverty control programs because deworming alone is not adequate to control parasitic infections.

Aim In this feasibility study, we aimed to implement a pilot telemedicine service at our healthcare facility in Faisalabad, Pakistan, and describe our experience. Methods Telemedicine service was established by Faisalabad Medical University at two of its affiliated locations: (i) a 24‐hour COVID‐19 Telephone Helpline was established at the Director Emergency Office, Allied Hospital, and District Headquarter (DHQ) Hospital. (ii) A Telemedicine Clinic comprising consultants and postgraduate residents from different specialties was established at Chief Office, Allied Hospital. The data related to the number and categories of calls and advice provided were collected from 27th March 2020 to 31st July 2020. Results A total of 4582 calls were received, at both locations, during the study period, out of which 2325 callers (51%) were male, and 2257 (49%) were females. At Allied Hospital, 172 patients were advised accordingly for their complaints, whereas, at DHQ Hospital, 320 patients were advised accordingly for their complaints. At the Telemedicine Clinic only, a total of 2436 calls were received during the study period, 1474 (60%) callers were male, and 962 (40%) were female. The majority of the calls were received by medicine (43%), dermatology (21%), and paediatrics (11%) specialties, respectively. Conclusion Despite some limitations, the benefits of telemedicine in this COVID‐19 era are enormous and it is feasible to implement telemedicine services in developing countries. The developing countries must invest in the internet and technology access to facilitate telemedicine and other e‐health services for not only curbing this pandemic but also to promote a more efficient healthcare system after the pandemic.