Objective: To compare the effect of Amitriptyline and Pregabalin in treatment of painful diabetic neuropathy. Material and Methods: The design of this study was Randomized Controlled Trial study design. This study was conducted in the Department of Medicine in, Holy Family Hospital, Rawalpindi and the duration of this study was Six months after the approval of synopsis i.e from 1st November 2019 to 1st May 2020. Approval from ethical committee of the hospital was taken. Written informed consent was taken from patients. Consent form is attached with this. Patients were randomly allocated into two groups by lottery method. The dose of Pregabalin was used as 50mg thrice daily for a period of six weeks and label as group-A and group B received amitriptyline as 25mg once daily before bedtime for a period of six weeks as prescribed by a senior consultant who was blind to object of the study. At the start and end of treatment pain was marked by patients on Visual Analogue Scale (VAS) and numerical score. It was noted on the Performa. Results: Total 100 patients were included according to the inclusion criteria of the study. The dose of Pregabalin was given in patients in group-A and group-B received amitriptyline. Mean age (years) in the study was 55.87+6.43 whereas there were 55 (55.0) male and 45 (45.0) female patients who were included in the study according to the inclusion criteria. In our study, frequency and percentage of effect (pain relief) among Pregabalin and Amitriptyline in treatment of painful diabetic neuropathy was 27 (54.0) and 11 (22.0) respectively which was statistically significant (p-value 0.001). Practical Implication: In this study Pregabalin is more responsible for pain relief than Amitriptyline in treatment of painful diabetic neuropathy. Further studies at multiple studies must be conduct in future for determining the efficacy of amitriptyline and Pregabalin in diabetic neuropathy in order to formulate guidelines for management of diabetic peripheral neuropathy. Conclusion: The study concluded that Pregabalin is more responsible for pain relief than Amitriptyline in treatment of painful diabetic neuropathy. Further studies at multiple studies must be conduct in future for determining the efficacy of Pregabalin and amitriptyline in diabetic neuropathy in order to formulate guidelines for management of diabetic peripheral neuropathy. Keywords: Amitriptyline, Pregabalin, Neuropathy, Pain Relief, Diabetic Sensorimotor Polyneuropathy, Prevalence.

Introduction: To determine reliability of leukocyte count on admission for prediction of mortality among patients with organophosphorus intoxication. Early prediction can help in preventing the poor outcome and improved management. This is cost and time effective method and better management and preventive protocols can be developed. Objective: To determine the diagnostic accuracy of leukocyte count in prediction of mortality in patients with organophosphorus intoxication keeping actual mortality as gold standard. Material and Methods: The design of this study was a Cross sectional study design. The duration of this study was six months from 31-03-2020 to 30-09-2020 and this study was conducted in the Department of Medicine (unit II), HFH, Rawalpindi. A total of one hundred and sixty (n=160) patients of either gender between age between 16-85 years who were confirmed cases of organophosphorus poisoning were enrolled. Leukocyte count levels were noted at the time of admission and patients were monitored for 7 days in the hospital for mortality. Results: The results showed that sensitivity, specificity, positive predictive value, negative predictive value and accuracy of raised leukocytes counts (>12000/uL) at admission as 60.4%, 77.8%, 50.0%, 84.3% and 73.1% respectively. ROC curve showed best cutoff value of raised leukocytes counts (>12000/uL) at admission as 10253/uL, where sensitivity of 72.1% and specificity of 58.1% was achieved. Area under the curve (AUC) was calculated as 0.707. Practical Implication: To determine the diagnostic accuracy of leukocyte count in prediction of mortality in patients with organophosphorus intoxication keeping actual mortality as gold standard Conclusions: Raised leukocytes counts (>12000/uL) at admission allowed prediction of mortality in patients with organophosphorus poisoning with reasonable accuracy. Our study results showed sensitivity, specificity, PPV, NPV and accuracy of 60.4%, 77.8%, 50.0%, 84.3% and 73.1% respectively. Keywords: Leukocyte Counts, Organophosphorus, Poisoning, Mortality, Intoxication, Predictive Value, Morbidity.

Background: Dengue fever is a viral disease caused by four different serotypes of dengue viruses from DENV, transmitted mostly by the Aedes aegypti mosquito. The disease has history of many outbreaks mostly in tropic and sub-tropic countries, costing many lives annually, with millions in mild to complicated forms, bringing stress to health systems and economies of poor countries. Dengue epidemic occurred in Pakistan in 2010 with 257 deaths during the epidemic and prevalence of 16580 cases in Rawalpindi, repeated epidemic in 2015, 2017, 2018 and 2019 with higher prevalence. Objective: To determine the frequency of dengue hemorrhagic fever in patients of dengue fever and to compare mean platecrit and platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever. Materials And Methods: The design of this study was an observational cross sectional study design. This study was conducted in the Department of Infectious Diseases, Holy Family Hospital, Rawalpindi and the duration of this study was 6 months after the approval of synopsis i.e 1st May 2021 to 30th Oct 2021. Patients fulfilling selection criteria were enrolled in the study from emergency of Department of Infectious Diseases, Holy Family Hospital Rawalpindi. Informed consent was taken. Then patients were evaluated and divided for severity score (annexure I). Reports were assessed for Platelet indices including platelet count, mean platelet volume, platelet distribution width (as per operational definition). All this information were recorded on proforma (attached). Results: Total 150 participants were enrolled in the study as per the inclusion criteria. Mean age in the study was 38.42+13.74 whereas there were 94 (62.7%) male and 56 (37.3%) female patients who were included in the study according to the inclusion criteria. Among 150 patients, 28 (18.7%) patients were presented with dengue hemorrhagic fever in patients of dengue fever. Mean Platecrit indices in patients with or without dengue hemorrhagic fever due to dengue fever in the study was 0.26+1.62 vs 0.08+0.02 (p-value 0.552) whereas mean platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever in the study was 64.19+41.11 vs 78.10+32.74 (p-value 0.097). Practical Implication: To determine the frequency of dengue hemorrhagic fever in patients of dengue fever and to compare mean platecrit and platelet indices in patients with or without dengue hemorrhagic fever due to dengue fever Conclusion: The study concluded that different indices of platelets within different forms of dengue fever to assess the severity of the disease process may serve as an early indicator of disease progress and severity which will help to decide early intervention. Keywords: Dengue Fever, Hemorrhagic, Platelet, Indices, Serotypes, Epidemic, Participants