Varicella-zoster virus (VZV) causes primary infection of chickenpox and when reactivated produces shingles along with the dermatomal distribution of the affected nerve. Immunocompromised and unvaccinated elderly people are at a higher risk of infection. Varicella can be prevented by vaccination. One of the potential complications of VZV infection is encephalitis. Our 44 years old immunocompetent patient development altered sensorium and seizures, five days after the onset of characteristic chickenpox lesions. CSF analysis was consistent with viral encephalitis. PCR of the CSF confirmed the diagnosis of VZV encephalitis. MRI reported bilateral periventricular small vessel ischemic changes. The patient was treated with injectable acyclovir for 14 days and prednisolone for 5 days with resulting dramatic clinical improvement. Anticonvulsants were given to control the seizures. The patient was discharged on the 15th day of admission with almost complete recovery without developing neurological sequelae.

Objectives: Glaucoma is the most common blinding condition in South Punjab of Pakistan and its management is a challenge due to illiteracy and lack of financial resources. Study Design: Randomized Clinical Trial. Setting: Department of Ophthalmology Nishtar Hospital Multan. Period: June 2016 - June 2018. Material & Methods: We have randomly selected patients on the basis of Cup to Disc ratio and applied randomized clinical trial of both medical and surgical modalities of glaucoma management to observe the visual outcomes in terms of Intraocular pressure and Cup to disc ratio. We have also linked the effects of our management with lenticular status of the patients which has shown significant results. Results: The vision survival of trabeculectomy in pseudophakics was 88.77% while only 9.8% was the survival rate of trabeculectomy in phakics. 90% of 31 phakic patients who underwent trabeculectomy failed. Similarly patients on 3 IOP lowering drugs had 70% vision survival rate out of 260 patients treated. Patients with C-D ratio 0.8 had maximum failure rate of 69% out of 78 patients in which medical treatment failed. Conclusion: Trabeculectomy significantly reduced the intraocular pressure in patients in which pharmacological treatment failed.The success rate of trabeculectomy among pseudophakics is high. In Phakics, when only Trabeculectomy is done, success rate is low. When trabeculectomy and clear lens extraction is done simultaneously, the success rate is slightly higher. When trabeculectomy is done after clear lens extraction, the success rate is highest. In case of Cataract, cataract extraction and trabeculectomy when done simultaneously, show low success rate. When trabeculectomy was done after cataract extraction, shows highest success rate.

Purpose:To establish the practicality of the survey scale in estimating baseline severity at the time of diagnosis and resolution of the vernal keratoconjunctivitis (VKC) symptoms after topical medication Study Design:Longitudinal survey design Place and Duration of Study: Ophthalmology department of Nishtar Medical Hospital, Multan.from June 2021 to November 2021 Methods: A total of 267 VKC (vernal keratoconjunctivitis) patients' data was filled in on preformed Google forms. Improvement in symptoms after follow-ups was recorded on it. Chi-squared test an Kruskal-Wallis test were employed to determine the statistical significance of the variables. Results:There were 52.4% females and mean age of the patients was 29.52+18.39 years. There was preponderance of patients falling under 20 years of age. At baseline, 63.3% patients were on topical steroids, while 5.6% of patients were using steroids at the second follow-up visit. The mean interval between patients’ visits to the hospital was 7.64 ± 2.086 weeks. Nonparametric Kruskal-Wallis test was used to calculate the difference in means of radial point scale scores at the baseline examination (4.47 ± 2.321) and second follow-up (1.31 ± 1.615) visits. Z-score value was 15.266 with a significance of 0.001. For patient satisfaction and resolution of symptoms at the second follow-up visit, Chi-square values were 164.75 and 119.55, respectively, with a significance of 0.001 in each case. Conclusion: The survey scale aided in quantifying disease symptoms, which can be useful in prescribing and adjusting the medications’ dosage easier.

Objectives: To determine the prevalence of depression among medical students and its association with various sociodemographic characteristics. Study Design: Cross-Sectional Study. Setting: Nishtar Medical University, Multan. Period: August 2019 to September 2020. Material & Methods: A sample of 315 medical students were chosen by stratified random sampling technique. Patient Health Questionnaire 9 (PHQ-9) was used for screening and assessing the severity of depression. A special questionnaire was designed containing sociodemographic and educational characteristics. Data were collected via online forms and were analyzed using SPSS V26. Results: Out of 315 students, who participated in the study, 134 (42.5%) were female students, and 181 (57.5%) were male students. 63 (20%) students were taken from each academic year from 1st year through 5th year (final year). 64% of the students were suffering from depression. The proportion of students suffering from mild, moderate, moderately severe, and severe depression was 27%, 18%, 11%, and 8% respectively. Depression was more prevalent among female students (73.1%) as compared to male students (58.0%) with a p-value <0.05. Conclusion: Depression is a serious problem for medical students. It was significant among female, preclinical students, living in the home with a family history of depression in financial pressure. It should be sorted out early to make early interventions.