Objective: The purpose of this research was to identify how often individuals with COPD suffer from depression and what variables may be contributing to their feelings of depression. Study Design: Cross-sectional study Place and Duration: This cross-sectional study was conducted at Department of Psychiatry, Lady Reading Hospital, Peshawar in the period from April, 2022 to September, 2022. Methods: Total 220 patients of both genders had age 20-85 years were included in this study. All the patients had chronic obstructive airway disease were presented. Patients' full demographic information, including age, sex, BMI, job status, and smoking history, was collected after obtaining informed written consent. Association of depression and its severity were recorded among all cases. We used SPSS 24.0 to analyze all data. Results: One hundred and forty (63.6%) cases were males and eighty (36.4%) were females. Patients mean age was 61.03 ±7.48 years and had mean BMI 25.6±7.26 kg/m2. Majority 150 (68.2%) cases were unemployed. 135 (61.4%) cases were smokers. We found a high frequency of depression in 130 (59.1%) patients in which 60 cases were had severe depression. Older age, living alone and unemployment were the risk factors of depression among COPD patients. Conclusion: We concluded in this study that frequency of depression among COPD patients were high found in 59.1%. Depressive symptoms were shown to be associated with several different risk factors in COPD patients. Older COPD patients, men, those who are retired or jobless, and those who do not have a significant other are at a higher risk of depression. Keywords: COPD, Depression, Old age, Severity

Aim: To assess the role of probiotics in reducing the frequency of necrotizing enterocolitis in adults. Study design: Retrospective study Place and duration of study: Department of Medicine, Bolan Medical College Quetta from 1st July 2021 to 31st December 2021. Methodology: Forty cases of adult necrotizing enterocolitis were examined clinically as well as through radiological, biochemical and microbiological testing were enrolled. The cases were categorized according to the severity of their disease and probiotics were used for a month in less severe cases for analyzing its role in reducing necrotizing enterocolitis with a one-month follow-up. Results: The mean age of the patients was 49.2±5.36 years with 27 cases of males in comparison to 13 cases of females. Metabolic acidosis and respiratory acidosis were presented only in stage 2 and 3 each respectivelyAround 43% of cases reported reduction in venous ammonia after probiotic usage while 21% of the patients claimed betterment in their cognition. Conclusion: Probiotics have an efficient role in reducing ammonia production and improving cognition in adult necrotizing enterocolitis. Key words: Necrotizing, Enterocolitis, Probiotics

Aim: To evaluate the effectiveness of beta blockers against hypertrophic cardiomyopathy. Study design: Retrospective study Place and duration of study: Department of Medicine, Islam Medical College, Sialkot from 01-10-2020 30-01-09-2021. Methodology: One hundred and thirty six confirmed hypertrophic cardiomyopathy cases within the age of 3-75 years were enrolled. Different types of beta blocker used and its efficacy result and side effects were documented. The average efficacy was assessed for each beta blocker uptil 5 years’ survival rate. Results: High doses of beta blocker were indicated for hypertrophic cardiomyopathy patients in majority of the cases. The efficacy of various beta blockers shows that cardio-selective blocker is much better in efficacy. Left ventricle outflow tract (LVOT) with a value greater or equal to 50 mmHg was observed in patients at or greater than 70 years. Conclusion: Beta blockers are effective in hypertrophy cardiomyopathy cases depending upon the left ventricle out flow tract for better outcome. Key words: Beta blockers, Cardiomyopathy, Efficacy, Therapeutic interventions

Aim: To examine the effect of remdesivir for treating non-hospitalized patients with COVID-19. Study design: Retrospective study Place and duration of study: Department of Medicine, Bolan Medical College, Quetta from 1st April 2021 to 30th September 2021. Methodology: One hundred patients were enrolled and divided into group A and group B within the age of 24-70 years. Group A was receiving remdesivir while group B is not receiving remdesivir. The clinical variables, BMI, comorbidities, duration of disease severity and viral load were determined. RT-PCR was conducted to determine viral load. Results: The mean age of study participants was 50±15 years with greater number of males. Diabetes was the major comorbidity. The time duration was decreased in group A upto 5 days and 8 days in group B. The viral load was decreased by mean value 6.32±1.76 to 6.2±1.78 in group B then group A respectively. Conclusion: Remdesivir is effective in COVID-19 treatment. Keywords: Remdesivir, COVID-19, Viral load

Aim: To estimate the incidence of hypoglycemia in type 2 diabetes mellitus patients. Study design: Cross-sectional analytical study. Place and duration of study: Department of Medicine, Bolan Medical College, Quetta from 1st January 2021 to 30th September 2021. Methodology: One hundred type 2 diabetic patients were enrolled. Each patient complete detail was documented on a well-structured questionnaire which was also used for assessing the hypoglycemia status using Whipple’s triad questionnaire based information. The Whipple triad is an assembly of three criteria named as Whipple’s criteria. The most important symptoms which are presented in it are those symptoms which show presentation of hypoglycemia post meal and exercise. Patients were asked for any of the following symptoms or biochemical test results have been noticed in previous 2-3 months and their responses were recorded. Results: There were 64% patients within the age of 40-60 years while 36% were above the age of 60 years. Within the rural, type 2 diabetic patients 89.3% were those who only checked their glucose once in three months. The treatment method which was adapted by majority of the type 2 diabetic patients was use of metformin. Conclusion: Hypoglycemia appeared to be the important determinant of diabetes mellitus and sometime even prove more fatal then hyperglycemia. Keywords: Hypoglycemia; Whipple triad; Diabetes mellitus; Prevalence; Urban areas