Objective: To assess the oxidized low density lipoprotein (ox-LDL) to low density lipoprotein (LDL) ratio as an indicator of subclinical atherosclerosis in haemodialysis patients Methodology: This case control study was carried out at Jinnah Post Graduate Medical Center Karachi, from January to December 2018. The haemodialysis patients were selected from the dialysis center (group B) whereas the controls were recruited from normal healthy population (group A). To access the status of atherosclerosis, doppler ultrasonography technique was employed to detect the intima media thickness (IMT) ratio of common carotid artery of study subjects as well as controls. Lipid peroxidation was detected by serum oxidized LDL (ox-LDL) levels. Results: The mean of carotid artery intima thickness in group A was 0.43±0.02, the mean intima thickness of group B samples was 1.0±0.09. The mean ratio of Ox-LDL/LDL in group A was 0.003±0.001. While in group B the mean of Ox-LDL: LDL was 0.012±0.002. Ox-LDL was found to have a positive linear relationship with mean carotid artery intima media thickness ratio (r=0.8) in haemodialysis group. Conclusion: Ox-LDL to LDL ratio is much enhanced in patients on maintenance haemodialysis showing increased lipid peroxidation. Ox-LDL has a positive linear relationship with mean carotid artery intima media thickness ratio which is a marker of sub clinical atherosclerosis. Early detection of elevated Ox-LDL will help nephrologists in early detection and treatment of sub clinical atherosclerosis.

Nepal has a multitiered health system involving the Ministry of Health, nongovernmental organizations, private for profit, and faith-based organizations. There are national, district, and community-level health centers and health workers that come together to deliver services and input information into both the community and national level health information systems. In terms of mental health, there is a very small portion of the budget allocated to mental health and very few mental health interventions and programs. The system has strengths including that the service delivery is put together in an effective manner and there is some mental health integration in primary care and in the health information system. However, there are weaknesses including that there needs to be an increase in the number of health workers and the training given to the workforce to further integrate mental health and there also needs to be more attention brought to mental health overall. Nepal's COVID-19 response highlighted weaknesses within its health system, especially in the context of its essential medicine products. The COVID-19 response from Nepal was especially hindered by a shortage of medical supplies, personal protective equipment, medications, and coronavirus tests.

hemical reactions alongside different molecules. Having been originated from constituents like oxygen, sulphur as well as nitrogen which contribute towards production of reactive oxygen species (ROS), reactive nitrogen species (RNS), reactive sulphur species (RSS)1.They include superoxide anion(O2-•), hydroperoxyl radical (HO2•), hydroxyl radical (•OH), hydrogen peroxide (H2O2), singlet oxygen (1 O2), hypochlorous acid (HOCl) and peroxynitrite (ONOO- ) .

Objective: To determine incidence, awareness and association of Lifestyle modalities with symptoms of Polycystic Ovaries (PCOS) among females of two institutes Study design and setting: It was a Pilot study based survey at University of Karachi and Bahria University, Pakistan. Methodology: Following ethical approval, structured questionnaire was designed, validated and distributed as per convenient sampling. Results: SPSS analysis for 196 responses revealed that 4.6% were PCOS afflicted while 26% of non-PCOS were vulnerable cases on account of suffering any two of the three criterion symptoms of PCOS namely: menstrual irregularities, hirsutism and acne. Chi-square based cross tabulations revealed that PCOS females were predominantly between 21-25 years and were lean singles who exhibited a tendency to exercise, consumed poultry, slept late at night and used plastics by large in daily routine. Females susceptible to PCOS significantly exhibited the criterion symptoms when associated to consumption of poultry chicken, passive smoking and plastic usage on regular basis. Significantly larger proportion (70%) of non-PCOS females were aware about this disease but symptomatic, diagnostic and treatment based knowledge was significantly less prevalent. A significant percentage of females (61.5%) associated PCOS to the occurrence of infertility. Conclusion: Thus, concluding that imparting awareness about etiological factors, symptomatology and lifestyle triggers can enable females to ensure self-check and curb the chances of being prone to PCOS by avoiding plastics and smoking environment and incorporating weight management in their lifestyle