Research Report 2021

Editor Dr. Fadieleh A. Sohail, Professor & Director Medical Education, Jinnah Medical & Dental College Associate Editors Prof. Dr. Rizwana S Waraich, Professor & Dean, Sohail University Section Editors Prof. Dr. Syed Sanowar Ali, Professor & Head of Community Health Sciences, Jinnah Medical & Dental College Dr. Sidra Rafi Assistant Professor Department of Biomedical & Biological Sciences Sohail University Gulnaz Khan, Manager Biomedical Research Centre Sohail University Assistant Editor Urooj Fatima Executive Officer, Medical Education Jinnah Medical & Dental College

I am delighted to welcome to you to the 4 th volume of the Research Report 2021. This volume of Research Report marks the increased number of publications in top category journals (W category) as classified by the Higher Education Commission. The editors would like to take this occasion to thank all the authors and critics for their scrupulous efforts in ensuing high quality contributions. A big thank you to our authors, reviewers and staff. This is an effort to encourage young clinicians and researchers to submit their work in the Research Report, which will in turn benefit our academic community. Continued evolution of the report with improvements in forthcoming volumes is our endeavor. Dr. Fadieleh A. Sohail Editor

To Evaluate research projects of undergraduate MBBS Final Year students of Batch 21, we would like to thanks our visiting jurists. Dr. Farhat Jafri MBBS, MPH Head of Community Health & Sciences Karachi Medical and Dental College Dr. Seema N. Mumtaz MBBS, MPH, Mphil, PHD Head of Community Health & Sciences Karachi Institute of Medical Sciences Dr. Abdul Manan Baig MBBS, PHD Assistant Professor Aga Khan University

1 st Prize Title: Relationship Between Social Capital And Mental Ailments Among Transgender Population In Karachi Supervisor: Dr. Sulail Fatima (Physiology) Group Members: Alina Ali Nawaz Lashari, Eman Arif Siddiqui, Urooba Siddiqui, Azhar Hussain 2 nd Prize Title: Impact Of Maternal Depression On Child’s Growth Supervisor: Dr. Aneel Kumar (Medicine & Allied-Psychiatry) Group Members: Ibrahim Shahid, Yumna Monis, Amtul Fatima, Arham Hassan 3 rd Prize Title: Ergonomic Practices And Frequency Of Cell Phone Vision Syndrome Symptoms Among Undergraduate Students Using Portable Electronic Devices Supervisor: Dr. Shahid Ahsan (Biochemistry) Group Members: Vohra Maham Hassan, Ayesha Amir, Alina Ganny, Muzzammil Naveed 3 rd Prize Title: Frequency And Factors Leading To Telogen Effluvium Among COVID-19 Patients Supervisor: Dr. Farina Zameer (Medicine & Allied-Dermatology) Group Members: Salman Ahmed, Nimrah Sarwar Awan, Tooba Hanif, Shahwaiz Aman

Contents RISK FACTORS OF MALNUTRITION IN CHILDREN UNDER 5 YEARS OF AGE IN SLUM AREAS OF KARACHI 1 Aaila Nayani, Aymen Kamal, Iqra Ali Kakar, Sajida Moiz Supervisor: Dr. Mehtab Hussain SOCIOECONOMIC FACTORS ASSOCIATED WITH MALNUTRITION AMONG DIFFERENT CLASSES OF KARACHI 2 Aiman Hameed, Qirat Aijaz, Nahil Saleem, Taskeen Fatima Supervisor: Dr. Asma Noreen RELATIONSHIP BETWEEN SOCIAL CAPITAL AND MENTAL AILMENTS AMONG TRANSGENDER POPULATION IN KARACHI 3 Alina Ali Nawaz Lashari, Eman Arif Siddiqui, Urooba Siddiqui, Azhar Hussain Supervisor: Dr. Sulail Fatima IS SMART PHONE OVERUSE ADVERSELY AFFECTING THE HEADACHE, SLEEP AND QUALITY OF LIFE IN MIGRAINEURS? 4 Syeda Samia Shams, Qubra Sarfaraz Mirjat, Syeda Fatima Haider, Umesa Mazhar Supervisor: Dr. Mehwish Butt CURRENT TRENDS IN PREVALENCE OF MULTIDRUG RESISTANT (MDR) AND EXTENSIVELY DRUG RESISTANT (XDR) SALMONELLA TYPHI AND S. PARATYPHI IN KARACHI……………………………………5 Owais Ameer, Usama Muhammadi, Muhammad Zohaib Javed, Zoha Asif Sharif Supervisor: Dr. Musarrat Jehan PREVALENCE OF STRESS AND EATING DISORDER IN MEDICAL STUDENTS DURING EXAM SEASON… 6 Kainat Amir Ali, Umm-e-Farwa, Zareena Jan, Syed Muhammad Waqas-ul-Haq Supervisor: Dr. Falak Abro COMPARISON OF LOCKDOWN PRACTICES AND BELIEFS REGARDING CORONA VIRUS AMONG PUBLIC DEALING AND WORK FROM HOME INDIVIDUALS - AN INTERVENTIONAL STUDY………………………….7 Bushra Syed, Bilal Fattani, Amna Haroon, Anshrah Imtiaz Supervisor: Dr. Syeda Urooj Riaz ERGONOMIC PRACTICES AND FREQUENCY OF CELL PHONE VISION SYNDROME SYMPTOMS AMONG UNDERGRADUATE STUDENTS USING PORTABLE ELECTRONIC DEVICES………………………………….8 Vohra Maham Hassan, Ayesha Amir, Alina Ganny, Muzzammil Naveed Supervisor: Dr. Shahid Ahsan RAISED MATERNAL BMI ASSOCIATED WITH INCREASE RISK OF WEIGHT OF BABIES AND CESAREAN SECTION 9 Ifham Imtiaz, Abdul Wahab, Owaim Atiq, Hamza Naseem Supervisor: Dr. Erum Memon

CORRELATION BETWEEN BIOCHEMICAL AND HAEMATOLOGICAL ANALYSIS FOR THE DIAGNOSIS OF HELICOBACTER PYLORI INFECTION 10 Faizan Ali, Abdul Wahab, Waleed Khan, Sher Khan Supervisor: Dr. Shaista Emad THE PSYCHOLOGICAL IMPACT OF COVID 19 PANDEMIC ON FACULTY AND MEDICAL COLLEGE STUDENTS OF KARACHI CITY 11 Javeria Raza, Durr-E-Sameen, Wania Ayub, Neha Asif Supervisor: Dr. Sabeen Hashmat Qazi COMPARE THE EFFECTIVENESS OF NEW PEDAGOGICAL METHODS AND PASSIVE TEACHING………12 Alizah Arshad, Areej Haider, Maryam Yousuf Supervisor: Dr. Zeelaf Shahid BENEFITS AND DISBENEFITS OF VIRTUAL TEACHING DURING THE COVID-19 PANDEMIC: STUDENT LEARNING EXPERIENCE 13 Maham Sohail Shaikh, Sara Mubeen, Mohammad Arqam Ashraf Hamidani, Inshrah Hanif Raja Supervisor: Dr. Samia Perwaiz Khan FREQUENCY AND FACTORS LEADING TO TELOGEN EFFLUVIUM AMONG COVID-19 PATIENTS………14 Salman Ahmed, Nimrah Sarwar Awan, Tooba Hanif, Shahwaiz Aman Supervisor: Dr. Farina Zameer RELATIONSHIP BETWEEN BLOOD GROUPS & CARDIOVASCULAR DISEASE: CASE CONTROL STUDY… .15 Haider Ali, Aisha Monis, Fatima Hashmi, Abdul Arham Khatri Supervisor: Dr. Sara Rafique HOW COMMON IS INTIMATE PARTNER VIOLENCE AND WHAT ARE ITS EFFECTS ON REPRODUCTIVE HEALTH OF WOMEN IN LOW SOCIOECONOMIC CLASS………………………………………………………...16 Ainulshifa Jamil, Soomal Jamil, Arooj Arshad Supervisor: Dr. Aliya Waheed RISK OF HYPERTENSIVE DISORDERS OF PREGNANCY IN WOMEN WITH A HISTORY OF SPONTANEOUS PRETERM BIRTH IN THEFIRST PREGNANCY………………………………………………...17 Syed Muzzammil Shah, SyedaUzma Sami, Tabeer Shaikh, Syeda Farwa Sultan Supervisor: Dr. Shazia Aftab IMPACT OF MATERNAL DEPRESSION ON CHILD’S GROWTH…………………………………………………..18 Ibrahim Shahid, YumnaMonis, Amtul Fatima, Arham Hassan Supervisor: Dr. Aneel Kumar COVID 19: ONLINE TEACHING AND STRESS AMONG TEACHING FACULTIES OF DIFFERENT MEDICAL COLLEGES IN KARACHI 19 Urooj-ul-Kainat, Kainat Karim, Sahar Jamil, Daniyal Hirani Supervisor: Dr. Sahrish Mukhtar PHYSICAL ACTIVITY ASSOCIATION WITH BMI GROUPS IN PRIMARY SCHOOL CHILDREN………………20 Haya Tariq, Hina Riaz, Kashaf Supervisor: Dr. Sassi Kanwal

DETECTION OF HELICOBACTER PYLORI USING REALTIME PCR………………………………………………21 Syed Ali Haider Zaidi, Hamza Sohail, Syed Muhammad Huzaifa Tahir Supervisor: Dr. Rubina Ghani DISCREPANCIES AMONG TEACHERS AND STUDENTS RELATED TO ONLINE COURSES……………...…22 Muhammad Khubab Ahsan, Muhammad Abdullah Rana, Khurram Shahid Supervisor: Dr. Ghulamullah Lail USAGE OF PPE AND FREQUENCY OF COVID-19 IN THE HEALTH PROFESSIONALS OF KARACHI-A CROSS SECTIONAL SURVEY…………………………………………………………………………………...………23 Amna Khan, Mandeep Kumar, Ali Murad Khan Supervisor: Dr. Shagufta Naqvi EFFECT OF AN INTERVENTION ON APPLICATION OF INFORMED CONSENT USE AMONG DOCTORS AND NURSE…………………………………………………………………………………………….………………….24 Siraj R. Syed, Humna Shahid Sheikh, Ali Ahmed Paracha Supervisor: Dr. Nadia Younus DOES MINI-CEX AND DOPS IMPROVES THE CLINICAL SKILLS OF A MEDICAL STUDENT?......................25 Yamna Khan, Madiha Fatima Agha, Urooj Fatima Supervisor: Dr. Zeelaf Shahid

A. Publication in International Scientific Index (ISI) & HEC Recognised Journals ASSOCIATION OF ACNE WITH FACE MASK IN HEALTHCARE WORKERS AMIDST THE COVID-19 OUTBREAK IN KARACHI, PAKISTAN 26 Sadia Yaqoob, Amna Saleem, Furqan Ahmad Jarullah, Areeba Asif, Mohammad Yasir Essar, Shaista Emad IMPACT OF ORAL HEALTH EDUCATIONAL INTERVENTIONS ON ORAL HYGIENE STATUS OF CHILDREN WITH HEARING LOSS: A RANDOMIZEDCONTROLLED TRIAL………………………………………………….27 Maria Moin, Sohail Saadat, Sara Rafique, Afsheen Maqsood, Abhishek Lal, Fahim Vohra, Mohammad Khursheed Alam, Naseer Ahmed OUTCOMES OF TUNNELED CUFFED HEMODIALYSIS CATHETERS: AN EXPERIENCE FROM A TERTIARY CARE CENTER IN KARACHI, PAKISTAN 28 Sonia Yaqub, Muhammad Raheel Abdul Razzaque , Azib Aftab, Nadeem Ahmed Siddiqui STRENGTHENING THE REFERRAL CHAIN AND PROVIDING ONE WINDOW DIABETES EYE CARE FACILITY TO PEOPLE WITH TYPE-2 DIABETES: A SIX-YEAR FOLLOW-UP STUDYFROM PAKISTAN…..29 Shahid Ahsan, Muhammad Saleh Memon, Muhammad Faisal Fahim, Tauseef Mahmood, Sikander Ali Sheikh VISUAL OUTCOMES OF CATARACT SURGERY: AN OBSERVATIONAL STUDY OF TEN YEARS FROM A TERTIARY EYE CARE HOSPITAL IN PAKISTAN 30 Shahid Ahsan, Muhammad Saleh Memon, Sadia Bukhari, Tauseef Mahmood, Muhammad Faisal Fahim, Uzma Haseeb, Muhammad Arslan AT-HOME MANAGEMENT STRATEGIES ADOPTED BY ORTHODONTIC PATIENTS DURING COVID-19 RELATED CLOSURE OF ORTHODONTIC CLINICS 31 Hana Pervez, Maria Khadija Siddiqui, Anam Sattar, Hareem Sultan, Taskeen Khan, Rabiya Haqqui EARLY RESPIRATORY SYMPTOMS OF WATER-PIPE (SHISHA) SMOKING IN MEDICAL STUDENTS OF KARACHI 32 Komal Kiran Galaria, Nadia Younus, Rahat Zubair, Malik Balaj Khan, Sameen Abid Rehman, Safa Shahab, Syed Muhammad Ishqaue PROTECTIVE EFFECT OF ZINGIBER OFFICINALE ON MOBILE PHONE INDUCED RATBRAIN INJURY…33 Syed Alamdar Raza Zaidi, Mohammad Fawad Saeeduddin, Aisha Qamar, Shabnam Khan, Rozina Khan, Syed Meesam Iftikhar Hussain Rizvi ASSOCIATION OF LOCATION OF CYST WITH THE FAMILY HISTORY AND MUTATED GENE AMONG PATIENTS OF MYELOMENINGOCELE 34 Urooj Fatima, Sabahat Gul, Imran Ishaq, Sahrish Mukhtar, Iram Quddus, Syed Hussain Mehdi THE RELIABILITY OF GINGIVAL CREVICULAR BLOOD AS A DIAGNOSTIC TOOL FOR DIABETES BY USING GLUCOSE SELF-MONITORING DEVICE IN PATIENTS WITH PERIODONTAL DISEASE WITH AND WITHOUT DIABETIES……………………………………………………………………………………………………35 Farhan Butt, Marium Iqbal, Saima Hanif, Mohsin Ghiraj, Faisal, Mudassir Hussain

THE RELATIONSHIP OF DIFFICULTY AND DISCRIMINATION INDICES WITH PHYSIOLOGY TEACHING AND LEARNING .36 Sadaf Fatima, Syed Tousif Ahmed, Shazia Hashmat, Afshan Iftikhar, Touqeer Alam Hashmi FREQUENCY AND ASSOCIATION OF MAXILLARY ECTOPIC CANINE WITH INCISOR ROOT RESORPTION AND DENTAL AGENESIS……………………………………………………………………………………………….37 Nasreen Iqball Nagani, Imtiaz Ahmed, Sadia Rizwan, Hana Pervez, Taskeen Khan, Tahira Arif COMPARISON BETWEEN TRADITIONAL, RECORDED AND ZOOM ONLINE PHYSIOLOGY TEACHING IN UNDERGRADUATE MEDICAL STUDENTS DURING THECOVID-19 PANDEMIC………………………….…..38 Sadaf Fatima, Sulail Fatima, Sara Rafique, Sassi Kanwal, Rabeea Rizwan, Kiran Zehra URINARY TRACT INFECTIONS IN PREGNANCY AND ITS COMPLICATIONS IN NEWBORNS……………...39 Mahjabeen Yaseen, Sadia Rashid, Shagufta Naqvi, Uzma Salman DEPRESSION AND ANXIETY IN HEMODIALYSIS PATIENTS……………………………………………………..40 Mahjabeen Yaseen, Shagufta Naqvi, Muhammad Ali TRANS ABDOMINAL VERSUS TRANSVAGINAL ULTRASOUND IN ASSESSMENT OF POLYCYSTIC OVARY 41 Shazia Kadri, Safia Izhar, Nazia Azeem, Sadia Rashid, Zafreen Naz Gudaro ASSOCIATION OF VITAMIN D BINDING PROTEIN WITH INTERLEUKIN-6 LEVELS IN PATIENTS WITH PERIODONTITIS………………………………………………………………………………………………….………42 Sara Rafique, Shazia Nazar Askari, Muhammad Mansoor Majeed, Afshan Mehboob Khan, Sassi Kanwal, Faiza Abdul Sattar CASE-CONTROL STUDY FOR ASSESSMENT OF FACTORS ASSOCIATED WITH PERIODONTITIS AMONG ADULTS ATTENDING A UNIVERSITY HOSPITAL IN KARACHI, PAKISTAN…………………………………….43 Sara Rafique, Sadaf Khan, Shahbaz Ahmed, Masood Anwar Qureshi, Rafat Amin ASSESSMENT OF ASSOCIATION OF FOLATE AND HOMOCYSTEINE LEVELS WITH DEVELOPMENT OF PRE-ECLAMPSIA AMONG PREGNANT WOMEN 44 Saira Ghafoor, Nazish Ali, Fehmida Salah, Syeda Fariha Hussain, Sumaira Zareen EVALUATION OF UPPER AIRWAY DIMENSION IN ALL FOUR FIRST PREMOLAR EXTRACTION CASES.45 Hana Pervez, Sara Shah, Rabia Haqqui, Anita Naseer, Faiza Azam, Warisha Ahmed MYELOPEROXIDASE: INDICATOR OF CARDIOVASCULAR DISEASE IN CHRONIC KIDNEY DISEASE PATIENTS OF TERTIARY CARE HOSPITALOF KARACHI………………………………………………….……..46 Sabeela Noor, Faiza Alam, Fasiha Fatima, Shehryar Orakzai PRE AND POST ORTHODONTIC TREATMENT CHANGES IN THE SAGITTAL AND VERTICAL SKELETAL DIMENSION FOLLOWING ALL FOUR FIRST PREMOLAR EXTRACTIONS………………………………….....47 Hana Pervez, Imtiaz Ahmed, Erum Behroz, Sadia Rizwan

USE OF ENDOSCOPE IN TEACHING OF OTOLARYNGOLOGY RESIDENTS ABOUT SITE AND SIZE OF TYMPANIC MEMBRANE PERFORATION AND ITS IMPACT ON DEGREE OF HEARING LOSS IN ADULT PATIENTS: A CROSS SECTIONAL STUDY 48 Muntazir Hussain, Muhammad Wasif, Muhammad Sohail Awan, Shayan Khalid Ghaloo, Zeeshan Sheikh, Haissan Iftikhar VOLUNTEERING ACTIVITY AS A SOURCE OF LIFE SATISFACTION AMONG MEDICAL AND DENTAL STUDENTS OF KARACHI, PAKISTAN 49 Shaista Emad, Faiza Nasir, Ayesha Akhlaq, Syed Raheel Pasha, Mohd Jahanzaib Noor, Rubina Ghani HR PRACTICES AND ORGANIZATIONAL PERFORMANCE: WHAT ROLE DOES EMPLOYEE SATISFACTION PLAY? 50 Dr. Shahzad Nasim, Dr. Musarrat Shamshir, Dr. Samina Sabir THE MEDIATION ROLE OF E-TRUST TOWARDS WEBSITES QUALITY AND SATISFACTION OF ECUSTOMERS 51 Zaibunnisa Siddiqi, Dr. Shahzad Nasim, Dr. Musarrat Shamshir NEXUS BETWEEN HUMAN CAPITAL, TECHNOLOGY AND ECONOMIC GROWTH: THE ROLE OF STAGES OF ECONOMIC DEVELOPMENT IN ASIAN COUNTRIES…………………………………………………………52 Samina Sabir, Sagher Suleria, Amena Sibghatullah and Musarrat Shamshir PHARMACY STUDENTS’ PERCEPTION FROM THEIR CURRENT HOSPITALWARD ROTATIONS……….53 Najia Rahim, Shagufta Nesar, Sarah Jameel Khan, Sabahat Jabeen, Sadaf Naeem5, Sharonia Butt, Shazia Naz, Mehwish Rizvi, Sabiha Gul, Tayyaba Mumtaz, Zeeshan Wasti SELF-MEDICATION IN THE COVID-19 PANDEMIC: SURVIVAL OF THE FITTEST……………………………54 Kiran Rafiq, Shagufta Nesar, Humaira Anser, Qurat-ul-Ain Leghari, Alisha Hassan, Alina Rizvi, Aleeza Raza, Zafar Saied Saify MANAGEMENT OF GESTATIONAL DIABETES MELLITUS WITH RISK FACTORS AND TRANS GENERATIONAL PREVENTION 55 Sabiha Gul, Kiran Rafiq, Shagufta Nesar, Syed Waleed Ahmed Bokhari, Muhammad Azhar Mughal, Hafiza Tania Naveel, Muhammad Idrees B. Publication In PM&DC Recognised Journals HISTOPATHOLOGICAL FINDINGS OF GALL BLADDER SPECIMEN AFTER CHOLECYSTECTOMY……...56 Bushra Tasneem, Aisha Tasneem, Fauzia Lateef, Saba Jamal, Rahil M Rehman, Abdullah Muttaqi TO COMPARE THE RESULTS OF PRIMARY CLOSURE OF PILONIDAL SINUS WITH OR WITHOUT REDIVAC DRAIN 57 Bushra Tasneem, Aisha Tasneem, Aqsa Ismail, Rahil M. Rehman, Abdullah Muttaqi DIETARY HABITS, PERCEPTIONS AND BARRIERS AMONG GOVERNMENT AND PRIVATE COLLEGE INTERMEDIATE STUDENTS IN KARACHI: A CROSS-SECTIONAL SURVEY…………………………………..58 Sabeela Noor, Mariam Rashid, Khadija Abdus Salam, Ramsha Irfan, Ayesha Siddique

PERINATAL OUTCOME IN RELATION TO HIGH RISK PREGNANCIES IN TERTIARY CARE SETTINGS...59 Shazia Aftab, Saadia Rashid, Aliya Waheed, Aasha Mahesh, Fariha Hussain, Samina Ayaz DETECTION OF NOVEL MUTATION IN VANGL1 GENE INDICATING GENETIC ASSOCIATION OF MYELOMENINGOCELE 60 Urooj Fatima, Syed Meesam Iftikhar, Sabahat Gul, Farrukh Mustafa Memon HISTOMORPHOLOGICAL EFFECTS OF WITHANIA SOMNIFERA ROOT EXTRACT AGAINST CISPLATIN INDUCED RENAL LESIONS IN RATS 61 Aaqiba Rasheed, Nadia Younus, Nausheen Adnan, Naureen Waseem, Lubna Faisal, Tayyaba Kazmi, Mohammad Mohtasheem Ul Hassan, M. Omar Shamim, Munair Badshah IMMUNOHISTOCHEMICAL EXPRESSION OF ALPHA (Α) A CRYSTALLIN IN SENILE DEGENERATIVE AND NON-CATARACT LENSES 62 Shabnam Khan, Bushra Wasim Khan, Madeeha Sadiq, Fawad Rizvi, FarazAhmed Baig, Rehan Ahmed Siddiqui PREVALENCE OF SECOND MESIO-BUCCAL (MB2) CANAL IN PERMANENT MAXILLARY FIRST MOLAR………………………………………………………………………………………………………………….…63 Huma Sarwar, Meshal Muhammad Naeem, Syed Ali Raza, Sanam Faheem, Amir Akbar Shaikh, Ujala Mushtaque IDENTIFICATION OF E-EXAMINATION AND E-LEARNING ENVIRONMENT RELATED FACTORS DURING COVID-19 AND ITS ASSOCIATION TO ACADEMIC FAILURE IN DENTAL STUDENTS OF A DEVELOPING COUNTRY: A CASE-CONTROL STUDY 64 Fareeha Farooq, Saher Mushtaque, Ujala Mushtaque, Ahsan Malik, Hebah Mushtaque, Hr Sukhia ASSOCIATION OF DIETARY INTAKE OF VITAMIN-C WITH PERIODONTITIS AMONG ELDERLY POPULATION OF KARACHI, PAKISTAN 65 Ujala Mushtaque, Muhammad Zohaib Younus, Yasir Raza, Hariza Surani, Hijab Fatemah, Jaweria Yousfani AWARENESS OF PERIODONTAL LIGAMENT INJECTION AMONG HOUSE OFFICERS AND POST GRADUATE TRAINEES-A CROSS SECTIONAL STUDY…………………………………………………………..66 Saima Hanif, Sameer Ahmed, Shaista Khan THE COMPARISON OF PHYSIOLOGY LEARNING IN UNDERGRADUATE MEDICAL AND DENTAL STUDENTS 67 Sadaf Fatima, Syed Tousif Ahmed, Shazia Hashmat, Huma Salahuddin, Kevin Joseph Jerome Borges, Syed Nudrat Nawaid Shah ONLINE PHYSIOLOGY TEACHING AND ASSESSMENT IN UNDERGRADUATE MEDICAL STUDENTS DURING COVID-19 PANDEMIC 68 Sadaf Fatima, Fadieleh Sohail, Sulail Fatima, Sara Rafique, Mohammad Sultan, Abdul Aziz THE DIFFERENCE BETWEEN ZOOM ONLINE AND TRADITIONAL PHYSIOLOGY TEACHING IN UNDERGRADUATE PHYSICAL THERAPY AND BIOTECHNOLOGY & BIOLOGICAL SCIENCES STUDENTS DURING COVID-19 PANDEMIC 69 Sadaf Fatima, Sulail Fatima, Sara Rafique, Sassi Kanwal, Mohammad Sultan, Abdul Aziz

THE COMPARISON OF ASSESSMENT SCORES BETWEEN MODULES TAUGHT FACE TO FACE AND ONLINE IN UNDERGRADUATE MEDICAL STUDENTS DURING COVID-19 PANDEMIC…………………….70 Sulail Fatima, Sadaf Fatima, Fadieleh A. Sohail, Sassi Kanwal, Kiran Zehra, Saqib Kamran ASSESSMENT OF OLIGOHYDRAMNIOS IN PREGNANT WOMEN: OUTCOME OF HYDRATION THERAPY…………………………………………………………………………………………………………………71 Sadia Rashid, Samia Perwaiz Khan, Safia Izhar, Shazia Kadri, Saira Ghafoor, Nazish Ali PRE-ECLAMPSIA AND PREGNANCY OUTCOME: A POPULATION BASED CASE CONTROL STUDY IN KARACHI PAKISTAN 72 Sadia Rashid, Safia Izhar, Shazia Kadri, Saira Ghafoor, Asma Abdullah FREQUENCY OF ACUTE KIDNEY INJURY AMONG SEPTIC CHILDREN, ADMITTED AT A TERTIARY CARE HOSPITAL 73 Meher Afroze, Maryam Haider, Uzma Arshad, Nadeem Noor, Shagufta Naqvi, Sameer Saleem Tebha MATERNAL AND FETAL OUTCOME IN CARDIAC PATIENTS: A CROSS-SECTIONAL STUDY AT TERTIARY CARE SETTING 74 Sadia Rashid, Humera Ismail, Lumaan Sheikh MATERNAL AND NEONATAL OUTCOMES IN PREGNANT WOMEN PRESENTED WITH OR WITHOUT COVID-19 DISEASE 75 Nazish Ali, Sadia Rashid, Zaib-un-Nisa Quraishi, Aliya Waheed, Saira Ghafoor, Fehmida Saleh COVID’S IMPACT ON MEDICAL STUDENTS’ PERFORMANCE…………………………………………………...76 Nabeeha Asif, Sidra Sohail ABO BLOOD GROUP SYSTEM AND COVID-19 SUSCEPTIBILITY IN DIFFERENT ETHNIC GROUPS OF MEDICAL STUDENTS IN KARACHI 77 Noorulain Thebo, Shah Jabeen, Asma Shahid, Muhammad Athar Khan, Sassi Kanwal, Shahida Kashif PRE AND POST ANALYSIS OF STRESS REDUCTION FOLLOWING PILATES EXERCISE AMONG UNDERGRADUATE STUDENTS OF PHYSICAL THERAPY……………………………………………………….78 Noman Ahmed, Nasir Mehmood, Ghazala Noor Nizami MENTAL HEALTH ISSUES IN FEMALE POPULATION DURING COVID-19 PANDEMIC…………………….79 Syeda Fariha Hussain, Shazia Aftab, Huma Baloch, Naila Qamar, Maryam Masood, Zakia Bano PERCEPTION OF OSCE AS AN ASSESSMENT TOOL IN UNDERGRADUATE STUDENTS OF PRIVATE MEDICAL COLLEGE IN KARACHI, PAKISTAN 80 Saba Pario, Shaista Bashir Anwar, Zafar Haleem Baloch, Saira Ghafoor, Shazia Aftab, Sadia Rashid, Sadia Suboohi, Zahra Salauddin FREQUENCY OF ABNORMAL PLACENTAL HISTOPATHOLOGY AND THEIR ASSOCIATION WITH ADVERSE PERINATAL OUTCOMES 81 Saira Ghafoor, Nazish Ali, Zafar Haleem Baloch, Syedafariha Hussain, Aliya Waheed, Fehmida

C. Publications in Other Journals MATERNAL AND PERINATAL OUTCOME IN ADOLESCENT AND ADULT PRIMIGRAVIDA………………….82 Shazia Afta, Huma Baloch, Komal, Saadia Rashid, Saira Ghafoor, Aliya Waheed CAN SIMULATION-BASED EDUCATION REPLACE THE HANDS-ON EXPERIENCE LEARNING DURING THE COVID-19 PANDEMIC? 83 Fadieleh A. Sohail, Marium Iqbal, Samia Perwaiz Khan, Safia Izhar IDENTIFICATION OF CONSUMER’S PREFERENCE TOWARDS STORE IMAGE: USING ANALYTICAL HIERARCHICAL PROCESS TECHNIQUE 84 Dr. Musarrat Shamshir, Dr. Shahzad Nasim, Zaibunnisa Siddiqi, Muhammad Raza, Muhammad Sameer Ahmed THE RELATIONSHIP BETWEEN HUMAN RESOURCE MANAGEMENT AND CORPORATE SOCIAL RESPONSIBILITY: ACRITICAL REVIEW 85 Zaibunnisa Siddiqi, Dr. Manzoor Ali Mirani, Dr. Shahzad Nasim, Dr. Musarrat Shamshir, Sidra Nisar TALENT MANAGEMENT, AN APPROACH FOR IMPROVING HR PRACTICES…………………………………86 Zaibunnisa Siddiqi, Shahzad Nasim, M. Anwer Baz Khan, Musarrat Shamshir DETERMINANTS OF CAPITAL STRUCTURE: A STUDY OF FERTILIZER INDUSTRY OF PAKISTAN……….87 Jahangir Tanveer, Musarrat Shamshir, Shahzad Nasim, Sidra Nisar, Salman Ahmed Shaikh A COMPARATIVE STUDY OF MANAGEMENT OF FEMORAL SHAFT FRACTUREIN CHILDREN…………..88 Hassan Amir Us Saqlain, Niaz Hussain Keerio, Ghazanfar Ali Shah, Syed Abdur Rub Abidi, Zahoor Illahi Soomro, Imtiaz Ahmed Tago ROLE OF ALENDRONATE AND PARATHYROID HORMONE IN POSTMENOPAUSAL OSTEOPOROSIS: A RANDOMIZED CLINICAL TRIAL 89 Zahoor Illahi Soomro, Imtiaz Ahmed Tago, Syed Abdur Rub Abidi, Ghazanfar Ali Shah, Niaz Hussain Keerio, Hassan Amir Us Saqlain ORGANIZATIONAL STRESS AND JOB PERFORMANCE: A CASE STUDY OF POLICE OFFICERS IN DISTRICT QUETTA 90 Muhammad Asif Buledi, Prof. Dr. Musarrat Adnan, Hafsa Karim, Tayyaba Zia, Rabeea Zia, Rafia Kanwal, Abdul Rauf Bangulzai ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS MISDIAGNOSED AS SMEAR NEGATIVE PULMONARY TUBERCULOSIS; A RETROSPECTIVE STUDYFROM PAKISTAN……………………………..91 Nousheen Iqbal, Muhammad Dawood Amir sheikh, Kausar Jabeen, Safia Awan, Muhammad Irfan MOTIVATION AND JOB SATISFACTION AMONG MEDICAL AND DENTAL COLLEGE FACULTY IN PAKISTAN AMID THE COVID-19 OUTBREAK 92 Saqib Ali, Beenish Fatima Alam, Sara Noreen, Madiha Anwar, Sabeen Hashmat Qazi, Talib Hussain

ASSESSING THE BELIEFS ABOUT ANTIDEPRESSANT MEDICATION AND ADHERENCE TO THERAPY IN PATIENTS WITH MAJOR DEPRESSIVE DISORDERS…………………………………………………………93 Prof. Dr. Samia Perwaiz Khan, Dr. Shagufta Naqvi, Dr. Rabeea Rizwan, Mariam Ansari, Shaista Emad, Habib ur Rahman Khan, Aafia Akhtar, Maniya Syed, Naija Ehsan, Anas Moorad AL-HIJAMA- A POSSIBLE CURE FOR DEPRESSION: A PILOT STUDY…………………………………………94 Sabeela Noor, Saida Haider, Fasiha Fatima, Mahparah Mumtaz COVID-19: AN EMERGING CULPRIT OF INFLAMMATORY ARTHRITIS…………………………………………95 Muhammad Shariq Mukarram, Muhammad Ishaq Ghauri, Sehrish Sethar, Nasir Afsar, Amir Riaz, Khizra Ishaq OCULAR MANIFESTATIONS IN A PATIENT WITH DANDY-WALKER MALFORMATION: A CASE REPORT 96 Qirat Qurban, Zeeshan Kamil, Sameer Saleem Tebha, Zain Ali Zaidi, Maahirah Said, Samar Fatima Zehra, Sajjad Ali, Sehrish Sethar INCIDENTAL FINDING OF RIGHT-SIDED IDIOPATHIC SPONTANEOUS ACQUIRED DIAPHRAGMATIC HERNIA……………………………………………………………………………………………………………………97 Zain Ali Zaidi, Sameer S Tebha, Sehrish S Sethar, Sakshi Mishra RESPIRATORY PATHOGENS IN PATIENTS WITH ACUTE EXACERBATION OF NON-CYSTIC FIBROSIS BRONCHIECTASIS FROM A DEVELOPING COUNTRY…………………………………………………………..98 Shayan Shahid, Kauser Jabeen, Nousheen Iqbal, Joveria Farooqi, Muhammad Irfan DEPTH OF INVASION AS A PREDICTOR OF CERVICAL NODAL METASTASIS OF ORAL TONGUE SQUAMOUS CELL CARCINOMA: FINDINGS FROM A TERTIARY CARE CENTER IN PAKISTAN…………99 Adnan Y. Muhammad, Rahim Dhanani, Summaiya Salman, Zeeshan Shaikh, Shayan K. Ghaloo, Mubasher Ikram FEAR AND PERCEPTION OF PEOPLE TO VISIT DENTIST DURING COVID-19 PANDEMIC AND THEIR SUGGESTIONS 100 Muhammad Mansoor Majeed, Zarah Sidiqqui, Muhammad Uzair, Azam Shahzad, Sara Rafique, Shoaib Durrani POSSIBLE INVOLVEMENT OF GLUTAMATERGIC, ADRENERGIC AND DOPAMINERGIC SYSTEM IN METHYLPHENIDATE-INDUCED MOTOR ACTIVITY AND MOOD-RELATED ALTERATIONS IN RATS……101 Kowsar Jahanbakshi, Sulail Fatima, Majid Motaghinejad, Manijeh Motevalian EFFECTS OF SCHOOL BASED FITNESS TRAINING ON BODY MASS INDEX OF CHILDHOOD OBESITY..102 Umeeda Baz Ali, Dr Amna Khan, Dr Syed Abid Medhi Kazmi, Dr Sumaira Farooqui WORK RELATED STRESS AMONG HEALTH CARE PROFESSIONALS IN KARACHI…………………..…...103 Shazia Tabussum, Ghazala Noor Nizami, Syed Mukhtar Ahmed, Muhammad Asif, Hina Rathi, Hina Muhammad Munaf

IVERMECTIN USE ASSOCIATED WITH REDUCED DURATION OF COVID-19 FEBRILE ILLNESS IN A COMMUNITY SETTING 104 Muhammad Ishaq Ghauri, Nasir Ali Afsar, Muslim Abbas, Muhammad Shariq Mukarram, Muhammad Yahya Peracha, Khizra Ishaq SESQUITERPENE FROM POLYGONUM BARBATUM DISRUPT MITOCHONDRIAL MEMBRANE POTENTIAL TO INDUCE APOPTOSIS AND INHIBITS METASTASIS BY DOWNREGULATING MATRIX METALLOPROTEINASE AND OSTEOPONTIN IN NCI-H460 CELLS…………………………………….………105 Zehra, Binte, Ayaz Ahmed, Ajmal Khan, Afshan Shams, Reaz Uddin, Sidra Rafi, Taseer Ahmed Khan, Umar Farooq, Syed Abid Ali POST COVID-19 TUBERCULOSIS: AN EMERGING THREAT OF PANDEMIC…………………………………106 Aqusa Zahid, Nousheen Iqbal, Sarosh Moeen, Muhammad Irfan QUALITY OF SLEEP AND ITS ASSOCIATED RISK FACTORS AMONG MAINTENANCE HEMODIALYSIS PATIENTS IN PAKISTAN 107 Mahjabeen Yaseen, Shagufta Naqvi, Amna Saleem, Rida Nasreen, Rida Imran, Aysha Mahmood RADIOLOGICAL FINDINGS OF COVID-19 PATIENTS WITH PNEUMONIA, KARACHI PAKISTAN………...108 Samia Perwaiz Khan, Safia Izhar, Shazia Kadri RAPIDLY PROGRESSIVE DIABETIC KIDNEY DISEASE: SOUTH ASIAN EXPERIENCE………………… ..109 Sonia Yaqub, Amna Hamid, Waqar Kashif, Muhammad Raheel Abdul Razzaque, Aisha Farooque, Bilal Ahmed, Nani k Ram CORNELIA DE LANGE SYNDROME: A RARE CASE……………………………………………………………..110 Syeda Seemin Raza, Maryam Haider, Maria Khan, Yousuf Farooqi, Uzma Arshad, Meher Afroze, Bushra Rafique, Nadeem Noor ROLE OF C-REACTIVE PROTEIN AND GAMMA-GLUTAMYL TRANSFERASE IN THE DIAGNOSIS OF METABOLIC SYNDROME 111 Rubina Ghani, Mozaffer Rahim Hingorjo, Samia Perwaiz Khan, Uzma Naseeb, Shaista Emad, Afrasayab Khan Khattak, Alina Fatima Iqbal, Mauyur Sarhadi, Navneet Sarhadi PREVALENCE OF BACTERIA AND ANTIMICROBIAL RESISTANCE GENES IN HOSPITAL WATER AND SURFACES……………………………………………………………………………………………………………..112 Maira Aleem, Abdul R. Azeem, Sidra Rahmatullah, Sufyan Vohra, Shumyila Nasir, Saadia Andleeb MEASURING A NEXUS BETWEEN FINANCIAL SECTOR DEVELOPMENT AND ECONOMIC GROWTH IN CASE OF PAKISTAN: AN EMPIRICAL APPROACH USING ARDL METHOD…………………………………..113 Prof. Dr. Masood Mashkoor Siddiqi, Dr. Nazia Abdul Rehman, Dr. Khurram Shakir, Dr. Musarrat Shamshir PATTERNS OF DRUG PRESCRIBING AND PRESCRIBING ERRORS AT IN-PATIENT PEDIATRIC DEPARTMENTS OF GOVERNMENT HOSPITALS, KARACHI, PAKISTAN……………………………………114 Najia Rahim, Shagufta Nesar, Muhammad Harris Shoaib, Syed Baqir Shyum Naqvi, Tahmina Maqbool, Shazia Qasim Jamshed

COVID-19 IMMUNIZATION PHASE; ACCEPTANCE & UNDERSTANDINGS ABOUT THE VACCINE……....115 Shagufta Nesar, Kiran Rafiq, Shaheen Perveen, Tayyaba Mumtaz PHARMACISTS’ INSIGHTS AND BEHAVIORS IN PREVENTING THE MISUSE OF TOPICAL CORTICOSTEROIDS IN PAKISTAN: A MIXED-METHOD STUDY……………………………………………….116 Sadia Shakeel, Shagufta Nesar, Wajiha Iffat, Hina Rehman, Samreen Aziz, Tayyaba Mumtaz, Hazrina Hadi, Shazia Jamshed APPROACHES AND PERSPECTIVES FOR ONLINE LEARNING DURING THE COVID 19 PANDEMIC AND FUTURE CHAOS 117 Shagufta Nesar, Kiran Rafiq, Muhammad Rizwan, Syed Mehmood Hasan

RISK FACTORS OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS OF AGE IN SLUM AREAS OF KARACHI Aaila Nayani, Aymen Kamal, Iqra Ali Kakar, Sajida Moiz Supervisor: Dr. Mehtab Hussain Introduction: One of the nations where malnutrition, difficulties with stunting, wasting, and underweight children are prevalent is Pakistan. Using a universally validated screening method to detect malnutrition and executing the right therapies in accordance with the severity of the malnutrition are key components of managing malnutrition in community settings. This narrative review was carried out to assess the nutritional status in Karachi's slum regions. This study sought Objective: - To determine the prevalence of malnutrition among young children under the age of five in Karachi's slum regions, as well as the contributing variables that contribute to it. Methodology: A cross-sectional study situated on a hospital in Karachi's urban slum district was carried out. Children between the ages of 5 and 59 months (5years) made up the study's target demographic. 200 kids in all participated in this study. Using a pre-designed questionnaire, the patient's guardian (preferably a mother) was interviewed to gather data. The questionnaire covered a wide range of topics, including marriage status, the number of children they have, the order in which they were born, their diet, level of education, and vaccinations. All these questions were asked to determine the risk factors associated with malnutrition. Stunting, wasting, and underweight were measured using the WHO growth standards height-for-age Z-scores (HAZ), weight-for-height Z-scores (WHZ), and weight-for-age Z-scores (WAZ). Results: The prevalence of stunting, wasting and underweight were 71.1%, 58.7% and 100% respectively. Stunting, wasting and underweight were relatively seen ore in boys than in girls. Children with Tb contact were more likely to be underweight. Monthly income showed a significant association with stunting. Similarly wasting was associated with vaccination status, measles and past 6 months and exclusive breast feeding. Factors such as mother’s education, occupation and family size were not associated with malnutrition in our study area. Conclusion: Our study's conclusions showed that malnutrition was common among children under the age of five. To improve the malnutrition condition in the study region and the nation, interventions based on food and nutrients should be combined with better hygiene habits and household wealth. Keywords: Risk factors, Malnutrition, Children, Slum areas 1

SOCIOECONOMIC FACTORS ASSOCIATED WITH MALNUTRITION AMONG DIFFERENT CLASSES OF KARACHI Aiman Hameed, Qirat Aijaz, Nahil Saleem, Taskeen Fatima Supervisor: Dr. Asma Noreen Introduction: Pakistan has one of the highest prevalence of child malnutrition. It is one of the main reason of morbidity and mortality. Children from low socioeconomic background are 2.5 times more vulnerable of malnutrition. The social background of children significantly impact their health, hence forth we conducted our research on the basic parameters linking the socioeconomic status, lifestyle, diet, their milestones and parents education/financial bearings. Objectives: - To find out the effect of socioeconomic factors on malnutrition among different classes of Karachi. - To reduce the prevalence of malnutrition among the children under five years and to improve the nutritional status. Methodology: The study design was Cross sectional study with Participants who were under 5years of age visiting Jinnah medical college hospital and Medicare cardiac and general hospital pediatrics OPD. The Duration of study was 6 months. The Sample size was of 160 participants. Systemic Random sampling Technique was used. The questionnaire was formulated on the basis of 28 questions including all the measurements. Data was collected by researchers through manual questionnaire with written informed consent. The data was analyzed SPSS version 25 Result: Total 160 children under 5 years of age were included. 42% children were malnourished. The number of boys and girls were equally affected. The results revealed that malnutrition was observed in children with chronic illness and incomplete immunization. The children from lower middle class family were mostly affected. Furthermore variables such as mother’s age, father’s income also had an impact on child’s overall health. Conclusion: It is concluded that the main factors associated with malnutrition are any chronic illness in the family, father’s employment and vaccination status. To overcome this we need to improve children’s nutrition health by creating awareness about vaccination and adequate nutrition. Keywords: Malnutrition, Socioeconomic factors, Children, Socioeconomic status 2

RELATIONSHIP BETWEEN SOCIAL CAPITAL AND MENTAL AILMENTS AMONG TRANSGENDER POPULATION IN KARACHI Alina Ali Nawaz Lashari, Eman Arif Siddiqui, Urooba Siddiqui, Azhar Hussain Supervisor: Dr. Sulail Fatima Introduction: Social determinants, like freedom from discrimination and violence, social inclusion, access to economic resources have a major positive impact on the mental health. Transgender adults are more likely to suffer anxiety, depression, substance - abuse and attempted suicide. The majority of transgender research is focused on occurrence and risk factors of sexually transmitted illnesses, overlooking social determinants of health particularly mental health. Objective: - To study the association between social capital and anxiety - depression along with suicidal ideation among adult transgender in Karachi. Methodology: This cross-sectional study included a convenient sample of 230 adult transgender aged between 18 – 40 years. The individuals were interviewed using Social Capital Questionnaire, The Beck Scale forSuicide Ideation, and The AgaKhan University Anxiety and Depression Scale. For non- normal data, median with interquartile range was reported. For categorical data, frequency along with percentage were presented. Spearman correlation (ρ) was calculated for total score of social capital with the scores of AKU-ADS and BSSI. Simple binary logistic regression was applied to estimate the odds ratio between categories of AKU-ADS and independent variables. Result: We found that 29.1% of transgender adults were positive for anxiety & depression. There was a moderate negative association between social capital and anxiety & depression (ρ = - 0.429, p < 0.001), and social capital and suicidal ideation (ρ = - 0.414, p < 0.001). Moreover, a moderate positive relationship appeared between anxiety & depression and suicidal ideation (ρ = 0.463, p < 0.001). Regression analysis showed that higher educational level, lower income, young age, lower score on social capital significantly increase the odds of having anxiety and depression among transgender adults (p value < 0.05). Conclusion: The findings of this study provide useful information for developing evidence – based interventions to strengthen social capital for reducing mental health ailments among transgender adults. Keywords: Social capital, Transgender, Anxiety, Depression, Suicidal ideation 3

IS SMART PHONE OVERUSE ADVERSELY AFFECTING THE HEADACHE, SLEEP AND QUALITY OF LIFE IN MIGRAINEURS? Syeda Samia Shams, Qubra Sarfaraz Mirjat, Syeda Fatima Haider, Umesa Mazhar Supervisor: Dr. Mehwish Butt Introduction: The number of regular smartphone users has increased dramatically worldwide. Headaches, followed by sleep difficulties, forgetfulness, dizziness, and other ailments, are among the most prevalent complaints among smartphone users during or after use. In addition, migraine is a debilitating disease and is the world's second leading cause of disability. Objective: - To determine how smartphone overuse influenced migraine patients' level of disability, pain intensity, sleep quality, and overall quality of life. Methods: In this observational study, the patients were divided into two groups high mobile phone use group (HMPUG) and the low mobile phone user group (LMPUG) using the Mobile Phone Problematic Use Scale. We assessed, for each group, patients’ level of disability, pain intensity, sleep quality, daytime sleepiness, and quality of life through the Migraine Disability Assessment Scale, Visual Analogue Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and 24-hour Migraine Quality of Life Questionnaire, respectively. Results: Our study showed that the respondents' average age was 27.59 (9.79) years. The average number of family members was 5.98 (2.3251). A total of 65.8% (n = 263) of the 400 participants were female, while 34.3 % (n = 137) were male. greater pain intensity, poor sleep quality, and reduced medication effectivity were found in HMPUG compared o LMPUG (p<0.05). however, increased duration of migraine and medication intake was reported in the LMPUG. (p<0.05) Conclusion: We observed that smartphone overuse could worsen pain, sleep, and reduce treatment efficacy in individuals with migraine. Therefore, controlled smartphone use is recommended to avoid worsening symptoms. Keywords: Migraine, Mobile phone overuse, Quality of life, Sleep quality, Daytime sleepiness 4

CURRENT TRENDS IN PREVALENCE OF MULTIDRUG RESISTANT (MDR) AND EXTENSIVELY DRUG RESISTANT (XDR) SALMONELLA TYPHI AND S. PARATYPHI IN KARACHI Owais Ameer, Usama Muhammadi, Muhammad Zohaib Javed, Zoha Asif Sharif Supervisor: Dr. Musarrat Jehan Introduction: Typhoid fever, a major healthcare problem, remains endemic and sometimes epidemic in Pakistan. Its treatment is becoming increasingly difficult due to emergence of multidrug resistant (MDR) and extremely drug resistant (XDR) strains which limits treatment options and necessitates use of expensive drugs. This poses a heavy economic burden on the poor which are the prime target for this disease. Objective: - To determine the current status of antibiotic sensitivities in Typhoid and Paratyphoid fever and assess the frequency of MDR, XDR, fluoroquinolones resistant and cephalosporin resistant strains of Salmonella typhi & S.paratyphi in Karachi. Methodology: Data was collected prospectively and retrospectively for antimicrobial susceptibility testing performed on S. typhi & S.paratyphi isolated from blood cultures during a period from November 2018 to June 2022. These blood culture samples were collected from outpatient, inpatient, and patients coming to the laboratories of Medicare cardiac & general hospital and Jinnah medical college hospital with a diagnosis of febrile illness and suspected for enteric fever. Result: A total of 80 cases of culture-positive enteric fever were included in the study. Age range was from 1 to 66 years. 55% of cases were 10 years and younger. Out of 66 S.typhi isolates, 47 were XDR (71.2%) and 8 (12.1%) were MDR. None of the 14S.paratyphiisolates were XDR or MDR. There was very high resistance to ciprofloxacin in both S. typhi (60/66 -90.9%) and S.paratyphi cases (12/14 - 85.7%). Altogether 46/66 (69.7%) of S. typhi isolates and 1/14 (7.1%) S.paratyphi isolates were resistant to third generation cephalosporin. Only 6 out of total of 80 cases (7.5%) were sensitive to almost all drugs. All isolates of S. typhi & S.paratyphi which were tested for imipenem (64), meropenem (73) and azithromycin (66) were found to be sensitive. Conclusion: Our study depicted high level of resistance especially in S.typhiisolates. The spread of XDR Salmonella typhi has reached an alarming level and it is a matter of time that it reaches a point where it becomes untreatable unless prompt, extensive and effective steps are taken to address the problem. Keywords: MDR, XDR, Fluoroquinolone resistance, S.typhi. 5

PREVALENCE OF STRESS AND EATING DISORDER IN MEDICAL STUDENTS DURING EXAM SEASON Kainat Amir Ali, Umm-e-Farwa, Zareena Jan, Syed Muhammad Waqas-ul-Haq Supervisor: Dr. Falak Abro Introduction: Stress is known as a general body response but it is also considered to be a global problem due to negative impact on human health. The pressure of studies in medical school can be considered an important factor able to produce stress. There are many factors that cause the stress to cause abnormal eating habits, one of them is the overload of work such as homework, assignments, lectures. These conditions cause stress, affecting the appetite of students by either skipping meals or by showing unhealthy eating behavior of consuming food such as fast foods, sweets and cold drink. Objective: - To find out relationship between stress and how it changes eating habits in medical students. Methodology: In this observational study, the students were divided into five groups no stress(NS), slight stress(SS), moderate stress(MS), high stress(HS), extreme stress(ES) using the ACADEMIC STRESS SCALE. We assessed for each group the presence or absence of eating disorder by COMPULSIVE EATING SCALE(CES). Data will be collected by distributing self-administered questionnaires that would be filled among medical students only. Data will be entered into and analyzed using the SPSS version 23, Mean and standard deviation will be calculated for quantitative variables like age. Frequency and percentages will be calculated. Post stratification CHI square test will be applied p value equal go 0.05 will be taken as significant. Results: Our study showed that the total of 63.2%(n=237) of the 375 participants were female, while 36.8(n=38) were male. In 41.6%(n=156) participants were stress was present, however in 58.6%(n=220) stress was absent. A total of 13.3%(n=50) students suffered from eating disorder while 326(n=86.4) didn’t suffer from eating disorder. And from the 156 students suffering from stress,44 have eating disorder and 112 don’t have eating disorder. From 220 students who had no stress,6 had eating disorder and eating disorder was absent in 214 students. The p value is <0.001 with odds ratio 4.2. Conclusion: Frequency of stress related eating disorder was found to be higher among females of MBBS studying in private university. Keywords: Stress, Medical students, Eating disorders, Obesity 6

COMPARISON OF LOCKDOWN PRACTICES AND BELIEFS REGARDING CORONA VIRUS AMONG PUBLIC DEALING AND WORK FROM HOME INDIVIDUALS-AN INTERVENTIONAL STUDY Bushra Syed, Bilal Fattani, Amna Haroon, Anshrah Imtiaz Supervisor: Dr. Syeda Urooj Riaz Introduction: The first case of Coronavirus was reported at a seafood market in Wuhan, China. However, due to its rapid transmission and swiftly increasing cases, Covid 19 was declared a global pandemic in March 2020. During this time of emergency and the oblivious nature of this virus meant much misinformation was spreading side by side, which aided the people's fears. This fear was why conducting this study was so important, to find out the gap in knowledge regarding COVID-19 spread, cure, and preventative measures. This study will also help us to figure out the best way to spread the correct information among citizens. Objective: - To compare the daily routine between both groups during lockdown and beliefs on the spread and cure of covid. - To compare the change of stance in both groups regarding covid after being shown the video. Methodology: We conducted a cross-sectional survey with an intervention (video) from September 2021 to January 2022. Our participants consisted of two groups; the first group had bankers as our Public dealers and teachers as work from home individuals. The questionnaire was designed, which consisted of five sections; demographics, daily routine practices; facts and myths regarding covid; thoughts on lockdown; beliefs regarding the covid vaccine. After filling out the forms, participants were shown a video of a confirmed case of complicated covid 19 infection and information regarding the covid 19 vaccine. Then a week later, they were contacted and asked to fill out the same form again. Result: We found out that there was a significant increase in mask-changing habits (P=0.01); further, there was a significant increase in people attending mass events (P=0.05). There was a change of 0.700 ± 2.350 SEM 0.332 (p-value = 0.040) in the times teachers washed their hands in a day. Further, there was a significant change in bankers' (P= 0.009) and teachers (P= 0.053) mask-changing habits. There was a significant increase in the number of bankers post-intervention who accepted social distance (P=0.006) and changed clothes when they came home from outside (P=0.016) as a precaution against covid. More bankers accepted that senna (P=0.031) or antibiotics (P=0.039) do not cure covid. Overall, the changes in teachers' practices and bankers' beliefs were more significant. Conclusion: Most cleanliness habits after coming from outside are the same for Public dealers and Work from Home Individuals. There was a significant rise in wearing masks after the intervention; our video showed that wearing a mask is one of the effective measures to prevent covid. There were more significant changes in bankers' beliefs and practices. We would suggest further studies in other parts of the country and on other professions to get accurate results. Keywords: Covid19, Bankers, Teachers, Public dealers, Work from home individuals, Vaccine. 7

ERGONOMIC PRACTICES AND FREQUENCY OF CELL PHONE VISION SYNDROME SYMPTOMS AMONG UNDERGRADUATE STUDENTS USING PORTABLE ELECTRONIC DEVICES Vohra Maham Hassan, Ayesha Amir, Alina Ganny, Muzzammil Naveed Supervisor: Dr. Shahid Ahsan Introduction: The use of portable electronic devices, has now become an important part of human life. The frequent usage of portable electronic devices has given rise to a complex of ocular and nonocular symptoms termed as cell-phone Vision Syndrome (CVS). Objectives: - The study aims to assess the ergonomic practices and frequency of CVS symptoms among undergrads students studying in different institutes of Karachi. Methodology: A cross-sectional survey with self-administered questionnaire, disseminated through online google forms and onsite hard copy forms was conducted. Demographic data, ergonomic practices and symptoms related to CVS was collected by using a validated questionnaire, CVS-Q. Result: A total of three hundred students participated in the study; among them 72.8% were females. Most of the students were 20-25 years old and were students of medical and allied fields. More than half of the participants 49.2%(n=148) adopted bending back/hunched-over posture during use of their laptop/computer or mobile phones. The usual posture adopted while using the mobile phones was neck-tilted 51.5%(n=155). Almost half of the participants 59.1%(n=178) had the center of their computer screen below the level of eyes, while using desk top and only 34.6%(n=104) kept it at the level of eyes. For 64.1%(n=193) of the participants, the most comfortable way for typing was to hold the device in both hands and type by both thumbs while least preferred one was hold by left-hand and type by right index finger 8.6%(n=26). The participants were also asked about subjective viewing distance, 47.1%(n=142) reported to be around 40 cm (an arm’s length) while 44.9%(n=135) reported it to be < 40 cm. Burning of eyes (52.49%), neck pain (52.82%), headache (50.83%), shoulder pain (49.17%) and tearing of eyes (47.84%) were the most common CVS symptoms. Colored halos (71.43%), double vision (68.77%) and difficulty focusing near vision (66.78%) were the least commonly experienced symptoms. Eighty-six per cent students were not aware of the term CVS and the 20-20- 20 rule. Conclusion: Majority of the participants did not follow recommended ergonomic practices while using portable electronic devices. Every second study participants experienced some symptoms of CVS. Majority of them were not aware of the term CVS and the 20-20-20 rule. Keywords: Cell-phone vision syndrome, University students, Digital devices, Karachi 8

RAISED MATERNAL BMI ASSOCIATED WITH INCREASE RISK OF WEIGHT OF BABIES AND CESAREAN SECTION Ifham Imtiaz, Abdul Wahab, Owaim Atiq, Hamza Naseem Supervisor: Dr. Erum Memon Introduction: BMI is a tool to measure maternal nutritional status. Maternal nutrition is a frequently reported health problem especially during child bearing age and effects neonatal birth weight and may impact mode of delivery. Pakistan ranks among the top 10 countries where obesity is prevalent. Maternal obesity is one of most common cause of macrosomia (large birth weight which is greater than 4kg). Rate of cesarean section increases in women who are pregnant with macrosomic babies. Objective: - The aim of this study to find any relationship between increase maternal with neonatal weight and mode of delivery. Methods: Prospective cohort study over a period of 1 year was conducted in which the study population consists of Patients who are primigravida with term pregnancy (Singleton) admitted in labour ward and in the post natal ward at sohail university hospital, korangi. The sample size was 432 and Questionaire based convenient sampling Technique was used. Data collection was done by Interviews, documents and records. Measurement of maternal BMI (in first visit), Mode of delivery, neonatal Apgar score, neonatal weight and complications were recorded and noted on proforma. Data analysis was conducted through SPSS22, Microsoft Excel and Word 2010. Consent was taken with reassurance of confidentiality. Results: Among the 432 patients involved in the study, the most common BMI classification the pregnant women fell under was in the Pre- obese category (25.0-29.9) with a total of 154 patients. The dominant form of mode of delivery observed among the patients involved in our study was the lowersegment cesarean section (55% of the patients). While the birth weight of the babies delivered mostly presented either in the overweight category (192 neonates) or normal weight category (191 neonates). Statistical comparisons of BMI with both birth weight and mode of delivery showed statistical significance when the p-value was considered less than 0.05. Hence allowing us to conclude that the hypothesis in our study was significant and correct. Conclusion: Studies determining the relationship of maternal BMI, neonatal birth weight and mode of delivery are lacking in Pakistan. Our study highlights that there is a noteworthy direct relationship between maternal BMI, neonatal birth weight and mode of delivery as raised prepregnancy maternal BMI results in high birth weight of neonates and increased risk of cesarean section. Hence proving our hypothesis. However there is need of such more studies to highlight impact of such kind. Keywords: BMI, Macrosomia, Cesarean section 9

CORRELATION BETWEEN BIOCHEMICAL AND HAEMATOLOGICAL ANALYSIS FOR THE DIAGNOSIS OF HELICOBACTER PYLORI INFECTION Faizan Ali, Abdul Wahab, Waleed Khan, Sher Khan Supervisor: Dr. Shaista Emad Introduction: Helicobacter pylori (H. pylori) is a spiral-shaped gram-negative bacterium that develops in the gastric mucosa. It is the most frequent cause of morbidity and mortality of upper GI diseases. H. pylori infection is associated with a variety of extra-digestive conditions, including coronary disease, myocardial infarction, migraine, hepatobiliary diseases, dermatological disorders, iron deficiency anemia and autoimmune diseases. Approximately 50.8% of the world populations are known to be infected with H. pylori, with a higher burden reported from developing countries. In Pakistan, the prevalence of H. Pylori infection is 81%. It is transmitted mostly through oro-faecal route due to unsatisfactory sanitation conditions and impure water availability. Objective: - To investigate association of haematological and biochemical parameters inpatients with H. pylori infection. Methodology: A cross-sectional study was conducted from January to June, 2022 among 120 Study participants. Blood samples were collected for haematological and biochemical investigations. Anti-H. pylori antibody was detected using immunoglobulin enzyme-linked immunosorbent assay (ELISA). Data was analysed using SPSS version 20. Results: Mean values of Hb, RBC, neutrophils, lymphocytes, and platelets in H. Pyloripatients were significantly lower than in controls (p<0.05). Biochemical studies showed increased C-reactive protein, serum amylase and lipase in both H. pylori-positive female and male patients compared to controls (p<0.001). Female iron profile of H. pylori-positive patients has lower iron and ferritin levels and increased total iron-binding capacity, which is significantly impaired than controls. However, no significant biochemical changes are observed in male patients infected with H. pylori. Conclusion: The current study shows an association between haematological and biochemical parameters in H. pylori infected patients. Therefore, haematological factors should be considered for the accurate diagnosis and treatment of patients infected with H.pylori and for the eradication of this bacterium in infected individuals. Keywords: H. Pylori, Amylase, Lipase, TIBC, CRP, Iron, Ferritin. 10

THE PSYCHOLOGICAL IMPACT OF COVID 19 PANDEMIC ON FACULTY AND MEDICAL COLLEGE STUDENTS OF KARACHI CITY Javeria Raza, Durr-E-Sameen, WaniaAyub, Neha Asif Supervisor: Dr.Sabeen Hashmat Qazi Introduction: The occurrence of novel Human Corona Virus Disease (n HCoVD) 2019 was first detected in December, 2019 in Wuhan city of China. On March 11, 2020, the World Health Organization declared the outbreak of the disease as a global pandemic. Due to the wide spread of COVID-19, the educational institution in Pakistan were closed on 20th March, 2020. This lockdown resulted in a strong impact on student’s wellbeing, with associated uncertainty about the future. It had similar effects on faculty as the lockdown situation caused a shift from traditional to online educational methods. The communication between students and faculty had become minimal with no to 50% attendance per day, this led to serious implications on both their mental health. Various recent studies have been conducted on the psychological impact of Covid19 pandemic on students but no study has yet reported the mental health status of both medical students’ and medical faculty. With the outcome of this study we can check the impact of Covid19 on medical students and faculty which can provide basic data for further research. Objective: - To evaluate the mental situation of medical college students and faculty during the epidemic. - To provide basic data for further applied and action research and the framework for medical colleges and policy makers in Pakistan. Methodology: This cross-sectional study was conducted from July 2021 to April 2022 via cluster sampling technique. The participants included students enrolled in MBBS and BDS in medical colleges of Karachi and faculty teaching the health sciences programs were included. After an approval from the Ethical Review Committee, a well-structured questionnaire was formed and validated. It had two sections; Demographic data and responses covering the Perceived Stress Scale (PSS-10) scale for stress. The Generalized anxiety disorder scale 7-items (GAD-7) for anxiety and The Patient Health Questionnaire (PHQ-9) for depression of faculty and medical students of Karachi city. The Questionnaire was uploaded at www.surveys.google.com as well as printed forms hand filled by the participants. SPSS version-25 was used for statistical analysis. Results: The Faculty of medical institutions in Karachi was found to be highly stressed (91.25%), followed by depression (78.1%) while anxiety was reported by (70%). The medical students were also found to be highly stressed (97.1%) followed by depression (52.1%) whereas anxiety was found to be (50%) Conclusion: The Corona virus disease has had a huge impact on the mental health status of both faculty and students of medical colleges. Keywords: Anxiety, Stress, Depression, Medical students & faculty, COVID 19 pandemic. 11

COMPARE THE EFFECTIVENESS OF NEW PEDAGOGICAL METHODS AND PASSIVE TEACHING Alizah Arshad, Areej Haider, Maryam Yousuf Supervisor: Dr. Zeelaf Shahid Introduction: Over the past several years there have been growing interest in promoting the active teaching methods considering it superior over passive lecture methods in developing interests and participation towards learning and retaining knowledge. Basically, this study aims the comparison of effectiveness of new pedagogical methods and passive teaching through which the students will be able to improve the knowledge and retention in Pharmacology selected for intervention and incorporate them in other subjects as well. Objective: - To compare the effectiveness of new pedagogical methods and passive teaching Methodology: The target population for this interventional study being the undergraduate students of Jinnah Medical and Dental College, Karachi with random sampling of 3rd year MBBS students divided into a unique combination for conventional/passive, Flipped classrooms and Flowcharts methods. Each group was taught the same topic by different teaching method with assessments. Statistical analysis was carried out using statistical package for social sciences (SPSS) Version 23. Paired & Independent t test used for categorical variables. Results: Demographic results were significant for students with A levels, day scholars, and self researchers. (Fig.1) The noteworthy finding was that the males (n=44) compared to females (n=55) showed most remarkable p value of <0.001 for knowledge and retention by active and passive teaching methods. Efficacy of active and passive teaching methods was based on the significant p value results. Lecture is most outstanding teaching method with p value <0.002 as compared to Flipped classrooms with p value <0.043 and Flow charts <0.222. Finally, most notable feature was 62.6% improvement in knowledge of students by intervention of active and passive teaching methods. Conclusion: Lecture, no doubt is still the most promising teaching method and males showing the most significant results for knowledge and retention after intervention of active and passive teaching methods. Keywords: Active teaching, Flipped classrooms, Flowcharts, Lectures 12

BENEFITS AND DISBENEFITS OF VIRTUAL TEACHING DURING THE COVID-19 PANDEMIC: STUDENT LEARNING EXPERIENCE Maham Sohail Shaikh, Sara Mubeen, Mohammad Arqam Ashraf Hamidani, Inshrah Hanif Raja Supervisor: Dr. Samia Perwaiz Khan Introduction: Comparable to the rest of the world, medical educational institutes in Pakistan had to conduct virtual teaching during COVID-19 pandemic lockdowns. Virtual online teaching has a number of advantages including augmenting and enhancing both teaching and learning processes. Advantages of learning through online lectures include increased accessibility to information, ease in updating content, personalized instruction, and continuing education. Disadvantages may include either be pedagogy or technical issues. Objective: - To explores the benefits, dis-benefits of online teaching of curriculum for medical and dental undergraduate students and assesses how to overcome the challenges to online medical education during the pandemic. Methodology: This quantitative study used a sample of one hundred and fifty undergraduate MBBS and BDS students of Jinnah Medical & Dental College, Karachi. Through a questionnaire-based survey conducted in the year 2021 benefits, dis-benefits of virtual teaching and learning of pharmacology as well as the difficulties faced by the participants, were assessed. Results: The overall results of this study were not satisfactory and disbenefits experienced by the participants in this study were high. This study also highlights certain issues which need addressing, including technical issues of internet interruptions/bandwidth (92%), disturbances during the online sessions (79%), missing the interactive dialogues with lecturers (75%), missing end of session revision (67%), quality issues of recorded lectures (66%), short duration of online sessions (44%). Conclusion: The present study finds that online teaching during COVID-19 pandemic lockdowns had been effective in filling in the gaps. It also highlights the areas which need to be addressed to remove the shortcomings in order to further improve the benefits and effectiveness of online learning. Online learning is likely to stay even in post-pandemic times. Thus, training of faculty and developing the courses using virtual online media should be undertaken by medical institutes. Keywords: Virtual teaching, pandemic, benefits, Disbenefits. 13

FREQUENCY AND FACTORS LEADING TO TELOGEN EFFLUVIUM AMONG COVID-19 PATIENTS Salman Ahmed, Nimrah Sarwar Awan, Tooba Hanif, Shahwaiz Aman Supervisor: Dr. Farina Zameer Introduction: Telogen Effluvium is characterized by diffuse baldness and is the most common cause of non-scarring alopecia. It can be caused by medicines, endocrine disorders, multiple surgeries, febrile infections and nutritional deficiencies. Acute Telogen Effluvium lasts for 3-6 months. Chronic Telogen Effluvium lasts for more than 6 months. Acute Telogen Effluvium has been associated with COVID 19, but information regarding frequency and factors leading to Telogen Effluvium remains concealed. Objectives: - To determine frequency and factors of Acute Telogen Effluvium associated with COVID-19. Methodology: Patients were included after taking informed concert. They were questioned about their hair loss during and after Covid-19 illness. Semi-structure questionnaire was provided to them. The principal investigator and his team collected the data by themselves. The control biased data was entered and analysis by SPSS version 25. The frequency and percentage were calculated for different variables. The test was performed to determine the association between hair loss and Covid-19. Univariate and multivariate logistics analysis were performed to determine the determent variable and independent variable. Results: According to our Research Females are affected more 64 % of the total people suffering from hair loss post covid as compared to males which were 36 %. The most common Comorbid our research found out to be associated with Telogen Effluvium was Diabetes at 4% followed by hypertension at 3%. Our Research also found out that ages 20-40 years were the most sensitive ages to develop telogen Effluvium post covid. Moderate degree of SARS infection was associated with the highest percentages of hair loss at 54%. 23% of patients did not develop hair fall after COVID-19. The most commonly affected scalp region was over the sides which was reported in 32 % followed by complete hair loss reported in 31 % of the patients. People who did not take any nutritional supplements were more likely to suffer from severe hair loss. 34.6 % of patients having hair loss did have other member in their family also suffering from hair loss which was mostly due to spread of COVID in their family and only 7 % received treatment for hair loss. Conclusion: Telogen Effluvium is caused by a variety of triggering stimuli and COVID-19 infection is a potential triggering and causative factor for it. Young adult females are affected more and people taking nutritional supplements are protected from developing Telogen Effluvium in convalescent phase of COVID 19 infection. Keywords: Frequency &factors, Telogen effluvium, COVID-19 Patients 14

RELATIONSHIP BETWEEN BLOOD GROUPS & CARDIOVASCULAR DISEASE CASE CONTROL STUDY Haider Ali, Aisha Monis, Fatima Hashmi, Abdul Arham Khatri Supervisor: Dr. Sara Rafique Introduction: Cardiovascular disorders have been linked to ABO blood groups, although other disease patterns have also been implicated. The leading cause of death in developed countries is cardiovascular disease, and its incidence is rising quickly in developing nations as well. Non-O blood type status has historically been strongly linked to an increase in various cardiovascular illnesses. The involvement of blood type antigens in the development of different cardiovascular disorders continues to be an engrossing topic with the potential to yield breakthrough treatments and prognoses and lower the worldwide burden of cardiovascular diseases. Objective: - To assess the relationship between the ABO blood group and the risk of cardiovascular disease Materials & Methods: In this case control study, 310 cases and 310 controls were selected from Medicare and JMCH to evaluate the correlation of ABO blood group and Rh factor with Cardiovascular disease (CVD). odds ratio of 0.55 Results: Non-O blood group had significantly higher risk for development of cardiovascular event as compared to O blood group, with blood group B having invariably highest risk of developing cardiovascular disease (odds ratio of 2.92), followed by blood group A (odds ratio of 1.58). No significant association was established between Rh factor and cardiovascular disease (p value=0.081). It was also seen that AB blood group came out to be cardio protective (odds ratio of 0.55). Conclusion: According to our study, non O/B blood group were more prone to developing cardiovascular events than people with O/other blood group. Keywords: Blood groups, Cardiovascular disease, Private hospitals 15

HOW COMMON IS INTIMATE PARTNER VIOLENCE AND WHAT ARE ITS EFFECTS ON REPRODUCTIVE HEALTH OF WOMEN IN LOW SOCIOECONOMIC CLASS Ainulshifa Jamil, Soomal Jamil, Arooj Arshad Supervisor: Dr. Aliya Waheed Introduction: According to WHO, almost 1/3rd of females report to have experienced IPV from their partners. Prevalence of IPV is expected to be higher in developing countries such as Pakistan, with a poorly developed health care system and lack of effective domestic violence programs for IPV victims. Despite the abundance of research, the role of violence in pregnant women’s health and childbirth outcomes remains an area where solid evidence is lacking. Objective: - To determine the frequency of IPV and poor reproductive health outcomes in married women along with the association of these two variables. Methodology: A cross-sectional study design was used to assess the association of IPV with poor reproductive health outcomes in low socioeconomic class. This study was conducted on married women, visiting Gynae/Obs OPD, of JMCH, Korangi, Karachi. Convenient sampling technique was used to fill the questionnaires of 160 participants. Data was entered and analyzed using SPSS software version 22, using Chi-squared test to determine the association between IPV and poor reproductive health outcomes. Results:14.4% of the total participants reported IPV. As per the frequency of poor reproductive health outcome, a total of 43.7% women had poor outcome in their last pregnancies. 71.9% women reported complications in outcome of previous pregnancies. Meanwhile, 82.5% experienced antenatal complications. Cases of PPH and instrumental delivery were found in 25.6% women and 27.5% underwent preterm labor. Chi-square test revealed significant association between poor reproductive outcome in last pregnancy and IPV (p-value = 0.049 and OR = 2.260). Researchers observed greater risks of complications in outcome of previous pregnancies in women with history of IPV (p-value = 0.001). The effect of IPV was non-significant (p-value = 0.253) in complications during delivery. It was further noticed that women with antenatal complications (p-value = 0.061) were slightly non-significant with IPV cases. Lastly, preterm labor (p-value = 0.067, OR = 2.284) appeared to be significant with IPV. Conclusion: The study concluded that intimate partner violence is associated with poor reproductive outcomes in the lower socioeconomic class. Preventive measures such as health programs, support systems and spreading awareness should be implemented. Keywords: Married women, Intimate partner violence, Poor reproductive health outcomes, Low socioeconomic class. 16

RISK OF HYPERTENSIVE DISORDERS OF PREGNANCY IN WOMEN WITH A HISTORY OF SPONTANEOUS PRETERM BIRTH IN THE FIRST PREGNANCY Syed Muzzammil Shah, Syeda Uzma Sami, Tabeer Shaikh, Syeda Farwa Sultan Supervisor: Dr. Shazia Aftab Introduction: Incidence of preterm birth is higher in developing countries than that in developed countries. Preterm birth which is before 37 weeks may affect the outcome of pregnancy through hypertensive disorders, causing SGA, abruptio placenta, and decreased amniotic fluid index. It is also the biggest cause of neonatal mortality and morbidity. Pakistan stands at number 4 in the list of top 10 countries with the greatest number of preterm births. Objective: - To find the frequency of hypertension in women with a previous history of spontaneous preterm birth in different gestational ages. - To find the effect of hypertensive disorders of pregnancy on the outcome of pregnancy –incidence of SGA, abruptio placenta, etc. Methodology: A survey based research involving questionnaires and interviews (cross sectional) was conducted and the information recorded for 215 cases. The study population consists of women (≤35 years) who delivered full term or preterm in ObGyn ward at JMCH, Korangi, Karachi. We used a purposive technique to carry out our study and analysed the data through SPSS22. Mean, standard deviation, correlation coefficient were calculated for continuous variables. Frequency, percentage, odds ratio, p value were calculated for categorical data. Pregnancy induced hypertension (BP≥140/90 mmHg on 2 occasions at least 4 hour apart) and preeclampsia that is hypertension and proteinuria (≥300 mg proteinuria in 24 hours). Results: Our research shows that the average age of women was 26.93 (4.319) years and their average weight was 73.52 (9.535). The average number of supplements they took was 2.88 (1.24). There is a positive association between weight, RBS, Hb and hypertension whereas a negative association between total number of supplements taken and hypertension. Hypertensive disorders in preterm deliveries are more common than in term deliveries. Conclusion: Preterm deliveries lead to an increased risk of hypertensive disorders in the subsequent pregnancies. There is a negative association of hypertensive disorders and number of supplements taken during pregnancy. Vitamin D and folic acid supplements are indicated. More than 1 year of interpregnancy interval decreases the risk of hypertensive disorders. Lower level of education, urinary tract and vaginal infections also increase the risk. Keywords: Hypertensive disorders of pregnancy, SGA, Abruptio placenta, Preterm birth. 17

IMPACT OF MATERNAL DEPRESSION ON CHILD’S GROWTH Ibrahim Shahid, Yumna Monis, Amtul Fatima, Arham Hassan Supervisor: Dr. Aneel Kumar Introduction: Depression is common in women of reproductive age in developing and developed countries. As mothers are primary care takers of their children they play a significant role in growth of the child. Therefore mothers who are depressed can adversely affect the growth of the child. Objective: - To assess the prevalence of maternal depression and its effect on growth of the child in developing countries such as Pakistan. Methodology: 84 participants in JMCH Korangi who met our inclusion criteria were given a consent form. We read out and explained everything to illiterate participants and their thumb prints were taken. The weight of the babies aged between 3 months to 36 months were plotted on a growth chart and their mother’s depression was assessed using ICD-10 and PHQ-9 questionnaire. We used SPSS version 25 to analyze the data. Result: 56% of mothers were depressed out of which 70.2% of the babies were below 3 rd; 10.7% were mildly depressed with 13.6% children below 3rd percentile, 29.8% were moderately depressed with 38.6% children below 3rd percentile, 11.9% were moderately severely depressed with 15.9% children below 3 rd percentile, 3.6% were severely depressed with 6.8% children below 3rd percentile. 29.8% were above 3rd percentile. Conclusion: Our data concludes that there is an association between maternal depression and the growth of a child. It was found that the children who were below the 3 rd centile had mothers who were dealing with depression. Keywords: Maternal depression, Below 3rd centile, Childs’ health 18

COVID 19: ONLINE TEACHING AND STRESS AMONG TEACHING FACULTIES OF DIFFERENT MEDICAL COLLEGES IN KARACHI Urooj-ul-Kainat, Kainat Karim, Sahar Jamil, Daniyal Hirani Supervisor: Dr. Sahrish Mukhtar Introduction: COVID 19 was a crucial phase in the history of education; the whole educational system was collapsed during the lockdown period not only in Pakistan but across the world. Teaching was shifted from its conventional physical form to the new online system which caused an unprecedented disruption in the medical education. Objective: - To analyze the role of anxiety and depression faced by teaching faculty of medical colleges due to online teaching plus the challenges faced in adapting online teaching process and technology used during COVID 19. Methodology: A cross sectional study was performed on the teachers of different medical colleges of Karachi. To do this we recruited 130 paper based and online questionnaires. The questionnaire which in addition to socio-demographic data measured stress and anxiety symptoms using the perceived stress scale. Results: The results revealed that 75.4% of the teachers were not stressed and only 24.6% of teachers showed stress and anxiety symptoms. Furthermore, sociodemographic variables such as marriage, gender and availability of appliances to conduct the classes showed significant correlation to the stress. Conclusion: It is concluded that in medical teaching, faculty was not found to be stressed. Instead they had a positive outlook and supported online teaching. Keywords: Covid, Teaching, Workload, Stress 19

PHYSICAL ACTIVITY ASSOCIATION WITH BODY MASS INDEX (BMI) GROUPS IN PRIMARY SCHOOL CHILDREN Haya Tariq, Hina Riaz, Kashaf Supervisor: Dr. Sassi Kanwal Introduction: Obesity is a condition of abnormal or excess fat accumulation in adipose tissues. Obesity has become a serious threat for the public health especially for Pakistan youth that majorly includes primary school, for whom rates of obesity has tripled in no time it will be 6 times. Multiple studies have been done to address this issue but have not successfully conveyed significance of physical activity intervention on obesity. Adherence to physical activity interventions is often difficult. Objective: - To find out association of physical activity with BMI in primary school children Methods: Data will be collected from different schools of Karachi District. Children age 3 to 12 years were enrolled by simple random sampling method. Weight, height and body mass index will be measured. Life style pattern, physical activity and Dietary patterns will be questioned from all students. Consent and questionnaires will be filled by parents of students less than 5 years Students from 5-12 years will be answered their questionnaires by themselves. Results: BMI of participants were according to WHO criteria in which underweight children were=35.5%Over/obese children were=20%Normal weight children were=61.6%Out of which 56% were female 43.3% were male. The age of participants was 3-12 years and the mean was 8.7. We performed Pearson’s correlation which showed positive and significant correlation between BMI ,Gender and Age with p value of 0.027 and less than 0.001 respectively and BMI had significant correlation with total leisure activity ,time spent in leisure activity ,total school activity and time spent in school activity in total leisure activity mean was 6.91 and it’s p value is 0.033 and total time spend in leisure activity was 184.72 with p value of 0.023Total school activity mean was 2.33 total time spend in school activity was 64.41 .and it’s p value was 0.017 total other activity mean activity was 9.35 and total time spent in other activity mean was 374.28. and the rest of the activities have p value greater than 0.05. Conclusion: There is significant association of BMI with age and gender. Significant correlation of BMI with total leisure activities, time spent in leisure activities, total school activities & time spent in school activities. Nonsignificant correlation of BMI with total sports activities, time spent in sports activities, total other activities & time spent in other activities. Keywords: Physical activity, BMI, Primary school children 20

DETECTION OF HELICOBACTER PYLORI USING REAL TIME PCR Syed Ali Haider Zaidi, Hamza Sohail, Syed Muhammad Huzaifa Tahir Supervisor: Dr. Rubina Ghani Introduction: Helicobacter pylori (H. pylori) infection is a serious human health threat. Although approximately half of the world’s population is infected with this bacterium, only a minority of infected individuals develop gastric cancer. Helicobacter pylori are one of the most common chronic infections in humans, the only host for the bacteria and is a major cause of gastric cancer A close relationship is now thought to exist between H. pylori and peptic ulcer disease, gastritis, and certain other gastroduodenal diseases. Objectives: - To confirm the positivity of H. Pylori by using PCR technology. - To perform real-time PCR in the diagnosis of H. pylori infection as an important diagnostic tool to reduce the resistance strain of H. pylori. Methodology: H. pylori infection was performed in all patients using molecular test based on RealTime Polymerase Chain Reaction (qPCR) in blood after DNA extraction. Blood samples from all participants were collected after patients’ history. Statistical analysis was performed via SPSS 20.0 (IBM Corp., Armonk, NY, USA). Result: This study enrolled 20 patients (10 males and 10 females) at mean age 45± 13 years. The molecular study was carried out by using qPCR from blood. We identified H. pylori infection in 14 patients (70%) before treatment. After treatment on follow-up 5 patients (35%) were non-responders. Gastrointestinal symptoms were more often reported in infected patients. Conclusion: H. pylori testing by molecular test based on qPCR in blood might be beneficial as the test’s accuracy is high. Still more work needs to be done on more patients. Keywords: Helicobacter pylori, qPCR–qualitative polymerase chain reaction, ELISA (Enzyme-Linked Immunosorbent Assays) 21

DISCREPANCIES AMONG TEACHERS AND STUDENTS RELATED TO ONLINE COURSES Muhammad Khubab Ahsan, Muhammad Abdullah Rana, Khurram Shahid Supervisor: Dr. Ghulamullah Lail Introduction: The sudden emergence of the pandemic coronavirus in 2019 caused a huge problem for educational institutions along with the daily lifestyles of many people. The urgent imperative by the WHO to move all classes online for the purpose of maintaining social distancing has been stressful for the faculty and staff specially in medical institutions. The teaching staff from all backgrounds and fields had to prepare to teach online lessons Which affected the productivity and practicality of their lessons. One of the greatest challenges faced by the institutions and the teachers were their lack of pedagogical content knowledge needed for online classes. Objective: - To evaluate the student’s performance between online and physical sessions. - To determine if E-learning an efficient replacement for the physical classes Methodology: This study is a documentation on student teacher’s perception regarding online Lectures in different medical and nonmedical universities of Karachi. Teachers and students were selected for this study on a random basis. Simple random sampling techniques were used for the selection of the sample. The sample size was 264, participants. Our research study conducted two surveys; one is for the student population and the other for the teacher population. Questionnaires were distributed to participants by using a Google form for the students and handout for the teachers. Result: In our study, a total of 264 person participated of which (N=124) 47% were students and 53%(N=140) were faculty members. Mean age of participants were 22.9 years with std ±1.96. In terms of gender 70.7% (N =170) were females and 29.3%(N=79) were males. Responses on quality, Motivation, Passive attitude, and satisfactory interaction with students, the teachers were agreed 72%, 74%,71%,64%. While the student’s response in the agreement was 26%,23%, 49%,28%. 67% instructors and 43% students agreed with the convenient environment of teaching and 79% and 53% agreed that online courses provided a flexible learning environment 76% instructors agreed that due to online course they got access to a wide range of resources while 45% students agreed to this notion, also it was agreed by 103 teachers & 47 students that they reached a diverse number of instructors/students due to online courses. Additionally, 104 teachers & 72 students were satisfied that students/Teachers can access to online courses from almost everywhere. Conclusion: Online methods are convenient than a traditional class room method but we cannot deny the fact this method has a lot of challenges especially for our instructor due to lack of pedagogical content knowledge. We can’t miss the point that medical students need exposure to the patient for better understanding. This method has lot of advantages and drawbacks hence we conclude that online teaching can be a replacement for our nonmedical school with proper technical and institutional support but for the medical learning it can be a challenge. Keywords: Online class, Teachers, Students, Perceptions, Online tools, COVID19. 22

USAGE OF PPE AND FREQUENCY OF COVID-19 IN THE HEALTH PROFESSIONALS OF KARACHI-A CROSS SECTIONAL SURVEY Amna Khan, Mandeep Kumar, Ali Murad Khan Supervisor: Dr. Shagufta Naqvi Introduction: Use of PPE was not very common before COVID 19 pandemic and most of the health care professionals didn’t have knowledge of proper use of PPE. PPE used in healthcare includes gloves, aprons, long sleeved gowns, goggles, fluid-repellant surgical masks, face visors and respirator masks. Objective: - To assess the availability of PPE during COVID-19 among health care workers. - To evaluate appropriate use of PPE by the health care workers during pandemic. - To measure the frequency of Covid-19 among health care workers. - To find out factors among health care workers that effect COVID-19 infection Methodology: A cross-sectional survey was conducted for a period of one month.Thequestionnairebased survey was used among doctors and Paramedical staff working in either Government or private setup during COVID Pandemic and had access to PPEs. A sample size of 300 was calculated via open Epi software. Data analysis was using IBM Statistical Package for the Social Sciences (SPSS), Version 25.0 Result: A total of 300 healthcare professionals participated in this study 52.3% (N=157) were male and 47.7%(N=143) were female. The mean age of the participants was 37.75 ±8.771. 82%(N=246) of participants are either graduates or have cleared postgraduate exams such as MCPS, FCPS, or MRCP. In was found that 7.67% were never infected by COVID-19 during that period. We found that 92%(N=276) of participants were provided PPEs from their workplace while the rest had to purchase it. Around 35% subjects had mask and gloves always available for their use however availability of gown and safety goggles were poor and only around 40% had these two available 6/10 occasions. A scale was provided to the HCWs regarding their perception of the correct use of different PPEs, around 30% thinks they always used gloves and mask correctly however around 30% thinks they are using gown and googles correctly. Further significant association was found with Covid-19 infection with 5 to 10 years working experience, Free availability of PPE and working sector. No Significant association of COVID with gender, pay scale, Profession, education and COVID exposure. Conclusion: Our study suggests that PPES is effective in preventing the spread if it is used regularly and properly disposed of. Employers must provide the appropriate PPE to protect employees against infection Keywords: Personal protective equipment (PPE), Healthcare Workers (HCWs), COVID-19. 23

EFFECT OF AN INTERVENTION ON APPLICATION OF INFORMED CONSENT USE AMONG DOCTORS AND NURSES Siraj R. Syed, Humna Shahid Sheikh, Ali Ahmed Paracha Supervisor: Dr. Nadia Younus Introduction: The principles of informed consent, confidentiality and privacy are often neglected during patient care. The aim of this study was to assess the degree to which the doctors and nurses employed by Sohail Trust hospital and Medicare hospital in Karachi understand informed consent and their ability to adhere to this principal of medical ethics. Furthermore, to observe whether the application of an intervention can help better their understanding. Objective: - To establish the knowledge of correct implementation required for Informed consent - To find out effect of an intervention on application of informed consent use among doctors and nurses Methodology: The study took place at auditorium located in Medicare Hospital, and Sohail Trust Hospital. Population included doctors and nurses, sampling technique was Non-probability. Design is as an interventional study. A sample size of 63 was calculated using Raosoft calculator. Data collection through interventional questionnaire, and analyzed using the Statistical Package for the Social Sciences (SPSS) software, using paired t-test, and independent t-test. Identities of participants was not recorded to ensure confidentiality, and data was accessible by members of research team. Result: There were 46 female participants, and 31 male participants. Of those 77, 25 were doctors, and 52 were nurses. Both groups cited the biggest difficulties to attaining informed patients were attitude, and that it is time consuming. From the interventional questionnaire, there were a total of 18 variables. The p-value of all except one were significant (<0.001) in the paired t-test. The p-values of the independent t-tests for difference between interventional questionnaires by profession was 0.99, and by gender it was 0.73. Conclusion: Intervention was successful as all but one variable were significant. Mean score raised by 6.26 with p-value <0.001. No difference in knowledge attained by doctors and nurses. Negligible difference in knowledge attained between males and females, with males attaining slightly more. Keywords: Informed consent, Intervention, Doctors, Nurses 24

DOES MINI-CEX AND DOPS IMPROVES THE CLINICAL SKILLS OF A MEDICAL STUDENT? Yamna Khan, Madiha Fatima Agha, Urooj Fatima Supervisor: Dr. Zeelaf Shahid Introduction: The most important dilemma in our country Pakistan is the lack of awareness about feedback system to students. Over the past several years there have been growing interest in the workplace-based assessment as they fulfil the 3 basic requirements for assessment techniques that is competencies, feedback, and outcomes. This study aims to address the concern and comparison of improvement being a novel finding by implementation of Mini CEX and DOPS. Objectives: -To improve the clinical skills for their performance. -To compare the degree of improvement by implementation of Mini CEX and DOPS for different clinical subjects. Methodology: Universal sampling of final year MBBS students was carried out irrespective of gender, age, and pre-medical academic background. Questionnaires were used to evaluate improvement by the implementation of Mini CEX and DOPS in the clinical subjects of final year. Judgement was made by comparing improvement of the clinical skills of clinical subjects. SPSS Version 23 was used for statistical analysis. Results: Among n=38 (42.2%) Male and n=52 (57.8%) female, 43.3% were assessed only once on DOPS. Though 47.8% were assessed twice in Mini-CEX. In Min-CEX, history taking skills was assessed. 85.6% from DOPS and 65.56% from Mini-CEX were satisfied with the time allotted for WPBA. From medicine 35% students have participated to assess the WPBA..Figure-1.While comparing WPBA; the participants were deemed satisfied for receiving feedback, time allotted, identified learning points and RITA (Record of in training assessment) having positive effect on overall performance (History taking and Clinical Skills)Table-1.; While comparing the good aspects of DOPS & Mini-CEX although cases are difficult to find for DOPS, not significant difference was identified in domains of time consuming, difficult to organize, stressful and artificial and disagreement over correct techniques-figure-3. Conclusion: DOPS & Mini-CEX have the significance impact over learning clinical skills in elective rotations of Medicine, Surgery, pediatrics & Gynae/OBS. To select the case is difficult aspect in both WPBA. Keywords: Competencies, DOPS, Mini CEX, Workplace based Assessment. 25

ASSOCIATION OF ACNE WITH FACE MASK IN HEALTHCARE WORKERS AMIDST THE COVID-19 OUTBREAK IN KARACHI, PAKISTAN Sadia Yaqoob, Amna Saleem, Furqan Ahmad Jarullah, Areeba Asif, Mohammad Yasir Essar, Shaista Emad Clinical, Cosmetic and Investigational Dermatology, 14, pp. 1427–1433. 2021 Background: In the wake of coronavirus (COVID-19) global alert, people have begun to practice safety measures in order to reduce the exposure to life-threatening disease. The largest at-risk population is undoubtedly the frontline healthcare workers (HCWs) who are using personalprotective equipment (PPE), essentially face masks, to battle against this deadly virus. This study was conducted with the prime intention to reveal an association between face mask and acne and measure the prevalence of acne amongst HCWs amidst COVID-19 outbreak in Karachi. Furthermore, this study aimed to identify the type of mask generating acne, locate the common sites, assess the severity and establish an association of mask use with the skin type. Methods: This cross-sectional study was carried out at Medicare Cardiac and General Hospital, Jinnah Medical College Hospital, Jinnah Postgraduate Medical Centre and Jamal Noor Hospital located in Karachi, Pakistan. A total of 348 HCWs were interviewed, of which only 193 met the inclusion criteria. All information was recorded on a predesigned proforma and analyzed using SPSS 25.0. Results: Among 193 participants, acne was prevalent in 103 (53.4%) participants with maximum cases reported in female HCWs, and in doctors (p<0.05). Out of 73 HCWs using N-95 masks, 46 (44.7%) developed acne, with a p-value of 0.036. Skin type and past history of acne also yielded statistically significant results. Among all the skin types, HCWs with oily skin (64, 62.1%) were prone to face resurgence of acne or new-onset acne. The most common sites of eruption of acne were along the cheeks (45.1%) followed by the nose (40.9%). Majority of the population suffered from mild acne. Moderate and severe acne eruption was particularly observed in those wearing N-95 and surgical masks. Conclusion: The use of face masks is associated with high rates of acne eruption. Disseminating the guidelines and indications of World Health Organization (WHO) regarding proper use of mask, encouraging awareness among HCWs and following proper doffing and donning protocol as endorsed by Centers for Disease Control and Prevention (CDC) will possibly minimize the adverse reactions. Keywords: acne, facemask, healthcare worker, COVID-19 26

IMPACT OF ORAL HEALTH EDUCATIONAL INTERVENTIONS ON ORAL HYGIENE STATUS OF CHILDREN WITH HEARING LOSS: A RANDOMIZED CONTROLLED TRIAL Maria Moin, Sohail Saadat, Sara Rafique, Afsheen Maqsood, Abhishek Lal, Fahim Vohra, Mohammad Khursheed Alam, Naseer Ahmed BioMed Research International pp 1-8, 2021 Introduction: Oral health is considered as one of the essential components of the overall health of every individual. Maintaining oral health is a gradual process that requires commitment. Children who require special care such as hearing impairment experience difficulty in maintaining oral health primarily due to communication difficulties. This study is aimed at using different interventions to evaluate the improvement of oral hygiene in hearing impaired children. Materials and Methods: Fifty-nine children were recruited in this study that was allocated randomly into each group with twenty children as follows: group 1: pictorial, group 2: video and group 3: control. Mean plaque and gingival scores were noted before and after the use of different interventions. Oral hygiene was categorized as “excellent,” “good,” and “fair.” Gingival health was categorized as “healthy,” “mild gingivitis,” and “moderate gingivitis.” Results: Thirty-four children (57.6%) were from 12-13 years of age bracket, and 25 (42.4%) belonged to 14-16 years of age. Regarding gender, there were 37 (62.7%) males and 22 (37.3%) females. About comparison of mean gingival and plaque scores before and after interventions in each group, a significant difference was found in group 1 (p < 0:001) and group 2 (p < 0:001), as compared to group 3 where the difference in scores was not significant (p > 0:05). Conclusion: Maintaining oral health requires the compliance of individuals to perform different methods of preventive dentistry, such as tooth brushing and use of dental floss. The use of different oral hygiene educational interventions such as pictorial and video methods have been proven and useful for hearing impaired children in improving oral health. 27

OUTCOMES OF TUNNELED CUFFED HEMODIALYSIS CATHETERS: AN EXPERIENCE FROM A TERTIARY CARE CENTER IN KARACHI, PAKISTAN Sonia Yaqub, Muhammad Raheel Abdul Razzaque , Azib Aftab, Nadeem Ahmed Siddiqui J Vasc Access 2022 Mar;23(2):275-279. doi: 10.1177/1129729821989904. Introduction: Tunneled cuffed catheters (TCC) are generally used as a temporary means to provide hemodialysis (HD) until permanent arteriovenous access is established. However, certain complications are associated with use of TCCs such as infections, catheter malfunction/malposition or venous stenosis. Limited data is available on outcomes and long term complications associated with TCCs in our country. The aim of this study was to study the outcomes of TCCs and associated long term complications during the course of its usage. Methods: We retrospectively studied case records of patients who had TCCs placed for HD at our institution, from January 2016 to June 2018. Results: A total of 116 TCCs were placed during the study period. The mean age of the population was 57.09 years; 58.6% were males. The right internal jugular vein (52.6%) was the most common site of TCC insertion followed by the left internal jugular vein (29.3%). Functioning TCCs were successfully removed in almost two-thirds of cases (65.7%) once their permanent access was mature. Development of catheter related blood stream infection (CRBSI) was seen in 22 patients (19.8%) requiring catheter removal in 14 (12.6%) patients. Mechanical complications leading to catheter removal were seen in seven patients (6.3%). The median catheter duration was 62.5 days ranging from 1 to 343 days. Conclusion: TCCs, though associated with complications particularly CRBSI, are a viable option for short- to intermediate-term use for HD till the maturation of permanent arteriovenous access in a limited-resource setting. 28

STRENGTHENING THE REFERRAL CHAIN AND PROVIDING ONE WINDOW DIABETES EYE CARE FACILITY TO PEOPLE WITH TYPE-2 DIABETES: A SIX-YEAR FOLLOW-UP STUDY FROM PAKISTAN Shahid Ahsan, Muhammad Saleh Memon, Muhammad Faisal Fahim, Tauseef Mahmood, Sikander Ali Sheikh Pak J Med Sci., 37(7):1837-1842, 2021 doi: https://doi.org/10.12669/pjms.37.7.3946 Objective: To report the results of implementation of two-pronged system for strengthening of referral and receiving end of referral chain for people with Type-2 diabetes mellitus (T2DM) at a tertiary eye care hospital in Karachi. Methods: This observational, cross sectional study was conducted from the data collected in “Strengthening Pakistan’s response to Diabetic Retinopathy” project. Peripheral referral was improved through community awareness camps (n=48), refreshing knowledge of primary healthcare professionals (PHCP) and conducting retinopathy screening camps (n=85) in the community. T2DM patients with best corrected visual acuity (BCVA) <6/18 or had retinopathy sign on screening were referred to tertiary center. The receiving end of the referral was improved by establishing “one window facility” at tertiary eye care center. Facility consisted of eight stations starting from registration, visual assessment, fundus photographs, consultation with ophthalmologist, anthropometry measurement, consultation with diabetologist to finally meeting with diabetes educator. At every station, patient’s information was directly entered in HIMS software. Results: A total of 50,595 patients attended tertiary center over six years. Among all 34685 (68.5%) were new registration and 15910 (31.4%) were follow ups. During first year (2014-15) out of total registered individuals with DM, newly registered were 4414 (89.5%) and 518 (10.5%) were follow-ups. In the final year (2019-20) new cases registered reached to 62% (n= 7916) with 38% (n=4852) followups. Patients referred by PHCP increased from 6.5% in 2014-15 to 43.7% in 2019-20. An increased uptake of all treatment modalities for retinopathy like laser (increased by 16.76%), intra-vitreal injections (by 14.72%) and vitrectomy (by 51.47%) were also observed. Conclusion: Implementation of two prong system resulted in improved service uptake, better referral system, enhanced follow-ups and increased intervention uptake. Keywords: Comprehensive eye care, Diabetic retinopathy, Referral source, Type-2 Diabetes Mellitus. 29

VISUAL OUTCOMES OF CATARACT SURGERY: AN OBSERVATIONAL STUDY OF TEN YEARS FROM A TERTIARY EYE CARE HOSPITAL IN PAKISTAN Shahid Ahsan, Muhammad Saleh Memon, Sadia Bukhari, Tauseef Mahmood, Muhammad Faisal Fahim, Uzma Haseeb, Muhammad Arslan Pak J Med Sci. 2021;37(7):1775-1781. doi: https://doi.org/10.12669/pjms.37.7.4428 Objectives: To observe and analyze the visual outcomes of cataract surgery of ten years at a tertiary eye care hospital, Karachi. Methods: An observational study with retrospective data search was conducted in Al Ibrahim Eye Hospital (AIEH), Karachi. Data of all adults (above 16 years) who underwent cataract surgery from 2010-2019 was retrieved from HIMS. Presence of opacity in the lens was labelled as cataract. Surgery was advised when patient’s BCVA was found to be 6/18. Visual assessments of the patients were done on day 01, one week and six weeks postoperatively. Postoperatively, 6/6 – 6/12 was considered as good, 6/18 as mild visual impairment, < 6/18 to 6/60 as moderate visual impairment and < 6/60 as severe visual impairment. Results: A total of 1,027,840 patients visited AIEH with different eye diseases. Among 1027840 individuals, cataract was identified in 88443 (8.6%). Surgery was advised to 58371 and performed in 38616. Records of operated cases (38616) were retrieved. Mean age of patients was 54.96±14.22 years. There were 20578 (53.29%) males and 18038 (46.71%) females who underwent surgery. At the end of sixth week, 3561 (18.4%), patients were found to have “good vision”, 12242 (63.43%) had mild visual impairment, 2676 (13.86%) had moderate visual impairment and 822 (4.26%) had severe visual impairment. Corneal Complications was the commonest cause (33.56%) at sixth week. Conclusions: The institution achieved WHO recommended criteria of “good visual outcome” (6/6 to 6/18) of 81.83% which is near to recommended ≥ 90% and severe visual impairment of 4.26%. Keywords: Cataract Extraction, Ophthalmic diseases burden, Visual Acuity, Phacoemulsification. 30