Lifestyle is the interest, behavior, opinion, style of living or world outlook of an individual, group, or culture; a combination of tangible factors like demographics and intangible factors like personal values and preferences. Recently researchers have more interest in the relationship between life style and health. Millions of people, following unhealthy lifestyle (or risk-factors), are plagued with morbidity, disability and mortality due to non-communicable, communicable diseases & nutritional disorders. Persons having unhealthy behaviors may be called as ‘at risk groups’.2 Although a healthy lifestyle has consistently been shown to decrease mortality, the population prevalence of healthy living remains low.

Background: Intrauterine growth restriction (IUGR) is a principal cause of fetal and neonatal morbidity and mortality. The placenta, as a vector for maternal-fetal nutrient and oxygen exchange has major influence on birthweight. The objectives of this study were to compare the placental weight (grams), number of syncytial knots and number of blood vessels in villi of IUGR placentas versus normal placentas. Materials & Methods: This cross-sectional study was carried out at Rai Medical College, Sargodha, Pakistan in collaboration with Zainab Memorial Hospital, Rawalpindi, Pakistan from December 2016 to November 2018. Study group included 45 IUGR placentas and control group included 25 normal placentas. Placental weight in grams, number of syncytial knots and number of blood vessels in villi of placentas were three research variables. These were described by mean, minimum, maximum, range and standard deviation for each group separately and were compared between the two groups through independent-samples t-test. Results: Descriptively the mean placental weight in grams in IUGR group (423.35±64.13g) was lower than control group placentas (535.92±44.57g). The number of syncytial knots in IUGR group placentas (22.04±5.21) was more than control group placentas (13.84±4.41). The number of blood vessels in IUGR placentas was lower than control group placentas. All three null hypothesis for research variables between the two groups were rejected (p=<.00001). Conclusion: In this study, significant differences were found between the IUGR and normal placentas. All the major histologic findings pointed towards reduced blood flow to placentas resulting in restriction of blood flow to fetus.

Background: Pseudo-epitheliomatous Hyperplasia (PEH) is a benign proliferation of epithelium occurring in response to various neoplastic lesions, infections and inflammatory processes. It can be mistaken especially in small biopsies for an invasive oral squamous cell carcinoma (OSCC). The objective of this study was to determine the expression and comparison of immunohistochemical marker E-cadherin in OSCC and PEH lesions. Materials & Methods: This cross-sectional study was conducted in Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from January 2013 to March 2016. 60 paraffin embedded cases, 30 each of PEH and OSCC were retrieved and stained with haematoxylin and eosin. They were then immune-stained with E-cadherin and expression evaluated and compared in two lesions by histopathologist. Age, sex, site of lesion and E-cadherin expression were variables. Age was described by mean and SD and other variables as frequency and percentages. Results: Mean age of OSCC group was 60.1±17.3 years and PEH group 52.7±16.6 years. OSCC group included 16 (53.33%) men and 14 (46.67%) women. PEH group included 18 (60%) men and 12 (40%) women. In OSCC group, site of lesion was buccal mucosa 12 (40%) cases, gingiva 10 (33.3%), tongue 7 (23.3%) and floor of mouth 1 (3.4%) case. In PEH group, site of lesion was buccal mucosa 12 (40%) cases, tongue 11 (36.67%), gingiva 6 (20%) and palate 1 (3.3%) case. The expression of E-cadherin was negative in all 30 cases of OSCC and positive in 29/30 (96.67%) cases in PEH. Conclusion: E-cadherin can be used as an ancillary marker in the differentiation of oral squamous cell carcinoma and pseudo-epitheliomatous hyperplasia.

A 40 years old man presented with bilateral mild dimness of vision and mild glare. Diffuse and focal illumination on slit lamp biomicroscopy did not reveal any pathology. Retro-illumination on slit lamp showed faint bilateral spokes like cortical lens opacities. Retro-illumination mode on Auto-Ref/Keratometer (HRK 7000A, Huvitz, Anyang-si, Gyeonggi-do, Republic of Korea) prominently revealed these insignificant bilateral spokes like cortical opacities (cataracts). Visual acuity was 6/9 in both eyes. No intervention was advisable and the patient was reassured.

Background: Falciparum malaria is a common disease in our area. Apart from its classical presentation, at times it may present with refractory anemia or pancytopenia. The aim of this study was to determine the refractory anemia and pancytopenia as complications of falciparum malaria and apart from peripheral blood smears the significance of rapid antigen tests and bone marrow examination in the diagnosis of falciparum malaria. Material & Methods: The descriptive study included 200 consecutive cases of fever and refractory anemia or pancytopenia from 2011 to 2014. Stratification of patients according to the clinical scenario included Group-A having fever with refractory anemia and Group-B with fever and pancytopenia. A detailed history, thorough clinical examination, and pertinent laboratory tests were performed. All patients were treated with antimalarial drugs and followed-up for eight weeks. The pre and post treatment hematologic parameters were compared. Results: Among the 200 patients, 85 were males and 115 females. The age ranged from 15 to 55 years. Stratification of patients on clinical scenario revealed 175(87.5%) patients with fever and refractory anemia (Group-A). Among these, 125(62.5%) patients were reported smear positive for P. falciparum. In the remaining 50 smear negative patients rapid antigen tests were performed and all were reported positive. In 25 patients of Group B with fever and pancytopenia, the peripheral smear for malaria was positive only in 5 patients. In the remaining 20 cases both the peripheral blood smears and rapid antigen tests were reported negative. Bone marrow examination was planned to confirm the bone marrow suppression as the cause of peripheral pancytopenia, to exclude leukemia and to identify P. falciparum. The bone marrow examination revealed P. falciparum in all these cases. All the patients had a dramatic response to treatment with antimalarials in terms of disappearance of fever and correction of anemia and bone marrow rescue with reversal of pancytopenia to normal counts. Conclusion: Plasmodium falciparum should be considered in all cases of prolonged fever with refractory anemia or pancytopenia in malaria endemic areas, even with negative smear and rapid antigen tests. Bone examination is mandatory for the diagnosis in such cases. There is dramatic response of such patients to treatment with antimalarial drugs and hematinics.

Background: Global Health Estimates 2015 has shown the stroke as second leading global cause of death and 3rd leading global cause for DALYs for year 2015. The objectives of this study were to determine the frequency, distribution and determinants of hypertension in adult stroke population of D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from February 1, 2017 to April 30, 2017. A sample 217 was selected with margin of error 5.59%, 90%CL and 50% prevalence of hypertension in 200,000 adults at risk of stroke population through consecutive sampling. All indoor adult patients of stroke were eligible. Sex, age groups, and residence and presence of hypertension were variables. Frequency and distribution of hypertension were analyzed by count and percentage. Hypotheses for distribution were substantiated by chi-square goodness-of-fit and of association by chi-square test of association. Results: Out of 217 patients with stroke, 123 (56.7%) were men and 94 (43.3%) were women, 86 (39.6%) were=60 years and 131 (60.4%) were>60 years, and 105 (48.4%) were urban and 112 (51.6%) were rural. Frequency of hypertension was 132/217 (60.83%). Out of 132 patients with hypertension, men were 74 (34.10%), women 58 (26.73%), age group=60 years 46 (21.20%), >60 years 86 (39.63%), urban 72 (33.18%) and rural 60 (27.65%). Presence of hypertension was associated to residence (p=.023) but not to sex (p=.817) and age groups (p=.072). Conclusion: Frequency of hypertension in adult stroke population of D.I.Khan Division, Pakistan was found to be similar as expected. Frequency was more in men, in older age group (of>60years) and in urban population. The presence of hypertension in adult stroke population of D.I.Khan Division was associated to residence but not to sex and age groups.

Background: Chronic suppurative otitis media (CSMO) is an important cause of preventable hearing loss, particularly in developing world. The objective of this trial was to compare efficacy of 2% acetic acid versus 0.3% ciprofloxacin ear drops in achieving dry ears in CSMO in adult population of Islamabad, Pakistan. Materials & Methods: This trial was conducted at Department of ENT, HBS Medical College, Islamabad, Pakistan from March 2018 to February 2019. With alpha 5%, beta 20% and power of study 80%, sample size was calculated 47 for each group. All adult patients of CSOM, having ear discharge for more than three months were eligible. Patients with aural poly, external auditory canal pathology, ear malignancy, having mastoid surgery in preceding 12 months or having used antibiotics in last one week were excluded. Experimental group received 2% acetic acid, twice daily while control group received 0.3% ciprofloxacin eardrops twice daily. At two weeks, achievement of dry ears was noted. Sex and age in years were matching variables. Primary end point was achieving dry ears, which was compared between the two groups using McNemar chi-square test. Results: Experimental group included 30 (63.8%) men and 17 (36.2%) women and control group included 32 (68%) men and 15 (32%) women. Mean age of experimental group 36±2.14 years was matching to the control group 36±2.59 years. Dry ears were achieved in 35 (74.47%) patients in experimental group and in 11 (23.40%) patients in control group. The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears (p<0.0001) in CSMO. Conclusion: The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears in chronic suppurative otitis media in adult population of Islamabad, Pakistan.

Cancer has been a fatal disease since many decades. Over the time, it is presented in multiple ways and is a matter of consideration as accounts for the high rate of mortality. The aim of the current review was to focus on the genetics, epigenetics factors and role of medicinal plants for the cure of this inimical disease. Related articles available in English language (2002-2018) were reviewed with help of different database, including PubMed, Springer Link, Medline, Google Scholar and ScienceDirect. In order to ensure credibility and accuracy of data only those articles were considered which are published in indexed journals i.e. Web of Science and Scopus. This project was conducted at the Department of Pharmacy, Government College University, Faisalabad, Pakistan from 02-01-2019 to 28-02-2019. The genetic machinery is vibrantly involved in the interpretation of the signals and is observed to be affected by various dietary factors. A sequence of modified activities is observed with use of these dietary elements. However, the modification is reviewed through the histone acetyltransferase (HAT), histone deacetylase (HDAC) and DNA methyl transferase (DNMTs), effecting the expression of gene. These modified genes, in turn then express the signals in multiple reformed ways. Different dietary elements that are used such as polyphenol, alkaloid and flavonoids are effective against cancer. The progression of disease involves genetics and epigenetics due to amplification, translocation and mutation during gene expression. Though, many studies have been conducted elaborating the role of plants and their ingredients which play a part in inhibition of cancerous cells by blockade of cell cycle and apoptosis; more in-depth investigations are still required to identify the new drug target and novel therapeutic modalities.

Background: The distribution of non-malignant hematological disorder varies across globe by sex, age groups and type of disease. The objectives of this study were to determine distribution of non-malignant hematological disorders by sex, age groups and type of disease based on bone marrow aspiration in population of Khyber Pakhtunkhwa, Pakistan. Materials and Methods: This cross-sectional study was conducted in Department of Pathology, Khyber Teaching Hospital, Peshawar, Pakistan from Jan.-Dec. 2014. 116 cases with non-malignant hematogical disorders were selected. Sex, age groups and type of disease were analyzed by count and percentage with confidence intervals for proportions. Chi-square goodness-of-fit test was used to testify two hypotheses. Results: Out of 116 cases, 63(54.31%, 80%CI 48.38-60.24) were men and 53(45.69%, 80% CI 39.76-51.62) women. Age groups wise; 31(26.72%, 80%CI 21.46-31.99) were child (=17 years), 57(49.14%, 80%CI 43.19-55.09) young adult (18-35 years), 19(16.38%, 80%CI 11.98-20.78) middle-aged adults (36-55 years) and nine (7.76%, 80%CI 4.57-10.94) older adults (=56 years). Frequency of type of disease was; hemolytic anemia 17(14.66%, 80%CI 10.45-18.86), megaloblastic anemia 16(13.79%, 80%CI 9.69-17.9), bone marrow hypoplasia 14(12.07%, 80%CI 8.19-15.95), iron deficiency anemia 13(11.21%, 80%CI 7.45-14.96), mixed deficiency anemia 9(7.76%, 80%CI 4.57-10.94), ITP 9(7.76%, 80%CI 4.57-10.94), aplastic anemia 8(6.89%, 80%CI 3.88-9.91), bi-liniage cytopenia 7(6.03%, 80%CI 3.2-8.87), erythroid hyperplasia 3(2.59%, 80%CI .7-4.47) and malaria 2(1.72%, 80%CI 0.18-3.27). In 18(15.52%, 80%CI 11.21-19.83) cases the bone marrow was diluted. Null hypothesis for distribution of sex (p=.3532) was accepted while that for age groups was rejected (p=<.00001). Conclusion: Hemolytic anemia was the most common disorder followed by megaloblastic anemia and bone marrow hypoplasia based on bone marrow aspiration in population of Khyber Pakhtunkhwa, Pakistan.

Lifestyle is the interest, behavior, opinion, style of living or world outlook of an individual, group, or culture; a combination of tangible factors like demographics and intangible factors like personal values and preferences. Recently researchers have more interest in the relationship between life style and health. Millions of people, following unhealthy lifestyle (or risk-factors), are plagued with morbidity, disability and mortality due to non-communicable, communicable diseases & nutritional disorders. Persons having unhealthy behaviors may be called as ‘at risk groups’.2 Although a healthy lifestyle has consistently been shown to decrease mortality, the population prevalence of healthy living remains low.