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9th Health Sciences Research Assembly 2015The Aga Khan Universityi

9th Health Sciences Research Assembly 2015The Aga Khan University9th Health Sciences Research AssemblyApril 8 and 9, 2015INAUGURAL SESSIONWednesday, April 8, 2015 8:30 – 9:30 amAga Khan University AuditoriumMaster of Ceremony: Dr Naghma Rizvi, School of Nursing and Midwifery Tilawat IntroductionDr Mohammad Wasay, Organizing Committee, 9th HSRA Remarks byDr Raisa Gul, Interim Dean, School of Nursing & Midwifery Remarks byDr Farhat Abbas, Dean, Medical College Remarks byDr El-Nasir Lalani, Dean, Research & Graduate Studies Success and challenges in obtaining extramural research grantsDr Ayesha Kamal, Department of Medicine Vote of thanksMs Kiran Shaikh, Co-Chair, 9th HSRA Inauguration of Scientific Exhibitioni

9th Health Sciences Research Assembly 2015The Aga Khan UniversityThemes1.0Bone and Joint Diseases/Orthopaedics2.0Cardiovascular Diseases3.0Clinical Trials4.0Dentistry/Orthodontics/Dental atologic & Oncologic Diseases8.0Health Sciences Education9.0Infectious Diseases10.0Neurosciences/Mental Health11.0Other12.0Public Health13.0Renal/Urology14.0Respiratory Diseases15.0Techniques/Innovations16.0Women and Child Healthii

9th Health Sciences Research Assembly 2015The Aga Khan UniversityMessage fromChair/Co-chairs, Organising CommitteeHealth Sciences Research Assembly (HSRA) plays a central role in dissemination and promotion ofresearch within the AKU community. This avenue provides opportunity to researchers at AKU toshowcase their research work that they have undertaken in the last one year. This is the 9th consecutiveresearch assembly with the emphasis on compliance on ethics in research; therefore this year only thoseresearch works which had appropriate ethics clearance and some studies that were exempted fromethical clearance were allowed for submission. HSRA is a very important event which provides a greatopportunity, specifically to novice researchers to curl their research ideas by interaction withresearchers in other disciplines.There will be brief presentations by distinguished academic leadership of AKU, followed by theopening of research poster exhibition. This year there are more than 400 posters on exhibition frommultidisciplinary clinical to translational research from all departments.We are extremely grateful to our committee members and Conference Secretariat in organization of the9th Health Sciences Research Assembly.We look forward to an active participation from faculty and staff and availing this opportunity tointeract with researchers and opening of new areas of collaborationDr Hammad AtherChair, Organizing Committee9th HSRADr Shahab AbidCo-Chair, Organizing Committee9th HSRAiiiKiran ShaikhCo-Chair, Organizing Committee9th HSRA

9th Health Sciences Research Assembly 2015The Aga Khan UniversityMessage fromDean, School of Nursing and MidwiferyThese days knowledge is not confined to the narrow boundaries of individual disciplines. On thecontrary, for a university to be active in the creation of new knowledge and the application of existingknowledge, we need cross-fertilization between disciplines. This way of working is not easy and needsstructures that can support it, as well as the will to work in this way.One way of encouraging and supporting it comes from meetings like the 9th Health Sciences ResearchAssembly, which lets faculty and students share their work and ideas in a collegial environment whereconnections can be made and new ideas emerge. Collaboration needs the opportunity to meet and talk.The organizers of this celebration of the exciting research culture in AKU are to be congratulated ontheir work and their initiative in creating this event.Dr Keith CashDean and ProfessorSchool of Nursing and MidwiferyAga Khan Universityiv

9th Health Sciences Research Assembly 2015The Aga Khan UniversityMessage fromDean, Medical CollegeThe Aga Khan University, in its journey to be a truly research led institution of the 21st century, placessignificant emphasis on continuing to foster and underpin our research culture; and support and forgenew multidisciplinary and interdisciplinary collaborations. Our research spans many disciplines andresponds to contemporary challenges currently facing the world today, to generate new knowledge andimprove human life.Following the University’s first Health Sciences Research Assembly in 2005, the event has become anintegral component of AKU’s academic and scholarly activities with abstract submission andparticipation surpassing expectations year after year. With the 9th HSRA, we look forward tocontinuing the exchange and dissemination of learning, ideas and work, both completed and inprogress, to provide greater opportunities for collegial efforts across disciplines and specialties.I am sure that our faculty, fellows, residents and students will actively participate in the event, in aneffort to make meaningful contributions to the contemporary knowledge-based society and for makinga sustainable impact on the intellectual landscape.I take this opportunity to convey my appreciation to Dr Hammad Ather and the Organising Committeeof the 9th Health Sciences Research Assembly. I sincerely appreciate all of your efforts and wish youall the best in making the event an unprecedented success.Dr Farhat AbbasDean, Medical CollegeAga Khan Universityv

9th Health Sciences Research Assembly 2015The Aga Khan UniversityMessage fromDean of Research and Graduate StudiesAt the recent convocation in Dar-es-Salam, this year, the Chancellor remarked that: “AKU willcontinue to be a valuable reference point for you, with its Africa and Asia-specific research, and itsContinuing Education opportunities”The annual Health Sciences Research Assembly takes into account the Chancellor’s views inadvancing the research agenda and captures the University’s thematic-research that provides aforum for faculty, staff, and students at AKU to showcase their work, discuss ideas, and becomeinformed of the diverse activities and opportunities. AKU’s research is not only about newknowledge or the application of it; but also about developing a steady stream of highly skilledindividuals.The organisers have worked tirelessly over many months to put together this year’s assembly.And I take this opportunity to extend my deepest appreciation for their extraordinary effort.Congratulations.Professor El-Nasir LalaniDean of Research & Graduate Studies andProfessor of Molecular and Cellular Pathologyvi

9th Health Sciences Research Assembly 2015The Aga Khan UniversityOrganising Committee9th Health Sciences Research AssemblyApril 8 and 9, 2015 Dr Hammad Ather (Chair), Department of Surgery Dr Shahab Abid (Co-Chair), Department of Medicine Kiran Shaikh (Co-Chair), SoNaM Dr Mohammad Wasay, Department of Medicine Dr Nasir-ud-Din, Department of Pathology and Microbiology Dr Almas Amin, Department of CPE Dr Bushra Chaudhry, Department of BBS Dr Samina Ismail, Department of Anaesthesiology Dr. Zahra Hoodbhoy, Department of Obstetrics and Gynaecology Dr Shafquat Rozi, Department of CHS Dr Uzma Khan, Department of Emergency Medicine Syeda Naghma Rizvi, SoNaM Jack Fernandes, Research Office Muhammad Irshad, Conference Secretariat Afifa Batool, Public Affairs Qurat Khan, Department of PsychiatrySecretarial and Logistic Support Mr Asad Yaqoob Mr Nayab Khanvii

9th Health Sciences Research Assembly 2015The Aga Khan UniversityTable of ContentsBone and Joint Diseases/Orthopaedics .1Cardiovascular Diseases .5Clinical Trials.22Dentistry/Orthodontics/Dental Surgery .26Endocrinology/Diabetes .34GI/Liver .54Haematologic & Oncologic Diseases .68Health Sciences Education .83Infectious Diseases .96Neurosciences/Mental Health .121Other .146Public Health.192Renal/Urology .213Respiratory Diseases .219Techniques/Innovations .225Women and Child Health .235viii

The Aga Khan University9th Health Sciences Research Assembly 2015Bone and Joint Diseases/OrthopaedicsBone and Joint Diseases/Orthopaedics1

The Aga Khan University9th Health Sciences Research Assembly 2015Bone and Joint Diseases/OrthopaedicsKeywords: Clinical and biochemical characteristics,Juvenile Idiopathic Arthritis, AKUH1.1CLINICAL AND BIOCHEMICALCHARACTERISTICS OF CHILDREN WITHJUVENILE IDIOPATHIC ARTHRITIS1.2SARCOIDOSIS WITH ARTERIOVENOUSMALFORMATION IN A 15 YEAR OLDShakeel Ahmed, Syed Rehan Ali, Sidra Ishaque,Nabil SamiDepartment of Paediatrics & Child Health, AgaKhan University, KarachiIman Qaiser, Kanwal Nayani, Shakeel AhmedMedical College and Department of Paediatrics &Child Heatlh, Aga Khan University, KarachiObjective: To determine the clinical andbiochemical characteristics of children withJuvenile Idiopathic Arthritis (JIA) at a tertiary carecentre in Karachi, Pakistan.Study Design: A descriptive study.Place And Duration Of Study: PaediatricRheumatology Clinic of The Aga Khan UniversityHospital (AKUH), Karachi, from January 2008 toDecember 2011.Methods: Clinical and laboratory profile andoutcome of children less than 15 years of ageattending the Paediatric Rheumatology Clinic of theAga Khan University, Karachi with the diagnosis ofJuvenile Idiopathic Arthritis according toInternational League against Rheumatism werestudied. These children were classified into differenttypes of JIA; their clinical and laboratorycharacteristics, response to therapy and outcomewas evaluated.Results: Sixty eight patients satisfying the criteria ofInternational League against Rheumatism (ILAR)for Juvenile Idiopathic Arthritis were enrolledduring the study period of four consecutive years,their age ranged from 9 months to 15 years. Meanage at onset was 6.45 4.03 years while mean ageat diagnosis was 7.60 3.93 years. Polyarticularwas the most predominant subtype with 37 (54%)patients, out of these, 9 (24%) were rheumatoidfactor positive. An almost equal genderpredisposition was observed. Fever and arthritiswere the most common presenting symptoms, withonly 2 patients presenting with uveitis.Conclusion: The clinico-biochemical characteristicsof JIA at the study centre showed a pattern distinctwith early onset of disease, high frequency ofpolyarticular type and a higher rheumatoid factor(QRA) and ANA positivity in girls.Introduction: Sarcoidosis is a multi systemicdisorder with many possible complications.Arteriovenous malformations are a rare vascularcomplication of sarcoidosis.Case Description: A 15 year old girl presented tothe Pediatric Clinic at AKUH in 2009 withpulmonary, hepatic, joint and skin manifestations.Physical examination and investigations pointedtowards sarcoidosis, including raised ESR, ACE,SGPT and serum calcium. An incidental finding ofpulmonary arteriovenous malformation (PAVM)was made on echocardiography. When treated withoral corticosteroids, her ACE and SGPT levelsstarted decreasing. There was lack of indication forpulmonary angioembolization for her PAVM. On 4year follow up, her condition is improving and sheis clinically well.Discussion: PAVM is an extremely rarecomplication of sarcoidosis, especially among thepediatric population. Hence, this is the first reportedcase of its kind. The relation between sarcoidosisand PAVM is difficult to establish, however, thereare some theories. This condition may be treateddepending on the symptoms. Since our patient didnot have any significant symptoms of PAVM, shewas treated for the underlying disease, i.e.sarcoidosis.Conclusion: While dealing with patients havingmulti-system disorders like sarcoidosis, one must bevery vigilant so as not to miss out on anycomplication. Regular follow-up visits should bescheduled to rule out new complications and tomonitor the past ones.Keywords: sarcoidosis, arteriovenous, malformation2

The Aga Khan University9th Health Sciences Research Assembly 2015Bone and Joint Diseases/Orthopaedics1.3PATTERN OF HEAD INJURIES ON HEAD CTSCAN IN TRAUMA PATIENTS1.4WHAT’S THE CAUSE OFREVIEWING MRI LS SPINEHuma Khalid, Raza Sayani, Farhana Mehmood,Farah Khurram, Maha HasanDepartment of Radiology, Aga Khan University,KarachiHuma Khalid, Raza Sayani, Farhana Mehmood,Farah Khurram, Maha HasanDepartment of Radiology, Aga Khan University,KarachiObjective: To evaluate the pattern of injuries seenon CT scan in patients with head injuries. Materialand Methods: Retrospective review of CT headreports was performed who had presented withhistory of head injury during December 2013 toJanuary 2014. Reports were evaluated for pattern ofinjuries found on the scans. This would in-turn helpin identifying types of finding to look for in certaintype of trauma.Results: CT scan showed noabnormality in 57% of patients with history oftrauma, they were abnormal in 43% of patients.Males had high ratio of head injury (85%) ascompared to females (15%). People with age rangeof 21 to 30 were more found.14% of epiduralhematoma and 86% sub dural hematoma wasestablish whether only 5% of gray white matterdifferential abnormality found. In 33% cases,intraparenchymal hemorrhage / contusion occurred.37% had associated head and 40% had facialfractures. Caused of trauma and their correlation isalso described. Attempt is also made to evaluate theoutcome associated with injury patternConclusion: Knowing the association of pattern ofinjuries may be helpful for their identification.These may also be helpful for technologist toidentify and communicate these at an early stage.Purpose: To evaluate patients presenting withbackache and review different aspects of lumbardisc degenerative disease on magnetic resonanceimage (MRI).Method: This study was conducted from January2013 to June 2013 at Aga Khan HospitalKarachi.Study was conducted on the diagnosedpatients of lumbar disc degeneration. Inclusion andexclusion criteria were based upon abnormalfindings in MRI. Patients with prior back surgerywere excluded.Results: During the targeted months, 101 patients oflumbar disc degeneration with age range between11 to 90 of years came into radiology department.Disc bulge and dehydration was most commonlyfound at the level of L4/L5 (38%) and at L5/S1(46%).Common level of disc protrusion was L5/S(42%) and lumbar spinal stenosis and disc extrusionlevel was L4/L5 (47%). Spinal recess stenosis wascommonly present at L4/L5 (40%). It was foundthat 77% have mild, 12% have moderate and 11%have severe degenerative lumber disorders.Conclusion: Study indicates strong association ofback pain with lumbar disorders such as spinalstenosis, disc extrusion and disc protrusion at themost common levels L4-L5 and L5-S1.Keywords: CT Head, Head Fracture, CT headTraumaKeywords: Backache, lumbar disorder, LumbarMRI3BACKACHE?

The Aga Khan University9th Health Sciences Research Assembly 2015Bone and Joint Diseases/OrthopaedicsIntroduction: Various shoulder bone deformitieshave been identified in the pediatric age group, withthe most common being undescended scapula.Sprengel’s deformity is dysplasia and malpositionof the scapula, especially in the supraspinatusportion, mainly due to abnormal descent in theembryonic life. The clavicle is shorter and has adifferent contour. It is associated with varioussyndromes, with the most common one beingKlippel-Feil syndrome.CASE: We report the case of a 3 year-old girl whopresented with difficulty in abducting right shoulderand was diagnosed to have Sprengel’s deformity.Also, our patient had hyperpigmentation along thelines of Blaschko (most likely due to cutaneousmosaicism).Conclusion: This case raises the possibility of anassociation between Sprengel’s deformity and theconditions in which cutaneous mosaicism is present.No such case has been previously reported inmedical literature. This is the first case in whichboth these pathologies occur simultaneoulsy.Introduction: Ossification of paravertebral regionand peripheral spinal ligaments is a rare disease thatcauses serious neurological manifestations. It canhappen as an unusual complication ofhypoparathyroidism. Studies have indicated a roleof various systemic hormones like insulin, 1,25dihydroxycholecalciferol, parathyroid hormone(PTH), as well as local tissue growth factors, suchas bone morphogenetic protein (BMP) and TGF- β,transforming growth factor-β in the causativeprocesses leading to the ossification of spinalligaments(OSL). During our literature review, wefound only five previously reported cases ofligamentous ossification in association withhypoparathyroidism.Case: We are reporting the first case ofhypoparathyroidism that presents with thy. It is interesting because it’s a firstreport of its kind from this region and the reportedcase has cervical myelopathy in addition to thoracicmyelopathy, which is very rare in ligamentousossification patients. After clinical assessment, adiagnosis of primary hypoparathyroidism wasmade.Conclusion: In patients presenting with symptomssuch as backache, lower limb weakness and urinaryretention, who after workup are diagnosed withhypoparathyroidism, radiological workup of thespine should always be ordered to rule out OSL as acause of compressive myelopathy.Keywords: Sprengel's,Shoulder deformityKeywords:hypoparathyroidism,ligamentum flavum1.5SPRENGEL'S DEFORMITY WITHCUTANEOUS MOSAICISMMuhammad Younus Khan Durrani, Abdul MalikAmir Humza Sohail, Fazal Khan, Pervaiz HashmiDepartment of Surgery, Aga Khan University,KarachiCutaneousMosaicism,1.6ISOLATED LIGAMENTUM FLAVUMCALCIFICATION: AN UNCOMMONPRESENTATION OF PRIMARYHYPOPARATHYROIDISMAbdul Malik Amir Humza Sohail, MuhammadSoban Arif Maan, Sarwar Malik, MuhammadQamar MasoodDepartment of Medicine, Aga Khan University,Karachi4calcification,

The Aga Khan University9th Health Sciences Research Assembly 2015Cardiovascular DiseasesCardiovascular Diseases5

The Aga Khan University9th Health Sciences Research Assembly 2015Cardiovascular Diseases2.1CARDIOVASCULAR EFFECTS OF AQUEOUSMETHANOLIC EXTRACT OF BERGENIALIGULATA IN EXPERIMENTAL ANIMALSKeywords: Bergenia Ligulata Rhizome,antihypertensive, Ca2 antagonistHasan Salman Siddiqi, Mohammad Ahsan SohailDepartment of Biological & Biomedical Sciences,Aga Khan University, Karachi2.2CARDIOVASCULAR EFFECTS OF AQUEOUSMETHANOLIC EXTRACT OF FUMARIAPARVIFLORA IN EXPERIMENTAL ANIMALSBackground: Hypertension is a significant healthcare challenge due to lack of patient compliance.Search for new anti-hypertensive drugs includesexploration of medicinal plants. Objective: The aimof this study was to explore the cardiovasculareffects of the aqueous-methanolic extract ofBergenia Ligulata (Bl.Cr) in order to providepharmacological basis for its medicinal use inhypertension.Materials and Methods: Aortae from SpragueDawley rats and atria from guinea-pigs were placedin 5 ml and 15 ml isolated tissue bath assembliesrespectively. The tissue bath assemblies, maintainedat 37oC with constant carbogen supply, were filledwith physiological salt solutions (Kreb’s solution)and were connected to Power-Lab.Results: Bergenia Ligulata rhizome extract (Bl.Cr),in isolated guinea-pig atria, equally inhibited forceand rate of spontaneous atrial contractions. On thebaseline of rat thoracic aortae, the plant extractcaused vasoconstriction, which was ephrine (PE, 1 μM) and K (80 mM)induced vasoconstriction, Bl.Cr caused aconcentration-dependent relaxation and also causeda suppression of PE (1 μM) control peaks in Ca2 free medium.Conclusions: These data indicate that the plantextract exhibits cardio-suppressant, vaso-dilatoryand vaso-constrictive properties. The vasodilatoreffect of the plant extract is mediated throughmultiple pathways like inhibition of calcium influxthrough voltage-gated calcium channels, theinhibition of alpha-receptors as well as by theblockage of the IP3 pathway. However, due to theextract’s vaso-constrictive component, furtherinvestigations have to be carried out to determinewhich effect (vaso-dilatory or vaso-constrictive)dominates the other.Hasan Salman Siddiqi, Muhammad Zarrar KhanDepartment of Biological & Biomedical Sciences,Aga Khan University, KarachiIntroduction: Hypertension is a significant healthcare challenge. Its prevalence is on the rise due tolack of compliance to current managementproviding a rationale for the search of newtreatments.Objective: This study was undertaken to explore thecardiovascular effects of aqueous-methanolicextract of Fumaria Parviflora (Fp.Cr) and toinvestigate its potential use as an anti-hypertensiveagent.Methods: The aerial parts of the plant were utilizedto prepare the extract. Aortae from Sprague-Dawleyrats and atria from guinea-pigs were placed in 5 mland 15 ml isolated tissue bath assembliesrespectively, filled with Kreb’s buffer (37oC)bubbled with carbogen and connected to a forcetransducer and PowerLab attached with a computer.All the graphing, calculations and statisticalanalyses were performed using Graph-Pad Prismsoftware version 4.00 for Windows.Results: Fp.Cr equally inhibited force and rate ofspontaneous atrial contractions in isolated guineapig atria. On the baseline of rat thoracic aortae, theplant extract caused vasoconstriction, which waspartially phentolamine-sensitive. When tested onphenylephrine (PE, 1 μM) and K (80 mM)induced vasoconstriction, Fp.Cr caused aconcentration-dependent relaxation and also causeda suppression of PE (1 μM) control peaks in Ca free medium.Conclusions: These data indicate that the plantextract exhibits cardio-suppressant, vaso-dilatoryand vaso-constrictive properties. The vasodilatoreffect of the plant extract is mediated through6

The Aga Khan University9th Health Sciences Research Assembly 2015Cardiovascular Diseasesinhibition of Ca influx via membranous Ca channels as well as Ca release from intracellularstores. Future studies are required to furtherelaborate the blood pressure lowering activity of theplant.Keywords: Fumaria Parviflora, antihypertensive,Ca antagonistConclusion: The myocardial damage in MI ismainly due to ischemic necrosis and inflammatorymechanisms while apoptosis and ischemic necrosisare the main mechanisms of cells death in IR. Theprocess of cardiomyocyte injury in MI and IR isdistinct and is determined by the localmicroenvironment of the myocardium.Keywords: Myocardial infarction, Reperfusioninjury, Apoptosis2.3MURINE MODEL OF MYOCARDIALINFARCTION AND MYOCARDIAL ISCHEMIAREPERFUSION: A COMPARISON2.4EFFECTIVENESS OF ALMOND INPREGNANCY-ASSOCIATED HYPERTENSIONAND DYSLIPIDEMIASatwat Hashmi, Suhail Al SalamDepartment of Biological & Biomedical Sciences,Aga Khan University, Karachi and United ArabEmirates University, UAEHumaira Jamshed, Raffat Bano, Anwar-ul-HassanGilaniDepartments of Biological & Biomedical Sciencesand Obstetrics & Gynaecolgy, Aga KhanUniversity, KarachiObjective: Reperfusion after myocardial infarction(MI) has the potential to salvage ischemicmyocardium but paradoxically can cause injurycalled as ‘reperfusion injury’ (IR). Inflammation,necrosis and apoptosis are the most importantmechanisms that are initiated during ischemia andcontinue over several hours into reperfusion.Methods: Our murine MI model has permanent leftanterior descending (LAD) artery ligation for 24hours while our IR model has LAD artery ligationfor 30 min followed by reperfusion for 24 hours.Histopathologic, apoptotic and inflammatorychanges were measured by using techniques likeimmunohistochemistry, immunoflorescence andELISA.Results: Our results show that the IL-6 levels in theLV (p 0.0008) and plasma (p 0.031) of the MIgroup were significantly raised as compared to theIR group. MI model was also associated withincrease in the neutrophil polymorphs number in theinfarction related myocardium as compared to there-perfused myocardium. A significant increase introponin I level in the MI group as compared to theIR group is also seen (p 0.00). Our IR modelshowed enhanced pro-apoptotic mediators likecleaved caspase-3 (p 0.005) and cytochrome c anddecreased antiapoptotic bcl-2 in the myocardium ascompared to the MI model.Several clinical studies have indicated the beneficialeffects of almond on the cardiovascular systemincluding our recent randomized controlled trialtrials showing HDL-raising potential of almonds.While exploring the underlying mechanism wefound amelioration of vascular dysfunction byalmonds. Keeping in view the lack of almondintervention trials on hypertensive patients we aimto conduct a randomized controlled clinical study onhypertensive and dyslipidemic pregnant womenvisiting the consultant clinics at the Aga KhanMaternity Hospital, Karimabad, Karachi. Thispopulation was selected since pregnancy-associatedhypertension and dyslipidemia are among majorcauses of maternal deaths, and there are myriad ofsafety concerns with the use of drugs in pregnancy.The objective is to compare low and high almonddoses, for their effectiveness in pregnancyassociated hypertension. Additional effects ondyslipidemia and/or gestational diabetes will also beinvestigated.Keywords: Pregnancy, Almonds, Hypertension7

The Aga Khan University9th Health Sciences Research Assembly 2015Cardiovascular Diseasesprevalent in today’s world among all age groupswith high epidemic of cardiovascular diseases(CVD). Among numerous behavioral changescontributing to CVD, meal skipping has not beenwell examined as a potential risk factor. Therefore,the objective of this literature review was tohighlight the importance of breakfast and its relationto various factors that leads to the development ofCVD. Method: A comprehensive systemic literaturereview was conducted through various databasesincluding science direct, Pub med, SAGE andgoogle search engines. The trends of study wasobserved amongst children, adults and health careprofessionals. The causal relationship of breakfastconsumption was studied with cardiovascular riskfactors and their ultimate risk for developingcardiovascular diseases. Results: Sajjad, Anwer,Zaidi, and Hasan (2014) noticed that trend ofskipping breakfast among medical students wasaround 45% however among Pakistani people was26.3%. This trend may result in high magnitude ofCVD as among men, follow-up data supported asignificant relationship between higher breakfastfrequency and lower development of CVD (Betts etal., 2014). Association of breakfast and CVD riskfactors were also noticed in multiple researches. In astudy of black and white young adults, breakfastconsumption was associated with a decreased riskof developing abdominal obesity, metabolicsyndrome, hypertension, and type 2 diabetes over18 years of follow-up (odegaard et al., 2013).Findings from a study on children and adolescentssuggested that breakfast skippers had a significantlyhigher BMI compared with frequent breakfastconsumers (Rampersaud, 2009) and those who tooktheir breakfast in early morning had lower BMI. Itwas also found that cereal breakfast consumers wereless depressed, less emotionally distressed and hadlower levels of perceived stress (Sajjad et al., 2014).Similarly, Shafiee et al. (2013) found that ‘‘seldombreakfast eater’’ were more likely to presentmetabolic syndrome (Mets) having elevated TG,elevated LDL-C and general obesity compared withnon-breakfast consumers. Also, eating breakfastwas negatively associated with fasting glucose asgreater frequency of meals help regulate short-terminsulin response (Rampersaud, 2009). Breakfastfrequency was also found to be associated with2.5ESTIMATION OF PREVALENCE OFDYSLIPIDEMIA AND HYPERTENSION INPREGNANCYHumaira Jamshed, Raffat Bano, Anwar-ul-HassanGilaniDepartments of Biological & Biomedical Sciencesand Obstetrics & Gynaecolgy, Aga KhanUniversity, KarachiDyslipidemia and hypertension during pregnancyare among the major causes of maternal deaths.These are also found to adversely affect neonatalhealth.

Dr Nasir-ud-Din, Department of Pathology and Microbiology Dr Almas Amin, Department of CPE Dr Bushra Chaudhry, Department of BBS Dr Samina Ismail, Department of Anaesthesiology Dr. Zahra Hoodbhoy, Department of Obstetrics and Gynaecology Dr Shafquat Rozi, Department of CHS

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Glossary of Social Security Terms (Vietnamese) Term. Thuật ngữ. Giải thích. Application for a Social Security Card. Đơn xin cấp Thẻ Social Security. Mẫu đơn quý vị cần điền để xin số Social Security hoặc thẻ thay thế. Baptismal Certificate. Giấy chứng nhận rửa tội