INTERNATIONAL CONFERENCE ON ADVANCES IN

ALLIED HEALTH SCIENCES

(25TH – 27TH OCTOBER 2022)
[Link].

1
 PREFACE
Dear Delegates,

All new conference attendees, as well as longtime friends and colleagues, are cordially welcomed. It
is very satisfying to have, once again, a record number of abstracts submitted. We know that there
are many conferences to choose from these days and that funds are always tight.

This is the 1st International Conference on Advances in Allied Health Sciences 2022’ or ICAAHS as
it commonly referred to. Over the last few years allied health science has been trying to arrange an
international conference in a beautiful country of Southern Asia, in the Walled city of Lahore,

Abstract book published by the Faculty of Allied Health Sciences includes 12 departments.

Original material in this book of abstracts may be reproduced with the permission of the publisher,
provided that

(1) The material is not for sale or profitable gain,

(2) The author is informed, and

(3) The material is prominently identified as coming from the, 1st International Conference on
Advances in Allied health sciences: The Book of Abstracts.

The authors are responsible for the contents of their abstracts and warrant that their abstract is
original, has not been previously published, and has not been simultaneously submitted elsewhere.
The views expressed in the abstracts in this publication are those of the individual authors and are
not necessarily shared by the editor or the reviewers.

2
 Chief Organizer
Prof. Dr. Syed Amir Gilani (Pro Rector, FAHS)

Secretary
Prof. Dr. Ashfaq Ahmad (Dean FAHS)

Organizing Committee
Prof. Dr. Abdul Majeed Akhtar (UIPH)
Prof. Dr. Ahmed Bilal Waqar (UIMLT)
Prof. Dr. Zareen Fatima (UIRSMIT)
Prof. Dr. Yasmeen Iqbal (DSS & PE)
Prof. Dr. Muhammad Afzal (LSN)
Prof. Dr. Muhammad Nawaz Anjum (RRS)
Associate Prof. Dr. Shahid Bashir (UIFST)
Associate Prof. Dr. Shahnai Basharat (UIDNS)
Associate Prof. Dr. Asad Ullah (UIPT)
Assist. Prof. Dr. Qazi Umair (DOVS)
Assist. Prof. Dr. Zeeshan Haider (DEAHT)
Assist. Prof. Dr. Usra Naeem (DHPT)

Editor in Chief
Prof. Dr. Abdul Majeed Akhtar
HOD - University Institute of Public Health

Editors
Assist. Prof. Ms. Iqra Hamid Khan

3
Message of Chancellor, The University of Lahore

It is a matter of great pleasure to know that in order to meet the challenges of 21st century, the
Government of Pakistan has introduced changes at higher education level. The present
administration, in its effort to "unleash" the untapped potential of the second youngest population in
the world would continue the "human capital" approach to education. Improving access and quality
of educational institutions is considered essential in capturing this potential, also reinforces through
its party manifesto. A national task force on education comprising experts across different sectors
has been formed for this purpose. I have firm believe in a famous quote of Quaid-e-Azam
Muhammad Ali Jinnah i.e.
"Education is a matter of life and death for Pakistan. The world is progressing so rapidly that without
requisite advance in education, not only shall we lag behind others but may be wiped out altogether."
Educational Institutions may play an important role in nation's building by promoting research,
objective learning, traditions, culture and academic values. I am exultant to see the contributions
made in the field of Higher Education by private sector. The Government of Punjab has adopted the
policy of encouraging the private sector to come forward and establish educational institutions. More
educational institutes are need of the time to meet with the challenges of the modern world for
providing quality education and promoting the culture of research and development. The University
of Lahore has ample potential to meet the challenges of twenty first century and the needs of Pakistan
in all walks of life.
Mission of The University of Lahore is synchronizing with higher education novel policies. This
University has maintained active and fertile collaboration with industry and service sectors to make
its programs dynamic and responsive in the ever-emerging needs of the time. I am sure that "The
University of Lahore" would provide quality education to the youth of Pakistan in a stimulating and
conducive learning environment. I wish to all team of University of Lahore for future success.

H.E. Baligh ur Rehman

Governor Punjab / Chancellor University Of Lahore

4
Message of Chairman, Board of Governors

The University of Lahore (UOL) is a destination for students striving for excellence in research and
learning. Our dedicated academic and non-academic teams are here to impart the relevant knowledge
and skills required to transform them into outstanding leaders of their chosen professions.
We are striving to prepare high-quality graduates with practical skills desired in the contemporary
industry worldwide. On one hand, we are greatly investing resources into entrepreneurship education
for the students to gain hands-on experiences that actually matter; and, on the other hand, we are
creating an enabling environment for the faculty to advance in meaningful applied research. We are
confident that our graduates are effectively fitting into the job market both as employees and job
creators.
In our 25-year journey of academic progress, we have so far produced 58, 725 graduates passed out
at 12 convocations. The latest QS Graduate Employability Rankings 2022, a robust exercise that
compares university performance in terms of graduate employability outcomes and prospects, places
UOL in the 301-500 band of the best universities with employable graduates worldwide and among
the top two private sector universities of Pakistan.
At UOL, we encourage independent academic and intellectual thinking driven by creativity and
critical insights that enable the University to be a center of excellence for both international faculty
and students. Our systematic focus on internationalization is a vital step towards expanding the
impact of the University beyond Pakistan. This explains why we are a host to the largest international
community among all the Private Sector universities of Pakistan having students from 15 different
countries. The University is globally ranked every year by the Times Higher Education (THE),
Quacquarelli Symonds (QS), UI GreenMetric, and is nationally recognized as the largest private
sector university of Pakistan.
We are progressively moving on the path of creating a world class University with market-driven
curriculum, excellent teaching and learning, robust applied and academic research, and efficient
management systems. We are focused on establishing systems that can transform us into a leading
academic institution in the country where intellectual thinking, dialogue, freedom of expression,
tolerance, meaningful debates, and amicable consensus over national and global issues can flourish.
On top of effective teaching and research, we are step-by-step introducing numerous community
engagement programs aimed at empowering communities and causing socio-economic change
through student outreach programs, free of charge healthcare activities, and collaborative efforts with
both private and public institutions. Beyond classroom environment, we are offering diverse
recreational activities intended to nurture all-round students, with much emphasis on extra-coaching
through skill development programs, and exposing our students to the industry through internships,
and motivational talks delivered by renowned entrepreneurs.
I welcome you to UOL where we are striving to nurture professionals outfitted with the desired
standards in creativity, transfer and application of knowledge to address the contemporary challenges
of our society.

Mr. Awais Raoof

5
Rector’s Message

As a leading university of the country in private sector, we have been educating Pakistan’s future
leaders, innovators and thinkers for the last 22 years. Since its emergence, The University of
Lahore (UOL) has achieved significant milestones and has emerged as an institution of quality
learning with integrated academic programmes. Based on continuous efforts and dedicated work of
the administration and faculty, the University has established its stature as one of the best
institutions at both national and global levels.

The UOL employs highly qualified faculty that produces world-class research, being published in
reputable research journals. Our students are valued for their knowledge, talents, skillfulness, and
ability to conduct research with a problem-solving approach keeping in view of the broader societal
interests. We create new knowledge through research and excellent teaching and improve the
welfare of the society through community services and outreach. We impart knowledge, attitudes,
practical skills and competencies of critical thinking and creativity to our students.

At UOL, we offer a platform that polishes students’ capabilities to become all-round graduates with
entrepreneurial skills that make them job creators. I would like to assure the parents and
prospective students that their decision to join the UOL will reap the desired fruits in the times
ahead.

We visualize a harmonious relationship with the students over the years they will spend with us.
We look forward to sending out in the world, graduates who are ready to take on the challenges and
make this world a better and safer place for the new generations.

Prof. Dr. Muhammad Ashraf

6
Pro Rector's Message
The Faculty of Allied Health Sciences is a leader in health science research and education in the
health sciences sector of the country.

We are known for excellence. Students are at the center of our education, and people at the center of
our research. We provide an engaging and stimulating student-centred education environment,
attracting the best students and researchers nationally and internationally. We offer undergraduate
and master’s courses and three majors across seven disciplines.

We collaborate with external partners and engage with real-world problems to anticipate the health
issues of tomorrow while overcoming the challenges of today. Our high-impact research is
acknowledged and translated into practice and policy nationally and internationally. Our graduates
are global citizens who solve issues critical to health and wellbeing. We engage in key issues, such
as healthcare reform and strive to achieve the best possible health and wellbeing outcomes for the
whole community.

I encourage you to explore your interest in health sciences and to begin your journey by reviewing
the UOL website and learn about the many programs available. I invite every eligible candidate to
join UOL, and together we move toward an exciting new era of health education, research, and
service.

Prof. Dr. Syed Amir Gillani

7
Dean's Message
Our staff and students strive to improve the lives of others through the provision of world-leading
health care. Everything we do at the Faculty of Health Sciences at UoL is guided by the values of
excellence, dignity and engagement.

When you study with us, you’ll go beyond the theory. Many of our courses have a clinical
component where you will be able to apply your skills in the real world through professional
experience with some of our many partners, or in our health clinics. Under the guidance of experts
in their fields, you’ll deliver health services to students, staff and the wider community.

Join us as students in the Faculty of Allied Health Sciences at the University of Lahore. I am looking
forward to welcoming you to join any of our programs, according to your choice, and I assure you
our holistic approach to the studies will make you leaders in the allied health profession.

Prof. Dr. Ashfaq Ahmad

8
 The 1st International Conference on Advances in Allied Health Sciences

Table of Content

No. Department Page No.

1. Department of Dietetics & Nutritional Sciences 9
2. University Institute of Public Health 36
3. University Institute of Medical Laboratory technology 67
4. Department of Sports Sciences & Physical Education 91
5. University Institute of Food Science and Technology 118
6. University Institute of Radiological Sciences & Medical 140
Imaging technology
7. Department of Optometry and Vision Sciences 173
8. Department of Rehabilitation Sciences 190
9. Lahore School of Nursing 220
10. Department of Health Professional Technologies 232
Department of Emerging Allied Health Technologies
11. University Institute of Physical Therapy 251

9
Department of Dietetics & Nutritional Sciences

10
 International Speakers
The Global Diet Quality Project and Its Implication For Monitoring Diet Quality In Pakistan
And Globally
Andoni Santamaria Kampfner
Project Manager, Knowledge Leadership Team, Global Alliance for Improved Nutrition (GAIN),
Geneva, Switzerland.

ABSTRACT
Poor diet quality is a major driver of all forms of malnutrition, including undernutrition, obesity,
micronutrient deficiencies and diet-related non-communicable disease. Despite the evidence on the
importance of diet quality, most countries lack routine, current, comparable data on what people eat.
Unlike most other public health priorities such as HIV, smoking and obesity, there is no global
monitoring system for diets. The Global Diet Quality Project, a partnership between GAIN, Gallup
and Harvard has an aim to change this by developing the tools and a data collection system to collect
dietary quality data in the general adult population across countries worldwide, to enable valid and
feasible diet quality monitoring within countries. To date we have released country-adapted diet
quality questionnaires (DQQ) for 104 countries and collected data in 40 countries in 2021. The DQQ
tool, is one of the main innovations of this project. Each DQQ consists of questions on the
consumption of 29 food groups. Depending on the food group, this can be covered by one to three
questions, so the full length of the questionnaire ranges from 30-32 questions approximately. Each
DQQ has been tailored to the food items most consumed in that country. In Pakistan, this was
assessed by reviewing available dietary intake data and conducting a series of key informant
interviews with in-country diet experts. Data collection was the next step for this initiative and data
analysis and visualization followed. The presentation seeks to introduce in detail the Diet Quality
Questionnaire; present the results of the data collected in Pakistan in 2021 in comparison with other
states in the region; and discuss both the opportunities that this tool offers, especially in relation to
the Food based dietary guidelines for Pakistan as well as the implications of the tool for monitoring
of diet quality globally.

11
Dietary Patterns and Nutraceuticals – Intersect Between Food Science And Human Nutrition
For The Management Of Cognitive Health
N1-3 Naumovski
1
Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Australia
2
Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Ngunnawal
Country, Australia
3
Department of Nutrition-Dietetics, Harokopio University, Greece

ABSTRACT
For over two years, the recent global events including the emergence of novel coronavirus, severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread through the human
population in early 2020 have accelerated attention to the overall health. After being declared a
pandemic, levels of cognitive health declined including the increase in anxiety, depression and
overall stress worldwide. Therefore, identifying dietary patterns, specific foods and food ingredients
that may promote beneficial effects on cognitive health have become increasingly important.
Although the emphasis on the consumption of ‘unhealthy’ foods has recently reached significant
proportions, despite the fact that these foods were consumed prior to the pandemic, consumption of
these food products has increased further adding to the decline in overall cognitive health.
Nevertheless, their consumption is widespread globally even throughout some of the most traditional
dietary patterns. The most prevalent dietary patterns relating to the management of mental health
include Mediterranean diet (traditional) and its modifications (DASH, MIND), Japanese, Nordic and
variety of plant-based diets. This presentation will include the findings from current studies relating
to the adherence to dietary patterns (Mediterranean diet), consumption of nutraceuticals and
bioactives that are used in the management of mental health. Some of the common nutraceutical
approaches include green tea components (theanine) and main anthocyanins found in blueberries.

12
 Determinants Of Child Undernutrition And Policy Interventions For Childhood
Undernutrition In Punjab
Anteneh Girma Minas, PhD
Chief of Nutrition, United Nations International Children's Emergency Fund, UNICEF Pakistan

ABSTRACT
The Punjab province has access to rich district-representative household survey data from the
Multiple Indicators Cluster Survey (MICS). Five survey rounds of the Punjab MICS have been
conducted in 2004, 2007, 2011, 2014 and 2018. However, a lack of secondary analysis on this data
in the thematic area of childhood undernutrition has obstructed policy makers from undertaking
evidence-based policy decisions in Punjab. This policy note identifies strategies and policies that can
help in preventing childhood undernutrition in Pakistan’s Punjab. It draws from a companion paper,
which underlines the relative importance of diverse correlates of childhood undernutrition in
Punjab.1 It relies on trend analysis, built on data from the previous rounds of Punjab MICS, to
provide insights on the grey areas, where current policies have remained ineffective to control
undernutrition. High risk factors associated with stunting, underweight, and wasting were identified
by employing multivariate logistic regressions on the data, consisting of 38,495 under-five children
obtained from the Punjab MICS 2018. To allow the impact to vary by age groups, the analysis was
also conducted on two sub-samples disaggregated by age groups of 6 – 35 months, and < 6 months.
The adjusted risk of the independent variables was determined by calculating the odds ratios (OR),
with 95% confidence intervals (CI), and the values with p < 0.05 were retained for further analysis.

13
 Health Benefits of Dietary Phytochemicals
Prof Gary Williamson
Head of Department, Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health,
Faculty of Medicine Nursing and Health Sciences, Monash University, Notting Hill BASE facility,
264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia.

ABSTRACT
Plant-derived foods, beverages and supplements contain naturally-occurring phytochemicals. Some
of these play a role in reducing the risk of developing metabolic syndrome, type 2 diabetes and
cardiovascular disease. These benefits are not due to simple antioxidant activities, but to specific
biological effects on proteins, transporters and receptors in different organs. For example, various
polyphenols affect different aspects of metabolic processes related to glucose metabolism, and
attenuate excessive post-prandial glycaemic responses by inhibiting target enzymes such as sucrase
or alpha-amylase. Many phytochemicals are effectively absorbed in the small intestine, but some
require the action of the gut microbiota. Absorbed phytochemicals, their metabolites and conjugates
have multiple metabolic effects in vivo. Taken together, these data show that phytochemicals can
have multiple benefits on health, as shown by human intervention studies on healthy volunteers and
at risk patients, and by cellular mechanistic studies.

14
 National Speakers
Physiochemical And Nutritional Characterization And Value Addition Properties Of
Cabbage Flour
Muhammad Waseem†1,2, Saeed Akhtar2, Tariq Ismail2, Zulfiqar Ahmad1, Umair Ali1,
Hammad Hafeez1, Tahir Mehmood, Faiz-ul-Hassan Shah1, [Link] Rehman
1
Department of Food Science and Technology, Faculty of Agriculture and Environment, The
Islamia University of Bahawalpur
2
Faculty of Food Science and Nutrition, Bahauddin Zakariya University Multan

ABSTRACT
Background: Present study was targeted at the value addition of cabbage flour in baked product
to improve nutritional malnutrition, to decrease the health disparities among impoverished
population groups. Methodology: The functional and nutritional features of the cabbage flour
were estimated accompanied with its rheological features to portray the baking quality of the
cabbage flour in unleavened flat bread. Results: The findings revealed significantly (p <0.05)
higher swelling power (7.5 g/g), and hygroscopicity (7.5%) of cabbage flour than the control.
Keeping in view of the functional features, the cabbage flour revealed good protein (12.0%), fiber
(25.0%), ash (10.0%). While the minerals revealed the 355, 52, and 32 mg/100g Ca, Na and Zn,
respectively. The cabbage flour addition in cereal flour at the rate of 2.5 – 20% resulted in decline
of some functional parameters but showed theenhancement in the protein and fibers, Na, Ca, and
Zn contents supplemented chapatis. The results showed the textural and sensorial features of the
chapatis to be affected adversely on above 5% supplementation levels. Conclusion: Addition of
the 5% cabbage flour in the cereal flour could help in ameliorating the nutritional insecurities,
micronutrient malnutrition and disorders by providing the fibers, proteins and minerals.
Key words: Chapatis, Brassica oleraceae, vegetables, cabbage flour, bakery products

15
 Prebiotic Based Microencapsulation System For Improved Stability Of Lactobacillus
Plantarum Under Simulated Digestive Conditions And In Orange Juice
Umair Ali1*, Muhammad Saeed2, Zulfiqar Ahmad1, Faiz ul Hassan Shah1, Muhammad
Waseem1,Muhammad Adil Rehman1, Hammad Hafeez1
1
Department of Food Science and Technology, Faculty of Agriculture and Environment. The
Islamia University of Bahawalpur, Pakistan
2
National Institute of Food Science and Technology, University of Agriculture, Faisalabad,
Pakistan.

ABSTRACT
Background: The study on stability of probiotics to digestive and enzymatic conditions is basic
need of the time for the development of functional foods and their commercialization. Current
research is focused on the microencapsulation of Lactbacillus plantarum NCDC201, its
survivability, stability, releasing behavior in simulated digestive system and probiotic orange juice
development. Methodology: Five different formulations of alginate (AL) and Arabic gum (AG)
were assimilated with various concentrations of prebiotics i.e., fructooligosaccharides (FOS), and
inulin for encapsulation by emulsion technique. Results: All treatments exhibited good
encapsulation efficiency (> 95 %) and survivability in simulated digestive conditions (> 6 log
CFU/g), however, T6 (1% AL+1% AG+1.5% inulin) showed the highest encapsulation efficiency
(98 %) and viability in simulated digestive system (8.2 log CFU/g). Moreover, T6 also indicated
the highest bacterial count (9.5 log CFU/g) in orange juice during 4 weeks of storage at 4 °C. It
was observed that encapsulated probiotics with various gel formulations released after 2.5 hour in
colonic conditions and were remain viable up to 12 hours. A smaller decline in pH (2.95-2.86)
and brix (11.0-10.7) of orange juice was noticed in formulation prepared with 1.5 % inulin.
Conclusion: Combination of alginate-arabic gum and inulin showed potential for improved
survival of probiotics in fruit juices to take the advantage of their therapeutic benefits.
Keywords: Lactobacillus plantarum, microencapsulation, Arabic gum, prebiotics,
Fructooligosaccharides, Inulin

16
 Profiling The Antioxidant And Antibacterial Potential Of Ber (Ziziphus Mauritiana)
Extract On Chicken Meat
Hafiz Muzammal Ali1, Tahir Zahoor1, Muhammad Saeed1, Zulfiqar Ahmad2, Umair
Ali2*, Faizul Hassan Shah2, Hammad Hafeez2, Muhammad Adil Rehman2
1 National Institute of Food Science and Technology, University of Agriculture, Faisalabad,
Pakistan
2
Department of Food Science and Technology, Faculty of Agriculture and Environment. The
Islamia University of Bahawalpur, Pakistan

ABSTRACT
Background: (Ziziphus mauritiana) is a traditional medicinal fruit having antioxidant,
antihistaminic, antidiabetic, hypolipidemic and anticarcinogenic properties. The study focused on
thedetermination of antioxidant and antibacterial potential of Ber extract and its application on
chicken meat. Methodology: Agar well diffusion and disc diffusion methods were used. Different
concentrations of Ber extract (10%, 20%, 30%, 40%) were applied on chicken meat to test its
antioxidant and antimicrobial properties. Results: The Ber extract was evaluated for its
phytochemical screening and results elucidated that phenolic and flavonoid content of Ber was
about 56.23 mg/100g GAEs and 9.8 mg/100 CEs respectively. Moreover, the ascorbic acid and
reducing sugar content was 18.12 mg/100 AEs and 1.36 g/100g respectively. T4 (40% Ber extract)
significantly (p<0.05) improved quality characteristics of chicken and minimal changes were
recorded for pH (6.32 to 5.53),color (55.36 to 55.04), and texture (1722 to 1525). The results
also showed significantly high antioxidant potential (80%) of T4 as compared to all other
treatments. The inhibition zone of different pathogens was 14.33 with MIC 300 (Salmonella
paratyphi), 15.23 with MIC 250 ([Link]), 11.63 with MIC 300 (Chromobacterium violaceum),
13.83 with MIC 200 (S. aureus), and 15.23 with MIC 250 (Pseudomonas aeruginosa).
Conclusion: Ber extract can inhibit the oxidation and bacterial attack in chicken meat and other
foods.
Key words: Ber, antioxidant, antibacterial, bioactive compounds, phytochemical

17
 Prebiotic Based Microencapsulation System For Improved Stability Of Lactobacillus
Plantarum Under Simulated Digestive Conditions And In Orange Juice
Umair Ali1*, Muhammad Saeed2, Zulfiqar Ahmad1, Faiz ul Hassan Shah1, Muhammad
Waseem1,Muhammad Adil Rehman1, Hammad Hafeez1
1
Department of Food Science and Technology, Faculty of Agriculture and Environment. The
Islamia University of Bahawalpur, Pakistan
2
National Institute of Food Science and Technology, University of Agriculture, Faisalabad,
Pakistan.

ABSTRACT
Background: The study on stability of probiotics to digestive and enzymatic conditions is basic
need of the time for the development of functional foods and their commercialization. Current
research is focused on the microencapsulation of Lactbacillus plantarum NCDC201, its
survivability, stability, releasing behavior in simulated digestive system and probiotic orange juice
development. Methodology: Five different formulations of alginate (AL) and Arabic gum (AG)
were assimilated with various concentrations of prebiotics i.e., fructo-oligosaccharides (FOS), and
inulin for encapsulation by emulsion technique. Results: All treatments exhibited good
encapsulation efficiency (> 95 %) and survivability in simulated digestive conditions (> 6 log
CFU/g), however, T6 (1% AL+1% AG+1.5% inulin) showed the highest encapsulation efficiency
(98 %) and viability in simulated digestive system (8.2 log CFU/g). Moreover, T6 also indicated
the highest bacterial count (9.5 log CFU/g) in orange juice during 4 weeks of storage at 4 °C. It
was observed that encapsulated probiotics with various gel formulations released after 2.5 hour in
colonic conditions and were remain viable up to 12 hours. A smaller decline in pH (2.95-2.86)
and brix (11.0-10.7) of orange juice was noticed in formulation prepared with 1.5 % inulin.
Conclusion: Conclusively, the combination of alginate-arabic gum and inulin showed potential
for improved survival of probiotics in fruit juices to take the advantage of their therapeutic benefits.
Keywords: Lactobacillus plantarum, microencapsulation, Arabic gum, prebiotics,
Fructooligosaccharides, Inulin

18
 Evaluation Of The Consumption Of Dairy Products And CurrentStatus Of Calcium And
Vitamin D In University Students Of Lahore
Hafsa Tahir1, Hira Amir Butt1, Sara Naveed Khan1, Almas Khursheed1, Rahma Arshad1,
Zainab Ulfat1, Umar Bacha1
School of Health Sciences, University of Management and Technology, Lahore

ABSTRACT
Background: Unhealthy eating patterns and lack of food diversity is leading towards the high
prevalence of osteomalacia, Osteoporosis and other bone related diseases in early adulthood along
with other diseases. The purpose of this study was to evaluate the dairy consumption and vitamin
D deficiency of university going students of Lahore. Methodology: Data was collected from the
students of University of Management and Technology, Lahore (age 20-25 years) through online
questionnaires. The survey included close ended questions and some open-ended questions. The
sample size was 100 students including both males and females equally. Results: The results
showed that the intake of dairy products is not enough in most of the university going students.
Only 36% students were consuming dairy products on daily basis. The status of calcium and vitamin
D revealed that no such healthy eating patterns are being followed. Average consumption of
Calcium was 660 mg which was less than the RDA i.e. 1000 mg/day. Meanwhile the daily
consumption of Vitamin D was 86.69 IU/day. Due to the unhealthy dietary pattern signs of major
diseases like early osteomalacia, osteoporosis, menopause, hypovitaminosis, weak bones,
neurological disorders like Alzheimer’s are gettingcommon in early adulthood. Conclusion: The
research has concluded that most of the students are not taking adequate amounts of particular
nutrients following unhealthy eating patterns due to which they are more prone to bone diseases
and some not even close to RDA which is the reason for the rapid rise of bone and bone related
diseases.
Keywords: Bone health, Dairy, University students

19
The Dietary Concepts, Patterns And Lifestyles In Adults With Diabetes In Punjab, Pakistan
Faran Khan1, Sheeza Imtiaz2, Anam Tariq1
1School of Health Sciences, University of Management and Technology
2Department of Health Sciences, University of South Asia, Raiwind Road, Lahore, Pakistan

ABSTRACT
Background: Diabetes mellitus needs special implementation and maintenance of dietary habits,
lifestyle practices, and food concepts for its management. Diabetes prevalence has been rising more
rapidly in middle and low-income countries. It is estimated that 1.5 million deaths were directly
caused by diabetes and 2.2 million deaths caused by high blood glucose This study was designed to
assess the relationship of food concepts, lifestyle practices and dietary patterns among adults with
diabetes mellitus. Method: The subjects with diabetes mellitus were selected from the OPD’s
(Outpatient department) and diabetic wards from different private and government hospitals of
Punjab. The total sample size was n= 600 subjects. The questionnaire was developed to assess
lifestyle, eatingpatterns and food perceptions among adults with diabetes. Questions related to food
concepts, diabetes awareness and physical activity were asked. Statistical techniques used were
Percentages (%) and cross tabs. Results: Study showed that 55.8% adults have family history of
diabetes mellitus. Approximately 41.8% people were physically inactive and have a sedentary
lifestyle. Participants having no or less education have more uncontrolled HbA1C as compared to
educated participants. 24% uneducated participants believe that consumption of too much sugar can
be origin of diabetes. 24.5% participants thought home remedies are effective in diabetes
management while 10% ofparticipants did practice home remedy at home while 88.8% of them did
not practice any homeremedy. Conclusion: By analyzing the findings of research, the food concepts
of diabetic patients vary from each other people have less knowledge regarding food concepts and
diabetes management. This study also demonstrates lack of physical activity among individuals
approximately half of the participants are physically inactive. Consumption of major meals was
adequate. Health education and other interventions to promote healthy eating and lifestyle habits,
especially prevention among high risk groups are suggested.
Keywords: Diabetes mellitus, Dietary practices, Food Concepts

20
 Determinants And Prevalence Of Dietary Supplements Use And Related Knowledge
Assessment Among University Students In Lahore - A Cross-Sectional Study
Azmat Ullah
Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences,
Lahore.

ABSTRACT
Background: Iron deficiency anemia is a major health concern around the globe and a particular
concern in underdeveloped countries where the number of new cases and severity of anemia is very
high. It affects children's cognitive and physical development and lowers adult productivity.
However, there is little information available about community awareness in Pakistan; so, this study
was carried out to check community awareness of the association of drinking black tea with iron
deficiency anemia. Objective: To find out the Determinants and Prevalence of Dietary Supplements
Use and related Knowledge Assessment among University Students in Lahore. Methodology: A
cross-sectional observational research was conducted with 394 residents of Lahore, Pakistan. These
people accepting to participate voluntarily. A questionnaire was used to gather sociodemographic
information, to assess public knowledge of Iron deficiency anemia and the link between tea intake
and anemia. SPSS version 22 was used to carry out descriptive statistics. To check the normality of
the knowledge score, the Shapiro-Wilk test was used. Similarly, differences in awareness scores were
examined using a one-way ANOVA and a two-sample independent t-test. Results: The large number
of participants have understanding of iron deficiency anemia and its possible causes. The total
awareness level of the link between black tea drinking and iron deficiency anemia was 33.2%. While
there was no statistical difference between awareness and the quantity of tea taken, there were
statistically significant differences between awareness and degree of education, type, age, and sex.
Conclusions: According to the findings, the participants were aware of iron deficiency anemia and
also had an awareness that tea consumption can be a possible cause of iron deficiency anemia. But
many of them don’t exhibit adequate practice and attitude. To improve nutritional habits awareness
as well as educational strategies regarding tea and its possible effect on dietary iron intake should be
planned.
Keywords: Awareness, Community, Iron deficiency anemia, Black tea consumption, Diet, IDA and
Tea

21
Innovative Malnutrition Combating Strategies With Special Reference To Food Fortification
Faiz Rasul
Global Alliance for Improved Nutrition (GAIN), Pakistan.

ABSTRACT
Background: There has been a bloom in food fortification and the urgency of this issue in the
developing economies nowadays. Pakistan is no exception to above and has attained immense
recognition from both the Government and Non-Governmental Organizations primarily reasoned to
some exceptionally poor indicators obtained in the light of National Nutrition Survey of 2011.
Besides, MICS and other independent surveys have reported even more worsened scenario in the
domain of nutrition. Food fortification program in Pakistan is aimed at addressing the leading
nutritional deficiencies like Iron, Zinc, Vitamin A & D. However, there are certain issues that need
to be considered while suggesting levels of fortificants in food fortification. Objective: To evaluate
combating Strategies with Special Reference to Food Fortification. Conclusion: There is a consistent
need to validate the consumption patterns, bioavailability, selection of the salt (fortificant) and
consideration of some other ongoing food fortification programs as well. Additionally, there is a need
to explore some other leading food sources apart from the conventional wheat flour fortification to
better validate the concept of addressing hidden hunger in the country. On the contrary, there is a
major share of single stage millers as well who are not being fortified in the ongoing fortification
regime in the country. In this context, there is a need to draft a strategy for the data, processing
information and coverage of single stage mills so that effects of fortification activity can be multi-
pronged and far reaching. Furthermore, rice and sugar fortification can be considered to be a very
effective approach in this regimen. Quite a number of countries are already engaged in fortifying
sugar and rice with some essential micronutrients.
Keywords: Fortification, malnutrition, Micronutrients, Hidden Hunger

22
 Bioactive Rich Foods: Status, Challenges And Oppertinities
Shahzad Ali Shahid Chatha
Director International Linkages, Government College University, Faisalabad, Pakistan

ABSTRACT
There has been a remarkable resurgence of interest in natural product based food items from the last
few decades. With the outstanding/developments in the areas of separation science, spectroscopic
techniques, and microplate-based ultrasensitive in vitro assays, natural product research is enjoying
renewed attention for providing novel and interesting chemical scaffolds. The various available
hyphenated techniques (GC-MS, LC-PDA, LC-MS, LC-FTIR, LC-NMR, LC-NMR-MS, CE-MS)
have made possible the personation analyses of crude extracts or fractions from different natural
sources, isolation and on-line detection of natural products, chemotaxonomic studies, chemical finger
printing, quality control of herbal products and metabolomics studies. This talk will present, with
practical examples, a general overview of the processes involved in natural product research, starting
from extraction to determination of the structures of purified products and their biological activity.
Keywords: Natural products; secondary metabolite; extraction; isolation; bioassay.

23
 Wheat Grass Juice - A Nutritional Weapon Against Various Maladies
Farhan Saeed and Tabussam Tufail
Institute of Home & Food Sciences, Government College University, Faisalabad Pakistan
University Institute of Diet & Nutritional Sciences, The University of Lahore, Pakistan.

ABSTRACT
Background: In the field of nutrition natural products are obtaining a lot of significance for the
treatment of different maladies and for the improvement in the quality of life. Amongst, natural
extracts are of momentous value for instance; these biochemical moieties are isolated by various
plants having nutraceutical attributes for utilization in various food based products. Numerous
bioactive components have been utilized as therapeutic agent and a variety of these vital components
are present in wheatgrass juice. It holds significance health claims owing to its better phytochemical
profile i.e. chlorophyll, flavonoids, apigenin, minerals, amino acids, enzymes, vitamins etc. It is
considered as a general-purpose health tonic for several years especially an outstanding blood tonic,
which improves oxygen transport by elevating the blood hemoglobin content, so due to this reason
it is very obliging with those subjects which are suffering anemia. Wheat grass juice is not only a
blood builder it is a purifying agent for the blood and it also assist it for the deletion of waste products
of the body because it also has a detergent property. Furthermore, it is very meaningful for the
removal of harmful chemicals, carcinogens and heavy metals available in the body. The rummaging
activity of wheatgrass juice is the free-radical and its dynamic constituents are beneficial for
controlling the progression of tumor growth and for the chemoprevention. Conclusion: In this
inclusive dissertation all the efforts are made to explicate the anti-inflammatory, gastro-protective,
antioxidant, anti-microbial, and anti-diabetic activity of wheat grass [Link] products of wheat
grass juice can be taken as fresh produce, tablets, frozen juice or powder. The current article is also
an attempt to cover all available literature pertaining to the wheatgrass juice with special reference
to phyto-chemistry and allied health claims.
Keywords: Extract, Wheatgrass Juice, Phytochemicals, chlorophyll, Hemoglobin

24
 Glycemic Index And Glycemic Load Of Dairy Products, Indigenous Recipes And
ConfectioneryItems Of Pakistan
Sanaullah Iqbal1*, Ayesha Amjad1, Rukh-e-mah Javed1, Muniba Khaliq1, Azmat ullah1
1
Department of Food Science and Human Nutrition, University of veterinary and animal sciences,
Shaykh Abdul Qadir Jilani Rd, Lahore, Pakistan 54000

ABSTRACT
Background: Diets characterized by low glycemic index (GI) and low glycemic load (GL) have
been repeatedly and independently associated with decreased risk of diabetes and other chronic
diseases. The GI and GL of Pakistani dairy based traditional foods and recipes are not available.
Objective: The aim of this study was to report the GI and GL values of fifty highly consumed
Pakistani foods which were divided into milks (n=7), dairy products (n=5), fruit milkshakes (n=5),
dairy-based local drinks (n=4), dairy-based traditional desserts (n=13) and traditional confections
(n=16). Methodology: For each test food 10±2 fasted healthy participants were served with (25 or
50 g carbohydrate) portions of glucose and bread (reference food) on three occasions, subsequently
the test foods containing equal amount of available carbohydrates. Capillary blood glucose levels
of the subjects at fasting and after ingestion of the reference and test foods were measured within a
2-hours period. The GI of the test foods was calculated by trapezoid rule and GL was determined
by the product of the test food’s GI and the amount of available carbohydrate in a reference serving
size. Results: Among these, forty-three test foods especially those derived from natural sources and
recipes containing milk as a major ingredient were placed among low GI foods. However,
confectionery items which have moderate available carbohydrate were categorized among medium
and high GI foods. Findings have illustrated several factors which influence GI of previously
untested foods. Conclusion: It overcomes the lack of information, contributing to a better
understanding of association between GI and GL and health, providing more informed choices to
Pakistani consumers and health practitioners.
Keywords: Glycemic Index, Glycemic Load, Pakistani foods, Indigenous recipes, Diabetes,
Carbohydrates

25
 Enrichment Of Chapatti Using Quinoa And Millet To Combat Malnutrition
Humna Raouf1, Shabbir Ahmad1, Sadaf Yaqoob1
1
Department of Food Science and Technology, MNS-University of Agriculture, Multan

ABSTRACT
Background: In Pakistan mostly wheat consumed in the form of chapatti. Wheat flour is not able to
fulfill the nutritional requirements (protein, iron, zinc) of pregnant women and the lactating mother.
Quinoa contains carbohydrate 65.70%, protein contents 13.7%, lipids 15.5%, ash contents 3.5%,
fiber 2.6%, while millet contains 7-11%% proteins, 1.5-5% fats, 2-7% crude fiber and 60-70%
carbohydrates and also contain some essential vitamins and minerals Objective: To find out the
effect of quinoa and millet enriched chapati for combating malnutrition. Methodology: Composite
flour was used to prepare, and dough rheological properties was assessed through farinograph.
Physiochemical analysis of the flour was based on the activity of amylase, starch retro-gradation and
gluten content. Chapatti was made by adding composite flour in different concentrations used at the
rate of (100 %, 80 %, 10 %, 10%), (60%, 10%, 10%), (70%, 15%, 15%) and (50 %, 25 %, 25%),).
Results: The results of rheological properties of composite flour showed that the dough development
time was increased from 6.23 to 10.69 minute. The stability and water absorption decreased from
16.46 to 11.76 minute and 62.98 to 58.59% respectively. The result showed that the moisture content
of composite flour chapati decreased form 35.83±0.07 to 29.66±0.25%. The texture hardness was
increased from 13.78±0.44 to 31.47±0.44 N. The chapati color value (L*, a* and b*) was decreased.
Linear relation was observed during sensory evaluation. For the preparation of millet and quinoa
supplemented chapatti T2 (60%, 20%, 20%) and T3 (70%, 15%, 15%) was best treatments.
Conclusion: Therefore, current study was designed to prepare the chapatti with composite flour of
wheat, quinoa and millet that meet the nutritional requirements of the pregnant women and the
lactating mother. And to increase the nutritional quality of chapatti, other cereals and pseudo cereals
can be added to the wheat flour to prepare chapatti.
Keyword: Malnutrition, Quiona, Farinograph, Physiochemical analysis.

26
 Resistance Starch (Rs): Health Effects, Mechanisms, And Measurements
Muhammad Adil Farooq1*, Muhammad Farhan Jahangeer Chughtai1, Atif Liaqat1, Adnan
Khaliq1, Samreen Ahsan1, Tariq Mehmood1
Institute of Food Science and Technology, Khwaja Fareed University of Engineering and
Information Technology- Rahimyar Khan

ABSTRACT
Background: Starch that resists digestion in the small intestine (resistant starch, RS) are excursed to
the colon and fermented by colonic microorganisms. The fermentation end-products, including short-
chain fatty acid (SCFA), provide a range of physiological benefits, similar to commonly known
soluble and insoluble [Link] aim of study was that the resistant starch is not the thermodynamic
property of starch, instead a kinetic property influenced by factors such as intra-human variation in
digestive enzymes, starch structure, physical location in food, and food processing conditions.
Outcomes: Compared to bulking (water holding) ability of insoluble fiber and the viscofying effect
of soluble fibres, RS are mostly insoluble and do not impart significant change on processing and
product properties. Its fine particles (except RS1) and bland taste make it a functional fibre with more
comprehensive application in food formulation and processing than traditional fibre products. This
review discusses types of resistant starch (RS 1, 2, 3, 4, and 5), the mechanism for enzyme resistance
of starches, analytical methods for resistance starch, and the factors affecting resistance.
Conclusion: Conclusively it provides comprehensive information on RS's functionality and
application, benefiting wider audiences.
Keywords: Resistance Starch, short-chain fatty acid, colonic micro-organism

27
 Prevalence Of Small Intestinal Bacterial Overgrowth In People With Gastrointestinal Signs
And Symptoms Using Glucose Breath Test
Sheeza Imtiaz1,2*, Sanaullah Iqbal2, Faran Khan3, Marriam Ahmed1
1Department of Health Sciences, University of South Asia, Raiwind Road, Lahore, Pakistan
2Department of Food Science and Human Nutrition, University of Veterinary and Animal Sciences,
Lahore, Pakistan
3School of Health Sciences, University of Management and Technology

ABSTRACT
Background: Small intestinal bacterial overgrowth (SIBO) is a condition characterized by high
bacterial population in small intestine. Its overall worldwide prevalence is absent due to
underdiagnosis and unspecific symptoms. Aspiration and breath tests are two possible diagnostic
tests. The study objective was to find prevalence of SIBO in individuals using Glucose H2 and
CH4 breath tests and to develop association of SIBO with age, gender, BMI, food and exercise.
Methodology: Total 385 individuals participated in study. Initial screening was done using
symptomatic questionnaire, filled by respondents in an interview style to find out suspected
individuals. Total sum of each symptom was calculated. Individuals with total score of ≥5 were
considered suspected for SIBO and further proceeded for confirmation through Glucose Breath Test
(GBT) using 50g glucose in 200 mL water. Individuals having at least 12 ppm increase in H2 and /
or CH4 were considered as positive for SIBO. Chi-square test was applied. P value < 0.05 was
considered as significant. Results: 14.02% individuals were found suspected to have SIBO on the
basis of positive gastro-intestinal signs and symptoms. In overall tested population, 4.42%
individuals were observed as SIBO positive, 9.61% were false positive and 85.97% were negative
for SIBO. Prevalence was high among individuals consumed starchy food and did not performed
exercise. There is no association of SIBO with age, gender and BMI. Conclusion: It can be
concluded that SIBO is present among individuals with gastro-intestinal signs and symptoms.
Testing SIBO with both H2 and CH4 gave better possible results as compared to individual gas testing.
Keywords: Small Intestinal Bacterial Overgrowth, Glucose Breath Test, H2 breath test, CH4 breath
test, Gastro- intestinal sign and symptoms

28
 Presenters
Prevalence Of Mam And Sam Children In Muzaffar Garh, Punjab Pakistan
1Ramsha Ajmal, 1Faheem Mustafa, 1Mouvez Zeeshan, 2Atif Amin Baig
1
School of Health Sciences, University of Management and Technology, Lahore
2
University Institute of Public Health, Faculty of Allied Health Sciences, TheUniversity of Lahore

ABSTRACT
Background: Malnutrition is one of the common and serious nutritional and public health issue in
developing countries. Malnutrition can be categorized as (MAM) Moderate Acute Malnutrition and
Severe Acute Malnutrition (SAM). Severe acute malnutrition has become a serious issue in
developing countries like Pakistan. Severe Acute Malnutrition is further categorized as primary
Malnutrition and secondary Malnutrition. Methodology: In this research, data of 6 months’ duration
was collected in Stabilization Center of district Headquarters Hospital,Muzaffar Garh. A careful
anthropometry measurement (e.g. weight, height, Mid Upper Arm Circumference) was performed to
diagnose the prevalence of Severe Acute Malnutrition patients in Muzaffar Garh, Punjab, Pakistan.
Along with these measurements, standard deviation and history of medical diagnosis was also
observed. After collecting this data, Severe Acute Malnourished children were then categorized
according to primary malnutrition and secondary malnutrition on the basis of acute and chronic
medical complications. Results: Research revealed a clear difference between primary malnutrition
and secondary malnutrition. Owing to the greater rate of primary malnutrition, it is of great
importance to decrease the main factors of malnutrition. As one of the main factors of primary
malnutrition are poverty and lack of nutrition education. But these days’ government is providing
resourcesto cope up with the poverty So, poverty is not the main cause of malnutrition these
days. Lack of nutrition education comes first. So, nutrition education sessions should be held to fight
with the one of the root cause of malnutrition. Conclusion: The aim of the resent research was
to help the world in fighting against malnutrition by determining the prevalence of severe acute
malnutrition in Pakistan, most common type of malnutrition and the cheapest and easiest possible
solution to control this rapidly increasing rate of malnutrition among children less than 5 years.
Keywords: Malnutrition, SAM, MAM, Children

29
 Comparative Effect Of Pomegranate Peel Powder And Sweet Orange PeelPowder In
Hypercholesterolemia Induced Experimental Rats
Ayesha Babar, Dr. Tabussam Tufail, Dr. Huma Bader UL Ain
University Institute of Diet & Nutritional Sciences, The University of Lahore, Lahore-Pakistan

ABSTRACT
Background: Pomegranate peel powder and sweet orange peel powder are considered as a valuable
source of polyphenols and other [Link] present study was performed to evaluate the
comparative effect of the pomegranate peel powder and sweet orange peel powder in
hypercholesterolemia induced experimental rats. Methodology: 120 male rats having weight of
150-160 g were usedas a biological model in the study and they were equally divided in to five groups
i.e., -ve GO, +ve GO, G1, G2 and G3. +ve Go, G1, G2, and G3 were subjected to high fat and
cholesterol rich diet forone week for the induction of hypercholesterolemia. G1 were subjected to
10% body weight of pomegranate peel powder, group G2 were given 10% body weight of sweet
orange peel powder, while the last group G3 were given 10% body weight of pomegranate peel
powder and 10% body weight of sweet orange peel powder along with the administration of normal
diet for thirty days. Results: Pomegranate peel powder and sweet orange peel powder significantly
reduced the level of the totalcholesterol, low-density lipoproteins and triglycerides such as (p<0.05)
in all the treated groups and greater reduction was seen in G3 group that was fed with both
pomegranate peel powder andsweet orange peel powder due to the presence of potent anti-oxidant
potential. It was also seen thatpomegranate peel powder and sweet orange peel powder didn’t have
any adverse effect on the liver and kidney. Conclusion: Pomegranate peel powder and sweet orange
peel powder may help to modify the risk of hypercholesterolemia and may be used as natural anti-
oxidant rich supplement.
Keywords: Pomegranate peel powder, sweet orange peel powder, anti-oxidant potential,
hypercholesterolemia

30
 Evaluating The Effect Of Sweet Orange Peel Powder Against HyperlipidemiaInduced
Experimental Rats
Huma Babar, Tabassum Tufail, Huma Bader Ul Ain
University Institute of Diet & Nutritional Sciences, The University of Lahore, Lahore-Pakistan

ABSTRACT
Background: Due to minimal negative effects as compared to medicines, natural products are
gaining huge importance now a day. Sweet orange peel powder is a byproduct waste that helps to
lower the level of fats and cholesterol in the blood as it contains significant amount of fiber,
antioxidants, a flavonoid called hesperidin, naringin, synephrine and polyphenols. This study is
conducted to investigate the effects of sweet orange peel powder against hyperlipidemia induced
experimental rats. Methodology: 32 male rats having weight of 100-150g were used for the study
trial and were divided equally into 4 groups such as To-ve, To+ve, T1 and T2. This study was
conducted fora period of one month. To -ve was subjected to normal basal diet throughout the study.
Group To +ve, T1, and T2 were subjected to high fat diet for one week for induction of
hyperlipidemia. To +ve hyperlipidemic rats were fed with normal diet without administration of
sweet orange peel powder. T1 hyperlipidemic rats were fed with normal Diet + 125mg/kg body
weight of sweet orange peel powder and T2 hyperlipidemic rats were fed with normal Diet +
250mg/kg body weight of sweet orange peel powder. Results: The results of this study provedthat
sweet orange peel powder showed significant reduction in LDL levels, total cholesterol and
triglyceride level such as (p<0.05) in all the treated groups and slight increase in HDL levels.
However, the highest reduction was achieved by feeding 250mg of sweet orange peel along with
normal diet. Conclusion: From the above findings, it was concluded that due to the presence of various
bioactive components and antioxidants, sweet orange peel powder can be used as an effective
byproduct tocure hyperlipidemia.
Keywords: Sweet orange peel powder, hyperlipidemia, antioxidant, LDL, lowering, Cholesterol

31
 Comparison Of Two Different Concentrations Of Sweet Potato Peel Powder On
Hyperlipidemia In Rat Model
Amara Arif, Tabussam Tufail, Huma Bader ul Ain
University Institute of Diet and Nutritional Sciences, University of Lahore, Lahore-Pakistan

ABSTRACT
Background: Sweet potato is a perennial crop belongs to Convolvulaceae family. Both roots and
leaves of sweet potato contains a variety of nutrients and bioactive components. This study was
conducted to characterize the chemical and nutritional profile of sweet potato peel powder and to
evaluate the effect of sweet potato peel powder on lipid profile in hyperlipidemic induce
experimental rats. Methodology: The study was conducted at the Institute of Diet and Nutritional
Sciences, University of Lahore. In the first phase the sweet potato peeled powder was analysed to
determine its nutritional profile and in phase 2 an experimental trail was performed. Both treatment
group (T1 and T2) was fed with different concentration of sweet Potato peel powder respectively.
The body weight changes and blood lipid levels of each group was monitored on 0 day and 28 day.
Results: Results shows that the sweet potato peel powder have good antioxidant activity and prevent
from oxidative damage. The reduction in total cholesterol levels from 186.3 ± 60.85 mg/dl to 135.2
± 57.32 mg/dl, decrease in triglycerides level from 144 ± 39.38 mg/dl to 136.4 ± 34.7 mg/dl, LDL
levels from 84.7 ± 29.7 mg/dl to 70 ± 28.48 mg/dl in both pre- and post-treatment groups. Results
indicated that there is significantly increase the level HDL from 48.2 ± 11.18 mg/dl to 52.9 ± 8.76
mg/dl. Conclusion: Sweet potato peel contains a lot of health promoting components. The sweet
potato peel powder has a significant reduction in serum lipid levels and have significant effect on
body weight. There is no significant effect of sweet potato peel powder on creatinine and total protein
statistically.
Keywords: sweet potato, body weight, lipid profile.

32
 Exploring The Effect Of Fenugreek Seeds And GarlicPowder On Induced Hyperlipidemic
Rat Model

Madiha Khan Niazi1, Tabussam Tufail1, Farooq Hassan2

1University Institute of Diet & Nutritional Sciences, The University of Lahore, Lahore-Pakistan
2
Punjab Healthcare Commission, Lahore, Pakistan

ABSTRACT
Background: Due to their high levels of dietary fibre, phytochemical content, and nutritional value,
fenugreek and garlic are significant herbs. Aim of this study was to evaluate the nutrient and chemical
compositions of garlic powder and fenugreek seeds and to investigate the effects of garlic powder
and fenugreek seeds in rats with induced hyperlipidemia. Methodology: The chemical components
of fenugreek and garlic, such as moisture, crude fibre, ash, crude fat, and protein, as well as minerals
and antioxidants, were analysed. Additionally, during 60 days,20 male albino rats were split into 4
groups, one of which served as the control group. Their lipidlevels have been monitored on a regular
basis, and each group gave a different quantity of fenugreek and garlic. Results: The findings
revealed that when compared to garlic, fenugreek had higher values for proximate tests and other
nutrients including minerals. The findings revealed that garlic contained more antioxidants than
fenugreek. Additionally, when different doses of fenugreek and garlic were given to hyperlipidemic
rats, the T3 group's cholesterol level was lowered to 170 mg/dl, LDLwas 120 mg/dl, triglycerides
were 500 mg/dl, while the level of HDL was raised to 45 mg/dl. Conclusion: Fenugreek and garlic
are recommended as part of a diet-based treatment for diseases associated with a rheostat lifestyle.
Keywords: Hyperlipidemia, Fenugreek, Garlic, High fat diet, Antioxidant

33
 Therapeutic Effect Of Aqueous Extract Of Mulberry Leaves OnBlood Lipid Profile In
Hyperlipidemic Patients
Eman Khakwani, Bahisht Rizwan, Sana Noreen
University Institute of Diet and Nutritional Sciences, The University of Lahore, Pakistan

ABSTRACT
Background: Regarding an increased attention to medicinal plants in the current healthcare system,
the effects of mulberry (Morus spp., Moraceae) leaves on metabolic disorder like hyperlipidemia
have been consecutively considered in scientific research. This study aimed to determine the
antihyperlipidemic activity of mulberry leaves extract. Methods: A sample size of 30 and 7-9 weeks
oldwhite albino male healthy rats having the weight of 200-250g were included in study. The rats
were divided into five groups and each group has 6 rats (G0; control negative, G1; control positive,
G2; rosuvastatin, G3; mulberry leaves extract 100 mg/kg/bw and G4; mulberry leaves extract 200
mg/kg/bw). In the present study hyperlipidemia was induced by giving rats a high-fat diet for 4 weeks
to increase cholesterol levels. After induction values was taken at 7,14,21 and 28th for analysis the
effect of mulberry leaves extract on hyperlipidemic induced rat’s model. Results: The results showed
that total cholesterol on 28th day was 322.00±2.607, 270.50±3.391, 229.16±2.316, 233.66±3.502,
241.66±10.80 in basal, control, rosuvastatin, mulberry leaves extract 100 mg and 200mg/kg/bw in
reduction of total cholesterol respectively with p-value <0.05 respectively. The results of
Triglycerides on 28th day was 118.83±3.488, 113.00±3.741, 58.50±1.870, 48.16±.2.639,
63.00±4.732 in in basal, control, rosuvastatin, mulberry leaves extract 100 mg and 200mg/kg/bw in
reduction of triglycerides respectively with p-value <0.000 respectively. The results of HDL on
28th day was 13.33±2.442, 12.25±0.935, 19.25±0.935,20.83±3.488, 11.70±2.389 in basal, control,
rosuvastatin, mulberry leaves extract 100 mg and 200mg/kg/bw increase in HDL levels respectively
with p-value <0.000 respectively. The results of LDL on 28th day was 283.33±2.160, 232.50±1.870,
180.50±1.870, 138.33±2.160,123.83±3.777 in basal, control, rosuvastatin, mulberry leaves extract
100 mg and 200mg/kg/bw LDL levels was reduced respectively with p-value <0.000 respectively.
The results of weight change on 28th day was 246.50±3.316, 233.50±2.406, 234.83±3.250,
225.00±3.741, 215.05±3.253 in basal, control, rosuvastatin, mulberry leaves extract 100 mg and
200mg/kg/bw in reduction of body weight respectively with p-value <0.000 respectively.
Conclusions: It was concluded that the effect of mulberry leaves extract on hyperlipidemia and body
weight were all significant.
Keywords: Mulberry leaves, Total cholesterol, Triglycerides, HDL, LDL, Body weight

34
 The Relationship Between Exercise And Systolic, Diastolic Blood Pressure And, Dietary
Habits Among Hypertensive People
Muhammad Saad, Muhammad Ammar Khan
University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The
University of Lahore.

ABSTRACT
Background: Hypertension is of the most prevalent health related issue in today’s era. It acts asa
potent risk factor of many other chronic diseases as well. According to National Nutrition Survey
(NNS) there are 45% adults over the age of 40 are suffering from hypertension. There aremany
contributing etiological factors of hypertension like lack of exercise, obesity, high sodium intake
etc. Objectives of the study were to determine the effect of exercise on systolic and diastolic blood
pressure of hypertensive patients and to assess their dietary habits. Methodology: 100 hypertensive
patients were recruited for cross sectional study. Participants were asked to fill an interview-based
questionnaire. Demographic and anthropometric data was recorded on questionnaire, their practices
and knowledge related to salt intake was also recorded. Participants were also asked about exercise
and what type of exercise they mostly do. Results: Average age of participants was 50.67±8.470,
their average BMI was 27.09±3.413. Most of the participants were overweight as their mean weight
was 77.60±7.328. 63.3% participants did not do exercise, 23.3% went for a daily walk, 10%
participants used to jog daily. 96.7% participants said that food which does not contain apparentsalt
does not cause hypertension. Correlation between weight and systolic blood pressure was highly
significant (P<0.01). Similar trend was seen in correlation between weight and diastolic blood
pressure. Conclusion: Lack of physical activity, food trend shifts among people, lack of knowledge
about hypertension etiological patients is making management of hypertension difficult.
Keywords: Systolic Blood Pressure, Diastolic Blood Pressure, Lack of exercise, Overweight.

35
 Comparative Effect Of Beet Root And Papaya Powder On Cyclophosphamide Induced
Thrombocytopenic Albino Rats
Nimra Naeem, Tahrem Nisar, Muhammd Nadeem Akhtar
University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The
University of Lahore.

ABSTRACT
Background: Viral diseases are increasing day by day and cause burden in developing countries.
Main issue faced in seasonal viral diseases are decrease in platelets count. Diet rich in natural
antioxidants like fresh fruit and vegetables has protective effect on human body. Methodology: This
study comprises of nutrition value of papaya and beet root and its effect on increasing platelets count
in thrombocytopenic rats. Proximate analysis of beet root and papaya were performed. Data was
analyzed by paired T test with alpha value of 0.005. Result: This study established that beet root and
papaya are good sources of antioxidants that help get rid of load of reactive oxygen species.
Conclusion: Betalinpresent in beet root and papin present in papaya help increase in platelets count.
As these are readily available food sources low socio-economic people can also use it easily for cure
purpose.
Keywords: Beet root, Platelets, Albino rats

36
 UNIVERSITY INSTITUTE OF PUBLIC HEALTH

The ‘International Conference on Advances in Allied Health Sciences 2022’ organized under the
esteemed banner of Allied Health Sciences is a revolutionary attempt to bring together leading
scientists, field professionals graduate and undergraduate students of Public Health onto a single
platform. It is with great honor that we announce that Public Health department is hosting
international speakers from United States of America as well as national speakers. The multiplicity
of work from the Public Health department being showcased at the conference is at par with
international standards and attendance is highly encouraged.

37
 International speakers
Enhancing education and awareness of public health issues with collaborative simulation
modalities.

Cynthia Price
MSMS, BSN, RN, CHSE, CHSOS

Abstract

How do I engage and train public health - healthcare providers and patients with simulation? This
presentation will demonstrate the basics of simulation education and the different simulation
modalities you can provide to your team members and patients. Learn how to develop, design,
implement and evaluate simulation events. To support educational curriculum needs, clinical
education, and patient education. Be taught learner psychological safety, pre-brief, facilitation, and
debriefing techniques in simulation. Capture ROI opportunities in education and healthcare through
simulation training.

38
 Fighting Malaria With New Tools That Target The Mosquito

Marcelo Jacobs-Lorena

Department of Molecular Microbiology and Immunology and Malaria Research Institute, Johns
Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Abstract
Over 600,000 people, mostly young African children, died of malaria in 2021. The development of
innovative approaches to reduce this intolerable burden is sorely needed. The strategy of targeting
the mosquito to fight malaria is based on two premises: 1) the mosquito is an obligatory vector for
parasite transmission and 2) a strong bottleneck of parasite numbers in the mosquito limits parasite
development. Since the early demonstration that mosquitoes can be engineered to be refractory to
the parasite, the effectiveness of this approach has been robustly demonstrated in the laboratory by
simultaneous expression of multiple effector genes (genes that stop parasite development without
affecting the mosquito vector). The major current challenge is to devise means to introduce the genes
that confer refractoriness into mosquito populations. This will most likely be achieved by use of
CRISPR/Cas9 gene drives. An independent approach to suppress the mosquito vectorial capacity is
to express effector genes from symbiotic bacteria rather than from the mosquito itself, an approach
referred to as paratransgenesis. Paratransgenesis has the advantage that the bacteria occur in the
mosquito gut in large numbers and in close proximity to the most vulnerable parasite forms. As is
the case for gene drive, the mosquito symbiont bacterium Serratia AS1 can spread through mosquito
populations and be engineered to secrete effector proteins that stop parasite development. This
presentation will address two unanswered questions: 1) which of the two genetic approaches –
transgenesis and paratransgenesis – is the most effective? and 2) can the two approaches be combined
to enhance the effectiveness of the intervention? We produced transgenic mosquitoes engineered to
express effector genes in the midgut and/or salivary glands and Serratia bacteria engineered to
express the same effector genes. We then measured the effectiveness of these two strategies,
individually and in combination, to inhibit malaria parasite transmission. We conclude that the
combination of the two strategies greatly enhances containment of Plasmodium transmission and
should be considered for field application.

39
 Landscape Of Research

Prof David Smith

Abstract
This research is mainly on the causes of cataract, the folded structures of proteins and calcium and
tracer methods. The greatest emphasis is on developing research to prevent cataract including protein
folding, protein-protein interactions, the structures of large complexes (e.g., chaperonins and viral
particles) and [Link] of the protein structure studies focused on the causes of cataract and
involved proteins isolated from the eye lens. Cataract is a major problem concerning millions of lives
who are suffering preventable blindness along with financial hardships, poor quality of life, the
additional health problems and a reduced span of life. They die early because of their bad health and
unable to get enough care. It can even lead to premature death. With 17 million people blind and 83
million visually impaired in world due to preventable cataract. This is a public health crisis. My
research has created early diagnosis and prompt attention to this matter and able to provide care for
millions of people in the world.
Keywords: Cataract, Vision, Blindness

40
 NATIONAL SPEAKERS
Public Health Workforce: An Agent Of Change In Post Covid Era

Prof. Dr. Ayesha Humayun

Abstract:
Public Health is the broadest discipline, encompassing entire health systems of the world. In
developing countries, as there is still a 10/90 gap in health research expenditure in countries where
actually the major burden of diseases exists, the focus on public health workforce (PHW)
development is missing. PHW is working with a great diversity and WHO being the largest public
health organization is actively collecting, interpreting and disseminating workforce data in all regions
of WHO. Public health workforce during the pandemic of COVID-19 was strengthened and took the
center stage in the management of this highly contagious disease. Public health measures were taken
and implemented amicably. On the other hand, pandemic lead to some degree of burnout sue to
mental and physical exhaustion, staff shortage and many other personal and institutional factors.
Public health professionals and entire workforce has a boosted moral as they were in the limelight,
explaining and discussing public health concepts and measures for control and prevention of cOVID-
19 and other infectious diseases with pandemic potential and this continues in the post-pandemic
period as well. It is crucial to learn about the change that is required in public health systems of the
world including the quality, relevant training of PHW during their under and postgraduate courses,
capacity building of existing workforce, response to disasters and infectious diseases emergencies,
evidence-informed policies, public health systems’ collaboration, strengthening of public health
infrastructure, information management and evaluation. No doubt, PHW has emerged as an
important pillar of health system as an agent of change but we need to learn more from the lessons
of mitigating this pandemic, critically evaluating the strategies used and developing future directions
and course of action.

41
 Public Health Emergency Preparedness In Pakistan: Challenges And Strategies

Rubeena Zakar

Abstract
We face diverse hazards influenced by complexities in our environment, demographics and social
constructs. Disasters and emergencies affect population health in various ways. Disaster risk
reduction and disaster management are very important challenges of public health. Disaster risk
reduction is greatly linked with sustainable development goals especially SDGs 3 (good health and
wellbeing), with a focus on “early warning, risk reduction and management of national and global
health risks”. To achieve sustainable development goals, it is imperative to integrate disaster risk
reduction and the building of resilience into policies, plans, programs and budgets at all levels. Risk
reduction is a key responsibility of public health sector. However, public health in Pakistan is facing
various challenges including lack of nationally representative data on population health, limited
resources and competing priorities in delivering community health protection and promotion
programs. Public health emergency preparedness deals with systematic analysis and management of
health risks posed by emergencies and disasters. Disaster management has four phases; hazards and
vulnerability reduction to prevent and mitigate risks, preparedness, early response and recovery
measures. Public health emergency preparedness includes involvement of the entire health system
and inter-sectoral and inter-institutional collaboration by developing polices and plans. Pakistan
faces various challenges with respect to fulfilling essential elements of public health emergency
preparedness particularly with respect to governance and leadership. During Covod-19 crisis, lack
of coordination was seen regarding decision making, planning, execution, service delivery,
information sharing and monitoring. Nevertheless, Pakistan performed very well with respect to
collaborative networks between healthcare system, planning and development, information and
broadcasting, education, finance, and National Disaster Management Authority which helped to deal
with Covid-19 pandemic related crisis effectively and efficiently. To deal with future emergencies,
better governance model is needed that could integrate disaster risk management into primary,
secondary and tertiary healthcare at all levels along with developing resilient integrated systems.

42
 Impact Of Refractive Errors On The Academic Performance Of High School Children Of
Lahore, Pakistan

Muhammad Zahid Latif

(MBBS, MPH, M. Med. Edu, PhD)

Abstract
Background: Refractive errors are a serious public health issue among the developed and
developing communities. Despite advances in the field of ophthalmic care including technological
innovations, refractive errors still pose a grave challenge for the public health planners and policy
makers. This is a problem of high, middle- and low-income countries and also affects the population
of different ages. Refractive errors are considered a global public health concern affecting a
substantial part of the school-going children as well. Methodology: A quantitative study was
conducted among high school children of Lahore, Pakistan, using a quasi-experimental design.
Multi-stage random sampling technique was opted and 2,000 high school children from class 6th to
class 10th of the sampled schools were recruited in the study. Children having ophthalmic infections,
visual acuity less than 6/60 and coexisting organic defects in the eye were excluded from the study.
A structured questionnaire was prepared, which was validated by the subject experts and pilot-tested
for reliability. Results: A total of 2000 study participants from eight high schools in Lahore were
recruited. The prevalence of refractive errors was 20.6%. Myopia was the leading type (52.2%)
followed by astigmatism (33%) and hypermetropia (14.8%). The cumulative group mean score
before intervention was 58.86±15.18. After intervention, the overall mean scores were 56.64±18.55
and 63.19±16.06 in the first and second follow up, respectively. Among public sector, average score
before intervention was 56.52±13.17, which was reduced to 52.50±17.44 at first follow up but
increased to 61.05±14.35% at the second follow up. The average score of public schools at different
time of study were found statistically significant at (p-value >0.05). Among private sector, average
score before intervention was 63.70±17.78%. After intervention it increased to 65.20±17.92 and
67.59±18.43 on first and second follow up, respectively. The difference between average score of
private schools at different time of study were statistically significant (p-value >0.05). Conclusions:
This study concludes that a significant number of school children in the high schools of Lahore suffer
from errors of refraction. The study revealed that despite the presence of multiple public, private
and free eye care services in Lahore, diagnosis and management of refractive errors is still a
serious issue which directly influences the academic achievement. The findings of the study also
reflect the state of affairs in the remote and deprived areas of the country demanding an immediate
response by the policy makers not only for health improvement but also for academic achievements
of the growing school children.
Key Words: Refractive errors, myopia, hypermetropia, astigmatism, academic performance,
spectacle compliance

43
 Tackling Tuberculosis And Diabetes Burden: A Syndemic Approach

Fatima Mukhtar

Abstract
Syndemic is a greek word which is a combination of “snyergos” and “demos”. Snyergos means that
two things acting together have a greater impact as compared to an individual one and demos means
people. Syndemic, therefore, has a greater impact as it is the aggregation of two or more diseases in
a population, which interact with each other at the biological, social and environmental level. This
interaction exacerbates the burden and prognosis of both diseases. The syndemic approach addresses
not only the causes of individual diseases but also understands and identifies the bonds and linkages
between the causes of both diseases before planning and implementing interventions against them.
Globally 537 million people have diabetes (DM) and Pakistan, with 1 in 4 adults living with diabetes
and a prevalence of 26.7%, is the third highest country with diabetic patients after China and India.
In terms of tuberculosis (TB), Pakistan ranks 5th amongst the high burden TB countries globally
with approximately 510,000 new TB cases and 15,000 drug resistant TB cases annually. TB and DM
do not just co-exist in Pakistan. Rather they have a bi-directional interaction. Diabetes alters the risk
of primary and latent TB, and affects the severity of TB and its treatment outcomes. The diabetes
tuberculosis treatment outcome (DITTO) study undertaken among 614 pulmonary tuberculosis
(PTB) patients demonstrated unfavorable treatment outcomes among diabetic PTB patients as
compared to non-diabetic PTB patients. Likewise, TB has an effect on the risk of diabetes, diabetic
treatment outcome and disease severity. Syndemic approach is what we require to tackle this
syndemic of TB and DM. The biological interactions between the two diseases is complicated with
underlying social factors such as poverty, overcrowding, lack of education/ awareness and
availability/utilization of health care services. As the way forward we propose integrated health
programs, intersectoral coordination, further research and policy guidelines to tackle this syndemic
of TB and DM. Keywords: Syndemic, Tuberculosis, Diabetes, Syndemic approach.

44
 Bioethics: Present And Future

Prof. Dr. Saira Afzal

Abstract
Bioethics are important for understanding and application in a true spirit in every day practices and
for professional development. Bioethics isn't restricted to the study of ethical, social, and legal issues
that arise in biomedicine and biomedical research but also encompasses the idea to make innovative
decisions to the healthcare challenges in the noblest way and producing greater good. In Bioethics
many case studies are presented to discuss medical ethical dilemma and difficulties in making the
right decisions, which focuses on issues in health care. The research ethics are also presented in real
scenarios and real life examples which focuses issues in the conduct of research. The environmental
ethics with elements of sustainability and effects of climate changes on health in general, which
focuses on issues pertaining to the relationship between human activities and the environment, and
public health ethics, which addresses ethical issues in public health. These discussions are concluded
in guidelines and recommendations that will help to draft institutional policies; constitution of ethical
committees, and provide consultation and advice on ethical issues. It will definitely help research
work for academic institutions, services delivery in hospitals and medical centers, government
agencies, private organizations and will provide the information for building better health care
services.

Keywords: Bioethics, health care, medical care

45
 Epidemiological Modelling Of Covid-19 In Lahore, Pakistan

Haram Fatima1 , Muhammad Hassan Mushtaq1 , Muhammad Usman Zaheer2 , Mamoona

Chaudhry1 , Masood Rabbani3 , Shakera Sadiq Gill1 , Abdul Rehman1 , Furqan Awan1
1. Department of Epidemiology and Public Health, UVAS
2. Fleming Fund, Islamabad
3. Institute of Microbiology, University of Veterinary and Animal Sciences, Lahore
Corresponding

Abstract
Background: Pakistan became victim of an ongoing pandemic of Severe Acute Respiratory
Syndrome Coronavirus (SARS-CoV-2) on 26th February, 2020. This virus is pathogenic with a high
transmission rate and multiple risk factors were involved in its spread. This study was aimed to
understand the current dynamics of COVID-19 and to forecast the future trends in Lahore.
Methodology: Data were collected from PSHD and SHC departments of Punjab. To implement the
SIR model, a python-based package CovisphyR was parameterized and utilized. Results: Index case
for Lahore City was reported on 15th of March, 2020 outbreak continued in parts reporting 96,300
cases, 2,633 fatalities and 79,178 deaths (till March 2021). Moreover, two-wave pattern were
observed i.e., in July and December 2020 which is attributed to high R(t) value of virus in May/June
and October/November. Prediction results presented for 700 days revealed epidemic to stop by the
mid of February 2023 with about 5000000 people infected with COVID-19, 11900000 people
recovered. Conclusion: The study is useful in understanding the disease dynamics of Covid-19 and
impact of different mitigation strategies on the spread of Covid-19 in Lahore, Punjab.
Key words: COVID-19, Trends, Mathematical modeling, Disease prediction

46
 Knockout Research Fear: Step By Step Guide To Write And Publish A Research Article

Prof. Dr. Asif Hanif

Prof. of Biostatistics, Director Research section, Director Biostatistics Unit,
Faculty of Allied Health Sciences, the University of Lahore

Abstract
Research planning and quality publications are one of the major challenges for medical students
and health researchers. It is generally assumed that due to lack of training and facilities regarding
research methodology and concepts of biostatistics, researchers feel hesitant to challenge
themselves with novel ideas. It is therefore inevitable to include research writing modules and
training in our undergraduate and postgraduate curriculum, and to ensure practical teaching and
guidance to help them knockout their fears and encourage them to do research and publish articles
in high impact journals. The motivation and zealth of students and researchers themselves is
equally important to learn the scientific and statistical concepts and sharpen their research skills
considering its future implications and professional benefits to them as well as to our society. For
this purpose, an integrated course work including Research Methodology, Biostatistics, Computer
Skills, Database Browsing and Data Analysis should be incorporated at early learning phases. They
should also be involved at departmental and intuitional level research projects during study, to
provide them with better exposure and material learning of the learned concepts. The objective of
this session is to deliver state-of-the-art content to persuade investigators and to knockout the fear
about research writing and publications of articles. The ultimate goal is to give realm of hope to
researchers, especially as young as undergraduate students, feel confident and motivated enough to
learn and conduct researches and contribute towards their institutes as well as body of knowledge.

Keywords: Medical research, Biostatistics, publication, epidemiology

47
 Dengue An Emerging Infectious Disease Of Past Rising Trend In Pakistan

Prof. Dr. Munir Saleemi

University of Lahore Medical and Dental College

Abstract
The Dengue an arboviral infection, in historical perspective it was limited to 30 degrees North and
South of equator due temperate climate prevailing in this geographical region. With change in
demographic trends, environment and human behaviour it has expanded its territorial hegemony.
Globally the explosive increase in use of fossil fuels by Industrialized nations and other countries
following the pursuit has led to global warming and climate change. Pakistan being a low-income
developing country has been worst hit by global and local change in climate change. In recent months
our country experienced Glacial Outbursts in our North and exceptional unusual heavy rains in rest
of the country leading to floods, widespread destruction and change in environment. With one third
area of country inundated in water and increase both water and vector diseases. In Pakistan major
determinants of Dengue infection, Climate Change, Increase in Population, Urbanization and
unhygienic life style of inhabitants make it prone to endemic infection with serial epidemics. The
current presentation highlights the brunt of climate change, floods and current epidemic of Dengue
infection with help latest statistics. The main template is based on Epidemiological triangle for
elaborating determinants and prevention.

48
 PRESENTERS
Prevalence And Risk Factors Of Postnatal Depression In Females With Cesarean Section
And Normal Vaginal Delivery

Muhammad Asif1, *, Muhammad Saleem Rana1 , Asif Hanif1 , Syed Amir Gilani1 , Sultan Ayaz3,
Ume Habiba2 , Benish Ali4
1. University Institute of Public Health, The University of Lahore, Pakistan.
2. Directorate of Medical Sciences, Department of Public Health, Government College
University Faisalabad, Pakistan.
3. Directorate of Medical Sciences, Department of Eastern Medicine, Government College
University Faisalabad, Pakistan.
4. Directorate of Medical Sciences, Department of Orthotics and prosthetics, Government
College University Faisalabad, Pakistan.

Abstract
Objectives: To find the prevalence and risk factors of postnatal depression and association of
parenting sense of competence with postnatal depression among females with cesarean section and
normal vaginal delivery. Methods: This case-control study was conducted in Allied hospital and
Children hospital Faisalabad during a period of 1-1-2019 to 30-06-2020. A non-probability purposive
sampling technique was used to enroll 284 women. The Urdu version of Edinburg Postnatal
Depression Scale was used to measure postnatal depression. Results: The mean age (in years) ± SD
was 27.39±5.26 (min 18 years, max 45 years). According to cut-off score ≥13 on EPDS 37.3%
women were found depressed while 62.7% women were found non-depressed. The mean EPDS
score ± SD was 10.12 ± 6.27 (min score 0; max score 27). The women’s age, women’s education,
education of head of family, monthly income of family and socio-economic status, mode of delivery,
delivery place, number of pregnancies, history of infant death, history of child death, history of
miscarriage and number of living children and parenting sense of competence were significantly
associated with postnatal depression (p<0.05). Conclusion: Socio-demographic, obstetric risk
factors, and parenting sense of competence are significant predictors of postnatal depression that
need to be addressed in order to sustain safe motherhood.

Keywords: Postnatal Depression, Risk factors, EPDS, Parenting knowledge.

49
 Study Of Prevalence, Its Deteriments And Genotypes Of Hepatitis C Virus Among Dialysis
Patients And Orgen Recipients In Lahore, Pakistan

Abdul Majeed Akhtar1 *, Wasif Majeed2 , Sufia Majeed3 , Shamsa Kanwal1

1. University Institute of Public Health, the University of Lahore
2. Institute of Applied Psychology, the University of Punjab, Lahore, Pakistan
3. Department of Medicine, Mayo Hospital, Lahore

ABSTRACT
Objectives: The aim of this study was to determine the prevalence and risk factors of hepatitis C
virus among dialysis and organ recipients patients infected with the disease, furthermore different
genotypes of HCV infection were also found and subsequently most prevalent subtype was predicted.
Materials and Methods: All samples were processed for Anti-HCV antibody detection through
ELISA by using third generation ELISA Kit. The Anti-HCV positive serum samples were stored for
RT-PCR to estimate the genotypes of HCV for study. DiaVlysis and organ recipients patients
selected from in and around Lahore Metropolitan from June 2018 to May 2019 were included. The
data analysis was completed by using SPSS version 16. A P-value of < 0.05 was considered to be
significant. Results: A total of 204 dialysis and organ recipients patients were enrolled and screened
for Anti HCV in the study. The mean age of reactive and non-reactive dialysis and organ recipient’s
patients was 44.88±14.12 and 39.56±14.18 years respectively. Gender, Undergone any surgery,
Blood transfusion, Received injections during treatment and Purpose of visiting barber/beauty salon
was significantly associated with HCV infection (P<0.05). Some utensils were also significantly
associated with HCV status i.e. P-value. Out of 84 reactive respondents, 05 patients’ viral genotype
was Type-1, 17 patients’ viral genotype was Type-2, 60 patients’ viral genotype was Type-3 and 2
patients’ viral genotype was not detected and the most prevalent subtype of HCV genotype was 3a
(n=50) followed by 2a (n=17). Conclusion: In our study the overall prevalence of HCV infection
among dialysis and organ recipients patients was high (41.17%) and any kind of surgery, blood
transfusion and Received injections during treatment were a source of infection of HCV.

Key Words: Dialysis patients, Organ recipients patients, ELISA kits, HCV infection.

50
 Seasonal And Spatial Quantitative Changes In Aedes Aegypti Under Distinctly Different
Ecological Areas Of Lahore, Pakistan

Ejaz Mahmood Ahmad Qureshi,Amtul Bari Tabinda, Seemal Vehra

Abstract
Objective: To find out the variations in larval and adult density of Aedes aegypti in different seasons
under different ecological conditions. Methods: This study was undertaken in all the nine towns and
the cantonment board of Lahore, Pakistan, during four seasons in three years. Ovitraps were placed
in houses in residential areas and were visited weekly in rainy and postrainy seasons each year to
determine the presence of immature and mature forms of [Link]. Densities of these were
measured by ovitrap index and per man hour density, respectively. Correlation coefficient and
coefficient of determination between ovitrap index, per man hour density and climatic variables were
established. SPSS 19 was used for data analysis. Results: Ovitrap index and per man hour density
values were lower in early rainy season compared to late rainy and early post-rainy seasons. These
became lowest in late post rainy season. Strong correlation coefficient and its determination between
ovitrap, per man hour density and climatic variables were observed. Conclusion: Density of
immature and mature forms of [Link] was influenced by environmental degradation.

Keywords: Aedes aegypti, Ovitrap, Environmental degradation, Seasonal variation, Ovitrap index
(OI), Per man hour density (PMHD). (JPMA 67: 1797; 2017)

51
 Knowledge, Attitude And Practices Of Personal Protective Equipment Among Health Care
Providers Of Tertiary Care Hospital

Ayesha Shahnawaz

Abstract
Background: Personal protective equipment (PPE) is meant to keep health care workers safe at work
from dangerous infections and injuries. Personal protective equipment (PPE) is clothing that you
wear to protect yourself from germs. This barrier reduces the chances of pathogens being touched
and spread. In the hospital, personal protective equipment (PPE) helps to prevent the transmission of
germs. This can help to keep people and health-care workers safe from infection. PPE give a physical
hindrance among microorganisms and health care [Link] offered assurance by keeping
microorganisms from polluting hands, eye, dress, hairs and shoes. Objective: To access the
knowledge, attitudes, and practices of personal protection equipment among health care providers in
tertiary care hospital. Methodology: A descriptive cross sectional study in which doctors, nurses and
allied health professional included. To access health care providers' knowledge, attitudes, and
practices about personal protection equipment in a tertiary hospital. Non-medical staff working in
hospital are exclude in this study. The data was analyzed by SPSS version 23. Result: This study
included 250 health care worker participate, in which doctors, nurses and allied health professional
and they were a knowledge about personal protective equipment and they know how to use PPEs.
Health care workers used all necessary PPEs such as (gloves, gown, mask, face shield, head cover
and shoe cover) during work. In which 91 health care workers Always (100% of the time) used of
all necessary PPEs during work, 114 health care workers Frequently (75% - Less than 100% of the
time) used of all necessary PPEs during work, 45 health care worker (50% - Less than 75% of the
time) used of all necessary PPEs during work. Some Inhibiting factors that inhibit the health care
workers to used PPE is 50 Forgetfulness, 25 Disturb working, 199 Uncomfortable to wear, 1
Unavailability. Health care workers take training about PPEs and hospital had a policy on PPE.
Conclusion: The study concluded that health care workers inclusive of doctors, nurses and allied
health professionals had knowledge about personal protective equipment and they know how to use
PPEs. Health care workers use all necessary PPEs such as (gloves, gown, mask, face shield, head
cover and shoe cover) while working. Most of the health care workers always use all necessary PPEs,
Majority of the health care workers frequently used all necessary PPEs, Whereas, very few health
care workers sometimes use all necessary PPEs. Factors inhibiting the health care workers from using
PPE were in majority cases uneasiness in wearing, forgetfulness, disturbed working and
unavailability. Health care workers were trained about PPEs as hospital had a policy about the PPEs.

Key words: personal protective equipment, health care worker, knowledge, attitude, practices

52
 Bacteriological Analysis Of Drinking Water In Islamabad

M. Amir, Syed Bilal Hussain, Dr Aysha Wajid, Kashaf Javed

Abstract
Background: This study was conducted to check the bacteriological contamination of drinking water
because contaminated water has microbes that cause water-borne diseases and clean drinking water
is necessary for survival. Total coliform and fecal coliform are the indicator organisms of water
contamination. Objectives: This study was designed to identify drinking water pathogens and fecal
contamination to prevent from water-borne diseases spreading in the area. Materials and method:
This was a descriptive-analytical study including 50 samples were taken from groundwater, filtration
plants, tanker water and water supplies in sectors G15, H15 and Islamabad Homes Phase II of
Islamabad Capital Territory (ICT) Pakistan. Stratified sampling included 28 water samples from
Groundwater (tube well), 2 from the Filter Plant, 10 from tankers and 10 from the water supply of
G15, H15 and Islamabad homes phase 2 for total heterotrophic bacterial count (THBC) by spread
plate count method, total coliform (TC), and fecal coliform including Escherichia coli by most
probable number technique along with physicochemical analysis. Two filtration plants are present in
G15 and there is no FP in H15 but there are many TW, bores in H15. People mostly use groundwater
in H15. G15 has a CDA water supply from khanpur Dam. We did Physiochemical and
Bacteriological analysis on samples and checked water quality. This study took 3 months. Result:
The result showed that 23(46%) out of 50 were contaminated. In total heterotrophic bacterial count
(THBC) 23 out of 50 samples were positive. Tanker water samples have highest THB count with the
value of 4,540 CFU/ml with an average log10 value of 2.32. All the water samples were founded
physiochemical acceptable. In total coliform test, 25 samples were positive and 21 samples were
positive in fecal coli and [Link] tests. Conclusion: According to this study 46% of the water sources
of G15, H15 and IHP2 did no longer meet the secure limits for drinking water as described inside
the WHO suggestions. The excessive THBCs obtained from tanker water indicate that people
utilizing tanker water directly are more exposed to contamination. The groundwater of H15 was
found more contaminated compared to groundwater of G15.

53
 Streptococcus pneumoniae vaccine candidates deployed for nets’ induction; towards the
development of novel, least toxigenic, highly immunogenic, and cost-effective s. Pneumoniae
vaccine candidate

Muhammad Hassan, Atif Amin Baig*, Farwa Munir, Faheem Mustafa, Ahmad Zubaidi Bin
Abdul Latif, Abdullahi Yusuf Muhammad, Mohd Khairi Bin Zahri Johari, Mohd Adzim
Khalili Bin Rohin

Abstract
Globally, Streptococcus Pneumoniae (S. pneumoniae) remains a major public health problem in
causing invasive diseases. This Gram-positive bacterium causes more morbidity and mortality
worldwide than other infections. Annually, a total of 1.6 million deaths occur due to pneumococcal
diseases; out of them, 0.7-1.0 million are children (less than 5 years of age) because of their
immunocompromised state. In Malaysia, pneumonia is considered the sixth largest cause of death.
Among the virulence proteins of S. pneumoniae, alpha-enolase and endonuclease-A (endA) possess
a pivotal role in the deterioration and progression of pneumococcal diseases, respectively. Where
alpha-enolase evokes neutrophil extracellular traps by binding on neutrophils to enhance its activity
during the innate immune response, contrarily, endA provides a strategy to ruin NETs phenomena
by degrading them into pieces. Currently, 94 serotypes of S. pneumoniae are identified, while
available vaccines of pneumococcal diseases, i.e., PPSV-23, PCV-7, PCV-10, and PCV-13, can
target only 23, 7, 10, and 13 invasive serotypes, respectively. Moreover, serotype switching and
escalating antibiotic resistance due to the natural competency of S. pneumoniae have raised alarming
situations for public health worldwide. We knocked out cell-surface alpha-enolase and endA of S.
pneumoniae to elucidate the mechanism of NETs, involved in the entrapment and destruction of S.
pneumoniae. The comparative study of wild-type and mutated strains allows insight into the
molecular function of NETs independent of alpha-enolase and endA effect, phagocytosis (for mutant
alpha-enolase), and correlation of S. pneumoniae immunogenicity. Our vaccine candidates are novel,
least toxigenic, cost-effective, environmentally safe, and highly immunogenic vaccine candidates of
S. pneumoniae independent of age restriction and serotypes, which is the main drawback of current
vaccines. Keywords: Neutrophil extracellular traps; Live attenuated vaccine; Pneumococcal
conjugate vaccine; Invasive pneumococcal diseases; alpha-enolase; endA

54
 Dengue burden estimation in punjab province, pakistan. Abstract of technical report

Mathieu Bangert1, Tran Minh Nhu Nguyen2, Tayyab Muhammad2, Jamshaid Ahmed, Irfan
Ahmad, Shehnaz Naeem4, Muhammad Amir Aslam4, Saflain Haider5, RamanVelayudhan1
1. WHO HQ
2. WHO EMRO
3. WHO Pakistan Punjab Office
4. Punjab Province DGHS
5. Punjab Information Technology Board

Abstract
BACKGROUND: Dengue data from surveillance systems are known to underestimate the true
burden of infection globally. WHO in collaboration with leading experts developed a toolkit for
Member States to estimate their own burden of infection. This report describes dengue surveillance
and burden, summarizes the estimation parameters and gives final estimates for dengue in Punjab
Province, Pakistan, 2017. METHODS: The WHO toolkit requires age and severity disaggregated
notified data for one year, plus five further estimation parameters are inputted into the MS Excel
toolkit: (1) Coverage and fidelity of surveillance system, (2) Under-reporting, (3) Over-reporting, (4)
Fever cohort studies and (5) Seroprevalence studies. Parameter inputs to the toolkit were chosen
based on quantitative analysis of routine surveillance data and qualitative analysis of discussions
with (1) secondary and tertiary HCF dengue focal points (2) district and provincial government
public health dengue specialists (3) HMIS IT specialists (4) local academic expert groups.
RESULTS: The Punjab Province dengue control program integrates clinical, epidemiological and
entomological data to monitor and control infections in real-time. Dengue cases in Punjab Province
from 2012 to 2018 ranged from 4,000 to 20,000 cases, with a total of 23 deaths reported since 2012.
Using the WHO toolkit, the burden of dengue in Punjab Province is estimated as 15,673clinical cases
(12,874-20,027) compared with the 8,493 cases reported through the routine surveillance system in
2017, a 1.9-fold difference. CONCLUSION: Punjab province has a strong integrated surveillance
and control program in place supported by a well-designed HMIS. Greater coverage of the HMIS,
strengthening of data input system and optimization of laboratory diagnostics can further strengthen
the system and reduce the difference between reported and estimated burden. Fever-cohort studies
and sero-prevalence studies should be conducted to ascertain the burden of sub-clinical and
asymptomatic dengue infections.

55
Frequency Of Iron Deficiency Anemia And Its Association With Persistent Diarrhea, Weight
And Parasitic Infestation In Children, 1-2 Years Of Age In Semi-Rural Area Of District
Sialkot, Pakistan

Abid Ali Ranjha1 , Ejaz Mahmood Ahmad Qureshi* 1 , Hajira Abid Ranjha2 , Muhammad
Abeer Mustafa Ranjha2
1. Department of Public Health, University of Lahore, Pakistan.
2. Ali Hospital Daska

Abstract
Background: Iron deficiency anemia (IDA) is a common health problem in Pakistan and persistent
diarrhea under two years of age is one of its major reason. Contributing factors include lack of beast-
feeding, low socio-economic status, low weight, worm infestation and persistent diarrhea.
Objectives: To determine the frequency of IDA among children 1-2 years of age by determining the
Hemoglobin (Hb), Serum Ferritin and Total Iron Binding Capacity (TIBC) in the blood, presence of
Ova and Cyst in the stool samples; and to find out the association of Iron Deficiency Anemia (IDA)
with persistent diarrhea, weight and parasitic infestation. Material and Methods: In this cross-
sectional hospital-based study, 345 children 1-2 years of age visiting Out-Patient Department (OPD)
of Tehsil Headquarter Hospital (THQH) located in semi-urban area with persistent diarrhea were
included. Socio-demographic characteristics of children and their parents were collected with the
help of questionnaire while total body iron stores were determined by checking Hemoglobin (Hb),
Serum Ferritin and Total Iron Binding Capacity (TIBC) in the blood while parasitic infestation was
determined by presence of Ova and Cyst in the stool samples. Status of their was determined
according to Z-score charts. Chi square test was used to test association. Data was statistically
analyzed using SPSS 20.0. Results: Out of total children, 55.9% children were bottle fed, weaning
was started among 97.7% children at the age of 6 months, 44.9% had weight 450 µg/dl and serum
ferritin level <7ng/ml. The association of IDA with age, gender, mode of feeding, food allergies and
vaccination history was significant while it was insignificant with persistent diarrhea and parasitic
infestation. Spearman test showed that there was very weak correlation between ferritin and
hemoglobin level (rs = .163). Conclusion: Study concluded that IDA was very frequent among
children in less than 2 years of age and among contributing factors lack of beast-feeding and diarrhea
are important. Correlation was significant between IDA with age and feeding mode while association
was insignificant with persistent diarrhea, low weight and parasitic infestation.

Keywords: Iron Deficiency Anemia, IDA, persistent diarrhea, low weight, parasitic infestation,
children

56
 Assessment Of Aflatoxin M1 Exposure And Associated Determinants In Children From
Lahore, Pakistan

Waseela Ashrafa2, Abdul Rehmana*, Mansur-ud-Din Ahmad1, Masood Rabbani3 ,

Muhammad Hassan Mushtaq1 , Khalida Aamir4 , Fareeha Akhtar3 , Wang, Jia-Sheng2
1. Department of Epidemiology and Public Health, University of Veterinary and Animal
Sciences Lahore, 54000, Pakistan
2. Department of Environmental Health Science, The University of Georgia, Athens, GA,
USA
3. Institute of Microbiology, University of Veterinary and Animal Sciences Lahore, 54000,
Pakistan
4. Department of Preventive Pediatrics, the Children’s Hospital and The Institute of Child
Health, Lahore, Pakistan

Abstract
Background: Aflatoxins are potent carcinogenic and immunomodulatory mycotoxins, and longer
exposure may lead to deleterious effects on human health. Aflatoxins contamination was reported in
a wide range of staple food from Pakistan including milk. Objective: This study aimed to detect
aflatoxin M1 (AFM1); a known milk contaminant, as biomarker of exposure and determine
associated risk factors in children attending the Children’s Hospital and The Institute of Child Health,
Lahore. Methodology: Urine samples collected from 238 children (1 – 11 years) during winter
(January – mid-March, 2020) and hot-humid summer (August – September, 2020) were tested for
AFM1 presence using ELISA. Data on potential risk factors was also collected. Statistical analysis
was performed using R software and logistic regression model was used for risk factor analysis.
Results: Of 238 samples, 156 (65.5%) were positive for urinary AFM1. Season was significantly
associated (OR=2.64; 95% CI=1.49 – 4.79; p=0.001) with AFM1 positivity, and prevalence was
higher in hot-humid months (74.6%) than winter (57.3%). Median value for creatinine-adjusted
AFM1 was 1.9 ng/mg creatinine (Q1 – Q3=0.82 – 6.0 ng/mg creatinine), while non-creatinine-
adjusted AFM1 was 0.57 ng/mL (Q1 – Q3=0.23 – 1.4 ng/mL). Significantly higher urinary AFM1
levels were detected in children; age ≤2 years vs. >2 years (3.2 ng/mg creatinine vs. 1.6 ng/mg
creatinine, p=0.037), who consumed more milk (250 – 499 = 1.6 ng/mg creatinine vs 500 – 1000 =
2.4 ng/mg creatinine vs >1000 = 5.6 ng/mg creatinine, p=0.048), who presented to nutrition-clinic
vs. OPD (3.2 ng/mg creatinine vs. 1.4 ng/mg creatinine, p=0.003). Conclusion: The study indicates
that the quality of food Pakistani children were consuming was compromised. There is a dire need
to establish a uniform mitigation strategy focusing on improving food quality through strict control
measures and public awareness programs. In addition, mothers should be encouraged to breastfeed
their young ones instead of providing animal/formula milk to reduce exposure to AFM1.

Keywords: aflatoxin; urinary AFM1; Pakistan; risk factors; children; ELISA

57
 Sars-Cov-2-Induced Phosphorylation, Deleterious Mutations Of Spike And Nucelocapsid
Proteins, Anti-Sense Technology, Drug Delivery System And Model Drugs For Its Treatment

Haram Fatima1, Muhammad Hassan Mushtaq1 , Muhammad Usman Zaheer2 , Mamoona

Chaudhry1 , Masood Rabbani3 , Shakera Sadiq Gill1 , Abdul Rehman1 , Furqan Awan1
1. Department of Epidemiology and Public Health, University of Veterinary and Animal
Sciences, Lahore
2. Fleming Fund, Islamabad
3. Institute of Microbiology, University of Veterinary and Animal Sciences, Lahore

Abstract
Background: Pakistan became victim of an ongoing pandemic of Severe Acute Respiratory
Syndrome Coronavirus (SARS-CoV-2) on 26th February, 2020. This virus is pathogenic with a high
transmission rate and multiple risk factors were involved in its spread. This study was aimed to
understand the current dynamics of COVID-19 and to forecast the future trends in Lahore.
Methodology: Data were collected from PSHD and SHC departments of Punjab. To implement the
SIR model, a python-based package CovisphyR was parameterized and utilized. Results: Index case
for Lahore City was reported on 15th of March, 2020 outbreak continued in parts reporting 96,300
cases, 2,633 fatalities and 79,178 deaths (till March 2021). Moreover, two-wave pattern were
observed i.e., in July and December 2020 which is attributed to high R(t) value of virus in May/June
and October/November. Prediction results presented for 700 days revealed epidemic to stop by the
mid of February 2023 with about 5000000 people infected with COVID-19, 11900000 people
recovered. Conclusion: The study is useful in understanding the disease dynamics of Covid-19 and
impact of different mitigation strategies on the spread of Covid-19 in Lahore, Punjab.

Key words: COVID-19, Trends, Mathematical modeling, Disease prediction

58
 Comparison Of Oral Hygiene Among Children Of Working And Non Working Mothers: A
Cross Sectional Survey

Zunaira Iqbal, Arooj Ul Hassan, Seema Shafique

Abstract
Background: The working status of mother is an independent factor for oral hygiene of children.
However, local literature in terms of quantification of poor oral health is scarce. Objective: To
compare status of oral hygiene among children of working and non-mothers. Materials and
Methods: An analytical cross sectional study was done on 200 children divided in two groups (100
of working and 100 of non-working mothers). After taking consent from mothers, socio-demographic
and variables related data was collected through non-probability convenience sampling. SPSS was
used for data collection and analysis. Mean and standard deviations were calculated for quantitative
variables, and frequency and percentages were calculated for categorical variables. Chi square test
was applied to find any possible association between measurements of oral hygiene with working
status of mothers. P-value of less than 5% was considered significant. Results: The average of
working mothers was 28.01 ± 4.3 years while of non-working mothers was 26.5 ±3.8 years. More
tooth decay, more filling of teeth, more missing teeth, higher frequency of bottlefeeding above >3
years, sleeping with bottle in mouth and lesser frequency of brushing teeth were significantly
associated with working status of mother (p-values<0.05 for all). The overall knowledge of working
mothers about oral hygiene was statistically better compared to non-working mothers (p-
value=0.03). Conclusion: Children of working mothers have relatively poorer hygiene compared to
those of non-working mothers despite of having better knowledge about oral hygiene. Working
mothers are recommended to pay close attention and acquire family support to maintain and improve
oral hygiene of children.

Keywords: Oral Hygiene, Dental Caries, Toothbrush, Flossing, Missing Teeth

59
 Epidemiological Modelling Of Covid-19 In Lahore, Pakistan

Haram Fatima1, Muhammad Hassan Mushtaq1 , Muhammad Usman Zaheer2 , Mamoona

Chaudhry1 , Masood Rabbani3 , Shakera Sadiq Gill1 , Abdul Rehman1 , Furqan Awan1
1. Department of Epidemiology and Public Health, University of Veterinary and Animal
Sciences, Lahore
2. Fleming Fund, Islamabad
3. Institute of Microbiology, University of Veterinary and Animal Sciences, Lahore

Abstract
Background: Pakistan became victim of an ongoing pandemic of Severe Acute Respiratory
Syndrome Coronavirus (SARS-CoV-2) on 26th February, 2020. This virus is pathogenic with a high
transmission rate and multiple risk factors were involved in its spread. This study was aimed to
understand the current dynamics of COVID-19 and to forecast the future trends in Lahore.
Methodology: Data were collected from PSHD and SHC departments of Punjab. To implement the
SIR model, a python-based package CovisphyR was parameterized and utilized. Results: Index case
for Lahore City was reported on 15th of March, 2020 outbreak continued in parts reporting 96,300
cases, 2,633 fatalities and 79,178 deaths (till March 2021). Moreover, two-wave pattern were
observed i.e., in July and December 2020 which is attributed to high R(t) value of virus in May/June
and October/November. Prediction results presented for 700 days revealed epidemic to stop by the
mid of February 2023 with about 5000000 people infected with COVID-19, 11900000 people
recovered. Conclusion: The study is useful in understanding the disease dynamics of Covid-19 and
impact of different mitigation strategies on the spread of Covid-19 in Lahore, Punjab.

Key words: COVID-19, Trends, Mathematical modeling, Disease prediction

60
 Treatment Outcomes And Adverse Drug Events Among Drug Resistant Tuberculosis
Patients Receiving All-Oral Ltr: First Record Viewing Report From Pakistan

Hira Aslam, Razia Fatima, Usman Lodhi, Aashifa Yaqoob, Waseem Ullah, Aamir Khan

Abstract
Background: Pakistan is among top five high burden countries globally in Drug resistant
Tuberculosis. In July 2019, the National Tuberculosis Program (NTP) Pakistan released the advisory
to implement all-oral LTR in the country. To-date, limited evidence is available from Pakistan on
the implementation experience, desired outcomes and safety profile of all oral-LTR. The study's
objectives were to assess the effectiveness of treatment and document adverse drug reactions (ADR)
in patients receiving all-oral LTR. Material & Methodology: This retrospective record viewing
study was conducted in 10 PMDT sites in Punjab, Pakistan. Patients with final and interim results
were included in the study (July 2019- December 2020). For the reporting and management of
adverse drug events, aDSM (active TB drug safety monitoring and management) was implemented
across all sites. Results: In the study, 947 patients with DR-TB were enrolled. Final results for 579
were available and showed superior results (68% of treatments were successful). 67.4 out of 368
individuals whose interim results were available demonstrated cultural change by the end of the
eighth month. Combining new medications was thought to result in fatal side effects such as QT
prolongation. However, this study did not record any severe adverse effects. According to the results,
15.2% of patients died and 4.7% lost the follow-up. Conclusion: There was no conclusive proof that
All-oral LTR was any more or less effective than standard regimens. The use of all-oral LTRs, is
recommended by World Health Organization, as it showed lesser side effects and equivalent
unfavorable outcomes. The study's findings give decision-makers the chance to strengthen aDSM
while minimizing the burden of acquired drug resistance and adverse events, thereby extending the
usefulness of these new drugs.

Key words: All-oral long-term Regime, LTR, Bedaquiline, Linezolid, Clofazimine, DR-TB,
Treatment outcomes, aDSM

61
 Prevalence And Risk Factors Of Drug Resistant Tuberculosis In Children

Hira Aslam, Usman Rasool, Asif Hanif

Abstract
Background: Children in contact with patients with pulmonary tuberculosis (TB) are a known high-
risk group for TB disease. At least half a million children fall ill with TB disease every year. The
advent of drug-resistant TB (DR-TB) strains compounds the challenges faced by underresourced TB
programmes. Objective: The core objective of this study was to identify the prevalence and risk
factors for drug resistant tuberculosis in children. Methodology: Children (0-14 years) either
contacts of a multi drug resistant TB patients or non-contacts were considered for this study. Data
related to their demography, clinical and social characteristics was collected based on questionnaire
from Patient’s attendants and household contacts. Results: The children above 13 years, were
infected significantly (65.4 %). There was 32.8 % prevalence of DR-TB in the children previously
treated for DS-TB. Among the risk factors, highest detection was noticed in children having co-
infection with other immune compromising diseases (100 %) followed by 37.3 % prevalence in
children with positive Mantoux test. Children having close contact with other patients of DR-TB also
had significant chances of acquiring the disease. Conclusion: The most important risk factors for
prevalence of DR-TB were poor immunity, history of previous treatment for drug sensitive
tuberculosis and close contact of children with patients of MDR TB. More focus and newer strategies
are required for early contact screening and diagnosis of DR-TB in children.

Keywords: Tuberculosis, Mycobacterium tuberculosis, Multi Drug Resistance, MDR TB suspects

62
 Effectiveness Of Pack Intervention In The Health Care Profession Community On Patients
Satisfaction

Ammara Waqar , Saleem Rana, Ejaz Mahmood Ahmad Qureshi , Muhammad Yaqoob ,
Syed Amir Gilani , Asif Hanif
University Institute of Public Health, The University of Lahore, Lahore

Abstract
Objectives: To explore the factors that measured the patient satisfaction Measurement Tool (PS-
MT) after the implementation of the Practical Approach to Care Kit at Primary healthcare centers of
Lahore, Pakistan with health professionals who had been trained in the protocol. Methodology: A
cross-sectional study through semi-structured interviews were carried out with doctors and nurses
working at Primary health care tiers / Basic Health Units (BHUs)/ Dispensaries in the metropolitan
city where the protocol was implemented. Descriptive information was represented in the form of a
frequency table and graph and paired t-test was applied on pre and post changing and facilities
provided to patients on primary health centers. Results: 100 subject index consisting of doctors,
nurses and paramedics who participated in the study were trained with the practical approach to the
care kit at primary health centers, BHUs and dispensaries of the metropolitan city of Lahore. The
majority of the participants were male. After the intervention, a significant difference was found in
healthcare provider behavior which was measured at p-value 0.02 and health information system at
p-value 0.000. Conclusion: We founded significant change after the implementation of the Practical
Approach to Care Kit at primary healthcare centers of Lahore in health professionals who had been
trained in the protocol.

Keywords: Primary Healthcare, Intervention, Protocols, Implementation, Health Professionals,

Patient satisfaction

63
 Impact Of District Level Decentralization Of Care On Early Outcomes In Drug Resistant
Tuberculosis Management

Usman Lodhi, Hira Aslam, Sarmad Wahaj, Muhammad Asif, Qasim Mehmood, Amir Khan,
Palwasha, Imran Kamal

Abstract
Background with a prevalence of 259 cases per 100,000 people, Pakistan is the fifth-highest burden
country for TB. Data shows 7.4% of DR-TB patients in re-treated cases and 4.2% in new PTB cases.
The National TB control Program started providing DR-TB services in 2010 at 03 tertiary care
hospitals (PMDT sites) and later expanded the centralized network. In centralized DR-TB care
model, 4-5 districts were attached with each PMDT Site. Patients travel long distances for
management which increased their travel cost, fatigue, and decreased compliance. Decentralization
of Drug-Resistant Tuberculosis management is therefore urgently required. Objective To assess the
impact of decentralized care on the interim treatment outcomes for Drug Resistant TB patients.
Methodology A retrospective analytical cross-sectional study including DR-TB patients from June
2021 to September 2022. Patients were retrospectively followed until completion of the intensive
phase of treatment (6 months), Interim Outcome (Culture/ Smear Conversion by the end of 6th
month), or final outcome (loss to follow up (LTFU), Failure or death). Results 80 patients with RR-
TB were enrolled in the study. Xpert MTB/RIF was the diagnostic test of rifampicin resistance for
100% (n =80). All 80 (100%) RRD in district Sheikhupura were enrolled on treatment at
Decentralized care. Median time between sputum testing and treatment initiation was 5 days. Interim
outcomes were available in 41 (51%) patients of whom 49% (n = 39) were still on treatment, 10%
(n = 8) had died, and 10% (n = 8) were LTFU by the end of 6 months. Amongst 80 patients with
culture positive pulmonary TB, 77 (97.5%) were culture negative at 2 months. There was no patient
with HIV co infection. Conclusions The availability of decentralized care and the quick diagnosis
of DR-TB have shortened the time to begin DR-TB treatment. Very early Culture conversion was
seen because of the lack of treatment initiation delays, but death and loss to follow-up still remained
significant

64
 Quality Of Life In Patients With Rheumatic Heart Disease

Areeba Riaz, Muhammad Imran Hanif, Iqra Hamid Khan, Asif Hanif, Sobia Mughal, Ayesha
Anwer
*Gulab Devi Chest Hospital, Lahore

Abstract
Objective: To assess the quality of life in patients with rheumatic heart disease. Methods: This case-
control study was conducted at the Gulab Devi Chest Hospital, Lahore, Pakistan, from October 2016
to March 2017, and comprised patients with rheumatic heart disease. Convenient sampling technique
was used. The 36-item short form health survey was used to collect data. The scores of several
dimensions of the questionnaire were calculated and compared using appropriate statistical tests.
SPSS 16 was used for data analysis. Results: Of the 300 subjects, 150(50%) each were cases and
controls. There were 45(30%) males and 105(70%) females among the cases and 63(42%) males and
87(58%) females among the controls. The affected individuals reported significant impairment not
only in total score (p<0.001) but also in all its domains (p<0.05 each). Conclusion: Rheumatic heart
disease imposed a considerable burden on the quality of life.

Keywords: Rheumatic fever, Rheumatic heart disease, SF36 questionnaire, Quality of life.

65
 Association Of Abuse By Spouse And In Laws With Low Birth Weight

Tahira Ashraf1 , Nyi Nyi Naing2 , Nadiah Wan-Arfah3 , Asif Hanif4

Universiti Sultan Zainal Abidin, Medical Campus, Jalan Sultan Mahmud, 20400 Kuala
Terengganu, Terengganu, Malaysia

Abstract
Background: Physical, verbal, financial and emotional abuse by husbands and in-laws is a prevalent
yet ignored aspect in our society. Despite of its potential hazardous feto-maternal outcomes, there is
no local tool available to measure the abuse by spouse and in laws as well. Objective: To find
association of abuse by spouse and in laws on Low Birth Weight (LBW). Methodology: A case-
control study was done on 236 females (118 cases and 118 controls) after taking ethical approval
from Human Research Ethics Committee of Universiti Sultan Zainal Abidin – UniSZA, Malaysia
and Data Collection Permission from Lady Aitchison Hospital, Lahore, Pakistan. Two independent
questionnaires were developed and validated for assessment of abuse by spouse and in laws among
females. Descriptively, Mean±S.D, or median(IQR) for quantitative, and frequency(percentages) for
qualitative variables, were calculated where applicable. Chi-square test and Multiple Logistic
Regression (MLR) were used for association and predictive modelling taking p-value ≤ 0.05 as
significant. Results: The mean age of mothers in cases was 24.8±4.03 years and in controls was
25.2±3.31 years. Maternal age, gestational age, monthly income in PKR, maternal BMI, general
social support, mean score of abuse by spouse and means score of abuse by in laws were all
statistically different among cases and control (p-values In final model of MLR, there were 8
significant factors including maternal anemia [OR = 9.80, 95% C.I 4.40, 21.89, p-value=0.000],
cousin marriage [OR = 6.15, 95% C.I 2.73, 13.78, pvalue=0.000], combined family system [OR =
4.39, 95% C.I 1.916, 10.05, p-value=0.000], rural residence [OR = 3.81, 95% C.I 1.76, 8.20, p-
value=0.001], taking daily iron supplement [OR = 3.28, 95% C.I 1.53, 7.05, p-value=0.002], score
of general support [OR =1.12, 95% C.I 1.05, 1.19, p-value=0.000], score of abuse by in laws [OR
=1.06, 95% C.I 1.02, 1.10, p value=0.003], and score of spouse abuse [OR = 1.08, 95% C.I 1.02,
1.10, p-value=0.002]. Conclusion: This study concludes that abuse by spouse and in laws were
significantly associated with LBW and, also, social support plays a pivotal role. All these factors are
modifiable and by opting timely awareness campaigns and early screening of population potentially
at risk, the burden of LBW may be reduced and overall quality of maternal life can be improved.

Keywords: Low birth weight, social support, spouse abuse, in-laws, logistic regression.

66
 Appraisal Of General Practitioners In The Management Of Acute Watery Diarrhea For
Children Under 5 Years Of Age

Prof. Dr. Muhammad Naeem (UIPH, FAHS, UOL)

Abstract
Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood
deaths, with an estimated 1.8 million deaths per year globally. The World Health Organization
(WHO) suspects that there are more than 700 million episodes of diarrhea annually in children less
than 5 year of age in developing countries. Up to a third of total pediatric admissions are due to
diarrheal diseases and up to17% of all deaths in indoor pediatric patients are diarrhea related.
Objective: Appraisal of General Practitioners in the Management of Acute Watery Diarrhea for
Children Under 5 Years of Age. Methods: This cross-sectional study was conducted on 380 general
practitioners (GPs) selected through simple random sampling from the list of GPs working in the
private sector in Lahore city with the objective to appraise the GPs in the management of acute
watery diarrhea (AWD) for children under 5 years of age and to identify various factors contributing
in the gaps of current practices of general practitioners for the case management of diarrhea. Their
knowledge and practices regarding management of AWD for the children under 5 years of age was
determined by using semi structured questionnaire and data was analyzed using SPSS version 16.0.
Results: Of the 380 GPs working in the private sector at Lahore city, 103 (27%) GPs had read
WHO/UNICEF criteria for proper management of AWD. The opinion of GPs in adopting various
treatment modalities showed that only 109 (29%) of GPs would like to prescribe ORS, 6% of GPs
stated that patients would require I/V fluids, while 8.4% of GPs would prefer to prescribe drugs in
80-100% of cases with AWD. Only 153 (40.3%) of GPs stated that children like to take ORS. It was
seen that 276 (77.7%) of GPs would like to prescribe antimicrobial drugs in AWD and 144 (37.9%).
It was shown that only 25 (15.6%) GPs knew the role of zinc in the management of AWD. It was
observed that 191 (50.3%) GPs would recommend continuing feeding milk only, while 83 (21.8%)
recommended feeding semisolids plus fluids including milk in such cases. 268 (70.5%) GPs were
visited by a medical representative and 165 (61.6%) deposed that there was no effect on the
prescription rate for a particular drug. Similarly, a statistically insignificant difference was also
observed between GPs experience, their working in a pediatric unit, attended diarrhea management
course, reading WHO guidelines on management of AWD and their prescribing trend for
micronutrient like zinc. Conclusion: It is concluded that there is dearth in the knowledge of GPs
pertaining to the latest protocols elaborated by WHO/ UNICEF which has unearthed a dire need for
their continuous medical education under the stewardship of the Government of Pakistan.

Key Words: GPs, CME, IEC, STGs, IMCI, Children U5, Stakeholders

67
University Institute of Medical Lab Technology

68
 INTERNATIONAL SPEAKERS
Elucidation of macrophage-derived mmps in atherosclerosis
Maryam koushkie jahromi

Jianglin Fan, M.D., Ph.D., F.A.H.A. Department of Molecular Pathology, University of Yamanashi
School of Medicine, Yamanashi, Japan

ABSTRACT
Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases with more than
23 kinds reported in humans. MMPs play crucial roles in several physiological processes, including
tissue remodeling, immune functions, reproduction and development, but are also involved in many
pathological processes, such as tumor invasion, autoimmune diseases, neurodegenerative disorders
and atherosclerosis. Our laboratory has been focusing on the functional roles of MMPs in the
pathogenesis of atherosclerosis. Profiling of the lesions of atherosclerosis of both humans and
experimental animals revealed that several MMPs are markedly upregulated including MMP-1
(collagenase), MMP-9 (gelatinase), and MMP-12 (elastase). To elucidate these MMP functions in
the pathogenesis of atherosclerosis, we created transgenic rabbits overexpressing these MMPs
specifically in macrophages using the human scavenger receptor promotor. Compared with wild-
type rabbits, overexpression of MMP-12 significantly increased the aortic atherosclerosis, suggesting
that macrophage-derived MMP-12 enhances the progression of atherosclerosis. Overexpression of
MMP-9 not only led to increased atherosclerosis but also prominent vascular calcification. On the
other hand, overexpression of MMP-1 did not affect the lesions of atherosclerosis but increased the
size of aortic aneurysms. Therefore, these studies demonstrated that MMPs play multiple roles in the
vascular pathology such as atherosclerosis and calcification.

69
 Targeted Capture Sequencing To Unveil Genetic Variation In Largest Multigene Family

Muhammad Shoaib Akhtar1, Ryuichi Ashino1, Hiroki Oota2, Hajime Ishida3, Yoshihito Niimura4,5,
Kazushige Touhara5, Amanda D. Melin6 and Shoji Kawamura1
1
Department of Integrated Biosciences, Graduate School of Frontier Sciences, The University of
Tokyo, Japan
2
Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Japan
3
Department of Human Biology and Anatomy, Faculty of Medicine, University of the Ryukyus,
Japan
4
Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Japan
5
Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences,
The University of Tokyo, Japan
6
Department of Anthropology and Archaeology & Department of Medical Genetics, University of
Calgary, Canada

ABSTRACT
OR gene family is comprised of hundreds of intact and disrupted genes. Compositional difference of
intact/disrupted genes among individuals causes olfactory variation. We examined genetic variation
of 554 OR genes and 85 neutral regions in 69 Japanese individuals. These sequences were enriched
by targeted capture and were subjected to massive parallel sequencing. Intact/disrupted gene
polymorphism and CNVs were observed in many OR genes. Tajima’s D values of intact OR genes
implied balancing selection. These results could lead to reveal variation of olfactory sensation in
Japanese population. (594 characters including spaces)

70
 Harnessing The Potential of Preconditioned Adipose Derived Stem Cells with Curcuma
Longa to Accelerate Tendon Healing
Dr. Somia

ABSTRACT

Due to the rising occurrence of tendon injuries from overuse or degradation from ageing, as well as
the insufficient outcomes of treatments and therapies, particularly in older individuals, regenerative
medicine has gained more attention. The purpose of the current study was to compare the potential
of curcumin-preconditioned adipose-derived stem cells (P-ASCs). 10 M curcumin was
preconditioned on cultured rat ASCs for 24 hours. For in-vitro investigation, a primary culture of
rotator cuff tendon cells (RCTCs) from Sprague Dawley rats (n=32) was injured with 0.5mM
hydrogen peroxide (H2O2). The wounded RCT culture was supplemented with P-ASCs (2 × 106
cells) after 24 hours. Through MTT assay, LDH assay, immunostaining, and western blotting, the
efficacy of this treatment was evaluated for proliferation, viability, LDH release, gene expression,
and proteome analysis. We discovered that P-ASCs had significantly reduced the injury level
compared to the untreated group and favourably boosted the proliferation and viability of wounded
RCTCs. At the molecular level, we found decreased expression of pro-inflammatory factors (IL-6 &
TNFα) and increased expression of type I collagen (COL I), tenascin-C, Scleraxis, and tenomodulin
(TNMD). TGF-, VEGF, and FGF were shown to be present in the treated group compared to the
untreated group, according to proteome analysis. We draw the conclusion that P-ASCs have proven
to be a powerful clinical treatment for tendinitis that works quickly.

Keywords: Tendon, Adipose derived stem cells, Curcuma Longa, Proliferation, Viability

71
 National Speakers
Theoretical Design Of Il24-Nbd Chimeric Molecule As A Potent Anticancer Drug Candidate

Wardah Shoaib, Fatima Zainab, Maham Noor, Tehrima Khan, Hafiz Muhammad Rehman
Punjab University

ABSTRACT
Introduction: The targeted approach of recombinant proteins as a potential anticancer therapeutic
agent contributes to drug efficacy enhancement as well as its cellular uptake. Molecular engineering
of proteins to elucidate biological mechanisms is critical for specific interactions between a chimeric
molecule and its cognate receptor. The in silico studies of a newly constructed chimeric molecule
serves a bottom-up method to see insight of the interacting protein residues. Objective: This study
aimed at in silico design of a chimeric protein by fusing one component as cell penetrating peptide
(NBD peptide) and other component as a cell targeting peptide (IL-24) via different linkers of
variable lengths. The newly designed recombinant protein was evaluated for its enhanced activity
against breast cancer. Method: After sequence retrieval from UniProt, we modified 3D structure of
peptide on I-TASSER and Alpha Fold. The predicted structures were subjected to quality check and
validation by Ramachandran plot, ERRAT, PROCHECK, and VERIFY 3D. the best model was
refined and evaluated for physiochemical properties. Further, the docking analysis was performed
on ClusPro and finally the interactions were studied. Result The Alpha Fold predicted model showed
RC score and solubility of 97.6%, 0.477 and 100 respectively. The secondary structure comprises
62.3% alpha helix, 9.55% extended strands and 28.09% coils. There were no salt bridges in the fusion
protein which ensures the proper functioning of linker. The docking and interaction studies revealed
a stable complex with 4 salt bridges, 23 hydrogen bonds and 236 non-bonded contacts which signals
its successful interaction with the potential receptor. Conclusion The results predicted that our newly
constructed protein is stable, soluble, validate and have the full potential of generating apoptotic
signal in breast cancer cell. The double action of chimeric molecule as a penetrating and targeting
peptide predicts increased activity. Computational tools for designing such fusion protein have
proven to be valuable as a first step towards its prediction.

72
 Association Of Hla-B27 Alleles And Sub-Alleles With Ankylosing Spondylitis
Hamza Altaf1, Nageen Hussain2, and Muhammad Ahmed Saeed3
1,2
Institute of Microbiology and Molecular Genetics, University of the Punjab Lahore, 54590,
Pakistan
3
Rheumatology, Central Park Medical College, Lahore, 54590, Pakistan

ABSTRACT

Ankylosing Spondylitis has a genetic association with human leukocyte antigen B27 (HLA-B27)
alleles and more importantly with sub alleles. The study showed that AS don't have a significant
association with gender, age, or marital status but has a strong association with C reactive protein
(CRP), Erythrocyte sedimentation rate (ESR), back pain, inflammatory bowel disease (IBD), uveitis,
and persons suffering from chronic infections, injuries to joints, and chemical pollutants. The
occurrence rate of AS is different in different ethnic populations and it also depends on the lifestyle
of a person i.e. the sedentary lifestyle promotes disease. Early stages of the disease can be treated
more efficiently but if the disease becomes chronic, then the symptomatic treatment is usually given.
During clinical surveys, ASDAS and BASDAI score was calculated to figure out the severity of
disease. . Genotyping of HLA-B27 alleles and sub-alleles were carried to estimate its frequency in
patients and in controls, which were taken from the general population. Results showed 72.72%
positivity of alleles of HLA-B27 in patients and 9.09% in general population (n=11). Similarly 87.5%
(n=8) positivity of sub-alleles in patients and zero in controls. Three sub-alleles were taken, HLA-
B27*02,*04, and *05, these have almost 100% occurrence rate in Ankylosing Spondylitis cases. The
output of this research is that, sub alleles of HLA-B27 should be used as a diagnostic tool for
Ankylosing Spondylitis. It is also figured out that a person with a positive HLA-B27 allele is more
vulnerable to be suffered from A.S, if also has the problem of uveitis or IBD and if have a high level
of inflammatory markers.

Keywords: HLA-B27, genotyping, inflammatory back pain, diagnostic tools, inflammatory markers.

73
 Stepwise Activatable Functionalized Nanocarrier For Photodynamic Therapy Induced
Bioreductive Chemotherapy
Dr. Ihsan

Abstract
Low tumor accumulation and poor penetration are two major challenges for anticancer
nanomedicines. However, PEGylated nanoparticles (NPs) have higher stability and prolong blood
circulation but PEGylation could inhibit cell uptake and extracellular matrix binding of NPs. We
successfully developed an intelligent cascade drug delivery system (TAT+AzoNPs), which was
constructed by hypoxia-sensitive linker azo-benzene containing polymer (PEG-Azo-PLGA) and
TAT-peptide functionalized polymer (DATAT-PEG-PLGA) for co-delivery of photosensitizer
chlorine e6 (Ce6) and hypoxia activatable prodrug tirapazamine (TPZ). The 2,3-dimethylmaleic
anhydride (DA) corona over TAT+AzoNPs protected them from serum proteases, while at tumoral pH
TAT-peptide activated and could remarkably improve TAT+AzoNPs accumulation and enhanced
cellular uptake due to nano-bio interaction. Upon external laser irradiation, TAT+AzoNPs can separate
into two parts: 1) TAT+AzoNPs achieve efficient PDT on tumor cell proximal to vessel, owing to
sufficient O2 supply; and 2) PDT-induced serious hypoxia microenvironment, which could trigger
TPZ released by breakage of Azo-benzene bond as well as accelerate the activation of TPZ for
improved combination therapy efficacy in tumor cells distal to vessels. Both in vitro and in vivo
experiments demonstrated the great antitumor activity of cascade TAT+AzoNPs compared to simple
nanoparticles. This work provides new insight into the development of an innovative cascade
delivery system for tumor-targeted PDT and hypoxia-activated chemotherapy.

74
 Investigation Of Morchella Esculenta And Morchella Conica For Their Antibacterial
Potential Against Methicillin-Susceptible Staphylococcus Aureus, Methicillin-Resistant
Staphylococcus Aureus And Streptococcus Pyogenes
Faiz Ul Haq, Muhammad Imran, Sidrah Saleem, Usman Aftab, Ayesha Ghazal
Abstract
Antimicrobial resistance is an alarming problem, especially due to emergence of methicillin-
resistance Staphylococcus aureus (MRSA). World Health Organization (WHO) has already listed
MRSA as a top priority pathogen for the development of novel antibacterial agents. Presently,
different therapeutic approaches against bacterial infections are in practice which includes targeting
bacterial virulence factors, bacteriophage therapy, and manipulation of the microbiome. Natural
products have been efficiently used for centuries to combat bacterial infections. Morchella is a natural
fungal product which has been reported to possess broad-spectrum biological activities against
bacterial infections. Hence, this study was aimed to evaluate the antibacterial efficacy of two macro-
fungi against S. aureus, MRSA, and Streptococcus pyogenes (S. pyogenes). The antibacterial
potential of both fungal extracts (Morchella esculenta and Morchella conica) was evaluated using
disk diffusion and standard broth microdilution methods. The chemical compounds of both fungi
were investigated using ultra-performance liquid chromatography mass spectroscopy (UPLC–MS)
analysis. All fungal extracts inhibited growth of tested bacteria with inhibitory zone ranging from
10.66±0.3 to 21.00±1.5 mm. The minimum inhibitory concentration (MIC) of tested bacterial growth
ranged from 03.33 to 16.0 mg/ml. It was noteworthy that Morchella extracts prevented S. aureus
growth in a bactericidal manner with minimal bactericidal concentration (MBC) of 8–16 mg/ml. The
extracts were also more effective against MRSA than currently available antibiotics. In conclusion,
the growth inhibition of tested bacteria by fungal extracts revealed their potential as antibacterial
agents and their compounds may be used as drug candidates.

Keywords: Antibacterial agents. Antimicrobial resistance. Minimum inhibitory concentration.

Fungal extract. MRSA. UPLC–MS

75
Ethnobiochemical Activity Of Nepeta Hindustana, Vitex Negundo, And Argemone Albeflora
Against Multiple Sclerosis

Dr. Inamullah, IMBB, UOL

ABSTRACT
Background: Multiple sclerosis is a chronic autoimmune neurological disorder that leads to
demyelination of nerves, which is the major cause of non-traumatic disability all around the world.
Herbal plants Nepeta Hindustana, Vitex Negundo and Argemone Albeflora, in addition to anti-
inflammatory and anti-oxidative effects, have shown a great potential as neuroprotective agents. Aim
And Objectives: The study was aimed to develop neuroprotective model and find the effectiveness
of herbal plants (Nepeta Hindustana, Vitex Negundo and Argemone Albeflora) against multiple
sclerosis. Materials And Methods: The research was aim to evaluate the in vivo neuroprotective
effects of Nepeta Hindustana, Vitex Negundo and Argemone Albeflora (ethanolic extract) in
Lipopolysaccharides induced multiple sclerosis rat model. Histopathological evaluation and
biochemical markers including circulatory stress and inflammatory (MMP-6, MDA, TNF-α, AOPPs,
AGEs, iNOS, OxLDL, NO, IL-17 AND IL-2), antioxidant (SOD, GSH, CAT, GPx), DNA damage
(Isop-2α, 8OHdG) as well as molecular biomarkers (RAGE, Caspase-8, p38, GSKβ and AKT) were
investigated. GraphPad Prism and SPSS version 21 was used for data analysis. Results: The different
extract treated groups (C,D,E,F,G) shows a substantial neuroprotective effect regarding
remyelination of axonal terminals, oligodendrocytes migration, reduced lymphocytic infiltrations
and reduced necrosis of Purkinje cells. The stress, inflammatory and DNA damage markers were
presented to be raised in diseased group B while the treatment groups, reported noteworthy improved
outcomes. While the antioxidant activity that was significantly reduced in group B was revealed to
be upgraded in treatment groups. However, group F (melange of all the extracts) most significantly
ameliorated the results. Conclusion: The present study concluded that all three plant (Nepeta
Hindustana, Vitex Negundo and Argemone Albeflora) seems to exhibit remyelination as well as
neuroprotective consequences and may be used as a potential natural neuro-therapeutic agent against
multiple sclerosis.

76
 Association Between Serum Phosphate And Calcium Level With Parathyroid Hormone In
Chronic Kidney Disease Patients

Iqra Munir*
University Institute of Medical Laboratory Technology, Faculty of Allied Health Sciences, The
University of Lahore.

ABSTRACT

Background: In chronic kidney disease, due to kidney damage blood does not properly filter through
kidneys resulting in the accumulation of waste material from blood in the body. Overtime CKD
mostly gets worse and progress to kidney failure. Parathyroid hormone is responsible for regulating
phosphate levels in the blood. A recurrent complication of CKD is hyperparathyroidism that occurs
in the initial stages of renal inadequacy. PTH level elevates to abnormal ranges in CKD due to
continuous reduction in kidney function, so that it cannot maintain mineral levels and results in
different complications. Objective: The objective of this study was to evaluate the association
between serum phosphate and calcium levels with parathyroid hormone in chronic kidney disease
patients. Methodology: In this study, the association between serum phosphate levels and
parathyroid hormone in chronic kidney disease patients was studied. Blood samples from 121 CKD
patients were collected and the samples were used for automated estimation of serum urea, creatinine,
phosphate, calcium and parathyroid hormone (PTH). Results: It was observed that out of 121 CKD
patients, 72 (59.5%) were males and 49 (40.5%) were females. However, when phosphate levels
were estimated among study population, it was observed that only 31 patients (25.6%) had normal
phosphate levels while 90 patients (74.3%) had elevated phosphate levels. Low calcium levels were
found among 92 patients and normal among 21 whereas, elevated among 3 patients out of 121
participants of the study. The analysis of parathyroid hormone (PTH) levels showed that only 2
patients (1.65%) had normal parathyroid hormone levels while 119 patients (98.3%) had elevated
parathyroid hormone levels. When the association between phosphate and calcium with parathyroid
hormone level was tested by using statistical method, it was found that there was no significant
statistical association between serum phosphate and parathyroid hormone (p > 0.05). However,
serum calcium and parathyroid hormone was found highly associated with each other (p < 0.01).
Conclusion: CKD prevalence in the tested population was found higher in males as compared to
females. In majority of the patients, high phosphate and low calcium levels were observed. However,
the patients had elevated parathyroid hormone levels. Serum calcium and parathyroid hormone was
found statistically associated with each other.
Keywords: CKD, Phosphate, Parathyroid hormone, Kidney disorder, Dialysis, Renal disorder

77
 Hla Linkages And Immunogenetic Features In Individuals With Sle From Pakistan
Dr. Nageen Hussain
IMMG, PU-LHR
ABSTRACT:

Systemic Lupus Erythematosus (SLE) is a complex cascade of autoantibodies, soluble

inflammatory mediators and of immunoglobulins. It is proved to be fatal when overlapped with
various syndromes or when multiple organs of the body get involved. The differences in the clinical
presentation and autoantibody profile of lupus patients were due to genetic differences. In this study,
ACE I/D Polymorphism, novel genetic variations in FoxP3 and IL-22 genes were found to be actively
in the progression of this disease, however, CTLA-4 gene was not found to be involved. Twenty-two
HLA alleles at A, 37 alleles at locus B and 17 alleles at locus DRB1 were studied. Major
Histocompatiability Complex (MHC) genes (HLA-A*01 , -A*03 , -A*11, -A*23, -A*26, -A*69,,
HLA-B*27, -B*40, -B*49, -B*51, -B*52, -B*53, -B*54, B*95,HLA-DRBI*01, -DRBI*03, -
DRBI*11, -DRBI*14, -DRBI*16) were identified to be involved in the development of SLE.

Keywords: Systemic Lupus Erythematosus, autoantibodies, Angiotensin Converting Enzyme,

Major Histocompatiability Complex, Cytotoxic T lymphocyte Antigen-4

78
 Genetic Analysis Of P53 And Hepatitis C Virus Induced Hepatocellular Carcinoma

Sajjad Ullah and Ahmed Bilal Waqar

ABSTRACT

Background: The p53 gene guards the genome by suppressing the tumor formation yet it is
comparatively more prone to point mutations resulting in its impaired function that leads to cancer.
Keeping in view the importance of elucidating the exogenous and as well as endogenous mutational
mechanisms, the current study was aimed to analyze the expression of VEGF and TGF-β IN HCC
patients for establishing a biomarker panel for early diagnosis and timely treatment. Methods:
Briefly, blood samples from patients were first subjected to third-generation sandwich enzyme-
linked immunosorbent assay (ELISA) for the serologic detection of HBV and HCV infection. To
analyze the level of gene expression of target genes (p53, VEGF and TGF-β) the extracted RNA
from the confirmed samples was reverse transcribed and amplified via real time PCR. It was found
that the level of VEGF and TGF- β was higher when compared to that of HCV. Results: Single
strand conformation polymorphism and direct sequencing were employed to find mutations in exons
4–9 of the p53 gene where two mutations were revealed. First mutation at codon 249 showing G→T
transversions that led to change amino acid arginine to serine and the second mutation at codon 250
with a C→T transition led to change amino acid proline to serine. Conclusion: It was concluded that
the level of VEGF and TGF-β together with mutation polymorphism of p53 exons found can serve
the purpose of biomarker that can be applied to stop the HCV progression to HCC.

79
 Therapy And Management Of Diabetes Mellitus In Pakistan
Dr. Samreen Riaz

1
Institue of Microbiology and Molecular Genetics, University of the Punjab, Lahore. Pakistan.
2
Pakistan Academy of Family Physician of Pakistan.

ABSTRACT
Diabetes Mellitus is one of the most widely and deadly ailment in current era. Type 2 Diabetes (T2D)
is a complex, heterogeneous disease characterized by defect in insulin resistance and pancreatic β-
cells dysfunction. Pancreatic β-cells are responsible for insulin secretion and control of
plasma glucose levels. Pancreatic β-cells dysfunction is considered as a main contributor to the
development and progression of type 2 diabetes resulting from genetic and acquired factors. A
number of gene variants have been associated with β-cell dysfunction. The purpose of this study is
to analyze the diabetogenic factors affecting individuals with diabetes. More than 1000 people will
be chosen, around half of them would be diabetic patients and the rest will be non-diabetic. Samples
and data will be collected using a standardized questionnaire after getting approval of patients being
interviewed. SPSS 32.0 will be utilized for analysis. Genomic and proteomic analysis will be
performed by using techniques mentioned in methodology section. To determine the relationship
between patients with diabetes and diabetogenic agents, the Chi-Square test and Mann-Whitney test
will be used to compare the effects of age, BMI, and sugar level fasting. Other factors like Stroke,
TIA, hypertension, and NAFLD will also be considered as contributing factors.
Key Words: Diabetes1 and 2, therapy, management, Pandemic, Pakistan

80
Genomics and proteomics analysis of brevibacterium sp. Strain cs2: a potential candidate for
arsenic bioremediation
Shahid Sheer

ABSTRACT
Arsenic is a ubiquitous metalloid with high toxicity, which pollute the environments. So, there is a
need of arsenic detoxification. Genomics and proteomic analysis of Brevibacterium sp. strain CS2
with MIC of (As+3 (40), As+5 (280)) was carried out through illumina, oxford nanopore and SDS
techniques respectively. Gene cluster of (9.6 KB) was found in the bacterium through illumina
sequencing. The genomic DNA from Bacterium was digested with Sau3A restriction enzyme and
the fragment was cloned in puC19 vector and electroporated in E. coli. Transcriptomic analysis of
aioB gene was carried out through RT-PCR. There was no significant size alternation in the presence
and absence of arsenite through Scanning electron microscopy (SEM) along with Energy Dispersive
X-ray (EDX). Shifting and sharping of peaks were observed under FTIR analysis, which could be
assigned to many functional groups that could be able to absorb and accumulate arsenic in the cell.
In the isolated bacterium, it was found that the proteins of 100, 48, 42, 37, 32, 30 and 25kDa were
expressed more in arsenic treated samples compared to the untreated sample. With the arsenic
bioremediation ability, the organism can be a good bioresource for green chemistry to eradicate
environmental arsenite.

81
 Cadmium Resistance Mechanism In Escherichia Coli P4 And Its Potential Use To
Bioremediate Environmental Cadmium
Dr. Zaman

ABSTRACT
A cadmium-resistant bacterium was isolated from industrial wastewater and identified as
Escherichia coli (dubbed as P4) on the basis of morphological, biochemical tests and 16S rRNA
ribotyping. It showed optimum growth at 30 °C and pH 7. E. coli P4 found to resist Cd+2 (10.6 mM)
as well as Zn+2 (4.4mM), Pb+2 (17mM), Cu+2 (3.5mM), Cr+6 (4.4 mM), As+2 (10.6 mM), and Hg+2
(0.53 mM). It could remove 18.8, 37, and 56 % Cd+2 from aqueous medium after 48, 96, and 144 h,
respectively. Fourier transform infrared spectroscopy (FTIR), scanning electron microscope (SEM),
and Energy-dispersive X-ray (EDX) analysis also confirmed the biosorption of Cd+2 by E. coli P4.
However, temperature and pH were found to be the most critical factors in biosorption of Cd+2 by E.
coli P4. Cd+2 stress altered E. coli P4 cell physiology analyzed by measuring glutathione (GSH) and
non-protein thiol (cysteine) levels which were increased up to 130 and 48%, respectively.
Quantitative real-time polymerase chain reaction (qRT-PCR) showed alteration in the expression
levels of ftsZ, mutS, clpB, ef-tu, and dnaK genes in the presence of Cd+2. Total protein profiles of E.
coli P4 in the absence and presence of Cd+2 were compared by sodium dodecyl sulfate
polyacrylamide gel electrophoresis (SDSPAGE), which showed remarkable difference in the
banding pattern. czcB gene, a component of czcCBA operon, was amplified from genomic DNA
which suggested the chromosomal-borne Cd+2 resistance in E. coli P4. Furthermore, it harbors
smtAB gene which plays a significant role in Cd+2 resistance.

82
 Presenters
Extraction Of Membrane-Bound Proteins Of Mycoplasma Synoviae For Diagnostics

Shazma liaqat
University of Karachi

ABSTRACT:
"Mycoplasmosis" is an infection that commonly prevails in birds, particularly in poultry chickens.
Mycoplasma gallisepticum and Mycoplasma synoviae are predominant and the most lethal pathogens
to the aves. M. gallisepticum infection severely affects the lungs of birds which leads to chronic
respiratory disorder while M. synoviae causes synovitis, arthritis, and less frequent pulmonary
infection in birds. Infected poultry if consumed by humans could have some drastic effects on their
health. These infections are not only lethal for fowls but they also badly affect the economy by
reducing egg production and by inducing higher rates of embryonic and chick death. It has also been
reported that these microbes have evolved to a level now that their host reservoirs now encompass
house finches, house sparrows, wild house sparrows, pigeons, corvid species, and turkeys.
Considering the increased incidence of infections by these bacteria and their suspected ability to
infect humans because of their ability to quickly mutate their genome, in this study, the prevalence
of Mycoplasma synoviae was deduced in poultry samples. Timely diagnosis of these bacteria could
help to prevent them from entering food chain. The infected bird tissue samples were collected and
investigated for infection by culturing in PPLO broth supplemented with serum and biochemical
analysis. Furthermore, the 16S rRNA gene from suspected samples was isolated, amplified by PCR,
and visualized by performing agarose gel electrophoresis. The results showed a considerable
incidence of these bacteria in birds and for the development of new diagnostic tools membrane-
bound proteins were extracted by hydrophobic extraction protocol which needs further investigation
to determine their role in virulence.

KEYWORDS:
Mycoplasma gallicepticum, Mycoplasma synoviae, PCR, Mycoplasmosis

83
Detection And Quantification Of Bacterial Contamination Using Rapid Pcr Method
Muhammad Waseem

Institute of Microbiology and Molecular Genetics, University of the Punjab Lahore

ABSTRACT
Enterobacteriaceae is group of microorganism having a big family of those bacterial species
which are gram negative and mostly found weak in capability of spore forming rods. The
anaerobes with facultative property retain capacity of fermenting sugars to numerous resulting
materials. The particularly bacterial strains were selected for sterility testing to evaluate the
minimum number of bacteria in product. Reason to select these bacterial strains, they are found
mostly in medicinal and food products as contaminated agents. Strains collection was done
from different hospital. Bacterial confirmation was processed by biochemical testing to specify
bacteria strains; leading to molecular characterization was performed by kit-method, rapid heat
shock method to evaluate the bacterial analysis. 16s-rDNA primer was used to process PCR at
specific amplification temperature. Serial dilution was also performed to check the sterility
testing for bacteria. PCR reaction was done for specific selected dilution tubes and bands were
observed under UV illuminator. In second phase bacterial growth curve was also identified after
taking an OD (optical density) after every hour periodically till 24 hours. Bacterial growth curve
was constructed for all selected bacteria and curve was designed by using statistical analysis
software Excel, SPSS and R-programming. This molecular method would be advantage to
reduce time, chances of contamination being molecular method while giving fewer chances of
false negative and false positive results and cost of sterility testing as it was taking more than a
week before for confirmation. This method would also assist to detect qualitative and
quantitative results in time. In molecular sterility testing technique a very low amount of
contaminated microorganism can be detected.
Key words: Sterility, Polymerase chain reaction, Molecular, Contamination, Microorganisms

84
 Analysis Of Single Nucleotide Polymorphisms Of Clock Gene Associated With
Cardiovascular Disorders

Yumna Matanat, Dr. Ammara Khalid, Fareeha Tariq, Dr. Warda Fatima
Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore.

ABSTRACT
Introduction: Circadian rhythms, regulated by the circadian clock, monitor the internal physiological
metabolism, and thus contribute to the pathology of various disorders. Cardiovascular disorders
(CVDs), that are responsible for 31% annual deaths globally, exhibit a marked disruption of circadian
clock in their etiology. Materials and Methods: This study included a total of 260 samples, 131 of
which were procured from CVD patients, and 129 were samples from healthy individuals as controls.
Demographic data was collected in order to assess the correlations between the environment and
CVD progression. Following DNA extraction and amplification, protein structures of six exonic
variants of the CLOCK gene, created in silico, were then superimposed with the structure of a
mutated protein. Results: The results of superimposition revealed that accumulation of SNPs in the
CLOCK gene is associated with significant changes in their protein products. Statistical analysis
showed considerable association between demographic characteristics and clinical parameters of
CVD, such as blood pressure and cholesterol, BMI and cholesterol, and BMI and blood glucose
concentrations. Conclusion: SNPs of the circadian CLOCK gene are valuable in assessment and
management of risk, as well as the evaluation of therapy for CVDs. Since circadian rhythms are
essential for energy balance at both cellular and organismic level, it is important to promote a better
understanding cardiovascular health. Furthermore, the genetic background of circadian rhythms and
their disruption can provide insights for better management and treatment, provided an extensive
study be carried out about the epidemiological relations of CLOCK gene and CVD with hypertension,
diabetes, obesity and other complications. Formulation of a potent preventive strategy for the
increasing incidence of CVDs is another necessity in this era of personalized medicine.

85
Virology And Immunological Implications Of Lumpy Skin Disease Virus (Lsdv) Outbreak In
Pakistan

Muhammad Zubair Yousaf, KAM, School of Life Sciences, Forman Christian College
University, Lahore, Pakistan

ABSTRACT

Lumpy skin disease virus (LSDV) of the Poxviridae family infects cattle. The disease is characterized
by skin nodules covering all parts of the body. There are many aspects of LSD remaining unknown
till date. LSD has broken out in Pakistan during February 2022 posing serious threat to cattle industry
months ahead of Eid-ul-Adha (Muslim festival of sacrificing animals) where trading of cattle is a
huge business activity. The current study was designed to diagnose LSDV in infected cattle at
molecular level and to check whether the available imported vaccine protected animals from the
disease or not. We concluded that the animals were infected by LSDV based on polymerase chain
reaction (PCR) amplification of P-32 gene resulted in 200 bp size band of capricivirus identification.
Further molecular identification of ORF of 650 bp gene fragment confirmed that it was the first ever
spread of LSDV in this country. Lastly, the available imported vaccine/s were failed to protect against
LSDV as almost all non-infected animals developed the infection even days and weeks after the
vaccination. It is therefore believed that the morbid animals survived due to natural protection after
the being infected. Whole genome sequencing of the pathogen is needed to further confirm the LSDV
strain and then a proper vaccine should be administered. Elucidation of transmission among animals
and from one area to the other is necessary to curtail LSD. In addition, regular surveillance at farm
as well as province level is recommended to prevent future outcomes.

86
 Association Of Disc1 Polymorphisms With Schizophrenia

Warda Fatima, Ammara Khalid, Khansa binte Afzal, Shahida Hasnain

ABSTRACT
Schizophrenia is a stressful, chronic and in many cases incorrigible psychological disorder. Till now
no biomarker is available for diagnosis of this condition and diagnosis is done purely on psychiatric
bases. A strong genetic association of human genome region 1q24.1 is implicated with onset of
schizophrenia in many studies. Present study is first from Pakistan to report effect of this locus in
transmission and liaison of schizophrenia in Pakistani population. For this analysis 300 samples were
genotyped of four SNPs, rs1417584, rs1954175, rs821616 and rs113012343 that were selected on
basis of minor allele frequency and effects on schizophrenia. Haplotype and transmission
disequilibrium analysis was also performed on data. Association of SNPs revealed a significant
relation between MAF of rs1417584 and schizophrenia in given samples (χ2 5.57; p 0.02). Haplotype
association led to formation of three significant blocks TCAG (OR 20.06), TTAG (OR 4.65) and
CCTG (OR 26.17) for rs1417584, rs1954175, rs821616 and rs113012343 that were expected to cause
schizophrenia in said combinations. rs1417584, rs1954175 and rs821616 were found to be in a
linkage block based on D` value (p <0.0001) with 22% co inheritance alongside disease onset. This
block was represented by 325kb on chromosome 1. It is concluded from this study that this 325Kb
region can be considered prognostic marker for schizophrenia development in Pakistani population.

87
 Admittance to understanding in the dementia
Of huntington's disease

1Mesam Hamad, 2Muhammad Ajmal Hameed, 3Muhammad Saad, 4Fazal Rahim, 5Baber Ali,
6Moumin Khalid

1, 2, 3,4,5,6
Institute Of Microbiology and Molecular Genetics, University of the Punjab-Lahore.

ABSTRACT
Patients with Huntington's disease (HD) and matched typical controls attempted to remember objects
of general information, made "feeling‐of‐knowing" decisions about unrecalled contraptions, and
endeavoured to figure out precise arrangements. The HD patients had weakened memory, but they
have been basically as skilled as normal in perceiving what they couldn't consider. Moreover, they
had been all around as precise as normal in foreseeing whether they might catch unrecalled
information. In contrast to normal, however, the HD patients didn't invest more energy attempting to
find texture they accepted. They were most likely to recollect than the material they accepted they
have won't remember. The results recommend that the dementia of HD incorporates a problem inside
the oversee memory methodologies that immediate recovery endeavours.
Keywords: Huntington's disease, dementia, memory, recall

88
 Clinico Hematological And Morphological Characteristics Of Aml Patients With Runx1/
Runx1t1 Gene Rearrangement

Muhammad AbuBakar

ABSTRACT

Objectives: To determine the frequency of RUNX1/RUNX1T1 gene rearrangement in AML patients

by
Polymerase Chain Reaction and analyze their clinical, hematological, and morphological features of
these positive patients. Study designs: Descriptive cross-sectional study. Patients and methods:
All newly diagnosed patients with Acute Myeloid Leukemia were included in the study. 101 AML
cases were calculated from the WHO formula. Sysmex Hematology Analyzer XP-100 performed a
complete blood picture of these positive patients. Molecular analysis was carried out by reverse
transcriptase-polymerase chain reaction. Results: A total of 101 AML cases were enrolled.
12(11.9%) were found positive for this specific recurrent RUNX1/RUNX1T1 gene rearrangement.
9(75%) were males, while 3(25%) were females. The mean age was 42 years. The most common
clinical feature was pallor. The Average count of haemoglobin, platelets, and total leukocyte count
were 8g/dl, 41.5×109/L, and 71.4×109/L, respectively. Bone marrow aspiration showed
erythropoiesis, thrombopoiesis, and myelopoiesis depressed in all positive cases of AML-M2. The
Mean blast percentage of AMLM2 was 58%. Auer rods were also found in these positive patients.

Conclusion:
Identifying this fusion protein in AML patients with AML-M2 FAB subtype is valuable because it
has prognostic and therapeutic significance.

89
 Comparison of pre-transfusion and posttransfusion
Haemoglobin level in pregnant ladies in a public
Health care facility

MARWAH SHAHID

ABSTRACT

Transfusion is a lifesaving procedure for a number of health-related issues, surgeries, deliveries, C

sections. Iron deficiency anaemia is the most common type of anaemia especially in females.
Undiagnosed or untreated iron-deficiency anaemia may cause serious complications as fatigue,
headache, restless legs syndrome, heart problems, pregnancy complications and developmental
delays in children. The best way to cure anaemia these days is transfusion. Transfusion helps improve
anaemia by maintaining haemoglobin level in the blood. Iron deficiency is recognized as a common
nutritional deficiency amongst women of childbearing age in both the developed and developing
world. Peri-partum iron deficiency anaemia (IDA) is associated with significant maternal, fetal and
infant morbidity. To compare pre-transfusion and post-transfusion haemoglobin level in pregnant
ladies the research was conducted at 91 pregnant ladies from gynaecology ward at Rashid Latif
Medical College, Lahore and Pathology laboratory
of Arif Memorial Teaching Hospital, Lahore from August 2021 to January 2022. The haematological
parameters were measured using automated haematology analyzer. Comparison of pre-transfusion
and post transfusion haemoglobin, pRBCs, MCV, MCH, MCHC, PCV of pregnant ladies has been
done to evaluate the effectiveness of transfusion process to compensate decreased level of
haemoglobin at the time of delivery. The mean increase of 1.19 in haemoglobin, 0.36 in pRBCs, 1.9
in MCV, 1.21 in MCH, 1.08 in MCHC, 0.89 in PCV was recorded. The results demonstrated a
significant rise in haemoglobin after transfusion, proving transfusion a good option for treating
anaemia in Pregnant women due to blood loss at the time of delivery.

90
 Naturally Occurring Phytochemical Baicalein As Potential Drug For Hepatitis C Treatment

Ramsha Ahmed, Arwa Ramzan, Ammara Khalid, Warda Fatima.

Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore,
Pakistan.

ABSTRACT

Background: Non-structural 5b (NS5b) protein is a RNA dependent RNA polymerase found in

hepatitis C virus (HCV) which has been widely used for designing anti-HCV agents. The present
study was designed to find out naturally occurring anti-HCV phytochemical compound for low cost
potential drug designing against HCV NS5b gene in low income countries. Methods: For this
purpose, procedures for in silico drug designing were performed and a total of 46 phytochemicals
taken from Dr Duke’s website were extracted and different software and filters like PubChem, Swiss
ADME, Lipinski rule of five, BBB permeability and TPSA were applied for determination of
ADMET properties of the drug candidates. After applying filters, molecular docking analysis of
NS5B protein with 14 medicinal phytochemicals was performed using Autodock vina and the results
were obtained in the form of binding affinities of the ligands with the target protein at nine different
junctions. Docking results were visualised as the binding sites in cartoon format using PyMOL
visualization graphic system. The compound with highest binding and best interactions were
identified. Results: After final screening and molecular docking, 14 phytochemicals out of 46
phytochemicals which were able to pass through all the filters had the binding energies (Kcal/mol)
as -7.3 for epicatechin, -5 for arginine, -7.6 for catechin, -5.8 for glutathione, -6.2 for caffeic acid, -
9.1 for baicalein, -5.3 for citrulline, -7.3 for curcumin, -8.2 for galbanic acid, -7.8 for
andrographolide, -8.1 for cleomiscosin-A, -7.4 for carnosolic acid, -4.8 for alliin and -6.8 for 3-
deoxysilychristin. The phytochemical with best binding energy i.e; the lowest binding energy was
selected for lead potential compound against HCV replication. Conclusion: Our results concluded
that the phytochemical Bicalein had strongest binding affinity (binding energy= 9.1 Kcal/mol) with
HCV NS5B polymerase and could be used as strong drug candidate for HCV NS5B polymerase.
Further research should be performed inet labs to find out it’s hidden potentials.

91
 Department of Sports Sciences & Physical Education

This conference is an endeavor to bring the leading academics, sportsmen,

coaches, teachers, psychologists, graduate and undergraduate students in the field of sport sciences
and physical education together with government and non-government organizations to share and
discuss both theoretical and practical knowledge about Sports Sciences and Physical Education. The
two-day Conference and one day workshop will provide the opportunity to the participants to learn
about the latest trends and best practices with biomechanics of sports in the world of Sport Sciences.
Leading academicians and sports scientists, researchers and research scholars will attend to exchange
and share their experiences and research results on all aspects of Sport Sciences & Physical
Education. We encourage research papers and presentations based on integrating different disciplines
applied in Sport Sciences to be submitted in the conference.

92
 International Speakers
Sport Disabilities As Social Construct
Joel Gaillard
Faculty of Sport Sciences, University of Lorraine, France

ABSTRACT
Most of these definitions’ present disability as the relationship or interaction between the person with
a disability and the barriers in the environment that do not allow the participation in relation to the
living conditions living conditions: health, work, education, working life and, in our specific case,
sport. The definitions of disability state that there are two clearly individualized currents: the
"medical" current, which defines disability as the consequence of a pathological condition (illness or
accident), and the "anthropological" and, more globally, social current, which considers disability to
be the result of a human being's confrontation with his or her abilities and his or her environment
with its requirements. In total, this can be summarized as follows: 1. It is the pathological bodily
injury (or impairment) that makes people disabled. 2. It is society and the living environment that
create situations of disability. In agreement with Alveiro Sánchez Jiménez (2013) it is evident that
the main dynamics of sport development for people with disabilities are economic resources, sport
facilities and interdisciplinarity. For resistance, it appears that the living conditions of disabled
sportspeople are not adequate: social security, academic level of training, employment conditions
and training and competition conditions.

93
 Sport Psychology, A Discipline With An Inclusive Approach
Marta Canizares Hernandez
Director of the Center for the Study of Psychology of Physical Activity and Sports, Manuel Fajardo
University, Havana, Cuba.

ABSTRACT
Sports Psychology is one of the various branches of psychological science that studies the
practitioner's mind of physical activity and sports and has different tasks, methods, and actions to
help raise their psychological performance. Its antecedents date back to the precursors of this science
who investigated in laboratories in Leipzig, Germany since 1879, the United States, Spain, and
Russia. In Cuba since 1964 with the former Soviet Union (USSR) contribution. The main objective
of this work is to assess the importance of sports psychology and physical activity as an important
discipline in sports science, with an inclusive approach. The methodology used is predominantly
qualitative that uses analysis, synthesis, interviews, and case studies. Results are obtained as, the
analysis of the role of the psychological preparation of athletes in raising psychological performance,
self-confidence, and self-esteem is obtained, as well as the need for governments to support the
inclusiveness of women in sports for their social empowerment. In addition, the results highlight the
role of Psychology as a discipline that uses the diagnosis of psychological processes such as attention,
memory, thought, reaction speed, will, and personality characteristics, among others, that contribute
to the knowledge of the state and manifestation of these in the athlete to be able to carry out an
adequate mental control. In addition, the use of methods such as relaxation, breathing, visualization,
educational talks, and orientation programs help understand sport as a tool to promote social cohesion
and inclusion in society through participation in physical and recreational activities and sports.
Experiences of Cuba's support in the development and possibilities of sport for all, in the
empowerment of women in sport, girls, and the disabled are exposed. Conclusions: It is remarkable
the importance of Psychology as a discipline applied to sports and physical activity to promote
psychological well-being and social inclusion.
Keywords: interdisciplinarity, inclusive development, sports psychology, psychological processes.

94
 Physical Activity For Prevention And During Treatment Of Breast Cancer
Maryam Koushkie Jahromi
Department of Sport Sciences, Shiraz University, Iran

ABSTRACT
Breast cancer is the most prevalent malignancy and the second leading cause of cancer death in
women in the world. Some evidence supports a probable preventive or complementary treatment role
for physical activity in breast cancer. However, the clear physiological mechanisms related to the
effect of physical activity on breast cancer is not clear now. Among several proposed mechanisms,
inflammation and angiogenesis are two different processes that their role has been challenging in the
effect of exercise on breast cancer prevention or treatment. The aims of this review were to propose
a biological model whereby physical activity prevent or reduce breast cancer risk and symptoms and
to discuss lacks or limitations in the available literature. For this purpose, the general preventive and
reducing effect of exercise will be discussed and inflammatory, immunologic, and genetic related
factors will be presented. The most convincing epidemiologic evidence supported associations
between breast cancer risk and inflammatory or immunologic factors. Breast cancer enhancing
situations such as obesity, inactivity, radiation or some disease can increase the risk of breast cancer
through increasing inflammatory factors. However, studies investigating the effects of physical
training in women with breast cancer are still limited, and the physiological mechanisms of the effect
of exercise on prevention and complementary treatment of breast cancer is not clear completely.
Some recently proposed mechanisms related to physical activity and recommendations for
prevention or treatment of breast cancer will be presented.
\

95
 Development And Validation Of A Multidimensional Measure Of Religious Faith In Sport:
The Athletic Religious Faith Scale
Young-Eun Noh
Faculty of Sports and Exercise Science, University of Malaya, Kuala Lumpur, Malaysia

ABSTRACT
The Athletic Religious Faith Scale (ARFS) is an instrument measuring religious faith in a sporting
context. Two studies were conducted to develop and validate the ARFS. Study 1 identified the
relevance of the domains through the religion and sport performance (RSP) model and systematic
review. The preliminary data consisted of 55 items to represent eight key domains (i.e., coping
strategies, religious support, psychological effects, performance outcomes, religious dietary
practices, mental health and healing, identity, and flow). A panel of seven experts assessed the
consistency, representativeness, relevance, and clarity of each item. After reviewing the feedback
obtained from a panel of seven experts, a total of 51 items within eight domains remained. A pilot
study was conducted with 40 participants to provide further reliability for the scale. The average
Scale Content Validity Index scores for consistency, representativeness, relevance and clarity were
slightly higher than the initial values, at .89, .91, .89 and .95, respectively. The second version of the
ARFS showed that the reliability value of all the domains ranged from .88 to .96 following a pilot
study. Study 2 validated the ARFS using exploratory factor analysis and confirmatory factor analysis
to reach a final version of the scale. From the exploratory factor analysis, seven domains were
reclassified. A total of 11 items were eliminated due to cross-loading variables or low factor loadings.
As a result, a total of 40 items were retained with seven domains. The seven domains were religious
coping (9 items), religious dietary (7 items), religious mental healing (6 items), dependence on faith
(5 items), religious psychological effects (5 items), athletic identity (4 items), and flow (4 items).
From the confirmatory factor analysis, all factor loadings of the construct were over 0.5, the
composite reliability ranged from 0.877 to 0.937 whereas Cronbach’s alpha values were between
0.814 and 0.921, which indicated adequate reliability for all the ARFS domains. The average
variance extracted (AVE) values were over 0.5, which showed the convergent validity of all the
constructs was established. In addition, the discriminant validity (HTMT) was also less than .90,
which indicated that there was sufficient discriminant validity for the domains. This new scale, the
ARFS, can mainly be used for two purposes. First, the scale will allow researchers and/or sport
psychologists to quantitatively assess research hypotheses. Second, the scale will help
researchers/sport psychologists to design intervention programmes to enhance sport performance by
using a validated measure.

96
The Growth And Development Of Sports Sciences: From 'Baby-Steps’ To Mature Impactful
Ian Whyte
International Network of Sport and Health Sciences, University of Sunderland, England

ABSTRACT
Sports sciences is still in its early infancy as an academic discipline and, concomitantly, as a
profession. As such, in many parts of the world sports scientists experience difficulties when seeking
employment in their chosen field. This is despite the fact that recruitment in sports sciences courses,
and their off-shoots, is strong, and courses in general are academically rigorous. There are many
reasons for this situation but I think that they can be distilled into three distinct categories. First, there
is a lack of understanding by employers about course content, course quality, and relevance to their
operation. Secondly, there are few recognised professional bodies to promote and regulate the
profession, therefore, leading to a lack of awareness and trust. Finally, for many years there has been
a protective shield around sport sciences, with many of those in positions of responsibility (e.g.
academics, policy makers, and practitioners alike) maintaining their status quo to the detriment of
their students and the profession. This paper intends to trace the history of sports sciences, identify
some of the key milestones along its developmental pathway, state where mistakes may have been
made, and make recommendations to help the future of the profession, and in particular its graduates.
Keywords: Sports science professional, education, vocational training, exercise, health and fitness.

97
 National Speakers
Frequency Of Physical Activity In Acute Or Chronic Smoker Among General Population Of
Karachi: A Cross-Sectional Study
Basit Ansari1, Fawad Qazi2
1
Health and physical education and sports science, University of Karachi, Karachi, Pakistan.
2
Sindh institute of physical medicine and rehabilitation, Karachi, Pakistan.

ABSTRACT
Objective: The objective of the study is to determine the frequency of physical activity in acute or
chronic smoker among general population of Karachi. Introduction: Smoking and physical activity
are two major factors which affect health of individual. Not only these factors have a causal effect
on non-communicable diseases but they can also affect each other. Smoking cause decline in bodily
function so the physical inactivity. The aim of this study is to appraise the frequency of physical
activity among smoker. Method and material: A total of (n=316) healthy adults aged 15-69 years
participated in this survey in 2020. Data on demographic characteristics, smoking status, physical
activity were collected and analyzed. The effect of smoking on physical activity was evaluated by
statistical package for the social sciences 0.22 Result: This study concluded that, out of (n=316)
participants, 243(76.9%) participants having job with frequency of low physical activity is
114(36.1%), moderate physical activity is 24(7.6%) and vigorous physical activity is 105(33.2%).
Almost all participants is using transport with frequency of low physical activity is 189(59.8%),
moderate physical activity is 80(25.3%) and vigorous physical activity is 47(14.9%). Participants
involve in housework, house maintenance and caring for family related physical activity with
frequency of low physical activity is 210(66.5%), moderate physical activity is 76(24.1%) and
vigorous physical activity is 30(9.1%). Participants involve in housework, House maintenance and
caring for family related physical activity with frequency of low physical activity is 218(69.0%),
moderate physical activity is 46(14.6%) and vigorous physical activity is 52(16.5%). Conclusion:
The present study showed that among cigarette smoker’s the frequency of physical activity is
extremely low.
Keywords: Smoking, Physical activity, MET

98
 Prevalence of sleep problems and sleep quality differs between university student-athletes
and non-athletes
Asif ali, mahpara
Department of Physical Education & sports Science, Government College University, Lahore,
Pakistan.

ABSTRACT
Sports participation and involvement in physical activities has been found to be associated with
numerous psycho-physical health outcomes and sleep. The purpose of this study was to demonstrate
that whether the university student-athletes were significantly differs with respect to sleep problems
and sleep quality than that of non-athletes or not. The participants were 378 (ages ranged from 18-
30 years) university students that were classified in to student-athletes (n=174) and non-athletes
(n=204), respectively. The data was collected using cross-sectional research design from five
universities using PSQI, questions concerning demographic information and level of physical
activity measures. The analysis yielded that sleep quality was significantly better and sleep problems
in the sleep parameters of subjective sleep quality, sleep latency, daytime dysfunction, habitual sleep
efficiency, and sleep duration were significantly fewer in student-athletes compared with non-
athletes. The percentage of good sleepers (PSQI global score equal to or less than 5) was significantly
greater in student-athletes group than those of non-student respondents. Regardless the group
conditions, in general, the prevalence of sleep problems were dangerously higher in university
students. The findings suggest that should be encouraged to participate in sports and exercise
programs to improve sleep health in university students. In addition to these, considering the serious
concern of sleep health, policy makers need to introduce interventional strategies to reduce sleep
problems and improve sleep health among university students.
Keywords: sleep, student-athletes, university

99
 Perception Of University Students Towards Human Psychological Development
Through Sports Participation
Shahzaman Khan, Nisar Ahmed Khaskheli, Muhammad Hashim Darya
Department of Physical Education & Sports Sciences, Sukkur IBA University, Sindh, Pakistan.

ABSTRACT
The existing study was conducted to evaluate the perception of university students toward human
psychological development through sports participation. The foremost objective of this research was
to assess the attitude of student-players toward the ultimate impacts of participation in sports from
the perspective of human psychological development. The research was conducted on the male &
female players of Shah Abdul Latif University Khairpur (SALU) who must have at least participated
in the All-Pakistan Intervarsity Sports to reach the study’s findings. The research was quantitative
and the data was collected through a self-administered survey questionnaire. The collected data was
analyzed through the SPSS version 22 and the frequency and percentage were computed to scrutinize
the data and to reach the findings of the study. Results showed that most of the respondents had
positive perceptions of human psychological development through sports participation. Thus, the
research’s objective was achieved and the set hypotheses proved to be correct. This study
recommends creating an effective and attractive environment for teenagers, and youths at Schools
colleges, universities, and local and community levels to ensure the maximum possible participation
so that the psychological problems be avoided.
Keywords: Students’ Perception, Sports-participation, Psychological-development

100
 The Impact Of Aerobic Training On The Performance Of Track &Amp; Field (Distance)
Runners
Shabbir Anjam, Muhammad Farhan Tabassum
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: The aerobic or cardiovascular training is the essence of middle- and long-distance
racers training cycle. The systematic aerobic training for male and females not only enhances the
oxygen consumption capacity during training but also is the key to improve overall performance.
Objectives: To evaluate the association of aerobic training on the performance of 5000m male and
female national athletes. Methods: This experimental study was conducted with non-probability
convenience sampling over a period of six months from December 2021 to May 2022. This study
included n=20 (10xmale & 10xfemales) national and international athletes, aged from 17-32 years,
during the preparation of National Athletics Championship at Pakistan Sports Board, Jinnah
Complex Islamabad, Pakistan. The athletes with any disease, or trauma including coaches were
excluded. The athletes underwent 8 Weeks Cardiovascular training to improve their overall
performance in a controlled environment. The pre & post experiment VO2MAX tests including
actual performance in 5000m run, beside the demographic sheet were analyzed by using SPSS 21.
Results: Study revealed significant difference in the scores of the beep test per-post experiment
including performance. Pre & Post beep test with Mean ± SD is 10.48 ± 1.35230 and 11.67 ±1.55126
respectively, whereas the actual performance of 5000m of both the genders were found 18.50 ±
3.00228 and17.47 ± 2.67894 respectively. The beep test improvement association on the actual event
performance (5000m) was also analyzed. The null hypothesis was rejected and association of aerobic
training showed two tailed significant difference < 0.001by analyzing through One Sample Test.
Conclusion: Study concludes that aerobic training in control environment showed significant
difference in overall performance of 5000m national long racer athletes.
Keywords: Aerobic, Cardiovascular training, Actual, Oxygen and Performance.

101
 Aggression And Violence In Sports, Its Effects On Sports Performance
Mohibullah Khan Marwat
Department of Sports Sciences and Physical Education, Faculty of Allied Health Sciences, The
University of Lahore, Lahore, Pakistan.

ABSTRACT
Aggression and violence have been the part of human psychology and its essence has been woven in
the very nature of the social animal. Sports sociologists have always been showing their concern
about the ill effects of the phenomenon of aggression and violence as it has been entirely against the
soft spirit of sports and recreation. This research study is undertaken to evaluate the existing
literature, examining the possible causes of the prevalence of the violent behavior and to suggest
practical preventive measures for controlling and curbing this menace. Aggression and violence in
sports are the two different forms of hostile behavior and they both are associated with the personal
vested interest of the person by inflicting harm to the opponent. Main focus of the study was to
evaluate the effect of violence upon sports participation. So, for, it has taken toll in terms of lives,
injuries and damage to the property at large scale. Research has confirmed a number of measures
which may prove productive in controlling aggression as well as violence in sports. These measures
include effective role of media in discouraging violent behavior among the fans, strict compliance
of rules and regulations of the game, affective surveillance system and stopping the suspects from
entering the gathering. In addition to that, timely, unbiased and fair decision of the referee, level
playing field for both sides and prompt supervision of the proceedings of the game are a few steps
that may eradicate the menace of aggression and violence in the field of sports.
Keywords: Aggression, Violence, Behavior, Sports, Player, Competition, Tolerance

102
 Artificial Intelligence And Data Analytics In Cricket
Muhammad Tahir Nazeer1, Muhammad Ahmad Tahir2, Hira Atta1
1
Department of Sports Sciences and Physical Education, University of the Punjab, Pakistan
2
Department of Computer Sciences, Information Technology University of the Punjab, Lahore,
Pakistan.

ABSTRACT
Cricket, as we all know, is one of the most popular sports in the world. Selection of the right players,
team strategy, conditions, and match-ups all play a vital role in the outcome of a cricket match. Each
of these factors can be improved with the use of latest technologies. Artificial Intelligence (AI) and
Data Science have helped take the game a step forward. Technologies such as Bat Sense, Ball
Sensors, Hotspot, Ultra edge and many others have helped bring fairness as well as competitiveness
in the game. Latest Machine Learning and Deep Learning techniques have also made the teams
smarter while selecting their players, making combinations, deciding strategies and many more.
These techniques help predict the performance of batters, bowlers, or even teams as a unit based on
their previous performances and different factors. Teams also use strategies on when and where to
use specific players. Roles of specific players have been made much clearer with the help of data.
Teams such as England Cricket Team, Nottinghamshire County Cricket Club, Multan Sultans and
many others have used these techniques and have achieved very quick success with limited resources.
This Paper reviews different types of Machine Learning and Deep Learning techniques being used
in the Cricketing Industry. Mostly the techniques being used are Linear Regression, K Nearest
Neighbors (KNN), Decision Tree and other similar techniques. From the success of different teams,
it is clear that data is helping teams go a step ahead of their opponents and is becoming a vital part
of their success.
Keywords: Data Analytics, Data Science, Cricket, Artificial Intelligence

103
 Challenges And Opportunities In Organizing Sports Tourism Events In Pakistan
Sumaira Sattar
Department of Physical Education, Lahore College for Women University, Lahore, Pakistan.

ABSTRACT
Background: Sports tourism means to travel from one place to another in order to participate into
events. This varies through hard sport tourism to soft sport tourism. Objectives: The present study
aimed to identify challenges and opportunities in sports tourism development in Pakistan.
Methodology: This study employed cross-sectional research design, in which student athletes,
coaches and sports mangers participated. Data was collected from different university level athletes,
coaches and sports mangers of different cities of Pakistan. A total number of 120 people participated
in this study. Data was collected using a 5-point Likert Scale. Descriptive analysis explained
population characteristics such as age, sex, education and work experience of participants, standard
deviation, and data display through charts and in inferential statistics, ANOVA and regression
analysis were used. Results: Most of the participants responded that different factors can impact the
success of organizing sports tourism events in Pakistan to a great extent. The study revealed that a
significant majority of the participants i.e. 55% were of the view that through sports tourism events,
they were able to visit tourist attractions within destination cities and 25% of the participants lent
support for this view. An average of 3.80 sports mangers suggests that holding sports tourism events
provides the opportunity to visit other attractions within the destination. Lastly, 34% of the
participants strongly agree that by holding sports tourism events, opportunities to promote national
tourism are created. Regression analysis points to the challenges and opportunities to host sports
tourism events accounting for up to 34.5% of the impact on the socioeconomic status of the host
community, thus indicating that the challenges and opportunities to host sports tourism events are
significant indicators of socioeconomic status. Conclusion: It is important to ensure that the required
facilities and funds are available to host a particular event successfully.
Keywords: Sports Tourism, Sports Participation, challenges, opportunities

104
 Relationship Between Obsessive Passion And Psychological Well-Being Of Female Athletes
Hummaira Farah, Yasmeen Iqbal
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: It is important to understand the role of passion in an individual’s life. Sometimes
passion is more suited to a higher level of Psychological Well-Being than other aspects of life. For
example, the Dualistic Model of Passion posits that obsessive passion can be over-emphasized in an
individual’s life, taking on a disproportionately conflicting role. Objectives: This paper is a part of
PhD Thesis and it covered one of the objectives “to explore the relationship between Obsessive
Passion and six dimensions of Psychological Well-Being among female athletes” Methodology: The
study employed a cross-sectional research design. A total number of 100 female athletes between the
age range of 19 and 24 participated in this study. Data was collected from university level female
athletes. “The Passion Scale”, composed of two subscales, each sub-scale contains 7 items that
evaluate the two types of passion, that is, harmonious passion and obsessive passion and
“Psychological Well-Being scales, composed of six subscales according to the six factors of positive
functioning” were used for data collection. Results: A significantly positive relationship was
observed between Obsessive Passion and six dimensions of Psychological Wellbeing including
Positive relationships with others (r= 0.910), Autonomy (r= 0.812), Environmental mastery (r=
0.910), Personal Growth (r= 0.893), Purpose of life (r= 0.952), and Self-Acceptance (r= 0.952),
Based on the results, it can be concluded that both the HP and OP showed a significant relationship
with six dimensions of PWB. Conclusion: Individuals with OP appear to be more impacted by wins
and misfortunes than those without OP. Conversely, individuals with OP don't respond all the more
firmly to their exhibitions regarding self-acknowledgment than individuals without that enthusiasm.
These outcomes affirm that individuals with OP give off an impression of being more responsive to
execution signals in their energetic. Further research is needed to confirm these results.
Keywords: Passion, Harmonious Passion, Psychological Well-Being, Female Athletes, Team Sports

105
 The Effects Of The Resistance Band And Dumbbells Training On The Sprint Performance
Of Male Athletes
Muhammad Shah
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: Speed and performance of athletes is very crucial. Sprinting needs high acceleration
levels and as such strength to overcome the body mass inertia. Generally stronger athletes do well in
sprint performance. The main aim of this study was to compare the effects of resistance training with
elastic resistance band and resistance training with dumbbells. Method: The design of the study is a
multi-centered open label parallel prospective. Randomized control trial (RCT). The total number of
participants were (n= 60), divided in three groups i-e Resistance band group (RBG), Dumbbells
Resistance Group (DRG) and control group (CG). Results: After training intervention resistance
band group performance in 30 meter flying speed with mean ± SD was 3.5980 ± 0.22867 and at week
8th mean ± SD was 3.0135 ± 0.72849. For 60-meter speed at the baseline mean ± SD was 7.8825 ±
0.55623 and at the 8th week mean ± SD was 7.4985± 0.50135. The results of dumbbells for 30 meters
flying, with mean ± SD at baseline was 3.6255± 0.23053 while at the end of week 8th mean ± SD
was 3.2770 ± 0.80194. For 60-meter speed were with mean± SD was 7.7715± 0.36458 and at the
week 8th mean ± SD was7.6760 ± 0.36890. Conclusion: Both the resistance methods showed
improvement in the performance of athletes while resistance band shows more significant results
than dumbbells. The coaches and the professional trainers should include Training with resistance
band in their training programs for the improvement of athlete’s sprinting performance.
Keywords: Speed, Resistance training, Resistance Band, Dumbbells,

106
 Impact Of External Rewards On Intrinsic Motivation Of Elite And Non-Elite Women
Cricketers Of Pakistan
Ammara Rubab
1
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
The goal of the current study was to determine how external rewards influence Pakistani elite and
non-elite women cricketers' intrinsic motivation. This research is a quantitative study located in
Pakistan. The sample of the study was elite and non-elite women cricketers of Pakistan. The data
was collected using a purposeful sampling technique while the number of participants was 200
women cricketers. The analytical tool used for data analysis was SPSS Version 23.0. The Sports
Motivation Scale (Palletier et al., 1995) and Effort & Reward Scale (IK-Park, 2021) were used in the
study. The results reported that external rewards have a positive impact on the intrinsic motivation
of elite (𝑅 2 = 0.408, 𝑝= 0.000𝑐 ) while no impact of external rewards was found on intrinsic
motivation of non-elite (𝑅 2= 0.003,𝑝 = 0.604𝑐 ) respondents. Motivation is a key factor in sports
participation and the development of an athlete’s peak performance. External rewards help to
improve intrinsic motivation. The findings of this study suggest that women's cricket organizations
concentrate on boosting sports motivation by considering the psychological requirements of athletes,
such as recognition, rewards, security, and support. The results obtained from this study will be very
effective for organizers as well as women cricketers as it can offer them an inside view and enriched
knowledge on how reward works to improve intrinsic motivation, which in turn can influence their
approach to training in particular ways that can keep them successful.
Keywords: External rewards, Intrinsic motivation, elite, non-elite, women, cricket

107
Effect Of Anthropometric And Kinematic Omponents On Drag-Flick Performance: A Study
On National Field Hockey Players
Rabia Wali
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: The anthropometric and kinematic components significantly influence sports
performance.
Objective: This study aimed to quantify the degree to which national elite field hockey players
incorporate kinematic skills in penalty corner drag-flick and examine the effect of both genders'
anthropometric and kinematic components on the performance of penalty corner drag-flick.
Methodology: A sample of eight male and eight female players were selected from Hockey Clubs
in Lahore, Pakistan. Three-Dimensional Biomechanical analysis was carried out to measure the
kinematic variables of the drag-flick performance through the VICON motion capturing system and
MATLAB software. The repeated measure of analysis (ANCOVA), Mann-Whitney(U) test, and
multiple regression were applied. Results: It was found that the national elite players were not
consistent in their performance. They had not much awareness of biomechanical skills, however,
male players were more consistent in their performance as compared to female players. Gender had
a significant effect on the kinematic components of the drag-flick. The age, height, drag time, and
left knee and right elbow angle significantly affected the performance of female players while the
approach distance, drag length, and stance width significantly affected the performance of male
players. It was also found that there were significant gender differences in selected kinematic
components. Conclusion: It was concluded that drag time and stance width were the most influential
kinetic components and that they differed by gender. The players and trainers should attention to
utilizing the optimum interaction of anthropometric components and kinematic skills for high ball
velocity in drag flick performance.
Keywords: Anthropometric, Kinematic, Consistency, Ball Velocity, Drag Flick

108
 Presenters
Ranked Based Topsis For Team Formation Of Basketball
Muhammad Farhan Tabassum
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Basketball is one of the most popular sports games in the world. Professional basketball has become
a significant contributor to global economics, business and sports. Considerable funds attracted by
the game motivate participants of the sporting process (players, coaches, club owners, administration
and etc.) to strive for better athletic results, this way promoting internal and external rivalry. A large
number of players and the desire of teams to attract better team members as well as improve the
quality of the already available athletes, boost the use of assessment and rating processes. The most
popular and widely used player rating systems are based on performance statistics, which reflect
situational factors of the game. Most specialists believe that such systems lack objectivity.
Meanwhile, the Author suggest a systematic solution, Rank Based Technique for Order Preference
by Similarity to Ideal Solution (RB-TOPSIS) and principles for the design of the algorithm based on
the method. As a consistent problem-solving system, algorithms based on multi-criteria decision-
making are regarded to be simple and clear, suitable to substantiate solutions as well as easily applied
in practice. Methodologies used by the Author will help ensuring a greater efficiency of player and
team rating, more accurate prognoses of sports results, team formation, and optimization of the
training process considering individualism of team players and encouraging their versatility, i.e.
conformity to general physical preparedness norms of the team. The suggested research methods
could be used in other sports. Furthermore, these principles could be used in business management
for team formation.
Keywords: Basketball, Multi-criteria decision-making, TOPSIS, Ranking

109
 Validation Of Leadership Rating Scale: A Quantitative Study
Rahila Nizami, Muhammad Bilal Gillani, Amir Latif
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
It was a quantitative study that investigated the roles of educational leaders for quality learning
environments in the public and private sector universities at Lahore. The objective of this paper was
to establish ed the validation of the rating scale regarding leadership roles. The study was restricted
to the public and private sector universities of Lahore which are recognized by Higher Education
Commission Pakistan (HEC). The population included were all the Deans, Directors, Head of
Departments (HODs), Professors, Associate Professors, Assistant Professors and Lecturers of the
universities working in the four faculties like Natural Sciences, Management Sciences, Arts and
Humanities and the Social Sciences. The population was divided in two tiers. One tier included
Deans, Directors, Professors, Associate Professors and second tier included Assistant Professors and
Lecturers. Census sampling was done for the first tier and second tier was approached and those who
gave their willingness were added in the sample. A self-developed rating scale was prepared and got
validated by the experts and then piolet tested. The Cronbach Alpha Coefficient was r= 0.873. The
rating scale was about the academic and administrative roles of educational leaders. The sample
consisted of 347 participants out of which 247 were from public and 102 were from private
universities. SPSS 23 was used for the data analysis. Findings showed that public universities faculty
are better in their academic and administrative roles than private universities. Further it was proved
that physical learning environments of public universities is more aligned with HEC Pakistan than
private universities.
Keywords: Educational leaders, Quality Learning Environments, Public Universities, Private
Universities

110
The Impact Of Aerobic Training On The Performance Of 5000m Male & Female Athletes Of
Pakistan
Shabbir Anjam1, Shahzaman Khan2
1
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.
2
Department of Physical Education & Sports Sciences, Sukkur IBA University, Sindh, Pakistan.

ABSTRACT
Background: The aerobic or cardiovascular training is the essence of middle- and long-distance
racers training cycle. The systematic aerobic training for male and females not only enhances the
oxygen consumption capacity during training but also is the key to improve overall performance.
Objectives: To evaluate the association of aerobic training on the performance of 5000m male and
female national athletes. Methods: This experimental study was conducted with non-probability
convenience sampling over a period of six months from December 2021 to May 2022. This study
included n=20 (10xmale & 10xfemales) national and international athletes, aged from 17-32 years,
during the preparation of National Athletics Championship at Pakistan Sports Board, Jinnah
Complex Islamabad, Pakistan. The athletes with any disease, or trauma including coaches were
excluded. The athletes underwent 8 Wks Cardiovascular training to improve their overall
performance in a controlled environment. The pre & post experiment VO2MAX tests including
actual performance in 5000m run, beside the demographic sheet were analyzed by using SPSS 21.
Results: Study revealed significant difference in the scores of the beep test per-post experiment
including performance. Pre & Post beep test with Mean ± SD is 10.48 ± 1.35230 and 11.67 ±1.55126
respectively, whereas the actual performance of 5000m of both the genders were found 18.50 ±
3.00228 and17.47 ± 2.67894 respectively. The beep test improvement association on the actual event
performance (5000m) was also analyzed. The null hypothesis was rejected and association of aerobic
training showed two tailed significant difference < 0.001by analyzing through One Sample Test.
Conclusion: Study concludes that aerobic training in control environment showed significant
difference in overall performance of 5000m national long racer athletes.
Keywords: Aerobic, Cardiovascular training, Actual, Oxygen and Performance.

111
 A Comparative Study Of Performance Of Players Of Punjab And Baluchistan With The
Provision Of Sports Infrastructure Facilities
Shah Khalid, Akhtar Nawaz Ganjera
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: The peculiarity of the sport is, it’s not only satisfied the individual fitness and health
needs but also effects on socialization, social integration, democracy, and public health. In 1947
when Pakistan was established Pakistan, Pakistan faced lots of problem initially and Pakistan
government do not give attention toward sports sector, Pakistan won the first silver medal in the
Olympic of Melbourn in 1956 and got 36th rank overall without any facility of sports infrastructure.
Objective: The main objective the present study to study the impact of sports infrastructure on
performance of players. Methodology: In this study a descriptive survey and questionnaire as tool
was used. Structured interview and personnel observation were also conducted from the selected
population of players of Punjab and Baluchistan. Data was analyzed statistically. Results: From the
questionnaire and interviews of the players it was assessed that Punjab Government got handsome
amount of budget form federal government for infrastructure of sports while the sports budget
allocated to the Government of Baluchistan is very low. Punjab has lot of sports Infrastructure at the
level international standards while in Baluchistan has shortage of infrastructure and few are meet the
international Standards. The performance of Punjab players at international level is excellent. In
Punjab128 players got the achievements at international level while only 43 players from Baluchistan
stands at international level. Conclusion: It is concluded form the above study that government
should allocate proper budget for sports infrastructure for all the provinces of Pakistan, to improve
the performance of player and promote the sports in Pakistan.
Keywords: Performance, Sports Infrastructure, Players

112
 Mindfulness For Sports Performance In Female Athletes
Aqsa Shamim Ahmed, Mufeez Alam
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: Mindfulness is a type of mental training that includes concentrating on mind and
experiences (like your own emotions, thoughts, and sensations) in the present moment. By enhancing
current moment awareness, mindfulness-based interventions for sports are effective because they
help athletes direct their attention to the current athletic task, while minimizing external distractions.
Objective: The aim of the study was to determine the impact of mindfulness on sports performance
of athletes. Methodology: The data was collected from 200 athletes using two questionnaires of
Mindfulness questionnaire (Baer et al., 2006) and athletic performance scale by (Wolanin, 2004).
Mindfulness scale had 39 items whereas performance scale had 11 items. Data was collected from
female athletes of Government and Private Sector Universities of Lahore including, PU, GCU, UMT
and COMSETS. Results: The overall Cronbach’s Alpha Reliability of the scale was found to be 0.83
where Mindfulness Training scale was found to be 0.83, whereas Athletic Performance scale was
0.77. The β1 (slope) coefficient for the regression line has positive value (β1=0.27) which indicates
that mindfulness training has positive impact on athletic performance of the university students.
Analysis of variance (ANOVA) was used to examine the significance of the fitted models; the
technique is used under the regression analysis. The results of ANOVA table show that the p-values
for the model is less than α=0.05, therefore, it is concluded that fitted model is significant (p<0.01).
The t and p-values show that the Mindfulness has significant (p<0.01) impact on athletic
performance. Conclusion(s): Thus, it was concluded that Mindfulness training has a positive
significant impact on performance of the athletes.
Keywords: Mindfulness, Sports, Performance, Female, Athletes.

113
 Problems And Prospectus For Special Population Towards Participation In Sports
Bilal Ahmad, Kashif Mehmood, Arsalan Gilani
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: The main focus of this study was to identify challenges experienced in sports
participation by children with disabilities. Objective: To examine the main problems and prospectus
for special population towards their participation in sports. Methodology: This study employed a
cross-sectional and analytical research design. Convenient sampling technique was used for the
selection of sample. Requisite information on the different variables such as the nature of the
disability, the duration in the institution and sports related data were obtained through the
questionnaire. The descriptive analysis involved the computation of frequency distributions of the
responses. Non-Parametric analysis was done for hypothesis testing as the data was categorical.
Results: The results indicated that physical challenges were being experienced by children with
disabilities (CWDs). There were 3% students who reported “having no opportunity, 8% reported not
having special aids and equipment, and 19% reported lack of sports fields, and 5% reported poor
fitness” are the main challenges in sports participation. They also reported that psychological
challenges also hindered their participation in sports. There were 6.1% who reported “fear of being
rejected, 15.2% reported not being able to do sports, and 78.8% reported their own health” as
challenges to take part in sports. They also reported that social factors including “financial problems
(93.9%) and non-availability of trained coaches (6.1%)” as another type of challenge to take part in
sports. Conclusion: The findings of this study showed that internal motivation was present as CWDs
want to play sports. Rather it is important to provide the necessary support from the administration
of the schools and the Government of the Punjab.
Keywords: Children, Disabilities, Issues, Challenges, Sports, Schools

114
 Masculinity And Femininity In Sports Performance
Rabia Karim
1
Assistant Director Sports, University of Home Economics, Lahore, Pakistan.

ABSTRACT
Background: A number of female athletes adopt masculine appearance to improve their confidence
and sports performance, as they think that this look is motivational to improve their sports
performance. From decades sports is linked with male who played it well as they have strong
muscular power. Female players feel like same muscular power when they adopt the appearance of
a tomboy or masculinity. Objectives: The aim of this research was to compare the femininity and
masculinity traits among female athletes and its effects on their performance. Methodology: The
data was collected from 200 female athletes through simple random sampling. Masculinity and
femininity were measured through Bem sex role inventory (Bem 1974) whereas performance was
measured by Self rating scale of athletic performance (Wolenin, 2004). Results: Results of the study
showed that both the scales were having high reliability. Masculinity scale showed the highest
correlation with the performance scale whereas, femininity scale showed the lowest correlation.
Conclusion: The study concludes that the female having a tomboy appearance or masculinity have
higher scores on the performance scale.
Key words: Masculinity, Femininity, Sports Performance, tomboy, Female athletes.

115
 Assessments Of First Aid Knowledge On Common Athletic Injuries In Contact Sports
Athletes
Hira Atta , Mudassar Mushtaq2
1
1
Sports Sciences & Physical Education Department, University of the Punjab, Lahore, Pakistan.
2
Sports Department, University of the Punjab, Lahore, Pakistan.

ABSTRACT
Contact sports athletes are more susceptible and at greater risk. Athletes must deal with a variety of
situations during training and competition, which necessitates medical attention and knowledge of
what to do. First aid is the immediate preliminary assistance given to a person who has been
wounded or has become ill. First aid involves evaluating the person for life-threatening
circumstances, conducting effective intervention to support life, and retaining the person in the
finest potential psychological and physical status till the support of emergency medical care is
gained. The objective of the study was to examine the levels of knowledge of contact sports
athletes in first-aid knowledge on common athletics injuries. Total 120 students voluntarily
participated in the study. The study was carried out by using a quantitative cross-sectional survey
with a stratified random sampling technique. The data was gathered, arranged, and statistically
analyzed. The present findings showed that 30% of the 120 samples had adequate knowledge, 35%
had intermediate knowledge, and 55% had inadequate knowledge. Overall, results showed that the
majority of contact sports athletes have inadequate first-aid knowledge which can lead to improper
actions to frequent emergency situations. The present study suggested that athletes who are
involved in contact sports should acquire first-aid training.
Keywords: First-aid, contact sports, knowledge, common injuries

116
Influence Of Sports Celebrities On Pakistani Television Advertisements: A Content Analysis
Abdul Fahim, Shagufta Akhtar, Basit Ali
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
Background: The study was seeking to uncover the possible appeals of advertisements that were
likely to have a substantial influence on customers for prioritizing advertisement and persuading the
public to get products using the Rhetorical Triangle approach. In Pakistan, total advertising
expenditure was occurred 81.5 billion rupees in fiscal year 2017-18 and 67.15 billion rupees in fiscal
year 2018-19. In 2019, TV ads had the highest share of the advertising market, accounting for 42
percent of the total. Ads are regarded as the most important money-making or revenue generating
product. Objectives: The aims of study were to determine the content of sports advertisements
broadcasted on Pakistani television and to investigate the appeals employed in these sports
commercials which comprehend the importance of athletes in Pakistani sports advertisements to
learn about organization’s marketing tactics for selling their items. Methodology: Companies
persuade the public to spend money on their products by influencing them through 30-60 second
advertisements. This is expert through the routine of various advertising types, and the most suitable
techniques. In this study, sports advertising from Pakistani TV channels Geo Super and PTV Sports
that were downloaded from YouTube and examined. There was a quantitative content analysis done.
The research was exploratory in nature, with the goal of analyzing the advertisements content in
which the researcher was created a coding sheet based on advertising appeals and conducted the
study. Results: This study finding demonstrate that when rational and emotional advertising appeals
were balanced blended, an effective commercial was made and the campaigns popularity grew.
Conclusion: Advertisements were ineffective owing to an imbalance between emotional and logical
appeals, according to Aristotle Rhetorical Triangle. Too several rational appeals become dull, while
so many emotional appeals become repugnant. The researcher determines that the sports advertising
used both forms of appeals in almost similar numbers after a comprehensive assessment.
Key words: Sports advertisements, Advertising Appeals, Rhetorical triangle, Celebrity
endorsement, Sports Industry

117
 Basic Understanding Of Backhand Strokes With Biomechanics Principals
Muhammad Rizwan Nawaz, Yasir Ali, Kainat Azam
Department of Sport Sciences & Physical Education, Faculty of Allied Sciences, University of
Lahore, Lahore, Pakistan.

ABSTRACT
The Purpose of this article is described the basic understanding of most important strokes of table
tennis backhand strokes with Biomechanics Principals. Through this study coaches as well as players
can enhance their knowledge of how biomechanical contributions will lead them to the accuracy
level of performing backhand strokes. Players must be learned backhand strokes skill because these
strokes are match winning strokes. As this Article focuses on just backhand strokes for the
biomechanical analysis and studies, each and every thing required for major backhand strokes will
be discussed. Learn basic skills of Backhand Push, Backhand Block, Backhand Topspin and
Backhand Flick with Aspect of Biomechanics because without biomechanics techniques and
knowledge we cannot improve their all-power strokes. Mostly players spend their maximum time in
practicing forehand strokes that affects their technical performance in backhand. in the modern table
tennis game backhand strokes have equal importance as forehand stroke, in this modern era of T.T
every professional and beginner player learned tactics and skills for quality of playing and all aspects
major strokes and tactical combination like backhand and forehand stroke.

118
 UNIVERSITY INSTITUTE OF FOOD SCIENCE AND TECHNOLOGY (UIFST)
The University Institute of Food Science & Technology is striving hard to provide quality education
at undergraduate and graduate levels and develop cutting-edge techniques to meet the national and
global challenges in food security and safety. There has been a significant increase in the
establishment of the food industry during the last two decades and consequently, the demand for
Food Technology graduates has increased tremendously at a national and international level,
especially in the Gulf countries. Food is a basic essential of life and requires humans to build, repair,
keep the body in good working condition and supply fuel for energy. The major thrust of UIFST is
the application of Food Science and Technology in handling, processing, and preservation of food to
cope with the challenges of the rapidly growing food industry. The aim of UIFST is to be recognized
as an excellent institution to provide quality education by producing competent human resources
capable of achieving excellence in knowledge dissemination and developing cutting edge techniques
to meet the national and global challenges in food processing, food preservation, halal food
development, food quality, food security, safety, and community wellbeing.

119
 International Speakers
Portion Size Control: A Public Health Priority

Basma Ellahi1
1
University of Chester, United Kingdom

Abstract

Obesity is a recognised global health problem with related healt complications such as diabetes and heart
disease particularly in the Pakistani population. Furthermore, recent evidence shows that COVID-19
mortality in Pakistani populations in the UK was dependant on BMI. Food portion size imbalance is
generally considered to be a factor in the development of obesity. Indeed, exposure to large portion sizes,
especially of high energy dense foods or sugars sweetened beverages has been related with high energy
consumption, thus resulting in weight gain. Obesity is a disease of affluence and of poverty. To address
the problem of weight gain, effective interventions for behaviour change, including educational elements
are needed. Behaviour change occurs when we have the capability and opportunity and we are motivated
to do the right thing (COM-B). However, we need to understand how we encourage change from less
desirable behaviours to adoption of healthier ones – challenging when behaviours are ingrained in our
social norms, everyday actions and wider influences. Portion size reduction of energy dense
commercially produced foods and the use of portion control tools for individuals in the home
environment are both strategies which can be used to control food/beverages portion size and
consumption. These present opportunities and challenges for the Pakistani context. Drawing on
international research the presentation discusses approaches to influence portion size consumed and
advocates for a variety of population level as well as individual approaches to be used in a concerted
intersectoral and multi-professional effort to address obesity and its prevalence in Pakistani
communities. The approach can also be useful for dietary assessment methodology to better capture
intakes. The value and importance of culturally appropriate education and communications to address
the obesity problem is fundamental to this. Harnessing social media and digital resources could prove
valuable as a delivery method.

120
 The Food Systems Dashboard: A New Tool For Visualising Food Systems Data

Stella Nordhagen

Global Alliance for Improved Nutrition, Switzerland

Abstract

Food systems – i.e., the people, institutions, infrastructure, and activities that relate to the production,
processing, distribution, sale, preparation, and consumption of food – are central to human health:
they shape diets, which influence health and susceptibility to a range of diseases. They also play
essential roles in environmental sustainability, culture, and economies. Given the complexity and
interconnections inherent to food systems, the data that describe them spans many different domains,
from food availability to nutrition outcomes. However, these data are rarely aggregated and presented
jointly, using data visualizations that are easily understandable. Dashboards are data visualizations
that collate, summarize, and communicate data from diverse sources in simple, visually appealing
graphics for stakeholders, which can facilitate understanding, decision making, and advocacy. The
Food Systems Dashboard (FSD) is the first-ever comprehensive dashboard for food systems,
bringing together extant data across over 200 indicators from over 40 sources for nearly every
country and territory in a visually appealing, easy-to-navigate platform. These sources, which are
both public and private, include United Nations agencies, the World Bank, Consultative Group for
International Agriculture Research (CGIAR), Euromonitor, and cross-country project-based
datasets. The indicators cover food supply chains; food environments; individual factors; consumer
behaviour; diets and nutrition and environmental outcomes. The data provide insights into different
aspects of food systems that are not commonly included together in data visualization tools, thus
allowing users to understand food systems in a more comprehensive way. The FSD also allows users
to ‘diagnose’ the performance of their food systems against a range of international thresholds, such
as child stunting and adult obesity rates. The tool can be used by researchers, policymakers, non-
governmental organizations, civil society leaders, and others to visualize their own national food
systems, understand the interconnections across multiple sectors, compare across countries, identify
key challenges, and prioritize actions. This presentation will offer an introduction to the FSD and
how it can be used for health research and decision-making; it will also preview plans to develop a
new version of the FSD specific to Pakistan and providing data at the level of subnational regions.

121
 Ensuring Quality Production Of Iodized Salt
Lorenzo Locatelli-Rossi

Global Alliance for Improved Nutrition, Italy

ABSTRACT

Wikipedia defines iodized salt as table salt mixed with a minute amount of various salts of the
element iodine. Sounds simple, salt mixed with a bit of iodine but investigate it, and its
slightly more complicated and reality proves it. Many salt processors who produce iodized
salt, are taking short cuts when it comes to adding and mixing producing a low standard
product that has negative results in overall population’s iodine intake. For this process of
adding and mixing, producers tend to “save investing” by using a simple approach while in
fact, if they invest in proper technology, the overall results will be a better overall return on
investment. How can this issue be practically resolved? What else needs to be in place to
give ensure quality in salt iodization? In recent years, a small, reliable, compact, heavy-duty
system iodizing machine for adding and mixing is available and proven to be successful.
Innovative system being small, compact, reduces costs of investment and ensures quality
iodization homogeneous mixture. However, all is fine that this system now exists, what is
needed is a policy that obligates any salt processor who wants to produce iodized salt, to
have certain basic technological solutions in operation in their process. Without technology
and a policy, processors will continue to take short-cuts and produce below standard fortified
product. It is the horse and cart approach; the horse being the policy and the cart the
technology of iodization.

122
Determination Of In Vitro Antibacterial Effects Of Selected Washing Solutions Against Some
Foodborne Pathogens

Omer Faruk CELIK*

Department of Food Engineering, Ordu University, 52200, Ordu, Turkey

Abstract

Consumers apply different disinfection processes, primarily washing, to the food products and/or
their packaging they buy to remove physical, chemical, and microbial contaminants since an
effective washing process generally provides an extended shelf life. Considering that the virus can
transmit via food, this disinfection process become a habit, even sometimes an obsession with the
recent COVID-19 pandemic. During the pandemic, the number of consumers who apply washing
and at least one additional disinfection process has increased. In this study, the antimicrobial effects
of (i) tap water, (ii) vinegar/water solution (1:2), (iii) a commercial vegetable/fruit washing solution
(bioxi®), (iv) sodium hypochlorous/hypochlorous acid/electrolyzed water generator, and (v) tap
water mixed with three types of essential oils against Escherichia coli (EC) and Staphylococcus
aureus (SA), common foodborne pathogens, and Enterococcus faecalis (EF) will be investigated
using a well-diffusion method.

123
 National Speakers
Food Safety Knowledge, Attitudes And Practices Of Restaurant Food Handlers From
Rawalakot City
Imtiaz Hussain, Nagina Rafique and Saiqa Bashir

Department of Food Science Technology & University of Poonch, Rawalakot

Abstract

Background: Accessibility to nutritious and safe food is key for sustainable life activities and for
maintaining good health. Contaminated food carries harmful bacteria, viruses, parasites or chemical
substances which causes more than 200 diseases, ranging from simple to complicated infection and
also creates a vicious cycle of infectious pathogens particularly infecting infants, young children,
and elderly sick individuals. Objective: The objective of the study was to assess the awareness and
practice of food safety in restaurants of Rawalakot city. Methodology: A cross sectional study was
conducted in Rawalakot city district Poonch Azad Jammu and Kashmir from September to
December 2021 with a sample size of 80 food handler staff of 40 restaurants. A pretested semi
structured questionnaire was used to collect the data. Results: the study shows that 50.8%
respondents of the subject had poor knowledge towardsfood safety practices and remaining had
moderate knowledge. Around 33% lack the knowledge of proper methods of maintainingpersonal
hygiene and about half of the food handlers washed their hands in sinks meant for dish washing,
57% did not use approved hand drying methods. Duringfood handling, over 90% workers did not
use any personal protective equipments. These observations found a significant relationship
between the knowledge and attitude of food handlers, but there was no significant relationship
between knowledge or attitude and food handling practices. Moreover, respondents had knowledge
of food service operations morepositive attitudes and better practices regarding food safety. Among
the socio-demographic factors investigated, only the level of education showed significant influence
(p = 0.005) on the food safety knowledge and practice. Results suggest a need for mandatory basic
and advanced training to improve the food safety knowledge, attitudes, and practices. Conclusions:
Findings showed significant positive correlation among the food safety knowledge, attitudes, and
practices of food handlers.

Keywords: safety awareness, Food handlers, Food infectious pathogens, cross contamination

124
Food And Nutrition Crises In Flood Disasters - A Pakistan Scenario

Saeed Akhtar1, Tariq Ismail1, Wisha Saeed1

1
Faculty of Food Science & Nutrition, Bahauddin Zakariya University, Multan

Abstract

Climate change driven recent catastrophic floods in Pakistan with multiple shocks of high prices of
food and fuel, COVID-19 related loss to income generating resources, poverty, drought and
increasing burden of livestock diseases have resulted in food crises exacerbating the state of food
security situation. United Nations Office for the Coordination of Humanitarians Affairs (OCHA)
advisory team estimates around 73% of the households in flood affected areas of Pakistan having
meager or no resources to buy food. An estimated 10 million of the people more specifically women
and the children are gravely vulnerable to hunger and malnutrition. Wheat provides 60% of the
average energy and protein requirements while the floods have destroyed the larger share of stored
food grains from the households, private and public sector storage facilities. FAO has reported
around 1.2 million hectares of agricultural land in Sindh, damaged by the floods while data from the
ministry of national food security report food and cash crops’ loss worth Rs. 320 billion. Remote
sensing technology estimates approximately 66- 80% loss to the annual rice and sugarcane
production only from Sindh province. In order to bring agriculture – the largest economic sector of
Pakistan back on the track and to prevent looming food security crises, the government is desired to
mobilize all available technical and financial resources.

125
 Role Of Dietary Diversity And Food Multimixes In The Food And Nutrition Security In
Pakistan
Mian Kamran Sharif1, Tabana Naz1, Hafiz Rizwan Sharif2
1
National Institute of Food Science and Technology, Faculty of Food, Nutrition & Home Sciences,
University of Agriculture, Faisalabad, Pakistan.
2
University Institute of Diet and Nutritional Sciences, Department of Allied Health Sciences, The
University of Chenab, Gujrat, Pakistan.

Abstract
The majority of the developing nations are suffering from more than one type of malnutrition.
According to recent estimates, 149 million children under 5 are stunted alongwith 45 million wasted
and 38.9 million overweight or obese. Pakistan has one of the highest burden of malnutrition in the
world. According to the World Food Programme estimates approximately 43% of Pakistanis are food
insecure and 18% of them fall in the category of acute food insecurity. Over the last three years,
Pakistan’s double-digit food price inflation, along with dwindling income, has left more Pakistanis
food insecure. Healthcare cost has also increased with escalating inflation making it very difficult to
promote health. A diet with less variety leads towards food insecurity, poor health outcomes, and
more food shortages. Dietary diversity promotes health by lowering hypertension, improving
hemoglobin level, lowering deaths from cancer, and improving birth weight. Diversity throughout
the food and nutrition system could be considered as a driver for change by improving direct
interactions between food producers and consumers, increasing the quality of diet, and fighting the
triple burden of malnutrition. Food multimix (FMM) is a novel scientific approach which is based
on the concept of food (and meal) diversification. It relies on the use of scientific methods combined
with traditional food technology, and tailoring food products to meet the needs of specific vulnerable
groups within different social and cultural contexts. Primarily, traditional varieties of food crops,
including cereals, grains, legumes, vegetables and fruit, and where appropriate, available and
affordable, animal products have been used to simulate real life community meal preparation
practices. However in rare instances where limiting nutrients are not sufficiently represented, there
may be a need to add external fortificants such as mineral and vitamin pre-mixes. The recipes thus
formed with known nutrient composition, are first made in powder form (can be packaged in sachets)
and subsequently developed into a variety of end products including porridge, soups, cakes, bread
and muffins. The flexibility and advantage of this approach is that the combination of traditional
126
food ingredients can be customized within any community harnessing their own available natural,
affordable, culturally acceptable and commonly consumed resources within their own economic
means, and taking into account their specific physiological and clinical needs for targeted
interventions e.g. in pregnancy, home or community-based nutrition rehabilitation, for normal
growing infants, young children and in school feeding programmes. More attention should be given
to diet diversification (FMM) to improve health and reduce risks of mortality and morbidity.
Establishing sustainable dietary guidelines, eliminating subsidies for commodity crops, adding cost
to the foods with high environmental degradation such as red meat will ultimately lead to more plant-
based diets and less meat consumption benefitting both the environment and reduce the risk of non-
communicable diseases among the people. There is need of legislation in developing countries like
Pakistan to ensure the consumption of blended diets to lower the stress on staple diets i.e., wheat and
rice. Furthermore, this strategy will help in alleviating malnutrition and improving food security.

Keywords: Malnutrition; Food insecurity, Food multimixes, Dietary Diversity.

127
 Polyphenols As Antidiabetic And Antilithogenic Agents
Dr. Shahina Naz
Department of Food Science & Technology, University of Karachi
Abstract
The lifetime risk of diabetes and kidney stone formation in human body has doubled partly because
of heredity and partly due to the environmental factors. Three different approaches are used for the
drug-based treatment of diabetes and its complications; first is to inhibit key digestive enzymes i.e.,
α-glucosidase, α-amylase, maltase, and lipase in the intestine, second is inhibiting incretin hormones
degrading enzymes (GLP and DPPIV) and third, is prevention of non-enzymic glycation. Likewise
kidney stone formation is inhibited either by preventing supersaturation of stone components in urine
using antilithogenic substances or by using surgical procedures. Though the use of oral anti- diabetic
drugs is common but there is a strong need to lessen reliance on drugs to reduce the cost of health
care and avoid the side effects of drugs. Similarly, the recurrence of stones needs to be controlled
through natural and safer remedies. Being powerful antioxidant and enzyme inhibitors, phyto-
phenols are not only effective against diabetes but also against nephrolithiasis. Therefore, detailed
research studies have been carried out on the plants that have been traditionally used in management
of diabetes or kidney stones and/ or have modern experimental evidence of antidiabetic or
antiurolithic activity. We extracted and fractionated polyphenols from fruits of Rhus coriara,
Opuntia Ficus indica and Terminalia catappa. The extracts and fractions were then studied for their
polyphenolic contents, antioxidant potential and in vitro efficacy as antidiabetic and antilithogenic
agent. Results obtained indicated that these fractions have the potential to inhibit the formation of
both calcium phosphate and calcium oxalate crystals and α-amylase in vitro. Evidences of in vivo
and in vitro efficacy of the polyphenols (as inhibitors of DDP IV, aldose reductase and urease)
derived from several other plant sources show their potential of commercialization for application in
the management of type 2 diabetes and nephrolithiasis.

Key words: Polyphenols, Antidiabetic activity, Antilithogenic activity

128
 Glycemic Index And Glycemic Load Of Dairy Products, Indigenous Recipes And
Confectionery Items Of Pakistan

Sanaullah Iqbal1*, Ayesha Amjad1, Rukh-e-mah Javed1, Muniba Khaliq1, Azmat ullah1
1
Department of Food Science and Human Nutrition, University of veterinary and animal sciences,
Shaykh Abdul Qadir Jilani Rd, Lahore, Pakistan 54000

ABSTRACT

Diets characterized by low glycemic index (GI) and low glycemic load (GL) have been repeatedly
and independently associated with decreased risk of diabetes and other chronic diseases. The GI and
GL of Pakistani dairy based traditional foods and recipes are not available. The aim of this study was
to report the GI and GL values of fifty highly consumed Pakistani foods which were divided into
milks (n=7), dairy products (n=5), fruit milkshakes (n=5), dairy-based local drinks (n=4), dairy-based
traditional desserts (n=13) and traditional confections (n=16). For each test food 10±2 fasted healthy
participants were served with (25 or 50 g carbohydrate) portions of glucose and bread (reference
food) on three occasions, subsequently the test foods containing equal amount of available
carbohydrates. Capillary blood glucose levels of the subjects at fasting and after ingestion of the
reference and test foods were measured within a 2-hours period. The GI of the test foods was
calculated by trapezoid rule and GL was determined by the product of the test food’s GI and the
amount of available carbohydrate in a reference serving size. Among these, forty-three test foods
especially those derived from natural sources and recipes containing milk as a major ingredient were
placed among low GI foods. However, confectionery items which have moderate available
carbohydrate were categorized among medium and high GI foods. Findings have illustrated several
factors which influence GI of previously untested foods. It overcomes the lack of information,
contributing to a better understanding of association between GI and GL and health, providing more
informed choices to Pakistani consumers and health practitioners.

Key words: Glycemic Index, Glycemic Load, Pakistani foods, Indigenous recipes, Diabetes,
Carbohydrates

129
 Enhancement Of Nutritional Profile And Quality Features Of Wheat Flour And Biscuits
Supplemented With Lentil-Oat Flour To Fulfill The Nutrient Requirement Of Children
Dr. Sadaf Javaria, Amara Karim
Institute of Foof Science and Nutrition, Gomal University, [Link]
Abstract
Confectionary and snack food are most consumed food item for children. Flour samples comprised
of from lentil and oat flour (5, 10, 15, 20 and 25%) were used to prepare suitable formulations with
wheat flour. The main aim of attaining high nutrient contributions in the blend of composite
[Link] composition of different flours indicated that oat flour had higher ash and fiber
content whereas, highest fat and protein were reckoned in lentil flour. The composite flour (WF: LF:
OF; 50: 25: 25) showed highest nutrient composition with ash (2.12%), fat (4.09%), fiber (2.96%)
Zinc (3.6mg/100g), iron (5.9 mg/100g) and protein (12.50%). Addition of supplement flours had
significantly affected the dough rheological properties. A significant reduction in wet gluten and dry
gluten was found with proportional rise of lentil-oat blends. Nutrient composition of lentil-oat
supplemented biscuits ranged as moisture (3.22-4.30%), ash (0.45-1.71%), fat (19.71-27.40%), fiber
(0.20-2.56%), and protein (5.44-8.90%), carbohydrate (56.64-69.80%), iron (3.30 to 5.9 mg/100g),
zinc (0.56 to 3.60 mg/100g), and energy value(528.26-588.76 kcal).Spread factor of such biscuits
varied between 45.90 and 56.00. The highest acceptability for biscuits was observed when wheat
flour was supplemented with lentil and oat flour at 15% level. By using 2-3 pieces of biscuits (45 g
approximately), the RDAs of children for basic required nutrients get satisfied. Effective advertising
of such products especially in developing countries like Pakistan is required to combat the mal
nutrition.

130
 Global Conflicts And Soaring Prices: Challenge To Nutritional Security
M Tauseef Sultan*, M Rizwan Azhar, Hassan Raza, Usman Khalid, and Iqra Baig
Faculty of Food Science and Nutrition, Bahauddin Zakariya University, Multan
Abstract
The global population is facing stringent problems regarding food due to several crises e.g. climate
change, global conflicts, rising population, and trade barriers. The raising global population (~7.80
billion) and soaring cost of food commodities are adding fuel to their miseries. The regional conflicts
in post-covid era resulted in limited but expensive energy supplies that increased the manufacturing
cost of producing safe and nutritious food. Moreover, inflation and income of the people are not in
harmony with each thus creating many problems for the communities living in developing
economies. Likewise, different regions of the world face severe repercussion due to climate change
like heat waves decreasing crops & grain yield. Moreover, changing rainfalls patterns, cloud
bursting, and melting of glaciers at unprecedented pace led to floods leaving millions of people
vulnerable to food insecurity. These all problems are leading to a new challenge for the stakeholders
working in the domain of food and nutrition to ensure food and nutrition security. The distribution
and affordability of foods are serious concern and demands attention of the stakeholders and they
should work together for sustainable model having enough provisions of food to peoples. Pakistan
is one of the hard-hit areas of the world and the government has put up many efforts. However, the
current scenario demands the attention of the scientists to mitigate the effects of climate change,
preparing the nation for disaster management and manufacturing of low-cost edible products. This
is high time that the government and healthcare professionals should work together in the face of
these challenges and play their role to alleviate food and nutrition insecurity.

131
 Hibiscus Sabdariffa Fermentation Studies
Ahmad Faraz, Sanabil Yaqoob, Kanza Aziz Awan, Waleed Sultan, Hiba
Naveed
Food Science & Technology, the University of Central Punjab, Lahore, Pakistan

Abstract
The effect of trona on the fermentation of roselle calyces was evaluated. The addition of
trona to the calyces raised the initial pH from 3.3 to 5.3. The important microorganisms of roselle
calyces fermentation were enumerated, isolated and identified. The fungi isolated consist of one
yeast identified as Saccharomyces cerevisiae and two moulds, Apergillus niger and Aspergillus
flavus. Of the aerobic bacteria, only Escherichia coli, Bacillus subtilis and Klebsiella sp. were
isolated. The total titratable acid (TTA) value increased throughout the fermentation (0.027-0.043).
The nutritional evaluation showed that there was an increase in the protein (6.56%), lipid (4.25%)
and carbohydrate contents (74.33%) of the fermented sample with a higher ash content (4.54%) in
the unfermented sample. The mineral contents (PPM); Zn (31.86), Fe (12.35), Mg (132.00), Ca
(294.31), Na (214.62) and K (382.13) of the fermented sample were generally low. This study
reveals that trona can be used to neutralize the acid in roselle calyx and that fermentation can
greatly influence the nutritional composition positively.

Key words: roselle calyces, trona, nutritional evaluation, fermentation

132
 Mulberry (Morus alba L.); Fruit Extracts' Antioxidant and AntibacterialActivities
Hiba Naveed, Sanabil Yaqoob, Kanza Aziz Awan, Waleed Sultan, Ahmad Faraz
Food Science & Technology, the University of Central Punjab, Lahore, Pakistan

Abstract
The fruit of mulberry trees (Morus sp.), mulberries, are traditionally utilized as a nutritional
food and provide health benefits as well as skin nourishment in Thailand. White mulberries (Morus
alba L.) from Chiang Mai and Mae Hong Son provinces were evaluated fortheir antioxidant and
antibacterial activities. The antioxidant activities as well as the total phenolic, flavonoid and
anthocyanin content of the aqueous and ethanolic extracts were determined using 2,2-diphenyl1-
picrylhydrazyl (DPPH), 2,20 -azinobis-(3- ethylbenzothiazolin-6-sulfonic acid) (ABTS) and ferric
reducing antioxidant power (FRAP) assays. The aqueous extracts of mulberries exhibited the highest
antioxidant activity, which was associated with a higher phenolic and anthocyanin content. In testing
the potent antibacterial activity against Escherichia coli, Salmonella Typhi, Shigella dysenteriae,
Staphylococcus aureus and Vibrio cholerae, the mulberry extracts proved to be quite efficient,
especially following water extraction. Time-kill and antibacterial adhesion assays further indicated
that aqueous mulberry extracts could inhibit bacterial growth and prevent adhesions of pathogenic
enteric bacteria on intestinal epithelial cells. It thus appears that mulberries can potentially be
consumed as a good source of antioxidants, containing antimicrobial propertiesagainst some
pathogenic bacteria which cause gastrointestinal tract infections.

Keywords: Anti-adhesion; antioxidation; inhibition; pathogenic enteric bacteria; mulberry

133
 Presenters
Functional exploration of Taro starch (colocasia esculenta) supplemented yogurt

Muhammad Shaheryar, Muhammad Afzaal, Farhana Nosheen, Rabia Noreen, Naveed Rasheed,
Hafiz Mehran Mukhtar

Institute of Food and Home Sciences, GC University Faisalbad, Pakistan

Abstract

Background: Stabilizers are important component in manufactured variousfoodproducts. The addition of

stabilizers improves body, texture, appearance, mouthfeel and prevents technical defects in the product.
The yogurt was enriched withdifferentconcentration of taro starch. Objective: Objectives of this study
were to optimize the taro concentrationforstabilizing the yogurt synthesis and to probe the effect of taro
starch on thephysio- chemical attributes of yogurt. Methodology: In current study, the different levels ((0,
0.5, 1, 1.5, 2, 2.5 and 3%) of tarostarch were used to probe its effect on the nutritional, functional and
sensory attributesof the yogurt. Purposely, the yogurt was prepared with defied level of taro
starchandsubjected for further analysis with storage (0, 14 and 28 days). Tuckey honestytest (HSD) used
for mean comparison (P0.05). Results: The results of the study indicated that addition of taro starch
significantly(P>0.05) a affected the physicochemical, microbiological and functional propertiesof
theyogurt. An increase in protein and carbohydrate content of yogurt, while decreasingtrend was recorded
in fat with storage intervals. Conclusion: The addition of taro starch could be way forward for the
development offunctional foods for the promotion of community health.

Key words: Taro starch, yogurt, functional properties, microbiological, stabilizer

134
 Effect Of Pomegranate And Papaya On Thrombocytopenıa
Rafıa Ijaz1 , Dr Tabussam Tufaıl1, Dr Anees Ahmed Khalıl1
University institute of diet and nutritional sciences, The university of Lahore, Pakistan

ABSTRACT

OBJECTIVE: Thrombocytopenia or decreased platelets count is a serious and common

complication. In dengue fever no specific treatment is available for thrombocytopenia. In some
countries carica papaya leaf extract and pomegranate isused to cure thrombocytopenia or decreased
platelets. So the study is planned to access the effect of carica papaya leaf extract of pomegranate in
thrombocytopenicpatients. METHODS: Participants were divided in random groups ( control group
, study group) and then they were given carica papaya leaf extract or pomegranate and one group is
only given normal diet. Results and conclusion :.In this study it is concluded that Carica papaya and
pomegranateincrease platelet count in thrombocytopenic patients without any side effect and prevent
the side effects of thrombocytopenia . This research included that the pomegranate ( punica grantum)
and papaya . Pomegranate fruit have many antiplatelet effect and it contains a large number of products
such as hydrolyzed tannins ellagitannins. In this research the main purposeis to find out the effect of
pomegranate fruit on decreased platelets count and we investigated in vitro the effects of treatment
with either pomegranate juice (PJ) or thepolyphenol-rich extract from pomegranate fruit (POMx) on
platelet aggregation. Study shows that pomegrante showed a stronger action in increasing low platelets
Pomegranates are rich in antioxidants and flavonoids, both of which are known to prevent free radicals
from damaging your cells. Pomegranate is rich in essential nutrients and minerals that provides the
body with required energy. Carica Papaya is also used to treat thrombocytopenia or decreased platelets
count in patients. Carica papaya leaf liquid extract is used as a therapy for chronic thombocytopenic
purpura. Inthis study it is concluded that Carica papaya and pomegranate increase platelet count in
thrombocytopenic patients without any side effect and prevent the side effects of thrombocytopenia.

KEY WORDS : Thrombocytopenia , Platelets, pomegranate, papaya.

135
 Profiling the antioxidant and antibacterial potential of Ber (Ziziphus mauritiana) extract on
chicken meat
Hafiz Muzammal Ali1, Tahir Zahoor1, Muhammad Saeed1, Zulfiqar Ahmad2, Umair Ali2*,
Faizul Hassan Shah2, Hammad Hafeez2, Muhammad Adil Rehman2
1 National Institute of Food Science and Technology, University of Agriculture, Faisalabad,
Pakistan
2
Department of Food Science and Technology, Faculty of Agriculture and Environment. The
Islamia University of Bahawalpur, Pakistan

Abstract
Ber (Ziziphus mauritiana) is a traditional medicinal fruit having antioxidant, antihistaminic,
antidiabetic, hypolipidemic and anticarcinogenic properties. The study focused on thedetermination of
antioxidant and antibacterial potential of Ber extract and its application on chicken meat by agar well
diffusion and disc diffusion methods. The Ber extract was evaluated for its phytochemical screening
and results elucidated that phenolic and flavonoid content of Ber was about 56.23 mg/100g GAEs and
9.8 mg/100 CEs respectively. Moreover, the ascorbic acid and reducing sugar content was 18.12 mg/100
AEs and 1.36 g/100g respectively. Different concentrations of Ber extract (10%, 20%, 30%, 40%) were
applied on chicken meat to test its antioxidant and antimicrobial properties. T4 (40% Ber extract)
significantly (p<0.05) improved quality characteristics of chicken and minimal changes were
recorded for pH (6.32 to 5.53),color (55.36 to 55.04), and texture (1722 to 1525). The results also
showed significantly high antioxidant potential (80%) of T4 as compared to all other treatments. The
inhibition zone of different pathogens was 14.33 with MIC 300 (Salmonella paratyphi), 15.23
with MIC 250 ([Link]), 11.63 with MIC 300 (Chromobacterium violaceum), 13.83 with MIC 200 (S.
aureus), and 15.23 with MIC 250 (Pseudomonas aeruginosa). In conclusion, Ber extract can inhibit the
oxidation and bacterial attack in chicken meat and other foods.

Key words: Ber, antioxidant, antibacterial, bioactive compounds, phytochemical

136
 Mechanisms of Action of Toxins Produced by Clostridium perfringens

Ali Raza

Abstract:
A rod-shaped Clostridium perfringens is an anaerobe that causes foodborne disease. This spore forming
rod is a gram positive that actually doesn’t need free oxygen for their survival. Its generation time is
almost less than ten minutes and can divide in ~45°C. This aerotolerant bacterium has few toxigenic
types (A, B, C, D and E) occur in humans. Two newly discovered toxinotypes are type F and type G.
Histotoxic, neurological, and intestinal infections in both peopleand animals are caused by Clostridium
perfringens using its extensive collection of protein [Link] or CPA, beta or CPB, epsilon or ETX,
iota ITX and enterotoxin CPE are the primary toxinsthat contribute to disease. CPA is the primary
pathogenicity factor in gas poisoning in humans, despite its limited and debatable involvement in animal
illnesses. Necrotizing intestinal inflammation and enterotoxemia in infants of various vertebrate
species, particularly humans, arecaused by CPB. Some other types occur in livestock causing illness.
The majority of the time, thehost-toxin reciprocity begins on the plasma membranes of target cell via
certain receptors, activating intracellular mechanisms with a range of outcomes, most often involving
cell death. Generally speaking, necrotic and apoptotic traits are present in the molecular pathways of
cell damage linked to C. perfringens toxins.

Keywords: Clostridium perfringens, toxins, pathways, apoptosis, cell killing, necrosis

137
 Valorization and food applications of mango waste (peel, seed & kernel): A review
Aasma Asghar1, Ali Ikram2
1
Department of Home Economics, Government College University, Faisalabad
2
University Institute of Food Science and Technology, the University of Lahore, pakistan
Abstract
In current studies, fruits and vegetable wastes have gained the attention that basically due to their
phytochemical profile and low cost treatments through use of new technologies. The world most harvested
tropical plant in the world is mango (Mangifera indica) belongs to Anacardiaceae family. A large amount
of by-products (peel, seed and kernel) are produced by mango processing industries. This waste material
contains many valuable compounds. Mango pulp processing industries produces mango peel waste; it is
good source of vitamins, pectin, phytochemicals (polyphenols) and dietary fibers. Mango kernel
remarkably contains vitamins, minerals, macronutrients and bioactive components. Phytochemicals or
bioactive components of mango wastes (seed and kernel) have notable therapeutic potential. Therefore,
valorization of fruit waste through different ways helps to reduced the environmental pollution but also
add in functional foods to enhance its functional properties. Mango peel and kernel offers antimicrobial,
antioxidants and lipid fractions that used potentially in food industries as an additive in food products and
extend the shelf life for the development of functional foods. This review presented that mango waste
(peel seed and kernel) have great potential of micronutrients and macronutrients. This novel food provides
a component that need for human health and a way to reduce the environmental pollution.

Key Words: Mango waste, mango seed, mango kernel, phytochemicals, food applications

138
 Banana peel: A potential biowaste in the food industry
Saadia Ambreen1, Umair Arshad2, Shahid Bashir1, Aiman Zafar1, Ali Ikram1
1
Institute of Food Science and Technology, The University of Lahore, Pakistan
2
Department of Food science, Government College University Faisalabad, Pakistan
Abstract
Agricultural waste has gained more attention from scientists in recent years, and instead of being treated
as unimportant waste, it is now intriguing to investigate and utilize. In tropical regions, banana peels are
frequently used as supplementary forage. Its massive waste products are a great source of extremely
valuable raw minerals. The bioactive constituents of banana peel, specifically the phenolic compounds,
are appreciated. Mainly hydroxycinnamic acids, catecholamines, flavan-3- ols, and flavanol are phenolic
compounds present in the banana peel. The nutritional quality of food products was improved by adding
banana peel, especially the dietary fiber and phenolic content. Banana peel has been proven to lessen lipid
oxidation, especially in meat-based products. Furthermore, banana peel possesses strong antimicrobial
and antibacterial capabilities. Banana peel contains dietary antioxidants that lower the risk of developing
oxidative stress-related conditions like diabetes, cancer, and cardiovascular disease (CVD). It may be used
pharmacologically to treat a wide range of ailments and as a good source of natural antioxidants. Peel has
long been used as a treatment for many illnesses, including burns, anemia, diarrhea, ulcers, inflammation,
diabetes, and cough. Because of its numerous bioactive components with possible health-promoting
effects, the banana peel has demonstrated outstanding nutritional quality and usage in a variety of food
items, including bakery, culinary, and meat products. That’s why it caught the attention of researchers
worldwide. Consequently, a rigorous analysis of the banana peel's nutritional data and bioactive
components is conducted. The objective of this work is to look into the antibacterial and antioxidant
properties of biomass waste.

Keywords: Biowaste, antioxidant, antimicrobial, phenolic, bakery, culinary

139
 Pomegranate Peel: A Waste Treasure For Humans

Aimen Zafar1, Saadia Ambreen1, Shahid Bashir1, Assam Bin Tahir1

1
University Institute of Food Science and Technology, The University of Lahore, Pakistan

Abstract

The fruit of the Punica granatum tree, recognized as the pomegranate, is also regarded as "nature's power
fruit." It has risen dramatically in production and consumption due to its taste and nutritional value.
However, a lot of byproducts are generated after the fruit is processed, like peels and seeds, which, if not
treated effectively, can cause environmental pollution issues. In recent decades, pomegranate peel has
gained more attention from scientists due to its various bioactive chemical components such as flavonoids,
polyphenols, and tannins. It is a rich source of phenolic acids such as vanillic acid, chlorogenic acid,
cinnamic acid, gallic acid, caffeic acid, and ellagic acid. It is reported that tannins are also abundantly
present in pomegranates. The most common tannins present are punicalagin, granatins, pedunculagin,
corilagin, and gallagyldilactone. The phytochemicals serve as antioxidants by enhancing oxidative
biomarkers and mitigating reactive oxygen species. Pomegranate peel also possesses a wide range of
antimicrobial properties, which seem to have an inhibitory effect on bacterial and fungal pathogens due
to tannins and flavonoid content. Additionally, pomegranate extracts also play a part in a variety of signal
transduction pathways that are involved in carcinogenesis, hyperproliferation, cellular transformation,
inflammation, and other processes whereas they also suppress the final stages of cancer and metastasis.
The major goal of this study is to understand the biochemical makeup of pomegranate peel which will
enable better utilization of the waste sources for physiological purposes.

Keywords: Pomegranate peel, Polyphenols, Tannins, Antioxidant, Antimicrobial, Anticancer

140
UNIVERSITY INSTITUTE OF RADIOLOGICAL SCIENCES & MEDICAL IMAGING
TECHNOLOGY

141
 NATIONAL SPEAKERS

Sonographic Clues To Fetal Chromosomal Abnormalities

Dr. Muhammad Saulat Nawaz, Consultant Radiologist/ Incharge Nawaz Medicare, Faisalabad.

Abstract

Antenatal soft ultrasound markers are fetal sonographic findings that are generally not abnormalities as
such but are indicative of an increased age adjusted risk of an underlying fetal chromosomal or some non-
chromosomal abnormalities. These obstetric ultrasound findings are subtle and considered variants of
normal but are important to note because they also increase the risk for underlying fetal aneuploidy. These
“soft markers” should be considered distinct from fetal anatomic malformations and growth restriction
that also increase perinatal and genetic risks. The presence of soft markers increases the risk for fetal
aneuploidy but is not diagnostic. Individual soft markers will vary in the degree of association with fetal
aneuploidy. Detection of multiple soft markers will increase the significance of the finding, compared
with seeing the same marker in isolation. Non-sonographic factors, including maternal age, gestational
age, past history, and family history also influence the chance for aneuploidy. In addition, maternal serum
testing as an alternate screening tool can complement and enhance the overall screening process. The use
and understanding of ultrasound soft markers and their screening relative risks is an important option in
the care of pregnant women. Currently, the presence of a “significant” ultrasound marker adds risk to the
likelihood of fetal pathology, but the absence of soft markers, except in controlled situations, should not
be used to reduce fetal risk.

142
 Role Of Spect/Ct In Musculoskeletal Disorders

Dr. Saima Haider. Deputy Chief Medical Officer, CENUM Mayo Hospital, Lahore.

Abstract

Skeletal scintigraphy is the most commonly performed procedure in Nuclear Medicine. Since Nuclear
Medicine is the functional imaging modality and is the sensitive test to detect bone metabolism with
manifestation as abnormal tracer uptake. Either planar or SPECT bone imaging procedures are employed,
they have inherent limitations in spatial resolution and specificity. The addition of anatomical imaging
(such as computed tomography) with nuclear medicine commonly known as Hybrid imaging can resolve
unanswered queries of equivocal bony lesions seen on bone scan. SPECT and CT images are processed
that allow them to be merged with the combination of information. Use of SPECT/CT has significantly
increases the diagnostic accuracy of skeletal lesions. It precisely pin points the anatomic position of
metabolically active areas. The qualitative hybrid image assessment defines the lesion with great certainty.
However quantitative processing of such lesions with various parameters (such as SUV, etc.) helped in
characterization with utmost confidence. The clinical application of this utility has revolutionized the field
of imaging

143
 Sonography Of Breast: An Overview
Dr. Saulat Sarfraz
Assoc. Prof. HOD Radiology Department, Sheikh Zayed Hospital, Lahore

Abstract

Breast ultrasound is very important part of clinical workup for screening as well as diagnosing breast
abnormalities. It is therefore very crucial for imaging personnel to be fully aware of the important aspects
of both normal appearances and pathological changes associated with spectrum of benign and malignant
conditions such as fibroadenoma on one hand and breast carcinoma on the other. This presentation will
cover the key points related to ultrasonography of breast essential for radiotechnologists, tech students
and postgraduate trainees in diagnostic radiology. Important topics covered in presentation are indications,
technique, sonographic anatomy, common benign and malignant findings, reporting pattern and BIRADS
classification of the lesions.

144
Correlation between serum levels of follicle stimulating hormone and graafian follicle vascularity
on doppler in infertile females of lahore.

Dr. Amjad Iqbal

Director Prime Ultrasound Clinic, Lahore

Background: Infertility has always been considered as a social stigma and has often been treated as
socially, mentally and physically damaging experience for the childless women rather than man. There
are different methods to diagnose infertility, in which Follicle-Stimulating Hormone (FSH) and
Luteinizing Hormone (LH) are commonly used, whereas Doppler ultrasound can also be helpful for initial
diagnosis of primary infertility. Objectives: 1. To determine the correlation between serum levels of
follicle stimulating hormone and Graafian follicle vascularity on Doppler in infertile females of Lahore.
2. To determine the role of power and spectral Doppler ultrasound in diagnosis of anovulation in infertile
females of Lahore. Methodology: This cross-sectional analytical was done at Prime Ultrasound center,
2-Shalamrar Link Road, Mughalpura Lahore. The study was done in 18 months by taking 100 infertile
females using simple random sampling. All the married women of reproductive age and married for more
than 12 months who have not conceived despite regular unprotected intercourse, having no other uterine
and endometrial or ovarian pathology were taken. The patients who fail to provide serum hormone
laboratory reports were excluded. Transvaginal Ultrasound (TVUS) was done for all females and graafian
follicle vascularity on Doppler was measured. Results: The mean age of females was 27.90 ± 4.05 years
with minimum and maximum age as 19 and 46 years. The mean FSH levels at day 12 was 7.63 ± 4.74
mlU/ml with minimum and maximum FSH values as 3.20 and 40 mlU/ml. The mean follicle size was 14
± 3.61 (mm) with minimum and maximum size as 10 mm and 26 mm. The mean resistive index and PI
was 0.65 ± 0.15 and 1.19 ± 0.52 respectively. There were 61(61%) females who had Grade-1 perifollicular
vascularity, 24(24%) females had grade-2 and 15(15%) females had grade-3 of perifollicular vascularity.
There was significant positive correlation between perifollicular vascularity grades and FSH levels day
12. (r = 0.309, p-value≤0.001) A negative sign correlation was found between Resistive Index (RI) and
FSH levels day 12 i.e. r = -0.268, p-value = 0.007. Conclusion: It is concluded that perifollicular
vascularity was found to be correlated with mid-cycle FSH, so Graafian follicle vascularity on Doppler
can be helpful in diagnosis of primary infertility in females of unstimulated cycles. Moreover, Doppler
ultrasound is helpful for functional assessment of Graafian follicle and can easily identify vascularity of
Graafian follicle which is expression of hormonal level.

Keywords: Infertility, Graafian follicle, Color Doppler, Power Doppler, Spectral (PW) Doppler, follicular
vascularity, resistive index, pulsatility index, Assisted reproductive technology, culture, fertilization,
history, in vitro fertilization, infertility.

145
 PRESENTERS

Clinical Significance Of Twinkling Artifact In The Diagnosis Of Urinary Stones

Raham Bacha, Iqra Manzoor, Syed Amir Gilani, Amjad Iqbal Khan

Abstract

The twinkling artifact is a color Doppler artifact, but it could be used in the confirmation of urinary stones.
Conventionally, gray-scale criteria (echogenic foci with acoustic shadowing) is used in the diagnosis of
urinary stones, but unfortunately, its reliability is very low. If the color Doppler twinkling artifact is
applied in conjunction with other provocative measures, then its overall reliability exceeds 95%. To
determine the clinical significance of twinkling artifact in the diagnosis of urinary stones, this cross-
sectional observational study was conducted at Gilani Ultrasound Center, Lahore, Pakistan. For the
determination of clinical significance, 1350 patients were recruited for this study. All the patients had
renal stones of variable size and location. All the patients were evaluated with gray-scale sonographic
criteria, and then color Doppler was applied to look for the twinkling artifact. The findings were confirmed
with other imaging modalities (i.e., plain X-ray, computed tomography scan, etc., or during patient follow
up). Sensitivity and specificity of the gray-scale ultrasound criteria in the detection of urinary stones was
96.1% and 57.9%, respectively, while the sensitivity and specificity of the color Doppler twinkling artifact
in the detection of urinary stones was 100.0% and 97.4%, respectively. It was concluded that the
application of twinkling artifact is useful in the confirmation of urinary stones, but specifically, it is of
great diagnostic value in the small (less than 5 mm) renal stones and stones adjacent to a strong reflector
(i.e., ureteric stones or stones in the prostatic urethra).

Key Words:
Twinkling artifact; Ureteric stone; Renal stone; Acoustic shadowing

146
 Comparison between shear wave elastography and serological findings for the evaluation of
fibrosis in chronic liver disease.

Mahjabeen Liaqat, Raham Bacha

Background: We sought to examine the optimal cutoff values for predicting different stages of liver
fibrosis, and to determine the level of agreement between shear wave elastography and aspartate
aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic
liver disease. Methodology: A descriptive, cross-sectional study was performed at the Radiology
Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and
APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√
(ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help
of SPSS version 24.0 and Microsoft Excel 2013. Results: Eighty individuals were conveniently selected,
of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85
years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%)
and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4
predicted F3–F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1–F4 compared
to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87
(Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI.
Conclusion: This study provides optimal cutoff values for different groups of fibrosis patients for both
serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be
superior to APRI in all disease stages.

147
 Comparative Prevalence Of Female Reproductive System Abnormalities In Fertile And Infertile
Females Of Lahore

Syed Muhammad Yousaf Farooq, Zareen Fatima, Asif Hanif, Syeda Khadija.

Background: Infertility is detrimental not only to psychological behavior of the individual but also to her
social interaction with other members of society. The abnormalities of the female reproductive system are
common not only in infertile but also in fertile females. We aimed to compare these abnormalities in both
groups of females during their reproductive age. This study will provide an insight to the obstetricians and
gynecologists that how important any abnormality could be for causing infertility in such females.
Objective: To compare the prevalence of female reproductive system abnormalities in fertile and infertile
females of Lahore. Methodology: It was a descriptive, multicentric study conducted at Gilani Ultrasound
center, University Green Town clinic and Jamiat Hospital Lahore in duration of 18 months. 600
participants were included by using convenient sampling technique. 300 of these were fertile and infertile
each. All married females with age group of 18 – 45 years who had any pelvic abnormality were included.
Females on infertility treatment and with pelvic congenital abnormalities were excluded. Ultrasound
machine Xerio with transvaginal (TVS) transducer frequency range 7 to 14 MHz was used. Chi- Square
test was used to find out the association of various pelvic pathologies with presence or absence of fertility.
Results: In 600 females mean age ± SD ratio was 32.39 ± 6.29 with age range of 19 to 45 years. In this
study, we found that out of total 1585 abnormalities the most common was ovarian found in 670 (42.3%)
of our population. It was followed by uterine (485 cases) and cervical (222 cases) conditions. Chi- Square
test showed significant association between these abnormalities and infertility. The most common
abnormalities found in infertile females were polycystic ovaries 119 (39.7%), hemorrhagic cyst 87 (29%),
Nabothian cyst 87 (29%), endometriosis 76 (25.3%) and subserosal fibroid 71 (23.7%) while those found
in fertile females were follicular cysts 64 (21.3%), simple cyst 43 (14.3%) and intramural fibroid 26
(8.7%). Conclusion: Our study concluded that the pelvic abnormalities are significantly different in
fertile and infertile females.

148
 Association Of Sonographic Findings And Routine Urine Examination In Patient With Acute
Pyelonephritis

Muhammad Uzair, Raham Bacha

Background: Pyelonephritis is a renal inflammatory condition diagnosed with patient’s history, physical
examination and imaging studies. Although laboratory finding, clinical sign and symptoms are considered
for the diagnosis and treatment. Objective: To compare the sonographic findings of pyelonephritis with
urine complete examination. Methodology: A cross sectional analytical study was conduct at Gilani
Ultrasound Center, Ferozepur Road, Lahore and routine urine examination was performed in the Sanabil
Health Services Hospital, Khayaban-e-Quaid, Lahore. Included patients were queried concerning
variables such as gender, age, clinical history, grey scale ultrasound findings, Doppler ultrasound findings
and lab findings. Results: Out of 138 patients, 77 were males and 61 were females, maximum age of
patients was 77 years and minimum was 18 years, 75 (54.3%) patients with clinical history of
pyelonephritis, 67 patients were with lab findings that support pyelonephritis and 71 patients had no lab
findings. Out of 138 patients, 67(48.6%) patients had right kidney acute pyelonephritis and 65(47.1%)
had left kidney acute pyelonephritis. Conclusion: The study concluded that there was an important
association among the Urine complete examination as well as sonographic findings in the evaluation of
acute pyelonephritis. However, the clinical and ultrasound findings in acute Pyelonephritis do not play a
significant role but these findings can be helpful in chronic cases of pyelonephritis.

Key words:
Acute pyelonephritis, Ultrasonography, Urine complete analysis, Routine urine examination.

149
Diagnostic Accuracy Of Sonographic Transvaginal Ovarian Biophysical Profile As A Predictor Of
Infertility Taking Transvaginal Ultrasound As A Gold Standard

Syeda Khadija Tul Sughra

Background: Ovarian biophysical profile refers to assessment of ovaries to produce a successful

conception and implantation environment. The ovarian scoring system for reproduction comprises the
following parameters, taken in mid-cycle: ovarian volume, follicular size, and ovarian artery Doppler flow
Resistive index and pulsatility index. Objective: To determine the diagnostic accuracy of sonographic
transvaginal ovarian biophysical profile as a predictor of infertility taking transvaginal ultrasound as gold
standard. Study Design: Cross sectional validation study. Material and methods: The study comprised
women visiting the department with diagnosed infertility for treatment during the period of two years. A
total of 550 cycles were inducted primarily referred for ovarian assessment by ultrasound with patent tubes
and normal utero-ovarian morphology. All those women having no conception with normal semen
analysis of their husbands. Male factor infertility was also excluded. Baseline transvaginal sonography
(TVS) was performed at proliferative phase, of the cycle. Mature follicles were studied by TVS. On an
individual basis, the following parameters, that is, follicle size, ovarian volume and ovarian artery Doppler
Pulsatility index, Resistive index were studied. Follicle size and ovarian artery Doppler flow were highly
significant for a pregnancy. Results: The Ovarian biophysical profile was determined by applying the
ovarian scoring system for reproduction (OSSR). In this research we compare infertile females with fertile.
Out of 550 patients 243 (44.18%) patients were infertile and 307 (55.82%) were normal were discussed,
as for as the primary infertile females were 99 (18.00%) and secondary infertile females were 144
(26.18%) and normal were 307 (55.82%). Out of five hundred and fifty cycles 331 woman had a perfect
ovarian biophysical profile score of 10. The mean score of fertile was 9.39 ±1.56 and in infertile female
was 7.05±2.55. The p- values <0.001. The sensitivity and specificity of ovarian biophysical profile at cut
off value 1is 100% and 0.04%. The sensitivity and specificity of ovarian biophysical profile at cut off
value 8 it can be consider to rule out in future with 85.3% and 63.8% respectively. Conclusions: Ovarian
scoring system for reproduction (OSSR) can prove to be a simple, diagnostic and authentic score to predict
the ovarian environment and thereby helping in the prediction of the outcome in infertility. Six out of the
nine parameters were found to be high score to predict a pregnancy all by themselves, but these parameters
needed expertise and better instrumentation for evaluation. Of the remaining three parameters, two was
same or equal on an individual basis and one was found to be not significant.
Key words:
Infertility, Doppler ultrasonography, Transvaginal ultrasonography, Resistive index, Pulsatility index,
Ovarian Biophysical profile, ovarian artery, ovarian volume, Follicle size

150
 STATE OF THE ART LECTURES
Real Time Dynamic Musculoskeletal Ultrasound And Its Future Prospects

Prof. Dr. Syed Amir Gilani, Pro Rector Faculty of Allied Health Sciences, The University of
Lahore, Lahore, Pakistan
In dynamic ultrasound imaging, the Patient performs a movement while the physician holds the ultrasound
probe relative to an anatomic landmark. This has particularly useful applications for musculoskeletal
(MSK) imaging, where several pathological conditions are elicited only through patient movement.
Benefits of Real-Time Dynamic Ultrasound: Reduce the need for X-rays, scans, and radiation. Advanced
imaging algorithms with fine-tuning of depth, gain, and color. Dynamic studies capturing muscle, tendon,
ligament, and soft tissues during motion. Doppler and functional studies to evaluate for vascular and nerve
entrapment. Benefits of Real-Time Dynamic Ultrasound: Reduces the need for X-rays, scans, and
radiation. Advanced imaging algorithms with fine-tuning of depth, gain, and color. Dynamic studies
capturing muscle, tendon, ligament, and soft tissues during motion. Doppler and functional studies to
evaluate for vascular and nerve entrapment. In the setting of a musculoskeletal injury, MRI utilizes
powerful magnets to provide images, which identify bone stress (such as fracture or contusion), ligament
tears, joint fluid (also called effusion), cartilage injury, and soft tissue inflammation. CT, on the other
hand, uses x-ray radiation to provide high-resolution images of bones to identify specific fracture details
and bony deformities. Generally, these imaging methods require static setting, that is, the patient must sit
completely still. Snapping occurs from impingement of a structure against another anatomic or heterotopic
structure. It is associated with abrupt movement and a clicking or snapping noise. Snapping syndromes
may also be called clunking, locking, or triggering. Patients may require surgical intervention in cases of
severe pain or dysfunction. Examples include trigger finger and snapping hip syndromes. Ultrasound is
particularly useful in snapping syndromes. Friction syndromes occur from a smooth impingement,
resulting in pain, but without the audible snaps or clicks. Examples include intersection syndrome of the
wrist and iliotibial (IT) band syndrome at the knee. Although ultrasound may demonstrate static findings
similar to MR imaging (MRI), dynamic imaging is proven and applicable in certain conditions, but not
well researched in others. A common indication for dynamic imaging at the shoulder joint is in the
evaluation of subacromial impingement. Impingement occurs when the greater tuberosity or soft tissues
encroach on the coracoacromial arch in abduction, flexion, and internal rotation. It is a common cause of
shoulder pain, and is seen in repeated overhead activities, such as weightlifting, swimming, and tennis.
Dynamic imaging is helpful in confirming clinical suspicion. Ultrasound is 79% sensitive and 88%
specific for impingement of the supraspinatus tendon. In dynamic ultrasound, a linear high-frequency
transducer (7–12 MHz) is placed at the anterolateral edge of the acromion in the oblique coronal plane.
The patient abducts the arm anterolaterally while held in internal rotation (thumb down). In mild clinical
impingement, ultrasound is normal. In patients with moderate subacromial impingement, images will
demonstrate subacromial subdeltoid bursal fluid located laterally to the acromion. Additionally, the
supraspinatus tendon will fail to pass over the greater tuberosity in active elevation of the arm halfway
between flexion and abduction. Ultrasound findings in severe impingement include superior migration of
the humeral head and bunching or bulging of the supraspinatus tendon laterally. Role of musculoskeletal

151
ultrasound with dynamic studies to be discussed in Shoulder; subacromial impingment, adhesive
capsulitis, Biceps subluxation & Disslocation and Snapping Scapula etc. Elbow; Ulnar collateral ligament,
snapping triceps, ulnar nerve subluxation, extensor carpi ulnaris subluxation, trigger finger, boxer’s
knuckle etc. Hip; Snapping hip. Knee & Calf; Snapping knee, intra-articular snapping, patellar clunck
syndrome and muscle herniation etc. Ankle & Foot; Syndesmosis injury, tibialis posterior tendon
dislocation, peroneal tendon subluxation Conclusion: Dynamic ultrasound imaging of the MSK system
will likely become more frequent as health care reform pushes for less costly examinations, as the modality
becomes more widely available, and referring physicians understand the benefit of dynamic imaging
compared to MRI. The majority of pathology involves snapping of tendons along soft tissue or osseous
structures. However, friction syndromes, impingement, and laxity are also potential applications. Future
work is exciting, with promise in more tracking of patients using computer and statistical technology and
comparing different patients. Additionally, sonoelastography is another potential open field for dynamic
MSK ultrasound application.

152
Controversies On The Beginning Of Human Life – Advances In The Visualization Made By 3d/4d
Sonography

Asim Kurjak, Professor of Obstetrics and Gynecology, Medical School University of Zagreb,
Croatia, and Professor Emeritus, University Sarajevo School of Science and Technology,
Sarajevo, Bosnia and Herzegovina

The list of necessary or sufficient conditions for being a person includes: minimum intelligence, self-
awareness, self control, a sense of time, futurity and the past, capability of relating to others, concerns for
others, communication, control of existence, curiosity, change and changeability, balance of rationality
and feeling, idiosincrasy and neo-critical functioning. The infrastructures of the above mentioned abilities
reside in the cortex that is well developed from the 30th week of gestation and on. From that point of view,
every neonate or fetus during the third trimester of gestation are person, in a moral or an ethical context.
There is no doubt that the embryo and fetus in utero are human individuals prior the birth. The child that
is born is the same developing human individual that was in the mother's womb. Legal capacity, as
provided for by civil law, is an ability of a natural person to enjoy rights and obligations. The human being
becomes a natural person at the moment of birth. If human life is worth being protected by law only after
delivery, for what reason does perinatology exist and perinatologists fight for? Nowadays, lots of medical
treatments, interventions and even surgeries during pregnancy are done for the benefit of the unborn child,
and not due to the mother's health. From legal perspective, it is better for a child to be born prematurely
than at the right time, since from the moment of birth child's life is protected by law. From the medical
point of view, this must seem as an absurd, as the best environment for a child to develop is his/her
mother's womb during all the period of the nine month pregnancy. All the known evidence support the
human fetus being a true ontological human individual and consequently a human person in fact if not in
law.

153
 PRESENTATIONS

Correlation Of Benign Prostatic Hyperplasia Diagnosed On Transabdominal Ultrasound With

Urinary Retention Checked With Post Micturition Residual Volume On Ultrasound

Awon Abbas Malik, Syed Muhammad Yousaf Farooq

Background: Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a
histologic disease in the proliferation of the cellular elements of the prostate occurs, leading to an enlarged
prostate gland. Chronic BOO due to BPH may cause urinary retention, impaired kidneys, repetitive urinary
tract infections, high degree hematuria, and bladder stones. Objective: To study the interconnection of
prostatic volumes with post-micturating residual urine volume (PMR) in males with benign prostatic
hyperplasia (BPH). Methods: It was a cross-sectional research comprising of 220 subjects who
underwent an Ultrasonography scan over duration of 4 months. This study was performed in Sanabil
Health Services Hospital Lahore, from 15th June, 2021 to 16th October, 2021. Men of all ages diagnosed
for BPH were a part of this research. The subjects with prostatic malignancies, who underwent mild
urinary tract and/or prostate surgeries and men with UTI or bladder calculi, were included in this
experiment. Abdominal ultrasonography was conducted using a curved array probe of 3.5-5 MHz
frequency. The outcomes were Prostate volumes and post PMR volumes. Results: In total, 220 subjects
were evaluated. Out of these, benign prostatic hyperplasia was not found in 60(27.3%) and was present in
160(72.7%). Normal PMRV was found in 75(34.1%) and was raised in 145(65.9%). A remarkable mean
difference of pre-void volume was observed in patients with BPH and without BPH. The p-value was
0.000<0.05. A significant mean difference of post-void volume was observed in patients with BPH as p-
value is 0.000<0.05. Conclusions: Ultrasound has been proven to diagnose early prostatic enlargement
and other prostate-related pathologies, our study found out that there is a remarkable connection between
PMR Volume and BPH i.e., with increasing prostatic weight, urinary retention increases.

154
 Comparison between findings of gallium-68 dota pet-ct and contrast enhanced ct scan in
neuroendocrine tumors.

Sheikh Danial Hanan, Sajid Shaheen Malik, Muhammad Numair Younis, Syed Amir Gilani, Syed
Muhammad Yousaf Farooq, Abubaker Shahid

Objective: To compare the efficiency of contrast enhanced CT-SCAN and Gallium 68-DOTA PET CT
for the detection of neuroendocrine lesions. Material & Methods: A cross sectional, analytical study
was conducted at INMOL Hospital Lahore for a period of 11 months. A total of 70 patients, 18-68 year
of age, coming to Nuclear Medicine department of INMOL (Institute of Nuclear Medicine & Oncology
Lahore) were included in the study convenient sampling technique were used to collect the data. Results:
70 patients were selected who had malignant type of tumor (mass forming or metastatic) patients, 29(41%)
were diagnosed with Pancreatic Tumors, 12 (17%) were diagnosed with Metastatic Tumors, 10 (14%)
were diagnosed with Mesenteric Tumors, 7 (10%) were diagnosed with Renal Tumors, 7 (10 %) were
diagnosed with Liver Tumors, 3 (4%) were diagnosed with Thyroid Tumors, 1(1.4 %) was Breast Tumor
and 1(1.4%) was mediastinal Tumor. In CT-Scan out of 70 patients 42(60%) patients were diagnosed with
tumor while 28(40%) patients were normal, meanwhile in PET CT, out of 70 patients 55(79%) patients
were diagnosed with tumor while 15(21%) patients were normal. Out of 70 patients PET CT was able to
identify all 55/55 tumor patients correctly while CT visualized 42 patients correctly but omitting I 3
patients, causing false negative diagnosis. PET CT has sensitivity and Specificity of 100% & 99.9%
respectively whereas CT had sensitivity & Specificity of 76.8 % and 51.8% respectively. Conclusion: In
contrast with international studies PET CT have better diagnostic finding for evaluation and follow up of
Neuroendocrine tumors as compared to contrast enhanced CT Scan. We can say PET CT is a good and
better modality other then any contrast enhanced modality like contrast enhanced CT scan for the
evaluation of neuroendocrine tumors.

Key words:
CECT, PET-CT, NETs.

155
Comparison Of Ultrasonographic Findings And Magnetic Resonance Cholangiopancreatography
With Endoscopic Retrograde Cholangiopancreatography For The Diagnosis Of
Choledocholithiasis
Tahira Naheed, Sajid Shaheen Malik

Background: Gall stones in the common bile duct are known as choledocholithiasis. It is composed of
either bile pigment or calcium and cholesterol salts. The prevalence of choledocholithiasis is between 10%
and 20%. The exact frequency and prevalence of choledocholithiasis are unknown. Objective: The main
objective of this study is to present the comparative analysis of diagnostic accuracy of ultrasonography
and Magnetic resonance cholangiopancreatography with endoscopic retrograde
cholangiopancreatography for diagnosis of choledocholithiasis. Methodology: One hundred twelve cases
of choledocholithiasis included were referred to the department of radiology district headquarter/teaching
hospital Gujranwala during the period of 9 months. Ultrasound, MRCP and ERCP were performed. An
informed consent to include their data with the assurance of confidentiality was obtained from patients.
Results: In this study, during the 9-month study period, a total of one hundred twelve patients ranging in
age from 18 years to 85 years old were included, with average age of 48.18 years ± 16.82 years. The
studied patients were of both genders, including 67 (59.8%) female, and male 45 (40.2%).
Choledocholithiasis had been diagnosed in 28 cases (25%), 44 cases (39.3%) and 54 cases (48.2%) out of
total of 112 cases on ultrasonography, MRCP, and ERCP, correspondingly. MRCP shows improved
diagnostic accuracy and higher sensitivity (88.39% and 78.18%) than that of ultrasonography (72.32%,
and 47.27%), correspondingly. MRCP had provided better visualization of distal CBD stone in 23.2%
than that of ultrasonography 14.3%. MRCP has shown better diagnostic accuracy in identifying (31.3%)
single CBD than that of ultrasonography 19.6%.Conclusion: MRCP can be replaced with invasive
therapeutic procedures like ERCP and preferably used due to high diagnostic accuracy, and high
sensitivity than that of ultrasonography for the diagnosis of choledocholithiasis ultrasonography is the
initial choice for investigation of choledocholithiasis.

Keywords:
MRCP; ERCP; Ultrasonography; CBD; Choledocholithiasis; Diagnostic accuracy

156
 Sonographic Comparison Between Echogenicity And Renal Length Among Patients Suffering
With Or Without Chronic Kidney Disease

Maryam Fatima, Syed Muhammad Yousaf Farooq

Background: Chronic kidney disease (CKD) is defïned as any abnormality and impaired kidney functions
for more than three months. The most common causes of CKD are diabetes and hypertension. Objective:
To determine the association between renal length and echogenicity in patients with or without CKD.
Methodology: A descriptive study was conducted on Ultrasound Machine, Nemio 17 Toshiba in Gilani
Ultrasound Centre, Lahore. A total of 70 patients with or without CKD were included. Patients with no
previous clinical record of diabetes, high blood pressure, and age below 15 were excluded. Results: Data
analysis demonstrated that a total of 70 patients, (35 normal and 35 with CKD) were selected for this
study. Out of 70, 46(65.7%) were males and 24(34.3%) were females. The results showed that (out of 70
patients) with right kidney echogenicity, 36(51.0%) patients showed normal echogenicity with grade 0,
18(25.7%) with grade I, 10(14.3%) with grade II, 6(8.6%) with grade III and in left kidney echogenicity,
37(52.9%) patients showed normal echogenicity with grade 0, 16(22.9%) with grade I, 10(14.3%) with
grade II, 7(10.0%) with grade III respectively. A significant correlation of CKD with right and left kidney
were found as in right renal length with CKD mean length was 8.914 ±1.43 cm and without CKD, 10.4 ±
1.2 cm. Similarly, the left renal mean length with CKD was 9.49 ± 1.48 cm and without CKD was 10.28
±1.14 cm. A significant correlation was found between CKD, right and left renal echogenicity (significant
P-value is .000 for right and .000 for left renal length). Conclusion: The study concluded that echogenicity
and renal length can help us to estimate the severity of CKD. It also states that a significant association
was found between renal echogenicity, renal length, and CKD.

157
 Doppler Analysis Of Maternal Femoral Veins During 2nd And 3rd Trimesters Of Pregnancy

Erah Yasin, Ifra Mehmood, Mahjabeen Liaqat

Background: Pregnancy induces alterations in the venous system. We use duplex ultrasound to detect the
changes in femoral vein in terms of its diameter and flow velocity. The aim of this study is to give the
trend of alterations that occur during pregnancy. Objective: To analyze maternal femoral veins using
Doppler sonography during 2nd and 3rd trimesters of pregnancy. Methodology: This is comparative
analytical study. Total 230 pregnant females of 2nd and 3rd with normal single term pregnancy were
included. All women of high risk pregnancy, any other maternal disease and with fetal anomalies were
excluded. Results: The normal range of flow velocity (cm/sec) in right and left femoral vein was 2.7 -
34.4 (mean = 8.3) and 1.5- 30 (mean = 8.2) respectively in all the subjects. The normal range of average
venous diameter (mm) on right and left sides was 4.15- 15.75 (mean = 9.3) and 4.2- 14.8 (mean = 8.2)
respectively. The flow velocity on both sides decreased with the advancement of pregnancy (P=0.001 on
both sides). No changes were noted in femoral venous diameters and flow velocities on right and left side.
Conclusions: Significant changes in flow velocity and diameter were noted during 2nd and 3rd trimester.
No changes were noted in right and left femoral vein of same patient.

Key words:
Femoral vein, Doppler, flow velocity, diameter, pregnancy

158
 Ultrasound measurement of plantar fascia thickness: is the current criterion for normality
applicable to everyone?

Fouad Nafees, Zareen Fatima, Sajid Shaheen Malik

Background: This study was planned keeping in mind the importance of knowledge about the normal
adaptation of plantar fascia thickness (PF) in weight bearing individuals. Objectives: To compare the
plantar fascia thickness (PFT) among weight bearing and non- weight bearing individuals,
sonographically. Methodology: A total of 154 patients, 77 in each category of weight bearing and non-
weight bearing groups were included in the study. PFT was assessed sonographically and compared in the
same individual on both sides using paired T test and between the two groups using independent sample
T test on each side separately. Analysis of covariance was used to test the effect of weight bearing and
gender, on plantar fascia thickness bilaterally, in both groups with adjustment for age, BMI, duration since
lifting weight and standing hours. Correlation of age with PFT was also calculated using Pearson’s
correlation analysis. Value of P ≤ 0.05 was taken as significant. Results: Mean PFT in all patients was
3.8mm and 3.2 mm on left and right respectively. There wasn’t any significant difference in the right and
left foot on paired sample T – test. Laborers had significantly thickened PF compared with the control
group bilaterally. ANCOVA showed that weight bearing and BMI had significant effects on PFT. Age
was found to be correlated with PFT in non-weight bearing group. Conclusions: Factors causing increased
stress on the plantar fascia such as increased BMI and weight lifting can cause it to get thickened as a part
of its normal adaptation.

Key words:
Plantar Fascia; Plantar Fasciitis; Plantar Fascia Thickness

159
 Assessment Of Physiological Changes In Maternal Carotid Arterial Doppler Parameters During
2nd And 3rd Trimesters Of Pregnancy

Zobia Bakhtawar, Zareen Fatima

Background: Physiological hemodynamic alterations occur in the maternal body during course of a
normal pregnancy. These changes are essential for maternal wellbeing and adequate growth of fetus. We
aimed to identify trends in Doppler Indices in common carotid arteries (CCA) during second and third
trimesters of normal pregnancies. Materials and Methods: This study included 184 pregnant females
during 14– 40 weeks of gestation. Doppler examination of bilateral CCA was done. Pulsatility Index (PI),
Resistive Index (RI), Peak Systolic (PSV) and End Diastolic velocities (EDV) were measured bilaterally.
Regression analysis was performed to find out trend of each of the Doppler parameters with advancement
of pregnancy during 14 to 40 gestational week. P value of ≤0.05 was taken as significant. Results: PI
showed significant rise till 31 weeks (P= 0.0168, 0.0032 for right and left respectively) but no significant
change was identified after this gestational age on both sides. RI values on the other hand did not show
any significant correlation with gestational age (weeks). Right sided PSV and EDV were seen to display
significant correlation with gestational age with slowing down of flow when regression analysis was
performed for whole of the studied duration. EDV in right CCA also showed significant decrease in
velocity till 31st week of gestation but both PSV and EDV remained almost the same afterwards. Left
CCA however showed no significant changes in flow velocities. Conclusion: The changes of flow pattern
in the CCAs during pregnancy are complex and might represent response to multiple factors.

160
 Frequency Of X- Ray Findings In Cases Of Cervical Spondylosis
Ms. Javeria

Background: Plain radiography is still the first line modality for the evaluation of cervical spondylosis
in most of the countries. Objective: The main objective of our study was to find out the frequency of
radiographic findings for the diagnosis of cervical spondylosis on x-ray. Material and Methods: A cross
sectional study was carried out after the approval from institutional ethical board. Convenient sampling
technique was used in which all the cervical radiographs were included which were performed during the
study duration. The study was carried out in Radiology Department of Surraya Azeem Waqf Teaching
Hospital Chuburji, Lahore. A total of 252 cervical radiograph of 131 female and 121 male were included
in the study. Their age range and mean were 27-92 years, 54.4 years respectively. All of these cases of
cervical spondylosis were reported during study duration. Case taking was done with the special emphasis
to ascertain the following points:1. The age, sex with the date of the radiograph. 2. All the symptoms
presented by the patient were recorded in chronological order. 3. The variables noted on X-ray of cervical
spine AP/LAT views were: [Link], [Link] of osteophyte and their frequency, c. Presence of disc
space reduction and frequency, d. Cervical rib (incidental finding of a normal variant not related to cervical
spondylosis), e. Degree of cervical spondylosis. Findings and data were then entered on EXCEL sheet.
Chi- Square test and Kruskal-Wallis tests were applied for the comparisons of different variables in
radiographic findings of cervical spondylosis. Results: Anterior marginal osteophytes were most
commonly seen in C5 (96.4%) followed by C6 (81.7%), C4 (76.6%), C3 (51.2%), C7(41.3%) and C2
(23%). C5-C6 space was most commonly affected by cervical spondylosis (81.7%) followed by C4-C5
(78.2%), C6-C7 (52%), C3-C4 (27.4%) and C2-C3 (23%). Chi-Square test showed no significant
difference between both the genders in presence of curvature abnormalities, osteophyte formation, disc
space reduction and degree of cervical spondylosis. Kruskal-Wallis test showed the strong association (P
0.000001) of the degree of cervical spondylosis with advancing age. Conclusion: On the basis of our
result we conclude that the cervical spondylosis is highly associated with advancing age. The changes are
more marked in lower cervical vertebrae as compared to the upper ones.
Keywords:
Spondylosis, cervical, severity, Osteophyte, Disc space reduction

161
 Correlation Between Renal Artery Resistive Index And Renal Function Tests In Type Ii Diabetic
Patients
Maham Nasir

Background: Diabetes mellitus is now one of the most common non communicable diseases globally. It
has emerged as one of the major health care problems in Pakistan. Diabetic nephropathy is a relatively
common form of chronic renal disease. It is the most frequent microvascular complication in diabetic
patients. Objective: To find out correlation between renal artery resistive index and renal function tests
in type II diabetic patients. Methodology: It was analytical research project conducted at Hamza Medicare
Rahim Yar Khan for 9 months duration. 60 type 2 diabetic patients having disease for more than 5 years
(over 20 years of age) along with HbA1c levels of more than 6.5% were included in the study. Patients'
biochemical data tests along with kidney examination and Renal Doppler ultrasounds were performed.
The renal artery resistive index and kidney parameters were noted. Results: The link between resistive
index (RI) and biochemical data was determined using Pearson's correlation. The resistive index and
serum creatinine had a positive correlation of r=0.438 (p=.000). The correlation between RI and
microalbuminuria was also positive, with r= 0.245 (p= 0.05). For r=-0.057 (p=0.663), there was negative
association between resistive index and 24-hour urine protein. There was also strong association between
RI and HbA1c levels, with r=0.162 (p=0.217). There was positive correlation between resistive index and
duration of diabetes (r= 0.312, p< 0.05). On the basis of duration of diabetes patients were divided in 3
groups. Mean difference between groups 1 and 2 was significant. But mean difference between groups 1
and 3 and groups 2 and 3 was insignificant. Conclusion: There is strong association between renal artery
resistive index and renal function tests of type II diabetic patients. Hence concluded that the intra-renal
resistivity index, as measured by the use of duplex Doppler ultrasonography is non-invasive process that
can be linked to biochemical profile renal dysfunction parameters in type 2 diabetes patients (DM2) with
diabetic kidney disease.

Keywords:
Diabetic nephropathy, Doppler evaluation, microalbuminuria, 24-hour urine protein, proteinuria,
Resistivity index, serum creatinine.

162
 Frequency Of Findings On Hysterosalpingography (Hsg) In Females Presenting With Infertility
Saba Zafar, Rabia Ahmed

Background: Hysterosalpingography is a very commonly used and easy to perform investigative

technique for detection of female reproductive system. Objectives: The aim of the study was to evaluate
the structural abnormalities of the uterus and fallopian tubes in infertile women as elucidated by
hysterosalpingography. Material and Methods: A prospective cross sectional study was done after
approval from departmental Board of Studies of Department of Radiological Sciences and Imaging,
Faculty of Health and Allied Sciences, ICBS. The study duration was 3 months and a total of 298
hysterosalpingography (HSG) performed for investigating the cause of infertility in the Radiology
department of Fatima Memorial Hospital (FMH) and the HSG findings were included. The data were then
analyzed statistically using MEDCALC. Results: A total of 298 patients were evaluated. Of these, 52%
were of secondary infertility and 48% of primary infertility. 211 patients had no abnormality while 87 had
at least one abnormal findings on hystteroalpingography. All patients had normal uterine cavities. Based
on free peritoneal spillage of contrast medium into the peritoneal cavity 213 patients were found to have
bilateral patent fallopian tubes, while 44 showed bilateral tubal obstruction. 23 had left while 18 had right
tubal blockage. Eight bilateral and two left fallopian tubes were not outlined by the contrast. Hydrosalpinx
was seen in 3 cases bilaterally, in 1 and 5 cases on the left and right sides only respectively. Conclusion
and Recommendations: This study showed that the secondary and primary fertility are almost equally
prevalent in our population. In all these patients tubal blockage is the commonest reason of infertility in
women as none of our patient showed uterine abnormality.

Key words:
Contrast material, fallopian tube, fluoroscopy, hysterosalpingography infertility, uterus.

163
 Association Of Neonatal Outcome With Sonographic Evaluation Of Amniotic Fluid In Third
Trimester Of Pregnancy
Noraiz Ali, Zareen Fatima
Background: Ultrasound evaluation of amniotic fluid is very important for the assessment of fetal well-
being. Objective: The objective of the study was to find out the association of neonatal outcomes with
the sonographic findings of amniotic fluid. Methodology: A cross-sectional study was carried out at the
Department of Obstetrics and Gynecology, Jinnah Hospital Lahore, Pakistan for a period of six months.
A total of 182 subjects were included in the study with mean age in years of 29.96±4.41 and age range of
21–36 years. The gestational age ranged from 27 to 38 weeks. 61 of these were hypertensives, 21 were
diabetics 71 had none while 29 had both of these diseases. Antenatal ultrasound was done trans-
abdominally within 72 hours prior to delivery. The amniotic fluid was assessed qualitatively and
quantitatively. The fetal outcome was then assessed by taking 5- minutes APGAR score in the neonates.
The results were calculated using MEDCALC. Mean and standard deviation were reported for quantitative
variable. Frequency and percentages were calculated for categorical variables. Chi-Square test was applied
to find out the association of categorical variables. Pearson’s correlation was found out to see the
association of APGAR score with maternal age and parity. Results: A statistically significant association
was found in APGAR score and amniotic fluid appearance and amount. AF appearance and amount both
had significant association with the presence of diabetes and hypertension. Maternal age, parity and
premature rupture of membranes (PROM) were also found to be associated with APGAR score having
negative effects on it. Conclusion: Amniotic fluid amount and appearance on antenatal ultrasound are
strongly associated with neonatal outcomes in terms of APGAR score.
Key words:
APGAR Score: Neonatal Outcome: Amniotic fluid amount: Amniotic fluid appearance.

164
 Frequency Of Hepatocellular Carcinoma In Patients Infected With Hepatitis C Virus, Visiting A
Tertiary Care Hospital In Lahore For Computed Tomographic Evaluation

Nozaina Irum, Amna Akhtar, Sidra Mehmood, Saliha Tariq, Fakher Un Nisa Bhatti, Rija
Zaigham.
Background: Hepatitis C virus has been identified as one of the leading causes of chronic liver disease
and its complications world-wide. Subsequent development of hepatocellular carcinoma in these patients
is a major complication of this infection having serious implications on morbidity and mortality rates.
Objective: The objective of this study was to find out the frequency of Hepatocellular carcinoma in
patients suffering from Hepatitis C visiting Radiology department of a tertiary care hospital for multi-
detector computed tomography evaluation. Methodology: This cross-sectional analytical study was
conducted at Shalamar Hospital Lahore. A total of 195 patients, suffering from Hepatitis C, visiting
Shalamar Hospital, Lahore for evaluation by CT during 6 months study interval were included in this
study. Abdominal CT was performed using Triphasic contrast enhancement protocol. All images were
interpreted by a senior Radiologist. Frequency of Hepatocellular carcinoma was calculated. Statistical
analysis was made using MEDCALC. Results: Out of 195, 63(32.3%) patients were seen to have
hepatocellular carcinoma. This disease was more common in male, 45(34.6%) as compared to female
patients 18 (27.7%). The presence of HCC showed statistically significant association with alcoholism,
obesity, diabetes mellitus and cirrhosis. Conclusion: The study concluded that a substantial number of
HCV positive patients develop HCC, which is more common in men as compared to women. The presence
of HCC is strongly associated with alcoholism, obesity, diabetes mellitus and cirrhosis.

Keywords:
Hepatocellular carcinoma (HCC); Hepatitis C (HCV); Multi-detector Computed Tomography (MDCT)

165
 Evaluation Of Radiation Hazards Among The Health Care Professionals Of Twin Cities
Basharat Bashir, Mudassir Riaz, M. Abdullah, Umer Zia, Mayra Nazir*, Dr Aysha Wajid,
Muhammad Amir, Kashaf Javed
Prime Institute of Health Sciences, H15 Motorway chowk Islamabad

Background: Radiations used in medical imaging for diagnostic and interventional purposes has
increased significantly in recent years, increasing the risk of radiation exposure for medical professionals.
Radiation is broadly classified into ionizing and non-ionizing radiation. Ionizing radiation is typically
produced by radioactive materials that emit radiation. Non-ionizing radiation is frequently produced by
visible light, microwaves, and infrared light. Health effects of ionizing radiation are usually classified into
two categories: deterministic and stochastic. Deterministic effects are also known as non-stochastic effect.
These effects depend on time of exposure, doses, type of radiation. Deterministic effects are those
responses which increase in severity with increased dose if the dose increases the severity of an effect
increases. Objective: To evaluate the radiation hazards among health care professionals working in
radiology department. Another main objective was to assess the knowledge of radiation hazards and
radiation protection practices of health care professionals. Methodology: An observational study was
based on a close ended questionnaire survey that will carried out among health care professionals working
in radiology department in different hospital of twin cities. Sample size of 200 people working in different
modalities were invited to participate in the study. Age range targeted was from 18 to 50 years. Results:
Total sample size of 200 potential participated in this study, out of which 50 participants were contacted
via email to participate the survey. The average age of participants was 18 to 28 years (75%) of whom
were male and (58.3+39.6) was female. The majority of participants were Technicians/Technologists
(58.3%) and their work duration was 2 to 5 years (35.4%) was most effected by radiation hazards.
Technicians /Technologists (58.3%) working in Radiography was at high risk and mostly affected by
radiation hazards (37.5%). The average participants(79.2%) were found to have good knowledge of the
risk and safety measures associated with radiation hazards. Conclusion: This study demonstrated poor
radiation protection practices despite good knowledge of radiation hazards among the participants, but
radiation exposure and prevalence of radiation hazards were found.

166
 Frequency Of Iodinated Contrast Reactions In Patient Undergoing Ct Scans In The Vicinity Of
Islamabad And Rawalpindi

Aniqa Anwar, Maham Nabeela, Sajjad Ahmad, Attia Bano*, Dr Aysha Wajid, Muhammad Amir,
Kashaf Javed.
Prime Institute of Health Sciences, H15 motorway chowk, Islamabad

Background: Computed Tomography(CT) is an essential tool in diagnostic imaging for evaluating many
clinical conditions and uses Ionizing rays i.e. X-rays. CT is mainly used in imaging blood vasculature via
Angiogram studies different bony structures of body and other regions such as abdominal studies. CT scan
was performed in either of two ways i.e. Plain CT (Without contrast media) and Contrast Enhanced CT
(with contrast media). Contrast was a special kind of dye which was used to highlight different region or
areas of the body being examined. Millions of contrast enhanced CT scans (CECT) are performed each
year. Our study was focused on patient undergoing CT scan with Intravenous (IV) Iodinated contrast
media. In accordance with previous literature, majority of patients shows contrast reactions varying from
mild to severe life threating conditions. Objective: The purpose of our study was to investigate the
frequency of contrast reactions in patients Contrast enhanced CT scans with Non Ionic Low Osmolar
Iodinated Contrast Media (LOCM). Methodology: A Retrospective cross sectional observational study
was performed. Sample size for this study was 250 patients to evaluate the contrast reaction. The study
was conducted in Radiology Department of different hospitals in the vicinity of Islamabad and
Rawalpindi. Simple random sampling technique was used for this study and data was collected via
Questionnaire. Low osmolar contrast media (LOCM) was used as contrast agent with high concentration
of 100mg/mL and low concentration of 50mg/Ml Via Intravenous (IV) administration. Data was analyzed
using SPSS version 26. Mean, descriptive and correlation analysis was performed. Results: A total 250
patients were examined using non- ionic iodinated contrast media. Out of 250 patients, 106(42.5%) were
male and 144(57.5%) were females. Adverse contrast reaction was reported in 96(38.4%) patients. Among
these 96 patients 64(26.2%) patients show mild contrast reaction while 32(12.8%) patients show moderate
reaction while 154 patients did not show any contrast reaction. Adverse Contrast reaction among cases of
different clinical history identified were itching in 13(5.2%) patients, headache in 6(2.4%) patients, nausea
in 13(5.2%) patients, vomiting in 13(5.2%) patients, dizziness in 6(2.4%) patients and Shortness of breath
in 13(5.2%) patients. For the age wise distribution of contrast reaction 63(25%) were at the age of 18-25
years, 56(22.5%) were at the age group of 26-35 years, 38(15.0%) were at the age group of 36-45 years
and 94(37.5%) were at the age group of 46-55 years. The marital status of patients out of 250 patients was
181(38.4%) were married while 69(27.6) were single. Conclusion: Rapid recognition of the signs and
presentations of a contrast reaction allows radiology personnel to identify the type of reaction which in
turn facilitates rapid treatment and reversal of the contrast reaction. It helps to promote awareness among
people regarding contrast enhanced CT scans.

167
 Sonographic Changes In Thyroid Glands Of Smokers- A Brief Communication

Muhammad Hamza Butt, Syeda Khadija Tul Sughra

Background and Objective: Pakistan is known to be one of the top users of tobacco in the world and
smoking- related health hazards remain largely under- reported from this part of the world. The purpose
of our study was to report sonographic changes in thyroid glands of smokers and in comparison to non-
smokers in our local population. Methodology: A cross-sectional study was conducted for a duration of
4 months. Total 166 healthy male volunteers, 83 each in smoker and non-smoker group participated in
this study. All patients underwent thyroid ultrasound. Size, echotexture, and presence or absence of nodule
was noted. MEDCALC was used to analyze the data. Independent sample T- test and Chi- Square test
were applied. P value of ≤0.05 was taken as significant. Results: Sizes of both lobes and isthmus of thyroid
gland were more in smokers as compared to the non- smokers but this difference was not statistically
significant. Heterogeneous echotexture of the thyroid gland was seen in 8 smokers and 1 non- smoker
(P=0.0168). Thirty two (38.6%) smokers showed the presence of nodule in the thyroid gland while these
were seen in just 2 (2.4%) of the total cases. The presence of the nodule thus showed significant association
(P < 0.0001) with smoking on Chi square test. Conclusion: Smoking is associated with insignificant
enlargement of thyroid glands with increased risk of nodule formation.

Key words: Smoking; Thyroid; Nodule

168
 Noninvasive tools for evaluation of chronic kidney disease: resistive index versus strain index,
which is better?

Saba Mushtaq, Zareen Fatima

Introduction: We aimed to compare the diagnostic accuracy of resistive index (RI) and strain index (SI)
for the non- invasive evaluation of chronic kidney disease (CKD) patients. Methods: Total of 800
subjects, 642 with different stages of CKD and 158 with normally functioning kidneys were recruited.
CKD patients were grouped in stage I to V based on eGFR. Calculation of SI and RI was done using
sonoelastography and Doppler imaging respectively. Krusal- Wallis test was done for comparison among
various groups. ROC analyses were performed to find out accuracy of both parameters for evaluation of
CKD. Spearman’s rank correlation test was also applied. Results: Mean RI and SI values in normal
healthy controls and CKD patients were 0.59±0.06, 0.43±0.04, 0.74±0.02 and 1.87±0.6 respectively. Both
of these were found to be significantly different not only between normal healthy controls and CKD
patients but also among various stages of CKD on applying Kruskal- Wallis test (P < 0.000001). Optimal
cutoff values of RI and SI were found to be 0.69 and 0.52 respectively on ROC analysis for differentiation
of normal and grade I CKD patients. RI was more sensitive than SI at these cutoff values while SI was
more specific than RI. Spearman's coefficient of rank correlation (rho) was found to be 0.92 with a P value
of <0.0001. Conclusion: Based on our findings we conclude that both RI and SI derived from Doppler
and sonoelastography respectively can serve as useful noninvasive means to diagnose and differentiate
stages of CKD patients.

169
 Sonographic Correlation Between Adnexal Masses And Endometrial Thickness In Infertile
Females

Syed Muhammad Yousaf Farooq,, Syeda Khadija tul Sughra, Guido C Robot, Hafiz Syed Arsalan
Gilani, Aima Gilani, Syed Zain ul Abdin, Hamza Ahmed

Background: Infertility is very common social, economic and medical problem. There is various cause
of infertility, adnexal masses and endometrial thickness play a vital role among them if we find out relation
between adnexal mass, endometrial thickness and infertility so we will be able to overcome this problem
to great cause. Objective: To determine the sonographic correlation between adnexal masses and
endometrial thickness in infertile females. Methods: This cross-sectional analytical study was conducted
at Gilani Ultrasound Center, Lahore, Jamiat Hospital and Green town clinic The University of Lahore.
Study duration was 9 months. Sample size was 150 patients. Sampling technique used was convenient
sampling. All Infertile Females with adnexal mass, age of 18-45 were included in study. Male with
infertility were excluded. Ultrasound machine Toshiba Xario with convex transducer frequency range 2.5
to 5 MHz was used. Results: Out of 150 patients the mean age was 32 ± 6.33, minimum age was 18 and
maximum age was 45. The mean endometrial thickness was 0.78mm with standard deviation 0.29,
minimum endometrial thickness was .10 cm, maximum endometrial thickness was 1.69 cm. Out of 150
patient's primary infertility was 30% with frequency of 45, and secondary infertility was 70% with
frequency of 105. The Chi-Square test was used between adnexal mass and endometrial thickness shows
that there is significant association because them. Conclusion: Study concluded that there was significant
correlation between adnexal masses and endometrial thickness in Infertile Females. Ovaries should not
neglected in infertility treatment because they play important role with respect to endometrium. The
removal of adnexal masses can improve infertility rate.

Keywords: Infertility, Endometrial thickness, Follicle stimulating hormone, luteinizing hormone,

Ultrasound.

170
 Carotid artery disease assessed by color doppler flow imaging: comparison between diabetic and
non-diabetic patients.

Ume Kalsoom Attique, Syed Muhammad Yousaf farooq, Areeba Mahmood.

Background: Carotid artery disease is most often seen in patients with diabetes mellitus. More than 50%
stenosis of extra cranial internal carotid arteries is linked with about 8–15% of ischemic strokes. The
incidence of carotid artery stenosis (CAS) among diabetic patients is rising as compared to non-diabetic
patients. Objective: This study aims to compare the Color Doppler findings for assessment of Carotid
Artery Disease in diabetic and non-diabetic patients. Methodology: A cross-sectional study was
performed on 120 patients, out of whom 60 were diabetic and 60 were non-diabetic. The study was
conducted at theuniversity ultrasound clinic in Green Town by Doppler ultrasonography using the Toshiba
XARIO XG, which features a linear probe of 5-7.5 MHz frequency. The data was analyzed with the help
of SPSS version 25.0. Variables like age, gender, diabetes, and Intima-media thickness (IMT) were
reported and the mean ±standard deviation of Pulsatility Index, Resistive Index, Peak Systolic Velocity,
and End Diastolic Velocity were calculated with a significant p-value, which is less than 0.05. An
independent t-test was applied to compare Doppler indices in diabetic and non-diabetic subjects. Results:
Data was collected from 120 patients. IMT of right and left carotid artery, PI and RI of right carotid were
observed to be statistically significant in diabetic and non-diabetic. Mean and standard deviation of IMT
of right and left carotid artery was 0.57 ± 0.14 and0.56 ±0.15 in non-diabetic while 0.63 ± 0.17 and 0.64
± 0.13 in diabetic patients respectively. Mean and standard deviation of PI and RI of right carotid artery
was 1.33 ± 0.84 and 0.63 ± 0.18 in non-diabetic while 1.02 ± 0.48 and 0.63 ± 0.18 in diabetic patients
respectively. Conclusions: This study concluded that there is a significant correlation found between
carotid artery disease and diabetes. Through ultrasonography, the presence of plaque and stenosis was
found in more diabetic patients than in non-diabetic patients.

Key words: Ultrasonography, carotid artery disease, carotid artery stenosis, carotid plaque, vascular
ultrasound, diabetes

171
 Sonographic Evaluation Of Median And Tibial Nerve In Diabetic And Non-Diabetic Individuals

Yusra Iqbal, Mahnoor Wahid, Syed Muhammad Yousaf Farooq. University Institute of
Radiological Sciences & Medical Imaging Technology, The University of Lahore, Lahore,
Pakistan

Background: Ultrasound is used to measure the cross-sectional area of median and tibial nerves with high
resolution and to associate it with diabetes. It demonstrates to be the most accessible, non-invasive, and
affordable method alternative to nerve conduction research (NCS). Objective: To evaluate the sonography
of median and tibial nerve in diabetic and non-diabetic individuals. Materials and Methods: In this
Analytical Case-Control study total of 90 individuals were examined. 45 were diabetics and 45 were non-
diabetics. The study was performed at Sehat Medical Complex Hanjarwal Lahore. The sample size was
calculated at a 99 % level of significance and 95 % power of the test. The ratio for sample size (diabetic /
non-diabetic) was 1. Data were evaluated and analyzed by statistical software for social sciences SPSS
25.0. Results: There were 90 individuals recruited during our study. There were 52(57.8%) female and
38 (42.2%) male. Patients with hypoechoic appearance of median and tibial nerve were 42 (46.7%) and
41 (45.6%) respectively. The mean size of the median nerve in healthy individuals was 6.88 ± 1.3 mm2and
in diabetic patients was 12.17 ± 2.1 mm2. In diabetes individuals, the cross-sectional area of the tibial
nerve was 15.06 ± 3.0 mm2, but in non-diabetics, it was 8.3 ±2.4 mm2. The difference in mean CSA of
the median nerve of diabetic and non-diabetic subjects was statistically significant in the Independent
Sample test (p ˂0.005). Conclusion: According to our research the vast majority of diabetic patients who
underwent ultrasonography had a significant increase in cross- sectional area of nerves in diabetic patients
as compare to healthy control individuals. Moreover these results suggest that sonographic examination
are useful for the diagnosis of diabetic neuropathy.

172
 Ultrasonographic comparison of deltoid muscle echogenicity in relation with bmi in diabetic and
non diabetic with inter-observer agreement.

Faiza Sarwar, Areeba Hassan, Iqra Naz, Ezza Majeed, Sidra Tul Muntaha

Background: Diabetes mellitus is a major health problem with rising tendency world-wide. In the various
types of musculoskeletal diseases, shoulder pain is the most common complication. Objective: To
compare the echogenicity of deltoid muscle in diabetic and non-diabetic individuals on ultrasound.
Methodology: It was case-control analytical study which included total 100 patients in which 50 were
diabetic and 50 were non diabetic visited Sehat medical complex, Hanjarwal, Lahore, Pakistan.
Consecutive sampling method was used. 9-15MHz frequency linear transducer of ultrasound was used for
shoulder ultrasonography. Echogenicity of deltoid muscle, BMI, age, diabetc duration, gender and
diabetic status were noted. Blind reviewed study was conducted by two MSK radiologist, and third was
as an arbitrator to evaluate the echogenicity of deltoid muscle. Crosstabs were made using SPSS version
25.0. Results: Total 100 patients were included in which 50% were diabetic and 50% were non diabetic
individuals. On the bases of 3 musculoskeletal radiologists that had 0.78 inter rater agreement (kappa)
identified 46% hyperechoic, 43% hypoechoic and 11% not clear individuals. 46% hyperechoic (diabetic
patients) had highest level of BMI with average of 58.68kg/m2 than 43% hypoechoic with average BMI
41.13 kg/m2 and 11% not clear with average BMI of 52.91kg/m2. In 50 diabetic patients diabetic duration
also noted with mean of 72.4 ± 73.1 SD. The 100% sensitivity and 86% specificity (p<0.001) of
ultrasonography was calculated by youden index in detection of echogenicity of deltoid muscle in diabetic
and non-diabetic individuals. Conclusion: By strong inter observer agreement this study concluded that
ultrasound is highly sensitive for detection of deltoid muscle echogenicity in diabetic and non diabetic
individuals. This method could be used as a complement tool for the earlier detection of diabetic patients
who may have undiagnosed.

Key words: Musculoskeletal ultrasound (MSK US), Diabetes mellitus (DM), Body mass index (BMI),
Deltoid muscle.

173
Department of Optometry and Vision Sciences (DOVS)

174
 INTERNATIONAL SPEAKERS
A case for strengthening eye health services in lower- and middle-income countries by building
capacity in public health in allied health professionals like optometrists.
Dr. Deon Minnies (South Africa) Phd. Public Health
Director of the Community Eye Health Institute (UCT-CEHI) in the Division of Ophthalmology
at the University of Cape Town, South Africa

Abstract
Despite the successes and achievements of the VISION 2020 and the Universal Eye Health / Global Action
Plan strategies, there is a high burden of vision loss in lower- and middle- income countries. In many
countries, there is a steady pipeline of qualified optometrists entering the health service sector. While
people making use of private eye care services have ready access to high quality, effective and accessible
optometric services, the same cannot always be said about the vast majority of people attending public
facilities for eye care services. The public sector in many countries is underserviced because too few eye
health care professionals are taking up leadership positions in public health. This paper explores the
notion that optometrists can play a major role in strengthening public eye care services in countries like
Pakistan.

175
 Significance Of Deploying Optometrists At Rural Health Centers In Prevention Of Avoidable
Blindness In The Category Of Optometry In Modern Ophthalmology
Dr Sergio Latorre Arteaga (Spain) PhD in health sciences
RAAB research and planning programme, Monitoring Peek in Pakistan, Ethiopia and Nepal.

Abstract:
In collaboration with College of Ophthalmology &amp; Allied Vision Sciences (COAVS) and Sindh
Institute of Ophthalmology &amp; Visual Sciences (SIOVS) and with the support of CBM (Christoffel-
Blindenmission Christian Blind Mission) in Pakistan a comprehensive eye health screening programme
using Peek technology has been implemented in 3 districts of Sindh and Punjab [Link] total 146
health facilities and over 1,500 schools have been connected and integrated across community, primary,
secondary and tertiary levels to deliver high quality eye care to the population. As of the end of August
2022*: 750000+ people screened in total (currently over 50000 people are screened per month). 25%
identified as needing further services. 90% of people referred from screening attended their appointment
with the Optometrist. 92% of those attending confirmed to have vision or eye problems. 82% had their
needs met effectively at the primary level and 18% required further referral to the ophthalmologist at
Tehsil Headquarter (THQ) Hospital, while less than 1% required a referral to a tertiary hospital. The
deployment of Optometrist at Rural Health centers is greatly contributing to enhance coverage and
efficiency of services

176
 Ocular Association In Hypothyroidism

Dr. Kalsoom Rani

Senior Optometrist at Northwest Clinic Dubai.

Abstract:
Ocular association is very common in the patients presenting with hyperthyroidism, but the purpose of
this study was to report a rare case of unilateral dry eye disease (DED) caused by hypothyroidism and
with graves ophthalmology signs. This case report and literature review showed the rare uniocular
association of dry eye with hypothyroidism discussing its clinical presentation and aetiology. A 53-year-
old woman with hypothyroidism presented with pain in preorbital area and a burning sensation in her left
eye with blur vision Ocular examination revealed conjunctival redness and inferior superficial punctate
fluorescein staining in the left eye. Her anesthetized Schirmer values and Tear Break Up Time (TBUT)
were 12 mm and 5sec in the Right eye (RE) and 3mm and 2sec, in the Left eye (LE) respectively.
Refractive status showed astigmatism with clear fundus and clear lens view in Both eyes (BE), on
evaluation LE was showing proptosis with solen orbital fat and on history patient also complaint of puffy
eyes in the morning in BE. Unilateral DED and signs of graves ophthalmology in primary hypothyroid is
very rare conditions although signs of graves ophthalmology are very common among hyperthyroidism
patients. On literature review I found only 3 cases of hypothyroidism showing graves ophthalmology, so
more research is required in this area to find out the exact a etiology of tear gland functional and sings
graves ophthalmology in hypothyroidism.

177
 NATIONAL SPEAKERS
Effect Of Ex-Vivo Non-Wet Hot Eye Pad Therapy On Tear Film Stability In Meibomian Gland
Dysfunction
Dr. Ayesha Kiran,OD,M Phil

Abstract
Introduction: In Meibomian gland dysfunction orifices of Meibomian glands clogged so, glands do not
secrete sufficient oil. Objectives: Purpose of the study was to determine the effect of ex-vivo non-wet hot
eye pad therapy on tear film stability in meibomian gland dysfunction and to access improvement in
evaporative dry eye and its associated symptoms. Methodology: A Quasi-study design of sample size of
30 patients aged 20-35 years females that have meibomian gland dysfunction with evaporative dry eye
were selected through purposive sampling technique at The University of Faisalabad from September
2021 – May 2022. Contact lens users &gt; one year, mild refractive errors
(Myopia,Hyperopia,Astigmatism), pregnant ladies, patient with all systemic and ocular pathologies except
dry eye were excluded. History, TBUT, and Meiboscale grading through slit lamp was done for diagnosis.
Hot eye pad was given twice a day for ten minutes, assessment was done immediately, after thirty minutes
and after fifteen days follow up. Data analysis was done by SPSS software-20 and analyzed by using
Repeated Measure ANOVA. Results: Results showed that hot eye pad therapy increased Meiboscale
grade and TBUT, the significant value was (p=0.00). Mean value of Meiboscale was increased from
baseline 4.03±.75 to 1.31±.50 at 3 rd follow up. Mean value of TBUT was increased from baseline
1.35±.48 to 2.96±.18 at 3 rd follow up. Conclusion: Result concluded that hot eye pad therapy improved
values of Tear Film Break Up Time and Meiboscale grade by unclogging gland orifices which treated
evaporative dry eye, also resolved signs and symptoms of Meibomian gland dysfunction.

Keywords: Evaporative dry eye, Ex-vivo, Meibomian gland dysfunction

178
 Contact Lens Practice In Pakistan; In Context Of Global Perspective
Dr. Memoona Arshad
Phd. Optometry University of New South Wales- Sydney, Australia
Assistant professor (HOD Optometry) The Green International University

Abstract

Refractive error has been acknowledged as the second greatest cause of avoidable blindness in Pakistan
and worldwide. Contact lenses are a relatively safe and effective modality for the correction of refractive
errors and the estimated number of contact lens wearers worldwide is approximately 175 million. Contact
lens practice across the world is at juncture with some potential opportunities, such as for myopia control,
multifocal lenses for presbyopia and specialty lenses; however, there are also looming threats such as
increasing competition from online business. As optometry, itself is a novel yet blooming field in our
country, the scope of practice for a subspeciality such as contact lenses is un-identified. There have been
a few studies conducted at individual levels to evaluate the lens wear and care education among eye health
workers and public but the understanding on this topic is limited. The prevalence of contact lens wear and
its associated complications is also widely unknown in this geographical region. With the fast-growing
population and consequent increase in contact lens market demands, it is essential to understand the
penetrance of contact lens wear and strategies to improve contact lens wear and care. My research goal is
to identify contact lens market in our population, understand the paradigm of current demographics and
improve contact lens wear habits, to get full benefit from this useful eyewear modality.

Keywords: Contact lens, contact lens demographics in Pakistan, contact lens hygiene, contact lens
industry in Pakistan.

179
 Role of optometry in providing advanced primary eye care at intermediary clinics to reduce
avoidable blindness in tehsil sadiqabad, rahim yar khan.
Fatima Zehra, Masters in project Management (SZABIST)
BS in clinical Opthalmology Technology (DOW University of Health Sciences) IAPB Eye Hero 2020,
National Inclusive Eye Health Trainer, Program Manager AL-Baseer Foundation

Abstract
The project aims to provide access to improved and inclusive eye health services in the Rahim Yar Khan
district of South Punjab. This is to be achieved by strengthening ophthalmic services at the primary and
secondary health level, by capacity-building measures for health staff in the region, strengthening self-
help groups and self-representative organizations (OPDs), and by systematic lobbying of health
authorities. Objectives :The Objectives of the project include 1: Access to high quality inclusive and
comprehensive eye health services is provided by trained eye health staff in BHUs, RHC, and THQ, 2:
People with disabilities and their families are organized and trained to raise awareness about disability,
their rights, and access to inclusive eye health services 3: A committee for actors in the ophthalmic field
in Rahim Yar Khan has been established. Its members pursue a strategy with common goals to provide
inclusive and high-quality eye health [Link]: Based on the findings and progress of the project,
it has been learned that optometrists play a key role in reducing avoidable blindness at the primary level.
Their role is pivotal in providing advanced primary eye care and creating awareness of primary eye care
and refractive errors. The optometrists deployed at centers are also trained on Inclusion in Eye Health
and ensuring access to inclusive eye care services. The deployment of optometrists at the primary level (5
RHCs) and Tehsil Head Quarter has created a great impact in terms of making eye care services available
in the tehsil. It has increased the coverage and reduced the burden of ophthalmologists at the tertiary eye
care level. Since 2021, more than 85,000 people have been screened under the project in tehsil Sadiqabad
(24 BHUs, 5 RHCs, and THQ Hospital) for refractive errors and different eye problems. More than 50,000
refractions were performed by trained optometrists, 27,181 spectacles were prescribed, and more than 500
cataract surgeries were performed. Out of the total Screened, more than 25,000 (29%) people have been
screened at primary eye care centers by deployed optometrists. Out of which, 11,856 refractions were
performed and 7343 spectacles were prescribed. More than 3000 people were referred from primary eye
care centers to Tehsil Head Quarter (THQ) hospital for detailed diagnosis and treatment. More awareness
is being created under the project about the availability of eye care at all centers.

180
 PRESENTERS
Rapid Assessment Of Refractive Errors In Tehsil Rawalpindi: A Community Based Study

Maimoona Rehmat1, Saba Shakoor2

1 Lecturer, DOVS, University of Lahore.
2 Ex Internee Optometrist, Shifa International Hospital Islamabad.

Abstract
Refractive error is the condition of the eye in which the parallel rays of light coming from infinity are not
focused on retina. Globally magnitude of visual impairment caused by refractive error among people aged
16–39 years is 27 million. Rapid Assessment of refractive error (RARE) is a community based cross
sectional study. It renders to examine the prevalence and cause of refractive errors among age group of
14-49 years. As it is a low cost survey it can be done to get sufficient data on prevalence and causes of
visual impairment and refractive errors. Purpose: To estimate the refractive errors and the causes of
visual impairment in the Tehsil Rawalpindi among the individuals aged 14 to 49 years. Material and
Methods: A population based cross sectional study was conducted from September 2019 to December
2019 in randomly selected villages of Tehsil Rawalpindi. Three hundred and eighty-four individuals aged
14-49 years were randomly included. A valid Performa was used to collect the socio demographic and
clinical observations. Data was entered in SPSS version 23. Descriptive analysis was done by reporting
frequency and percentages for quantitative variables. Results: Out of 384, more than half individuals
(204, 53%) had refractive error. The Most common refractive error was found myopia (22%). Most of the
individuals (75%) were not using glasses due to unmet need (33%). Patients with any pathology other
than refractive error were referred to tertiary Eye care hospital for detail examination and management.
Conclusion: Uncorrected refractive errors need urgent attention so that it may not cause further harm. It
is important to focus on the development of human resources and provision of eye care services at all
levels.

Keywords: Rapid Assessment, RARE, Myopia, Refractive errors, Visual impairment

181
 A Qualitative Study To Access The Barriers Faced By Low Vision Person During Rehabilitation

Sadia saddiqi, Tayyiba Ayesha, Sarah, Tabasum Qaiser, Ahmad Raza, Nida Amin, Memona
Arshad
Abstract
Background: There are 285 million visually impaired people across the world including 39 millions blind
and 246 million low vision population. The major barriers in the rehabilitation services are attributed to
lack of awareness, patient accessibility and communication problems. The aim of our study was to identify
the barriers faced by low vision population while taking rehabilitation services. Method: This was a
qualitative, observational study in which data was included from a convenient sample of 60 low vision
patient, presenting at various low vision rehabilitation centers, District Faisalabad in November 2017.
After written/informed consent, and meeting inclusion criteria of low vision as per WHO categorization,
a written/verbal interview was conducted by study investigators to investigate the barriers to low vision
service provision. Results: Travelling cost due to long distance was a significant barrier to low vision
rehabilitation(p>0.05), as reported by 47/60 (78.3%) participants. Other significant barriers included
missing follow ups (75%), fear of social rejection was (40%).Other barriers reported by participants
included inadequate information about low vision devices (36.7%), poor cosmesis with low vision devices
(33.3%) unawareness about disease (31.7%)Conclusion: This study reported major barriers in provision
of low vision services such as financial barriers, reduced mobility due to low vision and inadequateness
of low vision rehabilitation services by low vision practitioners. These barriers can be overcome by proper
low vision counseling of patients and their caretakers. Furthermore, low vision service delivery should be
improved by availability of advanced technology at reduced costs and professional education of low vision
providers
Key word; Visual impairment, Low vision, awareness, rehabilitation, knowledge

182
 Self-Esteem, Optimism And Their Associated Factors Among Optometry Students At The
University Of Lahore

Ansa Mudassar
Assistant Professor DOVS, University of Lahore

ABSTRACT:
Objectives: (1) To determine self-esteem and life-orientation (optimism) levels among Optometry
students at the University of Lahore (2) To investigate association between various sociodemographic
factors, self-esteem and optimism among the participants. Methodology: This cross-sectional study was
conducted in November 2021 at the Department of Optometry and Vision Sciences, University of Lahore.
A total of 168 undergraduate Optometry students were recruited by convenience sampling. Self-esteem
was estimated using Rosenberg Self-Esteem Questionnaire. Optimism was measured using Life
Orientation Test-Revised (LOT-R) questionnaire. Ethical approval was sought and obtained from the
Institutional Review Board of the Faculty of Allied Health Sciences, University of Lahore. The data was
analyzed using SPSS version-20. Chi-square was used to determine associations between
sociodemographic variables, self esteem and optimism. Results: Mean self-esteem score of the students
was 18.48±3.86 (range: 8-30). About 20% of the students had low self-esteem. Mean life orientation score
of the participants was 14.15±2.8 (range: 5-24). About 43% of the students had low optimism. Significant
associations were found between self-esteem, reason of admission in the Optometry program and their
family income. Moreover, significant associations were found between optimism, choice of the Optometry
program and reason of admission in the Optometry program. Conclusion: About 20% and 43% of the
Optometry students at the University of Lahore were found to have low self-esteem and low optimism,
respectively. Reason of admission in the Optometry program and family income were significantly
associated factors. Students’ own decision to choose a study program may increase their self esteem and
optimism. Financial assistance for the students from low socioeconomic background may also be a
positive approach to boost their self-esteem and optimism. Teachers, parents and counselors should
support the students to increase their self-esteem and optimism.
Keywords: self-esteem, optimism, life orientation, confidence, optometry, university students

183
 Awareness Of Contact Lens Care And Usage Among Medical Students In The University Of
Lahore
Javeria Mustafa1, Maimoona Rehmat2, Hifza Imtiaz3
1Internee Optometrist, University of Lahore Teaching Hospital
2Lecturer, DOVS, University of Lahore
3Assistant Professor, DOVS, University of Lahore

Abstract
Contact lenses are thin optical corrective lenses worn on the attention, resting on the surface of the cornea.
Contact lenses are becoming popular in young generation specially students of school and colleges. The
global burden of eye refractive disorders is increasing. Contact lenses (CLs) are prescribed since quite a
century for correction of refractive errors, cosmetic purpose, and as a therapeutic modality for corneal
pathologies. Purpose: The aim of study was to assess contact lens hygiene compliance and self-
management behavior in medical students. Methods: It was a cross sectional descriptive study, conducted
at The University of Lahore for four months, from May to August, 2020. Medical students were enquired
about the indications of usage, knowledge about clinical assessment and storage of different aspects of
contact lens wear recorded. Data was collected through a self-design questionnaire from 138 medical
students of University of Lahore, main campus, Lahore. Questionnaires were distributed among those who
used contact lenses presently or in the past. Questions were asked about contact lens hygiene and
complications related contact lens usage. Gender, visual acuity and contact lens fitting etc. Students related
to other professions and those who had eye problems but did not use contact lenses were excluded.
Results: In this study there were total 138 medical students whose ages ranging between 18-24 years and
most of them were females 122 and 16 were the male students’ participated. 67 of them were using for
cosmetic purpose, 62 for refractive correction and only 9 of them were using for therapeutic purpose. Most
of the students that is 130 used soft contact lenses and the other 8 wearing RGPs lenses. 91 students used
lenses for 6-8 hours daily, 33 individuals for 8-12 hours per day and 14 were using occasionally overnight.
127 students washed their hands before wearing contact lenses and 10 students were not. Conclusion:
Majority of the medicos were aware of the care and handling of contact lenses. However, a significant
number of individuals was not aware of important indications of contact lenses. Needs to spread the
awareness regarding the conditions in which contact lenses provide the best option.
Key words: Awareness, contact lens, medical students, optometry

184
 Association Of Convergence Insufficiency In Varying Degrees Of Myopia At The University Of
Faisalabad

Ayesha Mansoor, Lecturer Department of Optometry The University of Faisalabad

ABSTRACT

Objective: This study was conducted to find out association between convergence insufficiency in
varying degrees of myopia at The University of Faisalabad, [Link]: Comparative cross-
sectional study design was used to conduct the study at The University of Faisalabad. Convenient sampling
technique was used. Study duration was September-May 2019. Examination Performa was used to collect
relevant data including near point of convergence was measured by using Royal Air Force Ruler. Sample
size was 180 including men and women age ranging from 18-25 years wearing their prescription for far.
Assessment was done with glasses. According to prescription patients were classified into low, moderate
and high myopia. Chi Square test was used to analyze data through SPSS version [Link]: Out of 180
total patients 30% of males and 44.4% of females were suffering from convergence insufficiency
(P=.045). In low myopia there was 66% patients having reduced near point of convergence, moderate
myopia had 45% patients with reduced near point of convergence and high myopia had almost normal
(P=.000), near point of convergence with correction [Link]: Females more suffered
from convergence insufficiency than males. This study also concluded that varying degrees of myopic
patients were suffering from convergence insufficiency due to near exophoria and wrong prescription.
Orthoptic assessment and exercises had importance in patients experienced varying degrees of myopia
suffered from asthenopia at near with correction and normal visual acuity. Key Words: Convergence
insufficiency, myopia, near point of convergence.

185
 Frequency of color vision defects in retinitis pigmentosa patients
Areeba iqbal1, hira sattar2, anum fatima3, tehreem bashir4, [Link] rashid5, maimoona rehmat6,
hifza imtiaz7
1-5Internee Optometrist, University of Lahore Teaching Hospital
6Lecturer, DOVS, University of Lahore
7Assistant Professor, DOVS, University of Lahore
Abstract
Retinitis Pigmentosa (RP) is the pathology of rods and cones. In RP, rods and cones disrupt and decease
resulting in vision loss. Night blindness, gradual vision loss are the main symptoms and signs in which
fundus changes occur arteriolar attenuation, bone spicule and waxy pallor disc. Many ocular pathologies
in which color vision affects and RP is one of the pathology. RP is the genetic and progressive disease.
Purpose: To evaluate the frequency of color vision defects in RP patients and to find out frequency of
protanopia, deuteronopia and tritanopia in RP. Methods: This study design was Descriptive cross-
sectional study conducted at The Layton Rahmatullah Benevolent Trust Hospital from September 2021 to
December 2021. The sampling technique was Non-probability convenient sampling and the Sample size
was 37 patients. Patients having any other ocular or systemic pathologies were excluded. Equipment used
was Snellen chart for measuring visual acuity at distance and Farnsworth Dichotomous D-15 Test for
color vision defects. Results: the total number of patients was 37 out of which 22 were males and 15 were
females. 27(73%) patients were having defective color vision, while 10(27%) were with normal color
vision. 7 out of 27 color vision defected had protanopia, 14 had deuteranopia and 6 had tritanopia.
Conclusion: it was concluded that red-green deficiency (deuteranopia) was more than protanopia and
tritanopia. RP patients should use glasses available with filters to enhance color vision. Further researches
are required in different areas, large scale, and more duration to be done.
Key words: Color vision defects, Color vision, Retinitis pigmentosa, Farnsworth Dichotomous D-15 test.

186
 Comparison Of Color Vision And Contrast Sensitivity Among Amblyopes And Non Amblyopes
Misra Anjum1, Afrish Maqbool2, Gohar Amjad3, Wania Adan4, Tehami Babar5, Maimoona
Rehmat6, Hifza Imtiaz7
1 Optometrist, Haji Murad Hospital, Gujranwala
2 Internee Optometrist, Ibrahim Eye centre, Lahore
3-5Internee Optometrist, ULTH, Lahore
6 Lecturer, DOVS, University of Lahore
7 Assistant Professor, DOVS, University of Lahore

ABSTRACT
Background: Amblyopia is described as a unilateral or bilateral decrease in best corrected visual acuity.
It affects around 5% of the general population in developmental age and is the most common cause of
monocular visual impairment. 3 out of every 10 children have amblyopia and can lead to permanent visual
impairment if not treated early in life. Amblyopia is the most common problem among children, it has
been observed that suppression of vision also affects stereo acuity, color vision and contrast sensitivity in
amblyopic person. Objective: To compare the color vision and contrast sensitivity among amblyopes and
non amblyopes. Methodology: it was a comparative cross sectional study which was conducted on 32
normal subjects and 32 amblyopic subjects from September 2020 to December 2020. Visual acuity was
measured by Snellen chart. Color vision and contrast sensitivity was assessed by using ishihara plates (10)
and pellirobson chart. Age group of 8 years to 20 years was assessed in the study. Results: two groups
were taken with total 64 participants (32 each group). There were 29 males and 35 females. Mean visual
acuity of amblyopic patients was found 0.3938 OD and 0.3781 OS , significant difference (0.000) was
found in contrast sensitivity score of amblyopes ( mean values OD= 1.9063 , OS= 1.929) when compared
with normal subjects (mean value= 2.2 both eyes). There was significant difference of color vision of right
and left eyes between amblyopes and non amblyopes (p value 0.001 and 0.002 respectively)Conclusion:
By the results it was concluded that participants with amblyopia have considerably low contrast sensitivity
score and a little decrease in their color vision when compared with normal subjects. It was found that
suppression in amblyopia not only affects their visual acuity but somehow color vision and contrast
sensitivity as well.
Keywords: color vision (CV), contrast sensitivity (CS), amblyopia, ishihara plates, gratings.

187
 Corneal Thickness In Extra-Capsular Cataract Extraction And Phacoemulsification

Nimra Gull
Lecturer Department of Optometry The University of Faisalabad
Abstract
Introduction: Cataract is a condition in which crystalline lens of eye becomes opacified which then leads
to decreased vision. Phacoemulsification and Extra capsular cataract extraction are the two most
commonly used surgical options for cataract extraction. Objectives: To evaluate corneal thickness
changes after phacoemulsification and [Link] compare corneal thickness after phacoemulsification and
[Link]: This Quasi experimental study design was carried out from September 2021 to May
2022 at Madinah Teaching Hospital, Faisalabad. A total of 60 patients of both gender were included. Age
group of 18-70 years undergoing cataract surgery were included through Non-Probability convenient
based sampling. Pre-operative corneal thickness readings including central and peripheral corneal
thickness were noted using Corneal Topography. The patients were divided into two groups. One
underwent Phacoemulsification and one underwent Extra-capsular cataract extraction. Then post-
operative readings were taken after 1 week and 1 month of surgery. Data analysis was done by repeated
measure ANOVA and Independent t- test with SPSS version [Link]: Mean value of CCT for
Phacoemulsification was M=532.7333, SD=±25.57738 and for ECCE was M=546.4333, SD=±34.40397
with p= .000. Mean values of PCT for phacoemulsification was M=661.8333, SD=±55.99759 and for
ECCE was M=721.6000, SD=±85.19414 with p=0.18 which indicates that result is significant. When
independent t test was applied, p value for CCT was .497 and for PCT was [Link]: The Study
showed significant increase in CCT and PCT after phacoemulsification as compared to ECCE.

Keywords: Cataract, Corneal topography, Phacoemulsification, Refractive error

188
 Central Corneal Thickness In Females Using Oral Contraceptive Pills

Samia Iqbal1, Khizar Bashir2, Minahal Mateen3, Mateen Amir4, Iftikhar Ahmad5
1,2,4,5
University of Lahore Teaching Hospital, 3Services Hospital-Lahore

ABSTRACT
Purpose: To compare the central corneal thickness in females using oral contraceptive pills (OCP) with
age matched controls. Study Design: Descriptive Observational study. Place and Duration of Study:
Department of Ophthalmology, University of Lahore teaching hospital, from August 2018 to December
2018. Material and Methods: Fifty-one females who used OCP within last one year and 38 age-matched
controls were included in this study after approval from the ethical review board. Females with any
systemic disease, pregnancy and lactating mothers were excluded from the study. Females with ocular
diseases, like trachoma, cataract, keratitis, uveitis, corneal dystrophies, Keratoglobus, Keratoconus, ocular
trauma, and high refractive errors were also excluded. Each subject underwent full ocular examination
including best-corrected visual acuity using Snellen acuity chart and Bio-microscopic examination of
anterior segment and the fundus. Central corneal thickness (CCT) was measured with ultrasonic
pachymeter and the intraocular pressure was measured with non-contact tonometer at the time of
examination. The data was collected by self-designed proforma and analyzed by using SPSS version 20.
Results: Mean age of the females using OCP was 31.4 ± 6.8 years and mean age of age-matched controls
was 32.9 ± 5.5 years (p = 0.38). Mean Central corneal thickness values were higher in OCP group when
compared to controls (541.8 ± 31.39 μm and 518.7 ± 36.7 μm, respectively). P value was 0.004, which
was statistically significant. The mean IOP value was 14.5 ± 2.6 mm Hg in OCP group and 14.4 ± 2.8 mm
Hg in the control group (P = 0.86), which was not statistically significant. Conclusion: Central corneal
thickness values are significantly higher in patients using OCP.
Key Words: Oral Contraceptive pills, Central corneal thickness, Intraocular pressure.

189
 Effectiveness of syntonic phototherapy in different degrees of anisometropic amblyopia.
Dr Shakila Abbas
OD, MPhil

Abstract
Purpose: The purpose of this study was to assess and compare visual acuity, contrast sensitivity and
retinal nerve fiber layer thickness before and after syntonic phototherapy in different degrees of
anisometropic [Link]: A Quasi experimental study was carried out from September 2021 to
May 2022 at Madinah Teaching Hospital Faisalabad Pakistan. A total of 45 subjects age ranging from 7
to 18 years of both genders were included. 15 patients of mild, moderate, and severe anisometropic
amblyopia were selected through non-probability purposive sampling technique. Pre-assessment of Visual
Acuity with LogMAR Chart and Contrast Sensitivity with Pelli-robson Chart and RNFL thickness with
OCT was done. After assessment syntonic phototherapy in form of red glasses was prescribed to patient
for 4 weeks (20 sessions). After 4 weeks post assessment of VA and CS was done. Data analysis was done
by paired sample t-test and one way ANOVA with SPSS 20 version. Results: Mean value of mild VA
before and after syntonic Therapy was 0.14133(P=0.01) and CS was -0.07000(P=0.04), RNFL was -
0.133(P=0.889) VA of moderate was 0.24400(P=0.00), CS -0.09000(P=0.04), RNFL was 0.800(P=0.248)
and severe VA was0.24400(P=0.01), CS -0.06000(P=0.01) and RNFL -0.200(P=0.853).
Significant improvement was seen after therapy. One way ANOVA shows significant results of VA and
non-significant of Contrast Sensitivity and RNFL [Link]: Significant improvement was
seen in Visual Acuity, Contrast Sensitivity but no change was observed in RNFL thickness in mild,
moderate, and severe degrees of amblyopia. Improvement is more significant in severe degree of
anisometropic amblyopia as compared to mild and moderate.

Keywords: Amblyopia, Anisometropic Amblyopia, Syntonic phototherapy, Visual Acuity, Contrast

Sensitivity

190
 DEPARTMENT OF REHABILITATION SCIENCES
The ' 1st International Conference on Advances in Allied Health Sciences 2022' organized under the
esteemed banner of Allied Health Sciences is a revolutionary attempt to bring together leading scientist,
field Specialists, graduate and undergraduate students of Speech Language Pathology, Audiology,
Occupational Therapy and Rehabilitation Scientist onto a single platform. It is with great honor that we
announce that department of Rehabilitation Sciences is hosting international speakers from United
Kingdom and United State of America as well as national speakers all over the Pakistan. The multiplicity
of work from the rehabilitation sciences department being showcased at the conference is at par with
international standards and attendance is highly encouraged.

191
 INTERNATIONAL SPEAKERS
Update On Objective Assessment Of Hearing In Infants And Young Children

Dr James W. Hall

Abstract
This is a 2-hour session offered as a narrated PPT presentation. Accurate diagnosis of hearing loss in
infants and young children is possible with a test battery of objective auditory tests, such as aural
immittance measures (tympanometry and acoustic reflexes), otoacoustic emissions, auditory brainstem
response, auditory steady state response, and electrocochleography. Objective auditory tests offer
numerous clinical advantages in children. In combination, they invariably permit accurate diagnosis of
hearing loss and valid ear-specific estimations of auditory thresholds. This session includes a practical
overview of protocols for pediatric auditory assessment beginning with the crosscheck principle and
concluding with a summary of recent advances in objective auditory techniques and technologies. The
Learning Objectives will be to Identify 4 objective auditory measures for assessment of infant hearing,
defining the special contribution of otoacoustic emissions in pediatric hearing assessment and defining the
special contribution of acoustic reflexes in pediatric hearing assessment.

192
 Post Professional Education And Training In Audiology

Dr Girija Sunder

Abstract
Audiology as a discipline is composed of many critical aspects of foundational sciences and clinical
sciences, supporting multiple areas of specialized practice. General audiology education and training is
broad-based, providing the knowledge and skills required to provide basic diagnostic and intervention
techniques consistent with generalized practice and current standards-of-care. However, with the growth
of advanced technologies and specialized applications for assessment and intervention, practicing
audiologists are continuously challenged to keep up with the expanding knowledge base. It is imperative
that a new path be provided for practicing clinical audiologists, whereby they can stay current with
relevant science and technology updates, for patients with hearing and balance disorders. A major
limitation today is that there is no formal mechanism for these post-professional audiologists to further
their education in a standardized specialization process, such as the post-graduate fellowships which are
offered in other healthcare professions. This presentation proposes a new and ambitious model of specialty
training, implemented globally, leading to specializations in one or many areas of interest and [Link] is a
progressive and dynamic model, and can be applied internationally, in both high-resource and low-
resource countries.

193
 Augmentative And Alternative Communication And Language Intervention: A Paradigm Shift

Dr. AYESHA KAMAL Butt

Abstract
Augmentative and Alternative Communication (AAC) interventions are employed by speech and
language pathologists to assist people who struggle to comprehend and express themselves effectively.
AAC has been part of the speech pathology curriculum since the commencement of the first postgraduate
academic program over a decade ago, yet continues to remain the last option when planning intervention
in Pakistan. Evidence based practice places emphasis on interventions that promote functionality, greater
independence and a language enriched environment. The keynote will address the following areas
Communication is a right; importance of communication and the role that AAC plays, Decade of AAC in
Pakistan; current work that has been carried in Pakistan, Approaches to intervention; addressing the core
myths and cultural barriers hinder the widespread acceptance of such interventions, Optimum time for
intervention: better speech and language outcomes have been documented through the use of AAC. Early
assessment and intervention has been the hallmark of success regardless of the severity of impairment,
Paradigm shift: mapping a direction for the future as knowledge, confidence and attitude play a pivotal
role in the section of interventions, therefore, addressing these factors at grass root level is critical to the
success of AAC.

194
 NATIONAL SPEAKERS
Does multilingualism challenge speech language pathologist in pakistan?

Dr. Amina Siddique

Abstract
Pakistan is a linguistically and culturally rich county, with about 69 languages spoken by its people. Of
these there are six major languages Punjabi, Sindhi, Balochi, Pushtu, Brahwiand Urdu. English is the
official language of Pakistan along with Urdu. It is also the medium of instruction in primary, secondary
and higher secondary schools as well as universities. If the native language is L1, and Urdu is L2, then
English becomes L3 for most Pakistani children. Hence most Pakistanis are
multilinguals. Multilingualism and bilingualism are said to be cognitively advantageous, however, the
latter has been studied more than the former.
Typically developing Pakistani children who are not exposed to Urdu or English at home within the first
three years of life become sequential bilinguals. Their language skills are to be different from
simultaneousbilinguals. Typically developing Pakistani children who are not exposed to Urdu or English
at home within the first three years of life become sequential bilinguals. Their language skills are to be
different from simultaneous bilinguals. Speech-language therapists working with children and adults
having a language impairment of any type or degree must establish the language/s of use with them during
therapy. Prior to that an assessment of their language skills is warranted in the same language that they
speak. However, only a few speech and language assessments are available in Pakistani languages,
challenging speech-language therapists who must draw accurate goals post-assessment. The norms of
language acquisition in Pakistani bi/multilingual children have yet to be established for the construction
of standardized tools of speech and language assessment in native Pakistani languages.

195
 Technology; A Way Forward In Communication Rehabilitation

Dr. Munawar Ahmed Malik

Abstract
Since the dawn of this century we have all witnessed some exciting times in the form of technology. Life
today tends to lose its meaning without the use of digital devices which may include computers, tablets,
smart phones, chrome books etc. The impact of time and space has been reduced to minimum possible
through the advent of recent advancement in science. The challenge in front is to harness all these valuable
tools to make life more effective and meaningful regardless of the ability of an individual. At times
communication disorders pose challenges to us in the form of language use and may thus result in reduced
effectiveness and ease about it. For professionals in the field of communication scientists and therapists,
it becomes ominous if the traditional approaches are dwelled upon considering this vast expansion in the
field of technology and instruments. Technology on one hand reduces the impact of disability by providing
alternative and augmentative options and on the other hand it significantly contributes to the efficacy of
intervention. Technologists can provide solution through activity modification i.e. by lowering the input
demands and expectations on the part of user through human interface and make use of processors to
transcribe outputs in ways which are more effective and meaningful. Research has time and again
documented about contribution on the part of technology which capitalizes the end user and built in
motivation that was much limited and time consuming with traditional behavioral interventions. Further,
the dependency on a clinical setting, cost effectiveness and universality can be ascertained through it.
Through this keynote speech it is intended that the gap between allied health professionals, teachers,
engineers and health professional could be bridged in for the sake of a successful rehabilitative experience
through the use of assistive technologies. Professional support in the form of assistive technology
practitioners may serve the cause for which a broader allied health domain is mandated for present times
in Pakistan. The essence of it all is to revamp the educational model prevailing in the academia which
performs in isolated domains. The need of the time is to upscale the technical knowledge in rehabilitative
sciences in a close liaison with technological fields. The proponents of social model of disability rightly
believe in societal transformation as a way forward to “enable” the “differently abled”. This can only be
possible if our theory and practice can reiterate a balanced effort.

196
 Current And Advance Practices In Aphasia

Dr Humaira Shamim kiyani

Abstract

Aphasia is an acquired language disorder that impacts language comprehension, verbal expression,
reading and writing; provided other cognitive abilities intact. Aphasia is one of the most common clinical
features of functional impairment. About 21-40% of stroke patients have aphasia, which gradually impairs
one's quality of life and rehabilitation outcomes. Treatment strategies for aphasia after stroke including
Speech-language therapy, cognitive neurorehabilitation, telerehabilitation, computer-based Management.
Speech and language therapy (SLT) is the most common method of rehabilitation for post-stroke patients
with the main aim of helping them. Patients communicate in their environment (i.e., in everyday life
situations). Communication problems, in connection with cognitive impairment, can lead to depression,
which in turn affects the patient’s recovery. Therefore, it is paramount to enable effective communication,
both verbal and non-verbal, by any means.

197
 Should we implant or not?

Dr Atif Ikram

Abstract

At ULTH we have tried to devise an objective test protocol to reach a decision to recommend cochlear
implant or not and to have an objective idea of the prognosis of cochlear implantation in children more
than seven years old. The cortical auditory maturity and plasticity are key factors in determining suitability
of candidate for cochlear implant. Every parent with children above age seven years asks the question “Is
my child or adult dependant going to benefit from cochlear implant?” For children below a certain age the
clinician has research to backup the claim that the child will benefit. But for children above age seven the
question is difficult. Subjective test are available to ascertain candidacy. At ULTH we tried to have a
protocol to answer this question based on ongoing research. The test is Central Auditory Evoked Potential
{ CAEP}. Here we will discuss the test and how it is interpreted to give the parents an objective assessment
and also for the clinician to draw conclusion about implementation.

198
 Cochlear Implantation; Pre-Requisites And Basics Of Surgery

Dr Naveed Aslam

Abstract

Cochlear implantation is the gold standard treatment for severe to profound sensorineural hearing loss in
children and adults. The surgery requires special surgical skills and training as well as careful preoperative
evaluation of anatomical details of cochlea and internal auditory canal with targeted CT and MRI scans. I
would like to go through CT and MRI scans and talk about important anatomical landmarks and basic
surgical steps in this presentation.

199
 PRESENTERS
Simulation In Speech And Language Therapy

Dr Ayesha Kamal Butt

Abstract
Simulation has been widely used in health education; however, speech and language therapy courses have
yet to utilized simulation to its full potential. The sudden onset of Covid-19 left Universities in a
challenging position with needing to ensure that their students were able to access their clinical
placements, yet they were physically unable to be in schools, rehabilitation centres and care homes. This
led to Manchester Metropolitan University exploring simulation as a means of ensuring students were able
to meet their learning outcomes and gain the necessary clinical experience. The simulated placements
were designed to cover both virtual and face to face experiences based on campus. The added value was
a holistic experience with students being able to experience the effects of ageing through simulated
equipment such as simulation suits. The aim was to provide an enriching and enhanced learning experience
to create effective and efficient clinicians. This talk aims to provide an overview and an outline of a
simulated care home placement to encourage not only acquisition of academic but also professional skills
through the use of a lesser adopted medium in speech and language therapy.

200
 Translation And Cultural Adaptation Of The Phonological Awareness Skills Test In Urdu

Fehmina Mughal *, Dr. Humaira Shamim Kiyani2

5. Speech and Language Pathologist, Speech Clinic Islamabad, Pakistan.
6. Associate Professor/HOD SLP Department, Faculty of Rehabilitation and Allied Health
Sciences, Riphah International University, Islamabad, Pakistan

ABSTRACT
Background: Phonological awareness is a precursor to effective reading skills, hence its timely
assessment is essential for the identification and intervention of deficits in phonological awareness skills,
for better reading comprehension in later years. Objective: The present study aimed to translate and
culturally adapt PAST in Urdu. Additionally, it aimed to determine the reliability and validity of the tool
in Pakistani population sample. Methodology: PAST was translated and culturally adapted by following
steps for cross-cultural adaptation, including forward translation, experts’ review, backward translation,
removal of discrepancies, and finalization of the translated version. To determine the reliability and
validity of the test, a study was conducted, with sample N=100 (80 typical; 20 atypical). The participants
in this study were 4 to 8 years old bilingual males and females from Islamabad, selected through
convenient sampling technique. Results: Descriptive analysis of the study demographics analyzed
through SPSS showed that the mean age of participants in the typical and atypical groups was 6.7 (±1.27)
and 7.4 (±0.6) respectively. Similarly, the frequency of the gender indicated that 36 females and 44 males
in the typical, while 7 females and 13 males in the atypical group were part of this study. The Cronbach’s
alpha showed 0.96 reliability of the overall tool. Furthermore, the test-retest reliability of 9 out of 16
domains was significantly high (p<.001), while concurrent validity of all except one domain were in an
acceptable range. Conclusion: The study concludes with a successful translation and cultural adaptation
of the PAST assessment tool. It is determined to be a valid and reliable tool for the assessment of
phonological awareness of 4 to 8 years old males and females in Pakistani culture. It is recommended that
the adapted version of the tool be used in practical cultural settings, to establish confidence in its reliability
and validity in different regional samples as well.

Keywords: Postnatal Depression, Risk factors, EPDS, Parenting knowledge.

201
 Effectiveness Of Urdu Stimulability Character Cards To Deal With Speech Sound Errors On
Children Having Cerebral Palsy

Aneela Riaz1*
1. Speech and language Pathologist/Centre for Clinical Psychology, Faculty of Behavioral and
Social Sciences, University of the Punjab, Pakistan
ABSTRACT

Background: Speech intelligibility is the speech problem that is most frequently reported in children with
cerebral palsy. Stimulability treatment programs strives to improve phonetic inventory and, ultimately,
speech [Link]: To identify the effectiveness of Urdu stimulability character cards to deal
with speech sound errors on children with cerebral palsy. Methodology:Quasi-experimental research
design was used, and data was collected through purposive sampling from two special education schools.
The sample was consisted of (N=10) children with cerebral palsy. The sample consisted of 4 girls and 6
boys with a mean chronological age of 11.20 years and a functional level of 3.92 years. Pictured
Articulation Screener (PAS) which was also socially, culturally, and linguistically appropriate measure of
speech sound errors was used. All participants were assessed on PAS and SCC as a pretest measure and
after 6 weeks on a posttest. The sessions were scheduled in accordance with the therapeutic protocol
developed by Miccio and Elbert's treatment programme, which included 12 sessions of 45 minutes and be
held twice a week. Results: The data analysis indicated that all participants showed a statistically
significant difference in the total number of speech sound errors between pretest and posttest (p<0.05) of
Urdu [Link]:It is concluded that Urdu SCC is an effective tool for the treatment of speech sound
errors in children with cerebral palsy. This research would benefit speech and language pathologists in
clinical and school settings by providing evidence-based treatment to treat the speech sound errors
reported in children with cerebral palsy.

Keywords: Stimulability character cards, pictured articulation screener, cerebral palsy

202
 Speech Characteristics In Children With Cerebral Palsy

Nouman Pervaiz1*,Hafsa Noreen2

1. Lecturer Department of Physiotherapy Royal Institute of Health Sciences Lahore Pakistan.
2. Assistant Professor of Speech Language Pathology Faculty of Allied and Rehabilitation Sciences
Riphah International University Lahore Pakistan.

ABSTRACT

Background: Children diagnosed with cerebral palsy who do not suffer from an underlying intellectual
disability or hearing loss are able to grasp speech and language just like children of the same age who do
not have this condition. The children, however, is unable to articulate since they have poor control over
their [Link]:To compare the Frequency and Characteristics of Speech in Children with CP
age 4-7 [Link]:The study design was cross-sectional comparative. The sample was taken
from the following cerebral palsy institutions in Lahore: Rising Sun Institute, Rehab Care, and Children
Library Complex. All types of cerebral palsy children, both male and female, including children aged 4 to
7 years old, were included. Children with cerebral palsy who had an underlying psychosocial concern,
children with epileptic diseases, and children with any amount of unintentional or incidental trauma were
eliminated. The data was collected using a demographic questionnaire and a programme called Dysarthria
Profile. The data was analysed using SPSS 25.0Results: The results regarding type of cerebral palsy
showed that there were 64.9% spastic, 17.5% dyskinetic and 17.5% were having ataxic type of cerebral
palsy. The results regarding total scores of various dysarthria domains showed that the mean ± standard
deviation was found to be 56.3860±9.35392, 56.9123±7.73403, 56.7018±6.71800, 56.8421±9.81923,
57.5526±7.75977, 56.5614±9.92542, 55.7544±9.34355 and 56.6667±5.42799 for total scores of
respirations, phonation, facial, musculature, diadochokinetic, intelligibility, communicative competence,
eating swallowing, dysarthria profile, respectively, while there was significant association between
dysarthria profile and type, and it was seen that majority of fair dysarthria was associated with spastic as
compared to dyskinetic and ataxic types of cerebral palsy while almost all poor dysarthria patients were
associated with spastic cerebral [Link]:The study concluded that as the frequent speech
characteristics such as Respiration, Phonation, Facial Musculature, Diadochokinetic, Intelligibility,
Communicative Competence and Eating Swallowing issues were present fair to poor level as per
dysarthria profile scoring. There was no child in normal or ‘none’ category. Furthermore, these speech
characteristics were significantly associated with spastic type of cerebral palsy.

Keywords: Cerebral Palsy, Children, Dysarthria Profile, Speech Characteristics, Speech Therapy

203
 Perspective Of Speech Language Pathologist Regarding Organizational Policy Of Professional
Ethics

Ahrar Raza1*, Azzam Khan2 , Amna Rashid2

1. Link Medical Center, Lahore, Pakistan.
2. Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, The University of Lahore,
Pakistan.

ABSTRACT
Background: Medical morals or medical ethics is a tributary of ethics which checks not only the use of
clinical medication but also in relation to studies which are done through extensive research. These
medical morals are dependent on a set of ethics which are used by medical professionals all around the
world when they are presented with any challenge. These ethical principles include the view of liberty,
non-maleficence, altruism and [Link]: To find Perspective of Speech Language Pathologist
regarding Organizational policy of Professional Ethics. Methodology: The study design used was study
Crossectional observational places from where data was collected was from hospitals, rehabilitation
centers, clinics and social media platforms the total duration of the study was 6 Months. A sample size
120 SLPs was selected. Formula which was used was n=Z2p(1-p) /d2 where N= sample size Z=
confidence interval P= prevalence D= precision. The sample was calculated by getting the data from the
speech language association of Pakistan. The sampling technique which was used was Convenience
sampling technique. The inclusion and exclusion criteria for sample selection were SLPs with at least 1
year of experience SLPs students will not be considered in this study respectively. Equipment tool was a
standardized questionnaire with chrone Bach alpha 0.78. Data was collected from online and social media
platforms. Results: The questionnaire which was provide to 120 SLPs regarding ethics the data collected
showed that ethical values are compromised such as favoritism, use of power still exists with being more
than 35.0% on the topic of confidentiality 38.8% usually maintain it when talked about the balance in
personal and professional needs 33.8% usually try to maintain it the results also showed that 20.8% people
claimed that ethical behaviors are not rewarded. It was seen that only 18.5% people in organizations were
given some kind of training in ethical behaviors. Conclusion: The conducted Research on the topic states
that perspective of speech language pathologist regarding organization policy on ethics was viewed in
negative light.

Keywords: Ethics, organizational, speech language, policy

204
 Prevalence Of Autism In Toddlers Of Working Parents

Abeeha Fatima Mansoor1*Muhammad Ahmad 2

1. Lesser Clinic, Iqbal Avenue Lahore, Pakistan.
2. Halcyon clinic

ABSTRACT

Background: Autism is a neurodevelopmental disorder. It can be diagnosed after the age of 18 months to
2 years. It affects behavior, mental development, ability to communicate socially, respond to name, social
emotional reciprocity of a child. Autism can be caused by different genetically conditions. One of the
most common cause of autism is advance maternal age. But still any significant cause of autism is
unknown. Objective: The objective of this study was to find the prevalence of autism in children of
working parents in Lahore, Pakistan. Methodology: An observational cross sectional study design was
used in this study. Purpose sampling technique was used. A sample of 100 autistic children of working
parents was taken. The source of the sample size of this study was a study conducted in Saudi showed the
prevalence of autism in Makkah and Jeddah in 2018 was 2.81 per 1,000 children. Data was collected
through M-CHAT (Modified checklist for autism in toddlers) to diagnose the autistic children in a better
way. The checklist was filled by the parents. Demographics information includes name, age, birth order,
number of siblings and age at which autism was diagnosed in the toddler. Some information related to
parents of the toddler was also present in the questionnaire of demographics. The data collected was
assessed by the software called as SPSS. Results: The results assessed from the data showed, 17.3 out of
1000 was the prevalence of autism in children of working parents.
Conclusion: This study showed an increasing trend in the prevalence of autism among working parents
with the relevance of literatures.

Keywords: Autism, Prevalence, working parents

205
 PRESENTERS
Effectiveness Of Vocal Hygiene Training To Reduce Symptoms Of Voice Disorders And Improve
Voice Quality Among Professionals Of Rawalpindi, Pakistan - A Randomized Control Trial
Anam Jamil1*, Humera Shamim Kiyani1, Aniqa Jamil1
1. Department of Rehabilitation Sciences, Faculty of Pharmaceutical & Allied Health Sciences,
Shifa Tameer-e-Millat University Islamabad, Pakistan

ABSTRACT
Background: Voice acts as a tool of trade among professionals. Ironically, people in such professions are
more likely to experience vocal problems due to strain of frequent voice use. Teachers, lawyers and
telemarketers appear to be at a higher risk of voice related issues. Preventative care and prompt evaluation
of problems can help patients avoid the development of more serious vocal problems. Objective: The
study was aimed at providing vocal hygiene training and determining its impact upon reducing voice
related problems and improving voice quality among professionals of Rawalpindi, Pakistan.
Methodology:A randomized control trial was conducted from 2017-2018 among those teachers, lawyers
and telemarketers who screened positive on Voice Handicap Index-10. After being screened positive,
participants were divided into two groups; experimental and control, each having 30 participants from
specific profession. Literature based Vocal hygiene training was designed to improve physical, emotional
and functional aspects of voice was provided to each of three experimental groups. Post assessment was
done after a total of four training sessions; 20-35 minutes each, provided fortnightly. The data was
analyzed by SPSS-20. Results: Significant improvement was observed among the post assessment scores
of experimental groups. The decline in VHI-10 scores i.e. 76.60 to 48.27 among teachers, 64.54 to 38.20
among lawyers and 57.27 to 32.77 among telemarketers has depicted positive impact of vocal hygiene
training upon voice problems. Conclusion: The findings strongly suggest that vocal hygiene training had
significant impact on improving quality of voice. Such techniques with the appropriate dosage and length
of intervention plan should be embedded in daily routine plan of professionals.

Keywords: lawyers, teachers, telemarketers, training, vocal hygiene, voice disorders

206
 Autism Spectrum Disorder On The Basis Of The Executive Functioning Profile

Maria Ishtiaq1*
1. Clinical Psychologist / speech language pathologist Pak Red crescent medical and dental college

ABSTRACT

Introduction: Executive Functioning (EF) has been studied separately in both normal and Autistic
children but there are no specific studies on the comparative analysis of strengths and weaknesses of
executive functioning among children with Autism Spectrum Disorder (ASD) and normal children.
Objective: To evaluate and compare the strength and weaknesses of executive functioning (EF) among
children with autism spectrum disorder and normal children. Materials & Methods: A comparative cross-
sectional survey was conducted through purposive sampling from July 2018 to February 2019 involving
parents of normal school-going children and diagnosed Autistic children. Children aged 3 to 8 years old
with ASD (n=96) and normally developed children (n=96) were compared on a battery of Executive
Functioning (EF) tasks in both groups. Data were analyzed by SPSS version 21 for descriptive statistics;
comparisons were done by Independent Samples T Test, keeping p≤0.05 as significant. Results: There
was a male preponderance among the autistic children (67 versus 45 males in normal children). The most
represented ages were 4-4.11 years and 7-8 years. Tests of Executive Function showed a significant
decline in all the abilities (p<0.05), except in Time Management (p=0.21).Conclusion: Children with
Autism Spectrum Disorder show major deficits in Executive Functioning when compared to normal
children.

Keywords: Autism Spectrum Disorder, Executive Functioning, DSM-5 Diagnostic statistical Manual-5,
Applied Behavior Analysis.

207
 Development Of Therapeutic Exercises Manual For Oropharyngeal Dysphagia

Shabina rana1*
1. Center for clinical psychology, university of the Punjab,lahore

ABSTRACT
The present study developed a therapeutic exercises manual for Oropharyngeal Dysphagia (OD), dividing
into two phases. Phase I deals with the designing and validating “The Therapeutic Exercises Manual” and
Phase II determined the effectiveness of the therapeutic exercises manual on the patients of OD following
Head and Neck Cancer (HNC), Traumatic Brain Injury (TBI) and Cerbral Vascular Accidents (CVA)/
Stroke. It was hypothesized that there is significant difference of therapeutic exercises on the patients
(HNC, TBI, and CVA) in pre-test and post-test. It was also hypothesized that there is significant difference
in effectiveness of therapeutic exercises among all groups (HNC, TBI and CVA). Non-probability
purposive sample of 75 patients with (OD) was drawn from Mayo Hospital; (HNC=20), (TBI=20) and
(CVA=35) with age range of 25-70 years (M=44.7, SD=12.47).Two screening test (a) Glassgow Coma
Scale (GCS) (Teasdale and Jennett, 1974) and (b) The Repetitive Saliva Swallowing Test (RSST) (Oguchi
et al.,2000) were used to investigate patient’s consciousness and voluntarily swallow, respectively. The
Eating Assessment Tool (EAT-10) (Belafsky, 2008) was used to assess oropharyngeal dysphagia severity.
Quasi experimental design was employed to explore the effectiveness of therapeutic exercises on patients
with OD. Results of phase I was generated by Content Validity Index (CVI), Content Validity Ratio
(CVR), kappa statistics, and confirmed by the Confirmatory Factor Analysis (CFA), showing the
satisfactory level of all factors. Results of phase II were elicited by running the repeated measure ANOVA
on SPSS version. 20. The findings suggested a significant difference of therapeutic exercises manual on
the patients (HNC, TBI, and CVA) in pre-test and post-test equally. The significance of this study
addressed the utility of therapeutic exercises manual for patient’s practice at home setting.

Key words: Oropharyngeal Dysphagia, HNC, TBI, CVA, CVI, CVR, kappa, CFA

208
 Level Of Anxiety And Depression In Post-Operative Children With Facial Cleft
Plwasha Khan1*, Bareera Saeed2, Muhammad Sikander Ghayas Khan3
1
MS Scholar, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, The University
of Lahore
2
Senior Lecturer, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, The
University of Lahore.
3
Associate Professor, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, The
University of Lahore
Abstract
Background: Cleft palate and lip are considered that most common in hereditary either birth defect form
in craniofacial zone. Objective: This research was conducted to find out the level of anxiety and
depression among post-operative cleft patients. Methodology: It was observational cross sectional survey.
Data was collected from CLAPP Hospital Lahore. This duration of the study were nine months from
August 2021 to April 2022. Non probability sampling techniques were used to collect the data. Both type
of cleft patients was included i.e. cleft lip and cleft palate. Male and female patients were included.
Between 6-13 years age was included in this study. Only post-operative cleft patients was taken. The post-
operative 6 months cleft patients was included in this research. Cleft patient with other congenital-
abnormalities was not included in this study. The sample size of this research study was consisting of 190
with facial cleft. Results: Results shows that majority of the participants 30%(57) were having a little
level of anxiety. 18.9% (36) participants were having ‘very much so’ level of anxiety. 25.3% (48)
participants were having ‘some of the time’ levels of depression. 23.2% (44) participants were having
‘most of the time’ level of depression. Conclusion: It was concluded majority of patients were having ‘A
little’ level of anxiety. While one third majority of the patient were feeling depression most part of the
time.

Keywords: Anxiety, Depression, Post-operative, Facial cleft

209
 Language Development In 2-4 Year Old Children With Cerebral Palsy
Hunia Kashif
Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, University of Lahore,
Pakistan.
ABSTRACT
Background: One of the frequently occurring disabilities of early age is Cerebral Palsy. Impairments in
speech, language and communication usually co-occur with CP. These arise from the auditory, sensory
and visual disorders that accompany CP. Delay or impairments in the development of language in cerebral
palsy can lead to different speech and language disorders. Objective: To evaluate the development of
language in children with cerebral palsy between 2-4 years of age. Methodology: A cross-sectional study
design was utilized. Data was collected from different healthcare centers, clinics and hospitals.
Convenient-based sampling technique was used. Children with co-morbid conditions with CP were not
included in the study sample. The assessment tool used for evaluation of language development was
‘PORTAGE – early education program.’ The data for 108 patients of cerebral palsy between 2-4 years of
age was compiled. The results have been divided into demographics and the levels of portage i.e., 0-1
years, 1-2 years, 2-3 years and 3-4 years. The receptive as well as expressive language has been evaluated
for these children. Total 70 questions have been added from the portage guide for up to 4 years of age.
Results: It is observed that a little more than half of the patients included in the study experience varying
degrees of language difficulties. These difficulties are an accumulation of receptive as well as expressive
impairments. On the contrary, a little under half of the patients (46.38%) have language abilities developed
according to their age. Conclusion: The most vital period of language development ranges till 5 years of
age. So, 2-4 years is an important period of time for language development in an individual. An in-depth
assessment of speech, language, cognitive and motor skills should be conducted during this time for CP
children

Keywords: Cerebral Palsy, Language Development

210
 Prevalence Of Hearing Impairment And Common Risk Factors In Neonates
Anzila Rehman1*, Daniel Akhter1, Dr Sikandar Ghayas Khan1
1. Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, The University of
Lahore, Pakistan
ABSTRACT
Background: To screen new-borns for hearing impairment using transient evoked otoacoustic emission
and to determine its prevalence associated with risk factors. Reduce the negative impacts of hearing loss,
newborn hearing screening is crucial for early detection of the condition. Objective: To find out the
prevalence of hearing impairment and common risk factors in neonates. Methodology: The study design
was Observational cross-sectional. Data was collected from Hameed Latif Hospital. The duration of the
study was 6 months (Feb 2022-July 2022) after the approval of the synopsis. Based on the prevalence
(41.38) of the hearing impairment at-risk group the sample size was calculated at 328 through an online
sample size calculator. A non-Probability purposive sampling technique was used. Male and female
newborns were included in the study. Newborns with congenital anomalies like Anotia, Microtia, Atresia
and stenosis of external canal will be excluded in the study. The researcher did the otoscopic examination,
then performed Transient Evoked Otoacoustic emissions. Before starting the test /Procedure researcher
make sure that baby is in a sleeping state, so the results must be accurated. A Chi-square test was used to
determine the outcomes of hearing screening in risk and non-risk neonates. The significant level was set
as equal to or less than p < [Link]: The total of 328 neonates comprised in this study, in which
79.87% (n=262) neonates belongs to the control group and 20.1% (n=66) neonates belongs to the case
group. In addition,18.1%(n=12) were had refer due to duration of pregnancy less than 34
weeks,13.6%(n=9) were had refer due to positive cousin marriage, 3.0%(n=2) were refer due to family
history of hearing loss,19.6%(n=13) were had refer due to prenatal history,24.2%(n=16) were had refer
due to perinatal history and 21.2%(n=14) were refer due to postnatal [Link]: This study
concludes that the prevalence of Refer TEOAE’s finding is higher in perinatal, postnatal, and prenatal risk
factors respectively.

Keywords: W.H.O, Hospital-Based Hearing Screening Program, Paediatric Hearing loss, TEOAE’s

211
 Speech Characteristics In Children With Cerebral Palsy
Nouman Pervaiz1*, Hafsa Noreen2

1. Lecturer Department of Physiotherapy Royal Institute of Health Sciences Lahore Pakistan.

2. Assistant Professor of Speech Language Pathology Faculty of Allied and Rehabilitation
Sciences, Riphah International University Lahore Pakistan.
ABSTRACT
Background: Children diagnosed with cerebral palsy who do not suffer from an underlying intellectual
disability or hearing loss are able to grasp speech and language just like children of the same age who do
not have this condition. The children, however, is unable to articulate since they have poor control over
their [Link]:To compare the Frequency and Characteristics of Speech in Children with CP
age 4-7 [Link]:The study design was cross-sectional comparative. The sample was taken
from the following cerebral palsy institutions in Lahore: Rising Sun Institute, Rehab Care, and Children
Library Complex. All types of cerebral palsy children, both male and female, including children aged 4 to
7 years old, were included. Children with cerebral palsy who had an underlying psychosocial concern,
children with epileptic diseases, and children with any amount of unintentional or incidental trauma were
eliminated. The data was collected using a demographic questionnaire and a programme called Dysarthria
Profile. The data was analysed using SPSS 25.0Results: The results regarding type of cerebral palsy
showed that there were 64.9% spastic, 17.5% dyskinetic and 17.5% were having ataxic type of cerebral
palsy. The results regarding total scores of various dysarthria domains showed that the mean ± standard
deviation was found to be 56.3860±9.35392, 56.9123±7.73403, 56.7018±6.71800, 56.8421±9.81923,
57.5526±7.75977, 56.5614±9.92542, 55.7544±9.34355 and 56.6667±5.42799 for total scores of
respirations, phonation, facial, musculature, diadochokinetic, intelligibility, communicative competence,
eating swallowing, dysarthria profile, respectively, while there was significant association between
dysarthria profile and type, and it was seen that majority of fair dysarthria was associated with spastic as
compared to dyskinetic and ataxic types of cerebral palsy while almost all poor dysarthria patients were
associated with spastic cerebral [Link]: The study concluded that as the frequent speech
characteristics such as Respiration, Phonation, Facial Musculature, Diadochokinetic, Intelligibility,
Communicative Competence and Eating Swallowing issues were present fair to poor level as per
dysarthria profile scoring. There was no child in normal or ‘none’ category. Furthermore, these speech
characteristics were significantly associated with spastic type of cerebral palsy.

Keywords:Cerebral Palsy, Children, Dysarthria Profile, Speech Characteristics, Speech Therapy

212
 Utilization Of Occupational Therapists In Lahore, Pakistan
Nudrat Fatima1*, Ramsha Khan1, Muhammad Hussnain Maqsood1
1. Occupational Therapist, Occupational Therapy, University of Health Sciences, Pakistan
ABSTRACT
Background: Mental health is a state in which an individual can manage his abilities to control
one’s normal behavior and stress level. Occupational therapists are qualified with the procedures needed
to provide rehabilitation services to promote mental health and treat functional issues arising from
psychosocial problems. Occupational therapists work in mental health settings around the world.
However, given that occupational therapy (OT) is an emerging field in Pakistan, the breadth and depth of
occupational therapy is yet to develop in many domains of [Link]:To determine the
utilization of occupational therapists in mental health settings in Lahore, [Link]:This
descriptive, cross-sectional study was conducted using random sampling of all mental health institutes of
Lahore, Pakistan that fulfilled the inclusion criteria of the [Link] random sampling, 41 mental health
institutes were selected for data collection. A structured questionnaire was used with administrative staff
and professionals of selected mental health institutes. The questionnaire included questions on informant,
facility demographics, employment status of occupational therapist(s), and perceptions about [Link]:
Findings indicate that out of 41 institutes, there were 10 pediatric mental health settings and 31 were adult
mental health facilities. Out of these, only 8 (19.5%) of the pediatric mental health facilities had currently
employed occupational therapists and none at any of the adult mental health settings. Perceptions about
occupational therapy (OT) varied among respondents. Answers suggested that only 35% facilities clearly
knew about roles and responsibilities of OT, 37.5% were aware of its treatment and effectiveness, and
only 35% respondents showed positive response about importance of Occupational therapy treatments in
mental health [Link]: The Pakistan, especially in adult mental health settings. Perceptions
about occupational therapy may also need to address as they may be an important factor related to lack of
hirings. Further research is required to assess need of occupational therapy in mental health in Pakistan,
as well as the factors associated with employment status of occupational therapists.

Keywords: Occupational therapy, mental health, employment

213
 Development Of Therapeutic Manual For Pharyngoesophageal Dysphagia
Nimra Zafar1*
1. Center For Clinical psychology, University Of The Punjab, Lahore Pakistan
ABSTRACT
Background: Dysphagia is a very serious disease, which is taking lives of hundreds of the people yearly.
A significant number of studies done at international level do exist but there exists a wide gap between
these international researches and the indigenous ones. There is a dearth of local or indigenous bodies of
literature, which address the issues of dysphagia. Objective: The aim was to develop a therapeutic manual
for pharyngoesophageal dysphagia and checked its effectiveness by implementing the manual on
[Link]: Non-probability purposive sample of N=75 dysphagia patients of HNC (Head and
neck cancer), TBI (Traumatic Brain Injury) and CVA (Cerebrovascular Accidents) (M=44.5, SD=12.2)
was drawn from Mayo Hospital, Lahore. The Glasgow Coma Scale and the Repetitive Saliva Swallowing
Test (RSST), were used as screeners of the subjects before training. The pre and post assessment was done
by using Eating Assessment Tool (EAT-10). A quasi research design (pre and posttest) was
[Link]: The results showed that there was significant effect of exercises before and after the
implication of therapeutic manual. Repeated Measures ANOVA revealed that there was significant
differences in effectiveness of therapeutic exercises among all groups (HNC, TBI and CVA).Conclusion:
Therapeutic manual for pharyngoesophageal dysphagia was found to effective for HNC, TBI and CVA
patients.

Keywords: Pharyngoesophageal dysphagia. HNC, TBI, CVA, therapeutic manual

214
 Communication Attitude In Children Who Stutter And Who Do Not Stutter
Ali Hussain1*, Ms. Hafsa Noreen1
1. Riphah College of Rehabilitation & Allied Health Sciences, Riphah International University
Lahore, Pakistan
ABSTRACT
Background: It has been observed that children who stutter and who do not stutter, shows various
communication attitude in reciprocal communication. This study intends to find this variation in
communication attitude of both the groups to compare it. Objective: To investigate the communication
attitude in children who stutter and who do not stutter. Methodology: The Comparative Cross-sectional
Survey study was conducted in six months and sample was collected from different public sector schools,
centres and hospitals of Sialkot and Lahore. Sample size was 219 Children who do and do not stutter. The
written informed consent was taken from all the head of institutions and parents of students/children.
Author permission was taken before using the Scale. The collected data then analysed by using
[Link]: The results showed that Children who stutter, depending on the intensity of their
stuttering, have both a positive and a negative attitude toward communication, in contrast to those who do
not stutter. According to the study, 52/107 of children who stutter have positive attitudes, but 55/107 of
them have negative attitudes because of their stuttering. Conclusion: Based on the findings it is concluded
that Stutterers have more difficulty in communicating, which results in negative communication attitudes.

Keywords: Communication Attitude, Children who Stutterer, Children who do not Stutterer.

215
 Development Of An Urdu Resource For Minimal Pairs
Maria Nawab1 , Hina Saleem1*
1. Shifa Tameer e Millat University

ABSTRACT
Background: Auditory discrimination of speech sounds is an important perceptual ability to the
acquisition of language. Different treatment approaches have been introduced for children with SSD.
There are few standardized tests which are used to evaluate phonemic distinctive features in children with
or without speech and language disorders. Objective: The aim of this study was to develop an Urdu
resource for minimal pairs as minimal pairs are used in clinical settings as an intervention and treatment
purposes of children with [Link]: The descriptive method was used in this research. The
content validity was evaluated by the panel of 5 experts. Normative data was established on 40 mainstream
children and 8 children having SSD. Sample was taken using convenient sampling. Results: The results
show that typical children performed well on Minimal pairs resource pack. This interprets that minimal
pairs and the targeted pictures were appropriate for the targeted age range. Similarly children with SSD
recognized targeted pictures but showed articulation error. Conclusion: The developed resource pack is
found to be valid to administer as an assessment and intervention purposes for children with speech sounds
disorder.
Key words: Minimal Pairs, Speech sound disorder, Resource pack

216
 Effect Of Smartphone Overuse On Quality Of Sleep And Acedemics
Sania Ahmed khan1, Aaila Mussarat1, Ghazala bibi1 , Dr Seema Ghazal1, Dr Aysha Wajid1, Muhammad
Amir1, Kashaf Javed1*
1. Prime Institute of Health Sciences, H15 Motorway chowk Islamabad

ABSTRACT
Background: One of the greatest invention of 20 th century with highly boosting abilities is mobile phone.
The evolution of information technology brought a drastic change in our lives Objectives: To determine
the prevalence of smartphone addiction among university students, To determine the prevalence of quality
of sleep among university students, To determine the association between smartphone addiction and
quality of sleep, To determine the association between smartphone addiction and academic, To determine
the association between quality of sleep and academics, To compare the quality of sleep, smartphone
addiction and academics between male and female university students. Methodology: it was a
comparative cross sectional analytical study performed in the universities of pindi and Islamabad for a
duration of 3 months. The total sample size was 1000 subjects, using SPSS version 21. Data collection
tools were Pittsburgh Sleep Quality Index (PSQI), Smartphone addiction questionnaire using SAS,
SGPA&amp;CGPA (for the academic performance).Result: Mean and standard deviation of Pittsburgh
sleep quality index (PSQI) was 7.31±3.33 and Smartphone addiction scale was 93.05±[Link]:
When correlations were evaluated for finding the association between CGPA and SGPA with PSQI, no
significant correlation was found as the pt more than0.05.

Keywords: Smartphone, Quality of sleep, Academics.

217
 Common Causes Of Sensorineural Hearing Loss Among Children
Adeel Arshad1*, Asfara Badar2
1. Link Medical Center, Lahore,Pakistan.
2. Kind Edward Medical College, Lahore,Pakistan.

ABSTRACT
Background: Sensorineural Hearing Loss is caused by a lesion of the cochlea (sensory type) or the 8th
nerve, and it affects the central nervous system (neural type). Slight /Mild Bilateral SNHL is predominant
in children that have a deficiency in proper language and academic conditions. Many pathological
conditions cause Sensorineural hearing loss in [Link]: To find out the common causes of
sensorineural hearing loss (SNHL) among [Link]: Observational Cross Sectional study
was conducted to find the common causes of sensorineural hearing loss among [Link] study was
performed at the University of Lahore Teaching Hospital. The duration of study was six months (March
2022 to August 2022).There was sample size of 175 patients which was calculated through online
calculator. Non-probability Convenient sampling technique was used for data collection. Children with
Sensorineural Hearing Loss was included in this study. Multiple disability and Syndromes were
[Link] designed questionnaire was used to accumulate [Link]:Out of 175 participants,101
were male participants from age group 5 to 12 years while female participants were 74 from age group 5
to 12 years. The result of current study indicates ototoxic drugs(34.9%), meningitis(29.1%) and
toxoplasmosis(15.4%) were the main causes of Sensorineural hearing [Link]: The findings and
results of the study show that most prevalent cause of sensorineural hearing loss among children are
ototoxic drugs, delayed milestones, meningitis, jaundice, Toxoplasmosis and viral infections such as
measles and mumps while low prevalent causes of sensorineural hearing loss are cyto-megalo virus,
herpes simplex virus, syphilis and other systematic diseases.

Key words: Sensorineural Hearing Loss, Hearing Impairment, Children,,Pediatric Hearing Loss

218
 Severity And Types Of Hearing Loss In Patients With Hypertrophic Adenoids

Daniel Akhtar1*,Dr. M. Sikandar Ghayas Khan2, Babar Ali3

1. Lecturer, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, University

of Lahore, Pakistan
2. Associate Professor, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences,
University of Lahore, Pakistan
3. Clinical Coordinator, Department of Rehabilitation Sciences, Faculty of Allied Health Sciences,
University of Lahore, Pakistan

ABSTRACT
Background: Adenoid hypertrophy, also known as big adenoids, is a medical condition where the
adenoids expand in an uncontrolled manner. Adolescent patients frequently have adenoid hypertrophy.
Since OME is the most common cause of hearing loss in young children, it plays a role in the
pathophysiology of the condition. Objective: Is to find out the severity and type of hearing impairment
with the impact of hypertrophic adenoids. Methodology: Analytic cross-sectional study design. The
information was gathered at the Children's Hospital and Institute of Child Health in Lahore, Pakistan. On
the basis of prevalence (67.3%) of mild hearing loss the sample size was calculated 339 through online
sample size calculator. The margin of error was 10%, and the level of confidence was 90%. Using the
non-probability purposive sampling method, children with hypertrophic adenoids between the ages of 5
and 13 were included in the study. Children with Autism, Down syndrome, and other co-morbidities who
also have hearing loss were not included. The measurements were made using a 226 Hz probe tone Maico
MA42 Tympanometer and Audiometer. Frequencies and percentages of Data was measured by using
SPSS Version [Link]: The sample of the study consisted of 339 children, of whom 54.0% (n=183)
are Boys, 46.0% (n=156) are Girls and 46.0% are others. 26.0% (n=89) patients belonged to the age group
of 5-7 years, 32.0% (n=107) patients belonged to the age group of 8-10 years, 42.0% (n=143) patients
belonged to age group of 11-13 years. 53.1% (n=180) of patients had Normal (-10 to 25 dB) hearing,
27.1% (n=92) of patients had mild (26 to 40 dB) hearing, 16.2% (n=55) of patients had Moderate (41 to
55dB) hearing, 3.5% (n=12) of patients had Moderately Severe (56 to 70 dB) hearing. 53.1% (n=180) of
patients had Normal Hearing Levels, 43.4% (n=147) of patients had Conductive hearing loss, 1.5% (n=5)
of patients had Sensorineural Hearing Loss, 2.1% (n=7) of Patients had Mixed Hearing Loss. Conclusion:
The prevalence of the severity and type of hearing loss is high among hypertrophic adenoids patients.

Keywords: WHO, Hyypertrophic Adenoids, Audiometry, Hearing loss

219
 Correlation Between Vocal Self-Perception And Psychological Impact In Transgenders
Naveed Ahmed Aftab Bhutta1*, Hafsa Noreen1
1. Speech and Language Pathology, Allied Health Sciences, Riphah
International University, Pakistan

ABSTRACT
Background: Purpose of this research was to get info about the misconception in society regarding voice
issues and psychological impacts in [Link]: To investigate Correlation Between Vocal
Self-perception and Psychological Impact in Transgenders. Methodology: Cross sectional study design
was used and the data was collected from Zab Welfare Foundation Lahore. The sample size was 79 whose
age was 20-50 years old. TWVQ Trans women voice Questionnaire and SRQ20 Self-Reporting
Questionnaire was used for transgenders. Convenient sampling technique was used. transgenders were
target population. Questionnaire was filled by participants and data was collected. Frequencies, correlation
test and one-way ANOVA technique was used for data analysis. Results: Results indicated average age
of transgenders were 27% in this study. More than 50% people were uneducated and only 24.1% people
went to primary level. Mean score of belief and concerns were also calculated. Mean score of belief were
14.59 and mean score of concerns were 11.27. find positive correlation between TWVQ Trans women
voice Questionnaire and SRQ20 Self-Reporting Questionnaire was non-significant (TWVQ =.128 and
VSP=.259).Conclusion:It is concluded in this study that voice impact on transgenders has positive
relationship between vocal impact and psychological issues. There is no association b/w positive
relationship of voice and psychological problems. According to the recent study, there is no significant
difference between voice problems and normal people. It indicates that no correlated psychological issues
with their voice.

Keywords: SLP, Transgender, Voice Quality

220
 LAHORE SCHOOL OF NURSING

The International Conference Advances in Allied Health Sciences, 2022’ organized under the
esteemed banner of Allied Health Sciences is a revolutionary attempt to bring together leading scientists,
field professionals, graduate and undergraduate students of Nursing onto a single platform. It is with
great honour that Lahore School of Nursing is hosting International Speakers from United States of
America, United Kingdom, Norway, and World Health Organization, as well as national speakers.
Multicity of work from nursing being showcased at the conference is at par with international standards
and attendance is highly encouraged.

221
 INTERNATIONAL SPEAKERS
Achieving Sustainable Development Goals: Nurses' Roles
Prof. Liz Madigan
Chief Executive Officer of Sigma Theta Tau International Honor Society of Nursing, USA
Abstract
The presentation explains how nurses have an opportunity and an obligation to work on the United
Nations’ Sustainable Development Goals (SDGs). While nurses often see their work contributing to SDG
3, Good Health and Well-being, there are nursing contributions to be made for all the SDGs. For example,
nurses have contributions to make to SDG 1 No Poverty, SDG 2 Zero Hunger, SDG 5 Gender Equality
and SDG 6, Clean Water and Sanitation as these Goals impact health. The second part of the presentation
focuses on nurses’ roles as advocates for change and nursing leadership.
Keywords: Sustainable Development Goals, Nurses, United Nations Organization

222
 Advancements In Spiritual Care In Nursing

Prof. Dr. Tove Giske

Director of Research and Development at VID Specialized University, Faculty of Health Studies,
Bergen, Norway

Abstract
The presentation will focus on how spirituality and spiritual care are understood in nursing. There is no
agreed upon definition in nursing, however the definition of European Association for Palliative care
(EAPC) are widely acknowledge and the one which will be use in this presentation. Also, discussion will
be at research presenting why spiritual care is at the heart of nursing and see that patients report spiritual
care as important for alleviation suffering, for overcoming adversity and proving hope, inner peace, and
strength. Internationally nurses keep reporting that they feel unprepared to care for patients spiritually,
which is a challenge nursing education must address more adequately. However, nursing education can
only lay a foundation for graduate nurses to build on as spiritual care takes lifelong learning. Nursing
leaders therefor carry a responsibility to facilitate for continued education which also include spiritual
care.
Keywords: Nursing, spiritual care, spiritual care nursing

223
 Advancements In Nursing And Expectations At Who

Coordinator / Cluster Lead Health System Development, WHO, Pakistan

Abstract
Importance of health workforce is vital for functioning of health system of any country. World Health
Organization (WHO) gives direction to its member countries to bring changes in their respective countries.
For that, World Health Organization (WHO) has set Sustainable Development Goals (SDGs) and Pakistan
is signatory country. It is imperative to strengthen health workforce to build health systems that promote
both: Universal Health Coverage and Health Security. Main discussion points will comprise on
‘Importance of Health Workforce, Global and Regional Health Workforce Strategies and frameworks,
Regional Comparison for Health Workforce, Demography and Epidemiology of Pakistan, Health
Workforce in Pakistan, Recent Developments, Support provided by WHO Pakistan, and
Recommendations. Nurse leaders should reflect on standing of Pakistan in Region, and glimpsing Pakistan
Health Metrics and contribute in policy levers to shape health workforce market.

Keywords: Nursing, SDGs, WHO

224
 NATIONAL SPEAKERS
Advancement In Nursing Practice
Ms. Rehana Elahi
Director of Nursing, Shaukat Khanum Hospital & Research Centre, Lahore
Abstract
Nursing is progressively recognized by the health care community as a key to solving the nation’s health
care issues. This recognition by the vital stakeholders is a distinctive opportunity for nurses. Constantly
evolving care needs and advancement in healthcare system require nurses to demonstrate their
effectiveness through care collaboration in a multidisciplinary approach, evidenced -based quality and
safe nursing practice underpinned by research, leadership in clinical, education, and research. Over the
years, there have been tremendous advancements in the field of nursing which are used at the top hospitals
and health care services across the world. These advancements have enhanced nurses’ image and
facilitated to achieve better patient outcomes. The arena of Covid-19 pandemic has introduced numerous
advancements in health care system including nursing. Impacts of technology -driven innovation can be
found in the nursing field, where improved patient data access, artificial intelligence, and other emerging
concepts are driving changes in health care delivery. Professionals equipped with advanced nursing
degrees can use these technological advancements in nursing to help health care facilities work to improve
patient outcomes. All these advances required nursing to standardize the entry-level education for nurses
and developing a uniform professional career pathway and career advancement trajectory with appropriate
incentives to attract more brilliant candidates to nursing. A framework to guide and provide scientific
evidence to engage frontline nurses, the model for professional quality, mentorship and self-efficacy.

Keywords: Nursing, Nursing practice, spiritual care nursing

225
 Dynamics Of Nursing Leadership In 21st Century
Prof. Yasmeen Saggu
Principal, College of Nursing, Foundation University, Islamabad

Abstract
Background: Leadership is not a new concept. Nurses have been acquainted with this concept since it's
very conception. Over the past few years, a paradigm shift has been observed in its theory and execution.
What was previously thought to be the work of the CEOs and heads of organizations is now demanded
from every single person no matter what their hierarchy in the workplace Stephen Covey divides
leadership skills into 7 habits as a successful leader. Objectives are 1) explain leadership qualities of
leaders and managers, and 2) relate leadership dynamics in Pakistan and developed countries. Main
Discussion Points comprise on Comparison of leadership and management, leadership qualities,
relationship of dynamics of leadership in Pakistan with developed countries. Conclusion: Leadership in
the 21st century is not a foreign concept to an everyday man. It's broken down into simple habits which
are easy to adopt by a person who wishes to inculcate leadership qualities in him/her. In short, a leader is
no more a person with a higher status in the society! It's you, it's me and it's everyone around us!

Keywords: Nursing, leadership and management, dynamics of leadership

226
 Moving Towards Evidence Based Nursing Practice In Pakistan

Dr. Dildar Muhammad

Associate Professor & Lead, PhD in Nursing Program, Institute of Nursing Sciences,
Peshawar, KPK, Pakistan

Abstract

Background: Evidence based practice is an approach that enables clinicians to provide the highest quality
of care in meeting the multiphase needs to their patients’ and family. In Pakistan, the concept of evidence
based practice needs integration in clinical areas. Aim: The aim of this session is to give a brief account
of evidence based nursing practice and its utility in Pakistani context. Results: Evidence based practice
(EBP) is the process of making clinical decisions based upon evidence, combined with clinical experience
and patients’ expectations.  Evidence based practice is the conscientious explicit and judicious use of
current best evidence in making decision about the care of individual patients. The practice of evidence
based medicine means integrating individual clinical expertise with the best available external clinical
evidence from systematic research. In Pakistan, there are multiple challenges in implementation of
evidence based nursing practice. For nurse educators, researchers, clinicians and policy makers it is
important to make strategies to overcome challenges in implementing EBP. Conclusion: With
technological advancement in healthcare and patients’ expectation there is a dire need to move towards
evidence based nursing practice in Pakistan.

Keywords: Evidence based practice, nursing care, practice, research, Pakistan

227
 True Values Of Nursing: Transformation Of Nursing For Achieving Sdgs In Pakistan

Sarfraz Masih
Associate Professor & Lead, Office of Outreach Activities Lahore School of Nursing, The
University of Lahore, Lahore, Pakistan

Abstract

Background: Nurses are key player of the health system across the globe. Nurses have been contributing
in their roles in different capacities from direct patient care to leadership level. Professional image of
nursing is well weighed in developed countries, however, nursing image in underdeveloped or developing
countries, particularly in Pakistan is not at its actual prestige. Therefore, nurses need to think different
ways of working and contribution so that nurses’ roles should be more visible. For that, nurses need to
align their learning and practice in national and international standards. Sustainable Development Goals
(SDGs) are key area to align with nursing domains as Pakistan is signatory at World Health Organization
(WHO) for achieving SDGs. Objective: The objective of the presentation is session is to stir on aligning
true values of nursing in transformation of nursing for achieving SDGs in Pakistan. Main Discussion
Points: Main discussion points of the presentation are reflection on contextual health system of Pakistan,
nurses’ roles, inculcating values of nursing in transformation of nursing for achieving SDGs locally.
Conclusion: In technological paced era, nurse leaders should inculcate SDGs in national curricula and
shorts courses to assist government and other stakeholders for strengthening health system as well as in
achieving SDGs in Pakistan.

Keywords: Nursing values, nursing, SDGs, Transformation of Nursing

228
 Advancement In Community Health Nursing Practices In The 21st Century
Shahzad Bashir
Associate Professor & Program Coordinator – MSN, Faculty of Nursing & Midwifery, Ziauddin
University, Karachi, Sindh, Pakistan
Abstract
Background: Nurses are one of the founding groups of every civil society. However, Community Health
Nursing (CHN), in terms of health needs and social responses to achieve the Millennium Development
Goals (MDGs), is the product of centuries of transformation of society from sickness to well-being. In
order to meet the needs of a changing society, community health care practices have always maintained
the goal of improving people's health. (Gulzar, Mistry and Upvall, 2011; Bejster, Cygan, Stock and
Ashworth, 2020). CHN focuses on the whole community, including individuals, families and groups of
people. The main goal is health promotion and primary prevention through community engagement and
collaboration with various organizations. In fact, as a leader in developing countries, CHN can move
forward to achieve MDGs and sustainable development goals (SDGs). (Gulzar, Mistry and Upvall, 2011.
In Pakistani context, community based-organizations a continuously struggling to achieve the broader
goals for better health of the population including maternal and child health through the development of
Community Midwives (CMWs), Lady Health Visitors (LHVs) across the [Link]: 1) To
determine the advancement in community health nursing practices in the 21st Century; 2) To explore the
anticipating challenges for community health nursing practices in the 21st Century, and 3) To recommend
strategies to CHNs to overcome the anticipated challenges in Pakistani context to meet the SDGS goals.
Methods: The current cross-sectional computerized search was summarized in the data and literature
explored from recently done studies through five different scientific database searches from year 2011-
2020: Google Scholar, Science Direct, PubMed, CINHAL, Medline, and Research gate. Results: Overall
15 articles and 3 books has been explored for this search. The improvement in life expectancy has been
increased among American people to more than 75 years in the last decade of 20th Century. Significant
improvement noticed in the 21st Century specially in vaccination drives during COVID-19, control on
infectious diseases, declines in NCDs and strokes, safer and healthier foods, particularly healthier mother
and babies. Improvement also observed in motor-vehicle safety, and safer workplaces projects. Likewise,
Health authorities of Pakistan introduced different health related programs for population; door to door
COVID-19 vaccination, lady health worker program for family planning and primary health care, nutrition
support program, MCH and TB control program. Conclusion: Advancement in Community Health
Nursing Practices significantly improved in the 21st Century for the civil societies in terms of enhancement
in longevity and quality of life. QOL also improved in Pakistan, but
Keywords: Community Health Nursing, Primary Prevention, SDGs, Nursing Research, Developing
Countries.

229
 PRESENTERS
Nurses’ Knowledge About Arteriovenous Fistula Care At A Private Tertiary Care Hospital
Lahore

Ms. Rabbia Jaffar

Post RN BSN Student, Lahore School of Nursing, The University of Lahore
Mr. Sarfraz Masih
Associate Professor, Lahore School of Nursing, The University of Lahore, Pakistan
Abstract
Background: Patients on HD life span are said to be reliant on effective, patent vascular access.
Furthermore, the study emphasized the importance of cannulation procedures in maintaining vascular
access (Staaf, Fernström, & Uhlin, 2021). For best vascular access while employing HD treatment, an
arteriovenous (AV) fistula is used which have low-risk consequences and great long-term patency rates.
Despite this disadvantage, the patient on maintenance HD treatment has a significant risk of morbidity.
Choosing a suitable cannulation technique, whether rope-ladder, buttonhole, or region, is likely to be
based on the needling techniques used in each HD setup facility (Coventry et al., 2019). Objective: The
objective of this study was to assess knowledge of Nurses about Arteriovenous Fistula care at private
tertiary care hospital Lahore. Methodology: A cross sectional study was conducted at private tertiary care
hospital, Lahore. A convenient non probability sample of 100 nurses was recruited to complete the study.
The data was collected through close ended self-Administered knowledge based questionnaire. The data
was analyzed through SPSS version 21. Results: Findings of the study revealed that a good majority 79%
of the study participants had good knowledge, 16% of the participants had average knowledge regarding
AV fistula Care and 5% of the study participants have poor knowledge. Conclusion: It is concluded that
majority of the nurses are well familiar with all the content and processes of AV fistula care.

Key words: Arteriovenous fistula, Knowledge, End stage renal failure

230
 Low Back Pain And Contributing Factors Among Nurses At Clinical Setting In Public
Tertiary Hospitals, Lahore, Pakistan

Razia Sultana

Lecturer, Allama Iqbal College of Nursing, Jinnah Hospital, Lahore, Pakistan

Abstract
Background: Low back pain is a significant health problem among nurses The purpose of this
study was to investigate the prevalence and contributing factors of low back pain among nurses at
a clinical setting in a public tertiary hospital in Lahore, Pakistan. Methods: A cross-sectional study
was conducted among nurses at a clinical setting in a public tertiary hospital in Lahore, Pakistan.
Non-probability convenient sampling method was used to select the sampling units. Data was
collected by adopting Performa by Prof. Cilliers. Results: This study encompassed 191 nurses
working in Jinnah Hospital Lahore. The response rate was 100%. The prevalence of low back pain
among nurses on a regular basis was 41.4%. Contributing factors associated with the development
of low back pain were physical, psychological, social, patient care, and, work environment factors.
The physical factors that can contribute to the development of low back pain were the highest ratio
of poor posture 36.6% and psychological factors fatigue 52.4% and work environment factors the
majority of the participants 36.6% were facing low back pain due to work overload. Conclusion:
Low back pain is moderately prevalent among nurses. Contributing factors associated with the
development of low back pain were physical, psychological, social, patient care, and, work
environment.

Keywords:

Low back pain, Prevalence, associated factors

231
 Assessment Of Nurses' Knowledge Regarding Conflict And Conflict Resolution
Muhammad Sabir1
Post RN BSN Student, Lahore School of Nursing, The University of Lahore
Prof. Muhammad Afzal2
Principal, Lahore School of Nursing, The University of Lahore
Ms. Madiha Mukhtar3
Assistant Professor, Lahore School of Nursing, The University of Lahore

Background: Conflict is indispensable phenomena and can happen anywhere with anyone. This
is a state of disagreement among, between and organization on ideas, thought, motive and personal
likes and dislikes. Conflict is a changeable process; it can be positive or negative, functional or
dysfunctional at work place environment. The objective of the study is to assess conflict and
conflict resolution strategies among Nurses. Method: A cross sectional, quantitative study design
used for this research. The setting of the study was University of Lahore Teaching Hospital. The
target population of the study was registered nurses having two year working experience in a
tertiary care hospital. Slovin’s sampling formula was used to find the sample size of the study
population. The total population is 110, so according to formula total sample size was 86.
According to the finding of the study, (76.5%) nurses have positive response that conflict is
negative experience for them. Results: Conflict at work create disturbance at work place as shown
in study that (75.3%) of nurses were agreed that work place conflict hurt them and slow down their
work place activities. Good conflict resolution strategies have vital role for the professional nurses
that not only save their time but also improve professional harmony at work place setting.
Conclusion: Conflicts were described as discrepancies or opposition by both parties. A small
number of nurses have knowledge of conflict and can constructively settled disputes, but a great
number of them had insufficient knowledge and expertise for settlement of conflict situations.

Key Words: Knowledge, conflict, conflict management, health care setting

232
 International Conference on Advances in Allied Health Sciences
Department of Health Professional Technologies (DHPT)
Department of Emerging Allied Health Technologies (DEAHT)

This conference is an endeavor to bring the leading academics, technologist, therapist, teachers,
graduate and undergraduate students in the field of anesthesia technology, respiratory therapy,
operation theatre technology and biomedical engineering technology together with government
and non-government organizations to share and discuss both theoretical and practical knowledge
about health professional and emerging allied health sciences fields. The two-day Conference will
provide the opportunity to the participants to learn about the latest trends and best practices within
hospitals related to different health professional fields in the world of Allied Health Sciences.
Leading academicians and technologists, therapists, researchers and research scholars will attend
to exchange and share their experiences and research results on all aspects of Health professional
technologies and emerging allied health technologies. We encourage research papers and
presentations based on integrating different disciplines applied in Health professional technologies
and emerging allied health technologies to be submitted in the conference.

233
 International Speakers
Recent Advancements In Medical / Allied Health Professional Fields

Dr. Kashif Chauhan

Paediatric Surgeon, Nottingham University NHS Trust UK

ABSTRACT
Objective: Recent Advancements in Medical/Allied Health Professional Fields. Background:
There are major advancements taking place in the Medical and Allied health professional fields in
recent years. Results: Many new aspects and inventions are made including Telemedicine,
Artificial Intelligence , 3D Imaging , Robotic Surgery , Multi-Angle Rear-Viewing Endoscopic
Tool (MARVEL) , Video-Enabled Surgical Headlights which have revolutionized the treatment ,
teaching and management options. Recommendations: One needs to know and learn them and
going forward we can expect a training program and fully qualified degree in those fields.

234
 Multifunctional Photo- And Magnetoresponsive Graphene Oxide− Fe3o4
Nanocomposite−Alginate Hydrogel Platform For Ice Recrystallization Inhibition
Dr. Muhammad Hassan
Biomaterial, China

ABSTRACT
Tuning ice recrystallization (IR) has attracted tremendous interest in fundamental research and a
variety of practical applications, including food and pharmaceutical engineering, fabrication of
anti-icing coating and porous materials, and cryopreservation of biological cells and tissues.
Although great efforts have been devoted to modulation of IR for better microstructure control of
various materials, it still remains a challenge, especially in cryopreservation, where insufficient
suppression of IR during warming is fatal to the cells. Herein, we report an all-in-one platform,
combining the external physical fields and the functional materials for both active and passive
suppression of IR, where the photo- and magnetothermal dual-modal heating of GO−Fe3O4
nanocomposites (NCs) can be used to suppress IR with both enhanced global warming and
microscale thermal disturbance. Moreover, the materials alginate hydrogels and GO−Fe3O4 NCs
can act as IR inhibitors for further suppression of the IR effect. As a typical application, we show
that this GO−Fe3O4 nanocomposite−alginate hydrogel platform can successfully enable
lowcryoprotectant, high-quality vitrification of stem cell-laden hydrogels. We believe that the
versatile ice recrystallization inhibition platform will have a profound influence on
cryopreservation and tremendously facilitate stem cell-based medicine to meet its ever-increasing
demand in clinical settings.
KEYWORDS: GO−Fe3O4 nanocomposites, alginate hydrogels, photothermal, magnetothermal,
ice recrystallization inhibition.

235
 Ultrafast Open Channel Saw Based Active Micromixer For Microfluidics
Umar Farooq1, Zeeshan Haider2
1
Zhejiang Lab Nanhu Headquarters, Kechuang Avenue, Zhongtai Sub-District, Yuhang District,
Hangzhou, City, Zhejiang Province, 311121, P.R. China
2
The University of Lahore, Lahore,, Punjab, Pakistan

ABSTRACT
Background, Motivation and Objective: In microfluidics, a micromixer is an essential tool for
performing different fluid related operations. Fast and very finely mixing sample fluids and
different reagents at the micro level are always challenging. Previous studies have developed
different acoustic based microfluidic devices for active and passive mixing. These devices,
however, have limitations and challenging in living cells/bodies due to temperature elevation.
Several micromixers based on chaotic advection enhance the mixing efficiency in the enclosed
channel, increasing the complexity and cost of device. To address these issues, a surface acoustic
device with an open channel is fabricated that can provide a platform to drag different droplets
with the minimum drag force, merge the droplet into a single droplet, mix the variety of bio and
chemical solutions in a micro level and bio-compactable manner.
Statement of Contribution/Methods: We have developed a device that provides an open channel
surface for manipulation of microfluidic droplets, the convergence of droplets, mixing of
microfluidics with ultra-fast speed, and biocompatible temperature range. four Interdigital
transducer’s (IDT’s) have developed on Lithium Niobate (LiNbO3) substrate. The area between
the IDT’s (Blue labeled) has treated with silane to make it superhydrophobic. Two PDMS small
channels have attached between two consecutive IDT’s (Between IDT 1&2 and IDT 3&4). IDT’s
have energized with AC signal using a signal generator and with a low power amplifier. All IDT’s
are designed for the same resonant frequency signal. During operation, the fluid coming out from
channel 1 make droplet due to surface tension of hydrophobic surface, in meantime IDT 1 get a
pulse to drag the fluid droplet from channel 1 and move Infront of IDT 2, In the meantime, the
IDT 4 drag the droplet from channel 2 and move Infront of IDT 3, the IDT 3 and IDT 2 get same
time pulse for convergence of two droplets. IDT 2 get shorter pulse then IDT 4, where IDT 4 cause
mixing in the droplet. All four IDT’s provide a 2D open channel surface for droplet manipulation
and convergence. The operation time can calculate by the fluid velocity from channels, and IDT’s
operational pulse times. Results/Discussion: The droplets of regents were dragged on the
hydrophobic surface using the streaming force generated by IDT’s and after convergence of
different fluid droplets same streaming force cause mixing. The droplet size for efficiently mixing
was 1mm in diameter for the designed device, whoever higher size droplet mixing can achieve
with large aperture IDT’s. The maximum streaming velocity achieved at +30dBm was 3.57mm/s
for uniform mixing. The maximum mixing efficiency after 10 sec continues mixing was calculated
77.3±5% at +30dBm power by mixing a fluorescent dye into the DI water droplet.

236
 National Speakers
Environmental Controls In Operating Theatres

Professor Muhammad Shareef

King Edward Medical University/Mayo Hospital

ABSTRACT
Risk of surgical site infections due to airborne bacteria is a key area of consideration in developing
operating theatre ventilation design and monitoring procedures. SSI is the leading complication of
surgery. Normal skin flora of patients or healthcare workers is a significant source of infection
following clean surgery, nevertheless the importance of airborne bacteria remains significant as
well. In the last 300 years, the OR design has responded to changes in surgical needs and practice
with significant improvements in patient’s outcome. Since the awareness of the importance of
developing an antiseptic surgical environment, the design provision and monitoring of OR airflow
has gained massive attention in medical field. Modern operating theatres have conventional
plenum ventilation with filtered air where particles ≥5 μm are removed. For delicate surgeries,
laminar-flow systems are used with high-efficiency particulate air (HEPA) filters where particles
≥0.3 μm are removed. The use of ultra-clean air has been shown to reduce infection rates
significantly in surgery. Few countries have set bacterial threshold limits for conventionally
ventilated operating rooms, although most recommend 20 air changes per hour to obtain 50–150
colony forming units/m3 of air. The features of the airflow system for health protection are
ventilation, air distribution, room pressurization, and filtration. The higher the dilution effect, the
lower the concentration of airborne contaminants, which includes bacteria and anesthetic gas.
Turbulent airflow increases the effectiveness of air exchange and distribution, but speeds up
microbial dispersion. Low-velocity unidirectional flow tends to minimize the spread of airborne
contaminants and direct them towards the exhaust outlets. Consequently, the airborne infection
risk can be reduced.

To conclude, the systems that provide laminar flow regimes constitute the best option for an
operating theatre, in terms of contamination control, as they result in the smallest percentage of
particles impacting the surgical site.
Key words: Air born infections, air flow system, laminar flow, HEPA filters

237
 Recent Advances In Anesthesia
Dr. Abdullah Ali Lashari
Bahria International Hospital Lahore, Pakistan

ABSTRACT
Anesthesia is a relatively newer specialty of medicine. The development of anesthesia has
revolutionized the field of surgery. Modern anesthesia practice is dependent upon technology more
than most of other fields of medicine. The development of newer anesthetics, drugs delivery
systems and patients monitoring systems has made it possible to undertake as complex procedures
as liver and heart transplant. There are various aspects of anesthesia. These includes hypnosis,
analgesia, relaxation, precise drug delivery system and monitoring. The advances in all these have
greatly enhanced the safety profile of anesthesia. Many procedures can now be undertaken on
day-care basis and the list is ever increasing. All the recent advances in anesthesia cannot be
discussed in this limited time presentation. But few are: Pharmacology- Desflurane, xenon,
dexmeditomidine, fentanyl group esp. fentanyl and remifentanil, transdermal patches, intranasal
spray of opioid, trans mucosal immediate release formulation(TIRF) of fentanyl, aerosolized
liposome encapsulated fentanyl/ morphine, ketamine Monitoring- cardiac output monitoring from
invasive to non-invasive, anesthesia depth monitoring system(BIS) to prevent intraoperative
awareness, cerebral oximetry, transesophageal echocardiography(TEE). Procedural equipment-
Ultrasonography, G-Arm. Pain management- patient controlled analgesia (PCA), total intravenous
anesthesia (TIVA), spinal cord stimulation for chronic pain. Future prospects- Robotic anesthesia,
automated anesthesia, closed loop anesthesia delivery system(CLADS).
KEY WORDS: Anesthesia, recent advances

238
 Peptide- Based Hpv Vaccine Development And Its Immunogenicity Evaluation With
Serology Assays Using Sprague-Dawly Models
Dr. Mehreen Ismail
Bio-technologist

ABSTRACT
Human papilloma virus (HPV) cause cervical and many other cancers. Recent trend in vaccine
design has been shifted to epitope-based vaccines that are more specific, safe, and easy to produce.
In the present study, we predicted eight immunogenic peptides of CD4+ and CD8+ T-lymphocytes
including major capsid proteins (L1), Minor capsid protein (L2), early protein E2 and early protein
E6. Sprague Dawly rats in groups were immunized with each synthetic peptide and emulsified in
complete Freund’s adjuvant. L1M1, L1M2, L2M1 and L2M2 induced strong immunogenic
response compared to E2M1, E2M2, E6M1 and E6M2. We observed optimal titer of IgG
antibodies (>1.25g/L), interferon-ɣ (>64 ng/L) and granzyme-B (>40 pg/ml) compared to control
at second booster dose (240ug/500ul). The induction of peptide-specific IgG in immunized rats
designated the existence of B cell epitopes in peptide sequences. Activation of CD4 and CD8 T
cells is crucial for the generation of protective immunity against virus. Combining
immunoinformatics tools and experimental validation, we demonstrated that L1M1, L1M2, L2M1,
L2M2, E2M1, E2M2, E6M1 and E6M2 are likely to include potential epitopes for the induction
of protective immune responses supporting the feasibility of peptide-based vaccine development
for HPV.

239
 Atnced3 Is A Positive Regulator Of Salt Stress In Nicotiana Tabacum
Dr. Farva Masood
Biomedical Engineer Lahore, Pakistan.

ABSTRACT
Complex physiological and biochemical processes helps plants to acclimatize under salt stress. De
novo synthesis of Abscisic acid (ABA) plays an essential role in regulation of stomata providing
tolerance to osmotic stress via, induction of several genes. Of the products of such genes, 9-cis-
epoxycarotenoid dioxygenase (NCED) enzyme acts as rate-limiting step in ABA biosynthesis.
Among seven identified NCED genes of Arabidopsis, AtNCED3 gene was selected for
transformation in Nicotiana tabacum due to its high induction against osmotic stress. Incremental
NaCl stress, followed by maintained prolonged stress strategy was applied to both transgenic
AtNCED3 and wild type. Different experiments including plant biomass, total chlorophyll content,
relative water content, leaf K+ and Na+ content and chlorophyll a fluorescence were carried out.
Results suggested that all these attributes were significantly increased in AtNCED3 transgenic
lines than wild type under salt stress. OJIP transients and other associated biophysical parameters
ETo/RC, ETo/Csm and Tro/Csm were slightly reduced in AtNCED3 transgenic lines linked with
their photoacclimatory adaptations in PSII than wild type. Moreover, negative K and L band
appeared in transgenic plants at severe NaCl stress indicates, less damaging effect on structural
stability of PSII and imbalance between the electrons at the acceptor and donor sides of PSII,
respectively. However, AtNCED3 transgenic lines reduced the salt-induced osmotic and toxic
effects by improving stomatal conductance via, accumulation of ABA. In conclusion, genetic
manipulation of AtNCED3 gene in commercial crops can support both agriculture and economy
by improving tolerance against salt stress.

240
 Comparison Of Early Versus Late Mechanical Ventilation In Covid-19 Patients
Usra Naeem1, Chandni Roina2
1
Department of Health Professional Technologies, University of Lahore, Pakistan
2
Respiratory Therapist, University of Lahore, Lahore

ABSTRACT
Objective: To find the effects of early verses late mechanical ventilation in Covid-19 patients.
Introduction: Novel corona-virus 2019 is the cause of the 2020 pandemic that was announced by
the world health organization in March 2020. Coronavirus attacks the respiratory system and
causes mild to severe hypoxaemia. Therefore, a fraction of COVID-19 patients may need
intubation and mechanical ventilation. Method and Material: After synopsis approval Data was
collected from Covid ICU of Services Hospital, Lahore, Pakistan. Data was collected through
questionnaire comprising of questions related Early verses late Mechanical Ventilation in COVID-
19 Patients. Results: Out of 162 participants 56(69.1%) males and 25(30.9%) females were early
intubated and 46(56.8%) males and 35(43.2%) females were late intubated. Out of 162 participants
16 were 30-40 years, 26 were 41-50 years,15 were 51-60 years, 24 were 61-70 Years had early
intubated and 24 patients were 30-40 years 31 were 41-50 years 17 were 51-60 years and 9 were
61-70 years had late intubated. Out of 162 participants 64 patients stay at ICU for 4-12 days and
17 patients stay for 13-22 days were early intubated and 45 patients stay for 3-12 days and 36 stay
for 13-22 days were late intubated. Out of 162 participants 63 patients were at MV for 1-11 days,
18 patients at MV for 12-22 were early intubated and 52 patients at MV for 1-11 days, 29 patients
at MV for 12-22 days were late intubated. Out of 162 participants 56 patients stay at ICU after
getting free from MV for 0-4 days, 25 patients stay for 5-9 days were early intubated and 37
patients stay free for 0-2 days, 44 patients stay for 3-5 days were late intubated. Out of 162
participants 43 (53.1%) patients were died in early intubated and 59 (72.8%) patients were died
in late intubation. Conclusion: This research concluded that performing an early intubation in
COVID-19 patients may reduce long-term hospital stay, duration of mechanical ventilation, ICU
length of stay and mortality rate. Early intubation is associated with short term hospital stay and
lower mortality rate than late intubation. Mortality was lower in patients who were intubated early
than who were intubated late.
Key words: Acute respiratory distress syndrome, acute respiratory failure, Coronavirus

241
 Frequency Of Surgical Gloves Puncture During Gynecological And General Surgical
Procedures
Laiba Zahid , Muqadas Ashraf , Kashif Ali2, Hafiza Sania Azam2, Mubarra Falak Sher2
1 2
1
Department of Health Professional Technologies, University of Lahore, Pakistan
2
Operation theatre technologist, University of Lahore, Lahore,
Pakistan.

ABSTRACT
Background: Surgical Gloves was introduced for use as a new antiseptic methods or techniques
to save the surgeon and their assistants hand from dangerous skin problems. Paramedic staff are at
high chance of contracting blood -born infections (BBIs), such as Hepatitis (A&C) and HIV during
surgery. Objectives: To find the rate of surgical gloves puncture in gynecological and general
surgical procedures. Methodology: This is a descriptive cross-sectional study. The study was
conducted from 4th February 2022 to 8th June 2022, after approval of synopsis from the
department research committee & Supervisor committee of the university of Lahore Pakistan.
Then it was approved by MS of the Social Security hospital Multan Road Lahore with help of
Performa. A cross-sectional Survey was conducted by data using a water Snugness test as depicted
in the European Standard (EN455-1) to distinguish Spills. Results: Out of 175 pairs of
gloves,17(9.7%) C-section, 32 (18.3%) appendectomy,6(3.4%) hysterectomy ,14(8%)
herniorrhaphy and 106 (60%) other surgery were performed. Most of the duration was less than 1
hours, therefore the risk of perforation of the gloves was reduced. The duration of surgery follows
less than 1 hour 97(55.4%), 1-2 hours 71(40.6%),2-3 hours 6(3.4%) and the 4-5 hours (6%).
Mostly OT Staff wear powered gloves. Out 175 pairs of gloves,164(93.7%) used powered gloves
and 11(6.3%) used non-powered gloves. There is association between surgical procedures and
gloves puncture because (p<0.05). There is no association between powered& un- powered gloves
and gloves puncture because (p>0.05). There is also association between duration of surgery and
glove puncture because (p<0.05). Conclusion: It is concluded that frequency of glove puncture is
directly proportional to the nature and duration of surgery and pair of gloves which is used in
surgical procedures and inversely proportional to the gloves with or without powered.
Keywords: surgical gloves, surgical gloves puncture, double gloves, gloves perforation, single
gloves.

242
 Quality Of Life In Pulmonary Tuberculosis Patients
Ruhamah Yousaf1, Shakeel Ahmad2
1
Department of Health Professional Technologies, University of Lahore, Pakistan
2
Respiratory Therapist, University of Lahore, Lahore, Pakistan

ABSTRACT
Background: Tuberculosis (TB) is a major public health threat. It is a contagious illness caused
by Mycobacterium Tuberculosis. The disease is transmitted through droplet infection, typically
through inhaling bacteria. It generally affects the lungs however it may also influence other organs.
TB is one of the peak 10 reasons for fatality globally and individuals of all ages of either gender
are affected by it. Objective: The objective of this study was to assess the quality of life in
pulmonary tuberculosis patients.
Methodology: This cross-sectional study was conducted in Social Security Hospital, Multan Road
branch Lahore. Non-probability purposive sampling technique was used for the study. A
standardized questionnaire of World Health Organization Quality of Life (WHOQOL-BREF) was
used to collect the data. Data was entered and analyzed using SPSS 21. Results: This study
included 96 participants in total out of which 56 were male and 40 were females. From which 40
percent people belonged to a joint family and 56 percent belonged to nuclear family, were
interviewed to explore family factors associated with quality of life in pulmonary tuberculosis
patients. Results of the study highlighted that there is in significant association between the type
of family and quality of life of participants with a P-value of 0.101. The educational status of the
respondents was significantly associated with quality of life with p-value of 0.01. The present
study highlighted a non-significant association of the participant’s employment and quality of life
as the observed p-value is 0.536. The study also showed a significant association between monthly
household income of participants and quality of life as the observed p-value is 0.007. Conclusion:
The results of this study concluded the relationship between family factors and quality of life in
pulmonary tuberculosis patients. The educational status and monthly household income of the
participants were significantly associated with their quality of life. The ratio of disease is usually
more in individuals with a lower level of education and lack of knowledge about the disease and
also have a lack of money. Another reason for the increase of TB cases is poverty. Type of family
and employment status does not show a significant relationship with the quality of life of TB
patients.
Key words: Tuberculosis, Quality of life, Family factors, Pulmonary tuberculosis patients.

243
 Poster Presenters

Risk Factor Of Intestinal Perforation Associated With Peritonitis

Alia Naseer1*, Muzamil Irshad2, Imran Naz3, Muhammad Umair4
1
Lecturer, Department of Health Professional Technologies, University of Lahore, Pakistan
2
Operation theatre technologist, University of Lahore, Lahore, Pakistan
ABSTRACT
Background: Perforation is described as an abnormal opening in an empty organ or viscus. It is
derived from the Latin perforatus, meaning “to bore through.” The variety of etiology of
perforation is different in the middle of developing and developed countries. Objective: Objective
of the study is to find out the risk factor of intestinal perforation associated with peritonitis
Methodology: A cross-sectional investigation was carried out. The surgical emergency and
trauma units at Social security hospital Multan chungi Lahore and DHQ Hospital Gujranwala
provided the data for this investigation. Data was collected from 50 patients. On a Performa,
demographic information and risk factor of intestinal perforation were noted. Results: Out of 50
patients 19 were Female and 31 were Male and 19 patients (38%) were suffer from fever,16
patients (32%) suffer from Appendicitis,13 patients (26%)suffer from Trauma, 12 patients (24%)
suffer from Abdominal distention;11 patients (22%)suffer from Inflammation,10 patients (20%)
suffer from Intestinal Obstruction, 9 patients (18%) suffer from Ascities,4 patients (8%) suffer
from Gastric Ulcer ,4 patients (8%) suffer from Infection and 3 patients (6%) suffer from Duodenal
Ulcer in which 34 patients (68%) have Duodenal perforation, 11 patients (22%) have Colon
perforation , 7 patients (14%) have Stomach ,7 patients (14%) Jejunum, 7 (14%) Illum and 2
patients (4%) have Rectum perforation. Conclusion: This study conclude that Intestinal
Perforation was commonly seen between the age group of 21-30 years and most common
perforation was duodenal perforation (68.0%). Common risk factor of intestinal perforation was
appendicitis followed by trauma, fever and abdominal distension.
Key words: Intestinal perforation, Appendicitis, Fever

244
 Frequency And Risk Factors Of Surgical Site Infection With And Without Antibiotic
Prophylaxis In Adults Undergoing Minor Trauma Surgery
Saher Mudassar1, Alia Naseer2*, Wania Sadiq3

1. Operation theatre technologist, University of Lahore, Lahore,

2. Pakistan.2.1Lecturer, Department of Health Professional Technologies, University of
Lahore, Pakistan
3. Lecturer, Department of Health Professional Technologies, University of Lahore,
Pakistan

ABSTRACT
Background: Surgery patients who have undergone trauma surgery frequently develop surgical
site infections (SSI). A typical tactic used in trauma operations was preoperative antibiotic
prophylaxis. Objective: To determine the frequency and Risk Factors of Surgical site infection
with and without Antibiotic prophylaxis of adults undergoing Minor Trauma Surgery.
Methodology: A descriptive cross-sectional investigation was carried out. The surgical emergency
and trauma units at Jinnah Hospital and THQ Hospital DGK provided the data for this
investigation. Data from 190 patients were gathered and equally split into two groups. Before
surgery, Group A took antibiotic prophylaxis while Group B did not. Results: Both groups'
demographic information was comparable. Less than an hour was spent operating on patients in
groups A and B on average. 18 patients out of 190 patients experienced surgical site infections,
with 6 (6.3%) patients belonging to group A and 12 (12.6%) to group B. In Group A, 2 (2.1%) of
the patients who developed SSI were female, while in Group B, 12 (12.6%) of the patients who
had SSI were male and no female developed SSI. Contaminated wounds, diabetes, and failure to
remove hair from the surgical site were the three main risk factors for SSI in minor trauma cases.
Conclusion: It is concluded in our study that prophylactic antibiotics in Minor Trauma cases
performed in adult patients does significantly decrease the incidence of Surgical Site Infection.
The major risk factor to develop SSI in Trauma surgery were Contaminated wound, Diabetes and
patients without hair removal from surgical site before surgery Key words: Antibiotic prophylaxis,
Surgical site infection. Minor Trauma surgery

245
 Factors Affecting The Frequency Of Hypotension In Patients Undergoing General
Anesthesia
Afida Wajid1, Laiba Zahid2
1. Department of Health Professional Technologies, University of Lahore, Pakistan
2. Operation theatre technologist, University of Lahore, Lahore, Pakistan.

ABSTRACT
Background: In anesthesiology, hypotension after induction of general anesthesia is prevalent
and can affect outcomes. Our study's major objectives were to determine the frequency of general
anesthesia inducting hypotension (GAIH) in adult patients after non-cardiac surgery. Objectives:
The objective of this study was to find the frequency of hypotension before and after induction of
General anesthesia and to find the association between age and blood pressure AND diabetes and
blood pressure after induction of General anesthesia. Methodology: It was comparative Cross-
sectional study. This study was conducted in Surgical Department, unit 03 of Services Hospital
Lahore. Study duration was 4 months (October 2021 to January 2022). Sample size was 182 on
the basis of prevalence and purposive sampling technique was used. A Performa was developed
with the help of Literature review and expert opinion. Results: Out of 182 patients, 97 were male
and 85 were female. The mean of age was 2.91 and standard deviation was 1.499. 164 patients
were non-diabetic while 18 patients were diabetic in this study. Results show association of
hypotension with the age of patient in systolic blood pressure before induction (p=0.003) and after
induction (p=0.01) while there is no association of hypotension with the age of patient in diastolic
blood pressure before induction (p=0.914) and after induction (p=0.827) of general anesthesia.
Conclusions: The study concluded that the majority of the patients suffered hypotension soon
after induction of general anesthesia, and that patient’s age has a considerable impact on blood
pressure, whereas diabetes has a minor impact.
Key words: Hypotension, Anesthesia induction, General anesthesia, Risk Factors, Blood Pressure.

246
 Risk Factors Of Infection In Orthopedics Implants Following Lower Limbs Surgery
Sidra Naseem1, Muhammad Awais2, Mohsin Raza3, Muhammad Abdullah4, Muhammad
Muzamil5.
1
Lecturer, Department of Health Professional Technologies, University of Lahore, Pakistan
2
Operation theatre technologist, University of Lahore, Lahore,
Pakistan.
ABSTRACT
Background: Patients who have undergone orthopedics implants lower limbs surgery develop
surgical site infections (SSI) after surgery. Objective: We find the frequency and risk factors of
infection in implants lower limbs surgery Methodology: A Retrospective and descriptive
investigation was carried out. The surgical emergency and Orthopedics Unit Saidu Teaching
Hospital KPK and Social Security Hospital provided the data for this investigation. Data of 150
patients were gathered. Before surgery, On a Proforma, demographic information Age, Gender,
Name of surgery and the Types of the procedure Types of implants cemented and cemented less
were noted. Standard surgical protocols were followed during the surgical operation. Mostly
patient were Caused surgical site infection after surgery Due to common causes are mention
diabetes, smoking old age, above 60 years of ages. Results: Out of 150 infected patients,
Developed Surgical site infection From Diabetes 106 patients (70.7%), advanced age above 60
(43.3%) Smoking 92 patients (61.3%) Types of implant cemented less 103 patients (68.7%). And
without Antibiotics 128 patients (14.7%). Poor Nutrition 99 Patients (66.0%) Drain tube used in
93 patients (62.0%). The major risk factor to develop SSI in orthopedics implant surgery were
Diabetes, Smoking and used of cemented less types of implants. Conclusion: It is concluded in
our study that diabetes and types of Cement less implants, is high incidence risk of surgical site
infection. Use of antibiotics prophylaxis in orthopedic implants doesn’t significantly decrease the
incidence of surgical site infection, above 60 year of age can cause SSI, Smoking, poor Nutrition
and Drain tube can also develop SSI in orthopedics implants surgery. We could not find a
significant correlation with GIT, Liver disease, stress and blood transfusion to develop the SSI in
orthopedics implants surgery.
Key words: Surgical site infection, ASA American score of anesthesiologists

247
 Frequency and Risk Factors Associated With Perforated Peptic Ulcer Disease
Authors: Sidra Naseem1, Aqib Javaid2
1. Lecturer/Department of health professional technologies/Faculty of allied health
sciences/The University of Lahore, Lahore, Punjab, Pakistan

ABSTRACT

Background: Peptic ulcers are open sores on the interior lining of the stomach and the upper
region of the small intestine. Stomach discomfort is the most prevalent sign of a peptic ulcer. The
ulcers on the inside of the stomach are known as gastric ulcers. Duodenal ulcers are ulcers that
form on the interior of your small intestine's upper part (duodenum). Ulceration is a wide spread
disease that millions of people affected by this worldwide Methodology: It was a descriptive
cross-sectional study. After the synopsis has been Approved. Jinnah Hospital in Lahore provided
the information. After receiving approval from the Departmental Research Committee, the study
lasted for four months. The study's sample size was 289 people. Ages range from 20-55 years.
Both male and females. All cases reported with Perforated Peptic Ulcer in Gastro Ward. Results:
Out of 289 participants 139 (48.05%) were females and 150 (51.90%) were males. The participants
58 (20.06%) was aged of 25 to 35 years were 129 (44.63%) was aged 35 to 40years and 102
(35.29%) were aged of 45 to 55 days. Out of 289 participants 222 (76.81%) Males and Females
had presented complain of perforated peptic ulcer and 67 (23.19%) was not presented that same
history. Out of 222 participants 129 (58.10%) males and female have a peptic ulcer 103 (35.64%)
had duodenal ulcer and 93 (41.89%) was esophageal ulcer. Out of 222 participants 67 (30.18%)
Males and female had O blood group 59 (26.57%) were A blood group 60 (27.02%) was B blood
group and 43 (19.36%) was AB blood group. Conclusion: From our study we conclude that the
main factors contributing perforated peptic ulcer are use of NSAIDS ( Non steroid anti anti
inflammatory drugs), tobacco use, chronic stress, alcoholism, types of blood, co-morbidities
including: CVS, diabetes mellites, pulmonary disease)

Key words: Peptic Ulcer, Duodenal Ulcer, Gastric Ulcer, Esophageal

248
 Risk Factors And Complications Of Thyroidectomy
Fazeelat Akram1, Sakib Ali2, Muhammad Touqeer3, M Abu Bakar Yousaf4.
1. Lecturer/Department of health professional technologies/Faculty of allied health
sciences/The University of Lahore, Lahore, Punjab, Pakistan

ABSTRACT
Background: A thyroidectomy is an activity that includes the careful evacuation of all or part of
the thyroid organ. Overall medical procedure, endocrine or head and neck specialists frequently
play out a thyroidectomy when a patient has thyroid disease or another state of the thyroid organ
(like hyperthyroidism) or goiter. Objective: To find out the risk factors and complications of
thyroidectomy. Methodology: After synopsis approval data was collected from Jinnah hospital,
General hospital Lahore and DHQ Hospital Sahiwal. In this study, we included patients with the
Risk factor and complication of thyroidectomy patients’ data was collected through questionnaire
comprising of questions related thyroidectomy. First, participants’ consent was taken, and they
were informed about the objectives of the study. After consent demographic information was filled
by each participant including name, age, education, and other relevant personal information be
collected from patients. A Descriptive Cross Sectional Study survey was conducted using
Purposing sampling technique. Results: In this research we collected data of 122
participants,12(9.8%) participants are from age group between 30 to 40 while 36(29.9%)
participants are from age group between 40 to 50 while 48(39.3 %) Participants are from age group
between 50 to 60 and 26(21.3) participants from age group between 60 to 70. And the gender of
patients was 89(73.0%) participants are females while 33(27.0%) participants are male. And we
find out the risk factors of thyroidectomy like that out of 122 participants ,2(1.4%) participants
had presented complaint of laryngeal nerve injury while 120(98.6) participants have not. And
complications of thyroidectomy like that out of 122 participants, 28(23.0%) participants show
symptoms of wound infection while 94(77.0%) participants don’t show these symptoms.
Conclusion: We found that major risk factors for goiter are Multinodular goiter, bleeding in neck,
Hypocalcaemia, Uni nodular goiter and Grave’s Disease. We found that major complications are
wound infection. Recurrent laryngeal nerve paralysis, Post-operative hypothyroidism and
bleeding.
Key words: Thyroidectomy, Hypocalcaemia, Multinodular Goiter, Bleeding.

249
 Assessment Of Knowledge, Attitude And Practices Of Oxygen Therapy Among Health
Care Professionals
Areej , Iqra Rehman , Ruhamah Yousaf 3, Sonia Aslam4 and Usra Naeem5
1 2*

MPhil Physiology*/Lecturer/Department of health professional technologies/Faculty of allied

health sciences/The University of Lahore, Lahore, Punjab, Pakistan

ABSTRACT

Background: Oxygen therapy is considered a life-saving drug in an emergency situation. The

goal of oxygen administration is to restore patient oxygen levels to equal or near-normal oxygen
levels. Oxygen therapy causes serious illness due to a lack of adequate knowledge and the
negligence of healthcare providers. Objective: To access the knowledge, attitude and practices
related to oxygen therapy among doctor, nurses and respiratory therapist. Methodology: Cross-
sectional study was conducted by using purposive sampling technique. The data was collected
from Services Hospital in Lahore. A structured questionnaire from previous literature was used
to collect the data from 140 healthcare professionals of either gender. The doctors, RTs, and
nurses available at the workplace were included in the study. Results: The result of the study
shows that the mean age of participants is 27.09 and standard deviation is 4.184. In this study
there were 61 males representing 43.6% in total population and there were 79 female
participants which representing 56.4% in total population. There are 76 doctors which were 54.3
in population, 40 nurses which were 28.6% and 24 respiratory therapists of 17.1% of total
population. The study shows that 77.9% population had good knowledge and remaining 22.1%
population had no knowledge, 82.9% population had positive attitude and remaining 17.1%
population had negative attitude. And out of 140 participants, 92.9% population had good
practice and remaining 7.1% population had bad practice regarding oxygen therapy.
Conclusions: The result of the study concluded that majority of the studied participant had good
level of knowledge about oxygen therapy and adequate level of practice of oxygen therapy while
the rest of the participants had average level of knowledge about oxygen therapy and practice
of oxygen therapy. Therefore, regular training of healthcare workers should be encouraged to
update their knowledge and practice of oxygen therapy.

Keywords: Knowledge, Attitude, Practices, Oxygen therapy

250
 Association Of Bmi With Symptoms Severity In Non-Cystic Fibrosis Bronchiectasis
Sonia Aslam1*, Dr. Sayed Arif Saeed Zaman2
1. Lecturer, Department of Health Professional Technology, Faculty of Allied Health Sciences
(FAHS), University of Lahore, Pakistan
2. Assistant Professor & HOD, Pulmonology & Medical ICU, Sharif Medical City Hospital

ABSTRACT

Background: Non-cystic fibrosis (CF) bronchiectasis is characterized by endobronchial

suppuration, airway neutrophilic inflammation and poor mucus clearance and is associated with
persistent productive cough due to recurrent airway infections. Most recommendations are based
on expert opinion or extrapolated from CF practice. The objective of this observational study was
to evaluate the association of body mass index (BMI) with symptoms severity in non-cystic
fibrosis bronchiectasis. Methods: This study was performed at GULAB DEVI CHEST
HOSPITAL. 70 subjects were fulfilling the inclusion and exclusion criteria based on purposive
sampling technique. We used cross sectional descriptive study designed to collect the data. A self
made was developed by reviewing literature and with expert opinion. Data was entered and
analyzed using SPSS 21. Result: A total of 70 patients (25 females, 45 males) diagnosed with non-
cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four
groups: underweight (BMI>18.5 kg/m2), normal weight (18.5 ≥25.0 kg/m2), overweight

(25.0≥30.0 kg/m2), and obese (BMI>30.0 kg/m2), ( =.03,P> 0.04).In conclusion, The current
study was to evaluate the association of body mass index with symptoms severity in Non-cystic
fibrosis bronchiectasis patients. Conclusion: We conclude that two categorical variables are
independent to each other and in our population there is no association between BMI and
symptoms severity index in non-cystic fibrosis bronchiectasis.

Key Words: Bronchiectasis, BMI (Body mass index), NCFB (Non cystic fibrosis bronchiectasis).

251
 UNIVERSITY INSTITUTE OF PHYSICAL THERAPY
The 1st International Conference on Advances in Allied Health Sciences, has been honorary hosted
by University Institute of Physical Therapy, University of Lahore (Lahore, Pakistan). Under the
esteemed banner of Allied Health Sciences is a revolutionary attempt to provide a forum for
discussion, to facilitate integration in these fields, and to bring together researchers, scholars, and
students from all sub areas of Allied health sciences from all around the world.

The multiplicity of work from the Physiotherapy department being showcase at the conference is
at par with international standards and attendance is highly encouraged.

The conference held over two days, from 25th to 26th October (Tuesday and Wednesday) 2022 in
Lahore, Pakistan. The conference included more than 20 concurrent sessions in which there were

Invaluable presentations by both national and international presenters. We must sincerely thank
the presenters, chairpersons and the students in our department, who contributed so magnificently
to the success of the conference. We tried hard to ensure that the conference would be well -
organized. We hope that it met the expectations. We are grateful to the presenters and the
participants for their thought provoking contributions. We extend our very best wishes to you
wherever you may be around the world.

252
 INTERNATIONAL SPEAKERS
Rehabilitation Of Veterans After Second Karabakh War
Dr. Parvin AKbarov Alakbar
Director Azerbaijan Scientific Research Institute of Medical Rehabilitation, Azerbaijan
ABSTRACT
On September 27, 2020, Armenian forces attacked the border of Azerbaijan from various
directions. The emergency was met by recruiting ordinary men from little-known families to
defend the country. Some are still in rehab and experienced deep physical and mental strain after
the horrors of war. In addition Azerbaijani army soldiers were seriously injured several times. In
the 43 days of war, Azerbaijan lost 3,906 troops, many wounded. This has had the greatest impact
on the health of the country's younger generation. Veterans generally find it difficult to rebuild old
social connections and physical activity, so they also need a positive attitude from society because
they are already disabled. Although several organizations in the country are studying the interests
of soldiers, the needs of the families of those who have lost loved ones in war, and are trying to
resolve these issues as quickly as possible. They are trying to help them, help them not physically
and materially, but morally. They arrange meetings with civilians and veterans and help veterans
support their families. It is clear that if the injured recover from physical and mental illness
interacting with the public, they will be better able to cope with difficult problems.
Physiotherapists are endeavoring to impart their roles in prompt rehabilitation of the veterans.

253
 Role Of Cardiac Rehabilitation In Patient Care
Prof. Dr. Behrouz Attarbashi Moghadam
PhD PT Department of Physical Therapy, School of Rehabilitation, Tehran University of
Medical Sciences
ABSTRACT
Cardiac rehabilitation is a valuable treatment for patients with a broad spectrum of cardiac disease.
Current guidelines support its use in patients after acute coronary syndrome, coronary artery
bypass grafting, coronary stent placement, valve surgery, and stable chronic heart failure. Its use
in such spectrum of pathology supported by scientific research with improved clinical outcomes.
The Key benefits of CR derived from exercise training. Exercise training improves VO2 max along
with endurance capacity and the ability to maintain physical activity for extended [Link]
training has multiple other potentially beneficial effects, which improve myocardial blood flow
reserve, reduction in smoking, body weight, blood lipids, and blood pressure. A narrative review
conducted including different studies about cardiac rehabilitation approaches used in patient care.
Cardiac rehabilitation (CR) has evolved from exercise only into a comprehensive program that
also addresses other cardiovascular disease risk factors and provides education and social support.
There were positive benefits recommended by previous literature regarding beneficial outcomes
of CR in patients after cardiac surgery. The objective of this study was to review this literature
qualitatively and systematically. A literature search of MEDLINE, PsycINFO, CINAHL, Embase,
and EBM conducted from published articles from database inception to October 2019. Overall, 17
articles were included following a process of independent review of each article by 2 authors.
Seven (41.2%) were graded as good quality according to Downs and Black criteria. There were no
randomized controlled trials. Results showed that medical specialty (cardiac specialists more likely
to refer; n = 8 studies) and other physician-reported reasons (physician report of their reasons for
CR referral) were related to referral. Physician factors related to patient enrollment in CR were
physician endorsement, medical specialty, referral basis and physicians’ attitude toward CR.
Physician factors are consistently related to CR referral and enrollment. The role of physician
endorsements in promoting patient enrollment should be optimized and exploited. This review
indicates that cardiac rehabilitation improves the quality of life for coronary heart disease patients
and quality of life improvements have a bi-directional relationship with increased physical activity
and vocational status. Further research is needed to explore the relationship of quality of life
outcomes to cardiac mortality, the relationship between improved physical well-being and anxiety,
the quality of life and mortality effects of cardiac rehabilitation in older people.

254
 Ergonomics And Workplace Injuries
Dr. Salman Malik
Environmental health and safety Manager, Mississauga, Canada
ABSTRACT
Workplace accidents have been known for decades in the office environment. However, this
phenomenon has not been fully appreciated in the medical field. As an altruistic profession, health
care workers often neglect their own health when caring for patients. Additionally, the ever-
increasing pressure to improve productivity has created a culture that prioritizes performance at
the expense of healthcare professionals. Due to the increase in work-related musculoskeletal
injuries and the associated high cost to injured workers, physiotherapists are increasingly relying
on on-site treatment, including injury prevention programs, education, ergonomics, and exercise
instruction manuals. Recently, some in the physical therapy community have begun addressing
workplace health through injury prevention and workplace health programs. A physiotherapist has
an extensive background and training in orthopedic musculoskeletal care, making him one of the
most qualified and underused professions to perform ergonomic assessments and interventions.
Employers have a responsibility to provide a safe and healthy workplace for their employees. In
the workplace, applying ergonomic principles can significantly reduce the number and severity of
exercise-induced musculoskeletal injuries and associated costs. Ergonomic interventions include
workplace modifications, resistance training, stretching, postural training, rest training, body
mechanics, and home exercises. Employers who employ common ergonomic interventions will
see fewer injuries, higher productivity, lower costs related to direct and indirect costs of work-
related injuries, improved return to work, and experienced a decline in employee absenteeism. We
are uniquely positioned to help employers address employees concerns

255
 Basics Of The Concussion Assessment For The Physiotherapy Professionals
Dr. Rashid Hafeez Nasir
Return to Work Physiotherapist, Victoria Hospital, Ontario
ABSTRACT
Concussion is described as a quick onset of short-lived neurologic impairments that resolve
spontaneously usually with the first 7-10 days. Loss of consciousness may or may not occur with
a concussion. Concussion results in a constellation of physical, cognitive, visual, emotional, and
sleep-related disturbances. Signs and symptoms are broad and include headache, dizziness, gait
and balance disturbance, nausea, vomiting, photophobia, trouble focusing, and fatigue. A person
with concussion may have slowed mental processing, concentration deficits, memory impairment,
irritability, anxiety and depression. Amnesia and loss of consciousness are considered the most
critical signs indicating the severity of the injury. These factors would indicate the need for further
intervention and imaging. There is a sequencing of events that physical therapists should go
through when evaluating a patient who had a concussive event. Based on the patient's symptoms
and probably level of irritability, the PT should plan to strategically sequence or delay assessments
as needed. Examinations should begin with tests that are the least irritable progressing to more
irritable as tolerated. It is recommended for PTs to triage first neck pain irritability, followed by
dizziness and headache. If the patient has high neck irritability without any pathological cause, the
PT should assess cervical and thoracic spine muscular dysfunction and address any issues
appropriately. If the patient has dizziness, headache or vertigo, the PT should thoroughly examine
for cervical and thoracic dysfunction, oculomotor and vestibular dysfunction, and orthostatic
dysfunction to determine if any of these issues are contributing to the symptoms. After triaging
headache, dizziness and pain, PTs should complete a comprehensive evaluation of all domains
based on clinical judgement

256
 NATIONAL SPEAKERS
Research Misconduct
Prof. Dr. Haider Darain
Dean Allied Health Sciences, Khyber Medical University, Peshawar

ABSTRACT
The backbone of a research is its integrity that allows other individuals to have confidence on what
already done, how the research conducted and how the findings of a research reported. High profile
institutes are extremely conscious about the research integrity and have developed highest possible
standards and rigor policies that monitor and ensure research integrity. The reasons that research
reported from such institutions are always welcomed that one by the researcher and clinician.
However, there are some people who still find out means and ways to bypass and violate the
existence rigour policies and process and thus commit one of the three ‘Cardinal Sins’; fabrication,
falsification or plagiarism. These three ‘cardinal sins’ are labeled as research misconduct. These
three could occur during designing, conduction or reviewing phase of a research. Apart from the
three mentioned regimes, breach of confidentiality could be also labeled a major research
misconduct. If one or more these research misconducts are committed intentionally then the person
is said to have committed research misconduct. It is clear that such practices can lead to serious
effects on human life in terms of severs illness or loss of human life and wastage of financial
resources. The allegations should have sufficient evidences that could be proven by the experts. It
is evident that such misconducts in research could lead to serious consequences for the individual
as well and termination from services, blacklisting and in short to an end to individual career are
some of the possible consequences.

257
 Recent Advancement In Stroke
Prof. Dr. Arshad Nawaz Malik
Riphah College of Rehab & Allied Health Sciences, Riphah International University, Islamabad

ABSTRACT
Stroke is the 2nd cause of death and the most common cause of physical disability globally. Stroke,
the most disabling disorder, leads to wider range of impairments which hinder the activities of
daily life and locomotion. The disability declines the quality of life and hence the societal role of
individual, the lack of participation in community put a great economic and social burden on
society. There are number of traditional approaches have been used for rehabilitation but the main
barriers include the lack of repetition of tasks in appropriate manner, mostly patient lost their
interest and become bored during the performance of similar tasks. The Neural plasticity depends
on the number of repetitions for appropriate cortical re-organization. The recent advancement in
stroke rehab includes the Digital therapeutics which is a newly emerging concept of therapeutic
approach in the healthcare system. It is defined as a healthcare system driven using any form of
digital technology to enhance the efficacy of healthcare delivery, such as robotics and artificial
intelligence, genomics, mobile phone applications, and telemedicine. These technologies are
applied in the clinical field to aid in diagnosis, clinical decision making, treatment, and care
delivery. Digital therapeutics that perform similarly and focus on progressive repetitive practice
to stimulate cortical reorganization are being developed. Various technologies used in digital
therapeutics can deliver repetitive, goal-oriented tasks with variability while providing
performance feedback. In Pakistan, although we don’t have such latest technology, but we have
basic digital technology which can be used to train the stroke patients. We have opportunity to
develop customized technology assisted equipment or apps with collaboration of biomedical &
software engineering to promote the digital therapeutics in local context.

258
 Role of exercise & physical activity in
Type-ii diabetes mellitus
Prof. Dr. Syed Shakil Ur Rehman
Director, Riphah College of Rehabilitation and Allied Health Sciences, Faculty of Rehabilitation
and Allied Health Sciences, Riphah International University, Lahore.
ABSTRACT
Background: The population affected by non-communicable chronic diseases (NCDs) has grown
tremendously in the last decades and type-2 diabetes mellitus (T2DM) is one of the four top leading
NCDs, causing significant premature mortality and morbidity. Objective: To discuss the role of
physical activity and exercise in the management of type-2 Diabetes Mellitus. Methodology:
Physical Inactivity is the second leading cause of T2DM and among the top four leading causes of
NCDs. The current global diabetic population is approximately 536.6 million corresponding to
10.50 % of the world’s population and is projected to be 783.20 million by 2045, which will be
12.20% of the world population. T2DM also caused more than one million deaths per year, making
it the ninth leading cause of mortality. Several studies have shown that exercise and physical
activity are beneficial for managing and preventing type 2 diabetes. The blood glucose level,
glycemic control, insulin resistance, inflammation, physical fitness, and quality of life in patients
with T2DM can be significantly improved with mild to moderate physical activity at a minimum
duration of 150 minutes per week when combined with dietary control and regular medical care.
The prevention and delay of systemic complications in patients with type 2 diabetes can also be
accomplished through physical activity and exercise. Conclusion: The management of blood
glucose levels, glycemic control, insulin resistance, inflammation, physical fitness, and quality of
life can be positively improved by maintaining mild to moderate levels of regular physical activity
and exercise, coupled with diet control and regular medical care.

Keywords: Type 2 diabetes mellitus, physical activity & exercise, non-communicable chronic
diseases.

259
 Virtual Reality As A Priming Tool For Cognitive Motor Rehabilitation Among Subacute
Mca Stroke Patients
Dr. Sumaira Farooqi
Principal Ziauddin College of Rehabilitation Sciences
ABSTRACT
Stroke is the second leading global cause of mortality counting for 6.5 million deaths per annum.
The global prevalence of stroke is increasing with an estimated prevalence of 33 million per year,
affecting 1 out of 6 individuals during their lifetime. The international data suggests the overall
economic burden in Asia is projected to be increased to 1.3 Billion by 2050. Therefore, the
appropriate and timely stroke intervention is required to save healthcare costs and reduce the
burden of the disease. Studies have reported the effectiveness of VR intervention not only in
cognitive abilities but it has found to be simultaneously effective in improving other domains as
attention and coordination with motor retraining. VR combined with a newly developed concept
of motor priming has shown encouraging results in improving motor control and task execution in
stroke patients. Further studies are needed to analyze the impact of motor priming with VR in
stroke patients on varied neurological domains; hence the present study aims to investigate the
impact of VR based motor priming on sensorimotor, functional and cognitive outcomes among
sub-acute stroke patients rehabilitation. A total 62 patients were recruited in the study. After
voluntary consent, all the patients were randomly divided into Group-A and B through the
envelope method of simple random sampling. Patients in Group-A will be receiving VR based
motor priming intervention while Group-B patients will be receiving Motor-Relearning Program
as conventional therapy. Whereas, both the groups were given 16 sessions of their respective
protocol, comprising of 45 minutes, 4 times/week for the duration of 4 weeks. Pre and post
assessment performed for each patient on all three quantitative outcome measures i.e. FMA-UE,
CAHAI-13, and MoCA. A trial will be terminated, if the patient reported fatigue of >8 out of 10
on the Visual Analogue Scale, unable to execute movements, reports pain, eye strain, or signs of
volitional fatigue in hemiplegic or non-hemiplegic extremities.

260
 Future Of Rehabilitation And Allied Health Sciences In Pakistan
Prof. Dr. Naveed Babar
Dean Faculty of Allied Health Sciences, Superior University Lahore
ABSTRACT
The rehabilitation and allied health professions have developed an explicit, advanced and extensive
scope over the past decade. These professionals play a key role in the early diagnosis and prompt
management of various diseases and disorders. The growing global demand for trained healthcare
professionals has also enhanced these fields. Considerable variability in training and its assessment
leads to variability in practice, which can affect patient outcomes. There is a critical need for
formalized and widely recognized training to support these roles, and there are significant
challenges to providing such training. This is a huge responsibility to train professionals with such
an important and key role in diverse health care systems of developing world. We need to define
standards of clinical practice, research and innovation in the field of rehabilitation and allied health
sciences. The global chronic disease crisis and the failure of public health to stem the rise of highly
preventable risk factors have left populations vulnerable to acute health emergencies. As disability
becomes an increasingly large share of the global disease burden and a larger component of health
expenditure, there is an urgent and compelling need to identify new, more effective interventions.
The use of artificial intelligence and advance technologies in health care devilry is growing day
by day. Therefore, well-trained field specific, focused professionals are in high demand globally.
The Vital role of Rehabilitation and Allied Health Professionals in the health system must be
acknowledged especially in the developing countries like Pakistan.

261
 The Emerging Role Of Artificial Intelligence In Allied Health Education
Dr. Muhammad Salman Bashir
Associate Professor, Riphah International University, Lahore
ABSTRACT
Analyzing connections between clinical practises and patient outcomes is the main goal of applic
ations of artificial intelligence in the field of health. Programs using artificial intelligence
used in areas including medication research, personalised medicine, patient monitoring, and diag
nostics. Healthcare providers can better manage and guide their patients by using AI to gain a
deeper understanding of their diseases. AI has employed as a second set of eyes to decrease the
likelihood of misdiagnosis, pharmaceutical errors, and the amount of vital resources squandered.
Science fiction has immortalized the idea that AI may create a dystopian society in which machines
replace their creators, prompting some people to conclude that the risks outweigh the advantages.
Because the issues with AI in health care and HPE are more particular, they should be dealt with
more quickly. Concerns about potential job loss, threats to the traditional "expert" role, a lack of
strategies for integrating AI into current information technology and electronic health record
(EHR) systems, the lack of a team with the necessary training in data collection and analysis, and
worries that AI is a clinical tool that operates in a "black box" where decisions are not fully
transparent are some of the topics that frequently cause concern.

262
 PRESENTERS
Clinical Application Of Low-Level Laser Therapy (Photo-Biomodulation Therapy) In The
Management Of Breast Cancer-Related Lymphedema: A Systematic Review
Dania Mahmood
1
University Institute of Physical Therapy, Faculty of Allied Health Sciences, TheUniversity of
Lahore
ABSTRACT
Background: Breast cancer-related lymphedema (BCRL) is a frequent issue that arises after
mastectomy surgery in women and compromises physical and mental function. Previously
published studies have shown positive effects with the use of Low-level laser therapy in another
term Photo-bio modulation therapy (PBM). Objective: This research investigated the efficacy of
clinical use of LLLT (PBM) in the treatment of metastatic breast cancer-related lymphedema.
Material and Methods: PubMed, Pedro, Medline, and the Cochrane Library were searched for
LLLT clinical trials published before October 2021. The methodological quality of randomized
trials and the effectiveness of Laser Therapy for BCRL were evaluated. The primary objectives
were arm circumference or arm volume, whereas the secondary goals were to assess shoulder
mobility and pain severity. Results: Eight clinical trials were analyzed in total. Typically, the
included RCTs had good research quality. At four weeks, there was a considerable reduction in
arm circumference/volume, and this continued with long-term follow up. However, no statistically
significant change in shoulder mobility or pain severity was seen between the laser and placebo
groups at 0-, 1-, 2-, and 3-month short-term follow-up. Conclusions: The findings of this
comprehensive study demonstrated that LLLT (PBM) was successful in diminishing arm
circumference and volume than improving shoulder mobility and pain. Data indicates that laser
therapy (PBM) may be a beneficial treatment option for females with PML. Because of the scarcity
of evidence, there is a strong need for well-conducted and longer-duration trials in this field.

Keywords: Low-level laser therapy, Photo-biomodulation therapy, Laser therapy, Breast cancer,
Lymphedema, Postmastectomy lymphedema, Systematic review

263
Immediate Effects Of Dry Needling Vs Soft Tissue Release On Pain, Range Of Motion And
Functional Disability In Patients With Myofascial Neck Pain
Umber Nawaz1, Kanwal Arshad2
1,2
University Institute of Physical Therapy, the University of Lahore, Pakistan
ABSTRACT
Background: Dry needling is a minimally invasive therapy method that is inexpensive, simple to
learn with the right instruction, and carries a low risk. Numerous research has supported its
efficacy. The taut band, local ischemia and hypoxia, peripheral and central sensitization, and other
factors involved in the pathophysiology of myofascial trigger points to the potential effects of dry
needling. Objective: To discover the effects of dry needling vs soft tissue release on pain, range
of motion and functional disability in myofascial neck pain. Methodology: It was a randomized
clinical trial. 100 female participants were recruited fulfilling the inclusion and exclusion criteria
through purposive sampling. Data was collected through a standardized questionnaire from the
University of Lahore teaching hospital. Data was divided into two equal groups. Group A receive
dry needling and group B receive soft tissue release technique along with routine Physical therapy,
the effects of both treatment interventions were analyzed through SPSS 21 version. Results:
Normality of data suggest that, mean 23.67±9.03 and 14.20±7.43 with Kolmogorov-Smirnov test
has p-value .002 histogram indicate that the data was deviated. 7.62±1.22 before experiment and
4.40±1.41 after experiment suggest that there was a significant decrease in pain but p-value suggest
that there was no difference between the groups. 49.87±13.14 before treatment and 56.75±12.19
indicate that there was substantial improvement in rotation to right side 50.75±13.85 before
treatment and 57.00±12.21 indicate that there was significant improvement in rotation to left side
also p-value suggest that there was a moderate difference between the groups. 47.50±12.16 before
treatment and 52.25±11.41 indicate that there was significant improvement in neck flexion
furthermore p-value .000 suggest that there was a strong difference between the groups.
23.67±9.03 before treatment and 14.20±7.39 indicate that there was significant improvement in
functional disability consequently p-value .011 suggest that there was a strong difference between
the groups. Conclusion: It was established that dry needling and soft tissue release were both
beneficial for the myofascial neck pain. It had been established that dry needling was more
effective than the soft tissue release technique.

Key words: Dry Needling, Myofascial Trigger points, Soft tissue therapy, and Physical therapy

264
Translation And Initial Validation Of The Urdu Version Of Action Research Arm Test In
People With Stroke
Faiza1
1
University Institute of Physical Therapy, The University of Lahore, Lahore-Pakistan

ABSTRACT
Background: The Action Research Arm Test was created to assess the activity of Upper Extremity
(UE) after the recovery of cerebral trauma. This study's objectives were to translate the Action
Research Arm Test in Urdu and assess preliminary ARAT's validation in patients who had
experienced their first stroke. Methodology: An expert team used a forward-backward method so
as to maintain the initial ARAT from English into Urdu. In this study, 48 individuals (38 men and
10 women) experiencing their first stroke were enrolled. The U-Action Research Arm analysis,
Fugal-Meyer Assessment of upper extremity part, and the Wolf Motor Function Test were used to
examine the subjects (WMFT). Item-scale correlations and Cronbach's alpha coefficients were
used to analyses internal consistency. Through the use of Spearman's rank correlation coefficients,
concurrent validity was established. More than 20% of patients were deemed to have fallen both
the bottom and higher boundaries, as appropriate, in order for present the floor and ceiling
effects. Results: The Cronbach's alpha of 0.98 (p 0.001) or item-total correlations scoring from
0.729 to 0.946, the U-ARAT module had strong internal consistency (p 0.001). The WMFT
performance time displayed an outstanding negative association, and the UE-FMA and WMFT
functional ability (WMFT-FA) scores showed good-to-great correlations with the U-ARAT (p-
value of - 0.940, respectively) (WMFT-time). With scores from 0.774 to 0.926, the U-ARAT
subtests commonly showed good-to-excellent correlations with measures especial to stroke (p
0.001). The UE-FMA and WMFT-FA had scores on the gross subtest of 0.664 and 0.721, as
appropriate, and these scores exhibited moderate-to-good correlations (p 0.001). There was no
observable floor effect, and the WMFT-time was the only significant ceiling effect. Conclusion:
This experiment use to measure the function of stroke patients' upper extremity if they don't have
any cognitive impairment. The U-ARAT demonstrated both good to excellent concurrent validity
and exceptional internal consistency.

Key words: Action Research Arm Test, Validation, Stroke, Translation

265
 Referral Pattern Andsatisfaction Leyel Of Patients With Musculoskeletal Disorders
Towards Physiotherapy
Ishrat Fatimah1, Dr Seema Ghazal2, Dr Ayesha Wajid3, Muhammad Amir4, Kashaf
Javed5
1,2,3,4,5
Prime institute of Health Sciences, H15 Motorway Chowk Islamabad
ABSTRACT
Background: The objective of this study was to determine referral pattern and
satisfactionlevelofpatientswithmusculoskeletaldisorderstowardsphysiotherapy. Methods: Cross
sectional study with a consecutive series of participants was conducted in Peshawar, Pakistan in
[Link] was collectedfrom300participants who visited physiotherapy departments with
musculoskeletal complaints. A Structured Questionnaire comprised of questions related to
demographic information, referral mode and satisfaction with physiotherapy was used for data
collection. Results: The Percentage of participants that were referred to physiotherapy for the
treatment was 64% while 36% of the availed direct access to physical therapy. Most of participants
i.e. 50% were referred by Orthopedics. Most of the musculoskeletal disorder cases were back pain
i.e.38% followed by shoulder pain i.e.9.7%. Regarding satisfaction level 83% of the participants
were satisfied from physiotherapy. Conclusion: This study concluded that most of the participants
are referred for physiotherapy instead of direct access. Orthopedics and general physicians played
an important role in referral of the patients to physical therapy. This study showed that there was
great cooperation of specialist in referral and sufficient awareness of physical therapy among
participants which led to high level of satisfaction.

Key Words: Musculoskeletal disorders, Physiotherapy, Referral, Satisfaction level.

266
 Effect Of Smartphone Overuse On Quality Of Sleep And Acedemics
Sania Ahmed Khan1, Aaila Mussarat2, Ghazala Bibi3 , Dr Seema Ghazal4, Dr Ayesha
Wajid5, Muhammad Amir6, Kashaf Javed7
1,2,3,4,5,6,7
Prime Institute of Health Sciences, H15 Motorway chowk Islamabad
ABSTARCT
Background: One of the greatest invention of 20th century with highly boosting abilities is mobile
phone. The evolution of information technology brought a drastic change in our lives. To
determine the prevalence of smartphone addiction among university students. To determine the
prevalence of quality of sleep among university students. To determine the association between
smartphone addiction and quality of sleep. To determine the association between smartphone
addiction and academics. To determine the association between quality of sleep and academics.
To compare the quality of sleep, smartphone addiction and academics between male and female
university students. Methods: it was a comparative cross sectional analytical study performed in
the universities of pindi and Islamabad for a duration of 3 months. The total sample size was 1000
subjects, using SPSS version 21. Result: Mean and standard deviation of Pittsburgh sleep quality
index (PSQI) was 7.31±3.33 and Smartphone addiction scale was 93.05±21.4. Conclusion: When
correlations were evaluated for finding the association between CGPA and SGPA with PSQI, no
significant correlation was found as the more than 0.05.

Keywords: smartphone, quality of sleep, academics.

267
 Job Satisfaction Among Physiotherapists Working At Jatiyo Protibondhi Unnayan
Foundation In Bangladesh
Dr. Md. Shahid Khan1, Dr. Md. Ashraful Alam2, Dr. Mohammad Habibur Rahman3
Consultant Physiotherapy, Center for Physiotherapy and Rehabilitation (CPR), Chattogram,
Bangladesh
ABSTRACT
Background: Many countries are facing challenges in building human capacity within health care
systems due to lack of job satisfaction. The key steps are to establish a sympathetic and friendly
working and living environments and provide a prospect for professional growth for healthcare
workers are essential to achieve job satisfaction. The aim of this study was to find out the level
and the determinants of job satisfaction of physiotherapists working in National Disabled
Development Foundation (Jatiyo Pratibondhi Unnayan Foundation-JPUF), Bangladesh.
Methodology: This study was a cross-sectional study design, using the self-reported
questionnaires and “Job Satisfaction Survey (JSS)”. A total of 75 out of 123 physiotherapists
completed the questionnaire (response rate approximately 61%). Results: 57.3% (n=43) have
other higher degrees with BPT degree where only three person have MSc in physiotherapy degree
(4%). 86.7% (n=65) of the participants have professional experience between 5- 10 years.
Regarding job position, 57.3% (n=43) of them are the Consultant (Physiotherapy) and rest of them
are Clinical Physiotherapist. Daily working hours were quite even around 8 hours. Most of the
participants are living with their family members (n=57, 76%) and 72% (n=54) are living in an
Urban area. 68% (n=51) participant have distance from their home to workplace <2 kilometers.
65.3% (n=49) of them have monthly income around 30,000-50,000 BDT. No significant
differences were seen between participants among the Consultant (Physiotherapy) and Clinical
Physiotherapist position either for JSS total or subscale scores. The relationship between job
satisfaction level and demographic or work-related factors (experience, working hours, living area
& distance) was not statistically significant. The mean total score of JSS for participants was within
the “ambivalent” category (for 81.33%), only 16% of them are satisfied while 2.6% of them are
dissatisfied with their current job. Conclusion: Mean total score of JSS for participants in the
current study was within the “ambivalent” category. Therefore, further study should be needed
with large sample size.

Key words: Job Satisfaction, Physiotherapist, Jatiyo Pratibondhi Unnayan Foundation,

Bangladesh.

268
 Can addition of low level laser therapy to conventional physical therapy be
Beneficial for management of pain and cervical range of motion in patients with trigger
point of upper trapezius?
Iqra Waseem1, Fahad Tanveer2, Arooj Fatima3
1,2,3
University Institute of Physical Therapy, The University of Lahore, Pakistan

ABSTRACT
Background: Trigger points commonly develop in upper trapezius muscle. These might be
associated with neck pain arising from trigger points of trapezius. This study was conducted to
compare the effectiveness of conventional physical therapy (CPT) with and without low level laser
therapy (LLLT) on pain and cervical range of motion (ROM) in patients with trigger point of upper
trapezius muscle. Methodology: An RCT was conducted with a sample size of 62 patients. The
study was completed within 9 months after approval of synopsis. Data were collected from Health
Care Physiotherapy, Sports, Spine & Rehabilitation Center, Faisalabad (Pakistan). Patients were
randomly allocated into two equal groups; 31 patients of Group-1 received low-level laser therapy
with CPT, while Group-2 (n=31) patients received CPT as the only treatment protocol. Patients
pain level was assessed using Numeric Pain Rating Scale (NPRS) and cervical ROM was measured
by goniometry at baseline and subsequently at 2nd and 4th week follow-ups. Results: Results of
the study obtained by applying repeated measures ANOVA showed that there was mean reduction
in pain scores from day 1 to week 4 in within group analysis of LLLT + CPT Group (Group=1)
and within group analysis of CPT Group (Group=2) (p < 0.05). Statistically significant
improvement was observed in all mean cervical ROMs especially for lateral flexion ROM for both
groups in within group analysis (p < 0.05). Statistically significant improvement was seen in NPRS
score at week four between Group-1 and 2, measured by independent sample test with p < 0.05.
Whereas, independent sample t-test results showed no significant improvement in cervical ROMs
at week four between Group-1 and 2 (p ˃ 0.05). Conclusion: Conventional physical therapy and
low level laser therapy used in combination are more effective than conventional physical therapy
alone in patients of trigger points of upper trapezius

Keywords: Low level Laser therapy, Trapezius, Trigger points

269
 Effect Of Anthropometric, Physiological Variables, Strength And Power Attributes
Correlate With Running Performance In Young Runners
Wajeeha1
University Institute of Physical Therapy, The University of Lahore, Pakistan

ABSTRACT
Background: Anthropometry is the study of measuring the human species in a structured manner.
Anthropometric measurements have traditionally been enough to correlate based on race, social,
and psychological characteristics to the physical parameter. The researcher measured
anthropomorphic parameters concerning human size, including height, body weight, surface area,
and volume. The current study was designed to analyze the Effect of Anthropometric Variables,
Physiological Variables, Strength, and Power Attribute Correlated with 5kmT Running
Performance in young Runners at the University of Lahore. Methodology: In this study, I chose
150 young runners between 18 and 28. The study was divided into four different phases. The
anthropometric variables (Age, BMI, Facial index) were measured in the first phase. In the second
phase, physiological variables (VO2 max and RE) were calculated. In the third phase, runners
reported to the physical therapy lab, where strength and power were measured. In the final phase,
the participants completed the performance experiment activity across a 5-km distance. Results:
In anthropometric variables, BMI showed a negative correlation, but facial index showed no
correlation with [Link] was no correlation with physiological variables. Muscle showed a
significant relationship between knee flexion at 900, Strength of knee extension at 900, and
Strength of knee extension at 600 . On the other hand, data showed that the strength of knee flexion
at 600 does not significantly relate with 5km. Data showed that there was a negative correlation
between powers with 5kmT but a significant relationship with 5kmT. Conclusion: This study
confirms that muscle strength and power had a significant relationship with 5kmT among young
runners. These variables were a good predictor of running performance. Young runners had a
significant relationship between age and BMI with 5kmT. On the other hand, there was no
significant relationship of Physiological variables with 5kmT among young runners.

Keywords: Anthropometry, 5kmT, running performance, running economy, strength, power,

young runners.

270
 Effects of chewing exercise on postural instability in
Patients with pierre robin syndrome
Dr. Javaria Malik1
University Institute of Physical Therapy, The University of Lahore, Pakistan
ABSTRACT
Background: In Pierre Robin Syndrome (PRS) patients having Microganthia and hypermobility
in Cervical and lower limb. Chewing is an isotonic exercise that enhances masseter muscle activity
and by stimulation of temporomandibular joint (TMJ) joint, this can enhance neck stability and
decrease postural instability by improving kinesthetic sense. Objective: Aims of this study was to
find out the effects of chewing exercises in addition with routine physical therapy on postural
instability in patients with Pierre Robin syndrome. Material and methods: This randomized
controlled trial (RCT) conducted at Rising Sun Institute for Special Children and Children’s
Hospital Lahore. Diagnosed patients with Pierre Robin Syndrome (PRS) of both gender and age
between 4-12 years were included. Those with any other syndrome or epilepsy were excluded. A
total of ten children having Pierre Robin Syndrome were randomly divided in two groups. Group
A received routine physical therapy and chewing exercise while Group B received only routine
physical therapy. Children having Beighton Hypermobility Score (BHS) of more than 5 out of 9
were considered in this study. Twelve sessions were given for consecutive 4 weeks. Pediatric
balance score (PBS) was used for measuring postural imbalance before and after treatment in both
groups in three-month period using pediatric balance scale. SPSS version 23 was used for analysis
of results. Results: The results showed that chewing increase cervical stability and postural
balance. The data also revealed that Pediatric balance scale (PBS) of Group A at Baseline (24.40)
that was increased up to (12.25%) till 4th week, (30.7%) in 8th week and (41.60%) in 12th week
respectively showed marked increase in PBS value. In Group B pediatric balance scale (PBS)
value at base line (27.80) that was increased (3.24%) till 4th week, (9.80%) in 8th week and
(13.29%) in 12th week showed increase in PBS value. Statistically both groups showed A
significant difference in PBS value with same (p=0.002). P value calculated by Mann Whitney U-
Test after 4th week, after 8th week and after 12th week is 0.008 that shows statistically significant
increase in pediatric balance scale value between groups. Conclusion: chewing activity can
enhance the postural stability in static and dynamic posture. Pediatric balance scale (PBS) value
shows marked improvement in pediatric balance and stability of a child. These findings prove to
be of clinical significance in rehabilitating a child having musculoskeletal and balance problems
related to hypermobility.

Key words: Chewing, Jaw, Pierre Robin Syndrome, Pediatric Balance, Hypermobility.

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 Prevalence Of Non Specific Low Back Pain In Security Guards Of University Of
Lahore

Hassan1
1University Institute of Physical Therapy, The University of Lahore, Lahore-Pakistan

ABSTRACT
Background: Nonspecific Low back pain can be influenced by demographic, lifestyle (smoking
and prolong standing factor) and diseases (diabetes mellitus and hypertension).in all these factors
the role of prolong standing factor is more significant. Limited studies have been done on the
relationship between these factors and low back pain in security guards in university of Lahore.
The aim of this study was to determine the nonspecific low back pain in security guards of
university of Lahore in Pakistan. Methods: This is a cross-sectional study in which analysis of 80
participants with persistent non-specific LBP. Total 80 patients with nonspecific low back pain
were included in the study in which 17 were females and 63 were males. The tools used to assess
the outcome were Visual Analogue Scale. The study used a self-administered questionnaire on
security guards in the university. Results: The Mean Age 40.8 and SD± 6.68 in which 63 males
and 17 females. Results indicated that the point prevalence for nonspecific low back pain was 71%.
Most of the security guards were male aged between 24 to 58 years. Among the demographic
factors, male gender was associated with increased risk of nonspecific low back pain, prolong
standing factors, diseases (diabetes mellitus and hypertension) and smoking were associated with
the presence of nonspecific low back pain. Conclusion: The prevalence of nonspecific low back
pain in university of Lahore is 71%, security guards as an occupation and heavy physical duty are
associated with the development of low back pain.

Key words: Low back pain, Visual Analogue Scale

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 POSTER PRESENTERS

Association Of Age And Lack Of Strength In Squash Players With Golfer Elbow
Hamad Nasar1 , Umber Nawaz2
1,2
University Institute of Physical Therapy, University of Lahore, Lahore-Pakistan
ABSTRACT
Background: Golfer’s elbow (medial epicondylitis or pitcher's elbow) is tendinopathy caused by
overuse or overload and affects the medial common flexor tendon of the elbow. This may present
insidiously with patients reporting an aching pain that radiates from the epicondyle down to the
wrist. This article suggests that association of age and lack of strength due to golfers elbow, It may
also be referred to as pitcher’s elbow, or termed tendinosis or epicondylalgia instead of
epicondylitis. To determine the Association of age and lack of strength in Squash players with
golfer’s elbow. Methodology: The study was conducted from adolescent and young professional
Squash players. Study was conducted under ethical considerations. Informed written consent was
taken. A Performa with validated questionnaire Mayo Elbow Performance Index Oxford Elbow
Score Mayo wrist performance index. Results: The study's findings revealed that the participants'
average age was 15.95± 6.11. The lowest and maximum ages were 10 and 32 respectively. In this
study the age 10 to 18 years have greater frequency of participants in squash. The study results
disclosed that Out of 80 participants 66 were males and 14 were females. The study results
displayed that 48% of participants were playing since 1 year, 34% were playing since 2-5 years,
8% were those who were playing squash since 6-9 years and only 10% were playing squash for
more than 10 years. The study results evacuated that 2% of participants had session break after 1
hour, 54% of participants had session break after 15 minutes, 32% of participants had session break
after 30 minutes and only 12% of participants played Squash more 1 hour. The study results
displayed that only 3% of the participants were left hand dominant while 97% of participants with
right hand dominant. The results showed that about 75% of participants had their golfer elbow test
Positive and only 25% of participants had no issue with their elbow. The study exhibit that there
was a strong association of wrist strength with elbow performance with p-value .003which is <
.005. Conclusion: The results showed positive golfer elbow in adolescent Squash players as their
wrist and elbow strength was weak.

Key Words: Medial Epicondylitis C6 or C7 radiculopathy, cubital tunnel syndrome, ulnar or

median neuropathy, ulnar neuritis, anterior interosseous nerve entrapment, or tardy ulnar nerve
palsy

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 Assessment Of Awareness Regarding Preventive Measures Of Covid-19 Patients In Icu
Settings Of Government Hospitals
Muniba Shaheen1
University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of
Lahore.
ABSTRACT
Background: Coronaviruses are members of the Corona viridae family, with a measurement of
65- 125 nm and a solitary strand of RNA going long from 26 to 32 kb. Coronaviruses causes
illnesses like respiratory and gastrointestinal illnesses. Insufficient information is a gamble factor
for infection transmission, as it can prompt low degrees of care. The objective of this study was to
assess awareness regarding preventive measures of COVID-19 patients in ICU settings of
government hospitals. Methodology: A descriptive study was conducted on 101 physiotherapists
who were working in ICUs of different government hospitals. Physiotherapists who were working
in government hospitals and willing to participate were selected. The semi structured questionnaire
was used to conduct data in which first part consist of demographic data and second part consists
of questions regarding covid-19. Results: The majority were 69(68.3%) were female, having age
between 20-33years 65(64.4%) in which 81(80.20%) were unmarried, and 11(10.89%) were
married. Education of 42(41.6%) was Post graduate and 87(86.14%) Physiotherapist was from
urban area. Out of 101 Physiotherapists 99.01% were aware regarding the COVID-19 and 97.03%
know the protection of COVID-19 which was wearing the mask to prevent the disease and,
99(98.02%) were recognize that the patients who are impacted ought to be saved in segregation
for next 14 days. Conclusion: This study concluded that physiotherapist has high awareness
regarding preventive measures of covid-19 patients with 99%. This study also confirmed that they
had knowledge and experience with COVID-19 prevention, and they were using their knowledge
to improve their practice.

Key words: COVID-19, Physiotherapists, e questionnaire

274
 Prevelance Of Back Pain Among Physiotherapy Students As Compared To Medical
(Mbbs) Students

Rabia Akram1, Syed Shakir Ali Shah2, Bilal Shahid3

1,2,3
University Institute of Physical Therapy, The University of Lahore, Pakistan

ABSTRACT
Background: In the present era back pain is very common in all the people and especially in those
who have to maintain a specific body position for prolonged time. Mostly the medical students
spend most of their time in class or in hospital where they have to maintain the specific positions
for prolonged time i.e. sitting, standing or some other positions with bad posture. To check the
prevalence of back pain in physiotherapy students as compared to medical students. To check the
association of back pain with bad posture. To check the association of back pain with prolonged
sitting. To check the association of back pain with prolong standing. To check the association of
back pain with BMI. Material and Methodology: This study is a cross-sectional study. In which
the sample was collected under convenient sampling technique with the sample size of 195 in
which 98 subjects were Physiotherapy students and 97 subjects were medical students. Data was
collected from the Physiotherapy and medical students of Faisalabad and Lahore. The duration of
study was 3 months. Students aging 19-27 year were strictly selected on basis +++ inclusion
criteria and the exclusion criteria. All the subjects were given an informed consent form. The
subjects who read and signed in the informed consent participated in this study. Data was collected
by Self-Administered Questionnaire. Results: The present study was conducted to check the
prevalence of back pain and its associated factors. The prevalence of back pain is more in
physiotherapy students as compared to MBBS students. The back pain is more prevalent in female
students as compared to males. The most common associated factors of back pain are bad posture
and prolonged sitting. Conclusion: These findings suggest that preventive measures and normal
posture education should be given, in order to reduce the prevalence of back pain in physiotherapy
students.

Key Words: Low back pain, Occupational diseases, Risk factor, Physiotherapy, Students

275
 Kinesiotape muscles facilitation on wrist extensors in
Comparison to kinesiotpe muscle inhibition on wrist flexors among chronic hemiplegic
stroke patient
Saman1
University Institute of Physical Therapy, The University of Lahore, Pakistan
ABSTRACT
Background: Kinesiotape is a method used worldwide in Rehabilitation since 1979. Dr. Kenzo
Kase discovered kinesiotape to deal with clinical musculoskeletal disorders. It’s a wave like elastic
material with adhesive properties and stretch 140% from its length which is decided according to
the purpose if use of this technique. (Bernhardt et al., 2017). Muscle activities can be corrected
through the facilitation and inhibition techniques of kinesio-taping as it functions through skin
receptors. Stroke is a very common disease worldwide causing severe musculoskeletal disability
due to which quality of life of patient compromises, patient becomes dependent of assistance in
daily living activities and few becomes bed ridden. According to the symptoms different
physiotherapy techniques and rehabilitation is used along with medical treatment and counseling
of the patient. To compare the facilitation and inhibition techniques of muscle correction. To
determine the effect of Kinesiotape technique on wrist range of motion, spasticity, muscle strength
and overall functional improvement at wrist joint among the stroke patients. Methodology:
Randomized controlled trial was done, 24 patients were recruited according to inclusion exclusion
criteria. Patients were further divided into two groups; group 1 was given muscular facilitation
treatment for wrist extensors and group 2 was given sessions for muscle inhibition treatment for
wrist flexors. 6 sessions were given, 1 session per week over the period of 6 weeks to each patient.
Kinesiotape was worn 3-5 days after patch test. Wrist range of motion for extension, flexion, ulnar
and medial deviation was measured using goniometer before and after the 6 weeks. Manual muscle
test for wrist extensors, modified ash worth scale and upper limb functional index scoring was
done before and after sessions. Data was collected from a private clinic of PWD Rawalpindi.
Result: The statistical values showed no significant change in between both the groups, before
and after treatment. But a significant improvement was observed within the group analysis.
Conclusion: It can be concluded both treatments were equally effective. it helps in increasing
range of motion and in reducing spasticity.

Key Words: Manual Muscle Test, Range of Motion, Kinesiotape

276
 Effects Of Aging On Knee Range Of Motion
Sarah1, Ayesha Wajid2, Muhammad Amir3, Kashaf Javed4
University Institute of Physical Therapy, The University of Lahore, Pakistan

ABSTRACT
Background: The effects of aging are obvious on all body systems after certain age which
compromise function and reduce productivity of the human beings. The musculoskeletal system
is very important for our free mobility and more affected by the age related changes especially the
knee joint, which is at more risk as compare to the other joints. To observe the effects of aging on
knee range of motion. Methodology: This cross sectional survey was conducted from January to
June 2014 on the healthy population of Rawalpindi/ Islamabad. The inclusion criteria were healthy
individuals of age 40 to 85 years without any present history for medical condition, and individuals
with any medical problem, age minimum 40 and more than 85 were excluded. Result: The
majority of participants were between 50 to 59 years of age group, which was 34% of total study
sample. Where 53% were males and 47 % were females and occupationally the majority of 44%
were house wives. The 53% of total sample size had flexion range less than 120-130 degree, and
knee extension in 45% was less than 120 degrees, 33 %, with moderate difficulty in walking
upstairs, and 41% have moderate pain that restricts usual work. Conclusion: It is concluded on
the base of this research study that the aging affects the knee range of motion and many factors
which influence this change; including obesity, sedentariness, family history, physical activity,
while it the occupation has no effect on knee function with advance aging.

Key Words: Aging, effects of aging, Knee, degenerative joint disease

277