Role of Internet of things in diabetes healthcare: Network infrastructure, taxonomy, challenges, and security model.

The Internet of things (IoT) is an emerging technology that enables ubiquitous devices to connect with the Internet. IoT technology has revolutionized the medical and healthcare industry by interconnecting smart devices and sensors. IoT-based devices and biosensors are ideal to detect diabetes disease by collecting the accurate value of glucose continuously. Diabetes is one of the well-known and major chronic diseases that has a worldwide social impact on community life. Blood glucose monitoring is a challenging task, and there is a need to propose a proper architecture of the noninvasive glucose sensing and monitoring mechanism, which could make diabetic people aware of self-management techniques. This survey presents a rigorous discussion of diabetes types and presents detection techniques based on IoT technology. In this research, an IoT-based healthcare network infrastructure has been proposed for monitoring diabetes disease based on big data analytics, cloud computing, and machine learning. The proposed infrastructure could handle the symptoms of diabetes, collect data, analyze it, and then transmit the results to the server for the next action. Besides, presented an inclusive survey on IoT-based diabetes monitoring applications, services, and proposed solutions. Furthermore, based on IoT technology the diabetes disease management taxonomy has also been presented. Finally, presented the attacks taxonomy as well as discussed challenges, and proposed a lightweight security model in order to secure the patient's health data.

Human Psychological Disorder towards Cryptography: True Random Number Generator from EEG of Schizophrenics and Its Application in Block Encryption's Substitution Box.

Schizophrenia is a multifaceted chronic psychiatric disorder that affects the way a human thinks, feels, and behaves. Inevitably, natural randomness exists in the psychological perception of schizophrenic patients, which is our primary source of inspiration for this research because true randomness is the indubitably ultimate valuable resource for symmetric cryptography. Famous information theorist Claude Shannon gave two desirable properties that a strong encryption algorithm should have, which are confusion and diffusion in his fundamental article on the theoretical foundations of cryptography. Block encryption strength against various cryptanalysis attacks is purely dependent on its confusion property, which is gained through the confusion component. In the literature, chaos and algebraic techniques are extensively used to design the confusion component. Chaos- and algebraic-based techniques provide favorable features for the design of the confusion component; however, researchers have also identified potential attacks on these techniques. Instead of existing schemes, we introduce a novel methodology to construct cryptographic confusion component from the natural randomness, which are existing in the psychological perception of the schizophrenic patients, and as a result, cryptanalysis of chaos and algebraic techniques are not applicable on our proposed technique. The psychological perception of the brain regions was captured through the electroencephalogram (EEG) readings during the sensory task. The proposed design passed all the standard evaluation criteria and validation tests of the confusion component and the random number generators. One million true random bits are assessed through the NIST statistical test suite, and the results proved that the psychological perception of schizophrenic patients is a good source of true randomness. Furthermore, the proposed confusion component attains better or equal cryptographic strength as compared to state-of-the-art techniques (2020 to 2021). To the best of our knowledge, this nature of research is performed for the first time, in which psychiatric disorder is utilized for the design of information security primitive. This research opens up new avenues in cryptographic primitive design through the fusion of computing, neuroscience, and mathematics.

Block Cipher's Substitution Box Generation Based on Natural Randomness in Underwater Acoustics and Knight's Tour Chain.

The protection of confidential information is a global issue, and block encryption algorithms are the most reliable option for securing data. The famous information theorist, Claude Shannon, has given two desirable characteristics that should exist in a strong cipher which are substitution and permutation in their fundamental research on "Communication Theory of Secrecy Systems." block ciphers strictly follow the substitution and permutation principle in an iterative manner to generate a ciphertext. The actual strength of the block ciphers against several attacks is entirely based on its substitution characteristic, which is gained by using the substitution box (S-box). In the current literature, algebraic structure-based and chaos-based techniques are highly used for the construction of S-boxes because both these techniques have favourable features for S-box construction but also various attacks of these techniques have been identified including SAT solver, linear and differential attacks, Gröbner-based attacks, XSL attacks, interpolation attacks, XL-based attacks, finite precision effect, chaotic systems degradation, predictability, weak randomness, chaotic discontinuity, and limited control parameters. The main objective of this research is to design a novel technique for the dynamic generation of S-boxes that are safe against the cryptanalysis techniques of algebraic structure-based and chaos-based approaches. True randomness has been universally recognized as the ideal method for cipher primitives design because true random numbers are unpredictable, irreversible, and unreproducible. The biggest challenge we faced during this research was how can we generate the true random numbers and how can true random numbers utilized for strengthening the S-box construction technique. The basic concept of the proposed technique is the extraction of true random bits from underwater acoustic waves and to design a novel technique for the dynamic generation of S-boxes using the chain of knight's tour. Rather than algebraic structure- and chaos-based techniques, our proposed technique depends on inevitable high-quality randomness which exists in underwater acoustics waves. The proposed method satisfies all standard evaluation tests of S-boxes construction and true random numbers generation. Two million bits have been analyzed using the NIST randomness test suite, and the results show that underwater sound waves are an impeccable entropy source for true randomness. Additionally, our dynamically generated S-boxes have better or equal strength, over the latest published S-boxes (2020 to 2021). According to our knowledge first time, this type of research has been conducted, in which natural randomness of underwater acoustic waves has been used for the construction of block cipher's substitution box.

A hybrid mask RCNN-based tool to localize dental cavities from real-time mixed photographic images.

Nearly 3.5 billion humans have oral health issues, including dental caries, which requires dentist-patient exposure in oral examinations. The automated approaches identify and locate carious regions from dental images by localizing and processing either colored photographs or X-ray images taken via specialized dental photography cameras. The dentists' interpretation of carious regions is difficult since the detected regions are masked using solid coloring and limited to a particular dental image type. The software-based automated tools to localize caries from dental images taken via ordinary cameras requires further investigation. This research provided a mixed dataset of dental photographic (colored or X-ray) images, instantiated a deep learning approach to enhance the existing dental image carious regions' localization procedure, and implemented a full-fledged tool to present carious regions via simple dental images automatically. The instantiation mainly exploits the mixed dataset of dental images (colored photographs or X-rays) collected from multiple sources and pre-trained hybrid Mask RCNN to localize dental carious regions. The evaluations performed by the dentists showed that the correctness of annotated datasets is up to 96%, and the accuracy of the proposed system is between 78% and 92%. Moreover, the system achieved the overall satisfaction level of dentists above 80%.

A game theoretic power control and spectrum sharing approach using cost dominance in cognitive radio networks.

The wireless networks face challenges in efficient utilization of bandwidth due to paucity of resources and lack of central management, which may result in undesired congestion. The cognitive radio (CR) paradigm can bring efficiency, better utilization of bandwidth, and appropriate management of limited resources. While the CR paradigm is an attractive choice, the CRs selfishly compete to acquire and utilize available bandwidth that may ultimately result in inappropriate power levels, causing degradation in network's Quality of Service (QoS). A cooperative game theoretic approach can ease the problem of spectrum sharing and power utilization in a hostile and selfish environment. We focus on the challenge of congestion control that results in inadequate and uncontrolled access of channels and utilization of resources. The Nash equilibrium (NE) of a cooperative congestion game is examined by considering the cost basis, which is embedded in the utility function. The proposed algorithm inhibits the utility, which leads to the decrease in aggregate cost and global function maximization. The cost dominance is a pivotal agent for cooperation in CRs that results in efficient power allocation. Simulation results show reduction in power utilization due to improved management in cognitive radio resource allocation.

Multilevel information fusion for cryptographic substitution box construction based on inevitable random noise in medical imaging.

Block cipher has been a standout amongst the most reliable option by which data security is accomplished. Block cipher strength against various attacks relies on substitution boxes. In literature, extensively algebraic structures, and chaotic systems-based techniques are available to design the cryptographic substitution boxes. Although, algebraic and chaotic systems-based approaches have favorable characteristics for the design of substitution boxes, but on the other side researchers have also pointed weaknesses in these approaches. First-time multilevel information fusion is introduced to construct the substitution boxes, having four layers; Multi Sources, Multi Features, Nonlinear Multi Features Whitening and Substitution Boxes Construction. Our proposed design does not hold the weakness of algebraic structures and chaotic systems because our novel s-box construction relies on the strength of true random numbers. In our proposed method true random numbers are generated from the inevitable random noise of medical imaging. The proposed design passes all the substitution box security evaluation criteria including Nonlinearity, Bit Independence Criterion (BIC), Strict Avalanche Criterion (SAC), Differential Approximation Probability (DP), Linear Approximation Probability (LP), and statistical tests, including resistance to Differential Attack, Correlation Analysis, 2D, 3D histogram analysis. The outcomes of the evaluation criteria validate that the proposed substitution boxes are effective for block ciphers; furthermore, the proposed substitution boxes attain better cryptographic strength as compared to very recent state-of-the-art techniques.

An architecture for non-linear discovery of aggregated multimedia document web search results.

The recent proliferation of multimedia information on the web enhances user information need from simple textual lookup to multi-modal exploration activities. The current search engines act as major gateways to access the immense amount of multimedia data. However, access to the multimedia content is provided by aggregating disjoint multimedia search verticals. The aggregation of the multimedia search results cannot consider relationships in them and are partially blended. Additionally, the search results' presentation is via linear lists, which cannot support the users' non-linear navigation patterns to explore the multimedia search results. Contrarily, users' are demanding more services from search engines. It includes adequate access to navigate, explore, and discover multimedia information. Our discovery approach allow users to explore and discover multimedia information by semantically aggregating disjoint verticals using sentence embeddings and transforming snippets into conceptually similar multimedia document groups. The proposed aggregation approach retains the relationship in the retrieved multimedia search results. A non-linear graph is instantiated to augment the users' non-linear information navigation and exploration patterns, which leads to discovering new and interesting search results at various aggregated granularity levels. Our method's empirical evaluation results achieve 99% accuracy in the aggregation of disjoint search results at different aggregated search granularity levels. Our approach provides a standard baseline for the exploration of multimedia aggregation search results.

The spectrum of primary immunodeficiencies at a tertiary care hospital in Pakistan.

BACKGROUND: Primary Immunodeficiency Disorders (PIDs) are well-known disorders in the West. but the recognition and diagnosis of these disorders is challenging in developing countries. We present the spectrum of PIDs seen at a tertiary care center in Pakistan, identified using clinical case definitions and molecular methods. METHODS: A retrospective chart review of children suspected to have PID was conducted at the Aga Khan University Hospital (AKUH) Karachi, Pakistan from 2010 to 2016. Data on demographics, clinical features, family history of consanguinity, sibling death, details of laboratory workup done for PID and molecular tests targeted panel next generation sequencing (NGS) or whole exome sequencing (WES) performed at the Geha laboratory at Boston Children's Hospital, USA was collected. The study was exempted from the Ethical Review Committee of AKUH. RESULTS: A total of 43 children visited the hospital with suspected PID during the study period. Genetic testing was performed in 31/43 (72.1%) children. A confirmed diagnosis of PID was established in 20/43 (46.5%) children. A pathogenic gene variant was identified in 17(85%) of the 20 confirmed cases (Table 1). Twelve (60%) of the confirmed cases of PID were male. The most common presenting symptom was recurrent diarrhea 11/20 (55%). The mean (±S.D) age of the cases at the time of diagnosis was 4.2 (±4.1) years. Chronic granulomatous disease (CGD) was the most common 6/20 (30%) disorder, followed by severe combined immunodeficiency (SCID) 3/20 (15%), leukocyte adhesion deficiency (LAD) 3/20 (15%), agammaglobulinemia/hypogammaglobulinemia 3/20 (15%), and Hermansky-Pudlak Syndrome (HPS) 2/20 (10%). Wiskott-Aldrich Syndrome, Immunodeficiency Centromeric Instability and Facial Anomalies Syndrome (ICF 2), Trichohepatoenteric syndrome (TRES), and C3 deficiency were each diagnosed once {1/20 (4.3%) each} (Table 1). Of these 20 confirmed cases, almost all 19/20 (95%) had a family history of consanguinity. Sibling death was reported in 5/20 (25%) of these cases. Five out of the 20 (25%) children died over the 7-year period for various reasons. CONCLUSION: PIDs are not uncommon in Pakistan; their diagnosis may be missed or delayed due to the overlapping of clinical features of PID with other diseases and a lack of diagnostic facilities. There is a need to build capacity for early recognition and diagnosis of PIDs to decrease morbidity and mortality.

Ceftriaxone-resistant Salmonella Typhi Outbreak in Hyderabad City of Sindh, Pakistan: High Time for the Introduction of Typhoid Conjugate Vaccine.

BACKGROUND: The Aga Khan University clinical microbiology laboratory identified an outbreak of ceftriaxone-resistant Salmonella Typhi in Hyderabad, Pakistan, through antimicrobial resistance surveillance. An outbreak investigation was carried out to identify the risk factors and institute control measures. Here we report the preliminary findings of this outbreak investigation, using data collected from 30 November 2016 to 28 March 2017. METHODS: The design for the investigation was a case-control study that included identification of culture-proven ceftriaxone-resistant S. Typhi cases, suspected cases from the households or neighborhood of the confirmed cases, and enrollment of controls matched by age to identify the risk factors. Data were collected through face-to-face interviews using a structured questionnaire. Blood cultures were obtained from all suspected cases. Drinking water samples from each household of cases and controls were obtained for microbiological testing. Geographic Information System coordinates were obtained for all cases and controls. RESULTS: Only 2 subdistricts of Hyderabad (Latifabad and Qasimabad) were affected. A total of 101 confirmed cases of ceftriaxone-resistant S. Typhi had been reported in 4 months with the first case reported on 30 November 2016. Median age was 48 (interquartile range, 29-84) months. The majority (60% [61/101]) of the cases were 6-60 months old. More than half (56% [57/101]) of the cases were male. About 60% of the cases were admitted to hospital and treated as inpatient. More than half (57/101) of the patients developed complications related to typhoid. CONCLUSIONS: Community awareness was raised regarding chlorination of drinking water and sanitation measures in Hyderabad. These efforts were coordinated with the municipal water and sewage authority established to improve chlorination at processing plants and operationalize fecal sludge treatment plants. Outbreak investigation and control efforts have continued. Immunization of children with typhoid conjugate vaccine within Hyderabad city is planned.

Use of bone densitometry to assess bone disease in aluminum toxicity complicating parentral nutrition: A case report.

Aluminum toxicity affecting bone mineral density is a known complication of long-term parentral nutrition. In this report, we describe a similar patient who suffered from bone disease and had a favorable response to chelation therapy using deferoxamine. We believe this may be a possible agent improving the life quality for the above mentioned group of patients.

Impact of pediatric inflammatory bowel disease on linear growth: Data from a national cohort study in Saudi Arabia.

BACKGROUND/AIM: Linear growth impairment (LGI) is one of the most important features peculiar to children with inflammatory bowel disease (IBD). The aim of this report is to define the impact of IBD on the linear growth of children in the Kingdom of Saudi Arabia (KSA). SETTING AND DESIGN: Multicenter retrospective study. PATIENTS AND METHODS: Data from a cohort of newly- diagnosed children with IBD from 2003 to 2012 were analyzed retrospectively. The diagnosis of IBD was confirmed in accordance with the published criteria. Length/height for age was measured at diagnosis. The World Health Organization (WHO) reference was used and LGI was defined by length/height for age <-2 standard deviation. Chi-square test was used to test the significance of estimates and a P < 0.05 was considered significant. RESULTS: There were 374 children from 0.33 to 16 years of age, including 119 ulcerative colitis (UC) (32%), and 255 Crohn's disease (CD) (68%) patients. The prevalence of LGI was 26%, 28%, and 21% in IBD, CD, and UC, respectively. In children below 10 years, LGI was significantly more common in CD (P = 0.010), while in UC children, it was more common in older children (P = 0.011). CONCLUSION: This study demonstrates a prevalence of LGI consistent with that reported in the literature, but higher in CD children with early onset (<10 years) and in older children with UC, underscoring the importance of monitoring growth in children with IBD in the Saudi population. Prospective studies are needed to define the impact of IBD on growth velocity, puberty, and final adult stature.

Nutritional status of children with inflammatory bowel disease in Saudi Arabia.

AIM: To assess the prevalence of nutritional disorders in children with inflammatory bowel disease (IBD) in Saudi Arabia. METHODS: The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn's disease (CD) and ulcerative colitis (UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index (BMI) of each child [weight (kg)/height(2) (m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and < -2 standard deviation score were used to define overweight and thinness, respectively. Age stratification analysis was performed to investigate any age-related variation in the prevalence of nutritional status between children < 10 years of age and older. RESULTS: There were 374 children from 0.33 to 17 years of age, including 119 (32%) children with UC and 255 (68%) with CD. All of the children were Saudi nationals, and 68 (57%) of the UC and 150 (59%) of the CD children were males. A positive history of anorexia at the time of diagnosis was found in 30 (25%) patients with UC and 99 (39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC (P = 0.037) only in the age group of 10-17 years (P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years (P = 0.020). CONCLUSION: A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care.

Identifying ADHD in adults using the international personality disorder examination screening questionnaire.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is frequently diagnosed concurrently with a personality disorder (PD) in adulthood. Both are trait-like chronic disorders with substantial similarities. AIM: To measure the accuracy of the International Personality Disorder Examination screening questionnaire (IPDE-SQ) in identifying ADHD in adults from a psychiatric population. METHOD: Participants (n = 119) from mental health services completed an ADHD interview and the IPDE-SQ. MAIN RESULTS: Although many IPDE-SQ subscales demonstrated good sensitivity in identifying ADHD, a potential 11-item scale from IPDE-SQ components had excellent sensitivity (84%) and specificity (82%). CONCLUSIONS: An 11-item subscale from the IPDE-SQ shows potential as a screening instrument for ADHD in an adult psychiatric population.

Incidence of pediatric inflammatory bowel disease in Saudi Arabia: a multicenter national study.

BACKGROUND: Pediatric inflammatory bowel disease (IBD) is increasingly recognized in developing countries; however, the incidence and trend over time have not been reported. METHODS: This retrospective study included children diagnosed with IBD in gastroenterology centers in the Kingdom of Saudi Arabia between 2003 and 2012. The date of birth, date and age at diagnosis, gender, and final diagnosis were collected on special forms. Clinical, laboratory, imaging, endoscopy, and histopathology results were reviewed to confirm the final diagnosis. Descriptive statistics were used to compare ulcerative colitis and Crohn's disease in different age groups, and significance was assessed by the chi-square test. Incidence rates and trend over time were analyzed with the assumption of Poisson distribution. The incidence rate over time was compared in 2 periods (2003-2007 and 2008-2012). A P value of <0.05 and 95% confidence intervals were used to assess the significance and precision of the estimates. RESULTS: A total of 340 Saudi Arabian children aged 0 to 14 years were diagnosed. The mean incidence rate per 100,000 individuals was 0.2, 0.27, and 0.47 for ulcerative colitis, Crohn's disease, and IBD, respectively. Except for the 0- to 4-year age group, there was a significant increase in incidence over time. CONCLUSIONS: Although the incidence of pediatric IBD in Saudi Arabian children is lower than suggested in the Western literature, there is a significantly increasing trend over time. However, decreased trend in the younger age group over time is identified. Prospective studies will be important to identify the risk factors for IBD in different age groups.

Analysis of clinical observation on acute psychiatric wards.

BACKGROUND: Clinical observation is very important to manage risk of people who are acutely ill on psychiatric wards. It is always an area of dispute between different specialities and disciplines in serious untoward incidents (SUI). Three levels of observations have been applied on acute psychiatric words. Assessing practice is important to help to identify any area needs improving. METHODS: A questionnaire was developed by HN to collect demographics. Medical notes on Westley and Grangewater wards were reviewed. Excel Microsoft Office World Computer Programme was used to analyse the results. RESULTS: 57% were men. 62% were above 41 years of age. Majority were suffering from schizophrenia and schizoaffective disorders 61%. 64.28% were admitted as formal patients. 31.42% were on level I observation.62.53 were informal. 54.76% were risk to themselves, 28.57% risk to others. 82.3% were on level II observation, 31.42% formal and 68.50% informal. 21.32% were on level III observation. 66.66% were formal and 66.66% had an incident before this level. CONCLUSION: This study have shown that patients are assessed properly before they go on any level of care. Some patients need to go on level III as they pose a risk mainly to other people. Regular reviews of patients, especially on high level of observation should be done more promptly, as being on observation is not a comfortable experience to go through and applying the least restrictive practice should always be sought and adopted.

Food behaviors and youth obesity in Pakistan / Tendências alimentar e a obesidade juventude no Paquistão

The epidemic of obesity took off from about 1980 and in almost all countries has been rising inexorably ever since. Only in 1997 did world health organization accept that this was a major public health problem. It is also becoming an important public health problem among Pakistani children due to changes in life style and other factors. The increasing prevalence of childhood obesity and its concomitant health risks justify widespread efforts toward prevention. A Cross-sectional study was conducted to elaborate the various types of foods and change in eating behavior leading to abnormal weight gain among the youth. A total of 504 male and female students of class six to ten were selected through simple random sampling. Anthropometric measurements were done with calibrated instruments using the age and sex specific BMI cut off points according to World Health Organization growth reference. Results showed significant proportion of girls (86%) and boys (85%) had abnormal waist to hip ratio. The determinants of the obesity lie within the rapid changes in food intake behavior and lifestyle patterns which had a clear and significant impact on the prevalence of obesity in youth of Pakistan.

A epidemia de obesidade decolou de 1980, e em quase todos os países aumentou inexoravelmente o número de obsessos desde então. Apenas em 1997, a Organização Mundial da Saúde aceitou que este era um problema de saúde pública. Também está se tornando um importante problema de saúde pública entre crianças paquistanesas pelas mudanças no estilo de vida e outros fatores. O aumento da prevalência da obesidade infantil e seus riscos de saúde concomitante em justificar esforços generalizados para a prevenção. Um estudo transversal foi conduzido para a elaboração dos vários tipos de alimentos e a mudança no comportamento alimentar levando ao ganho de peso anormal entre os jovens. Um total de 504 estudantes do sexo masculino e feminino da classe 6-10 foram selecionados através de amostragem aleatória simples. Medidas antropométricas foram realizadas com instrumentos calibrados usando a idade e o sexo IMC específicos cortado pontos de acordo com Mundial de referência de crescimento Organização Mundial de Saúde. Os resultados mostraram significativa proporção de meninas (86%) e meninos (85%) com cintura anormal ao quadril. Os determinantes da obesidade encontram-se nas rápidas mudanças no comportamento de consumo alimentar e os padrões de estilo de vida que teve um impacto claro e significativo sobre a prevalência de obesidade em jovens do Paquistão.

Intraocular pressure measurement: Goldmann Applanation Tonometer vs non contact airpuff tonometer.

BACKGROUND: An accurate assessment of Intraocular pressure (IOP) is vital in establishing diagnosis of Glaucoma and decision making regarding various treatment modalities available. The purpose of this study is to compare Goldmann Applanation Tonometer (GAT) with Air puff tonometer. METHODS: Cross-sectional comparative study conducted. 73 eyes from 73 patients were included in this study and intraocular pressure (IOP) was measured by GAT and PT100 at Sheikh Khalifa Bin Zayed Hospital, Muzaffarabad, Benazir Shaheed Teaching Hospital, Abbottabad. RESULTS: Mean age of the patients was 53.17 +/- 13.80 years. Mean IOP measurements showed significant differences in measurements performed by the two tonometers (p < 0.05). Correlation revealed significant relation between PT100 and GAT (Pearson's correlation 0.715, p < 0.01). CONCLUSIONS: Compared to non-contact air-puff tonometer, the Goldmann applanation tonometer is a reliable and consistent technique for measurement of intraocular pressure.

Prevalence and factors associated with HCV (hepatitis C virus) seropositivity in Islamabad, Pakistan.

An estimated 150-200 million people worldwide are infected with hepatitis C. Prevalence is higher in some countries in Asia and Africa. Only limited information about the epidemiology of Hepatitis C Virus (HCV) infection especially in females is available. The aim of this study is to determine the prevalence of anti-HCV antibodies and the possible factors for transmission in the female population of a largely urban city Islamabad. A cross sectional study was conducted from May 2006 to August 2006 in Islamabad. We select 252 female households (n=252) following the selection criteria. The primary outcome variables were HCV seropositivity and factors like history of major surgical procedure, blood transfusion, Intravenous drug use etc. The results showed mean age of the sample was 33.21 (±9.95) years and HCV seropositivity was present in 62 (24.6%) females. Final Forward Stepwise multiple logistic regression showed blood transfusion [OR, 10.094 95% CI 1.950-52.257], dental procedure [OR, 5.381 95% CI 2.315-12.507] and dilation and curettage [OR, 3.869 95% 1.867-8.015] were significantly associated with HCV seropositivity in females. The study highlights poor quality of care provided and a massive need to educate general population including patients as well as health professionals and allied health workers.