Journal of Peoples University of Medical & Health Sciences Nawabshah. (JPUMHS)

THE SEVEN-STAR DOCTOR: SYNCHRONIZING THE PMDC, WHO, AND PUMHSW’S ASPIRATIONS FOR EDUCATIONAL DISTINCTION IN HEALTH.

2025-08-08T05:00:21+05:00

The Seven-Star Doctor is a concept put
forth by the World Health Organization
(WHO) which looks to reframe the role of
medical practitioners in the 21st century1.
It elaborates on the seven critical functions
of a doctor which include: care provider,
decision maker, a communicator, a leader
of the community, a manager, an advocate
for health,

PREVALENCE AND RISK FACTORS OF SURGICAL SITE INFECTIONS FOLLOWING ELECTIVE GENERAL SURGERY PROCEDURES.

2025-08-08T05:05:28+05:00

BACKGROUND: In low- and middle-income countries like Pakistan, surgical site infections (SSIs)
result in increased health care expenditures, prolonged hospital stays, and increased morbidity.
Establishing successful preventive measures requires identifying region-specific risk factors and
prevalences. OBJECTIVE: To assess the prevalence of surgical site infections and identify
associated risk factors among patients who undergo elective general surgical procedures in a tertiary
care hospital. METHODS: It was a prospective observational study conducted between July 2023
and December 2024 at Hayatabad Medical Complex (HMC), Peshawar. There were 398 patients who
underwent elective general surgery procedures during the study period. The elective surgeries
involved were not emergency surgeries but they were scheduled to take place and occurred in sterile
conditions. Amongst the total, 18 patients were lost to followup. RESULTS: Of all the procedures,
172 (45.3%) were laparoscopic and 208 (54.7%) were open surgery. The most common surgeries
were appendectomy (14.5%), laparoscopic cholecystectomy (26.3%), and hernia repair (28.2%).
Based on wound classification, 238 cases (62.6%) were clean, 115 cases (30.3%) were clean
contaminated, and 27 cases (7.1%) were contaminated. Overall, the SSI rate was observed in
42(11.1%,) patients. Amongst which 28(7.4%) were superficial infections, 4(1.1%) organ/space
infections, and 10(2.6%) deep incisional infections. CONCLUSION: In elective general surgery,
SSIs play a significant role as postoperative complications and there are several modifiable risk
factors. Targeting procedures such as improved preoperative risk stratification, glycemic control,
weight reduction, consistent aseptic technique, may decrease the incidence of SSI and improve the
overall surgical experience.

DIAGNOSTIC ACCURACY OF ULTRASOUND IN DETECTION OF SYMPTOMATIC URETERIC CALCULI TAKING NON CONTRAST CT SCAN AS A GOLD STANDARD.

2025-08-08T05:08:54+05:00

BACKGROUND: Urolithiasis is defined as the presence of calculi in the urinary tract. Multiple
studies have shown that urinary tract stones are one of the most common incidental findings in medical imaging. These stones are potentially dangerous and can cause severe impairment to renal function if they remain undiagnosed for a long time. To evaluate the diagnostic accuracy of ultrasound in the detection of symptomatic ureteric calculi taking a non-contrast CT scan as a gold standard. METHODOLOGY: A cross sectional analytical study was conducted in 9 months at Department of Diagnostic Radiology D.H.Q Hospital Jhang, Pakistan. 100 patients were selected with Consecutive sampling technique, Age of 18 to 80 years, both genders, Patients who presented with urinary symptoms and were suspected to have a urinary stone patients were included in this study. Patients with renal masses, previous renal surgeries, renal transplants and end-stage renal disease and pregnant females and patients not willing to participate in the study were excluded. RESULTS: The sensitivity of Ultrasound was 90.91%, specificity was 100%, Predictive positive value was 100% and predictive negative value was 10% so the diagnostic accuracy was 91%. CONCLUSION: Study concluded that the sensitivity of USG for diagnosis of ureteric calculi was high.

GASTRIC PATHOLOGIES AND HELICOBACTER PYLORI: A CORRELATIVE STUDY.

2025-08-08T05:20:35+05:00

BACKGROUND: Given that H. pylori have a well-established function in gastric pathology, little is known about the relationship between H. pylori infection, histological findings, and demographic characteristics including age and gender. OBJECTIVE: To assess the degree of H. pylori infection and how it relates to histopathological alterations. METHODS: This retrospective observational study was carried out at Khyber Teaching Hospital, Peshawar, from January to June 2024. A sample of 150 patients was selected based on a 99% confidence interval and 5% margin of error. Adult patients (≥18 years) with complete clinical, endoscopic, and histopathological data were included. Data were analyzed using SPSS version 26, with chi-square tests was applied to assess associations. RESULTS: Among total (n=150) patients, with 44 (29.3%) testing positive for H. pylori. Majority were diagnosed with inflammatory conditions (90.7%, n=136) with Chronic non-specific gastritisbmost common. Malignant tumors were observed in 8.0% (n=12) patients, with adenocarcinoma in 9 cases. There was a significant correlation between H. pylori infection and gastric adenocarcinoma (p=0.001). No significant associations were found between H. pylori infection and age groups (p=0.298), or gender (p=0.637). CONCLUSION: There is no correlation between H. pylori infection and age or gender, however there is a substantial correlation between H. pylori infection and stomach cancer. These results underline the significance of H. pylori testing in patients with precancerous esions and chronic gastritis, as well as the crucial role that H. pylori plays in stomach pathophysiology.

HISTOPATHOLOGICAL CORRELATION WITH HELICOBACTER PYLORI IN MALIGNANT AND NON-MALIGNANT GASTROINTESTINAL DISORDERS.

2025-08-08T05:24:36+05:00

BACKGROUND: Gastrointestinal (GI) disorders, ranging from benign to malignant, are major global health concerns. Helicobacter pylori infection is a key risk factor for GI diseases, especially gastric cancer. OBJECTIVE: To evaluate the prevalence of malignant and non-malignant gastrointestinal disorders in GI biopsies and to determine the prevalence of H. pylori and its relationship with histopathological findings. METHODS: This retrospective observational study enrolled 363 patients who underwent gastrointestinal biopsies at the Pathology Department of Hayatabad Medical Complex, Peshawar. Histopathological diagnoses were classified as malignant or
non-malignant, with H. pylori presence confirmed through Giemsa staining. SPSS version 26 was used to analyze the associations between H. pylori, patient demographics, and histopathological outcomes using Chi-square tests, with statistical significance set at p<0.05. RESULTS: Among the 363 patients, 88.4% (n=321) presented with non-malignant conditions, with chronic non-specific gastritis being the most frequent (55.3%). Malignant diagnoses accounted for 11.6% (n=42), with adenocarcinoma being the predominant malignancy about 7.7% (n=28). H. pylori infection was detected in 10.2% (n=37) of cases, showing a significant association with non-malignant conditions (p=0.019), particularly in patients aged 19–49 years. However, there was no significant association between H. pylori and malignancy (p=0.225) or with gender (p=0.225). CONCLUSION: This study highlights the predominance of non-malignant GI disorders, with H. pylori infection significantly linked to inflammatory conditions but not to malignancy. Age was a significant factor in H. pylori prevalence, underscoring the importance of age-targeted screening.

DIAGNOSTIC YIELD FROM SYMPTOMATIC COLONOSCOPY: A CROSS SECTIONAL STUDY FROM GAJJU KHAN MEDICAL COLLEGE SWABI.

2025-08-08T05:27:58+05:00

BACKGROUND: Colonoscopy is an essential diagnostic tool for detecting underlying lower gastrointestinal pathologies. Evaluating its diagnostic yield and its relationship with patient demographics and clinical indications can enhance its utility and improve patient care outcomes. OBJECTIVE: To evaluate the diagnostic yield of colonoscopy in patients presenting with lower gastrointestinal symptoms and to analyze its association with patient demographics, clinical indications, and underlying pathologies. METHODS: This retrospective study, conducted at Gastroenterology Department, Gajju Khan Medical College, Swabi, from September 2019 to September 2024. A total of 1119 adult patients presenting with lower gastrointestinal symptoms were enrolled. Data on demographics, clinical indications, and colonoscopy findings were collected through structured questionnaires and medical records. Data analysis was conducted using SPSS version 26 to calculate diagnostic yield and assess associations with age, gender, and clinical symptoms. RESULTS: Mean age of participants was 41±14 years, with 62% being male. The most common clinical indications were per rectal bleeding (42.1%), chronic diarrhea (17.2%), and abdominal pain (12.7%). The overall diagnostic yield of colonoscopy was 69%, with hemorrhoids (24.8%), rectal polyps (5.1%), and ulcerative colitis (4.9%) being the most frequent findings. Significant associations were observed between diagnostic yield and clinical symptoms (p=0.001). Hemorrhoids were more prevalent in males (p<0.001) and older age groups. CONCLUSION: Colonoscopy demonstrated a high diagnostic yield of 69% in patients with lower gastrointestinalbsymptoms. Patient demographics and clinical indications, particularly per rectal bleeding, were significantly associated with diagnostic outcomes, highlighting the importance of targeted diagnostic approaches to improve patient management.

FUNCTIONAL RHINOPLASTY IN PATIENTS WITH EXTERNAL NASAL DEFORMITY AND CHRONIC RHINOSINUSITIS.

2025-08-08T05:31:59+05:00

BACKGROUND: External nasal deformity is often associated with functional nasal obstruction and may coexist with chronic rhinosinusitis (CRS), leading to significant impairment in nasal airflow and quality of life. Functional rhinoplasty, with or without endoscopic sinus surgery (ESS), aims to address both external structural abnormalities and internal sinonasal pathology. However, the outcomes of combined procedures in this population remain underreported in local settings. OBJECTIVE: To evaluate the functional, radiological, and patient-reported outcomes of functional rhinoplasty in patients with external nasal deformity and CRS, and to determine the impact of combining ESS on these outcomes. METHODS: This prospective observational study was conducted at Jinnah Postgraduate Medical Centre (JPMC) and Sir Syed Hospital, Karachi between January 2023 and December 2024, following approval from the Institutional Review Board (IRB). A total of 100 adult patients with external nasal deformity and CRS were enrolled. Patients underwent either functional rhinoplasty alone or combined functional rhinoplasty with ESS. Preoperative and six-month postoperative outcomes were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale, anterior rhinomanometry, and Lund-Mackay CT scoring (for those undergoing ESS). Paired t-tests and multivariate regression were applied for statistical analysis. RESULTS: The mean age of patients was 32.6 ± 8.4 years, with 68 (68%) males and 32 (32%) females. Crooked nose was the most frequent deformity (54%). Combined rhinoplasty and ESS were performed in 64 (64%) patients. The mean NOSE score improved significantly from 67.8 ± 10.2 to 21.6 ± 9.1 (p < 0.001). Nasal airflow increased from 290 ± 85 mL/sec to 530 ± 110 mL/sec (p < 0.001). Lund-Mackay scores in the ESS group improved from 12.4 ± 3.6 to 4.2 ± 2.1 (p < 0.001). The complication rate was 8%, with 94% of patients satisfied or very satisfied. CONCLUSION: Functional rhinoplasty, especially when combined with ESS, provides significant functional and radiological benefits with high patient satisfaction and low complication rates.

PATIENT REPORTED OUTCOMES AFTER ULTRASOUND GUIDED HIATAL EPIDURAL STEROID INJECTION FOR LUMBAR RADICULOPATHY.

2025-08-08T05:35:42+05:00

BACKGROUND: Ultrasound-guided hiatal epidural steroid injection is a minimally invasive intervention for lumbar radiculopathy. This study evaluates patient-reported outcomes following this procedure. OBJECTIVE: The objective of this study is to assess patient-reported outcomes, including pain relief, functional improvement, and the need for additional interventions, following ultrasound-guided hiatal epidural steroid injection for lumbar radiculopathy. METHODS: This retrospective study analyzed 200 patients undergoing ultrasound-guided hiatal epidural steroid injection (2022–2024). Outcomes included VAS pain scores, functional improvement, additional interventions, satisfaction, and adverse events. Statistical analyses involved paired t-tests, chi-square tests, and multivariate regression. RESULTS: The mean age of participants was 48.3 ± 10.2 years, with 56% males. Baseline mean VAS was 7.2 ± 1.3, which significantly decreased to 4.3 ± 1.2 at one week, 3.1 ± 1.4 at one month, and 2.5 ± 1.2 at three months (p < 0.001). At three months, 62% of patients reported full functional recovery, 14% required repeat injections, and 6% were referred for surgery. Patient satisfaction was high, with 79% expressing a positive response. Adverse events occurred in 11% of patients, primarily transient pain flare-ups (9%). Regression analysis identified baseline VAS and BMI as significant predictors of pain relief (p < 0.05). CONCLUSION: Ultrasound-guided hiatal epidural steroid injection significantly improves pain and functional outcomes in lumbar radiculopathy patients, with minimal adverse effects. Higher baseline pain and BMI predict lower pain relief.

DERMATOLOGICAL CHALLENGES: ADOLESCENTS STRUGGLING WITH SKIN PROBLEMS.

2025-08-08T05:38:40+05:00

BACKGROUND: Adolescence is the period of development from childhood to adult life, which starts with puberty. As a transitional phase with bio-psycho-social development, this period is very challenging for both parents and children. OBJECTIVE: To fathom out the pattern and frequency of skin diseases in adolescent patients presenting in tertiary care hospital. METHODS: A descriptive cross-sectional study was conducted at Fazaia Ruth Pfau Medical College from Jan to Dec 2023. Adolescents (10–19 years) with puberty-related skin conditions were enrolled via non-probability convenience sampling. Hormonal dermatoses were included; congenital and unrelated conditions were excluded. Diagnoses were clinical, supported by investigations where needed. Data were recorded using a structured proforma, and dermatoses were grouped into ten categories for analysis. RESULTS: A total of 331 adolescents (mean age 15.75 ± 0.29 years; 56.2% females) were enrolled. Most (67.4%) were aged 15–19 years. Infections (27.8%) and infestations (24.8%) were the most common dermatoses, followed by acne (20.2%) and eczema (15.7%). Fungal infections were noted in 12.7%, with pityriasis versicolor and tinea being most frequent. Viral infections (7%) included warts, chickenpox, and molluscum. Five females with hirsutism were diagnosed with PCOS. Dermatoses were grouped into ten categories for descriptive analysis. CONCLUSION: Adolescents frequently present with infections, infe tations, acne, and eczema, which significantly affect quality of life. Though less common, papulosquamous, hair, and nail disorders also carry considerable psychosocial impact.

CORRELATION BETWEEN MOTIVATING FACTORS AMONG NURSING STUDENTS AND CHOOSING PROFESSION AS A CAREER: A STUDY FROM PAKSITAN.

2025-08-08T05:41:59+05:00

BACKGROUND: A person's choice of career is a significant life decision. This choice entails picking a vocation that meets one's needs and expectations among a variety of possibilities. People are educated in the field they choose for this crucial decision. It is generally acknowledged that
society views nursing favorably as a vocation since it provides social mobility, job security, and a wide range of career options. OBJECTIVE: This research study was intended to determine motivating factors of nursing studetns toward decide on nursing field as a career. DESIGN OF
STUDY: Descriptive Cross-Sectional study. PLACE & DURATION: from Government Nursing School Januray 2018 to March 2018. MATERIALS AND METHODS: This cross cross-sectional study was lead during Jan-March 2018 on 98 nurses, studying at Government nursing school in Karachi, with minimum qualification of 3 years diploma in nursing. The data collection instrument consisted of a section on demographic information and Structured Questionarrie. The analysis of data was done through SPSS v27, and Data scrutiny involved in the use of descriptive statistics and chi square test were used. RESULTS: In this study, 61.7% and 56.6% answered that the reason for prefer nursing profession is the providing of care and helping to the people. A extraordinary proportion of students (100%) choose to nursing profession based on their perception for an ideal opportunity of employment. At a rate of (83.8%) and (60%) students stated that nursing is a valuable work in the society. The highest percentage of the students (100%) stated that the main reason for choosing nursing profession include the anticipation for attractive salaries and advance degrees in nursing. At a rate of (70.5%) students would be willing to work another field. CONCLUSION: Students' preference for advanced degrees in nursing, the possibility of easily accessible employment, high income, and the desire to assist and care for others continue to be the most compelling reasons for selecting the nursing profession.

QUALITY OF LIFE (QOL) AFTER FUNCTIONAL ENDOSCOPIC SINUS SURGERY (FESS) IN PATIENTS WITH CHRONIC RHINOSINUSITIS (CRS).

2025-08-08T05:48:44+05:00

BACKGROUND: CRS in adults is among common medical conditions for which people seek treatment, leading to significant direct medical expenses. OBJECTIVE: To assess enhancement in patients' QOL symptomatically following FESS. STUDY DESIGN: Descriptive Study PLACE AND DURATION OF STUDY: METHODOLOGY: 100 individuals, with or without nasal polyposis, had surgery for CRS. Before beginning any operation, as well as at 1, 3, 6 9 and 12 months following endoscopic sinus surgery, our patients underwent an item-by-item SNOT-22 test. SPSS Version 26 was utilized to analyse data, P-value of <0.05 was deemed significant statistically. RESULTS: The mean age of 100 patients in our research was 35.33 + 5.14 years, with 59 (59%) of them being male. 28 patients (28%) were diagnosed with CRS with polyps, 40 patients (40%) were diagnosed with CRS without polyps, 32 patients (32%) had an allergic fungal sinusitis diagnosis, and 23 patients (23%) had a history of asthma. The preoperative SNOT scores were greater, according to the results of the One-Way ANOVA, but they substantially decreased at the first, third, sixth, and twelve months after surgery after FESS. CONCLUSION: This study indicated that FESS is the best surgical option for CRS

ADVANCING PEDIATRIC HERNIA SURGERY: A COMPARATIVE STUDY OF OPEN AND LAPAROSCOPIC REPAIR.

2025-08-08T05:53:27+05:00

BACKGROUND: Pediatric inguinal hernia repair is a common surgical procedure, with open herniotomy being the traditional approach in resource-limited settings. However, the introduction of laparoscopic techniques has shown promising outcomes. OBJECTIVE: This study evaluates and compares the outcomes of open and laparoscopic hernia repairs in pediatric patients at Peoples University of Medical and Health Sciences (PUMHS) Nawabshah. METHODS: A retrospective cohort study was conducted, including 300 pediatric patients (aged 1 month to 14 years) who underwent hernia repairs between January 2020 and December 2024. Patient demographics, surgical techniques, operative duration, post-operative complications, and recurrence rates were collected. Statistical analysis was performed using chi-square and t-tests to identify significant differences between the two approaches. RESULTS: Open herniotomy was performed in 76.7% of cases, while 23.3% underwent laparoscopic repair. The mean operative time for open surgery was 47 minutes, significantly longer than 38 minutes for laparoscopic repair (p < 0.05). Post-operative complications were higher in open repairs (30%) compared to laparoscopic repairs (7%) (p < 0.05). Recurrence rates were also higher in the open group (6%) versus the laparoscopic group (3%). Laparoscopic repairs demonstrated superior outcomes in terms of fewer complications, shorter operative times, and reduced recurrence. CONCLUSION: Laparoscopic hernia repair offers significant advantages over open surgery in pediatric patients, including shorter operative times, lower complication rates, and fewer recurrences. Given these benefits, investment in laparoscopic training and infrastructure in resource-limited settings like PUMHS Nawabshah is recommended to improve surgical outcomes and patient satisfaction.

A COMPARATIVE CLINICAL INVESTIGATION ON LIPID-LOWERING EFFECTS OF SITAGLIPTIN AND METFORMIN IN TYPE II DIABETIC DYSLIPIDEMIA.

2025-08-08T16:57:12+05:00

BACKGROUND: Diabetic dyslipidemia is an imbalance of lipid profiles in diabetic patients that exacerbate higher risk of cardiovascular complications. Among anti-diabetic agents Metformin, is first-line biguanide and Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, are widely utilized owing to its emerging and promising effects on lipid metabolism, nevertheless their comparative and combined outcomes on lipid profiles remains as a major area of investigation. The objective of our study was to evaluate the effects of Metformin as monotherapy and combination of Sitagliptin along with metformin on the lipid profile in type II diabetic patients. METHODS: This randomized, prospective controlled study was conducted involving 100 patients diagnosed with type II diabetes.
The patients were divided into three treatment groups; group-I had received Sitagliptin 50 mg twice daily; group-II was administered Metformin 500 mg twice daily; and patients in group-III had received combination therapy of Sitagliptin (50 mg once daily) and Metformin (500 mg twice daily) over a period of 36-week. The blood samples were collected at baseline, 18th and 36th week analyzed for biochemical lipid parameters including total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), very-low-density lipoprotein (VLDL), and low-density lipoprotein (LDL). Statistical analysis was performed using SPSS 24.0, applying two-way ANOVA and paired t-test with level of significance set at p<0.05. RESULTS: Sitagliptin, Metformin, and their combination exhibited significant improvement in lipid profiles in Type II diabetic patients. Both anti-diabetic agents as monotherapy reduced TC, TG, VLDL, and LDL, with significant increase in HDL. Metformin demonstrated a marginally higher reduction in TC and TG levels, while Sitagliptin displayed modest but favorable outcomes. The combination treatment resulted in the most pronounced improvement in all lipid biochemical parameters, suggesting a possible synergistic effect. CONCLUSION: This study reveals that the combination of Metformin and Sitagliptin is superior in targeting diabetic dyslipidemia therefore; it may be considered a favorable option in the comprehensive management of type II diabetes.

INCIDENCE OF CONGENITAL DEFECTS IN NEWBORNS: A SURGICAL AND CLINICAL STUDY.

2025-08-08T06:00:37+05:00

BACKGROUND: Newborn congenital defects remain a major reason behind mortality and health problems among infants globally particularly within low- and middle-income nations. The analysis sought to find the occurrence rate besides risk elements and health results of birth defects manifesting
among newborns who received care at PUMHS Nawabshah. METHODS: A prospective observational research investigation took place throughout January 2021 to December 2022. The researchers studied 1,200 newborns and diagnosed 120 of them with congenital defects. The researchers used SPSS version 25 to process data which they gathered from newborns in addition to demographic, prenatal and clinical information. RESULTS: Eight newborns among 1200 had congenital defects resulting in an incidence rate of 10%. Newborns with CHDs comprised the largest group of anomalies at 35.8% and NTDs followed closely behind at 22.5%. Varying studies identified consanguinity as a 45.8% contributor to risk together with maternal ages above thirty years at 19.2% and non-utilization of folate supplements at 65.8%. Consanguinity along with maternal age greater than 30 years and the absence of folate supplementation emerged as separate danger signs for birth defects through logistic regression analysis (aOR = 2.10, aOR = 1.82, aOR = 1.67 respectively). Roughly 70.8% of patients required surgery while the total complications reached 18.3% and mortality exceeded 12.5%. CONCLUSION: This region experiences a high frequency of congenital abnormalities which requires immediate public health initiatives for folate supplementation besides genetic healthcare support and better surgical treatment services for newborns.

EVALUATING THE PREOPERATIVE NEUTROPHIL TO LYMPHOCYTE RATIO FOR PREDICTING POSTOPERATIVE INFECTIOUS COMPLICATIONS IN CHILDREN WITH ACUTE APPENDICITIS.

2025-08-08T06:04:44+05:00

INTRODUCTION: Appendicitis is among the primary causes of acute abdomen in children, with appendectomy being the standard treatment. However, postoperative complications, occurring in 5 28% of cases, present significant challenges. OBJECTIVES: This study evaluates the prognostic
value of preoperative neutrophil-to-lymphocyte ratio (NLR) for postoperative infectious
complications in children with acute appendicitis. METHODS: Current prospective cross-sectional research was carried out at Avicenna Medical College & Avicenna Hospital, Lahore, involving 57 children (aged 5-12) who underwent emergency appendectomy from April 2023 to April 2024.
Preoperative medical data, including NLR, were collected. Postoperative complications were tracked for one month. Statistical analysis was done using SPSS-26, with logistic regression analysis and the receiver operating characteristic (ROC) curve analysis was applied to identify predictors. RESULTS: Of the 57 children, 12 (21.1%) developed postoperative complications, primarily superficial surgical site infections and prolonged paralytic ileus. The mean NLR was significantly higher in the complication group (12.6 ± 7.97) compared to the non-complication group (5.01 ± 3.45; p < 0.001). Logistic regression identified NLR as an independent predictor (OR: 1.24; 95% CI: 1.002-1.58), with an ROC AUC of 0.85, indicating strong predictive value. The optimal NLR cutoff was 9.4, with 78.6% sensitivity and 94.3% specificity. CONCLUSION: Elevated preoperative NLR is a significant predictor of postoperative infectious complications in pediatric acute appendicitis. Implementing NLR assessment may help identifying high-risk patients at early stage, optimizing postoperative monitoring and management to reduce morbidity.
Postoperative Complications, Predictive Biomarker

CLINICAL ACUMEN IN DIFFERENTIATION OF DIRECT AND INDIRECT INGUINAL HERNIA IN ADULTS.

2025-08-08T06:08:37+05:00

BACKGROUND: Inguinal hernia is a frequent case to come across in the outpatient clinic as well as in emergency. OBJECTIVE: To determine the diagnostic accuracy of clinical acumen in differentiating indirect from direct inguinal hernia in adult population by keeping surgery-open inguinal hernia repair (tension-free with mesh/Lichtenstein or by reconstruction of the floor with tissue)- as gold standard. PLACE AND DURATION OF STUDY: This cross sectional study was executed at department of General Surgery, Liaquat University of Medical & Health Sciences, Jamshoro. The duration of the study from 01/01/2023 to 31/12/2023 for one year. PATIENTS AND METHOD: This cross sectional study was executed at department of General Surgery, Liaquat University of Medical & Health Sciences, Jamshoro. The duration of the study was from 01/01/2023 to 31/12/2023. On surgery, position of hernia will be noted and direct or indirect hernia will be confirmed through the scrotum towards the external inguinal (as per operational definition). All this information will be recorded on pro-forma (attached). RESULTS: For this study the mean age of the patients was 45.42±15.33 years, 68(68%) and they were married. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of clinical findings were 89.36%, 79.25%, 79.25%, 89.36% & 84% respectively taking surgical findings as gold standard. CONCLUSION: According to this study we may conclude that clinical acumen has good diagnostic accuracy in differentiating indirect from direct inguinal hernia in adult population by keeping surgery as gold standard.

DIAGNOSTIC ACCURACY OF COLOR DOPPLER ULTRASOUND FOR DIAGNOSIS OF ACUTE RENAL TRANSPLANT REJECTION BY TAKING HISTOPATHOLOGY AS GOLD STANDARD IN PATIENTS PRESENTING AT TERTIARY CARE HOSPITAL, KARACHI.

2025-08-08T06:17:16+05:00

OBJECTIVE: To assess how effective color Doppler ultrasound (CDUS) is in diagnosing acute renal transplant rejection (RTR) compared to using histopathology as the standard in patients showing signs of acute rejection following renal transplant at a specialized hospital in Karachi. METHODS: This A detailed cross-sectional research was carried out at the Radiology Department of SIUT in Karachi., from February 2019 till August 2019. All the patients of either gender aged 18 years and above who have undergone renal transplantation and are presenting with clinical suspicion of acute renal transplant rejection were included. All patients those patients underwent Color Doppler Ultrasound evaluation of the transplanted kidney followed by histopathological examination through renal transplant biopsy. Findings were cross-tabulated To evaluate the sensitivity, specificity, positive and negative predictive values, and diagnostic precision. RESULTS: Mean age of the patients The average age of the participants was 51.12±7.57 years. Out of the total, 18 individuals (60%) were males and 12 individuals (40%) were females. Additionally, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CDUS in detecting acute rejection of renal transplants, with histopathology as the reference standard, were determined to be 92%, 80%, 95.8%, 66.7%, and 90%, respectively. CONCLUSION: CDUS observed to be an accurate, reliable, and non-invasive diagnostic tool for acute renal transplant rejection, helping to avoid unnecessary surgeries and enabling early, effective management, particularly in resource-poor settings.

A HISTOPATHOLOGICAL AUDIT OF BRAIN TUMOR RECEIVED IN 3 YEARS AT A SINGLE TERTIARY CARE HOSPITAL.

2025-08-08T06:20:58+05:00

OBJECTIVE: To determine the frequency of various brain tumor subtypes in different age groups and gender. METHODS: This retrospective study was done at Pathology Department of JPMC Karachi. Brain tumor specimens submitted in 10% buffered formalin for histopathological evaluation
between October 2019 and September 2022, from patients of any age and gender, were included. Tumors were classified according to the WHO Classification of Central Nervous System (CNS) Tumors. Data regarding tumor type, histologic grade, and distribution across age and gender were
recorded and analyzed using Microsoft Excel and SPSS 26 version. RESULTS: There were 40.7% specimens of males and 45.8% of females. Meningiomas and astrocytomas were the most common brain tumors, each comprising 31.7% (57 cases), followed by pituitary adenomas (5.6%), medulloblastomas (5%), schwannomas (4.4%), necrotic tumors (2.8%), oligodendrogliomas (2.2%), and ependymomas (1.1%), with rare tumors like hemangioblastoma, osteoma, and undifferentiated high-grade tumors each accounting for 0.6%. Meningiomas were more common in females, while astrocytomas and pituitary adenomas were higher in males (p=0.06). Additionally, astrocytomas and meningiomas were the most common with mean ages of 34 and 41 years; medulloblastomas were more frequent in younger patients, with a significant age difference in tumor types (p=0.03). CONCLUSION: Brain tumors showed diverse histopathological subtypes, with meningiomas more common in females and astrocytomas in males, occurring across all ages with subtype-specific age and gender patterns.

COMPARISON OF OUTCOME OF ZYGOMATIC BONE FRACTURE MANAGED BY TWO DIFFERENT TREATMENT PROTOCOLS KEEN’S APPROACH AND PERCUTANEOUS HOOK METHOD.

2025-08-08T06:24:19+05:00

OBJECTIVE: The objective of this study was to compare the outcome of zygomatic bone fracture managed by Keens/Buccal sulcus approach and Percutaneous hook method with respect to facial aesthetic and functional occlusal stability. MATERIALS AND METHODS: This randomized control trial was conducted at Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences, Hyderabad/ Jamshoro, Sindh, Pakistan from 5th November 2020 to 13th September 2021. Total 60 patients were included. Postoperative x-rays PNS view or CT scan showed exact approximation of fractured segments. Patients were recalled after 1st, 2nd and on 3rd week for assessment of functional outcome. Mouth opening was measured by metallic ruler. Cheek flattening and facial asymmetry were clinically assessed by Holmes and Mathew’s classification system respectively. Stratification was done using Chi square test considering p-value ≤ 0.05 as significant. RESULTS: Seventy per cent patients had grade-III in Group-A, while 66.7% patients had grade-III
in Group-B. 60% patients had class-II in Group-A and 63.3% patients had class-II in Group-B. The cheek flattening grade was insignificantly associated with the study group. The mouth opening class after 1st week was significantly associated with the study group while no significant association was found after 2nd and 3rd week. CONCLUSION: The Keen intraoral approach offers had good functional outcome with the advantage of avoiding skin incisions.

KAP SURVEY ON HEPATITIS B AMONG MBBS, NURSING, AND AHS STUDENTS AT A TERTIARY CARE HOSPITAL.

2025-08-08T06:27:30+05:00

BACKGROUND: Hepatitis B remains a notable public health concern accounting for 1.1 million fatalities worldwide in 2022. It requires sufficient knowledge for specific prevention and control. This study aimed to evaluate the knowledge, attitudes, and practices among MBBS, Allied Health Sciences
(AHS), and nursing students regarding Hepatitis B infection. ETHODOLOGY: This cross-sectional study was conducted at Sheikh Zayed Medical College/Hospital from September 2023 to February 2024 with 320 participants, using non-probability consecutive sampling. MBBS, Allied Health Sciences, and Nursing students were screened for Hepatitis B and completed a questionnaire assessing knowledge, attitude, and practices. Data were analyzed in SPSS 29. Stratification by study program and gender was performed, followed by post stratification Chi-Square testing (p < 0.05) to assess significance. RESULTS: Out of 320 students, 124 (38.75%) were MBBS, 134 (41.88%) were AHS, and 62 (19.38%) were nursing students. The
overall gender distribution was 188 (58.75%) females and 132 (41.25%) males. The study revealed that a significant proportion of students recognized contact with open wounds (p = 0.000) and sharing needles as sources of Hepatitis B transmission. A majority believed Hepatitis B could lead to liver cirrhosis (p = 0.006). Attitudes towards vaccination were positive, with 90% acknowledging its importance, though concerns about Hepatitis B were higher among nursing students (p = 0.000). Vaccination rates were lower among AHS (16.4%) and nursing students (32.3%) compared to MBBS students (66.6%) (p = 0.000). CONCLUSION: The study revealed knowledge gaps about Hepatitis B among nursing students compared to MBBS and AHS students. While awareness of transmission and vaccination importance was high, vaccination rates were lower among nursing students. Targeted educational interventions are essential to improve Hepatitis B awareness and practices across all healthcare disciplines.

FREQUENCY AND CLINICAL SPECTRUM OF DIABETIC DERMOPATHY IN A TERTIARY CARE HOSPITAL: A DESCRIPTIVE STUDY.

2025-08-08T18:04:04+05:00

BACKGROUND: The most frequent cutaneous manifestation of diabetes mellitus is diabetic dermopathy, usually found as asymptomatic brown macules on the shins. Though it is frequent, local information on its frequency and clinical spectrum in Pakistan is scarce. OBJECTIVE: To find the frequency and outline the clinical spectrum of diabetic dermopathy among patients with diabetes mellitus in a tertiary care hospital. METHODS: This was a descriptive cross-sectional study at the Dermatology and Medical Departments, Peoples Medical College Hospital (PMCH), Nawabshah, spanning six months. 385 consecutive diabetes mellitus patients were enrolled using non-probability consecutive sampling after informed consent. In-depth history, dermatological examination, and documentation of diabetic dermopathy (lesion features, number, location, symptoms) were obtained. RESULTS: In 385 patients (mean age 54.6 ± 10.8 years; 56% women), the prevalence of diabetic dermopathy was 34.8% (n=134). Most lesions were brownish macules on the anterior shins that were asymptomatic (89%), with 65% being bilateral. The number of lesions per patient varied from 2 to 12 (mean 5.1 ± 2.3). The incidence of dermopathy was more in the poorly controlled glycemic group (HbA1c >8%; p<0.05). There was no gender predilection. Forearms (7%) and thighs (4%) were other affected areas. 12% of dermopathy cases presented with pruritus. CONCLUSION: Diabetic dermopathy occurred in more than one-third of diabetes mellitus patients in our tertiary healthcare center, with the most prevalent presentation being asymptomatic brown macules on the shins. Routine dermatologic checks in diabetic patients help in the early recognition of dermopathy as a clinical marker of microangiopathic complications and disturbed glycemic control.

VISUAL HEALTH IN CHILDREN: PREVALENCE AND TYPES OF REFRACTIVE ERRORS IN SCHOOL GOING CHILDREN’S.

2025-08-08T06:35:19+05:00

BACKGROUND: Refractive errors are the most frequent cause of vision impairment in school-age children globally. Uncorrected refractive defects have long-term detrimental impacts on visual health, social integration, and academic achievement. Preventing needless morbidity requires early diagnosis and treatment. In many low-middle-income nations, including Pakistan, routine vision screening for school-age children is urgently needed, and there is little to no recent local data on the prevalence of
refractive errors. OBJECTIVE: To determine the prevalence and types of refractive errors among school-going children and identify associated risk factors. METHODS: This cross-sectional study was performed at the Ophthalmology Department of Hayatabad Medical Complex, Peshawar,
between July 2023 and June 2024. Total 1198 children aged 5-16 years were chosen from public and private schools by stratified random sampling. Snellen charts were used for visual acuity assessment, pinhole was performed and cycloplegic refraction was also tested. Age, gender, screen time, outdoor activity and spectacle use were documented. RESULTS: Mean age was 10.4 ± 2.9 years, with a male predominance 53.3%, the prevalence of refractive errors was 32.9%. The most prevalent refractive error was myopia (18.6%), astigmatism (10.0%), and hyperopia (4.3%). Refractive error was bilateral in 76.8% of the affected children. Prior to the study only 40.6% had worn spectacles despite having refractive errors, of whom only 39.3% were wearing spectacles regularly. CONCLUSION: This study reported a high burden of refractive error in school-going children of Peshawar, with a low rate of spectacle usage and compliance. Older age, more screen time, and urban residence were major risk factors.

FACTORS ASSOCIATED WITH HIGH HBA1C IN CHILDREN WITH DIABETES MELLITUS AT A TERTIARY CARE HOSPITAL.

2025-08-08T06:40:18+05:00

BACKGROUND: Diabetes mellitus (DM) is a common chronic endocrine disorder among children, with type 1 diabetes (T1D) being the predominant form. Glycated hemoglobin (HbA1c) is a key biomarker used to assess long-term glycemic control. This study aimed to identify factors associated
with poor glycemic control in diabetic children attending a tertiary care hospital. METHODS: It was a cross-sectional analytical study performed at Department of Pediatrics, Khyber Teaching Hospital Peshawar a tertiary care centre having a catchment area of primary and secondary care facilities for both urban and rural population of Khyber Pakhtunkhwa. The research was conducted between January 2024 and December 2024 for 1 year. All children aged 1–18 years diagnosed to have diabetes mellitus (mainly type 1 diabetes) who were being seen at pediatric outdoor and admitted to pediatrics wards of Khyber Teaching Hospital were included. RESULTS: There was a modest female dominance (54.5%) and an average age of 11.2 ± 3.5 years. Most patients (62.1%) reported living in an urban area, and 58.6% reported having a poor socioeconomic status. Diabetes lasted an average of 3.1 ± 1.8 years. Of all patients, 47 (32.4%) had HbA1c ≤7.5%, while 98 (67.6%) had poor glycemic control (HbA1c > 7.5%). CONCLUSION: Uncontrolled glycemia among diabetic children can be modified by caregiver education, diabetes self-management and the availability of structured educational programs. 'Family centered diabetes care and promotion of awareness may be a strategy to improve glycemic outcomes in children, particularly in low resource health care settings.

ORIGINAL ARTICLE PREVALENCE OF HYPERTENSION AND ASSOCIATED RISK FACTORS AMONG GOVERNMENT PRIMARY SCHOOL TEACHERS OF TALUKA SANGHAR, SINDH.

2025-08-08T06:44:01+05:00

BACKGROUND: Health issues like hypertension are getting worse in the majority of developing nations. It is also known as the "silent killer disease" as there are no specific signs or symptoms. The most important cause of Cardiovascular disease (CVD) is Hypertension. OBJECTIVES: To determine
the frequency of hypertension and the risk factors for hypertension among primary school teachers at Taluka Sanghar, Sindh. MATERIAL & METHODS: This was a cross-sectional study conducted for six months at Taluka and District Sanghar, Sindh. A total of 295 primary school teachers were included in the study. The blood pressure was measured by a mercury sphygmomanometer through the auscultatory method. The SPSS version 25.0 was used to analyze the Data. A P-value of less than 0.05
was considered significant. DURATION: July 2022 to Dec 2022 RESULT: The prevalence of hypertension among primary teachers was found to be higher in the present study. Out of 295, 88 school teachers (29.8%) were found to be hypertensive and a few 207 (70.2%) were non hypertensive.
The female participants were 157 (53.2%) while male were 138(46.8%) and in the age range of 35-45 years. The risk factors found to be associated with hypertension include male gender, smoking, family history of hypertension, and BMI. CONCLUSION: The present study concluded that hypertension is common among the teachers of primary schools in Taluka Sanghar, Sindh, Pakistan. The burden of hypertension among the school teachers can be decreased by certain changes in lifestyle like quitting smoking, doing regular exercise and physical activity.

PRESENTATION PATTERN OF FIREARM INJURIES AT ORAL & MAXILLOFACIAL SURGERY UNIT IN A PUBLIC SECTOR TERTIARY CARE HOSPITAL AT KARACHI.

2025-08-08T06:47:03+05:00

OBJECTIVE: To evaluate patterns of firearm injuries of oral & maxillofacial region, in terms of demography, etiology, clinical features presenting at the Oral and Maxillofacial Surgery Unit, Shaheed Mohtarma Benazir Bhutto Institute of Trauma (SMBBIT) Karachi. STUDY DESIGN: Descriptive, Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Oral &
Maxillofacial Surgery, SMBBIT from December 2022 to July 2024. METHODOLOGY: The current study included sixty (60) patients who were identified having firearm injuries in oral & maxillofacial region. Data were collected regarding patient’s age, gender, etiology, associated hard and soft tissue injuries and analyzed using SPSS version 24. RESULTS: The mean age was 36.52±11.14 years and majority of the patients were male’s n = 56 (93.3%) as compared to female’s n = 4 (6.7%). Most of the events occurred at roadside n = 44 (73.3%) and at daytime n = 48 (80%). The most common reason for injury was robbery n = 24 (40%). Perforating injuries were commonly observed n = 52 (86.7%). The most common site of entry wound was middle & lower third of face (31.7%, n = 19). The most affected dental hard tissues between entry and exit wounds were lower anterior teeth n = 12 (20%). CONCLUSION: Scientific values from our study shows that young males and roadside incidents were prevalent. An injury entry site from left side and right sides exit were commonly observed. Future studies need to be conducted on a larger scale to find detailed dynamics about firearm trauma.

THE IMPACT OF FLIPPED CLASSROOM ON ENHANCING BASIC MEDICAL SCIENCES EDUCATION ACROSS MBBS YEAR GROUPS: A MULTIDISCIPLINARY LITERATURE-ENRICHED STUDY.

2025-08-08T06:50:28+05:00

BACKGROUND: Flipped Classroom (FC) is an innovative pedagogical strategy where students engage with instructional materials before class, using face-to-face time for active learning. Although widely studied in clinical disciplines, its role across pre-clinical and paraclinical subjects—such as anatomy, physiology, biochemistry, pathology, and pharmacology—among MBBS students across multiple academic years has not been extensively evaluated. OBJECTIVE: To assess the effectiveness
of the flipped classroom model in enhancing comprehension, critical thinking, and application of basic medical sciences among first-, second-, and third-year MBBS students. METHODS: A cohort of 240 MBBS students (80 from each year) participated in a semester-long FC intervention across five subjects: Anatomy and Physiology (1st year), Biochemistry (2nd year), Pathology and Pharmacology (3rd year). Pre-class learning consisted of video lectures, textbook chapters, and interactive quizzes. In class sessions involved clinical case discussions, concept mapping, peer teaching, and simulations. Pre- and post-tests along with perception surveys were used to evaluate outcomes. RESULTS: Overall, student performance improved significantly, with mean post-test scores increasing from 65.2% to 82.7% (p < 0.001). First-year students reported stronger foundational understanding; second-year students emphasized improved integration; and third-year students valued enhanced clinical correlation. Across all years, over 80% agreed that FC increased their engagement and clarity of complex topics. CONCLUSION: The flipped classroom model is effective across MBBS year groups and subjects. It promotes interactive learning, enhances foundational and clinical reasoning, and fosters interdisciplinary integration. A broader adoption across medical curricula is recommended.

THE EFFECTIVENESS OF OPEN BOOK ASSIGNMENTS IN ENHANCING LEARNING ACROSS BASIC AND CLINICAL MEDICAL SCIENCES: A MULTI YEAR MBBS PERSPECTIVE.

2025-08-08T06:54:55+05:00

BACKGROUND: Deep learning and clinical reasoning may be limited by the traditional evaluation methods used in medical school, which frequently place an emphasis on rote memory. OBAs, or open book assignments, are a cutting-edge method of encouraging critical thinking, information integration, and real-world application. Although OBAs are being used in some areas, such as pharmacology, little is known about how they affect students from different years across disciplines. OBJECTIVES: To assess how well OBAs work in enhancing the academic performance, critical
thinking abilities, and learner satisfaction of MBBS students in their first through fourth years in the following important subjects: anatomy, physiology, biochemistry, pathology, pharmacology, and
community medicine.METHODS: At Suleman Roshan Medical College, a prospective, multidisciplinary study was carried out between September 2023 and January 2024. 320 MBBS students in all, 80 annually from first to fourth grade, took part. Students finished open-book assignments related to their courses in public health (Community Medicine), paraclinical (Pathology, Pharmacology), and basic science (Anatomy, Physiology, Biochemistry). Academic gains were quantified by pre- and post-assessment scores, while satisfaction and perceived benefits were assessed by surveys. RESULTS: The mean pre-assessment score was 66.9%, while the post
assessment score was 84.2%, indicating a significant improvement in overall academic performance (p < 0.001). The clinical application tasks in pathology and community medicine showed the greatest improvements. Feedback from students was very positive: 76% felt more prepared for making medical decisions in the real world, 85% said their critical thinking had improved, and 80% said they preferred OBAs over standard assessments. CONCLUSION: OBAs work well in a variety of MBBS
course levels and subjects. They encourage critical thinking, inter-subject integration, and greater comprehension. Future physicians' academic performance and professional preparedness may be improved by using OBAs as a regular formative tool.

THERAPEUTIC IMPACT OF GARCINIA CAMBOGIA EXTRACT ON PANCREATIC HISTOPATHOLOGY IN ALLOXAN-INDUCED DIABETIC ALBINO RATS: A PRECLINICAL INVESTIGATION.

2025-08-08T06:59:25+05:00

BACKGROUND: According to the most recent data from the NCD Risk Factor Collaboration (2022), type 2 diabetes affects 828 million people worldwide, with almost 95% of those patients having the illness. Diabetes mellitus (DM) is a progressive metabolic disorder marked by chronic hyperglycemia due to insulin resistance and/or β-cell dysfunction. The burden of DM in South
Asia, particularly Pakistan, is substantial. As pharmacological management remains partially effective in curbing long-term complications, alternative therapies such as plant-based treatments are being explored. According to most product labels, the Hydroxycitric acid HCA, the stated active component, is generally present in high amounts in G. cambogia fruit.This study evaluates the histopathological featues of Garcinia cambogia extract (GcE) on pancreatic β-cell mass structure in alloxan-induced diabetic rats. METHODS: This year-long preclinical study was conducted at the Department of Pharmacology and Therapeutics, BMSI, JPMC, Karachi. Sixty
male albino Wistar rats were randomly divided into three experimental groups (n=20 each) and induced with diabetes using Alloxan monohydrate (120 mg/kg). GcE was administered at doses of 25, 50, and 75 mg/kg for eight weeks. At the end of the experiment, rats were sacrificed, and histopathological analysis of pancreatic tissues was conducted. Fasting serum insulin levels and β-cell mass were recorded. RESULTS: Group C (75 mg/kg GcE) demonstrated the highest mean body weight (305.96±36.16 g), significantly greater than Groups A (293.06±44.16g) and B (295±51.17 g) (p < 0.001). Histopathological findings showed a marked increase in β-cell mass in Group C (356±55 units), compared to Group A (282±35 units) and Group B (276±40 units). CONCLUSION: Extract of Garcinia cambogia significantly improves pancreatic β-cell mass and islet architecture in diabetic rats, supporting its potential role in complementary DM therapy. Further studies are warranted to elucidate the mechanisms and establish clinical efficacy.

A NOVEL SURVEY OF THE TREATMENT TRENDS AND TECHNICAL DETAILS FOR EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY.

2025-08-08T07:04:59+05:00

OBJECTIVES: This study aims to address that gap by examining the treatment patterns and technical aspects of extracorporeal shockwave lithotripsy (ESWL) in the local clinical context. METHODOLOGY: A descriptive survey-based study was conducted among urologists registered
with the Pakistan Urology Association. Data were collected using a structured, web-based questionnaire, which was distributed via email to registered urologists. To improve response rates, a follow-up reminder was sent after one month. Responses were gathered over a six-month study
period. RESULTS: The study found that 83.19% of urologists had direct access to an ESWL device, with most respondents (n=65) indicating trained technicians and (n=21) indicating medical officers as primarily responsible for operating the unit. Factors influencing ESWL decisions included stone size, location, density, composition, and renal anatomy. Stone density was the most prioritized factor, with 77 urologists using a cut-off value of <1000 Hounsfield units (HU) for eligibility. NSAIDs were the most commonly used analgesia during ESWL sessions. Routine antibiotics prophylaxis was not commonly practiced (n=67), however cephalosporins were preferred when pre-procedure antibiotics were administered. Ureteroscopy (n=81) was the most commonly adopted intervention, and X-ray KUB was the most used radiological method for post-ESWL evaluation. Furthermore, 89 urologists complied with European Association of Urology guidelines in deciding when to offer ESWL as s treatment modality. CONCLUSION: ESWL practices in Pakistan align with international standards, guided by stone characteristics. NSAIDs are commonly used, technicians operate units, but antibiotic use and post-procedure evaluation require standardization and training.

EFFECTS OF FENUGREEK (TRIGONELLA FOENUM-GRAECUM) SEEDS EXTRACT ON THE TESTOSTERONE LEVELS IN RABBITS.

2025-08-08T07:07:44+05:00

Background: Fenugreek (Trigonella foenum-graecum L.) seeds have been known for its therapeutic properties, particularly its influence on male reproductive hormones. Despite extensive data from rodent and human models, limited studies have investigated its androgenic potential in lagomorphs, particularly rabbits, which share notable physiological homology with humans in steroidogenesis. Objective: To evaluate the dose-dependent effects of fenugreek seeds extract on serum testosterone
levels in healthy adult male rabbits under controlled experimental conditions. Methods: A randomized controlled animal study was conducted using thirty adult male rabbits (aged 16-24 months), assigned into three groups, in each group (n=10). Group-A labeled as control, while Group
B and Group-C have received fenugreek seed extract at 500 mg/kg and 1000 mg/kg bodyweight, respectively, orally for 45 days. Blood samples were collected at Day 0, Day 23, and Day 45, and serum testosterone levels were analyzed using standard biochemical assays. Statistical comparisons
were made by using SPSS version 25.0, ANOVA test, where p<0.05 was considered as significant. Results: Testosterone levels remained stable in the control group (Group-A) across all time points (p>0.05). Group-B exhibited a statistically significant increase from 27.77 ± 3.27 ng/dl at baseline to 29.77 ± 3.67 ng/dl at Day 45 (p=0.01), while Group-C demonstrated a comparable elevation from 26.86 ± 3.67 ng/dl to 29.11 ± 3.83 ng/dl (p=0.001). The dose-dependent response was evident, with
both treated groups showing sustained testosterone elevation. No major adverse events were noted except for mild lethargy in one subject from Group-B. Conclusion: Fenugreek seed powder extracts significantly enhanced serum testosterone levels in rabbits in a dose-dependent manner without adverse effects, highlighting its potential as a natural androgenic agent. These findings support its translational relevance and warrant further exploration in human clinical trials.

CONTRIBUTING FACTORS LINKED TO THE INCREASED RISK OF MULTI-DRUG- RESISTANT TUBERCULOSIS IN PAKISTAN, META-ANALYSIS.

2025-08-08T17:58:32+05:00

BACKGROUND: One of the most important public health issues related to tuberculosis (TB) is the
growing problem of multidrug-resistant TB (MDR-TB), especially in high-burden countries like
Pakistan. MDR-TB is defined as tuberculosis caused by strains which are resistant to at least two of
the most used first-line treatments for TB. There are many factors supporting the emergence and
spread of MDR-TB in Pakistan including socio-economic status, healthcare infrastructure, treatment
compliance levels, and even population movement. OBJECTIVE: This aim of this meta-analysis is
looking into demographic details along with previous treatment history, somatic illnesses, surrounding
environment, and other relevant factors to assess their contribution towards the development and
progression of MDR-TB in Pakistan. METHODS: We reviewed literature published from 2000 to
2024. The studies included in this meta-analysis featured both cross-sectional and cohort designs of
varying sample sizes. Multiple databases related to medicine and public health were searched for
relevant articles. Information including age, sex, education, job title, previous tuberculosis
management, other existing health illnesses, and their housing conditions were gathered. RESULTS:
The most significant risk factors are a history of treatment for TB, low educational level, poor
compliance with treatment, lack of employment, and close contact with MDR-TB patients. The most
affected age group is 20 to 40 years, with an almost equal predominance of males. The most common
reported comorbidities are diabetes, CKD, and HIV, that also raise the risk of developing MDR-TB.
Moreover, crowded living arrangements and restricted healthcare access were identified as prominent
drivers of the problem. CONCLUSION: This meta-analysis calls for complete strategies to address
MDR-TB in Pakistan. It is essential to counteract socio-economic disparities, enhance TB medication
adherence, and enhance household screening and prevention measures to manage the transmission of
MDR-TB efficiently. Public health activities should target high-risk populations, especially those with
a past history of TB infection or comorbid conditions.

FREQUENCY OF SPONTANEOUS BACTERIAL PERITONITIS IN ASYMPTOMATIC PATIENTS WITH CIRRHOTIC ASCITES.

2025-08-08T07:17:41+05:00

BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a serious intra-abdominal infection that commonly occurs in patients with cirrhotic ascites. Although it is usually seen in symptomatic patients, its frequency in asymptomatic patients with cirrhotic ascites remains a topic of clinical interest, as it can go unrecognized, thus increasing the risk of complications. OBJECTIVE: To identify the prevalence of asymptomatic spontaneous bacterial peritonitis in patients with cirrhotic ascites. To proponent timely detection and enhance clinical outcome via treatment.METHODOLOGY: A cross-sectional study was conducted at Department of Medicine, Chandka Medical College Hospital, SMBBMU Larkana and 154 patients was enrolled in their first visit between 2024 and January 2025. Totally, 154 cirrhotic consecutive patients aged 18–65, ascites patients but no spontaneous bacterial peritonitis symptoms were enrolled. Following obtaining informed consent, the abdominal paracentesis was executed. Ascitic fluid was studied for PMN count and culture result. Data was analyzed using SPSS version 25. RESULTS: Of 154 patient, 39 (25%) were found to have asymptomatic Spontaneous bacterial peritonitis by increased PMN and positive fluid culture. Culture positivity was shown in 20(51%) with E. coli being most common organism isolated (60%). Majority of the patient were in Child-Pugh B stage (63.6%). CONCLUSION: Twenty five percent of patients with ascites had asymptomatic Spontaneous bacterial peritonitis. Routine diagnostic paracentesis should be done in all such patients whether symptoms is present or not so to reduce morbidity & mortality.

EFFECTIVENESS OF TELEMEDICINE INTERVENTIONS IN ASTHMA MANAGEMENT IN SCHOOL GOING CHILDREN: A COMMUNITY BASED APPROACH.

2025-08-08T07:20:26+05:00

BACKGROUND: Telemedicine has evolved as a potential method of distant healthcare delivery, especially the management of chronic illnesses such as asthma. The purpose of this study was to compare the effectiveness of telemedicine treatments in asthma. METHOD: A quasi-experimental study was conducted with n=114 asthma children from the different private schools of district Hyderabad for the period of 01 year from August 2023 to July 2024, using the convenience sampling technique. Patients received remote asthma management services, such as virtual consultations, remote symptom monitoring, and education via digital platforms. The primary outcomes were asthma-related symptoms. Data was analyzed using SPSS (Version 26.0) Descriptive statistics and Chi square tests were applied for association. RESULTS: 114 students from 13 different private schools were enrolled with a participation percentage of 79.1%. Sixty-eight (59.46%) of the 114 children enrolled were male, with a mean age of 7.7 (1.5). Children had more symptom-free days (SFDs) after the intervention compared to baseline (11.6 vs 7.0; difference, 4.6; 95% CI, 0.15-1.22; P =.01). Furthermore, compared to baseline, children reported fewer symptom days, symptom nights, and days with limited activity post treatment. Furthermore, more children were prescribed preventive asthma medication, while fewer children required emergency department visits or hospitalizations for asthma (7% vs 15%; odds ratio, 0.52; 95% CI, 0.32-0.84). CONCLUSION: Our research showed that school-based programs have a favorable influence on improving care and outcomes for children with chronic asthma. We have successfully increased access to guideline-based therapies and facilitated appropriate primary care follow-up assessments by integrating telemedicine with school based care.