http://publication.pumhs.edu.pk/index.php/ojs/issue/feedJournal of Peoples University of Medical & Health Sciences Nawabshah. (JPUMHS)2025-07-14T06:14:46+05:00Dr Anwar Ali Jamalijpumhs@pumhs.edu.pkOpen Journal Systems<table> <tbody> <tr> <td width="716"> <p><strong>About the Journal</strong></p> <p><strong>JPUMHS </strong>is an official journal of Peoples University of medical and Health Sciences, Pakistan. JPUMHS came into existence in 2011. It is a quarterly published, multi- disciplinary, peer reviewed journal. We have a team of highly qualified editorial board members who are dedicated to meet and improve the standards of Journal as per the laid International guidelines. In addition, we are in process of maintaining a multidisciplinary reviewer’s bank, which comprises of dedicated national and international researchers and subject specialists, who strive their best to evaluate the manuscript in the shortest possible time the journal has its own dedicated website, where all previous, current issues are available with an <strong><u>open </u></strong><strong><u>access</u></strong> permitted to everyone.</p> <p>The journal is devoted to provide updates and advancements to health care providers in the field of basic as well as applied medical sciences. It is committed to rapidly publish the high quality research work in the form of original research articles, review articles, meta-analysis reviews, letter to the editor, case reports, case series report and short communication.</p> <p>We are striving to promote the quality research papers along with its free online availability to the readers all over the world for reference and awareness purpose. It is a forum for communicating the health related issues around the Globe. Moreover the <strong><u>ethical considerations</u></strong> and <strong><u>conflicts of interest</u></strong> amongst the co-authors are observed strictly to maintain the research protocols.</p> <p>Regardless of the employment status, journal accepts the quality research and updated authentic / evidence based information from any source. From patient's perspectives, this evidence based research will ultimately be a step forward to improve the health care facilities at National and International levels.</p> <p><strong>Checklist for authors</strong></p> <p>All corresponding and co-authors must ensure a complete protocol of submission processing order to avoid delay in publishing process of their papers. Incomplete submission will not be considered for the publications.</p> <p>Please complete the following requirements with following</p> <p>♦ <strong>Covering letter</strong> duly signed by all authors.</p> <p>♦ <strong>Undertaking/Certificate</strong> duly signed by all authors.</p> <p>♦ Copy of <strong>ethical permission</strong> letter issued to be signed by the Chairman/Head of Institutional Review Board/Ethical Committee, where research has been conducted.</p> <p>♦ Complete article with tables, figures and references.</p> <p>♦ Identification of <strong>corresponding author</strong> with full name, degree, affiliated institute, institutional title, e-mail address, corresponding address and phone numbers.</p> </td> </tr> </tbody> </table> <ul> <li>Details of <strong>ALL AUTHORS</strong> including full names, degrees, affiliated institute, institutional title, e- mail address, corresponding address and phone</li> <li>The journal will only correspond with the assigned corresponding</li> <li>Contributions of all authors in accordance with <strong>ICMJE guidelines</strong>.</li> <li>Declaration of <strong><u>Conflict of interest</u></strong> and funding information</li> </ul> <p>Before proceeding for submission of this manuscript, please follow the link:</p> <p>Complete the checklist and make sure that the manuscript is prepared according to the checklist. After completing the checklist, email the duly signed checklist by corresponding author, to editor thru email:</p> <p><a href="mailto:jpumhs@pumhs.edu.pk">jpumhs@pumhs.edu.pk</a></p> <p><strong>Important note: </strong>Delay in compliance and incomplete documentation may lead to delay in the processing of your manuscript.</p> <p><strong>Review Process</strong></p> <p>JPUMHS has a uniform and structured, <strong>blind peer-review</strong> process during which all manuscripts go through certain steps before a manuscript is accepted for publication. A manuscript goes through following steps during JPUMHS review process.</p> <ol> <li>After receiving a manuscript will be sent for initial <strong>Editorial review</strong>, to assess whether the submitted manuscript is written according to <strong><u>ICMJE authors guidelines</u></strong> and format and suitable for review or If manuscript is found suitable for further processing the correspondence author is informed within <strong><u>02 weeks</u></strong> regarding acceptance for further processing otherwise the author is asked to re-submit his manuscript after making necessary amendments as per <strong><u>ICMJE</u></strong> guidelines and format.</li> <li>After acceptance for processing a unique Ref will be allotted to the manuscript which will be used for future correspondence.</li> <li>After Editorial Review, the manuscript will checked thru <strong><u>TURNITIN Plagiarism Checker</u></strong> and sent to the Plagiarism Committee for judging Similarity Index (SI). The Technical assistant will submit its report within 02 weeks regarding Similarity If the report has similarity index <=17%, then benefit of doubt may be given to the author but, in case, any single source has similarity index</li> </ol> <p>>=5% without citation then it needs to be revised and will be sent back to the author for revision to bring similarity index down to permissible limit.</p> <ol start="4"> <li>In next step, the manuscript will be sent to reviewers of concerned specialty who will review the manuscript meticulously keeping in view all technical The reviewers will submit their review report within <strong><u>six weeks</u></strong>.</li> <li>After receiving the reviewers comments, the correspondence author will be informed immediately about the reviewers comments and asked to make necessary amendments in manuscript in the light of reviewers comments or give their comments where he don't agree with the reviewers comments within two</li> <li>After receiving the amended version from author, the manuscript will be evaluated by the Editorial Committee to see whether necessary amendments advised by reviewers were incorporated in the manuscript properly or not and whether the manuscript needs further review or This process will take <strong><u>two weeks </u></strong>to complete.</li> </ol>http://publication.pumhs.edu.pk/index.php/ojs/article/view/1137CHALLENGING THE INCREASING HEALTH DANGER OF HEAT WAVES IN PAKISTAN. 2025-07-02T12:26:48+05:00Prof Muzaffar Ali Shaikhanonymous@pumhs.edu.pk<p>By way of Pakistan deals with additional <br>challenging summer, the power & rate of <br>high temperature waves had turn out to be a <br>terrible community healthiness worry.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1138ANALYZING MENTAL HEALTH DISORDER RATES AMONG PRIVATE SECTOR MEDICAL STUDENTS: TACKLING GENDER DISPARITIES. 2025-07-02T12:49:01+05:00Mahnoor Tariq1, Kainat Javed2, Jannat Tariq 3, Ayesha Shahid Butt 4, Zarmin Ali5, Muhammad Ashir Naveed6 anonymous@pumhs.edu.pk<p>ABSTRACT <br>BACKGROUND: This study investigates the frequency of Mental Health Disorders among <br>students at Private sector medical college and university with a specific focus on the mental <br>health challenges faced by undergraduate students. OBJECTIVE: This study aims to explore <br>the prevalence of these mental health disorders between university students and to identify <br>key risk factors, providing insights for targeted interventions to support student well-being. <br>METHODOLOGY: A total of 247 students (166 females and 81 male) from different <br>programs, including MBBS (132 participants), BDS (44 participants), and other medical <br>disciplines (71 participants), participated in this cross-sectional study. Random sampling was <br>used to choose participants according to their educational attainment, gender, and field of <br>study. Students who had used on-campus wellness and counseling services met the inclusion <br>criterion, whereas those who had never used these services were not included. This study <br>employed six established instruments to evaluate mental health conditions, including the <br>GAD-7 (generalized anxiety disorder-7) to screen for generalized anxiety disorder, the PHQ<br>9 (patient health questionnaire-9) to gauge the severity of depression, and the PHQ-15 to <br>measure somatic symptoms. Obsessive-compulsive disorder symptoms were evaluated using <br>the OCI-R (obsessive-compulsive inventory-n revised). SPIN was used for social anxiety, and <br>the severity measures for specific phobia and panic disorder, both showing strong validity and <br>reliability. The DAST-10 (drug abuse screening test) was used to assess substance use. <br>RESULTS: Results indicated a high prevalence of mental health disorders: 58.9% for somatic <br>symptom disorder, 39.9% for depression, 22.3% for generalized anxiety disorder, and 48% <br>for obsessive-compulsive disorder and 4.1% in substance-use disorder. Notably, female <br>students exhibited significantly higher scores in depression and anxiety disorders compared <br>to their male counterparts. Significant comorbidities were observed, with depression <br>frequently co-occurring with somatic symptom disorder and anxiety disorders. <br>CONCLUSION: Enhancing mental health resources and support systems within university <br>settings is crucial to promote student well-being and academic success. Further research is recommended to explore the underlying causes of these gender disparities in mental health. <br><br></p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1139THE IMPACT OF VITAMIN D3 LEVELS ON INFERTILITY. 2025-07-02T12:52:43+05:00Palwasha1, Hajira Naila Rahu2, Altaf Khan Pathan3, Iftikhar Ali4, Nida noor5, Sidra6 anonymous@pumhs.edu.pk<p>ABSTRACT <br>BACKGROUND: Infertility is the fifth most serious global physical or mental health <br>condition. It may have detrimental effects on both partners' social, psychological, <br>physical, and financial well-being. The literature reveals positive relationship between <br>infertility and vitamin D3 level but data on their complex interaction is relatively scarce <br>in Pakistan, highlighting the need for further research. OBJECTIVE: To examine the <br>impact of vitamin D3 levels on infertility. METHODOLOGY: A cross-sectional <br>investigation was conducted on 132 infertile and 132 fertile women selected through <br>convenience sampling at the Gynecology and Obstetrics ward of the PMC hospital, <br>Nawabshah, Pakistan. Data were collected through a questionnaire and entered and <br>analyzed in computer software Statistical Package for Social Sciences (SPSS) <br>version 25.0. The link between infertility and qualitative variables was examined using <br>the chi-square test, and the mean difference in vitamin D3 across research groups was <br>evaluated using the independent sample t test. A confidence interval of 95% was used for <br>the study. RESULTS: Vitamin D3 deficiency and insufficiency were significantly higher <br>in infertile women (53%, 18.9%) compared to fertile women (22%, 11.3%). Infertility <br>significantly increases with the age of participants increased ranging from 3.8% in 20-25 <br>years to 34.8% in 36-40 years. Infertility was higher in the middle class (81.1%) compared <br>to the poor class (18.9%) and significantly higher in illiterates 43.2% followed by primary <br>(30.3%) and low in graduation (3.8%). CONCLUSION: Infertile women had <br>significantly greater levels of vitamin D3 inadequacy and insufficiency than fertile <br>women. Besides Vitamin D3, Infertility was found to be associated with age and <br>education of women. Initiatives such as vitamin D3 supplementation, improving women’s <br>education and social status and health interventions should be implemented to address <br>this issue.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1140THE ROLE OF RESILIENCE AS A MEDIATOR AND ITS IMPACT ON NURSES AND HEALTHCARE PROFESSIONAL’S PSYCHOLOGICAL WELL-BEING AND MENTAL DISTRESS.2025-07-02T12:56:05+05:00Qamar Yasmeen anonymous@pumhs.edu.pk<p>ABSTRACT <br>BACKGROUND: Professional healthcare providers and nurses' jobs are classified as <br>stressful and demanding. The possibility of emotional distress is high. OBJECTIVE: The <br>study aims to investigate the role of resilience as a mediator and its impact on nurses and <br>healthcare professional’s psychological well-being and mental distress. METHODS: A <br>questionnaire survey was employed though random sampling strategy. The study involved <br>120 certified professional healthcare practitioners and nurses who were working in different <br>hospitals and clinics. Data were collected via a demographic questionnaire, The Kessler <br>Psychological Distress Scale (K-10) for measurement of emotional distress, The Satisfaction <br>with Life Scale (SWLS) for assessment of psychosocial well-being, and the brief resilience <br>scale (BRS) for analysis of resilience among nurses and healthcare provider. Descriptive <br>statistics and graphs as numbers, frequencies, and percentages was applied. RESULTS: The <br>result indicated major participants (35.8%) belong to age group 20-30 YARS. 55% <br>participants were females. 48.3% were in nursing profession. 78% participants were in 12hour <br>working shift. On K-10 scale, Majority of the participants the participants showed emotional <br>stress on K10 scale. The result of satisfaction with life scale in our findings showed that lower <br>number of participants were satisfied (4.16%, 10% and 12%) while major population was <br>dissatisfied. 42% participants showed high resilience levels on BRS scale. CONCLUSION: <br>The mediation analysis found that resilience protected against direct correlations between <br>stress and emotional/psychological suffering. In conclusion, our results confirmed the <br>hypothesis that resilience moderated the link between emotional distress and psychosocial <br>well-being</p>2024-12-31T00:00:00+05:00Copyright (c) 2024 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1141SYNERGISTIC EFFECTS OF ESCITALOPRAM COMBINED WITH LEVOSULPRIDE AND ANTIOXIDANT VITAMINS ON ANTIOXIDANT ENZYME ACTIVITY IN PATIENTS WITH DEPRESSION: A COMPARATIVE CLINICAL STUDY. 2025-07-02T12:58:46+05:00Muhammad Anwar Bangulzai1, Palwasha Abbasi2, Shuja Anwar Kazi3, Samreen Ali4, Maria Jawed5, Darya Khan Laghari6. Mahnoor Abbasi7. anonymous@pumhs.edu.pk<p>ABSTRACT <br>BACKGROUND: Depression has been increasingly linked to oxidative stress, yet the <br>therapeutic role of antioxidants in conjunction with antidepressants remains underexplored. This <br>study investigates the effects of escitalopram alone and in combination with ascorbic acid, <br>vitamin E, and levosulpride on the activity of key antioxidant enzymes in patients diagnosed <br>with Major Depressive Disorder (MDD). METHODS: A total of 380 patients with MDD, aged <br>20–70, were recruited from the Baluchistan Institute of Psychiatry and Behavioural Sciences, <br>Quetta. Participants were randomized into four treatment groups: (1) Escitalopram only, (2) <br>Escitalopram + Vitamin C, (3) Escitalopram + Vitamin E, and (4) Escitalopram + Levosulpride. <br>After two months of treatment, serum levels of Superoxide Dismutase (SOD) and Glutathione <br>Peroxidase (GPx) were measured using colorimetric methods. RESULTS: The combination of <br>Escitalopram and Levosulpride significantly increased both SOD and GPx levels compared to <br>control (p < 0.05), suggesting a synergistic antioxidant effect. While vitamin C and E <br>combinations showed mild increases in enzyme levels, they were not statistically significant. <br>CONCLUSION: Escitalopram combined with Levosulpride may offer enhanced antioxidant <br>benefits in the management of depression by modulating oxidative stress pathways. These <br>findings support further exploration of combination therapies for personalized treatment <br>approaches in depressive disorders.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1142FROM KNOWLEDGE TO ACTION: BARRIERS TO ADOPT HEALTH LIFESTYLE TO PREVENT HYPERTENSION. 2025-07-02T13:00:56+05:00Areeba Ali1, Samina Waseem2, Zain Ahmed Noor3, Seemal Waseem4, Tauseef Javaid5 Mumtaz Ali Lakho6.anonymous@pumhs.edu.pk<p>ABSTRACT <br>BACKGROUND: Our study documented the specific barriers to adopting a healthy <br>lifestyle in Pakistan, particularly regarding hypertension. Despite extensive research, <br>counselling and health education programs, we aim to uncover why residents of our <br>country struggle with self-care practices for preventing hypertension. OBJCTIVE: To <br>investigate the barriers Pakistani citizens face in adopting a healthy lifestyle for the <br>prevention of hypertension, this research employed a descriptive cross-sectional study <br>design. METHODS: A cross-sectional descriptive statistical analysis was done <br>among the general population. RESULTS: According to our study, infrastructure, <br>social, employment and stress related factors significantly influence the adoption of <br>regular walk or exercise. Economic barriers are most commonly faced by the <br>participants that further lead to stress and anxiety related barriers. CONCLUSION: <br>Barriers, such as lack of awareness (75.25%), prevent positive lifestyle choices. Stress, <br>influenced by employment and financial issues, affects the way of living. Economic <br>stability is linked to a healthier lifestyle. Raising awareness and providing guidance on <br>mental health and stress management is crucial.</p>2024-12-31T00:00:00+05:00Copyright (c) 2024 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1179PREVALENCE OF MUSCULOSKELETAL DISORDERS AND ITS CORRELATION TO PHYSICAL ACTIVITY AMONG UNDERGRADUATE HEALTHCARE STUDENTS.2025-07-14T06:14:46+05:00Rajkumari1, Iqra2, Bahadur Ali3, Sejal4, Maryam5, Fakharunisa6, Attiq ur Rehman7, Imran Ahmed8anonymous@pumhs.edu.pk<p><strong>BACKGROUND: </strong>Musculoskeletal disorders (MSDs), characterized by self-reported musculoskeletal strain, are among the conditions that physical activity (PA) can help prevent. Conversely, insufficient PA increases the risk of developing MSDs. In Malaysia, studies have shown that musculoskeletal pain is prevalent among medical undergraduates, influenced by factors such as a family history of trauma and academic-related stressors. This study aims to determine the prevalence of MSDs and assess how these disorders affect levels of physical activity in undergraduate medical students. <strong>OBJECTIVE: </strong>study was planned to explore the prevalence of MSDs and its correlation to PA in undergraduate healthcare students. <strong>METHODS: </strong>The cross sectional study was carried out among the medical students of various subjects for the time period of 06 months. Total 403 sample were selected through convenience sampling technique. Standardized Nordic Musculoskeletal Questionnaire (NMQ) and Physical activity measured through IPAQ questionnaires were used to assess the sensitivity and severity of musculoskeletal pain. <strong>RESULTS: </strong>From the collected data, it was observed that 32.5% (131) were involved in less physical activity during their routine work whereas 23.1% had maintained their life with routine exercise. The severity of pain was different among medical students as low back pain was observed among 59.3%, followed by neck pain 55.3%, shoulder pain 54.6%, upper back 43.9%, wrists/hands 40.4%, and ankles/feet 36.5%. There was a significant association between the musculoskeletal disorders in elbow, knee and ankles/feet region with the level of PA. <strong>CONCLUSION: </strong>The present study revealed a high prevalence of musculoskeletal disorders among undergraduate medical students, with pain most frequently reported in the lower back (59.3 %), neck (55.3 %), and shoulder (54.6 %). A subset of participants maintained sufficient levels of physical activity to permit analysis of the relationship between musculoskeletal complaints in the elbow, knee, and ankle/foot regions and overall activity level.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1144EFFECT OF STEROID SPRAY ON ADENOIDS AND THE CORRELATION OF RADIOGRAPHIC AND ENDOSCOPIC FINDINGS IN ASSESSING THE PEDIATRIC PATIENTS. 2025-07-02T13:06:33+05:00Muhammad Azeem1, Pershant Rai2, Zarafshan3, Mariam 4, Rida Raziq5, Rashid Hussain Memon6. anonymous@pumhs.edu.pk<p>OBJECTIVE: To determine the effect of steroid spray on adenoids and the correlation of <br>radiographic and endoscopic findings in assessing the pediatric patients during a one-year <br>period STUDY DESIGN: Cross sectional study. PLACE AND DURATION OF STUDY: <br>Department of Pediatric surgery of Peoples University of Medical & Health Sciences for <br>Women, Shaheed Benazir Abad, Sindh (June 25, 2022 to June 24, 2023). SUBJECTS AND <br>METHOD: 83 patients of age bracket of 2 years to 19 years with nasal obstruction, discharge, <br>mouth breathing, sleep apnea, ear complaints, with adenoid tissue on x-ray imaging and with <br>clinical symptoms of adenoid hypertrophy lasting consistently for 6 months were included. <br>Patients were assessed clinically along with endoscopic and radiographic assessment followed <br>by pharmacological management with corticosteroid nasal spray. Mean + SD deviation was <br>determined for quantitative variables, whereas frequency and percentages were derived for <br>qualitative variables. Pearson’s Correlation was used to determine the correletion between <br>A/N ratio and Endoscopic results. Statistical package for social science (SPSS) software <br>version 26. RESULTS: The most of the children 36 (43%) were found in age group between <br>6-10. Male Female ratio was 2.4:1. A significant improvement has been found in clinical <br>symptoms after steroid nasal spray usage. The A/N ratio and endoscopic adenoid size were <br>found significantly positively correlated (r=+0.46, p=0.01). CONCLUSION: A significant <br>correlation between the A/N ratio and endoscopic adenoid assessment. Furthermore, the use <br>of steroid nasal spray as a treatment technique for the conservative management of adenoid <br>hypertrophy is also very beneficial.</p>2024-12-31T00:00:00+05:00Copyright (c) 2024 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1145BONE HEALTH ASSESSMENT AND PROFILING IN CHILDREN WITH SEVERE ACUTE MALNUTRITION STUDY FROM LARKANA. 2025-07-02T13:09:40+05:00Ishfaque Ahmed Mugheri1, Delijan Baloch2, Jamshed Ahmed3, Aijaz Ali Tunio4, Faryal Adnan5, Ghulam Shabir Mallah6.anonymous@pumhs.edu.pk<p>INTRODUCTION: Malnutrition in children is a significant public health and growth issue <br>in Pakistan. Children who suffer from malnutrition are much more likely to die and suffer <br>from illnesses. OBJECTIVE: A prospective study was conducted in a PEDS ward of <br>Nutrition Shaikh Zaid Hospital Larkana, to determine the status of Bone Profile and associated <br>risk factors in severe acute malnutrition in children up to 5 years of age. METHODS: A total <br>of 105 patients with severe acute malnutrition (SAM) who were admitted to our PAEDS <br>nutrition ward and met the inclusion criteria were included in the study, which lasted six <br>months. Following a thorough history and examination, the patients' calcium, phosphorus, <br>alkaline phosphatase, and vitamin D levels were assessed. RESULTS: The study examined <br>105 patients, mainly females, with a higher mean age and majority living in cities. Symptoms <br>included fever, weight loss, cough, and diarrhea. Laboratory tests revealed significant <br>biochemical imbalances, including low vitamin D levels, calcium, ALP, and phosphorus <br>levels. These imbalances could impact health outcomes and require additional therapeutic <br>care. The case group's vitamin D levels were significantly lower than the control group. <br>CONCLUSION: The study found that the patient group had serious health imbalances, such <br>as low levels of calcium, phosphorus, vitamin D, and ALP, which called for therapeutic care <br>and focused interventions.</p>2024-12-31T00:00:00+05:00Copyright (c) 2024 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1146INVESTIGATING THE ANTIOXIDANT EFFECT OF VITAMIN E AGAINST MSG INDUCED OXIDATIVE STRESS ON OVARIES OF WISTAR ALBINO RATS.2025-07-02T13:16:42+05:00Piriha Abbasi1, Raima Kalhoro2, Roomi Memon3, Safiya4, Sana Kashif5, Farzana6. anonymous@pumhs.edu.pk<p>BACKGROUND: MSG, a flavoring agent is well known for its toxic effects on reproductive <br>system due to its oxidative stress which may leads to infertility. Antioxidants like Vit E helps <br>to overcome this issue. OBJECTIVE: To evaluate the toxic effects of MSG on the ovaries of <br>Albino Wistar rats and the possible protective effects of vitamin E on damaged ovarian tissues. <br>STUDY DESIGN: Experimental study. PLACE OF STUDY: The study was performed at <br>the Animal House department, Sindh Agriculture University Tandojam and, the department <br>of Anatomy and Postgraduate laboratory of Isra University Hyderabad. DURATION OF <br>STUDY: 6 months. MATERIALS AND METHODS: 40 Albino Wistar rats were divided <br>into 4 groups. Among them first was controlled group, second was treated with 0.08mg/g of <br>MSG daily, third and fourth were treated with Vit E in the dosage of 0.4mg/g for 30 and 15 <br>days respectively. After a month the animals were sacrificed and slides of 4-6 µm of thickness <br>were made for examination. Spss version 21. and MS Excel was used, chi-square test was <br>applied at the P value of <0.05. RESULTS: The results show that Group A shows no sign of <br>damage, Group B shows hemorrhage, atretic follicles, vacuolation, distorted basement <br>membrane, hypertrophied theca cells, and less mature follicles while Group C shows a marked <br>reduction in all of this damage whereas Group D shows improved results on all of these toxic <br>effects other than vacuolation and atretic follicles. CONCLUSION: MSG causes damage to <br>ovarian tissue and contrary to this Vit E shows a protective effect against this damage.</p>2024-12-31T00:00:00+05:00Copyright (c) 2024 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1147SOCIAL AND PSYCHOLOGICAL EFFECTS ON DAILY WAGERS DUE TO INFLATION IN HYDERABAD. 2025-07-02T13:18:57+05:00Rai Chand1, Muhammad Ilyas Siddiqui2, Kanwal Naz Ariser3, Fozia Jamal4, Mehnaz Shaikh5, Faiza Nazeer6 anonymous@pumhs.edu.pk<p>BACKGROUND: Inflation has effected deeply all walks of life of people but the most <br>acutely effects daily wagers, who depend on everyday wage, experience social and financial <br>distress as their incomes lose their worth, causes them to experience greater stress, anxiety, <br>and depression. This research aims to offer a thorough evaluation of the difficulties <br>encountered by daily wagers during inflation by exploring the underlying financial variables, <br>societal contexts, and psychological wellness. OBJECTIVE: To identify the social and <br>psychological effects on daily wagers due to inflation. ETHODOLOGY: The descriptive <br>cross sectional study was conducted among 422 daily wagers both male and female aged 19<br>60 years old in Hyderabad city, using 11-self-administered questionnaires for social effects <br>and 21-items depression, anxiety and stress scale for psychological effects. The outcome <br>variables were effects on earning, paying for basic necessities, family’s lifestyle, social life, <br>saving money and depression, anxiety, stress. Statistical analyses were conducted to analyze <br>the data. RESULTS: Depression, anxiety and stress were found 43.4%, 76.3% and 83.9% <br>among daily wagers respectively. The study participants were reported to be effected on daily <br>earning 84.6%, effected on paying basic necessities 88.4%, effected on social lives 83.2% and <br>effected on saving money 84.6% respectively. CONCLUSION: This study has brought into <br>light that inflation is one of the sticking points in the current situation that having an impact <br>on individuals' daily earnings, paying necessities, social lives, saving money and their level <br>of depression, anxiety, and stress.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1148MODIFIED METABOLIC SYNDROME2025-07-02T13:38:00+05:00Nayab1, Madiha Shah2, Muzaffar Ali Shaikh3, Sadia Shaikh4, Ghulam Mujtaba Shah5, Fiza Shah6anonymous@pumhs.edu.pk<p>BACKGROUND: Metabolic syndrome refers to a set of clinical factors leading to a <br>multitude of complex multi-system complications. Derangement of phosphate homeostasis <br>may suggest a tendency towards metabolic syndrome. OBJECTIVE: To determine the <br>frequency of hypophosphatemia in patients with metabolic syndrome METHODOLOGY: <br>A cross-sectional study undergone from February to August 2024 upon a sample of 150 <br>consenting adults of either gender, diagnosed with Metabolic syndrome lasting ≥ 6- weeks <br>duration having age 30-60 years presenting at Liaquat University Hospital, Hyderabad, <br>Pakistan. Data was composed on predesigned proforma and the frequency (percentage) <br>and mean ± SD was calculated for qualitative and quantitative variables. RESULTS:, Of <br>the study sample, hypophosphatemia was noted in 90 (60%) patients, from which 49 <br>(54.4%) were males and rest were females .The statistical significance was analyzed for <br>hypophosphatemia in accordance with age (p=0.00), residence (p=0.00), duration of <br>metabolic syndrome, (p=0.03), smoking (p=0.02), obesity (p=0.03), hyperlipidemia <br>(p=0.02), hypomagnesemia (p=0.00), hyperuricemia (p=0.00) and uncontrolled diabetes <br>mellitus (p=0.00) while in context to gender it was observed as non-significant <br>(p=0.13).CONCLUSION: There was a significant association of hypophosphatemia <br>among patients with metabolic syndrome, with significant association with regards to <br>various patient demographic and clinical data.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1150ORIGINAL ARTICLECOMPARISON OF MEAN HEALING TIME WITH HONEY VERSUS 1% ACETIC ACID IN THE TREATMENT OF INFECTED WOUNDS 2025-07-02T13:42:29+05:00Abdul Rashid Surahio1, Amjad Ali Burhutt2, Faiza Hameed3, Bilal Rasool4, Mohammad Anwar Memon5, Zafar Ali Seenharo6 anonymous@pumhs.edu.pk<p>BACKGROUND: Infected wounds pose a significant challenge in medical practice, <br>requiring effective treatment strategies to facilitate timely healing. The use of topical solutions <br>is a common approach for wound management. The antimicrobial properties of honey <br>compare with 1% acetic acid make it an attractive option for treating infected wounds. Honey <br>creates an acidic environment that decrease the bacterial growth of bacteria, also MRSA <br>Methicillin-resistant Staphylococcus aureus and commonly Pseudomonas aeruginosa, can <br>happen due to wound infections. OBJECTIVE: To compare mean healing time with honey <br>versus 1% acetic acid in the infected wound treatment. PLACE AND DURATION OF <br>STUDY: This is a Randomized Control Trial Study was done on patients in the Department <br>of general surgery, Liaquat University of Medical & Health Sciences Hospital Jamshoro, for <br>the period of one and half year July 2022 to March 2023. PATIENTS AND METHOD: All <br>patients who fulfilled the inclusion criteria and visited LUMHS, Jamshoro were included in <br>the study. Informed consent was taken after explaining the procedure, risks and benefits of the <br>study. The sample was divided into two groups (intervention and control). For the intervention <br>group, honey available commercially was used for cleaning and debriding the wound and <br>placed on the wound via soaked gauze. The dressing was done twice daily. The same was <br>done for the control group using obtained 1% acetic acid. All the collected data were entered <br>into the proforma attached at the end and used electronically for research purposes. Total 440 <br>cases with clinical diagnosis of infected wound were admitted through outpatient department. <br>All the data was recorded on predesigned Performa. RESULTS: The mean ± standard <br>deviation of age in group A (Honey locally available) was 41.10±12.95 and group B (1% <br>acetic acid) was 43.65±13.62 years. In the group-wise distribution of gender, 146 (66.4%) <br>males and 74 (33.6%) females have included in group A while 166 (75.5%) males and 54 <br>(24.5%) females were included in group B respectively. The mean ± SD for the duration of <br>healing time was noted as 5.31±3.50 and 13.68±7.64 days in group A and group B respectively <br>while having a highly significant P-value i.e. (0.0001) CONCLUSION: It is to be found that <br>the healing time of infected wounds with honey is significantly less as compared to 1% acetic <br>acid. More well-controlled prospective randomized trials with bigger sample size, with more <br>parameters in large centers in Pakistan are</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1168BIOCHEMICAL EFFECTS OF LYCOPENE ON BLOOD GLUCOSE IN HIGH SUCROSE DIET FED MALE WISTER ALBINO RATS.2025-07-02T16:57:52+05:00Hafsa Usman Sheikh1, Salauhdiin Shaikh2, Mubina Laghari3, Farheen Malik4, Afsheen5, Rutesh Kumar6 anonymous@pumhs.edu.pk<p>OBJECTIVE: To evaluate the Biochemical effects of lycopene on blood glucose in high <br>sucrose diet fed male wister albino rats. METHODS: An experimental research, spanning six <br>months and carried out at LUMHS Jamshoro, utilized 60 adult male Albino Wistar rats, which <br>were randomly assigned to four groups. Group A received 0.9% normal saline, while Group B, <br>serving as the positive control, was given a sucrose-rich diet with no additional treatment. <br>Experimental Groups C and D were administered the same sucrose diet along with lycopene at <br>doses of 40 mg/kg and 60 mg/kg body weight, respectively, over a 28-day period. Lycopene was <br>delivered daily through intragastric intubation. After the treatment phase, blood samples were <br>collected via cardiac puncture, and serum was separated for biochemical testing to assess blood <br>glucose levels. Statistical evaluation was carried out using SPSS software version 23.0. <br>RESULTS: After four weeks, Group A (negative control) had a mean glucose level of <br>135.8 mg/dL, while Group B (positive control) showed a significantly higher level of <br>206.8 mg/dL (P=0.0001). Lycopene-treated Groups C and D exhibited reduced glucose levels of <br>177.1 mg/dL and 152.4 mg/dL, respectively, showed a statistically significant decrease compared <br>to the positive control (P=0.0001). CONCLUSION: The study revealed that lycopene <br>significantly lowered serum glucose levels, suggesting its potential as a safe, accessible, cost<br>effective, and community-friendly natural option for managing hyperglycemia.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1152WOUND INFECTION IN IMMUNE COMPROMISED PATIENTS WHO WERE OPERATED IN EMERGENCY DEPARTEMENT. 2025-07-02T13:47:20+05:00Ahsan Ali Lagari1, Areeba laghari2, Qunber Ali Laghari3, Nawaz Ali Dal4, Isharat Rahmeen Kaytear5 , Tufail Ahmed Baloch6 anonymous@pumhs.edu.pk<p>AIM OF STUDY: To determine the wound infection in immune compromised patients <br>who were operated in Emergency department. STUDY DESIGN: Prospective observational <br>study. PLAC E & DURA TION: Two years’ study January 2018 to March 2020 conducted <br>at Liaquat University of Medical and Health Sciences / Jamshoro in department of surgery <br>PATIENTS & METHOD: The study comprises 100 patients. All were admitted from <br>Emergency department. All patients were evaluated fully after history & clinical <br>examinations and specific investigations pre operatively ,per operatively and post operatively <br>(CBC) complete blood count , C reactive protein , Blood culture , urine culture, IV cannula <br>Tip culture ,Pus culture and Sensitivity, ultra sound of abdomen, pelvis and Chest , X- ray <br>abdomen supine and erect posture ,X Ray chest PA view ,Urine DR, Protein A/G Ratio, level <br>of serum Albumin, Liver function Test (LFT) Serum ferritin , Lactate Dehydrogenase, Blood <br>urea, sugar, serum electrolyte, HBSAG, HCV, & HIV, PT, APTT, INR and ECG . Typhi dot, <br>Tuberculin test, Biopsy report and general assessment of the patients. Post operatively <br>Contrast iv and Oral C T scan if needed RESULTS: This was a hospital based case series <br>study of 100 patients, the maximum number of patients were in age group between 12 to 75 <br>years. Out of 100 patients 33 patients were presented with age group between 12 to 34 year. <br>45 patients were presented with age group between 35 to 55 years. 22 patients were presented <br>with age group between 54 to 75 years. Out of 100 patients, 62 were operated through mid <br>line incisions, 25 patients were operated through right Para median incision. Out of 100 <br>patients 10 patients were operated through Gird Iron incisions. Out of 100 patients 61 patient <br>present with serious discharge, 25 patients with Pus discharge, 10 patients with abdominal <br>dehiscence 4 patients presented with fecal fistula. Out of 00 patients 55 patients were <br>presented with serum Albumin level 2 gram ,22 patients were presented Serum Albumin level <br>2.5 gram ,13 patients were presented Serum albumin level 3 gram ,12 patients Were presented <br>serum Albumin level 3.3 gram Out of 100 patients 31 patient were presented hemoglobin 10 <br>to 12 gram .44 patients were presented Hemoglobin 8 to 10 gram. 13 patients were present <br>HBA1c 7 to 8 gram. 12 patients were presented serum creatinine. Level between 2 to 3. <br>CONCLUSION: Patients were admitted and operated in emergency department, already <br>immune compromised, depleted, comorbid, anemic and edematous prone to developed wound <br>infection either superficial or deep if not treat as soon as possible patient can die systemic <br>complications.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1153UNIQUE PRESENTATION OF CARCINOMA OF TONGUE AND ITS MODALITIES OF TREATMENT. 2025-07-02T13:50:11+05:00Areeba laghari1, Ahsan Ali laghari2, Zameer Hussain Lagari3, Qunber Ali Laghari4, Ishrat Rahim Kaytear5, Tufail Ahmed Baloch6anonymous@pumhs.edu.pk<p>BACKGROUND: Carcinoma of Oral cavity are most common problem all over the world <br>due to un hygiene conditions. AIM OF STUDY: To determine the Unique presentation of <br>carcinoma of tongue and its modalities of treatment. STUDY DESIGN: Prospective <br>observational study. PLACE AND DURATION: Two years’ study from January 2023 to <br>March 2024 Was Conducted at Oral and Maxillofacial surgery at dental department and <br>General surgery department at Liaquat University of Medical Health sciences jamshoro and <br>Hyderabad. PATIENTS AND METHODS: The study comprises 100 patients all were <br>admitted from Oral and maxillofacial surgery dental department and General Surgery <br>Department of Liaquat university of medical and Health Sciences jamshoro and Hyderabad. <br>The patients were evaluated fully after history, clinical examination and specific investigation <br>of Blood Complete Picture, Cytology of ulcer Edge biopsy of tongue ulcer and FNAC of <br>Cervical Lymph Node Biopsy X-ray Head, Neck and Chest, Ultra sound of neck Endo <br>luminal ultra sound, Contrast C.T scan of Head Neck and Chest, MRI of head, Neck, thorax <br>and PECT Scan and General assessment of the patients who were diagnosed malignant <br>tongue ulcers and bone scan. Base line investigations. Complete Blood Count, Blood Urea, <br>Blood sugar, HBSAG, Anti HCV, HIV Covid 19 and urine detail report. RESULT: In this <br>study of 100 patients of Carcinoma of tongue were in age group. Age range between 12 to 60 <br>years .65 sixty five patients were presented age range between 12 to 35 years ,19patients <br>were presented with age range between 35 to 50 years and 16 patients were presented with <br>age range between 51 to 60 years .Out of 100 patients 60 patient were presented with Non <br>Healing ulcer ,16 patients were presented Non healing ulcer along with hard nodule of <br>tongue ,12 patients were presented with Non healing ulcer along with tongue nodule , <br>bleeding , dysphagia with unilateral cervical lymph node enlargement , 12 patients were <br>presented with non-healing ulcer , hard nodule of tongue ,bleeding, dysphagia and with <br>bilateral cervical lymph node , Out of 100 patients 21 patients were presented in stage 1, 24 <br>patients were presented in Stage 11 ,55 patients were presented Stage 111 and 1V . Out of 100 <br>patients 21 patients were treated local excision 24 patients were treated partial glossectomy <br>along with selective and Modified Radical Neck dissection ,55 patients were treated on radio <br>and chemotherapy. CONCLUSION: Oral cavity problem now a day is a common world wide <br>due to eating of Most carcinogenic substance in diet may lead to damage normal Oral cavity <br>epithelium may lead Non Healing Ulcer, dysplasia and metaplasia then convert in to <br>malignancy.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1154HBV, HCV, AND HIV SEROPOSITIVITY: RISKS AND PREVENTION STRATEGIES. 2025-07-02T13:56:23+05:00Muhammad Bilal1, Shazar Kiani2, Maryam Zahra3, Izzah Rahim4, Haroon ur Rasheed5, Sanum Sultana Khattak6anonymous@pumhs.edu.pk<p>BACKGROUND: Serological testing serves as the frontline methodology for the diagnosis of <br>viral infections including hepatitis B virus (HBV), hepatitis C virus (HCV) and human <br>immunodeficiency virus (HIV) infection, especially in cases where direct identification of the <br>pathogen is complicated. OBJECTIVE: Public screening and health monitoring of a <br>population using serological assays are vital from a public health perspective since these tests <br>identify both current and past infections. METHODS: This cross-sectional study diagnosed <br>150 patients for HBsAg, anti-HCV, and HIV antigen/antibody using rapid serum <br>immunochromatographic lateral flow assays. Each sample was processed using the enclosed <br>instructions, and test lines and control lines' marking were used to conclude on results <br>interpretation. Stratifications were made based on sex, age, region of residence, and transfusion <br>history. Relations of patient attributes and infection status were studied with Chi-square tests. <br>RESULTS: Within the cohort of 150 patients, the prevalence rates of HBsAg and HCV were <br>63.3% and 42.0% respectively. There was no statistically significant difference associated with <br>gender for positivity of HBsAg (p = 1.00), HCV (p = 0.60), or HIV (p = 0.36). There were also <br>no age group associations with positivity for any of the infections (HBsAg: p = 0.50; HCV: <br>0.38; HIV: 0.47). Area of residence was not significantly associated with infection status for <br>HBsAg (p = 0.92), HCV (p = 0.57), or HIV (p = 0.21). A significant association was observed <br>between a history of blood transfusion and HCV positivity (p = 0.023), and borderline <br>association for HIV (p = 0.062); for HBsAg no significant association was noted (p = 0.20). <br>CONCLUSION: The investigation exposed the examined population with concerning levels <br>of HBV and HCV seropositivity alongside notable associations between HCV infection and a <br>history of blood transfusions. The study illustrates the persistent danger of transfusion-related <br>infections and reinforces the need for stringent blood donation protocols, enhanced infection <br>control measures, and intensive epidemiological surveillance. Additional studies with broader <br>scopes, along with deeper analyses into the factors of risk are necessary for designing effective <br>health policy frameworks for prevention and proactive public health responses.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1155DEEP VENOUS THROMBOSIS PROPHYLAXIS, STANDARDS AND PRACTICES. 2025-07-02T13:59:12+05:00Nasir Bakhtiar1, Muhammad Tayyab2, Shafi Ullah3, Ambareen Subhan4, Sheikh Muhammad Ibqar Azeem5, Ahmad Arsalan Tahir6 anonymous@pumhs.edu.pk<p>BACKGROUND: Deep venous thrombosis is life life-threatened critical vascular condition <br>in which the formation of blood clots occurs in deep veins, especially in lower limbs that may <br>lead to pulmonary embolism and post-thrombotic syndrome. Despite standardized guidelines <br>and protocols for the assessment of DVT risk and its prophylaxis, utilization remained <br>suboptimal, especially in developed or underdeveloped countries OBJECTIVE: The current <br>study aimed to evaluate current practices regarding DVT risk assessment by using the Caprini <br>Risk Assessment Model (RAM) in hospitalized patients. Moreover, it also aimed to investigate <br>the implementation of prophylaxis. METHODS AND MATERIAL: A prospective clinical <br>study was held in two phases across multiple wards of tertiary care hospitals (Prime Teaching <br>Hospital & Kuwait Teaching Hospital) in Peshawar. A total of 271 patients were recruited in <br>Phase I and 340 patients in Phase II. Healthcare professionals received education about the <br>dangers of DVT and the significance of prompt prophylaxis. Posters were also displayed in the <br>ward for underlining the necessity of VTE prophylaxis. Data was collected through a structured <br>checklist based on Caprini RAM protocols and SPSS v.22 was used for data analysis. <br>RESULTS/FINDINGS: The findings revealed that in both phases of the clinical study, the <br>majority of patients were observed to be at moderate risk followed by a high risk of DVT. <br>Preoperative risk assessment was conducted for 84.1% of patients in Phase I and 86,2% in <br>Phase II but a small percentage of patients received prophylaxis in the first phase (22.1%). <br>Then in the second phase of study, a significant improvement was observed up to 56.5%. <br>Regarding the type of prophylaxis, mechanical prophylaxis was a commonly used intervention <br>in both phases. CONCLUSION: Significant improvements observed in phase II highlighted <br>the potential of structured interventions and also enhanced awareness among health care <br>providers. Furthermore, it may benefit patients' quality of life and overall, well-being by <br>reducing the burden of complications associated with DVT.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1156BIOPSY SITE AND HISTOPATHOLOGY IN DIAGNOSING BENIGN AND MALIGNANT GASTROINTESTINAL CONDITIONS. 2025-07-02T14:01:31+05:00Saima Nadeem1, Muhammad Tariq Hamayun Khan2, Faiqa Mubeen3, Sana Ullah Khan4, Arshad Khan5, Mohammad Tahir6 anonymous@pumhs.edu.pk<p>BACKGROUND: Gastrointestinal illnesses exhibit a broad range of histological findings, with <br>malignancies and benign ailments differing throughout age demographics. Precise <br>identification of biopsy kinds, locations, and histological results is essential for diagnosis and <br>treatment. OBJECTIVE: This study aims to investigate the distribution of benign and <br>malignant gastrointestinal lesions by age group, biopsy type, and histological results, as well <br>as their correlations. MATERIALS AND METHODS: A cross sectional study was conducted <br>on 159 patients undergoing gastrointestinal biopsies in Khyber Teaching Hospital, Peshawar. <br>Variables included patient age groups, biopsy types (colonoscopy, endoscopic), biopsy sites, <br>and histopathological diagnoses. Frequency, percentages, and chi-square tests were used to <br>evaluate associations, with logistic regression applied for malignancy prediction. RESULTS: <br>Most samples were endoscopic (88.7%), with the stomach site being the predominant location <br>(54.7%). Benign lesions constituted 87.4% of patients, whereas cancers represented 12%. The <br>greatest frequency of benign lesions occurred in the 20-30 age group (100% positive), but <br>malignancies were more prevalent in older demographics, however without any correlation <br>(p=0.168). Histopathologically, chronic non-granulomatous colitis (CNCG) was the most <br>prevalent benign finding, occurring in 43.3% of cases. Dyspepsia was a prevalent symptom, <br>occurring in 15.7% of cases. Substantial relationships were identified between benign status <br>and age group (p=0.024), however malignant status exhibited no significant link with age. <br>Logistic regression identified age and biopsy type were significant predictors of malignancy. <br>CONCLUSION: This study emphasizes the prevalence of benign gastrointestinal lesions in <br>younger individuals and the significance of age and biopsy type in assessing malignancy risk. <br>Histopathological examination is critical for correct diagnosis and clinical decision-making.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1157PERIOPERATIVE ANALGESIC PRACTICES AND POSTOPERATIVE PAIN MANAGEMENT IN OPHTHALMIC SURGERIES: A CROSS-SECTIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN PAKISTAN. 2025-07-02T14:04:31+05:00Qazi Maaz ul Haq1, Aftab Ur Rehman2, Hammad Tariq3, Arsala Zaman4, Muhammad Numan5, Muhammad Ayub Khan6 anonymous@pumhs.edu.pk<p>BACKGROUND: Effective perioperative and postoperative pain management is essential for <br>ensuring optimal recovery and patient satisfaction in ophthalmic surgery. However, analgesic <br>practices often vary depending on the type of surgery and institutional protocols. <br>OBJEVCTIVE: This study aimed to evaluate perioperative therapy, analgesic use, and their <br>associations with different ophthalmic surgical procedures in a tertiary care hospital setting. <br>METHODS: A descriptive cross-sectional study was conducted among 231 patients <br>undergoing various ophthalmic surgeries. Data were collected regarding demographic <br>characteristics, ASA physical status, perioperative medications, and postoperative analgesic <br>use. Frequencies, percentages, means, and standard deviations were calculated. Associations <br>between type of surgery and analgesic administration were examined. RESULTS: <br>The study population had a mean age of 67 ± 14 years, with 54.1% males. ASA II status was <br>most prevalent (64.5%). Preoperative sedatives were administered to only 45.9% of patients. <br>Atropine (80.1%) and neostigmine (80.5%) were the most common intraoperative agents. <br>Postoperative analgesia was not administered in 45.9% of patients. Diclofenac (26.8%) and <br>metamizole sodium (29.9%) were the most frequently used analgesics. Analgesic use was <br>highest among patients undergoing enucleation (83.3%) and evisceration (80.0%), while <br>cataract surgeries had the lowest (10.0%). A single dose on the first postoperative day was the <br>most common pattern (52.8%). CONCLUSION: <br>Analgesic use following ophthalmic surgery is inconsistently applied, with nearly half of <br>patients receiving no pain relief. Invasive procedures showed higher analgesic needs, <br>highlighting the need for standardized, procedure-specific pain management protocols to <br>ensure adequate postoperative care.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1158EVALUATION OF ANTIBIOTIC SUSCEPTIBILITY PATTERNS OF BACTERIAL PATHOGENS IN CLINICAL SPECIMENS. 2025-07-02T14:06:52+05:00Shehnaz Bakhtiar1, Muhammad Tariq Hamayun Khan2, Fatima Muhammadi Burki3, Madeeha4, Amber Javaid5, Jawwad Ahmed6anonymous@pumhs.edu.pk<p>BACKGROUND: The prevalence of bacterial resistance to antibiotics has escalated in recent <br>years. Resistance against Gram-negative bacteria (GNB) and Gram-positive bacteria (GPB) <br>has been documented. OBJECTIVE: This study investigated the frequency, antibiotic <br>susceptibility, and resistance mechanisms of clinical sample isolates from Department of <br>Pathology.MATERIAL AND METHOD: This study investigated the frequency, antibiotic <br>susceptibility, and resistance mechanisms of clinical sample isolates from Department of <br>Pathology. Aseptically collected 793 bacterial isolates from wound swabs, urine, blood, central <br>venous pressure line tips, and respiratory specimens to grow on CLED or Blood agar for 24 <br>hours at 37°C. The isolate will be identified using microbiological methods after culture. <br>RESULT: From wound samples, which included pus, swabs, and tissue, 237 bacterial isolates <br>were identified: Enterococcus species (n=59, 24%), Enterobacterales (n=148, 62%), and <br>Pseudomonas aeruginosa (n=30, 12%). The urine sample produced a uniform distribution and <br>quantity of isolates. In blood and CVP line tip cultures, 168 bacterial isolates were detected, <br>including Acinetobacter species (n=37, 22%), Enterobacterales (n=56, 33%), and Salmonella <br>Typhi (n=75, 44%). Included were Escherichia coli (n=8, 5.2%), Acinetobacter species (n=46, <br>30%), Klebsiella pneumoniae (n=20, 13.2%), and Pseudomonas aeruginosa (n=77, 50%). <br>Whereas Ciprofloxacin resistance varied from 65–68% across locations, pus swab and urine <br>isolates were resistant to Penicillin (75%) and Ampicillin (97%). Respiratory samples were <br>moderately resistant to Ciprofloxacin (65.2%) and Gentamicin (52.8%) but low to Polymyxin <br>B (6.2%) and Tigecycline (13.7%). These results show extensive first-line antibiotic resistance <br>and continued vulnerability to last-resort medicines. CONCLUSION: This study shows that <br>diverse clinical specimens often resist common antibiotics. The effectiveness of last-resort <br>medicines like Polymyxin B and Tigecycline shows their importance in treating multidrug<br>resistant diseases.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1159FUNCTIONAL OUTCOMES AFTER OPEN RELEASE OF GLUTEUS MAXIMUMS CONTRACTURE.2025-07-02T14:09:19+05:00Zubair Shah1, Abdullah2, Abid Rehman3, Nadeem Akbar4, Miqdad Hussain5, Asnaf Siddique6 anonymous@pumhs.edu.pk<p>BACKGROUND: Fibrosis and shortening of the gluteal muscles characterize gluteal <br>Maximums contracture (GMC), a musculoskeletal disorder that causes limited hip motions and <br>functional constraints such trouble squatting. It is frequently seen in adolescents and children, <br>especially in underdeveloped areas. For moderate to severe instances, open surgical release is <br>the usual course of therapy; however, there is currently little information available on the <br>results of surgery in the local community. OBJECTIVE: To assess the functional outcomes <br>of open surgical release in patients with gluteal muscle contracture treated at Khyber Teaching <br>Hospital, Peshawar. METHODS: This retrospective cross-sectional research conducted in <br>District Headquarters Hospital, Batkhela, from January to December of 2024. Included were <br>100 patients, 50 of whom were male and 50 of whom were female, ages 6 to 14, who had been <br>diagnosed with gluteal muscle contracture and treated with open surgical release. Demographic <br>information, contracture laterality, involvement type, and functional level were examined in <br>clinical records. SPSS version 25 was used to analyze the data. To investigate correlations <br>between gender, age, contracture type, and functional results, statistical techniques included <br>one-way ANOVA, independent t-test, and chi-square test. RESULTS: Bilateral contracture <br>was more prevalent in female patients (p = 0.043) out of 100 patients (50 males and 50 <br>females), with a mean age of 9.36 ± 1.69 years. Age differences across contracture types were <br>not statistically significant (p = 0.074). 58% of patients (n = 58) showed bilateral contractures, <br>whereas 42% (n = 42) had unilateral involvement. Bilateral contracture was found in 58% of <br>patients and unilateral in 42%. A significant association was noted between gender and <br>contracture laterality (p = 0.043). Males were more likely than females to have unilateral <br>engagement on the right side, although the difference was not statistically significant (p = <br>0.200). There was no significant difference in mean age between the bilateral and unilateral <br>groups (p = 0.710). CONCLUSION: Open surgical release offers positive functional <br>outcomes in children with GMC. Early surgical intervention improves mobility and quality of <br>life.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1171EFFICACY OF 0.01% ATROPINE EYE DROPS IN REDUCING MYOPIA PROGRESSION. 2025-07-02T17:38:52+05:00Nazli Gul1, Shahzad Ahmad2, Aftab Ur Rehman3, Hammad Tariq4, Asif Mehmood5, Bilal Khan6, Ansa Benazir7 anonymous@pumhs.edu.pk<p>BACKGROUND: Myopia is a widespread refractive error that is becoming more common in <br>young children and adolescents. Severe myopia predisposes individuals to degenerative ocular <br>problems, including retinal detachment and myopic maculopathy, necessitating early <br>management. Atropine eye drops at 0.01% may reduce myopia progression, although further <br>research is needed on their efficacy and safety. OBJECTIVE: To evaluate the safety and <br>efficacy of 0.01% atropine eye drops in controlling myopia progression in children. <br>METHODS AND MATERIALS: The Department of Ophthalmology, Medical Teaching <br>Institution-Khyber Teaching Hospital, Peshawar, Pakistan, conducted this quasi-experimental <br>study. This study included 44 children aged 6-12 with SER -1.00-6.00 diopters with myopia <br>progression > -0.50 diopters in the previous year. Every night for 18 months, participants were <br>randomly either 0.01% atropine eye drops or a placebo. Main results were SER and AL. The <br>data was analyzed with IBM SPSS (Version 25) and R. We used ANOVA to compare group <br>time and medicine. RESULTS: The results show that 0.01% atropine may help delay the <br>evolution of myopia, but the change was not statistically significant and should be examine <br>cautious. Primary outcomes were the changes in spherical equivalent refraction (SER) and axial <br>length (AL) over a six-month period. The intervention group showed a slower rate of myopia <br>progression compared to the control group. The mean change in SER in the intervention group <br>was -0.30 ± 0.18 diopters, while the control group showed a greater shift of -0.51 ± 0.22 <br>diopters. Similarly, the increase in axial length was lower in the intervention group (0.14 ± 0.07 <br>mm) compared to the control group (0.21 ± 0.09 mm). These findings reflect a trend toward <br>reduced progression in the atropine-treated group, although the differences did not reach <br>statistical significance (p > 0.05). CONCLUSION: These findings suggest a potential benefit <br>of 0.01% atropine in slowing myopia progression, though differences were not statistically <br>significant.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1173FREQUENCY AND ANTIBIOGRAM OF PSEUDOMONAS AERUGINOSA IN A TERIARY CARE HOSPITAL.2025-07-03T11:38:16+05:00Shehnaz Bakhtiar1, Safdar Ali Jamali2, Fatima Gul3, Jawwad Ahmed4, Faleesha Gul5, Mukhtyar Khatoon6 anonymous@pumhs.edu.pk<p>BACKGROUND: Pseudomonas aeruginosa is a significant cause of healthcare-associated <br>infections, with rising antimicrobial resistance posing a global public health challenge. <br>OBJECTIVE: This study aimed to evaluate the frequency, antibiogram, and gender-based <br>distribution of P. aeruginosa isolates in a tertiary care hospital in Pakistan. METHODS: This <br>cross-sectional study was conducted from January to December 2023. Clinical samples were <br>collected from 502 patients and processed using standard microbiological techniques. <br>Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method, <br>and data were analyzed for gender-based differences and resistance patterns. RESULTS: The <br>majority of patients were male (60.6%, n=304), while females accounted for 39.4% (n=198). <br>Blood samples were the most common (53.4%, n=268), followed by tissue and fluid samples <br>(14.3%, n=72 each). The medical ward contributed the highest number of samples (59.6%, <br>n=299, p=0.004). Meropenem exhibited the highest sensitivity (90.4%, n=454), while <br>Levofloxacin showed moderate sensitivity (65.9%, n=331, p<0.001). Gender-based differences <br>were observed, with males showing higher sensitivity to Levofloxacin (224 vs. 112) and Co- <br>trimoxazole (285 vs. 162, p<0.001). Resistance rates for Capreomycin (48.8%, n=245) and <br>Minocycline (25.1%, n=126) were higher in females. Significant differences in sample <br>distribution and susceptibility patterns were noted across genders and wards. <br>CONCLUSIONS: This study highlights the high burden of P. aeruginosa infections and <br>antimicrobial resistance in Pakistan, emphasizing the need for antimicrobial stewardship <br>programs and gender-sensitive approaches to infection control. Targeted interventions in high- <br>burden wards are essential to mitigate the impact of resistant infections.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1162EVALUATION OF TIME OF DELIVERY IN SMALL FOR GESTATIONAL AGE (SGA) FETUSES: EFFECT ON NEONATAL OUTCOMES. 2025-07-02T14:19:45+05:00Nusrat Fouzia Pathan1, Aqsa2, Kainat3, Shahzadi Pir4, Areeba Batool5, Samina Waseem6 anonymous@pumhs.edu.pk<p>OBJECTIVE: The objective of this research is to assess the effect of delivery time on the neonatal outcomes of small for gestational age (SGA) fetuses using a cohort of 385 subjects at a tertiary care facility. METHODS: Retrospective cohort study was performed on 385 SGA infants born in a tertiary care center. Patients were divided according to the gestational age at delivery into early preterm (<34 weeks), late preterm (34-37 weeks), and term (>37 weeks). Neonatal outcomes, such as Apgar score, NICU admission, RDS, sepsis, and perinatal death, were compared between these categories. RESULTS: 95 (24.61%) of the 386 SGA fetuses were delivered early preterm, 134 (34.71%) late preterm, and 157 (40.67%) at term. Neonatal complications were higher in early preterm group significantly, with 77.9% needing NICU admission against 55.2% in late preterm and 19.7% in term delivery (p < 0.05). Incidence of RDS was 56.3% in early preterm, 38.1% in late preterm, and 10.2% in term delivery. Perinatal mortality was 10.5% for early preterm, 3.7% for late preterm, and 1.3% for term deliveries. CONCLUSION: Delay of delivery of SGA fetuses after 34 weeks greatly minimizes neonatal complications and mortality. Individualized evaluation, however, is required to counterweigh risks of intrauterine compromise against complications of preterm delivery.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1170PREVALENCE AND RISK FACTORS OF PRE-ECLAMPSIA IN PREGNANT WOMEN: A CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL. 2025-07-02T17:21:32+05:00Kainat1, Aqsa2, Nusrat Fouzia Pathan3, Shahzadi Pir4, Areeba Batool5, Mehvish Saleem6 anonymous@pumhs.edu.pk<p>BACKGROUND: Pre-eclampsia (PE) significantly contributes to maternal and perinatal <br>mortality rates and is particularly prevalent in resource-limited regions. In rural Pakistan, where <br>healthcare disparities are pronounced, there is a lack of comprehensive data regarding PE <br>epidemiology. OBJECTIVE: This study aimed to determine the prevalence, risk factors, and <br>clinical outcomes associated with PE among pregnant women in rural Sindh, Pakistan. <br>METHODS: A cross-sectional study conducted at a tertiary care facility enrolled 1,800 <br>pregnant participants. PE was identified using ACOG guidelines. Researchers collected <br>sociodemographic information, medical histories, and pregnancy outcomes using structured <br>questionnaires and clinical assessments. Adjusted odds ratios (aOR) were calculated using <br>multivariable logistic regression. RESULTS: The prevalence of PE was found to be 6%, <br>exceeding the rates observed in urban Pakistan (4–5%). Key risk factors included primigravida <br>status (aOR = 2.5, 95% CI: 1.6–3.8), chronic hypertension (aOR = 4.2), and obesity (aOR = <br>3.8). A family history of PE increased the risk by twofold (aOR = 2.1). The rural healthcare <br>landscape revealed stark inequalities: 70% of PE patients lived more than 50 km from <br>healthcare facilities, with 58% of these individuals having low household incomes. <br>Complications linked to PE included eclampsia (11.1% compared to 0.4% in non-PE <br>pregnancies), preterm delivery (50%), and low birth weight (44.4%). Only 35% of rural women <br>accessed four or more antenatal visits nationally. CONCLUSION: In rural Sindh, PE is driven <br>by biological vulnerabilities, poverty, and systemic deficiencies in healthcare. Immediate <br>action is required to address obesity, hypertension, and access to medical services. Community- <br>level screening, ensuring magnesium sulfate availability, and maternal education initiatives <br>could help mitigate preventable health issues. This research highlights the urgent necessity for <br>cohesive strategies to tackle PE in low-resource environments.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1169PREVALENCE OF RISK FACTORS OF UMBILICAL CORD PROLAPSE IN LABORING WOMEN: A MULTICENTER CROSS-SECTIONAL STUDY. 2025-07-02T17:18:50+05:00Aqsa1, Kainat2, Nusrat Fouzia Pathan3, Shahzadi Pir4, Areeba Batool5, Mehvish Saleem6. anonymous@pumhs.edu.pk<p>BACKGROUND: Umbilical cord prolapse (UCP), a rare but life-threatening obstetric <br>emergency, is linked to increased perinatal mortality and morbidity. Although previous studies <br>have established risk factors, multicenter data concerning their prevalence and effect are scarce. <br>AIMS: The aims of this study were to establish the prevalence of maternal, fetal, and obstetric <br>risk factors for UCP and also to assess their correlation with maternal and neonatal outcomes. <br>METHODS: Multicenter cross-sectional study in eight tertiary hospitals over five years. UCP- <br>confirmed laboring women (n=150) were compared with matched controls with no UCP <br>(n=300). Demographic data, fetal presentation, obstetric interventions (such as amniotomy), <br>and outcomes (APGAR score, NICU admission, delivery mode) were compared using chi- <br>square tests and multivariate logistic regression. RESULTS: Non-cephalic fetal presentation <br>(OR=6.2, 95% CI: 3.8–9.9), multiparity (OR=2.4, 95% CI: 1.5–3.8), polyhydramnios (OR=4.1, <br>95% CI: 2.3–7.4), and amniotomy (OR=3.0, 95% CI: 1.7–5.2) were risk factors for UCP. <br>Neonates within the UCP group had lower 5-minute APGAR scores (7 vs. 9, p<0.001) and <br>higher NICU admission rates (32% vs. 8%, p<0.001). Cesarean delivery was more common in <br>UCP cases (88% vs. 25%, p<0.001). CONCLUSION: Multiparity, amniotomy, <br>polyhydramnios, and non-cephalic presentation are significant non-modifiable and modifiable <br>risk factors for UCP. These results highlight the importance of strict intrapartum surveillance <br>of high-risk pregnancies and aware decision-making during obstetric procedures.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1165CORRELATION BETWEEN HBA1C LEVELS AND THE PROGRESSION OF DIABETIC NEPHROPATHY IN TYPE 2 DIABETES MELLITUS PATIENTS. 2025-07-02T14:30:19+05:00Naveed Sattar Shaikh1, Ghulam Mustafa Jamali2, Mohsin Ali3, Mujahid Ali Chandio 4, Mumtaz Ali Lakho 5, Muhammad Hammad Jawaid 6anonymous@pumhs.edu.pk<p>BACKGROUND: Diabetic nephropathy (DN) is a leading complication of type 2 diabetes <br>mellitus (T2DM), with glycemic control playing a pivotal role in disease progression. This <br>meta-analysis evaluates the association between HbA1c levels and DN progression in T2DM <br>patients. METHODS: We systematically reviewed 20 studies (14 cohorts, 5 RCTs, 1 meta<br>analysis) comprising 48,050 participants from diverse regions (South Asia, East Asia, Western <br>countries). Primary outcomes included albuminuria progression, eGFR decline, and end-stage <br>renal disease (ESRD). Random-effects models were used to pool effect sizes (OR/HR) with <br>95% CIs, and heterogeneity was assessed via I² statistics. RESULTS: Elevated HbA1c showed <br>a strong, dose-dependent relationship with DN progression. Each 1% increase in HbA1c was <br>associated with 25–40% higher odds of albuminuria progression (pooled OR: 1.65, 95% CI: <br>1.50–1.82, I² = 72%). For eGFR decline, HbA1c >7% conferred a 30–80% greater hazard <br>(pooled HR: 1.52, 1.35–1.72, I² = 58%), while HbA1c >8.5% increased ESRD risk 2- to 4-fold <br>(pooled HR: 2.20, 1.85–2.62, I² = 65%). South Asian populations exhibited the highest risks <br>(e.g., OR: 3.10 for HbA1c >9% in Pakistan). Adjustments for hypertension and diabetes <br>duration were consistent, but socioeconomic factors were less frequently addressed. <br>Renoprotective medications (e.g., SGLT2 inhibitors, RAS blockers) attenuated HbA1c<br>associated risks. CONCLUSION: HbA1c is a robust, modifiable predictor of DN progression <br>in T2DM, with risks escalating above 7–8%. Regional disparities underscore the need for <br>tailored glycemic targets. Intensive control, combined with renal-protective therapies, may <br>mitigate DN risk, particularly in high-burden populations.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1174A-CROSS SECTIONAL CLINICAL ASSESSMENT ON MENTAL HEALTH AND NEURODEGENERATIVE SYMPTOMS IN RETIRED INDIVIDUALS. 2025-07-06T15:20:09+05:00S Jamil Hussain1, Fahad ul Zain2, Muhammad Iqbal Memon3, Mujeebullah Khan Doutani4, Jamil Junejo5, Sana Zain6, Haseeb Khaliq7anonymous@pumhs.edu.pk<p>ABSTRACT <br>BACKGROUND: Retirement is a critical life transition that can impact cognitive health, <br>potentially contributing to neurodegenerative symptoms. Early detection of cognitive decline <br>in retired individuals is essential for timely intervention. This study assesses cognitive function <br>and neurodegenerative symptoms using the Mini-Mental State Examination (MMSE) and <br>Dementia Rating Scale-2 (DRS-2) in retired individuals. METHODS: After study approval <br>(24/IMCH/034), this cross-sectional study was conducted between January 2024 to July 2024 <br>on 90 retired individuals (mean age: 68.5 ± 5.4 years) using questionnaire based consecutive <br>data collection technique following an informed consent. Cognitive function was evaluated <br>using MMSE and DRS-2. The association between cognitive scores and socio-demographic <br>variables was analyzed using chi-square tests, Pearson correlation, and multivariate regression. <br>A p-value of <0.05 was considered statistically significant. RESULTS: The mean MMSE <br>score was 24.1 ± 3.7, with 31.1% of participants showing cognitive impairment (MMSE <24). <br>Cognitive decline was significantly associated with age (r = -0.42, p = 0.003) and years since <br>retirement (r = -0.37, p = 0.008). The mean DRS-2 score was 121.3 ± 9.2, with impaired <br>individuals showing lower scores in memory (p = 0.002), attention (p = 0.004), and <br>conceptualization (p < 0.001). Hypertension (OR = 2.6, p = 0.009) and social isolation (OR = <br>3.1, p = 0.004) were independent predictors of cognitive impairment. CONCLUSION: <br>Cognitive impairment and neurodegenerative symptoms are prevalent in retired individuals, <br>with chronic illnesses and social isolation being key risk factors. MMSE and DRS-2 <br>assessments provide valuable insights into early cognitive decline, highlighting the need for <br>targeted mental health strategies post-retirement.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025 http://publication.pumhs.edu.pk/index.php/ojs/article/view/1172BURDEN OF DECOMPENSATED LIVER DISEASE IN PAKISTAN: AN EPIDEMIOLOGICAL EVIDENCE. 2025-07-03T11:30:44+05:00Shohabudin Rind1, Mohsin Ali2, Ghulam Mustafa Jamali3, Muhammad Hammad Jawaid 4, Sana Aqeel5, Naveed Sattar Shaikh6, Mujahid Ali Chandio7 anonymous@pumhs.edu.pk<p>BACKGROUND: Decompensated liver disease (DLD) is a leading cause of morbidity and <br>mortality in Pakistan, driven primarily by viral hepatitis, metabolic dysfunction-associated <br>steatotic liver disease (MASLD), and alcohol-related liver injury. Despite its high burden, <br>comprehensive epidemiological data remain scarce. This meta-analysis synthesizes available <br>evidence to quantify the prevalence, etiological distribution, and clinical outcomes of DLD in <br>Pakistan. METHODS: A systematic search was conducted across PubMed, Google Scholar, <br>and Pakistani medical journals (2000–2023) for studies reporting DLD prevalence, etiology, <br>complications, or mortality. Pooled estimates were calculated using random-effects meta<br>analysis, with subgroup analyses by etiology and region. RESULTS: Among 18 eligible <br>studies (n=19040 patients), the pooled prevalence of DLD in cirrhotic patients was 15.6% <br>(95% CI: 12.4–19.2%), with HCV (63.5%), HBV (18.7%), and MASLD (12.1%) as leading <br>causes. The 1-year mortality rate was 47.3% (95% CI: 41.5–53.2%), with variceal bleeding <br>(32%), hepatorenal syndrome (24%), and sepsis (19%) as major contributors. DLD accounted <br>for 9.8% of hepatology admissions, with significant regional disparities higher in Punjab <br>(17.1%) and Sindh (14.5%) compared to Khyber Pakhtunkhwa (10.3%). <br>CONCLUSION: Pakistan faces a severe and growing burden of DLD, predominantly due to <br>untreated viral hepatitis and rising metabolic risk factors. Delayed diagnosis, restricted access <br>to antiviral medications, and insufficient transplant services worsen patient outcomes. <br>Immediate public health actions, such as broadening HCV screening, providing affordable <br>direct-acting antivirals (DAAs), and implementing strategies for preventing MASLD, are <br>essential for alleviating this crisis.</p>2025-03-31T00:00:00+05:00Copyright (c) 2025