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

HEALTHINESS LITERACY: THE LOST VACCINE IN PAKISTAN’S CONTEST AGAINST ILLNESS.

PROF ANWAR ALI JAMALI — 2025-12-02

Pakistan has eliminated smallpox, nearly abolished polio, & moved out COVID-19 vaccines to lots—but still we remain unprotected contrary to a far lethal pathogen: unawareness. Little healthiness knowledge is the quiet collaborator in motherly expiries, vaccine denial, quackery, and then the fast spread of avoidable illnesses.

AN EVALUATION OF COVERAGE OF TETANUS TOXOID VACCINE AMONG WOMEN OF CHILD BEARING AGE (15-45) YEARS: A COMMUNITY BASED SURVEY.

2025-12-02

BACKGROUND: Vaccination is one of the best general wellbeing drives in current period. It is in
this manner, stressing to become familiar with the degree of under-immunization in Pakistan.Vaccine
preventable sicknesses that have been effectively disposed of through the organization of antibodies
increated nations lockjaw infection while Pakistan is as yet battling to builds inclusion of Lockjaw
Pathogen inoculation among under 2 years and ladies of childbearing age. OBJECTIVE: This
research study was intended to measure level of coverage for Tetanus toxooid vaccination among
women of child bearing age of sindh. MATERIALS AND METHODS: The Cross-Sectional study
was conducted among females in many Districts of sindh including urban and rural area through 4th
year medical students of PUMHSW during one month. All females who were willing to participate in
study were included in the study as respondent. Data collected on pre-designed structured
questionnaire. DESIGN OF STUDY: Cross-Sectional. PLACE & DURATION: Various district of
sindh, from August 2022 -to-November 2022. RESULTS: Total 300 females were studied regarding
use of Tetanus Toxoid vaccine amongwomen of child-bearing age, out of then most of the females
70.7% were young with age groupof 25-35 years and out of all, 73 % have heard about TT
vaccination, majority of females werenot aware about inclusion of TT vaccine in childhood and
percentage was 59.7%. 65% female ofchild bearing age does not have knowledge about tetanus toxoid
vaccine schedule during theirreproductive years, related to significance of TT vaccination most of
females were aware (57%).According to the assessment of use of vaccine 55.3% women are willing to
getvaccination during childbearing age while 75% had not gotten single dose of TT vaccinationduring
childbearing age. CONCLUSION: It is revealed that the majority of female (child bearing age) were
not vaccinated against Tetanus diseaes and their attitude was found to be good toward tetanus
vaccination and they prefer to get vaccination during pregnancy. Tetanus Toxoid vaccination is useful
vaccine in preventing tetanus for adult female if she completed all dosese of vaccination she will be
protected for 20 years and she don’t need TT vaccination during their pregnancy through this
approach we can prevent and control material and neonatal tetanus at grass root level

CLINICOPATHOLOGICAL ANALYSIS AND ASSOCIATION OF FINE NEEDLE ASPIRATION WITH THE DIFFERENT LYMPH NODE LESIONS IN RURAL SINDH.

2025-09-25

BACKGROUND: Using Fine needle aspiration cytology FNAC as a mode of investigation is helpful
in knowing the common patterns of lymphadenopathies which assist in diagnosing the clinical
pathology where there is a dilemma in reaching the final diagnosis. FNAC is effectively used for both
superficial and deep soft tissue masses and the most commonly targeted sites are the lymph nodes,
breast, thyroid, salivary glands, and skin thus eliminating the need for unnecessary surgical
interventions such as open biopsies. OBJECTIVE: The aim of this study was to observe the most
common diagnosis for FNAC in patients presenting with lymph node swellings in the outpatient
department in patients of both genders and all age groups. METHODOLOGY: In this cross-sectional
study, 297 patients were recruited from the rural areas of Sindh. All the samples were collected from
“The Laboratory” from “February 2019” to “December 2019” after taking informed consent. The
sampling method in this study was non-probability consecutive sampling. FNAC was performed in
each patient after observing all aseptic measures, slides were prepared and evaluated by a panel of
histopathologists. Quantitative data was represented by Mean and Standard Deviation while the
qualitative data was represented by frequency and percentages. The chi-square test was used to
determine the association of different clinical variables with the diagnosis. RESULTS: 297 patients,
113 (38%) were males and (184) 62% were females. The subjects' ages ranged from 1 -75 years and
were divided into 3 respective groups, (0-19 years, 20-39 years, and ≥40 years). The majority of the
patients (128, 43.1%) fell in the 0-19 age group, followed by 124 (41.8%) patients in the 20-39 age
group and only 45 individuals (15.2) were ≥40 years of age. The most common site of lymph node
involvement was observed to be the cervical group with a total of 227 cases, of which 135 (45.5%)
affected the right cervical group and 92 (31%) affected the left cervical group. This was followed by
the right axillary group with 12 cases (4%) and the sub-mental group with 10 cases (3.4%). A sum of
192 cases was diagnosed with granulomatous inflammation by the histological findings, out of which
161 (54.2%) cases were Tuberculous/Chronic Specific Lymphadenitis and the remaining 31 (10.4%)
were of tuberculous abscess. The next common lesion observed was Chronic non-specific
lymphadenitis with 87 cases (29.3%). 12 cases (4%) were Suspicious of Malignancy. A significant
association was observed between the cause of lymphadenopathy and the age of the patient (p value=
0.002), the site of the lymph node (0.002). CONCLUSION: In the current survey female of younger
age groups were more frequently presented with right cervical lymphadenophies having chronic non-
specific lymphadenitis. Age and site of the lymph node involved had an association with the diagnosis
of FNAC.

SERUM BILIRUBIN AND GAMMA- GLUTAMYL TRANSFERASE IN WOMEN SUFFERING FROM MIGRAINE.

Haji Khan Khoharo1, Muhammad Akbar Memon2, Fatima Qureshi3 — 2025-12-02

BACKGROUND: Migraine is a common health issue of predominantly women than men. It affects
the lifestyle of person. New biomarkers need to be addressed for an old problem.
OBJECTIVE: To study serum bilirubin and liver enzyme in women suffering from migraine at our
tertiary care hospital. STUDY DESIGN: A cross- sectional study, STUDY PLACE: Out- patient and
Medicine Department, Isra University Hospital from March 2024 to January 2025. METHODS: One
hundred migraine cases and controls were selected according criteria. Women of age 20- 40 years
were selected. Visual Analogue Scale (VAS) was used for migraine severity. Volunteers were asked
for blood samples. Blood samples were collected in Na-F containing tubes for detecting liver function
tests analyzed on Cobas Roche Analyzer. Study variables and statistical analysis was performed on
SPSS (22.0) using Student t-test and correlations by Spearman`s testing. Correlation scatter plots were
developed on Microsoft Excel sheet. Statistical analysis was taken at P ≤ 0.05 as significant.
RESULTS: Total (TB), direct (DB) and Indirect bilirubin (IB) among migraine patients and controls
were found 1.01±0.32 vs. 1.35±0.07 mg/dl (P=0.0003), 0.61±0.02 vs. 0.77±0.08 mg/dl (P=0.0002)
and 0.13±0.02 vs. 0.28±0.05 mg/dl (P=0.003) respectively. GGT in migraine patients was 77.6±9.3
IU compared to 35.3±5.07 IU in controls. TB, DB and IB show negative correlation with VSA
migraine severity while GGT exhibited positive correlation. CONCLUSION: The present study
shows reveals bilirubin levels and elevated gamma glutamyl transferase (GGT) in women suffering
from migraine.

FASTING LIPID PROFILE AND ITS ASSOCIATION WITH THE RISK OF DIABETIC FOOT ULCERS IN TYPE 2 DIABETES MELLITUS.

2025-09-25

BACKGROUND: Diabetic foot ulcer is the leading micrcirculatory complication of type 2 diabetes
mellitus (T2DM) and is considered a significant factor leading to lower limb amputation.
Objective: To evaluate the fasting lipid profile and its association with the risk of diabetic foot ulcers
in individuals with T2DM. METHODS: A comparative cross-sectional study was carried out at
Baqai Medical University from June 2023 to 2024. A total of 138 participants were grouped into
healthy controls, T2DM, and foot ulcer in diabetic patients, enrolled via convenience sampling. The
median values of three groups were analyzed using one-way ANOVA technique and the Kruskal-
Wallis test for parameters that were not normally distributed. Post hoc analysis was performed with
Dunnett’s T3 test for variables with significant (p<0.05) differences, and risk assessment was
conducted based on 95% confidence intervals and odds ratio. SPSS version 23 was used for gathering
and evaluating the data. RESULTS: The median fasting lipid profiles differed significantly among
the three groups (p<0.01). Low-density lipoproteins (LDL), triglycerides (TG), and very low-density
lipoproteins (VLDL) did not show significant differences (p>0.05) among the all three groups,
according to Dunnett's T3 test for multiple comparisons. However, significant association (p<0.05)
existed between cholesterol and HDL levels. Among these parameters TG, HDL, and VLDL were
significantly associated with risk in T2DM, and serum cholesterol, TG, HDL, LDL, and VLDL
showed significant risk association for DFUs with p<0.05 by using Multinomial Logistic Regression.
CONCLUSION: The results of this research showed a significant association of fasting lipid profile
components (TG, HDL, VLDL) with T2DM, and plasma fat, TG, HDL, LDL, and VLDL with DFUs.

SYPHILIS PREVALENCE AND ITS CO-INFECTION WITH HBV, HCV, AND HIV AMONG HEALTHY BLOOD DONORS AT A TERTIARY CARE CENTER.

2025-09-25

However, there is a risk for the recipient of acquiring TTIs, so it is crucial to have data regarding the
prevalence of these TTIs and to have strict strategies to reduce their transmission. OBJECTIVE: To
determine the prevalence of syphilis and its co-infection with HBV, HCV, and HIV among healthy
blood donors. To find out the association of syphilis with different age groups. DESIGN: A
descriptive study with non-probability, consecutive sampling. PLACE of study: Blood Bank, Jinnah
Postgraduate Medical Centre, Karachi. DURATION OF STUDY: January 2021 to December 2022
METHODOLOGY: All blood donors who fulfilled standard departmental blood donation selection
criteria and consented were included in the study. Using an aseptic technique, the serum blood sample
was taken from blood donors. Serological tests for HBsAg, Anti-HCV, HIV antigen-antibody
combination, and syphilis were analyzed by an automated chemiluminescent microparticle
immunoassay (CMIA) method. RESULTS: The study included a total of 48,731 blood donors. The
mean age was 29.5±8.56 years (range 18-65). The prevalence of syphilis positivity was seen in
1125(2.3%) cases. According to age groups, it was most prevalent in 18 to 32 years in 638(1.3%),
then in 48- 65 years, which was found in 404(0. 8%), whereas it was least prevalent in the middle age
group and accounted for 83(0.2%). The co-infection of syphilis with HBV, HCV, and HIV was also
reported in 20 (1.8%), 32 (2.8%), and 07 (0.6%) cases, respectively. CONCLUSION: Syphilis was
found in 2.3% of healthy blood donors. The study proposes to impose strict measures to control the
spread of syphilis and co-infection with other TTIs.

STUNTING AND ITS ASSOCIATED FACTORS IN SCHOOL-AGE CHILDREN OF WAH CANTONMENT, PAKISTAN.

2025-09-25

BACKGROUND: Stunting is used as one of the indicators of malnutrition in children. Children are
considered stunted if their height-for-age is less than two standard deviations of the World Health
Organization (WHO) Child Growth Standards median. Data related to stunting in older children is
scanty so this study was planned. OBJECTIVE: To determine the frequency of stunting in school-
going children of Wah Cantonment and its association with their gender and type of school.
METHODOLOGY: The study was conducted using a cross-sectional design among primary and
middle schools in Wah Cantonment, Pakistan, belonging to both the public and private sectors from
August 2024 to October 2024, using a convenient sampling technique. Data was collected using a
structured questionnaire and was analysed using SPSS version 25. RESULTS: 11.6% of the children
were found to be stunted. Out of 60 children with stunting, 27 were males and 33 were females (p-
value=0.27). 61.7% of these stunted children were found to be enrolled in public sector schools (p-
value=0.02). CONCLUSION: The frequency of stunting was relatively lower than in other regions of
Pakistan. There was no difference in stunting across genders. The majority of the children with
stunting were enrolled in public sector schools, highlighting the need for targeted interventions in
public schools to reduce stunting.

ASSESSMENT OF VACCINE COLD CHAIN EQUIPMENT AND THEIR MANAGEMENT IN GOVERNMENT HEALTHCARE FACILITIES IN DISTRICT THARPARKAR.

2025-12-02

BACKGROUND: Vaccination programs are essential for controlling infectious diseases, and their
effectiveness relies heavily on maintaining vaccine potency through proper storage and handling. The
vaccine cold chain system—comprising temperature-controlled environments for storage,
management, and transportation—is critical for ensuring vaccine efficacy. OBJECTIVE: Any lapse
in cold chain maintenance can lead to vaccine degradation, reducing effectiveness and posing serious
public health risks. METHODOLOGY: This descriptive cross-sectional study was conducted in
Tharparkar District, targeting government healthcare facilities providing vaccination services. Out of
189 total facilities, 21 were randomly selected using Open Epi software, with inclusion based on
accessibility and consent. Participants from these facilities were selected through convenient
sampling. Data were collected using a structured, written questionnaire covering knowledge,
perceptions, and practices regarding cold chain and vaccine management. RESULTS: The findings
revealed that all participants (100%) were aware of the recommended vaccine storage temperature.
However, only 57% correctly performed the shake test, and 85% accurately interpreted Vaccine Vial
Monitors (VVMs). Improper vaccine storage arrangements were observed in 52% of facilities.
Additionally, only 43% of the facilities kept daily temperature records, and just 33% maintained
accurate logs. Encouragingly, 81% of handlers adhered to the four-week open vial policy.
CONCLUSION: The study highlights significant shortcomings in cold chain management practices
across healthcare facilities in Tharparkar. Deficiencies in temperature monitoring, storage
arrangements, and documentation practices threaten vaccine potency and compromise immunization
efforts. Addressing these gaps through enhanced training, systematic monitoring, and resource
provision is crucial to safeguard public health and ensure effective vaccine delivery.

CORRELATION OF OBSTRUCTIVE JAUNDICE, SERUM GAMA-GLUTAMYL TRANSFERASE AND ALKALINE PHOSPHATASE IN CHILDREN BELOW OF 14 YEARS IN SOUTHERN PUNJAB.

2025-12-02

BACKGROUND: Obstructive jaundice in children is a significant clinical concern that requires
timely diagnosis to prevent long-term hepatobiliary complications. OBJECTIVE: This study aimed
to assess the correlation between serum Gamma-Glutamyl Transferase (GGT), Alkaline Phosphatase
(ALP), and the presence of obstructive jaundice in children under 14 years of age in Southern Punjab.
METHODS: A cross-sectional study was conducted on 250 pediatric patients diagnosed with
jaundice. Demographic, clinical, diagnostic, and laboratory data were collected. Serum GGT, ALP,
and bilirubin levels were measured. Patients were categorized into obstructive and non-obstructive
groups based on imaging and clinical diagnosis. Statistical analyses included correlation, group
comparisons, logistic regression, and ROC curve analysis. RESULTS: The mean age was 7.13 ± 3.94
years; 50.8% were male. Dark-colored urine (62%) and pruritus (58%) were the most common
symptoms. Ultrasonography revealed dilated bile ducts in 41.2% and gallstones in 24.0%. The mean
GGT and ALP levels were 306.48 ± 169.65 U/L and 780.71 ± 420.45 IU/L, respectively. A strong
positive correlation was found between GGT and ALP (r = 0.68, p < 0.001), and both were
significantly elevated in obstructive jaundice cases (p < 0.001). Logistic regression showed GGT (OR
= 1.014), ALP (OR = 1.005), and direct bilirubin (OR = 1.186) as independent predictors. ROC
analysis yielded AUCs of 0.91 for GGT and 0.88 for ALP. CONCLUSION: GGT and ALP are
reliable, accessible markers for identifying obstructive jaundice in pediatric patients, especially in
low-resource settings. Their integration into early diagnostic protocols can significantly improve
clinical outcomes.

PREGNANCY COMPLICATIONS IN WOMEN ADDICTED TO PAAN, GUTKA, CHALIA AND NASWAR.

2025-12-02

BACKGROUND: The consumption of psychoactive substances during pregnancy remains a
pressing global health concern. OBJECTIVE: This paper explores the impact of smokeless
tobacco (SLT) products such as gutka, paan, naswar or chalia on pregnancy outcome in Karachi
Pakistan. METHODS: We conducted a cross sectional observational study at Gynecology and
Obstetrics Department of Abbasi Shaheed Hospital from June to December 2024. At the time of the
study, pregnant women who had developed an addiction to SLT were included. Such patients should
have consumed at least one gutka packet per day for a period of more than a year. The demography
and clinical examination were assessed in a systematic way including assessment of anemia by
complete blood count (CBC). Exclusion criteria included any woman who smoked tobacco or who
was suffering from anemia unrelated to tobacco use. We carried out statistical analysis by using SPSS
v23. 0 using chi-square tests, odd ratio and independent sample t-tests. RESULTS: SLT use during
pregnancy was significantly associated with adverse maternal and fetal outcomes with major
complications including anemia (p<0. 05), preterm delivery (p <0. 05), and congenital defects (p<0.
05). Prevalence of anemia did not appear to correlate with long-term SLT addiction. These data
indicate the serious risks associated with SLT use during pregnancy. CONCLUSION: Smoking less
tobacco during pregnancy poses serious health risks to women owing to abortion in spontaneous
manner (stuck baby syndrome), still births, preterm delivery and low birth weight. This is to augment
maternal and neonatal health issues prevalent in Karachi. This study highlights that urgent steps need
to be taken in public health to mitigate this problem including efforts at awareness building, policy
implementation and culturally sensitive cessation counseling.

COMPARISON OF GCS VS MOTOR COMPONENT ALONE AS AN EFFECTIVE PREDICTOR IN SEVERE HEAD TRAUMA TRIAGE.

2025-12-02

BACKGROUND: Severe head trauma is a leading cause of disability and mortality
worldwide, particularly among young adults, and imposes a substantial burden on healthcare
systems. OBJECTIVES: This study aims to compare the accuracy of the total GCS (GCSt) versus
the GCS motor component (GCSm) alone in triaging patients with head trauma. METHODS: This
six-month longitudinal study was conducted in the Emergency Department of Ziauddin University
Hospital, Karachi, enrolling 127 head trauma patients (aged 18–60) via consecutive sampling. Those
with ischemic stroke, GCS score of 3, polytrauma, spinal trauma, and prior neurologic conditions
were excluded. Background information, vitals and trauma details were recorded, and each patient
was assessed using both GCSt and GCSm. Diagnostic accuracy measures sensitivity, specificity, PPV,
NPV, and ROC curves were calculated. RESULTS: The mean patient age was 43.0 ± 13.0 years;
65.35% were male. Road traffic accidents were the leading cause of head injury, followed by falls.
For severe cases; the GCSm demonstrated perfect diagnostic performance with 100% sensitivity,
specificity, PPV, NPV, and overall accuracy. In moderate cases, GCSm showed 91.38% sensitivity,
100% specificity, and 96.88% accuracy, with only two false negatives. For mild cases, GCSm
achieved 100% sensitivity, 96.55% specificity, and 98.35% accuracy. ROC analysis showed excellent
discriminative ability for both GCSt (AUC 0.916; 95% CI: 0.866–0.966) and GCSm (AUC 0.914;
95% CI: 0.862–0.965), both p<0.001. GCSm consistently demonstrated high diagnostic accuracy
across all injury severities and mechanisms, including RTAs and falls CONCLUSION: The GCS
motor component showed high diagnostic accuracy across head trauma severities, closely aligning
with total GCS performance, and demonstrated near-perfect sensitivity and specificity in mild and
severe cases. Its simplicity and reliability make GCSm a strong, efficient alternative for routine triage
in emergency care.

THE ROLE OF ELECTROLYTE IMBALANCE IN ASSESSING DISEASE SEVERITY AND OUTCOMES IN ACUTE EXACERBATION OF COPD: A TERTIARY CARE HOSPITAL STUDY.

2025-12-02

BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD)
significantly increase morbidity and mortality. Electrolyte imbalances are common in hospitalized patients
with AECOPD, but their prevalence, clinical correlations, and impact on outcomes in South Asian tertiary
care settings remain underexplored. Determining the prevalence of electrolyte anomalies, such as those
involving sodium, potassium, chloride, calcium, and magnesium, in AECOPD and evaluating their
correlation with the severity of the disease and in-hospital outcomes are the goals of this study.
OBJECTIVE: The study's goal is to find out how common and what kinds of electrolyte imbalances
patients with AECOPD have in a Karachi tertiary care hospital, as well as how they relate to the disease's
severity and in-hospital outcomes. DESIGN: Since this research is a prospective observational study, data
will be gathered starting at the time of patient admission and continuing throughout time. Without
changing the management or treatment plan, the research will record clinical data in real time. An in
depth study of how electrolyte imbalances arise and connect to the course and results of disease will be
possible by tracking patients during their hospital stay. RESEARCH LOCATION: The study was
conducted in Karachi, Pakistan, at the Jinnah Postgraduate Medical Centre (Ward 12, Chest Medicine
Centre). RESEARCH DURATION: The research was conducted from early February 2025 to the end
of July 2025. METHODS: A prospective observational research was carried at the Department of Chest
Medicine (Ward 12), Jinnah Postgraduate Medical Centre, Karachi, from February 2025 to July 2025.
Consecutive patients ≥40 years with spirometry-confirmed COPD admitted with AECOPD were enrolled.
Serum sodium, potassium, calcium, magnesium, and chloride were measured within 24 hours of
admission. Electrolyte disturbances were defined using standard laboratory reference ranges. Outcomes
included disease severity (GOLD criteria), ICU admission, need for mechanical ventilation, hospital stay,
and in-hospital mortality. Logistic regression was used to recognize predictors of severe AECOPD.
RESULTS: The study included 150 patients with a mean age of 63.8 ± 9.7 years, 74.7% of whom were
male. 82.7% of patients had electrolyte abnormalities, with the most prevalent being hyponatraemia
(57.3%), hypokalaemia (42.7%), hypochloremia (27.3%), hypocalcaemia (25.3%), and hypomagnesaemia
(19.3%). CONCLUSION: Electrolyte imbalances—particularly hyponatremia, hypokalemia, and
hypochloremia—are highly prevalent in AECOPD and are strongly linked to increased disease severity,
prolonged hospitalization, and mortality. Routine electrolyte monitoring, including chloride, and prompt
correction should be integral to the management of hospitalized AECOPD patients to improve outcomes.

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

2025-12-02

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
patients, 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.

LOBECTOMY A LIFELINE FOR CONGENITAL LOBAR EMPHYSEMA. A TWO DECADES EXPERIENCE OF A TEACHING HOSPITAL.

2025-12-02

BACKGROUND: Respiratory complications in children are a severe clinical issue that will tend to
develop early in life and, in most instances, will require surgical interventions. The symptomatology,
the lobar involvement, and the consequences of the postoperative aspect are also important to
understand to improve the management strategies. OBJECTIVE: The aim of the study was to assess
the clinical presentation, lobar involvement, outcome of surgery and complications in patients who
had respiratory conditions, and whose course was managed in early childhood. METHODS: The
present retrospective study focuses on the pediatric CLE patients who have already undergone
lobectomy in the Nishtar Medical University Hospital during the period 2005 to 2024. Demographic
data, clinical history, surgical complications and outcome data were obtained. Each of them had a
standard posterolateral thoracotomy. The data were analyzed using SPSS 27 with chi-square, where p
0.05 was taken to be significant. RESULTS: There were 68 patients, 90% of the patients were
introduced before six months old, and 60.3% were male. The most common one was the left upper
lobe (37 cases), then the right middle lobe (16 cases), and the right upper lobe (9 cases). In 66.2 % of
cases, histopathology showed a deficiency of bronchial cartilage. There was no reported
intraoperative mortality. The number of postoperative complications was low, with atelectasis (7.4%)
and wound infection (4.4%) being the most prevalent ones. The vast majority of patients (85.3%)
were cured without any complications, and the average hospitalization was 7.6 +-2.1 days.
CONCLUSION: Early presentation and favorable surgical outcomes emphasize the importance of
timely intervention, effective postoperative care, and continued research on risk factors influencing
complications.

INSULIN SECRETING ACTIVITY OF CAMELLIA SINENSIS ON ALLOXAN INDUCED DIABETES MELLITUS IN MALE WISTAR ALBINO RATS.

2025-09-25

BACKGROUND: Camellia Sinensis belongs to Theaceae family. It may be black tea, brown tea, green
tea or oolong tea; all are derived from Camellia Sinensis. Camellia sinensis contains polyphenols,
flavonoids, and catechins. Polyphenols possess antioxidant, anti-inflammatory and anti-microbial activity,
and show probiotic properties. Growing interest has diverted the researchers to natural herbs for diabetes
mellitus as complementary alternative therapy. OBJECTIVE: The present study is conducted to
determine the insulin releasing effects of Camellia Sinensis in Alloxan induced diabetes mellitus in male
Wistar Albino rat model. MATERIAL AND METHODS: The present experimental study was carried
out at Department of Biochemistry LUMHS Jamshoro and animals were kept at Sindh agricultural
university Tando Jam. Laboratory investigations were performed at the Diagnostic and Research Lab,
LUMHS. Rats were purchased from the animal house of Agriculture University fulfilling the inclusion
and exclusion criteria. Rats were housed in stainless steel cages with saw dust bedding. Animal housing
and handling was in accordance to the NIH Guide (Care and Use of Laboratory Animals). A sample of n=
60 Albino Wistar rats were divided into negative control (A) and positive controls (B) and experimental
group C (Diabetic rats given Alloxan 120 mg/kg body weight (bwt) i. p + C.sinensis 100 mg/kg bwt).
Blood samples were collected from all 3 groups (A, B & C) through cardiac puncture after 4 weeks of
experiment. Samples were taken in EDTA – containing tubes and plain tubes. Samples were centrifuged
and sera collected for biochemical measuremen of serum insulin. Data was analyzed on SPSS version
22.0 (IBM, Incorp, USA). Variables were analyzed using one – way ANOVA (analysis of variance) and
Fischer`s LSD post-Hoc testing. Level of statistical significance was at confidence interval 95% (p≤
0.05). RESULTS: Fasting Insulin (FI) in control group A 10.49±1.06 µU/L compared to low levels in
positive control group B noted as 3.44±0.81 µU/L. Camellia sinensis treated experimental group C shows
5.60±1.64 µU/L fasting insulin. F=176.2 value and P=0.0001 reveals Camellia sinensis therapy (30 days)
increases the insulin secretion. CONCLUSION: In conclusion, the Camellia sinensis exerts significant
insulin secretory potential in Alloxan induced male albino rat model. The findings are of clinical
significance for treating an ever increasing diabetes health problem. However, further human studies are
recommended with large sample size to validate the findings.

DETERMINATION OF ACCURACY OF ULTRASONOGRAPHY IN 1st TRIMESTER OF PREGNANCY IN DETECTION OF DATE OF DELIVERY.

2025-12-02

INTRODUCTION: The estimated date of delivery carries significant medical, social, and personal
importance for pregnant women and serves as a critical reference for physicians responsible for
ensuring a safe birth. Accurate determination of gestational age is essential in obstetric care. Precise
pregnancy dating enables obstetricians to counsel women at risk of preterm birth (delivery before 37
weeks) regarding potential neonatal outcomes. Earlier evidence has shown that first-trimester
ultrasound using CRL provides more accurate estimation of gestational age compared to later
assessments. OBJECTIVE: To determine the accuracy of Ultrasonography in 1st trimester of
pregnancy in detection of date of delivery. METHODS: this descriptive cross sectional study was
conducted at Obstetrics and Gynaecology department-2 of Bahawal Victoria Hospital, Bahawalpur
from 2022-2023. Al the women aged 18 to 44 years either parity and booking status, presented with
singleton intrauterine pregnancy with presence of participant had a first-trimester ultrasound (7 to
13+6 weeks) with crown–rump length–based dating performed by experienced sonographer and
ultrasound with available records estimated date of delivery (EDD) and the actual date of delivery
were included. The accuracy of ultrasonography in the 1st trimester was considered positive if the
actual date of delivery occurred on the date estimated by the ultrasound performed during early
pregnancy. Data were analyzed using SPSS version 26. RESULTS: Overall mean age of women was
32.56+6.11 years. The mean gestational age at first-trimester ultrasound being 10.15±0.86 weeks and
at delivery was 38.87+2.40 weeks. Accuracy of first-trimester ultrasound in predicting the date of
delivery was found to be high, with 83.6% (92 out of 110) of cases accurately matching the estimated
and actual delivery dates, while 16.4% (18 out of 110) were inaccurate. Maternal age, mode of
delivery, and parity showed no statistically significant differences in accuracy p->0.05.
CONCLUSION: 1st trimester ultrasonography is a reliable method for estimating the expected date
of delivery, with crown–rump length being the most accurate parameter for early gestational dating,
while due few significant limitation of the study further large-scale studies is recommended to
validate these findings and to establish robust evidence for routine clinical use in clinical practice.

PREVALENCE OF CHEWING TOBACCO AND ARECA-NUT USE AMONG PATIENTS ATTENDING DENTAL OPD AND ASSOCIATED ORAL MUCOSAL LESIONS.

2025-12-02

BACKGROUND: Chewing tobacco (smokeless tobacco) and areca nut (Areca catechu
derivative) are widely consumed psychoactive substance in South Asian region, including
Pakistan. OBJECTIVE: To determine the prevalence of chewing tobacco and areca-nut use among
patients attending dental hospital and associated oral mucosal lesions METHODS: This descriptive
cross sectional study was carried out at Oral biology department of Bhittai Dental and Medical
College Mirpurkhas from April 2024 to September 2024. Individuals of chewing tobacco and areca
nut users, aged 18 years or older of either gender who visited the dental OPD for routine dental
examinations or treatment were included. After taking demographic information patients underwent a
comprehensive intraoral examination under adequate lighting, and review the medical record to assess
the oral lesions. Expected lesions were further evaluated using toluidine blue staining and, where
clinically indicated, subjected to incisional biopsy for histopathological confirmation. All patients
were interviewed about their chewing tobacco and areca nut consumption habits, including the type of
product used frequency, quantity, and duration of use. Data entry and analysis was done by SPSS
version 23. RESULTS: Total of 139 participants were studied, with most aged 31–60 years (49.6%)
and predominantly male (56.8%). Gutka was the most commonly used substance (66.2%), followed
by mainpuri (12.9%), a mix of betel and tobacco (8.6%), betel nut (7.2%), and naswar (4.3%). Over
half of the users (55.4%) had been consuming these products for less than one year, while 36.0%
reported use for more than five years. Pigmentation was the most common lesion (84.9%), among
gutka users, followed by white patches (48.9%, p=0.027) and ulcers (36.0%, p=0.001). Erosive
lesions (28.8%) and growths (24.5%) were also significantly associated with tobacco chewing p
0.001. additionally, white patches linked with oral submucous fibrosis (48.9%), whereas OSF features
(20.9%) and other OPMDs (8.6%) did not show significant associations (p->0.05), while only 14.4%
of participants had no mucosal changes (p=0.054). CONCLUSION: Gutka observed as the most
commonly used smokeless tobacco product, predominantly among middle-aged males, with a
considerable proportion using it for prolonged duration. Chewing of Tobacco observed significantly
linked to oral lesions, particularly pigmentation, white patches, ulcers, and erosive changes. However,
the findings highlighted the urgent need for targeted awareness, early screening, and preventive
strategies to reduce the burden of oral potentially malignant disorders in high-risk populations.

AN ASSESSMENT OF FETO-MATERNAL OUTCOME IN PREGNANT WOMEN WITH HYPERTHYROIDISM.

2025-12-02

BACKGROUND: Adequate levels of the thyroid hormone are very important for a healthy
pregnancy, normal growth of the fetus and maturation, while untreated thyroid issues are
associated to several complications affecting both maternal outcomes and growth of a child.
OBJECTIVE: To evaluate the fetal and maternal outcomes among pregnant women presented with
hyperthyroidism. METHODS: This prospective cross-sectional study was conducted at Obstetrics
and Gynecology department of Bahawal Victoria Hospital, Bahawalpur, from September 2024 to
February 2025. All the women during pregnancy, aged 18 to 40 years presented with pre-existing or
the gestational hyperthyroidism of either parity were included. The outcomes of the pregnancy
including pre-eclampsia, abruptio placentae, gestational diabetes, c-section, and postpartum thyroiditis
were evaluated through detailed reviews of medical records, clinical assessments, and laboratory
findings, concentrating the frequency and severity of complications. The data was entered and
analyzed using SPSS version 26. RESULTS: Overall average age of women was 31.62 years.
Maternal outcomes noted as 20.8% preeclampsia, 15.2% GDM, 4% abruptio placenta, followed by
increased rate of cesarean deliveries at 41.6% and postpartum hemorrhage 12.8%. Additionally, the
fetal outcomes were assessed as preterm births 30%, and low birth weight babies 25%. Though, no
statistically significant impact was found of maternal age, gestational age, or parity on feto- maternal
outcomes (p = > 0.05). CONCLUSIONS: The hyperthyroidism during pregnancy observed to be a
significant clinical concern and contributor to adverse feto-maternal outcomes. Consequently, the
early diagnosis, careful monitoring, and individualized management is very important, for better feto
maternal outcome.

COMPARISON OF ANESTHETIC GEL AND ANTI-INFLAMMATORY GEL IN PAIN MANAGEMENT DURING INITIAL ALIGNMENT OF FIXED ORTHODONTICS.

2025-12-02

BACKGROUND: The pain is a usual part of the fixed orthodontic treatment and ranks amongst its
most common side effects. In the management of this discomfort, a range of strategies have been
employed in the clinical practices including NSAIDs and topical anesthetics etc. OBJECTIVE: To
determine the therapeutic effectiveness of anesthetic gel versus anti-inflammatory gel in the pain
management during the initial phases of alignment of fixed orthodontics. METHODS: A randomized
clinical trial was conducted in the Orthodontics Department at DIKIOHS over six months from
October 2024 to March 2025. Patients aged 17–35 years undergoing fixed orthodontic treatment of
either gender were enrolled. The oral cavity each participant was divided: a 5% anesthetic gel was
applied twice daily to the left side, and an anti-inflammatory gel to the right side, during the initial
alignment phase. Pain intensity was recorded using the Visual Analogue Scale (VAS) on days 15 and
30. Data were analyzed using SPSS version 26. RESULTS: A total of 32 patients (mean age
19.0 ± 5.47 years; 56.3% female) were enrolled. Mean VAS pain scores differed between gels at day
15, with significantly lower the pain scores on the anti-inflammatory side (2.90 ± 1.61) compared to
the anesthetic side (3.65 ± 1.58), (p=0.053). By day 30, pain scores were nearly identical (1.96 ± 1.25
vs. 1.93 ± 1.11; p=0.941). Additionally, gender-based comparisons showed slightly higher pain in
females at both time points. Overall, pain decreased significantly over time for both gels and genders,
with no statistically significant difference (p>0.05). CONCLUSION: Both anesthetic and anti
inflammatory gels observed to be effective in reducing orthodontic pain during the initial alignment
phase, with pain progressively declining over time for both, showing greater pain reduction with the
anti-inflammatory gel on day 15, suggesting the anti-inflammatory gel may offer earlier pain relief.

USE OF SOCIAL MEDIA FOR SEEKING HEALTH-RELATED INFORMATION AMONG CARDIAC PATIENTS.

Syed Fayaz Mujtaba¹, Mashooq Ali Dasti², Sajid Ali³, Altaf Hussain⁴ — 2025-12-02

BACKGROUND: The use of social media for seeking health-related information among
cardiac patients has gained significant attention, particularly as digital platforms have
transformed how individuals access and share health information. This article explores the
multifaceted role of social media in facilitating health information seeking behavior,
especially in the context of cardiovascular health. OBJECTIVE: Therefore, the aim of this
study was to determine prevalence of use of social meid in patients with ischemic heart doses
who underwent intervention. METHODS: This study was conducted at Larkana Satellite
Center of National Institute of Cardiovascular Diseases (NICVD), Pakistan from November
2024 to April 2025. Patients who underwent cardiac Intervention within one month were
enrolled in this study. Patients were interviewed regarding their Basic demographics,
profession, level of education. Patients were interviewed to determine frequency of use of
social media, type of social media, and duration of social media. They were also asked what
type of content they seek on social media. RESULTS: A total of 253 patients were included
in this study out of which 162(68.9%) were males and 73(31.15%) were females. 182 (77.4
%) were Sindhi speaking while remaining were siraiki, balochi, Brohi Urdu and others. 121
(51.5%) were not educated. Almost 80 (34%) used one or other form of social media. 75
(31.9%) used Facebook. 37 (15.7%) used YouTube. Among them only 7 (3%) use social
media for health related material. CONCLUSION: social media use is common in patient
with cardiac disease. But very few use this medium for seeking health related information.