https://thejas.com.pk/index.php/pjhs/issue/feedPakistan Journal of Health Sciences2025-06-02T10:11:45+00:00Khurram Mehboobeditor@thejas.com.pkOpen Journal Systems<p><strong>Title of Journal: </strong><strong>Pakistan Journal of Health Sciences (Lahore)</strong></p> <p><strong> (ISSN Online: 2790-9352, Print: 2790-9344)</strong></p> <p><strong>Frequency: </strong><strong>Monthly (w.e.f July-2022)</strong></p> <p><strong>Affiliated with:</strong> Lahore Medical Research Center</p> <p><strong>Website:</strong> (<a href="http://www.lmrc.com.pk">www.lmrc.com.pk</a>)</p> <p><strong>Published By:</strong> <strong>CrossLinks International Publishers LLC, (w.e.f 23/4/25)</strong></p> <p><strong>Website:</strong> (<a href="http://www.clip.com.pk">www.clip.com.pk</a>)</p> <p><strong>Address:</strong> 117 S Lexington St Ste 100, Harrisonville, MO 64701, USA</p> <p>Lahore Medical Research Center has published <strong>"Pakistan Journal of Health Sciences (Lahore)</strong><strong> (PJHS-Lahore)</strong>"; A Monthly, Double Blind peer-reviewed open access Journal. The aim of the Journal is to provide a platform for allied health professionals to publish their research work. All materials, articles and information published in <strong>PJHS-Lahore</strong> will be peer-reviewed.</p> <p>Research papers, Short communications, Review or mini-reviews, Commentaries, Perspectives, opinion, Meta-analysis, Case reports, Case studies, Case-control studies</p> <p>Reviews on recent progress in Health Sciences are commissioned by the editors. The purpose of the <strong>PJHS-Lahore</strong> is to publish scientific and technical research papers to bring attention of international researchers, scientists, academicians, health care professionals towards recent advancements in Health Sciences. The articles are collected in the form of reviews, original studies, clinical studies etc. It may serve as a global platform for scientists in relevant fields to connect and mutually share ideas. This journal is open to all the research professionals whose work fall within our scope. </p> <p><strong>Aim & Scope</strong></p> <p>The Pakistan Journal of Health Sciences (Lahore) (PJHS-Lahore) provides a platform for research and discussion across a broad spectrum of disciplines. Its scope encompasses Medical and Clincal Sciences, Public Health, Physical Therapy, Dentistry, Pharmacology, Nursing and Medical/Health Professions Education. Through comprehensive coverage, PJHS aims to foster collaboration and advance knowledge in these vital areas of healthcare and academia.</p> <p><span style="text-decoration: underline;"><strong>Accreditation:</strong></span></p> <p><strong>Approved by Higher Education Commission of Pakistan for the year 2024-25</strong></p> <p><strong>Approved by Pakistan Medical and Dental Council till 31st July, 2025</strong></p> <p><span style="text-decoration: underline;"><strong>Fee & Subscription Charges</strong></span></p> <p>Article Processing Fee: Rs 5000/ Article (w.e.f 1st May, 2024) <strong>(Non-Refundable)</strong></p> <p>Article Publication Fee (National) Rs 30000 / Article</p> <p>Article Publication Fee (International ) 200 USD / Article</p> <p>Printed Version (Selected Articles on Authors Request) : Rs 2500/per copy (For InLand Delivery)</p> <p><span style="text-decoration: underline;"><strong>Annual Subscription for Printed Versions</strong></span></p> <p>For Institutes: Rs 20,000/ Annually</p> <p>Single Copy (Selected Articles): Rs 2500/-</p> <p><span style="text-decoration: underline;"><strong>Bank Details</strong></span></p> <p style="margin: 0cm;">Account Title: Lahore Medical Research Center LLP</p> <p style="margin: 0cm;">Bank Name: Meezan Bank</p> <p style="margin: 0cm;">IBAN: PK36MEZN0002840105377903</p> <p style="margin: 0cm;">Account # 02840105377903</p> <p><span style="text-decoration: underline;"><strong>Waiver Policy</strong></span></p> <p>If an author has no funds to pay such charges, he may request for full or partial waiver of publication fees. The decision may however vary from case to case.</p> <p>We do not want charges to prevent the publication of worthy material.</p> <p><strong><u>Submissions</u></strong></p> <p>Submission are welcome and may be submitted here: <u><a href="mailto:editor@thejas.com.pk">editor@thejas.com.pk</a></u></p>https://thejas.com.pk/index.php/pjhs/article/view/3208Obesity and Life-Related Disorders2025-05-29T11:34:16+00:00Sami Ullah Mumtazdrsumumtaz@gmail.com<p>Obesity has turned into a global public health emergency with its impact on millions and causing a mass increase in life-style diseases encompassing type 2 diabetes, cardiovascular diseases, hypertension and others cancers.</p> <p>This pandemic is not only a personal health crisis, but also a societal issue that requires a holistic intervention that goes beyond effective cure and strong preventive strategies.</p> <p>Managing obesity and the related disorders demands a multi-faceted strategy. For the most severe, medical therapies (e.g, bariatric surgery) can achieve great weight loss and result in improvements of conditions including diabetes. In fact, progress has been made in the area pharmacotherapy with drugs like GLP-1 receptor agonists providing hope to treat a weight and metabolic health derangements. But, these therapies are expensive and don’t reach all especially in the low-income regions. At present, lifestyle interventions such as diet modifications and increased physical activity are the mainstays of obesity management. A few programs such as nutritional counseling integrated with exercise regimens have delivered sustainable results, although retention is a problem due to time constraints, loss of motivation, or socioeconomic disadvantages.</p> <p>Treatment is important above all, and prevention should be the number one goal to stop this obesity epidemic. Awareness-driven public health campaigns may increase knowledge of healthy eating and active living, but they need to be combined with systemic shifts. The government should set some policies to for example tax sugar-sweetened beverages and mandate clear nutritional label, subsidize fresh produce. Schools have a critical role by embedding nutrition education and physical activity into curriculums that encourage lifelong habits. Walkable cities, and access to recreational spaces through improving urban planning can also facilitate movement.</p> <p>Harmful social determinants of health are also addressed by community-based initiatives such as cooking or fitness groups that reach people who do not have the benefit of stronger support systems.</p> <p>Addressing basic factors of health will attend to social determinants of obesity. Obesity, exacerbated by poverty stress and poor healthcare access. Targeted community-level interventions, such as providing free or reduced-cost health screenings, can bring attention to and alleviate the problem prior to full-blown disease. For example, technology such as wearables and remote patient monitoring are being used to track health indicators and wellness behaviors.</p> <p>Obesity is a multifaceted problem that involves biology, environment and culture. Maybe treatments can, to some degree, decrease incidence but prevention driven policy and education with equitable access to resources has to be the answer if we want to stop this from dramatically increasing. Societies can reduce obesity and noncommunicable disease epidemics through health-promoting, empowering cultures that enable healthier lives.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2988Association of Glycated Hemoglobin and Microalbuminuria with Renal Function Parameters in Type 2 Diabetic Patients2025-05-14T09:12:09+00:00Nazia Qamar1@gmail.comRehana Faryal Mehdi2@gmail.comSamar Ekram3@gmail.comZona Irfan4@gmail.comSadia Sundususadsun_dr@yahoo.comAbdul Rehman5@gmail.comSalman Zafar6@gmail.com. Iqrah6@gmail.com<p>One of the most serious complications of type 2 diabetes (T2DM) is diabetic nephropathy, which can eventually lead to kidney failure. While microalbuminuria is commonly used to detect early kidney damage, relying on it alone may not be enough. Additional markers could help improve early detection and timely treatment. <strong>Objectives:</strong> To look at how HbA1C levels, a key indicator of blood sugar control, relate to microalbuminuria in people with T2DM. Also, to explore how HbA1C correlates with other markers of kidney function, including the albumin-to-creatinine ratio (ACR), serum urea, creatinine, fasting blood sugar (FBS), and random blood sugar (RBS). <strong>Methods:</strong> The study included 250 participants: 200 patients with T2DM and 50 healthy individuals matched by age and sex. Those with hypertension, kidney disease, urinary tract infections, or other health issues were excluded. Blood and urine samples were collected. Hemoglobin A1C was measured using high-performance liquid chromatography (HPLC), and A1C was calculated. Data were analyzed using SPSS-20, and correlations were assessed with Pearson’s coefficient. <strong>Results:</strong> Compared to healthy controls, diabetic patients had significantly higher levels of FBS, RBS, HbA1C, serum urea, creatinine, and microalbuminuria. Higher HbA1C levels were linked with worse kidney function, suggesting that poor blood sugar control may signal early kidney damage. <strong>Conclusions:</strong> It was concluded that monitoring both HbA1C and microalbuminuria offers a better chance of catching kidney problems early in T2DM patients. Adding both markers to routine screenings could help delay or prevent serious kidney issues.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3044Comparison of Operative Outcomes of Open Thyroidectomy with Electrothermal Bipolar Vessel Sealer versus Conventional Hemostasis for Benign Thyroid Swelling in Adults Population2025-05-03T11:31:59+00:00Muzammal IslamIslammuzammal@gmail.comAbsar Nazir2@gmail.comMuhammad Tahir Usman1@gmail.comTayyaba Jamil3@gmail.comGhazala Bano4@gmail.comMehwish Raheem5@gmail.comMohammad Amir Jan6@gmail.comSaiqa Afzal7@gmail.comSyeda Aleena Zahra8@gmail.com<p>Precise dissection and effective hemostasis are crucial for safe thyroid surgery. The bipolar vessel sealer, a first-generation electrosurgical instrument, is widely used in thyroidectomies to improve hemostasis, reduce tissue trauma, shorten surgery time, and eliminate the need for sutures. <strong>Objective:</strong> To compare the operative outcomes of electrothermal bipolar vessel sealer in total thyroidectomy. <strong>Methods: </strong>At the Department of Surgery, Sir Ganga Ram Hospital, from August 2024 to January 2025, a quasi-experimental study was carried out, involving 80 patients undergoing total thyroidectomy. Exclusion criteria included patients with significant comorbidities, bleeding disorders, or renal and liver dysfunctions. The study participants were divided into two groups: Group A (bipolar vessel sealer) and Group B (clamp-and-tie technique). Primary outcomes included surgery duration, intraoperative blood loss, and hospital stay. Data were entered and analyzed by SPSS version 25.0. <strong>Results:</strong> The average age of patients was 35.5 ± 4.9 years. Group A had 70% female and 30% male, while Group B had 77.5% female and 22.5% male. Group A had significantly shorter hospital stays (3.8 ± 1.2 days) compared to Group B (5.2 ± 2.3 days, p=0.000). Intraoperative blood loss was significantly lower in Group A (109.7 ± 7.3 mL) compared to Group B (154.3 ± 6.7 mL, p<0.000). Surgery duration was longer in Group A (121.3 ± 13.1 minutes) than in Group B (94.3 ± 11.3 minutes, p<0.05). <strong>Conclusions: </strong>It was concluded that the bipolar vessel sealer in total thyroidectomy for benign thyroid swelling is effective, and results in shorter hospital stays without increasing complications or costs.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3028Reliability of Mandibular Plane in Determining Gonial Angle on Lateral Cephalogram2025-04-04T09:19:22+00:00Maleeha Mustafamaleeha.mustafa@ubas.edu.pkAsma Shafique1@gmail.comAbir Arif Syed2@gmail.com<p>Gonial angle is an essential cephalometric indicator used in orthodontic diagnosis and treatment planning. The precise evaluation of the gonial angle is vital for understanding mandibular growth patterns and formulating efficient treatment strategies. <strong>Objectives:</strong> To assess the mean gonial angle according to the three mandibular planes, Tweed's, Steiner's, and Down's, on lateral Cephalogram and panoramic radiograph for Orthodontic Diagnosis and Treatment Planning. <strong>Methods:</strong> The Descriptive Cross-Sectional Survey was performed in the Orthodontics Department, Lahore Medical and Dental College (LMDC). Lateral Cephalogram and Ortho-pantomography (OPG) of 100 patients were used. The Gonial angle was assessed on the OPG by drawing a tangent to the lower border of the mandible and the most distal point of the ascending ramus and condyle. On the Lateral Cephalogram, however, the Gonial angle was measured by drawing a tangent to the posterior border of the ramus and making three mandibular planes according to Down, Tweed, and Steiner analysis. The Gonial angle assessed on the lateral Cephalogram was compared to that on OPG to evaluate which plane provides the gonial angle value closest to that obtained on OPG. All data were collected and recorded on a Performa. <strong>Results:</strong> The mean gonial angle on lateral Cephalogram was 123.06 ± 6.80º, 121.5 ± 6.40, and 123.77 ± 6.43 using Tweeds, Steiner's, and Downs mandibular planes, respectively, and on OPG, the mean gonial angle was 123.45 ± 6.89. <strong>Conclusions:</strong> It was concluded that Down’s mandibular plane provides the Gonial angle reading that is closest to that found on OPG.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2896Frequency of Diabetic Nephropathy among Patients of Type 2 Diabetes Mellitus2025-05-14T10:05:52+00:00Muhammad Irfan Jamilirfanravian51@gmail.comYasir Hussaindryasirhussainyh@gmail.comMuhammad Shahid Nawaz Khandrshahidnawaz@yahoo.comAnjum Shahzaddoc_anjum123@hotmail.comAzhar Iqbalazhariqbaldr@gmail.comAdeel Ahmedmohammodadeel786@gmail.comIqra Naeemiqraanaeem2011@gmail.com<p>Diabetic Nephropathy (DN) is a predominant consequence of Type 2 Diabetes Mellitus (T2DM), contributing to chronic renal disease. <strong>Objective:</strong> To determine the frequency of diabetic nephropathy and its correlation with glycemic control. <strong>Methods:</strong> A cross-sectional study was conducted at the Nephrology and Diabetic OPD of Lahore General Hospital from July to November 2024. A total of 282 type 2 diabetic patients were enrolled. Clinical evaluation, fundoscopy, neurological examination, and laboratory tests were performed. Diabetic nephropathy was diagnosed based on albuminuria and eGFR. Statistical significance was set at p < 0.05.<strong> Results: </strong>Out of 282 patients, 150 (53.2%) were males and 132 (46.8%) females. The majority (43.3%) were aged 50–59 years. Microalbuminuria and macroalbuminuria were present in 20.9% and 32.3%, respectively. Mean serum creatinine and eGFR were 1.16 ± 0.53 mg/dL and 68.15 ± 24.58 mL/min/1.73m². Mean HbA1c and FBS levels were 8.40 ± 1.84% and 137.03 ± 19.19 mg/dL. Hypertension was noted in 41.5%. Diabetic nephropathy was significantly more prevalent in those with FBS >140 mg/dL (29.1%) and HbA1c >7.5% (32.6%) compared to those with lower values (p < 0.05). Declining eGFR was also significantly associated with nephropathy, with most cases found in those with eGFR <60 mL/min/1.73m² (p < 0.001).<strong> Conclusion: </strong>The study revealed a high frequency of diabetic nephropathy in type 2 diabetes, linked to poor glycemic control, declining eGFR and complications.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2909Identification of Genetic Polymorphism of Centrosomal Protein 290 to Assess Its Role as A Novel Diagnostic and Prognostic Biomarker for Ovarian Cancer2025-05-14T10:35:23+00:00Ambreen Tauseefambertauseef@hotmail.comSana Batool3@gmail.comZaima Ali1@gmail.comUzma Zargham2@gmail.com<p>Ovarian cancer (OC) is one of the most lethal gynecological malignancies, with the dilemma of diagnosing at an advanced stage due to the lack of sensitive early detection markers. Centrosomal protein 290 (CEP290) is important for various functions within cellular processes, and its genetic changes may contribute to tumor development and progression. Identifying polymorphisms in the CEP290 gene could provide valuable insights into its potential as a novel diagnostic and prognostic biomarker for OC. <strong>Objective: </strong>To identify genetic polymorphism of CEP 290 in ovarian cancer and to determine its role as a novel prognostic and diagnostic biomarker for OC. <strong>Methods: </strong>A genetic profiling methodology was utilized to detect single-nucleotide polymorphisms (SNPs) within the CEP290 gene in patients diagnosed with ovarian cancer. Techniques such as polymerase chain reaction (PCR) and DNA sequencing were implemented to ascertain these genetic variations, followed by statistical analysis to evaluate their association with disease susceptibility and prognosis. <strong>Results: </strong>Two potential SNPs, CXCR2 C+785T and VEGF C+936T, were identified in the CEP290 gene. These polymorphisms may be linked to ovarian cancer pathogenesis, influencing tumor growth, angiogenesis, and immune response mechanisms. <strong>Conclusions: </strong>It was concluded that this study highlights CXCR2 C+785T and VEGF C+936T as potential SNPs within the CEP290 gene, suggesting their role in ovarian cancer diagnosis and prognosis. Further research with larger cohorts is necessary to validate these findings and discover their clinical utility as predictive biomarkers.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2796Role of Foley’s Catheter as Intra-Uterine Balloon Tamponade in Controlling Primary Post-Partum Hemorrhage after Vaginal Delivery2025-05-08T07:12:53+00:00Aalia Khanaalia_akbar111@yahoo.comNasir Khan1@gmail.comAsima Khan2@gmail.comBalqees Raisani3@gmail.comSher Afgan Raisan4@gmail.comMuhammad Farrukh Habib5@gmail.com<p>One of the leading causes of maternal morbidity and mortality is primary post-partum hemorrhage (PPH). The utilization of intrauterine balloon tamponade has drastically reduced this deadly complication. In low-resource areas, the balloon of a 24-French Foley catheter is used for the same purpose. <strong>Objectives: </strong>To determine the safety and success rate of 24 Fr Foley’s catheter as intra-uterine balloon tamponade in controlling Primary Post-Partum Hemorrhage after vaginal delivery. To determine the amount of bleeding at 15 and 30 minutes after the Foleys insertion to predict failure. <strong>Methods:</strong> This cross-sectional study included 140 consecutive women with PPH after failed medical treatment. A 24-French Foley catheter was placed in the uterine cavity, and the balloon was filled with 100 ml of normal saline. Bleeding was observed for the next 15 and 30 minutes. <strong>Results:</strong> The Foley Balloon tamponade was successful in controlling hemorrhage in 125 (89.2%) patients. While 15 (9.8%) patients had failed balloon tamponade. Patients with failed balloon tamponade had a higher rate of anemia, coagulopathy, and more bleeding after delivery, after 15 minutes, and after 30 minutes of Foley balloon placement. The positive predictive value for 150 ml and 200 ml was 0.60 and 0.80, respectively. <strong>Conclusions:</strong> It was concluded that the 24 Fr Foley is effective in controlling primary post-partum hemorrhage. A blood loss of ≥200 ml after 15 minutes of Foley balloon placement should alert the physician to adopt a more aggressive approach to control bleeding.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2757Awareness and Knowledge for Risk Factors, Screening, Control of GDM and its Effect among Pregnant Women Visiting Gynae Outpatient Department at Tertiary Care Hospital Bahawalpur2025-02-20T09:28:25+00:00Nabila Shaheennabilashaheen112@gmail.comRabia Sajjadrabia999@ymail.comViqar AshrafViq109@yahoo .comSyeda Uzmasyedshezihussain78@gmail.comNaheed Hayatnaheedhayyat@gmail.com<p>This study explores the disparities observed in knowledge and awareness of Gestational Diabetes Mellitus (GDM) among pregnant women attending a military hospital. <strong>Objective:</strong> To determine the awareness and knowledge on GDM among pregnant mothers during antenatal visit, to identify factors that can influence such knowledge (demographics) population. <strong>Methods:</strong> This cross-sectional study was carried out in the Department of Obstetrics and Gynaecology, Tertiary Care Hospital Bahawalpur during November 24, 2022 till June 23, 2023. The data were collected via face to face interview employing a pretested structured questionnaire and it aimed the risk factors of GDM, history and lifestyle with regard to GDM screening/management. Statistical analysis involved the chi-square tests and ANOVA to investigate associations among demographic variables with knowledge of GDM. <strong>Results:</strong> Total 196 pregnant women were selected. The pre-pregnancy, mean BMI was 25.00 ± 4.384, mean age was 31.42 ± 8.215 years, and the average fasting glucose level was 96.71 mg/dL (SD = 15.588). Significant associations were found between family history and GDM knowledge (p = 0.004), as well as previous history of GDM and screening awareness (p < 0.001). <strong>Conclusion</strong><strong>s</strong><strong>:</strong> There was a notable gap in GDM knowledge among pregnant females, influenced by demographic factors. Enhanced targeted educational programs are necessary to improve awareness and management of GDM.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2358Level of Patient Satisfaction with Mandibular Acrylic Removable Partial Dentures (RPDS) for Different Kennedy Classes2025-05-15T04:52:30+00:00Shahzad Balochshahzadbaloch7@gmail.comSamreen Zubair1@gmail.comUsman Bashir Shaikh2@gmail.com. Aqsa3@gmail.comIsmatullah Qureshi4@gmail.comFarhan Javed5@gmail.com<p>Tooth loss affects facial profile, speech, and mastication, limiting social activities. Maintaining oral health involves using prostheses like implants, bridges, and partial dentures, with acrylic polymers being widely used. Various classifications are used for partially edentulous arches, among them Edward Kennedy's classification being the most often accepted. <strong>Objective:</strong> To assesses patient satisfaction for two months about mandibular Removable Partial Dentures (RPDs) utilizing the Short Assessment of Patient Satisfaction (SAPS) scale from the University of Wollongong's Centre for Health Service Development. <strong>Methods: </strong>A Cross-sectional observational study was conducted at Outpatient Department (OPD) of prosthodontics, Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad. Fifty three patients were selected on Non-probability convenient sampling. Data on comfort, speech, chewing ability, and prosthesis aesthetics were collected at insertion and after two months. The outcomes were categorized using the 5-point rating scale, The Short Assessment of Patient Satisfaction (SAPS). <strong>Results:</strong> SAPS was significantly differentiated among Kennedy Classifications at the time of insertion, out of 53 patients who were categorized into class 1 to class 4. The mean age of the patients was 39.6 years, 22 patients were very satisfied, 16 satisfied, and 15 not satisfied, with 25 males and 28 females this studies revealed that female patients are more likely to suffer from tooth loss and manage with partial dentures. <strong>Conclusion:</strong> The majority of patients were satisfied with Mandibular Removable Partial Dentures, with significant differences in SAPS among Kennedy Classifications at insertion and after two months.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2726Analytical Study of Beneficial Effects of Magnesium Sulfate for the Neuroprotection in Pre-Term Babies in Tertiary Care Hospital Bahawalpur2025-02-08T10:22:59+00:00Shabana Bibidrshabanameyo75@gmail.comSyeda Uzmasyedshezihussain78@gmail.comRabia Sajjadrabia999@ymail.comSadia Zainab Chaudharysadiazaineb459@gmail.comViqar AshrafViq109@yahoo .comSadaf Moinsadmoin1992@gmail.com<p><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0">Neonatal morbidity and mortality are </span><span class="NormalTextRun SCXW259625864 BCX0">greatly influenced</span><span class="NormalTextRun SCXW259625864 BCX0"> by preterm birth. </span><span class="NormalTextRun SCXW259625864 BCX0">Magnesium sulfate (MgSO4) has been suggested as a neuroprotective therapy to reduce the negative consequences on neurodevelopment in preterm infants.</span> </span><strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0">Objective:</span> </span></strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0">To </span><span class="NormalTextRun SCXW259625864 BCX0">investigate how MgSO4 works to reduce the incidence of cerebral palsy as well as other neurodevelopmental impairments in preterm infants.</span></span><strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"> <span class="NormalTextRun SCXW259625864 BCX0">Methods:</span> </span></strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0">This </span></span><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0" data-ccp-charstyle="Strong">quasi experimental</span><span class="NormalTextRun SCXW259625864 BCX0" data-ccp-charstyle="Strong"> study </span></span><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0">was conducted at Tertiary Care Hospital Bahawalpur in the Department of Obstetrics and Gynecology from September 30, </span><span class="NormalTextRun SCXW259625864 BCX0">2022</span><span class="NormalTextRun SCXW259625864 BCX0"> to March 29, 2023.</span><span class="NormalTextRun SCXW259625864 BCX0"> This research involved 312 preterm infants. The infants were</span><span class="NormalTextRun SCXW259625864 BCX0"> divided</span><span class="NormalTextRun SCXW259625864 BCX0"> to a group of treatment with MgSO4 or compared with a group without MgSO4 exposure. The incidence of intraventricular hemorrhage (IVH), need for mechanical ventilation, neonatal mortality, as well as cerebral palsy were also measured and compared between the groups using Chi-square and T-tests.</span></span><strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"> <span class="NormalTextRun SCXW259625864 BCX0">Results:</span> </span></strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0">The administration of MgSO4, dramatically reduced the rate of IVH (6.4%, 16%, p = 0.007 respectively treatment and control group) and neonatal mortality (3.2%, 10.3%, p = .013). It did not significantly affect the need for mechanical ventilation. This proved to be effective in reducing cerebral palsy by 21.8 percentage points (4.5% vs 26.3%, p<0.001).</span></span><strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0"> Conclusion: </span></span></strong><span class="TextRun SCXW259625864 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW259625864 BCX0">MgSO4 administration antenatally </span><span class="NormalTextRun SCXW259625864 BCX0">greatly decreases</span><span class="NormalTextRun SCXW259625864 BCX0"> the risks of IVH and neonatal mortality while decreasing the incidence of cerebral palsy in preterm infants, thereby resulting more to be a 'gold standard' neuroprotective strategy in prenatal care.</span></span><span class="EOP SCXW259625864 BCX0" data-ccp-props="{"201341983":0,"335551550":6,"335551620":6,"335559739":0,"335559740":240}"> </span></p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3064Etiology of Short Stature in Children Presenting At a Tertiary Care Hospital2025-05-19T07:18:54+00:00Arusa Farooqarusafarooq92@yahoo.comQamar Uz Zamanqamar.zaman@sihs.org.pkHina Nasirhina.nasir335@yahoo.comNida Mukhtarmukhtarnida81@gamil.comHira Siddiquehirasiddique1212@gmail.com<p>Short stature is frequently a rationale for consultation with pediatric endocrinology departments. It may arise from a multitude of origins, encompassing both physiological variations and pathological conditions. <strong>Objective:</strong> To ascertain the prevalence of various etiologies of short stature in pediatric patients attending a tertiary care medical facility. <strong>Methods:</strong> This cross-sectional study was carried out within the Pediatric Department of Shalamar Hospital, Lahore from August 2024 to February 2025. Subjects comprised 180 children exhibiting short stature as per operational definition, height falling beneath the 3rd percentile or two standard deviations below the mean corresponding to age and gender, included via non-probability consecutive sampling. Comprehensive history taking, physical assessments, anthropometric evaluations, and pertinent diagnostic tests were conducted. Data were analyzed using SPSS version 25.0 and various etiologies of short stature were presented as percentages and frequencies. Data were stratified by age, gender, residence, and socioeconomic status. <strong>Results:</strong> Familial Short Stature (FSS) constituted the predominant diagnosis among the pediatric population, impacting 20.6% of the subjects, followed closely by Constitutional Delay of Growth and Maturation (CDGM) and Primary Malnutrition, each accounting for 16.1%. Growth Hormone Deficiency (GHD) was identified in 15.6% of cases, while Hypothyroidism was present in 11.1%. Less prevalent etiologies included Celiac Disease (8.3%), <span class="TextRun SCXW110182623 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW110182623 BCX0">Type 1 Diabetes Mellitus (T1DM) </span></span>(7.8%), and Turner Syndrome, which affected 4.4% of the cohort. <strong>Conclusions:</strong> The main causes of short stature in children are familial and constitutional growth delay, along with endocrine disorders like hypothyroidism and growth hormone deficiency. Timely intervention is essential for optimal growth potential.</p> <p> </p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2950Prevalence of Vitamin D Deficiency in Newly Diagnosed Multiple Myeloma Patients2025-05-19T10:16:58+00:00Rija Shadab Rizvirijarizvi45@gmail.comSyeda Mah Alidr.mah92@gmail.comNaila RazaDrNaila.Raza@lnh.edu.pkSidra Dawoodsidra.rabia629@gmail.comShehla Parveenshehla.parveen745@gmail.com<p>Multiple Myeloma (MM) is a plasma cell disorder with skeletal complications. Vitamin D deficiency may contribute to these complications. <strong>Objective: </strong>To check vitamin D levels and determine the prevalence of Vitmain D deficiency in newly diagnosed MM patients. <strong>Methods:</strong> A prospective cross-sectional study was conducted from July 2024 till February 2025 at Liaquat National Hospital, Karachi, including 85 newly diagnosed MM patients. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured. Demographic and laboratory data, including hemoglobin, calcium, creatinine, LDH, uric acid, and serum protein electrophoresis, were collected. Blood samples for vitamin D analysis were collected in red-top tubes. All the data analysis was done by IBM SPSS Version 22.0. <strong>Results:</strong> A total of 85 newly diagnosed MM patients (mean age: 55 ± 8.6 years) were evaluated for vitamin D deficiency. Males comprised 54 (63.5%) patients, while females accounted for 31 (36.5%). The mean vitamin D level was 21.79 ± 7.2ng/mL. 56 (65.9%) of the patients had Vitamin D deficiency (<20ng/mL), 22 (25.9%) had insufficiency (20–29ng/mL), and only 7 (8.2%) had sufficient levels (≥30ng/mL). Urban residents had significantly lower vitamin D levels than rural residents (p = 0.03). <strong>Conclusions: </strong>Vitamin D insufficiency was prevalent in newly diagnosed MM patients and may contribute to skeletal complications. Variations in vitamin D levels based on patient residence suggest further investigation into potential contributing factors.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2934Comparison of Cut-Off Value of Neutrophil to Lymphocyte Ratio in the Diagnosis of Non-Perforated Versus Perforated Appendix2025-05-19T07:30:30+00:00Mudasir Abbasmudasirabbas693@gmail.comLyba Ghayour1@gmail.comQaim Deen2@gmail.comMuhammad Nadeem5@gmail.comKhawaja Salman Ahmed4@gmail.comMuhammad Siddique3@gmail.com<p>Neutrophil-To-Lymphocyte Ratio (NLR) gives diagnostic clue about non-perforated and perforated appendixes. However, there are many variations in its cut-off values in diagnosis of non-perforated and perforated appendixes, and there is no single value to differentiate severity of appendicitis. <strong>Objective:</strong> To determine the optimal NLR cutoff value for diagnosing perforated vs. non-perforated appendicitis in patients presenting with acute appendicitis. <strong>Methods:</strong> This cross-sectional analysis was carried out at Surgical Department of Mayo Hospital, Lahore from July 2022 to January 2023. Total 105 patients with acute appendicitis undergoing open appendectomy were enrolled after written informed consent. The patients were grouped according to perforated and non-perforated appendicitis, and NLR value was compared in both groups. Continuous and categorical variables were presented as mean ± SD and frequency (%). <strong>Results:</strong> Non-perforated appendix group comprised 84 (80%) patients, whereas perforated appendix group comprised 21 (20%) patients. Mean NLR in perforated appendicitis group was higher as compared to non-perforated group (14.7 ± 12.6 vs. 7.36 ± 8.93, p = 0.01). Cut-off point for NLR was obtained at 5.71, with sensitivity and specificity noted was 66.7 % and 62%, respectively. <strong>Conclusions:</strong> The study highlighted the potential of NLR as predictive marker for distinguishing between perforated and non-perforated appendicitis. Its clinical utility is supported by identified cut-off value of 5.71, suggesting its role in aiding timely intervention and reducing complications. The findings reinforce the importance of NLR, particularly in identifying patients at higher risk of appendiceal perforation.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2509The Knowledge, Experiences, and Barriers Associated with Male Involvement in Family Planning at Tehsil Lal Qila, District Dir (Lower), KPK, Pakistan2025-01-06T07:17:06+00:00Jalal Khanjalalkhan519@gmail.comTazeen Saeed Alitazeen.ali@aku.eduNasim Zahid Shahnasim.zahid@aku.eduInayatullah KhanInayatkhn12@gmail.com<p>Pakistan is one of the world’s most populous countries, with a high growth rate affecting the country’s socioeconomic progress negatively. Family Planning (FP) can reduce fertility rates, enhance maternal and child health. With the use of FP, mothers will have a low risk of pregnancy-related complications, and the best care can be provided to a child. Moreover, FP has a significant role in accelerating the Sustainable Development Goals (SDGs). Investing in FP will lower poverty and improve economic stability. <strong>Objectives: </strong>To explore the knowledge, experiences, and barriers associated with male involvement in family planning in Tehsil Lal Qila, Dir Lower, KPK. Also, to propose strategies to promote male participation in FP through improved awareness, accessibility, and inclusion in reproductive health programs. <strong>Method</strong><strong>s: </strong>A qualitative exploratory design was used with a total of 12 in-depth interviews with male clients using a purposive sampling technique. The data were analysed using content analysis. <strong>Results: </strong>Myths and misbeliefs about FP, the unavailability and unaffordability of contraceptives, pressure from intimate partners and relatives, lack of proper FP services, and gender discrimination were significant barriers to the use of FP. <strong>Conclusion</strong><strong>s: </strong>Collaborative efforts among various stakeholders, for instance, community-level awareness campaigns, accessible and affordable FP services, male involvement in healthcare initiatives (alongside females), and improved communication skills among healthcare providers working in FP programs can promote the use of FP.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2618Assessing Medical Students’ Interest in Community Medicine/Public Health as a Career Path: A Cross-Sectional Study at Sahiwal Medical College, Sahiwal, Pakistan2025-05-19T05:38:23+00:00. Menahalstep.menahal@gmail.comMushayyad Hussainmushayyadhussain2003@gmail.comMuhammad Hassam Rehmhassamrehm@yahoo.comMuhammad Hassaanhassanmuhamma00@gmail.comHira Iftikharhiraiftikhar294@yahoo.comMuhammad Imran Ul HaqLpiGas70@gmail.com<p>Public health should be the priority of underdeveloped countries like Pakistan to have better management plans for combating diseases. But it was observed that medical students are less interested in a career as a public health specialist, and they are less inclined towards community medicine. <strong>Objectives: </strong>To determine the preferences of the undergraduate medical students towards the choice of subject for specialization and to determine their attitude towards community medicine as a future career. <strong>Methods: </strong>A cross-sectional questionnaire-based study was conducted at a public sector medical college of Punjab using a convenient sampling technique. After receiving approval and having informed consent from the 315 study participants, we shared the questionnaire via WhatsApp in the form of Google Forms. The data were then analyzed using SPSS version 26.0. <strong>Results: </strong>Out of the total 315 participants, 170(54%) were females and 145 (46%) were males. The majority (96%) of the students were inclined towards opting for clinical sciences after graduation. Surgery 139 (44.1%) and Medicine 84 (26.6%) were the most preferred fields for specialization, only 9(2.8%) students preferred community medicine (p-value=0.001). When asked for the reason for not choosing community medicine, the majority, 189 (60%), said that they are not impressed by this subject. Career dissatisfaction was identified as the second main reason (14.6%) for not opting for this subject as a future career path. <strong>Conclusions: </strong>It was concluded that appropriate teaching methodology should be adopted and the curriculum should be designed in such a way that it may increase students’ interest in community medicine.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3020Comparative Effectiveness of Duloxetine and Pelvic Floor Exercises for Stress Urinary Incontinence in Postmenopausal Women: A Quasi-Experimental Study in a Secondary Care Setting, Islamabad2025-05-19T05:29:35+00:00Asia Rubab1@gmail.comAyesha Inamdr.aishh1990@gmail.comAfsah Ayub2@gmail.comAmna Raza3@gmail.com<p>Stress urinary incontinence has great impact on female daily activities, emotional well-being, and overall quality of life; hence the need of most effective treatment is mandatory. <strong>Objective:</strong> To evaluate the effectiveness of Duloxetine and Pelvic Floor Muscle Training (PFMT) in the management of Stress Urinary Incontinence (SUI) in postmenopausal women. This study also aims to estimate symptom reduction, adherence rates, quality of life, and associated factors. <strong>Methods:</strong> Sample consist of 100 participants who were randomly assigned to two groups: Duloxetine (n=50) and PFMT (n=50). Reduction in weekly incontinence episodes over the period of 12 weeks was considered as the primary outcome. Improvement in quality of life, adherence rates, strengthening pelvic floor muscle and reduction in adverse effects was considered as the secondary outcome. <strong>Results:</strong> A considerable reduction in the weekly incontinence episodes was seen in both groups and no statistically significant difference (p = 0.08) was found among two groups. Similarly, quality of life scores was also improved significantly (p < 0.001), post intervention with PFMT group exhibiting a marginal advantage. Only the PFMT group exhibited significant pelvic floor muscle strengthening (p < 0.001). Mild adverse effects, including nausea and fatigue, were reported in 12% of participants in the Duloxetine group, while PFMT had no reported side effects. <strong>Conclusions:</strong> Both Duloxetine and PFMT effectively reduced SUI symptoms and improved quality of life. However, PFMT had advantages in adherence, safety, and pelvic floor muscle strengthening, making it the preferred first-line treatment.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2584Single Dose Intravenous Tranexamic Acid Efficacy in Reducing Blood Loss in Total Hip Replacement2025-05-22T08:11:25+00:00Muhammad Badar Ud Din Zafirdrzafir77@yahoo.comRana Shahid Waseem Ronaqdrronaq205@gmail.comMazhar Ali1@gmail.comMukhtar Ahmad Tariq2@gmail.comIsrar Ahmad3@gmail.com<p>Total Hip Replacement is a commonly performed procedure for Hip joint degeneration. Despite its hazards, blood transfusion has to be performed due to significant perioperative blood loss. The effects of pre-operative intravenous single-dose tranexamic acid in our population have been presented in this study. <strong>Objectives</strong>: To compare the mean blood loss during and after total hip replacement for hip osteoarthritis with or without a single dose of tranexamic acid. <strong>Methods:</strong> This quasi-experimental study was performed in the Orthopedic Surgery Department Unit II, Nishtar Medical University Hospital, Multan, from October 2022 to March 2024. In the experimental group, tranexamic acid (20mg/kg) was administered intravenously ten minutes before skin incision, while in the control group, no such drug was given. Preoperative and postoperative Hematocrit data were collected. THA was done as per standard protocol. The operative blood loss and blood transfusions were recorded and compared with the controls. <strong>Results: </strong>Among 60 patients, the mean age was 54.85 ± 12.23 years. Male were 19 (31.7%) and female were 41 (68.3%). BMI was 26.04 ± 3.48 Kg/m<sup>2</sup>. Mean age (p=0.746), mean BMI (p=0.633), age (p=0.417), gender (p=0.781) and BMI (p=0.749) were comparable in both groups. The estimated total loss of blood was significantly less in patients receiving intravenous tranexamic acid (1169.10 ± 191.92ml vs. 1730.07 ± 203.62ml; p<0.001) as compared to the control group. <strong>Conclusions: </strong>It was concluded that a pre-operative intravenous single dose of tranexamic acid decreased blood loss during surgery significantly in patients having total hip arthroplasty regardless of gender, age and BMI.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2041Physical Activity among Middle-aged Adults After Total Hip Arthroplasty Following One Year2024-11-29T08:32:40+00:00Muhammad Waqas Waheedwaqaswaheed612@gmail.comSamreen Sadiqsamreen.sadiq19@gmail.comKhizra Hamidkhizra.hamid@ubas.edu.pkAhmad Miraanahmedmiraan10@gmail.comZeeshan Mushtaq1@gmail.com<p>Total hip arthroplasty is one of the common surgical procedures that is used to treat the diseases of the hip joint and improve mobility and physical activity. Evaluating the physical after total hip arthroplasty is critical to understanding recovery and outcomes for long-term effectiveness. <strong>Objective: </strong>To evaluate physical Activity after total hip arthroplasty following one Year. <strong>Methods:</strong> The questionnaire-based descriptive case series included 50 subjects (27 Male and 23 Female) after total hip arthroplasty. The sample size was collected using the WHO calculator. Physical Activity and pain were evaluated using the Harris Hip Score. The data were analyzed using SPSS version 20. <strong>Results: </strong>Middle-aged patients aged 55-65 years were evaluated using the Harris Hip Score. Physical Activity was gradually fair to good in patients with total hip arthroplasty following one Year. In 50 patients of THA, the grades of total Harris hip score were with 14 patients (28%) in Poor grade (˂70), 17 patients (34%) in Fair grade (70-79), 18 patients (36%) in Good grade (80-89) and one patient (2%) in Excellent grade (90-100). <strong>Conclusions: </strong>It was concluded that the majority of middle-aged adults, after total hip arthroplasty, presented with fair to good (34 % & 36 %) physical activity following one Year.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2629Efficacy of 0.25% Bupivacaine Alone vs. with Dexmedetomidine for Ultrasound-Guided Supraclavicular Block in Upper Limb Surgery2025-05-27T04:37:47+00:00Sara Sabirsara.92816@gmail.comRehan Hassan Khan Niazi2@gmail.comShahzad Imran1@gmail.comHafiz Faheem Asghar3@gmail.comShumaila Ashfaq3@gmail.comAamna Muzaffar4@gmail.com<p>The pain after upper limb surgeries can be intense. The brachial plexus block is an effective and commonly used method to manage this pain, reduce opioid use, and facilitate smoother recovery.<strong> Objective:</strong> To see the effect of combining bupivacaine with dexmedetomidine in upper limb surgeries. <strong>Methods:</strong> Quasi-experimental research was carried out at Islam Medical College, Sialkot. 100 patients undergoing upper limb surgeries who were aged between 25 to 65 years. All the patients who were comprised allergies to study drugs, severe organ impairment, coagulopathy, neurological disorders affecting pain perception, and pregnancy were excluded and divided to receive either 0.25% bupivacaine alone or with dexmedetomidine. The outcome variables included pain, analgesia duration, sensory/motor block onset, and 24-hour analgesic consumption. Data were analyzed by SPSS version 23.0. The comparison of quantitative data was done by an independent sample t-test and chi-square test for insightful comparisons between qualitative variables, with the significance level at p-value<u><</u>0.05. <strong>Results:</strong> The average age of patients was 40.1 ± 11.5 and 39.8 ± 10.5 years in Group I and Group II, respectively. Male were more in both groups. Group II showed significantly longer analgesia duration (12.7 vs. 5.3 hours), faster sensory/motor block onset, and lower analgesic consumption (p<0.001). There were no significant differences in adverse effects. <strong>Conclusions:</strong> It was concluded that combining dexmedetomidine with bupivacaine significantly extended analgesia, quickened sensory and motor block onset with a reduction in overall consumption of analgesia. Although sedation was more frequent, no major adverse events were observed. <strong> </strong></p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2500Frequency and Risk Factors Associated with Postoperative Sore Throat (POST) in Adults Undergoing General Anesthesia during ENT and Eye Surgery: A Cross-Sectional Study2024-12-31T08:07:43+00:00Asad Khanasadipms@gmail.comInam Ullah1@gmail.comAroob Zaki Khawajaaroobke@gmail.comAbdul Bary4@gmail.comTaimoor Riaz Ullahtaimoor.riaz@dhpt.uol.edu.pkSumbal Shahbazsumbal.shahbaz@dhpt.uol.edu.pkNiaz Aliniazanesthetist@gmail.com<p>Postoperative Sore Throat and hoarseness are two common complications after intubation during general Anesthesia. It is crucial to understand the frequency and associated risk factors of POST to improve patients’ outcomes and reduce its incidence in patients of ENT and eye surgeries undergoing General Anesthesia (GA). <strong>Objectives: </strong>To emphasize the frequency and risk factors of POST after endotracheal intubation in patients undergoing GA for elective ear, nose, throat (ENT) and eye surgeries. <strong>Methods: </strong>A DHQ Hospital hosted this cross-sectional study from August 2024 to October 2024. The number of participants was 215. A consecutive non-probability sampling technique was used for patient selection. The ASA tool was used to assess the health status of patients undergoing GA. All participants were observed perioperatively, including for 10 minutes in the Post Anesthetic Care Unit (PACU). This was not a blinded study. <strong>Results: </strong>In this study, female subjects comprised 62.8% of the total sample. Complications included sore throat in 102 patients (47.4%) and hoarseness in 25 (24.2%). After the surgeries lasting for 31-60 minutes (51 cases, p=0.01) and in throat surgeries (89 cases, p=0.006), the sore throat was more common. <strong>Conclusions: </strong>Sore throat and Hoarseness are two common complications reported postoperatively with high frequency. The problem may arise more frequently during long surgical procedures; other factors may include the type of surgery, use of an NG tube, and large diameter ETT size. Knowing these hazards makes it clear that the best airway management techniques are required to reduce patient discomfort and enhance recovery.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2980Assessing the Effects of Metformin on Lipid Metabolism in Women with PCOS2025-05-27T05:02:24+00:00Sanodia Afridisanodia.afridi@gmail.comShabina Saifullahdrshabinasaif@gmail.comShaikh Fahad Falahfahadfalah@yahoo.comFalak Nazfalak.naz60@yahoo.comShafiq Ahmadshafiq.kcd@gmail.comAsma Shaukata_shaukat11@yahoo.com<p>Polycystic ovary syndrome (PCOS) is a prevalent hormonal imbalance condition that is linked with insulin resistance and abnormal lipid metabolism. Metformin is a common drug given in the management of PCOS; the impact on the lipid profile and the role of adherence to therapy are not established. <strong>Objectives:</strong> To assess the therapeutic effects of Metformin on lipid profile, hormonal status, and insulin resistance in PCOS while exploring the influence of patient adherence on overall treatment response. <strong>Methods:</strong> One hundred and ten women with a diagnosis of PCOS in Health Net Hospital, Peshawar, were given Metformin (1500 mg/day) for six months. The assessments for the study included lipid profile, glucose, insulin level, HOMA-IR, and hormonal profiling both at baseline and after the treatment. Treatment adherence was evaluated with pill count and attendance to follow-up visits. Pre- and post-comparisons were done using paired t-tests, while group differences were examined using independent t-tests and chi-square tests. <strong>Results: </strong>Metformin significantly reduced total cholesterol (199.43 to 167.60 mg/dL, p<0.001), LDL-C (131.71 to 111.20 mg/dL, p<0.001), triglycerides (178.15 to 149.66 mg/dL, p<0.001), and VLDL-C (35.72 to 30.03 mg/dL, ‘p<0.001’), while HDL-C increased (39.70 to 45.24, p<0.001)’. Insulin resistance and androgen levels also improved, with greater benefits observed in adherent participants. <strong>Conclusions:</strong> It was concluded that metformin positively impacts lipid metabolism, hormonal levels, and insulin responsiveness in patients with PCOS. Adherence significantly enhances therapeutic outcomes, emphasizing the need for strategies that promote consistent medication use.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2870Outcomes in Conservative Versus Surgical Treatments in Ludwig’s Angina Cases: A Comparative Study2025-05-30T04:42:42+00:00Fatima Imam1@gmail.comMuhammad Shahzad2@gmail.comZaheer Hussain Chachar2@gmail.comMaya Madhuri3@gmail.comUzma Bashir4@gmail.comJunaid Naveed Gaju5@gmail.comSalman Shamssalman.shams@lumhs.edu.pk<p>Rapid airway impairment brought on by Ludwig's angina may require careful antimicrobial treatment or surgery.<strong> Objective: </strong>To compare the airway compromise and hospital stay in conservative versus surgical approach in cases with Ludwig's Angina.<strong> <a name="_Toc421548298"></a>Methods:</strong> This experiment was conducted at Liaquat University using a non-probability consecutive sampling technique to recruit 76 patients, aged 18 to 40, diagnosed with early-stage Ludwig’s angina without airway obstruction. Quasi-experimental study. There were 38 patients in each group, and participants were randomized to either the surgery group or the conservative treatment group. Outcomes such as airway compromise and length of hospital stay were recorded and compared between groups using t-tests and Fisher’s exact tests. Findings: The conservative group's mean age was 30.58 ± 5.52 years, while the surgical group's was 31.34 ± 5.92 years. There were 11 females (28.95%) and 27 males (71.05%) in the conservative group and 8 females (21.05%) and 30 males (78.95%) in the surgical group. There was a statistically significant difference (p < 0.001) in the length of hospital stay between the surgical group (6.97 ± 1.10 days) and the conservative group (5.05 ± 0.89 days). Five patients (13.16%) in the surgical group and three patients (7.89%) in the conservative group experienced airway impairment; however, this difference was not statistically significant (p = 0.706). <strong>Conclusion:</strong> Conservative treatment, being less invasive, can be effective in mild cases, leading to shorter hospital stays and a reduced risk of airway compromise.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3026Comparison between Oral Nifedipine and Intravenous Labetalol in Managing Severe Preeclampsia2025-05-29T07:36:20+00:00Ayesha Siddiquaayeshactn33@gmail.comAnila Sabir1@gmail.comNadia Siddique2@gmail.comFaraz Bakht3@gmail.comHina Rauf4@gmail.comHania Zafar5@gmail.com<p>Hypertensive disorders contribute to significant maternal morbidity and mortality in pregnancy. Immediate treatment is required to avoid serious complications. <strong>Objectives: </strong>To compare the mean time taken to achieve the target BP with oral nifedipine versus intravenous labetalol in patients with severe preeclampsia. <strong>Methods:</strong> This quasi-experimental study was conducted at Lady Willington Hospital, Lahore, over six months after taking approval from CPSP, involving 100 patients diagnosed with severe preeclampsia. Participants were divided into two equal groups: Group oral nifedipine and IV labetalol. Study outcome time taken to reach target BP <140/90 mmHg was compared among groups using an independent sample test, with a p-value≤ 0.05 as significant. <strong>Results:</strong> Target BP was achieved earlier at 43.96 ± 5.93 minutes with oral nifedipine compared to IV labetalol at 48.60 ± 6.80 minutes (p<0.001). <strong>Conclusions:</strong> It was concluded that the findings strongly support the use of nifedipine as a more effective option for rapidly lowering blood pressure compared to labetalol. Its faster onset of action makes it the preferred choice for achieving timely blood pressure control in patients with severe preeclampsia.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2941Primary Cesarean Section: A Gateway to Repeat Surgery 2025-05-29T06:22:13+00:00Shagufta Tabassumdr.shaguftatabassum@hotmail.comFaiza Suman1@gmail.comAyesha Uzaima Tarin2@gmail.comSaima Ayaz Rao3@gmail.com<p><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0">The rising rate of </span><span class="NormalTextRun SCXW108925518 BCX0">Cesarean Sections </span><span class="NormalTextRun SCXW108925518 BCX0">(CS) is a significant concern globally. While C-sections are lifesaving in many cases, an increasing number of unnecessary procedures pose risks to both mothers and babies. It has been found that the most common </span><span class="NormalTextRun SCXW108925518 BCX0">indication</span><span class="NormalTextRun SCXW108925518 BCX0"> of CS is </span><span class="NormalTextRun SCXW108925518 BCX0">previous</span><span class="NormalTextRun SCXW108925518 BCX0"> CS. </span></span><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><strong><span class="NormalTextRun SCXW108925518 BCX0">Objective</span></strong><span class="NormalTextRun SCXW108925518 BCX0"><strong>:</strong> </span></span><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0">To assess the indications and the factors leading to primary CS</span><span class="NormalTextRun SCXW108925518 BCX0">.</span> </span><strong><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0">Method</span><span class="NormalTextRun SCXW108925518 BCX0">s</span><span class="NormalTextRun SCXW108925518 BCX0">:</span></span></strong><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0"> T</span><span class="NormalTextRun SCXW108925518 BCX0">he</span> <span class="NormalTextRun SCXW108925518 BCX0">study was conducted at a tertiary care hospital of Pakistan employing non-probability consecutive sampling. A detailed </span><span class="NormalTextRun SCXW108925518 BCX0">history of</span><span class="NormalTextRun SCXW108925518 BCX0"> participants revolving around their first CS was taken including </span><span class="NormalTextRun SCXW108925518 BCX0">indication</span><span class="NormalTextRun SCXW108925518 BCX0"> and the associated demographics. All the information was entered on a specific </span><span class="NormalTextRun SCXW108925518 BCX0">proforma. </span><span class="NormalTextRun SCXW108925518 BCX0">Data analysis was conducted using SPSS software version 26.0. The primary outcome variable was the </span><span class="NormalTextRun SCXW108925518 BCX0">indication</span><span class="NormalTextRun SCXW108925518 BCX0"> for primary cesarean section, while the secondary variables included factors contributing to the procedure. </span></span><strong><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0">Results: </span></span></strong><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0">A total of 264 women who had CS for at least one of their </span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW108925518 BCX0">pregnancy</span><span class="NormalTextRun SCXW108925518 BCX0"> were considered. The vast majority (n=195</span><span class="NormalTextRun SCXW108925518 BCX0">, 73.9</span><span class="NormalTextRun SCXW108925518 BCX0">%) were primigravida, had 4-6 antenatal visits (n=174</span><span class="NormalTextRun SCXW108925518 BCX0">, 65.9</span><span class="NormalTextRun SCXW108925518 BCX0">%</span><span class="NormalTextRun SCXW108925518 BCX0">) and</span><span class="NormalTextRun SCXW108925518 BCX0"> underwent CS at term (180</span><span class="NormalTextRun SCXW108925518 BCX0">, 68.2</span><span class="NormalTextRun SCXW108925518 BCX0">%). There were more emergency CS (n=140.53%) performed at private clinics/hospitals (n=201. 57.4%).</span> <span class="NormalTextRun SCXW108925518 BCX0">Regarding</span><span class="NormalTextRun SCXW108925518 BCX0"> the indications of primary CS, the most prevalent </span><span class="NormalTextRun SCXW108925518 BCX0">was</span><span class="NormalTextRun SCXW108925518 BCX0"> failed progress of </span><span class="NormalTextRun SpellingErrorV2Themed SCXW108925518 BCX0">labour</span><span class="NormalTextRun SCXW108925518 BCX0">, followed by oligohydramnios, breech presentation/transverse lie, fetal distress, reduced fetal movements and maternal request. </span></span><strong><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0">Conclusion: </span></span></strong><span class="TextRun SCXW108925518 BCX0" lang="EN-US" xml:lang="EN-US" data-contrast="auto"><span class="NormalTextRun SCXW108925518 BCX0">It is need of time to scrutinize the </span><span class="NormalTextRun SCXW108925518 BCX0">indication</span><span class="NormalTextRun SCXW108925518 BCX0">s</span><span class="NormalTextRun SCXW108925518 BCX0"> of primary CS and to adopt potential strategies to minimize its number with the aim to lower overall CS rate.</span></span><span class="EOP SCXW108925518 BCX0" data-ccp-props="{"134233279":true,"335551550":6,"335551620":6}"> </span></p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3079Perceptions of Artificial Intelligence in Medical Education: A Cross-Sectional Study Among Students and Faculty at HBS Medical and Dental College, Islamabad2025-05-29T07:53:44+00:00Sarah Alisarahalyz@gmail.comSaiqa Saleemsaiqasaleemgandapur@gmail.comRehab Falakrehabfalaq@gmail.comKarishma Alikarishmasiki@gmail.comRuhina Salmanruhinaali1214@gmail.comSikandar Ali Khansiki4sikandar@gmail.com<p>As artificial intelligence (AI) continues to transform healthcare, its integration into medical education is increasingly critical. However, many institutions lack formal AI curricula, leaving students and faculty underprepared for the digital demands of clinical practice. <strong>Objectives:</strong> To assess awareness, familiarity, perceived benefits, and concerns regarding AI among medical students and faculty, and to explore training preferences and barriers to AI integration in academic settings. <strong>Methods: </strong>A descriptive cross-sectional survey was conducted at a HBS Medical and Dental College, with a total of 100 participants (76 students and 24 faculty). A questionnaire assessed demographic characteristics, AI familiarity, perceived benefits and concerns, and interest in formal training. Chi-square tests and logistic regression were used to analyse group differences and predictors of training interest. <strong>Results: </strong>Most participants (60%) were under 25 years old, and 76% were students. While 68% had heard of AI, only 43% reported basic familiarity. Interest in AI training was high (87%). Commonly cited benefits included faster knowledge access and personalized learning, while concerns focused on ethical issues and misinformation. A significant association was found between academic role and perceived lack of training (p=0.041). Logistic regression showed a non-significant trend linking prior AI exposure with interest in training (p=0.125). <strong>Conclusions: </strong>It was concluded that there is strong enthusiasm for AI in medical education among both students and faculty. However, limited familiarity and perceived barriers highlight the need for structured training and targeted curriculum reforms to build digital competence in future healthcare professionals.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2834Hepatitis B and C Infections in Pregnant Women Undergoing Chorionic Villus Sampling in Pakistan (2023–2024)2025-04-12T10:09:13+00:00Shahida Parveenshahidawahla@hotmail.comBushra Khanbushrakhan@yahoo.comAmna Azizdramna14@gmail.comTehreem RaziaTehreemrazia771@gmail.comRida Sanaridas2540@gmail.comRubaida Mehmoodrubaidasana@gmail.com<p>Pregnant women with high viral loads of HBV and HCV are at increased risk of vertical transmission and long-term complications. <strong>Objectives:</strong> To determine the disease burden of hepatitis B and C infections in pregnant women who underwent chorionic villus sampling (CVS).<strong> Methods: </strong>A comparative cross-sectional study was done in MINAR Cancer Hospital, Multan, from January 2023 to June 2024 for eighteen months using a non-probability purposive sampling technique. 1000 pregnant ladies who were scheduled for CVS were included after fulfilling the exclusion and inclusion criteria. Participants were divided into two age groups: 16–25 years and 26–50 years. Blood samples were taken and tested for HBV and HCV infections using commercial kits. The data were recorded and explored using SPSS version 24. <strong>Results: </strong>The participants had an average age of 27.78 ± 4.93 years (range: 16–46 years). HBV DNA was detected in 21 women (2.1%), while 66 (6.6%) tested positive for HCV RNA, leading to a total infection rate of 8.7%. Participants were divided into two age groups: 16–25 years (n=370) and 26–50 years (n=630). HBV infection rates were 1.6% and 2.38% in younger and older groups, respectively (P=0.418), while HCV infection rates were significantly higher in the older group (7.77% vs. 4.59%, p=0.04). <strong>Conclusion: </strong>It was concluded that the study highlights a significant prevalence of HBV and HCV infections in pregnant women undergoing CVS, emphasizing the need for routine screening and preventive strategies to reduce vertical transmission.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3052Causative Organisms and Antimicrobial Sensitivity Pattern in Patients with Urinary Tract Infection 2025-05-30T07:55:26+00:00Mamoona Zaman1@gmail.comShahan AhmadShahan_shanu@yahoo.comNauman Idrees2@gmail.comFaryal Ahmad4@gmail.comSana Naseer5@gmail.comRabia Gul6@gmail.com<p>Patterns of pathogens in urinary tract infection (UTI) and antibiotic sensitivity have been scarcely studied in the recent past in local settings. Hence, the study has been planned to address the knowledge gap arising from the non-availability of recent data. <strong>Objectives:</strong> To evaluate the causative organisms and antimicrobial sensitivity patterns in patients with urinary tract infections. <strong>Methods: </strong>This descriptive cross-sectional study was carried out at the Medicine Department of Khyber Teaching Hospital, Peshawar, during the period 1<sup>st</sup> July 2022 till 31<sup>st</sup> December 2022. Male and female patients aged 20 to 80 years with culture-proven urinary tract infections were enrolled. Pathogens isolated were noted their sensitivity to antibiotics was assessed. Data were analyzed using SPSS version 26.0. <strong>Results: </strong>The majority of study participants were aged more than 50 years (n=92, 51.4%). 109 patients (60.9%) were male, and 85 patients (47.5%) were diabetic. 89 patients (49.7%) were enrolled from the Outpatient Department. The most common pathogen was E coli, recorded in 48 patients (26.8%). Isolates in 154 (86.0%) out of 179 participants were susceptible to nitrofurantoin, followed by meropenem in 151 (84.3%). <strong>Conclusions: </strong>It was concluded that people of all ages can be affected by urinary tract infection. The most common bacterial cause of UTI is E coli. Nitrofurantoin and meropenem are the most effective antibiotics against uropathogens.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3027Investigating Motorcycle Accident Risk Factors among Educated Riders: Associations with Driver Behaviour, Road Conditions, and Vehicle Safety Concerns2025-05-30T08:21:09+00:00Muhammad Hammaddrhammadims@gmail.comSarba Khalidsarbach450@gmail.comRoman Ashrafdrromaan.ashraf@gmail.comDurdana Zafardrdurdanazafar40@gmail.comZulfiqar Ali Buzdarforensicatitbest@gmail.comMuhammad Asif Shahabmuhammadasifshahab@hotmail.com<p>Motorcycle accidents pose a significant threat to public health and often present as serious medicolegal challenges, particularly in developing countries. <strong>Objectives:</strong> To identify and analyze key risk factors, over speeding, poor driving sense, lighting defects, and mirror faults, associated with motorcycle accidents among an educated population comprising students and faculty. Also, to explore the association of these factors with demographic characteristics and varying road conditions. <strong>Methods: </strong>A cross-sectional study was conducted using a self-administered questionnaire to gather data on participants' demographics, motorcycle usage patterns, self-reported safety concerns, and perceived road hazards. Chi-square tests were used to assess associations between variables. <strong>Results:</strong> Over-speeding emerged as the most frequently reported safety concern, especially among younger riders and during peak traffic hours. Although notable trends were observed across different age groups, professions, and road conditions, none of the associations reached statistical significance (p>0.05). <strong>Conclusions: </strong>It was concluded that although over-speeding was consistently reported as the most frequent safety concern among students and faculty, statistical analysis revealed no significant associations between reported concerns and demographic or road condition variables. These findings suggest that motorcycle safety risks are broadly distributed across rider categories. Institutional interventions such as safety awareness programs, infrastructure improvements, and strict enforcement of traffic laws may still be beneficial in promoting safer riding practices within the academic community.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3090Role of a Teacher in Medical Education: A Faculty’s Perspective from HBS2025-05-31T05:50:05+00:00Amara Hayat Awanamarahayatdme@gmail.comSarah Alisarahalyz@gmail.comUzma Siddiqueuzmafaisal141@gmail.comRoma Salmanromasalman99@gmail.comYasir Khanyasirkhanay@gmail.comHassan Ayubhassan.ayub490@gmail.com<p>Medical educators are vital in delivering knowledge and shaping students' professional behaviour and critical thinking. However, their effectiveness is influenced by institutional support, teaching training, and the ability to adapt to innovative methodologies. <strong>Objectives: </strong>To assess faculty members' perceptions, teaching practices, and institutional involvement in medical education and to explore the association between formal training and innovative teaching methods. <strong>Methods: </strong>A descriptive cross-sectional survey was conducted at HBS Dental College, Islamabad, including 85 faculty members. Data were collected using a structured questionnaire covering demographics, teaching methods, perceptions of educational roles, and barriers faced. Statistical analysis was performed using SPSS version 25.0, applying Chi-square, Mann-Whitney U, and Kruskal-Wallis tests. <strong>Results: </strong>Lecture-based teaching was universal, while small group teaching (68.2%) and PBL (41.2%) were also common. Only 35.3% of faculty had formal training in medical education. A significant association was found between training and the use of innovative methods (p=0.001). Reflective teaching scores were higher among trained faculty (p=0.049). Lack of time was the most reported barrier (69.4%). <strong>Conclusions: </strong>It was concluded that faculty with formal training were more likely to adopt innovative and reflective teaching practices. Addressing institutional barriers and investing in structured faculty development can significantly enhance the quality of medical education.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3060Differences in Depressive Symptoms, Perceived Social Support, and Quality of Life among Patients with Hepatitis C and Psychiatric Patients: A Cross-Sectional Study2025-05-30T10:47:15+00:00Mafia Shahzadimafiashahzadi62@gmail.comMumtaz Lakho2@gmail.comZahid Hussain Soomromafiashahzadi62@gmail.comAhmed Ali Kanhar3@gmail.comIffat Jamal3@gmail.comArooba Pervez4@gmail.comIshrat Rana5@gmail.comAqila Unbrin5@gmail.com<p>Hepatitis is a series of viral illnesses that can impact a person's health and social life. <strong>Objective:</strong> To investigate the differences in depressive symptoms, perceived social support, and quality of life among the normal population, patients with Hepatitis C, and patients with psychiatric disorders. <strong>Methods: </strong>402 participants were taken from Faisalabad's different urban and rural areas. The participants 'ages ranged from 25 to 54 years. The sample consisted of married participants (n=189, 47%) and unmarried participants (n=213, 53%). A purposive sampling technique was used to collect the data. The following measures were used to assess the findings: Demographic Form, Patient Health Questionnaire, Multidimensional Scale of Perceived Social Support, and World Health Organization Quality of Life-BREF scale. <strong>Results:</strong> The findings revealed that patients with hepatitis C and patients with psychiatric disorders perceived a high degree of depression as compared to individuals having no history of medical and psychiatric treatment. Similarly, patients with hepatitis C and patients with psychiatric disorders perceived a low degree of social support and quality of life as compared to individuals having no history of medical and psychiatric treatment. <strong>Conclusion:</strong> In this study, depression, perceived social support, and quality of life were found to significantly differ between the general population, Hepatitis C patients, and people with a mental health condition.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2969Preoperative Total Leukocyte Count: A Key Predictor for Better Optimization and Conversion Risk in Laparoscopic Cholecystectomy for Cholelithiasis2025-06-02T06:30:20+00:00Hafiz Waqas Ahmed1@gmail.comRabia Khanum2@gmail.comTooba Mahmud Gauharangel.july17@gmail.comSafiullah Khan3@gmail.comRubab Nafees4@gmail.comJahanzaib Babar5@gmail.com<p>Gallstone disease requires laparoscopic cholecystectomy (LC) as the standard of care. Sometimes, the surgeon decides to convert LC to open cholecystectomy (OC) for patient safety. Several factors help us predict preoperatively whether there is any chance of conversion of LC to OC. The role of elevated total leucocyte count (TLC) as a predictor for conversion is being proposed. This study investigates the association between pre-operative TLC levels and conversion rates from LC to OC. <strong>Objective</strong>: To determine the association between increased TLC and conversion from LC to OC. <strong>Methods:</strong> This study was conducted at Al-Tibri Medical College Hospital, Karachi, over eighteen months from 1st July 2023 to 31st December 2024. A total of 230 patients were included. We selected 115 patients with TLC above 11.0x10^9/L and 115 patients with non-elevated TLC. All patients underwent LC, and conversions to OC were recorded. Data were analyzed using SPSS version 23.0. Mean and standard deviation were computed for numerical variables, and percentages for categorical variables. The chi-square test was applied to find the association between categorical variables. The relative risk (RR) was calculated to compare the risk of conversion of LC to OC among Elevated and Non-elevated TLC Groups. <strong>Results</strong>: The average age of patients was 31.82±10.06 years. The conversion risk was 117% higher in the elevated TLC group compared to the non-elevated TLC group (RR=2.17, 95%CI: 1.32-3.56). <strong>Conclusions</strong>: It was concluded that elevated pre-operative TLC is significantly associated with a higher risk of conversion from LC to OC, indicating its potential as a predictive factor for surgical planning.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3035Evaluation of Variability in Macular Thickness in Primary Open Angle Glaucoma: A Spectral Domain Optical Coherence Tomography-Based Study2025-06-02T10:11:45+00:00Tehreem Tanveerttanveer@hotmail.comMahmood Alidrmahmoodali@alshifaeye.orgFatima Akramfatimakram999@gmail.comUme Sughradr_sughra@yahoo.comAsma Anwardrasmaanwar2018@gmail.comFarah Khanfarahakhan97@outlook.com<p>The world’s number of fatal blindness cases caused by glaucoma is mainly due to primary open-angle glaucoma (POAG). This disease is connected to damage of the optic nerve, death of retinal ganglion cells and problems with how we see things. Objectives: To check the thickness and the amount of volume in the retinal macula using spectral-domain optical coherence tomography (SD-OCT) among patients of POAG and subjects without glaucoma. <strong>Methods:</strong> The observational case-control study, where 40 participants had POAG and 40 participants the same age did not. Only the right eye or only the left eye from each subject was examined in the study. All subjects had a thorough check of their eyes which included history, eye chart testing, slit-lamp examination, dilated fundus inspection, gonioscopy and measuring intraocular pressure (IOP). Visual fields were assessed using the Humphrey Field Analyzer. Macular thickness (MT) was analyzed with SD-OCT using OCT Spectralis. Parameters evaluated were macular inner thickness (MIT), macular outer thickness (MOT), macular central thickness (MCT) and macular total volume (MTV). <strong>Results: </strong>Patients with POAG exhibited markedly reduced MTV, IMT and OMT in comparison to healthy controls, with the greatest decline observed in the temporal as well as the inferior quadrants. These observations confirm that structural differences in the macular parameters are correlated with glaucoma and can aid in early diagnosis and monitoring progression. <strong>Conclusion: </strong>This study emphasizes the diagnostic utility of SD-OCT in determining macular thickness variability in individuals with POAG. Our findings show that macular thickness is much lower in glaucomatous eyes than in healthy controls, with distinct patterns of regional thinning indicating retinal ganglion cell vulnerability.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/3092Association of Gestational Hypertension with Neonatal Cardiovascular Physiology2025-05-30T05:57:58+00:00Sanodia Afridisanodia.afridi@gmail.comImran Khandrimranbettani2017@gmail.comAsfa Mumtaz1@gmail.comShabnam Bibishantulktk@gmail.com Haji Gul7@gmail.comKhalil Ahmadrabail_muneer@yahoo.com<p>Gestational hypertension (GH) is a common hypertensive disorder of pregnancy associated with increased maternal and neonatal risks. While its impact on maternal cardiovascular health is well-established, its effects on neonatal cardiovascular physiology remain insufficiently explored. <strong>Objective</strong>: To examine the association between GH severity and neonatal cardiovascular outcomes. <strong>Methods: </strong>A cross-sectional observational study was conducted at Health Net Hospital, Peshawar, including 150 mother-neonate pairs diagnosed with GH. Participants were categorized into mild, moderate, and severe GH groups per ACOG criteria. Neonatal cardiovascular parameters heart rate, blood pressure, pulmonary artery pressure, LVEF, and CHD, were assessed. One-way ANOVA and Chi-square tests analyzed group differences, while logistic regression identified independent predictors of NICU admission. <strong>Results:</strong> Of the 150 neonates, 34% required NICU admission, with all severe GH cases admitted (p<0.001, Cramer's V=0.638). One-way ANOVA showed no significant differences in heart rate, blood pressure, or LVEF across GH groups (p>0.05), though LVEF showed a borderline trend (p=0.059). Logistic regression confirmed GH severity as an independent predictor of NICU admission (OR: 0.181, 95% CI: 0.097–0.339, p<0.001), while birth weight was non-significant (p=0.575). <strong>Conclusions:</strong> It was concluded that the severity of gestational hypertension is significantly associated with adverse neonatal cardiovascular outcomes, particularly NICU admission. GH severity independently predicted NICU requirement, emphasizing the need for close monitoring and early intervention in pregnancies complicated by moderate to severe GH.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Scienceshttps://thejas.com.pk/index.php/pjhs/article/view/2881Hematological Ratios versus Disease Characteristics versus Surgeons’ Experience and Expertise: What Stands Out as Predictor of Conversion to Open Cholecystectomy?2025-05-31T11:09:25+00:00Maryam Afzalmaryam.afzal99@hotmail.comMehmood Ul Haq Farooqidrmhfarooqi@gmail.comSobia Ashrafsobia.ashraf@ucm.uol.edu.pkMuhammad Afzalmafzal0155@gmail.com<p>Conversion of laparoscopic to open cholecystectomy is often a surprise for the surgeon. <strong>Objective:</strong> To evaluate predictors like inflammatory ratios, gallbladder wall thickness and surgeons’ experience to see what predicts conversion best. <strong>Methods:</strong> Retrospective cohort study was done on adult patients diagnosed with acute cholecystitis (Tokyo guidelines) at Surayya Azeem Hospital from 2021 to 2024. Data collected included demographics, CBC findings, surgeons' experience, operation details and ultrasound findings. Patients with chronic cholecystitis, comorbidities and other gallbladder pathologies were excluded. Ratios like NLR, MLR, PLR, SIRI, SII, NLPR and d-NLR were calculated. Chi square, Mann Whittney U, binary logistic regression and ROC analysis were used as per requirement. P-value of less than 0.05 was considered significant. <strong>Results:</strong> 80% of 475 patients were females. 22 (4.8%) patients underwent conversion. Old age and male gender were associated with adverse outcome. WBC count, NLR, d-NLR, SIRI, SII and NLPR were higher in conversion group. Platelet count, PLR and MLR had no associations. Higher hemoglobin (>12.3 g/dL) and ALC (> 1.8x109/L) were predictive of successful laparoscopic procedure. Highest predictive value for conversion was found for NLR and d-NLR (AUC=0.84) followed SIRI (AUC=0.78) with cut-offs of 4.97, 3.76, and 1.69 respectively. Gallbladder wall thickness of <u>></u>7mm (AUC=0.64) and inexperienced surgeons (AUC=0.69) also increase the probability of conversion. <strong>Conclusion:</strong> Systemic inflammatory indices predict conversion better than ultrasound findings and surgeons’ experience. Experienced laparoscopic surgeons should operate on patients with thick gallbladder wall and high inflammatory ratios to minimize the risk of conversion.</p>2025-05-31T00:00:00+00:00Copyright (c) 2025 Pakistan Journal of Health Sciences