Pakistan Journal of Health Sciences

The Rise of Polycystic Kidney Disease (PKD): Early Detection and New Treatment Options

Sami Ullah Mumtaz — 2025-01-31

Polycystic Kidney Disease (PKD) is a hereditary disorder that results in the formation of fluid-filled cysts in the kidneys. Cysts can cause damage or worse renal failure over time. Although PKD has no cure, recent developments have helped in early detection and provided additional therapies that can control the condition and improve the quality of life of the affected. Early detection is essential to slow its progression and maintain renal function. It is inherited in an autosomal dominant pattern so the children of the afflicted parents have a 50% chance of developing this condition. The symptoms include kidney infections, flank pain, high blood pressure, and frequent urination, they don’t show up until later in life. Cyst formation may start sooner in childhood, and the condition may advance more quickly in certain instances. PKD can be confirmed by performing genetic testing in families with a history of the condition. Imaging methods such as MRI and ultrasound are essential in early diagnosis. Ultrasonography can be used to visualize the cyst. If this condition is diagnosed early medical professionals can treat the patient and control the symptoms while delaying kidney impairment. Some medications can delay its progression, but currently, no cure is there. There is a drug called Tolvaptan which inhibits the growth of kidney cysts and aids in maintaining renal function, is considered one of the noteworthy achievements. It has shown promising results in delaying the need for dialysis or kidney transplants by inhibiting the hormone vasopressin, a hormone responsible for the formation of cysts. Hypertension can worsen renal damage so drugs such as ACE inhibitors and angiotensin receptor blockers (ARBs) are prescribed to maintain blood pressure levels.

Stem cell researchers are working on the repairing and renewal of damaged kidney tissue. Research on this subject has just started but the potential of this research can be foreseen in producing novel medicines that could revolutionize PKD care shortly. Life style plays an important role in controlling PKD, kidney strain can be reduced by maintaining a healthy life style, eating a diet that is low in proteins, and avoiding smoking.

Frequent exercise can improve health and blood pressure. PKD is a health concern that affects people significantly but early detection and new treatments like tolyaptan and ongoing research are the hope for patients.

Although no cure is available advancements in managing the disease can improve the quality of life and delay renal failure. With early intervention and the right treatment approach, PKD patients can lead healthier and more fulfilling lives.

Prevalence of Tardive Dyskinesia and Its Association with Antipsychotic Drug and Depression in Geriatric Population in Lahore, Pakistan

Maria Mustafa — 2025-01-31

“Tardive Dyskinesia” is the subtle onset of rhythmic, stereotype, repetitive movement of the face, mouth, and tongue. The basic pathology behind this disease is hypersensitization of dopamine receptors. Objective: To find out the prevalence of tardive dyskinesia and its association with depression and antipsychotic drug administration in the geriatric population. Methods: A cross-sectional descriptive study was conducted for a period of four months from February 2023 to May 2023. The data were collected from different hospital settings in Lahore. A sample size of 150 elderly individuals aged 55-80 years were included. Depression was evaluated through Geriatric Depression Scale whereas abnormal involuntary movement Tardive Dyskinesia is evaluated through AIMS scale. Chi square test was used to determine the association between variables Depression, Antipsychotic drug and Tardive Dyskinesia. Informed consent and ethical approval were taken from all participants. Results: Out of 150 respondents, 78 (52%) male and 72 (48%) were female. Mean age was 65 years ± 7.21 SD. Among all individuals 20% experienced mild, 42.7% with moderate and 37.3% experienced severe depression.27.3% of the population taking antipsychotic drug experienced Tardive dyskinesia while it was absent in 22.67% of the individuals who were taking antipsychotic drug.20.67% of old individuals with severe depression were with Tardive dyskinesia. Conclusions: It is concluded from above study depression is common among geriatric population. Antidepressant drugs used to treat depression for longer duration because abnormal movement called tardive dyskinesia. There is significant relation of Tardive Dyskinesia with depression and antipsychotic drugs.

Effectiveness of Aromatherapy on Pain and Anxiety among Burns Patients at Public Hospital of Karachi

Amir Haider — 2025-01-31

Aromatherapy is a safe supplement to reduce the pain and anxiety among burn patients. Objective: To determine the effectiveness of aromatherapy on pain and anxiety among burn patients at a public tertiary care teaching Hospital, Karachi, Pakistan. Methods: A quasi-experimental design was employed, on participants of both genders aged between 18-54 years and had burns that were less than 40% Total Body Surface Area. The sample size for this study was calculated through Open Epi version 3.0 with a proportion formula and the calculated sample size was 88. Two open accessed questionnaires Pain and Anxiety Symptom Scale (PASS-20) and Visual Analogue Scale (VAS) was used to collect the data. Wilcoxon signed-rank test was used to test the effect of the intervention (8.00 to 5.75). Results: The results showed that aromatherapy significantly reduced post-intervention pain (p-value0.001). The sub-scale “cognitive”, “escape avoidance”, and the global PASS score was significant after intervention with P-values <0.0001, 0.039, and 0.025 respectively. The mean scores of PASS in all sub-scales and the global score was significantly decreased after the intervention with a large effect size (r>0.5) using Cohen's (1988) criteria. Conclusions: The findings suggested that aromatherapy was a safe supplement to reduce the pain and anxiety among burn patients. Nurses can use at the clinical practice to enhance the use of aromatherapy by which the pain and anxiety can reduce among burn patients.

Thyrotoxicosis: What is the Cause in Our Population?

Ashfaq Ali — 2025-01-31

Thyrotoxicosis is an endocrine disorder in which excess amount of thyroid hormone is secreted in the blood stream and causes its action at the tissue level. Thyrotoxicosis highly affects the quality of life of patients suffering from the disease in carrying out daily activities. Proper treatment of thyrotoxicosis requires an accurate diagnosis. Objective: To determine the causes of thyrotoxicosis in patients reported for evaluation and management to specialized endocrine unit. Methods: This was a descriptive cross sectional observational study conducted by convenient sampling in Outpatient Department (Endocrinology Clinic) Khyber Pakhtunkhwa in six month’s duration (15^th December 2023 to 15^th May 2024) having sample size n=118. Thyrotoxicosis was labeled if patient has high T3, T4 (thyroxine and/or triiodothyronine) levels and suppressed thyroid stimulating hormones TSH levels. Information was gathered from the patients regarding their clinical signs and symptoms and anthropometrics. Laboratory investigations of thyroid function tests were obtained and analyzed. Results: The mean age of 118 patients was 40.39 ± 13.69 years, 28% male and 72% female patients were in enrolled in the study. Graves’ disease was most common form thyrotoxicosis making count of 50% of patients followed by toxic adenoma, toxic MNG, thyroiditis 16% and 14 % respectively. Anti-thyroid drugs count 43% of most of the patient’s treatment offered followed by radioactive iodine 28%. Conclusions: In conclusion, the main cause of thyrotoxicosis, includes grave’s disease, toxic adenoma and toxic MNG in Pakistani population. Thyrotoxicosis was more prevalent among female population as compared to males.

Sleep Disorders and Quality of Life in Children with Cerebral Palsy

Ubedullah Bahalkani — 2025-01-31

Sleep disorders are common in children with Cerebral Palsy (CP) and can adversely affect their health and quality of life. Objective: To investigate the factors associated with sleep disorders in children diagnosed CP with age ranged from 5 to 10 years. Methods: A cross-sectional study was conducted for six months from March 2024 to August 2024, with 150 children aged 5 to 10 years diagnosed with CP at Department of Pediatrics, Khairpur medical college Khairpur Mir’s. Data on demographics, type of CP, motor function levels (GMFCS), epilepsy presence, physiotherapy intensity, co-sleeping practices, and sleep disorder prevalence were collected. Odds Ratios (OR) and Adjusted Odds Ratios (Adjusted OR) were calculated using chi-square tests and multivariate analysis. Results: Participants were predominantly aged 8 to 10 years (53.3%), with spastic CP being the most common type (56.7%). Significant associations were found between sleep disorders and several factors: type of CP (OR = 2.57, P = 0.004), GMFCS levels III and IV (OR = 2.94, P = 0.001), epilepsy (OR = 2.67, P = 0.01), and low physiotherapy intensity (OR = 3.11, P < 0.001). Multivariate analysis confirmed that the type of CP (Adjusted OR = 2.45, P = 0.007) and motor impairment severity (Adjusted OR = 3.10, P = 0.001) were significant risk factors for sleep disorders. Conclusion: The study highlighted a high prevalence of sleep disorders among children with CP, emphasizing the need for targeted interventions addressing specific risk factors to improve sleep quality and overall well-being.

Impact of Anesthesia Type on Stone Clearance and Morbidity in Ureteroscopy: General Versus Spinal Anesthesia

Atif Iqbal — 2025-01-31

Anaesthesiologists prefer regional anesthesia for ureterorenoscopy to prevent difficulties after the procedure, whereas surgeons prefer general anesthesia in order to prevent ureteral damage. However, limited comparative data exist regarding the outcomes of these anesthesia techniques in ureteroscopy-assisted stone clearance Objective: To compare spinal and general anesthesia regarding efficacy, safety, and patient outcomes during ureteroscopy for ureteric stones. Methods: This quasi-experimental study included 90 patients aged between 20-60 years in total were chosen. Using a semi-rigid ureteroscope (8/8.4 fr), all individuals had ureteroscopic treatment for ureteric stones. Equal numbers of 45 patients were divided between the two groups. General anesthesia was administered to Group A, and spinal anesthesia was provided to Group B. The participants' demographic data, hospital stays, operating times, stone removal rates, and intra- and post-operative problems were all recorded. Data on intraoperative parameters, stone clearance, and postoperative complications were collected and analysed using SPSS 23.0. Results: General anesthesia significantly reduced the dilatation time (104.01 ± 12.772 vs. 130.552 ± 22.532 sec, p < 0.001) and time to reach the stone (126.68 ± 12.592 vs. 137.602 ± 17.841 sec, p < 0.001) compared to spinal anesthesia. However, no significant differences were observed in lithotripsy time, operation time, stone-free rates, or postoperative complications between the two groups. Patients in the GA group reported higher VAS scores and an increased frequency of nausea/vomiting after surgery. Conclusion: General anesthesia reduced the time for dilatation and stone access but showed no significant advantages in lithotripsy time, operation time, stone-free rates, or complications.

Prevalence of the Modifiable Risk Factors of Cardiovascular Diseases in Young Adults of District Hyderabad Sindh Pakistan

Shakil Ahmed Shaikh — 2025-01-31

Cardiovascular diseases are the major cause of morbidity and mortality around the world. Numerous studies concluded that populations of the subcontinent are more prone to develop cardiovascular diseases including Pakistan as compared to other countries. Objective: To determine cardiovascular disease risk factors in the healthy population of the Hyderabad district, Sindh. Methods: The cross-sectional study was conducted from July 2023 to December 2023, in this study, apparently healthy young adults of not more than 40 years of age were included. A self-designed questionnaire was set for the collection of data. Blood pressure was taken using the standard method, a mercury sphygmomanometer. South Asian standards calculated BMI, and the blood sample was taken after 10 hours of fasting for lipid profile and fasting blood sugar. Collected data were analyzed by SPSS version 23.0. Results: In this study, one risk factor was found in 276 (76%) of the participants, and Obesity was found in 41 (17%) and 66 (52%) respectively in group I and group II participants. Central obesity was found to be higher in group II 92 (72%) than in group I 69 (29%). Group II participants were found to have higher blood pressure than group I 61 (48%) and 61 (26%) respectively. Conclusions: It was concluded that 3 risk factors were found higher in females, and 4 risk factors were found higher in males, thus making the male population more prone to be affected by cardiovascular diseases even at an early age.

Perceptions of Medical Students towards Artificial Intelligence

Shazia Rizwan — 2025-01-31

The incorporation of technological advancements, particularly Artificial Intelligence has transformed healthcare systems globally, especially post-COVID-19. Medical education faces challenges in incorporating AI due to instructor shortages and high software costs. Understanding medical students' attitudes towards AI is crucial for its successful integration into medical practice and education. Objective: To evaluate the attitude of medical undergraduate students towards AI in medicine. Methods: A descriptive, online cross-sectional study was executed among undergraduate medical students utilizing a non-probability convenience sampling. The questionnaire, distributed to 340 participants, included demographic details, perceptions towards artificial intelligence, and its effect on medical education. A total of 252 responses were received, receiving a 74% response rate. Data analysis was executed through SPSS version 26.0. Results: Demographic characteristics of 252 subjects revealed a mean age of 23.5 years, with a majority being female (74.2%) and in their first to third year of study (58.3%). Participants generally had intermediate computer literacy (75.7%) and used technology consistently for learning (57.5%). Regarding perceptions of AI, most students strongly agreed that AI will significantly impact healthcare (48.8%) and that all medical students should be educated about it (31.3%). Additionally, a substantial majority believed that integrating AI into medical education would enhance its quality (66.6%) and facilitate the learning experience (57.9%). Conclusions: It was concluded that students have positive perceptions regarding AI systems, demonstrating enthusiasm for expanding their knowledge of AI within their medical education.

Autoimmune Hemolytic Anemia in Children: Clinical Profile and Outcome

Kamran Ali — 2025-01-31

Autoimmune Hemolytic Anemia (AIHA) is an idiopathic condition marked by red blood cell destruction. Objective: To compare the clinical features, laboratory parameters, treatment approaches, and responses between idiopathic and secondary AIHA in pediatric patients, with the aim of identifying key distinctions that can inform the development of tailored diagnostic and therapeutic strategies. Methods: This was cross sectional study and conducted for six months from April 2024 to September 2024 at Department of pediatrics at Khairpur medical college khairpur mirs. Data were collected on demographics, presenting symptoms, laboratory findings (hemoglobin, bilirubin, LDH levels), antibody profiles, and treatment outcomes. SPSS 23 was used for statistical analysis to compare treatment responses and clinical characteristics between idiopathic and secondary AIHA patients. Chi-square tests were used for categorical variables and t-tests for continuous variables. Results: The mean age of participants was 6.8 years, with 58% male. Patients with idiopathic AIHA had higher hemoglobin levels (7.5 g/dL versus 6.9 g/dL for secondary, p=0.03) and lower bilirubin (3.6 mg/dL versus 4.1 mg/dL, p=0.02). Treatment varied significantly: 89% of idiopathic patients received steroids compared to 86% of secondary patients. Secondary patients were more likely to receive IVIG (51% versus 34%, p=0.04) and rituximab (37% versus 11%, p<0.01). Complete response rates were higher in idiopathic AIHA (83% versus 63%, p=0.01). Conclusions: Significant differences exist in the clinical presentation and treatment responses of idiopathic versus secondary AIHA. Tailored treatment strategies on AIHA type are essential for improving patient outcomes, warranting further research into these distinctions and new therapies.

Assessing the Alkaline Phosphatase Levels as A Bone Biomarker in Gingival Crevicular Fluid during Semi-Rapid Expansion

Ahmad Shamim — 2025-01-31

In orthodontics, the expansion of the maxilla is done to treat transverse maxillary deficiency in childhood. The cause of maxillary constriction may be genetic or environmental leading to crowding of teeth, cross bite and development of malocclusions. This expansion leads to increased maxillary dimensions. Objectives: To detect changes in alkaline phosphatase level as a bone biomarker in crevicular fluid during the phases of semi-rapid palatal expansion. Methods: Fifteen growing patients with an age range from 8-13 years were selected who needed maxillary semi-rapid palatal expansion as a part of orthodontic treatment. This quasi-experimental study was based on a non-probability purposive sampling technique conducted from August 2023 to July 2024. The samples were collected by inserting paper points in the gingival sulcus. The Periodontal status was evaluated before starting the sampling. The probing depths were recorded at different levels throughout the study until the completion of the retention period. The alkaline phosphatase levels in the gingival crevicular fluid were measured at buccal and palatal sites before, during and in the retention period after treatment. The alkaline phosphatase values were compared using the ANOVA test at different points in time with p<0.05 considered as statistically significant. Results: The ANOVA test showed a statistically significant increase in enzyme activity at different sites throughout maxillary semi-rapid palatal expansion treatment. Conclusions: It was concluded that the enzyme alkaline phosphatase as a biomarker is an indicator of active bone metabolism in growing children while going through the maxillary semi-rapid palatal expansion treatment.

Endometrial Hyperplasia on Rising Trends among Peri-Menopausal Women

Shagufta Tabassum — 2025-01-31

Endometrial hyperplasia demonstrates a uterine pathology characterized by a range of endometrial morphological remodeling. The clinical importance of endometrial hyperplasia lies in its progression to endometrial carcinoma. Objectives: To analyze histopathological findings of endometrial biopsy in perimenopausal women having abnormal uterine bleeding and to observe the correlation of various risk factors with endometrial hyperplasia. Methods: The cross-sectional study was conducted at the Department of Gynaecology, Nishtar Medical University, Pakistan. Two hundred and fifty-five perimenopausal women having abnormal uterine bleeding of 3-12 months’ duration were included. The participants were subjected to histopathological analysis of endometrial biopsy obtained by dilatation and curettage. All the information and the histopathology report were entered on a specific proforma. Data analysis was performed using SPSS software version 26.0. Results: Out of a total of 255 patients, the mean age was 48+/-6 years. A vast majority was grand multiparous (n=163, 64%). Out of a total of 255 endometrial samples, the majority (n=88, 34.5%) turned out to be proliferative endometrium, indicating hormonal imbalance like unopposed estrogen stimulation. In total, 66 (25.9%) samples fulfilled the criteria of endometrial hyperplasia. 54 (21.7%) had endometrial hyperplasia without atypia, while 12 (4.2%) had atypical endometrial hyperplasia. Regarding atypical uterine bleeding, the commonest symptom was heavy regular cycle (n=74, 29%) followed by irregular vaginal bleeding (n=70, 27.5%). Conclusions: It was concluded that atypical uterine bleeding in the peri-menopausal life period is alarming. All such women should undergo endometrial histopathological examination to detect endometrial hyperplasia to prevent its progression to endometrial carcinoma.

Potential Obstacles to Achieve Successful Outcomes Following Stuttering Interventions

Alia Hassan — 2025-01-31

Stuttering is a common speech problem affecting all age groups. Speech-language pathologists face barriers in attaining favourable therapeutic results. Identification of these barriers could help attain therapy results. Objectives: To identify the perceived barriers that speech-language pathologists encounter in achieving successful outcomes following stuttering interventions. Methods: The current qualitative study was conducted at Riphah International University from September 2023 to February 2024. A sample of n=10 speech-language pathologists was taken from Rawalpindi and Islamabad using purposive sampling. The sample included qualified speech-language pathologists of both genders, any age, practicing for at least 05 years with clients having fluency disorder. The study involved semi-structured interviews with the option of face-to-face and online interviews using an interview guide. Information obtained was transcribed followed by thematic analysis. Results: The study revealed six major themes including collaborative approaches in intervention and the role of various professionals, Patient engagement and empowerment for successful intervention outcomes, empowering families for effective communication and support in successful intervention, strengthening speech-language pathologists' practices, therapeutic accessibility and holistic approach to stuttering intervention. The findings demonstrated that speech-language pathologists understanding of stuttering especially their unique roles within it, is somewhat restricted due to barriers including i). Diverse perspective held by the speech-language pathologists, ii) Clinical challenges, iii) Systematic and environmental factors and iv) lack of collaboration and support. Conclusions: It was concluded that speech-language pathologists perceive the following main barriers i) Diverse perspectives held by the speech-language pathologists, Clinical challenges, Systematic and environmental factors and lack of collaboration and support.

Variation of Epithelial and Nuclei Morphohistology in Oral Submucous Fibrosis Patients

Rida Rubab Ahmed — 2025-01-31

In the background of oral submucous fibrosis, oral cancer is the most commonly present malignant transformation in South Asian regions. Alteration of tissue architecture contributes significantly to determine the exact pathological state of the disease. Objective: To evaluate histological changes in structure of oral submucous fibrosis patients in context of textural properties of epithelium and morphology of nuclei. Methods: A total of 50 subjects were inducted in this cross-sectional study performed at dentistry department of Jinnah Postgraduate Medical Center (JPMC) in Karachi. Punch biopsy samples were taken from buccal mucosa followed by preparation of tissue blocks and slide preparation to analyze histology of premalignancy and record abnormal features present in normal oral tissue. Results were analyzed through SPSS version 23.0 and p value of ≤0.05 was considered as statistically significant. Results: 37 (74%) subjects had prominent Oral Submucous Fibrosis histologically out of which abnormal epithelial parameters such as stratified squamous, hyperplastic, keratotic, and neoplastic were noted in 5 (10%), 31 (62%), 10 (2%), 0 (0%) subject respectively. p value 0.041 was calculated using Chi square analysis for qualitative data which depicted relevance of hyperplastic epithelium in Oral Submucous Fibrosis. 29 (87.9%) subjects showed pleomorphism in nucleus and 8 (47.1%) showed normal/round nucleus in Oral Submucous Fibrosis subjects with a p value of 0.003. Conclusions: Histological analysis which is not routinely performed in oral submucous fibrosis patients could visualize accurate extent of disease through structural variability of epithelium and nucleus.

Comparison of Open and Close Exposure with Orthodontic Traction of Impacted Maxillary Canine in Orthodontic Treatments

Muhammad Amjad Bari — 2025-01-31

Labial impactions make maxillary canines the most affected permanent teeth after third molars, at one third. Orthodontic advice is often needed for impacted canines. Objective: To compare the outcomes of open and close exposure with orthodontic traction of impacted maxillary canine in orthodontic treatments. Methods: In this comparative prospective cohort study 54 patients with labial impacted maxillary canine were included in this study. Study was conducted from Jan 2023- Jun 2023. Non-consecutive sampling technique was used. 27 patients were managed with open technique in group I and 27 patients with closed eruption technique in group II. The evaluation encompassed a comparison of two surgical exposure methods (open and closed) mobility, vitality, periodontal health, amount of impaction, length of orthodontic therapy, and postoperative discomfort. Results: Compared to the close eruption approach, the postoperative recovery time for open eruption was significantly greater (P < 0.05). Patients reported comparable levels of postoperative discomfort; but, the closed eruption approach resulted in a more rapid resolution of that pain. The open eruption approach required less time during surgery on average compared to the closed eruption technique (P <0.05). In a direct correlation with the amount of impaction, the overall length of orthodontic treatment was shown to be longer for deeper levels of impaction. Both methods produced canines with comparable levels of energy and movement. Conclusions: In this study, the closed eruption approach took longer but reduced postoperative pain faster. Orthodontic therapy took longer with deeper impaction. Closed eruption surgeries improve periodontal tissues surrounding guided erupted teeth.

Comparison of the Side Effects of Chlorhexidine and Honey Mouthwash among Dental Patients: A Randomized Controlled Trial

Muhammad Abid — 2025-01-31

Gingivitis, primarily caused by bacterial plaque buildup, was managed through mechanical removal, though this requires consistency. Chemical agents like chlorhexidine mouthwash were effective but have notable side effects. Honey, with its antibacterial properties, offers a potential alternative with fewer adverse effects. Objective: To compare the side effects of 0.12% chlorhexidine gluconate and 10% honey mouthwash to determine which offers a safer and more comfortable option for oral hygiene in young adults. Methods: This randomized controlled trial was conducted from June 2020 to December 2020 to compare the side effects of two oral care solutions, 0.12% chlorhexidine gluconate and 10% honey mouthwash, among young adults. Sixty subjects were recruited from the Department of Periodontology at a tertiary care hospital in Karachi. The primary focus of the study was to observe and document any side effects associated with each mouthwash during and after three weeks of usage for plaque removal and gingival health. Results: The study revealed that participants in Group A (chlorhexidine) reported a higher incidence of adverse effects, including a pronounced bad taste, numbness in the mouth, and noticeable tooth discoloration. In contrast, Group B (honey) participants generally reported a pleasant taste, with significantly fewer and milder side effects. Conclusions: Honey mouthwash offers a more comfortable user experience with fewer negative side effects, including a pleasant taste. This makes it a promising alternative for individuals seeking an effective and gentle approach to maintaining oral health.

Comparative Study on Histochemical Expression of CD34 in Different Variants of Ameloblastoma

Nasiha Bashir — 2025-01-31

Ameloblastoma is a benign, locally aggressive, tumor of the oral cavity having a high propensity for recurrence. The growth potential of the tumor is linked to the proliferation of preexisting vasculature and is reflected in CD34 expression. has been rephrased as “Mean Vascular Density (MVD) which measures CD34 expression, aids in predicting this proliferation. Objectives: To evaluate the biological behavior of different variants of Ameloblastoma according to expression of CD34 and to correlate it with age and gender. Methods: The present study was analytical, cross-sectional study composed of total 40, already diagnosed cases of ameloblastoma. Immuno-histochemical expression of CD34 was analyzed. Results: Follicular variant has more growth potential in females 21 (62%) and males reveal more vascular growth in plexiform 19 (80%) acanthomatous (50%) and unicystic variant (50%). More endothelial proliferation in age group of > 40 years was seen in follicular variant, whereas, in age group of < 40 years, plexiform type was more dominant. However, relationship between the age groups and MVD scores were found to be insignificant (p > 0.05). Relationship between CD34 expression in ameloblastoma and its histological variants were also found to be statistically non-significant (p=0.9). Conclusions: All variants display highest Mean Vascular Density (MVD) score in posterior mandible. Follicular variant has more growth potential in females while in males it is found more in plexiform, acanthomatous and unicystic variants. More epithelial proliferation in the follicular variety is observed in the age group over 40, whereas more plexiform type was shown in the age group below 40.

Clinical Pattern of Limb Loss in Electrical Burn Injuries

Aamna Sanober — 2025-01-31

Electrical burn injuries are severe and often lead to significant morbidity, including amputations, especially in high-voltage cases. These injuries commonly occur in occupational settings and can result in prolonged hospitalization and complications. Studying clinical patterns in electrical burn injuries is crucial to identifying risk factors, improving early interventions, and guiding effective treatment plans. Objective: To analyze the clinical pattern of amputation in electric burn patients at Burns Unit, Liaquat University Hospital, Hyderabad. Methods: This prospective observational study was conducted at Liaquat University Hospital, Hyderabad, from Nov 2023 to May 2024. A total of 84 patients, of all ages and both genders who presented with electrical burn injuries were included. While those with scald burns, dry flame burns, contact burns, thermal burns, or uncontrolled diabetes mellitus were excluded. Data collection involved recording demographic details and clinical parameters like the type of burn, total body surface area affected, cause and place of burn, duration of hospital stay, mortality rate and surgical intervention. Results: Among all, 54.8% (n=46) required amputations, with 35.7% involving a single limb and 19% multiple limbs. Upper limb amputations were more common (60.9%) compared to lower limb amputations (39.1%), with an 11.9% mortality rate. High-voltage burns were significantly associated with severe total body surface area involvement, prolonged hospitalization, fasciotomies, and multiple limb amputations. Conclusion: It was concluded that the study reported a high frequency of limb loss (due to amputation) i.e. 54.8% (n=46) among patients with electric burn.

Comparative Analysis of Host and Virus-Driven Variables Affecting Response to Ribavirin and Interferon Therapy in Hepatitis C Patients

Iffat Jamal — 2025-01-31

Current guidelines advocate for individualized treatment approaches for the management of Hepatitis C, that incorporate baseline assessments of viral genotype, host comorbidities, and socioeconomic factors to maximize therapeutic success. Objectives: To analyze the impact of host and virus-driven variables on treatment response in patients receiving ribavirin and interferon therapy. Methods: This prospective cohort study was conducted on 138 patients aged 18–65 with confirmed chronic HCV infection who were eligible for interferon and ribavirin therapy. The patients were followed up to a 24-week post-treatment to assess recovery measured in terms of sustained virological response (SVR). The host-driven factors included age, gender, BMI, and the presence of IL28B polymorphism while virus-driven factors included HCV genotype and baseline viral load. Results: The study sample predominantly consisted of male (55.1%), and genotype 3 virus accounted for 68.1% of participants. A high proportion (76.1%) of participants achieved SVR. Factors associated with better treatment outcomes included younger age (90.7% in the 31–45 age group), gender (89.5% of male), normal BMI (91.2% of those with a BMI of 18.5–24.9), and the favorable IL28B polymorphism CC genotype (91.8%). Low baseline viral load was observed in 60.1% of patients, and those with genotype 3 had better SVR rates. Conclusions: It was concluded that younger age, male gender, normal BMI, favorable IL28B polymorphism along with low baseline viral load, and genotype 3 were positively associated with achieving SVR.

Diagnostic Accuracy of Fine Needle Aspiration Cytology in Salivary Gland Lesions: A Comparative Study with Histopathology as the Reference Standard at Bahawal Victoria Hospital, Bahawalpur, Pakistan

Asmah Afzal — 2025-01-31

Fine-needle aspiration cytology (FNAC) is one of the most widely used diagnostic tools for evaluating salivary gland lesions. However, its diagnostic accuracy is uncertain due to certain factors. Objective: To analyze the diagnostic accuracy of FNAC in salivary gland lesions compared to histopathological examination in a clinical setting. Methods: This cross-sectional study was conducted from October 2021 to June 2022 at Bahawal Victoria Hospital, Bahawalpur, Pakistan. A total of 75 patients, aged 18 to 75 years, were included in the study who were previously clinically diagnosed with salivary gland lesions. Every patient included in the study underwent the FNAC, and the outcomes were compared to the histopathological analysis of the excised biopsies. The results are analyzed in terms of sensitivity, specificity, NPV, PPV, and diagnostic accuracy. Results: Among the 75 patients, the mean age was 42.5 ± 14.3 years, with a male-to-female ratio of 1:1.08. FNAC results showed 7 non-neoplastic lesions (9.3%), 61 benign (81.3%), and 7 malignant neoplasms (9.3%). A histopathological analysis identified 63 benign, 5 malignant, and 7 non-neoplastic neoplasms. FNAC showed a 96.0% overall diagnostic accuracy, with sensitivity, specificity, Positive predictive value (PPV), and Negative Predictive Value (NPV) of 97.0%, 88.9%,98.5%, and 80.0% respectively. Two false-negative instances (2.7%) and one false-positive case (1.3%) were found in the study. Conclusion: FNAC is an extremely sensitive and accurate diagnostic tool especially when it is required to distinguish between benign and malignant neoplasms. However, its low specificity increases the risk of false-negative results where histopathological confirmation becomes an integral part of the diagnosis especially the cases where clinical suspicions are high.

Evaluating the Impact of Site of Oral Cancer on Quality of Life of Patients

Syeda Gulrukh Saba Shah — 2025-01-31

The Oral Health Impact Profile-14 was created to evaluate how oral health disorders affect the life of the patient, though it is widely utilized in patients with cancer, still, there is limited information regarding its measurement specifically related to the impact of cancer sites in a patient. Objectives: To evaluate the site of oral cancer and its impact on patients' oral Health-related quality of life. Methods: Diagnosed oral cancer patients were employed from the dental college of Peshawar, and 134 individuals were recruited. Patients of oral cancer, aged 20-59 of both genders were interviewed by using a convenience sampling technique. The Patients were asked about age gender, dental visit, site of cancer, treatment modalities, and various questions related to oral health impact profile. Data analysis was performed using SPSS version 26.0. Results: The study revealed that the majority of patients were aged 20-29 and predominantly male (67.9%), and most frequently occurs in the buccal mucosa (35.1%). The results revealed significant challenges among participants, with 30.6% experiencing difficulties in speech and 28.4% with a reduced sense of taste. Physical pain was reported by 38.8%, with 54.5% having eating uncomfortably. Conclusions: It was concluded that the study emphasized how patients' quality of life regarding oral health is greatly impacted by the location of cancer.

Adverse Perinatal Outcomes: Their Association with Maternal Anemia

Amna Aziz — 2025-01-31

The incidence of anemia during the third trimester of pregnancy correlates with a heightened risk of negative postnatal outcomes. Objective: To access the relationship between hemoglobin levels in laboring women and perinatal outcome. Methods: A prospective cohort study was done at Department of Obstetrics and Gynecology, Nishtar Hospital, Multan from September 2020 to December 2021 using non-probability purposive sampling technique. A total of 135 anemic pregnant women (Group A) fulfilling inclusion and exclusion criteria was recruited for the study from labour room plus 135 non-anemic women were also recruited as control group (Group B). The data was recorded and explored. Results: 135 anemic laboring pregnant ladies were taken in this study having mean age 25.63 ± 4.53 years (range; 19-37 years) and 85.2% had ages less than 30 years. Cesarean section deliveries were noted to be in 50.4% in group A (anemic women) versus 48.1% in group B (non-anemic women). Preterm birth was noted to be 29.6% in group A versus 6.7% in group B. Small for gestational age was 53.3% in group A versus 12.6% in group B. Low birth weight was 54.8% in group A versus 16.3% in group B. Still birth was 7.4% only in anemic women while it was not observed in control group. Conclusions: The results of this study supported strong relationship of low haemoglobin in mothers with untoward perinatal outcome; growth retarded babies, preterm, Low birth weight and cesarean section rate. Strong media awareness campaigns should be launched for awareness for iron supplementation among targeted population.

Knowledge and Practices of Breast Self-Examination among Female Students of Bahria University of Health Sciences Karachi

Farzeen Tanwir — 2025-01-31

Breast Self-Examination is an efficient approach for investigating physical and visual abnormalities in breast tissue. Objective: To evaluate the awareness, knowledge, practice of breast self-examination among female university students in five colleges of Bahria University Health Sciences Karachi. Methods: A cross-sectional study at Bahria University Health Sciences Campus Karachi with random sampling among female students from the Dental, Medical, Doctor of Physical Therapy, Nursing sections and Medical Laboratory Technicians. The data were collected using a self-administered google questionnaire form distributed online via WhatsApp. The questionnaire encompassed sections on the socio-demographic characteristics of the participants, as well as their awareness, knowledge, attitude, and practice towards BSE. For data analysis SPSS Software version 25.0 was used. Results: 240 female participants were enrolled in study, 77.5% knew the meaning of BSE, while 31.7% had complete knowledge. 5.4% BDS students did it in routine practice, 63% believed, it helps in cancer monitoring, 22.8% performed to detect nodules and 8.7% carried out because of family history. Out of 110 participants from nursing section, 7.3% followed BSE in routine practice, 65.5% believed it’s beneficial in the detection of cancer. However, the main reason for performing was detection of cancer 62.9%. Several barriers were encountered such as time constraint, lack of knowledge 46.7%, uncomfortable 6.7%, fear 30.4% and misconception. Conclusions: Participants had understanding of BSE but they lacked complete knowledge of breast self-examination due to limited access to health care resources and insufficient understanding about the technique also encounter significant barriers during practicing.

Evaluation of Use of Intensive Care Unit (ICU) Scoring Systems among Healthcare Professionals

Aneela Jahangir — 2025-01-31

The prognosis of patients in the Intensive Care Unit (ICU) is a matter of worry for critically ill patients, their families, and healthcare personnel. However, predicting the chances of recovery in the ICU can be challenging. Scoring systems serve as standardized instruments utilized in critical care research to determine which patients should be included in a study and to establish the comparability of different patient groups. Objective: To determine the frequency of use of Scoring Systems to predict the outcome of critically ill patients in the intensive care units of Pakistan. Methods: This cross-sectional study was conducted in all the healthcare institutions of Pakistan that are recognized by CPSP for fellowship in ICU training, from 10th April 2018 till 10th October 2018. Forty-one ICU physicians were included. Pre-designed questionnaires were sent to these physicians. Results: Out of 41 physicians, 33 (80.5%) of them used and 8 (19.5%) did not use ICU scoring systems. Only 3 consultants reported the use of Anatomical scoring systems. GCS was the most used Disease Specific Scoring System (97.5%), followed by Child Pugh’s Score (80%) and Ranson’s Criteria (70%). 50% reported the use of Sequential Organ Failure Assessment (SOFA) and 42% used Multiple Organ Dysfunction Score (MODS). 63% used Acute Physiology and Chronic Health Evaluation (APACHE). 93% did not use any Therapeutic Weighted Score. 77.5% used Richmond Agitation-Sedation Scale (RASS) and 25% used Ramsey’s. Conclusion: It was found that 80.5% physicians used ICU scoring systems to assess mortality and severity of illness.

Prospective Study on the Incidence of Hospital Acquired Infections in Intensive Care Unit

Abdul Hayee Phulpoto — 2025-01-31

Hospital-Acquired Infections (HAIs) in the ICU significantly impact patient morbidity, mortality, and length of stay. Objective: To determine the incidence of HAIs, identify key risk factors, and analyze their impact on clinical outcomes in ICU patients. It was prospective observational study. Methods: A total of 220 ICU patients were included. Data on demographics, ICU stay duration, device use (e.g., central lines, ventilators, urinary catheters), comorbidities, and infection control practices were collected. HAIs were diagnosed based on CDC definitions and categorized as Ventilator-Associated Pneumonia (VAP), Central Line-Associated Bloodstream Infection (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), and Surgical Site Infections (SSI). Incidence rates were calculated using descriptive statistics, and risk factors were identified through multivariate logistic regression. Results: Results showed that 150 (68.2%) patients developed HAIs, with VAP being the most common (30%), followed by CAUTI (16.7%), CLABSI (20%), and SSI (13.3%). Independent risk factors for HAIs included ventilator use (p<0.001), prolonged ICU stay (p=0.004), and use of urinary catheters (p=0.002) and central lines (p=0.003). Patients with HAIs had higher mortality (30% vs 12%, p=0.003) and longer ICU stays (21 days’ versus 12 days, p<0.001). Conclusions: HAIs are frequent in ICU patients, particularly VAP. They significantly increase mortality and prolong ICU stays, highlighting the need for enhanced infection control practices, especially for patients with extended ICU stays or those requiring invasive devices.

Corneal Endothelial Cell Loss after Cataract Extraction by Phaecoemulsification versus Conventional Extra Capsular Cataract Extraction Technique

Ayaz Ali Khoso — 2025-01-31

A cataract is a condition affecting the eye in which the lens, previously clear, has developed cloudiness and flexibility, obstructing the passage of light. This condition progressively deteriorates and is a significant contributor to global blindness. A cataract is identified through a thorough examination of the pupil using a torch light and a slit lamp, both in dilated and non-dilated states. In 1967, Charles Kelman introduced phacoemulsification, an innovative surgical technique for the treatment of cataracts. Objective: To compare the corneal endothelial cell loss after cataract extraction performed with conventional extra capsular cataract extraction versus standardized Phacoemulsification. Methods: Non-randomized clinical trial study was conducted at Department of Ophthalmology, Chandka Medical Hospital Shaheed Mohtrama Benazir Bhutto Medical University Larkana in time frame of six months by using probability consecutive sampling technique. Data analysis was performed by using SPSS version 24.0. The Chi-square test was utilized for cross-tabulation. Results: In comparison to individuals receiving ECCE, those undergoing PHACO tended to be younger and exhibited a greater proportion of females. While the PHACO group consistently exhibited a higher endothelial cell count during all post-operative intervals, both techniques led to a significant decrease in the number of endothelial cells observed post-operation. Conclusion: The present study supported the common understanding that phacoemulsification is linked to a significantly reduced incidence of endothelial cell loss.

Comparison of Perception and Academic Outcome of Final Year BDS Students Regarding Lecture-Based Learning and Problem-Based Learning

Aamna Khalil — 2025-01-31

This study explores the differences in student perception and academic outcomes between traditional lecture-based learning and problem-based learning methods in an educational setting. Objective: To find the effectiveness of Problem-Based Learning (PBL) versus Lecture-Based Learning (LBL) in enhancing academic performance and student satisfaction. Methods: Comparative cross-sectional study was carried out among final year BDS students at Watim Medical and Dental College Rawalpindi. The study evaluated lecture-based learning (LBL) versus problem-based learning (PBL) in Prosthodontics and Operative dentistry. LBL consisted of interactive lectures with clear objectives, while PBL involved group-based problem solving over two months. Academic outcomes were assessed via class tests, with feedback gathered through a structured questionnaire. Data were analyzed using SPSS version 21.0. Results: A total of 131 final year BDS students were included. Both genders were considered however majority were females (74%). Mostly participants appreciated both teaching methodologies (58%), a significant proportion favored lecture-based learning (26%) over problem-based learning (11.5%). Perceptions varied on the effectiveness of each method in fostering understanding, self-learning habits, and analytical skills. Many participants expressed dissatisfaction with resource availability and syllabus coverage in PBL sessions, despite positive views on facilitator training. Exam results showed a higher pass rate with PBL (76.3%) compared to LBL (56.5%), but satisfaction with PBL did not significantly influence exam outcomes (p>0.05). Conclusions: The study concluded that future research should focus on optimizing educational methodologies in dental education to effectively prepare students for the complex demands of healthcare through innovative and balanced approaches.

Predictors Of Antepartum Hemorrhage In Patients With Placenta Previa

Sadaf Bashir — 2025-01-31

Antepartum Hemorrhage (APH) is a significant complication in pregnancy that poses serious risks to both maternal and fetal health. Objective: To find the predictors of antepartum hemorrhage in patients with placenta previa among the local population of Pakistan. Methods: This cross-sectional study was conducted at PAF Hospital Mianwali from November 2023 to April 2024. A total of 208 patients were included in the analysis. Patients diagnosed with placenta previa confirmed through ultrasound examination were included in the study. Results: The mean age of the patients was 32.83 ± 4.56 years. Out of 208, there were 60 (28.8%) and nulliparous, 148 (71.2%) were multiparous. 85 (40.9%) had previous C-section and 30 (14.4%) were suffered from hypertension. 15 (7.2%) were diabetic and 180 (86.5%) were non-smokers. APH increased by 15% (Adjusted OR: 1.15, 95% CI: 1.05-1.26, p = 0.005). Furthermore, patients with a history of previous cesarean sections had over twice the odds of developing APH compared to those without this history (Adjusted OR: 2.12, 95% CI: 1.23-3.66, p = 0.007). Conclusions: This study concluded that advanced maternal age and a history of previous cesarean sections are significant predictors of antepartum hemorrhage in patients with placenta previa.

Frequency of Erectile Dysfunction among Smokers and Non-Smoker Men Visiting Tertiary Care Hospital Nawabshah

Sadia Ayoub Chandio — 2025-01-31

Epidemiological studies have shown that cigarette smoking is the independent risk factor for erectile dysfunction (ED), with smokers 1.5–2 times more likely to develop ED than nonsmokers. Additionally, long-term research has shown that quitting smoking improves erectile function, with noticeable improvements even within 24 hours of cessation. Objective: To determine the frequency of erectile dysfunction among male smokers and non-smokers at PMC Hospital Nawabshah. Methods: This research was conducted at the Department of Urology, Peoples Medical University Hospital, Nawabshah. A formal written consent /agreement was obtained from every subject/individual who fulfilled the inclusion criteria and then decided to participate. The measure divides ED into four groups based on IIEF-5 scores: mild to moderate (12–16), mild (17–21), no ED (22–25), moderate (8–11), and severe (1–7). Data were being analyzed by computer software statistical package for social sciences version 23. Frequency and percentage were computed for variables. 85.9% are confirmed to have some degree of ED, and 14.1% are found not to have ED. Results: Among the smokers, 39(27%) had mild ED, but in non-smokers, 53(37%) had mild ED. Among the smokers, 50(35%) had moderate ED, and in non-smokers, 51(36%) had moderate ED. In smokers, 64(45%) had severe ED, and in non-smokers, 38(27%) had severe ED. Conclusions: Smoking tremendously affects the erection of patients. Whereas non-smokers had a little bit less effect on erectile function.

Effect of Supra Choroid Triamcinolone Acetate On Intraocular Pressure

Sohail Bukhari — 2025-01-31

Intraocular pressure is a critical parameter in maintaining the physiological function of the eye. Dysregulation of Intraocular pressure can lead to ocular pathologies. Objective: To evaluate change in intraocular pressure after supra-choroidal triamcinolone acetonide use. Methods: This prospective interventional studyas carried out at the vitreo-retina Department of Al Ibrahim Eye Hospital Karachi, ISRA Postgraduate Institute of Ophthalmology for six months from July to December 2023. Adult patients attending the vitreoretinal Outpatient Department with resistant macular oedema were included. Intraocular pressure readings at 1 week, 4 weeks, 8 weeks and 12 weeks were recorded and compared with baseline values by applying One-way ANOVA keeping the p-value of <0.05 as statistically significant. Data were analyzed using SPSS v 22.0. Results: Among all, 21 (46.67%) cases received injections to the right eye and 24 (53.33%) cases to the left eye. The mean intraocular pressure before injection was 12.07 ± 2.14 mmHg. At three months’ post-injection, the mean intraocular pressure was 13.60 ± 5.2 mmHg. For the right eye; the mean pre-injection intraocular pressure was 12.38 ± 1.96 mmHg. Three months’ post-injection, the mean intraocular pressure was 13.43 ± 5.59 mmHg (p<0.001). For the left eye; the mean pre-injection intraocular pressure was 11.79 ± 2.28 mmHg while three months’ post-injection, the mean intraocular pressure was 13.75 mmHg ± 4.96 (p-0.06). Conclusions: It was concluded that supra-choroidal triamcinolone injections increase intraocular pressure but stabilized over time. These findings support earlier trials and add to the evidence of this therapy's efficacy and safety.

The Frequency of Blood Transfusion Reactions: A Retrospective Study from a Tertiary Care Hospital

Uzma Chohan — 2025-01-31

Blood Transfusion Reactions (BTRs) are complications that may occur during or after transfusion, in which allergic reactions and Febrile Non-Hemolytic Transfusion Reactions (FNHTRs) being the most common. Objective: To assess the frequency and types of transfusion reactions among patients at Shahida Islam Medical College Hospital and a blood transfusion service supplier. Methods: This study analyzed transfusion reactions reported between January, 2022, and September, 2024. A total 1936 transfused has done during this time frame. Data were collected using non-probability convenience sampling, covering patient demographics, blood products used, and Incident rate of transfusion reactions. IBM SPSS version 28.0 was utilized for statistical analysis, with categorical variables presented as frequencies and percentages. Results: Out of 1936 transfusions a total 12 (0.6%) reported transfusion reactions in which allergic reactions accounted for the majority (50.0%), followed by FNHTRs (33.33%) and none or very limited reactions of other reactions seen both on whole blood and PCV. The overall incidence of transfusion reactions was 0.53%. Conclusions: This study highlighted that allergic reactions are the most prevalent Blood Transfusion Reactions, emphasizing the need for premedication protocols for high-risk patients. Future research should focus on identifying predictive markers for allergic reactions, refining transfusion protocols.

Relationship of Hypoalbuminemia in Colistin-Induced Acute Kidney Injury (AKI) among Adult Intensive Care Patients

Sughandh Umer Memon — 2025-01-31

Acute kidney injury incidence ranges from 30-60% among critically ill patients and stands as the primary death cause within this population. A serious concern is a global rise in major drug-resistant-gram-negative organisms among hospital-acquired infections. Objectives: To determine the incidence of colistin-induced acute kidney injury in intensive care patients receiving colistin therapy and to investigate its relationship with albumin levels. Methods: It was a follow-up prospective cohort study executed at Shaheed Mohtarma Benazir Bhutto Institute of Trauma Pakistan in an adult intensive care unit over 6 months. The study end-point was an injury in intensive care injury at the end of colistin therapy. A total of 250 patients were studied. The median age of patients was 40 (IQR=22-48) years with an age range of 18-70 years. The majority of patients were male (75.2%). Median colistin dosage was 4 (IQR=3.5-4.5) MIU. In univariate analysis, the risk of developing injury in intensive care was significantly increased with increased age, use of nephrotoxic drugs, and increasing colistin dosage whereas injury in intensive care risk was decreased with increasing albumin levels. In a multivariable model, only colistin dosage was found to be significantly associated with increasing injury in intensive care risk with increasing colistin dosage. Conclusions: It was concluded that the present study analyzed a higher burden of acute kidney injury incidence following colistin therapy. Albumin levels were not found to be linked to acute kidney injury incidence in the multivariable model. Acute kidney injury incidence was significantly related to increasing colistin dosage.

Effectiveness of Cognitive Behavioral Techniques for Diabetes Distress in Patients Presenting With Diabetes Related Distress at a Tertiary Care Hospital

Salahudin Mahmood — 2025-01-31

Diabetes-related distress is a common psychological issue among diabetic patients, often affecting their ability to manage the condition effectively. Objective: To determine the effectiveness of cognitive behavioral techniques for diabetes distress in patients presenting with diabetes related distress at a tertiary care hospital. Methods: This study was conducted in the General Medicine Department at Nishtar Medical University and Hospital, Multan, a tertiary care hospital, over a period of 12 months. It was a Quasi Experimental Study. Sample size was 64 patients with diabetes related distress, (32 in each group) calculated by using sample size formula for comparing two proportions. Sampling technique was non probability consecutive sampling. Results: The mean age of patients experiencing diabetes-related distress was 51.45 ± 8.34 years, with an age range of 37 to 65 years. Among the 64 participants, only 20 (31.3%) had controlled diabetes, while 41 (64.1%) had uncontrolled diabetes. Efficacy was observed in 23 (35.9%) of the study cases. Specifically, 17 (53.1%) participants in group an exhibited efficacy, compared to 6 (18.8%) in group B (P=0.004). Conclusions: The findings of the study supported cognitive behavioral techniques for the management of diabetes related distress as these techniques were found effective and reliable in the management of diabetes related distress. Effectiveness of therapy was significantly higher among experimental group as compared with control group.

Mortality Associated with Tuberculosis Meningitis in HIV Infected Patients and Non-HIV Infected Patients

Salma Haji — 2025-01-31

Human Immunodeficiency Virus (HIV) infection significantly worsens Tuberculosis meningitis (TBM) outcomes, leading higher mortality rate in HIV-positive patients compared to HIV-negative individuals. Objectives: To find out the frequency of HIV Infected Patients with TBM and their outcome as mortality and to compare their mortality of TBM without HIV infection. Methods: This cross-sectional-observational study was conducted at Jinnah Postgraduate Medical Center Karachi, from September 2020 to October 2024. All patients diagnosed with TBM on clinical findings and Cerebrospinal Fluid analysis as TBM were admitted an HIV test was carried out and a CD4 cell count was done in HIV-positive patients. Treatment with Anti-Tuberculosis Therapy and Antiretroviral Therapy was done, the outcome as mortality was recorded up to 1 year and results were analyzed by SPSS version 26.0. Results: A total of 260 patients were enrolled who presented with TBM. The mean age was 39 ± 12.7 years. 20/260 (7.69%) were HIV positive and 240/260 (92.3%) were HIV negative TBM patients. 130/240 (54.16%) were male and 110/240 (45.93%) were female in HIV-negative and HIV-positive TBM 12/20 (60%) were male and 8/20 (40%) patients were female. age in HIV-positive patients was 32.5 ± 5.5 and 38.5 ± 6 in HIV-negative patients. 13/20 (65%) HIV-positive patients expired and 55/240 (22.9%) of HIV-negative patients expired. Conclusions: It was concluded that HIV Infected patients in our setup were increasing and had a high mortality rate as compared to HIV-negative patients of TBM and TBM patients presented in stage 3 had high mortality in both HIV-positive and HIV-negative patients.

Association of Physical Activity With Perceived Stress and Well-Being in the Third Trimester of Pregnancy

Waqar Ahmed — 2025-01-31

Physical inactivity is considered a worldwide pandemic that leads to numerous health problems. The World Health Organization advises pregnant women to participate in at least 150 minutes of moderate exercise each week to enhance health outcomes. As in the last trimester of pregnancy, considerable physical, hormonal, and psychological changes at this stage need further exploration. Objectives: To determine the association between physical activity, perceived stress, and well-being in the third trimester of pregnancy. Methods: A cross-sectional study of 245 third-trimester pregnant mothers was conducted at a local healthcare center using non-probability purposive sampling from June 2024 to November 2024. The Pregnancy Physical Activity Questionnaire (PPAQ) was used to quantify physical activity, stress levels were measured with the Perceived Stress Scale-04 (PSS-04), and well-being was assessed using the WHO-5 Well-Being Index. Spearman correlation analysis and descriptive statistics were used to investigate the connections among stress, physical activity, and well-being. Results: Increased physical activity is associated with decreased levels of stress, based on the data, It demonstrated a strong inverse relationship between physical activity and perceived stress (ρ=-0.342, p<0.01). Additionally, there was a positive correlation between well-being and physical exercise (ρ=0.232, p<0.01). Conclusions: It was concluded that physical activity decreased stress and improved well-being in the third trimester of pregnant women. This implies that medical professionals should recommend physical activities in prenatal care, especially in various cultural needs programs. More research is needed with larger, diverse groups.

Plastic Surgery Awareness and Perceptions among Healthcare Professionals: A Single Centre Study at Liaquat University Hospital

Aamna Sanober — 2025-01-31

Plastic surgery encompasses both reconstructive and aesthetic procedures, addressing functional and cosmetic needs. Misconceptions about its scope are common, even among healthcare professionals, underscoring the need to evaluate their awareness and perceptions. Objectives: To assess the level of awareness and perceptions of plastic surgery as a speciality among healthcare professionals at Liaquat University Hospital, Hyderabad and Jamshoro. Methods: A cross-sectional questionnaire-based study was carried out at Liaquat University Hospital, Hyderabad, and Jamshoro. Participants included 108 house officers and postgraduate residents working in nonsurgical specialities. The study excluded doctors from other specialities related to surgery and dermatology due to overlaps in the scope of practice with plastic surgery. Results: A majority of participants (79.6%) recognized that cosmetic surgery was a component of plastic surgery, while 12% considered them to be the same, and 3.7% disagreed. In terms of the origin of the term "plastic surgery," 82.4% of participants did not know the reason behind the term. Regarding the aesthetic procedures, participants reported rhinoplasty as done by plastic surgeons (61.1%), with 37% favouring ENT surgeons. Non-surgical procedures such as Botox were mostly attributed to dermatologists (51.9%), with 40.7% selecting plastic surgeons. Conclusions: It was concluded that the study revealed significant gaps in both awareness and perceptions regarding plastic surgery among healthcare professionals. There was a noticeable misunderstanding regarding the appropriate speciality for aesthetic procedures, such as liposuction and breast reduction, where other surgeons were preferred over plastic surgeons, indicating a need for improved education and awareness in the medical community.

Enhancing Neonatal Sucking Reflex: A Study on the Efficacy of Magnesium Sulphate in Severe Birth Asphyxia

Muhammad Akram — 2025-01-31

One of the main causes of prenatal deaths and a known factor in neuromotor disabilities is perinatal asphyxia. Objectives: To compare the efficacy of magnesium sulphate on the appearance of a good sucking reflex in cases of birth asphyxia with controls (without magnesium sulphate). Methods: This randomized controlled trial was conducted at the Department of Neonatology, The Children’s Hospital and the Institute of Child Health, Multan, from January 2024 to June 2024. A total of 80 full-term newborns of both genders with severe birth asphyxia admitted within six hours of life were randomly assigned to either the study group or the control group. The study group received 3 doses of magnesium sulphate 24 hours apart by intravenous infusion at 250 mg/kg/dose, and the control group did not receive this treatment. Supportive care was given to both study groups. Both groups were examined for sucking reflexes. Results: 46 (57.5%) were male, while 43 (53.8%) had a body weight of ≥2.5 kg. The mean age at the time of presentation was 3.2 ± 1.5 hours. Overall efficacy was observed in 48 (60.0%) babies. The distribution of efficacy in terms of the appearance of a good sucking reflex was significantly better in the magnesium sulphate group versus the control group (75.0% vs 45.0%, p=0.0062). Conclusions: It was concluded that magnesium sulfate was found to significantly improve the appearance of a good sucking reflex among newborns with severe birth asphyxia, highlighting its potential as a neuroprotective intervention in neonatal care.

Frequency and Pattern of Retinopathy in Newly Diagnosed Type 2 Diabetic Patients

Faisal Mehmood — 2025-01-31

Diabetic Retinopathy (DR) is among the leading causes of blindness in adults, particularly in individuals with type 2 Diabetes Mellitus (T2DM). Diabetic Retinopathy (DR) is one of the commonest reasons for blindness in the adult population especially in the type 2 Diabetes Mellitus (T2DM) population. It is important to detect and manage these diseases early to prevent vision loss. Objective: To evaluate the prevalence and pattern and the associated risk factors of Diabetic Retinopathy (DR) in newly diagnosed T2DM. Methods: The study design was descriptive cross-sectional which was conducted at Arif Memorial Teaching Hospital/Rashid Latif Medical College, Lahore. The study enrolled 300 participants (age≥35 years) with newly diagnosed T2DM. After a general and systemic examination, data were collected, including laboratory data with blood glucose, HbA1c, serum cholesterol, and serum creatinine. Retinopathy grading was performed by fundoscopic examination into background, pre-proliferative and proliferative grades. The statistical analysis was performed in SPSS version 23.0. Results: In newly diagnosed T2DM, the overall prevalence of DR was 22% (66/300). Among cases of DR, 78% were NPDR, and 22% were PDR. Most of the NPDR was moderate (43%), mild (35%) and severe (22%). DR risk factors were HbA1c > 8% (OR: 3.5, p < 0.001) and hypertension (65% DR, p < 0.05). DR was not significantly correlated with BMI and other biochemical markers including serum creatinine. Conclusions: The prevalence of diabetic retinopathy was notably high among newly diagnosed T2DM patients, with HbA1c levels and hypertension identified as significant risk factors.

Impact of Team-Based Learning on Medical Students Academic Performance

Zainab Abdullah — 2025-01-31

The effectiveness of different educational strategies in medical education is still essential to students’ academic performance and satisfaction. Objectives: To determine the effect of Team-Based Learning versus Small Group Discussion (SGD) on academic outcomes for students in a medical curriculum. Methods: The study design was a quasi-experimental non-equivalent control group design involving 100 medical students divided into two groups of 50 for Team-Based Learning and 50 for Small Group Discussion. Data collection comprised pre-test and post-test scores, changes in scores, and levels of satisfaction measured using structured surveys. Statistically, independent t-tests were used to compare academic performance and satisfaction between the two groups. Results: The Team-Based Learning group had significantly higher post-test scores, 76.42 ± 9.14 as compared to the Small Group Discussion group, 68.00 ± 9.45. The difference in change scores was significant: 16.56 ± 7.50 for Team-Based Learning versus 9.24 ± 6.50 for Small Group Discussion, p<0.0001. Satisfaction levels were also higher in the Team-Based Learning group at 4.14 ± 0.88 than in the Small Group Discussion group at 2.94 ± 0.79, with a statistically significant difference p<0.0001. Conclusions: It was concluded that Team-Based Learning versus Small Group Discussion generated significant differences in the academic performance and satisfaction levels of medical students. Team-Based Learning appears to be a more effective teaching-learning strategy compared to Small Group Discussion in enhancing engagement and better learning outcomes in medical education.

Association of Age Shock Index with Mortality among Trauma Patients in the Emergency Department

Areej Zehra — 2025-01-31

Trauma injuries cause significant global morbidity and mortality. While current scoring systems like ISS and TRISS are complex, the Age Shock Index (ASI) offers a simpler, potentially more effective method for estimating patient outcomes. Objective: To evaluate the association of Age Shock Index with 48-hour in-hospital mortality in a trauma population in an Emergency Department (ED). Methods: A comparative cross-sectional study was conducted over eight months in the Emergency Department of Ziauddin University, focusing on pre-selected trauma patients aged 18-65 years. Patients were divided into two groups: the exposed group and non-exposed group, with an Age Shock Index (ASI) ≥ 50, and < 50 respectively. Data analysis was carried out using descriptive statistics, the chi-square test, and independent t-tests with the Statistical Package for Social Sciences (SPSS) version 21.0. Results: Patients with an Age Shock Index (ASI) ≥ 50 had significantly higher 48-hour in-hospital mortality (72%) compared to those with an ASI < 50 (12%) (p < 0.001). The exposed group also received more intravenous fluids, inotropic support, and blood products. No deaths occurred in the emergency room among the exposed group, but a trend towards higher overall mortality was observed (hazard ratio 48.584, 95% CI: 0.511 - 4622.17, p = 0.095). Conclusions: The Age Shock Index (ASI) ≥ 50 is associated with significantly higher 48-hour in-hospital mortality in trauma patients. The exposed group required more intensive interventions, indicating a higher severity of injury. ASI may serve as an effective predictor of patient outcomes in emergency settings.

Correlation of Clinical Frailty Scale Assessment and in-Hospital Mortality in Elderly Critically Ill Patients Admitted to Intensive Care Units of Private Sector Tertiary Care Hospital

Saima Muzaffar — 2025-01-31

Frailty is a complex geriatric condition marked by increased vulnerability to adverse health events. In intensive care unit patients, there is a clear correlation between the Clinical Frailty Scale and higher short- and long-term mortality rates. Objectives: To evaluate the prognostic importance of frailty, measure the risk of death in the Intensive Care Unit for all Clinical Frailty Scale scores, and methodically evaluate the association between frailty and Intensive Care Unit mortality. Methods: This cross-sectional study was conducted over 1 year (Jan 2023 to July 2023) at the Department of Medical Intensive Care Unit of Ziauddin University Hospital, Karachi Pakistan. Irrespective of gender, all patients of age more than 60 years admitted to the Medical Intensive Care Unit were included. In this study, individuals ≥60 years of age had their pre-admission frailty and hospital mortality compared using the Clinical Frailty Scale. Results: The median age was 75 years. The overall mortality rate was 9.9%. The Clinical Frailty Scale score indicated that 29.7% of patients were classified as non-fragile, 18.7% as vulnerable or pre-fragile, and 51.6% as frail. A significant association of Clinical Frailty Scale assessment was observed with gender, age, outcome, Acute Physiology and Chronic Health Evaluation score and invasive (mechanical ventilation). According to multivariate logistic regression, patients on mechanical ventilators have a higher mortality rate. Conclusions: It was concluded that the findings demonstrated a strong correlation between mortality and the Clinical Frailty Scale among critically sick patients admitted to the intensive care unit.

Prevalence of Medicolegal Cases During Covid-19 Pandemic Lockdown; A Local Experience

Tasneem Murad — 2025-01-31

Medical examinations are essential in legal cases, providing critical evidence that influences judicial outcomes. The COVID-19 pandemic impacted various societal aspects, including the nature and frequency of medical examinations. Objective: To compare the prevalence and types of medicolegal cases reported at District Headquarters Hospital, Rawalpindi, during the pre-pandemic and pandemic periods. Methods: A retrospective comparative cross-sectional study was conducted using data from March 2019 to August 2019 (pre-pandemic) and March 2020 to August 2020 (pandemic). Demographic details, including age and gender, as well as the types of cases (e.g., physical assault, sexual assault, trauma), were analyzed using SPSS version 24.0. Results: The total number of cases increased significantly from 389 in the pre-pandemic period to 441 during the pandemic (P < 0.01). During the pandemic, physical assault cases increased from 122 (31.36%) to 151 (34.24%), and sexual assault cases rose from 39 (10.02%) to 54 (12.24%) (P = 0.013). Blunt trauma cases increased from 79 (20.31%) to 101 (22.9%) and sharp trauma cases from 67 (17.22%) to 89 (20.18%). However, cases involving road traffic accidents (RTA) decreased significantly from 41 (10.54%) to 16 (3.63%) (P = 0.04). Poisoning incidents saw slight changes and the occurrence of burns, particularly chemical burns, increased from 3 (0.77%) to 5 (1.13). Conclusions: The COVID-19 pandemic lockdown has had a profound impact on the prevalence and nature of medicolegal cases. These findings emphasized the need for targeted interventions to address the specific medicolegal challenges exacerbated by pandemic conditions and to support vulnerable populations, particularly in urban areas and among women.

Association of Plateletcrit Value with Gestational Diabetes Mellitus: A Case Control Study in A Tertiary Care Setting

Saima Chaudhary — 2025-01-31

Gestational Diabetes Mellitus (GDM) is linked to numerous maternal and fetal complications. Typically diagnosed in the third trimester with OGTT, early detection could prevent many adverse outcomes. Emerging evidence highlights the role of platelets in GDM pathogenesis, suggesting platelet indices, including plateletcrit, might aid early diagnosis. Objective: To determine the association between GDM and elevated plateletcrit levels. Methods: A case-control study was conducted over six months (May - October 2024) in Gynaecology and Obstetrics Unit 1, Sir Ganga Ram Hospital, Lahore. After ethical approval, 100 pregnant women meeting the inclusion criteria were enrolled. At 24–28 weeks’ gestation, all participants underwent a 75g OGTT. Based on results, they were divided into Group A (controls with normal OGTT) and Group B (cases with deranged OGTT). Plateletcrit values from the second trimester were obtained retrospectively from medical records. Quantitative variables were analyzed using Student’s t-test (P ≤ 0.05 deemed significant), while qualitative variables were expressed as percentages. Results: Group B (GDM patients) had significantly higher mean plateletcrit values (0.24 ± 0.08) compared to Group A (non-GDM) (0.14 ± 0.03) (P = 0.000). Conversely, the mean platelet count was higher in Group A than Group B (P = 0.000). Conclusion: Pregnant women with GDM exhibited higher plateletcrit values and lower platelet counts compared to non-GDM women, suggesting plateletcrit as a potential marker for early GDM diagnosis.

Impact of Dengue Fever on Pregnancy Outcomes: A Prospective Observational Study

Muhammad Zubair — 2025-01-31

Dengue in pregnancy has a profound negative impact on both maternal and fetal outcomes, leading to increased maternal and neonatal mortality. Objective: To evaluate the maternal and fetal outcomes in pregnant women affected by dengue fever. Methods: A prospective observational study was carried out at Niazi Welfare Foundation Teaching Hospital, Sargodha. Non probability convenient sampling technique was used to collect data from 36 pregnant women enrolled after confirming dengue infection through NS-1 and IgM/IgG tests. Maternal and fetal outcomes were monitored throughout pregnancy, labor, and the postpartum period. Data was analyzed using SPSS version 26.0 and presented in frequency and percentages. Results: Fetal complications observed in this study were, preterm delivery in 16 cases (44.4%), term delivery in 14 cases (39%), fetal growth restriction in 8 cases (22%), and intrauterine death in 6 cases (16.6%). Maternal outcomes included, postpartum hemorrhage in 6 cases (16.6%), 7 infected women (19.4%) were admitted to the ICU, and two mothers (5.5%) died. The frequency of neonatal admission to the NICU was 30.5%. Conclusions: Dengue infection in pregnancy is linked to heightened risk of maternal and perinatal morbidity and mortality. Timely clinical interventions are necessary to avoid devastating consequences.

Preliminary Investigation of AI Adoption among Healthcare Practitioners in Pakistan

Samrat Habib — 2025-01-31

Artificial intelligence (AI) is progressively revolutionizing healthcare systems globally, delivering innovative solutions for diagnosis, treatment, and operational efficiency. However, its acceptance among healthcare providers in Pakistan remains unexplored. Objectives: To explore the trends of artificial intelligence on healthcare professionals' knowledge, attitudes, and practices in Pakistan and to focus on variations across medical specialities, professional experiences, and work environments. Methods: A cross-sectional survey was conducted from May to July 2024, using Google Surveys to collect data from 321 healthcare professionals across various medical specialties in Pakistan. Structured questionnaires were distributed electronically, and the responses were analyzed using Chi-Square tests to determine associations between AI knowledge, attitudes, and professional characteristics. Results: Results obtained indicated varying levels of AI awareness and practice, with notable disparities across different specialties and experience levels. Younger professionals with less experience considerably accepted AI technologies, whereas relatively more experienced professionals exhibited increasing reluctance to adopt AI technology in their professions. Positive attitudes toward AI were more prevalent in academic and tertiary care settings compared to primary care environments and medical teaching. Conclusions: This study concludes that there is a crucial knowledge gap and poor AI adoption among Pakistan's healthcare practitioners, which is compounded by insufficient training and technological constraints. Addressing these challenges is critical for attaining AI's potential in improving healthcare outcomes.

Evaluating the Diagnostic Accuracy of High-Resolution Computed Tomography in Detecting COVID-19: A Comparative Study Using Polymerase Chain Reaction as the Gold Standard

Rida Saleem — 2025-01-31

Pakistan has faced three waves of COVID-19, each intensifying the strain on diagnostic resources. Delayed diagnoses during these waves hindered timely treatment and contributed to disease transmission. Objective: To evaluate the diagnostic accuracy of High-Resolution Computed Tomography (HRCT) in detecting COVID-19, using Polymerase Chain Reaction (PCR) as the gold standard. Methods: A cross-sectional study was conducted from November 26, 2021, to May 26, 2022, at the Department of Radiology, Northwest General Hospital & Research Centre, Peshawar. The study included 234 clinically suspected COVID-19 patients, aged 20–60 years, of both genders. Chest CT scans were performed, and results were compared with PCR. Data were analyzed using SPSS version 20, with p<0.05 considered significant. Results: Of the 234 patients, 133 tested positive for COVID-19 via PCR, while 101 were negative. HRCT demonstrated an overall accuracy of 73.9%, sensitivity of 72.9%, specificity of 75.2%, positive predictive value of 79.5%, and negative predictive value of 67.8%. Chi-square analysis revealed significant correlations of HRCT accuracy with BMI (p=0.004) and illness duration (p=0.010) but not with age (p=0.956) or gender (p=0.113). Conclusions: HRCT shows reasonable sensitivity, specificity, and overall accuracy as a diagnostic tool for COVID-19. Its performance improves in women, those with higher BMI, and longer illness duration but should not replace PCR testing due to its modest negative predictive value.

Prevalence of Nonalcoholic Fatty Liver Disease among Obese Patients Presented in Liaquat University Hospital Hyderabad/Jamshoro

Yasra Memon — 2025-01-31

Non-Alcoholic Fatty Liver Disease (NAFLD) is a common liver disorder strongly linked to obesity and metabolic syndromes. Its identification in obese patients is critical for early management and prevention of complications. Objective: To evaluate the prevalence of NAFLD in obese patients presenting to a tertiary care hospital in Hyderabad, Pakistan. Methods: A cross-sectional study was conducted in Liaquat University Hospital Hyderabad and Jamshoro, over six months. Initially, 78 obese patients (BMI>30) were included through convenience sampling but after weight adjustment (IPW) it became 500 Patients. Demographic, anthropometric, and clinical data were collected. NAFLD diagnosis was based on ultrasound findings. Data were analyzed using SPSS version 22.0. Results: The prevalence of NAFLD was 41% in obese patients presented to hospital. In the adjusted model, BMI was the strongest predictor of NAFLD (OR = 1.205, 95% CI: 1.165–1.246, p<0.001), with each unit increase in BMI increasing the odds of NAFLD by 20.5%. Male had significantly lower odds of NAFLD compared to female (OR = 0.644, 95% CI: 0.540–0.767, p<0.001). Waist circumference (OR = 0.981, p=0.017p) and weight (OR = 0.969, p<0.001) were negatively associated with NAFLD, likely reflecting residual effects after adjusting for BMI. Conclusions: NAFLD is prevalent among obese patients in Pakistan, with Body Mass Index as the primary risk factor. Adjusting for sampling biases via IPW provided more accurate and generalizable findings. Routine screening for NAFLD and targeted interventions for weight management, particularly in female, are essential to mitigate disease progression.

The Impact of Education on Knowledge and Use of Contraceptive Methods: A Comparative Analysis of Educated and Under educated Populations

Zarish Suhail — 2025-01-31

Abstract: Contraception is a critical aspect of public health, significantly influenced by education, which enhances individuals' knowledge and decision-making regarding contraceptive methods. Objectives: This study aims to assess the impact of education on the knowledge and use of contraceptive methods by comparing educated and undereducated populations. Material and Methods: A cross-sectional study was conducted among 400 participants in Lahore, using convenience sampling. Data were analyzed using SPSS version 23, with frequency, percentages, mean, and standard deviation applied. Results: The results show that higher education levels are associated with significantly greater knowledge of contraceptive methods, with 35.2% of college/university-educated participants being aware of condoms, compared to only 15.2% of uneducated participants. Moreover, the use of modern contraceptive methods, such as condoms and oral contraceptives, was notably higher among the educated group (18.8% and 28.7%, respectively) than among the uneducated group. Discussion: The study also highlights significant disparities in contraceptive use and knowledge between educated and undereducated populations, emphasizing the socio-economic and cultural barriers faced by the latter. Conclusion: In conclusion, the findings reinforce the critical role of education in enhancing contraceptive knowledge and use, highlighting the need for targeted public health interventions to address the unmet contraceptive needs of undereducated populations.

High Mortality Rate Due to Inflated Prevalence of Drowning Cases; An Observational Study Reflecting Regional Trends and Factors Affecting Asphyxial Deaths Due to Drowning in District Muzaffargarh

Sanaila Gull Sana — 2025-01-31

Asphyxia deaths due to drowning, especially accidental deaths are soaring daily in many areas of Pakistan. This fact led us to conduct this study on prime areas of Muzaffargarh on the bank of River Chenab. Objectives: To determine the frequency of drowning cases and factors affecting their high prevalence. Methods: A retrospective study comprising 5 years (2019-2023), including both genders and age groups, asphyxia deaths particularly due to drowning but excluding unidentified bodies and other modes of asphyxia deaths. All variables are analyzed through SPSS-27. Results: Out of 412 drowning cases, 309 cases belong to accidental drowning (75%) with a predominance of the male population, almost 68.68%. The most prevalent age group involved is 11-20 years (31.31%). The majority of cases happen in the monsoon and summer seasons, 28.88% and 26.45% respectively. Conclusions: It was concluded that asphyxia deaths due to drowning are rising day by day, especially the cases involving accidental deaths. This showed the lack of proper preventive strategies in areas of Chenab River in District Muzaffargarh.

Shovel Shaped Incisors: A Non-Metric Dental Trait in Local Population of Punjab, Pakistan

Shaher Bano — 2025-01-31

Maxillary Incisors being the anterior teeth hold great importance for function and esthetics. Different morphological traits can affect the shape of incisors. Shoveling is a non-metric morphological trait predominantly seen in maxillary incisors and is characterized by prominent mesial and distal ridges enclosing a central fossa on the lingual surface of incisors. Objective: To determine the frequency of shovel shaped Incisors and its distribution according to gender in a local population of Punjab, Pakistan. Methods: The study was a cross-sectional study carried out on 176 students of age between 17-23 years. Probability, stratified random sampling technique was employed and the study was conducted from March, 2023 to November, 2023. The participants taken for the study were carefully examined clinically to diagnose the presence or absence of this trait. Results: Out of total population of 176, only 55 (31.2%) individuals were positive for shoveling trait. Among the positive individuals, no gender predilection of this trait was observed. Conclusion: Non-metric dental traits can be assessed to identify ethnic groups, forensic odontology and inform clinical management in various dental procedures.

Weight Gain in Severe Acute Malnutrition Children after Discharge from CMC Children’s Hospital Larkana Followed-Up for Two Months

. Mehak — 2025-01-31

Globally, 19 million children under five suffer from severe acute malnutrition, causing 400,000 deaths annually. Early detection is crucial for treatment and reducing consequences in community and healthcare settings. Objectives: To assess weight gain in severe acute malnutrition (SAM) children two months after discharge from Children's Hospital. Methods: A prospective cohort study was conducted on children with SAM, receiving treatment at the oral therapy program (OTP) clinic at Chandka Medical College, Children Hospital, Larkana. Through consecutive sampling, 99 children aged 6-60 months with SAM and good appetites during discharge were enrolled. Mothers were explained about OTP. Follow-ups were conducted every 15 days up to two months after discharge to assess weight gain. SPSS version 22.0 was used to analyze the data. Results: Analysis revealed that 58.6% were male, with a mean age of 16.4 ± 8.2 months, while 52.5% were below 12 months old, mostly in rural areas (58.6%), and (32.3%) had illiterate maternal education status. Mean body weight at discharge was 4100 ± 620 grams. By the end of 2 months, weight gain was noted among 91 (91.9%) children. Weight gain was “good” in 51.5% of children, moderate in 34.3%, and poor in 14.2%. The weight gain was significantly associated with younger age groups (p=0.0085), literate mothers (p=0.0071), and increased monthly income families (p= 0.0416). Conclusions: The study found a significant association between weight gain and SAM management. Clinical-based treatment is often only the first step; however, sociodemographic factors like age, maternal education, and family income are crucial for sustaining nutritional and medical recovery and reducing morbidity and mortality.