Pakistan Journal of Health Sciences

Pumpkin Seeds and Heart Health: A Comprehensive Review of Their Role in Cardiovascular Disease Prevention and Management

Minahil Adnan — 2025-04-30

Cardiovascular Diseases (CVDs) remain a major global health concern, with an increasing prevalence requiring urgent preventive strategies. Diet and lifestyle play a crucial role in CVD development, emphasizing the need for healthy food interventions. To explore the potential cardioprotective benefits of pumpkin seeds (Cucurbita spp.) and their bioactive compounds in promoting cardiovascular health. Relevant literature was reviewed to evaluate the macronutrient and micronutrient profile of pumpkin seeds, as well as their bioactive compounds. Study Design: A comprehensive review of the nutritional composition and functional properties of pumpkin seeds was conducted, focusing on their role in cardiovascular disease prevention. Key components, including linolenic acid, phytosterols, antioxidants, and pumpkin seed oil, were analyzed for their potential impact on cardiovascular health. Pumpkin seeds are rich in proteins, carbohydrates, and unsaturated fatty acids, along with essential micronutrients such as zinc, phosphorus, magnesium, potassium, and selenium. Linolenic acid in pumpkin seeds offers protective effects against CVDs, diabetes, and certain cancers. Phytosterols contribute to lowering LDL cholesterol levels, while their strong antioxidant properties help reduce oxidative stress, lower blood pressure, and prevent arteriosclerosis. Pumpkin seed oil, rich in magnesium, enhances Nitric Oxide (NO) production, supporting vascular function and aortic protection. Given the increasing focus on plant-based diets for chronic disease prevention, regular consumption of pumpkin seeds may provide significant benefits in improving cardiovascular health. Further research and clinical trials are recommended to establish optimal dietary intake guidelines for maximizing their protective effects.

Impact of Pharmacist-Led Interventions On Medication Adherence in Patients with Chronic Psychiatric Disorders

Usman Ul Haq — 2025-04-30

Mental health disorders represent a growing global health challenge, affecting an estimated 970 million people worldwide as of 2019. These disorders not only impair individuals' ability to function but also impose significant economic and social burdens. In a country like Pakistan, mental health treatment resources are minimal, and chronic psychiatric disorders like bipolar personality disorder, schizophrenia, and chronic depression have become an enormous burden. Objectives: To assess the impact of pharmacist-led interventions on medication adherence among psychiatric patients in Rawalpindi, Pakistan. Methods: This quasi-experimental mixed-method study employed a pre-post intervention design. Conducted in two psychiatric clinics in Rawalpindi, it involved a total sample of 60 participants for the quantitative phase and 10 for the qualitative phase. Quantitative data were analyzed using McNamara’s test and the Wilcoxon signed-rank test, while qualitative data underwent thematic analysis. Results: Significant improvements in medication adherence were observed post-intervention, as evidenced by Paired Chi-Square (McNamara’s test) and Wilcoxon Signed Rank Test. Thematic analysis of the qualitative data identified four main themes with three sub-themes, providing insights into the patients’ attitudes, knowledge, and practices regarding medication adherence. Conclusions: It was concluded that pharmacist-led interventions were found to be effective in enhancing medication adherence among psychiatric patients. The study underscores the importance of ongoing support and education for this patient group and recommends the continuation of such interventions to sustain improvements in adherence.

Impact of Marriage on Performance, Behavior, and Work-Life Changes among Female Employees in the Health Sector

Naheed Khuhro — 2025-04-30

According to the World Bank, only 20% of Pakistani women hold a university degree linked to professional employment. Furthermore, women's participation across all sectors remains notably low, with figures below 5%.

Objective: To assess the variations experienced by married female employees within the healthcare sector. Specifically, it investigates the changes in performance, WLB, and PB as perceived by the participants after marriage. Methods: This survey was conducted over the period of 01 years from public and private organization where women practitioner was working as doctor or postgraduate students affiliated with the College of Physicians and Surgeons of Pakistan (CPSP) or General Practitioners (GPs) within the province of Sindh. Results: The paired sample t-test also reveals a statistically significant difference between Work-Life Balance of Before-Marriage Status (mean = 2.0961, SD = 0.61938) and After-Marriage Status (mean = 2.2167, SD = 0.66697), with the difference t (203) = -3.070, p = 0.002 (two-tailed), α = .05 and finally there was a significant difference between Professional Behavior of before and after marriage (mean = 1.8255, SD = 0.63691), (mean = 1.9382, SD = 0.70962); t (203) = -2.917, p = 0.004 (two-tailed), α = .05 respectively. Conclusion: This study highlighted the significant impact of marital status changes on women’s professional lives, particularly in the health sector.

Association of TLR7 rs864058 Genotypic Variation and mRNA Expression with COVID-19 Severity and Clinical Outcomes

Beenish Khalid — 2025-04-30

Genetic variations in TLR7 could modulate the severity of COVID-19. Objectives: To find the association between TLR7 mRNA expression, genotypic variations, and disease severity in COVID-19 patients. Methods: A cross-sectional observational study was conducted on 59 PCR-confirmed COVID-19 patients at Ziauddin Hospital, Karachi (June 2022–May 2023). Blood samples were analyzed for TLR7 genotyping via PCR and Sanger sequencing. Disease severity was classified into three groups based on clinical guidelines. TLR7 mRNA expression was quantified using real-time PCR (qPCR), and hospitalization, ICU admission, and complications were documented. Results: Higher TLR7 mRNA expression was observed in patients with the GG genotype compared to those with the GA genotype (p=0.04). Individuals carrying the GG genotype exhibited greater hospitalization rates (75.5% vs. 40%, p=0.009), increased ICU admission (28.6% vs. 10%, p=0.041), and a higher need for mechanical ventilation (20.4% vs. 10%, p=0.049). Respiratory failure occurred more often in the GG genotype group (20.4% vs. 10%, p=0.038). Conclusions: It was concluded that the GG genotype of TLR7 was related to higher susceptibility to severe COVID-19 outcomes, with higher hospitalization rates, ICU admission, and respiratory failure.

Association of Maternal BMI with Obstetric and Perinatal Outcomes

Shabana Bibi — 2025-04-30

The increasing prevalence of obesity among women of childbearing age is linked to a higher risk of pregnancy complications. Maternal obesity affects both obstetric and perinatal outcomes, posing risks for mother and child. Objective: To investigate the relationship between maternal BMI and obstetric and perinatal outcomes. Methods: A cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Tertiary Care Hospital Bahawalpur, from January to July, 2022. A total of 254 pregnant women were categorized into underweight, normal, overweight, and obese groups based on BMI. Data on Gestational Diabetes Mellitus (GDM), Pregnancy-Induced Hypertension (PIH), and mode of delivery, labor complications, postpartum hemorrhage, preterm labor, and NICU admissions were analyzed using SPSS version 25.0. Results: Higher incidences of GDM (31.9% in obese vs. 10.6% in underweight) and PIH (23.1% in obese vs. 7.7% in underweight) were observed, though not statistically significant (p = 0.088 and p = 0.463, respectively). Obese mothers had more cesarean sections (24.6% vs. 13.8% in underweight, p = 0.178) and increased NICU admissions (18.9% vs. 8.1%, p = 0.788). Conclusions: This study observed clinically relevant trends suggesting that higher maternal BMI may be associated with adverse obstetric and perinatal outcomes, including increased rates of gestational diabetes, hypertension, cesarean sections, and NICU admissions. Although statistical significance was not reached, findings emphasize the importance of maternal weight management in prenatal care.

Clinical, Serological and Radiological Profile of Patients with Autoimmune Disease Associated Interstitial Lung Disease

Hajra Ahmad — 2025-04-30

The clinical, serological, and radiological profiles of interstitial lung disease in patients with autoimmune diseases vary significantly and are poorly studied. Objectives: To determine the clinical, serological and radiological profile of patients with autoimmune-associated interstitial lung disease. Methods: This cross-sectional study was carried out at the Department of Rheumatology, Khyber Teaching Hospital, Peshawar, during the period from 16^th December 2023 to 15^th December 2024. A total of 105 male and female patients in the age range of 40 to 80 years diagnosed with autoimmune-related interstitial lung disease were studied. History, clinical examination, blood tests and high-resolution computerized tomographic (HRCT) scan were performed to determine the clinical, serologic and radiologic features of AI-ILD. Results: The mean age of the participants was 51.51 ± 12.34 years. Female patients outnumbered men (n=61, 58.1%). Arthritis was most commonly recorded in 47 participants (44.8%) followed by skin rash (n=33, 31.4%). Antinuclear antibody (ANA) and anti-dsdna (double-stranded deoxyribonucleic acid) constituted the most frequently found serological factors observed in 32 (30.5%) and 28 (26.7%) patients, respectively. Usual interstitial pneumonia was observed in 19 patients (17.4%), non-specific interstitial pneumonia in 36 (34.2%) and lymphoid interstitial pneumonia was recorded in 7 participants (6.7%). Conclusions: It was concluded that middle-aged women with inflammatory arthritis and skin rashes with rheumatoid arthritis as background disease were more likely to have interstitial lung disease. Serologic factors lack specificity. The most common radiological finding on HRCT was ground glass opacities and non-specific interstitial pneumonia as the most frequent radiological diagnosis.

Involvement of Paranasal Sinuses in Patients with Bilateral Nasal Polyps: A Cross-Sectional Descriptive Study at Swabi

Jawad Badshah — 2025-04-30

Non-neoplastic, pedunculated swellings of the sinonasal mucosa are called sinonasal polyps. They are called polyposis when they occur in multiple numbers. Objectives: To determine the frequency of paranasal sinus involvement in patients with bilateral nasal polyps aged 20–50 years using a validated self-structured questionnaire and radiological imaging. Methods: A cross-sectional descriptive study was conducted at the ENT Department of Bacha Khan Medical Complex, Swabi, from January 24, 2024, to June 23, 2024. A sample size of 50 patients was selected using a convenient sampling technique. Data were collected using a pre-tested, validated questionnaire, and sinus involvement was assessed via CT scans. Descriptive statistics were analyzed using SPSS version 26.0. Results: Among 50 patients, 72% (n=36) were male, and 28% (n=14) were female. The 20–25 age group constituted 30% (n=15) of the sample. Maxillary sinus involvement was most common (36%), followed by ethmoid (26%), frontal (26%), and sphenoid sinuses (18%). Bilateral maxillary sinus involvement was observed in 40% of patients. Conclusions: It was concluded that the study highlights the predominant involvement of maxillary sinuses in bilateral nasal polyps, emphasizing the need for comprehensive radiological evaluation to guide management. The findings align with existing literature but underscore the need for larger, randomized studies to improve generalizability.

Association of Age and Gender with Early Onset Seizures in Patients of Acute Ischemic Stroke at a Tertiary Care Setting

Rekha Kumari — 2025-04-30

The prevalence of ischemic stroke is more in south Asian countries. Individuals having an early seizure have a significantly elevated chance of developing epilepsy after stroke than individuals having stroke but no early seizure. The seizures that occur following the stroke has been observed as contributing to more worse outcomes and disabilities. Objective: To determine the association of age and gender with earliest inception seizures in sufferers of acute ischemic stroke at a tertiary care setting in Sindh Pakistan. Methods: This cross sectional study was organized at Department of Medicine of Bilawal Medical College Hospital, Kotri from 26 May 2023 to 26 October 2023. In this study, the patients attending Bilawal Medical College Hospital reporting with stroke were recruited for this research study. The presence or absence of earliest seizures is dependent variable while, the age, gender and sociodemographic status are variables in present study. The data were analyzed on International Bussiness Machine Statistical Package for Social Sciences Version 26.0. Results: Out of 118 stroke patients, 17 (14.4%) found with early seizures. The gender and age appeared to have significant association with early onset of seizures with p value 0.01 and 0.04 correspondingly. Conclusions: It was concluded that male patients and all patients aged between 51 to 60 years were more likely to experience an early seizure. After an acute stroke, earliest seizures could not resemble to unfavorable functional prognosis.

Diagnostic Accuracy of MRI in Detecting Stromal Invasion in Early Cervical Cancer Patients Taking Histopathology as Gold Standard

Nosheen Ahmad — 2025-04-30

Cervical cancer is a major cause of cancer-related deaths among women. MRI is a non- invasive imaging technique commonly used to evaluate tumor extent, but its diagnostic accuracy in detecting stromal invasion in early cervical cancer remains uncertain. Objective: To determine the diagnostic accuracy of MRI in detecting stromal invasion in early cervical cancer patients taking histopathology as gold standard. Methods: This Cross-sectional validation was conducted at the Department of Radiology, Faisalabad Medical University (FMU), Faisalabad, form 1st April 2024 to 30th September 2024. A total of 200 patients aged 30-70 years with early cervical cancer were included in the study. All patients underwent pelvic MRI scans using a 1.5 Tesla MRI machine. The MRI findings were assessed for the presence or absence of stromal invasion and compared with histopathology results. All the data was analyzed in SPSS and sensitivity, specificity, and diagnostic accuracy was calculated for MRI against histopathology. Results: The overall sensitivity, specificity, Positive Predictive Value (PPV), negative predictive value (NPV), and diagnostic accuracy of MRI in detecting stromal invasion in early cervical cancer patients, were 91.26%, 89.70%, 90.38%, 90.63%, and 90.50%, respectively with histopathology as the gold standard. Conclusion: This study concluded that MRI has a high diagnostic accuracy in detecting stromal invasion in early cervical cancer patients.

Frequency of Angles Malocclusion, Psychological Effects in Patient Using Oasis Questionnaire and Treatment Needs in Patients Visiting Dental Teaching Hospital

Saira Arshad — 2025-04-30

A person's psychological health and confidence are greatly influenced by their facial appearance. It encourages acceptance, integration, and social recognition. Objective: The objective of current study was to establish the frequency of Angle’s malocclusion, assess its psychological impact using the OASIS questionnaire, and evaluate orthodontic treatment need using the Index of Orthodontic Treatment Need (IOTN) in patients visiting dental teaching hospital. Methods: Both gender patients between 14-20 years, fully erupted first molar from one arch to another were included while participants with a history of jaw injuries, experiencing orthodontic treatment, or had prior orthodontics treatment were not included in the current study. The Oral Aesthetic Subjective Impact Scale (OASIS), self-evaluation validated tool was used to determine perceived therapeutic requirements. Index of Orthodontic Treatment Need (IOTN) index was also reported. Results: Among the 350 people examined, 70% (245) were females and 30% (105) were males. The mean age was 17 years with S.D ± 1.26. 54 (15.4%) of the patients had normal dental occlusions, 175 (50%) had class I malocclusion, 99 (28.3%) had class II, and 22 (6.3%) had class III malocclusion. 202 (57.7%) of patients reported good psychological well-being about their dental looks, whereas 90 (25.7%) and 58 (16.6%) had satisfactory and poor psychological well-being respectively, based on sample size. Conclusions: This study showed a significant rate of malocclusion, with Class I being the most frequent. Psychological effects were obvious, as many patients expressed unhappiness with their oral look.

Deciphering the Diagnostic Potential of α-Methylacyl CoA Racemase (AMACR) in Prostatic Neoplasms

Huma Abbasi — 2025-04-30

Prostate cancer is a prevalent malignancy that affects males globally, posing a substantial impact both locally and globally. A critical marker for improving prostatic cancer diagnostic accuracy is α-Methylacyl CoA Racemase (AMACR), an enzyme involved in the metabolism of certain fatty acids and bile acid precursors. Objective: To explore the immunohistochemical expression of α-Methylacyl CoA Racemase and assess its association with the histological grading of prostatic adenocarcinoma. Methods: This retrospective cross-sectional study was carried out at Liaquat University of Medical and Health Sciences, Jamshoro between April 2023 to February 2024. Total 71 prostate cancer patients with age range of 45 to 99 years were selected for this study according to the selection criteria. The study used formalin-fixed paraffin-embedded tissue blocks for histopathology to evaluate AMACR expression through immunohistochemistry and the data was analyzed by using the Statistical Package for the Social Sciences (SPSS) for windows. Results: The immunohistochemical study revealed that 57.7% of cases showed AMACR expression, with a significant correlation between the expression levels and the tumor's histological grade (P-value < 0.05). Conclusion: The findings of this study highlighted AMACR's potential as a diagnostic biomarker for aggressive prostate cancer.

Prevalence and Risk Factors of Congenital Heart Disease in Patients Admitted in NICU: A Study from Tertiary Care Hospital in Karachi

Farah Zaidi — 2025-04-30

Congenital heart disease (CHD) is the most common cause of neonatal morbidity and mortality. The earlier the diagnosis and management, the better the outcome. Several maternal factors predispose to the development of congenital heart disease, including gestational diabetes, pregnancy-induced hypertension, and TORCH infections. Objectives: To determine the frequency and factors associated with CHD in neonates admitted to the Neonatal Intensive Care Unit (NICU) at a tertiary care hospital in Karachi. Methods: A cross-sectional study was conducted from 20 Nov 2024 to Feb 20, 2025, at Ziauddin University Hospital Karachi. Non-probability consecutive sampling included neonates (0-28 days) with confirmed CHD, recurrent respiratory symptoms with a cardiac murmur, or asymptomatic neonates with a cardiac murmur detected on examination. Data were collected regarding maternal risk factors, clinical features, laboratory findings, and neonatal outcomes. Results: A total of 162 neonates were included in the study. The mean maternal age was 30.5 ± 7.7 years. The most common maternal conditions included gestational diabetes (30%) and pregnancy-induced hypertension (37%). Clinical features included tachypnea in 44%, tachycardia in 52%, poor feeding in 48%, and cyanosis in 46%. Common defects were revealed on echocardiography, such as patent ductus arteriosus (23%) and atrial septal defects (19%). The average hospital stay was 16 ± 8.1 days, and the neonatal mortality rate was high. No associations between mortality and maternal factors were established. Conclusions: It was concluded that this study emphasizes a high prevalence of CHD in neonates and its association with maternal risk factors such as gestational diabetes, pregnancy-induced hypertension, and TORCH infections.

Analyzing Risk Factors Associated with Post Myocardial Infarction Complications: A Retrospective Analysis

Tayyeb Muhammad — 2025-04-30

Myocardial infarction is a major cause of mortality and results in several complications including post-MI arrhythmias, pulmonary edema, and cardiogenic shock. Objective: To evaluate and examine the clinical and demographic factors and their association with post-MI complications. Methods: This was a retrospective observational study and non-probability convenient sampling was recruited for assessment. A total of 188 patients aged 45 to 65 years, hospitalized for acute STEMI and of both genders were included. However, patients with NSTEMI or with comorbidities such as chronic renal failure or cirrhosis were not included. Age, gender, BMI, duration of hospitalization, etc. were recorded on a structured form. Patients were assessed for post-MI arrhythmias, cardiogenic shock, and pulmonary edema. This study took six months its completion. SPSS version 25.0 software was employed for analysis and a chi-square test was used to identify associated risk factors with post-MI complications at a significant level (p<0.05). Results: Findings revealed that the occurrence of post-MI arrhythmias showed a significant association with smoking and family history (p<0.001), while no significant association was observed for BMI, hospital duration, hypertension, or family history. Cardiogenic Shock (CS) is strongly associated with DM (p=0.001) but shows no association with smoking, BMI, duration of hospital stays, hypertension, or family history. Conclusions: Smoking and a family history of cardiovascular disease are prevalent and found significant association with post-MI arrhythmias (p<0.001) after myocardial infarction; diabetes mellitus also resulted in significant association with pulmonary edema and cardiogenic shock (p<0.001).

Frequency of Coexisting Meningitis in Neonates Admitted with Late-Onset Sepsis in Nursery, MTI DHQ Hospital, Dera Ismail Khan

Ayesha Khan — 2025-04-30

Neonatal Late-Onset Sepsis (LOS) is a serious condition that can lead to co-existing meningitis, increasing the risk of long-term complications and mortality. Early diagnosis remains challenging due to non-specific clinical symptoms and limitations in performing Lumbar Punctures (LPs). Objective: To determine the frequency of co-existing meningitis in neonates with LOS and identify clinical and laboratory markers associated with it. Methods: Neonates aged ≥72 hours with signs of LOS were included. Demographic data, clinical symptoms, and laboratory parameters were recorded. A comparative cross-sectional study was conducted in the neonatal nursery of DHQ Hospital, MTI, Dera Ismail Khan. Blood samples were analyzed for C - Reactive Protein (CRP), White Blood Cell (WBC) count, and blood culture, while CSF analysis included WBC count, protein, glucose, and culture. Data were analyzed using SPSS version 25.0, with the Chi-square test used for categorical variables and independent t-tests for continuous variables. A p-value of <0.05 was considered statistically significant. Results: Among 95 neonates with LOS, 53.7% had meningitis. Lethargy (p = 0.024) and previous antibiotic use (p = 0.034) were significantly associated with meningitis, while other clinical signs showed no significant difference. CSF analysis revealed elevated WBC counts in meningitis cases, but CRP and blood WBC were not significantly different. Conclusions: Meningitis was frequent among neonates with LOS, with lethargy and prior antibiotic use as key risk factors. Early identification of these factors may aid in timely diagnosis and intervention. Further multi-center studies are recommended to validate these findings.

Comparative Analysis of Autopsy Case Characteristics Before and During the COVID-19 Lockdown at DHQ Sahiwal

Noureen Hafeez — 2025-04-30

COVID-19 has impacted all spheres of life during the pandemic era. It not only affected health but also impacted the socioeconomic conditions of our lives. In hospitals, autopsies continued to be conducted during the pandemic. The Lockdown has not impacted autopsy conduct in hospitals. Objective: To compare and identify various characteristics of autopsies conducted in 2019 and 2020. Methods: An observational retrospective study was conducted from 15^th March 2020 to August 2020 and from 15^th March 2019 to August 2019 in DHQ Sahiwal. Data were analyzed through SPSS 27. Results: A total of 257 autopsy cases were collected, of which 114 cases were referred in 2019, while the remaining 143 cases were from 2020. The most prominent cause of death in 2019 and 2020 was trauma, at almost 64% and 63.6%, respectively. The highly prevalent manner of death was homicidal, in 2019 it was 47.4%, and in 2020 it was 46.2%. Conclusions: It was concluded that the COVID-19 lockdown did not significantly influence the character of the autopsy cases that were referred to DHQ Sahiwal.

Knowledge, Attitude, and Practice of Infection Control Measures among Medical Students and Residents of a Private Medical College in Lahore, Pakistan: A Comparative Cross-sectional study

Rabail Fatima — 2025-04-30

Healthcare workers, especially medical students, are constantly exposed to pathogens in hospitals, which significantly increases the risk of them being infected. Infection control measures are pivotal in safeguarding them from these infections and reducing any risk of transmissibility. Objective: To assess the knowledge, attitude, and practice of Infection Control Measures among medical students and residents of a private medical college in Lahore. Methods: This was a cross-sectional study conducted from April to June 2023 at CMH Lahore Medical College, using a purposive sampling technique that included residents and medical students from the third to the final year, regardless of age or other demographic factors. A pretested structured questionnaire was used. Data were analyzed using SPSS 23.0. Results: In this study, the total number of responses collected was 378. Out of these responses, 95% possessed good knowledge. 55.8% of participants showed a positive attitude towards infectious control measures. 91.5% of participants said that they followed good practices in infection control. On comparison between House officers, PGs, and undergraduates, significant p-values were obtained in terms of Knowledge, Practice, and Attitude, indicating that the participants in all three categories are well-informed regarding infection control measures and putting them into practice. Conclusions: This study highlighted the extent to which medical students and residents effectively implement infection control measures in their work environment. Furthermore, it underscores their level of receptiveness to these practices, shedding light on both strengths and areas for improvement.

Cross-Sectional Analysis of Probable Causative Factors Leading to Iron Deficiency Anemia in Primigravida During Their First Trimester

Aisha Altaf — 2025-04-30

Anemia is a common nutritional deficiency that impacts approximately 1.6 billion individuals globally, representing around 25% of the world’s population. Objectives: To assess the prevalence of factors associated with anemia due to iron deficiency in primigravida females during their first trimester. Methods: A descriptive, cross-sectional study was conducted at Agha Khan University Hospital, Karachi, from January 4 to July 3, 2019. The study aimed to screen pregnant women during their first antenatal visit in the Outpatient Department for eligibility based on the inclusion criteria. Data were recorded using a structured proforma. Effect modifiers were controlled by stratifying age in years and gestational age in weeks, with comparisons between stratified groups made using Chi-square analysis. Results: Mean ± SD of age and gestational age in primigravida females was 27.50 ± 5.36 years and 7.93 ± 2.07 weeks, respectively. Mean ± SD of height, weight and BMI was 156.44 ± 5.81 cm, 65.90 ± 10.84 kg and 28.84 ± 4.10 kg/m^2, respectively. In frequency of associated factors, advanced maternal age was found to be responsible for iron deficiency anemia in 27 (55.10%) women, underweight in 2(4.08%), low educational status in 7 (14.28%) and low socioeconomic status was 13 (26.53%) women. Conclusions: It was concluded that in the Pakistani population, the prevalence of iron deficiency anemia is high among pregnant women. Maternal anemia is significantly linked to maternal age and low socioeconomic status. The results emphasize the critical need to raise awareness among pregnant women and their families regarding the significance of antenatal care.

Frequency of Hypoglycemia and Hypothermia amongst Newborns Admitted at Pediatrics Emergency of CLF Larkana

. Anuradha — 2025-04-30

Neonatal hypoglycemia is a prevalent metabolic disorder associated with acute neurological issues and long-term developmental complications. Objectives: To assess the frequency of hypoglycemia and hypothermia among newborns admitted to the Neonatal Emergency Department at Child Life Foundation (CLF), Larkana. Methods: The study, conducted from August 15, 2022, to February 15, 2024, involved 200 neonates of both genders in the Neonatal Emergency Department of CLF, SMBBMU, Larkana. Comprehensive demographic and clinical data—including age, gender, delivery mode, birth location, and maternal residence were collected. Axillary temperature was measured using a sterilized thermometer, and capillary glucose was assessed at five intervals (2, 6, 12, 24, and 48 hours’ post-birth) before feeding using an Accu-Chek Glucometer. Results: In a study of 200 newborns, the average age was 3.2 ± 2.4 days, with a mean height of 48.3 ± 7.3 cm, weight of 2.7 ± 0.8 kg, and gestational age of 39.6 ± 6.3 weeks. Most participants were female, and 42.5% were appropriate for gestational age. Cesarean section was the most frequent delivery method (48%). Hypoglycemia occurred in 16% of cases, while hypothermia was more common, affecting 47.5% of newborns. Hypothermia showed significant associations with lower height (p=0.008), weight, gestational age, and cesarean/instrumental deliveries. Hypoglycemia was significantly linked to low birth weight, with gestational age and delivery location showing borderline significance. Gender and age had no notable effects. Data were analyzed using SPSS version 20.0. Conclusions: Hypothermia was more frequent than hypoglycemia among the admitted neonates. Further research is needed to validate and expand on these findings.

Relationship of Systemic Inflammatory Markers and Body Mass Index with Primary Osteoarthritis

Roma Gulzar — 2025-04-30

Osteoarthritis (OA) is degenerative disorder which involves synovial inflammation. Erythrocyte sedimentation rate, Body mass index and C-reactive protein are commonly used markers to determine infection or inflammation. Objective: To measure the level of raised levels of erythrocyte sedimentation rate and C-reactive protein in primary osteoarthritis and to identify the association of body mass index with osteoarthritis in Pakistani population. Methods: This descriptive cross-sectional study was conducted at Department of Rheumatology, Shaikh Zayed Hospital, Lahore, Pakistan from July 2021 to April 2022. A total of 216 patients were enrolled. All patients over the age of 30 years with primary osteoarthritis were included. Association of C-reactive protein and erythrocyte sedimentation rate with OA grade and highest score in case of multiple joints were checked by using chi-square test and odds ratio. Results: Most were females and large group of individuals were overweight or obese. Mean BMI was 29.50 ± 4.94 kg/m². The radiographic progression of OA was seen more in women compared to men for Grade 4 OA. The systemic inflammatory markers erythrocyte sedimentation rate and C-reactive protein were plotted against the Grade of OA and it was found that erythrocyte sedimentation rate was elevated in (n=118) most individuals however C-reactive protein was normal in the majority (n=196). Radiographic advancement of OA with the rise of these acute phase reactants was not significant i.e. p-value was 0.804 for erythrocyte sedimentation rate and 0.497 for C-reactive protein. Conclusion: There was no significant correlation between raised inflammatory markers and radiographic progression of osteoarthritis.

Maternal Hyperuricemia in Normotensive Singleton Pregnancy, a Prenatal Finding with Continuous Perinatal and Postnatal Effects

Hafiza Asifa Saleem — 2025-04-30

Maternal hyperuricemia has been associated with various adverse pregnancy outcomes in hypertensive disorders, but its effects in normotensive singleton pregnancies remain unclear. Objective: To assess the impact of maternal hyperuricemia on perinatal and postnatal outcomes in normotensive singleton pregnancies, with a focus on birth weight, gestational age, NICU admissions, and gestational anemia. Methods: This study was conducted at the Department of Obstetrics and Gynecology, Tertiary Care Hospital, Bahawalpur city, from 30-11-2022 to 29-06-2023. The Study Design was prospective observational cohort study. A cohort of normotensive pregnant women was prospectively followed to assess the association between maternal hyperuricemia and perinatal as well as postnatal outcomes. Results: Significant differences were observed in birth weight and gestational age between hyperuricemic and normouricemic mothers. Infants born to normourecemic mothers had higher birth weights (3.80 ± 0.35 kg vs. 3.51 ± 0.40 kg, p = 0.015) and were delivered earlier (38.50 ± 1.20 weeks vs. 39.35 ± 1.00 weeks, p = 0.025). Additionally, hyperuricemic mothers showed a higher prevalence of NICU admissions (42.9% vs. 26.5%, p = 0.035) and gestational anemia (42.9% vs. 19.1%, p = 0.043). Logistic regression revealed that maternal uric acid levels significantly influenced the likelihood of NICU admissions, suggesting a complex interaction with perinatal outcomes. Conclusions: Maternal hyperuricemia in normotensive singleton pregnancies significantly influences birth weight, gestational age at delivery, NICU admission rates, and the prevalence of gestational anemia, indicating a notable clinical impact in this population.

Long-term Postoperative Outcomes of Pediatric Cataract Extraction with IOL Implantation in a Tertiary Eye Care Centre at Karachi

Muhammad Moeez Uddin — 2025-04-30

Cataracts in the pediatric age group present with challenges distinct from the adult age group. Objectives: To determine the long-term postoperative outcomes of pediatric cataract extraction with IOL implantation at a tertiary eye care center in Karachi. Methods: This retrospective cross-sectional study was carried out at Al-Ibrahim Eye Hospital for six months after ethical approval. Medical records of pediatric children below 10 years that had undergone cataract surgery along with implantation of IOL at the hospital in-between January 2020 to December 2024 were selected. Children having abnormalities, such as condition limiting eye’s visual potential like retinal disorders, retinal detachment, glaucoma, persistent fetal vasculature, abnormalities of the cornea, diseases of optic nerve, uveitis (either active or signs suggesting history of uveitis), or a history of cryotherapy for retinopathy due to prematurity, or treatment with laser, children with complications of surgery, placement of IOL in sulcus or children that failed to follow-up were all excluded. SPSS version 23.0 was used for data analysis. Results: A total of 140 eyes from pediatric patients were studied, with 56.43% male and 43.57% female. Bilateral cataracts were more common (72.86%). The mean age at surgery was 74.77 ± 29.94 months, with a follow-up of 5.22 ± 3.82 months. Postoperative refractive biometry significantly improved from +24.50 ± 4.50 D to +18.50 ± 2.50 D (p<0.001), showing a mean reduction of -6.00 ± 2.00 D. Conclusions: In long-term post-operative outcomes of pediatric cataract extraction with IOL implantation, surgery was generally well-tolerated with positive outcomes and minimal side effects.

Frequency of Serum Electrolytes in Children Suffering from Acute Gastroenteritis Aged 6 Months to 3 Years Admitted to MTI DHQ Hospital Dera Ismail Khan

Oushna Khan — 2025-04-30

Acute Gastroenteritis (AGE) is a major contributor to morbidity, dehydration, and hospitalizations among young children in low-resource settings. Electrolyte disturbances are common complications that may worsen disease severity and outcomes. Objective: To evaluate the clinical presentation and laboratory findings, particularly serum electrolyte levels, in children aged 6 months to 3 years diagnosed with AGE, and to assess their association with dehydration severity. Methods: A descriptive-analytical cross-sectional study was conducted at MTI DHQ Hospital, Dera Ismail Khan, involving 110 children with AGE. Data on demographics, clinical features, hydration status, and laboratory results (including serum electrolytes) were recorded. Statistical analysis was performed using SPSS Version 25.0. Chi-square, ANOVA, Kruskal-Wallis, and Tukey’s HSD post-hoc tests were applied. A p-value ≤ 0.05 was considered statistically significant. Results: Vomiting (76.4%) and fever (64.5%) were the most frequent clinical features. Moderate dehydration was most common. Significant differences (p ≤ 0.05) in electrolyte levels were observed across dehydration groups: sodium, potassium, chloride, urea, and creatinine levels were elevated in severe cases, while bicarbonate and magnesium were lower. No significant associations were found between dehydration severity and demographic or most clinical variables. Conclusions: Electrolyte abnormalities were significantly associated with dehydration severity in children with AGE, emphasizing the need for routine electrolyte monitoring and individualized fluid management, especially in moderate to severe cases. These findings support improved diagnostic protocols and targeted treatment strategies in paediatric gastroenteritis care.

The Relationship of Dental Pulp Stone with Cardiovascular and Renal Disease: A Cross Sectional Study

Roma Zulfiqar — 2025-04-30

Calcification of bodily tissues can occur by pathological or physiological means due to deposition of calcium. Normally, calcium deposits in teeth and bone, but ectopic areas in the body such as kidneys, vascular system and joints may precipitate calcium due to imbalance in the metabolism of calcium results hypercalcemia is known as metastatic calcification. Objective: To determine the association of pulp stones with cardiovascular and renal disease. Methods: Through non-probability sampling, cross-sectional study was carried out over the course of six months at the Department of Operative Dentistry and Endodontics, DUHS, Karachi. The current study comprised 150 patients, both male and female, between the ages of 30 and 60, who had teeth with pulp stones; individuals without pulp stones were not included. The chi-square test was utilized to evaluate the relationship between dental pulp stones and the existence of cardiovascular and renal disorders, and SPSS was used for data analysis. Results: Females were mostly affected as compare to males (63%).The mean age of the patients was noted as 42.2 years.A significant association between dental pulp stones cardiovascular and renal disease was documented. (p=0.001). Conclusion: A significant association was observed between CVD and pulp stones (p-value 0.001) and also significant association was established between PS and RS (p-value 0.001).

Diagnostic Accuracy of Fasting Blood Sugar and Oral Glucose Challenge Test for Gestational Diabetes Mellitus

Kinza Ayesha — 2025-04-30

Despite multiple studies on gestational diabetes mellitus (GDM) screening, evidence on the concurrent validity and practical use of fasting blood glucose (FBS) and glucose challenge test (GCT) remains limited. Objectives: To compare the diagnostic accuracy of FBS, and oral GCT in detecting GDM, taking oral glucose tolerance test (OGTT) as the gold standard. Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Shahida Islam Teaching Hospital, Lodhran, Pakistan, from March to December 2023. A total of 160 pregnant women aged 20–40 years (gestation>20 weeks) were included. Diagnostic performance of FBS and GCT was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. IBM-SPSS Statistics, version 26.0, was used for data analysis. McNemar’s test was applied to these how FBS, or GCT, agreed with GTT in diagnosing GDM, taking p<0.05 as significant. Results: The mean age and gestational age were 29.54 ± 5.35 years and 27.81 ± 2.48 weeks, respectively. The sensitivity of FBS in the diagnosis of GDM was 78.3%, and that of GCT was 84.2% (p=0.700). The specificity of FBS and GCT was 86.8% and 96.9%, respectively. The PPV of FBS was 81.8%, and that of GCT was 85.7%. The NPV of FBS and GCT were 84.0% and 91.8%, respectively (p=0.994). Accuracy of FBS was 83.1%, and GCT was 89.4%. Conclusions: It was concluded that the diagnostic accuracy of FBG and GCT in diagnosing GDM is high, with GCT demonstrating superior effectiveness. OGTT remains the definitive gold standard for confirming GDM.

Efficacy of Topical Dapsone 5% Gel and Topical Adapalene 0.1% Gel In Treatment of Mild to Moderate Acne Vulgaris

Attiya Fatima — 2025-04-30

Acne is a common dermatological condition, affecting 9.4% of the global population, and is found in all age groups, particularly in adolescents and young adults. Objective: To compare effectiveness of dapsone 5% gel once daily with adapalene 0.1% gel monotherapy for mild to moderate acne vulgaris. Methods: Fifty individuals with mild to moderate acne, with a lesional count ranging from three to thirty, participated in an open-label, quasi-experimental comparative trial. Two therapy groups Group B received adapalene 0.1% gel (n = 24) and Group A received Adapsone 5% gel (n = 23). Patients were directed to cover their faces with a small amount of the gel that was supplied to them. At weeks 0, 4, 8, and 12, non-inflammatory lesion counts, total lesion counts, and adverse effects were assessed. Results: In all treatment groups, the prevalence of all forms of acne lesions declined from baseline. Dapsone 5% gel was less effective than adapalene 0.1% gel in reducing inflammatory lesions (p < 0.05). Adapalene 0.1% gel group experienced somewhat more adverse effects than dapsone 5% gel group, with a statistically significant difference (p-value 0.04). Conclusions: The conclusion has been updated to emphasize the clinical relevance of the findings. Specifically, it is now stated that Dapsone 5% gel is an effective and safer alternative for patients with mild to moderate acne who have sensitivity to retinoids, while Adapalene remains the preferred option for patients requiring more aggressive treatment of inflammatory lesions. This provides clear guidance for dermatologists in clinical practice.

Comparison of Pre-emptive Tramadol versus Diclofenac in Postoperative Pain Management after Laparoscopic Cholecystectomy

Ahmad Nawaz — 2025-04-30

Effective Pre-emptive analgesia is essential to improve pain control and reduce opioid consumption. Non-opioid analgesics such as diclofenac and tramadol are commonly used, but their comparative efficacy remains an area of interest. Objective: To compare mean postoperative pain intensity and time to 1^st analgesic requirement between diclofenac and tramadol groups as Pre-emptive analgesics among patients undergoing laparoscopic cholecystectomy. Methods: This quasi-experimental study was conducted at Department of Anaesthesia, Mayo Hospital, Lahore, over period of six months. Quasi experimental study. 50 patients scheduled for elective laparoscopic cholecystectomy were included and randomized into two groups using lottery technique. Group D (diclofenac sodium 100mg), and Group T (oral tramadol 100mg), respective drug was given two hours before surgery. Postoperatively, NRS score were assessed at 8th hour, and time to first analgesic request was recorded. Data were analyzed using SPSS version 26.0, p-value ≤ 0.05 considered statistically significant. Results: Postoperatively, mean NRS score at 8th hour was significantly lower in Group T (3.56 ± 1.32) compared to Group D (4.52 ± 1.22) (p=0.01). Mean time to first analgesic request was significantly longer in Group T (104.04 ± 12.02 minutes) than in Group D (91.64 ± 8.51 minutes) (p<0.001). Conclusions: Preoperative administration of oral tramadol provides superior postoperative analgesia compared to diclofenac sodium, as evidenced by lower pain scores at the 8th postoperative hour and longer time to first analgesic request. Tramadol may be more effective option for pain control in patients undergoing elective laparoscopic cholecystectomy.

Patterns of Dyslipidemia among Patients with Non-Alcoholic Fatty Liver Disease

Kaleem Ullah Shaikh — 2025-04-30

Non-alcoholic fatty liver disease (NAFLD) affects a significant proportion and is frequently associated with dyslipidemia and metabolic disorders. Objective: To explore the patterns of dyslipidemia among patients with NAFLD and their association with disease severity. Methods: A cross-sectional study was conducted at the Department of Cardiology, Liaquat National Hospital, Karachi. All participants diagnosed with NAFLD were included, and NAFLD severity was assessed using Fibro Scan, categorizing patients into no significant fibrosis, mild fibrosis, significant fibrosis, and advanced fibrosis. Dyslipidemia patterns were evaluated based on lipid profiles. Results: The cohort (n=300) had a mean age of 51.44 years, with a majority being female (60.3%) and over 45 years old (71.3%). NAFLD severity was distributed as follows: 33% mild fibrosis, 32% no significant fibrosis, 29.3% significant fibrosis, and 5.7% advanced fibrosis. As NAFLD severity increased, waist circumference, liver enzyme levels (AST and ALT), and lipid markers (TC, LDL-C, TG) increased, while HDL-C decreased. Advanced cases showed higher hemoglobin A1c levels and increased hepatic steatosis and CAP values. Dyslipidemia associated with metabolic syndrome (24%), low HDL-C (61.3%), and hypertriglyceridemia (2%) were observed, with combined and general hyperlipidemia affecting 3.7% and 1.3% of participants, respectively. The patterns of dyslipidemia varied with severity; normolipidemia was common in cases with no significant fibrosis, combined hyperlipidemia was seen in significant fibrosis, and hyperlipidemia was exclusive to advanced NAFLD. Conclusion: It was concluded that the study found significant associations between NAFLD severity and dyslipidemia patterns.

Clinical Risk Factors of Post-Surgery Hemorrhage in Patients Undergoing Tonsillectomy

Sanaullah Bhatti — 2025-04-30

Post-tonsillectomy hemorrhage is rare but life-threatening and poses a critical emergency. However, limited research has been conducted on adults undergoing tonsillectomy. Objective: To analyze the predictors of post-tonsillectomy hemorrhage in adults undergoing tonsillectomy. Methods: A retrospective study was conducted in the ENT and Surgery Department of Bakhtawar Amin Hospital from April 2024 to Jan 2025. A total of 150 adult patients underwent bilateral tonsillectomies for recurrent tonsillitis, obstructive sleep apnea, tonsillar hypertrophy, palmoplantar pustulosis, or IgA nephropathy. The surgery was performed according to the usual procedure under anesthesia. Age, gender, duration of surgery, obesity, antibiotic administration, smoking status, and type of analgesia were recorded as probable predictors of hemorrhage. Smoking status included current smokers, non-smokers, and former smokers who had stopped smoking at least 1 month before the procedure. Results: There was a significant difference between smokers and non-smokers (OR=3.52, 95% CI: 1.76- 6.68, p<0.001) and smokers and former smokers (OR=3.55, 95% CI: 1.63-7.61, p<0.003). Male gender (OR: 4.03, 95% CI: 1.63-9.89, p=0.005) and NSAID (OR: 7.87, 95% CI: 1.007-63.53, p=0.0502) were significantly associated with post-operative hemorrhage. Smoking status (p=0.052) and older age (p=0.005) were significant risk factors in the primary hemorrhage group, and smoking status (p<0.001) and male gender (p=0.010) were significant in the secondary hemorrhage group. Conclusions: Post-tonsillectomy hemorrhage had a significant association with male gender, smoking status, and administration of NSAIDs during surgery. Therefore, it is advisable for surgeons to strongly suggest that patients maintain a healthy lifestyle before surgery and opt for other analgesics to prevent the risk of hemorrhage.

Frequency of Thrombocytopenia in Septic Neonates Admitted to Nursery Section of Pediatric Unit, DHQ Dera Ismail Khan

Alina Yahya — 2025-04-30

Neonatal sepsis is a major cause of morbidity and mortality, often complicated by thrombocytopenia, which increases the risk of bleeding and worsens prognosis. Reported frequencies of thrombocytopenia in septic neonates vary widely, and local data are limited. Objectives: To determine the frequency of thrombocytopenia in septic neonates and its association with clinical and laboratory parameters. Methods: This cross-sectional study was conducted at the Department of Paediatrics, DHQ Hospital, Dera Ismail Khan, over six months. A total of 110 septic neonates were enrolled. Demographics, clinical presentations, and laboratory findings were recorded. Blood samples were analyzed for platelet count, white blood cell count, C-reactive protein (CRP), and blood cultures. Data were analyzed using SPSS Version 25, with chi-square and Mann-Whitney U tests applied. Logistic regression identified predictors of thrombocytopenia, with p<0.05 considered significant. Results: Thrombocytopenia was found in 69.1% of septic neonates. Early-onset sepsis was significantly associated with thrombocytopenia (p=0.032), while blood culture results, bacterial pathogen type, CRP, and White Blood Cells (WBC) count were not. Mechanical ventilation showed a significant association (p=0.033), and thrombocytopenic neonates had higher mortality (p=0.053). Logistic regression identified mechanical ventilation (p=0.047, OR=0.386) as a significant predictor, while early-onset sepsis showed borderline significance (p=0.056, OR=2.489). Conclusions: It was concluded that thrombocytopenia is common in septic neonates, with early-onset sepsis and mechanical ventilation as key risk factors. Routine platelet monitoring in critically ill neonates is essential for timely intervention.

Comparing the Efficacy of Intralesional Saline Versus 35% Trichloroacetic Acid Peel in the Treatment of Atrophic Acne Scar

Kainat Usman — 2025-04-30

Atrophic acne scars are a common sequela of acne vulgaris impact patients’ quality of life. Despite the availability of several treatment modalities, there is a need for simpler and cost-effective approaches. Objective: To compare the efficacy of intradermal normal saline versus trichloroacetic acid (TCA) in treating atrophic acne scars. A randomized controlled trial conducted at the Dermatology Department, Sheikh Zayed Hospital, Rahim Yar Khan, from 1^stApril 2023 to 31^st October 2023. Methods: 126 patients were enrolled. Scar grading was based on Goodman and Baron's Qualitative Scar Classification. The Patients Observer Scar Assessment Scale (POSAS) was used by dermatologists. Efficacy was defined as ≥50% improvement in the POSAS. Results: Among 126 participants, the NS group showed significantly greater improvement in PSAS and OSAS scores post-treatment. While total POSAS score reduction was higher in the NS group, the difference was not significant. A ≥50% POSAS improvement was more frequent in the NS group (88.9%) than in the TCA group (73.0%; p = 0.023).Conclusion: This study found that intradermal normal saline is more effective and satisfactory than trichloroacetic acid for treating atrophic acne scars, with greater improvements in scar severity and patient satisfaction.

C-Reactive Protein (CRP) and Total Leukocyte Count (TLC) as Inflammatory Markers for Monitoring the Progression of Odontogenic Fascial Space Infection

Haseeb Uddin — 2025-04-30

Dental infections can cause serious morbidity and mortality even with modern medical improvements. When infections from tooth pulp rupture cortical plate and move via fascial channels, they can spread through bone or periodontal tissues and result in potentially fatal consequences. Objective: To determine frequency of increased levels of C-Reactive Protein (CRP) and Total Leukocyte Count (TLC) and mean change in CRP and TLC during the course of treatment in Odontogenic fascial space infection. Methods: A descriptive cross-sectional study was conducted in OMFS department at PIMS, involving patients with odontogenic infections. Blood samples were taken before and at specified intervals to monitor CRP and TLC levels such as before Incision and Drainage (I&D) and post I&D (after two hours of meal at 1^st , 2nd, 3rd, and 7th d post I&D Day. Using SPSS Version 23.0, frequencies, percentages, means, and standard deviations were measured to examine both quantitative and qualitative data. Results: There were 43 (55%) females and 35 (45%) males with a mean age of 39.17 ± 14.68 years. 17% showed elevated CRP levels and 12% presented with elevated TLC levels after seven days of follow-up. Pearson correlation was significant preoperatively and on 1^st and the 2^ndday Postoperatively as P value was 0.000. Conclusions: This study highlighted importance of monitoring CRP and TLC levels in odontogenic maxillofacial infections, both markers indicate inflammation. CRP is more sensitive than TLC during treatment, making it valuable tool for postoperative assessment.

Comparing the Efficacy of Weekly Azathioprine Pulse versus Betamethasone Oral Mini-Pulse in the Treatment of Moderate to Severe Alopecia Areata

Kainat Usman — 2025-04-30

Alopecia Areata (AA) is a disease that leads to unpredictable hair loss. Objective: To assess and compare the efficacy of Weekly Azathioprine Pulse (WAP) versus Betamethasone Oral Mini-Pulse (BOMP) therapy in Alopecia areata. Methods: Sixty patients with ≥15% scalp involvement were divided into two groups. The WAP group given azathioprine (300 mg) once weekly; the BOMP group received betamethasone (5 mg) on two consecutive days weekly. A randomized controlled trial was performed at the Dermatology Department of Sheikh Zayed Hospital, Rahim Yar Khan, over a 6-month (March–September 2023). Both treatments continued for 12 weeks. At baseline, 12 weeks, and 12 weeks post-treatment SALT scores were recorded. Efficacy was defined as ≥75% hair regrowth. Results: The male-to-female ratio was 1.9:1 with 39 (65%) males and 21 (35%) females. WAP group baseline SALT score of 42.60 ± 13.75 decreased to 13.97 ± 11.79 after a follow-up period of 12 weeks post-treatment, compared to BOMP group reduction from 38.67 ± 10.76 to 21.63 ± 10.96; regrowth percentage was higher in WAP (68.62%) vs. BOMP (44.28%), p=0.001. In the WAP group, 13 (43.3%) of patients achieved efficacy with ≥76% hair regrowth, compared to 3 (10%) in the BOMP group, showcasing a significant disparity (p-value=0.009). Relapse at three months occurred in 1 (3.3%) participant in the WAP group and 2 (6.7%) participants in the BOMP group (p-value of 0.500). Conclusion: This study demonstrated that WAP therapy was superior to BOMP in moderate to severe AA with notable hair regrowth.

Correlation of Serum Bilirubin with Severity of Acute Ischemic Stroke

Muhammad Naeem Awan — 2025-04-30

Serum bilirubin is associated with stroke severity, existing data on this relationship remain limited and inconclusive. Objectives: To determine the correlation between serum bilirubin and the National Institute of Health stroke scale score in patients with acute ischemic stroke. Methods: This cross-sectional study was done at the Medical Emergency of Mayo Hospital Lahore from June 2022 to December 2022. A total of 205 patients suffering from acute ischemic stroke were included. Serum bilirubin was obtained within 24 hours of the onset of stroke at presentation, and stroke severity was assessed same time using NIHSS. Data analysis was done using SPSS version 26.0. Pearson correlation was determined between serum bilirubin and NIHSS score at presentation. Results: In current study population, 44.5% of patients were diabetics, 77.6% were hypertensive, and 27.8% were smokers. Mean serum bilirubin level was 0.98 ± 0.19 mg/dL, and mean NIHSS score is 19.51 ± 8.94, Pearson correlation coefficient between bilirubin and NIHSS is -0.082, p-value=0.240, statistically not significant. Conclusions: It was concluded that in our study, a weak negative correlation was observed between serum bilirubin levels and NIHSS scores in patients with acute ischemic stroke. This suggests that higher bilirubin levels may have a slight protective effect, as stroke severity (NIHSS scores) tended to decrease minimally with increasing bilirubin levels.

Demographic and Clinical Factors Influencing the Peripheral Neuropathy in Anti-HCV Positive Patients

Sajid Hussain Seelro — 2025-04-30

Peripheral neuropathy is a common complication affecting individuals with various underlying conditions, often influenced by factors such as age, gender, and disease duration. Objectives: To assess the prevalence of peripheral neuropathy by age, gender, and disease duration. Methods: It was a cross-sectional descriptive study conducted at the Neurology Department of Jinnah Postgraduate Medical Centre, from March 20, 2021, to September 19, 2021. The total number of patients was 164. The study enrolled patients aged 18-60 of either gender who had peripheral neuropathy. Patients with hepatitis other than hepatitis C, who received treatment for HCV, patients having diabetes mellitus, autoimmune disorder, kidney failure, vitamin B deficiency, thyroid disorders, hematological disorders, alcoholism, HIV infection, drug addiction or toxic agents were excluded. A questionnaire-based study was designed for the collection of data regarding demographics and clinical aspects. Results: The mean age of the study patients was 42.7 ± 18.2 years. Peripheral neuropathy was found in 98 (59.8%) participants. Among 164 patients, 94 (57.3%) were male, while 70 (46.4%) were female. Diabetes mellitus and hypertension were documented in 63 (38.4%) and 85 (51.8%), respectively. Conclusions: It was concluded that gender is statistically significantly associated with the prevalence of peripheral neuropathy in anti-HCV positive patients, while a higher body mass index and extended duration of infection were also associated with peripheral neuropathy, but were not statistically significant.

IMNCI Classification of Neonatal Jaundice and Its Relation to Cause of Jaundice at Neonatology Unit, CMC-SMBBMU Larkana

Bakhtawer Balouch — 2025-04-30

Neonatal jaundice significantly impacts neonates' health and mortality, leading to frequent hospitalizations. The IMNCI classification improves early diagnosis, treatment, and outcomes. Objective: To classify jaundice based on IMNCI classification and evaluate its etiology across different severity levels. Methods: A cross-sectional study was conducted in the Neonatology unit at CMC-SMBBMU Larkana from July 2022 to January 2024, involving 147 neonates aged 0 to 28 days with jaundice, using a non-probability, consecutive sampling technique. Results: The study examined 147 neonates, with 81 (55.1%) males and 66 (44.9%) females. Most had a birth weight between 2000g to 2499g, with 36.1%, while only 14(9.5%) weighed 3500g or more. In gestational age 93(63.26) % were born at term, 46(31.29%) preterm, and 8(5.44%) post term. Delivery methods varied, with 81(55.1%) vaginally, 49(33.33%) C-section, and 17(11.56%) instrumented. The IMNCI classification revealed that 78.91% of neonates had jaundice, while 21.09% had severe jaundice, highlighting that gender (p=0.03), residence (p=0.04), aetiology (p=0.001), gestational age (p=0.04), and birth weight (p=0.01) all significantly influence the severity of jaundice and highly significant association in post-term neonates and those with lower birth weights are at a higher risk of severe jaundice. Data was input and examined using the SPSS version 26.0 software. Conclusions: Neonatal jaundice severity is influenced by gestational age, birth weight, and delivery mode, with post-term and low-birth-weight neonates at higher risk. Early identification and targeted interventions are crucial, and improving maternal education and healthcare accessibility, especially in rural areas, can reduce jaundice incidence and severity.

Efficacy of Oral Zinc Sulphate in Patients of Acne Vulgaris

Mahwish Javed — 2025-04-30

Acne is a chronic condition that affects pilosebaceous units, which manifest as either inflammatory or non-inflammatory lesions. Objective: To determine the efficacy of oral zinc sulphate in patients with acne vulgaris. Methods: An observational study was held at the OPD Department of Dermatology, Jinnah Hospital-Lahore, Pakistan, which enrolled 93 patients. The Global Acne Grading System was used to evaluate acne severity. These patients were given oral zinc sulphate 220mg twice a day for 3 months. Efficacy of treatment was labelled if there was ≥50% reduction in the baseline GAGS score at the end of 3 months of treatment. All the data were processed by SPSS version 26.0. Frequency and percentages were used for categorical parameters. The chi-square test was applied, in which a p-value<0.05 was considered significant. Results: It involved cheeks and nose in 26 (28.0%) patients, followed by forehead and chin in 23 (24.7%) patients. Efficacy of treatment was observed in 53 (57.0%) patients. An insignificant difference in the frequency of efficacy across various subgroups was observed. The percent reduction in mean GAGS score from baseline ranged from 25.0% to 75.0%, with a mean of 51.2 ± 11.9%, with a significant p-value of 0.001*. There was a statistically insignificant difference in the frequency of efficacy across various subgroups based on patients’ age, gender and severity (p-value=0.870) of disease and baseline GAGS score (p-value=0.993). Conclusions: It was concluded that almost 57% of patients with mild to moderate acne showed improvement in their disease progression with oral zinc sulphate treatment. It was cost-effective with easy availability.

Comparison of the Outcomes of On-Lay and Sub-Lay Mesh Repair in Patients with Ventral Abdominal Wall Hernias

Ahmad Arsalan Tahir — 2025-04-30

Hernias of the ventral abdominal wall are a frequent surgical problem that has to be repaired well to reduce complications and recurrence. Objective: To determine which method yields better clinical outcomes. Methods: In two groups of 40 individuals, 80 patients with ventral abdominal wall hernias had the results of Onlay and Sublay mesh repair compared. This prospective study, conducted at Prime Teaching Hospital/Kuwait Teaching Hospital (Peshawar Medical College) from June to December 2024. Data analysis was conducted using SPSS version 23.0 with a significance level of p < 0.05. Results: The mean age of patients was 43.13 ± 11.76 years, among them 62.5% were male. Among this 64% had midline ventral hernias. Patients undergoing Sublay mesh repair experienced significantly lower wound infections (5% vs. 15%, p < 0.05) and less seroma formation (4.61% vs. 20%, p < 0.05) as compared with the Onlay group, notably, the study also found that the duration of hospital stay was significantly longer for the Onlay group compared to the Sublay group (p < 0.05). The sublay technique showed zero recurrence cases (0%), while the On-lay technique had six cases (15%) with statistically significant (p < 0.05). Conclusions: Sublay mesh repair demonstrates distinguishing clinical outcomes over Onlay mesh repair, with lower infection rates, less seroma formation, and shorter hospital stays. The findings suggest that Sublay mesh repair should be preferred for ventral abdominal wall hernias to minimize patient morbidity and improve recovery.

Supine Percutaneous Nephrolithotomy (PNCL)-2 Years’ Experience in a Tertiary Care Hospital

Shoukat Ali — 2025-04-30

Percutaneous Nephrolithotomy (PCNL) has basically substituted open surgery for managing large, complex renal stones. Supine PCNL provides multiple benefits compared to the prone position, yet its adoption in Pakistan remains limited. Objective: To evaluate the experience and outcomes of supine PCNL at a tertiary care hospital in Pakistan. Methods: This retrospective study included 113 patients (aged 3–74 years) who underwent PCNL at the Urology Unit of Baluchistan Institute of Nephro-Urology Quetta (BINUQ) between June 2021 and June 2023. Data on demographics, operative position (supine/prone), Extracorporeal Shock Wave Lithotripsy (ESWL) sessions, and postoperative hospital stay were retrieved from medical records. Descriptive statistics were analyzed using SPSS version 26. Results: Age of the patients was 32.68 ± 15.59 years. Among 113 patients, 63 (55.8%) were male, and 50 (44.2%) were female. Age distribution included 28 (24.8%) patients aged 3–20 years, 54 (47.8%) aged 21–40 years, 24 (21.2%) aged 41–60 years, and 7 (6.2%) aged 61–74 years. Right-sided PCNL was performed in 64 (56.6%) cases, while 49 (43.4%) involved the left kidney. A total of 82 (72.6%) patients experienced (Supine) PCNL, and 18 (15.9%) (Prone). The mean number of ESWL sessions was 0.24± 0.52, and the average postoperative hospital stay was 2.99 ± 1.85 days. Conclusions: Supine PCNL demonstrated favorable outcomes, including shorter hospital stays, effective stone removal, and reduced postoperative recovery time. This study supported the broader adoption of supine PCNL in clinical practice.

Knowledge Regarding the Administration and Regulation of High Alert Medications among Nurses in Tertiary Care Hospitals, Bannu KPK

Sana Bibi — 2025-04-30

High-alert medications (HAMs) have a significant potential for causing severe harm if mismanaged. Proper administration and regulation of these drugs are critical to ensuring patient safety. However, limited knowledge and adherence to safety practices among healthcare professionals increase the risk of medication errors. Objective: To assess nurses’ knowledge regarding the administration and regulation of high-alert medications. Methods: Using convenience sampling, this descriptive cross-sectional study involved 113 registered nurses from tertiary care hospitals in Bannu. Data were collected through an adopted questionnaire distributed via Google Forms, encompassing demographic details and specific questions on HAM administration and regulation safety practices. Data analysis included descriptive and inferential statistics using Microsoft Excel. Results: Among the respondents, 64.3% correctly identified HAMs as posing significant risks, yet 35.7% displayed critical knowledge gaps in identifying safe administration practices. Errors were most notable in dosage calculations, drug labeling, and administration methods, particularly for potassium chloride and epinephrine. While 57.1% acknowledged the importance of double-checking doses, only 42.9% demonstrated comprehensive knowledge of storage protocols. Significant gaps in education and training were identified, highlighting the need for improved safety practices. Conclusions: It was concluded that substantial gaps in nurses' knowledge and practices related to HAMs, underscoring the necessity for targeted training programs. Enhanced education, adherence to safety protocols, and interdisciplinary collaboration are essential to minimizing medication errors and improving patient safety.

Maternal And Neonatal Outcome in Major Degree Placenta Praevia

Ammara Shah — 2025-04-30

Placenta praevia relates to pregnancy complications where the placenta is positioned on, or covers the relevant cervix region thus leading to uncontrolled bleeding as being its major risk. The evaluation of mother and fetus outcomes of primary degree placenta praevia is quite important for constructive management and prevention policies to be put in place. Objective: To measure the incidence of negative fetomaternal outcomes in patients with major degree placenta praevia. Methods: This descriptive cross-sectional study was carried out at the Mardan Medical Complex Mardan in the Department of Obstetrics and Gynaecology from the 21st of October to the 31st of December 2024. The sample population includes 177 pregnant women with major degree placenta praevia who were monitored until delivery and 30 days after the birth of the child. Results: The mean maternal age was 29.25 ± 2.10 years, gestational age was 29.32 ± 1.44 weeks, and weight was 67.08 ± 6.17 kg. Associated maternal morbidity encompassed obstetric hysterectomy (14.1%) and bladder injury (11.3), postpartum hemorrhage (24.3%), sip and gout infections (18.6%), and preterm labor (16.9%) with little relations being observed with maternal factors (p>0.05). Some neonatal outcomes included NICU admission (18.6%), while stillbirth had some numbers reported around (15.8%) along with low Apgar scores (15.3%) where once again no significant associations with maternal factors were found (p>0.05). Conclusion: Clinical patterns indicate elevated risks with severe placenta praevia, which calls for close observation even if no statistically significant relationships have been observed.

Comparison of Functional Outcome of Locking Plate versus External Fixation in Management of Comminuted Intra Articular Fracture of Proximal Tibia

Syed Usman Shah — 2025-04-30

The surgical management of Schatzker type V or VI tibial plateau fractures can be challenging, and complications may include compartment syndrome, soft-tissue and ligament damage, and neurovascular injury. A successful course of treatment necessitates articular cartilage regeneration, biological integrity preservation, mechanical axis realignment, joint stabilization, and mobility preservation. Objective: To compare the outcomes of locking plate vs. external fixation in management of comminuted intra articular fracture of proximal tibia. Methods: In this quasi experimental study 82 patients of proximal tibia fracture were presented. Patients were admitted to orthopedic department and were included after getting informed written consent. Two groups were created, in group I 41 patients received locking plate and 41 patients of group II received external fixation. Outcomes among both groups were compared after treatment. SPSS version 23.0 was used to analyze all data. Results: There were majority males in both groups. Patients of group I had mean age of 36.13 ± 10.63 years and in group II mean age was 34.8 ± 7.49 years. Postoperative functional outcome was significantly better in group I as compared to group II with p value <0.05. As per Rasmussen’s clinical functional knee score, group I had higher score 23.61 ± 6.154 as compared to group II 21.45 ± 6.187 with p value <0.03. Post-operative frequency of infection was lower in group I as compared to group II with p value <0.02. Conclusion: It was concluded that in this study that internal locking plate showed better outcomes in terms of functional results while had higher blood loss and longer operative time as compared to external fixation.

Presoaking of Peroneus Longus Tendon Auto-graft in Vancomycin Decreases the Occurrence of Infection Following Arthoscopic Primary Anterior Cruciate Ligament Reconstruction

Abdul Munaf Saud — 2025-04-30

Septic arthritis following anterior cruciate ligament (ACL) repair surgery is an extremely rare but possibly fatal consequence. To mitigate this danger, our team began presoaking grafts with vancomycin. Objectives: To determine the association of septic arthritis following anterior cruciate ligament (ACL) restoration using hamstring autografts with and without grafts presoaked in vancomycin. Methods: This study included 350 patients who had primary hamstring autograft ACL repair. Patients were equally divided into two groups. Group I had a pre-vancomycin protocol among 175 cases, and 175 cases of Group II received the vancomycin protocol. Postoperative septic arthritis was a likely outcome in both groups. Combining clinical findings with cytological examination of joint aspiration (cell count >50,000/μL and >90% neutrophils), a diagnosis of likely septic arthritis was reached. A Fisher's exact test was used for statistical analysis. We fixed the significance level at p<0.05. Results: There were a majority of 240 (68.6%) male and 110 (31.4%) female among all cases. Included cases had a mean age of 27.18 ± 11.58 years and had a mean BMI of 26.12 ± 8.38 kg/m². Post-operatively, the frequency of septic arthritis was only found in group I among 7 (17.1%) cases, and no cases were found in group II. Among 7 cases of septic arthritis in group I, 4 cases had Staphylococcus epidermidis, and no organisms were isolated in 3 cases. Conclusions: It was concluded that presoaking the grafts in vancomycin for primary ACL repair decreased the likelihood of postoperative septic arthritis compared to not soaking them.

Autopsy as a Teaching Methodology In Forensic Medicine: Students’ Perspective

Nida Yousaf — 2025-04-30

Autopsy as a teaching tool has been historically accepted as a valued method for medical students but its usage has been reduced due to newer technologies being available. Objective: To assess the students opinions’ on autopsy as a learning tool and their views on alternative teaching methods. Methods: A cross-sectional questionnaire-based study was conducted in 2024 at Rashid Latif Medical College. Prevalidated questionnaires were distributed among the third year MBBS students and participation was voluntary. 115 complete questionnaires were analyzed by SPSS version 25.0. Results: All participants demonstrated an understanding of autopsy and considered its significance in medical education as a learning tool. 36.52% and 47.83% of the students considered videos and printed materials respectively as viable alternatives. However, 80.87% of students agreed that medical students should observe more autopsies for better understanding and appreciate their role in forensic and clinical correlation. Conclusions: Although students are aware of the potential benefits of autopsy, there is still a need to further emphasize its importance in this modern medical training. Without firsthand exposure, future doctors may struggle to explain procedures that have never been witnessed.

Accuracy of Tympanometry in the Diagnosis of Otitis Media with Effusion in Children's at Myringotomies

Muhammad Arif — 2025-04-30

Otitis media with effusion is a common cause of hearing impairment in children, required accurate diagnostic tools for timely intervention. Tympanometry is commonly used for assessing middle ear function, but its diagnostic accuracy compared to myringotomy, the gold standard, remains a topic of debate. Objective: To assess the diagnostic accuracy of tympanometry in identifying otitis media with effusion (OME) in children, using intraoperative findings during myringotomy as the gold standard. Methods: This observational cross-sectional study was carried out from January 2022 to June 2024 at the ENT Department, Hayatabad Medical Complex Peshawar. Ethical approval was obtained from Institutional Review Board (IRB) of the hospital, and written consent was obtained from parents or guardians of all children involved in the study. Total of 157 children aged 2 to 12 years, were included. Results: Proportion of sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were determined. Type B tympanograms, suggestive of OME, were seen in 112 children (71.3%). Type A was observed in 25 children (15.9%) and type C in 20 children (12.7%). Myringotomy verified middle ear effusion in 120 children which is 76.4%. Within this group, 111 children presented with Type B tympanograms resulting in a true positive ratio of 92.5%. 9 cases (5.7%) were noticed with false positive results. Conclusion: Tympanometry stands as one of the top diagnostic instruments for OME identification in children. Their use, especially alongside otoscopy and audiometry, adds value in clinical practice.

Role of Dexamethasone at the Surgical Site in The Control of Pain and Oedema in Management of Bilateral Mandibular Fractures Osteosynthesis Using the Split-Mouth Technique

Benish Pervaiz — 2025-04-30

Osteosynthesis is a widely used technique for the treatment of fractures, ensuring stability in the healing process. This might cause postoperative pain, edema, trismus, infection, and reduced jaw mobility. Objectives: To assess the effectiveness of Dexamethasone in alleviating pain and oedema at the surgical site in patients undergoing bilateral mandibular fracture osteosynthesis using the split-mouth technique. Methods: A quasi-experimental study was conducted at the Pakistan Institute of Medical Sciences from 11th October 2023 to 10th August 2024, enrolling 30 participants with bilateral mandibular fractures. They were divided into two groups using the split-mouth technique, with 30 surgical sites in each group. Using a table of random numbers, surgical sites were assigned to Group A (study group), in which submucosal dexamethasone was administered after closure of the incision site, and Group B (control group), which did not receive submucosal dexamethasone. Postoperative pain and edema were evaluated at 24 hours, 72 hours, and one week postoperatively. Results: The mean age of the participants was 25.77 ± 8.274, with 73.3% being male. Group A experienced slightly reduced pain than group B (p s 0.005). After 24 hours and 1 week postoperatively, there were statistically significant differences in postoperative oedema among the two groups (p≤0.05), but not at 72 hours (p>0.05). Conclusions: It was concluded that dexamethasone can be used as an adjunct to improve postoperative outcomes in patients with mandibular fractures by decreasing pain and oedema.

Frequency of Risk Factors for Developmental Dysplasia of the Hip in Patients Presenting to a Tertiary Care Hospital

Muhammad Saqib — 2025-04-30

Developmental dysplasia of the hip (DDH) involves abnormal hip joint development and is influenced by several perinatal risk factors. Early diagnosis is essential for optimal management. Objective: To evaluate the frequency of DDH-associated risk factors and their statistical associations. Methods: A cross-sectional study was conducted at Quaid-E-Azam Medical College, Bahawalpur, from January to August 2024. A total of 153 DDH patients were included. Risk factors such as gender, gestational age, birth weight, mode of delivery, breech presentation, oligohydramnios, multiple pregnancies, firstborn status, family history, and maternal complications were documented. Associations were analyzed using chi-square tests (p<0.05). Results: Of the 153 patients, 77 (50.3%) were male and 76 (49.7%) female. Term births were predominant (75.2%), and 19.6% had low birth weight. Breech presentation was seen in 13.7%, and oligohydramnios in 16.3%. Cesarean section accounted for 66.7% of deliveries, with no significant association with breech presentation (p=1.000). A significant association was found between multiple pregnancies and low birth weight, as all multiple births had low birth weight infants (p=0.000). No significant associations were found for gender, oligohydramnios, firstborn status, or family history. Conclusions: It was concluded that multiple pregnancies and resulting low birth weight showed a significant association with DDH. Other risk factors, including breech presentation and oligohydramnios, demonstrated no significant correlation. Focused DDH screening is recommended in infants from multiple gestations with low birth weight to ensure early detection and intervention.

Correlation between Placenta Weight and Birth Weight at Full Term Pregnancy

Zobia Munaf — 2025-04-30

Placental pathology is a recognized factor contributing to perinatal adverse health outcomes, and it might be linked to the growth of the placenta, potentially being evaluated through indirect physical measurements. Objective: To examine the average weight of the placental tissue and its association with newborn weight. Methods: The study, conducted at Civil Hospital, Karachi, from October 2017 to February 2018, was a descriptive cross-sectional study. It enrolled 36 primigravida females with singleton pregnancies who delivered in the labor room. Placental weight and newborn weight were recorded at the time of delivery, and a structured questionnaire was completed for each participant. Results: The average age of participants was 25.5 years, with a typical pregnancy period of 38.8 weeks. Mean placental weight was 604 grams (range 500-670 grams), and mean fetal weight was 2958 grams (range 2500-3400 grams). A statistically significant positive correlation was found between placental weight and neonatal weight (Pearson’s correlation at the 0.01 level), as well as between maternal age and placental weight (significant at the 0.05 level). Conclusions: This study establishes a reference range for placental and fetal weight in the Pakistani population and highlights the significant correlation between the two. Placental weight serves as a reliable indicator of fetal health, underlining the importance of monitoring placental development and assessing the placenta post-delivery to evaluate neonatal health.

Association Between Meal Skipping and Premenstrual Syndrome Among Young Females

Rimsha Malik — 2025-04-30

Premenstrual syndrome (PMS) is the combination of physical, emotional, psychological and behavioural issues related to many symptoms. Due to which female are unable to perform their tasks. Somehow, PMS is linked with poor eating patterns and lifestyle. Modification in these things has seen lower prevalence in young female. Objective: To check the association between meal skipping and PMS in young females. Methods: A cross-sectional study was conducted among young female of the age group 18 to 30 at different educational institutions in Lahore. The target sample size of the study was 400 female. The data were gathered using a questionnaire sampling technique. A self-administered meal skipping questionnaire was used to check the dietary pattern, while the Premenstrual Syndrome Scale (PMSS) was used to examine the presence of PMS symptoms. After data collection, statistical analysis was done to find the results. Results: The p-value was 0.016, which was a significant level that indicates a positive association between PMS and meal skipping. Research revealed a significant link (p=0.016) between skipping meals and the severity of PMS symptoms, implying that dietary habits may influence symptom intensity. Conclusions: It was concluded that young adults, especially female, skip meals more frequently due to various reasons, which causes major health issues. It was seen that female who skip meals regularly have a more prominent association with premenstrual syndrome.

Cost-Benefit Analysis of Preventive Healthcare Programs

Khurram Mehboob — 2025-04-30

In an age where healthcare systems are burdened with rising costs and increasing demands, one truth remains constant: preventing disease is far less expensive—and more effective—than treating it. Preventive healthcare programs, often overshadowed by curative medicine, are a long-term investment with undeniable economic and social returns. Programs for health promotion have been heralded as having enormous potential to assist in addressing the issue of rapidly rising health care expenses. Program evaluation must include a cost-benefit or cost-effectiveness analysis to determine whether health promotion initiatives are "worth it." Preventive healthcare includes a wide range of interventions—regular screenings, vaccinations, smoking cessation programs, nutrition education, and early detection of diseases. These initiatives aim to catch health issues before they become severe and costly. And while the upfront costs of such programs can seem steep, the cost savings over time are substantial. Fewer hospital admissions, reduced need for expensive treatments, and minimized emergency room visits all translate into billions in savings for healthcare systems. All project-related expenses and benefits must be measured and converted into monetary values to determine the welfare change attributable to the project (i.e., the project's net benefit to society as a whole). In ex ante evaluation, policymakers utilize CBA as a tool to choose between different projects or determine whether a certain plan is beneficial to society. It can also be used ex post to calculate the net social value of a particular program that has been fully completed. Moreover, preventive care enhances health equity. Community-based initiatives, mobile screenings, and free vaccination clinics can bridge the gap for underserved populations, ensuring that everyone has access to the tools they need to stay healthy. Preventive care is not just an economic decision—it’s a public good. So, what should we do? Policymakers must prioritize funding for preventive services, insurers should cover them comprehensively, and public awareness campaigns should emphasize their importance. We must shift the conversation from curing disease to preventing it. Investing in preventive healthcare is investing in our collective future. The cost-benefit analysis isn’t just in the numbers—it’s in the healthier lives, stronger communities, and sustainable systems we build along the way. preventive care promotes a healthier, more productive population. When people are healthy, they can work, care for their families, contribute to the economy, and live longer, more fulfilling lives. Chronic illnesses like diabetes, heart disease, and certain cancers—many of which are preventable or manageable if caught early—account for a large portion of healthcare spending and productivity loss. Tackling them through prevention makes fiscal and moral sense.

The Efficacy and Safety of Semaglutide-Based Medications for Long-Term Weight Loss and Cardiovascular Health

Sadaf Khalid — 2025-04-30

The advantages of semaglutide associated with weight loss have been well documented. However, its utilization regarding clinical safety and efficacy in treating obesity and Cardiovascular Health (CVH) conditions is less described. Objective: To focus on evaluating the effectiveness and safety of semaglutide-based medications for long-term weight loss and CVH. Methods: PubMed, Google Scholar, Cochrane Library, Scopus, and Clinical Trial. Gov. was systematically explored to undertake a detailed search of relevant papers from January 2015 to February 2024. Following PRISMA guidelines 1500 papers were identified initially, of which 500 papers were screened for their titles and abstracts, leading to a screening of eligibility of 200 full-text papers. Finally, 22 studies were further evaluated based on inclusion, and exclusion criteria, relevant data was gathered, and a systematic review was performed. Results: The results highlight the substantial contribution of semaglutide to clinically meaningful weight reduction among individuals with obesity. Overweight participants with semaglutide compared to other AOMs showed improved clinical efficacy and safety for sustainable weight loss, healthy BMI, and CV-related factors such as improvements in blood pressure, lipid profile, and risk factors. Conclusions: Semaglutide-based medicines not only are safe in clinical terms, but also work well for people with obesity, assisting them to reduce their weight in the long term while enhancing conditions of cardiovascular health. Results show benefits in terms of BMI, BP and lipid profiles thereby indicating that semaglutide may serve as a valuable, sustainable intervention for managing obesity and associated cardiovascular risks.

Investigating the Impact of Patient Education and Self-Management Programs in Reducing the Burden of Chronic Postoperative Pain

Munazzah Aziz — 2025-04-30

Chronic postsurgical pain (CPSP) remains a significant clinical challenge, as many patients experience severe pain after surgery and find conventional management strategies inadequate. These complications adversely affect patients’ quality of life, underscoring the need for effective self-management methods. Objectives: To investigate the impact of Patient Education and Self-Management Programs in reducing the burden of chronic postoperative pain. Methods: A systematic review was conducted of all studies currently published between 2013 and 2023 examining various patient education and self-management interventions for chronic postoperative pain. Data were extracted from relevant studies to assess the effectiveness of these programs across different surgical procedures and follow-up periods. Results: The review indicates that interventions such as structured patient education, relaxation exercises, device-assisted therapies, and telehealth applications show promise in reducing CPSP. Compared to control groups, participants who received these interventions reported superior health outcomes and lower levels of discomfort. The benefits were observed across diverse surgical contexts and timeframes. Conclusions: It was concluded that tailored patient education and self-management programs play a crucial role in alleviating chronic post-surgical pain, enhancing patient satisfaction, and reducing healthcare costs.

Effectiveness and Function of Dietary and Medical Iron Interventions in Treating Iron-Deficiency Anemia: A Systematic Review

Akbar Ali — 2025-04-30

Iron-deficiency anaemia is a widespread nutritional disorder affecting individuals across all age groups, particularly children, pregnant women, and those with chronic illnesses. It arises due to insufficient dietary intake, impaired absorption, or increased iron loss, reducing haemoglobin and oxygen-carrying capacity. Objectives: To compare the effectiveness of dietary and medical iron interventions in preventing and treating iron-deficiency anaemia across different populations. Methods: A comprehensive search was conducted in PubMed, Scopus, Google Scholar, and Cochrane Library for studies published between 2017 and February 2025. Eligible studies included randomized controlled trials and clinical trials evaluating iron interventions in individuals with or at risk of iron-deficiency anaemia. Primary outcomes included changes in haemoglobin, serum ferritin, total body iron, and anaemia prevalence. Results: Both dietary and medical interventions were effective in improving iron status. Iron-fortified foods, micronutrient powders, and bioavailability enhancers such as vitamin C and probiotics were cost-effective for population-level prevention. Medical therapies, including oral and intravenous iron, provided rapid correction in individuals with moderate to severe anaemia. Adherence and long-term sustainability remained key challenges across both approaches. Conclusions: It was concluded that integrating dietary strategies with medical interventions offers the most effective approach for managing iron-deficiency anaemia. Future research should focus on enhancing adherence, improving iron bioavailability, and personalizing treatment based on individual needs.

Iodine Levels and Thyroid Hormones in Pregnant Women and Neonatal Outcomes: A Systematic Review

Seema Ashraf — 2025-04-30

Iodine plays a vital role in the synthesis of thyroid hormones, which are essential for fetal growth and brain development. During pregnancy, maternal iodine needs to increase. Both deficiency and excess can impair maternal thyroid function and lead to complications such as hypothyroxinemia, fetal growth restriction, or thyroid dysfunction in the mother or child. Objectives: To assess the relationship between maternal iodine levels, thyroid function, and neonatal outcomes, and highlight the risks associated with both iodine deficiency and excess. Methods: A systematic search was conducted in PubMed, Web of Science, Scopus, Springer, and MDPI for studies published from 2021 to 2025. Inclusion criteria involved studies assessing iodine status (Urinary Iodine Concentration (UIC) or Serum Iodine Concentration (SIC)), maternal thyroid function (TSH, FT4, FT3), and neonatal outcomes. Articles were screened using PRISMA guidelines. The risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool. Due to heterogeneity in methods and outcomes, results were narratively synthesized. Results: Ten studies were included. Iodine deficiency was consistently associated with low birth weight and disrupted thyroid hormone levels, while iodine excess particularly at levels ≥500 µg/L was linked to transient neonatal hyperthyrotropinemia. Environmental exposures such as endocrine-disrupting chemicals also influence maternal thyroid function. Conclusions: It was concluded that both iodine deficiency and excess pose risks to maternal and neonatal thyroid health. Routine monitoring and individualized supplementation based on regional dietary patterns and environmental exposures are recommended.

A Case Report on Two-Month-Old-Infant Atypical Kawasaki Disease

. Razia — 2025-04-30

Kawasaki Disease (KD) is a rare vasculitis that predominantly affects children under five, with atypical presentations posing significant diagnostic challenges, especially in infants. This case report describes a two-month-old male who initially presented with high-grade fever and rash, misdiagnosed as subclinical meningitis. Despite multiple hospitalizations and extensive investigations, a definitive diagnosis was delayed. The patient later developed seizures, respiratory distress, and shock, necessitating intensive care. Laboratory findings revealed elevated inflammatory markers, anemia, thrombocytosis, and abnormal echocardiographic findings. Whole-body CT and detailed ECHO ultimately confirmed atypical KD with multiple thromboses and giant coronary aneurysms. Prompt treatment with intravenous immunoglobulin (IVIG), corticosteroids, anticoagulants, and antiplatelet agents was initiated. Although the patient improved clinically, irreversible cardiovascular complications had developed. This case highlights the importance of maintaining a high index of suspicion for atypical KD in febrile infants lacking classic symptoms. Early diagnosis and timely initiation of IVIG are essential to prevent long-term cardiac sequelae. Enhanced clinical awareness and refined diagnostic protocols are critical for improving outcomes in such vulnerable pediatric populations.