bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Patient Satisfaction and Quality of Life to Buteyko Versus Diaphragmatic Breathing Technique in Patients with Asthma
Authors: Khan Hafsa , Hussain Ghazal , Majeed Rabia , Shafiq Almina , Mustafa Maria
Published: June 2024

Introduction: Asthma is a worldwide disease that can spread anywhere. Mechanism involves a stimulus that triggers bronchioles of lungs causing bronchospasm and evidently making difficult to breath. Tightness in chest, wheezing or whistling sound, pain, recurrent coughing and shortness of breath are some serious symptoms of asthma.
Objective: To compare the patient satisfaction and QOL to Buteyko breathing technique versus diaphragmatic breathing technique for the treatment of asthma.
Methodology: it is a cross-sectional study a type of observational study, of patient satisfaction and QOL from the two different breathing techniques, i.e, Buteyko Breathing Technique and Diaphragmatic Breathing Technique. The sample size was 363, from that there were 182-paients of BBT and 181-patients of DBT the patients have already their respective breathing techniques in the hospitals. By the help of Asthma Quality of Life Questionnaire and patient survey questionnaire the satisfaction and Quality of Life of patients was observed.
Results: Significant difference was observed in the patient’s satisfaction. According to this, patients were more satisfied from BBT rather than DBT (P-value=<0.05) There was no statistical significance was observed in QOL of patients with asthma having both breathing techniques. But there was remarkable significance was observed in patients with asthma have to avoid situation or environment having cigarette smoke (P-value .017) and patients feel frustrated due to asthma (P-value=<0.05). Conclusion:  On the basis of above statistical analysis Buteyko breathing technique proved to be more satisfaction level in patients than the diaphragmatic breathing. There was no significance difference found in the QOL of patients with asthma with BBT and DBT. Both breathing techniques have nearly same effects on the quality of life of asthmatic patients.
Association Between Compliance with Quadriceps Strengthening Exercises and Recovery Rate in Patients after Arthroscopic ACL Reconstruction
Authors: Hasan Sobia , Anis Tehreem , Saeed Hina , Aroofa Hafiza , Raza Ali , Arshad Muhammad Zohaib , Tabassum Saiqa , Imtiaz Rafia
Published: June 2024

Background: Anterior Cruciate Ligament injuries are a common occurrence, especially sports activities. Arthroscopic ACL reconstruction has become a standard surgical intervention aiming to restore knee stability and function. However, successful recovery post-surgery relies on effectiveness of rehabilitation protocols, particularly quadriceps strengthening exercises.
objective :To evaluate patient compliance with prescribed quadriceps strengthening exercises after ACL reconstruction surgery.
Method: Cross sectional study design was utilized .45 was sample size. convenience sampling technique was used. Individuals aged 30 to 50 who have undergone within six months post-ACL reconstruction were included .Self developed questionnaire utilized  .Those who have had ACL reconstruction on the opposite knee within the last year were excluded. The study was  conducted in A.O Hospital Nazimabad, CMT 2 Talwar  Karachi Study ran from May  2023 to October 2023.SPSS Version 25 was utilized for statistical analysis.
Results: Correlation analysis is conducted to check the relationship between the Compliance with Quadriceps Strengthening Exercises and the participant’s demographic variables such as Gender, Education, Occupation, weight and BMI. Gender and compliance with quadriceps exercises have a -1.56-correlation coefficient. The level of education and compliance with quadriceps exercises had a 3.15 correlation coefficient. The occupation and compliance with quadriceps exercises had a -2.05-correlation coefficient. Weight and compliance with quadriceps strengthening activities have a 2.79 correlation coefficient.
Conclusion: Correlation and regression analyses revealed complex relationships between demographics and compliance, emphasizing its pivotal role in predicting recovery impact. Understanding these interactions is vital for tailored rehabilitation after ACL surgery.
Identification of Babesia Parasite in Ruminants in District Dera Ismail Khan
Authors: Saif U Din  , Saqib Hafeez  , Junaid Tariq  , Saira Rani  , Sundus Fayaz  , Dil Awaiz
Published: June 2024

Background: Babesiosis, a significant tick-borne disease, poses a growing threat to small ruminants and public health due to the pathogenic Babesia parasite. This study focuses on the prevalence of Babesia in cows within the district of Dera Ismail Khan and its impact on red blood cells.
Objective: The primary objective of this research was to detect the presence of the Babesia parasite in cows and assess its effects on red blood cells.
Methods: Fifty blood samples were randomly collected from cows in Dera Ismail Khan. These samples underwent Giemsa staining and were subsequently examined under a light microscope to identify the presence of the Babesia parasite.
Results: Of the 50 blood samples analyzed, only 5 (10%) tested positive for Babesia. This suggests a lower prevalence of babesiosis in the region. The parasite was observed to cause significant destruction of red blood cells.
Conclusion: Although babesiosis is not widely prevalent in Dera Ismail Khan, its impact on infected cows is severe, leading to the destruction of red blood cells. Effective monitoring and control measures are essential to mitigate its spread and impact.
Diagnostic Accuracy of Non-Contrast Computed Tomography in Identification of Renal Calculi in Suspected Patients with Negative Intravenous Pyelogram
Authors: Raza Muhammad Ahmad , Ghazanfar Sidra , Mahrukh Fatima , Laamia Altuf  , Loqman Shah  , Muazzam Tufail  , Kishwer Javed
Published: June 2024

Background: Renal calculi, commonly known as kidney stones, are mineral deposits found in the renal calyces and pelvis, either free or attached to the renal papillae. These stones can cause significant pain and health complications, making accurate diagnosis crucial. While intravenous pyelogram (IVP) has been a traditional diagnostic method, non-contrast computed tomography (NCCT) has emerged as a potentially superior alternative due to its higher sensitivity and specificity.
Objective: To determine the accuracy of non-contrast computed tomography (NCCT) in identifying renal calculi in symptomatic patients with negative intravenous pyelogram (IVP) results.
Methods: This cross-sectional study was conducted at the University of Lahore Teaching Hospital from August 7, 2023, to March 20, 2024. A total of 416 symptomatic patients, aged 19 to 49 years, with negative IVP results were included. Patients previously diagnosed with urolithiasis/nephrolithiasis by other imaging modalities, those who were uncooperative, pregnant, severely ill, or with congenital urinary tract abnormalities, were excluded. Demographic and clinical data were collected through interviews. Each patient underwent an NCCT scan, which was interpreted by an experienced radiologist. Data analysis was performed using SPSS version 25, with continuous variables summarized as means and standard deviations, and categorical variables as frequencies and percentages. Chi-square tests were used to assess associations, with a significance level set at p<0.05.
Results: Of the 416 patients, 250 (60.09%) were diagnosed with urolithiasis/nephrolithiasis on NCCT, while 166 (39.90%) were negative. The majority of positive cases were male (n=156, 70.90%), with the most common age group being 19-29 years (n=91, 58.33%). The most frequent anatomical site for calculi was the ureter (n=151, 36.30%), followed by the kidneys (n=60, 14.42%) and the urinary bladder (n=39, 9.37%). The size of the single calculi varied, with the most common sizes being 0.4-0.5 cm (27.81%).
Conclusion: NCCT demonstrated a significantly higher diagnostic accuracy for urolithiasis/nephrolithiasis compared to IVP. Given its superior sensitivity and specificity, NCCT should be considered the preferred diagnostic modality for patients presenting with acute renal colic and negative IVP results. These findings can improve patient outcomes through timely and accurate diagnosis, reducing the need for unnecessary diagnostic procedures.
Impact of Anticoagulation on Upper Gastrointestinal Bleeding in Cirrhosis
Authors: Kumar Chandar , Salman Ali  , Faiza Bibi  , Adil Hassan  , Sidra Soomro  , Muhammad Sadik Memon
Published: June 2024

Background: Liver cirrhosis is often associated with upper gastrointestinal bleeding (UGIB), complicating the clinical management due to the fragile hemostatic balance and potential for portal hypertension-related complications. Anticoagulation therapy, while necessary for preventing thrombotic events, may increase the risk of bleeding, making its use in cirrhotic patients a critical area of study.
Objective: To evaluate the impact of anticoagulation therapy on the incidence and severity of UGIB in patients with liver cirrhosis.
Methods: This prospective study enrolled 100 patients with liver cirrhosis at the Asian Institute of Medical Sciences (AIMS) in Hyderabad. Patients were randomly assigned into two groups: Group A (n=50), receiving anticoagulation therapy, and Group B (n=50), without anticoagulation. UGIB sources were diagnosed via upper digestive endoscopy. Data were analyzed using SPSS version 26.0.
Results: The mean age was 60.82 years (SD ± 8.98) in Group A and 62.20 years (SD ± 8.72) in Group B. Male participants comprised 68% and 62% of Groups A and B, respectively. Clinical outcomes showed shock incidence at 26% in Group A versus 12% in Group B (p=0.074), active bleeding at 30% versus 36% (p=0.523), hepatic failure at 20% versus 16% (p=0.603), and mortality rates at 16% versus 10% (p=0.372).
Conclusion: The study indicates that anticoagulation therapy does not significantly impact the likelihood of adverse clinical outcomes in patients with liver cirrhosis. However, the need to balance thrombosis prevention with bleeding risk underscores the necessity for further large-scale studies to refine anticoagulation guidelines in this population.
Unveiling Healthcare Practitioners' Knowledge and Acceptance of Artificial Intelligence in Healthcare
Authors: Tahseen Shazma , Channar Husan Bano , Bhatti Urooj , Laghari Tasleem Akhtar , Areej Sana , Kamran Shah Muhammad
Published: June 2024

Background: The rapid advancement of artificial intelligence (AI) is poised to revolutionize healthcare delivery systems profoundly. With its capacity to enhance diagnostics, treatment, and patient care, understanding AI's role and integration in healthcare is crucial for medical professionals and students.
Objective: This study aims to assess the familiarity, knowledge, and comprehension of AI among medical students and physicians, identifying both challenges and opportunities associated with its use in medicine.
Methods: A structured questionnaire, adapted from established scales, was used to collect data from students and physicians at a public sector medical university. The study employed simple random sampling to ensure a representative sample, with a focus on collecting comprehensive demographic and AI-related knowledge data.
Results: Of the 600 participants surveyed, 70% reported basic knowledge of AI, yet only 28% were aware of its specific applications in healthcare. Interestingly, 85% of respondents acknowledged the potential of AI to significantly enhance healthcare delivery and research.
Conclusion: While there is a basic awareness of AI among medical professionals and students, there is a notable gap in understanding its specific applications in healthcare. The study highlights the need for mandatory training programs that enhance AI awareness and application in medical settings.
Role of Artificial Intelligence in Grading and Prognosis of Prostate Cancer
Authors: Nadir Masud Malik  , Muhammad Haseeb  , Huzafa Ali
Published: June 2024

Artificial Intelligence (AI) and Machine Learning (ML) are increasingly influencing the medical field, particularly in the diagnosis and prognosis of prostate cancer. AI technologies facilitate complex tasks in identifying and characterizing prostate cancer through image-based analyses, including histopathology and MRI. These advancements are enhancing evaluation methods and improving patient outcomes by incorporating additional data such as demographic factors and experimental markers into risk prediction models, increasing the accuracy of prostate cancer prognosis from 60% to 80%. ML, a subset of AI, leverages large datasets to improve predictions regarding cancer susceptibility, recurrence, and survival rates. Despite its potential, AI still requires significant human input in its development and faces various challenges before it can fully integrate into clinical practice.
Dietary and Lifestyle Characteristics and Metabolic Disorders in Reproductive-Age Women: Explorative Study in Peshawar Pakistan
Authors: Iqbal Rabina , Janat Ul Mawa  , Huma Naqeeb  , Sadaf Ambreen  , Sidra Shah  , Maria Noor Us Saba  , Amna  , Zia Ud Din  , Muhammad Zubair
Published: June 2024

Background: In rural areas, women significantly contribute to both household and agricultural activities. Their involvement in diverse tasks impacts their health, emphasizing the need to study how their lifestyle, dietary habits, and stress levels relate to metabolic health.
Objective: This cross-sectional study aims to examine the relationship between lifestyle, dietary diversity, psychological stress, and metabolic indicators among rural women of reproductive age.
Methods: Data were collected from 300 women aged 20 to 40, free from chronic conditions, using standardized subjective and objective measures. These included assessments of nutritional status, psychosocial factors, dietary habits, physical activity, sleep duration, body composition, blood pressure, and fasting glucose levels. Dietary patterns were analyzed using Principal Component and Factor Analysis via SPSS.
Results: The average age of the participants was 27 years. Mean weight was 61.7 ± 14.2 kg and mean height 156.3 ± 5.7 cm. About 31% were overweight and 13% underweight. The average Perceived Stress Score was 14.9, with 47.5% experiencing low stress and 8.5% high stress. Dietary diversity was low for 42.5% of the women. Sedentary lifestyles correlated strongly with adverse metabolic indicators. Principal dietary patterns identified were savory cereals, dairy-based vegetables, and high-fat red meat. High-fat red meat consumption showed strong correlations with increased BMI and visceral body fat.
Conclusion: Lifestyle factors, psychological stress, and dietary patterns, especially high consumption of red meat and fat, significantly influence metabolic health among rural women.
To Study the Physico Chemical Characteristics and Mineral Contant of Pomegranate Arils Juice
Authors: Mawa Janat Ul , Humaira Wasila  , Imran Ahmed  , Murad Ali  , Lubna Pervez  , Hina Saleem  , Maria Noor Us Saba  , Kalsoom Bibi  , Muhammad Zubair
Published: June 2024

Background: Pomegranate arils juice is renowned for its nutritional qualities, which are influenced by various storage conditions and varietal characteristics. This study explores the physico-chemical properties and mineral content of three distinct pomegranate varieties—Ghandhri, Bedana, and Tarnab Gulabi—under different storage conditions.
Objective: The primary goal of the research was to examine the impact of storage on the TSS, pH, acidity, and mineral content (iron, zinc, and calcium) of pomegranate arils juice from three regional varieties.
Methods: The study was conducted at the Human Nutrition and Agriculture Chemistry laboratory at the University of Agriculture, Peshawar, and the Food Science division of the Agriculture Research Institute Tarnab. Fresh and stored juices from the three varieties were analyzed to assess changes in physico-chemical properties and mineral content.
Results: Storage led to an increase in the levels of zinc and iron, with recorded increases in zinc to 0.568±0.04 ppm in Ghandhri and iron peaking at 0.19±0.2 ppm in Tarnab Gulabi. However, calcium content decreased during storage, with a notable reduction to 3.13±2.93 ppm in stored juices. TSS was highest in Ghandhri and Tarnab Gulabi at 15.6±1.02, while acidity was highest in Ghandhri at 2.139±0.19.
Conclusion: The study confirms that storage significantly alters the physico-chemical properties and mineral content of pomegranate arils juice, with detrimental effects on calcium levels but beneficial impacts on zinc and iron content. Notable varietal differences were observed, with Tarnab Gulabi displaying the highest phenolic content.
Comparison Of Functional Outcomes of Arthroscopic Bankart Repair Vs Open Bristow-Latarjet Procedure for Shoulder Joint Instability
Authors: Azam Waqas , Uddin Shuja , Saddique Mudassar , Shiraz Hafiz Muhammad , Waqas Abdul , Abbas Syed Zain , Haneef Mian Muhammad
Published: June 2024

Background: Anterior shoulder instability predominantly affects collegiate athletes, with a notable incidence of 0.12 per 1000 athletic exposures. Acute dislocations pose an orthopedic emergency requiring immediate repositioning to prevent complications such as brachial plexus or artery compression, avascular necrosis of the humeral head, and chronic disability. Conservative therapy often precedes surgical intervention due to concerns over recovery time, discomfort, decreased range of motion, and high recurrence rates.
Objective: This study aims to compare the efficacy of Arthroscopic Bankart Repair and open Bristow-Latarjet Procedure in terms of pain reduction, return to normal activities, and improvement in Western Ontario Shoulder Instability (WOSI) score among patients with anterior shoulder joint instability.
Methods: A 12-month comparative study was conducted at Lahore General Hospital from April 2022 to April 2023, following ethical review board approval. Thirty-two patients aged 18–32, with severe unidirectional dislocation, consented and participated. They were divided into two groups: Group A underwent Arthroscopic Bankart Repair, and Group B underwent the open Bristow-Latarjet Procedure.
Results: The average age was 23 in Group B and 25 in Group A. Males comprised 80% of Group A and 68% of Group B. WOSI scores averaged 72 for Bankart and 76 for Latarjet. Rowe scores were 75 (Bankart) and 69 (Latarjet), with Quick DASH scores of 11 (Bankart) and 15 (Latarjet). External rotation was 77 degrees in Bankart and 73 degrees in Latarjet. Functional satisfaction was reported by 84.0% of Bankart and 11.7% of Latarjet patients. The cost of Latarjet was significantly lower than that of Bankart.
Conclusion: The open Latarjet procedure demonstrated higher functional satisfaction and lower operational costs compared to Arthroscopic Bankart Repair, which exhibited a higher recurrence rate. Given the economic constraints in a developing country like Pakistan, Latarjet may be a more viable option despite the non-invasive appeal of Bankart Repair.
Effects of Sub-Occipital Muscle Inhibition with and Without Hold Relax Agonist Contraction of Hamstrings on Pain, Disability and Craniovertebral Angle in Neck Pain Patients with Hamstring Tightness
Authors: Sumaiya  , Riaz Saima , Javed Asnia , Liaqat Rabia , Mohsin Faiza , Hashim Adnan
Published: June 2024

Background: Neck pain is a prevalent musculoskeletal disorder with significant impacts on individuals' daily functioning and quality of life. The Superficial Backline (SBL) concept suggests that muscles and fascial structures are interconnected, implying that addressing muscle tightness in one area can influence distant regions. This study explored the effects of sub-occipital muscle inhibition (SMI) with and without hold-relax agonist contraction (HR-AC) of the hamstrings on pain, disability, and craniovertebral angle in patients with neck pain and hamstring tightness.
Objective: To determine the efficacy of SMI with and without HR-AC on pain relief, neck disability, and craniovertebral angle in patients suffering from neck pain and hamstring tightness.
Methods: This randomized controlled trial included 34 participants aged 20-40 years with neck pain (NPRS ≥ 5) and hamstring tightness (≥ 30° extension lag). Participants were randomly assigned to two groups: Group A (SMI without HR-AC) and Group B (SMI with HR-AC). Interventions were administered three times per week for two weeks. Pain, craniovertebral angle, and neck disability were assessed using the Numeric Pain Rating Scale (NPRS), Bubble Inclinometer, Image J software, and Neck Disability Index (NDI). Data were collected at baseline and post-treatment. Statistical analysis was performed using SPSS version 25, with paired and independent t-tests used to compare outcomes within and between groups.
Results: Significant reductions in NPRS scores were observed in both groups: Group A (mean pre-treatment: 6.25 ± 0.85, post-treatment: 3.18 ± 0.98) and Group B (mean pre-treatment: 6.40 ± 0.986, post-treatment: 2.133 ± 0.743). Craniovertebral angle improved significantly in both groups: Group A (mean pre-treatment: 41.25° ± 3.51, post-treatment: 45.48° ± 2.94) and Group B (mean pre-treatment: 40.99° ± 2.70, post-treatment: 49.02° ± 2.868). NDI scores also showed marked improvement: Group A (mean pre-treatment: 32.96 ± 3.04, post-treatment: 15.38 ± 3.39) and Group B (mean pre-treatment: 33.03 ± 2.89, post-treatment: 11.25 ± 3.27). Group B demonstrated more significant improvements in all measured outcomes compared to Group A (p < 0.05).
Conclusion: Both interventions, SMI without HR-AC and SMI with HR-AC, significantly reduced pain, improved craniovertebral angle, and decreased neck disability. However, the combination of SMI with HR-AC was more effective, highlighting the importance of addressing both ends of the myofascial chain in managing neck pain and hamstring tightness.
Comparison of Balance in Habitual High Heels Wearers and Flat Shoe Wearers by Star Excursion Balance Test
Authors: Tariq Wajeeha , Alam Muhammad Mahmood , Akhtar Muhammad Waseem , Perwaiz Saadia , Burhan Muhammad , Hassnain Ali
Published: June 2024

Background: The capacity to maintain a stable and upright posture, or balance, is influenced by footwear type. High heel shoes (HHS) alter foot alignment and weight distribution, potentially impacting balance and increasing fall risk. Despite the popularity of high heels, the balance effects compared to flat shoes remain underexplored.
Objective: To compare the balance between habitual high heel wearers and flat shoe wearers using the Star Excursion Balance Test (SEBT).
Methods: A cross-sectional study was conducted from July 2022 to January 2023, including 70 female participants aged 18-35 years. Participants were habitual wearers of high heels or flat shoes for at least six months. Individuals seeking medical care for lower extremity issues or with a history of lower extremity fractures or surgeries were excluded. Balance was assessed using the SEBT, which involves reaching in eight directions from a central stance. Each participant performed three trials per direction. Leg length was measured to normalize reach distances. Data were analyzed using SPSS version 25.0. The Mann-Whitney U Test was used to compare balance between groups, with a significance threshold of p<0.05.
Results: The mean age of participants was 23.83 years (SD = 3.43). For the anterior reach on the dominant side, flat shoe wearers had a significantly better balance with a mean rank of 38.93 compared to 27.50 for high heel wearers (p=0.031). No significant differences were observed in other directions: anterior reach non-dominant side (p=0.499), anteromedial reach dominant side (p=0.384), anteromedial reach non-dominant side (p=0.887), medial reach dominant side (p=0.174), medial reach non-dominant side (p=0.524), posteromedial reach dominant side (p=0.544), posteromedial reach non-dominant side (p=0.913), posterior reach dominant side (p=0.704), posterior reach non-dominant side (p=0.350), posterolateral reach dominant side (p=0.177), and posterolateral reach non-dominant side (p=0.934).
Conclusion: Habitual high heel wearers and flat shoe wearers showed no significant differences in balance across most SEBT directions, except for a significantly poorer anterior reach in high heel wearers. These findings suggest that high heel use may specifically impact anterior balance, highlighting the need for further investigation into the biomechanical and physiological impacts of high heels on balance.
Evaluating Malaria Prevalence Across Different Age and Gender Groups in Peshawar Through Light Microscopic Analysis
Authors: Raasti Aamna , Nasir Omazia , Khalid Muhammad Arslan , Zafar Shifa , Khan Wali , Nadeem Syeda Fatima
Published: June 2024

Background: Malaria poses a significant public health challenge in Peshawar, Pakistan, where conditions are ideal for Anopheles mosquito breeding. This study investigates the prevalence of malaria across different demographic groups, employing light microscopy to detect Plasmodium parasites.
Objective: The primary objective was to assess the prevalence of malaria in specific age and gender groups in Peshawar using light microscopy. A secondary aim was to identify demographic patterns in malaria spread to facilitate targeted public health interventions.
Methods: This descriptive cross-sectional study was conducted from January to August 2021. It included 750 participants suspected of having malaria, selected through systematic sampling. Diagnostic procedures involved preparing both thick and thin blood smears stained with Giemsa to identify and quantify malaria parasites.
Results: Among the participants, 299 tested positive for malaria, representing an infection rate of 39.87%. Males exhibited a higher infection rate of 43.83% compared to females at 35.77%. The highest prevalence was observed in the 41-60 age group, with an infection rate of 50.83%. Statistical analysis using a Chi-square test indicated a significant variation in malaria prevalence by gender (Chi-square = 5.079, df = 1, P = 0.0242).
Conclusion: The study confirms a substantial malaria burden in Peshawar, with notable variations by gender and age. These results support the need for more focused malaria control strategies that address the specific vulnerabilities associated with these demographic factors.
Impact of Computer-Aided Design and Computer-Aided Manufacturing Boston Brace on Level of Dyspnea among Patients with Adolescent Idiopathic Scoliosis
Authors: Rizwan Aimon , Saeed Zeeshan , Sadiq Samreen , Asim Hafiz Muhammad , Faheem Muhammad Umer  , Ismail Saad
Published: June 2024

Background: Adolescent Idiopathic Scoliosis (AIS) is a prevalent spinal deformity characterized by a lateral curvature exceeding 10°. Bracing, particularly with the Boston brace, is a common conservative treatment aimed at halting the progression of spinal curvature. However, the impact of bracing on pulmonary function and the resultant dyspnea remains a concern, especially in developing countries like Pakistan where larger scoliotic curves are more common.
Objective: This study aimed to evaluate the effect of the CAD/CAM Boston brace on dyspnea levels in patients with AIS and to examine the correlation between dyspnea severity, Cobb's angle, and the duration of brace wear.
Methods: Necessary approvals were obtained from the institutional ethical review board, and informed consent was secured from all participants. The study included 145 participants (aged 10-19 years) diagnosed with AIS, recruited through non-probability convenient sampling. The sample size was calculated using the WHO sample size calculator, ensuring a minimum of 134 participants. Data collection involved the 6 Minute Walk Test (6MWT) followed by the Modified Borg Scale (MBS) to assess dyspnea. Participants were instructed to walk a distance of 400 to 700 meters within 6 minutes. Post-test, participants rated their dyspnea on a scale of 0 to 10. Demographic data and brace wear duration were also collected. Data were analyzed using SPSS version 25. Means and standard deviations were calculated for continuous variables, and frequency tables were used for categorical variables. Pearson correlation coefficients were computed to determine the relationships between dyspnea levels, Cobb's angle, and brace wear duration.
Results: The mean age of participants was 14.71 years (SD = 2.309). The mean Cobb's angle was 52.08° (SD = 5.3729), and the mean duration of brace wear was 26.08 hours per week (SD = 7.0458). Dyspnea severity varied, with 54.5% of participants reporting "somewhat severe" dyspnea, 15.9% reporting "very, very severe" dyspnea, and 9.0% reporting "moderate" dyspnea. Pearson correlation analysis revealed a strong positive correlation between dyspnea severity and Cobb's angle (r = 0.681), and a moderate positive correlation between dyspnea severity and brace wear duration (r = 0.414).
Conclusion: The study highlights the significant impact of the CAD/CAM Boston brace on dyspnea levels among AIS patients. Higher Cobb's angles and longer brace wear durations were associated with increased dyspnea severity. These findings underscore the need for careful monitoring of respiratory symptoms in AIS patients undergoing bracing and suggest exploring alternative or adjunctive treatments to minimize pulmonary compromise.
From Fields to Families: Understanding the Health Impacts of Excessive Soil Fertilization
Authors: Zeeshan Ali , Muhammad Waqas  , Muhammad Talha Ramzan  , Fatima Ghafoor  , Usama  , Muhammad Uzair Ibrahim  , Noor Fatima  , Abdul Rauf  , Ayesha Hussain  , Mustansar Abbas  , Noman Zahid  , Sana Hanif
Published: June 2024

Background: Fertilizers play a crucial role in modern agriculture, significantly boosting crop yields and global food production. However, their widespread use has unintended consequences that raise significant environmental and health concerns. Nitrogen-based, phosphorus-based, and potassium-based fertilizers contribute to nutrient replenishment in soils but can lead to soil and water contamination, posing risks to ecosystems and human health.
Objective: This narrative review aims to comprehensively examine the health and environmental impacts of excessive soil fertilization, with a focus on understanding the mechanisms by which fertilizers affect soil and water quality and the subsequent implications for human health.
Methods: An extensive literature search was conducted across multiple electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar. Articles published between 2000 and 2023 were selected based on predefined inclusion criteria, focusing on studies that provided empirical data or substantial theoretical insights into the environmental and health impacts of fertilizer use. A qualitative analysis was performed to synthesize findings and identify common themes.
Results: The review highlighted that nutrient runoff from excessive fertilizer use leads to significant water quality degradation, with nitrate concentrations in some regions exceeding recommended safety limits by 30-50%. Prolonged exposure to contaminated water is linked to various health issues, including a 20% increased risk of methemoglobinemia in infants and a 15-25% higher risk of gastric and colorectal cancers in adults. Additionally, heavy metal accumulation in crops due to fertilization practices raises concerns, with cadmium levels in some crops surpassing safe consumption limits by 40-60%.
Conclusion: While fertilizers are essential for enhancing agricultural productivity, their excessive use poses significant environmental and health risks. A balanced approach integrating sustainable agricultural practices, effective water management, and comprehensive regulatory frameworks is imperative to mitigate these adverse effects. Continued research and collaboration among scientists, policymakers, and the agricultural community are necessary to promote a sustainable and health-conscious approach to fertilizer use.
Ethnoveterinary Study of Medicinal Plants of District Okara, Pakistan
Authors: Aslam Saira , Mubeena Mansoor  , Sadaf Bano  , Ali Zeeshan  , Aqsa Ilyas  , Anam Eman  , Fatima Javed
Published: June 2024

Background: Herbal medicines have long been integral to disease treatment, particularly in developing countries like Pakistan, where 84% of the population relies on traditional remedies. The ethnoveterinary practices in District Okara, Punjab, Pakistan, involve the use of medicinal plants for livestock health management.
Objective: This study aimed to document and analyze the ethnoveterinary uses of medicinal plants in District Okara, focusing on their application in treating livestock and bird diseases.
Methods: The study was conducted in District Okara, located between 31º-55’ and 32º-30’ North latitudes and 74º-35’ and 75º-21’ East longitudes. Ethnoveterinary data were collected from 150 local inhabitants through a semi-structured questionnaire during five visits from April to June 2023. Participants included 46 women and 104 men, aged 25-70 years, from diverse occupations such as hakims, merchants, shepherds, nomads, woodcutters, baildaars, instructors, cowmen, farmers, and local healers. The questionnaire gathered detailed information on livestock diseases treated, medicinal plants used, their local names, plant parts utilized, and preparation methods. Data analysis was performed using SPSS version 25, employing descriptive statistics to summarize demographic characteristics and the usage patterns of medicinal plants. The study adhered to ethical standards as per the Declaration of Helsinki, with verbal consent obtained from all participants.
Results: The study identified 60 medicinal plant species from 29 families used to treat livestock ailments. Fabaceae was the largest family, with 8 species, followed by Solanaceae and Apiaceae, each with 5 species. Herbs were the predominant plant habit, comprising 39 species, followed by trees (16 species), shrubs (4 species), and herbaceous vines (1 species). The most frequently used plant parts were leaves, followed by fruits and seeds. The ethnoveterinary practices included the use of Ficus religiosa for foot and mouth disease, Brassica campestris for muscle cramps and heat stress, and Zingiber officinale for oral diseases and fever. Cross-referencing among informants validated the data.
Conclusion: This study highlighted the extensive use of medicinal plants in District Okara for livestock health management, with Fabaceae being the most represented family and leaves being the most commonly used plant part. The documentation of these practices underscores the need for conservation efforts to protect these valuable plant resources from threats such as overgrazing, urbanization, and agricultural expansion. Raising awareness among the local population about the importance of medicinal plants is crucial for their preservation and sustainable use.
Prevalence of In-Stent Restenosis in Patients having Drug Eluting Stents with Lengths Exceeding 40mm: A Single-Center Study
Authors: Khan Muhammad Zubair , Syed Muhammad Nayab Ali  , Waqas Ahmad Jan  , Amjad Ali Hulio  , Noman Ullah Wazir  , Deepak Lal
Published: June 2024

Background: Coronary artery disease (CAD) remains a significant global health challenge, with percutaneous coronary intervention (PCI) being a primary treatment method. The use of long drug-eluting stents (DES) has been linked to varied outcomes, particularly concerning in-stent restenosis (ISR), which may be influenced by factors like stent length and patient comorbidities.
Objective: To assess the prevalence of ISR in patients undergoing PCI with long DES (>40mm), considering patient demographics, comorbidities, and lesion characteristics.
Methods: This cross-sectional study was conducted at Frontier Corps Teaching Hospital (FCTH) and Lady Reading Hospital in Peshawar, Pakistan, involving 102 patients. The study focused on the frequency of ISR post-angioplasty, particularly in relation to comorbid conditions such as diabetes and hypertension. Data collection included demographics, echocardiographic assessments, and detailed angiogram analysis. Statistical analysis was performed using SPSS version 23.0, with a significance threshold set at p<0.05.
Results: The overall prevalence of ISR was found to be 18.63%. Diabetes and hypertension showed a significant association with ISR, with p-values <0.0015. The ISR frequencies for single vessel disease (SVCAD), double vessel disease (DVCAD), and triple vessel disease (TVCAD) were 26.32%, 31.58%, and 42.10%, respectively, with TVCAD showing a statistically significant association (p=0.0185).
Conclusion: The study highlights a significant association between long DES and increased ISR rates, particularly in patients with complex coronary anatomies and multiple comorbidities. Shorter stents are recommended to potentially reduce restenosis and improve outcomes in CAD management.
Shifting the Paradigms: Empowering Slum Dwellers through Hygiene Training and Educational Awareness
Authors: Altaf Kishwar , Zahra Kiran
Published: June 2024

Within the expansive urban landscapes of the world, characterized by tall buildings dominating the skyline and bustling streets swarming with activity, there exists an alternate reality—the reality of slum dwellers. These densely populated areas, often concealed from public view, accommodate millions of individuals contending with poverty, substandard housing, and limited access to essential amenities. Among the adversities inherent in slum dwellers' existence, there lies a hope of optimism—It's about how education and knowledge about hygiene can bring positive change. It is imperative to alter the prevailing paradigm and empower residents of slum areas through targeted educational campaigns on hygiene and initiatives aimed at enhancing access to education.
Exploring Genetic Variants in Ellis-Van Creveld Syndrome: Insights from a Consanguineous Family
Authors: Khalid Maryam , Areej Munir  , Abdullah Sajid  , Ammar Mehfooz  , Usama Khalil Qadri  , Shahzeera Begum  , Mohsan Aslam  , Rehmatullah Zadran  , Mehak Khalid  , Waseem Ahmed
Published: June 2024

Background: Ellis-Van Creveld Syndrome (EVC) is a rare genetic disorder characterized by skeletal abnormalities and developmental anomalies, presenting significant challenges in diagnosis and understanding its genetic underpinnings.
Objective: This study aimed to comprehensively investigate the clinical and molecular aspects of EVC within a consanguineous family from Pakistan, identifying the genetic variants involved.
Methods: A detailed clinical assessment was conducted on all family members, documenting phenotypic features such as polydactyly, syndactyly, dental abnormalities, and short stature. Pedigrees were constructed following established guidelines to depict familial relationships and inheritance patterns. Venous blood samples were collected for genomic DNA extraction using the Phenol-Chloroform Method. Microsatellite marker analysis was performed for linkage mapping, guided by the UCSC Genome Browser and Rutgers Combined Linkage-Physical Map. Mutation screening of the EVC and EVC2 genes was conducted using Sanger sequencing, with primers designed targeting exon-intron boundaries and coding exons. PCR amplification and sequencing were performed according to standard protocols. Data analysis was carried out using SPSS version 25.
Results: Clinical assessment revealed classical EVC phenotypes, including bilateral postaxial polydactyly in 80% of affected individuals and dental abnormalities in 70%. Microsatellite marker analysis identified linkage to the EVC/EVC2 locus on chromosome 4p16.2. However, Sanger sequencing of the 21 coding exons of EVC and the 22 exons of EVC2 did not detect any pathogenic mutations. Haplotype analysis confirmed the segregation of specific markers with affected individuals, suggesting the involvement of additional genetic factors.
Conclusion: The study's findings challenge the traditional understanding of EVC, highlighting the necessity for advanced genomic techniques such as whole-genome sequencing to fully elucidate its genetic contributors. These insights underscore the heterogeneous nature of EVC and emphasize the importance of comprehensive genetic screening for accurate diagnosis and personalized management of this rare genetic disorder.
Assess the Knowledge Regarding ABGs Analysis among Nurses
Authors: Maseeh Sameer Munir , Humaira Saddique  , Rubina Jabeen
Published: June 2024

Background: Arterial blood gases (ABGs) provide crucial information about the respiratory and metabolic systems. They help in identifying imbalances and assessing the compensatory mechanisms of these systems. Accurate knowledge of ABG analysis is essential for nurses to ensure effective patient care and safety in critical care settings.
Objective: To assess the level of knowledge regarding ABG analysis among staff nurses in a tertiary care hospital.
Methods: A descriptive cross-sectional study was conducted using a convenience sampling technique. The study included 140 staff nurses from a tertiary care hospital. Data were collected using a validated questionnaire and analyzed using descriptive statistics, including frequency distribution and normality checks.
Results: Among the participants, 58 (41.4%) demonstrated low knowledge, 36 (25.7%) had moderate knowledge, and 49 (32.9%) exhibited high knowledge of ABG analysis. In terms of ABG sampling techniques, 59 (42.1%) had low knowledge, 37 (26.4%) had moderate knowledge, and 44 (31.4%) showed high knowledge.
Conclusion: The study concluded that a significant proportion of nurses had low knowledge regarding ABG analysis, indicating a need for enhanced educational programs and continuous training to improve their competency in this area.
Comparative Efficacy of Aloe Vera Gel versus Normal Saline in Accelerating Episiotomy Wound Healing: A Randomized Controlled Trial
Authors: Zahra Sadaf , Saba Qayyum  , Maira Mansoor  , Muhammad Essa  , Moiz Arshad Chohan  , Snovia Ishaq  , Umair Khurshid  , Uswah Shoaib  , Abdul Hassan Khan  , Abid Hafiz Muhammad Usman , Rafia Rafi
Published: June 2024

Background: Episiotomy is a common obstetric procedure designed to aid vaginal delivery but often complicates postpartum recovery due to wound-related issues. Traditionally, these wounds are treated with normal saline. Recent studies suggest that aloe vera gel may enhance wound healing more effectively, yet comprehensive local data is lacking.
Objective: To compare the efficacy of aloe vera gel with normal saline in promoting episiotomy wound healing by the 10th postoperative day.
Methods: This randomized controlled trial included 60 gravid females undergoing normal vaginal delivery with episiotomy, randomly allocated into two groups: one treated with aloe vera gel and the other with normal saline. The primary outcome was wound healing, assessed on the 10th postpartum day using the REEDA score, categorized as complete (score <5), partial (score 5-9), or no healing (score 10-15). Written informed consent was obtained from all participants.
Results: Participants had an average age of 27.6 ± 5.2 years. The mean REEDA score on the 10th day postpartum was significantly lower in the aloe vera gel group (1.97 ± 1.22) compared to the normal saline group (3.57 ± 2.05; p = 0.001). The frequency of complete wound healing was 100% in the aloe vera group versus 76.7% in the saline group (p = 0.011).
Conclusion: Aloe vera gel significantly outperformed normal saline in healing episiotomy wounds by the 10th postoperative day, suggesting its advantageous use over traditional saline dressings in obstetric practice.
Molecular Spectrum of K-RAS Mutations in Colorectal Cancer Patients in Peshawar, Pakistan
Authors: Wahid Ullah  , Haroon Rasheed  , Shameem Khan  , Inam Ullah Khan  , Kamran  , Umer Majeed  , Kaleem Ullah  , Umair Muhammad
Published: June 2024

Background: The global incidence of colorectal cancer (CRC) has surged, presenting a significant health challenge with an annual occurrence of 1.7 million cases. The American Cancer Society reports that KRAS and BRAF mutations contribute to 20-50% of CRC cases. This study addresses the gap in data on KRAS mutations in CRC patients in Peshawar, Pakistan.
Objective: To determine the prevalence and types of KRAS mutations in colorectal cancer patients in Peshawar, Pakistan.
Methods: This retrospective, cross-sectional study was conducted at the Nuclear Medicine, Oncology, and Radiotherapy Institute (NORI) Hospital in Islamabad from April to November 2022. DNA was extracted from formalin-fixed, paraffin-embedded tissue blocks of 58 CRC patients, regardless of age and gender, following informed verbal consent. KRAS mutation testing was performed using the Cobas Z480 Real-time thermal cycler.
Results: Among the 58 CRC patients, 34 (58.6%) were females, and 24 (41.4%) were males. The highest CRC incidence (36.2%) was observed in the 11-25 years age group. KRAS mutations at codons 12 and 13 were found in 18% of cases, with all isolates carrying the G12D mutation. Kaplan-Meier analysis revealed a lower survival probability for patients with codon 12 mutations compared to those with codon 13 mutations.
Conclusion: The study highlights the need for broader research on KRAS mutations across diverse ethnicities and geographical regions in Pakistan to better understand CRC prevalence and improve patient outcomes.
Synergistic Effect of Pakistani Honey with Black Seeds against Food Borne Pathogens
Authors: Ibrahim Fariha , Mahnoor Fatima  , Shiza Ali  , Humera Rashid
Published: June 2024

Background: Food borne infections is a major public health problem all over the world. For centuries, honey has been used as a gastrointestinal and topical remedy and also as a food preservative. It has been exploited not only as a food but, utilized for multiple purposes such as for the treatment of various disease, for wound healing etc. Black seeds have also been used in traditional medicine and food preservation due to their effective therapeutic properties. The synergy-based combination of both the herbal extracts may enhance the antimicrobial potential against food borne pathogens.
Objective: This study aims to evaluate the antibacterial potential of different variants of Pakistani honey (Acacia honey, Ziziphus honey, and Sidr honey) in combination with black seeds against foodborne pathogens.
Methods: The antibacterial activity of different Pakistani honey (Acacia honey, Ziziphus honey, and Sidr honey) was evaluated using an agar well diffusion assay. The synergistic effect of honey and black seed was also examined. Moreover, the Minimum Inhibitory Concentration (MIC) was determined using the tube dilution method.
Results: The combination of Ziziphus honey and black seeds showed the most significant antibacterial effect such as 25.0, 28.0- and 30.0-mm zones of inhibition against Escherichia coli, Salmonella typhi, and Staphylococcus aureus respectively. The inhibition zone of the synergistic antibacterial effect of honey and black seed extracts against foodborne pathogens was significantly larger than the extracts used separately. Furthermore, the lowest MIC was observed 3.12 mg/ml against Escherichia coli and Staphylococcus aureus in the combination of Ziziphus honey with black seeds whereas, 6.25 mg/ml was observed against salmonella typhi.
Conclusion: The present finding supports the traditional use of these different Pakistani honey variants in combination with black seeds for treating food borne pathogens to promote good health without any adverse side effects. The results suggested that present combination of natural extracts could be further explored clinically as a potent synergy-based therapeutic approach for treating various multidrug resistant food pathogens.