bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of TTG Positivity in Diarrhea Predominant IBS Patients at Peshawar, Pakistan
Authors: Khan Bughdad , Khan Muhammad Shadab Aslam , Naeem Awais , Naim Fahad , Utmani Nizamuddin , Safiullah .
Published: December 2024

Irritable Bowel Syndrome is abdominal discomfort and alterations in bowel habits without an identifiable organic cause. Objective: To determine the frequency of tissue transglutaminase positivity in diarrhea-predominant IBS patients. Methods: This cross-sectional study was done from 1st January 2021 to 30th July 2021 in the Medicine department of Khyber Teaching Hospital, Peshawar, Pakistan. Patients of either gender aged between 18-60 years presenting in the medical outpatient department with diarrhea-predominant irritable bowel syndrome. Diarrhea-predominant irritable bowel syndrome was defined as a patient who fulfilled the Rome-IV criteria for irritable bowel syndrome with ≥2 of the features. Tissue transglutaminase antibodies were done for all patients and tissue transglutaminase positivity was defined as anti-tissue transglutaminase IgA or IgG antibody levels ≥10 AU/ml on laboratory tests performed by the chemi-luminescence immunoassay technique. Results: In a total of 96 patients, 59 (61.5%) were male. The mean age, weight, and duration of diarrhea were 37.64 ± 6.28 years, 81.48 ± 7.70 kg, and 11.67 ± 3.81 months, respectively. The tissue transglutaminase positivity was seen in 12 (12.5%) of patients. Duration of disease above 6 weeks was found to have a significant association with tissue transglutaminase positivity (p<0.001) as all tissue transglutaminase-positive patients had a duration of disease above 6 months. Conclusions: It was concluded that the frequency of tissue transglutaminase positivity was high in diarrhea-predominant irritable bowel syndrome patients. Screening for celiac disease in irritable bowel syndrome patients can be worth considering especially in cases with relatively longer duration of irritable bowel syndrome diarrhea predominant symptoms.
Comparison of Outcomes between Open and Closed Haemorrhoidectomy
Authors: Mahmood Khalid , Iqbal Muhammad , Khan Ahmed Hassan , Nawaz Allah , Farrukh Raza , Arshad Khawaja
Published: December 2024

Horrhoidectomy can prolong hospital stays due to pain, bleeding, and wound infections. Horrhoidectomy improves postoperative pain and wound healing. This research examined postoperative pain, hemorrhage, operating time, and wound healing after open and closed hemorrhoidectomy. Objective: To determine the post-operative outcomes of open and closed haemorrhoidectomy in terms of wound healing, pain perception and complications. Methods: This comparative study was conducted at Department of Surgery, DHQ Teaching Hospital, Sargodha from 1st September 2022 to 28th February 2023. Sixty patients were selected and divided into two groups; open and closed haemorrhoidectomy. Grade-III and grade-IV patients were underwent haemorrhoidectomy on the basis of severity and internal haemorrhoids. SPSS version 26.0 was used to analyse all the data. Results: There were 40 (66.7%) males and 20 (33.3%) females. Approximately 43.3% of the patients from closed group showed mild pain whereas 36.6% of the cases from open group complain mild pain after open haemorrhoidectomy. An open haemorrhoidectomy incision healed in 22 days, but a closed one took 15 days (p=0.56). The early onset of post-operative closed haemorrhoidectomy patients had 3.3%, 6.6%, and 3.3% cases of hemorrhoid, infection, and urinary retention, while the early onset of open patients had 6.6%, 10%, and 6.6%. There was just one patient in the open haemorrhoidectomy group with late-onset anal stenosis, and no other patient in either group developed fissure or faecal incontinence. Conclusion: Almost similar pain perception was observed in both surgical procedures before and after the surgery.
Nervous Discrepancy of Spinal Cord Schwannoma Causing Posterior Neck Swelling
Authors: Saeed Soobia , Ghani Rubina , Shahid Zeelaf , Naseeb Uzma , Khan Ubaid Ahmed
Published: December 2024

A 20-year-old man with chronic cervical pain has been diagnosed with cervical spinal schwannomas, a benign tumor in the posterior neck. Objective: To analyze the spinal cord schwannomas causing posterior neck swelling. Methods:  In the first step, the vertebral canal portion of the tumor at C4 was removed entirely with a midline approach to the posterior spinal column. The patient underwent a laminectomy procedure in the second surgical session to remove tumors at C2 and C3, resulting in no neurological issues upon discharge from the hospital. Results: Schwannomas was diagnosed histopathologically. In patients with cervical intra-spinal schwannomas that have spread to the extra vertebral paravertebral neck region, the first goal of surgery is to treat the neurological deficits. Conclusions: It was concluded that the posterior midline and laminectomy approach approaches are combined in the same session or at different times in the surgical strategy.
Assessment of the Proximal Femoral Nailing and Dynamic Hip Screws in Intertrochanteric Fractures
Authors: Ali Muhammad Rizwan , Ahmad Irfan , Ahmed Nauman Naeem , Shahzad Muhammad Farhan , Umer Yasir , Lavisha . , Shahzad Shafqat
Published: December 2024

An intertrochanteric fracture is one of three types of proximal femur fractures, occurring in the proximal part of the femur. The other two types are subtrochanteric fractures, which occur below the trochanters, and proximal (or cephalad) fractures of the femoral neck. Objective: To assess the differences in hospital stay, blood loss, and operative time between proximal femoral nailing and dynamic hip screws in the management of intertrochanteric fractures of the femur. Methods: Quasi-experimental study was conducted in Unit II of the Orthopedic Surgery department at Jinnah Hospital Lahore. It included eighty patients whose demographic profiles (name, age, gender, and BMI) were collected. Using a non-probability consecutive sampling technique, patients were divided into two groups: Group A underwent Dynamic Hip Screw (DHS) surgery, while Group B received Proximal Femoral Nailing (PFN) surgery. Data on operative time, blood loss, and hospital stay were analyzed using SPSS version 21.0, with outcomes compared via independent sample t-test at p < 0.05 significance. Results: Regarding hospital stay, blood loss, and operating time, DHS and PFN differed significantly. Compared to the DHS group, the PFN group's operating time, blood loss, and length of hospital stay were much lower. Conclusion: This study has demonstrated that PFN is a far superior option to DHS for treating femur intertrochanteric fractures. Going forward, suggested PFN rather than DHS for femur fractures of this kind.
Correlation of Developmental Dysplasia of Hip in Newborns with Mode of Presentation on Graf Method Ultrasound
Authors: Marvi Nasim , Khokhar Samia Khalid , Alam Omar , Qamar Aisha , Mahar Yasmeen , Fatimee Sarwath
Published: December 2024

Developmental dysplasia of hip (DDH) affects 1.5-20/1000 live births. Early detection and treatment have spared many patients from crippling. The dislocation of the hip is always postnatal. Defects in hip occur because of the flexibility of the joint capsule at birth, underdeveloped hip acetabulum and immature femur head. Objective: To correlate incidence of developmental dysplasia of hip in newborns with modes of presentation at birth (vertex, breech and transverse) using Graf method ultrasound. Methods: The six-month analytical cross-sectional study was conducted after ethical approval and informed parental consent. A total of 115 healthy newborns below 28 days age were inducted in the study. The study excluded neuromuscular disease, neural tube defects and genetic anomaly cases. The bilateral hip angles were measured on ultrasound, categorized and recorded. Modes of presentation (vertex, breech and transverse) and physical exam findings were included.  Results: Hip angles were measured in 115 newborns. The vertex presentation was the most common; 96 (83.48%). Infants with vertex presentation had the significantly smaller frequency of dysplasia (p<0.001). Breech presentation had significantly high incidence of hip dysplasia (p<0.001). Bilateral pathological immature hip (2a-) and centered unstable (2c) hip dysplasia types were most common in all groups. Severe dysplasia types D and 4 were seen in the vertex and breech groups. Conclusions: Developmental dysplasia of hip occurs with vertex, transverse and breech presentation postnatally. The most frequent variants are the immature pathological and centered unstable hips. The severe forms of dysplasia occur in vertex and breech presentations
Etiology and Outcome of Acute Kidney Injury; A Single Centre Study
Authors: Nazar Mubashar , Naz Somiya , Mujtaba Ur Rehman Muhammad , Sana . , Jabeen Aqsa
Published: December 2024

Acute kidney injury is a syndrome defined by the rapid decline of renal excretory function, commonly identified through the accumulation of nitrogenous waste products. Objective: To identify the etiology and outcome of acute kidney injury. Methods: The study was carried out from September 2023 to April 2024. 135 patients diagnosed with acute kidney injury, aged 18-75 years were included. To categorize the causes of acute kidney injury into pre-renal, intra-, and post-renal categories, comprehensive histories, clinical evaluations, laboratory tests, and kidney imaging using ultrasound were performed. Outcomes were assessed as full recovery, partial recovery, or failure to recover within three months of diagnosis. Descriptive statistics and SPSS version 23.0 were used for analysis. The chi-square test examined the relationship between age, gender, etiology and outcomes; a p-value<0.05 is considered significant. Results: The patients were 41.63 ± 14.55 years old on average. Pre-renal causes were identified in 135 cases, with sepsis 77 (54.8%) being the most common etiology, followed by diuretic overuse 44 (32.6%). Intra-renal causes included acute tubular necrosis 63 (46.7%) and glomerular diseases 48 (35.6%). Post-renal causes were predominantly due to renal stones 68 (50.4%). Full recovery was achieved in 92 (68.1%) cases, partial recovery in 28 (20.7%), and 15 (11.1%) patients failed to recover. Conclusions: It was concluded that the maximum number of patients with acute kidney injury fully recovered. Sepsis is the leading pre-renal cause of acute kidney injury, while acute tubular necrosis is the most common intra-renal cause. Renal stones are the primary post-renal cause.
Comparing the Clinical Effectiveness of High-Dose and Low-Dose Statin Therapy in Patients with Atherosclerotic Coronary Artery Disease (CAD)
Authors: Ghafoor Adnan , Rehman Tanzil Ur , Sarfaraz Maria , Rind Aslam , Nasir Ali , Khan Jahanzeb Kamal , Shahzad Shafqat
Published: December 2024

Coronary artery disease is associated with the circulatory system and leading cause of death around the globe, Objective: To compare the mean changes in low-density lipoprotein cholesterol with high and low doses of statin therapy. Methods: A non-randomized controlled trial at the Department of Cardiology, Fauji Foundation Hospital Rawalpindi was conducted from January 26-2023 to July 25-2023, among patients aged 45-75 years of both genders with ST-elevation myocardial infarction or non-ST-elevation myocardial infarction. Patients were divided into groups using a convenience sampling technique. Patients in Group A were given high-dose statin therapy atorvastatin 40mg orally daily. While Group B received low-dose statin therapy atorvastatin 20mg orally daily. The low-density lipoprotein cholesterol level was repeated after 3 months. Data were entered and analyzed using SPSS version 23. Results: The mean age of Group A was 56.14 ± 8.9 years and Group B was 57.5 ± 9.7 years, as per gender distribution group A showed 57.1% and Group B 68.6%, whereas, the females in Group A, were calculated as 42.9% and in Group B 31.4%. The mean changes observed in low-density lipoprotein cholesterol were significantly higher in groups in comparison to the group with low-dose statin therapy. The changes observed were significant at 35 ± 27.8mg/dl in higher statin therapy versus 21.4 ± 20 mg/dl with a p-value of 0.024. Conclusions: It was concluded that high-dose statin causes a greater reduction in low-density lipoprotein cholesterol levels. The high-dose therapy could be a great option in treating the low-density lipoprotein in initial management.
Stanniocalcin 2 Expression: A Significant Marker in the Prognosis of Colorectal Carcinoma
Authors: Zafar Salman , Qamar Nazia , Shahid Madeeha , Kamran Shahid , Sundus Sadia , Aziz Zubia
Published: December 2024

Colorectal Cancer (CRC) is one of the most common cancers worldwide and causes significant morbidity and mortality. Biomarkers that predict tumor behavior and prognosis were essential. Stanniocalcin-2 (STC2) was a glycoprotein hormone involved in tumor progression but its association with clinicopathological parameters in colorectal cancer needs to be studied. Objective: To evaluate the correlation of Stanniocalcin-2 expression with clinicopathological features of colorectal cancer including tumor grade, invasion, lymph node metastasis, perineural invasion, and disease prognosis. Methods: This retrospective observational study was conducted at Life Care Molecular and Polymerase Chain Reaction Lab Services, Karachi in collaboration with Fazaia Ruth Pfau Medical College. 60 paraffin-embedded blocks from colorectal cancer patients diagnosed between January 2020 and December 2022 were included. 10 colonic biopsies negative for malignancy were taken as controls. Immunohistochemically analysis of Stanniocalcin-2 was compared with clinicopathological parameters including tumor grade, invasion, lymph node status, and perineural invasion. Statistical significance was calculated at a 95% confidence level and 5% margin of error. Results: Stanniocalcin-2 was significantly associated with higher tumor grade, invasion, lymph node metastasis, and perineural invasion (p<0.05). Strong stanniocalcin-2 expression was associated with poor disease prognosis and aggressive tumor behavior. Conclusions: Stanniocalcin-2 was a poor prognostic marker in colorectal carcinoma and was linked to aggressive tumor features. Stanniocalcin-2 can be a useful biomarker to predict disease progression and treatment strategy.
Alkaline Phosphatase as Marker of Hepatocellular Carcinoma
Authors: Hussain Atif , Khan Bahawal , Ziauddin . , Asmatullah . , Anwar Muhammad , Haq Noman ul
Published: December 2024

Hepatocellular carcinoma (HCC), the fifth most common cancer worldwide, is often detected at a late stage and is frequently fatal.. Liver resection is the main treatment for cases originating from normal liver tissue, but most cases arise from diseased liver parenchyma, such as HBV-related cirrhosis. While many studies link alkaline phosphatase (ALP) to HCC, its diagnostic accuracy in distinguishing HCC from other liver disorders remains limited.. Objective: To assess the diagnostic accuracy of rising ALP levels as an indicator for hepatocellular carcinoma. Methods: The cross-sectional study at Sheikh Zayed Hospital, Lahore, included 130 non-probability sampled patients. Individuals aged 18–65 suspected of first-time hepatocellular carcinoma (HCC) were included, excluding those with prior HCC diagnosis or biliary obstructions. Triphasic CT scans confirmed HCC and assessed ALP/AFP. Data were analyzed using SPSS version 23.0, showing numerical variables as mean ± SD and categorical variables as frequency/percentage. Results: In 130 patients, ALP-based detection outperformed CT scans (81.40%, 9.20%) in sensitivity (93.00%) and positive predictive value (95.00%). HCC detection and performance vary greatly by age and gender. ALP is sensitive across age (95.00%) and gender (98.00% male, 86.00% female). In 108 positive (83.08%) and 22 negative (16.92%) HCC detections on ALP, demographics affect specificity, supporting nuanced ALP interpretation for accurate HCC diagnosis. Conclusions: Elevated ALP levels serve as risk predictors in HCC patients. The prognostic model proposed in this study has the potential to influence outcomes for patients across different risk groups.
Patterns of Infraorbital Nerve Injury in Zygomatic Maxillary Complex Fractures: A Study from A Public Hospital in Karachi
Authors: Saleem Qasim , Shaikh Tanzeela , Akhtar Zulakha , Samreena . , Habiba Ume , Irshad Farah
Published: December 2024

The zygomatic region is highly susceptible to zygomatic maxillary Complex fractures, making it the second most common facial fracture in the lateral midface. Objective: To determine the types and frequencies of infraorbital nerve injuries (anesthesia, paresthesia, dysesthesia, and hypoesthesia) in patients with zygomatic maxillary complex fractures. Methods: A cross-sectional study was conducted over six months at the Department of Oral and Maxillofacial Surgery, Jinnah Postgraduate Medical Centre, Karachi. The total sample size of 72 was determined using OPEN-EPI software, based on a 95% confidence interval, 7% margin of error, and an assumed 89.77% proportion of infraorbital nerve injury in zygomatic maxillary fractures from a previous study. Non-probability consecutive sampling was employed. Demographic data (gender, age, residence, Body Mass Index) and infraorbital nerve injuries were recorded, and categorized into hypoesthesia, paresthesia, dysesthesia, and anesthesia based on clinical examination and radiographs. Data were analyzed using SPSS version 20.0, with means and percentages used for analysis. The chi-square test was utilized to explore associations between categorical variables. Results:Among 72 patients, 62.5% were male, with a mean age of 37.43 ± 11.04 years. Urban residents made up 65.3%. The mean Body Mass Index was 24.77 ± 3.0 kg/m², and 19.4% were obese. Infraorbital nerve injury was present in 75% of cases, with paresthesia the most common (59.7%), followed by hypoesthesia (8.3%), dysesthesia (4.2%), and anesthesia (2.8%). Conclusion: It was concluded that infraorbital nerve injuries are frequent in zygomatic maxillary fractures, with paresthesia being the most common. Early detection and treatment are essential to improve patient outcomes.
Use of YouTube for Mastery of Clinical Skills in Dental Education
Authors: Qureshi Muhammad Ammar , Khalid Saria , Rana Azeem , Munawar Huzaifa , Malik Khizar Ansar
Published: December 2024

The increasing integration of digital platforms has transformed the way clinical skills are taught in dental education. YouTube has emerged as a prominent resource, offering an array of instructional videos that can supplement traditional learning. However, the extent to which dental students in Pakistan utilize this platform for clinical skill acquisition remains underexplored, highlighting a significant gap in the existing literature.  Objectives: To evaluate the utilization and effectiveness of YouTube as a learning tool for clinical skills among dental students and house officers. Methods: A cross-sectional survey was conducted with 150 dental students and house officers at Combined Military Hospitals, Lahore Medical College, Institute of Dentistry. House officers from other medical professions were excluded. The sample size of 150 was calculated through the M Calculator. Participants completed a 19-item questionnaire. The collected data were analyzed using SPSS version 26.0. For the data analysis, descriptive tests, frequencies, chi-square and the Kruskal Wallis tests were employed.  Results: Most students (87.3 %) solely depended on internationally produced videos. 26.7% of the participants used the platform for educational purposes. Only 44% of the participants used YouTube as a supplement to learn clinical procedures. 47.3% reported watching YouTube videos before their first attempt at a procedure. Conclusions: It was concluded that YouTube is a valuable source of learning and presents the necessity of incorporating technology-enhanced tools, such as YouTube, into dental schools.
Effectiveness of Dynamic Condylar Screw (DCS) in Treating Unstable Proximal Femoral Fractures
Authors: Afzal Mir , Memon Shakeel Ahmed , Jokhio Muhammad Faraz , Hussain Agha Mahtab , Bhutto Irshad , Bhatti Rasheed Ahmed
Published: December 2024

Despite the availability of various treatment modalities for proximal femoral fractures, there remains ongoing debate regarding the optimal fixation method especially those for unstable fractures, particularly in patients with resource-limited areas. Objective: To assess the effectiveness of dynamic condylar screw fixation in treating unstable proximal femoral fractures. Methods: A longitudinal prospective study was conducted from Nov 2021 to Dec 2022. 47 patients aged between 18 to 65 years with unstable proximal femoral fractures (intertrochanteric, sub-trochanteric, or complex fractures involving the femoral neck or shaft), were included in the study and followed up for 1 year. Patients with open fractures, poly-trauma, and ipsilateral hip surgery were excluded from the study. The effectiveness of the dynamic condylar screw in treating unstable proximal femoral fractures was measured through a structured clinical and radiographic follow-up process. Patients underwent open reduction and internal fixation using a 95° DCS to ensure optimal fracture stabilization. Results: The study involved 47 patients with intertrochanteric (42.6%), sub-trochanteric (31.9%), and complex fractures (25.5%). The effectiveness of treatment and postoperative outcomes was reported in 43 patients (91.5%), with unsuccessful outcomes in 4 (8.5%). The acceptable alignment as per the radiological evidence was seen in 38 patients (80.9%), mal-unions were observed in 5 (10.6%), and implant failure in 4 (8.5%). Functional outcomes showed 29.8% excellent, 44.7% good, 17.0% fair, and 8.5% poor results. Conclusions: it was concluded that the study demonstrated a high rate of successful treatment across different fracture types, with no significant differences in success rates.
Prevalence of Post-Surgical Pain and Quality of Life After Total Knee Replacement
Authors: Hannan Abdul , Wasif Hafiz Muhammad , Ali Muhammad , Naseer Muhammad Kashaf , Ali Waqas , Mustafa Yasir
Published: December 2024

Total knee arthroplasty appears to be particularly advantageous for patients with significant knee joint disorders such as osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. Objective: To investigate the prevalence of post-surgical pain after total knee replacement and its impact on quality of life. Methods: This cross-sectional study was conducted at The University of Lahore Teaching Hospital during the period of 5th April, 2023 to 5th January, 2024 on 185 participants using a non-probability convenience sampling technique. It included both male and female patients between age of 50 to 80 years, undergoing TKR following diagnosis of osteoarthritis only, and patients who had undergone a TKR operation at least six months previously. A numeric pain rating scale was used for data collection. Data were analyzed using IBM SPSS version 25.0. Results: The participants' average age was 62.94 ± 6.33 years. 79 (42.7%) participants reported light pain, 82 (44.3%) reported moderate pain, and 24 (14.0%) reported severe pain. The mean and standard deviation of pain is 4.62 ± 2.08 and quality of life is 61.05 ± 15.16. The results showed a moderately negative correlation (r = -0.482, p=0.000) between pain and quality of life, demonstrating that there is a substantial decrease in quality of life with increasing pain levels. Conclusions: This study demonstrates that a significant percentage of individuals following total knee replacement have moderate to severe post-surgical pain. The findings indicate a clear relationship between higher pain levels and a decrease in quality of life.
Early Blood Pressure Changes in Neonatal Sepsis and the Risk of Mortality
Authors: Ali Kamran , Haque Tayyaba , Bahalkani Ubedullah , Bhanbhro Bakhtiar Ahmed , Bharo Mumtaz Ali , Ali Faiza Kamran
Published: December 2024

Neonatal sepsis is an increasingly common cause of mortality and morbidity in newborns, with hemodynamic abnormalities impacting prognosis. Objectives: To evaluate the relationship between blood pressure levels and in-hospital mortality rate in newborns with sepsis.  Methods: The comparative cross-sectional study was conducted for six months from August 2023 to January 2024 at the Department in the Neonatal Intensive Care Unit of Khairpur Medical College to Khairpur Mir’s Medical College Teaching Hospital. The total number of participants was n=300 (n=150 participants per group). Blood pressure was monitored at three different periods: 0-24 hours, 24-48 hours, and 48-72 hours. Data were analyzed using t-test independent, chi-square and multivariable logistic regression to assess the association between blood pressure parameters and in-hospital mortality. Results: Our findings indicated that lower systolic, diastolic, and mean blood pressures at all measured time points were closely linked to higher mortality rates in newborns. At 72 hours, culture-positive infants had a median systolic blood pressure of 64 mmHg, while those with clinical signs had a median of 70 mmHg (p=0.008). Each unit's reduction in blood pressure corresponded to a significant increase in the risk of death. Conclusions: It was concluded that neonates with sepsis had lower mean, diastolic, and systolic blood pressures have a higher mortality rate in hospitals which shows that sepsis with positive culture has a higher risk of severe hemodynamic instability when compared to sepsis with clinical signs.
Immuno-Histochemical Analysis of PDGFRβ in OSCC: Clinical Significance and Prospects for Targeted Therapy
Authors: Rabbani Sarah , Rehman Aman ur , Anjum Rabia , Khan Nauman Rauf , Chudhary Saima
Published: December 2024

The most prominent and key cells in cancer development are fibroblasts, known as cancer-associated fibroblasts. Limited data available on Head and Neck Cancer showed the presence of platelet-derived growth factor receptor beta as the most prevalent marker. Furthermore, therapies can be targeted against this receptor for the treatment of cancer. Objectives: To evaluate the expression of Platelet-derived growth factor receptor beta as a specific marker of cancer-associated fibroblasts in different grades of oral squamous cell carcinoma through immunohistochemistry. Methods: This descriptive study included 51 cases of squamous cell carcinoma of the head and neck region.  Platelet-derived growth factor receptor beta expression was assessed based on the extent and intensity of immune-labelling in a tumor. SPSS was used to determine the association between the grade of tumor and Platelet-derived growth factor receptor beta expression. Results: Mean age was found as 53.65 + 17.15 years and there were 30 (58.8%) male and 21 (41.2%) female. The most commonly affected sites were glottis and supra-glottis areas accounting for 18.9% of total cases followed by the tongue which accounts for 13.2% of cases.  The majority of the patients 34 (66.7%) patients had an intermediate grade of squamous cell carcinoma. In most cases, the degree of staining was strongest, with intermediate-grade tumors exhibiting the highest platelet-derived growth factor receptor beta staining. Conclusions: It was concluded that platelet-derived growth factor receptor beta emerges as a promising tumor marker in head and
Clinical and Demographic Factors Associated with Preterm Labor in Twin Pregnancies at Mardan Medical Complex
Authors: Sumaira . , Qayyum Sumera , Adil Aimen , Sarwar Sadaf , Bibi Noushad , Khan Sara Jamil
Published: December 2024

Twin pregnancies (TP) were often associated with preterm labor due to excessive dilation of the endometrium. Most twin pregnancies result in delivery before 37 weeks of gestation. In this study, which did not focus on cervical selection, the average pregnancy duration was 35.83 ± 8.7 weeks, with 50% of the babies delivered before 37 weeks. Objective: To figure out how frequently twin pregnancies that present at Mardan Medical Complex, Mardan, result in preterm labor. Methods: This descriptive case series was conducted over six months, from January 1st, 2022, to June 30th, 2022, in the Obstetrics and Gynaecology Department of Mardan Medical Complex. The study included 98 women pregnant with twins, and each was followed up until 36 weeks of pregnancy. Data analysis was performed using SPSS version 23.0. Results: There was a significant association between preterm labor and maternal weight. Women weighing 70 kg or less had a higher rate of preterm labor (55.7%) compared to those weighing more than 70 kg (35.1%) with a p-value of 0.048. Preterm labor occurred in 49.2% of women aged 18-30 years and 45.5% of those over 30 years (p=0.724). Conclusions: Maternal weight appears to be a key factor in the risk of preterm labor. Future studies should investigate the impact of weight on preterm labor and explore weight management interventions as part of antenatal care.
Evaluation of Platelet Indices and Sepsis Markers in Neonates with Different Types of Sepsis
Authors: Arshad Hira , Latif Tanveer , Usman Muhammad
Published: December 2024

Sepsis in neonates was the main reason for morbidity and mortality globally, primarily in developing countries. The World Health Organization (WHO) approximates that sepsis affects approximately 3 million neonates annually, causing about 750,000 deaths. Platelet indices such as Platelet Crit distribution width (PCT), Platelet Width Volume (PWV), and Mean Platelet Distribution (MPD) were considered major biomarkers for diagnosis. Objective: To evaluate the alterations in platelet indices and septic markers (CRP) in neonates with sepsis as compared to established reference values. Methods: This cross-sectional study was conducted at the Department of Hematology and Transfusion Medicine in the Children's Hospital and University of Child Health Sciences, Lahore, from November 2023 to February 2024. 57 neonates of the Neonatal Intensive Care Unit (ICU) were sampled. Platelet indices, including PCT, PDW, MPV, and C-reactive protein (CRP), were measured using automated hematology analyzers. Data were analyzed by using SPSS V-23.0. One sample T-test was used to compare the means with the reference value. Results: The mean platelet count was significantly lower. MPV and PDW were significantly elevated in neonates with sepsis compared to the reference value, while PCT was considerably lower. CRP levels were significantly elevated in neonates with sepsis. Conclusions: This study concluded that platelet indices and CRP levels were valued biomarkers for diagnosing and treating neonatal sepsis. These well-established inflammatory markers suggest a strong systemic inflammatory response typically associated with sepsis.
Knowledge and Preparedness Regarding Chemical, Biological, Radiological and Nuclear (CBRN) Warfare among Doctors and Medical Students at Combined Military Hospital (CMH) Lahore Medical College
Authors: Rahman Fariha , Shakoor Fatima , Raza Tahira , Sher Gull , Aziz Bushra
Published: December 2024

Chemical, biological, radiological and nuclear-related disasters have become increasingly common all around the world. Objectives: To assess the knowledge and preparedness regarding chemical, biological, radiological and nuclear Warfare among Doctors and Medical students at Combined Military Hospital Lahore Medical College. Methods: In this descriptive cross-sectional study, 311 respondents participated from November 2022 to May 2023. Non-probability convenience sampling technique was used. Data were analyzed on SPSS version 26.0. Results: The study revealed a significant knowledge gap regarding chemical, biological, radiological and nuclear warfare. Almost 290 participants had never encountered the term 'chemical, biological, radiological and nuclear' signifying a substantial lack of awareness. Furthermore, a slightly higher knowledge gap was observed among female participants, although this difference did not reach statistical significance (p-value=0.07). Additionally, students in their 3rd, 4th, and final years of medical college demonstrated a more comprehensive understanding of chemical, biological, radiological and nuclear compared to those in their initial years of study (p-value=0.008). Conclusions: It was concluded that there is a significant knowledge gap about chemical, biological, radiological and nuclear Warfare and its management among medical professionals. A very low percentage of professionals were properly trained in chemical, biological, radiological and nuclear emergency management. Respondents stressed the inclusion of chemical, biological, radiological and nuclear emergency management training in the curriculum. These findings suggest that proper provision of knowledge, and training related to these disasters is inevitable for timely management and future risk reduction from such events.
Types of Inherited Hemoglobin Disorders among the Patients Attending a Tertiary Care Hospital
Authors: Anwar Rehan , Arzoo Kamran , Riaz Adnan , Ali Riasat , Saghir Sumera , Habib Bilal
Published: December 2024

The genetic conditions known as hemoglobinopathies, which include thalassemia impact the synthesis and structure of Hemoglobin, the red blood cell protein that carries oxygen. Objectives: To investigate the prevalence of different types of thalassemia associated with age, gender and Hematological parameters. Methods: The total number of participants was n=139. The cross-sectional study was conducted at Rai Medical College Sargodha. The study was conducted for six months, from July 2023 to Dec 2023. Biochemical parameters investigated such as Hemoglobin, mean corpuscular hemoglobin MCH, reticulocyte and ferritin were done in the Hematology lab. Collected data were analyzed by SPSS version 25.0. Results: The gender distribution among the participants included male 50.3% and female 49.6%.  The mean age of the patients was approximately 34.8 years. This study of 139 participants found Hb-E Beta Thalassemia (25.4%) to be the most common type, especially among those with a history of cousin marriage. Severe forms like Hb-E Beta Thalassemia and Beta Thalassemia Major had low hemoglobin and MCH levels, indicating severe anemia, while milder forms showed near-normal levels. In mean corpuscular Hemoglobin E Beta Thalassemia (29.7 ± 4.1), p=0.001, mean corpuscular Hemoglobin A levels are considerably lower than Beta Thalassemia Trait. There was no association with age and gender, p>0.005. Conclusions: It was concluded that our investigation offered important insights into the biochemical profiles linked to various thalassemia types, even though it did not identify any appreciable variations in thalassemia prevalence by age or gender.
Ankle-Brachial Index as a Predictor of Peripheral Arterial Disease in Newly Diagnosed Hypertensive Patients
Authors: Pervez Safdar Ali , Channa Munir Ahmed , Kumar Mahesh , Phulpoto Abdul Hayee , Memon Abdul Qayoom , Aziz Asif
Published: December 2024

Hypertension was a major risk factor for cardiovascular disorder including Peripheral Arterial Disease (PAD). Objective: To evaluate the risk of Peripheral Arterial Disease (PAD) in newly diagnosed hypertensive patients using Ankle-Brachial Index (ABI) measurements and to determine its potential role as a predictor of cardiovascular risks in this population. Methods: The study was an observational, cross-sectional study. This study was conducted in Khairpur Medical College Civil Hospital Khairpur Mirs. The duration of this study was six months, from November 2023 to April 2024This study include n= 246 newly diagnosed hypertension. Three levels of ABI had been identified through determining the ABI in both legs: low ABI (<0.9), normal ABI (0.9-1.4), and high ABI (>1.4).  Student’s t-test. Pearson correlation test have been utilized when assessing the significance of the association between ABI levels and blood pressure values. Results: ABI was normal in 60% of the 246 participants, low in 20% and high in 20% of them. In comparison to those who had normal and high ABI, participants who had low ABI showed considerably higher SBP in both lower limbs (p < 0.001). Furthermore, there was additionally a significant distinction (p < 0.001) in the SBP and DBP among people who had high ABI. Participants with average ABI had higher SBP in their right upper limb than those who suffered from elevated ABI (p < 0.001). Conclusion: This study showed that in individuals who have recently identified high blood pressure, there was a significant relationship among ABI levels and arterial pressure levels.
Association of Bacterial Vaginosis with Preterm Labour in Pregnant Women
Authors: Qamar Ayesha , Aziz Moizza , Riffat Najia , Tehseen Saema , Yaqoob Shagufta , Zaheer Fareeha
Published: December 2024

Bacterial Vaginosis (BV) was a common vaginal infection associated with adverse pregnancy outcomes, including premature birth. Objective: To evaluate the association between the BV and the risk of preterm Labor in pregnant women and to assess whether BV prevalence differs based on obstetric history, including parity and prior delivery outcomes. Methods: This case-control study was conducted in the Obstetrics and Gynecology Department at PAF Hospital Mushaf, Sargodha, from July 2022 to January 2023. A total of 130 participants were included in the study. BV was diagnosed using laboratory and diagnostic methods. Participants were enrolled using non-probability consecutive sampling. Data were analyzed using SPSS version 21.0. Chi-square tests and odds ratios were employed to assess the association between bacterial vaginosis and variables such as age, gravida, and history of preterm delivery, with a p-value ≤ 0.05 considered statistically significant. Results: The mean age of the participants was 25.32±6.8 years. Parity also had a notable impact, with multiparous women showing a significantly higher prevalence of BV (46.2%) compared to controls (18.2%), with an OR of 3.86; P=0.006. However, the difference among primiparous women was insignificant (P=0.477, OR=1.56). Women with no prior delivery history had a higher BV prevalence in the case group, 41.5%, compared to the control group, 20.0%, with an OR of 2.83; P=0.130. Conclusions: Bacterial vaginosis was significantly associated with older maternal age and multiparity, but no strong correlation was found with previous preterm delivery. Timely diagnosis and management of BV may help reduce the risk of preterm labor.
Neuropharmacology of Fisetin as a Senotherapeutic Agent: Investigating Its Role in Neurodegeneration and Brain Aging
Authors: Javaid Sidra , Memon Abeer , Anwar Binish , Bader Zarafshan , Aftab Ayesha , Perveen Fouzia , Haq Ehsan Ul
Published: December 2024

Fisetin, a flavonoid in various fruits and vegetables, has emerged as a promising chemotherapeutic agent with potential neuroprotective effects, particularly in neurodegeneration and brain aging. Objective: To explore the role of fisetin in mitigating age-related neuronal damage by targeting oxidative stress, inflammation, and cellular senescence, common contributors to neurodegenerative diseases such as Alzheimer's and Parkinson's. Methods: Following PRISMA guidelines, relevant studies were sourced from ScienceDirect, Google Scholar, and PubMed, spanning publications between April 2014 and August 2024. One website was also used to retrieve studies, i.e., Frontiers. Fisetin's mechanism of action includes modulating key pathways, such as the inhibition of inflammatory markers, reduction of Reactive Oxygen Species (ROS), and protection against neuronal apoptosis. Results: Studies conducted on various animal models and human-derived neurodegenerative cell lines reveal its potential to improve cognitive function and reduce the progression of age-related brain disorders. Conclusions: Fisetin's ability to selectively target senescent cells, reduce neuroinflammation, and enhance synaptic function positions it as a potential therapeutic for brain aging. Future research focusing on clinical trials and dosing optimization was crucial to establishing fisetin as a viable treatment for neurodegenerative conditions and cognitive decline associated with aging.
Forensic Analysis of Injury Patterns among Occupants in Fatal Motor Vehicle Accidents in Karachi, Pakistan
Authors: Waheed Abdul , Alam Syed Perwez , Ram Hari , Qayyum Sadia Abdul , Khan Farzana Azam , Khan Iqbal Ahmed
Published: December 2024

Drivers and passengers in Motor Vehicle Accidents (MVAs) may sustain a wide range of injuries. Objective: To investigate the patterns of injuries and factors responsible for differences between drivers and passengers in fatal motor vehicle accidents in Karachi, Sindh. Methods: Retrospective study was conducted carried out from 2nd July 2022 to 30th June 2024 by Department of Forensic medicine and Toxicology, Karachi Institute of Medical Sciences, Karachi. All victims involving drivers and passenger’s road traffic accidents fatalities, belongs to either gender, of any age from three major tertiary care hospitals in Karachi, Sindh were investigated and evaluated. Incomplete information, those of other fatalities and pedestrian related data were excluded. Results: Most (70.8%) were drivers, 20.0% were front-seat passengers, and 9.2% were rear-seat passengers. Over two-third, 80.5% died within one hour after the crash whereas, majority, 67.3% of the deaths occurred in front crashes, 13.7% in near edge hits, 13.5% in rollovers, and 5.5% in other accidents. Fatal injuries to the abdomen, thorax, head, and neck in 63.6%, 10.7%, 61.6%, and 27.4% of cases, respectively. Compared to drivers, those in the front seats experienced less heart and spleen traumas. In comparison to drivers, passengers in the front and back seats experienced a higher frequency of seat belt abrasions and a lower frequency of fractures to the extremities. Conclusion: The findings revealed significant differences in the types and frequency of injuries between drivers and passengers, highlighting the greater vulnerability of drivers to severe abdominal and head injuries.
Association between Clinical Manifestations and Candida Carriage in Patients with Oral Sub-Mucous Fibrosis
Authors: Zain-Ul Abedeen Muhammad , Rafiq Muhammad Talal , Kanju Abid Hussain , Liaqat Sahrish , Abi Waqas Muhammad , Riaz Muhammad Mashood
Published: December 2024

A chronic, progressive disorder known as oral sub-mucous fibrosis causes the oral mucosa to become inflamed and fibrotic, which limits mouth opening, causes a burning sensation, and reduces salivary flow. Objectives: To assess the relationship between candida carriage in oral sub-mucous fibrosis patients and demographic traits, tobacco use, and clinical parameters such as burning sensation, salivary flow rate, and mouth opening. Methods: A comparative cross-sectional study was conducted from May 2024 to Oct 2024. This study was conducted in Multan Medical and Dental College. The total number of patients was 384 divided into 192 with oral sub-mucous fibrosis and 192 control participants split into groups with and without risk exposure. Clinical characteristics such as mouth opening, salivary flow rate, and burning sensation (measured using a visual analogue scale) were evaluated. Data were analyzed with descriptive, mean, Post Hoc analysis, and Chi‑square tests. Results: Comparing the oral sub-mucous fibrosis positive group (93%) to the negative group (7%), the oral sub-mucous fibrosis group had a considerably greater prevalence of candida carriage. Reduced salivary flow rate (≤0.2 ml/min), restricted mouth opening (≤20 mm), and severe burning sensation (3-5 (Visual Analogue Scale)) were shown to be strongly correlated with candida positivity (p<0.001). A greater prevalence of candida colonization was also seen in patients who used tobacco more frequently (p<0.001). Conclusions: It was concluded that comprehensive treatment methods should include patient education on oral hygiene and quitting smoking, given the major impact that these behaviours play in candida's carriage.
Exploring the Effectiveness of Guided Tissue Regeneration Techniques in Periodontal Disease Treatment and Its Long-Term Effects on Patients
Authors: Imtiaz Ayesha , Sadiq Rabia , Tasleem Farah , Rashid Usman , Saif Sarmad , Amir Malyla , Hussain Muhammad
Published: December 2024

Periodontal disease is a bacterial infection that affects gums, alveolar bone and periodontal ligaments. An innovative approach to treat such infections is guided tissue regeneration which helps in the regeneration of tissues which are lost by this disease. Objectives: To assess the appropriateness of guided tissue regeneration procedures in periodontal management and evaluate the clinical benefits for patients. Methods: An intensive review of literature was made using PubMed, Science Direct and Google Scholar, by considering articles published between 2020-2024. Some of the analysed works investigated the effectiveness of guided tissue regeneration techniques as compared to other traditional methods of periodontal treatment. The parameters that have been evaluated include tissue repair, decrease in periodontal pocketing, gain in clinical attachment, and the aesthetic crown height index. The studies have been sourced from America, Europe and Asia. Results: Results from the studies highlight the efficacy of guided tissue regeneration techniques in the tissue repair process. It significantly highlights the improvements in dental attachment levels, long-term periodontal health and pocket reduction. However, variation in patients and their specified underlying conditions remain. Conclusions: It was concluded that guided tissue regeneration appears to provide an effective line of treatment for periodontal disease with the prediction of long-term therapeutic outcomes. Further studies should be carried out to enhance the properties of guided tissue regeneration materials and application methods to obtain more consistent results.
Prevalence of Hyperprolactinemia in Patients Undergoing Long-Term Proton Pump Inhibitor Therapy
Authors: Zubair Muhammad , Amil Javaria , Noureen Sadia , Ikram Ul Haq Muhammad , Azmat Saddiqa , Majeed Sadia
Published: December 2024

Proton pump inhibitors used to treat gastrointestinal disorders cause various threatening effects and lead to an increase in serum prolactin levels. Objectives: To evaluate serum prolactin and macroprolactin levels in long-term proton pump inhibitor therapy patients. Method: An observational cross-sectional study was done between February 2023 and June 2024, at Niazi Welfare Foundation Teaching Hospital, Sargodha after approval from the institutional review board. Patients of either gender using proton pump inhibitors for ≥3 months, alone or in combination with histamine 2 receptor antagonists or pro-kinetics were included to measure serum prolactin levels. A duration of >3 months was taken as long-term therapy to see the impact on prolactin levels. The data were analyzed using SPSS version 25.0. Results: Out of the 166 patients, 102 (61.4%) were female, and 64 (38.6%) were male. The patient's mean age was 42.6 ± 14.3 years, and serum prolactin level was 23.2ng/mL. Among the participants, 97 (58.4%) had normoprolactinemia, while 69 (41.6%) had hyperprolactinemia. A significant increase in hyperprolactinemia with longer proton pump inhibitor treatment duration was revealed. Conclusions: It was concluded that prolonged use of proton pump inhibitors has the potential to raise serum prolactin levels, highlighting the importance of thorough evaluation for optimal clinical management.