The Professional Medical Journal

Protective effects of natural products in neurodegeneration: A narrative review.

2025-10-18T06:18:41-07:00

This systematic review aims to analyze published studies from databases such as PUBMED, Google Scholar and Research Gate, while focusing on the role of bioactive components found in the natural medicinal products in Grape, Honey, Pomegranate juice and Moringa Oleifera in neuroprotection. The literature search was done from 2019 till 2025 with key words of natural products, neuroprotections and neurodegeneration and more than 50 full articles were included. This review highlights the therapeutic potential of natural products and their bioactive compounds in providing neuroprotective effects against the pathologies associated with neurodegenerative diseases. Neurodegenerative diseases of the nervous system manifested through various syndromes, with progressive dementia being the predominant symptom in mostly cases. The bioactive compounds include vitamins, minerals, carotenoids, polyunsaturated fatty acids, and polyphenols, alkaloids, and some other compounds found, will be the primary focus of this document. This document provides the evidence basis to determine the nutritional benefits of these medicinal products in improving the health and well-being of various groups.

Comparison of efficacy of subconjunctival bevacizumab and diathermy cauterization in corneal neovascularization.

2025-10-01T03:52:07-07:00

Objective: To compare the efficacy of subconjunctival bevacizumab injection vs diathermy cautery in treatment of corneal neovascularization. Setting: Eye Unit-3, Institute of Ophthalmology, Mayo Hospital, Lahore. Period: September’24 to February'25. Methods: A total of 100 patients with superficial CNV were randomized into two equal groups. Group A received a single subconjunctival injection of bevacizumab (2.5 mg/0.1 mL)., while Group B received diathermy cauterization Efficacy was defined as ≥50% regression of neovessels after 4 weeks. Visual acuity, complication rates, and demographic variables were analyzed using appropriate statistical tests. Results: Efficacy was significantly higher in the bevacizumab group (48.0%) compared to the Diathermy group (24.0%) (p = 0.012). Complication rates were lower in the bevacizumab group (14.0%) than in the diathermy group (28.0%), though not statistically significant. Subgroup analysis revealed higher efficacy in females treated with bevacizumab (50.0%) versus diathermy (16.7%, p = 0.021). Conclusion: Subconjunctival bevacizumab is more effective and safer than Diathermy cauterization for the treatment of superficial corneal neovascularization. It offers a practical solution and may be considered the preferred first-line option in similar clinical scenarios.

Comparison of outcome of single versus double Dartos layer for preventing fistula in Tubularized incised plate repair of distal hypospadias.

2025-12-27T06:04:01-08:00

Objective: To compare urethrocutaneous fistula rates between single and double Dartos flap coverage in TIP urethroplasty for distal hypospadias. Study Design: Parallel-group, Randomized Controlled trial. Setting: The Children’s Hospital and Institute of Child Health in Lahore. Period: 01-01-2021 to 12-03-2022. Methods: Out of 150 boys with distal hypospadias, the requisite inclusion & exclusion criteria were applied and 150 were assigned to 2 equal (n=75) groups, with randomization. Group A had TIP repair with single Dartos layer coverage, while Group B had double Dartos layer coverage. Postoperative care was standardized in all groups and included 5 days of IV antibiotics and catheter removal on postoperative day 10. 1, 2, 4, 12, 24, 36 and 54 week follow up were conducted. The main measure of success was the formation of urethrocutaneous fistula. Results: In the single Dartos group, 12% developed fistulas, compared with 4% in the double Dartos group, showing a clinically significant trend in favor of double-layer coverage. Conclusion: Double Dartos flap coverage in distal hypospadias repair seems to decrease the risk of urethrocutaneous fistula formation in comparison to single-layer coverage.

Efficacy and safety of sertaconazole 2% in the treatment of dermatophytosis.

2025-11-17T06:45:44-08:00

Objective: To determine the efficacy and safety of sertaconazole 2% cream in patients with dermatophytosis. Study Design: Descriptive Case Series. Setting: Department of Dermatology, Shalamar Hospital, Lahore. Period: September 2024 to February 2025. Methods: A total of 131 patients aged 18–70 years with a clinical diagnosis of dermatophytosis were enrolled via non-probability consecutive sampling. Patients applied sertaconazole 2% cream twice daily for four weeks. Efficacy was assessed using a Clinical Assessment Score (CAS) for erythema, pruritus, and scaling, with a complete cure defined as a CAS of 0. Safety was evaluated by monitoring for adverse events. Data were analyzed using SPSS version 26. Results: The mean age of participants was 36.7 ± 11.2 years, with a male predominance (58.8%). Complete clinical cure was achieved in 90 patients (68.7%). A significant reduction was observed in all CAS parameters, with the highest mean reduction in pruritus (−2.3). Efficacy was significantly higher in patients with a disease duration of ≤4 weeks (75.5% vs. 48.5%, p=0.03) and in those with a normal BMI (77.0% vs. 57.9%, p=0.04). Adverse effects, primarily mild pruritus, were reported in only 7 patients (5.3%). Conclusion: Sertaconazole 2% cream is an effective and well-tolerated treatment for dermatophytosis, demonstrating high cure rates and a favorable safety profile. It is particularly effective when initiated early in patients with a normal body mass index.

Frequency of hypomagnesemia in patients presenting with acute coronary syndrome.

2026-03-27T04:47:22-07:00

Objective: To assess the rate of hypomagnesemia in patients presenting with ACS in a local population. Study Design: Cross Sectional Descriptive study. Setting: Faisalabad Institute of Cardiology (FIC), Faisalabad. Period: 17^th January 2022 to 16^th July 2022 (six months). Methods: Nonprobability consecutive sampling was used to enroll 185 ACS patients, aged 35–80 years. Excluded patients were those on diuretics, alcoholics or with malabsorption. Hypomagnesemia was defined as serum magnesium levels below normal range (1.7 to 2.5 mg/dl) and were measured in all patients. Chi square tests were used to explore the relationships of the data through SPSS version 21. Results: A total of 185 patients (mean age 57.67±10.70 years, 65.4% male) had a mean serum magnesium level of (1.81±0.31 mg/dl). Out of 185 patients, hypomagnesemia was seen in 34 (18.4%) patients. Prevalence was 21.1% in unstable angina, 15.4% in STEMI, and 20.3% in NSTEMI, with no significant association (p=0.665, across ACS types). No significant correlation was seen between hypomagnesemia and age, gender, and BMI (p>0.05). Conclusion: Hypomagnesemia was seen in (18.4%) of ACS patients, and no significant correlation was seen with demographic or clinical characteristics. Hypomagnesemia in ACS patients merits routine screening to help identify high-risk individuals so that management strategies can be guided.

Accuracy of Alberta stroke program early computed tomography score (aspects) as a predictor of outcomes in acute ischemic stroke patients.

2026-02-17T03:40:01-08:00

Objective: To evaluate the diagnostic accuracy of ASPECTS in determining the outcomes (good versus poor) among AIS patients by taking Modified Rankin Score (MRS) as gold standard. Study Design: Validation study. Setting: Department of Radiology, Shifa International Hospital, Islamabad. Period: July 2025 to November 2025. Methods: A total of 646 patients aged 18–65 years with middle cerebral artery territory acute ischemic stroke who underwent NCCT within two days of symptom onset were included using consecutive sampling. ASPECTS was calculated on NCCT and categorized as good (8–10) or poor (0–7). Functional outcome was assessed at discharge using the modified Rankin Scale, classified as good (0–3) or poor (4–6). DA parameters including sensitivity, specificity, PPV, NPV, and receiver operating characteristic (ROC) curve analysis were calculated using SPSS version 25. Results: Out of 646 patients, 53.3% had good ASPECTS scores, while 63.3% achieved good functional outcomes. Using an ASPECTS cutoff of ≥8, sensitivity was 73.1%, specificity 81.0%, PPV 86.9%, and NPV 63.6%. The overall diagnostic accuracy was 76.0%. The area under the ROC curve was 0.79, indicating good discriminative ability of ASPECTS in predicting functional outcomes. Conclusion: ASPECTS is a reliable and clinically useful imaging tool for early prediction of functional outcomes in acute ischemic stroke. Its good diagnostic accuracy, ease of application, and reliance on widely available NCCT make it particularly valuable for early stroke assessment, especially in resource-limited settings.

Coronary artery disease in patients undergoing coronary angiography pre-valve surgery.

2025-12-18T02:46:44-08:00

Objective: This study aimed to determine the incidence of CAD in patients undergoing coronary angiography prior to valve surgery and identify associated risk factors. Study Design: Retrospective study. Setting: Conducted on patients who underwent coronary angiography before valve surgery. Period: 1^st January 2022 to 31^st December 2024. Methods: CAD was defined as ≥50% stenosis in a major coronary artery. Demographic, clinical, and angiographic data were analyzed using SPSS version 22. Results: Among 80 patients, (07)8.8% had significant CAD, with higher prevalence in patients with mitral valve disease. The most commonly affected vessel was left circumflex artery. Risk factors such as hypertension (HTN), diabetes mellitus (DM), and smoking were significantly associated with CAD. Conclusion: A substantial proportion of patients scheduled for valve surgery have concomitant CAD, emphasizing the need for routine preoperative angiography. Risk stratification based on clinical factors may help identify high-risk patients.

Plica Palatine: A multicentric morphometric odonatological analysis for gender and age groups in Karachi, Pakistan.

2026-01-13T03:10:22-08:00

Objective: To analyze age groups and gender-related rugoscopic morphometric analysis in our population and compare it with other nations. Study Design: Cross-Sectional Study. Setting: FJDC, DIDC and AIDM. Period: March 2024 to Aug 2024. Methods: With ERB approval (letter no: MAR-2024-SUR01 from FJDC scientific and ethical review board, dated 17^th March 2024) and sample size calculated with WHO sample size estimation calculator, 456 participants with defined criteria were enrolled with convenience sampling. After written informed consent, jaw imprints of the subjects were engaged using Alginate and cast to measure the length and analyze the shape with Thomas classification and pattern of palatine rugae as documented by Kapali. Data was collected on a predesigned form and was further analyzed by SPSS 24 for descriptive and inferential statistics. Results: The most common pattern of rugae observed in our study was wavy. Significantly longer primary rugae were seen on the right side in the 41–60-year age group (p=0.02). Fragmentary rugae were significantly longer in females on the both, right (p=0.002) and on the left side (p=0.001) of the palate. When the mean results were compared to the other nations, our population has significantly longer rugae compared to statistics from Saudia, Iran, Lebanon and Sudan in contrast, similar rugae lengths were observed in the Indian Population. Conclusion: The palatine rugae are longer with mostly wavy patterns in our population. Furthermore, the 41–60-year-old age group has the longest primary rugae and the female gender has longer fragmentary rugae.

Comparison of outcomes of early vs delayed cholecystectomy in acute biliary pancreatitis at a tertiary care hospital.

2025-10-21T06:00:56-07:00

Objective: To compare the mean length of hospital stay and frequency of conversion from laparoscopic to open in early versus delayed cholecystectomy in patients with moderate acute biliary pancreatitis. Study Design: Randomized Clinical Trial. Setting: Department of Surgery in Mayo Hospital Lahore. Period: 02-04-2022 to 02-04-2023. Methods: All the patients meeting the required criteria were included in the study. Patients were admitted through surgical emergency. Procedure was explained to patients/guardian and informed consent was taken. Patients were randomized by lottery method into two groups. Group A (early cholecystectomy EC) and group B (delayed cholecystectomy DC). Patients were operated and assessed postoperatively by the same operating surgeon to minimize the bias. Data of these patients was collected using a predesigned pro-forma containing details about demographic profile of the patient and severity of the disease. Duration of hospital stay of every patient in each group will be recorded. Frequency of conversion from laparoscopic to open cholecystectomy was noted. Smoking and BMI was taken as confounders. Results: Total of 60 patients (30 in each), mean age of EC group was 45.33±3.79 years and mean age of DC group 46.60±4.14 years. Distribution of BMI was 25.41+ 3.66 kg/m2 in early cholecystectomy group and 29.68+6.53 in delayed cholecystectomy group. (p=0.003) There were 52.0% (n=13) male in EC group and 48.6% (n=17) females in EC group and 48.0% (n=12) male in DC group and 51.4% (n=18) females. (p= 1.000). Mean length of hospital stay was 5.36+ 0.76 days in early cholecystectomy group and 8.96+0.76 days in delayed cholecystectomy group. (p=0.000), 22.2% (n=4) had conversion to open cholecystectomy in EC group and 77.8% (n=14) in DC group. Conclusion: We concluded that early laparoscopic cholecystectomy reduced the hospital stay and conversion to open cholecystectomy in patients with moderate acute biliary pancreatitis.

Comparison of the hemodynamic parameters of magnesium sulphate versus control group receiving normal saline in patients undergoing laparoscopic cholecystectomy using carbon dioxide pneumoperitoneum.

2026-02-11T03:18:49-08:00

Objective: To compare the haemodynamic parameters between magnesium sulphate and control group (experiencing laparoscopic cholecystectomy using carbon dioxide pneumoperitoneum) with normal saline. Study Design: Quasi-Experimental Study. Setting: Department of Anesthesia CMH Lahore. Period: 16-05-2025 to 16-11-2025. Methods: The sample size was 60 (30 in each group) patients aged between 18 and 50 years old who were ASA II or I, and underwent an elective laparoscopic cholecystectomy. Group A received intravenous magnesium sulphate (30 mg/Kg in 100 ml saline), and Group B received 100 ml of normal saline. Haemodynamic parameters were measured at premedication, postmedication at baseline, and at different periods during the operation, until the removal of the tube (HR and MAP). The SPSS 25.0 was applied to analyze the data; an independent sample t-test was applied with a p-value of less or equal to 0.05. Results: The gender distributions were the same in both groups; 40.0% of the members of Group A were male and 36.7 were female. In the Group B, the percentages were 60.0 and 63.3. The baseline of Group B of 99.0 ± 7.7 mmHg of the mean artery pressure (MAP) was similar to Group A 98.2 ± 7.4 mmHg (p = 0.64). After premedication, the MAP in group A was significantly lower (93.4 ± 6.9 vs. 97.8 ± 7.1 mmHg; p = 0.01) and this lower MAP continued to be observed during all the great periods. Group A recorded a mean arterial pressure (MAP) of 100.5 ± 7.8 mmHg after intubation and Group B reported a 112.6 ± 8.3 mmHg mean arterial pressure (MAP) (p < 0.001). All the differences, p-value (less than 0.001), were preceded by pneumoperitoneum (98.8 ± 7.6 vs. 110.2 ± 8.0 mmHg), 10 minutes (97.3 ± 7.2 vs. 109.3 ± 7.8 mmHg), 30 minutes (94.5 ± 6.6 vs. 105.8 ± 7.3 mmHg), and after extubation (92.3 ± 6.0 vs. 101.8 ± 6.8 mmHg). Conclusion: The perioperative hemodynamic stability of laparoscopic cholecystectomy is enhanced by the magnesium sulphate, which prevents the increase in heart rate and mean arterial pressure.

Advance laparoscopy in minimal resource settings of Brig Shafique Ahmed Khan Niazi Memorial Trust Hospital, Bhakkar.

2023-09-23T07:13:51-07:00

Objective: To share our experience of performing basic and advance laparoscopic procedures with minimal resources in a small trust hospital of Bhakkar. Study Design: Retrospective study. Setting: Brig Shafique Ahmed Khan Niazi Memorial Trust Hospital, Bhakkar. Period: 19^th April, 2020 to 11^th February, 2022. Methods: No new intervention was done. On admission to hospital, an informed consent was taken. Another informed consent prior to surgery was taken as well. All the cases were done by a single surgical team. All the procedures were done according to proper guidelines and regulations. Procedures were again divided into basic and advance laparoscopic procedures. Laparoscopic cholecystectomy, laparoscopic appendectomy and diagnostic laparoscopy were considered as basic laparoscopic procedures. All others were classified as advance ones. Types of procedure, conversion to open surgery, complications and outcomes were recorded. Results: In 22 months duration total 1152 laparoscopic surgeries were performed at Brig Shafique Ahmed Khan Niazi Memorial Trust Hospital, Bhakkar. About 752 were basic and 400 were advance. About 12 procedures were converted to open. The complication rate recorded was about 2%. Conclusion: Advance laparoscopic procedures can be safely performed in trust hospitals of lower middle income countries with limited resources.

Assessing diagnostic precision of the modified Alvarado score using histopathology as benchmark.

2026-01-14T03:56:17-08:00

Objective: Acute appendicitis (AA) represents a frequent surgical emergency necessitating timely identification and intervention to avoid adverse outcomes. While appendectomy is the standard care, inappropriate clinical diagnosis leads to unnecessary surgeries. The Modified Alvarado Scoring System (MAS) offers a simplified tool to diagnose the entity clinically. Study Design: Cross-sectional Project. Setting: Ayub Teaching Hospital, Abbottabad. Period: 1^st June 2022 to 11^th December 2022. Methods: A total of 185 patients aged 12–90 yrs. with suspected AA who underwent emergency appendectomy were studied. MAS was calculated at admission, and diagnosis was confirmed via histopathological analysis of appendectomy specimen. Diagnostic accuracy was inferred by commuting sensitivity, specificity, PPV, and NPV, with stratification by age and gender. Results: MAS diagnosed 54.6% of cases as AA-positive. Histopathology confirmed AA in 80.5% of patients. MAS correctly identified 62.7% of cases. Inferential analysis revealed 50.3% sensitivity, 15.1% specificity, 62.4% PPV, and 33.3% NPV. Sensitivity was higher in males (89.2%) and in the 26–35 age group (75.6%). Conclusion: MAS is an easily applicable practical tool to diagnose AA: especially at score extremes. However, moderate sensitivity and low specificity highlight the continued importance of clinical acumen. A cut-off score >5 may improve diagnostic accuracy in this population, and region-specific thresholds should be considered.

Impact of laparoscopic lens contamination in operation theatre a study on the frequency and duration of lens contamination and commonly utilized to maintain clear vision.

2025-04-04T04:09:48-07:00

Objective: To evaluate the frequency and duration of laparoscopic lens contamination in the operation theatre and assess the effectiveness of commonly used techniques to maintain clear vision. Study Design: Observational study. Setting: Department of Surgical, Ittefaq Hospital, Lahore. Period: August 2023 to January 2024. Methods: A total of 83 laparoscopic procedures were analyzed using a non-probability purposive sampling technique. Data were collected on lens contamination events, time wasted due to impaired vision, and cleaning methods, including antifog solution, warm saline, and organ tapping. Descriptive statistics and comparative analysis were performed using SPSS version 25. Results: The study found that an average of 7.92% of operative time was spent cleaning the lens, with 4.11 contamination events per procedure. Warm saline resulted in fewer contamination events (mean: 3.93) compared to antifog solution (4.96) and organ tapping (4.81), though differences were not statistically significant (p = 0.609). The percentage of time wasted on cleaning was highest with antifog solution (13.30%) and lowest with organ tapping (9.86%), approaching statistical significance (p = 0.051). Conclusion: Laparoscopic lens contamination significantly disrupts surgical efficiency, necessitating frequent cleaning. While no technique showed a statistically significant advantage, warm saline demonstrated a trend toward better clarity maintenance. Further research on advanced cleaning systems is needed to optimize laparoscopic workflow.

Comparison between open and laparoscopic needle repair in pediatric inguinal hernia in terms of operating time and complications.

2026-04-04T05:44:43-07:00

Objective: To compare between open hernia repair and needle-assisted laparoscopic repair in pediatric patients with inguinal hernia in term of operative time and postoperative wound infection. Study Design: Randomized Controlled Trial. Setting: Department of Surgery, Independent University Hospital, Faisalabad. Period: March 2024 to March 2026. Methods: A total of 384 pediatric patients aged 1–13 years diagnosed with inguinal hernia were randomly assigned to Group A (OHR, n=192) or Group B (NALR, n=192). Operative time was recorded from skin incision to closure, and wound infection was assessed during a one-month postoperative follow-up using CDC criteria. Data were analyzed using independent t-tests for operative time and chi-square tests for wound infection, with significance set at p≤0.05. It is done in period of 2 year from March 2024-March 2026, Ethical approval no IUH/IRB/000055 date of approval is 01-01-2025. Results: The mean operative time was significantly shorter in the NALR group (12.87 ± 3.16 min) compared with the OHR group (24.68 ± 4.25 min, p<0.001). Wound infection occurred in 30 patients (7.8%) in the OHR group, whereas no infections were observed in the NALR group (p<0.001). Operative time and infection rates were consistently lower across all demographic and clinical subgroups in the laparoscopic group. Conclusion: Needle-assisted laparoscopic repair offers a safe and efficient alternative to open hernia repair in children, with shorter operative times and reduced postoperative wound complications.

Role of HRCT temporal bone in diagnosis of chronic suppurative otitis media in correlation with intraoperative findings.

2026-01-26T03:06:23-08:00

Objective: To evaluate the role of high-resolution computed tomography (HRCT) of the temporal bone in diagnosing and delineating disease in chronic suppurative otitis media (CSOM) by comparing preoperative HRCT findings. Study Design: Prospective Diagnostic Evaluation study. Setting: Departments of Radiology and Otolaryngology, CMH, Gujranwala, Pakistan. Period: January 2024 to December 2024. Methods: A total of 57 patients aged 1–60 years, clinically diagnosed with CSOM and scheduled for mastoid surgery were analyzed. Patients underwent preoperative HRCT of the temporal bone. Radiological findings were documented and compared with intraoperative observations. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated for each anatomical structure. Results: In a total of 57 patients, the median age was 26.00 years (IQR: 17.50-41.50). There were 38 (66.7%) males and 19 (33.3%) females. HRCT demonstrated 100% sensitivity and specificity for incus, malleus, scutum, stapes suprastructure erosion, sigmoid plate erosion, and jugular bulb dehiscence. Bony external auditory canal erosion showed 80% sensitivity and 100% specificity. Facial canal dehiscence had 50% sensitivity and 100% specificity. Mastoid cortex erosion had high sensitivity (100%) but lower PPV (66.7%), while tegmen erosion had 100% sensitivity and 98.2% specificity. Overall diagnostic concordance was excellent (Cohen’s Kappa=0.935, p<0.001). The McNemar-Bowker test showed no significant discordance between HRCT and surgical findings (p=0.223). Conclusion: HRCT of the temporal bone demonstrated excellent diagnostic accuracy and agreement with surgical findings in evaluating structural changes associated with CSOM.

Diagnostic accuracy of 160-slice CT coronary angiography as compared to invasive coronary angiography keeping invasive coronary angiography as gold standard in patients of coronary artery disease.

2025-10-28T06:23:16-07:00

Objective: To determine diagnostic accuracy of 160 –Slice Computed Tomography (CT) in detection of coronary artery disease in patients with known or suspected coronary artery disease as compared to coronary angiography as a gold standard. Study Design: Cross sectional prospective study. Setting: Tertiary Care Hospital Sargodha. Period: February 2024 to December 2024. Method: The study evaluated 100 patients of both genders with age range of 40 to 80 years, reported with history of angina. The study comprised of patients having known coronary artery disease or suspected coronary artery disease. The patients reported with other cause of chest pain were excluded. Positive angiography was considered to be a significant stenosis of 50 percent or more of lumen diameter. Correlation analysis was used to determine the correlation between Coronary Computed Tomography Angiography (CCTA) and Coronary Invasive Angiography (CIA). Results: 160 – Slice CT was used for 100 patients (70 % male (n=70) and 30 % females (n=30) with mean age 67.4 ± 9.03 years). Oral beta blockers were administered before the scan. Mean interval between Coronary Artery stenting or Bypass Grafting (CABG) surgery and CTA was 9.59 ± 2.7 (range 0 to 20) years. Mean heart rate during scanning was 65.04 ± 4.04 (range 48 to 92) beats/min. 64 % (n=64) patients were CCTA positive and 60 % (n=60) were CIA positive. In comparison to CIA, CCTA showed sensitivity of 95 %, specificity of 82.5 % and accuracy of 90%. Conclusion: 160 – slice CT is a reliable and accurate while performing CCTA in detection of coronary artery stenosis (CAS). Premedication of oral beta blockers improves the study accuracy. CCTA is also reliable in assessing stents and grafts patency. With the help of CCTA, the number of invasive procedures can be reduced.

Diagnostic accuracy of contrast-enhanced CT in diagnosis of adrenal adenoma taking histopathology as gold standard.

2026-03-03T03:13:37-08:00

Objective: To determine the diagnostic accuracy of contrast-enhanced CT in diagnosis of adrenal adenoma taking histopathology as gold standard. Study Design: Cross-Sectional Validation Study. Setting: Department of Radiology, Allied Hospital, Faisalabad. Period: July 2025 to December 2025. Methods: A total of 130 patients aged 50–80 years suspected of adrenal carcinoma were enrolled through consecutive sampling. All underwent contrast-enhanced CT (CECT), interpreted by a blinded consultant radiologist. Adenomas were defined as lesions with unenhanced attenuation ≤10 HU and absolute percentage washout >60%. Histopathology after surgical excision or biopsy served as the gold standard. Diagnostic accuracy parameters including sensitivity, specificity, PPV, NPV, and overall accuracy were calculated using a 2×2 table. Data were analyzed with SPSS 25, with stratification for demographic and clinical factors. Results: Among 130 patients, CT detected adenoma in 40.8% while histopathology confirmed 75.4%. CT showed high specificity and PPV (93.8% and 96.2%) but low sensitivity and NPV (52.0% and 39.0%), reflecting substantial false-negative rates. Conclusion: Although contrast-enhanced CT remains a valuable first-line modality with strong specificity and confirmatory accuracy, its low sensitivity requires cautious interpretation when classic washout features are absent. Emerging quantitative radiomics and functional imaging techniques may enhance diagnostic confidence and support more precise patient management.

The frequency and determinants of reproductive tract infections in married women of rural areas of Khyber Agency KPK.

2025-12-22T06:29:48-08:00

Objective: To assess the awareness, causal factors and frequency of occurrence of reproductive tract infections among married women of rural areas. Study Design: Quantitative Descriptive study. Setting: MTI-HMC/KGMC Hayatabad Peshawar. Period: April 2025 to July 2025. Methods: Married women of reproductive age (16-45 years) were interviewed for their reproductive tract infections. The women were questioned about their symptoms, frequency and knowledge about RTI’s. The questionnaire was filled through Google forms. The study used the World Health Organization's (WHO) syndromic approach guideline to collect information on previous RTI symptoms. SPSS software was used for the analysis. Results: In about 130 women in rural areas, 58.5% women had been aware of the term Reproductive tract infection while 41.5% women had never heard of it. When asked about their knowledge of information about transmission of RTI’s out of 130 only 32.3% women had knowledge regarding it. The study also collected data of their menstrual hygiene in which 72.3% of the women were using reusable cloth. 63.1% of the women were not using contraceptive methods among the population. The major symptoms of RTI that they were facing were vaginal discharge and vaginal itching followed by dysuria and dyspareunia. The frequency of RTI was found to be 56.9% among married women of Khyber agency in which 43.1% percent of the females had a recurrence. Conclusion: The frequency of RTI’s was very high among rural women of Khyber Agency and the main reason behind it was the lack of awareness, lack of knowledge of its prevention and transmission, low menstrual hygiene status and limited access to healthcare.

Gestational age at the diagnosis of fetal neural tube defects in a Tertiary Care Hospital.

2025-09-23T12:13:35-07:00

Objective: To determine the frequency of pregnant women presenting with fetal neural tube defects diagnosed after 20 weeks of gestation at a tertiary care hospital. Study Design: Cross-sectional study. Setting: Sir Ganga Ram Hospital, Lahore. Period: 01 Feb 2025 to 01 Aug 2025. Methods: A total of 150 pregnant women aged 19–40 years with ultrasound-confirmed fetal neural tube defects were included using non-probability consecutive sampling. Demographic data including maternal age, parity, gestational age, education level, and socioeconomic status were recorded. Data were analysed using SPSS version 20. Chi-square test was applied and p-value ≤0.05 was considered statistically significant. Results: Out of 150 cases, 61.3% were diagnosed after 20 weeks of gestation. The mean maternal age was 29.47 ± 5.25 years. Majority of women were above 25 years of age (86.66%), belonged to low socioeconomic status (74%), and were illiterate (43%). Late diagnosis showed significant association with maternal age (p=0.009), parity (p=0.006), education (p=0.0005), and socioeconomic status (p=0.00003). Conclusion: Fetal neural tube defects are frequently diagnosed after 20 weeks of gestation, particularly in women with low literacy, low socioeconomic status, and advanced maternal age. Strengthening preconception counselling, promoting folic acid supplementation, ensuring early antenatal booking, and expanding first-trimester screening services are critical strategies to reduce the burden of neural tube defects.

Comparative study of gum chewing versus routine care in post operative gut motility after cesarean section.

2025-09-01T05:52:14-07:00

Objective: To compare the postoperative gut motility in terms of time to first bowel sound, passage of flatus, and stool between patients receiving gum chewing versus routine care after elective cesarean section. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics & Gynecology, Akhtar Saeed Trust Hospital, Lahore. Period: 27 March 2025 to 20 Aug 2025. Methods: Seventy women undergoing elective lower segment cesarean section under spinal anesthesia were enrolled in this randomized controlled trial. They were equally randomized into two equal groups consisting of 35 cases each in Group A and B, gum chewing (sugar-free) in Group A was started within 6 hrs of the procedure where B group cases were those with routine care (without gum). The study monitored each participant for the return of bowel activity, including bowel sounds, flatus, and stool passage. Results: The mean age of participants was 30.34 ± 6.23 years. Chewing gum significantly improved postoperative gut motility. Mean time to first bowel sound was 8.16 ± 1.36 hours in Group A versus 12.31 ± 1.79 hours in Group B (p < 0.001). Mean time to flatus was 10.21 ± 2.45 vs. 14.47 ± 2.37 hours (p < 0.001), and time to stool passage was 24.97 ± 3.86 vs. 36.83 ± 5.38 hours respectively (p < 0.001). Conclusion: The use of chewing gum notably expedites the return of gastrointestinal activity after cesarean delivery. It may be recommended as a safe, inexpensive adjunct to enhance recovery in postoperative care.

Single dose preoperative dexamethasone in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy.

2026-02-02T06:00:36-08:00

Objective: To evaluate the efficacy of a single dose dexamethasone in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy. Study Design: This Placebo-controlled, Randomized Trial. Setting: Department of Surgery, Allied Hospital-II, Faisalabad, Pakistan. Period: June 2025 to August 2025. Methods: Sixty patients (30 in each group) undergoing elective laparoscopic cholecystectomy were randomly divided into either Group-A (injected 2ml [8mg] dexamethasone in a 2-mL preparation), and Group-B (injected 2ml of normal saline), at the time of induction. Occurrence of nausea and vomiting during 24-hours following surgery were noted among all patients. Results: In a total of 60 patients (30 in each group), 53 (88.3%) were females. In Group-A, 9 (30.0%) patients had nausea during 1^st post-operative hour, versus 20 (66.7%) in Group-B. There were 5 (16.7%) patients in Group-A who experience vomiting during 1^st hour post-surgery, in comparison to 10 (33.3%) patients in Group-B. In Group-A, 4 (13.3%) patients experienced nausea at 6^th post-operative hour, in comparison to 11 (36.7%) patients in Group-B. In Group-A, 1 (3.3%) patient experienced vomiting at 6^th post-operative hour, in comparison to 4 (13.3%) patients in Group-B. At 24 postoperative hours, 3 (10.0%) patients in Group-A experienced nausease, versus 4 (13.3%) in Group-B. At 24-hours, 1 (3.3%) patient in Group-A, while 2 (6.7%) patients in Group-B experienced vomiting. Anti-emetic was needed in 2 (6.7%) patients in Group-A, in comparison to 4 (13.3%) in Group-B. Conclusion: Pre-surgery single dose of dexamethasone is effective in preventing post laparoscopic cholecystectomy nausea and vomiting up to 24 hours.

Comparison of small versus large size endotracheal tube use with and without intravenous lignocaine on the occurrence of postoperative sore throat in women undergoing elective thyroid surgery at Tertiary Care Hospital, Karachi.

2025-12-27T06:00:40-08:00

Objective: To compare small and large size endotracheal tube utilization with and without intravenous lignocaine on the occurrence of postoperative sore throat among women who have undergone elective thyroid surgery in Tertiary Care hospital, Karachi. Study Design: Randomized Control Trail. Setting: Department of Anesthesia, Civil Hospital, Karachi. Period: Six Months from 09-11-21 till 09-05-22. Methods: In this research, 204 patients in an elective thyroid surgery were utilized. Such patients were randomized in four groups, 51 in group A (ETT size 7.0 with saline); 51 in group B (ETT size 6.0 with saline); 51 in group C (ETT size 7.0 with lidocaine ad 51 in group D (ETT size 6.0 with lidocaine). Quantitative and qualitative data were gathered and displayed and examined. Post stratification chi square test was used with p-value of 0.05 as significant. Results: The mean age of the patients was 40.22+5.19 years. Group D showed a significantly lower rate of POST than Group A (23.53% vs.58.82%, P=0.0005), B (23.53% vs. 39.22%, P = 0.088) and C (23.53% vs. 43.14%, P = 0.036). Conclusion: The use of lignocaine with large size endotracheal tubes resulted in fewer episode of postoperative sore throat.

To determine clinicopathologic profile of patients presenting with hoarseness of voice using fiber-optic laryngoscopy in Sir Ganga Ram Hospital, Lahore.

2026-01-17T05:25:56-08:00

Objective: To Determine clinicopathologic profile of patients presenting with hoarseness of voice using fiber-optic laryngoscopy in Sir Ganga Ram Hospital, Lahore. Study Design: Cross-Sectional Study. Setting: Department of ENT Sir Ganga Ram Hospital, Lahore. Period: The study was conducted over a six-month period, from July 4, 2025 to January 3, 2026. Methods: In this Cross sectional study, 179 patients were selected from OPD having completed the criteria. After informed consent, History taking and thorough physical examination was done and proformas were completed. HIV, HBV and HCV screening was done to ensure proper sterilization protocol. Intravenous access in the patient was maintained and an emergency management tray was arranged before procedure. Flexible Fibreoptic laryngoscopy was performed with topical anesthesia. Findings were noted and a differential diagnosis made which can be later confirmed with biopsy. Results: Out of 179 patients, 14.0% (n=25) were in age group of 12-40 years and 86.0% (n=154) were in age group of 41-80 years. Mean age was 47.29±6.70 years. There were 87.7% (n=157) male and 12.3% (n=22) females. Among comorbidities, 5.6% (n=10) TB and 7.3% (n=13) had GERD. We found that out of 179 patients, 8.9 %( n=16) were substance abuse, 15.6% (n=28) alcohol and 36.9% (n=66) were smokers. Among the clinopathological profile, 34.1% (n=61) had chronic laryngitis, 14.0% (n=25) benign lesion, 6.1% (n=11) and malignant tumor. Distribution of duration of hoarseness was 12.11±3.45 weeks. Conclusion: We concluded that fiber-optic laryngoscopy found to be helpful technique for identifying different causes of voice hoarseness and to optimize treatment outcomes along with early diagnosis.

Clinical and radiological features predicting outcome of operated acute subdural hematoma.

2026-01-14T04:14:08-08:00

Objective: Acute subdural hematoma (ASDH) is a common and life-threatening complication of traumatic brain injury, with high mortality despite surgical evacuation. Clinical and radiological factors influencing outcome remain incompletely defined in low- and middle-income settings. Study Design: Prospective Observational study. Setting: Lady Reading Hospital, Peshawar, Pakistan. Period: July 2024 to June 2025. Methods: 116 consecutive patients aged 2–65 years undergoing surgery for traumatic ASDH. Patients requiring conservative management, expiring before surgery, or with significant comorbidities were excluded. Data on demographics, Glasgow Coma Scale (GCS) at presentation, pupillary reactivity, hematoma thickness, midline shift, and in-hospital mortality were collected. Frequencies, means/medians, chi-square/Fisher's exact tests, and multivariable logistic regression were used for analysis. Results: Of 116 patients, in-hospital mortality was 48.3% (56/116). Mean age was 38.4 ± 16.2 years; 78% were male. Road traffic accidents caused 62% of cases. Median GCS was 7 (IQR 5–9); 52% had non-reactive pupils at presentation. Mean hematoma thickness was 18.6 ± 6.4 mm; mean midline shift was 9.8 ± 4.7 mm. Mortality was significantly higher with GCS ≤8 (62.9% vs. 18.2%, p<0.001), non-reactive pupils (71.7% vs. 23.2%, p<0.001), hematoma thickness ≥15 mm (64.8% vs. 21.4%, p<0.001), and midline shift ≥10 mm (70.9% vs. 25.0%, p<0.001). Multivariable analysis confirmed GCS ≤8 (OR 5.42, 95% CI 2.18–13.48), non-reactive pupils (OR 6.81, 95% CI 2.76–16.79), and midline shift ≥10 mm (OR 4.17, 95% CI 1.68–10.34) as independent predictors. Conclusion: In-hospital mortality after surgical evacuation of traumatic ASDH was 48.3%, with low GCS, fixed pupils, and significant midline shift independently predicting poor outcome. These factors can guide prognostication and resource allocation in resource-limited settings.

Clinical and functional outcomes of isolated posterior cruciate ligament reconstruction in patients.

2026-02-03T05:08:37-08:00

Objective: To evaluate the clinical and functional outcomes of isolated PCL reconstruction in adult patients using standardized objective and patient-reported measures. Study Design: Prospective Observational study. Setting: Department of Orthopaedics & Spine Centre, Ghurki Trust Teaching Hospital, Lahore. Period: January 15, 2025, to July 15, 2025. Methods: Included 76 patients aged 18–60 years with symptomatic isolated PCL tears. Arthroscopic reconstruction was performed. Preoperative and postoperative assessments included IKDC, Lysholm, and Tegner scores, posterior drawer testing, radiographic evaluation, and return to activity. Patient Acceptable Symptom State (PASS) was defined as IKDC >75.9. Statistical analysis was performed using paired t-tests and chi-square or with p <0.05 considered significant. Results: The mean age was 36.8 ± 9.4 years, with a predominance of male patients (68.4%). Most injuries were grade III (76.3%), with 25% having associated meniscal lesions. Postoperatively, significant improvement was observed in functional scores: IKDC increased from 46.5 ± 9.1 to 79.0 ± 8.7, Lysholm from 65.5 ± 8.7 to 88.3 ± 7.9, and Tegner from 2.3 ± 0.8 to 4.0 ± 1.1 ( p <0.001). PASS was achieved in 50 patients (65.9%), and objective stability was restored in 67 patients (87.8%). Return to pre-injury activity was achieved in 39 patients (51.2%). Radiographic evaluation showed no osteoarthritis in 67 patients (87.8%). Conclusion: With a favorable short-term radiographic profile, arthroscopic isolated PCL reconstruction significantly improves functional scores, knee stability, and patient-reported outcomes. Only roughly half of patients were able to resume their pre-injury activity levels, though, which emphasizes the importance of thorough patient counseling and rehabilitation.

Programmed Death-Ligand 1 (PD-L1) expression in triple-negative breast cancer: A cross-sectional study from a Tertiary Diagnostic Laboratory in Pakistan.

2025-12-31T06:20:59-08:00

Objective: To evaluate the frequency of PD-L1 expression by combined positive score (CPS) and analyze the clinic-pathological characteristics in TNBC patients presenting at Chughtai Lab, Lahore. Study Design: Cross Sectional Analytical study. Setting: Chughtai Lab, Lahore. Period: Sep 2024 to Feb 2025. Methods: Newly diagnosed TNBC patients. Based on diagnosis, 85 patients were diagnosed with TNBC. All of the tumors were classified as invasive ductal carcinomas. Immunohistochemistry was performed via DAKO 22C3 pharm-Dx assays. PD-L1 expression was divided into three categories: CPS 0, CPS <10, and CPS ≥10. The date regarding pathological characteristics and demography like patient age, tumor grade, and Ki-67 index was collected. The SPSS version 20 was used for data analysis. Results: Out of 85 TNBC patients, 75 (88.2%) were classified as tumors with grade 3, with 10 (11.8%) classified as grade 2. Regarding the distribution of PD-L1 expression, we found that 7 (8.2%) patients had CPS 0, 20 (23.5%) had CPS <10, and 58 (68.2%) had CPS ≥10. Ki-67 values were greater than 14% for all tumours. PD-L1-positive expression (CPS ≥10) was observed more frequently in grade 3 tumors, and the association was statistically significant (p < 0.001). Conclusion: The study demonstrates the high prevalence of PD-L1 positivity in TNBC patients, indicating that there may be a valuable role for immunotherapy for TNBC patients. This study contributes to the growing body of evidence for the use of PD-L1 testing in the routine diagnostic process for TNBC patients in Pakistan.

Diagnostic accuracy of multislice CT scan in the detection of cervical lymph node metastasis in head and neck squamous cell carcinoma taking histopathology as gold standard.

2026-01-10T05:19:37-08:00

Objective: To determine the diagnostic accuracy of multislice computed tomography (MSCT) in the detection of cervical lymph node metastasis in patients with head and neck squamous cell carcinoma, taking histopathology as the gold standard. Study Design: Cross-sectional study. Setting: Department of Radiology, Liaquat National Hospital, Karachi. Period: 31^st May 2023 to 30^th November 2023. Methods: A total of 252 patients with biopsy-proven head and neck squamous cell carcinoma were included in the study. Contrast-enhanced multislice computed tomography was performed in a craniocaudal direction. Cervical lymph nodes were considered positive for metastasis based on predefined radiological criteria. During surgery, lymph nodes were excised and sent for histopathological examination. A 2×2 contingency table was used to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy of MSCT. Post-stratification analysis was also performed. Results: Among the study population, 70.2% were male and 29.8% were female. Central necrosis was observed in 54% of lymph nodes, spherical shape in 32.9%, conglomeration of three or more lymph nodes in 34.1%, and extracapsular spread in 26.6% of cases. Multislice CT demonstrated a sensitivity of 93.8%, specificity of 95.1%, PPV of 95.3%, NPV of 93.6%, and an overall diagnostic accuracy of 94.4%. Conclusion: Multislice computed tomography showed high sensitivity, specificity, and diagnostic accuracy for detecting cervical lymph node metastasis in head and neck squamous cell carcinoma, supporting its role as a reliable preoperative imaging modality.

Frequency of catheter associated urinary tract infections in PICU of NICH, Karachi, Pakistan.

2026-01-17T05:33:44-08:00

Objective: To determine the frequency of catheter associated urinary tract infections (CAUTI) in children admitted to pediatric intensive care unit (PICU). Study Design: Cross-sectional study. Setting: The PICU of National Institute of Child Health, Karachi, Pakistan. Period: 10^th July 2025 to 25^th November 2025. Methods: A total of 158 children aged 1 month to 12 years who underwent urinary catheterization for ≥1 week were enrolled through consecutive sampling. Demographic and clinical data, catheter duration, and outcomes were recorded. Data were analyzed using SPSS v26.0, applying chi-square, Fisher’s exact, t-test, or Mann–Whitney U test, with p<0.05 considered significant. Results: Among 158 children, 92 (58.2%) were males, and 66 (41.8%) females, with a median age of 3.4 years (IQR 1.2–7.8). Respiratory diseases were observed in 104 (65.8%), neurological disorders in 22 (13.9%), and cardiac disorders in 16 (10.1%). CAUTI developed in 31 (19.6%) children after a median of 10 days (IQR 9–13). Malnutrition (22.6% vs. 8.7%, p=0.029). and sepsis (19.4% vs. 6.3%, p=0.022) were significantly associated. E. coli (45.2%), and K. pneumoniae (29.0%) were common isolates with highest sensitivity to meropenem (80.6%) and resistance to ciprofloxacin (71.0%). CAUTI cases had longer catheterization (12.7 vs. 9.2 days, p<0.001), PICU stay (14.2 vs. 10.5 days, p=0.004), and higher mortality (35.5% vs. 16.5%, p<0.001). Conclusion: Catheter-associated urinary tract infection was identified in nearly one-fifth of critically ill children admitted to the PICU. Prolonged catheterization, malnutrition, systemic infection, and mechanical ventilation significantly increased CAUTI risk.

Predictors of mortality in children under 5 years of age hospitalized with severe acute malnutrition in a Tertiary Care Hospital.

2025-12-20T06:27:33-08:00

Objective: To determine the predictors and time of mortality in hospitalized children under 5 years with severe acute malnutrition (SAM). Study Design: Prospective, observational cohort study. Setting: Nutritional Rehabilitation Unit, Pediatric Medicine Department of National Institute of Child Health, Karachi, Pakistan. Period: August 2024 to April 2025. Methods: Enrollment of 273 SAM children, aged between 6 and 60 months, hospitalized and getting treatment, was made. All those children who had a weight-for-height Z score of <- 3, < 70% of the expected weight for height, or bilateral edema were considered as SAM children. The length of hospital stay and outcomes were recorded. Data were analyzed in SPSS 26 using chi-square and Mann-Whitney U tests, followed by multivariable logistic regression for variables with p<0.05. Results: In 273 children, 160 (58.6%) were male, with a median age of 18.0 months. Sepsis 102 (37.4%) and pneumonia 50 (18.3%) were leading diagnoses. Mortality occurred in 58 (21.2%) children. Multivariable analysis showed low weight adjusted odds ratio (aOR) 0.8 (95% CI 0.5 to 0.9, p=0.005), cough aOR 3.6 (1.2 to 10.1, p=0.018), reluctance to feed aOR 6.3 (1.9 to 20.3, p=0.002), SpO2 below 94% at admission aOR 28.7 (9.3 to 88.4, p<0.001), and skin changes aOR 6.4 (2.4 to 17.2, p<0.001) were independent predictors or mortality. Conclusion: Mortality in children with SAM is influenced by the presence of hypoxia, feeding difficulty, respiratory involvement, skin changes, deranged biochemical parameters and low body weight at admission.

Outcome of premature and low birth weight infants who received kangaroo mother care in neonatal intensive care unit at a tertiary care hospital.

2026-01-21T05:25:22-08:00

Objective: To evaluate the effects of Kangaroo Mother Care (KMC) on the outcome of growth amongst preterm low birth weight (LBW) infants. Study Design: Quasi-experimental study. Setting: Neonatal Intensive Care Unit (NICU), Shifa International Hospitals Limited, Islamabad, Pakistan. Period: April 2025 to September 2025. Methods: A total of 82 LBW and preterm newborns admitted to the NICU, were included. Group allocation was pragmatic and non-random. Weight, length, and head circumference measured at birth and then serially till the time of discharge, duration of hospitalization along with complications were recorded. Analyses used IBM-SPSS Statistics v26, by applying appropriate statistical tests taking p<0.05 as significant. Results: Amongst 82 participants, 45 (54.9%) received KMC, and 37 (45.1%) did not. Females accounted for 44 (53.7%) infants. Discharge weight was 2410.8±295.6 g with KMC, and 2178.9±318.1 g without KMC (p=0.001), and daily weight gain was 17.2±4.1 g/day with KMC, and 14.1±4.7 g/day with non-KMC (p=0.002). Length (p=0.029), length gain (p=0.034), head circumference (p=0.041), and head circumference gain (p=0.018) at discharge were significantly higher among infants undergoing KMCs. Hospital stay was 8.0 (6.0 to 11.5) days among KMC infants, and 12.0 (6.0 to 16.5) days among non-KMC infants (p=0.010). Complication occurred in 6 (13.3%) KMC infants, and 12 (32.4%) non-KMC infants, with risk ratio 0.4 (0.2 to 0.9; p=0.031). Conclusion: KMC significantly improves growth outcomes, reduces hospitalization, and lowers overall morbidity in stable preterm LBW infants, including those on non-invasive respiratory support. Structured KMC should be integrated into routine NICU practice.

Factors associated with dermatology life quality index scores in children with chronic skin disorders: A cross-sectional analytical study.

2026-03-09T04:52:51-07:00

Objective: To identify factors associated with dermatology specific quality of life impairment in children with chronic skin conditions. Study Design: Cross Sectional Analytical study. Setting: Pediatric Dermatology Clinic in Multan. Period: January–December 2025. Methods: Enrolled 381 children aged 4–18 years with physician confirmed chronic dermatoses Participants completed age-appropriate quality of life instruments (CDLQI for ages 4–15; DLQI for ages 16–18) alongside assessments of demographics, clinical characteristics, bullying exposure, and anxiety symptoms. Multivariate linear regression identified independent predictors of quality of life scores. Results: Mean CDLQI/DLQI score was 8.5 ± 5.3, with 52.8% experiencing moderate-to-severe impairment (scores ≥6). Atopic dermatitis predominated (47.8%) and demonstrated highest mean impairment (9.9 ± 5.5). Multivariate analysis revealed seven independent predictors: greater body surface area involvement (β=0.27, p<0.001), female sex (β=1.35, p<0.001), lower socioeconomic status (β=2.38, p<0.001), atopic dermatitis diagnosis (β=1.84, p<0.001), bullying exposure (β=2.61, p<0.001), anxiety symptoms (β=1.92, p<0.001), and longer disease duration (β=0.03, p=0.005). The final model explained 49% of variance in quality of life scores. Conclusion: Quality of life impairment reflects complex interactions between clinical severity, psychosocial stressors and socioeconomic context. Holistic management must integrate dermatological treatment with anti-bullying initiatives and mental health support.

Comparison between therapeutic efficacy of itraconazole pulse therapy and terbinafine in treatment of tinea capitis in paediatric population.

2026-01-26T03:42:20-08:00

Objective: To compare the therapeutic efficacy of itraconazole pulse therapy and terbinafine in the treatment of tinea capitis in children. Study Design: Prospective, Randomized Controlled Trial. Setting: Department of Dermatology, Jinnah Hospital, Lahore, Pakistan. Period: April 2025 to September 2025. Methods: A total of 118 (59 in each group) children aged 3–14 years with clinically and mycologically confirmed tinea capitis, were randomized to itraconazole pulse therapy or continuous terbinafine. Primary outcome was therapeutic efficacy noted in terms of clinical and mycological cure at 8-weeks, while secondary outcomes were recorded as time to symptom relief and adverse events. Data were anlayzed using IBM-SPSS version 26.0, taking p<0.05 as significant. Results: Of 118 children enrolled, 68 (57.6%) were males, with a median age of 8.1 years (IQR 5.2–9.7). A total of 113 (95.8%) completed follow-up evaluation. Therapeutic efficacy was achieved in 97 (85.8%), clinical cure in 101 (89.4%), and mycological cure in 97 (85.8%). Efficacy was noted among 91.1% with itraconazole versus 80.7% with terbinafine (p=0.114). Adverse events included gastrointestinal disturbances in 11 (9.7%) and liver enzyme elevation in 3 (2.7%) patients while no one discontinued the treatment due to adverse events. Conclusion: Both itraconazole pulse therapy and terbinafine were found to be effective, well-tolerated, and safe options for the treatment of pediatric tinea capitis.

Anthropometric assessment of children with un-operated congenital heart disease presenting at Faisalabad Institute of Cardiology, Faisalabad.

2026-04-16T07:26:21-07:00

Objective: To assess the anthropometric and nutritional status of children with un-operated congenital heart disease. Study Design: Prospective, Cross-sectional study. Setting: Pediatric Cardiology Department of Faisalabad Institute of Cardiology (FIC). Period: July 2025 to December 2025. Methods: 355 children (6 months to 10 years of age) having an echocardiographic confirmed diagnosis of CHD. Anthropometric measurements including mid-upper arm circumference (MUAC), body mass index (BMI), weight-for-age, height-for-age, and weight-for-height were recorded by standard technique and nutritional status assessed. Data was analyzed using SPSS version 22, with p value <0.05 considered statistically significant. Results: Of 355 participants, 53% were female (n=188). The largest age group was 2-5 years (42.8%, n=152). Cyanotic CHD was present in 20.6% (n=73) while remainder had acyanotic CHD. Overall, 85.9% of study subjects were malnourished. Malnutrition was seen in 89% of Cyanotic CHD (n=65) children while 85.1% of acyanotic CHD were malnourished (n=240). BMI was significantly lower in cyanotic patients (p=0.03). Height-for-age and weight-for-height also showed significant differences (p=0.04 and p=0.03, respectively), with cyanotic patients showing greater stunting and wasting. Weight-for-age did not differ significantly (p=0.06). Conclusion: Children with cyanotic CHD exhibit more severe malnutrition than those with acyanotic CHD. Early nutritional screening and targeted interventions are crucial to improve growth and reduce complications in this vulnerable population.