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Impact of Marital Stress on Psychological Resilience and Self-Monitoring Among Married Working and Non-Working Women
Objective: To examine the effect of marital stress on psychological resilience and self-monitoring of married working and non-working women. Methodology:A quantitative, cross sectional correlational research was conducted at department of Psychology, Bakhtawar Amin Memorial Trust Hospital, Multan, from February 2025 to August 2025. This purposive sampling method was used to obtain self-reported questionnaires from (N=100) married women of both professions working/non-working in urban and semi-urban areas to assess their marital stress, psychological resilience and self-monitoring. Marital stress was defined as internalizing and feeling of stress in the marital relationship following unresolved marital conflict, emotional distance, communication issues, lack of support and daily marital problems that have a negative impact on the emotional and psychological well-being. Psychological resilience was defined as an individual's capability to bounce back, adjust and remain psychologically healthy in the aftermath of stress, adversity, or difficult life experiences.Data analysis was performed using SPSS version 27. Results:The mean age of participants was 28.93 ± 4.85 years. The percentage of working women and non-working women was 51 and 49 % respectively. There was a considerable negative linkage between marital stress and psychological resilience (r = -.26, p < .01), which means that the higher marital stress was less psychological resilience among married women. Similarly, marital stress showed a significant negative correlation with self-monitoring (r = -.23, p < .05), which indicated that marital stress was negatively related to self-monitoring skills. Conclusion:Themarital stress negatively correlates with psychological resilience and self-monitoring, and significantly negatively predicts, both outcomes among married women, while no significant work status differences were found between working and non-working women.
Copyright (c) 2025 Tayyaba Chaman, Nimra Ishfaq https://creativecommons.org/licenses/by/4.0
Comparison of Two Different Dosing Regimens of Oral Tranexamic Acid in Treatment of Facial Melasma
Objective: To compare the effectiveness of oral tranexamic acid 250 mg twice daily and tranexamic acid 500 mg twice daily in patients with melasma using the mMASI score. Methodology: Randomized controlled trial conducted at dermatology department Pak Emirates Military Hospital Rawalpindi from January 2021 to December 2022 in one year duration. Participants were adults aged 18–40 diagnosed with moderate to severe melasma based on the Melasma Area and Severity Index (MASI). Using computer-generated randomization, patients were randomly assigned into two groups. Group A received oral TXA 250 mg twice daily, while Group B received oral TXA 500 mg twice daily for 12 weeks. Follow-up assessments were conducted every four weeks to determine the variation in MASI scores and monitor treatment adherence. Primary outcomes included the percentage reduction in MASI score at the end of 12 weeks. Results: In terms of treatment outcomes, 7 patients (23.3%) in Group A achieved mMASI-75, compared to 12 patients (40.0%) in Group B (p < 0.001) (Figure I). Further comparison of mMASI scores between the two groups is presented in Table II, showing that Group B demonstrated significantly better mMASI scores than Group A (p < 0.050). Conclusion: A 500 mg twice-daily dose of tranexamic acid (TXA) is more effective than 250 mg twice-daily in reducing melasma severity and improving quality of life, as shown by significant improvements in the Modified Melasma Area and Severity Index and Melasma Quality of Life scores over 12 weeks.
Copyright (c) 2025 Saima Shahid https://creativecommons.org/licenses/by/4.0
Prevalence of Risk Categories in Chronic Myeloid Leukaemia Patients in Chronic Phase According to Sokal Score at a Tertiary Care Centre in Multan
Objective: This study aimed to determine the prevalence of risk categories (low, intermediate, and high) in newly diagnosed CML patients in the chronic phase using Sokal score-based risk stratification at Nishtar Medical University, Multan. Methodology: A cross-sectional study was conducted at hematology department of Nishater Hospital, Multan over six months from 1st February 2025 to 30th July 2025. Study enrolled 166 newly diagnosed CML-CP patients aged 16–60 years via non-probability consecutive sampling. Demographic data, clinical parameters including spleen size by ultrasonography, and laboratory values (WBC count, platelet count, haemoglobin, basophils) were recorded. Results: The Sokal score was calculated and patients were stratified into low (score <0.8), intermediate (0.8–1.2), and high risk (>1.2) categories. Of 166 patients, 97 (58.4%) were male and 69 (41.6%) were female with a mean age of 38.7±14.2 years. Based on Sokal score stratification, 89 patients (53.6%) were in the high-risk category, 58 patients (34.9%) in the intermediate-risk category, and 19 patients (11.4%) in the low-risk category. Conclusion: High Sokal score was significantly associated with higher WBC count, larger spleen size, and longer disease duration before presentation (p<0.05). The majority of newly diagnosed CML patients presenting to this centre had high Sokal risk scores, underscoring the importance of early accurate risk stratification to guide frontline TKI therapy selection.
Copyright (c) 2025 Mishal Arif https://creativecommons.org/licenses/by/4.0
Comparison of Meglumine Antimoniate and Miltefosine in Cutaneous Leishmaniasis
Objective: The study aims to compare the efficacy and safety of meglumine antimoniate and miltefosine in the treatment of cutaneous leishmaniasis in Pakistan. Methodology: This randomized-controlled trial was conducted at the Dermatology Departments of Pak Emirates Military Hospital Rawalpindi, Pakistan, from January to December 2021. Efficacy was graded on Day 28 as excellent (91-100% improvement), good (75-90%), fair (50-74%), or poor (<50%) based on re-epithelialization, flattening, and induration reduction. Both groups received 28 days of treatment. Results: According to the response to treatment, 10 (28.6%) and 7 (20.0%) had excellent responses in Group I and Group II, respectively. Meanwhile, 8 (22.9%) and 2 (5.7%) were discontinued in Group I and Group II, respectively. Adverse effect was noted as 14 (40.0%) and 18 (51.4%) in Group I and II, respectively. Chest tightness, myalgia/arthralgia and raised ALT were the most common side effects in both groups. Conclusion: Meglumine antimoniate is more effective than miltefosine for treating cutaneous leishmaniasis, showing better parasite eradication and faster lesion healing. However, the use of both drugs is limited by side effects like chest tightness, muscle pain, elevated ALT levels, and gastrointestinal symptoms, which can affect susceptible patients.
Copyright (c) 2024 Saima Shahid, Aisha Akhter https://creativecommons.org/licenses/by/4.0
Efficacy of Continuous Peripheral Nerve Block in Patients with Proximal Femur Fracture
Objective: To evaluate the efficacy of continuous peripheral nerve block in reducing pain, decreasing opioid consumption, and improving functional outcomes in patients with proximal femur fractures. Methodology: This prospective study was conducted on 100 patients presenting with proximal femur fractures. Patients received continuous peripheral nerve block using a catheter-based technique. Pain was assessed using the Visual Analog Scale (VAS) at baseline and at 6, 12, 24, and 48 hours post-intervention. Secondary outcomes included opioid consumption, early mobilization, patient satisfaction, and procedure-related complications. Data were analyzed using appropriate statistical methods. Results: The mean VAS score significantly decreased from 8.5 ± 1.2 pre-block to 2.3 ± 0.7 at 48 hours post-block (p < 0.001). A majority of patients (65%) did not require additional opioid analgesia, while those who required opioids had reduced mean consumption (12.5 ± 4.3 mg morphine equivalents). Early mobilization within 48 hours was achieved in 70% of patients. Patient satisfaction was high, with 75% reporting satisfactory pain control. Complications were minimal, with the majority of patients (82%) experiencing no adverse effects. Conclusion: Continuous peripheral nerve block is an effective and safe modality for pain management in patients with proximal femur fractures. It significantly reduces pain scores, minimizes opioid requirements, and facilitates early mobilization, thereby improving overall patient outcomes.
Copyright (c) 2025 Hamid Mehmood, Abdul Ghani https://creativecommons.org/licenses/by/4.0
Treatment outcome in different classes of Lupus nephritis
Objective: To evaluate treatment outcomes across different classes of lupus nephritis and to assess the association of baseline serum creatinine and proteinuria with remission status. Methodology: This prospective observational study included 157 adult patients with biopsy-proven lupus nephritis at a tertiary care center. Patients were classified according to the ISN/RPS classification and treated according to standard protocols based on LN class. Baseline demographics, clinical features, serum creatinine, proteinuria, complement levels, and anti-dsDNA antibodies were recorded. Outcomes were categorized as complete remission, partial remission, no response, or progression to end-stage renal disease (ESRD). Statistical analyses were performed using SPSS, with a significance level of p ? 0.05. Results: The cohort included predominantly female patients (84.1%), with a mean age of 33.8 ± 9.6 years. Class IV LN was the most frequent (38.9%), followed by Class III (24.8%) and Class V (14.0%). Complete remission was achieved in 38.2% of patients, partial remission in 38.9%, no response in 13.4%, and 9.6% progressed to ESRD. Patients achieving complete remission had significantly lower baseline serum creatinine (1.32 ± 0.48 vs 2.11 ± 0.74 mg/dL; p < 0.001) and proteinuria (2.41 ± 0.86 vs 4.12 ± 1.23 g/day; p < 0.001) compared with those with partial remission. Treatment outcomes differed significantly among LN classes (p < 0.001), with Class I and II showing the highest rates of complete remission and Class VI the poorest response. Conclusion: Histological class, baseline renal function, and proteinuria are key determinants of treatment outcomes in lupus nephritis. Patients with lower serum creatinine and proteinuria at presentation are more likely to achieve complete remission, highlighting the importance of early detection and aggressive management to improve renal prognosis.
Copyright (c) 2025 Abdul Aziz, Rashid Asgher, Nayyar Saleem, Zubair Ahmed, Aimon Riaz, Khuram Bashir https://creativecommons.org/licenses/by/4.0
Prevalence of pulmonary tuberculosis in end stage renal disease patients: A single center study
Objective: To determine the prevalence of pulmonary tuberculosis and its associated factors among patients with end-stage renal disease at a single tertiary care center. Methodology: This cross-sectional study included 145 patients diagnosed with ESRD. Demographic data, clinical characteristics, comorbid conditions, and dialysis duration were recorded. Pulmonary tuberculosis was diagnosed based on clinical, radiological, and microbiological criteria. Data were analyzed using appropriate statistical tests, and a p-value ?0.05 was considered statistically significant. Results: The mean age of participants was 52.6 ± 13.4 years, with a male predominance (63.4%). The mean body mass index was 23.4 ± 3.2 kg/m². Hypertension was the most common comorbidity (74.5%), followed by diabetes mellitus (46.2%), ischemic heart disease (20%), and hepatitis C infection (15.2%). The overall prevalence of pulmonary tuberculosis among ESRD patients was 12.4%. PTB prevalence was significantly higher in patients undergoing dialysis for more than three years compared to those with a dialysis duration of three years or less (18.8% vs. 8.3%, p = 0.04). Conclusion: ESRD patients on maintenance dialysis are at substantially increased risk of PTB. In our cohort, the prevalence of 12.4% and the significant association with longer dialysis duration underscore the need for sustained screening and preventive strategies.
Copyright (c) 2025 Abdul Aziz, Zubair Ahmed, Rashid Asgher, Aimon Riaz, Nayyar Saleem, Khuram Bashir https://creativecommons.org/licenses/by/4.0
Evaluating the preoperative accuracy of multislice ct in determining resectability of periampullary pancreatic carcinoma
Objective: To determine the preoperative diagnostic accuracy of Multislice CT in determining Resectability of Periampullary Pancreatic Carcinoma. Methodology: This cross-sectional validation study was conducted in the Radiology Department, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences Gambat, from January 2025 to April 2025. Patients with clinically suspected periampullary pancreatic carcinoma who underwent preoperative MDCT followed by surgical exploration were included. Resectability on MDCT was assessed based on tumor-vessel relationship, local invasion, and metastatic spread. Imaging findings were compared with intraoperative and histopathological results to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Results: MDCT scan findings showed that 45 patients 76.3% had a clear tissue plane between the tumor and the superior mesenteric artery (SMA), and <180° SMV–PV involvement was seen in 64.4% patients. No evidence of metastasis was found in 74.6% patients. Other findings included abdominal ascites in 15.3%, SMA involvement in 22.0%, SMV–PV junction occlusion in 13.6%, liver metastasis in 11.9%, extra-pancreatic or peritoneal spread in 23.7%, and distant lymph node involvement in 22.0%. Conclusion: Multislice CT provides a reliable non-invasive modality for preoperative assessment of periampullary pancreatic carcinoma resectability, particularly in ruling out unresectable disease.
Copyright (c) 2025 Suhail Ahmed, Munazza Zaffar, Muhammad Irfan, Habibullah Maitlo, Liaqat Ali, Jawad Ali https://creativecommons.org/licenses/by/4.0
Frequency of peripheral nerve injury in oral and maxillofacial trauma
Objective: To assess the peripheral nerve injury incidence among patients suffering from oral and maxillofacial trauma. Methodology: This cross-sectional study included 100 patients presenting with maxillofacial trauma to the Department of Oral and Maxillofacial Surgery at Jinnah Postgraduate Medical Centre, Karachi, from 13th July 2024 to 12th January 2025. Data regarding demographics, etiology of trauma, site of injury, fracture type, and presence of peripheral nerve injury were collected. Trigeminal, facial, and concurrent nerve injuries were assessed clinically. Statistical analysis was performed to evaluate associations between nerve injuries and clinical variables. Results: The mean age of participants was 32.5 ± 11.4 years, with males comprising 72% of the sample. Road traffic accidents were the leading cause of trauma (54%), followed by assault (22%) and falls (12%). Peripheral nerve injury was present in 18% of patients. Trigeminal nerve injury occurred in 14%, facial nerve injury in 4%, and combined nerve injury in 2% of cases. A significant association was found between the presence of fractures and nerve injury (p < 0.05). Conclusion: Peripheral nerve injuries are a notable complication of oral and maxillofacial trauma account for 18% of patients, with trigeminal nerve involvement being more frequent than facial nerve injury.
Copyright (c) 2025 Sundas Iqbal Aslam, Jehan Alam, Neha Joel https://creativecommons.org/licenses/by/4.0
Intra-dialytic serum potassium changes among patients on maintenance hemodialysis thrice weekly
Objective: To determine the mean change in serum potassium levels before and after the maintenance haemodialysis session. Methodology: A Quasi experimental study. Department of Nephrology,Sir Ganga Ram Hospital Lahore from 23-01-2025 to 22-04-2025. Total 110 patients were selected according to inclusion criteria. Age, gender, height, weight and comorbids were documented Serum potassium levels of MHD patients were checked before and just after the end of haemodialysis. The duration of dialysis was documented. Results: Mean duration of dialysis was 3.93 hours. Mean change in the potassium levels was 1.54±0.23 mmol/L. Mean change in potassium was compared between the groups based on age, BMI, gender and comorbs stratification, however, no statistically significant difference was observed (p>0.05). Paired t-test was applied for pre- and post-dialysis and the change was statistically significant (p<0.001). Conclusion: Maintenance hemodialysis session of 4 hours can significantly reduce serum potassium levels and subsequently reducing the risk of arrythmias due to hyperkalemia in ESRD patients.
Copyright (c) 2025 Umaar Azhar, Shahid Anwar, Sajad Ahmad, Hafiz Tahir Usman, Adeela Alam, Shehran Bilal https://creativecommons.org/licenses/by/4.0
A study to assess quality of life in end stage renal disease patients undergoing hemodialysis: A single center study
Objective: To assess the quality of life in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis and to identify factors influencing it. Methodology: Study was descriptive cross-sectional commenced at the Multan Institute of Kidney Diseases, Multan, from October 25, 2024, to April 24, 2025. Study included 100 patients with ESRD having age ?18 years, on hemodialysis from least three months. Main variables of study were demographics, duration of dialysis, vascular access type, co morbidities and the Kidney Disease Quality of Life Short Form (KDQOL-36) scale. Results: The mean age of participants was 49.2 ± 11.3 years, with 62% males and 38% females. Most patients (72%) received hemodialysis three times per week, and hypertension (68%) was the most common comorbidity. The mean score of physical and mental component were 43.25 ± 9.12 and 47.36 ± 8.74, respectively. Patients of young age on dialysis for ?12 months, and individuals without comorbidities had significantly higher quality of life scores (p < 0.05). Conclusion: Quality of life among ESRD patients on hemodialysis is moderately reduced, particularly in physical and psychological domains. Older age, prolonged dialysis duration, and comorbidities are key predictors of poor outcomes.
Copyright (c) 2025 Zubair Ahmed, Abdul Aziz, Muhammad Rashid Asgher, Khuram Bashir, Aimon Riaz, Nayyar Saleem https://creativecommons.org/licenses/by/4.0
Comparison of ibuprofen versus celecoxib in post-extraction pain relief
Objective: To compare mean pain score of celecoxib versus ibuprofen in post tooth extraction pain relief at a tertiary care hospital. Methodology: The study was Quasi experimental design conducted in the Department of Oral and Maxillofacial Surgery, Jinnah Postgraduate Medical Centre, over a period of six months (July 2024 to January 2025). A total of 78 patients undergoing tooth extraction were enrolled and randomly allocated into two groups, with 39 patients in each group receiving either ibuprofen or celecoxib postoperatively. Pain intensity was assessed using the Visual Analogue Scale (VAS) at predefined intervals over a 24-hour postoperative period. Demographic data, including age, gender, and smoking status, were recorded and analyzed. Results: The mean age of participants was 34.9 ± 8.0 years, with a near-equal gender distribution (52.6% male, 47.4% female). Most participants (59.0%) were from rural areas, and 24.4% were smokers. At 24 hours postoperatively, the celecoxib group reported significantly lower mean VAS scores (2.23 ± 1.36) compared to the ibuprofen group (3.37 ± 2.14) (p < 0.05), demonstrating superior analgesic efficacy. Conclusion: Celecoxib provided significantly better pain relief than ibuprofen following tooth extraction, suggesting that selective COX-2 inhibition may offer an effective and well-tolerated alternative for postoperative analgesia in dental procedures.
Copyright (c) 2025 Sundas Iqbal Aslam, Jehan Alam, Neha Joel, Ammara Siddiqui https://creativecommons.org/licenses/by/4.0
Incidence of common nerve injuries in patients with oral and maxillofacial trauma present at tertiary care hospital
Objective: To determine the frequency of common nerve injuries among patients presented with maxillofacial trauma. Methodology: The study was designed as a cross-sectional study and conductedin the Department of Oral and Maxillofacial Surgery at Jinnah Postgraduate Medical Centre, Karachi, from November 2023 to May 2024. A detailed history was obtained from each patient, followed by a clinical examination to identify any nerve involvement due to maxillofacial trauma. Radiological evaluation in the form of Orthopantomogram (OPG) and Paranasal Sinus (PNS) views was carried out to assess the presence of fractures and any associated nerve injuries. The type of nerve injury was confirmed through a comprehensive clinical assessment and history to detect involvement of the olfactory, infraorbital, inferior alveolar, and facial nerves. Results: Mean age was 32.4 ± 11.7 years. The majority of patients were male (70.0%), with females comprising 30.0% of the study population. In terms of type of nerve injury, the inferior dental nerve (IDN) was most commonly affected (44.6%), followed by the infraorbital nerve (ION) (28.5%), the facial nerve (18.5%), and the olfactory nerve (8.5%). Conclusion: This study's findings align with global trends in oral and maxillofacial nerve injuries, showing male predominance and high RTA-related trauma incidence, though assaults are more common in developed nations, reinforcing known trauma-nerve injury associations.
Copyright (c) 2024 Sarfraz Ali, Jehan Alam, Ruqayah Shah, Ahmad Sohail https://creativecommons.org/licenses/by/4.0
Comparison between the efficacy of in-plane vs out-of-plane needle technique for ultrasound guided intravascular access
Objective: To compare the efficacy in terms of first pass success rate of in-plane vs out-of-plane needle technique for ultrasound guided central venous catheterization. Methodology: Randomized controlled trial was conducted at the Anesthesia Department, Shaikh Zayed Hospital Lahore, for a duration of 6 months i.e. from Jan 16, 2025 till June 15, 2025. After obtaining written informed consent, 280 patients who met the selection criteria were enrolled and were split into two equal-number groups using the lottery technique.i.e. 140 in each group. Patients in Group A underwent internal jugular vein catheterization via in-plane approach and Group B underwent out-of-plane approach. Outcomes were assessed and were statistically analyzed. Results: The mean age of the patients in Group A was 5211.49 years and in Group B was 5111.32 years. The mean time take for CVC in Group A was 557.71 seconds and in Group B was 427.29 seconds (p<0.001). The mean number of needle passes in Group A were 21.21 and in Group B were 10.55 (p=0.02). In Group A, the in-plane approach was efficacious in 87% patients compared to out-of-plane approach which was efficacious in 84.3% patients (p=0.495) Conclusion: There was no discernible difference in the effectiveness of the in-plane and out-of-plane approaches for CVC in patients undergoing heart surgery.
Copyright (c) 2025 Hira Khalil, Riffat Zahid , Unais Ahmed, Syed Mehmood Ali , Tayyaba Mumtaz, Hafsa Hafeez https://creativecommons.org/licenses/by/4.0
Efficacy of adjunctive corticosteroid therapy in severe community acquired pneumonia (SCAP) at a tertiary care hospital in Pakistan
Objective: To determine the adjunctive corticosteroid therapy in severe community acquired pneumonia (SCAP) at a tertiary care hospital in Pakistan. Methods: A randomized controlled trial was conducted at department of Pulmonology, Gujranwala Medical College / DHQ Gujranwala from 07-11-2024 to 06-05-2025. Sixty patients admitted in the department of pulmonologywere selected and divided into two groups. Group-A received only antimicrobial therapy and group-S received antimicrobial and 40?mg/day prednisone for 7 days as adjunctive therapy. Baseline data was recorded. Duration of antibiotics and hospital stay were also documented. Re-evaluation was done at seventh day of treatment and efficacy was assessed.Data was analyzed through SPSS version 25. Student t-test, chi square test or Fisher’s Exact test were applied. P ?0.05 was taken as statistically significant. Results: Duration of antibiotics therapy and hospitalization were significantly shorter in the steroid group (10.60±1.59 vs. 14.83±3.79 days, p<0.001; 11.43±2.03 days vs. 13.93±3.77 days, p=0.003, respectively). The outcome was better in the steroids group as compared to the antibiotics alone group (70% vs. 43.3%, p= 0.037). Conclusion: The use of corticosteroids has a beneficial role in improving the outcome and reducing the hospital stay among the elderly patients of severe community acquired pneumonia.
Copyright (c) 2025 Asad Iqbal Khan, Muhammad Younus, Asim Saleem Sheikh, Abdullah Khalid, Ali Raza, Hanzala https://creativecommons.org/licenses/by/4.0
Pattern of dentoalveolar injuries in trauma patients presenting in maxillofacial department of tertiary care hospital
Objective: To determine the patterns of dentoalveolar injuries in patients presenting to the Maxillofacial Surgery Department of a tertiary care hospital. Methodology: The study employed a cross-sectional design and was conducted in the Department of Oral and Maxillofacial Surgery at Jinnah Postgraduate Medical Centre, Karachi, from December 2023 to June 2024. A detailed history and clinical examination, including extra-oral and intra-oral assessments, were conducted. Radiographic evaluations such as periapical, panoramic, and cone-beam CT scans were performed as needed. Injuries were classified according to Andreasen’s criteria. Results: Regarding the causes of nerve injury, road traffic accidents were the most common etiology, accounting for nearly half of the cases 49.7%, followed by assault 22.7%, falls 14.9%, epileptic seizures 9.4%, and firearm injuries 3.3%.The pattern of dentoalveolar injuries showed that enamel fractures were the most prevalent 24.9%, followed by root fractures 16.6%, subluxation and concussion 14.4%, dentine fractures 12.6%, extrusion 8.3%, crown fractures 6.6%, and intrusion 2.2%. Conclusion: Young males were predominantly affected by dentoalveolar trauma, with road traffic accidents and falls as the leading causes. Avulsion, subluxation, and luxation were the most common injury patterns.
Copyright (c) 2024 Ahmad Sohail, Jehan Alam, Ruqayah Shah, Sarfraz Ali https://creativecommons.org/licenses/by/4.0
The Frequency and Histological Type of Oral and Maxillofacial Malignancies Presenting at Tertiary Care Hospital
Objective: to determine the frequency of common types of oral and maxillofacial malignancies in patients presenting with malignant tumors at tertiary care hospital. Methodology: The study employed a descriptive cross-sectional design and was conducted in the Department of Oral and Maxillofacial Surgery at Jinnah Postgraduate Medical Centre, Karachi, from November 2023 to May 2024. The study focused on the histological types of oral and maxillofacial malignancies, which were classified based on cellular and tissue characteristics identified through microscopic examination. Data were collected using a customized proforma, recording biographical details and study variables such as frequency and histological typing based on histopathology reports. Results: The study included 175 patients, majority of the patients 85.1% aged >40 years. Tobacco use was prevalent among the study patients i.e. smoking 35.4%, pan 27.4%, and ghutka 22.9%. It was seen that squamous cell carcinoma 54.9% dominated carcinomas, followed by mucoepidermoid 24.6% and adenoid cystic 13.7%. Among sarcomas, Burkitt’s lymphoma 58.3% was most frequent, followed by osteosarcoma 34.9%. Conclusion: This study highlights the predominance of squamous cell carcinoma among carcinomas and Burkitt’s lymphoma among sarcomas, with significant age-related differences in sarcoma subtypes. The high prevalence of tobacco use underscores the need for targeted public health interventions to reduce modifiable cancer risk factors.
Copyright (c) 2024 Sarfraz Ali https://creativecommons.org/licenses/by/4.0
Pattern of Mandibular Fractures Presenting in Maxillofacial Department of Tertiary Care Hospital.
Objective: This study will be conducted to evaluate the pattern of mandibular fractures presenting in maxillofacial department of tertiary care hospital. Methodology: The study was conducted in the Department of Oral and Maxillofacial Surgery at Jinnah Postgraduate Medical Centre, Karachi, over a period of six months from December 2023 to June 2024, after the synopsis was approved. A validated questionnaire was used to collect demographic data, including age, gender, and residential status, as well as details regarding the etiology of the fracture (e.g., road traffic accidents, falls, assaults, sports injuries) and fracture characteristics (location, type, and complexity). Results: Unilateral fractures 55.5% were more common than bilateral fractures 44.5%, with the angle 32.0% and body 26.5% being the most frequent fracture sites. Gender analysis showed no significant differences in fracture type (unilateral fractures: 53.5% in males vs. 60.7% in females, p=0.355) or fracture location (p=0.602), though males had a higher incidence of para-symphysis fractures 7.6% vs. 1.8%. Similarly, age stratification (18–40 years vs. 41–60 years) revealed no significant associations with fracture type or location. Conclusion: Mandibular fractures are a fairly common injury in severe trauma, primarily affecting young males. The most frequent sites of fracture are the mandibular angle, followed by the body and the condyle, while symphyseal, parasymphyseal and ramus fractures are relatively rare.
Copyright (c) 2024 Ahmad Sohail, Jehan Alam https://creativecommons.org/licenses/by/4.0
Prevalence of eczema in breast feed versus bottled feed
Objective: To compare the prevalence of eczema in infants who are exclusively breastfed versus those who are bottle-fed during the first six months of life. Methods: This cross-sectional study was conducted at Abbasi Shaheed Hospital, Karachi, Pakistan from 8 July 2023 to 7 January 2024 among infants aged 6 months to 2 years attending pediatric outpatient clinics. Feeding practices were recorded based on caregiver interviews, categorizing infants as either exclusively breastfed or bottle-fed. The diagnosis of eczema was made clinically by a pediatrician using standard diagnostic criteria. Statistical analysis was performed to compare the prevalence between the two groups. Results: In a study of 200 infants aged 1 month to 2 years, eczema prevalence was significantly higher in bottle-fed (28%) than breastfed (12%) children (p = 0.004). Among males, 28.6% of bottle-fed and 11.1% of breastfed had eczema (p = 0.016), while in females, rates were 27.3% and 13.0%, respectively (p = 0.046). Eczema was more common in bottle-fed infants across both normal BMI (17.2% vs. 7.3%, p = 0.047) and overweight categories (42.9% vs. 33.3%, p = 0.001). Conclusion: This study demonstrates a significantly higher prevalence of eczema among bottle-fed children compared to breastfed children aged 1 month to 2 years, highlighting the protective role of breastfeeding against early childhood eczema.
Copyright (c) 2024 Ushna Fatima, Shaheen Masood, Syed Zaidan Shuja , Taimoor Naeem Faridi, Shafaq shahid, Amber Naseer https://creativecommons.org/licenses/by/4.0
Comparison of outcome with 50% salicylic acid versus cryotherapy in the treatment of plantar warts
Objective: “To compare the outcome of 50% salicylic acid versus cryotherapy in treating plantar warts.” Methodology: An RCT was conducted at the dermatology department of Nishtar Hospital, Multan, from August 1st, 2024, to January 31st, 2025. A total of 656 patients with plantar warts were randomly allocated to Group A (cryotherapy) and Group B (50% salicylic acid). All patients were evaluated at the conclusion of week 12 following the commencement of therapy. The outcome was classified as complete response (absence of warts), partial response (decreased number of warts), and no response after 12 weeks of treatment. The outcome was compared using a 5% significance level chi-square test, and a p-value of ? 0.05 was considered significant. Results: Both groups were comparable in terms of mean age, gender, duration of warts, and the number of warts. Group A had a higher complete response rate than Group B (30.8% vs. 24.7%; p = 0.134). No significant associations were found between patient response and study groups for age (p = 0.180), gender (p = 0.120), duration of warts (p = 0.249), or number of warts (p = 0.458). Conclusion: Our study concludes that cryotherapy had a better complete response rate than 50% salicylic acid at 12 weeks of therapy. Key Words: Cold Therapy; Cryotherapy; Human Papillomavirus; Salicylic Acid; Plantar Warts; Verruca; Warts;
Copyright (c) 2025 Shoaib Iqbal, Aliya Akhtar, Raheel Tahir, Sidra Tahir, Amra Batool, Asma Batool https://creativecommons.org/licenses/by/4.0
Correlation of creatine phosphokinase (CPK) levels with severity of organophosphate poisoning
Objective: To determine the correlation of creatine phosphokinase (CPK) levels with the severity of organophosphate poisoning in assessing the prognosis. Material and Methods: A cross-sectional study was conducted from January 9, 2025, to July 9, 2025, at the Department of Accident and Emergency, Mayo Hospital, Lahore. A total of 60 patients presenting with organophosphate poisoning were enrolled. The Peradeniya Organophosphate Compound Poisoning Scale (POP) assessed the severity of OP poisoning. Then, blood samples were collected for serum creatine phosphokinase. A comparison of CPK levels between mild to moderate and severe organophosphate poisoning was performed using a paired t-test. To find a correlation between CPK levels and the severity of OP poisoning (POP score), the Pearson correlation coefficient (r) was used. Results: The mean age was 37.63±13.48 years, with 55.0% of patients being under 40 years old. There were 78.3% males. The mean serum CPK level was 615.95±407.75 (IU/L). Patients with mild to moderate POP scores had a mean CPK level of 515.11 ± 248.65 IU/L, whereas those with severe scores had a significantly higher mean of 1374.33 ± 189.65 IU/L (p < 0.001). Pearson correlation analysis revealed a strong positive correlation between POP severity and CPK levels (r = 0.807, p < 0.001). Conclusion: Our study concluded that the creatine phosphokinase level is positively correlated with severe organophosphate poisoning, as measured by the POP scale. Key Words: Atropine; Creatine phosphokinase; Creatine kinase; Organophosphorus; Organophosphate; Organothiophosphonate Poisonings; Malathion;
Copyright (c) 2025 Awais Amin, Layla Mazhar, Abdul Shakoor Shakir, Salman Raza https://creativecommons.org/licenses/by/4.0
Growth Assessment and Nutritional Profiling of School-Aged Children: A Cross-Sectional Study
Introduction: Childhood malnutrition, encompassing both undernutrition and overnutrition, is a major public health issue. Regular growth monitoring using anthropometric indices is vital to evaluate the nutritional status of school-aged children and to guide intervention strategies. Material & Methods: A cross-sectional study was carried out on a sample of 1300 school children. Data collected included age, height, weight, and BMI. Nutritional status was assessed using WHO growth standards for Weight-for-Height (WFH) and Height-for-Age (HFA). Children were categorized into Severe, Moderate, and Mild Malnutrition, Normal, Overweight, Obese+, and Obese++. Results: Of the 1300 children examined, 14.3% were identified with severe wasting, 25.1% with moderate wasting, and 30.5% with mild malnutrition. Only 20.2% of children fell within the normal range. Overweight and obesity were found in 7.0%, 2.5%, and 0.4% of the children respectively. Conclusion: A significant proportion of the study population exhibited malnutrition, with a majority falling into various categories of undernutrition and a considerable portion affected by overnutrition. These findings underscore the need for regular nutritional surveillance and targeted health programs to address the dual burden of malnutrition in school-aged children.
Copyright (c) 2025 Muhammad Naveed Mazhar, Syed Hassan Danish, Muhammad Zeeshan Khalid, Muhammad Karina Naveed, Farah Ahmad, Asghar Latif Shamsi https://creativecommons.org/licenses/by/4.0
Pudendal nerve block for post-opertive pain following per-anal surgeries in non-suppurative conditions
Objective: To compare patient outcomes of pain scores, time to first mobilization, need for intravenous opioids and mean hospital stay in patients receiving bilateral pudendal nerve block versus those receiving intravenous analgesia undergoing hemorrhoidectomy Methodology: This Quasi-experimental study was conducted at department of surgery, Combined Military Hospital, Multan from February 2024-December 2024. The patients were randomized into two groups of 80 patients each. Group A (n=80) to receive bilateral pudendal nerve block and Group-B (n=80) to receive intravenous analgesia in the form of opioids. Primary variables studied were median pain scores on the Visual Analog scale assessed at 6, 12, 24 and 36 hours. Secondary variables of study were need for rescue opioid analgesia and mean hospital stay. Mean total dose of IV Nalbuphine used till discharge was 13.44±5.87 mg versus 38.94±6.34 mg (p<0.001). Mean hospital stay was 2.35±0.48 days versus 3.76±0.55 days (p<0.001) Results: Median pain scores assessed post-operatively after spinal effect wore off showed that pain scores between both groups were 2.00 (1.00) versus 4.00 (2.00) at 6 hours (p<0.001), scores were 3.00 (1.00) versus 3.00 (1.00) at 12 hours (p=0.415), scores were 4.0 (1.00) versus 5.00 (1.00) at 24 hours (p<0.001) and scores were 4.00 (1.00) versus 4.00 (2.00) at 36 hours (p=0.081). Conclusion: The study concludes that PNB is associated with lesser pain scores, lesser duration of admission and lower need of opioids as rescue analgesia in patients undergoing hemorrhoidectomies.
Copyright (c) 2025 Afsa Nayyar https://creativecommons.org/licenses/by/4.0
Effect of letrozole on shrinking the size of uterine fibroids in symptomatic patients of the reproductive age group
Objective: To compare the mean fibroid size (cm) before and after treatment with letrozole and the frequency of symptom improvement in symptomatic patients of the reproductive age group. Methodology: Quasi-experimental study was conducted between November 1st, 2024, and April 30th, 2025, at the Obstetrics and Gynaecology Department of Nishtar Hospital in Multan. Thirty women aged 25-45 who presented to the outpatient department were enrolled in this study. Throughout the trial, married women were encouraged to use barrier methods of contraception. Symptoms were graded according to the operational definition. Every woman took 5mg of the tablet Letrozole daily for three months. The myoma size before and after treatment, and the improvement of symptoms, were recorded. Results: The mean age of the study population was 34.70 ± 5.31 years. Most patients were married (76.7%, n=23), had 0–2 children (66.7%, n=20), and were non-obese (73.3%, n=22). Leiomyomas were primarily single in 63.3% (n=19) patients, with a mean size of 4.63 ± 1.22 cm, and 60.0% (n=18) exceeded 5 cm. Letrozole therapy significantly reduced uterine fibroid size from 5.37 ± 0.88 cm (pre-treatment) to 4.64 ± 0.70 cm (post-treatment), with a mean reduction of 0.73 cm (p=0.003). Among 30 patients, 66.7% (n=20) reported symptom improvement after letrozole therapy. Conclusion: Reduced uterus-leiomyoma size, improved control of related symptoms, and fewer adverse effects were observed after treatment with Letrozole. Key Words: Aromatase Inhibitors; Fibroid; Leiomyoma; Letrozole; Uterine fibroids;
Copyright (c) 2025 Amara Malik, Saima Ashraf, Moiz Hassan Azdee https://creativecommons.org/licenses/by/4.0
Comparison of effect of Fentanyl versus Esmolol on attenuation of hemodynamic response to laryngoscopy and endotracheal intubation
Abstract Objective: This study aimed to compare the efficacy of esmolol and fentanyl in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation. Methodology: A randomized controlled trial was conducted at CPEIC Multan, involving 194 patients undergoing elective surgery under general anesthesia. Patients were divided into two groups: Group A received 0.5 mg/kg of intravenous esmolol, and Group B received 1 mcg/kg of intravenous fentanyl, administered three minutes before intubation. Hemodynamic parameters, including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were recorded at baseline and five minutes post-intubation. Results: Both groups had comparable demographic and baseline hemodynamic characteristics. Post-intubation, Group A exhibited significantly lower HR (84.18±6.33 bpm) than Group B (96.72±5.39 bpm, p<0.001). Although SBP and DBP differences between the groups were not statistically significant (p=0.112 and p=0.229, respectively), MAP was significantly lower in Group B (92.48±8.44 mmHg) compared to Group A (96.14±6.89 mmHg, p=0.001). Conclusion: Esmolol was more effective in attenuating the tachycardic response to laryngoscopy and intubation, whereas fentanyl showed a greater effect on MAP reduction. These findings suggest esmolol may be preferable for controlling heart rate, while fentanyl may better manage blood pressure surges. Tailored dosing or adjunct therapies might be necessary for comprehensive hemodynamic control.
Copyright (c) 2025 Salwa Sheeraz, Kaneez Umme Farwa https://creativecommons.org/licenses/by/4.0
Comparing rubberband ligation vs sclerobanding for second degree hemorrhoids: A prospective comparative study
Objective: To analyze the findings related to rubber band ligation versus sclerobanding in patients presenting with second degree hemorrhoids. Methodology: Quasi experimental study was conducted at surgery Department, Combined Military Hospital Multan from April 2024 to March 2025. A total of 260 patients belonging to both genders with second degree hemorrhoids were divided into two groups of 130 patients each. Patients in Group A underwent rubber band ligation while patients in Group received sclerobanding. The operative time was documented in both groups. Patients were followed up at 2, 4 and 8 weeks intervals for resolution of symptoms and any complications. SPSS version 25 was employed for data analysis, and a p-value below 0.05 was regarded as indicative of statistical significance. Results: The average age of participants in the study was 43.6 ± 11.4 years. The mean duration of surgery in the RBL group was 5.9 ± 2.0 minutes, compared to 9.4 ± 2.2 minutes in the sclerobanding group a difference that was statistically significant (p < 0.001). At 8 weeks follow up, complete resolution of symptoms was reported in 110 patients in Group A (84.6%) versus 121 patients (93.1%) in Group B. There was a statistically significant difference between the two groups (p = 0.030). At the 8-week follow-up, recurrence was observed in 7.7% of patients (10 individuals) in Group A, compared to 2.3% (3 individuals) in Group B—a difference that reached statistical significance (p = 0.046). Conclusion: Sclerobanding was found to be better than rubber band ligation alone in patients presenting with second degree hemorrhoids.
Hemorrhoids, postoperative pain, rubber band ligation, sclerobanding.
Copyright (c) 2025 Dr. Hamza Ali Malik, Dr. Muhammad Ali Khan, Dr. Rizwan Shabbir, Dr. Muhammad Ibtisam Raza, Dr. Abdullah Sher Kakar, Dr. Hassan Shabbir https://creativecommons.org/licenses/by/4.0
Increase in vessel luminal diameter after rotational atherectomy: a study from multan institute of cardiology, pakistan
Objective: To determine the increase in vessel luminal diameter in patients undergoing rotational atherectomy at Multan Institute of Cardiology, Pakistan. Material and Methods: A descriptive study enrolled 100 patients undergoing rotational atherectomy at Multan Institute of Cardiology, Pakistan. After baseline characteristics, the pre- and post-procedural minimal luminal diameter and reference vessel diameter were recorded. The change in luminal diameter was recorded in terms of mean and standard deviation. We stratified the data, applied a post-stratification t-test, and considered a p-value of less than 0.05 as significant. Results: The mean age was 52.20 ± 11.19 years, with more male (76.0%) patients. Risk factors included hypertension (45.0%), smoking (40.0%), diabetes (34.0%), and hyperlipidemia (32.0%). Lesions most frequently involved was the left anterior descending artery (LAD: 55.0%), with mid-distal location (65.0%) and severe calcification (71.0%). The minimal lumen diameter (MLD) significantly increased from pre-procedure and post-procedure 0.75?±?0.14?mm to 1.88?±?0.22?mm (p?<?0.001). At the same time, the mean luminal gain was 1.13±0.026?mm. The luminal gain with relation to reference diameter was 46%. Conclusion: Rotational atherectomy can lead to significant luminal gain with remarkable procedural success.
Copyright (c) 2025 Momin Rasheed, Badar Ul Ahad Gill, M. Ikram Farid, Mubashir Sherwani, Muhammad Shahzad Fareed, Masood Ahmad Khan https://creativecommons.org/licenses/by/4.0
Comparison of small versus large intracoronary thrombus burden on angiographic and short-term outcomes in patients undergoing primary PCI
Objective: To compare the angiographic and short-term clinical outcomes of small vs. large intracoronary thrombus in patients undergoing Primary PCI. Methodology: A prospective comparative study was conducted at the CPEIC, Multan, from 10-04-2024 to 31-04-2025. Three hundred thirty patients with STEMI were enrolled, and the thrombus burden was analysed. Patients with thrombus grades of 0-2 were labelled as small thrombus burden (STB), and those with ?3 were considered large (LTB). The primary outcome variables were TIMI III flow (procedural success), 30-day mortality and 30-day re-infarction. Qualitative data was compared using the Chi-square test, and quantitative data with an independent t-test. Results: Out of 330 patients, there were 160 (48.5%) with STB and 170 (51.5%) with Large TB. No significant differences were observed in STEMI types (anterior wall: 58.1% vs. 60.0%, p=0.809; inferior wall: 32.5% vs. 29.4%) or culprit vessels (left anterior descending: 61.9% vs. 64.7%, p=0.765; right coronary artery: 32.5% vs. 31.2%). Mortality was higher in the STB group (11.9% vs. 5.9%, p=0.05), while re-infarction rates were comparable (8.8% vs. 7.1%, p=0.569). Procedural success (TIMI III flow) was significantly higher in STB (95.6% vs. 88.8%; p=0.022). Conclusion: Although the angiographic differences for thrombus burden were insignificant, small thrombus burden was associated with relatively more procedural success, 30-day mortality and 30-day reinfarction.
Copyright (c) 2025 Muhammad Shahzad Fareed, Muhammad Ikram Farid, Badar Ul Ahad Gill, Mubashir Sherwani, Momin Rasheed, Masood Ahmad Khan https://creativecommons.org/licenses/by/4.0
The Role of Magnetic Resonance Imaging in the Intra-Operative Evaluation of Fistula in Ano
Abstract: Objective: assessing the role of magnetic resonance (MRI) imaging in intraoperative evaluation of fistula in ano. Study Type: Cross Sectional Analytical Study Study Place and Duration: Department of Radiology, Combined Military Hospital Gujranwala, from September 1, 2023 to August 30, 2024. Material and methods: Sixty patients were referred to the hospital's Radiology Department. Subsequently, these patients were referred for MRI scans in the Radiology Department. The MRI scanner used was equipped with a 16 channel body coil and a surface-coil. The data of all 60 patients who underwent surgical intervention were included in the study. The interval between MRI and surgery was from one week to two months. The gold standard was considered to be surgical findings, which were recorded independently by the surgeon. The researcher personally collected the data for the study and analyzed using SPSS version24. Continuous variables (age) were examined using descriptive statistics, namely; standard and mean deviation while categorical variables (gender) were using frequency and percentage. Results: Diagnostic performance indicated sensitivity (94.9%) and specificity (100.0%). The PPV was 100.0%, and the NPV was 25.0%, with an overall diagnostic accuracy of 95.0%. Conclusion: MRI offers precise anatomical and pathological information essential for directing pre-surgical decisions and planning in the management of perianal fistulas. Keywords: Magnetic Resonance Imaging (MRI), Intra-operative, Evaluation, Fistula in Ano, Accuracy, Sensitivity, Specificity.
Intra-operative evaluation of fistula in ano
Copyright (c) 2025 Iqra Aslam https://creativecommons.org/licenses/by/4.0
Comparison of solifenacin versus mirabegron for the treatment of double j stent related lower urinary tract symptoms
Objective: Overactive bladder is mostly treated with a combination of behavioural interventions and commonly prescribed anti-muscarinic medication therapy, including solifenacin, which has considerable side effects and lowers the quality of life. Mirabegron relaxes the detrusor muscle and is a recently approved drug for the treatment of OAB. This study examined the effectiveness and safety of two medications, solifenacin and mirabegron. Methods: This study was a comparative cross-sectional study conducted at Sami Medical Center, Abbottabad for a period of 6 months from August 2022 to January 2023. Female patients of aged ?18 years with symptoms of OAB were enrolled. Results: Current study showed that the average age of patients was 37.47±12.48 years in Group S and 39.93±7.93 in Group M. The population consists of 60 (100%) females. After 4 weeks of follow up dizziness, dry mouth, constipation hypertension and blurred vision were found insignificant between both groups with p-values of 0.312, 0.161, 0.076, 0.076, and 0.313 respectively. OABSS score improved significantly and after therapy 4.20±1.32 in Group S and 3.43±1.13 in Group M. There was no significant difference in frequency of treatment withdrawal p-value 0.150. Conclusion:When it comes to relieving symptoms of OAB, both solifenacin and mirabegron are effective. The OABSS improved with both drugs; however, mirabegron was associated with fewer treatment-related adverse events. We advocate using mirabegron as the first-line treatment. Solifenacin can be utilized if patients are no longer getting the desired effects from Mirabegron.
Copyright (c) 2025 Ali Hussain https://creativecommons.org/licenses/by/4.0