Annals of Punjab Medical College

Sialorrhea: Less Commonly Addressed Symptom of Patients Presenting with Neurological Disorders in Neurology and Oral Medicine Specialties

Mon, 30 Sep 2024 00:00:00 +0000

Background: Saliva-related challenges significantly impact individuals diagnosed having motor neuron disease (MND). Despite existing clinical guiding principles outlining evaluation and management protocols, research attention towards the management of saliva problems has been limited. Objective: To evaluate physicians' perspectives on sialorrhea as a major concern for patients presenting with neurological disorders in neurology clinics. Study Design: Retrospective hospital-based cross-sectional study. Settings: Department of Oral Medicine, Lahore Medical and Dental College. Neurology departments of various hospitals in Lahore including Lahore General Hospital, Jinnah Hospital and Sharif Medical & Dental College, Lahore Pakistan. Duration: An analysis was conducted on individuals diagnosed with MND between January 2021 and January 2023. Methods: The association between clinical factors and drool matters was scrutinized through univariate and multivariable logistic regression, with outcomes presented as odds ratios and corresponding 95% confidence intervals. Additionally, a survey involving health care authorities responsible for patients with motor neuron disease (pwMND) care was carried out to provide context to the conclusions. Results: 250 individuals with motor neuron disease (pwMND) received a diagnosis, with data on saliva issues available for 125 (50%) through direct questioning. Those without available data on saliva problems were slightly older (mean age 68.0 vs. 65.2 years; p = 0.032), but no significant differences found in terms of gender, location of onset, and MND subtype. Conclusion: Saliva problems are prevalent in individuals with MND. Despite this association, a noteworthy proportion of pwMND encountering drooling did not undergo suggested treatments.

Comparative Analysis of Serum Magnesium Levels in Alcoholic and Non-Alcoholic Patients with Type 2 Diabetes Mellitus

Mon, 30 Sep 2024 00:00:00 +0000

Background: It is estimated that 343 million people throughout the world are suffering from type 2 Diabetes mellitus. Alcohol use produces decreased serum magnesium levels in diabetes patients, so a vicious cycle is initiated in diabetes patient. Objective: The aim of this study was to find out the effect of alcoholism on serum magnesium levels in diabetic type 2 patients. Study Design: It was a cross-sectional study. Settings: It was conducted in the Physiology Department of Sindh University Jamshoro in association with the Diabetic OPD of Liaquat University Hospital, Pakistan. Duration: From January 2022 to April 2022 (3 months). Methods: The sample size was comprised of 220 patients who were divided into two groups. The control group consisted of 140 Type 2 diabetic patients with no history of alcoholism, and the test group consisted of 80 diabetic Type 2 patients with alcoholism. A Roche C3-11 auto analyser was used to estimate the serum magnesium level. Blood sugar was calculated by a Care Sens N Glucometer Model No. GM 505 Pad. Results: Those who were suffering from diabetes mellitus and were alcoholics were significantly more suffering from hypomagnesaemia (P value 0.0002, odds ratio = 3.9, likelihood ratio = 1.81) and Obesity (p = 0.040). Conclusion: Patients with type 2 diabetes mellitus who are addicted to alcohol have a higher chance of having hypomagnesemia.

Comparison of Post-Operative Outcome with and without Application of ERAS Protocols in Patients of Acute Appendicitis

Mon, 30 Sep 2024 00:00:00 +0000

Background: The application of ERAS allows for a multidisciplinary and multimodal approach to perioperative care which not only expedites recovery but maximizes patient outcomes. Objective: Comparison of post-operative outcome with and without application of ERAS protocols in patients of acute appendicitis. Study Design: Randomized controlled trial. Settings: Surgical Emergency, Allied Hospital, Faisalabad Pakistan. Duration: 01-05-2023 to 31-12-2023. Methods: 160 patients were included with non-probability consecutive sampling technique. All data was recorded in a predesigned proforma. Results: In our studies mean of Pain score in Group A was 2.45 (Sd-0.53) after 4 hrs.,2.25 (sd-0.43) after 08 hrs,1.66(sd-0.52) after 12 hrs,1.08 (sd-0.28) after 24 hrs. Mean of pain score in Group B was 3.42 (Sd-0.56) after 4 hrs., 3.03(sd-0.29) after 08 hrs., 2.77(sd-0.44) after 12 hrs., 2.20(sd-0.40) after 24 hrs. Mean of Activity score in Group A was 1.41 (Sd-0.58) after 4 hrs.,2.17(sd-0.59) after 08 hrs,2.75(sd-0.56) after 12 hrs,3.68 (sd-0.49) after 24 hrs. Mean of activity score in Group B was 0.08 (Sd-0.28) after 4 hrs., 0.86(sd-0.47) after 08 hrs., 1.62(sd-0.48) after 12 hrs., 2.25(sd-0.46) after 24 hrs. In Group A mean of rescue analgesia needed postoperatively is 0.17 (0.44) and in Group B, the mean is 2.22(sd-0.67). Conclusion: Patients who underwent appendicectomy with ERAS protocols had less pain postoperatively, were mobile and able to perform routine activity earlier, had less need of rescue analgesia postoperatively, were oral-free earlier, less incidence of surgical site infection and were discharged from the hospital earlier

Efficacy of Topical and Submucosal Local Anesthesia in Reducing Pain and Anxiety during Inferior Alveolar Nerve Block

Mon, 30 Sep 2024 00:00:00 +0000

Objective: To compare the efficacy of topical and submucosal local anesthesia in reducing pain and anxiety during inferior alveolar nerve block. Study Design: Quasi-experimental study. Settings: Institute of Dentistry, CMH Lahore Medical College, Lahore Pakistan. Duration: From December 2021 to January 2023. Methods: Patients were divided into three groups. In group 1, conventional IANB was given, in group 2, submucosal anesthesia was given before IANB; and in group 3, topical anesthesia was given before IANB. An interview-administered questionnaire was used to mark their level of anxiety and pain. Mann-Whitney U and Kruskal Wallis were used to compare the mean VAS and MDAS scores. Results: The mean VAS score was 3.95 ± 1.74. Younger age, females, and the patients in the simple IANB group reported higher VAS scores. Patients in the simple IANB group had significantly higher VAS scores, followed by the patients who received submucosal and topical anesthesia prior to INAB (p=0.01). The mean MDAS score of the patients was 10.16. Middle-aged adults, females, and the simple IANB group reported higher mean MDAS scores. Males (p<0.001) and those who received topical anesthesia (p=0.019) were less anxious. Conclusion: The use of topical or submucosal anesthesia before administering IANB can effectively reduce pain and anxiety. The highest anxiety and pain perception levels were found in the simple INAB group, while the lowest pain as well as anxiety levels were reported in the topical anesthesia group.

A Cross-Sectional Study to Assess the Healthy Lifestyle Profile of University Students in Faisalabad; Pakistan

Mon, 30 Sep 2024 00:00:00 +0000

Background: This study described the effect and correlation of independent variables such as discipline (MBBS, BDS, DND, AHS, DPT, and OD), study years (first, second, third, and fourth), and living system (with family or university hostel) with a healthy lifestyle. Objective: The study aims to assess the healthy behaviors of students enrolled in various disciplines at The University of Faisalabad. Study Design: Cross-sectional. Settings: The data was collected from students enrolled in various disciplines such as Bachelor of Medicine & Bachelor of Surgery (MBBS), bachelor of dental surgery (BDS), doctor of nutrition and dietetics (DND), allied health sciences (AHS), doctor of physical therapy (DPT), and doctor of optometry (OD) during different study year such as first, second, third and fourth years at the University of Faisalabad (TUF). Duration: Dec 2023 to January 2024 Methods: A questionnaire designed for health-promoting lifestyle profile II (HPLP-II) was distributed among 384 students to assess their healthy life profile. One-way ANOVA and chi-square tests were applied to check the effect and regression analysis was done to determine the correlation of independent variables with the overall HPLP-II and its six subscales (p>0.05). Results: MBBS participants got the overall HPLP-II mean value of 2.541±0.068 with the highest mean score 2.869±0.036 for spiritual growth and the lowest mean score 2.169±0.075 for health responsibility. This overall HPLP-II score declined among BDS (2.529±0.089), DND (2.521±0.059), AHS (2.513±0.058), DPT (2.498±0.078), and OD (2.493±0.019). The first-year participants showed significantly better health responsibilities, physical activity, spiritual growth, and nutrition than the participants of the second, third, and fourth years. The participants who were living with their families had significantly better nutrition, health responsibility, interpersonal relations, and physical activity scores as compared to those students living in university hostels. Conclusion: These findings relate the HPLP-II to a variety of university disciplines, study years, and students’ living systems. This will allow university administrators and healthcare practitioners to devise interventions aimed at enhancing and designing healthy lifestyles and suitable educational programs for students.

Role of Calcium in Mental Development and Intelligence of School-Aged Children of District Hyderabad, Sindh

Mon, 30 Sep 2024 00:00:00 +0000

Background: Calcium ions are essential regulators of a variety of neuronal activities that take place in the nervous system. “These neuronal activities include the formation and maturation of neural circuits, as well as long-term memory. However, Calcium ions are also important in the early stages of neurogenesis. Objective: The purpose of this study was to assess the impact that calcium on the mental development of school-aged children. Study Design: Cross-sectional study. Settings: The study was conducted in different government schools in Qasimabad, Hyderabad Pakistan. Duration: October 2021 to March 2022. Methods: Informed consent was obtained before the enrolment of participants, 121 children were recruited. A structured questionnaire was formed for the assessment, and a blood sample of five milliliters was drawn for the laboratory's investigation of serum calcium. Data analysis was performed using SPSS 26.0, and a P-value of less than 0.05 was set to be statistically significant. Results: In this study, the mean age of all participants was 11 ±2.296 years, serum calcium was 9.12 ± 4.21mg/dl, and the FSIQ score was 91 ± 11.3. In this study, serum calcium was related to the development of IQ. Conclusion: This study concluded that an increase in serum calcium levels may lead to an increase in FSIQ levels and vice versa. As a result, one may conclude that the mental development of children is contingent on the quantities of calcium in their blood.

Effectiveness of Orthopedic Bracing in the Management of Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial

Mon, 30 Sep 2024 00:00:00 +0000

Background: Scoliosis is a complex spinal condition that often requires bracing as a significant treatment to prevent spinal deterioration in adolescent idiopathic scoliosis (AIS). Adaptation can be difficult; the effectiveness of support is well documented and treatment aims to improve the spine and body's quality of life. Objective: The objective of the study is to evaluate the effectiveness of bracing as a treatment for preventing spinal deterioration in adolescent idiopathic scoliosis (AIS) and to assess its impact on the quality of life and spinal health of patients. Study Design: This one-arm quasi-experimental study. Settings: Outpatient department of tertiary care hospitals of Sindh i-e Civil Hospital, Suleman Roshan and Memon Charitable Hospital, Pakistan. Duration: One year from 15-04-2023 to 15-04-2024. Methods: The study evaluated the effectiveness of bracing in 20 AIS patients aged 10-17 with Cobb angles of 20°-40°, excluding those with prior treatments or other pathologies. Patients received thoracolumbosacral orthoses (TLSO) and were monitored regularly, required to wear braces 23 hours daily. Assessments of trunk inclination, Cobb angle, and body image were conducted every six months over a year, with radiographic and shoulder balance evaluations performed and bisphosphonates were advised during visits. Results: The study involved 20 AIS patients (11 females, 9 males) with a mean age of 13.8 years and an average baseline Cobb angle of 27.6 degrees. Over 12 months, the mean Cobb angle significantly decreased to 23.12 degrees, indicating a meaningful reduction in spinal curvature. Notable improvements were observed from baseline to 6 months (mean reduction of 2.23 degrees, P < 0.001) and from 6 months to 12 months (mean reduction of 2.89 degrees, P < 0.001), demonstrating significant and clinically meaningful corrections in spinal alignment. Conclusion: The findings highlight the effectiveness of bracing in reducing spinal curvature in adolescents with scoliosis, suggesting promising interventional strategies to improve patient outcomes.

Cause-Specific Mortality Pattern Variation of Unnatural Deaths; A Comparative Demographic Study in the settings of South Punjab

Mon, 30 Sep 2024 00:00:00 +0000

Objective: To examine the demographic profile of unnatural deaths, in order to explore variation over time, in cause-specific mortality patterns of unnatural deaths, in South Punjab.Study Design: Cross sectional (descriptive) study. Settings: Department of Forensic Medicine & Toxicology, Sheikh Zayed Medical College, Rahim Yar Khan Pakistan. Duration: Six years, (1^st January, 2015 to 31^st December, 2017) and (1^st January, 2021 to 31^st December, 2023). Methods: Non-probability convenient sampling technique. Data from 2015 to 2017 taken as group A, while 2021 to 2023, as group B. Information collected from police papers, hospital record & autopsy reports entered on pre-designed performa. Statistical analysis is done by SPSS version 26. Results: Male victims were 79.71% in group A and, 72.57% in B as compared to 20.29% and 27.43% females respectively in group A and B. The age range of 21–30 year was common among victims in both groups. Accidents ratios decrease from 26.09% to 8.85% in recent times. The incidence of deaths due to sharp weapon risen to 12.39% as compared to 2.17% while the blunt weapon cases increased (17.70%) from (2.90%). Conclusion: Males are commonest victims of unnatural deaths across both groups but with a noticeable rise in ratio of females in B. Prevalent manner of death is homicidal. Common cause of death is firearm in group A, shifted to sharp edged weapons in B. A raise in sharp & blunt weapon cases needs coining preventive strategies.

Antibiogram of Pathogens Isolated from Surgical Site Infections at a Tertiary Care Hospital, Rawalpindi

Mon, 30 Sep 2024 00:00:00 +0000

Background: Surgical site infections are the most commonly reported healthcare-associated infections. However, in developing nations, data regarding the antibiogram of pathogens isolated from these infections are scarce. Objective: This study aimed to assess the bacterial profile and antimicrobial susceptibility of isolates from surgical site infections in post-operative patients at a tertiary care hospital in Rawalpindi. Study Design: Retrospective observational study. Settings: Department of Microbiology, Pakistan Railway hospital (PRH), Rawalpindi Pakistan. Duration: January 2021 to December 2021. Methods: All specimens (301) with positive cultures were recruited from surgical wards. Following standard procedures, specimens were cultured; and data were retrieved from the hospital database. Pathogens were identified using laboratory techniques including Gram staining and biochemical tests, and the antibiotic sensitivity patterns were recorded. Antimicrobial susceptibility testing was performed according to the protocols of the Clinical & Laboratory Standards Institute CLSI, using the modified disk diffusion method. The data was analyzed using SPSS version 24.0. Results: A total of 1128 patient samples were found to be culture positive in study period, out of them 301 (27%) patients samples were with surgical site infections, cultures comprised both gram-positive (33%) and gram-negative organisms (65%), with a small portion (1-2%) of mixed microbial growth. Escherichia coli was the most prevalent gram-negative species 105(34.88%), followed by Klebsiella pneumoniae 63(21%). Appreciable resistance was observed against Penicillin, Cefotaxime, Ceftriaxone, and Carbapenems. Conclusion: Various gram-positive and gram-negative microorganisms, such as E. coli, Klebsiella, Staphylococcus aureus, MRSA, and Pseudomonas, are commonly found in surgical site infections. No antibiotics were universally effective; however, Penicillin, Ceftriaxone, Cefotaxime, and Quinolone resistance was observed.

Spectrum of Residual Symptoms in Post COVID Patients

Mon, 30 Sep 2024 00:00:00 +0000

Background: There are limited studies regarding post-COVID-19 infection patient’s health status. Objective: To analyze the prevalence of post COVID-19 residual symptoms in local population of Faisalabad. Study Design: Cross sectional study. Settings: This study was conducted in Govt. General Teaching Hospital, GM Abad / Faisalabad Medical University, Faisalabad Pakistan. Duration: Over a period of 6 months. Methods: 212 patients fulfilling inclusion and exclusion criteria were enrolled in the study after obtaining a written informed consent. Demographics, relevant history, symptoms at presentation, date / duration since discharge from hospital, symptoms present on follow up date, severity of disease and treatment given were recorded for the patients discharged from the hospital in last 4 months. Results: Out of 212 COVID-19 patients, 56.6% were male and 43.4% were females Mean length of Hospital stay and mean time to follow up was 6.8 days and 88 days respectively. 94.3% patients returned to baseline functional status and jobs after recovery while 5.7% could not return to baseline functional status. 56.6% patients reported no post covid residual symptoms. Most frequently reported symptoms after covid recovery were Fatigue 24.5%, Depression 22.6% and Body Pains 20.8%. Fever, cough and dyspnea were reported in 11.3%, 17% and 3.8% respectively. Conclusion: Despite apparent recovery from Covid-19 infection many patients still face a wide range of post covid symptoms months after initial infection.

Obstructive Sleep Apnea in Patients with Difficult to Treat Asthma

Mon, 30 Sep 2024 00:00:00 +0000

Background: Bronchial Asthma(BA) is quite a common chronic ailment affecting more than 334 million people worldwide. Many patients have poorly controlled asthma despite adequate treatment. Many factors are known to influence asthma control. Previously, various authors reveal the association between Obstructive sleep apnea(OSA) and BA regarding risk and popularity. The essential point of this examination was to research the occurrence of OSA in patients with difficult-to-treat asthma (DTA). Objective: Our objective was to determine the frequency of OSA in difficult to treat asthma patients. Study Design: Cross-sectional study. Settings: The study was conducted in the Department of Pulmonology, District Head Quarter (DHQ) Hospital, Faisalabad Pakistan. Duration: The time duration was 6 months starting from July 2018 to December 2018. Methods: 73 patients fulfilling the selection criteria were enrolled in the study from the Department of Pulmonology, DHQ Hospital, Faisalabad. Information regarding their demographic data was noted in the proforma. The frequency of obstructive sleep apnea in difficult-to-treat asthma was noted. Results: Mean age was 39.44+7.62 years, males were 43.8%(n=32) whereas female were 56.2% (n=41). Frequency of OSA in patients with difficult to treat asthma in our study was recorded in 56.16% (n=41) of the cases. Conclusion: We concluded that the frequency of OSA in difficult to treat asthmatic cases is very high. However, identification of this condition is important to reduce the cost of morbidity and quality of life, early and effective management.

Association of Achilles Tendinitis and Tendinopathy with Knee Osteoarthritis among Older Adults

Mon, 30 Sep 2024 00:00:00 +0000

Background: Achilles tendon is a band of connective tissue, in some cases due to overuse activity, tendon may inflame which causes pain and irritation. Achilles tendinitis and tendinopathy is common in osteoarthritis because calf muscles become weak due to additional support they are providing to inflamed joint. Objective: The objective was to determine the prevalence and association of achilles tendinopathy and tendinitis in patients with knee osteoarthritis among older adults. Study Design: Cross sectional survey. Settings: Allied Hospital, District Headquarter Hospital, Madinah Teaching Hospital Faisalabad and Tehsil Headquarter Jaranwala Pakistan. Duration: February to June 2023. Methods: Study was conducted on 80 diagnosed knee osteoarthritic participants and onetime data was collected analyzed to check the association of Achilles tendinitis and tendinopathy with knee osteoarthritis among older adults. Data was assessed by using the VISA-A questionnaire to rule out the pain and functional limitations and Thompson test to evaluate the association of Achilles tendinopathy. Results: Descriptive statistics and frequency distribution was used for the demographic data. Correlation test was applied to analyze the association between Achilles tendinopathy and knee osteoarthritis. It showed that 16 out of 80 patients have Achilles tendinitis and tendinopathy when Thompson test was performed. Change in gait cycle, Pain and functional limitations were present in most patient according to score of visa-a questionnaire. Conclusion: The study revealed that there is no association between knee osteoarthritis and Achilles tendinopathy but association present on the basis of visa-a questionnaire.

Teaming up to Learn: An Experience of Team-Based Learning in A Private Medical College

Mon, 30 Sep 2024 00:00:00 +0000

Objective: We aim to explore the experience of team-based learning in a newly implemented integrated MBBS curriculum. Study Design: Cross-sectional study. Settings: ABWA Medical College, Faisalabad Pakistan. Duration: The study duration was from April 2023 to September 2023. Methods: This cross-sectional study involved 100 medical students via non-probability purposive sampling from 1st-year MBBS who participated in 2 team-based learning sessions offered in the “Hematopoietic Module”. Students were asked to fill out a 16-item survey questionnaire regarding their experience of team-based learning. Data was analyzed through SPSS 25.0 software. Results: A total of 86/100 students returned the survey questionnaire. Overall students had a positive experience regarding team-based learning The highest student rating was received for “Instructor facilitation in the learning process” while the lowest rating was received for the theme "learning outcomes achieved”. Conclusion: The results provide an understanding of 1st-year MBBS students' perceptions of TBL, indicating areas of strength and opportunities for improvement. The positive reception emphasizes the importance of refining TBL practices to maximize its benefits in medical education.

A Study of Various Factors Associated with Placenta Previa in Previous Non-Scar Uterus

Mon, 30 Sep 2024 00:00:00 +0000

Background: Placental tissue is abnormally near the internal cervical os during the second and third trimesters of pregnancy significant risks of morbidity and mortality associated with illness for both the mother and the fetus. Effective counseling, close monitoring, early detection, and timely intervention are required. Objective: To determine the frequency of placenta previa in patients with previous non-scar uteruses. Study Design: Descriptive cross-sectional study. Settings: Department of Obstetrics & Gynecology, Khyber Teaching Hospital, Peshawar Pakistan. Duration: One-year of period (March 2022-March 2023). Methods: A total of 331 women between the ages of 20 and 40 were recruited for this study; these included singleton pregnancies, women with placenta previa in both scarred and non-scarred uteri, and women whose gestational ages were 28 weeks or older. SPSS version 20 was used, with a p-value of less than 0.05 regarded as statistically significant. Results: Of the 331 patients, with a mean age of 32.67 years, 17 (5%) were diagnosed with placenta previa. About 67% were multipara, and 65% were multigravida. No significant association was found between placenta previa and maternal age (p=0.9745), parity (p=0.8314), gravida status (p=0.9823), or history of cesarean sections (p=0.8216). Conclusion: It is concluded that there is a 5% prevalence of placenta previa in patients with a previous non-scarred uterus. Effective management of this condition, which can lead to severe complications, requires a multidisciplinary approach.

Diagnostic Accuracy of Magnetic Resonance Spectroscopy for Differentiation of Benign and Malignant Brain lesions using Histopathology as a Gold Standard

Amber Manzoor, Nayab Aliya, Marryum Mukhtar, Muhammad Qasim Khan, Aamna Gilani — Mon, 30 Sep 2024 00:00:00 +0000

Background: Academic sources showed that MRS has a high accuracy rate for recognizing malignant brain lesions and is more reliable than any other modality. However, there is much less data for the accuracy of MRS. So, more studies are needed to validate the evidence. MRS is a minimally disruptive technique that shows the neurochemical profile of the brain. Objective: To find the diagnostic precision of MRS for differentiation of aggressive & benign cerebral focal lesions taking1histopathology as the ultimate criterion. Study Design: Cross-sectional study. Settings: Imaging department, Madinah Teaching Health Institution, Faisalabad Pakistan. Duration: Six months from December 20, 2020 to June 21, 2021. Methods: A total of 155 Radiology Department patients fulfilling the selection criteria were enlisted. Then all patients underwent MRS using 3T. Findings were documented & patients were labeled as positive or negative. Then, the biopsy sample was sent to the hospital laboratory for histopathological evaluation after being under the supervision of the surgical team. Results: The mean age was 47.17±16.46 years. There were 69(44.5%) males & 86(55.5%) females in this study. The mean duration of symptoms was 11.44±2.79. The sensitivity and specificity of MRS were 90.79% and 86.08%, or PPV & NPV were 86.25% & 90.67%, respectively, and the 1overall diagnostic accuracy was 88.39%. Conclusion: Results demonstrate that the sensitivity (90.79%) and specificity (86.08%) of MRS are high enough to differentiate between malignant & benign brain lesions.

Comparative Histopathological Analysis of Ovarian Tumors with an Emphasis on High-Grade Serous Carcinoma Prevalence

Mon, 30 Sep 2024 00:00:00 +0000

Background: Ovarian cancer is the world's second most frequent gynecologic malignancy, accounting for the fifth leading cause of cancer-related death among women in developed countries. Ovarian tumors present with diverse histopathological diagnoses. Objective: To determine the prevalence and histological examination of various forms of ovarian malignancies. Study Design: A descriptive cross-sectional study. Settings: Pathology Department of Hayatabad Medical Complex, Peshawar, Pakistan. Duration: 01 January to 31 December, 2023. Methods: 146 ovarian tumor specimens were collected over one year. All confirmed histopathological cases of ovarian tumors were selected in the study. The collected data was analyzed through SPSS-26. The Chi-square test was applied to find the significant associations between categorical parameters. Results: Among the 146 specimens, high-grade serous carcinoma (HGSC) was frequently observed, accounting for 31.5% of cases, followed by clear cell carcinoma (4.1%), mucinous carcinoma (4.1%), and endometrioid carcinoma (4.1%). Geographic analysis revealed significant variations in HGSC prevalence, with Peshawar showing the highest number of HGSC cases 28.2% (n=22/7). A statistically significant association has been determined between geographic location and HGSC diagnosis (p=0.006). Conclusion: It is concluded that the HGSC was the most prevalent ovarian tumor case in Khyber Pakhtunkhwa, with significant geographic variations. Enhancing awareness, early detection, and standardized diagnostic practices are essential to improve patient outcomes.

Recent Advances, Future Directions and Clinical Outcomes of Hepatectomy in Hepatocellular Carcinoma

Mon, 30 Sep 2024 00:00:00 +0000

Background: Hepatocellular carcinoma (HCC) represents the predominant and most fatal malignancy globally. The primary therapeutic approach for HCC is Hepatectomy, which presents a potential for curative outcomes. This analysis aims to offer an exhaustive examination of the clinical repercussions linked to liver resection or Hepatectomy in HCC, underscore recent advancements in surgical methodologies, and deliberate on future pathways to enhance treatment efficacy in this domain. Methods: A thorough exploration of the literature was carried out across prominent databases, including Google Scholar, PubMed, ScienceDirect, and Cochrane Library. Research articles were chosen based on their pertinence to the outcomes of Hepatectomy in HCC, advancements in surgical techniques, and forthcoming therapeutic schemes to scrutinize the short- and long-term clinical consequences and the variables influencing these outcomes. Results: Hepatectomy for HCC manifests notable diversity in clinical outcomes, impacted by the nature of the tumor, characteristics of the patient cohort, and proficiency of the surgical team. Short-term results, like perioperative morbidity and mortality rates, have demonstrated enhancements in tandem with refinements in preoperative evaluations and intraoperative management. The duration of outcomes, encompassing overall survival and disease-free survival, displayed significant associations with extended resections, tumor characteristics, and postoperative assessments. Recent progressions in Hepatectomy have played a role in diminishing perioperative complications and expediting the recovery process. Furthermore, the amalgamation of adjuvant and neoadjuvant therapies, alongside the emergence of pharmaceutical modalities, can elevate survival rates and enhance the quality of life for individuals with HCC. Conclusion: Hepatectomy emerges as a pivotal intervention for HCC, yielding progressively superior outcomes owing to technological advancements and enhanced perioperative care. Prospective investigations will refine surgical techniques, optimize adjuvant therapies, and formulate robust predictive frameworks for diverse therapeutic modalities. This comprehensive assessment accentuates the significance of sustained innovation and interdisciplinary cooperation to elevate the standard of care for HCC patients. Moreover, continuous investigation into adjuvant and neoadjuvant treatments, such as immunotherapy and targeted therapies, is imperative for enhancing long-term prognoses.

Unusual Presentation of Stevens-Johnson Syndrome Induced by Trimethoprim-Sulfamethoxazole: A Case Report

Mohammad Ali, Urbah Viqar — Mon, 30 Sep 2024 00:00:00 +0000

Stevens-Johnson syndrome (SJS) is a severe and potentially life-threatening adverse drug reaction characterized by mucocutaneous lesions. Here, I present a unique case of SJS induced by trimethoprim-sulfamethoxazole (TMP-SMX) with an unusual clinical presentation. A 45-year-old female patient with a history of urinary tract infection presented with the development of widespread erythematous macules and papules, progressing to blisters and erosions involving the oral mucosa. The patient's condition rapidly deteriorated, necessitating intensive care management. The temporal association between TMP-SMX initiation and the onset of symptoms, the characteristic clinical and histopathological findings supported the diagnosis of SJS. Prompt withdrawal of the offending drug, supportive care, and multidisciplinary management resulted in a favorable outcome for the patient.

Innovative Approaches to Tackle Under diagnosis of Osteoporosis in Pakistan

Ayesha Haque, Humaira Ali — Mon, 30 Sep 2024 00:00:00 +0000