Pakistan Journal of Medical & Cardiological Review
The Pakistan Journal of Medical & Cardiological Review (ISSN-P3007-2379 ,ISSN-E 3007-2387) is a peer-reviewed, open-access medical journal dedicated to the advancement of health sciences and clinical practice. It serves as a platform for the dissemination of high-quality, evidence-based research, clinical innovations, and expert commentary across all areas of medicine. The journal publishes original research articles, systematic reviews, meta-analyses, case reports, and editorials that contribute to improving patient care, public health, and medical education. Committed to scientific rigor, ethical standards, and global accessibility, the Pakistan Journal of Medical & Cardiological Review welcomes submissions from researchers, clinicians, and healthcare professionals worldwide. The journal aims to bridge the gap between research and practice by promoting interdisciplinary dialogue and fostering collaboration among professionals from diverse healthcare backgrounds.
Forum for Education, Knowledge and Reform (FEKR)
Determination of Serum Adiponectin and Vitamin D Levels in Patients with Depression
Objective: In this study we aimed to determine serum levels of adiponectin and vitamin D in patients with depression. We further tried to find association between adiponectin, vitamin D and inflammatory marker, high sensitivity C reactive protein, and oxidative stress marker malondialdehyde in these patients. Methods: This is a cross-sectional/ analytical study carried out in the out patient’s department of the psychiatry department of Hayatabad Medical Complex, Peshawar. A total of 120 participants were randomly selected and divided into two groups. Group A was labelled as Cases and consisted of 60 newly diagnosed patients with depression. Group B was labelled as Control and consisted of age and gender matched healthy participants with no major physical or mental illness. Any subject with prior anti-depressant treatment or any other major physical illness was excluded from the cases group. A fasting 5 mL blood sample was collected from all participants after well informed written consent and was analyzed for serum adiponectin, vitamin D, malondialdehyde (MDA), total anti-oxidant capacity (TAC) and high sensitivity CRP (hs-CRP). Statistical analysis was done with SPSS version 21. Comparisons between the two groups were done with independent student’s t test. Pearson’s correlation co-efficient r was used to find association of adiponectin with other biomarkers. Significance of the results was considered with a p value of less than 0.05. Results: Adiponectin µg/mL (4.3±7.0 vs 9.4±5.5, P<0.0001) and vitamin D levels ng/mL (17.06±6.4 vs 30.81± 3.3, P<0.0001) were found to be significantly lower in cases than control. The inflammatory marker hs-CRP (mg/L) and oxidative stress marker MDA (nmol/L) were significantly higher in patients with depression (4.4±2.7 vs 1.2 ±1.1) and (5.83±0.62 vs 2.52±0.84). Adiponectin correlated significantly positively with vitamin D (r 0.45, P<0.0001), and TAC (r 0.52, P<0.0001), and negatively with hs-CRP (r-0.33, P<0.0001). Conclusion: Adiponectin and vitamin D were both low in patients with depression and associated inversely with inflammatory markers and oxidative stress markers i.e hs-CRP and MDA respectively. Future studies may implicate a potential combined therapeutic role of adiponectin and vitamin D supplements in these patients. Keywords: Adiponectin, Vitamin D, Depression, hs-CRP, Malondialdehyde.
Copyright (c) 2026 Sadaf Durrani, Naheed Khattak, Sobia Ali*, Ubaid ur Rahman, Mudassir Ahmad Khan (Author)
Evaluating Antibiotic Prophylaxis in Breast Cancer SurgeryAn Experience of Post-COVID Era
Background: The role of prophylactic antibiotics in reducing surgical site infections (SSI) and improving wound healing after breast cancer surgery remains debated. This study assessed the effectiveness of a single preoperative dose of amoxicillin–clavulanic acid on postoperative infection rates and wound outcomes. Objective: To evaluate the impact of prophylactic antibiotics on the frequency of surgical site infections in breast cancer surgery. Methods: A quasi-experimental study was conducted on 180 patients undergoing breast cancer surgery at Khyber Teaching Hospital, Peshawar. Demographic variables, BMI, ASA classification, comorbidities, tumor receptor status, type of surgery, antibiotic use, COVID-19 infection history, and vaccination status were recorded. Postoperative wound outcomes were assessed on Day 7 and Day 14. Statistical associations were analyzed using chi-square tests, with p<0.05 considered significant. Results: The mean age was 48.2 ± 10.15 years, and mean BMI was 21.9 ± 1.88. Most patients were ASA I (55%) or ASA II (40%). Comorbidities were present in 45.8%, predominantly hypertension and diabetes. Antibiotic use showed significant associations with age, BMI, type of surgery, ER/PR/HER2 status, and comorbidities (p<0.001). Patients receiving prophylactic antibiotics had significantly fewer postoperative complications at Day 7 and Day 14 (p<0.001). COVID-19 positivity was also significantly associated with higher infection rates (p<0.001). Conclusion: Prophylactic antibiotic use was associated with reduced postoperative complications and SSI in breast cancer surgery. However, concerns regarding antimicrobial resistance highlight the need for judicious antibiotic use and further research into patient-specific prophylactic strategies. Keywords: Prophylactic antibiotics, Surgical Site Infection (SSI), breast cancer surgery, COVID-19, randomized allocation, quasi-experimental study.
Copyright (c) 2026 Dr. Faryal Saeed, Dr. Anum Wahid*, Dr. Spogmay Naeem, Dr. Naveed e Sahar, Dr. Irum Sabir Ali (Author)
Phytochemical Profiling and Novel Drug Delivery Approaches Enhancing Therapeutic Potential of Traditional Medicinal Plants Globally
Medicinal Plants remain a major source of bioactive compounds used in the prevention and treatment of many diseases around the world. Advances in phytochemical profiling techniques such as chromatography, spectroscopy, metabolomics, and mass spectrometry have greatly improved our ability to identify and characterize plant-derived constituents, including alkaloids, flavonoids, phenolics, terpenoids, and glycosides. Many of these phytochemicals exhibit multiple pharmacological properties, including antioxidant, antimicrobial, anti-inflammatory, anticancer, antidiabetic, and neuroprotective activities. However, despite their therapeutic importance, many herbal compounds have limitations including limited solubility, low bioavailability, instability, and rapid metabolism which impede their ability to be clinically used effectively. To overcome these limitations, novel drug delivery systems, including nanoparticles, liposomes, phytosomes, nanoemulsions, hydrogels, and solid lipid nanoparticles have been developed with the goal of improving targeted delivery, controlled release and therapeutic activity. These sophisticated technologies enhance the pharmacokinetic and pharmacodynamic properties of phytoconstituents while reducing toxicity and adverse effects. The combination of traditional herbal medicine with nanotechnology and contemporary pharmaceutical science represents exciting new avenues for creating effective plant-based therapeutic agents. This literature review aims to provide an overview of the latest developments in phytochemical profiling and innovative drug delivery strategies to maximize the worldwide therapeutic potential of medicinal plants. Keywords: Traditional medicinal plants, phytochemical profiling, phytochemicals, herbal medicine, nanotechnology, drug delivery systems, nanoparticles, phytosomes, liposomes, nanoemulsions, therapeutic potential, bioavailability, targeted delivery, ethnopharmacology, plant-based therapeutics.
Copyright (c) 2026 Muhammad Abuzar Ghaffari, Muhammad Shoaib Khan, Ijaz Ali, Umbreen Anwar, Khuram Ashfaq, Asad Ali, Muhammad Sohaib, Mehreen Jabeen, Muhammad Hafeez, Amir Abbas, Muhammad Kamran Khan, Muhammad Asad, Humaira Majeed, Muhammad Yousaf Quddoos, Arshia , Muhammad Hamza , Syed Muhammad Muneeb Zahid, Ghulam Abbas (Author)
ASSOCIATIONS OF BODY MASS INDEX, AGE, AND GENDER WITH SYSTOLIC BLOOD PRESSURE AMONG U.S. ADULTS: NHANES 2021–2023
Background: Systolic blood pressure (SBP) is a major determinant of cardiovascular disease risk and is influenced by demographic and physiological factors such as age, gender, and body mass index (BMI). Objective: To examine the associations of BMI, age, and gender with systolic blood pressure among U.S. adults using nationally representative data. Methods: A cross-sectional analysis was conducted using data from 5,805 adults aged 20 years and older from the National Health and Nutrition Examination Survey (NHANES) 2021–2023. Descriptive statistics summarized participant characteristics. Pearson correlation analysis assessed the relationship between BMI and SBP. Univariate and multiple linear regression models were applied to evaluate the associations of BMI, age, and gender with SBP. Additionally, binary logistic regression analysis was performed to examine the association of these variables with a categorical outcome. Statistical significance was set at p < 0.05. Results: The mean age of participants was 53.85 years, and the mean BMI was 29.73 kg/m². The average systolic blood pressure was 122.87 mmHg. BMI showed a weak but statistically significant positive correlation with SBP (r = 0.027, p = 0.037). In multiple linear regression analysis, BMI (β = 0.087, p = 0.004), age (β = 0.404, p < 0.001), and gender (β = -4.21, p < 0.001) were significant predictors of SBP. Age demonstrated the strongest association, with SBP increasing with advancing age. Females had significantly lower SBP compared to males. The model explained approximately 16% of the variance in SBP (R² = 0.1626). In logistic regression analysis, age remained a significant predictor (OR = 1.07, p < 0.001), while BMI and gender were not significantly associated. Conclusion: Age, gender, and BMI are important factors associated with systolic blood pressure among U.S. adults, with age showing the strongest influence. These findings highlight the importance of targeted monitoring and preventive strategies, particularly among older populations and males, to reduce the burden of hypertension and related cardiovascular risks
ASSESSMENT OF DEPRESSION PREVALENCE IN KARACHI POPULATION
This study explores the two-way relationship between depression and immune system dysfunction, focusing on how emotional distress can translate into physical illness. A cross-sectional study was carried out on 100 participants in Pakistan, mainly students and young adults. A multiple-choice questionnaire was designed to assess participants emotional well-being alongside physical symptoms such as fatigue, chronic pain, and frequency of illness, in order to identify possible immune-related issues. The results indicate a notably high prevalence of depressive symptoms, particularly among females (85%) and individuals aged 19–28 (87%). Many participants also reported physical health concerns commonly linked to weakened immunity, including gastrointestinal issues (62%), persistent fatigue (62%), and joint pain (51%). In addition, 43% of respondents reported falling ill multiple times a year, suggesting reduced immune resilience. These findings align with established biological explanations, including increased levels of pro-inflammatory cytokines and over-activation of the (HPA) axis, both of which connect chronic stress to systemic inflammation and possible long-term neurological effects. The study is limited by its relatively small sample size (n = 100) and its focus on a specific population in Pakistan, which may affect the generalizability of the findings. With 74% of participants reporting that they had not received any form of treatment, the findings highlight an urgent need for more accessible and integrated mental health services. Addressing both the psychological and physical aspects of depression is essential to reduce long-term health risks. This study contributes to existing literature by combining survey-based evidence with insights from neuro-immunology, emphasizing the significant physical consequences of untreated depression among young adults
Depression; Immune system; Stress; Inflammation; Fatigue; Body pain; Frequent illness; Young adults; Mental health
The existence of chronic hyperglycemia is characterized by metabolic disorder is known as diabetes or diabetes mellitus. It may be a diabetes mellitus type1 (immune mediated), diabetes mellitus type2 (insulin resistance), gestational diabetes and others (genetic flaw, environment, infection and certain drugs). Diabetes mellitus is diagnoses by different approach in individuals like oral glucose tolerance test (OGTT), fasting blood glucose test (FBG), and random blood glucose test (RBG) and hemoglobin A1c test (HbA1c). Diabetes mellitus increase the risk of severe complications in patients which suffer from diabetes mellitus such as autonomic neuropathy, retinopathy, and diabetic foot, impairment of immune system, nephropathy, periodontal disease and cardiovascular diseases. There are many medication like sulfonylureas, meglitindes/ glinides, biguanides, dipeptidyl peptidase- 4 inhibitors but in this thesis we will study and focus on herbal medications used to treat diabetes mellitus
diabetes mellitus, herbal treatment, insulin resistance
AI Based Medical Diagnosis for Early Detection of Tuberculosis Using Chest X Ray Images
Tuberculosis (TB) has recently reclaimed its status as the world’s leading infectious killer, surpassing COVID-19 mortality rates. A primary obstacle to eradication is the "missing millions" millions of undiagnosed cases that drive community transmission. This research explores the transformative role of Artificial Intelligence (AI) and Deep Learning (DL) in automating the interpretation of chest X-ray (CXR) images to bridge this diagnostic gap. We analyze the evolution of neural network architectures, from Convolutional Neural Networks (CNNs) like ResNet and EfficientNet to Vision Transformers (ViTs) and hybrid models, which have achieved diagnostic accuracies exceeding 99%. The paper further investigates the critical role of precision lung segmentation using U-Net variants and the emergence of multimodal data fusion combining CXR with acoustic cough analysis and clinical data to enhance diagnostic robustness. Clinical evidence, such as the Yichang study, demonstrates that AI can increase diagnostic yields by over 230% compared to manual reviews, particularly in resource-constrained primary care settings. Finally, we address deployment challenges, including "black-box" skepticism mitigated by Explainable AI (XAI), domain shift problems, and the potential of Edge AI for real-time inference in remote areas
Tuberculosis, Artificial Intelligence, Deep Learning, Chest X-ray, Computer-Aided Detection (CAD), Explainable AI (XAI), Edge AI, Medical Imaging
Comparative Study of Silver, Gold, and Zinc Oxide Nanoparticles for Their Antimicrobial Activity and Cytotoxicity Against Cancer Cell Lines
The rapid advancement of nanotechnology has positioned metallic nanoparticles as promising alternatives to conventional antimicrobial and anticancer agents. This review provides a comprehensive comparative analysis of silver (Ag), gold (Au), and zinc oxide (ZnO) nanoparticles, focusing on their synthesis strategies, physicochemical characteristics, antimicrobial efficacy, and cytotoxic potential against various cancer cell lines. Emphasis is placed on the influence of synthesis routes particularly green synthesis on particle morphology, stability, and biocompatibility, highlighting how phytochemical-mediated approaches enhance therapeutic performance while reducing toxicity. Among the three nanomaterials, Ag nanoparticles demonstrate the strongest broad-spectrum antimicrobial activity due to sustained Ag⁺ ion release and membrane disruption, while ZnO nanoparticles exhibit potent reactive oxygen species (ROS)-mediated antibacterial effects and notable selective cytotoxicity against cancer cells. Au nanoparticles, although relatively inert in antimicrobial applications, serve as highly effective drug delivery platforms and sensitizing agents in combination therapies. The review further discusses the mechanistic basis of anticancer activity, including oxidative stress induction, mitochondrial dysfunction, DNA damage, and activation of apoptotic signaling pathways such as p53 and caspase cascades. Comparative cytotoxicity data indicate that nanoparticle efficacy is strongly dependent on size, shape, dose, and surface functionalization, with smaller and biogenically synthesized particles generally exhibiting higher biological activity. Additionally, hybrid nanocomposites such as Ag/ZnO and Au/ZnO show synergistic effects, enabling enhanced antimicrobial and anticancer performance at reduced dosages. Despite their promising biomedical applications, challenges such as long-term toxicity, biodistribution concerns, and regulatory limitations remain significant barriers to clinical translation. Overall, this review underscores the potential of Ag, Au, and ZnO nanoparticles particularly in green-synthesized and hybrid forms as next-generation therapeutic agents for addressing multidrug-resistant infections and improving cancer treatment outcomes
silver nanoparticles, gold nanoparticles, zinc oxide nanoparticles, green synthesis, antimicrobial activity, anticancer cytotoxicity, reactive oxygen species, apoptosis, nanomedicine, synergistic nanocomposites
Evaluation Of Mri In The Assessment Of Epidural Hematoma, Spinal Cord Transection And Soft Tissues Injury In Spinal Trauma
Introduction: Spinal trauma can cause spinal cord injury (SCI) leading to severe neurological deficits, requiring early diagnosis. MRI is the gold standard for assessing spinal cord and soft tissue injuries, though its use is limited by availability and lack of standard protocols. Objective: To assess the diagnostic effectiveness of MRI in detecting epidural hematoma, spinal cord transection, and soft tissue injuries in spinal trauma patients. Methodology: A descriptive cross-sectional study was conducted at DHQ Gujranwala over 4 months with a sample of 60 patients selected through non-probability sampling. Data were analyzed using SPSS 24.0 and Excel 2016. Descriptive statistics frequencies, percentages, mean ± SD were applied, while Chi-square and t-tests assessed associations, with p < 0.05 considered significant. Results: Out of 60 cases, males were 53.3%, with most injuries from non-specific causes (71.7%) and lumbar involvement (55.0%). Pain (60%) was significantly linked to injury level (p = 0.002), and paralysis (21.7%) was associated with key MRI findings (p ≤ 0.020). Mode of injury correlated with major abnormalities (p < 0.05). MRI showed high specificity for epidural hematoma (94.3%) and cord transection (90.6%), but low sensitivity for soft tissue injury (20.0%). Conclusion: MRI is a highly specific and reliable imaging tool in spinal trauma, particularly effective for ruling out epidural hematoma and correlating with neurological deficits such as paralysis. Overall, it plays a key role in accurate diagnosis, management, and outcome prediction, while age and gender are not significant predictors of spinal cord injury.
MRI, Spinal Trauma, Epidural Hematoma, Spinal Cord Transection, Soft Tissue Injury
Copyright (c) 2026 Adeena Noor, Rida Fatima, Rida Fatima (Author)
Neurocognitive Impairment Profiles and Cortical Dysregulation in Schizophrenia Spectrum Disorders
Schizophrenia spectrum disorders (SSDs) are severe neuropsychiatric conditions characterized not only by positive and negative symptoms but also by profound neurocognitive impairments that significantly affect functional recovery and quality of life. This review paper examines the neurocognitive impairment profiles and cortical dysregulation mechanisms underlying SSDs, with emphasis on the interaction between cognitive dysfunction, large-scale brain network abnormalities, and neurochemical disturbances. The study explores the stratified continuum of cognitive impairment across healthy individuals, first-degree relatives, clinical high-risk populations, first-episode psychosis, and chronic schizophrenia patients. Core cognitive deficits including processing speed, working memory, executive function, attention, verbal learning, and social cognition are critically analyzed in relation to their impact on daily functioning and psychosocial outcomes. The review further highlights the role of the triple network model involving the Salience Network (SN), Default Mode Network (DMN), and Central Executive Network (CEN), whose dysregulation contributes to impaired cognitive control and abnormal information processing in schizophrenia. Cellular mechanisms such as dendritic spine loss, excessive synaptic pruning, GABAergic interneuron dysfunction, and excitation-inhibition imbalance are discussed alongside neurochemical abnormalities involving dopamine, glutamate, and GABA systems. Additionally, computational psychiatry approaches and predictive coding frameworks are examined to explain aberrant salience and impaired reality processing. Emerging therapeutic interventions including cognitive remediation, virtual reality-based therapies, repetitive transcranial magnetic stimulation (rTMS), magnetic seizure therapy (MST), and artificial intelligence-assisted rehabilitation are also reviewed. Overall, this paper emphasizes that neurocognitive dysfunction and cortical dysregulation represent central pathophysiological features of SSDs and critical targets for future personalized therapeutic strategies.
Schizophrenia spectrum disorders; Neurocognitive impairment; Cortical dysregulation; Salience network; Default mode network; Executive dysfunction; Cognitive remediation; Predictive coding; Dopamine dysregulation; Social cognition.
Copyright (c) 2026 Saba Parveen , Saima Parveen, Kazbano Amur, Saba Batool, Faryal Ahmed, Huang Lei (Author)
Breaking Addiction Through Self-Discipline, Heart Protection, Mental Wellness, and Lifelong Prevention of Smoking and Alcohol Abuse
Maintaining good health and preventing catastrophic ailments, particularly those affecting the heart and lungs, requires abstaining from alcohol and tobacco. Smoking lowers oxygen levels, destroys blood vessels, and raises the risk of cancer, heart disease, and stroke. Excessive alcohol use can weaken the heart muscle, cause liver damage, and raise blood pressure. Adopting a healthy lifestyle by abstaining from these detrimental behaviors raises life expectancy, improves mental health, and increases physical fitness. Reducing reliance on alcohol and tobacco in order to create a healthier society requires public awareness, education, and responsible individual decisions. Keywords: Addiction Control,Heart Health,Self-Discipline,Mental Well-Being,Lung Protection,Disease Prevention,Stress Management,Risk Reduction,Awareness
Copyright (c) 2025 Maham Khan*, Muhammad Imran Tipu, Somia Batool, Rafia Hassan , Amjad Ali , Muhammad Amir, Muhammad Hamza , Ghulam Abbas , Syed Muhammad Muneeb Zahid, Atiq Ullah Tariqi , Syed Waqas Hussain Shah, Syed Waqas Hussain Shah, El Hadji Seydou Mbaye (Author)
STUDY HABITS AND ACADEMIC PERFORMANCE AMONG UNDERGRADUATE NURSING STUDENTS IN KARACHI: A DESCRIPTIVE CROSS-SECTIONAL STUDY
Background Study habits are important factors that influence students’ academic success. Good study habits like managing your time taking notes and reviewing what you learned as well as contribution in learning activities help students achieve better academic performance. Nursing students especially need to keep learning and studying in a way that works for them so they can meet the standards that nursing education requires. Nursing education is, about continuous learning and using effective study practices to to maintain high academic standards. Methods: A descriptive cross-sectional design was used. The sample size was calculated through open EPI software. The sample size was 167. An adopted questionnaire was used from (Alex et al.,2024). The permission was taken from the primary author. In the study, the “Study habits Scale- Student Form” and the students’ Grade Point Average (GPA) were used. The data was obtained through questionnaire in google form. This study was done at the private institute of Karachi. Data was entered and analyzed through SPSS 27. Result: The majority of students were male (89.2%) n=149 and aged 18–23 years (58.1%) n=97. Majority of the students (93.4%) n=156 had good study habits, while (6.6%) n=11 had poor study habits. Regarding academic performance (78.4%) n=13 of students achieved a GPA of 3.50–4.00. Cross-tabulation showed that (73.7%) n=123 with good study habits were more likely to achieve higher GPA, indicating a positive relationship between study habits and academic performance. Conclusion: The study found that good study habits really helps and also positive influence academic performance among undergraduate nursing students in Karachi. Nursing students who regularly to manage their time, review lessons, write down notes, and maintain regular study routines tend to achieve better academic results. Encouraging effective study habits can achieve better academic results and professional competence among under graduated nursing students.
Study habits, Academic performance, Undergraduate Nursing Students
Evaluation of High-Sensitivity Cardiac Troponin I in Patients with Acute Myocardial Infarction
Background: Acute myocardial infarction (AMI) is a major global cause of morbidity and death, and prompt treatment depends on a quick diagnosis using high-sensitivity cardiac troponin I (hs-cTnI). Objective: This study's objective was to evaluate hs-cTnI's diagnostic value in individuals with suspected AMI. Methodology: The study was a prospective observational study carried out from March 2024 to February 2025 in the Department of Cardiology, Saidu Teaching Hospital, Swat, and the Department of Pharmacy, Abasyn University Islamabad Campus. All eligible patients with suspected AMI were recruited using consecutive sampling and the levels of hs-cTnI were measured at baseline and 3–6 hours; the final clinical diagnosis was the gold standard for diagnostic accuracy. Data were analysed with the SPSS software version 25. Results Of the 326 patients, 152 (46.63%) had no AMI and 174 (53.37%) had an AMI diagnosis. The most prevalent symptom (88.65%) was chest discomfort. The most common risk factors were diabetes mellitus (45.40%) and hypertension (53.99%). For hs-cTnI, the corresponding sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were 91.95%, 81.58%, 85.11%, 89.86%, and 87.12%. Excellent diagnostic performance was shown by the area under the ROC curve, which was 0.91 (95% CI: 0.88–0.94). AMI patients had considerably higher mean hs-cTnI levels (12.84 ± 4.56 ng/L) than non-AMI patients (2.36 ± 1.18 ng/L, p < 0.001). Conclusion Hs-cTnI is a strong discriminator and a reliable early biomarker for the diagnosis of AMI.
Acute Myocardial Infarction, High-Sensitivity Cardiac Troponin I, Diagnostic Accuracy, Roc Curve, Cardiac Biomarkers.
Copyright (c) 2026 Laiba Farooq, Awais Ahmed Uttra , Aurang Zeb, Muhammad Musawir Khan, Nazish Iftikhar (Author)
Frequency of Abnormality of Semen in Infertile Couple
Background: Infertility is a significant global health concern affecting approximately 10–15% of couples, with male factors contributing to nearly half of all cases. Semen analysis remains the cornerstone investigation for evaluating male infertility, providing key insights into sperm concentration, motility, and morphology. This study aimed to determine the frequency and pattern of semen abnormalities among male partners of infertile couples. Methodology: This descriptive cross-sectional study was conducted at a tertiary care hospital over a period of 6 months. A total of 200 male partners of infertile couples, aged 24–40 years, were included. Infertility was defined as failure to conceive after at least 12 months of regular unprotected intercourse. Semen samples were collected following 2–5 days of abstinence and analyzed according to WHO 2010 guidelines. Data were analyzed using SPSS version 27, and frequencies and percentages were calculated. Results: The mean age of participants was 32.4 ± 5.8 years, with a mean duration of infertility of 3.2 ± 1.6 years. Primary infertility was observed in 66% of couples, while 33% had secondary infertility. Normal semen parameters were found in 39% of participants, whereas 61% showed abnormalities. Among abnormal cases, asthenozoospermia was the most common finding (36.1%), followed by oligozoospermia (24.6%), teratozoospermia (16.4%), and azoospermia (14.8%). Combined abnormalities (oligoasthenoteratozoospermia) were observed in 8.2% of patients. Conclusion: The study demonstrates a high prevalence of abnormal semen parameters among male partners of infertile couples, with sperm motility defects being the most common abnormality.
Male infertility, Semen analysis, Asthenozoospermia, Oligozoospermia, Azoospermia, Infertility.
Copyright (c) 2025 Ghulam Fatima, Shahida Shaikh , Shaista Ameen (Author)
Correlation Of Thyroid Stimulating Hormone With Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome (PCOS) is a complex endocrine disorder characterized by hyperandrogenism, ovulatory dysfunction, and metabolic disturbances. While the roles of insulin resistance and obesity are well-documented, the influence of thyroid function specifically within the subclinical and high-normal range on the severity of PCOS remains a subject of clinical debate, particularly in the South Asian demographic. The primary objective of this study was to find out the correlation between Thyroid Stimulating Hormone (TSH) levels and the clinical, hormonal, and metabolic profile of PCOS. A cross-sectional study was conducted involving 138 female patients diagnosed with PCOS according to the Rotterdam Criteria at clinical centers in Lahore. Anthropometric measurements and biochemical profiles, including TSH, Total Testosterone, Anti-Müllerian Hormone (AMH), and the LH/FSH ratio, were recorded. Insulin resistance was assessed using the HOMA-IR index. Statistical analysis was performed using Pearson correlation test, Independent Samples T-Tests to compare euthyroid and high-TSH groups, and Linear Regression to identify independent predictors of hyperandrogenism. The study revealed a high prevalence of subclinical thyroid dysfunction, with nearly 70% of participants exceeding a TSH level of 2.5 mIU/L. Significant positive correlations were found between TSH and HOMA-IR (r = 0.91, p < 0.001), Total Testosterone (r = 0.85, p < 0.001), and AMH (r = 0.79, p < 0.01). Comparative analysis showed that patients with TSH > 2.5 mIU/L exhibited significantly higher testosterone (95.8 vs 42.5 ng/dL) and insulin resistance (92% vs 18%) than euthyroid patients. Regression analysis confirmed TSH as the strongest independent predictor of testosterone levels (beta = 0.68, p < 0.001), outweighing the influence of BMI. TSH is a critical modulator of the PCOS phenotype, where even minor elevations within the high-normal range exacerbate hormonal and metabolic severity. Clinical management of PCOS should prioritize a more stringent TSH threshold of 2.5 mIU/L.
PCOS, TSH, Hyperandrogenism, Insulin Resistance, HOMA-IR, Subclinical Hypothyroidism, AMH.
Copyright (c) 2026 Manahil Ilyas, Hifsa Mobeen, Hifsa Mobeen, Ghulam Mohi Ud Din, Asma Fatima (Author)
Prevalence Of Planter Fasciitis Among School Teachers In Lahore, Pakistan
Plantar fasciitis is one of the most common musculoskeletal disorders of the foot and a leading cause of heel pain, particularly among individuals exposed to prolonged weight-bearing activities. School teachers are considered a high-risk occupational group due to extended standing hours and repetitive mechanical stress on the plantar fascia. The present study aimed to determine the prevalence of plantar fasciitis among school teachers in Lahore and to identify its associated demographic, clinical, and occupational factors. A quantitative cross-sectional study was conducted among 574 school teachers from various government and private schools in Lahore, Pakistan, using a non-probability convenience sampling technique. Participants aged 25–60 years were included, and data were collected using a structured questionnaire, the Plantar Fasciitis Pain/Disability Scale (PFPS), and the Visual Analogue Scale (VAS), while the Windlass test was used as a clinical assessment tool. Data were analysed using SPSS version 20, employing descriptive statistics and inferential tests including chi-square test, independent t-test, correlation analysis, and binary logistic regression. The results showed that the prevalence of plantar fasciitis was 41.3% (n = 238). Among participants, 376 (65.5%) were aged 25–40 years and 198 (34.5%) were aged 41–60 years. Females were slightly more represented (52.3%) than males (47.7%). Plantar fasciitis was significantly more common in females (50.6%) compared to males (31.7%), and in the older age group (41–60 years: 68.1%) compared to younger participants (27.3%) (p < 0.001). The most affected individuals reported deep heel pain (69.7%), mainly at the bottom of the heel (61.3%), with pain occurring many times daily (61.8%) and most severe during first morning steps (56.3%). Mean VAS scores were significantly higher in affected participants (7.8 ± 2.1) compared to non-affected participants (4.9 ± 2.3), while PFPS scores were also higher in the plantar fasciitis group (48.6 ± 8.5 vs 36.2 ± 7.9) (p < 0.001). Significant positive correlations were found between VAS, PFPS, and functional limitation scores (r = 0.69–0.81, p < 0.001). Logistic regression analysis revealed that female gender (OR = 2.08, 95% CI: 1.42–3.05), age above 40 years (OR = 3.31, 95% CI: 2.15–5.09), higher VAS scores (OR = 1.81, 95% CI: 1.37–2.40), and higher PFPS scores (OR = 1.11, 95% CI: 1.05–1.17) were significant predictors of plantar fasciitis. In conclusion, plantar fasciitis was found to be highly prevalent among school teachers in Lahore, affecting 41.3% of participants, with significantly higher occurrence in females and older age groups. The condition was strongly associated with increased pain severity, functional disability, and occupational strain. These findings highlight the need for ergonomic interventions, early screening, and physiotherapy-based preventive strategies in school settings to reduce the burden of plantar fasciitis
Copyright (c) 2026 Dr. Sobia Mukhtar, Dr. Muhammad Shakir Nasir, Dr. Tuba, Dr. Eshaa Tahir, Dr. Kanza Azmat, Dr. Zainab Mazhar, Dr. Fizza Mazhar, Dr. Moen Akhter (Author)
Frequency of Cardiac Events Associated with Circadian Rhythm Disruption: A focus on Cardiac Arrest
Circadian rhythm indicates any physiological process that displays a day-night cycle. Biological measures of the circulatory system, such as heart rate (HR), blood pressure (BP), vascular resistance, and cardiac electrical cycle duration, display notable daily variation, (Zhang et al., 2014). Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. Their primary source is the development of atherosclerotic plaque (arterial fatty deposits), which comprises the accumulation of fats and inflaming leukocytes within the coronary arteries. Besides high cholesterol, diabetes mellitus, excess body weight, hypertension and nicotine consumption, the disturbance in circadian cycle has recently been launched as a contributing risk factor liable for the formation and evolution of cardiovascular diseases, (Tian et al., 2024). Heart disease is a significant reason for fatalities globally, while adopting biological rhythm research in cardiac science (and evidence-supported healthcare overall) supplies an innovative applied research strategy to benefit patients clinically, (Reitz & Martino., 2015). In 2017, cardiovascular diseases resulted in about 17.8 million deaths worldwide, corresponding to 330 million years of diminished life expectancy and an additional 35.6 million years lived with impairment
Circadian Rhythm Disruption, Cardiac Arrest, Cardiovascular Events, Biological Clock, Sleep Disorders, Cardiac Arrhythmia
Copyright (c) 2026 Tehleel Fatima, Muhammad Junaid Irshad, Atiqa Zulfiqar, Aqsa Sameer, Amjad Assadullah, Sehrish Kanwal (Author)
Impact of Awareness Session on Assessment of Breast Self-Examination among Female University Students and Faculty Members
Background: Breast cancer is diagnosed most often in women around the globe and late detection in areas with fewer resources leads to a high number of deaths. Despite being convenient to do and costing little, BSE is underused among even those who have access to information. Negative attitudes, unclear knowledge and fear of the disease make BSE less likely to be used. Aim: To evaluate the impact of a structured awareness session on BSE knowledge, attitude, and practice (KAP) among female university students and faculty members. Methods: Researchers carried out a quasi-experimental pre-post intervention study at Iqra University in Pakistan. Two hundred and fifty people (235 students and 15 faculty) filled out pre-intervention questionnaires on their knowledge of BSE. For 30–60 minutes, participants received an educational session with visuals, practical demonstrations and discussions. Post-intervention KAP was measured using the same tool. Each numerical variable was tested by paired t-tests using SPSS v27 (statistical significance was set to p < 0.05). Results: Knowledge: Overall scores increased from 18.55 ± 3.82 to 36.40 ± 2.76. Practice: Pre-intervention, only 22.8% performed BSE; post-intervention, >90% understood techniques (e.g., visual inspection: 38.4% to 91.2%). Awareness: Screening knowledge rose from 36.8% to 92.8%. Key barriers pre-intervention included lack of knowledge (59.2%) and fear of results (34.4%). Significant improvements (P < 0.001) were observed across all domains: Conclusion: Sessions designed to raise awareness about BSE improve what university students know about the subject. It is important to add structured BSE education to health programs at institutions to encourage early detection and reduce the incidence of breast cancer. Keywords: Breast self-examination, Awareness session, Knowledge-attitude-practice, Early detection, University students, Faculty members
Copyright (c) 2025 Asad Ullah*, Bacha Rahmat , Faras , Abdullah Shah, Hamza Khan , Zainub Tabbasum (Author)
Iron Overload, Chelation Gaps and Marrow Injury in Beta-Thalassemia Major: A Cross-Sectional Study from Khyber Pakhtunkhwa, Pakistan
Background: Beta-thalassemia major (BTM) remains the most prevalent hereditary haemoglobinopathy in Pakistan, with an estimated carrier frequency of 5–7%, which translates to several thousand new diagnoses each year, further straining the healthcare system. Repeated transfusions improve their survival rate but inevitably expose them to iron overload that can damage their organs, especially the bone marrow. Objective: To correlate haematological profiles of BTM patients with their bone marrow histopathological findings and determine predictors from haematological variables for advanced marrow disease. Methods: An analytical cross-sectional study, enrolling 100 consecutive BTM patients at a tertiary referral centre in Khyber Pakhtunkhwa province, i.e., Khyber Teaching Hospital Peshawar, was undertaken (April–October 2024). Complete blood count, reticulocyte count, serum ferritin, and foetal haemoglobin were measured. Trephine biopsies of bone marrow were assessed for cellularity, erythroid hyperplasia, iron stores (Gale grading), and fibrosis (Myelofibrosis grading). Extramedullary haematopoiesis was also recorded through additional imaging. Spearman's rank correlation, chi-square, and Kruskal-Wallis tests were applied. P <0.05 was considered significant. Results: Patients had mean age of 10.52±3.05years (49% males), haemoglobin of 6.26±1.34g/dL, and serum ferritin of 2568±1483 ng/mL. Marked marrow hypercellularity was noticed in 33%, while marked erythroid hyperplasia in 34% of patients. Serum ferritin correlated strongly with Gale grades of iron stores (rₛ = +0.78, p < 0.001) and fibrosis grades (rₛ = +0.71, p < 0.001). Haemoglobin demonstrated inverse correlation with marrow cellularity (rₛ = −0.69, p < 0.001). Patients had significantly less serum ferritin and lower marrow histopathological grades when on deferasirox as compared to no chelation therapy or other alternatives (p <0.001). Conclusion: Serum ferritin and haemoglobin are reliable indicators for marrow disease burden in BTM, where marrow biopsy is not convenient. Inadequate chelation is strongly associated with advanced marrow injury. These findings should be adopted by thalassemia programmes in Pakistan along with uninterrupted chelation access. Keywords: Beta-thalassemia major; bone marrow histopathology; iron overload; serum ferritin; erythroid hyperplasia; chelation therapy; Pakistan.
Copyright (c) 2025 Muhammad Idrees , Muhammad Waqas*, Barjis Irum, Manzoor Ur Rehman , Inayat Ur Rahman , Savaira Elahi (Author)
Combined Effects Of Buteyko And Paranayama Breathing Techniques For Cardiovascular Fitness And Quality Of Life Of Asthmatic Patients
Background: Asthma is a long-term lung disease, which causes inflamed airways, which become swollen, narrow and produce excessive mucus, making it difficult to breathe. Buteyko and Pranayama breathing techniques are breathing re-education strategies that alleviate respiratory and other health problems through re-education of abnormal breathing habits or patterns like chronic dysfunctional over-breathing and entails controlling the breath in order to bring the mind, body and spirit into union. Aims and Objectives: The objectives and aims of the given research were to observe the outcomes of the combination of two breathing exercises (Buteyko and Pranayama) to enhance Cardiovascular fitness and Quality of life of asthmatic patients and to reduce hyperventilation. Material and Methodology: A quasi-experimental study was conducted including a convenient sample of 60 patients with history of asthma. Baseline (pre-intervention) measurements were taken and the participants were then introduced to a four-month program of a structured breathing exercise program of a combination of the Buteyko and Pranayama to be performed on patients in both the public and the private Hospitals in Faisalabad. Training of the participants took 3 days and the participants were advised to perform the exercises 10 to 15 minutes twice daily along with conventional medical treatment.Oxygen saturation, Respiratory rate, Modified Borg Dyspnea Scale, Nijmegen Questionnaire, Asthma Quality of Life Questionnaire and the Six-minute walk test were assessed for post-intervention measurements.Results: By using paired sample T test analysis through SPSS there is statistically significant improvement with p value of< 0.001 . Conclusion: It was concluded that both breathing techniques were proven to be effective in cardiovascular fitness and quality of life of asthmatic patient.
Asthma, Quality Of Life, Buteykobreathing Technique, Cardiovascular Fitness, Pranayama Breathing Technique.
Copyright (c) 2025 Ramiza Khalid, Rasham Riaz, Rasham Riaz, Unaiza Fatima, Pareeha Batool, Alishba Zafar, Zainab Tariq (Author)
ARTIFICIAL INTELLIGENCE BASED PNEUMONIA DETECTION USING IMAGING MODALITIES: A REVIEW
Pneumonia remains to be one of the leading causes of morbidity and mortality across the world. Timely and correct diagnosis is important for clinical treatment and to minimize the mortality. Medical imaging modalities play an important role in the detection of pneumonia, its severity and monitoring of treatment. This is a general review of the imaging technologies applied in detecting pneumonia covering the evolution of the early conventional methods and the modern advanced technologies into emerging technologies. The conventional modalities are explained in relation to the diagnostic performance, clinical utility, and limitations, including radiation exposure and access issues, i.e. chest X-ray (CXR), computed tomography (CT), the methods of ultrasound and their increasing place as bedside, radiation-free methods. The recent advances in the field of artificial intelligence (AI) and machine learning is to detect and classify pneumonia in different imaging modalities are reviewed in a systematic manner. This review will mainly concentrate on the use of artificial intelligence (AI) in the pneumonia detection using imaging. The application of machine learning (ML) and deep learning (DL) methods to chest X-ray and computer tomography images to obtain automatic classification of diseases and the evaluation of their performance is thoroughly reviewed. Moreover, the novel findings of AI-based pneumonia detection in thermal imaging are discussed, which is one of the radiation-free, non-contact, and fast screening modality. This review compares model, data sets, and reported performance metrics of imaging modalities and determines the challenges concerning data quality, generalizability, and clinical validation. Lastly, research directions in the future are described, which include the necessity to further examine the thermal imaging modality and multimodal AI systems to create safe, accessible, and clinically portable pneumonia diagnostic systems.
Pneumonia Detection, Chest X-ray, CT Imaging, Thermal Imaging, Deep learning
ULTRASOUND ASSESSMENT OF EXTERNAL CAROTID ARTERY DOPPLER HEMODYNAMICS IN PATIENTS WITH MALIGNANT THYROID NODULES
Thyroid nodules represent a relatively prevalent endocrine disease, with increasing incidence due to the use of high-resolution ultrasonography. Although the majority of nodules are benign, a small but clinically significant proportion are malignant, making early and accurate diagnosis essential. Risk stratification is commonly performed using grayscale ultrasound and Thyroid Imaging Reporting and Data System (TI-RADS); however, their diagnostic accuracy may be limited due to overlapping imaging features. This study was conducted to evaluate the Doppler hemodynamic parameters of the external carotid artery (ECA) in patients with malignant thyroid nodules and to determine their relationship with TI-RADS classification. A cross-sectional analytical study was carried out on 55 patients with malignant thyroid nodules. All patients underwent grayscale ultrasound, TI-RADS classification, and Doppler examination of the external carotid artery. Doppler parameters including peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) were recorded. The results demonstrated that hypoechogenicity, irregular margins, taller-than-wide shape, and microcalcifications were common grayscale ultrasound findings associated with malignancy. Doppler evaluation showed a mean PSV of 99.49 ± 7.62 cm/s, mean EDV of 27.60 ± 4.18 cm/s, and mean RI of 0.79 ± 0.04. A statistically significant positive correlation was observed between TI-RADS category and PSV (r = 0.41, p = 0.003) as well as RI (r = 0.56, p < 0.001), while no significant association was found with EDV (p = 0.162). It is concluded that external carotid artery Doppler parameters, particularly PSV and RI, have a strong association with malignant thyroid nodules and can serve as a useful non-invasive adjunct to conventional ultrasound.
Evaluation Of Hepatoprotective Activity Of Thiourea Derivatives On Gentamycin Induced Hepatotoxicity
The vital organ liver performs many of functions in the body, including the production of bile, elimination of bilirubin, cholesterol, metabolism of drugs, fats, proteins, activation of enzymes, storage of glycogen, and synthesis of plasma proteins like albumin and clotting factors. Hepatotoxicity is a definitive aspect of liver repeatedly caused by exposure to xenobiotics such as drugs, alcohols, toxins and chemicals. Thiourea and thiourea derivatives are a well-known class of synthetic organosulfur compound also known as carbamides. The present study was designed to elucidate the scientific background for the use of Thiourea derivatives as hepatoprotective agent. The compound was evaluated for the hepatoprotective activity in animal model by analyzing the blood biomarkers and examining the histological changes in the liver. For this purpose, the synthetic compound thiourea derivatives were prepared by Dr Wadood Ali Shah (Assistant Professor UOM). The dose of 50mg/kg and 250mg/kg from all the three compounds entitled as CA= STO-II, CB= Psoduct-M, CC= Para-Thio-STP were selected to evaluate the hepatoprotective effect. After dosing for 8 consecutive days, the blood samples were then analyzed for hepatic biomarkers such as Alanine aminotransferase (ALT) / Serum Glutamic Pyruvic Transaminase (SGPT) blood serum along with Alkaline Phosphatase ALP levels and the histology of liver. The blood serum levels of SGPT and the level of ALP were highly significantly lowered down by TUD in higher dose level of 250mg/kg, while the microscopic examination of liver histology revealed that TUD has improved clogged blood vessels, fatty changes, and inflammatory infiltrate markedly, induced by gentamicin. Therefore, it was concluded from the findings of present study that thiourea derivatives has marked dose dependent hepatoprotective effect. As the literature review has declared that TUD constitutes different group of chemicals such as thiocarbonyl which possess antioxidant effect thus it might be concluded that the hepatoprotective effect of TUD may be due to thiocarbazone present in it.
TUD= Thio Urea Derivatives, H&E= Haematoxylin and Eosin resins, SGPT= Serum Glutamic Pyruvic Transaminase, ALT= Alanine aminotransferase, ALP= Alkaline Phosphatase, ROS= Reactive Oxygen Species, MDA= Malonaldehyde level, LPO= lipid peroxidation, CA= STO-II, CB= Psoduct-M, CC= Para-Thio-STP.
Copyright (c) 2026 Humza Yusuf, Haroon Badshah, Musa Muhammad Sher, Tooba Humza, Maryam Zulfat, Beenish Naz, Saqib Jahan, Abdul Mateen, Atta Ullah Shah, Atta Ullah, Syed Wadood Ali Shah, Muhammad Ikram (Author)
Knowledge, Attitude and Practice of Critical Care Nurses regarding Palliative care at Tertiary Care Hospitals, Peshawar
Background: By caring to the physical, psychological, and spiritual needs of patients with life-threatening illnesses, palliative care plays a critical role of improving their quality of life. As front-line healthcare providers, nurses play a crucial role as they offer effective and compassionate palliative care. However, the delivery of the best end-of-life care may be complicated by nurses' lack of knowledge, attitudes, and practical skills. The purpose of this study is to assess nurses working in tertiary hospital settings' present levels of palliative care knowledge, attitudes, and practices. Finding these gaps can assist shape focused training initiatives and legislative changes to improve the caliber of palliative care services, which will eventually improve patient outcomes and provide dignified end-of-life experiences. Objectives: To asses’ nurses' knowledge of palliative care in critical care department in tertiary care settings. To evaluate nurses' attitude of palliative care in critical area in tertiary care settings. To investigate nurses' practice in critical area in tertiary care settings. Methodology: A descriptive cross sectional was used at this study. The data gathered from nurses working in important clinical departments like the Intensive Care Unit (ICU), Coronary Care Unit (CCU), and High Dependency Units (HDU) at Lady Reading Hospital and Hayatabad Medical Complex. Results: The study involved 109 healthcare participants working in various critical care units, predominantly female (86.2%) and aged primarily between 26-35 years. The majority held a Bachelor of Science in Nursing (67.0%) and had between 1-5 years of professional experience (76.1%). Participants were distributed across critical care specializations, including general ICU (45.9%), HDU (8.3%), neurosurgery ICU (14.7%), pediatric ICU (13.8%), and NICU (17.4%). Regarding knowledge, attitude, and practice towards palliative care: •Knowledge: The majority demonstrated high knowledge about palliative care (67.9%), with a mean knowledge score of 2.6789 (SD = 0.46906). Moderate knowledge was held by 32.1%. •Attitude: Most participants exhibited a neutral attitude (62.4%) but had a positive attitude (35.8%), with a mean attitude score of 2.3519 (SD = 0.49887). •Practice: A significant portion showed good practice toward palliative care (67.9%), with an average practice score of 2.6697 (SD = 0.49169). Conclusion: The study demonstrates that critical care nurses generally possess good knowledge and engage in appropriate practice behaviors related to palliative care. Nevertheless, attitudes tend to be neutral, signifying potential areas for attitude enhancement through targeted education and emotional support. Strengthening positive perceptions of palliative care could foster more proactive implementation in clinical practice. Continued training and awareness programs are essential to bridge the gap between knowledge and attitude, ultimately improving palliative care delivery in critical care settings.
Copyright (c) 2025 Ayesha BiBi*, Sudais Ur Rehman, Doonyadar Dar, Sahil Sajjad, Aman Ullah, Muhammad Ali, Sikandar Shah, Muhammad Siyar Khan (Author)
Knowledge, Attitude and Perception of Undergraduate Dental Students Towards Artificial Intelligence and Robotics in Dentistry
Background: Artificial Intelligence and Robotics in the dental field is an emerging concept worldwide, but it remains unexplored in Pakistan and there is very limited data that offers insight of dental students towards AI/R in dentistry in KCD, Peshawar. Objective: To determine undergraduate dental students’ knowledge, attitude, and perception about the implementation of Artificial Intelligence and Robotics in Dentistry. Methodology: A Descriptive cross-sectional study was conducted using non-probability convenience sampling in undergraduate dental students from 1st to final year BDS studying in Khyber college of Dentistry, Peshawar from September 2023 to February 2024. Pre-validated questionnaires were distributed among the students. Chi square test was used for association, using R programming. Result: Out of 134 participants included in the final analysis, a substantial proportion of respondents exhibited good knowledge (n = 92, 68.66%) and perception (n = 98, 73.13%), while a fair attitude was observed among many respondents (n = 58, 43.28%). The mean scores for knowledge, perception, and attitude were 10.40 ± 2.57, 11.97 ± 2.45, and 12.64 ± 4.48, respectively. Statistically significant association was observed for knowledge (p = 0.023), whereas no significant associations were found for attitude (p = 0.105) or perception (p = 0.077). A majority of the participants, 108 (80.6%), expressed interest in learning about Artificial Intelligence and Robotics in the future. Conclusion: Most of the participants were unaware with Artificial Intelligence and Robotics. As it may increase the effectiveness and efficiency of dental treatment therefore there is significant need in the near future to increase awareness of this concept to maximize its benefits in Dentistry.
Robotics, Artificial Intelligence, Dental students
Copyright (c) 2026 Syeda Hafsa Shah, Laiba Shah, Dr. Aliya Khan , Mehwish Rasool, Muhammad Imad (Author)
TERT Promoter Mutation: A Molecular Link Between HCV and Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) ranks sixth among cancers globally and is the third leading cause of cancer-related mortality. Hepatitis C virus (HCV) infection accounts for approximately 25–30% of HCC cases worldwide. Although direct-acting antiviral agents (DAAs) now achieve viral eradication in over 95% of patients, HCC risk persists even after viral clearance, making it essential to understand the molecular mechanisms linking HCV to tumor development. Among the most significant molecular alterations in HCC are TERT promoter mutations, occurring in 54–60% of all cases. The two predominant mutations, C228T and C250T, create novel ETS transcription factor binding sites including GABPα driving persistent TERT activation and conferring replicative immortality upon cancer cells. HCV promotes these mutations through interconnected mechanisms: virus-induced oxidative stress damages the TERT promoter region; HCV proteins NS3/4A and NS5A enhance telomerase stability; the core protein remodels chromatin architecture; and chronic inflammation elevates IL-6 and TNF-α, activating STAT3 and NF-κB pathways that further upregulate TERT expression. Clinically, TERT promoter mutations correlate with tumor aggressiveness, elevated AFP levels, microvascular invasion, and poor prognosis. Importantly, these mutations are detectable in patient plasma, offering a promising avenue for non-invasive HCC diagnosis.
Copyright (c) 2026 Uswa Masood, Nehal Chuahdry, Aqsa Afzal , Iram Qayyum, Fatima Liaqat, Tuba Javed, Ahmad Hassan, Shahid Nadeem, Rizwan Shaukat (Author)
Assess the Communication Challenges Faced by Clinical Nurses in Providing Quality Care Nursing
Background: Effective communication is an essential component of nursing practice and plays a critical role in ensuring patient safety, satisfaction, and quality healthcare delivery. However, clinical nurses frequently encounter communication barriers such as workload, time constraints, language differences, and inter professional communication gaps, which may negatively affect patient care outcomes. Objective: To assess the communication challenges faced by clinical nurses in providing quality care and to evaluate the impact of these challenges on patient care outcomes. Methodology: A descriptive cross-sectional study was conducted among 140 clinical nurses working in different hospital departments, including medical, surgical, emergency, ICU, and OPD units. A non-probability convenience sampling technique was used to recruit participants. Data were collected using a structured self-administered questionnaire consisting of demographic information, communication challenges, and quality of care indicators. The collected data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. Results: The findings revealed that clinical nurses experienced a moderate level of communication challenges, with an overall mean score of 3.26 ± 0.56. Heavy workload (M = 3.72 ± 0.70) and lack of time (M = 3.60 ± 0.66) were identified as the most significant barriers. Communication challenges moderately affected the quality of care (M = 3.38 ± 0.60), particularly patient dissatisfaction, delays in care, and risk of medical errors. Nurses strongly supported communication improvement strategies, including communication training, teamwork enhancement, and workload reduction. Conclusion: Communication challenges remain a significant issue in clinical nursing practice and moderately affect the quality of patient care. Addressing workload, improving communication skills, and promoting supportive organizational strategies are essential to enhance patient safety and healthcare outcomes.
Communication Challenges, Clinical Nurses, Quality of Care, Patient Safety, Nurse-Patient Communication, Healthcare Communication.
Copyright (c) 2026 Aliza Hussain, Sana Iqbal, Shandana Tariq, Aqib Dil Awaiz, Nida Abid, Misbah Alia (Author)
Hemorrhage Detection In Patients With Traumatic And Non-Traumatic Brain Injuries Through Multidetector Computed Tomography
Background: Brain injuries, including traumatic brain injuries (TBI) and non-traumatic brain injuries (nTBI), are significant causes of morbidity and mortality worldwide. Intracranial hemorrhages, including subdural, epidural, subarachnoid, and intraparenchymal types, are critical complications that require prompt diagnosis. Multidetector computed tomography (MDCT) is a rapid and reliable imaging modality for detecting and assessing these hemorrhages in terms of type, volume, and location. Objective: To evaluate the role of multidetector computed tomography in detecting types of hemorrhages and their anatomical region in traumatic and non-traumatic brain injuries. Methods: A cross-sectional study was conducted from June 2025 to November 2025, including 67 patients (46 TBI, 21 nTBI) who underwent non-contrast MDCT scans of the brain. Data on hemorrhage type, region, volume, and patient demographics were collected using a self-structured proforma and analyzed with SPSS v27. Results: Among the 67 patients, 68.7% had TBI and 31.3% had nTBI. Subdural hemorrhage was the most common type (58.2%), followed by intraparenchymal (22.4%), epidural (10.4%), and subarachnoid hemorrhages (9.0%). The most frequent hemorrhage volume ranged from 41–50 cc, and the left frontal lobe was the most commonly affected region (17.9%). The majority of cases were male (73.1%). Conclusion: Subdural hemorrhage is the most prevalent intracranial hemorrhage in both TBI and nTBI patients, with the left frontal lobe being the most frequently involved region. MDCT provides a rapid and reliable means to assess hemorrhage type, volume, and location, which is critical for clinical decision-making. Further studies with larger sample sizes and multiple centers are recommended to enhance generalizability, especially for non-traumatic brain injuries.
Traumatic Brain Injury (TBI), Non-Traumatic Brain Injury (nTBI), Intracranial Haemorrhage, Subdural Haemorrhage, Epidural Haemorrhage
Copyright (c) 2026 Muhammad Jammal, Madiha Naheed , Hafiz Ayaz Ahmad (Author)
Due to the numerous biological and medicinal applications for these compounds, medicinal chemistry and Schiff base chemistry have garnered a lot of interest. Schiff bases are chemical compounds that typically have an azomethine (–C=N–) functional group that is created when primary amines and aldehydes or ketones condense. Significant biological potential and exceptional structural flexibility are imparted by the imine bond and several substituent groups. The antibacterial, antifungal, antiviral, anti-inflammatory, antioxidant, antitubercular, and anticancer properties of bio-active Schiff bases and their metal complexes have made them attractive candidates in pharmaceutical and medical research in recent years. Their pharmacological characteristics and biological efficacy are further improved by their capacity to coordinate with transition metal ions. Primary biological activities of bio-active Schiff bases described in recent literature are highlighted in this review. Their therapeutic significance, mode of action, and uses in coordination chemistry and drug development are given particular attention. The role of Schiff base derivatives as chelating agents, enzyme inhibitors, and possible leads for the creation of new medications is also briefly covered in the review. Schiff bases remain an important family of molecules in contemporary medicinal chemistry and bioinorganic research because of their easy synthesis, structural variety, and wide range of biological activity.
Copyright (c) 2026 Adnan Shahzad, Muhammad Tahir, Naila, Abdul Latif, Muhammad Jamil, Sunbal Khan, Ikramullah, AzmatUllah, Asad Khan, Zia Ullah (Author)
CORRELATION OF MALARIAL MICROSCOPIC FINDINGS WITH SOCIODEMOGRAPHIC AND ENVIRONMENTAL RISK INDICATORS IN SABZAZAR, LAHORE
Background: Malaria remains an important public health concern in many developing countries, including Pakistan. Environmental conditions, population density, and socioeconomic factors can influence the spread of the disease, particularly in urban communities. Microscopic examination of blood smears remains a reliable method for detecting malaria parasites and identifying species. Understanding the relationship between malaria findings and associated risk factors can help in improving prevention and control strategies. Objective: To evaluate the correlation between malarial microscopic findings and selected sociodemographic and environmental risk indicators among residents of Sabzazar, Lahore. Methodology: A cross-sectional study was conducted over a period of four months in Sabzazar, Lahore. A total of 125 participants were included in the study. Sociodemographic information and environmental risk factors, including presence of stagnant water near the house, outdoor sleeping habits, and use of insecticide-treated nets (ITNs), were collected through structured questionnaires and direct field observations. Axillary temperature was measured to assess fever. Blood samples were collected in EDTA vials, and both thick and thin blood smears were prepared. The slides were stained with Giemsa stain and examined under a microscope to detect and identify Plasmodium species. The collected data was entered and analyzed using SPSS software 20. Descriptive statistics and appropriate statistical tests were applied to determine associations between malaria positivity and potential risk factors. Results: Microscopic examination showed that 19.2% of participants were positive for malaria. Plasmodium falciparum was the most detected species, while Plasmodium vivax was found in fewer cases. Sociodemographic factors such as age and gender did not show a strong association with malaria infection. However, environmental factors like stagnant water near houses, outdoor sleeping, and irregular use of mosquito nets were more common among infected individuals. In addition, malaria-positive participants had slightly lower hemoglobin levels compared to those without infection. Conclusion: The study demonstrates that environmental and behavioral factors significantly influence malaria transmission in Sabzazar, Lahore. Interventions such as improving environmental sanitation, eliminating potential mosquito breeding sites, encouraging the consistent use of insecticide-treated nets, and promoting protective behaviors can effectively reduce malaria prevalence in the community.
Malaria, Microscopy, Environmental Risk Factors