Journal of Muhammad Medical College

A Comparative Analysis of Patient Satisfaction Across Departments at Muhammad Medical College Hospital, Mirpurkhas.

2026-11-02T09:19:09+00:00

Objective: The aim of the study is to compare the patient satisfaction in four departments (Obs/Gynae, Surgery, Pediat-rics and General Medicine) in Muhammad Medical College Hospital Mirpurkhas.
Methodology: In this study, we analyzed patient satisfaction forms (n=451) was administered between January and April 2026 were examined in nine domains of satisfaction.
Results: Gynae patients showed the highest satisfaction at 94.4%, Surgery was associated with the overall satisfaction of (94%), Pediatrics 90.3%, and Medicine 90.0%. Overall cleanliness was rated poorly by both the staff and patients in washroom cleanliness and patient wards which was the most important area of major concern among all depart-ments. While MMC Hospital's performance appears acceptable when compared with national and internation-al standards, it is relatively strong, compared to many Pakistani public-sector institutions but represents major defi-cits internationally.
Conclusion: These findings highlight the need for the specific quality improvement, intervention addressing these im-portant domains of care such as environmental hygiene and pain management protocol.
Key Words: patient satisfaction, Institutional Scientific Report, Medical College,

Accreditation or Assimilation? A Postcolonial Critique of International Accreditation Standards in Health Professions Education: A Scoping Review

2026-11-02T09:19:09+00:00

Objective: As a scoping review, this article critically reviewed the research of international accreditation standards in health profession education (HPE) with a postcolonial lens, most of all through epistemic authority, curriculum standardi-zation and contextual adaptation.
Methodology: The review was conducted based on “Hilary Arksey and Lisa O'Malley structure with PRISMA-Sc R guidelines. Literature from 2010 to 2025 was searched across PubMed Scopus ERIC, Web of Science, and Google Scholar”. Findings from a thematic analysis of peer-reviewed articles, editorials, and policy papers were synthesized.
Results: Thirty-eight articles were included. Five themes took shape: global standardization; epistemic imbalance; con-textual conflicts in LMIC; institutional compliance and decolonial alternatives. In these findings, accreditation mecha-nisms were found to impose Western norms and systems of standards of educational quality upon contexts where they may not always be relevant, Mainly to the extent to which they were silent about capitalizing indigenous knowledge sys-tems and locally relevant health priorities.
Conclusion: International accreditation can strengthen quality assurance; however, without contextual adaptation, it may reinforce colonial patterns of knowledge dominance and institutional dependency. Future accreditation reforms should support equity, local autonomy, and diverse knowledge systems in HPE.
Keywords: Health professions education, accreditation, WFME, postcolonialism, decolonization, medical education, curriculum reform, LMICs.

Use of Artificial Intelligence for Posture Correction: A Systematic Review Using PRISMA Guidelines and PICO Framework

2026-11-02T09:19:09+00:00

Objective: To methodically locate and compile peer-reviewed RCTs, quasi-experimental studies, cohort studies, and
crossover trials (2014–2026) that assess AI-based posture detection, monitoring, or correction systems in human subjects.
Methodology: The PRISMA 2020 statement and a PICO(S) framework were used to organize this review, which was limited
to AI/ML-driven systems (such as computer-vision pose estimation, deep neural networks, or ML classifiers) assessed in
comparative human-trial designs. Using combinations of "artificial intelligence," "machine learning," "deep learning,"
"posture," "posture correction," "posture monitoring," "randomized controlled trial," "quasi-experimental," "cohort," and
"crossover," a multi-database exploratory search was carried out across PubMed/MEDLINE, IEEE Xplore, Scopus, ACM
Digital Library, and ProQuest Central, supplemented by JMIR/PMC full-text repositories and Google Scholar-indexed
sources. PRISMA 2020 guidelines were followed for screening, data extraction, and risk-of-bias assessment (Cochrane
RoB 2 for RCTs; ROBINS-I for non-randomized designs).
Results: 55 distinct studies (out of 57 citation records) satisfied the eligibility requirements and were added to the narrative
synthesis after duplicate cross-database indexing was eliminated. Five technological families comprised the included
studies: (1) camera/video-based human pose estimation (HPE); (2) wearable pressure-sensor and inertial measurement
unit (IMU) systems; (3) hybrid AIoT and edge-AI platforms; (4) explainable and causal AI frameworks for spinal/
postural monitoring; and (5) AI-assisted clinical and educational interventions assessed in randomized or quasiexperimental
designs. Numerous intervention trials indicated statistically significant changes in postural measurements,
pain, disability, and functional outcomes, and reported categorization accuracies were consistently high (usually 90–
99%). However, the majority of technical validation studies were in the prototype or laboratory stage, sample numbers
were often small, external validation was few, and outcome measures were inconsistent, making meta-analysis impossible.
Conclusions: Strong technical accuracy and growing clinical potential are demonstrated by AI-based posture systems,
especially for biofeedback-based correction, ergonomic risk monitoring, and tele-rehabilitation. Future research should
focus on multi-center randomised trials, standardized outcome reporting, external and cross-population validation, and
transparent reporting of AI model development in accordance with PRISMA-AI guidelines because there is still relatively
little evidence at the clinical-effectiveness level.
Registration: Prospectively registered on open Science Framework (OSF) Registration DOI: 10.17605/OSF.IO/E9PBH
Keywords: artificial intelligence; machine learning; deep learning; posture detection; posture correction; pose estimation;
rehabilitation; PRISMA 2020; PICO framework; systematic review

A Rare Case of Disseminated Histoplasmosis in an Immunocompetent Young Male: Diagnostic Value of Bone Marrow Biopsy and Fungal Morphological Identification.

2026-11-02T09:19:10+00:00

The dimorphic fungus Histoplasma capsulatum causes histoplasmosis, an infection that can manifest as anything from a simple, self-limiting illness to a serious, widely spread illness. Fungal culture is still the gold standard for confirmation, but diagnosis is sometimes delayed by its slow development. Bone marrow analysis can offer a quick and accurate di-agnostic substitute in these situations. We describe a male immunocompetent patient, age 21, who has had a persistent fever and malaise for three months that have not improved with empirical treatment. Repeated blood cultures and sero-logic testing came out negative, but laboratory studies showed cytopenia. Grocott-Gomori Methenamine Silver (GMS) and Periodic acid–Schiff (PAS) stain, on the other hand, revealed intracellular and extracellular yeast-like organisms in bone marrow aspirate and trephine biopsy that were morphologically consistent with Histoplasma capsulatum.
Keywords: Histoplasma capsulatum, disseminated histoplasmosis, bone marrow biopsy, cytopenia, fungal morphology

Clinical Audit of Rheumatoid Arthritis Management: Adherence to NICE and EULAR Guidelines.

2026-11-02T09:19:10+00:00

Objective: To assess adherence to National Institute for Health and Care Excellence; Guideline number 100 (NICE NG100) and European Alliance of Associations for Rheumatology (EULAR 2022) guidelines across five domains: initia-tion of Disease-Modifying Antirheumatic Drugs (DMARDs) at an early stage, selection of appropriate first-line therapy, implementation of treat-to-target monitoring, timely escalation to biologics in non-responders, and comprehensive pre-biologic evaluation including infectious disease screening and vaccination.
Methodology: A retrospective audit of 153 recently diagnosed rheumatoid arthritis patients was conducted. Data col-lected included demographics, diagnostic intervals, DMARD initiation times, first-line therapy choice, DAS28-ESR scores, remission rates, biologic escalation, and pre-biologic screening compliance.
Results: The cohort comprised 121 females (79.1%) and 32 males (20.9%), with diagnostic intervals of 7–24 days. All patients initiated DMARDs within 6 weeks of diagnosis. First-line therapy included methotrexate monotherapy (n=128, 83.7%), methotrexate plus hydroxychloroquine (n=6,3.9%), and sulfasalazine plus hydroxychloroquine (n=19, 12.4%), Remission was achieved in 101(66.0%) patients with first-line conventional synthetic DMARDs within an average of 10 weeks. The remaining (n=52, 34.0%), were escalated to biologics after 12 weeks; mean DAS28-ESR decreased from 4.2±1.1 pre-biologic to 1.8±0.8 post-biologic at 3 months. Pre-biologic infectious disease screening (hepatitis B, hepati-tis C, tuberculosis, lipid profile) showed 100% compliance. However, no patients received pneumococcal, influenza, or varicella vaccines before biologic initiation, and COVID-19 vaccination status was undocumented.
Conclusion: This audit demonstrates strong adherence to core guideline recommendations, including: Early DMARD initiation, Methotrexate-based first-line therapy, Implementation of treat-to-target strategies, Timely escalation to biologic therapy in non-responders. Compliance with infectious disease screening was satisfactory. However, a significant gap was identified in pre-biologic vaccination, underscoring the urgent need for standardized vaccination protocols prior to initiating biologic therapy.
Keywords: Rheumatoid arthritis, clinical audit, DMARD therapy, treat-to-target, vaccination compliance.

Multidrug-Resistant Tuberculosis (MDR-TB) Prevalence and Risk Factors Among TB-Patients at a Tertiary Care Hospital in Nawabshah, Sindh.

2026-11-02T09:19:10+00:00

Objective: The purpose of this research was to ascertain the magnitude and determinants of multidrug resistant tuberculosis
(MDR-TB) among TB patients in Nawabshah.
Methodology: This cross-sectional study was conducted at Biosafety level (BSL-2) TB laboratory at PMC hospital Nawabshah
during August 2025 to October 2025. After getting informed consent sputum of 246 patients diagnosed as pulmonary
tuberculosis (PTB) was tested using GeneXpert test (using real-time Polymerase Chain Reaction). This study
includes new as well as recurrent cases. The laboratory performed the Xpert MTB/RIF Ultra and Xpert MTB/XDR tests
to investigate rifampicin and isoniazid resistance respectively. Data collected on a structured questionnaire
Results: Among 246 PTB patients, the frequency of MDR-TB was 2.8%, with younger age groups accounting for nearly
70% of cases. The impact was disproportionately felt by urban residents, especially from densely populated areas. MDR
-TB was significantly associated with low socioeconomic status (72%) and educational attainment, with 68% of patients
having only primary or no formal education. Nearly two-thirds of cases were among low-skilled workers and unemployed
individuals. Patients who were married (61%), underweight (54%), or had a family history of tuberculosis (43%) were at
higher risk.
Conclusion: The study revealed a 2.8% prevalence of Multidrug-Resistant Tuberculosis (MDR-TB) across population of
TB patients at Nawabshah, with high retreatment rates (3.84%). This finding underscores the need for effective control
programs, especially for the most vulnerable populations, and the importance of improving DOTS monitoring, awareness
initiatives, and access to remote areas to avoid travelling cost of patient and support for relapses.
Keywords: GeneXpert, Multidrug-Resistant Tuberculosis (MDR-TB), Frequency and determinants.

Medical Students’ Lived Experiences with Administrative Systems: A Phenomenological Study at CMH Kharian Medical College.

2026-11-02T09:19:10+00:00

Objective: To explore medical student’s lived experiences and emotional challenges related to organizational adminis-trative systems at CMH Kharian Medical College.
Methodology: This phenomenological qualitative study involved was conducted at CMH Kharian Medical College over four months from August 2025 to November 2025. Purposive sampling was used to obtain 22 MBBS students from different academic years. Data were collected through semi-structured, in-depth interviews conducted in English or Urdu. Inter-views focused on student’s experiences with administrative departments, including academic affairs, examinations, ac-counts and student services. All interviews were audio-recorded, transcribed verbatim, and anonymized. Data were ana-lyzed by using NVivo 12 Pro to identify significant statements, formulate meanings and to develop themes.
Results: Analysis revealed seven major themes. These included difficulty in understanding administrative procedures, poor and inconsistent communication, rigid administrative rules, interdepartmental transfers and inefficiencies, emotion-al exhaustion and administrative anxiety, perceived lack of empathy and respect and feelings of powerlessness leading to a culture of silence. These challenges contributed to stress, fear of clerical errors, frustration and reluctance to voice concerns, negatively affecting student’s academic focus and emotional well-being.
Conclusion: The findings indicate that administrative systems significantly influence medical student’s academic and emotional experiences. Addressing issues related to transparency, coordination, flexibility and empathetic communica-tion may help develop more student-centered administrative practices and improve the overall educational environment.
Keywords: Administrative systems, Medical education, Organizational Culture, Student experiences.

Investigate the Prevalence & Mechanisms of Biofilm Formation in Indwelling devices (e.g., catheters, prosthetics) & its Role in Persistent Infection and the Efficacy of Novel Anti-Biofilm Strategies or Coatings

2026-11-02T09:19:10+00:00

Objective: To evaluate the biofilm formation by Staphylococcus aureus along with Pseudomonas aeruginosa on sili-cone and polyurethane surfaces as well as to evaluate the antimicrobial efficacy of polymer-based coatings in reducing biofilm adherence and associated complications.
Methodology: For research we used in vitro model to investigate biofilm formation by S. aureus and P. aeruginosa on silicone and polyurethane surfaces. The reduction of bacterial adhesion, extracellular polymeric substances (EPS) pro-duction and the total biofilm density was evaluated for polymer-based antimicrobial coatings. We performed microscopic analysis along with viability testing to confirm the results.
Results: The results were very different after using these coatings. P. aeruginosa made more biofilms than S. aureus, and silicone surfaces kept biofilms with high biomass levels. Polymer-based antimicrobial coatings worked very well to stop biofilm from forming and sticking. Microscopic analysis and viability assessment verified a substantial reduction in biofilm density on coated surfaces. The coatings also made it harder for bacteria to stick to surfaces and made less EPS.
Conclusion: The results show how important it is to have better material engineering and polymer-based antimicrobial coatings to reduce infections related to biofilms in medical implants. Future studies should focus on improving the formu-lation of the coatings and evaluate extended use of antibiotics in clinical settings. Sophisticated preventive mechanisms could help to increase the service life and safety of in-vivo medical implants.
Keywords: bacterial adhesion, biofilm, indwelling devices, catheter infections, and antimicrobial coatings.

Assessment of Superficial Vascular Density in the Unilateral Amblyopic Eyes by Using Optical Coherence Tomographic Angiography.

2026-11-02T09:19:10+00:00

Objective: To assess the superficial vascular density (SVD) in the foveal avascular zone (FAZ) of the unilateral aniso-metropic amblyopic eye by utilizing the optical coherence tomography angiography.
Methodology: The present study was conducted during the period from February 2023 to November 2024, at the Insti-tute of Ophthalmology at Liaquat University of Medical & Health Sciences (LUMHS) Jamshoro Pakistan. The partici-pants included 50 children with unilateral anisometropic amblyopia was referred by the pediatric ophthalmology clinic of IOL LUMHS. All patients received a full eye checkup, which included testing their vision, assessing their refraction, measuring axial length, and examining both the front and back parts of the eye. An inbuilt proprietary software of OCTA was used to scan the 3 × 3-mm area of the foveal area to quantify the SVP at the horizontal and vertical axis.
Results: The two groups have shown a clear-cut distinction in visual acuity. The amblyopic eyes have a better correct-ed visual acuity of 20/ 64 {Logarithm of the Minimum Angle of Resolution; (logMAR) 0.51 ± 0.17}, with values ranging from 20/40 to 20/126 (logMAR 0.30–0.80). Conversely, the fellow eyes evidences better vision, with an average BCVA of 20/ 18 (logMAR −0.03 ± 0.05), which ranges between 20/ 15 and the 20/ 20 (logMAR −0.12 to 0.00). The overall, differ-ence among the two groups was significant, with a mean logMAR gap of 0.54 (95% CI, 0.45–0.63; P < .001). Although the amblyopic eyes usually show hyperopia > 3 diopters. The two groups were not considerably different in terms of equivalent cylinder, sphere, or spherical refraction.
Conclusion: Amblyopic eyes showed greater hyperopia, shorter axial lengths, and reduced visual acuity, consistent with prior reports on anisometropic amblyopia. OCT‑A revealed decreased superficial and deep capillary densities, suggest-ing microvascular alterations—particularly in the deep plexus—as potential biomarkers of amblyopia severity and thera-peutic response.
Keywords: Amblyopic FAZ, OCT of amblyopic eyes, superficial vascular Density, superficial vascular plexus of amblyop-ic eyes.

Roxadustat Versus Erythropoietin for Anemia Treatment in Diabetic Nephropathy.

2026-11-02T09:19:10+00:00

Objective: To compare Roxadustat and Erythropoietin in improving haemoglobin levels among patients with diabetic nephropathy.
Methodology: This comparative observational study was conducted in the Department of Nephrology, Sheikh Zayed Hospital, Lahore. Sixty-four patients aged 18–75 years with diabetic nephropathy, chronic kidney disease, and anaemia were enrolled. Patients were allocated into two equal groups by the lottery method. Group A received Roxadustat 100 mg orally three times per week. Group B received erythropoietin 4000 IU subcutaneously twice weekly. Follow-up was three months. Data were analysed in SPSS version 27.0. A p-value of ≤0.05 was taken as significant.
Results: Baseline characteristics were similar between groups. Post-treatment haemoglobin was better among patients of Roxadustat group than in the group of erythropoietin (10.54 ± 1.75 vs 9.05 ± 2.17 g/dL). Mean haemoglobin rise was also greater (1.97 ± 1.21 vs 0.98 ± 1.87 g/dL). Haemoglobin response was higher with Roxadustat (78.1% vs 40.6%). Roxadustat was an independent predictor of haemoglobin response (adjusted OR 6.41, 95% CI 1.86–22.07; p=0.003).
Conclusion: We found Roxadustat more effective than erythropoietin for improving haemoglobin in anaemic patients with diabetic nephropathy.
Keywords: Anaemia; Diabetic nephropathy; Erythropoietin; Haemoglobin; Roxadustat.

Efficacy of Finerenone in Slowing the Progression of Chronic Kidney Disease in Type 2 Diabetes.

2026-11-02T09:19:10+00:00

Objective: To evaluate short-term effects and safety of Finerenone in clinical practice of nephrology.
Methodology: A prospective observational study was done at the Department of Nephrology, Shaikh Zayed Hospital, Lahore, Pakistan from 01 September 2025 to 30 March 2026. 100 adults (18-80 years) with type 2 diabetes and chronic kidney disease (CKD) (eGFR ≥ 25 mL/min/1.73 m², Urine Albumin-Creatinine Ratio (UACR) ≥ 30 mg/g), who were on stable ACE inhibitor/ARB therapy, were consecutively enrolled, with baseline potassium levels of ≤ 4.8 mmoL/L. Follow-up visits were conducted after 1 and 3 months. Paired t-tests and Wilcoxon signed-rank tests were used to test the changes from baseline for continuous variables and UACR, respectively, at p<0.05.
Results: The mean age was 64.8±8.0 years and 70% of the population was male. Baseline eGFR was 45.0±10.7 mL/min/1.73 m² and median UACR was 800 mg/g [IQR 330–1643]. At 1 month, 95% and 3 month, 92% of the children were attending. UACR decreased to 607 [272–1277] at 1 month and 540 [244–1142] at 3 months (both p<0.001). Mean eGFR declined to 43.9±11.2 at 1 month and 41.9±11.8 at 3 months (both p<0.001). Mean potassium increased from 4.35±0.24 to 4.56±0.47 at 1 month (p<0.001) and 4.47±0.43 at 3 months (p=0.004); potassium >5.5 mmol/L occurred in 5.3% and 2.2%, respectively. The combined outcome of kidney was seen in 7% and hyperkalaemia requiring ER/hospitalization occurred in 2% in 3 months.
Conclusion: Finerenone was associated with early albuminuria reduction and acceptable short-term safety with potas-sium monitoring.
Keywords: Albuminuria; Chronic kidney disease; Finerenone; Hyperkalaemia; Type 2 diabetes mellitus.

Correlation of Urinary Protein & Serum Uric Acid with Serum 25-Hydroxyvitamin D Levels in Pre-Dialysis Chronic Kidney Disease Patients.

2026-11-02T09:19:10+00:00

Objective: To evaluate the correlation between urinary protein and serum uric acid levels with serum 25‑hydroxyvitamin D concentrations in patients with chronic kidney disease who are not yet on dialysis.
Methodology: This is a cross-sectional study performed in the Department of Nephrology at Shaikh Zayed Hospital, Lahore from 10th December 2025 to 10th June 2026. Using non-probability consecutive sampling, 87 pre-dialysis pa-tients with chronic kidney disease were selected. Enrolled were patients between the ages of 18 and 60, with an esti-mated glomerular filtration rate (eGFR) of 15 and 60 mL/min/1.73 m². Structured proforma used for recording demo-graphic, clinical and laboratory data. Blood and urine samples were subjected to usual hospital procedures for evalua-tion.
Results: The average age was 30.59 ±8.71 years. Most patients were females and at Stage IV of CKD. The median for the daily urinary protein concentration was 162.50 mg. The average serum uric acid level was 5.30 ± 1.11 mg/dL. The mean serum 25-hydroxyvitamin D concentration was 16.58 ±5.98 ng/mL. Vitamin D exhibited a substantial negative cor-relation with urinary protein (r = -0.691, p < 0.001). Additionally, serum uric acid demonstrated a substantial negative correlation (r = -0.675, p < 0.001).
Conclusion: In pre-dialysis CKD patients, S-25-HD levels were decreased when urinary protein and serum uric acid were elevated. Early risk assessment may be facilitated by these markers.
Keywords: Chronic kidney disease; Pre-dialysis; Proteinuria; Uric acid; Vitamin D.

Bridging General And Plastic Surgery in abdominal wall hernia repair: A Retrospec-tive Comparative Study Of Mesh-Based Techniques Versus Component Separation At Sheikh Zayed Medical College And Hospital, Rahim Yar Khan, South Punjab.

2026-11-02T09:19:10+00:00

Objective: This study compares the effectiveness and safety of standard mesh-based abdominal wall repair with com-ponent separation techniques with or without mesh. Out study is based on to look the following parameters like surgical recurrence rates, postoperative complications, aesthetic results, and patient satisfaction in this study.
Methodology: This retrospective comparative study that carried out during January 2021 to December 2025 includes total 120 adult patients that by divided into 2 groups (Group A & Group B). Each group having 60 patients. Group A pa-tients received a mesh-based repair, while Group B patients underwent component separation, with or without mesh.
Results: Regarding results of study, Group B had less recurrence rate (8.3% compared to 16.7%, p=0.031) and fewer overall complications (58.3% compared to 71.7%, p=0.036). Patients in group B also reported increased satisfaction, with an average score of 7.9 out of 10 versus 6.4 in group A (p=0.008).
Conclusion: Our studies results shows that there is fewer recurrence rates and higher patients satisfaction in In compo-nent separation techniques at South Punjab tertiary care setting. General and Plastic Surgeons should work together for better outcome.
Keywords: abdominal wall hernia; mesh repair; component separation; ventral hernia; South Punjab; Pakistan; surgical outcomes.

Effects of Piperine on Relative Tissue Weight Index of Ovaries and Gonadotropin Levels in Female Albino Rats.

2026-11-02T09:19:10+00:00

Objective: To evaluate the effects of piperine on ovarian relative tissue weight index and serum gonadotropin levels in adult female albino rats.
Methodology: This experimental study was conducted at the department of Anatomy, Niazi Medical and Dental Col-lege, Sargodha, over a period of four-month period from September 2025 to December 2025. Thirty adult female Wistar albino rats were divided into three groups (each group 10 rats): Group A (control; normal saline), Group B (piperine 5 mg/kg/day) and Group C (piperine 10 mg/kg/day). Drugs were given orally for 30 days daily. Body and ovarian weights were recorded to calculate RTWI. Serum levels of FSH and LH were quantified by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA with Tukey’s post hoc test were used to measure the group differences.
Results: A significant increase in ovarian Relative Tissue Weight Index (RTWI) was observed after piperine treatment, with the highest values recorded in the 10 mg/kg group (p < 0.001). Serum FSH and LH levels were significantly in-creased in piperine-treated groups, particularly in Group C (p < 0.001).
Conclusion: Piperine induces dose-dependent ovarian toxicity with altered RTWI, structural ovarian damage and signif-icant disruption of gonadotropin secretion. Therefore, prolonged or high-dose piperine exposure can disturb female re-productive function.
Keywords: Follicle-Stimulating Hormone; Luteinizing Hormone; Ovaries; Piperine; Relative Tissue Weight Index.

Changing Trends of Peptic Ulcer Disease & Helicobacter pylori Infection: A Retrospective Analysis.

2026-11-02T09:19:10+00:00

Objective: To analyze the current trends in Peptic ulcer disease (PUD) with respect to ulcer type, H. pylori status, and associated risk factors in a tertiary care setting.
Methodology: This retrospective descriptive study was conducted at Shalamar Hospital, Lahore, from November 2023 to November 2025. This study included 285 patients who underwent upper gastrointestinal endoscopy during the study period. Demographic data, clinical features, endoscopic findings, H. pylori status (determined by rapid urease test and histopathology), and risk factors such as NSAID use, smoking, and alcohol intake were extracted from hospital records.
Results: The mean age of patients was 46.8 ± 13.2 years, with a male-to-female ratio of 1.3:1. Duodenal ulcers were more frequent (58.9%) than gastric ulcers (36.1%), while combined lesions accounted for 4.9%. H. pylori infection was detected in 60% of patients overall, with a significantly higher prevalence among duodenal ulcers (68.5%) compared to gastric ulcers (48.5%) (p = 0.002). NSAID use was reported in 32.3% of patients, showing a strong association with gas-tric ulcer development (p = 0.01).
Conclusion: H. pylori remain a major risk factor for duodenal ulcer disease, gastric ulcers are increasingly associated with NSAID exposure, particularly among elderly patients.
Keywords: Helicobacter pylori, prevalence, NSAID, Gastric ulcer, Duodenal ulcer.

Frequency of intra-aortic balloon pump insertion in coronary artery bypass grafting.

2026-11-02T09:19:11+00:00

Objective: To determine the frequency of intra-aortic balloon pump insertion in coronary artery bypass grafting.
Methodology: This Quasi-Experimental descriptive observational study conducted after enrolling 118 patients of either gender, aged 25-70 years during April 2025 to Oct 2025 at Cardiac Surgery Department, Peshawar Institute of Cardiolo-gy undergoing CABG, after diagnosis of coronary artery disease, defined by chest pain (VAS>3) and dyspnoea with confirmatory ECG findings. Patients with past history of cardiac surgery, end-stage renal disease, severe arrhythmias, pregnancy, neurological impairment, and chronic pulmonary disease were excluded. CABG was performed in all pa-tients. SPSS 25 was used. Frequency of intra-aortic balloon pump was determined. Mann-Whitney and Fisher’s exact tests were used, keeping p value significant at ≤ 0.05.
Results: Median age of 118 patients was 60 (52.75-65.25) years, with majority patients (n=90, 76.3%) being male. The median ejection fraction was 57 (46-59) %. The frequency of IABP insertion among CABG patients was 2.5% (n=3) (95% CI: 0.005 to 0.073). Ejection fraction was significantly lower in patients of IABP.
Conclusion: The observed correlation between IABP use and reduced ejection fraction underscores its role in managing patients with impaired ventricular function. These findings reinforce the value of IABP as a strategic perioperative inter-vention to optimize hemodynamic support in high-risk cardiac surgery.
Keywords: Intra-aortic balloon pump, coronary artery bypass grafting, cardiac surgery, ventricular dysfunction, ejection fraction

Digital Photoaging Across Ethnic Groups: Patterns of Skin Changes and Protective Behaviors.

2026-11-02T09:19:11+00:00

Objective: To analyze the distinctions between ethnic differences in the expression of premature aging as well as the protective behaviors of those who have been exposed to LED screen devices.
Methodology: This cross-sectional study was carried out at PNS Shifa Hospital, Karachi, between October 2023 and May 2024. A total of 450 participants aged 27 to 40 years were recruited through convenience sampling. Data were col-lected using a structured questionnaire encompassing demographic details, LED exposure patterns, protective practic-es, and self-reported indicators of premature aging. Participants were classified into ethnic groups: Punjabi, Sindhi, Mu-hajir, Pashtun, Balochi, and Others. Statistical analyses, including chi-square tests and logistic regression, were per-formed using SPSS version 29, with a p-value of <0.05 considered statistically significant
Results: Most of the participants were Punjabis (31.1%), followed by Sindhi (20.2%) and Muhajir (18.2%). Ethnicity was not significantly associated with the use of UV protection (χ ² =5.54, p=0.353) and use of SPF (χ ² =9.23, p=0.100). Similar-ly, ethnicity did not show a strong relationship with dark circles (p=0.57), decreased elasticity (p=0.68), dry skin (p=0.60), grey hair (p=0.56), or hair fall (p=0.47). However, fine wrinkles showed borderline statistical significance (p=0.05).
Conclusion: Ethnicity does not appear to be a significant determinant of digital photoaging in Pakistan. Instead, expo-sure to visible light emerges as the primary contributing factor. Universal photoprotective measures are therefore recom-mended, while further research is warranted to elucidate the underlying mechanisms.
Key words: Ethnicity, digital photoaging, visible light exposure, skin aging.

Comparison of Intra Articular Injection of Platelet Rich Plasma with Hyaluronic Acid in Osteoarthritic Knee.

2026-11-02T09:19:11+00:00

Objective: To compare the efficacy and safety of intra articular injection of Platelet Rich Plasma (PRP) and Hyaluronic Acid (HA) in patients with osteoarthritic knee.
Methodology: This observational comparative study was carried out in the Anesthesia Department of the Abbassi Shaheed Hospital (ASH) from December, 2022 to May, 2023. There were 42 patients with confirmed diagnosis of Knee Joint Os-teoarthritis with eligibility criteria were enrolled. Twenty-one study participants were randomized to receive intra articular injection of PRP (Group A), while the remaining 21 study participants received HA (Group B). Socio demographics data, anthropometric measurement, disease duration data was collected. Importantly, the pain score using Visual Analogue Scale (VAS) and WOMAC a validated tool was used to clinically assess the patients at baseline and first- and third-month follow-up. SPSS version 21 was used to analyze data.
Results: There was no significant difference in mean age, gender, ethnicity, disease duration and disease grading among patients randomized to Group A or B. Moreover, no significant difference was identified between mean pain score and mean WOMAC score at baseline. Importantly, significant difference was observed in mean pain score and mean WOMAC score at first- and third-month follow-up. Importantly, significant decrease in mean pain score on VAS and mean WOMAC score was observed among patient randomized to receive Platelet Rich Plasma as compared to Hyaluronic Acid.
Conclusion: Patients with knee osteoarthritis treated with intra-articular injection of Platelet Rich Plasma showed im-proved clinical outcomes as compared to Hyaluronic Acid. This is evident from the significant decrease in mean pain score as well as mean WOMAC score at follow-ups on first and third month.
Keywords: Knee osteoarthritis, Platelet Rich Plasma, Hyaluronic Acid, Visual Analogue scale, WOMAC, pain.

Comparing MELD-3 and Child-Pugh Scores in Predicting 90-Day Readmission and Mortality in Patients with Liver Cirrhosis.

2026-11-02T09:19:11+00:00

Objective: This comparative analysis aims to quantify the superior predictive performance of MELD-3 relative to Child-Pugh scores and to evaluate its implications for clinical decision-making and resource allocation in patients with liver cirrhosis.
Methodology: This prospective observational study was performed at the Department of Medicine, Dr. Ruth. K. M. Pfau, Civil Hospital, Karachi, Dow University of Health Sciences, from May 2025 to November 2026. 250 patients of decom-pensated cirrhosis of >18 years meeting the inclusion/ exclusion criteria were included. The data collection consisted of demographic information, and blood samples were taken, and scores were calculated at discharge and readmission within 3 months on a pre-designed proforma. Data analysis was done by using SPSS 25, and descriptive statistics were applied.
Results: Among 250 hospitalized patients, 20 (8%) died, and 230 (92%) survived. The mean Child-Pugh Score (CPS) increased from 8.68 ±1.92 at discharge to 9.87 ±2.06 at readmission. While the mean MELD 3.0 score rose from 17.83 ±8.10 to 21.00 ±9.26. Mortality was significantly associated with CPS at discharge (mean difference 1.27, p=0.004) and readmission (mean difference 1.87, p<0.001), as well as MELD-3 at discharge (mean difference 7.47, p<0.001) and re-admission (mean difference 5.05, p=0.019). Logistic regression analysis identified CPS at readmission, MELD-3 at dis-charge and readmission, and CPS class as independent predictors of mortality.
Conclusion: CPS, particularly at readmission, demonstrated slightly better predictive accuracy, while MELD-3 remains a useful adjunct. A combined or dynamic approach may provide the most clinically meaningful risk stratification.
Key words: MELD 3, CPS, Decompensated Cirrhosis, mortality.

Patterns Of Dermoscopy in cases with pigmented skin lesion in A Tertiary Care Hospital.

2026-11-02T09:19:11+00:00

Objective: To determine the frequency of different pigmented skin lesions identified on dermoscopy in patients present-ing to a tertiary care hospital and to assess their distribution according to demographic and clinical variables
Methodology: This cross-sectional study was conducted in the Department of Dermatology, Nishtar medical university, Multan over a period of one month after obtaining ethical approval. The study was carried out over a period of six months from 08-10-2020 to 07-04-2021. After taking informed consent, a total of 156 patients of both genders, aged be-tween 20 to 60 years, presenting with pigmented skin lesions were included using a non-probability consecutive sam-pling technique. Patients who had received any treatment in the last one month or had a documented malignancy were excluded. Data was collected using a predesigned proforma including demographic variables (age, gender) and clinical characteristics such as duration of lesion, itching, diabetes mellitus, and family history of melanoma. All patients under-went dermoscopic examination using a FireflyPro DE350 dermatoscope, performed by a consultant dermatologist. The collected data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 23.0, where quantitative variables were presented as mean ± standard deviation and qualitative variables as frequencies and per-centages and chi-square test was used to assess associations, with a p-value ≤ 0.05 considered statistically significant.
Results: In this study, a total of 156 cases were included, comprising 85 females (54.49%) and 71 males (45.51%). The mean age of participants was 43.06 ± 8.23 years, with an average symptom duration of 3.14 ± 2.11 months. Among the 156 cases, itching was reported in 47 (30.13%), diabetes mellitus in 18 (11.54%), a family history of melanoma in 7 (4.49%), and bleeding in 23 (14.74%). The most frequently observed lesions were melanocytic nevi in 33 (21.15%), li-chen planus in 24 (15.38%), dysplastic nevus in 14 (8.97%), and seborrheic keratosis in 11 (7.05%).
Conclusion: Dermoscopy is a useful tool for diagnosis of pigmented lesion and the most commonly noted lesion was melanocytic nevi followed by lichen planus. There was no significant association between confounders of the study and study outcomes.
Keywords: Dermoscopy, Melanocytic nevi, seborrheic keratosis, Lichen planus.

A Comparative Study of Hips Treated with Core Decompression Versus Vascularized Fibular Graft for Avascular Necrosis: A Survival Analysis.

2026-11-02T09:19:11+00:00

Objective: To compare the effectiveness of core decompression and vascularized fibular grafting in terms of pain relief, functional recovery, prevention of disease progression, and short-term hip survival.
Methodology: This prospective observational comparative study was executed in department of orthopedic surgery, Shifa International hospital, Islamabad, from august 2025 to march 2026. Seventy-six patients were enrolled, with 38 in each group; those lost to follow-up were excluded from final analysis. Adults aged 18 to 60 years with radiologically con-firmed Association Research Circulation Osseous classification (ARCO) stage II or III avascular necrosis were included.
Results: A total of 61 patients were analyzed, including 32 treated with core decompression and 29 with vascularized fibular grafting. Baseline age, preoperative Harris Hip Score (HHS) and preoperative visual analog scale pain score were comparable between groups. At 6 months, HHS remained higher (81.79 ±10.41 vs 74.75 ±12.83, p=0.023) and pain score remained lower (2.20 ± 1.16 vs 3.77 ±1.54, p<0.001) in the graft group. Disease progression, arthroplasty conversion, and Kaplan-Meier survival showed favorable but non-significant trends for grafting.
Conclusion: Vascularized fibular grafting demonstrated superior early outcomes compared to core decompression in patients with avascular necrosis of the femoral head, particularly in terms of functional recovery and pain relief. Although trends also favored grafting for disease progression and short-term hip survival, these differences did not reach statisti-cal significance within the 6‑month follow-up period.
Keywords: Avascular necrosis, core decompression, vascularized fibular graft, survival analysis.

The ‘Spoil Syndrome’: From Textbooks to Tabs – Exploring the Paradigm Shift from Textbook Learning to Internet Dependence among MBBS Undergraduates.

2026-11-02T09:19:11+00:00

Objective: To evaluate the patterns and extent of internet and artificial intelligence (AI) use among MBBS students in private medical colleges of Punjab, Pakistan, with attention to gender-based differences, and to compare their perceived outcomes of textbook-based learning versus digital/AI-assisted learning. The study will reference the phenomenon of “spoil syndrome,” defined as superficial, exam-oriented learning that arises from over-dependence on internet and AI resources.
Methodology: This cross-sectional, questionnaire-based study was conducted from September 2024 to February 2026 in three private medical colleges of Punjab, Pakistan, among students from first to final year. A pre-tested, semi-structured questionnaire assessed demographics, devices and access, preferred sources, learning activities, and per-ceived outcomes. Of 1615 students approached, 1336 met the inclusion criteria and responded. Gender differences were tested using chi-square (α=0.05).
Results: AI awareness was high among both female and male students (83.0% vs. 87.5%; p=0.082). However, males reported significantly greater daily use of AI tools (88.3% vs. 71.1%; p<0.001) and a stronger preference for AI over con-ventional internet resources (80.2% vs. 69.5%; p<0.001). The primary applications of AI included concept clarification (65%), quick revision summaries (60%), and MCQ/quiz generation (59.5%) (all p<0.001), whereas its use for research and methodology support remained low (11.5%). Learning preferences indicated a clear inclination toward blended ap-proaches, with 38.5% favoring books plus internet/AI and 29.5% preferring slides plus internet/AI. Only 4.5% of students relied exclusively on internet/AI resources. Among AI platforms, ChatGPT emerged as the most frequently used tool (44.2%). Students perceived that internet/AI use enhanced their digital skills, motivation, and receptiveness to learning.
Conclusion: Students mainly use AI alongside conventional resources, but its concentration in exam-oriented tasks indicates a risk of superficial learning. The findings are self-reported, cross-sectional, and limited to private colleges, and are therefore exploratory. Curricular policies, faculty training, and assessment reform are needed to promote ethical, critical use of AI alongside textbooks and to prevent “spoil syndrome.”
Keywords: Spoil syndrome; artificial intelligence; internet-based learning; medical education; MBBS students; Pakistan.

Profile of Adults with Acute Suppurative Otitis Media: An insight for primary care providers.

2026-11-02T09:19:11+00:00

Objective: To evaluate the clinical profile and determine the risk factors associated with acute suppurative otitis media among adults presenting to the outpatient section of the Otorhinolaryngology department with recent onset ear symp-toms.
Methodology: This hospital-based analytical cross-sectional study was conducted in the Otorhinolaryngology outpa-tient department of Niazi Welfare Foundation Teaching Hospital, Sargodha, between April 2025 and March 2026. Adults aged ≥18 years presenting with recent-onset ear symptoms (≤2 weeks) were consecutively enrolled. A detailed clinical history followed by otoscopic examination was performed to confirm the diagnosis of acute suppurative otitis media (ASOM). Binary logistic regression analysis was applied to identify independent predictors, with odds ratios (ORs) and 95% confidence intervals (CIs) reported. Statistical significance was set at a p-value ≤0.05.
Results: Among 305 participants, 73 (23.9%) were diagnosed with ASOM. Logistic regression analysis identified smoking, nasal pathologies, history of recurrent ear infection, self-induced Valsalva maneuver and recent air travel are recognized as independent predictors of ASOM (p≤0.05).
Conclusion: Strengthening primary healthcare capacity for recognition of aforementioned risk factors may promote timely diagnosis and referral, consequently disease burden and preventing long-term complications will be prevented.
Keywords: Earache, Eustachian Tube, Hearing loss, Otitis Media, Mastoiditis, Tympanic membrane, Valsalva maneuver.

Impact of Age at Surgical Repair on Early Outcomes of Hypospadias: A Retrospective Cohort Study.

2026-11-02T09:19:11+00:00

Objective: To document the impact of age at surgical repair of Hypospadias at Ibne Sina University, Mirpur Khas.
Methodology: In this study we have included 33 male patients who underwent primary hypospadias repair between Jan-uary 2024 and March 2026. Patients were divided into three age groups (11 each): Group A (≤18 months), Group B (19 months–5 years), and Group C (>5 years). Outcomes within 3 months included urethrocutaneous fistula, meatal steno-sis, wound gapping, surgical site infection and re-intervention.
Results: All operations were performed by senior consultants. Distal and midshaft cases were repaired with TIP tech-nique; proximal cases with two-stage repair. Overall complication rate was 18.2% (6/33). Urethrocutaneous fistula oc-curred in 2 (6.1%), wound dehiscence in 2 (6.1%), surgical site infection in 2 (6.1%). No meatal stenosis or flap necrosis. Re-intervention was required in 2 (6.1%), both after two-stage repair for proximal hypospadias. Complication rate by age Group A were 9.1%, Group B 18.2%, Group C 27.3%.
Conclusion: Hypospadias repair achieves acceptable outcomes across all age groups at our institution when performed by experienced surgeons. Two-stage repairs for proximal hypospadias carry the highest complication burden.
Keywords: Hypospadias; age at repair; urethrocutaneous fistula; Pakistan.

The Role of Artificial Intelligence in Antimicrobial Susceptibility Testing: Perceptions and Expectations of Medical Doctors of South Punjab, Pakistan.

2026-11-02T09:19:11+00:00

Objective: To evaluate clinicians’ reliance on antimicrobial susceptibility testing (AST) and their perceptions, trust, and readiness to adopt artificial intelligence (AI)–enabled AST in clinical practice.
Methodology: A descriptive cross‑sectional study was conducted among 366 healthcare workers in South Punjab, Pa-kistan. Data on reliance, perceptions of AI‑enabled AST, trust, implementation, and concerns were analyzed using chi‑square (χ ²) tests.
Results: Demographic analysis showed that 51.0% of participants had less than five years of clinical experience, with medical officers comprising 48.9% (P<0.001). Females predominated (59.2% vs. 40.7%; P<0.01). Most respondents practiced in Lahore (37.7%) or Multan (33.0%; P<0.001), with surgery (34.4%) and pediatrics (22.9%) being the leading departments (P<0.001). Reliance on AST was high: 69.6% strongly agreed and 21.5% agreed that AST guided prescrib-ing decisions, though 72.9% noted delays limited optimal selection. Interpretation was seen as judgment‑dependent (41.5% strongly agree). Perceptions of AI were highly positive: 84.4% strongly agreed AI could improve accuracy, 76.2% reduce inappropriate use, and 82.2% aid earlier decisions. Trust and willingness to adopt were strong (95.9% trusted validated AI; 93.4% were willing to use it alongside conventional AST). Concerns included transparency (35.2%), bias (59.8%), unclear legal responsibility (78.9%), and infrastructure (75.9%). Most supported training (81.1%) and regu-latory oversight (71.8%). Significant variation was observed across responses (P<0.001).
Conclusion: Clinicians view AI‑enabled AST as a promising complementary tool, contingent on validation, governance, training, and integration.
Keywords: Antimicrobial susceptibility testing; Artificial intelligence; Antimicrobial resistance; Clinical decision support; Stewardship; Healthcare workers.

Frequency of Surgical Site Infection Following Open Appendectomy in A Tertiary Care Hospital.

2026-11-02T11:31:34+00:00

Objective: Globally, acute appendicitis is regarded as one of the leading surgical emergencies and appendectomy con-sidered the definitive treatment. Although appendectomy is a routine procedure, surgical site infection (SSI) remains one of the frequently encountered adverse outcomes that contributes to patient morbidity and increased healthcare burden.
Objective: To determine the frequency of “surgical site infection” (SSI) among patients presenting with acute appendici-tis who underwent open appendectomy.
Methodology: This prospective descriptive observational study was conducted at Department of Surgery, “Dr. Ruth K.M. Pfau Civil Hospital Karachi”, between April and July 2026. A total of 105 patients aged 15–60 years diagnosed with acute appendicitis and undergoing open appendectomy were included through consecutive sampling. SSI was defined as Southampton Grade II or above within 30 days postoperatively. Patients were followed on postoperative days 2, 7, 14 and 30. Statistical analysis conducted using SPSS version 26, with a p-value ≤0.05 considered statistically significant.
Results: Among 105 patients included, SSI was observed in 13 patients (12.4%). Male patients (n=78-74.3%) outnum-ber female patients (n=27-25.7%), with a mean age of 24.5±9.4 years. SSI observed more frequently in patients with higher ASA grades, history of smoking, diabetes mellitus and hypertension, contaminated wounds and complicated ap-pendicitis.
Conclusion: SSI following open appendectomy remains relatively common in our setting, with a frequency consistent with rates reported in similar low- and middle-income countries.
Keywords: Appendectomy, Surgical Site Infection, Southampton wound grading system, Open appendectomy, Wound infection.

Exploring the Impact of Formative Assessment on Summative Assessment Outcomes: A Feedback-Based Quasi-Experimental Study in Forensic Medicine Education.

2026-11-02T11:31:25+00:00

Objective: To assess the effect of OSPE-based formative assessment with structured feedback on students’ summa-tive assessment performance.
Methodology: This quasi-experimental pretest–posttest study was conducted in the Department of Forensic Medicine and Toxicology, Liaquat University of Medical and Health Sciences, Jamshoro, from August 2025 to January 2026. A total of 97 third-year MBBS students were enrolled through non-probability consecutive sampling. Students completed a baseline pretest followed by three formative Objective Structured Practical Examinations (OSPEs), with structured feed-back after each assessment. Academic performance was evaluated using pretest, formative and summative scores. Students’ perceptions were assessed through a structured questionnaire. Data were analyzed using paired t-test, Pear-son correlation and descriptive statistics.
Results: The mean posttest score was significantly higher than the pretest score (66.8 ± 9.1 vs. 59.2 ± 8.7; t=10.84, p=0.031). Performance improved progressively across the three OSPEs. Individual OSPE scores were not significantly associated with summative performance, but the mean OSPE score showed a significant positive correlation with sum-mative scores (r=0.39, p<0.001). Most students reported positive perceptions, and 87.6% recommended routine use of this method.
Conclusion: OSPE-based formative assessment with structured feedback improved academic performance and showed a positive relationship with summative outcomes.
Keywords: Formative Assessment; Feedback; OSPE; Medical Education; Competency-Based Medical Education.

Comparison of Treatment Efficacy of Extracorporeal Shock Wave Lithotripsy Verses Ureteroscopy in Patients Presenting with Upper Ureteric Stone: A Randomized Controlled Trial.

2026-11-02T11:31:16+00:00

Objective: Upper ureteric stones cause pain, hematuria, obstruction, and renal complications. Extracorporeal shock-wave lithotripsy (ESWL) is non-invasive but may require repeated sessions. Ureteroscopy (URS) permits direct stone fragmentation and removal. To compare the treatment efficacy of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) in patients with upper ureteric stones.
Methodology: This comparative study included 100 patients from 01 December 2025 to 01 June 2026 aged 18–75 years with a single upper ureteric stone smaller than 10 mm and density not exceeding 1000 Hounsfield units. Patients were allocated by lottery into ESWL and URS groups, with 50 patients in each group. ESWL was performed with a MODULITH SLX-F2 lithotripter for up to three sessions. URS was performed under general anesthesia using a semirigid ureteroscope and pneumatic lithotripsy. Stone clearance was assessed by non-contrast computed tomography after four weeks. Data were analyzed using IBM SPSS Statistics version 21.
Results: Complete stone clearance at four weeks occurred in 40 of 50 patients (80.0%) after ESWL and 47 of 50 pa-tients (94.0%) after URS (p=0.037). Treatment failure occurred in 20.0% and 6.0% of patients, respectively. Immediate procedural complications occurred in 4.0% of the ESWL group and 6.0% of the URS group. Post-treatment complica-tions occurred in 18.0% and 20.0% of patients, respectively (p=0.799).
Conclusion: URS achieved a higher four-week stone-clearance rate than ESWL. Both treatments had comparable short-term complication rates.
Keywords: Extracorporeal shock-wave lithotripsy,Hounsfield unit, Stone clearance, Upper ureteric stone, Ureteroscopy.

Radiological Assessment of Chronological Age Using Epiphyseal Fusion of the Pelvic Bones in a subset of Pakistani Adults Aged 18–25 Years.

2026-11-02T11:31:07+00:00

Objective: To evaluate the stages of epiphyseal fusion around the pelvis using radiographic imaging in individuals aged
18 to 25 years within a subset Pakistani population.
Methodology: The current study was a radiological prospective study, carried out at the Dow Institute of Radiology, Karachi from Dec 2025 till Feb 2026. Radiographs of the Pelvis of the enrolled patients were taken in AP (anterioposterior)
view and the epiphysis of Iliac crest and ischial tuberosity were examined at the pelvic bone for 4 stages of
fusion. Data was entered and analyzed in computer software SPSS 21.0.
Results: In the current study, there were 105 (50%) males and 105 (50%) female patients. Degree 3 fusion of iliac crest
was observed amongst 34 (32.38%) males and 36 (34.29%) females. Degree 3 fusion of Ischial tuberosity was observed
amongst 34 (32.38%) males and 36 (34.29%) females. All the subjects’ (100%, n=27) shows degree 3 fusion of
iliac crest and Ischial tuberosity in age group 25 years.
Conclusion: Our study concludes that epiphysis of iliac crest and Ischial tuberosity fused in majority of the cases in age
group 24-25 years. Earliest fusion of iliac crest occurs at the age of 22 in both males and females. Complete fusion of
Ischial tuberosity occurs at the age of 23 years in males while in females it occurs at the age of 22 years.
Key words: Radiological; Epiphyseal fusion; Pelvis; Iliac crest; Ischial tuberosity.

Correlation of Vitamin D Deficiency with Levels of Calcium and Phosphate in the Adult Population of Khairpur Mir's.

2026-11-03T11:31:24+00:00

Objective: To determine the correlation between vitamin D level and serum calcium and phosphate in the adult population
of Khairpur Mir's, and to identify independent predictors of vitamin D deficiency.
Methodology: This cross-sectional study enrolled 210 asymptomatic adults aged 20-39 years from Khairpur Mir's. Serum
vitamin D, calcium, and phosphate were measured biochemically, and demographic and lifestyle data were recorded.
Vitamin D deficiency was defined as <20 ng/mL. Associations were assessed using chi-square and independentsamples
t-tests; independent predictors of deficiency were identified using univariate and multivariable binary logistic
regression; and the vitamin D-calcium and vitamin D-phosphate relationships were quantified using Pearson's and
Spearman's correlation coefficients.
Results: Mean serum vitamin D was 19.54±8.00 ng/mL; 53.3% of participants were deficient. Mean calcium was
8.75±0.98 mg/dL (36.7% deficient) and mean phosphate was 3.31±0.73 mg/dL (32.4% deficient). Vitamin D correlated
moderately with calcium (r=0.451, p<0.001) but only weakly and non-significantly with phosphate (r=0.125, p=0.071). On
multivariable logistic regression, employment (adjusted OR=4.52, 95% CI 2.41-8.48, p<0.001) and inadequate sun exposure
(adjusted OR=4.41, 95% CI 2.32-8.40, p<0.001) were independent predictors of vitamin D deficiency; age, sex,
education, and dietary intake were not.
Conclusion: Vitamin D deficiency is common among adults in Khairpur Mir's and correlates significantly with serum calcium
but not phosphate, consistent with their differential regulation. Employment and inadequate sun exposure, rather
than demographic factors, independently predict deficiency, supporting targeted, exposure-based screening and supplementation
strategies for this and similarly under-studied districts.
Keywords: Vitamin D deficiency; Calcium; Phosphate; Correlation; Khairpur Mir's; Pakistan.

Anatomical Diversity & Bilateral Symmetry: CT-Based Native Acetabular Surface Characterization in Pakistani Adults.

2026-11-03T11:31:14+00:00

Objective: The contralateral acetabulum serves as a reliable internal anatomical reference for evaluating pelvic and hip morphology. At the population level, however, bilateral symmetry may coexist with considerable inter-individual varia-tion. This study quantified right–left differences in native acetabular morphology and characterized selected morphomet-ric variants within a multicenter adult Pakistani population.
Methodology: Retrospective cross-sectional analysis of the CT examinations was conducted from January 2023 to De-cember 2024, from three tertiary care hospital. Eligible were adults aged 18-75 years, who had both acetabula and prox-imal femora completely visible. Examinations that had fractures, prior hip surgery or arthroplasty, developmental dyspla-sia, advanced OA, destructive arthropathy, femoral-head collapse, a tumor of the pelvis, congenital deformity, substan-tial pelvic rotation, incomplete visualization or poor image quality were excluded. The maximum acetabular diameter, depth, depth-to-diameter ratio, anatomical anteversion, inclination, lateral center-edge angle and wall indices were measured with a standardized multiplanar CT assessment. The main analysis was a comparison between paired meas-urements from the right and left side. Secondary analyses involved describing sex-associated differences and the inci-dence of selected morphometric categories.
Results: Two hundred and four subjects and 408 acetabula were included in the study. The measurements of the ace-tabula of both the right and left side were comparable. Maximum diameter was 52.1±3.6 mm on the right and 51.9±3.6 mm on the left, with a mean paired difference of 0.20 mm (p=0.126). Differences were similarly small for depth (0.17 mm; p=0.141), depth-to-diameter ratio (0.18 percentage points; p=0.339), anteversion (0.31°; p=0.174), inclination (0.22°; p=0.263), and lateral center-edge angle (−0.19°; p=0.491).
Although this is bilaterally symmetrical, there was morphometric variation with 14.0 % hips with a diameter <48 mm, 22.5 % hips with a depth-to-diameter ratio (DDR) <45, 15.2 % hips with anteversion >25°, 8.3 % hips with inclination >50° and 8.6 % hips with a lateral centre-edge angle (CEA) <25°. For several variants, a significant difference between sexes was observed.
Conclusions: CT-based measurements of the acetabulum demonstrated good bilateral symmetry across all major pa-rameters. However, this symmetry was observed within a population characterized by substantial inter-individual and sex-related anatomical variation. Consequently, native morphology alone may be insufficient to define an individual’s hip anatomy, and the contralateral acetabulum may serve as a more reliable patient-specific reference.
Keywords: Bilateral symmetry, acetabulum, computed tomography, pelvic morphology, anatomical variation, hip, ante-version, acetabular depth, and center-edge angle.

Carrier Identification in Families of known Factor XIII Deficient Patients.

2026-11-03T11:31:05+00:00

Objective: The aim of the study is to determine the prevalence of carriers within families affected by factor XIII deficien-cy, in interior Sindh population with the objective of understanding genetic distribution and potential implication for dis-ease management and counseling.
Methodology: Cross-sectional study approved by Institutional Review Board (IREB) Baqai University was conduct at Department of Baqai Institute of Hematology at Baqai Medical University Karachi At Hemophilia Center Hyderabad and Research diagnostic lab Jamshoro The immediate family members of known carriers of factor XIII were enrolled. The Berichrom® Factor XIII assay was performed. The study highlighted the role of FXIII activity and the identification of mu-tations in FXIII Gene in the identification of carriers in FXIII deficient families, providing a simple, cost-effective approach to improve patient care and genetic counselling.
Results: A statistically significant difference in FXIII activity between carriers and non-carriers is shown by a one-way ANOVA (F = 19.44, p =.000) The variance in FXIII activity is mostly due to variations between groups rather than within-group variability, as indicated by the high F-value and low p-value.
Conclusion: This study concluded that Factor XIII and bleeding score are notable for identifying carriers in FXIII-deficient families also these measures to clinical practice can improve diagnosis, patient care, and genetic counselling
Keywords: Intracranial hemorrhage, coagulation tests, consanguinity, and factor XIII. Intracranial hemorrhage, coagula-tion tests, consanguinity, and factor XIII.

Histological Alterations of Diazepam & Diclofenac Potassium in the Kidney of Epileptic Rat Model.

2026-11-03T11:30:55+00:00

Objective: To evaluate the effects of diazepam (an anticonvulsant and anxiolytic agent) and diclofenac potassium (a
non-steroidal anti-inflammatory drug) on the histopathological changes in renal tissues within an experimental rat model
of epilepsy.
Methodology: A total of 32 male Wistar albino rats (2–4 months old, 200–250 g) were randomly assigned to four groups
(n = 8 each): Epilepsy, Epilepsy + Diazepam, Epilepsy + Diclofenac potassium, and Epilepsy + Diazepam + Diclofenac
potassium. Epilepsy was induced by intraperitoneal injection of penicillin under urethane anesthesia, and 30 minutes
after seizure onset, diazepam (0.1 mg/kg), diclofenac potassium (10 mg/kg), or both were administered intraperitoneally.
Kidney tissues were subsequently examined histopathologically for inflammatory infiltration, glomerular atrophy, tubular
dilatation, flattening of the epithelial lining, epithelial shedding, vacuole formation, loss of brush borders, vascular congestion,
and hemorrhage.
Results: No significant differences were observed in vacuolization, glomerular atrophy, tubular dilation, or hemorrhage
between the diazepam and diclofenac potassium groups. However, both treatment groups demonstrated marked reductions
in inflammation, vascular congestion, and thinning of the tubular epithelium compared to the Epilepsy + Diazepam
group. Minimal brush border loss and tubular desquamation were noted in the epilepsy‑only group, but these variables
did not differ significantly among the three treatment groups.
Conclusion: The combined administration of diazepam and diclofenac potassium produced fewer adverse histopathological
alterations in renal tissues compared to their individual use, suggesting that co‑administration may mitigate renal
toxicity and exert a comparatively protective effect.
Keywords: Epilepsy, diclofenac potassium, diazepam, kidney, Wistar albino rats.

Clinical efficacy of 0.5% clobetasol propionate and 0.1%triamcinolone acetonide in the treatment of oral lichen planus

2026-11-03T11:30:46+00:00

Objectives: To compare the efficacy and short-term safety profile of clobetasol propionate 0.05% ointment and triamcin-olone acetonide 0.1% orabase adhesive in moderate to severe oral lichen planus (OLP) in terms of pain, burning sensa-tion, and lesion extension.
Methodology: A quasi-experimental study conducted on 42 adult patients with moderate to severe OLP. All subjects were equally divided into two groups for receiving either clobetasol or triamcinolone for four times in a day for four weeks. The clinical severity was assessed by an ordinal four-point scale (no disease= 0; severe disease= 3) at the start, week four, and two weeks after treatment completion (week six). Differences between groups were analyzed using the Mann-Whitney U test, while differences within groups were analyzed using Wilcoxon signed rank test.
Results: Significant higher rates of complete remission of triamcinolone were found in all domains at week four (pain = 66.7% vs 4.8%; burning = 95.2% vs 0%, mucosal extension = 57.1% vs 0%, all p < 0.001). At week six, remissions of burning sensation and lesion extension were found in the triamcinolone group, but in clobetasol group all domains showed significant rebound of disease symptoms (p< 0.05).
Conclusion: Triamcinolone acetonide 0.1% orabase was significantly more efficacious than clobetasol propionate 0.05% ointment in moderate to severe OLP cases.
Keywords: Oral Lichen Planus; Clobetasol Propionate; Triamcinolone Acetonide; Topical Corticosteroids; Orabase; Oral Mucosal Disease.

Exploring the Relationship between Physical Activity Patterns and the Prevalence and Severity of Anxiety

2026-11-03T11:30:37+00:00

Objective: To measure/explore the relationship between physical activity patterns and the prevalence and severity of anxiety.
Methodology: This analytic cross-sectional study was conducted at Bahria University of Health Sciences, Karachi from 1/07/2024 to 31/12/2024. Using non-probability consecutive sampling, 136 participants between the ages of 20-23 vol-untarily participated in this study. The participants were medical students of either gender, studying at Bahria University of Health Sciences, Karachi. To quantify anxiety, the Generalized Anxiety Disorder-7 (GAD-7) scale was utilized, and to measure physical activity, the Global Physical Activity Questionnaire (GPAQ) was utilized. SPSS-26 version was utilized for data analysis. P-value ≤ 0.05 was taken as statistically significant after correlation and stratification analyses.
Results: The mean age of participants was 20.75 ± 0.82 years and mean BMI was 25.38 ± 6.77 kg/m². The mean physi-cal activity among the participants was 2939.71 ± 2167.54 MET-minutes/week, while the mean GAD-7 score was 9.21 ± 4.97. Moderate anxiety was the commonest type 52(38.2%), followed by minimum 34(25.0%), mild 27(19.9%), and se-vere 23(16.9%). The physical activity of participants was of low among 36(26.5%), moderate 34(25.0%) and high 66(48.5%) levels. Physical activity and anxiety were shown to be strongly correlated negatively (r = -0.898, p < 0.001). Stronger associations were seen in females (r = -0.922) and overweight persons (r = -0.952).
Conclusion: Increased physical activity is a preventive, non-pharmacological strategy for reducing anxiety in adults, as evidenced by its high correlation with decreased anxiety levels.
Keywords: Anxiety; Body Mass Index; Exercise; Generalized Anxiety Disorder-7; Physical Activity; Psychological Well-being; Sedentary Behavior.

Drug Resistance Patterns & Treatment Outcomes among Patients Enrolled for MDR-TB Treatment under PMDT at a Tertiary Care Teaching Hospital in Swat.

2026-11-03T11:30:28+00:00

Objective: To evaluate drug resistance patterns and treatment outcomes among patients with Multidrug‑Resistant Tu-berculosis (MDR‑TB) enrolled in the Programme for Management of Drug‑Resistant Tuberculosis (PMDT) at Saidu Teaching Hospital, Swat, Pakistan. A secondary objective was to identify determinants of poor treatment outcomes and to assess the impact of fluoroquinolone resistance.
Methodology: This retrospective cohort study included 166 MDR-TB patients enrolled between May 21, 2014, and Feb-ruary 6, 2020. Patient data were obtained from medical records, and drug resistance was determined using phenotypic drug susceptibility testing. Treatment outcomes were categorised as cure, failure, death, lost follow-up, or transfer out. Chi-square tests were performed to assess associations between drug resistance and treatment outcomes.
Results: Of the 166 patients, 130 (78.3%) were cured, 15 (9%) died, 13 (7.8%) were lost to follow-up, and 2 (1.2%) failed treatment. Rifampicin (n=50, 30.1%) and Isoniazid (n=52, 31.3%) showed the highest resistance rates. Fifteen percent of the patients (n=25) were found to be resistant to fluoroquinolones. The resistance to rifampicin had a signifi-cant impact on the treatment results (p < 0.00001), whereas the resistance to fluoroquinolone also had a strong effect (p < 0.00001).
Conclusion: This study highlights the critical issue of drug resistance among MDR‑TB patients in Swat, particularly to rifampicin, isoniazid, and fluoroquinolones. The findings underscore the urgent need for improved diagnostic strategies, stronger medication adherence, and enhanced healthcare services, especially in rural areas. Larger multicentre investi-gations are warranted to validate these results and to strengthen local treatment approaches.
Keywords: Multidrug-resistant tuberculosis, drug resistance, treatment outcomes, fluoroquinolone resistance, Pakistan.

Association of Dyslipidemia & Chronic Kidney Disease Presenting to Tertiary Care Hospital.

2026-11-03T11:30:18+00:00

Objective: Chronic kidney disease (CKD) is associated with dyslipidemia and cardiovascular risk. Evidence describing lipid abnormalities across CKD stages remains limited. To determine the frequency of LDL-C/HDL-C-defined dyslipidemia and assess its association with CKD stage among patients presenting to a tertiary care hospital.
Methodology: This cross-sectional study included 84 patients aged 20–80 years with CKD stages 3–5 admitted to the medical units of Ayub Teaching Hospital, Abbottabad. Patients were enrolled through non-probability consecutive sam-pling. A fasting lipid profile was measured. The primary dyslipidemia outcome was defined as low-density lipoprotein cholesterol (LDL-C) ≥115 mg/dL and/or high-density lipoprotein cholesterol (HDL-C) ≤40 mg/dL. Hypercholesterolemia and hypertriglyceridemia were assessed separately as secondary lipid abnormalities. Data were analysed using com-parative tests and binary logistic regression. A p-value <0.05 was considered significant.
Results: LDL-C/HDL-C-defined dyslipidemia was present in 66 patients (78.6%). Its frequency increased from 68.0% in stage 3 and 69.2% in stage 4 to 93.9% in stage 5 CKD (p=0.022). Median LDL-C increased across the stages (p=0.035), while median HDL-C decreased (p=0.001). Patients with dyslipidemia had a lower median estimated glomer-ular filtration rate than those without dyslipidemia (15.8 versus 26.2 mL/min/1.73 m²; p=0.008). After adjustment for age, gender, diabetes mellitus, and current lipid-lowering therapy, stage 5 CKD remained associated with LDL-C/HDL-C-defined dyslipidemia (adjusted odds ratio 6.20, 95% confidence interval 1.29–29.89; p=0.023).
Conclusion: LDL-C/HDL-C-defined dyslipidemia was common and increased with advancing CKD. Regular lipid assess-ment is particularly important in stage 5 disease.
Keywords: Chronic kidney disease; Dialysis; Dyslipidemia; Lipid profile; Renal function

Oral Health Needs and Barriers to Access in Rural Population: A Cross-sectional Study.

2026-11-03T11:30:09+00:00

Objectives: To identify the socio-economic and cultural barriers impacting oral healthcare access and to analyze factors influencing oral health utilization patterns among rural populations in Umerkot, Sindh.
Methodology: This cross-sectional study, focused on 350 adults from Umerkot, Sindh, over the course of six months, who were chosen through a non-probability convenience sampling method. A structured questionnaire, converted into local languages for better accessibility, was used to gather data. SPSS v23 is used to analyze gathered data.
Results: The study revealed marked disparities in oral health access. Overall, 64.9% of participants presented with den-tal cavities, while 36.9% exhibited gum disease. Females (63.7%) were more likely than males to seek dental care; how-ever, financial barriers remained a major hindrance, with 62.6% delaying treatment due to cost. Furthermore, 73.4% re-ported the absence of nearby dental facilities, and 45.1% encountered transportation difficulties, underscoring significant infrastructural shortcomings in rural areas.
Conclusion: Toothbrushes and neem sticks emerged as the most commonly used oral hygiene methods among partici-pants. The majority had never visited a dental clinic previously and expressed a preference for public healthcare facili-ties. Financial constraints were identified as the most critical barrier, with 63% postponing dental appointments due to cost. Accessibility challenges were further compounded by transportation difficulties, geographic limitations, and the ab-sence of nearby dental facilities, underscoring systemic gaps in rural oral healthcare infrastructure.”
Keywords: Oral health needs, Cultural barriers, Socio-economic factors, Dental care access.

The tendency in the use of the antibiotics, and is evidence of resistance in culture-positive cases.

2026-11-04T11:31:04+00:00

Objective: To evaluate the trend of antibiotic use in neonatal sepsis and to evaluate the prevalence of antimicrobial re-sistance in culture-positive cases
Methodology: This retrospective observational study was done in the Neonatal Intensive Care Unit (NICU) of a tertiary care hospital, Hashim Medical City, Hyderabad. This research involved nearly 120 + infants who were hospitalized with-in the specified study period. The information was collected in the medical records of the hospital, the admission rec-ords, and the laboratory records.
Results: Cohort showed male preponderance (60 65 percent), and gestational age was 26 to 40 weeks. Most of the neo-nates were preterm (6570%). Weights of birth were between 0.69 and 3.9kg with almost 70 percent of the children hav-ing low birth weight and a few cases of extremely low birth weight. The majority of the deliveries were through LSCS/elective LSCS and a large percentage of neonates were peripheral center referrals. The most frequent were respiratory distress syndrome, transient tachypnea of the newborn, birth asphyxia and neonatal sepsis. Many of them needed repiratory support, such as CPAP and mechanical ventilation; often oxygen therapy was used. Length of stay was 1-58 days. The outcome measures were discharge, mortality, referral, and leave against medical advice (LAMA), with mortali-ty being higher in cases of neonates with severe sepsis and extreme prematurity. The use of broad-spectrum antibiotic therapy was a common practice of empirical antibiotic therapy, such as aminoglycosides, vancomycin, and car-bapenems. A majority were culture-negative, but culture-positive cases showed pathogens to include Staphylococcus aureus, Klebsiella, Serratia, Acinetobacter, and E. coli. Multidrug resistance was evidenced especially in Gram-negative organisms.
Conclusion: Overuse of broad-spectrum antibiotics and emerging resistance indicate enhanced need to improve stew-ardship and infection control measures.
Key words: antibiotics, resistance, swab culture, neonatal intensive care, birth asphyxia.

Intravenous Levocarnitine Reduces Erythropoiesis-Stimulating Agent Requirements and Improves Anaemia Indices in Maintenance Haemodialysis Patients: A Prospective Cohort Study.

2026-11-04T11:30:54+00:00

Objective: To determine whether adding levocarnitine to individuals on maintenance haemodialysis lowers the need for
Erythropoiesis-stimulating agents (ESAs) while preserving hematologic control.
Methodology: This prospective observational cohort study was conducted at the Department of Nephrology, Shaikh
Zayed Hospital, Lahore, from July to December 2025. Adults on thrice-weekly hemodialysis were enrolled into an exposed
cohort receiving levocarnitine 1,000 mg intravenously after dialysis three times weekly and an unexposed cohort
receiving no levocarnitine. Both groups received recombinant human erythropoietin according to a standardized titration
protocol. Haemoglobin (Hb), hematocrit (Hct), weekly ESA dose, and erythropoietin responsiveness index (ERI = weekly
ESA dose ÷ [dry weight × average Hb]) were recorded monthly for six months.
Results: Ninety-four patients were included (47 each cohort). Baseline characteristics were generally comparable, although
controls were older, heavier, and had slightly higher baseline Hct. No clear advantage was seen at Month 1.
From Month 2 onward, levocarnitine was associated with higher Hb and Hct and lower ESA dose. By Month 6, Hb was
12.00 vs 9.77 g/dL, Hct 36.19% vs 29.29%, weekly ESA dose 7,715 vs 11,094 units, and ERI 10.07 vs 17.36 (all
p<0.0001).
Conclusion: Adjunctive levocarnitine improved erythropoiesis efficiency and reduced ESA requirements over six
months.
Keywords: anaemia; erythropoiesis-stimulating agents; erythropoietin responsiveness index; haemodialysis;
levocarnitine.

Assessment of Smoking Prevalence, Awareness, and Addiction Risk Factors in Medical Students of Hyderabad.

2026-11-03T09:57:26+00:00

Objective: To assess the prevalence of smoking habits among medical students in Hyderabad, their level of knowledge
regarding health hazards associated with smoking, and the determinants associated with smoking.
Methodology: A cross-sectional study was conducted among medical students of Isra University, Hyderabad, Pakistan,
using a simple random sampling technique. A total of 312 participants were included in the study. Data were collected
using a self-structured, pre-tested questionnaire, and internal consistency was assessed using Cronbach’s alpha (α =
0.78). Statistical analysis was performed using SPSS version 26, and a p-value ≤0.05 was considered statistically significant.
Results: Out enrolled medical students, 28.2% were current smokers, 33.3% were former smokers, and 38.5% were
non-smokers. The highest smoking was observed in the age group of 21-25 years. Out of the total current smokers,
45.5% were smoking between 5 and 10 cigarettes per day. According to the results of the regression analysis, nonsmoker
students were found to have greater knowledge compared to their counterparts (β = 6.78, p = 0.012).
Conclusion: It was observed that medical students are smoking despite being aware of the health hazards associated
with smoking. Peer pressure, stress, and nicotine addiction were found to be the key factors associated with smoking. It
is recommended that tobacco cessation programs and stress management techniques be introduced in medical colleges
for medical students.
Keywords: Smoking, Tobacco Use Disorder, Prevalence, Risk Factors, Health Knowledge, Attitudes, Practice.

Knowledge, Perception, and Future of Artificial Intelligence Among Graduates and Undergraduates. A Cross-sectional study.

2026-11-02T09:19:12+00:00

Objective: This study aimed to evaluate the understanding, attitudes, and future outlooks regarding AI among under-graduate and postgraduate students at Baqai Dental College.
Methodology: A cross-sectional online survey was conducted between November and December 2024. A pre-validated questionnaire was shared with 200 participants via WhatsApp groups, achieving a response rate of 86.5% (173 partici-pants). The survey assessed participants’ demographic information, knowledge of AI, perceptions of its potential appli-cations, and outlook on AI in dentistry. The collected data were analyzed using SPSS version 22, with frequencies and percentages presented in table format.
Results: The results showed that 88.4% of participants were familiar with AI, and 87.9% recognized its beneficial appli-cations in medicine. However, 48% were unaware of AI's potential in diagnosing oral soft tissue lesions, while 52% be-lieved AI could significantly advance dentistry. Diagnostic applications were perceived as the most valuable use of AI (31.8%). When faced with discrepancies between AI recommendations and their own judgment, 61.3% of participants favored their judgment. Additionally, 47.4% expressed intentions to integrate AI into their future diagnostic and treatment planning processes.
Conclusions: The findings highlight the need for greater AI literacy through foundational curricula in dental education. Promoting ethical awareness and trust is essential for successful integration into clinical practice. Overall, AI holds sig-nificant promise for revolutionizing dentistry and improving patient care outcomes.
Keywords: Artificial Intelligence, Dental Students. Knowledge, Radiography.

Patient Awareness, Attitudes, and Perceptions Toward Cosmetic Dentistry in a Dental Outpatient Setting in Karachi.

2026-11-02T09:19:12+00:00

Objective: To assess the level of knowledge, attitudes, and perceptions of patients visiting the outpatient department (OPD) regarding cosmetic dental procedures.
Methodology: A cross-sectional study was conducted at the Department of Oral Diagnosis, Jinnah Medical & Dental College, Karachi, over a period of six months; from 10-5-2025 to 9-11-2025. A non-probability convenience sampling technique was used. Data from 385 participants were analyzed using SPSS version 26. Associations between variables were determined using the Chi-square test, with a significance level of p ≤ 0.05.
Results: Among 385 participants, 350 (90.9%) were aware of cosmetic dental procedures. Of these, 320 (83.1%) had previously undergone at least one procedure, most commonly crowns/bridges (37.5%) and tooth whitening (31.25%). The primary motivations were improving appearance (34.38%) and peer/social influence (17.18%). Most participants considered cosmetic dental procedures safe (83.12%) and believed they improve self-esteem (79.22%). Participants' awareness, attitudes, and perception were shown to be significantly correlated with gender, age, income, and education (p < 0.05).
Conclusion: Awareness of cosmetic dental procedures among dental OPD patients visiting dental outpatient depart-ment was high, and attitudes and perceptions were generally positive. Demographic factors including gender, age, edu-cation, and income significantly influenced participants’ knowledge and perceptions of cosmetic dentistry.
Keywords: Cosmetic Dentistry, Knowledge, Attitude, Aesthetics.

Encouraging Attitudes but Insufficient Knowledge of Stem Cell Applications and Banking Among Undergraduate Dental Students: Implications for Curriculum Reform.

2026-11-02T09:19:12+00:00

Objective: This study aimed to assess the knowledge and attitudes of undergraduate dental students regarding stem cells and their role in dentistry, including awareness of stem cell banking, and to examine their relationship with demo-graphic characteristics.
Methodology: A descriptive cross‑sectional survey was conducted among 130 undergraduate dental students at Baqai Medical University, Karachi, Pakistan, between February and May 2020. A validated questionnaire was used to collect demographic data, 15 items on knowledge, and 10 attitude statements measured on a Likert scale. Knowledge was cat-egorized as poor (0–5), moderate (6–10), and good (11–15), while attitude was classified as poor (10–20), moderate (21–30), good (31–40), and excellent (41–50). Data were analyzed using SPSS version 26, with chi‑square tests applied to assess associations at a significance level of p < 0.05.
Results: Students demonstrated a moderate level of knowledge, with 73.1% recognizing stem cells as undifferentiated cells capable of differentiation, though gaps remained regarding their specific role in dentistry. Attitudes were generally favorable: 72.3% expressed willingness to recommend stem cells to future patients, and 81.6% supported public educa-tion on the topic. However, only 53.8% felt the curriculum adequately addressed stem cells. No significant association was found between gender and knowledge (p = 0.90), but attitudes varied significantly by gender (p = 0.04).
Conclusion: Dental students exhibited positive attitudes toward stem cell applications in dentistry, yet knowledge gaps highlight the need to strengthen curricular content on regenerative dentistry and stem cell science.
Keywords: Stem Cells, Regenerative Endodontics, Dental Pulp, Dental Students, Tissue Engineering.