p-ISSN 2410-163X e-ISSN 3079-2924 The Journal of Rashid Latif Medical College (JRLMC), affiliated with the Rashid Latif Khan University of Lahore, is a bi-annual, peer-reviewed open access publication. JRLMC invites original research, covering a wide range of health related topics and adhering to international editorial standards. The journal offers a no-cost publication option for healthcare professionals and includes five sections: editorial, original articles, review articles, case reports/series, and short communications.
Prevalence and Risk Factors of Diabetic Peripheral Neuropathy
Background: Diabetic peripheral neuropathy (DPN) is a prevalent and severe complication of diabetes mellitus, resulting in high morbidity in the form of foot ulcers, amputations, and reduced quality of life. Early detection and management of risk factors can reduce its burden. Objective: To evaluate the prevalence of diabetic peripheral neuropathy (DPN) and determine its risk factors. Methodology: This descriptive cross-sectional study was carried out at the Diabetic Clinic, Department of Medicine, Arif Memorial Teaching Hospital, Lahore, from January 2023 to December 2023. Consecutive sampling was used to enroll 200 diabetic patients. Demographic information, clinical history, blood pressure, and blood glucose levels were noted. All the participants were recommended HbA1c and lipid profile. DPN was evaluated by the Michigan Neuropathy Screening Instrument (MNSI), and the data were statistically analyzed. Results: Among 200 patients, DPN was diagnosed in 83 patients (41.5%). Significant associations were found with increased duration of diabetes, hypertension, hyperglycemia, and pre-diabetes. Conclusion: DPN prevalence continues to be high among diabetic patients. Early detection, strict control of glycemia, and treatment of related risk factors are the keys to avoid this disabling complication.
Diabetic Neuropathy, Risk Factors, MNSI, HbA1c, Hyperglycemia
Copyright (c) 2025 Journal of Rashid Latif Medical College https://creativecommons.org/licenses/by/4.0
Background: The rapid evolution of smartphones has revolutionized healthcare delivery and medical education. Ophthalmology, being a visually intensive specialty, has particularly benefited from mobile technology through apps, imaging tools, and instant access to resources. Smartphones are now playing a vital role in diagnostics, documentation, and communication, helping practitioners enhance patient care and academic collaboration. Objective: This study aims to evaluate the use of smartphones for academic and clinical purposes among ophthalmologists. Methodology: A cross-sectional survey was conducted from June to December 2023 in the Department of Ophthalmology at Sheikh Zayed Hospital. The study involved 100 ophthalmologists, including consultants, postgraduate residents, and registrars from various hospitals. A structured questionnaire was distributed via emails, messaging apps, and phone interviews. Data were analyzed using SPSS version 25. Results: Of the 100 respondents, 50% were consultants, 44% were postgraduate residents, and 6% were registrars. Android phones were used by 55% of participants, while 45% used iPhones. The flashlight feature was frequently used by 18%, occasionally used by 40%, and never used by 42%. Camera usage for documenting ocular findings was frequent among 26%, occasional in 49%, and never in 25% of participants. About 28% did not have any books downloaded on their phones, while 52% had multiple books. Google was the most used online resource (76%), followed by Eyewiki (9%) and PubMed (5%). Notably, 78% of respondents used messaging platforms for group discussions. Conclusion: Smartphones are becoming indispensable tools in ophthalmology. They offer cost-effective solutions by replacing several traditional tools and improving efficiency in clinical practice. Ophthalmologists should further explore these technologies for both educational and clinical advancements
Smartphones, Android, iPhone, Applications, Ophthalmology, Pdf Books, Websites
Tetanus in Children: Risk Factors, Vaccination, and Outcomes
Background: Tetanus remains a life-threatening yet preventable disease, particularly in low- and middle-income countries. Despite global efforts, its burden persists among children due to insufficient immunization coverage, lack of booster doses, and poor awareness of post-exposure prophylaxis. In Pakistan, these challenges continue to contribute to morbidity and mortality associated with post-neonatal tetanus. Aim: This study aimed to evaluate the frequency of risk factors, immunization coverage, and clinical outcomes among children diagnosed with tetanus beyond the neonatal period at a tertiary care center. Methods: Conducted in 2024, this prospective observational study took place at the University of Lahore Teaching Hospital. Pediatric patients aged 1 month to 15 years admitted with clinical tetanus were included. Variables such as age, gender, immunization status (including DTP and TT boosters), identifiable risk factors, duration of hospitalization, and final outcomes were analyzed using SPSS version 16. Results: Among 74 participants, 46 (62.2%) were boys and 28 (37.8%) girls. The mean age was 6.8 ± 3.2 years, with the highest prevalence in children aged 6–10 years (52.7%). Vaccination data revealed 51 (68.9%) children were unvaccinated; none had received booster doses or post-exposure prophylaxis. Trauma accounted for the majority of cases (34; 45.9%), followed by ear discharge (14; 18.9%) and piercing injuries (3; 4.1%). The risk factor remained unidentified in 23 (31.1%) cases. Mean hospital stay was 13.7 ± 11.2 days. A mortality rate of 20.3% (15 patients) was significantly linked with shorter hospital stays (p<0.001) and absence of vaccination (p=0.01). Conclusion: The study revealed significant gaps in routine immunization and post-injury tetanus prophylaxis. Implementation of booster vaccination and early identification of high-risk groups, such as those with otorrhoea, is essential for prevention.
Impact of Energy Drinks on Students’ Health and Academics at a Private Nursing College
Background: Energy drinks are increasingly consumed by college students in Pakistan, primarily for enhanced alertness and academic stamina. However, their potential cardiovascular effects and influence on academic performance remain controversial. Aim: This study aimed to assess the short-term effects of energy drink consumption on academic performance and cardiovascular indicators, including blood pressure and pulse rate, among nursing students in Pakistan. Methods: A randomized controlled experimental design was used. From 193 nursing students in Karachi, 50 habitual energy drink consumers were randomly selected and assigned to either an experimental group (received a commercial energy drink) or a control group (received bottled water). Pre- and post-intervention measures included systolic/diastolic blood pressure, pulse rate, and academic performance via standardized tests. Results: The experimental group showed an increase in mean systolic blood pressure from 119 to 125 mmHg and diastolic pressure from 70 to 74 mmHg. No significant changes were observed in pulse rate or academic performance within the group. However, systolic and diastolic blood pressure differences between the experimental and control groups were statistically significant (p < 0.05). Academic performance showed no significant difference between groups. Conclusion: Energy drink consumption among Pakistani nursing students may elevate cardiovascular indicators such as blood pressure but does not significantly impact academic performance in the short term. These findings highlight the need for awareness campaigns about the potential health risks of energy drink use.
Caregivers' Knowledge for Prevention of Acute Diarrheal Diseases in Children
Background: Diarrhea is a leading cause of childhood mortality worldwide. Timely interventions by caregivers play a crucial role in managing and preventing this condition. Aim: This study aimed to evaluate caregivers' knowledge and practices regarding the prevention of diarrheal diseases in children under the age of 5 years. Methods: A cross-sectional study was conducted from January to July 2023 using a convenience sampling technique. Data were collected from 158 caregivers of children under 5 years old using a self-structured, pre-tested questionnaire. Chi-square test was applied, and a p-value <0.05 was considered significant. Results: A total of 158 caregivers participated in the study. The mean age of respondents was 28.4 ± 7.6 years. Among them, 22.8% were illiterate, 84.2% were housewives, and 37.4% had an income exceeding 31,000 rupees/month. The majority (43.1%) had 'poor' knowledge, 24% exhibited 'poor' attitudes and practices, while 12% demonstrated good practices. Significant associations were observed between caregivers' knowledge and education (p-value=0.004), income (p-value=0.001), frequency of diarrhea in a child (p-value=0.053), and practices with education (p-value=0.039). Conclusion: This study highlights the relationship between caregivers' literacy levels and family income with improved knowledge and feeding practices in preventing diarrhea. It underscores the crucial role of caregivers in managing acute diarrheal diseases.
Public Awareness and Perceptions of Breast and Cervical Cancer
Objective: A serious public health issue is the general population's lack of understanding, ignorance, and ubiquity of myths and misconceptions about breast and cervical cancers (CCs). The purpose of this study was to assess people's knowledge and attitudes on cancer, specifically with regard to breast and cervical malignancies. Methodology In Lahore, Pakistan, a cross-sectional survey with a descriptive focus was administered to 345 individuals. Data on demographics, exposure to chemical and biological carcinogens, lifestyle choices, and individual behaviors were gathered using a pretested, standardized questionnaire. The study population was examined in relation to important factors using frequency distribution and proportions. Results: Cancer awareness and early detection play crucial roles in reducing morbidity and mortality. This descriptive cross-sectional study assessed public awareness and perceptions regarding cancer, particularly breast and cervical cancers, in Lahore. A total of 298 participants were surveyed, with an average age of 25.19 years. Males comprised 52.0% and females 48.0% of the respondents. Mass media (34.6%), schools (28.5%), and health professionals (6.7%) were the primary sources of cancer-related information. While 72.8% of participants reported fear upon first hearing about cancer, 66.7% believed it is preventable. Only 4.7% had undergone cervical cancer screening, indicating low participation in preventive measures. Additionally, 98.1% of respondents had never smoked, though awareness of smoking-related cancer risks was limited to 66.7%. These findings highlight the need for increased public education, awareness campaigns, and access to screening programs to improve early detection and treatment outcomes in Lahore. Conclusion: In Lahore, Pakistan, there is still a lack of awareness and education regarding cancer, especially breast and cervical cancers. The following prioritized risk factors must be addressed in the public health education campaigns’ sexual and reproductive health component: early onset of sexual intercourse, low level of disease knowledge, and unhealthy lifestyles.
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Evaluating the teaching abilities of Residents to assess the effectiveness of their instruction.
Objective: Interns are frequently given teaching responsibilities in Pakistan. Interns are often recruited at the bottom of the teaching scale with little or no teaching experience and usually without any formal teacher training while pursuing undergraduate programs. Methodology: Assess the interns' level of teaching skill, so that if needed, appropriate action can be taken to raise the bar on instruction. This cross-sectional study was conducted by University of Faisalabad, from April to June 2023. Using Medical Education Teaching Readiness Questionnaire (METRQ) the knowledge, skill and attitude of the responders based on different experiences pertaining to medical teaching were accessed from fifty first-year dental interns approached for the questionnaire that was statistically evaluated in SPSS 21. Results: Forty (80%) of the interns considered that mastering the basics of teaching, for example planning "what to teach" was necessary, but they were not prepared to teach. For skills, 38 (76%) respondents said that viewing their lecturers was very helpful, while only 1 (2%) said receiving feedback on their own instruction was helpful. At graduation, most of the factors, ranked as traits of teaching—such as drive, excitement, and competence—began to depreciate. When some experience in teaching had been accumulated during the internship, similar qualities showed clearly higher ratings. Conclusion: In creating teacher-training programs or assessing the current state of those teaching in the health professions, METRQ can be a great tool to conduct needs assessments. Important for improving the quality of instruction and, thereby, the quality of education, are teacher training programs. Keywords: Aptitude, Cross sectional studies, Needs Assessment, Teacher training.
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Artificial intelligence in Medical Education-A Crosssectional study in Private Setup
Objective: For healthcare providers, expectations, duties, and job descriptions must change as the information age fades and the artificial intelligence age becomes more prevalent. In order to identify areas that can benefit from curriculum restructuring, this study looked at how aspiring doctors perceived the potential effects of artificial intelligence on medicine. Methodology: A nationwide study including 3018 medical students was carried out using a cross-sectional approach across multiple centers. An online survey created and disseminated using a web-based service served as the study's instrument. Results: Artificial intelligence was viewed by the majority of medical students as an assistive technology that might ease patients' access to healthcare (76.7%), physicians' access to information (85.6%), and errors (70.5%). Nonetheless, 44.9% of the participants expressed concern over a potential cutback in physician services, which would result in joblessness. Additionally, it was decided that the application of artificial intelligence in medicine would harm patient-physician interactions (42.7%), devalue the medical profession (58.6%), and erode trust (45.5%). Furthermore, almost half of the participants (44.7%) agreed that they could maintain professional secrecy when using AI apps, whereas 16.1% contended that AI in medicine could lead to professional confidentiality violations. Out of all the individuals involved, a mere 6.0% claimed to be knowledgeable enough to advise patients about the advantages and disadvantages of artificial intelligence. Conclusion: The participants indicated that the medical curriculum needed updating in light of the requirements for transforming healthcare through artificial intelligence. In addition to ensuring that professional values and rights are upheld, the update should focus on providing aspiring physicians with the information and abilities they need to use artificial intelligence technologies successfully. Keywords: Medical Students, Medical Ethics, Medical Curriculum, Artificial Intelligence Medicine
Patient Safety Culture in Operation Theatres of Peripheral Teaching Hospitals
Objective: to learn how postgraduate surgical and allied trainees at Arif Memorial Teaching Hospital (AMTH), Pakistan, feel about non-technical abilities in the operating room. Methodology: A cross-sectional survey was conducted at the AMTH theaters, thirty postgraduate trainees filled the Operating Room Management Attitudes Questionnaire (ORMAQ). Results: Except for procedural compliance and error disclosure, which point to differences in implementation and awareness, postgraduate trainees have good opinions about every aspect of the ORMAQ survey. Conclusion: The findings mostly match those of earlier ORMAQ surveys of surgical teams conducted in other nations. Due to shady systematic working practices and cultural norms, the disparities highlight the possible hazard to patient safety. The results validate the use of human factor training and team interventions to apply protocols and guidelines. This survey also aids in gathering information for a hospital's quality assurance program. Keywords: Non-technical skills, ORMAQ, patient safety, surgery, human factors
An analysis of health system experts' viewpoints on strategies for dealing with the aging population: A qualitative investigation
Objective: It is critical to develop planning and action plans to deal with future aging in light of the growing trend of aging, the health system's limited resources, the absence of long-term prior government planning, and the slow expansion of the productive force in society. In this sense, the goal of the study was to determine health system specialists' ideas for addressing the aging population. Methodology 29 Pakistani men and women from Lahore, Karachi, Islamabad, and Faisalabad who were experts in the fields of health and aging willingly took part in the semi-structured interview for the qualitative content analysis research. Data were classified through the use of qualitative content analysis. Results: The opinions of the experts who participated in the discussion revealed two concepts regarding the approaches taken by the Pakistani health system to deal with future aging: "executive policy" strategies, which include "evaluation and standardization," "design, planning and implementation," "strengthening demand-driven," and "modeling national and international experiences." "Preventive policies" strategies, on the other hand, include "Focus on prevention," "Focus on values and competencies," "Educational empowerment," "Knowledge-based empowerment," "Empowerment of age-related groups," "Economic empowerment," and "Social support." Conclusion: The extensive variety of approaches discussed suggests that health care must be completely prepared and tailored to the unique needs and circumstances of the aged. Using workable solutions will enable deliberate planning and prompt program and policy implementation to better handle the health system as the population ages in the future. Keywords: Aging, health system, Pakistan, qualitative, strategy
Exploring Knowledge and Contributing Factors of Gestational Diabetes Mellitus Among Students at a Private Sector Medical University
Objective: Global health concerns about gestational diabetes mellitus (GDM) are growing. For prompt prevention and management, early and precise awareness of GDM is essential, particularly for young individuals. The purpose of this study is to determine the factors impacting the degree of GDM knowledge among students at a private medical university. Methodology: Students at medical universities participated in a cross-sectional study utilizing a validated self-administered questionnaire. The survey evaluated students' knowledge of GDM (classified as poor, fair, or good) and awareness of the condition (i.e., if they had ever heard of it). Factors linked to GDM understanding were found using ordinal logistic regression. Results: 735 students in all, with an average age of 21.0 years, took part in the study. 72.8% of participants said they have heard of GDM. Interestingly, 20.3% of female students and 52.9% of male students were unaware of GDM. Male students' greater GDM knowledge was linked to their age (p = 0.019) and postgraduate status (p = 0.026). Twenty-four percent had weak knowledge, fifty-eight percent had fair knowledge, and seventeen percent had strong knowledge. Out of 12, the average GDM knowledge score was 6.3 ± 2.4. Being married (aOR = 1.82, 95% CI 1.10–3.03) and knowing someone with GDM (aOR = 1.78, 95% CI 1.23–2.60) were factors that were independently linked to greater knowledge. Friends and relatives served as the main information sources. Conclusion: This study shows that medical university students, particularly male students, have a substantial knowledge gap about GDM. Better knowledge is linked to factors like marital status and firsthand experience with GDM. These results highlight the necessity of focused educational initiatives on GDM awareness in order to raise awareness among college students and the general public in Pakistan. Keywords: Gestational Diabetes Mellitus, Students, GDM, Knowledge.
Sleep Quality and Perceived Stress among Students during Online Education
Background: Recently, online education has been gaining prominence in university life. Our survey aimed to examine sleep quality and perceived stress levels among students at the University of Faisalabad, Faculty of Health Sciences. Methods: A cross-sectional, quantitative, descriptive survey was conducted between February and March 2023. The online survey included the internationally validated Athens Insomnia Scale (AIS) and Perceived Stress Scale (PSS). Statistical analysis involved descriptive statistics, independent t-tests, analysis of variance (ANOVA), and Mann–Whitney and Kruskal–Wallis tests (p < 0.05). Results: We analyzed 304 responses, and females dominated (n = 270; 88.8%). Students in a relationship had significantly higher AIS scores (t = −2.470; p = 0.014). Medium average (2.50–3.49) students and those who rarely/never exercise showed significantly higher AIS and PSS (p ≤ 0.05). Conclusion: Students on the phone/watching a series during online education, daily laptop/TV use for more than 2 h, and pre-sleep use of smart devices for more than 60 min also negatively affected AIS and PSS scores (p ≤ 0.05). Nursing, physiotherapy, and radiography students were the most affected regarding insomnia and perceived stress (p ≤ 0.05). Our survey shows that excessive smart device use and lack of exercise are associated with higher stress levels and poorer sleep quality. Keywords: sleep quality; perceived stress; Athens Insomnia Scale; Perceived Stress Scale; student; smart device; online education
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The Factors Related to Job Satisfaction of Teachers
Background: Throughout human history, education has been a vital institution in every society. It has significantly contributed to the global migration of nations. In all educational institutions across the globe, teachers are tasked with the mental, physical, and moral upbringing of their students, making them the pivot around which global education revolves. The most significant role in the educational process is that of the teacher. Objective: The purpose of this study is to understand the satisfaction of job in teachers. Methodology: This is a qualitative exploratory study. The investigator chose a range of publications and records pertaining to teachers' job satisfaction. Its goal is to capture the intricacy, richness, and background information of the topic being studied. The study reveals underlying meanings, social processes, and theoretical explanations that can improve our comprehension of the elements that contribute to teachers' feeling more satisfied in their jobs. Conclusion: It's critical to comprehend the elements influencing teachers' job happiness in order to promote a pleasant workplace culture and raise the standard of education in general. The subject matter and grade level taught, together with teaching experience, can influence how environmental, personal, and organizational factors affect job satisfaction. However, based on personal preferences and contextual variations, these characteristics' relative relevance may change. It is imperative that educational institutions customize their approaches to improve job satisfaction by taking into account the unique demands and attributes of their faculty. Keywords: Job Satisfaction, Organizational Factors, Environmental Factors, Personal Factors.
Problem-Based Learning vs. Traditional Lectures among Medical Students at Fatima Jinnah Medical University, Pakistan
Objective: One of the most significant innovations in education during the last forty years is problem-based learning (PBL). In terms of the learning outcomes (such as knowledge, attitude, and skills) obtained from both approaches, the study's goal was to compare medical students' preferences for PBL versus regular lectures. Methods: In 2023, Fatima Jinnah Medical University’s medical students enrolled in the hybrid curriculum (PBL and traditional lectures) participated in a cross-sectional study. A self-administered, pre-constructed, validated, confidentially anonymous questionnaire was used to collect the data. The views of students of PBL and regular lectures were assessed through asking them to rate 20 statements on both forms of instruction on a five-point Likert scale. Software used for the analysis and descriptive statistics was SPSS, version 21 (SPSS Inc., Chicago, Ill., USA). Results: PBL was preferred by learners over traditional lectures because it allowed them to better connect their understanding of basic and clinical sciences (t test=10.16, P<.001). Regarding the quantity of fundamental information recalled using both approaches, there was, however, no statistically significant difference (P>.05. PBL was chosen by students over lectures in terms of improved learning attitudes, skills, outcomes for the future, and learning satisfaction (P<.05). PBL encourages learning more than lectures do (P<.05.05). According to the students, there was a highly significant difference (t test=20.9, P<.001) between the mean total skill gained by PBL (47.20 [10.68]) and lectures (33.01 [9.97]). Conclusions: Students preferred PBL more to traditional lectures for improving most of learning outcome domains, especially, learning attitudes and skills. Keywords: Problem-based learning, Traditional Lectures, Medical Students
Neck Pain among Students and Its Association with Smart Phone and Laptop Usage
Introduction: In the modern era of advancement and technology, use of smart phones and laptops is common. Literature suggests that these digital devices have many negative effects on the health of humans. One of the most common adverse effects associated with prolonged use of mobile and laptop is neck pain. Methods: A cross-sectional study was carried out at University of Lahore from July 2022 to December 2022. A total of 206 undergraduate physical therapy students having age 18 to 25 years participated in the study. For data collection, smart phone & laptop usage and neck pain questionnaire was used. For data analysis, SPSS version 20 was used. Results: The mean age of the subjects was 21.15 ±1.89 years. The prevalence of neck pain was 82.5% (n=170). Neck pain was significantly associated (P-value< 0.05) with smart phone and laptop usage for greater than 4 hours. Surprisingly, neck pain was not associated (p valve>0.05) with different positions (standing/sitting/lying) in which students use smart phones for majority of the time, however, it had significant association (P-value< 0.05) with use of laptops in sitting position for majority of the time. Conclusion: The prevalence of neck pain is high in students who used smart phones and laptops for long hours Keywords: Back pain, Laptop, Neck pain, Phone, Students.
Asthma in Pregnancy: Insights from the Latest Research
Objective: The aim of this study is to present a thorough overview of asthma during pregnancy and to summarize the state of the art and to advance patients' and doctors' understanding of the significance of appropriate asthma care during pregnancy. Methods: A comprehensive literature search in PubMed, Medline, and Taylor and Francis was conducted. We have searched for review articles as well as prospective and retrospective studies published in English, investigating the bilateral relationship between asthma and pregnancy, using the key words mentioned below. Manual search through both national and international guidelines as well as relevant journals and publications on the topic was also conducted. Results: Several studies have highlighted the significant impact of asthma on pregnancy outcomes. Maternal asthma is associated with increased risks of low birth weight, preterm delivery, and preeclampsia. Pregnancy complications linked to asthma include gestational diabetes and placental abnormalities. Asthma exacerbations during pregnancy are linked to a higher incidence of cesarean sections. Conclusions: To reduce the negative effects on the mother and the fetus/neonate, it is crucial to have optimal asthma management and to avoid, diagnose, and treat exacerbations. Active asthma care is advised during pregnancy, according to guidelines. Keywords: Asthma, Pregnancy, Neonatal, COVID-19
Objective: Data obtained through high throughput technologies is increasing our current understanding of the fact that like the hepatitis viruses, hepatitis E virus (HEV) has been difficult to study because of limitations in cell culture systems and small animal models. The objective of this study was to determine the frequency of hepatitis E virus infection in pediatric patients reporting to a tertiary care hospital. Materials and Methods: Six months (1- 04-08 to 31-10-08) study was conducted at Department of Pediatrics, Services Hospital Lahore. One hundred and sixty patients and sampling technique used was Non probability (Purposive sampling). Both genders were included in the study. Results: Hepatitis E was seen in 20 patients, constituting a total of 12.5% of all the patients. Conclusion: Hepatitis E is a fairly common and under diagnosed cause of acute hepatitis in pediatrics patients and introducing adequate preventive measures can reduce the morbidity.
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Agents Targeting Apoptosis Take Center Stage in the Battle against Cancer
Effective therapy of cancer requires elimination of tumor cells through programmed cell death or apoptosis, which is a highly regulated process that avoids the unwanted inflammatory response when cells die. Morphologically, the manifestation of apoptosis is similar across various cell types and species, and is observed as a series of cellular changes that begin with chromatin condensation, followed by nuclear fragmentation, cell shrinkage, blebbing and finally phagocytosis1,2. When tumor cells are exposed to therapeutic agents, the damage to cellular organelles or macromolecules creates substantial intracellular stress, which triggers the onset of the apoptotic cell death program
Epithelial malignancies of Endometrium: 2 years experience at Fatima Memorial Hospital
Objective: Rapidly accumulating sophisticated information highlights the fact that differential diagnosis of endometrial hyperplasia and well differentiated endometrioid adenocarcinoma is complicated not only by the resemblance of these lesions to each other, but also by their tendency to be misdiagnosed. Detailed comprehension of rules and pitfalls in the grading of endometrioid adenocarcinomas and the estimation and reporting of myometrial invasion is of substantial importance to have a better understanding of issue. Study design: A cross- sectional study. Duration of study: Two years. Place of study: Departments of Pathology, Fatima Memorial Hospital. Methods: The study consisted of 27 specimens of endometrial tumors, received fixed in 10% formalin. Haematoxylin and Eosin stained slides were examined to determine the histological type by WHO classification, and immunohistochemistry was done in difficult cases. Results: Majority of these tumors were endometriod adenocarcinomas, Serous tumors 1 clear cell carcinoma 1 and one case of squamous cell carcinoma in situ. In one cases there is simultaneous tumor in ovary and endometrium. 2 cases have tumor both in cervix and endometrium. Conclusion: Detailed and accurate analysis of patients' tissue as 'deeply' as possible is necessary to obtain information on morphological background to provide the clinicians with information relevant for individualized medicine
HR regions of env gene in HIV: PCR Diagnostic targets for AIDS
Objective: Two heptad repeat regions are present at envelop of HIV. It is assumed that this region plays an important role in the entry of viral genome into human cell. Present study was conducted for isolation and characterization of the HR region of env gene in samples of HIV taken from Pakistani patients. Methods: QIAamp MinElute® Spin Kit was used to isolate viral RNA and RT-PCR was used to amplify the specific regions from synthesized cDNA; and gel electrophoresis was used to characterize it. Results: It was observed that on comparison with marker DNA, all samples of HR regions have almost 500 base pairs identifying HR regions. Conclusion: In this study the identification of HR regions shows that occurrence of mutations in HR regions are not enough strong to prevent their attachment with the primer used.
Characterization and Biochemical Studies of the Oils Extracted from FourCultivars of Vigna mungo, Grown in Pakistan
Objective: Vigna mungo (mash) is a widely consumed legume in Pakistan and also used globally. This study was carried out for detailed characterization of oils from mash seeds from four indigenously cultivated varieties, as very little information is available on the oil composition of mash seeds and inter-varietal variation in oil composition. Materials and Methods: Morphological study was done for each cultivar prior to extraction and characterization of mash seed oil by conventional methods. Seed volume, seed density, hydration capacity, hydration index, swelling capacity, swelling index was determined for mash seeds of each of four cultivars. Oil extraction was done by soxhlet apparatus and characterization of oil for different ingredients was done using GC-MS and HPLC. Results: The oil content was relatively low (1–2%). The investigated physiochemical parameters included refractive indices (RI) at 40 C (1.6–1.9), relative density (1), iodine value (IV) (114.3 –117.1), saponification value (SV) (156.0–167.4 mg KOH/g) and unsaponifiable matter (UM) (14.3-15.3%). Tocopherol contents were also determined and each cultivar was found to contain appreciable amounts of these constituents (Table 4).The concentration of ãtocopherols were found to be greater than the δ-and á-tocopherol which is quite different than mungbean.. Bulk chemical properties such as acid value (AV), saponification value (SV), iodine value (IV), PV, and p-anisidine value (pAV) give structural, stability, and quality information about oils and fats. The UM ranged from 14.3 to 15.3 (Table 2) and it was revealed that cultivars differed significantly with respect to UM. These values are in consistent with the UM pattern observed for low oil-bearing seeds. Conclusion: The findings of the study showed that mash [Vigna mungo(L.) Happer], is a potentially valuable legume crop with considerable nutritional quality oil among all the cultivars.
Diagnostic Accuracy of Frozen Section in Salivary Gland Neoplasms
Introduction: Research over the years has systematically revealed that morphological, histological, and molecular data from human cancers available to pathologists has revolutionized quantitative systems science. By measuring morphological parameters such as tumor stage and grade, it is now possible to integrate relatively large data sets thus reconceptualization of knowledge available, provides better prediction of the behavior of tumors and their interaction with the host. Histological diagnosis prior to surgery is not possible, as incisional biopsies are contraindicated due to the possibility of facial nerve injury and incomplete resection of the tumor. Objective: To compare the results of the frozen section examination with definitive histological diagnosis. Identifying malignancy intraoperatively can have a significant impact on the management of the salivary gland tumors. Materials and Methods: The study was done in Histopathology department of SIMS/Services hospital, Lahore. 40 cases of salivary gland neoplasms previously diagnosed on FNAC. Results: Comparing the perioperative result with definitive diagnosis, 10% (6/40) were true positive, 77.5% (31/40) true negative, 7.5% (3/40) false positive, 0% (0/40) false negative, prevalence, 66.6% positive predictive value and 100% negative predictive value. Thus, the sensitivity of frozen section for malignancy was 100% and the specificity was 91%. Conclusion: We consider that frozen section examination for salivary gland neoplasms is not sufficient on its own for deciding on the best management. Their interpretation must be correlated with clinical and intraoperative findings, in association with surgeon's experience.
Stem cell therapy in improving the motor function of patients with cerebral palsy: Systematic review with meta-analysis
Background: Cerebral palsy (CP) has no cure yet. This study was aimed to evaluate the efficacy and safety of stem cell therapy (SCT) for improving the gross motor function (GMF) of patients with CP. Methods: A systematic literature search was performed in CENTRAL, PubMed, Embase, and Google Scholar to identify relevant randomized controlled trials from the year 2012 to 2022. The outcome measures were GMF and adverse events. For the meta-analysis, treatment effects on GMF improvement were expressed as standardized mean differences (SMD) with 95% confidence intervals (CI), using a random-effects model. Results: There were seven trials that either used autologous or allogenic stem cells, with 411 participants, and were met with inclusion and exclusion criteria. The age, severity, and type of CP in participants varied. Follow up duration ranged from 6 to 24 months. Four studies had single transplantation while the other three had two to four sessions. Overall, a significant positive effect on GMF was seen in SCT than control group, SMD = 2.22 [95% CI 1.15 - 3.29] with a high heterogeneity (I² = 95%). In a separate analysis, umbilical cord blood (UCB) was the most effective cell type, SMD = 3.24 [1.38,5.10]. Serious adverse events were rare, with similar effects in treatment and control groups. Conclusion: A positive and safe effect of SCT, specially UCB on GMF, was observed. However, the standardizations of treatment regimes, therapeutic-cell dose, and SCT optimal timing are needed to maximize the efficacy of treatment. Keywords: Cell Therapy, cerebral palsy, efficacy, motor function, movement disorders, stem cell
Quality of life and associated factors among patients with tuberculosis at the University of Lahore Teaching Hospital, Lahore.
Abstract Methods: In 2019, cross-sectional research was carried out between April and June. a total of four hundred patients altogether were chosen. QOL was measured using the World Health Organization Quality-of-Life (WHOQOL-Bref) questionnaire. Potential predictors were examined using linear regression analysis, and variables were classified as statistically significant if their P value was below 0.05. Results The participants had a mean age of 38.04 ± 13.53 years; the percentage of patients with pulmonary TB (PTB) was 52.71% and 57.36% were male. Conclusion In contrast to earlier researches, this study showed that the patients' quality of life was comparatively low. Social domains were notably more affected than other domains. PTB and non-adherence indicated a negative correlation with every domain. Therefore. health care providers should stress patients' medication adherence. Keywords Quality of life · Tuberculosis · WHOQOL-Bref · Ethiopia
Incidence of Helicobacter pylori infection in the population of Islamabad
Background: The prevalence of Helicobacter pylori shows the wide variation among developing and developed countries. The main reason to higher prevalence in developing countries is their low basic hygiene, poor diet and improper sanitation. All these factors favor to the spread of H. pylori infection in human population. The prevalence of H. pylori in a specific area shows the level of hygienist of that area. The main focus of study was to estimate the seroprevalence of H. pylori infection in population of Islamabad. Methods: The study was conducted among 435 clinically suspected patients. Samples were collected and serum was separated. H. pylori 'One Step Test Device' based on immune-chromatographic technique was used for the detection of H. pylori antibodies. Results: In the tested 435 clinically suspected patients, the subjects were categorized into 2 groups. Male group with 211 patients showed 34 positive cases, while 56 females from second group are positive out of 224. The overall percentages revealed 12.87%, females and 7.80% males as H. pylori positive. Overall there are 20.67% positive and 79.30% negative cases for H. pylori infection. Conclusion: The present results showed the prevalence of H. pylori in reported area and confirmed that the prevalence of disease is higher in developing countries.
Nutritional status of under five year children from Shinkiari and Bedadi areas of District Mansehra, Pakistan
Objective: To measure the prevalence of malnutrition with the gender difference and age trend among the children. Information about nutritional status is an indicator of the nutritional situation in our society. Methodology: A cross sectional survey was conducted by structured questionnaire, a nutritional status of each child from household was assessed through anthropometric measurements. Two important indicators of nutritional status i.e. disease and malnutrition were studied by measuring the height for age, weight for age and weight for height. Results: Children from Shinkiari were more affected and malnourished than those of Bedadi area. Among the Shinkiari children, 59% were found stunted, 40.5% were under weight and 42.9% were wasted. Among the children of Bedadi village, 55.8% were stunted, 46.5% were under weight and 44.2% were wasted. In comparison, nutritional status of girls were found to be more affected than boys, which indicated that the parents paid more attention to boys in comparison to girls. Conclusion: Malnutrition rate is very high in District Mansehra, Pakistan due to lack of maternal education and poor quality of food. Malnutrition can be reduced by increasing female education and quality of food for growing population.
Self-Medication in Bahauddin Zakariya University, Multan, Pakistan
Objective: This study was conducted to evaluate 1) ratio of people practicing self-medication in BZU, Multan; 2) their knowledge about effects of self-medication; and 3) views about ways to reduce self medication practices. Methodology: The study conducted was questionnaire based during December 2014. It involved a total of 100 participants of which 50 were male and 50 were female. Results: The prevalence of self-medication was found out to be 75%. 48% of the people stated that self-medication can cause both the death of the person as well as the person can become addicted to the medicine. 39% of the participants think that due to lack of awareness people get attracted to self-medication; and 53% of the people take lack of awareness as the leading cause of increasing self-medication practices in Pakistan. 81% people stated that self-medication can be stopped. 52% participants think as media can be used to spread awareness while 15% think that by arranging free camps for the poor, we can reduce the self-medication. While 33% people think that by arranging seminars, we can stop self-medication. Conclusion: The prevalence rate as indicated by this study was very high so proper measures should be taken to reduce its rate. For this purpose, the help of media, seminars or camps can be arranged.
In Silico docking of piperazin analog for non-small cell lung cancer having mutations in EGFR, ALK, and BRAF proteins.
Background: Mutations in different genes like EGFR, ALK and BRAF are the sources of non-small cell lung cancer. Mutation of ALK occurs of small inversion on short arm of chromosome 2. The most commonly found EGFR mutations in patients with NSCLC are deletions in exon 29 or in exon 21. Common BRAF transversion mutations occur at exon 15. The missense mutations of BRAF have been detected in exon 11 and exon 15. Objective: The objective of study was to design new chemical compounds to block the targeted sites for receptor proteins present on cells surface, which control the growth or stop the proliferation of cancer cells. Methods: After screening large amount of data, we designed an in silico drug compound for lung cancer that block the mutations in EGFR, ALK and BRAF genes. Results: We suggested a novel compound (7-[2-({6-[4-(chloromethyl) piperazin-l-yl] oxan-3-yl} amino) pyrimidin-5-yl]-octahydropyrano[2,3-c]pyridin-3-ol) to control mutations in EGFR, ALK and BRAF genes. Molecular formula of ligand compound C22H35C1N603 showed promising Lipinski rules of five values having Log P 0.58-1.86, molar refractivity 123.13 ± 0.3 cm3, H bond acceptors and donor 8 and 2 respectively. ALA, LYS, ARG were common interacting residues for EGFR, ALK genes and ALA, GLY were common for ALK, BRAF mutant genes and ligand complex interaction. Conclusion: ALA was common among all interactions that showed less side effects and long resistance against non-small cell lung cancer.
Prevalence of Hepatitis C Genotypes in Bhimber (AJK)
Background: The HCV genotyping provides valuable epidemiological therapeutic information. It is rightly ratify the importance of genotype proficiency before clinical therapy. In the connection this particular study will be valuable for the health care providers and clinicians in designing the therapeutic strategies to cope this manic disease. The aim of the study is to investigate the prevalence of genotype present in District Bhimber. Materials and Methods: For this purpose 100 HCV antibody positive samples were collected and analyzed using Real Time PCR. Results: In our findings the prevalence of HCV in patients having age group greater than 40 was high. Most prevalent genotype is 3a 96(64%) followed by 1b 15(10%) and 3b 12(8%). 3а is found to be the prevalent genotype of the young patients and 1b among old patients. We have not found any correlation between viral load and gender. Intermediate viremia is seen in 3a genotype. Conclusion: It is also concluded that more work is needed in order to determine the genetic diversity and characterization of genotype among gender.
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A Study on Seroprevalence of ABO Blood groups in Lahore, Pakistan
Objective: The blood group system (ABO) and Rhesus genes (Rh) phenotypes vary widely between populations and ethno-geographical areas.The present study aimed to determine the distribution of ABO and Rh groups in a subset of population from Lahore, Pakistan. Methodology: The study included 1000 subjects (76.1% males and 23.9% females) from INMOL hospital, Lahore. Forward grouping was performed by using antigen-antibody agglutination method. Results: The distribution of phenotypes in the total sample was 23.9%, 35.2%, 8.8% and 32.1% for groups A, B, AB and O respectively. However, the seroprevalence of Rh positive (R) and Rh negative (r) was 91.7% and 8.3%, respectively. Conclusion: It was concluded that blood group B had highest prevalence and AB was the least frequent in population from Lahore and surroundings. This data may be helpful in keeping record for the management of availability of blood for crises. Also, it represents the variety in allele distribution in this population.