Allied Hospital

Objective: To determine the frequency of maternal and neonatal outcomes following implementation of the World Health Organization (WHO) Labour Care Guide in term pregnancies. Study Design: Descriptive Observational study. Setting: Department of Obstetrics and Gynaecology, Allied Hospital, Faisalabad, Pakistan. Period: July 2024 to December 2024. Methods: A total of 73 term pregnant women monitored using the WHO Labour Care Guide were included. Women with singleton, cephalic pregnancies at ≥37 weeks were enrolled, while high-risk and medically complicated pregnancies were excluded. Maternal outcomes and neonatal outcomes were recorded. Data were analysed using SPSS version 26. Results: The mean maternal age was 26.8 ± 4.2 years, and 52.1% of participants were primigravida. The mean duration of the second stage of labour was 64.8 ± 25.4 minutes, with 87.7% experiencing a normal second stage. Spontaneous vaginal delivery occurred in 76.7% of women, while 23.3% required operative delivery. Maternal complications were infrequent, including postpartum haemorrhage 5.5%, perineal trauma 12.3%, and infection 4.1%, with no cases of uterine rupture. Most neonates 94.5% had normal 5-minute APGAR scores ≥7, 8.2% developed respiratory distress, and 9.6% required NICU admission. Maternal age, parity, and gestational age were not significantly associated with most maternal or neonatal outcomes, although younger mothers (18–25 years) had significantly higher NICU admission rates (p = 0.031). Conclusion: Implementation of the WHO Labour Care Guide was associated with favorable maternal and neonatal outcomes in term pregnancies. The guide supported structured intrapartum monitoring while maintaining maternal and neonatal safety.

BACKGROUND:Gastroesophageal reflux disease (GERD) is increasingly recognized as a condition with systemic effects extending beyond the gastrointestinal tract. OBJECTIVE:To evaluate the long-term impact of GERD on cardiovascular function and the development of hypertension in pediatric populations through a multi-center, one-year longitudinal analysis. METHODS:This longitudinal study was conducted at The Children's Hospital, Lahore, and Allied Hospital, Faisalabad, from June 2024 to May 2025. A total of 285 children aged 5-16 years with confirmed GERD were enrolled from multiple tertiary care hospitals. Participants underwent baseline assessments including clinical evaluation, anthropometry, blood pressure measurement, echocardiography, heart rate variability (HRV) analysis, and inflammatory biomarkers (CRP, IL-6, TNF-α). RESULTS:Over the three-year period, 48 children (16.8%) developed hypertension, with the highest incidence in the severe GERD group (30.7%). Systolic blood pressure increased significantly from 106.8 ± 8.9 mmHg at baseline to 114.7 ± 10.1 mmHg at 36 months (p < 0.001). Children with moderate and severe GERD showed marked reductions in HRV and increased low frequency/high frequency (LF/HF) ratios, indicating sympathetic predominance. Inflammatory biomarkers rose progressively, with CRP correlating positively with systolic blood pressure (r = 0.38, p < 0.01). Echocardiography revealed significant increases in left ventricular mass index over time, particularly in severe GERD cases. Multivariate analysis identified severe GERD (β = 0.31, p < 0.001), elevated CRP (β = 0.27, p = 0.002), and higher BMI (β = 0.22, p = 0.008) as independent predictors of hypertension. CONCLUSION:GERD in pediatric populations is associated with progressive cardiovascular alterations, including rising blood pressure, autonomic dysregulation, systemic inflammation, and early cardiac remodeling.

Background: Manual small incision cataract surgery is widely used in high-volume ophthalmic practice, but intraoperative complications and tissue manipulation can influence postoperative recovery. Real-time computer-vision systems may supplement conventional surgeon monitoring. Objective: To compare AI-assisted intraoperative monitoring with standard visual monitoring during manual small incision cataract surgery. Methods: This single-center parallel-group randomized controlled trial enrolled 96 adults undergoing elective surgery in Southern Punjab between March and July 2025. Participants were allocated 1:1 to AI-assisted monitoring or standard visual monitoring. Ninety-two participants had 4-week follow-up data. Outcomes included surgical duration, intraoperative complications, best-corrected visual acuity (BCVA), endothelial cell density loss, and central corneal thickness change. Results: Surgical duration was shorter with AI-assisted monitoring (14.2±2.1 vs 17.8±2.9 min; mean difference −3.60 min, 95% CI −4.63 to −2.57; p<0.001). Complications occurred in 3/46 (6.5%) versus 8/46 (17.4%) participants (RR 0.38, 95% CI 0.11-1.33; p=0.108). At 4 weeks, BCVA was better (0.18±0.08 vs 0.28±0.11 LogMAR), endothelial cell loss was lower (184.5±42.1 vs 278.3±56.4 cells/mm²), and CCT increase was smaller (12.4±3.8 vs 24.8±6.2 μm) in the AI-assisted group (all p<0.001). Conclusion: AI-assisted monitoring was associated with shorter surgery and more favorable early visual and corneal outcomes, while a statistically significant reduction in complication incidence was not demonstrated

Background: Surgical antibiotic prophylaxis is essential in preventing surgical site infections (SSI) in orthopedic procedures; however, inappropriate use may reduce effectiveness and contribute to antimicrobial resistance. Objective: To assess adherence to antibiotic prophylaxis guidelines in orthopedic surgeries and examine its association with postoperative infections. Methods: A clinical audit was conducted over six months in a tertiary care hospital in Faisalabad, Pakistan, including 148 adult patients undergoing orthopedic surgery. Data on antibiotic choice, timing, dose, route, and duration were collected and compared with international guidelines. SSI occurrence and microbiological findings were analyzed. Statistical analysis included descriptive measures and comparative tests with odds ratios and 95% confidence intervals. Results: Full guideline adherence was observed in 24.3% of cases. Correct timing was achieved in 58.1%, and correct duration in 29.1%. Ceftriaxone was the most commonly used antibiotic (48.0%), while cefazolin was used in 15.5% of cases. The overall SSI rate was 8.8%, with lower incidence in the adherent group (2.8%) compared to the non-adherent group (10.7%) (OR 4.17; 95% CI 0.52–33.3; p=0.18). Prolonged postoperative antibiotic use was the most frequent deviation. Conclusion: Antibiotic prophylaxis practices showed low adherence to standard guidelines, particularly in timing and duration. Improved stewardship and protocol-based interventions are needed to optimize antibiotic use and reduce SSI risk

Background: Coronary artery disease (CAD) is the leading cause of death worldwide. After percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) is recommended to reduce thrombotic events. This meta-analysis assesses the effectiveness of clopidogrel compared to aspirin monotherapy following DAPT post-PCI. Methods: From inception to April 2025, an exhaustive literature search was conducted across electronic databases, including PubMed, Cochrane Library, ScienceDirect, EMBASE, and Web of Science. Risk ratios (RRs) along with 95% confidence intervals (CIs) were pooled using the random-effects model in Review Manager. Leave-one-out sensitivity analysis and funnel plots were used to evaluate heterogeneity and publication bias, respectively. Results: Six studies, including 3 RCTs and 3 observational studies, spanning over 19 494 patients, were included in our analysis. Clopidogrel significantly reduced major adverse cardiovascular events (MACE) (RR = 0.78; 95% CI: [0.69, 0.89]; P = .0002; I 2 = 0%) and myocardial infarction (MI) (RR = 0.73; 95% CI: [0.56, 0.94]; P = .02; I 2 = 21%) compared to aspirin. Likewise, the clopidogrel group demonstrated a substantial advantage in reducing the incidence of any stroke (RR = 0.66; 95% CI: [0.49, 0.89]; P = .006; I 2 = 14%), including ischemic stroke (RR = 0.69; 95% CI: [0.49, 0.97]; P = .04; I 2 = 0%). All other endpoints, including hemorrhagic stroke, all-cause mortality, cardiac death, major bleeding, stent thrombosis, repeat, and target vessel revascularization, were comparable between the 2 arms. Conclusion: Clopidogrel significantly reduced the incidence of MACE, MI, and stroke after DAPT following PCI compared to aspirin, indicating greater effectiveness. However, the main conclusion of this meta-analysis depends primarily on the estimates from RCTs. Additional randomized studies are necessary to confirm these results and support clinical decision-making.