Ayub Teaching Hospital

OBJECTIVE:To analyse the spectrum of biopsy-proven glomerulonephritis and associated demographic and clinical characteristics in patients undergoing ultrasound-guided renal biopsy. Methods:The prospective, cross-sectional, descriptive study was conducted at the Department of Nephrology, Ayub Teaching Hospital, Abbottabad, Pakistan, from April 5, 2023, to December 30, 2024, and comprised adult patients with biopsy-proven glomerulonephritis. Clinical, demographic and laboratory data was recorded. Biopsies were performed under ultrasound guidance, and analysed via light microscopy and immunofluorescence. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Data was analysed using SPSS 23. RESULTS:Of the 180 patients with mean age 36.79±16 years, 98(54.44%) were males and 82(45.56%) were females. There were 115(63.9%) cases of primary glomerulopathy, followed by secondary glomerulopathy 53(29.4%), vascular diseases 7(3.9%) and tubulointerstitial disease 5(2.8%). The distribution of glomerulonephritis subtypes differed significantly by age group (p<0.001). Oedema 135(74.9%) and acute kidney injury 78(43.3%) were the most common presentations, with nephrotic syndrome 129(71.7%) as the leading biopsy indication. Histopathology showed crescents 21(11.7%), post infectious glomerulonephritis 22(12.2%), mild interstitial fibrosis and tubular atrophy 56(31.1%), and moderate-to-severe interstitial fibrosis and tubular atrophy 22(12.2%). Hypertension 81(42.5%) and diabetes 17(9.2%) were the frequent comorbidities. Conclusion:Primary glomerulopathies were predominant, while oedema and nephrotic syndrome were common findings.

OBJECTIVE: This study aimed to compare the outcome of Lichtenstein inguinal hernia repair using stainless steel staples versus polypropylene sutures for mesh anchorage. METHODOLOGY: A Prospective analytical study was conducted at the Surgical Department Lady Reading Hospital, Peshawar, from June to December 2022. Consecutive non-probability sampling was used to assess a total of 100 cases (50 undergoing repair by each method). The study included primary unilateral inguinal hernia cases aged 20 to 70 years. Patients with complicated inguinal hernia, chronic ailments, BMI > 30, or immunocompromised state were excluded to avoid confounders. Outcome was assessed in terms of operative time, postoperative pain, and surgical site infection. RESULTS: Surgical site infections (SSI) were noted in 6% cases of Group A and 16% cases of Group B (with p-value = 0.11). The only parameter that showed a statistically significant difference between the two groups was operative time (Group A: 36.63 +/- 3.14 minutes, Group B: 45.68 +/- 2.69 minutes, p-value <0.001). The differences in postoperative pain between the two groups were not statistically significant (p-value of 0.47). CONCLUSION: Both techniques provide excellent results. However, mesh anchoring using stainless steel staples takes less time than the polypropylene anchoring, which can have essential implications in postoperative recovery.

Glomerulonephritis (GN), secondary to tuberculosis, is quite a rare condition. Here we report the case of membranous nephropathy, which completely resolved after the treatment of tuberculosis. A 42-year-old man presented to a nephrologist with burning micturition. His urine routine examination (RE) was suggestive of 2+ protein. His 24-hour urinary protein was 4.2 grams. Renal biopsy revealed membranous nephropathy. His autoimmune, hepatitis B, hepatitis C, and HIV workups were non-conclusive. The nephrologist advised him to take Rituximab. Before the commencement of immunosuppressants, his Interferon-gamma Release Assay (IGRA) was tested which turned positive. He was referred to a pulmonologist for treatment of latent tuberculosis and further workup. His sputum geneXpert detected pulmonary TB. He was treated with anti-tuberculous therapy (ATT), and his proteinuria improved gradually and settled. The patient did not require any immunosuppressants for MN. The initial symptoms of MN secondary to TB are subtle. It is imperative to evaluate the cause of membranous nephropathy before starting an immunosuppressant. GN secondary to TB can be treated successfully with ATT. Key Words: Glomerulonephritis, Pulmonary tuberculosis, Rituximab, Antituberculosis therapy (ATT).

Introduction Placenta praevia is a recognized pregnancy complication characterized by the placenta implanting partially or completely within the lower uterine segment, and it is associated with significant maternal and perinatal morbidity. Antepartum hemorrhage is a cardinal sign of placenta praevia, and it is unusual for a woman with placenta praevia to reach the late third trimester without vaginal bleeding. Many risk factors, i.e., age >30 years, previous caesarean section, history of dilatation and curettage, history of assisted reproductive techniques (ARTs), multiple pregnancies, and history of placenta praevia in previous pregnancies, need to be addressed so that a confirmed diagnosis can be made in the antenatal period, and women who are at increased risk for this condition can be managed or referred to a setup where proper and vigilant care is provided to both mother and baby. This study aims to identify the risk factors unique to our population and to stratify antenatal patients into high-risk and lower-risk pregnancy groups.  Methods The study was conducted in the Obstetrical Department of Ayub Teaching Hospital, Abbottabad, Pakistan, after approval of the topic and completion of all prerequisites, for a period of three months from July 1, 2025, to September 30, 2025. Women diagnosed with placenta praevia, including low-lying placenta praevia, through ultrasound examinations after 32 completed weeks of gestation were included in the case group. A total of 30 patients were included in the case group. Similarly, 60 women with normal placental localization were included in the control group (case:control ratio, 1:2). Detailed history was taken and recorded in a predefined proforma. For qualitative data, the Chi-square test was used, and a p-value of <0.05 was considered significant. Results In our study, several factors were associated with placenta previa. Women older than 30 years were more likely to develop placenta previa, with nearly four times higher odds compared to younger women (odds ratio (OR) 3.92, 95% confidence interval (CI): 1.55-9.93; p = 0.0064). A history of previous cesarean section also increased the risk, with cases showing six times higher odds than controls (OR: 6.00, 95% CI: 2.28-15.77; p = 0.00037). Similarly, women who had previously undergone dilatation and curettage had over five times higher odds of placenta previa (OR: 5.20, 95% CI: 1.97-13.70; p = 0.00095), and those who conceived through ARTs were nearly four times more likely to develop the condition (OR: 3.80, 95% CI: 1.49-9.67; p = 0.0037). Notably, a previous history of placenta previa was the strongest predictor of recurrence, with affected women facing markedly higher odds of developing the condition again (OR: 11.0, 95% CI: 3.23-37.42; p = 0.0001).  Conclusion Our study highlights several key risk factors for placenta previa, including advanced maternal age, previous cesarean section, history of dilatation and curettage, ARTs, and prior placenta previa. Identifying these factors early can help clinicians recognize women at higher risk and implement careful monitoring to prevent complications. While our findings align with larger studies, they provide additional insight by examining these associations within a focused case-control setting. Overall, these results emphasize the importance of individualized risk assessment and proactive management to improve maternal and fetal outcomes in pregnancies complicated by placenta previa.

PURPOSE:This study explores expert consensus on the benefits and future potential of generative artificial intelligence (GAI) in mental health care, using the Technology Acceptance Model (TAM) to interpret these perceptions. METHODS:A two-round Delphi study using a mixed-methods design was conducted with 15 purposively selected experts in psychiatry, clinical psychology, counselling, and digital mental health. Round 1 gathered open-ended responses that were thematically analysed to identify benefit and future-potential dimensions. In Round 2, experts ranked these dimensions, and consensus was assessed using Kendall's coefficient of concordance. RESULTS:Twenty-eight themes were identified across eight benefit dimensions, and 29 themes across eight future-potential dimensions. Statistically significant consensus was achieved for both benefits (W = 0.145, p = 0.034) and future potential (W = 0.152, p = 0.025). Accessibility and availability ranked as the most important current benefit, while AI as a collaborative and informative tool was prioritised for future application. DISCUSSION:Experts perceived GAI as a transformative adjunct to mental health practice, particularly in expanding access, supporting personalised care, and augmenting professional capacity. Adoption is contingent on usability, transparency, trust, and robust ethical governance to ensure equitable and human-centred integration.