Frontier Medical College

Objectives: Hepatitis B virus (HBV) infection remains an occupational risk for dental health care providers due to exposure to blood, saliva, sharp instruments, and contaminated surfaces. Although vaccination is effective, completion of the three-dose schedule is often inconsistent. This study aims to determine the selfreported hepatitis B vaccination status of dental faculty, staff, and clinically exposed dental students at five dental colleges in Pakistan, and to compare complete vaccination coverage across participant categories. Methods: A multicentre cross-sectional study was conducted during the 2024–2025 academic year. A census-style, consecutive sample of eligible participants, comprising faculty members, staff, third-year dental students, and final-year dental students, was included. Participants who reported receiving all three doses of the hepatitis B vaccine were classified as fully vaccinated. In comparison, those who did not report completion of three doses were classified as not fully vaccinated. The primary outcome was self-reported complete vaccination status, not serologically confirmed immunity. Descriptive statistics, chi-square testing, Cramer's V, and unadjusted odds ratios were used for analysis. Results: Overall, 395 of 1,038 participants were fully vaccinated, giving a vaccination coverage of 38.1%. Vaccination coverage was 42.0% among faculty, 33.2% among staff, 46.1% among third-year students, and 32.0% among final-year students. Participant category was significantly associated with vaccination status, χ² = 13.81, p = 0.003. Bonferroni-corrected pairwise comparisons showed significant differences between staff and third-year students and between third-year and final-year students. Compared with faculty, staff had 8.8 percentage points lower vaccination coverage, and final-year students had 10.1 percentage points lower coverage. Among students, vaccination coverage declined significantly from the third year to the final year (χ² for trend = 8.15, p = 0.004). Conclusion: Self-reported completion of hepatitis B vaccination was suboptimal across all participant groups. The findings support the need for a structured institutional vaccination pathway, verification of vaccine records where feasible, reminder systems for dose completion, and post-vaccination anti-HBs testing for individuals with ongoing clinical exposure.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition and is characterized by a need for lifelong medical treatment with medications to control blood sugar and prevent complications. Continuous use of antidiabetic medications is frequently associated with adverse drug reactions (ADRs), which may negatively affect patient compliance, therapeutic outcomes, and overall safety. Objective: To assess the adverse drug effects and safety profile of antidiabetic drugs in patients with Type 2 DM receiving antidiabetic therapy at a tertiary care hospital. Methods: The study was a cross-sectional observational study conducted at the Aziz Bhatti Shaheed Teaching Hospital in Gujrat, Pakistan, from January 2025 to January 2026. Non-probability consecutive sampling was used, and 100 diagnosed T2DM patients taking oral antidiabetic drug and/or insulin therapy were enrolled. Structured interviews and medical record reviews were used for demographic data, treatment patterns, laboratory parameters, and adverse drug reactions. The causality and severity for ADRs were determined by the Naranjo Probability Scale and Modified Hartwig and Siegel Severity Scale, respectively. Data analysis was carried out by SPSS 26.0 software. Results: Among 100 participants, 46.0% experienced at least one adverse drug reaction during therapy. The most frequent ADRs were gastrointestinal, such as nausea, diarrhea, and abdominal discomfort, especially in those taking metformin. Sulfonylureas and insulin therapy were the greatest risk factors for hypoglycemia. The majority of ADRs were either mild (60.9%) or moderate (30.4%), with severe reactions making up 8.7% of cases. The frequency of ADR was significantly associated with combination therapy, advanced age, obesity, long duration of diabetes, and high HbA1c level (p < 0.05). Conclusion: Adverse drug reactions are a frequent problem in Type 2 diabetes mellitus patients on antidiabetic treatment. To enhance the safety of medicines and therapeutic compliance in diabetic populations, regular pharmacovigilance monitoring, individualized treatment, and counseling of patients are required.

Objective: The present study aimed to assess the pre- and post-intervention feedback literacy scores of undergraduate dental students. It also aimed to evaluate the effect of peer and self-assessment strategies embedded within a structured feedback literacy intervention and to determine whether these strategies improve feedback literacy. Study Design: A Quasi-experimental study design. Place and Duration of Study: Foundation University College of Dentistry & Hospital (FUCD & H), Islamabad, Pakistan, from Aug to Sep 2024. Methodology: A total of fifty second-year Bachelor of Dental Surgery (BDS) students were recruited through universal sampling. The students were divided into two groups: a Peer Assessment (PA) group and a Self-Assessment (SA) group (n=25 each). A validated FLS was administered before and after the intervention. A series of feedback literacy development workshops and assessment activities were part of the intervention. Data was analyzed using paired and independent sample t-tests to compare pre- and post-test scores within and between groups. Results: Both groups showed significant improvement in feedback literacy scores after the intervention (p<0.001). At baseline, the self-assessment group scored significantly higher than the peer-assessment group (p=0.027). Post-intervention, no significant difference was observed between the groups (p=0.301), indicating comparable effectiveness of both assessment conditions. Conclusion: Both peer and self-assessment strategies contributed equally to the development of feedback literacy; however, their effect varies. The findings highlight the importance of incorporating structured feedback literacy interventions in dental education to improve students’ learning strategies.

BACKGROUND:The combination of doravirine and islatravir (DOR/ISL) is a novel two-drug regimen for HIV-1. Early development faced challenges due to dose-dependent immunological signals. We aimed to synthesize the evidence on the efficacy and safety of DOR/ISL across all treatment-experience categories, specifically evaluating the impact of islatravir dosage (0.25 mg vs 0.75 mg) on clinical and immunological outcomes. METHODS:We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) following PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, and Google Scholar from inception through April 2026. Primary outcomes were virological suppression (<50 copies/mL) and mean change in CD4+ T-cell count at week 48. Data were pooled using random-effects models. Islatravir dose was evaluated as a pre-specified moderator. Quality was assessed using Cochrane RoB 2.0 and certainty of evidence was graded using the GRADE approach. RESULTS:Seven RCTs (n = 3,600 participants) were included. At Week 48, DOR/ISL showed non-inferior suppression rates (RR 1.01 [95% CI 0.99-1.02]; p = 0.516; moderate-certainty evidence) and a statistically significant reduction in virological failure risk (RR 0.55 [0.33-0.92]; p = 0.022) compared to active control. Overall CD4+ gain was lower with DOR/ISL (MD -34.55 cells/μL; low-certainty evidence); however, a profound moderator effect of dose was observed (p < 0.0001). The 0.75 mg dose was associated with significant CD4+ and lymphocyte declines, whereas the approved 0.25 mg dose was immunologically neutral. DOR/ISL was weight-neutral compared to bictegravir/emtricitabine/tenofovir alafenamide (MD -0.25 kg [-0.66 to 0.16]; low-certainty evidence). CONCLUSION:DOR/ISL 100/0.25 mg once daily achieved virological suppression comparable to standard-of-care ART regimens and was associated with lower rates of virological failure compared with active comparators. The immunological safety concerns observed in early trials were successfully resolved by dose optimization. These findings support the use of DOR/ISL (IDVYNSO) as a potential treatment option for both treatment-naïve and virologically suppressed adults while emphasizing long-term safety surveillance.

Hypertriglyceridemia is a frequently seen lipid disorder. It is linked to a higher risk of cardiovascular diseases and adds a significant burden on healthcare systems. Olezarsen, a novel antisense therapy targeting apolipoprotein C-III, offers effective triglyceride reduction with the convenience of infrequent dosing. This meta-analysis evaluates the safety and efficacy of olezarsen in hypertriglyceridemia to guide clinical decision-making. A comprehensive literature search across major databases identified randomized control trials comparing olezarsen with usual care in patients with hypertriglyceridemia. Data extraction and bias assessment were conducted independently, using RoB 2.0 and the GRADE framework. A meta-analysis was performed using RevMan 5.4.1, applying random effects models and assessing heterogeneity with the I2 statistic. Eight randomized controlled trials were included. Olezarsen significantly reduced triglycerides (MD -58.57, 95% CI -63.10 to -54.04; I2 = 13%) and apolipoprotein C-III (MD -69.81, 95% CI -75.77 to -63.84; I2 = 56%). Significant improvements were also observed in apolipoprotein B, nonhigh-density lipoprotein cholesterol, and achievement of TAG targets (<150 mg/dL). There was no increase in overall or serious adverse events, although injection-site reactions, liver enzyme elevations, and treatment discontinuation were higher with olezarsen. Olezarsen significantly improves TAG levels and atherogenic lipid parameters in patients with hypertriglyceridemia, demonstrating robust efficacy across multiple outcomes. It maintains an overall favorable safety profile, supporting its role as a promising therapeutic option, although monitoring for liver enzymes and injection-site reactions is warranted.