The Hayatabad Medical Complex is a large medical complex and hospital located in the Hayatabad suburb of Peshawar in Khyber Pakhtunkhwa, Pakistan. The second largest hospital in the city, it is a medical postgraduate training centre. The hospital provides medical and surgical specialties in the fields of optometry, cardiology, paediatrics, physiotherapy, plastic surgery, psychiatry, as well as dentistry and skin treatment. Apart from the western parts of Peshawar, the hospital also serves patients coming from surrounding regions and neighboring Afghanistan for treatment..
Background: Even in countries with far superior health resources, the immunization rate for vulnerable populations, such as those with chronic liver disease, is still below ideal despite the strong recommendations. Although the issue is worse in nations with fewer resources than ours, there is still a dearth of information regarding the immunization rate in our community. The study was designed as a result which aimed to determine the frequency of hepatitis A, B, pneumococcal and influenza vaccination among chronic liver disease patients. Materials and methods: This cross sectional study was conducted at the department of Medicine, Khyber Teaching Hospital, Peshawar during the period 01-08-2024 to 31-01-2025. A total of 246 male and female patients aging 20 to 60 years diagnosed with chronic liver disease were enrolled and evaluated for hepatitis A and B, pneumococcal and influenza vaccination. Vaccination status was confirmed through history taking and medical record assessment. Results: Mean age of the participants was 42.06±10.09 years, mean BMI was 24.008±2.64 kg/m2 and mean illness duration was 33.59±5.301 months. Participants aging more than 40 years were 139 (56.5%), and 157 patients (63.8%) were male. HCV and HBV constituted the most prevalent etiology of CLD recorded in 90 (36.6%), 98 (39.8%) participants. Hepatitis B vaccination was most prevalent recorded in 84 patients (34.1%) followed by hepatitis A (n = 77, 31.3%) and pneumococcal in 55 (22.4%). Influenza was least common recorded in 54 patients (22.0%). Conclusion: Comprehensive vaccination against preventable disease in chronic liver disease patients is lacking. Vaccination against hepatitis B virus was most common followed by hepatitis A.
Objective: To evaluate the clinical and functional outcomes of humeral derotation osteotomy in patients with OBPP, with emphasis on improvement in shoulder external rotation, functional scores, and postoperative complications. Methods: This retrospective cohort study included 46 children with OBPP who underwent HDO at a tertiary orthopedic center. We retrospectively assessed demographic, surgical, radiographic, functional, complication, and follow-up data. We compared shoulder range of motion and Mallet scores preoperatively and postoperatively using paired t-tests. Results: Mean external rotation improved from −25.6° ± 8.4° to 32.8° ± 10.2°, while abduction increased from 62.5° ± 14.3° to 118.7° ± 16.9% (p<0.001). Mallet scores improved from 9.2 ± 2.1 to 16.8 ± 2.4 (p<0.001). Minor complications included stiffness, implant irritation, and infection. Conclusion: Humeral derotation osteotomy is an effective surgical procedure for correcting internal rotation deformity in patients with OBPP. It provides significant functional and cosmetic improvement with a low complication rate. Early identification and appropriate surgical intervention can substantially enhance quality of life in affected children.
This meta-analysis assessed the latest clinical efficacy and safety of adjuvant chemotherapy (ACT) after concurrent chemoradiotherapy (CCRT) compared to CCRT alone for locally advanced cervical cancer. Studies were pooled via random effects model. Overall survival (OS; risk of death from any cause) and progression-free survival (PFS; risk of disease progression) were primary endpoints. Secondary outcomes included disease-free survival (DFS; absence of recurrence), local failure rate, distant metastasis rate (DMR), and toxicities. A total of 22 studies (n = 7466) were included. CCRT + ACT was associated with significant improvement in OS, PFS, and DMR compared to CCRT alone. Subgroup analyses of RCTs, studies with >3 ACT cycles, and with a follow-up of 5 years indicated no statistical difference in OS and PFS between two groups, suggesting that the clinical advantage of ACT may be limited, particularly given emerging immunotherapies. Moreover, ACT was associated with a higher rate of hematologic and gastrointestinal toxicities.
Background: Measles remains a significant public health challenge in developing nations, with resurgence episodes often complicated by severe systemic manifestations. Cardiac involvement, particularly acute myocarditis, is a life-threatening complication that significantly increases morbidity and mortality in pediatric populations, especially in children under five years of age. Objective: To determine the frequency, clinical presentation, and associated outcomes of acute myocarditis among children under 5 years hospitalized with acute measles at the Pediatric Department, Hayatabad Medical Complex, Peshawar. Methods: This cross-sectional observational study was conducted over a 12-month period in the Pediatric Department at Hayatabad Medical Complex, Peshawar. A total of 154 confirmed measles patients aged 1 to 59 months admitted to the pediatric ward/PICU were consecutively enrolled. Diagnosis of myocarditis was established using clinical criteria (tachycardia disproportionate to fever, gallop rhythm, muffled heart sounds, heart failure), elevated cardiac biomarkers (Troponin I and CK-MB), and electrocardiographic (ECG) / echocardiographic abnormalities (reduced ejection fraction, wall motion abnormalities). Data were analyzed using SPSS version 26. Results: Results: Out of 154 evaluated children, acute myocarditis was diagnosed in 24 patients, establishing a frequency of 15.6%. The mean age of children with myocarditis was 28.4 ± 11.2 months, with a male predominance (58.3%). The most common presenting symptoms among myocarditis cases included persistent lethargy/irritability (91.7%), tachypnea (83.3%), and severe tachycardia disproportionate to fever (79.2%). Electrocardiographic changes revealed sinus tachycardia (75.0%), ST-T wave abnormalities (54.2%), and low voltage complexes (33.3%). Echocardiography demonstrated left ventricular dysfunction (ejection fraction < 55%) in 70.8% of cases. Elevated cardiac biomarkers were universally observed. Mortality among myocarditis cases was 16.7% (4/24), significantly higher than uncomplicated measles cases. Conclusion: Acute myocarditis is a frequent and critical complication in young children hospitalized with measles at our center, accounting for substantial morbidity and mortality. Early clinical vigilance, serial cardiac enzyme evaluation, and prompt echocardiography are essential for timely diagnosis and management.
