Jinnah Medical and Dental College (Sindhi: جناح ميڊيڪل ۽ ڊينٽل ڪالج or JMDC) was established in 1998 in Karachi, Sindh Pakistan. It is located in the heart of Karachi on Shaheed-e-Millat Road. The first batch of doctors and dentists graduated from JMDC in 2003 and 2004 whereas first batch of pharmacy graduated in 2009. The college is affiliated with the JINNAH SINDH MEDICAL UNIVERSITY (JSMU), which awards MBBS, BDS and pharm-D degrees to its graduates. Graduates from JMDC are eligible to sit for foreign qualifying examinations such as USMLE (ECFMG) and PLAB.To date, JMDC students have earned over 578 distinctions in MBBS subjects and over 348 distinctions in BDS subjects on the Professional Examinations conducted by the University of Karachi. It is also recognized by the Pakistan Medical and Dental Council..
Growth hormone deficiency (GHD) requires long-term hormone replacement therapy, most commonly through daily injections of recombinant human growth hormone (rhGH). Although effective, this daily regimen may lead to poor adherence, particularly in children. Somapacitan, a long-acting growth hormone analog administered once weekly, has emerged as a potential alternative. This systematic review and meta-analysis compares the efficacy, safety, and biochemical outcomes of once-weekly somapacitan with daily Norditropin in patients with GHD. Following PRISMA guidelines (PROSPERO: CRD420251118208), PubMed and CENTRAL were systematically searched up to August 2025. Randomized controlled trials comparing somapacitan with Norditropin in patients with GHD were included. Data were pooled using a random-effects meta-analysis in Review Manager 5.4, and risk of bias was assessed using the Cochrane RoB 2 tool. Ten randomized controlled trials involving 920 participants were included. Somapacitan and Norditropin demonstrated comparable outcomes in height velocity (MD = 0.12; 95
Abstract Traumatic brain injury (TBI) remains a leading cause of death and long-term disability worldwide, and in severe TBI sustained intracranial hypertension is a major driver of secondary injury; decompressive craniectomy (DC) is widely used to control refractory intracranial pressure, yet optimal timing remains controversial, partly because studies often conflate primary DC performed during index evacuation of a focal mass lesion with secondary (rescue) DC performed for refractory intracranial hypertension after maximal medical therapy. This systematic review synthesised contemporary evidence on DC timing/strategy and outcomes while separating adult and paediatric findings and considering surgical intent. After screening 874 records and assessing 139 full texts, seven cohort studies were included (sample size range 89–2,032) from the USA, China, India, Jordan, Germany, and a multinational collaboration; study quality was moderate-to-high (Newcastle–Ottawa Scale 5–6). In adults, early and/or primary DC generally showed lower mortality and modestly higher favourable functional recovery (GOS 4–5), with the largest cohort reporting reduced mortality for early versus late DC (22.4% vs 28.1%; RR 0.80) and higher favourable recovery at 6 months (41.2% vs 36.8%). Primary-versus-secondary comparisons in adult cohorts demonstrated consistent directional trends favouring primary DC, though precision was limited in smaller studies. In paediatric cohorts, findings diverged, with early DC associated with higher mortality in one study and registry analysis identifying timing as prognostic. Early/primary DC was also associated with shorter ICU and hospital length of stay and fewer ventilator days in the largest adult cohort, while overall complication rates were broadly similar but with differing profiles (more haemorrhagic events in early/primary cohorts and more infection/hydrocephalus reporting in late/secondary cohorts). Overall, adult data support early/primary DC when aligned with appropriate indications, whereas paediatric evidence supports physiology-guided individualisation and caution with rigid time thresholds.
The introduction of robotic surgical technology for instrumentation in spinal surgery is a breakthrough of tremendous importance to spinal surgical practice in terms of precision, safety, workflow, and efficiency. Robotic assisted systems utilize a targeting device that supports the placement of pedicle screws to within one millimeter of perceived accuracy while allowing for less intra-operative radiation exposure and decreased soft tissue trauma. Specifically, studies comparing robotic assisted techniques and workflow to traditional freehand or fluoroscopy guided techniques have demonstrated improved targeted accuracy, and fewer pedicle screw breaches with performance of greater than 90% and even >96% with some robotic systems. Briefly, the accuracy of several robotic platforms for the placement of pedicle screws, including Medtronic's Mazor X; Globus Medical's ExcelsiusGPS; and Brainlab's Cirq, have been evaluated to demonstrate accuracy >96%.
Coronary artery calcium (CAC) scoring has emerged as a valuable tool for cardiovascular risk assessment, yet its role in asymptomatic individuals at low-to-intermediate risk remains an area of ongoing investigation. This systematic review aimed to evaluate the prognostic value of CAC scoring for predicting hard cardiovascular events and its utility in risk reclassification beyond traditional risk models. A comprehensive literature search was conducted across PubMed/MEDLINE, Embase, and the Cochrane Library for studies published between 2000 and 2025. Prospective cohort studies assessing CAC in asymptomatic adults without established cardiovascular disease and reporting hard coronary outcomes were included. A total of eight studies met the inclusion criteria. Across these studies, CAC demonstrated a consistent and graded association with incident coronary heart disease events, independent of conventional risk factors. Higher CAC scores were associated with significantly increased risk, with several studies reporting markedly elevated risk at CAC ≥100, including hazard ratios approaching 4.6 in low-risk populations, while a CAC score of zero was consistently linked to very low short- to intermediate-term event rates. Importantly, CAC improved risk stratification, particularly among individuals initially classified as intermediate risk, with studies reporting substantial risk reclassification and net reclassification improvement values of approximately 0.25. Evidence also suggested that CAC is more strongly predictive of coronary events than stroke, supporting its role as a coronary-specific risk marker. Although the review included only eight studies and demonstrated methodological heterogeneity in CAC categorization, comparator models, and outcome definitions, findings were directionally consistent across diverse populations and study designs. These results indicate that CAC scoring provides incremental prognostic value and may serve as a clinically useful tool to refine risk assessment and guide individualized preventive strategies in asymptomatic adults at low-to-intermediate cardiovascular risk.
