Khawaja Muhammad Safdar Medical College (formerly, Sialkot Medical College) is a public sector Medical College in Sialkot, Pakistan. It was established on the initiative of CM Shehbaz Sharif to give quality education in the region of Punjab and especially in Sialkot. It was named after Khawaja Muhammad Safdar in 2017, who took an active part in the Pakistan Movement before 1947 and was the father of current political leader of Pakistan Muslim League (N), Khawaja Muhammad Asif. It was established in 2008 with a sanction of PKR 450 million. Affiliated Hospitals include Allama Iqbal Memorial Hospital, Sialkot (400 Beds) and Sardar Begum Memorial Hospital, Sialkot (240) beds. The College is recognised by the Pakistan Medical and Dental Council (PMDC). and is listed by the Foundation for Advancement of International Medical Education and Research (FAIMER). The students and alumni of KMSMC are commonly referred to as Kmsians..
Hospital-acquired infections (HAIs) associated with increasing antimicrobial resistance (AMR) are becoming a global health challenge, causing AMR spread and a serious health threat. This study was designed to evaluate the phenotypic and genotypic status of AMR in Gram-negative HAI-associated bacteria, to gain a current insight into the local settings. Kirby-Bauer method and Double Disc Synergy Test were used for phenotypic assessment of AMR and extended-spectrum β-lactamase (ESBL) producers, respectively. Genes encoding antimicrobial resistance, ESBLs, and carbapenemases were identified by PCR followed by Sanger sequencing. Among 102 HAI samples, 62 were Gram-negative, identified as Escherichia coli (E. coli) (42.2
Background: Unintentional injuries remain a contributor to childhood morbidity and mortality, with the disease burden fall-ing disproportionately on children in third-world countries. Therefore, this study aimed to determine the patterns, determi-nants and mechanisms of unintentional injuries among children presenting to the paediatric emergency of Allama Iqbal Memorial Teaching Hospital, Sialkot. Methods: An analytical cross-sectional study was conducted from 1st June to 30th November 2024 after IRB approval. Of 389 children aged 0–12 years with unintentional injuries were included by non-probability purposive sampling after taking written informed consent from parents or legal guardians. While children with chronic illness, congenital anomalies and intentional injuries were excluded. A structured questionnaire was administered. Data were analysed in SPSS version 27. Frequencies and percentages were calculated for categorical variables (gender, residence, socio-economic class), and mean ± standard deviation for continuous variables (age, monthly income). The chi-square test was used to assess associ-ations, with p-values ≤ 0.05 considered significant. Results: Of 389 children, the mean age was 6.6 ± 3.17 years and 248 (63.8%) were male children. Among determinants, inside home was the place of injury for 198 (50.9%) children, family members were caretaker at the time of injury for 382 (98.2%), and daytime was the time of injury among 256 (65.8%), while 167 (43.0%) children were under supervision. Trunk and extremities were the pattern among 248 (63.8%) children, while 256 (65.8%) had soft tissue injuries. Road traffic ac-cidents among 163 (41.9%) and falls 154 (39.6%) were the leading mechanisms. Most injuries occurred during daytime (p = 0.043) and male children were more often unsupervised at the time of injury (p = 0.021). Conclusion: Road traffic accidents and falls accounted for the majority of unintentional injuries, with male gender, daytime hours and inadequate supervision emerging as the dominant determinants. Trunk and extremities were the predominant anatomical site of injury involving mainly soft tissues as pattern of injuries.
Objective: Mental and behavioral disorders due to psychoactive substance use, as defined by ICD-10 codes F10-F19, include a spectrum of substance use disorders such as acute intoxication, withdrawal, harmful use, and dependence related to alcohol, opioids, stimulants, cannabis, tobacco, and other substances. These conditions significantly increase the risk of suicide, yet national trends in suicide-related mortality among affected individuals remain underexplored. This study aimed to evaluate national trends in suicide and self-harm mortality among individuals with these disorders from 1999 to 2023. Methods: We conducted a retrospective analysis of U.S. death certificate data from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database (1999-2023). Decedents with mental and behavioral disorders due to psychoactive substance use were identified using ICD-10 codes F10-F19, encompassing acute intoxication, withdrawal, harmful use, and dependence. Suicide and self-harm deaths were defined by ICD-10 codes U03, X60-X84, and Y87. Age-adjusted mortality rates (AAMRs) per million and average annual percentage changes (AAPCs) were estimated using Joinpoint regression. Analyses were stratified by sex, age, race/ethnicity, and metropolitan status. Results: Between 1999 and 2023, 37,473 suicide-related deaths were identified among U.S. individuals with mental and behavioral disorders due to psychoactive substance use. AAMRs increased from 2.2 to 5.7 per million (AAPC: 3.31; p < .01). Males had higher mortality than females (6.6 vs. 2.9), though females had a steeper rate of increase over time. Middle-aged adults had the highest AAMR (8.2), followed by younger (6.9), older adults (3.4) and children and adolescents (1.1). Non-Hispanic (NH) American Indian/Alaska Native individuals (AI/AN) had the highest AAMR (13.5), followed by NH White (6.2), Hispanic/Latino (1.6), NH Black (1.6), and NH Asian/Pacific Islander (API) (1.4). From 1999 to 2000, non-metropolitan areas had higher AAMRs than metropolitan areas (6.5 vs. 4.3), with significant increases in both settings. Conclusions: Suicide-related mortality among individuals with mental and behavioral disorders due to psychoactive substance use has increased significantly increased in the United States from 1999 to 2023, demonstrating substantial disparities by sex, age, race/ethnicity, and geographic region. These findings highlight the critical need for integrated approaches in suicide prevention and substance-related treatment settings.
Background: Drug-resistant tuberculosis (DR-TB) poses a major challenge to global TB control, with increasing incidence and poor treatment outcomes. Differences in resistance patterns between pulmonary and extrapulmonary TB remain inadequately explored. Objective: To evaluate the patterns and predictors of drug-resistant tuberculosis in pulmonary and extrapulmonary TB patients. Methodology: This was a comparative cross-sectional study conducted at Sialkot medical college Sialkot from march 2025 to march 2026 including 266 patients diagnosed with tuberculosis. Results: Drug-sensitive TB was more common in extrapulmonary TB (67.3% vs 60.3%), while MDR-TB (20.5% vs 16.4%) and mono-resistance (14.1% vs 10.9%) were slightly higher in pulmonary TB. Patients with DR-TB were older (44.8 ± 13.9 vs 40.6 ± 14.4 years) and had lower BMI (20.7 ± 3.1 vs 21.9 ± 3.3 kg/m²). Previous TB treatment (59.2% vs 26.2%), diabetes (36.7% vs 22.6%), HIV positivity (20.4% vs 11.9%), and malnutrition (53.1% vs 31.0%) were significantly associated with DR-TB. Multivariable analysis identified previous treatment (AOR 3.42), malnutrition (AOR 2.76), low BMI (AOR 2.21), diabetes (AOR 1.94), HIV (AOR 1.88), and age >45 years (AOR 1.67) as independent predictors. Conclusion: Drug-resistant TB is influenced by multiple factors, with prior treatment being the most significant predictor. Both pulmonary and extrapulmonary TB require equal attention in resistance surveillance and management strategies.
INTRODUCTION:Plastibell circumcision is widely practiced in neonates because of its simplicity and low complication rate. Understanding factors influencing safety, especially ring size and operator experience, is essential for reducing preventable complications. OBJECTIVE:The objective of the study is to determine the rate and predictors of complications following neonatal Plastibell circumcision in a tertiary military hospital. METHODS:A retrospective cohort study of all male neonates < 90 days was done, who underwent Plastibell circumcision between June 2024 and May 2025 at Prince Sultan Military Medical City. Variables included age, weight, ring size, surgeon level, diathermy use, and postoperative outcomes upon presentation to the hospital. Statistical analysis included chi-squared tests and multivariable logistic regression. RESULTS:Among 552 neonates, complications among patients presenting to the hospital occurred in 17 (3.1%), which were bleeding in 15 (2.7%), infection in one (0.2%), and ring migration in one (0.2%). Ring size 1.3 was the only independent predictor of complications (odds ratio (OR) 2.10; p = 0.048). Age, weight, surgeon level, and diathermy use were not significant predictors. CONCLUSION:Neonatal Plastibell circumcision is safe with a low complication rate. Ring-size selection remains the main modifiable factor, highlighting the importance of objective sizing protocols and enhanced surgical training.
