Khyber Girls Medical College (Urdu: خیبر خواتین طبی کالج, Pashto: د خیبر ښځو طب پوهنځی) is the first public sector medical college for girls in Khyber Pakhtunkhwa which came into existence in May 2004 as a female Campus of KMC Peshawar. It was declared as an independent college in December 2005, and is recognized by Pakistan Medical & Dental Council in December 2008..
Resistant hypertension remains a major clinical challenge despite multidrug therapy. Baxdrostat, a highly selective aldosterone synthase inhibitor, has emerged as a novel treatment option. We conducted an updated systematic review and meta-analysis to evaluate its efficacy and safety. PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov were searched through April 30, 2026, for randomized controlled trials comparing baxdrostat with control in uncontrolled or resistant hypertension. Random-effects meta-analyses, Trial Sequential Analysis (TSA), subgroup/sensitivity analyses, risk of bias, and GRADE evaluations were performed. Baxdrostat significantly reduced seated systolic blood pressure (SBP) overall (MD: − 6.69 mmHg, 95
Background/Objective: Hand hygiene is a cornerstone of infection prevention; however, compliance is inconsistent in intensive care units (ICUs), particularly in resource-constrained settings. This study evaluated whether a low-cost, multimodal quality improvement intervention could improve process-level hand hygiene compliance using routine, episode-based audits embedded in the ICU practice. Methods: We conducted a single-cycle Plan-Do-Study-Act quality improvement project in a 12-bed mixed medical-surgical ICU in Pakistan (December 2023-January 2024). Hand hygiene performance was assessed using the unit's routine weekly episode-based audit protocol, aligned with the WHO Five Moments framework. A targeted multimodal intervention comprising education, point-of-care visual reminders, audit feedback, and leadership engagement was implemented between the pre- and post-intervention phases (four weeks each). Non-applicable moments were scored as "compliant by default" according to the institutional protocol. A sensitivity analysis was performed excluding these moments to calculate pure adherence. Compliance proportions were summarized using exact 95% Clopper-Pearson confidence intervals without inferential testing. Results: A total of 942 audit episodes (471 per phase) generated 4710 moment-level assessments were generated. Composite hand hygiene compliance increased from 63.1% pre-intervention to 82.0% post-intervention [absolute increase: 18.9 percentage points (pp)]. Sensitivity analysis excluding non-applicable moments demonstrated pure adherence improvement from 54.2% to 82.5% (+28.3 pp), confirming a genuine behavioral change rather than a measurement artifact. Compliance improved across all five WHO moments, with the largest gains in awareness-dependent moments targeted by the intervention: before touching the patient (+27.0 pp) and after touching patient surroundings (+40.0 pp). Week-by-week compliance remained stable within both phases, without immediate post-intervention decay. Conclusions: A pragmatic, low-cost multimodal intervention embedded in routine ICU workflows was associated with substantial short-term improvements in hand hygiene compliance over a four-week observation period, particularly for awareness-dependent behaviors. Episode-based audit systems can support directional process monitoring in resource-limited critical care settings without the need for electronic surveillance. However, its long-term sustainability beyond one month and generalizability to other settings remain unknown. Sensitivity analyses are essential when using "compliant by default" scoring to distinguish adherence patterns from measurement artifacts.
BACKGROUND:Acute suicidality is an emergency psychiatric condition that requires urgent treatment. Traditional treatment approaches, such as antidepressant pharmacotherapy and psychotherapy, take weeks to achieve optimal effectiveness, hence exposing patients in imminent crisis to significant risk. Ketamine is a fast-acting N-methyl-D-aspartate (NMDA) receptor antagonist that has been suggested as a possible treatment option for suicidality. The current meta-analysis aims at comparing the relative efficacy and safety of ketamine with midazolam, an active sedative/anxiolytic comparator used in ketamine trials to support masking/blinding and control nonspecific acute effects, for reducing suicidal ideation and co-occurring depression severity. METHODS:The systematic search was done on PubMed, Embase, and Cochrane Central databases by July 2025. Randomized controlled trials (RCTs) that involved ketamine and midazolam in adults with acute suicidality were chosen. The major outcomes were the variations in suicidal ideation as assessed by the Montgomery-Åsberg Depression Rating Scale-Suicidal Ideation item (MADRS-SI) and Beck Scale of Suicide Ideation (BSS). Additional outcomes were the severity of depression in general (Montgomery-Åsberg Depression Rating Scale (MADRS) total score) and adverse events. Pooled effects were calculated using a random-effects model. RESULTS:This systematic review comprised ten randomized controlled trials (RCTs) with 649 participants. The meta-analysis showed that the administration of ketamine was linked to a considerable decrease in suicidal ideation in comparison to midazolam with mean differences of -1.23 points on the Montgomery-Åsberg Depression Rating Scale (MADRS-SI; 95% confidence interval (CI) -2.14 to -0.32) and -4.30 points on the Beck Scale for Suicide Ideation (BSS; 95% CI -8.01 to -0.59). Ketamine was also associated with reduced severity of depressive symptoms compared to midazolam, with a difference of -6.23 (95% CI -10.37 to -2.08) on the MADRS total score. At the same time, adverse events such as nausea, emotional disturbance, derealization, and dizziness were much more frequent in the ketamine group. CONCLUSIONS:Ketamine is much more effective than midazolam in the short-term improvement of suicidal ideation and depressive symptoms in adult patients with acute suicidality. Despite the fact that ketamine is linked to increased rates of transient adverse effects, its quick action makes it an especially appealing intervention in emergency psychiatric treatment. Further research is thus needed to clarify the long-term effectiveness of the agent and to optimize the best treatment regimes.
Background:Lucid dreaming (LD), which involves being aware of and controlling one's dreams, is of particular interest in the study of consciousness and has potential therapeutic applications. In this narrative review, we highlight the neurobiological aspects of LD, specifically its mechanisms associated with the activation of prefrontal and parietal areas, increased gamma oscillations, and the influence of cholinergic and dopaminergic signaling, primarily during rapid eye movement (REM) sleep.Objective:To evaluate human data on brain mechanisms and clinical effects, synthesizing the neurobiological foundations and therapeutic possibilities of LD, including remarkably controlled lucid dreams.Methods:A narrative review of peer-reviewed research involving clinical groups [e.g., post-traumatic stress disorder (PTSD), chronic nightmares, Parkinson's] and healthy individuals (18-45) was synthesized. Objective lucidity verification [vented eye movements, electroencephalography (EEG)/functional magnetic resonance imaging] was a requirement for inclusion criteria. Neurobiological indicators (gamma, alpha, beta waves, and prefrontal cortex/parietal activation), therapeutic benefits (e.g., frequency of nightmares, PTSD and anxiety scores, motor and cognitive gains), and safety and ethical considerations (dissociation and sleep disruption) were among the outcomes evaluated.Results:LD demonstrates efficacy in modulating nightmares, improving cognitive functions, and potentially alleviating some symptoms in PTSD and neurodegenerative disorders, albeit with methodological constraints. Developments in portable EEG and virtual reality headsets will refine LD research, while interdisciplinary approaches are necessary to address potential risks of dissociation and privacy concerns.Conclusion:Although evidence remains preliminary, LD shows promise as a therapeutic remedy for PTSD and anxiety symptoms, including a reduction in nightmares. It combines neuroscience and self-agency, highlighting the need for more funding and public awareness campaigns to harness its scientific and clinical prospects. Larger randomized trials with a variety of groups and standardized induction techniques are necessary to verify long-term efficacy and safety.
Cannabidiol (CBD) has gained significant attention for its potential therapeutic benefits, but its safety profile in healthy populations remains underexplored. This systematic review and meta-analysis aim to evaluate the safety of CBD compared to placebo in healthy adults. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov identified four randomized controlled trials (RCTs) involving 269 healthy adults. The primary outcome was headache, with secondary outcomes including fatigue, abdominal pain, diarrhea, upper respiratory tract infection (URTI), and dizziness. The results revealed that CBD use was associated with a significantly higher risk of diarrhea (RR = 5.85; 95% CI = 1.14-30.02; P = 0.03). While there was a trend toward increased abdominal pain and headache, these results were not statistically significant. Fatigue, dizziness, and URTI showed no significant differences between the CBD and placebo groups. These findings suggest that while CBD appears safe for short-term use in healthy adults, gastrointestinal side effects, particularly diarrhea, should be monitored. Further large-scale studies with longer follow-up periods are warranted to confirm these results and explore long-term safety.
