Punjab Social Security Hospital

Background: Traditional nursing education may provide limited opportunities for repetitive, self-paced clinical practice. Augmented reality (AR) offers immersive, interactive training with real-time guidance, but evidence from Pakistan remains limited. Objective: To evaluate AR-based training effectiveness in improving clinical procedure accuracy among nursing students. Methods: A quasi-experimental single-group pre-test post-test design was employed. A total of 250 nursing students were recruited from two nursing colleges (Siddiq Institute of Nursing and Allied Health Sciences Multan and Nishtar Nursing College Multan) using purposive sampling. Data were collected using a structured knowledge questionnaire and a clinical procedure accuracy checklist before and four weeks after the AR-based training intervention. The intervention comprised comprehensive AR-based training sessions covering five core clinical procedures: wound dressing, intramuscular injection, urinary catheterization, endotracheal suctioning, and medication administration. Data were analyzed using SPSS version 26.0, employing descriptive statistics and paired t-test. Results: The mean pre-test knowledge score was 13.28 ± 4.12, which significantly increased to 26.94 ± 3.87 at post-test (t = 28.46, p < 0.001). Similarly, the mean clinical procedure accuracy score improved from 16.42 ± 5.23 pre-intervention to 33.58 ± 4.14 post-intervention (t = 26.73, p < 0.001). The AR-based training intervention demonstrated a highly statistically significant improvement in both knowledge and clinical procedure accuracy among the study participants. Conclusion: Augmented reality-based training significantly enhances nursing students' knowledge and accuracy in performing clinical procedures. Integrating structured AR-based training programs into nursing curricula is recommended to bridge the gap between theoretical knowledge and clinical competence, particularly in resource-constrained settings like Pakistan.

Lung disorders rank among the leading causes of mortality worldwide, presenting a critical challenge in healthcare. The underlying limited regenerative capacity of the lung makes this an unmet clinical need, often necessitating lung transplantation for patients with severe lung disease. However, the lack of viable donor organs underscores the urgent need for alternative therapeutic strategies. Addressing this challenge requires a comprehensive understanding of the structure of lung tissue and the complexities inherent in its regeneration. In this review, we explore recent breakthroughs in lung regenerative medicine, highlighting innovative approaches aimed at tackling lung and tracheal diseases. From stem cell and cell-based therapies to the utilization of biological and synthetic materials, as well as the strategic deployment of growth factors, a diverse array of strategies is being explored to rejuvenate lung function. By critical analysis of in vitro, preclinical, and clinical studies, this review aims to provide a comprehensive overview of the emerging technology of lung regeneration research, shedding light on promising avenues for future therapeutic interventions.

Cardiovascular diseases (CVD), primarily ischemic heart disease and stroke, remain leading global health burdens. Environmental risk factors have a major role in the development of CVD, particularly exposure to heavy metals. The Triglyceride Glucose Index (TyG), a measure of insulin resistance and CVD risk, is the primary focus of this study, which summarizes the most recent findings on the effects of lead (Pb), arsenic (As), and cadmium (Cd) on CVD risk. A higher risk of CVD is correlated with an elevated TyG index, which has been linked to insulin resistance. Exposure to Cd is associated with disturbance of lipid metabolism and oxidative stress, which increases the risk of CVD and TyG. Exposure reduces insulin secretion and signaling, which raises the TyG index and causes dyslipidemia. Pb exposure increases the risk of CVD and TyG index via causing oxidative stress and pancreatic β-cell destruction. These results highlight the need of reducing heavy metal exposure by lifestyle and environmental modifications in order to lower the risk of CVD. To comprehend the mechanisms and create practical management plans for health hazards associated with heavy metals, more study is required.

Objective: To assess correlation of Aspartate Aminotransferase (AST) to platelet ratio index with other biochemical markers such as white cell count, platelet count, hemoglobin, hematocrit and liver function tests in patients of dengue fever for disease severity. Methods: Data was collected from 223 dengue fever patients admitted to a hospital setting in an out- break of 2022. Binary logistic regressions analysis was employed. AST to Platelet Ratio Index (APRI) was calculated and all parameters were studied to assess their association with the disease sever- ity. Severity of dengue was based on development of complications like bleeding, shock, end organ damage and duration of stay in the hospital. Results: The analysis done by software SPSS version 26.0 showed that 3.6% of the patients were se- verely ill while 96.4% were non severe with mean duration of stay in the hospital of 4.95 days. Univariate analysis showed ALT and age have positive correlation with disease severity with CI 95% and APRI significant positive correlation was at CI 90%. Multivariate analysis showed age and APRI to have association with disease severity with OR 1.06 and OR 1.16 respectively (p <0.05). Area under the Receiver Operating Characteristic (ROC) curve for APRI was 0.59. Conclusion: In addition to other biochemical parameters APRI can be used as an independent marker of predicting severity of disease in dengue patients thus it can add value in timely management of the dengue patients.

Percutaneous coronary intervention (PCI) is a widely used therapy for coronary artery disease (CAD), but it carries risks and complications. Adhering to evidence-based practice guidelines is crucial for optimal outcomes. This review compares the recommendations of the 2021 American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions (ACC/AHA/SCAI) and 2018 European Society of Cardiology (ESC) guidelines for coronary artery revascularization and discusses emerging trends and novel devices in PCI. A comprehensive literature review of mixed studies, clinical trials, and guidelines was conducted. Intravascular imaging, including intravascular ultrasound and optical coherence tomography, for stent optimization, is also recommended when feasible. However, differences reflecting variations in evidence quality interpretation and applicability were identified. Furthermore, novel devices and technologies with the potential for improving outcomes were highlighted, but their safety and efficacy compared to standard-of-care techniques require further evaluation through extensive randomized trials. Clinicians should stay updated on advancements and personalize treatment decisions based on individual patient factors. Future research should address evidence gaps and barriers to adopting innovative devices and techniques. This review provides recommendations for clinical practice, emphasizing the need to remain current with the evolving landscape of PCI to optimize patient outcomes. The discoveries provide valuable counsel for the deliberation of clinical interventions and prospective inquiries within the realm of interventional cardiology. Overall, the review underscores the importance of evidence-based practice and ongoing advancements in PCI for CAD management.