Sahara Medical College

Background: Iron-deficiency anemia may alter HbA1c interpretation by affecting erythrocyte turnover and hemoglobin glycation independently of plasma glucose. Objective: To compare HbA1c concentrations between non-diabetic adults with iron-deficiency anemia and non-anemic controls and assess their relationship with fasting plasma glucose and iron-status parameters. Methods: This hospital-based case-control study included 200 adults in Dera Ismail Khan, Pakistan, comprising 100 participants with iron-deficiency anemia and 100 non-anemic controls. Hemoglobin, HbA1c, fasting plasma glucose, serum ferritin, serum iron, total iron-binding capacity, and transferrin saturation were assessed. Groups were compared using independent-samples tests, with p < 0.05 considered statistically significant. Results: Mean HbA1c was higher in the iron-deficiency anemia group than in controls (6.18 ± 0.52% vs 5.49 ± 0.41%; mean difference, 0.69%; 95% CI, 0.56–0.82; p < 0.001), whereas fasting plasma glucose was comparable (91.4 ± 9.8 vs 89.7 ± 8.9 mg/dL; p = 0.201). The iron-deficiency anemia group had lower hemoglobin, serum ferritin, serum iron, and transferrin saturation and higher total iron-binding capacity (all p < 0.001). Conclusion: Iron-deficiency anemia was associated with disproportionately higher HbA1c despite similar fasting plasma glucose. Iron status should therefore be considered when HbA1c and plasma-glucose findings are discordant

Background: Unsafe drinking water remains an important environmental and public health concern, particularly in communities located near industrial areas where microbiological and chemical contamination may coexist. Objective: To assess the microbiological, physicochemical, and selected chemical quality of drinking water from industrial-area supply points in Multan, Pakistan, and examine its association with recent gastrointestinal morbidity among adjacent communities. Methods: A community-based analytical cross-sectional study was conducted from January to June 2026 among 300 adult residents. Sixty drinking-water samples were assessed for total coliforms, Escherichia coli, physicochemical parameters, nitrate, lead, and arsenic. Gastrointestinal symptoms during the preceding 14 days were collected using a structured interviewer-administered questionnaire. Descriptive statistics, chi-square testing, and logistic regression were used for analysis. Results: Total coliforms were detected in 35/60 samples (58.3%) and E. coli in 25/60 (41.7%). High turbidity and TDS occurred in 30.0% and 36.7% of samples, respectively; nitrate, lead, and arsenic exceeded reported limits in 15.0%, 13.3%, and 8.3%. Gastrointestinal morbidity was reported by 96/300 participants (32.0%), with diarrhea reported by 21.3%. Reported morbidity among participants classified as exposed to E. coli-contaminated water was 47.1% (p<0.001). Conclusion: Microbiological contamination was common in sampled industrial-area water supplies and was associated with greater reported gastrointestinal morbidity. The cross-sectional findings support strengthened water-safety surveillance but do not establish causality

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition and is characterized by a need for lifelong medical treatment with medications to control blood sugar and prevent complications. Continuous use of antidiabetic medications is frequently associated with adverse drug reactions (ADRs), which may negatively affect patient compliance, therapeutic outcomes, and overall safety. Objective: To assess the adverse drug effects and safety profile of antidiabetic drugs in patients with Type 2 DM receiving antidiabetic therapy at a tertiary care hospital. Methods: The study was a cross-sectional observational study conducted at the Aziz Bhatti Shaheed Teaching Hospital in Gujrat, Pakistan, from January 2025 to January 2026. Non-probability consecutive sampling was used, and 100 diagnosed T2DM patients taking oral antidiabetic drug and/or insulin therapy were enrolled. Structured interviews and medical record reviews were used for demographic data, treatment patterns, laboratory parameters, and adverse drug reactions. The causality and severity for ADRs were determined by the Naranjo Probability Scale and Modified Hartwig and Siegel Severity Scale, respectively. Data analysis was carried out by SPSS 26.0 software. Results: Among 100 participants, 46.0% experienced at least one adverse drug reaction during therapy. The most frequent ADRs were gastrointestinal, such as nausea, diarrhea, and abdominal discomfort, especially in those taking metformin. Sulfonylureas and insulin therapy were the greatest risk factors for hypoglycemia. The majority of ADRs were either mild (60.9%) or moderate (30.4%), with severe reactions making up 8.7% of cases. The frequency of ADR was significantly associated with combination therapy, advanced age, obesity, long duration of diabetes, and high HbA1c level (p < 0.05). Conclusion: Adverse drug reactions are a frequent problem in Type 2 diabetes mellitus patients on antidiabetic treatment. To enhance the safety of medicines and therapeutic compliance in diabetic populations, regular pharmacovigilance monitoring, individualized treatment, and counseling of patients are required.

Objective: To determine emerging antibiotic resistance of Escherichia Coli among isolated from the patients with urinary tract infection. Study Design: Cross-sectional study. Place and Duration of Study: Pathology Department, Sahara Medical College, Narowal Pakistan, from Mar to Aug 2022. Methodology: Two hundred cases of multi drug resistance urinary tract infection (UTI) were studied, and E. coli was isolated in their urine specimen. Cases of either gender were included with age >15 years. Data of the patients was documented on a proforma regarding demographic data, WBC count, urine culture and antibiotic susceptibility pattern result of the isolated pathogen. After detection of the pathogen (E. coli), antibiotic susceptibility patter was determined using Kirby Bauer disc diffusion method on Mueller Hinton agar. Antibiotic susceptibility of E. coli was determined against commonly used antibiotics. Results: In our study, multidrug resistant Escherichia Coli (E. coli) was detected in 139(69.5%) cases. There were 78(39.0%) males and 122(61.8%) females. Age of the patients ranged from 14-65 years, with a mean age of 33.4±9.1 years. One hundred and seventy-one (85.5%) cases were resistant to cephalosporins, 173(86.5%) to quinolones, 86(43.0%) to aminoglycosides, and 27(13.5%) were resistant to carbapenems. Conclusion: Multidrug resistant E. coli infection is common among patients with urinary tract infection. E. coli was resistant to most of the commonly used antibiotics, but it showed good sensitivity to carbipenems, penicillins and amikacin.

Background Molluscum contagiosum is a viral skin infection in children, often causing cosmetic concerns and requiring treatment because of its contagious nature. Various treatment modalities are available, but an ideal therapy should provide effective lesion clearance with minimal pain and adverse effects. Objective To compare the effectiveness and safety of cryotherapy vs. 10% KOH solution in treatment of paediatric Molluscum contagiosum patients in a South Asian tertiary care centre. Methods A total of 70 patients fulfilling the inclusion criteria were enrolled from OPD of dermatology department, Mayo Hospital. Participants were divided into two equal groups. Group A received cryotherapy every 15 days while group B applied 10% KOH solution, twice daily at home until clearance of lesions. Follow-up assessments were conducted at weeks 2, 4, 6, 8, 10 and 12. Treatment response was categorized as complete (100%), moderate (50-99%), or mild (1-49%) clearance of lesions. Results All the patients completed the study. Complete response was achieved by the 3rd visit in group A and by 4th to 5th visit in group B. Mean cure time was significantly shorter in the cryotherapy group compared to the KOH group (56 vs. 84 days, P<.001). Pain was the most common adverse effect and was significantly more frequent in the cryotherapy group than in the KOH group (62.8% vs. 31.4%; P=.0004; 95% CI: 1.2-2.8). Hyperpigmentation and scarring were also observed more commonly with cryotherapy, although no serious adverse effects or treatment discontinuation occurred. The difference in treatment efficacy between the two groups was statistically significant during follow-up visits (P<.05). Conclusion Topical 10% KOH solution is a better therapeutic option as compared to cryotherapy in the treatment of MC in terms of pain and regional side effects.