Services Hospital

Objective: To find the frequency of subclinical hypothyroidism in non-diabetic patients with obesity.Material and Methods: This retrospective cross-sectional study was conducted over six months. The datawas collected from 10.03.23 to 11.09.23 (in the year 2023) while the study was done in 2026. A total of 134cases from the Department of Medicine, Services Hospital Lahore who fulfilled the inclusion and exclusioncriteria were enrolled. Thyroid function tests were taken. The lab reports were evaluated for thepresence/absence of hypothyroidism.Results: Out of 134 patients, 89.55% (n = 120) were between 20-50 years of age whereas 10.45% (n = 14)were between 51-70 years of age, 43.28% (n = 58) were male and 56.72% (n = 76) were female. Thefrequency of subclinical hypothyroidism in non-diabetic obese cases was recorded in 19.40% (n = 26)whereas 80.60% (n = 108) had no findings of the morbidity.Conclusion: The frequency of subclinical hypothyroidism is higher in non-diabetic obese cases; however,obese subjects should be evaluated for thyroid disorders for early recognition and management.Keyword: non-diabetic, obese, hypothyroidism.How to cite: Faiz B, Taqi I, Yasmeen K, Riaz MU, Baig MAS. Frequency of Subclinical Hypothyroidism in Non-Diabetic Patients with Obesity. Esculapio - JSIMS 2026;22(03):DOI: 10.51273/esculap.v22i03.1671

Both lung cancer and diabetes are the leading causes of death worldwide. These two conditions commonly coexist, especially in older patients, and result in worsening of prognosis and lower survival rates. Very limited scientific data are available about their correlation. Studying the mortality trends using data from Centers for Disease Control and Prevention Wide-Ranging Online Data of Epidemiologic Research (CDC WONDER) can help us in designing better health policies and treatment strategies. We analyzed the US mortality data from 1999 to 2023 using the CDC WONDER dataset. The ICD-10 codes were used. For lung cancer, it is C34, and for diabetes, they are E10-14. Temporal trends were analyzed by using joinpoint regression (V5.4.0) and a p value < 0.05 was considered statistically significant. From 1999 to 2023, a total of 174,418 deaths were reported in the United States. Most of them occurred at home (39.6

Background: Smartphones are increasingly used by caregivers to calm preschool children during bedtime routines, but repeated reliance on screen-based soothing may reduce opportunities for caregiver-led co-regulation and adaptive emotional coping. Objective: To examine the association between parental nighttime smartphone-based soothing practices and emotional dysregulation among preschool-aged children attending urban outpatient clinics. Methods: A cross-sectional observational study was conducted from August to November 2025 in pediatric and family medicine outpatient clinics in the Islamabad–Rawalpindi region. Seventy-eight parent–child pairs involving children aged 3–5 years were recruited through consecutive sampling. Nighttime smartphone soothing frequency and duration were assessed using a structured interviewer-administered questionnaire, and emotional dysregulation was measured using the Emotion Regulation Checklist dysregulation component. Data were analyzed using SPSS version 26.0. Descriptive statistics, Pearson correlation, independent-samples t-tests, and one-way ANOVA were applied, with p<0.05 considered statistically significant. Results: The mean child age was 4.2 ± 0.8 years, and 44 children (56.4%) were male. Daily nighttime smartphone soothing was reported in 36 children (46.2%). Mean ERC dysregulation scores increased progressively from 22.1 ± 4.8 among children exposed for less than 15 minutes to 33.4 ± 5.2 among those exposed for more than 30 minutes. Smartphone exposure duration was positively correlated with dysregulation score (r=0.61, 95% CI: 0.45–0.73; p<0.001). Conclusion: Longer and more frequent nighttime smartphone soothing was associated with higher emotional dysregulation scores among preschool children. These findings support parental counseling on structured bedtime routines and non-digital soothing strategies.

Background: Elderly patients undergoing general anesthesia are vulnerable to delayed cognitive recovery and postoperative delirium, partly because age-related physiological changes may increase sensitivity to excessive anesthetic depth. Objective: To compare BIS-guided anesthesia with standard anesthesia management for early postoperative cognitive recovery, delirium incidence, anesthetic consumption, and immediate recovery outcomes in elderly patients undergoing elective non-cardiac surgery. Methods: This parallel-group randomized controlled trial was conducted at a tertiary care teaching hospital in Central Punjab, Pakistan, from August 2025 to January 2026. Eighty patients aged 65–80 years undergoing elective non-cardiac surgery under general anesthesia were randomized to BIS-guided anesthesia or standard anesthesia management. In the BIS-guided group, anesthetic depth was maintained within a BIS range of 40–60. Cognitive recovery was assessed using MMSE and MoCA at baseline, 24 hours, and 72 hours postoperatively, while delirium was assessed using the Confusion Assessment Method. Final complete-case analysis included 73 participants. Results: At 72 hours, the BIS-guided group had higher MMSE scores than the standard anesthesia group (27.1 ± 1.5 vs 25.4 ± 1.9; mean difference, 1.7; 95% CI, 0.90–2.50) and higher MoCA scores (25.0 ± 1.8 vs 22.9 ± 2.1; mean difference, 2.1; 95% CI, 1.19–3.01). BIS-guided anesthesia also reduced sevoflurane consumption, extubation time, and recovery-room stay. Delirium occurred in 8.1% and 25.0% of participants, respectively, with exact testing indicating a clinically relevant but statistically non-definitive difference. Conclusion: BIS-guided anesthesia was associated with better early postoperative cognitive recovery and improved immediate recovery efficiency in elderly surgical patients.

Background: Thoracic trauma is a leading cause of injury-related morbidity and mortality worldwide, disproportionately affecting young, economically active adults, particularly in low- and middle-income settings. Tube thoracostomy remains the cornerstone of its emergency management, yet locoregional data describing the clinical profile and outcomes of thoracic trauma managed this way remain scarce in Pakistan. This study describes the clinical profile, management, and short-term procedural outcomes of thoracic trauma patients requiring tube thoracostomy at a tertiary care hospital.Methodology: This retrospective cohort study included 700 patients with blunt or penetrating thoracic trauma who underwent tube thoracostomy at the Department of Thoracic Surgery, Services Hospital, Lahore, over five years (January 2019-December 2024). Data on demographics, department performing the procedure, documented mechanism of injury, and procedure-related complications were extracted from hospital records using pre-specified operational definitions. Continuous variables were summarized as mean ± standard deviation and categorical variables as frequencies and percentages, using SPSS version 26.Results: Of 700 patients, 526 (75.1%) were male and 174 (24.9%) female; 480 (68.5%) were aged 12-50 years. The Thoracic Surgery Department performed 457 of 700 procedures (65.3%); 144 (20.6%) patients were referred after tube placement else-where. A documented traumatic mechanism was recorded in 352 of 700 patients (50.3%), most commonly hemopneumothorax (141/352, 40.1%) and pneumothorax (94/352, 26.7%). Technical complications occurred in 244 of 700 procedures (34.9%), pre-dominantly lung parenchymal malposition (163/244, 66.8%); process-related complications occurred in 323 of 700 (46.1%), most often ineffective placement requiring re-intervention (113/323, 35.0%).Conclusion: Thoracic trauma managed with tube thoracostomy in this cohort predominantly affected young males and was associated with a substantial procedure-related complication rate, most often related to tube malposition and ineffective placement.