Objective: This study aimed to determine the effectiveness of extracorporeal Shock Wave Lithotripsy and retrograde Intrarenal Surgery on obtaining stone-free status for renal pelvic stones measuring 1-2 cm in diameter. Material & Methods: This quasi-experimental study was conducted at the Department of Urology, Khyber Teaching Hospital, Peshawar, where a total of 60 patients with renal pelvic stones measuring 1–2 cm were randomly assigned to two equal groups: ESWL (n = 30) and RIRS (n = 30). Stone clearance was assessed on the 7th postoperative day using ultrasound and X-ray KUB. Results: The mean age of participants in Group A (ESWL) increased to 41 years (SD = 10.67), while the mean in Group B (RIRS) increased to 42 years (SD = 9.09). For Group A (ESWL), the sample included 20 males and 10 females, representing 67% and 33%, respectively. For Group B (RIRS), 21 participants were males, and 9 were females, accounting for 70% and 30%, respectively. The Chi-square test results indicate no statistically significant difference between the two groups regarding gender ratio (p = 0.7813). The data indicated that the patients with renal pelvic stones of 1–2 cm were more likely to be stone-free after retrograde intrarenal surgery (RIRS) than after extracorporeal shock wave lithotripsy (ESWL). In the RIRS group, 73% were stone-free, while only 33% were stone-free in the ESWL group (p = 0.0019). Conclusion: The study finds that RIRS is more effective than ESWL for managing 1-2cm renal pelvic stones. RIRS achieves higher stone-free rates, especially when anatomical difficulties and challenges associated with ESWL are common, and it can precisely locate stones and utilize advanced laser treatment features.
Objective: This study aims to compare mini-percutaneous cystolithotripsy and transurethral cystolithotripsy in children with bladder stones at our hospital. Materials and Methods: A total of 84 patients were divided equally (42 in each group) into two groups (A and B) based on self-selection of stone size, and the type of management was decided by the researcher after clinical examination. Mini-percutaneous cystolithotripsy was performed on patients in Group A utilizing a mini-nephroscope and a 15 Fr access sheath. 4.5/6 Fr or 6/7.5 Fr pediatric ureteroscopes were used to treat transurethral cystolithotripsy in patients in Group B. A Holmium YAG laser was used to break apart the stone. Results: Patients in group A had an average age of 8.38 ± 3.48 months, while those in group B were 8.30 ± 3.23 months old. Of the 84 patients, 49 (58.33%) were male and 35 (41.67%) were female, with a male-to-female ratio of 1.4:1. In my study, the mean operative time for group A (mini-percutaneous cystolithotripsy) was 31.43 ± 5.43 minutes, and for group B (transurethral cystolithotripsy), it was 39.52 ± 7.31 minutes, with a p-value of 0.0001. Conclusion: PCCL allows for easier fragmentation, quicker extraction of larger bladder stone fragments, fewer urethral complications, and reduced operative time. Keywords: Urinary bladder calculi, Lithotripsy, Operative time.
Objective: To determine the diagnostic accuracy of Magnetic Resonance Imaging (MRI) in detecting anterior cruciate ligament (ACL) tears, using arthroscopy as the gold standard. Material And Methods: We conducted this cross-sectional validation study in the Orthopedics Department at Khyber Teaching Hospital, Peshawar. A total of 296 patients were enrolled. All participants underwent knee MRI and were compared with arthroscopic findings, which served as the reference standard. Diagnostic parameters and overall accuracy were calculated. Statistical analysis was performed using SPSS 25. Results: Of the 296 patients, MRI detected ACL tears in 172 (58.1%) cases, while arthroscopy confirmed tears in 197 (66.6%) cases. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI were 70.1%, 65.7%, 80.1%, and 52.4%, respectively, with an overall diagnostic accuracy of 68%. A statistically significant association was observed between MRI and arthroscopy findings (p< 0.01). The ROC curve demonstrated fair discriminative ability of MRI. Conclusion: MRI exhibits moderate diagnostic accuracy in detecting ACL tears, with a reliable predictive value when results are positive. However, its limited sensitivity and specificity in this context highlight the need for cautious interpretation, especially in MRI-negative cases. Arthroscopy remains the definitive diagnostic tool, particularly for ambiguous or complex injuries. Keywords: Anterior Cruciate Ligament Injuries, Magnetic Resonance Imaging, Arthroscopy
Objective: This study aimed to assess medical students' engagement levels and identify socio-demographic factors associated with participation. Materials and Methods: A cross-sectional study was performed at a single medical college using self-reported surveys to assess student engagement across different age groups, genders, and academic years. Data were analyzed to determine the prevalence of "Good," "Neutral," and "Poor" engagement levels, with P < 0.05 set as the cutoff for statistical significance. Results: Most students (63.75%) exhibited a neutral level of engagement, while 20% demonstrated high engagement and 16.25% reported low engagement. Significant correlations were found between engagement and demographic variables (P < 0.05); notably, high engagement was most common among 21-year-olds (47.7%) and third-year students (59.6%), whereas engagement decreased significantly in older students and those in their fourth year of MBBS. Female students also reported significantly higher "Good" engagement (36.9%) compared to their male counterparts (1.31%). Conclusion: Engagement levels notably decline as students advance through their medical education and age. Although the study is limited by its single-center, cross-sectional design, these findings highlight the importance of targeted interventions to sustain student motivation in the later stages of medical training. Keywords: Student engagement, Modular Teaching System, Impact of Assessment Weightage, student motivation
OBJECTIVE: To assess the prevalence of sensorineural impairment in patients with type 2 diabetes and to explore the relationship between hearing loss and variables such as age, gender, HbA1C, and duration of diabetes. MATERIALS AND METHODS: This cross-sectional study was conducted from April to August 2025 and included patients with type 2 diabetes mellitus. Data were collected using the Hearing Handicap Inventory for Adults (HHIA) to screen for diabetes among individuals with hearing impairment. A non-probability convenience sampling method was used. Pure-tone audiometry (PTA) was employed to assess hearing. SPSS Statistics version 20 was used for data analysis. The chi-square test was used to assess associations, with results presented as frequencies and percentages. RESULTS: The study included 195 patients with Type 2 Diabetes mellitus aged 25-65 years. Of these, 7.7% were found to have sensorineural hearing loss, which primarily affects higher frequencies (2-4 kHz) and is usually mild to moderate. Additionally, it was found that sensorineural hearing impairment was significantly (p<0.005) associated with diabetes duration, hypertension, poor glycemic control, and chronic kidney disease. CONCLUSION: In this study, SNHI was found in only a small portion of diabetic patients. HHIA responses showed that most participants faced minimal hearing-related issues, while a significant link was observed between SNI and the duration of diabetes, poor blood sugar control, hypertension, and chronic kidney disease. KEYWORDS: Pure Tone Audiometry, Sensorineural Hearing Impairment, and Diabetes Mellitus
Objective: To compare the effectiveness and safety of 400 mg of sublingual and per rectal Misoprostol when given 1 hour prior to abdominal Myomectomy in reducing intraoperative blood loss. Material and Methods: A quasi-experimental study involving women with uterine leiomyoma was conducted at Khyber Teaching Hospital, Peshawar, Pakistan, including patients who underwent abdominal myomectomy. Participants were enrolled after providing informed consent and were randomly assigned to either group 1, which received 400 mg of misoprostol rectally, or group II, which received 400 mg of misoprostol sublingually one hour before surgery. A total of 48 participants were enrolled. The primary outcome measures were intraoperative blood loss and the difference between preoperative and postoperative hemoglobin levels; secondary measures included postoperative febrile morbidity, gastrointestinal complaints, and other side effects. All data were stored and analyzed using SPSS 20. A p-value of <0.05 was considered statistically significant. Results: The mean age of patients in group 1 (per rectal) was 32.6 (± 4.8) years, and in group 2 (sublingual) it was 33.8 (± 4.5) years. The mean parity in group 1 was 1.8 (1.3), while in group 2 it was 1.3 (1.2). The mean uterine size in group 1 was 17.6 (2.3) cm, and in the per rectal group, 15.8 (2.2) cm. Blood loss during the myomectomy procedure was 342.8 (154.6) ml in group 1 and 386.5 (118.3) ml in the sublingual group. Complications of misoprostol were very rare and minor, such as nausea and uterine cramps. Conclusion: Sublingual misoprostol is an effective and safe agent for reducing blood loss during abdominal myomectomy. When compared with the use of the same dose of per rectal misoprostol given 1 hour before surgery, it did not show a significant difference; however, the ease of administration via the sublingual route is favored and acceptable to women in the Asian community. Keywords: Sublingual Misoprostol, Intraoperative Blood Loss, Myomectomy
Objective: To determine the Diagnostic accuracy of sonourethrography (SUG) in the diagnosis of anterior urethral stricture, taking retrograde urethrogram (RUG) as a reference standard Materials and Methods: This cross-sectional study was performed at the Radiology Department of the Combined Military Hospital (CMH) in Peshawar, Pakistan, from November 3, 2022, to May 3, 2023. A total of 104 clinically suspected cases of anterior urethral stricture were included. Male patients aged 15–65 years presenting with lower urinary tract symptoms for at least one week were enrolled. Patients with posterior urethral strictures, allergies to contrast media, or severe perineal conditions were excluded. SUG was conducted using a Toshiba Xario 200 Doppler scanner, with RUG serving as the gold standard for confirmation. Diagnostic accuracy metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy, were calculated using SPSS version 25. Results: The average age of participants was 37.80 ± 9.245 years. SUG identified strictures in 32 patients, with 71.8% located in the bulbar urethra and 28.1% in the penile urethra. Severity assessment showed 65.6% of strictures as mild, 28.1% as moderate, and 6.25% as severe. Average stricture lengths were 2.1 ± 0.31 mm on SUG and 2.8 ± 0.46 mm on RUG. SUG demonstrated a sensitivity of 97%, specificity of 96%, PPV of 91.2%, NPV of 98.6%, and a diagnostic accuracy of 96.1%. Conclusion: Sonourethrography is a dependable diagnostic tool for anterior urethral strictures, showing excellent sensitivity and specificity. Its superior ability to evaluate stricture length and severity makes it a crucial modality for clinical practice. Keywords: Sonourethrography, Retrograde Urethrography, Diagnostic accuracy
OBJECTIVE: To determine the correlation of the FIB-4 Score with the Child Pugh Score in patients with liver cirrhosis, presenting to Khyber Teaching Hospital, Peshawar, Pakistan MATERIALS AND METHODS: We conducted this cross-sectional study from October 1, 2023, to December 31, 2024, in the Medical Department of Khyber Teaching Hospital, Peshawar. Patients with liver cirrhosis were enrolled after providing written informed consent. All data, including age, gender, disease duration, BMI, Child-Pugh Score, and FIB-4, were recorded on an approved pro forma. RESULTS: According to the inclusive criteria, 81 patients were included. The mean age was 49 years, with a standard deviation of 10.91 years. Of these, 65 (80%) were males, and 16 (20%) were females. The mean FIB-4 score was 5.69 ± 0.903, and the mean Child-Pugh score was 9.08 ± 1.014. A statistically significant but modest positive correlation was observed between FIB-4 score and Child-Pugh score (r = 0.329, p = 0.0003). CONCLUSION: The FIB-4 score demonstrated a statistically significant yet modest positive correlation with the Child-Pugh score in patients with liver cirrhosis and may serve as an adjunct rather than a surrogate marker. KEY WORDS: Correlation, FIB-4 Score, Child Pugh Score, Cirrhosis
OBJECTIVE: To assess drug prescribing competency and compare these competencies across the clinical levels at Sindh Institute of Oral Health Sciences (SIOHS), Jinnah Sindh Medical University (JSMU). METHODS: A cross-sectional study was conducted over 4 months involving final-year dental students, house officers, and residents of SIOHS, JSMU. Data were collected using a modified questionnaire and analyzed with IBM SPSS. Descriptive statistics summarized the demographic data. ANOVA was used to compare the means of competency across four domains: Information Gathering, Clinical Decision Making, Communication, and Monitoring/Review. Tukey’s Post Hoc test was conducted to identify group-wise differences. A p-value of <0.05 was considered statistically significant. RESULTS: About 102 participants responded. Most participants reported adequate knowledge of drug dosage, frequency, duration, and route. Residents (50.0–65.38%) and house officers (54.54–61.36%) showed higher prescribing competency than final-year students (9.37–31.25%). CONCLUSION: When comparing prescribing competency, only the Information Gathering and Clinical Decision-Making domains were significant, with p-values of 0.018 and 0.042, respectively. Tukey’s Post Hoc test showed that only the Information Gathering domain was significantly different between final-year students and house officers, with a p-value of .013. Seniors demonstrated greater confidence in prescribing practices than their juniors, likely due to increased clinical exposure. KEYWORDS: Prescription writing, dental students, clinical competency, drug prescriptions
Objective: To evaluate the accuracy of magnetic resonance imaging (MRI) in detecting meniscal injuries, with arthroscopy as the gold standard. Materials and Methods: We conducted this prospective observational study at Khyber Teaching Hospital from August 2024 to May 2025. A total of 263 adults, aged between 20 and 60 years, with symptoms suggestive of meniscal pathology, underwent MRI followed by arthroscopic confirmation. Diagnostic accuracy was evaluated using a 2×2 table to calculate diagnostic metrics for the medial and lateral meniscus separately. Statistical significance was assessed, and receiver operating characteristic (ROC) curves were constructed. Results: Of 263 patients, 76.8% were male; the average age was 30 ± 4.32 years. MRI detected meniscal tears in 65.0% of patients, while arthroscopy confirmed them in 73.4%. For medial meniscal injuries, MRI showed a sensitivity of 60.9%, specificity of 44.9%, PPV of 68.4%, NPV of 37.0%, and diagnostic accuracy of 55.5%. For lateral meniscal injuries, sensitivity was 55.6%, specificity 95.6%, positive predictive value 66.7%, negative predictive value 93.1%, and diagnostic accuracy 90.1%. ROC analysis indicated an area under the curve of 52.9% for medial and 75.6% for lateral meniscus tears. Conclusion MRI demonstrates greater diagnostic accuracy and specificity in detecting lateral meniscal tears compared to medial tears. Due to lower sensitivity and specificity for medial meniscal injuries, arthroscopy remains crucial for a definitive diagnosis, especially in symptomatic patients with negative or inconclusive MRI results. Keywords: Meniscal Injuries; Magnetic Resonance Imaging; Arthroscopy; Knee Joint; Diagnostic Accuracy; Sensitivity and Specificity; Medial Meniscus; Lateral Meniscus
Objective: This study aims to compare the conjunctival complications and postoperative infections between Small Incision Manual Cataract Surgery (SIMICS) and phacoemulsification. Materials & Methods: This comparative observational study was conducted at the Department of Ophthalmology, MTI-Khyber Teaching Hospital, Peshawar, from June 2024 to December 2024. A total of 462 patients undergoing cataract surgery were enrolled, with 231 patients in each group (SIMICS and phacoemulsification), selected through non-probability consecutive sampling. Postoperative assessments for conjunctival chemosis, hyperemia, and infections were performed at 1 week, 1 month, and 3 months using slit-lamp biomicroscopy. Data were analyzed using SPSS version 25. Chi-square tests and binary logistic regression were applied; p < 0.05 was considered statistically significant. Results: Conjunctival chemosis was more common in the SIMICS group (27.7%) than in the phacoemulsification group (10.0%) (p < 0.001). Conjunctival hyperemia was observed in 39.0% of SIMICS patients, compared to 17.7% in the phacoemulsification group (p < 0.001). Postoperative infection rates were also significantly higher in SIMICS (13.0%) versus phacoemulsification (6.5%) (p = 0.019). Logistic regression analysis confirmed that surgical technique independently predicted infection (p = 0.028), while age, gender, and chemosis were not statistically significant. Conclusion: SIMICS is linked to a higher rate of conjunctival chemosis, hyperemia, and postoperative infections compared to phacoemulsification. These findings highlight the need to improve surgical techniques and postoperative care, especially in low-resource settings where SIMICS is common. Keywords: Cataract surgery, Conjunctival chemosis, Conjunctival hyperemia, Endophthalmitis, Phacoemulsification, Small Incision Manual Cataract Surgery
Objectives: To evaluate the digital skills of undergraduate allied health sciences educators using the European DigCompEdu framework and to identify barriers and enablers affecting their use of digital tools for teaching and learning. Methods: This study employed a sequential explanatory mixed-methods design from January to April 2025. In the quantitative phase, a self-assessment questionnaire based on the DigCompEdu framework was given to all 83 eligible educators; after excluding seven with less than six months of experience, 53 completed responses (26 via Google Forms, 27 on paper) were analyzed. Participants identified as newcomers or integrators were interviewed to gather qualitative data on the needs and challenges affecting their digital competence. Results: Among the educators in the Allied Health Sciences Department, 45% were integrators, 36% were leaders, and 19% were newcomers. Educators scored highest in facilitating students' digital competence (average 13.69 ± 7.5), while evaluation and feedback scored lowest (average 7.34 ± 4.1). A two-tailed Pearson correlation test indicated that professional status significantly affected digital competency (p = 0.01), whereas age, institutional affiliation, and gender were not significant factors. Qualitative data analysis employed the thematic coding approach outlined by Braun and Clarke. It identified the digital divide (digitally illiterate students), insufficient digital resources (unreliable internet, absence of an official LMS), inadequate training and skills, lack of administrative support (such as limited technical staff and incentives), and professional status (non-permanent faculty) as major barriers to digital competency. Conclusion: The Department of Allied Health Sciences must promptly enhance its administrative framework and digital resources to align with international educational technology standards. Institutions should address structural challenges by improving professional status, delivering focused training, and motivating digital involvement to support inclusive and sustainable digital capacity enhancement. Keywords: Allied Health Sciences, Digital competency, Educators.
Objective: To determine how accurately MRCP identifies choledocholithiasis when compared with Endoscopic Retrograde Cholangiopancreatography (ERCP), which serves as the reference standard. Methods: A cross-sectional study was conducted in the Department of Radiology at the Combined Military Hospital in Peshawar, Pakistan, from April 3, 2022, to October 3, 2022, including patients with choledocholithiasis who had been symptomatic for at least 3 months. Diagnostic accuracy was assessed using sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: A total of 100 patients, aged 18-60 years and of both genders, with suspected choledocholithiasis for at least 3 months, were included. The diagnostic accuracy of MRCP was evaluated. When compared with ERCP as the reference method, MRCP showed a sensitivity of 91.07%, a specificity of 81.82%, a positive predictive value of 86.44%, and a negative predictive value of 87.80%. CONCLUSION: The results of this study show that MRCP is a reliable and effective noninvasive method for detecting choledocholithiasis, with a sensitivity of 91.07% and a specificity of 81.82%. KEYWORDS: Magnetic Resonance Cholangiopancreatography (MRCP), Choledocholithiasis, Endoscopic Retrograde Cholangiopancreatography (ERCP), Diagnostic Accuracy
Objective: To assess the knowledge, attitudes, and perceptions of patients with chronic lung diseases about long-term oxygen therapy (LTOT). Materials and Methods: This cross-sectional study was conducted in the Pulmonology Department of MTI-Khyber Teaching Hospital, Peshawar, from January 1, 2023, to June 1, 2023. Patients with chronic lung diseases receiving LTOT were included, while terminally ill patients and those unable to communicate were excluded. Data were collected using a structured proforma that assessed demographics, indications, duration of LTOT, and knowledge, attitudes, and perceptions regarding LTOT. Results: Among 50 patients studied, 42% used oxygen for more than 15 hours daily, 76% used it both day and night, 70% preferred oxygen concentrators over cylinders, and 68% were unaware of the potential hazards of oxygen therapy. Regarding benefits, 56% experienced improvement in dyspnea, and nine patients reported complete (100%) relief with LTOT. Conclusion: The findings emphasize the importance of structured patient education programs and psychosocial support to improve the effectiveness and acceptability of LTOT. Customized interventions can enhance compliance, quality of life, and overall clinical outcomes for patients dependent on long-term oxygen therapy. Keywords: LTOT, COPD, KAP, Long-term oxygen therapy
Objective: To evaluate hematological parameters in pediatric patients with enteric fever admitted to the Department of Child Health at Khyber Teaching Hospital, Peshawar, Pakistan. Materials and Methods: This was a retrospective chart review of 219 patients admitted to the ward who met our inclusion criteria. The data collected was from September 20, 2022, to September 20, 2023. They were managed in accordance with the department's protocol. Blood culture data for patients with Enteric fever were collected and recorded. Data were analyzed using SPSS-23. Results: A total of 219 patients participated in this study. The average age was 7.51±3.36 years. Of these patients, 61.6% (n=135) were male, and 38.4% (n=84) were female. Seventy-six percent showed signs of anemia. Regarding hematological parameters and gender, anemia occurred in 87% of females compared to 69% of males, with a significant association (p=0.002). Neutropenia was more common among males (13%) than females, while leucopenia (15.5%), thrombocytosis (12%), thrombocytopenia (25%), bi-cytopenia (20%), and pancytopenia (6%) were more common in females. Anemia (90%) and neutropenia (19%) were most frequent in the youngest age group (1-5 years), with significant links (p=0.000 and 0.014, respectively). Leucopenia (13%) and pancytopenia (6%) were common among the oldest group, aged 11-15 years. Thrombocytopenia (24%) and bi-cytopenia (21%) were prevalent among patients aged 6 to 10 years. Conclusion: Enteric fever is endemic in our region. Hematologic abnormalities are a feature of enteric fever and can be used as a diagnostic clue for early diagnosis. Keywords: Enteric Fever, Thrombocytopenia, Anemia, Neutropenia.
Objective:This study explored faculty and students’ perspectives on cultural competence in dental education at dental colleges in Abbottabad, Pakistan. Methods:A qualitative study design was used, involving four focus group discussions with 24 purposely selected participants (13 faculty members and 11 students). Each group included six participants. Discussions were audio-recorded, transcribed verbatim, and thematically analyzed based on Braun and Clarke’s framework. Ethical approval was obtained from relevant institutional review boards, and informed consent was obtained from all participants. Results:The analysis identified six interconnected themes: (1) limited formal training, (2) language barriers, (3) an intuitive reliance on ethical practice, (4) informal cultural exposure, (5) institutional constraints, and (6) perceived impact on patient care. While participants valued culturally responsive care, they frequently relied on improvised methods rather than formal guidance. Conclusion:Faculty and students recognize the importance of cultural competence and demonstrate an intuitive understanding of its principles. However, the lack of a structured curriculum limits their ability to turn this awareness into consistent practice. Incorporating clear learning objectives, skill-based training methods (such as simulations and workshops), and faculty development initiatives into the curriculum could enhance cultural competence in dental education and improve patient outcomes. Keywords: Cultural competence; Dental education; Dental colleges; Student perspectives; Faculty perspectives.
Objectives: The goal is to identify the key attributes of transformational leadership and explore their connection to patient safety practices as well as the overall performance of dental staff in public sector hospitals in Karachi. Specifically, it aims to assess the relationship between transformational leadership styles and patient safety practices in dental work environments. Materials and Methods: A cross-sectional study was carried out between October and November 2024 at SIOHS, JSMU, after IRB approval. A sample size of 137 participants was determined, including 3rd and 4th-year BDS students, house officers, and postgraduate trainees. Convenience sampling was employed. Two close-ended questionnaires were used for data collection after obtaining consent. Results: The final sample included 137 participants, mostly female, aged 21 to 55. Participants consisted of clinical faculty, house officers, resident physicians, and BDS students, most with 1–2 years of experience. Charisma received the highest ratings as a leadership attribute (Mean score=11.95), while Delegation showed the greatest variability (SD=2.63). Responses to the APSQ III patient safety scale generally indicated agreement, although items Q11, Q12, Q13, Q15, Q16, Q17, and Q25 had higher disagreement rates. Pearson’s correlation analysis found a significant positive correlation between the Transactional attribute and Error Inevitability (p < 0.05) and a significant negative correlation between Vision and Error Reporting Confidence (p < 0.001). Conclusion: A strong patient safety culture develops with transformational leadership, which enhances service quality and decreases preventable errors. Keywords: Organizational Culture; Leadership; Patient Safety; Patient Satisfaction; Motivation.
Objective: This study aimed to determine the relationships between hip joint parameters, functional mobility, and quality of life in patients with DDH. Methods:This cross-sectional study involved 35 patients suffering from DDH. Functional mobility was measured with the timed up and go (TUG) test. Hip joint parameters were assessed for range of motion (ROM), abduction, and internal/external rotation. Quality of life was assessed via the Short Form-36 (SF-36) Health Survey. Pearson correlation analysis was conducted to establish variable relationships, considering a statistical significance of p < 0.05. Results: A strong positive correlation, r = 0.683, p < 0.01, was found between the right and left hip ROMs. Fixed flexion contracture was significantly associated with both fixed abduction (r = 0.592, p < 0.01) and limb length discrepancy (r = 0.350, p < 0.05). Avascular necrosis (AVN) showed a strong correlation with limb length discrepancy (r = 0.655, p < 0.01). There was no significant relationship between sex and hip joint parameters (p > 0.05). The average TUG test time was 14.65 seconds (SD = 2.98), indicating a moderate level of functional disability. Conclusions:This study revealed significant associations between hip joint parameters, mobility, and quality of life in DDH patients, emphasizing the need for early intervention. Key findings include bilateral hip symmetry, contracture-related limb discrepancies, and AVN impacts, highlighting the importance of multidisciplinary care to improve outcomes. Keywords:Developmental Dysplasia of the Hip, Functional Mobility, Quality of Life, Range of Motion, Avascular Necrosis, Limb Length Discrepancy, Public Health
Background and Objectives: Visual impairment due to refractive error (RE) affects a global population of approximately 2.2 billion individuals. Contact lenses and refractive surgeries (RS) exist for correction, but the most accessible and non-invasive choice remains glasses. Although the factors for not opting for RS remain a mystery. This study examines the frequency of correction of RE through RS among medical students of Peshawar and the reasoning behind medical students not opting for RS. Methods: This cross-sectional study was conducted among undergraduate medical students in Peshawar. A total of 202 students were recruited through purposeful sampling. Students from the first year to the final year who consented to participate were included. Data were collected using a self-validated questionnaire. Results: The study revealed that 128 students had a refractive error (RE) in 202, of which 25% of students with RE considered refractive surgery (RS) (p=0.026, q=0.319), with LASIK being the most common procedure at 46.8%. Regarding institutional affiliation, the consideration for RS was significantly higher among private institutions (25.8% vs. 9.3%, p=0.026). Barriers to RS included satisfaction with eyeglasses (41.6%). Conclusion: The high prevalence of RS consideration signifies a strong trust and preference for permanent correction. Advancements in surgical techniques, increased awareness, and a heightened sense of aesthetics may be contributing factors. Keywords: Refractive error, Refractive Surgery, Eyesight.
Introduction and objective: Thyroid diseases affect 2%-33% of pregnant women. Maintaining TSH levels during pregnancy is crucial for normal thyroid function, and iron deficiency undermines thyroid hormone synthesis and metabolism. Understanding these relationships can optimize maternal and neonatal health. This research aims to explore this connection. Methods: This cross-sectional study was conducted at Darul-Sehat Hospital, involving 174 participants with a 13.2% prevalence of thyroid dysfunction in the third trimester of pregnancy. Convenience sampling was used, enrolling women with singleton pregnancies in labor regardless of iron supplementation status. Demographic and medical details were recorded. Blood specimens were collected for CBC, TSH, and Ferritin during the third trimester or at the onset of labor. Neonatal outcomes included birth weight, Apgar score, birth defects, low birth weight, preterm birth, birth asphyxia, hyperbilirubinemia, hypothyroidism, and NICU admissions. Results: In this study, 20.6% of neonates were preterm, and 47.7% were admitted to NICU. TSH and Apgar scores were significant, with p-values of 0.05 and 0.03. A significant weak inverse correlation was seen between TSH and serum ferritin levels (P-value<0.05). Conclusion: The research findings indicate a notable negative association between maternal TSH and serum ferritin concentrations, demonstrating a connection where decreased iron reserves are associated with elevated TSH levels Keywords: Pregnancy, Thyroid Stimulating Hormone, Serum Ferritin, Third Trimester, Neonate
