Bipolar depression is the most prevalent and disabling phase of bipolar disorder, yet its treatment is limited by modest efficacy, metabolic adverse effects, and the risk of mood destabilization. Lumateperone, a recently approved agent for bipolar depression, exhibits a distinctive multimodal pharmacological profile, modulating dopaminergic, serotonergic, and glutamatergic systems at relatively low receptor occupancy and targeting key neurobiological mechanisms implicated in depressive symptoms. This narrative review synthesizes mechanistic, translational, and clinical evidence from studies published between 2020 and 2025, drawing on data from pharmacodynamic investigations and randomized controlled trials. Lumateperone demonstrates an integrative mechanism involving presynaptic partial dopamine D₂ agonism, postsynaptic D₂ antagonism, potent 5-HT₂A antagonism, modest serotonin reuptake inhibition, and indirect enhancement of NMDA receptor–mediated glutamatergic signaling. Phase 3 trials show significant and early reductions in depressive symptoms in bipolar I and II disorder, with a favorable tolerability profile characterized by minimal metabolic, extrapyramidal, and prolactin-related adverse effects. While indirect comparisons suggest potential tolerability advantages over existing treatments, further long-term and comparative studies are required to establish its definitive role in bipolar depression management.
Background: Transurethral resection of the prostate (TURP) is commonly associated with dilutional hyponatremia due to absorption of hypotonic irrigation fluids, leading to TURP syndrome, particularly in elderly patients. Preventive strategies targeting electrolyte imbalance are crucial. Tolvaptan, a selective vasopressin V2 receptor antagonist, promotes aquaresis without significant electrolyte loss and may help prevent perioperative sodium decline. Aim: To evaluate the efficacy of a single preoperative dose of Tolvaptan in preventing TURP syndrome in elderly patients undergoing TURP. Objectives: To assess whether a single oral dose of Tolvaptan (15 mg) prevents a decrease in serum sodium levels compared to control patients during and after TURP. Materials and Methods: This prospective randomized controlled trial was conducted at ESIC Medical College and Hospital, over a period of one year. A total of 70 male patients aged 50–80 years scheduled for elective TURP under spinal anesthesia were enrolled and randomly allocated into two groups (n=35 each). The case group received oral Tolvaptan 15 mg with water 2 hours before surgery, while the control group received no intervention. Serum sodium and potassium levels were measured preoperatively, 1 hour after the start of resection, and 1 hour postoperatively. Data were analyzed using independent samples t-test and chi-square test, with p <0.05 considered statistically significant. Results: Baseline demographic characteristics and preoperative electrolyte levels were comparable between the two groups. In the Tolvaptan group, mean serum sodium levels increased from 140.54 ± 3.12 mEq/L preoperatively to 142.54 ± 3.60 mEq/L at 1 hour intraoperatively and further to 144.20 ± 3.84 mEq/L postoperatively, indicating no sodium decline from baseline. In the control group, sodium levels showed a smaller rise without a protective trend. Intergroup comparison did not show statistically significant differences; however, within-group analysis demonstrated effective prevention of sodium reduction in the Tolvaptan group. Serum potassium levels remained stable in both groups. No patient developed clinical features of TURP syndrome. Conclusion: A single preoperative dose of Tolvaptan effectively prevents perioperative reduction in serum sodium levels in elderly patients undergoing TURP. Tolvaptan appears to be a safe and useful prophylactic agent against the biochemical component of TURP syndrome.
Background: Primary Sjögren’s syndrome (pSS) is a chronic systemic autoimmune disease that predominantly affects women in the third to fifth decades of life. Diagnosis in adolescence or early adulthood is uncommon, making this case notable for the early onset of disease at 20 years of age. Hypokalemic paralysis is a particularly uncommon presentation of distal renal tubular acidosis (dRTA), a less common renal symptom that affects only 3–5% of patients with primary Sjögren's syndrome. In maternal Sjögren's syndrome, anti-Ro/SSA and anti-La/SSB antibodies greatly increase the likelihood of fetal cardiac involvement, specifically congenital heart block (CHB). Case description: Fetal bradycardia with pericardial effusion was found when a 23-year-old woman with primary Sjögren's disease presented for a routine anomaly scan during her first pregnancy. Fetal echocardiography confirmed complete heart block, leading to pregnancy termination. In her subsequent pregnancy, early initiation of hydroxychloroquine and intensive fetal cardiac surveillance resulted in a normal fetal cardiac course. Delivery at 34 weeks was indicated for late-onset fetal growth restriction (FGR) with abnormal Doppler findings, and a healthy female neonate was delivered with a normal postnatal echocardiogram. Conclusion: Early detection, hydroxychloroquine therapy, and structured fetal surveillance are essential for optimizing outcomes and are pivotal in anti-SSA–positive pregnancies. Although the first pregnancy was complicated by irreversible fetal complete heart block, appropriate antenatal surveillance facilitated a successful outcome in the next gestation. Clinical significance: The case highlights the early onset of the autoimmune disease in the absence of classical sicca symtoms. Proper preconception counselling, adherence to medical therapy and adequate fetal surveillance are the key to a successful pregnancy outcome.
Abstracts: Introduction: Moringa oleifera (MO) gum has gained significant attention over the past decade as a natural, multifunctional excipient for drug delivery. This review highlights the versatile roles of moringa gum in pharmaceutical formulations, including as a binder, disintegrant, matrix former, suspending agent, and mucoadhesive polymer. Key physicochemical properties (e.g., high polysaccharide content, water-swelling, and film-forming ability) underlie these functions. Near about 12 studies were reviewed in which 5 were in vitro, 6 were in vivo, and 2 were clinical studies. Despite its promising properties, the pharmaceutical application of Moringa Oleifera gum is limited by batch-to-batch variability, limited clinical data, and need for further regulatory validation. Methods: A comprehensive review of recent studies was conducted focusing on moringa use as a multifunctional excipient for drug delivery. Special emphasis was given to oral drug delivery and colon targeted drug delivery systems (CTDDS) integrated with other bioactive compounds and its multifunctional potential. Results: Moringa gum-based excipients have been shown to improve tablet integrity and disintegration, sustain drug release in oral and colon-specific systems, and enhance bio adhesion for mucosal delivery. The gum is a biodegradable polysaccharide composed mainly of galactose, arabinose, and xylose, and its natural origin translates to excellent biocompatibility and low toxicity in formulations. Discussion: Recent studies demonstrate that Moringa gum can match or outperform certain synthetic excipients in drug release control and tablet performance. Moreover, chemical modifications (e.g., carboxymethylation, thiolation, grafting) further expand its functionality, yielding improved mucoadhesive strength and controlled-release profiles. With its wide availability and sustainable production, Moringa gum offers an eco-friendly alternative to synthetic polymers. Conclusion: This review discusses the current state of research (2015–2025) on Moringa gum in drug delivery, covering its extraction, composition, pharmaceutical applications across dosage forms, and recent advances in modified Moringa gum derivatives. Ongoing research and development are expected to facilitate the incorporation of this promising natural excipient into more effective and patient-friendly drug delivery systems.
Background: Objective The 1999 classification of periodontal diseases has been widely used in both clinical practice and research; however, several conceptual and practical limitations prompted the development of an updated system in 2017. This study aimed to evaluate how patients previously diagnosed with periodontitis under the 1999 classification were reclassified according to the 2017 periodontal disease classification framework. Methodology A cross-sectional quantitative study was conducted among 100 patients aged 40–50 years who had been previously diagnosed with periodontitis using the 1999 classification system. Comprehensive periodontal examinations were performed, including probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BoP), and radiographic bone loss assessment. Patients were reassessed and categorized according to the 2017 classification using staging and grading criteria. Results Reclassification of patients demonstrated notable differences in diagnostic categorization when applying the 2017 classification. The newer system allowed more precise stratification based on disease severity, extent, and progression risk compared to the 1999 classification. Conclusion The 2017 periodontal classification provides a more comprehensive and biologically relevant framework for diagnosing periodontitis. Its application enhances diagnostic accuracy and supports individualized treatment planning compared to the 1999 classification system.
Background: Parikartika, described in Ayurvedic classics, is a painful anorectal condition comparable to acute fissure-in-ano, characterized by cutting pain, burning sensation, bleeding, and constipation. Early conservative O.P.D based management is essential to prevent chronicity. Objective: To evaluate the efficacy and safety of Himsradi Taila Pichu in the management of Parikartika (acute fissure-in-ano) through a pilot study. Materials and Methods: A single-arm, open-label pilot study was conducted on 15 patients diagnosed with acute fissure-in-ano. Himsradi Taila was applied locally as Taila Pichu once daily. Assessment was done before and after treatment using subjective and objective parameters. Descriptive statistical analysis was applied. Results: Mean pain score reduced from 2.6 to 0.0 (100% relief), bleeding score from 1.6 to 0.0 (100% relief), and sphincter tone score from 1.8 to 0.0 (100% normalization). Constipation improved in all patients, and fissure healing occurred within 28 days. No adverse effects were observed. Conclusion: Himsradi Taila Pichu is safe, effective, and suitable for conservative management of Parikartika.
MnNiBa₂O₄ nanoparticles were synthesized via co-precipitation method and systematically characterized using XRD, FE-SEM/EDX, PL, UV-Vis, and XPS across different calcination temperatures. These nanoparticles exhibited a direct optical band gap of 3.25 eV with strong absorbance at 464 nm, confirming visible-light photocatalytic potential. Objectives: Develop and optimize quaternary MnNiBa₂O₄ nanoparticles for efficient photocatalytic degradation of textile dye—toluidine blue (TB),. Methods: Co-precipitation synthesis with calcination optimization; comprehensive characterization; Tauc plot analysis; reactive species scavenging experiments; four-cycle reusability assessment. Findings: Achieved 81-85% dye degradation within 60 minutes; photogenerated holes (h⁺) identified as primary reactive specie; maintained consistent photocatalytic performance over four successive cycles. Novelty: Mn-Ni-Ba-O quaternary oxide system demonstrating superior visible-light-driven textile dye degradation with calcination temperature optimization and confirmed reactive specie mechanism, offering promising wastewater treatment solution.
Background: Atypical squamous cells of undetermined significance (ASC-US) remain the most common borderline abnormality in cervical cytology, presenting a clinical challenge for risk stratification. High-risk human papillomavirus (HPV) genotyping offers a potential triage solution, particularly for identifying women at greatest risk of underlying high-grade cervical lesions. This study aimed to evaluate the performance of HPV genotyping as a triage tool in women with ASC-US cytology. Methods: Our study conducted a prospective observational study from January 2024 to January 2025, enrolling 72 women with ASC-US. All participants underwent high-risk HPV genotyping using the Cobas 4800 assay, with classification into HPV16, HPV18, other high-risk (HR) HPV, or HPV-negative groups. Colposcopy and histopathology were performed in HPV-positive cases to confirm cervical intraepithelial neoplasia (CIN). Diagnostic accuracy measures (sensitivity, specificity, PPV, NPV) for detecting CIN2+ were calculated. Results: HPV positivity was found in 52.8% of women, with HPV16 in 16.7% and HPV18 in 11.1%. CIN2+ was present in 83.3% of HPV16-positive, 75.0% of HPV18-positive, and 44.4% of other HR-HPV-positive women, but only 5.9% of HPV-negative women (p<0.001). HPV genotyping showed a sensitivity of 91%, specificity of 68%, positive predictive value of 58%, and negative predictive value of 94% for CIN2+ detection. Conclusion: HPV genotyping is a reliable triage strategy for ASC-US cytology, with HPV16/18 positivity strongly predicting high-grade lesions. Reflex testing safely reduces unnecessary colposcopies while effectively identifying women who need immediate evaluation.
The therapeutic relationship between nurses and patients forms the cornerstone of mental health care and significantly influences clinical outcomes. A strong therapeutic alliance supports patient trust, encourages emotional expression, promotes treatment adherence, and facilitates recovery across a wide spectrum of psychiatric conditions. This review article presents a comprehensive analysis of the nurse–patient relationship within mental health settings, synthesizing theoretical perspectives, empirical evidence, and clinical best practices. Core components such as communication, empathy, emotional intelligence, cultural competence, and ethical professionalism are explored to understand their roles in strengthening therapeutic engagement. The review also examines challenges commonly experienced by mental health nurses, including stigma, workload pressures, emotional burnout, and managing professional boundaries. Emphasis is placed on recovery-oriented practice, trauma-informed care, and collaborative decision-making as essential frameworks for enhancing the therapeutic alliance. Findings underscore the need for systematic training, reflective practice, organizational support, and patient empowerment to cultivate meaningful nurse–patient relationships. The review concludes with evidence-based recommendations to guide mental health professionals in fostering effective, respectful, and trust-centered therapeutic alliances.
Objectives: To evaluate the left ventricular systolic function in patients presenting with new onset non–ST elevation myocardial infarction using transthoracic echocardiography.Study Design: Descriptive cross-sectional study.Place and duration of study: This study was conducted at the department of Cardiology, Shifa International Hospital Islamabad, Pakistan from Feb-2023 to Jul-2023. Methodology: A total of 70 patients aged ≥ 18 years and admitted to the cardiology unit with a first episode of non–ST elevation myocardial infarction were enrolled. Diagnosis was based on clinical features, absence of persistent ST-segment elevation (on electrocardiography), and elevated cardiac biomarkers. Transthoracic echocardiography was performed and left ventricular systolic function was assessed by calculating left ventricular ejection fraction (modified Simpson’s biplane method) and categorized as normal, mildly reduced, moderately reduced, or severely reduced. Regional wall motion abnormalities were also evaluated using the standard 17-segment model. Descriptive statistics were employed to share the study findings.Results: The mean age of study patients was 58.93 ± 6.73 years, with a male predominance (67.14%) in overall study population. Mean left ventricular ejection fraction was recorded as 47.24 ± 9.7%. The results showed reduced systolic function in 64.29% of patients, with mild, moderate, and severe dysfunction present in 27.14%, 22.86%, and 14.29%, respectively. Regional wall motion abnormalities were present in 74.29% of patients, where most commonly reported was hypokinesia (45.71%). Conclusions: Impaired left ventricular systolic function and regional wall motion abnormalities are present in a notable proportion of patients reported with new onset non–ST elevation myocardial infarction
Background: Diabetes mellitus is a chronic health problem which is affecting all age groups without gender discrimination in all countries globally. Severe complication of diabetes is diabetic ulcers, that leads to increased total morbidity in people. Diabetes related ulcers require a multi-disciplinary assessment, that by diabetes specialist nurse, a tissue viability nurse, podiatrists, diabetes specialists & surgeons. Objective: To compare efficacy of phenytoin dressing in diabetic ulcers with conventional povidone iodine dressing. Methodology Design of the study: Randomized control trial Setting: General Surgery Department, Ghurki Trust Hospital, Lahore Data Collection: After meeting the inclusion criteria 60 (30 in each group) patients were enrolled. Informed consent and demographic information was taken. Upon presentation complete history and general physical examination was done. After surgery, upon presentation complete history & examination was also done. Clinical examination for the wound area along with peripheral vascular status & peripheral neuropathic changes in lower extremities was carried out. The patients would be followed up after 04 week in both study and control groups. Primary outcome variables efficacy measured. Results: The mean age was 41.27±14.04 years, there were 31(51.67%) were male and 29(48.33%) were females. The efficacy was achieved in 31(51.67%) patients. In group A the efficacy was achieved in 22(73.3%) patients whereas in group B the efficacy was achieved in 9(30%) patients (p-value=0.001) Conclusion: This study concluded that the use of topical Phenytoin for healing of Diabetic ulcer is suitable for alternative to conventional process and showed significantly better out come in terms of efficacy. It’s safe, available, easily apply and in expensive
Background: Dermatoglyphics is the information of ridge patterns on the fingers and palm that produce a permanent mark throughout life. These ridge patterns are genetically determined as they develop during fetal development. Because of these unique characteristics of fingerprints pattern are used for personal identification, population studies and in the discipline of anthropology. Objectives: This study examine the distribution of fingerprint patterns of undergraduate medical students and the possible relationship between those patterns and the two demographic variables of gender, age, residence and ethnicity. Methodology: A cross-sectional analysis was conducted including 500 undergraduate medical students involved in this. The study conducted from 12.08.2025 to 11.11.2025. Each participant's five fingerprints from each hand (a total of 2500) were collected and analyzed. Four standard ridge pattern types i.e. loop (70 percent), whorls (20 percent), arches (6 percent) and composites (4 percent) were included. Data were analyzed and the frequency of each pattern type included found in the study. Results: Loop patterns were the commonest (59.16%), followed by whorls (34.30%), arches (4.26%) and composite patterns (2.24%), with least variation across demographic groups. Conclusion: Loop fingerprints predominated in the study population and dermatoglyphic patterns demonstrated genetic stability with no significant influence of demographic or educational factors.
Head and neck cancers correspond to a considerable clinical burden in tertiary care hospitals particularly in developing countries where late presentation remains common. This retrospective study analyzed the clinico-pathological profile of 187 patients diagnosed with head and neck malignancies at a tertiary care hospital. Demographic characteristics, primary tumor site distribution, TNM classification and stage at presentation were evaluated using descriptive statistical methods. The disease largely affected older individuals with most patients presenting in the sixth and seventh decades of life and displayed a marked male predominance. The larynx was the most frequently involved primary tumor site accounting for 98 cases (52.4%) followed by the nasopharynx and oral cavity. Analysis of TNM classification revealed a high proportion of patients presenting with advanced primary tumors and regional nodal involvement. Consequently, Stage III and Stage IV disease constituted the majority of cases at diagnosis, while early-stage disease was less common. Less frequent primary sites included the hypopharynx, parotid gland, thyroid and other rare subsites. Overall the findings highlight a predominance of laryngeal malignancies and advanced-stage presentation in this cohort, highlighting the need for improved early detection, accurate staging, and systematic documentation to better characterize regional disease patterns and support future research initiatives.
Digital Breast Tomosynthesis (DBT) has emerged as an advanced imaging modality with improved diagnostic accuracy over Full-Field Digital Mammography (FFDM), particularly in dense breast tissue. However, concerns persist regarding increased radiation exposure associated with DBT.Objective:To compare radiation dose parameters—Average Glandular Dose (AGD), Entrance Surface Dose (ESD), and Exposure Index (EI)—between DBT and FFDM across different breast density categories in a Pakistani population.Methods:This retrospective observational study analyzed 1,600 mammographic images from 200 female patients (December 2018–December 2022). All patients underwent bilateral imaging in COMBO mode using a Hologic Selenia Dimensions system. Breast density was categorized according to the American College of Radiology (ACR) classification (A–D). Radiation parameters (AGD, ESD, EI) were evaluated for both modalities in craniocaudal (CC) and mediolateral oblique (MLO) views. Statistical analysis was performed using SPSS version 22.0, with p<0.05 considered significant.Results: DBT demonstrated significantly higher radiation dose parameters compared to FFDM across all breast density groups (p<0.001). The highest AGD (0.50 mSv) and ESD (0.74 mSv) were observed in the DBT MLO view of Group A. Group D exhibited the highest ESD overall (0.27 mSv). Exposure Index values were consistently higher in DBT, reflecting increased detector exposure. Dose variations were influenced by breast density and imaging projection, with MLO views generally associated with higher radiation levels.Conclusion:DBT is associated with increased radiation dose compared to FFDM; however, its diagnostic advantages may justify its use, particularly in selected patient groups. Optimization of imaging protocols and adherence to radiation safety principles are essential to balance diagnostic benefit with patient safety
Introduction: Depressive disorders are multifaceted mental health conditions with increasing global prevalence characterised by persistent sadness, loss of interest, and impaired daily functioning. Despite advancements in diagnostic tools and treatments, moderate depressive disorders remain understudied and inadequately addressed. Methods: A rigorous search was conducted in the SCOPUS database using keywords like depression, depressive disorders, and depression & interventions; and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used for extracting relevant information from the selected papers. Articles published from 2010 onwards were analysed with a focus on assessment tools, severity classifications, and intervention strategies. Results: The search yielded 7,779 articles, with 2,219 fitting the core theme. Three primary themes emerged: (1) Assessment tools for depressive disorders, (2) Severity and types of depressive disorders with emphasis on moderate cases, and (3) Interventions: Medical and Psychological. The review identified key diagnostic scales like DSM-V and BDI, highlighting their efficacy and limitations. It also revealed a significant research gap in moderate depressive disorders, with most studies conflating them with mild or severe cases. Both medical and psychological interventions showed varied success with recent trends favouring integrated approaches. Conclusions: Moderate depressive disorders are often overshadowed in research, necessitating clearer diagnostic criteria and targeted interventions. Future studies should focus on developing and validating specific treatments for moderate depression to enhance therapeutic outcomes and reduce societal burden. This review underscores the critical need for specialized research to bridge existing gaps and improve clinical practices.
We present a case of an elderly male who came for below-knee amputation (BKA) due to complicated synovial sarcoma. The patient had history of chronic obstructive pulmonary disease(COPD) and had undergone multiple cycles of chemotherapy and radiotherapy before surgical intervention was deemed necessary. Spinal anesthesia with a local anesthetic was planned due to his COPD. Despite two attempts by an experienced anesthesiologist, no sensory or motor block was achieved, even with confirmed cerebrospinal fluid backflow. Consequently, general anesthesia was administered.Upon further inquiry, the patient revealed a history of two previous scorpion bites. Based on relevant evidence-based studies and history given by the patient it was concluded that both are interlinked and scorpion venom may have contributed to the development of resistance to local anesthetics in the patient. Scorpion venom affects the sodium channel’s pumping mechanism, which plays a crucial role in the action of local anesthetics, leading to a possible resistance mechanism.
Menopause represents a natural biological transition marked by progressive ovarian follicular depletion and declining estrogen levels. This transition typically occurs between 40 and 55 years of age worldwide, yet regional differences are well-documented. The research aims to comprehensively examine the prevalence and severity of menopausal symptoms and their impact on quality of life among menopausal women in the North Gujarat region. To assess HRQOL domains affected during menopausal transition. A community-based, cross-sectional observational study was conducted among 209 menopausal women aged 40–60 years in North Gujarat. 209 menopausal women having aged 40-60 years who provided informed consent were enrolled in the study as per the inclusion criteria. Pregnant, lactating women and not willing to participate in the study were excluded from the study. Data were collected using a structured socio-demographic questionnaire, Menopause Rating Scale (MRS) and Menopause specific quality of life (MENQOL). Data was collected, coded, entered in Microsoft Excel and analyzed using the IBM SPSS version 2.0. Descriptive statistics were used to summarize the prevalence and severity of menopausal symptoms, expressed as frequencies, percentages, mean scores, and standard deviations. A high prevalence of menopausal symptoms was observed across all MRS and MENQOL domains. The most commonly reported symptoms included joint and muscular discomfort (96%), physical and mental exhaustion (94%), vaginal dryness (92%), sexual problems (92%), and sleep disturbances (86%). Vasomotor symptoms such as hot flushes and sweating were reported by 78% of women. Psychological symptoms, including anxiety (82%) and depressive mood (78%), were also frequent. The highest mean symptom score was observed for joint and muscular discomfort (2.35 ± 1.06), indicating moderate to severe severity. Overall, menopausal symptoms significantly affected the quality of life of the participants. The severity of menopausal symptoms, as reflected by mean MENQOL scores, further reinforced the dominance of physical symptoms. The highest mean scores were observed for Feeling bloated (1.92 ± 0.85), Flatulence or gas pains (1.88 ± 0.88), Weight gain (1.79 ± 0.96), Aching in muscles and joints (1.77 ± 0.85), Feeling tired or worn out (1.65 ± 0.81). Menopausal symptoms are highly prevalent among women in North Gujarat and substantially impair physical, psychological, and urogenital aspects of quality of life. Early identification, awareness programs, and comprehensive management strategies are essential to improve health outcomes and quality of life during the menopausal transition.
Background: Numerous conditions that affect people worldwide, including diabetic nephropathy, are among the leading contributors to the development of chronic kidney disease and end-stage renal disease. The condition has a gradual continuum consisting of increments of microalbuminuria and leading to advanced kidney failure. HbA1c values that indicate glycemic control and long-term clinical prognosis are the most vital of the factors that can be controlled that will affect the decline of renal function among diabetic patients. Objectives: To assess the range of manifestations of diabetic nephropathy and examine the influence of glycemic control on the progression of the condition and the development of end-stage renal disease in diabetic patients. Methodology: One hundred patients with diabetic nephropathy who are users of a tertiary care centre were the subject of the observational study. Based on diabetes management, clinical information, plus HbA1c values, serum creatinine, and the glomerular filtration rate were documented. Using SPSS 24 and relevant statistical tests for the study, with p<0.05 considered statistically significant, the renal outcomes were examined. Results: One hundred patients signed up to study with ages averaging to 54.2 with an 11.8-year standard deviation. Poorly controlled patients experienced mean eGFR and progression of disease at an elevated rate than their counterparts who exhibited better clinical control. The loss of renal function between groups of glycemic control was different at a significant rate (p=0.01). Conclusion: Uncontrollable symptoms of diabetes cause a large spectrum of diabetic nephropathy cases, having different symptoms and results depending on how well blood sugar levels are controlled. Poorly controlled blood sugar levels of diabetic patients fast pass the process of healthy functioning kidneys becoming diseased and eventually terminally diseased.
Lung adenocarcinoma (LUAD) is the most common subtype of non-small cell lung cancer (NSCLC), exhibiting heterogeneous histopathology, molecular alterations, and variable pulmonary physiology. Early detection and targeted therapy with EGFR inhibitors, such as erlotinib, improve clinical outcomes. Objective: To evaluate the integration of histopathological subtypes, molecular biomarkers, and pulmonary function in detecting LUAD and predicting response to erlotinib. Methods: A cohort of 150 biopsy-confirmed LUAD patients underwent histopathology, immunohistochemistry (TTF-1, Napsin A, Ki-67), and molecular profiling for EGFR, ALK, and KRAS mutations. Pulmonary function tests (FEV1, FVC, DLCO) were performed at baseline. Patients with activating EGFR mutations received erlotinib (150 mg/day), and response was assessed over six months using RECIST criteria. Correlations between histopathology, pulmonary function, biomarkers, and treatment response were analyzed. Results: EGFR mutations were detected in 52% of patients. Histopathological subtypes included acinar (30%), lepidic (20%), papillary (20%), micropapillary (17%), and solid (13%). Erlotinib response was highest in acinar (84%) and lepidic (83%) subtypes; micropapillary and solid subtypes showed limited response (15–24%). Preserved pulmonary function correlated with better response and tolerability. Conclusion: Combining histopathology, pulmonary physiology, and molecular biomarkers enhances LUAD detection and predicts erlotinib response. Acinar and lepidic subtypes with preserved lung function show superior outcomes, supporting an integrated precision oncology approach.
ackground: Aesthetic surgery has seen exponential growth, driven by an interplay between internal psychology and social influences. While these procedures aim to improve physical appearance, their primary success is measured by the patient’s psychological satisfaction. Understanding the relationship between preoperative body image distress and postoperative mental health is vital for surgical efficacy and patient selection. Objectives : To determine the effectiveness of aesthetic surgical procedures in improving body image and psychological health and to identify preoperative psychological markers that predict postoperative patient dissatisfaction and surgical outcomes. Methodology :This prospective study assessed 86 patients at Riphah International University Hospital over one year. Evaluations occurred at initial consultation and eight weeks postoperatively. Validated instruments included the Body Uneasiness Test (BUT) for body image, the General Psychological Health Index (GPHI) for emotional well-being, and the Glasgow Benefit Inventory (GBI) for surgical satisfaction. Data were analyzed to correlate preoperative psychological profiles with postoperative satisfaction and overall mental health improvements across various procedures. Results: A total of 86 patients were included in the analysis, with a mean age of 32.50 ± 8.58 years. At baseline, 41.2% of participants demonstrated clinically significant body image distress, defined by a Global Severity Index (GSI) ≥ 1.3. Postoperatively, psychological health scores showed a statistically significant improvement, increasing from a mean of 14.2 preoperatively to 22.8 postoperatively (p < 0.001). Correlation analysis revealed a strong negative association between preoperative GSI scores and postoperative satisfaction (r = −0.913, p < 0.001), indicating that higher levels of preoperative psychological distress were associated with lower postoperative satisfaction. Subgroup analysis demonstrated that these outcomes were consistent across different types of aesthetic surgical procedures, with no statistically significant variation observed (p = 0.935). Conclusion: Aesthetic surgical procedures significantly improve body image and psychological health in the majority of patients. However, high preoperative body image distress is a primary predictor of postoperative dissatisfaction. Integrating psychological screening into surgical consultations allows clinicians to identify high-risk patients and manage expectations. Collaborative care between surgeons and psychologists ensures technically successful results, which translate into meaningful psychological benefits, ultimately safeguarding the clinician’s reputation and the patient's long-term well-being.
