Objective: To evaluate adherence of platelet transfusion practices to British Society for Haematology (BSH) guidelines – 2024 and identify patterns of non-compliance across clinical settings. Study Design: A descriptive cross-sectional study. Place and Duration of Study: Department of Haematology and Blood Bank, Fauji Foundation Hospital, Rawalpindi, from July 01, 2025 to December 31, 2025. Materials and Methods: A total of 260 patients who received platelet transfusions during the study period were included. Demographic details, clinical diagnoses, indications for transfusion, and requesting departments were recorded. The appropriateness of platelet transfusion practices was assessed in accordance with the 2024 BSH platelet transfusion guidelines. Data were analyzed using SPSS v29. Guideline adherence was classified as adherent or non-adherent, and associations between diagnosis and adherence were assessed using the Chi-square test. Results: Adults constituted 56.2% of study population, whereas paediatric patients accounted for 43.8%. Females constituted 66.5% of the study population. Most platelet transfusions were administered in the NICU (18.1%), followed by oncology units (15.4%), ICU (14.2%), Medical wards (14.2%), paediatric wards (14.2%) and others (23.9%). Overall, 161 platelet transfusions (61.9%) were found to be compliant with the recommended transfusion guidelines, whereas 99 transfusions (38.1%) were identified as non-compliant. Conclusion: Despite reasonable overall compliance, a substantial proportion of platelet transfusions were inappropriate, particularly in non-haematology settings. These findings highlight the need to strengthen transfusion management, to improve guideline adherence, enhance patient safety and optimize platelet utilization.
Objective: This study aimed to determine the effect of various neonatal factors on the serum 17 alpha hydroxyprogesterone (17α-OHP) levels in neonates. Study Design: An observational analytical study. Place and Duration of Study: This study was conducted at the Department of Chemical Pathology of Shifa International Hospital Islamabad, Pakistan from 29th January 2026 to 30thJune 2026. Materials and Methods: The study was conducted on 132 study participants that included healthy neonates as controls and sick neonates as cases. The sample size was calculated using the WHO sample size calculator. Non-probability consecutive sampling techniques were employed. Clinical data of all neonates were collected using a structured data sheet and their serum 17 alpha hydroxyprogesterone levels were measured using a chemiluminescence-based auto analyzer (Maglumi X3, Snibe Diagnostics, China). Statistical analysis was performed on IBM SPSS Software version 26, with the Mann–Whitney U test applied for comparison of continuous variables to determine statistical significance. Results: A total of 132 neonates were included in the study, of which 92 (69.7%) were full-term and 40 (30.3%) were preterm. Among them, 44 (33.3%) were sick and 88 (66.7%) were healthy. 17α-OHP levels were significantly higher in preterm compared to term neonates (p < 0.05), in sick compared to healthy (p < 0.05). Conclusion: The present study supports existing evidence that several neonatal factors are associated with elevated 17α-OHP levels. Therefore, these neonatal factors should be taken into account when interpreting 17α-OHP levels in the neonates.
Objective: To determine the frequency of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae isolated from culture-confirmed pediatric urinary tract infections and to evaluate their antimicrobial susceptibility patterns according to age and sex. Study Design: Analytical cross-sectional study employing consecutive sampling. Place and Duration of Study: Holy Family Hospital, Department of Pediatrics from 1st April 2023 to 1st April 2024. Materials and Methods: Children aged 1 month to 12 years with clinical features of urinary tract infection and a positive urine culture were recruited. Urine specimens were processed for bacterial identification, antimicrobial susceptibility testing and confirmation of ESBL production. Age, sex, isolated organism, ESBL status and antimicrobial susceptibility findings were recorded and analyzed. Results: Among 384 children, 236 (61.5%) were female and 148 (38.5%) were male. Escherichia Coli was the most frequently isolated organism, accounting for 284 (74.0%) cases, followed by Klebsiella Pneumoniae in 62 (16.1%) cases. Of 346 Enterobacteriaceae isolates, 208 (60.1%) produced ESBL. ESBL production was detected in 162 (57.0%) Escherichia coli isolates and 46 (74.2%) Klebsiella pneumoniae isolates. Infections were more frequent among children aged 1 month to <5 years and among females. Resistance was highest to ampicillin, co-amoxiclav and ciprofloxacin, whereas meropenem and fosfomycin retained complete antimicrobial activity. Conclusion: Extended-spectrum beta-lactamase producing Enterobacteriaceae were common among children with urinary tract infections, particularly in younger children and females. The high resistance to commonly prescribed antibiotics supports regular antimicrobial surveillance and culture guided treatment. Routine urine culture and antimicrobial susceptibility testing should be encouraged before initiation of definitive therapy to optimize antibiotic stewardship.
Objective: To compare the prevalence, patterns, and atherogenic indices associated with dyslipidemia among patients with controlled and uncontrolled diabetes mellitus. Study Design: Cross-sectional observational study. Place and Duration of Study: The study was conducted at the Punjab Institute of Cardiology, Lahore, from October 2 to December 29, 2025. Materials and Methods: Fasting blood samples of 503 eligible patients were analyzed for their lipid profiles and HbA1c levels. Participants were grouped into controlled and uncontrolled diabetes groups based on ADA criteria, while dyslipidemia classification was made using NCEP ATP III cutoffs. Clinical characteristics, lipid profile parameters, and atherogenic indices were compared between the two groups using independent t-test for parametric variables while Mann-Whitney U test was employed for non-parametric variables. Logistic regression analysis was used to assess the association of specific dyslipidemia phenotypes with glycemic control status. Results: The overall prevalence of dyslipidemia in the study population was 87.3%, which was significantly higher in the uncontrolled group (89.5% vs. 82.8%, χ²=4.510, p=0.034). Patients with uncontrolled diabetes showed significantly higher median values of HbA1c, triglycerides, duration of diabetes, Castelli Risk Index I and II, atherogenic coefficient, and cardiometabolic index, while HDL-C levels were lower. Uncontrolled diabetes was a strong, independent predictor of the combined dyslipidemia phenotype (OR: 3.43, 95% CI: 1.61–7.31, p=0.001), while LDL-C did not differ significantly between groups. Conclusion: Uncontrolled diabetes mellitus is strongly associated with a more atherogenic lipid profile. Atherogenic indices should be incorporated into routine lipid profile along with a detailed assessment of dyslipidemia patterns, especially in the diabetic population.
Objective: To identify professional attitudes among physical therapy graduates and to find patterns of professional attitudes in relation to academic performance using cluster analysis. Study Design: An analytical cross-sectional study. Place and Duration of Study: Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Thailand between March 01, 2025 to September 30, 2025. Materials and Methods: The study included 65 physical therapy graduates. Participants completed an adapted questionnaire assessing professional attitudes across four domains. Grade point averages (GPAs) were obtained from official academic records. K-means cluster analysis was used to identify clusters based on GPA and professional attitude scores. Cluster characteristics were summarized descriptively, followed by exploratory comparisons using the Kruskal–Wallis test with post-hoc Mann–Whitney U tests. Results: Overall, participants reported favourable attitudes toward the physical therapy profession. Three distinct profiles emerged. The profiles were characterized by lower relative GPA with high attitude scores, higher GPA with high attitude scores, and intermediate GPA with comparatively lower attitude scores. These profiles illustrate that academic performance, and professional attitudes do not necessarily align. Conclusion: The findings indicate variation in professional attitudes across levels of academic performance among physical therapy graduates. These findings highlight the importance of considering professional attitudes alongside academic performance in physical therapy education.
Objective: To determine the site-distribution and relative frequency of head and neck cancers and to study their age and gender distribution and histological types across different anatomical subsites. Study Design: A Retrospective cross-sectional record-based descriptive study. Place and Duration of Study: This study was conducted from July 01, 2020, to December 31, 2024, in the ENT Department, Fauji Foundation Hospital Rawalpindi. Materials and Methods: The record of 305 patients, with age range of 14-79 years, and histologically confirmed cases of head and neck cancers, was reviewed over a period of four and a half years. Data on tumour sites, type, age, and gender were extracted and analyzed using SPSS v26. Descriptive statistics (frequencies and percentages) were calculated for each tumour category, and age was recorded as a range across the study population. Results: Out of total 305 patients, 211 (69.2%) were males, while 94 (30.8%) were females. Oral cavity tumours were the most common, found in 76 cases (24.9%), followed by hypopharyngeal carcinomas, 51 cases (16.7%), oropharyngeal cancers, 47 cases (15.4%), nasal/paranasal carcinomas, 29 cases (9.5%) nasopharyngeal cancers, 27 cases (8.9%), laryngeal cancers, 23 cases (7.5%), salivary carcinomas in 18 cases (5.9%), thyroid carcinomas and neck tumours with unknown primary each 15 cases (4.9%) and aural cancers in 4 cases (1.4%). Conclusion: Head and neck cancers predominantly involved the oral cavity, hypopharynx, and oropharynx, together accounting for nearly two-thirds of all cases. An overall male predominance was observed, consistent with reported regional patterns. However, the near-equal gender distribution of hypopharyngeal cancers among males and females was a noteworthy finding and warrants further investigations through larger multicentre studies to explore potential regional demographic, environmental, and risk factor influences.
Objective: To determine the prevalence of selected traditional cardiovascular risk factors and CKD-related cardiovascular risk-associated abnormalities among patients with chronic kidney disease receiving maintenance hemodialysis. Study Design:Descriptive cross-sectional study. Place and Duration of Study: Department of Nephrology, Shifa International Hospital, Islamabad, from 15 September 2020 to 14 March 2021. Materials and Methods: A total of 150 patients with CKD on maintenance hemodialysis, aged 18–70 years, were recruited using consecutive sampling. Patients with congenital or rheumatic heart disease, chronic liver disease or malignancy were excluded. Demographic and clinical data were collected, and laboratory investigations included complete blood count, serum calcium, phosphate, and HbA1C. Data were analyzed using SPSS version 22.Continuous variables were presented as mean ± standard deviation, and categorical variables as frequencies and percentages. Associations were assessed using chi-square tests, with p ≤0.05 considered statistically significant. Results: The mean age of participants was 51.2 ± 8.4 years; 103 (68.7%) were male and 47 (31.3%) female participants. Hypertension was present in 64.0% of patients, diabetes mellitus in 38.0%, hypocalcemia in 64.7%, hyperphosphatemia in 50.0%, and anemia in 72.0%. Anemia was slightly more prevalent in females (78.7%) than males (68.9%). Diabetes mellitus was significantly more common in males (44.7%) than females (23.4%) (p=0.013). Other risk factors did not show statistically significant sex or age differences. Conclusion: Traditional cardiovascular risk factors and CKD-related abnormalities associated with cardiovascular risk were highly prevalent among patients receiving maintenance hemodialysis. Anemia was the most prevalent CKD-related cardiovascular risk-associated abnormality, followed by hypocalcemia, hypertension, hyperphosphatemia, and type 2 diabetes mellitus.
Communication is a fundamental human right and the cornerstone of learning, employment, social participation and overall well-being. Communication disorders including speech, language, voice, fluency, hearing, and cognitive abilities, affect hundreds of millions of people worldwide. The World Health Organization (WHO) reported that more than 430 million people have hearing loss that is incapacitating, while millions more experience acquired and developmental communication disorders associated with autism spectrum disorder, stroke, traumatic brain injury, Parkinson's disease, dementia and other neurological conditions. Due to a lack of epidemiological data, underreporting, insufficient screening programs and a shortage of speech-language pathologists the actual prevalence in Pakistan is still unknown. Consequently, many people remain undiagnosed or only receive intervention after the most effective period for recovery has been lost. Communication disorders represent a silent burden, making them one of the most overlooked health challenges. In contrast to physical disabilities, communication difficulties such as problems with speaking, understanding, reading, writing, or social communication often go unrecognized which can result in delayed diagnosis, poor academic performance, unemployment, social isolation, psychological distress, and a lower quality of life. The nature of these impairments can make early recognition difficult, complicating clinical assessment and delaying informed decision-making. Artificial intelligence (AI) offers an unprecedented opportunity to make invisible burden visible by identifying early or subtle changes in speech language, and communication abilities that may not be readily observed during traditional clinical assessment. Progress in speech analytics, natural language processing, machine learning, and digital biomarkers can generate objective data to supplement traditional evaluation methods and support more accurate and timely clinical decision making................................
Objective: To assess maternal knowledge, attitudes, and cultural-religious perceptions regarding human milk donation and acceptance of donor human milk among postpartum mothers at a tertiary care hospital in Karachi, Pakistan. Study Design: It was a descriptive cross-sectional study. Place and Duration of Study: Over the course of six months, October 1, 2025, to March 30, 2026, this study was carried out at Pakistan Naval Ship (PNS) Shifa Hospital in Karachi. Materials and Methods: A total of 375 postpartum mothers with infants younger than six months were enrolled using non-probability consecutive sampling. Data were collected using a standardized intervieweradministered questionnaire covering sociodemographic characteristics, obstetric history, knowledge, attitudes, and cultural-religious perceptions regarding human milk donation and milk banking. Descriptive statistics and Chi-square test were used for data analysis, with p<0.05 considered statistically significant. Results: A total of 375 postpartum mothers participated in the study, with a mean age of 28.73 ± 4.43 years. Awareness of human milk banks was reported by 169 (45.1%) mothers, while 209 (55.7%) believed donor human milk was more nutritious than formula milk. Most participants (321; 85.6%) expressed concerns regarding infection transmission through donor milk, and 342 (91.3%) were aware of the concept of milk kinship (Rada'a). Only 82 (21.9%) mothers were willing to donate breast milk, and 49 (13.1%) were willing to receive donor human milk for their infants, indicating low acceptance despite moderate awareness. Conclusion: Despite moderate awareness of human milk banking, willingness to donate or receive donor human milk remained low among postpartum mothers. Fears of infection and cultural-religious concerns were the principal barriers to acceptance.
Objective: To explore undergraduate medical students' perspectives on the adoption of electronic portfolios (e-portfolios), focusing on perceived benefits, challenges, and influence on learning and professional growth. Study Design: A convergent mixed-methods design was employed. Place and Duration of Study: Bahria University College of Medicine, Bahria University Health Sciences Campus, Islamabad, Pakistan, from May 27, 2025 to January 30, 2026. Materials and Methods: All 100 first-year MBBS students were invited through census sampling and all participated. A structured questionnaire assessed awareness, perceptions, perceived benefits, and barriers to e-portfolio use. Semi-structured interviews with 21 purposively selected students explored these experiences in greater depth. Quantitative data were analysed using descriptive and inferential statistics; qualitative data underwent thematic analysis. Results: Only 8% of students used the institutional e-portfolio. Educational background was not associated with use (Fisher's Exact Test, p = 1.000). Overall perceptions were positive (mean composite score 23.84 of 30): 63% high, 36% moderate, and 1% low. Female students scored higher than male students on the Mann- Whitney U test (p = 0.042), although this should be interpreted cautiously because the parametric analysis was not significant (Welch's t-test, p = 0.069). Lack of awareness (42.4%) was the commonest barrier, followed by perceived irrelevance to undergraduate education (19.0%) and uncertainty regarding expected use (12.9%).p Greater support and guidance (46.8%) and evidence of educational benefit (26.0%) were the measures most often endorsed to encourage future use. Thematic analysis generated four themes: Knowledge Acquisition and Self-Awareness, Skill Development and Reflective Practice, Learning from Mistakes and Growth Mindset, and Necessary Support Structures. Conclusion: Medical undergraduates held predominantly positive perceptions of e-portfolios despite limited experience of their use. Improving awareness, structured orientation, faculty support, and curricular integration may enhance meaningful adoption in undergraduate medical education.
Objective: This study aimed to find out the frequency, microbiological profile, pattern and predictors of wound site infections comparing emergency and elective midline laparotomy. Study Design: Prospective comparative observational study. Place and Duration of Study: was conducted in Department of General Surgery Hayatabad Medical Complex, Peshawar from 1 February 2024 to 30 September 2025. Materials and Methods: The complete data was collected on a standardized proforma. Patients were operated and post-operative data was collected during follow-up for one months. Results: Among 328 patients, 200 (60.9%) underwent emergency and 128 (39.1%) elective laparotomies. Baseline demographics, ASA class, and comorbidities were comparable between groups. Emergency surgeries had longer operative duration (p < 0.001), higher peritoneal contamination (63% vs. 3.1%) (p < 0.001), more contaminated/dirty wounds (p < 0.001), and greater ICU admission (37.5% vs. 17.1%) (p < 0.001). Surgical site infection (SSI) was significantly higher after emergency surgery (17.0% vs. 7.8%), with more superficial and deeper or organ-space infections (p < 0.001). Emergency cases also showed higher rates of reoperation, readmission, 30-day mortality (5.5%), and longer hospital stay (8.7 ± 4.7 vs. 6.9 ± 1.9 days). Conclusion: Surgical site infections were frequently higher in emergency laparotomy than in elective laparotomy, driven by contamination, wound class, and operative complexity. Several risk factors in emergency signify risk of SSI, like contamination, prolonged operative duration and intra-abdominal sepsis.
Objective: This study aims to ascertain the prevalence of thrombotic disorders and thrombophilia profile among patients in Northern Pakistan. Study Design: Cross sectional descriptive study. Place and Duration of Study: This study was conducted at the department of hematology, Shifa International Hospital, Islamabad, Pakistan from 1st June 2024 to 31st July 2025. Materials and Methods: Ethical approval was obtained from the Institutional Review Board (IRB) prior to commencement of the study. The sample size was calculated using the WHO sample size calculator, considering a confidence level of 95% and anticipated prevalence of 2.5%. Non- probability consecutive sampling technique was employed. Data were collected using a structured proforma and analysed using SPSS version. Results: Out of the 926 patients, there were 256 patients with portal vein thrombosis (PVT) (27.6%), 192 with stroke (20.7%), 160 with Deep vein thrombosis (DVT) (17.2%), mesenteric thrombosis 124 (13.3%) and 94 with Pulmonary embolism (PE) (10.1%) remaining 100 were presented with minor thrombotic episodes. Thrombophilia profiles revealed that 368 patients had protein S deficiency, 298 had anti-thrombin deficiency, 146 had protein C deficiency, and 114 patients had an activated protein C resistance. A total of 50 thrombotic disorders patients underwent molecular testing, out of which 10% were heterozygous for the Factor V Leiden mutation. 2% were homozygous for the Prothrombin (Factor II) mutation, and 88% did not exhibit any mutation. Conclusion: According to this study, Protein S and anti-thrombin deficiencies are the most common deficiencies among thrombotic disorders patients in northern Pakistan. The prevalence of undetected site thrombosis, such as PVT, was higher than reported globally.
Drugs of Abuse (DOA) group includes drugs ranging from therapeutic drugs e.g., benzodiazepines, opioids to illegal drugs e.g., Phencyclidine, lysergic acid diethylamide etc. Prevalence of DOA is on the rise in our society.1 According to United Nations Office of Drugs and Crime(UNODC) there are 6.7million drug users in Pakistan which also happens to be the largest consumer of heroin in south east Asia.2 Besides addiction, drug abuse is linked to a variety of health problems, including HIV/AIDS, cancer, heart disease, and many more. It is also linked to homelessness, crime, and violence. In essence, DOA addiction is costly to both individuals and society. Keeping in view the increasing use of DOA in our society, its testing has become an indispensable service in modern laboratories and many large or medium sized medical laboratories in Pakistan are involved in DOA testing. From emergency departments and workplace compliance programs to pain management clinics and forensic investigations, laboratories play a central role in detecting these drugs that can impair judgement, threaten safety or contribute to morbidity and mortality. However, as new patterns of substance of abuse evolve and analytical technologies advance, laboratories face mounting scientific, operational, ethical and regulatory challenges in delivering accurate and clinically meaningful results. One of the most pressing challenges is the rapid proliferation of new psychoactive substances leading to shifting in patterns of drug abuse.3 Synthetic cannabinoids, designer stimulants, novel benzodiazepines and synthetic opioids like fentanyl analogues have complicated traditional testing paradigms. Standard immunoassay screening panels that are designed to detect common drugs like opiates, cannabinoids, cocaine, amphetamines, benzodiazepines and barbiturates often fail to identify newer compounds or cross react unpredictably. This puts the laboratories under pressure to develop and validate methods for the new drugs that have joined the DOA menu.........................
The education of health professionals is at a critical pedagogical crossroads that requires urgent attention. The student population of most current medical, dental, nursing, and allied health schools is made up of Generation Z: students born from 1997 to 2012. They demonstrate radically different thinking patterns, the way they engage, and what they learn compared to previous generations. The so-called 8-second brain generation, often referred to in literature, is a manifestation of short attention spans among Gen Z, likely conditioned by their digital upbringing, being mesmerized by streams of information and multimedia flowing rapidly. Although this tag begs to be oversimplified and generalized, it is true to a significant pedagogical fact: students today do not receive, process, and prioritize information in the same way as past generations did. The traditional pedagogical practices, which are based on didactic lectures, passive learning, and delayed feedback, constitute a significant part of the curriculum delivered. Such approaches are becoming less in harmony with the changing learning environment that modern learners are taking. It is not the lack of attention span or discipline, but rather the learned adaptive cognitive strategies used in the information saturated environment in Gen Z. Instead of viewing generational traits as an obstacle to interdisciplinary teaching and learning, the educators can exploit normalizing behaviour as the chance to establish new forms of exploration, motivate more personal investment in the learning process, promote clinical reasoning and promote adaptive expertise..................
Objective: To describe the institutional pattern of histologically confirmed malignancies managed surgically at a tertiary care hospital in Gilgit-Baltistan (GB), Pakistan, and to identify the need for structured cancer surveillance in the region. Study Design: Retrospective record-based descriptive analysis. Place and Duration of Study: Department of General Surgery, Shaheed Saif ur Rehman Government Teaching Hospital, Gilgit, 1st January 2021 – 31st December 2024. Materials and Methods: Records of patients with confirmed malignant tumors treated surgically during the study period were reviewed. Tumor sites were classified using ICD-10 codes and histological diagnoses verified from pathology reports. Descriptive statistics were applied to summarize demographic and tumor characteristics. Association between gender and tumor site was analyzed using the Chi-square test. Results: One hundred twenty-one surgically managed malignancies were included (mean age 52.4 ± 14.8 years; male-to-female ratio 1.05:1). The most frequent tumor sites were stomach (18.1%), skin (15.7%), retroperitoneum/peritoneum (15.7%), colorectal (9%), breast (9%), and ovary (8.2%). Gastrointestinal malignancies collectively constituted 35.3% of cases. Adenocarcinoma was the predominant histological subtype in gastrointestinal cancers. The annual number of cases treated increased over the four-year period, reflecting expanding surgical capacity. Conclusion: These findings represent hospital-based case distribution rather than population-level incidence. Establishment of a regional cancer registry is essential to generate reliable epidemiological data for health planning in Gilgit-Baltistan.
hypercoagulability and metabolic stress. Anaesthetic management in adult patients undergoing non-ocular surgery has rarely been reported. We describe the anaesthetic management of a 29-year-old man with homocystinuria, marfanoid features, and dystonia who underwent elective orthopaedic foot surgery. Perioperative care focused on minimizing thromboembolic and metabolic risks through reduced fasting duration, maintenance of normothermia and adequate hydration, avoidance of nitrous oxide, and use of mechanical thromboprophylaxis. General anaesthesia was administered using a laryngeal mask airway with sevoflurane and atracurium. The intraoperative and postoperative courses were uneventful, and the patient was discharged on the same day of the surgery. This case highlights that with careful, physiologically guided planning, safe anaesthesia can be achieved in adult patients with homocystinuria, even in resource-limited settings.
Objective: This study aimed to determine the molecular subtypes of breast cancer using immunohistochemistry and to assess their distribution in the study population. Study Design: It was a retrospective observational study. Place and Duration of Study: The study was done at Combined Military Hospital, Quetta, from January 2022 to May 2025. Materials and Methods: The study included 105 patients with complete histopathological data. The data was analysed using SPSS version 20, and employing chi-square tests to evaluate their associations. Statistical significance was determined at p-value < 0.05. Results: Among the 105 cases, Invasive Ductal Carcinoma (IDC) was most common (89.5%, n=94), followed by Invasive Lobular Carcinoma (ILC) (4.8%, n=5) and Mucinous Carcinoma (3.8%, n=4). Rarer types included Metaplastic carcinoma and Medullary carcinomas. IHC-based molecular subtyping revealed Luminal A as the predominant subtype (40%, n=42), followed by Luminal B (24%, n=26), Triple-Negative Breast Cancers, TNBCs (19%, n=20), and HER2-enriched (16.2%, n=17). These subtypes were correlated with the patient's age, histological grade, and proliferation index. Conclusion: Luminal A emerged as the most common molecular subtype, typically presenting with a lower histological grade than Luminal B, HER2-enriched, and TNBCs. Most lobular carcinomas were Luminal A type. TNBCs were high-grade, more frequent in younger patients, while other subtypes were common in older age groups. Utilizing IHC markers for molecular subtyping can enhance prognosis and facilitate targeted therapies for improved patient outcomes.
Objective: To determine the proportion and laboratory-identified mechanisms of pseudothrombocytopenia among patients with automated platelet counts <100 × 10⁹/L in a tertiary care hospital. Study Design: Descriptive Cross-sectional study Place and Duration of Study: This study was conducted in the Department of Pathology, Fauji Foundation Hospital Rawalpindi, from January 01, 2025, to June 30, 2025. Materials and Methods: All patients undergoing complete blood count analysis during the study period with an automated platelet count below 100 × 10⁹/L were included. Peripheral blood smears were examined to classify the subtypes of thrombocytopenia into true thrombocytopenia and pseudothrombocytopenia, including platelet clumping, giant platelets, and abnormal platelet distribution. Data was analyzed using SPSS Statistics version 29.0. Chi-square test was applied for categorical variables, and p-value < 0.05 which is considered statistically significant. Results: Out of total 755 blood samples, morphologically consistent with true thrombocytopenia (absence of smear artefacts) accounted for the majority of cases (70.7%). Among the 221 cases of pseudothrombocytopenia (29.3%), platelet clumping was the most frequent cause (19.7%), followed by giant platelets (7.9%) and abnormal platelet distribution (1.6%). Conclusion: Pseudothrombocytopenia remains a frequent laboratory artefact in patients with low automated platelet counts. Accurate classification through systematic peripheral blood smear evaluation is essential to differentiate pseudothrombocytopenia from true thrombocytopenia. Implementation of standardized laboratory verification practices supports reliable platelet count reporting and enhances patient safety.
Objective: The present study aimed to explore final-year undergraduate dental students' learning experiences and their perceived enablers and barriers during the post-COVID-19 transitional phase from online to onsite education. Study Design: A qualitative case study design using focus group discussions was employed in accordance with the Consolidated Guidelines for Reporting Qualitative Research (COREQ) checklist. Place and Duration of Study: Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, from April 2022 to June 2023. Materials and Methods: Homogeneous convenience sampling was used to identify final-year undergraduate dental students currently enrolled at AIMST University Malaysia. Eighteen dental students were recruited and randomly assigned to three groups. They were invited for an online discussion through the recorded Zoom platform. The focus group discussions were audio-recorded and transcribed verbatim. Thematic analysis was performed using an inductive approach. Results: Three major themes were discovered: (1) Perception of learning facilitating experiences, (2) Perceptions of learning impeding experiences, and (3) Factors influencing learning during transition. The first major theme is divided into five sub-themes: clinical hands-on, treating 'real' patients, knowledge acquisition and understanding, teaching quality, and social interaction. Meanwhile, two sub-themes emerged from the second major theme: expectation and challenging schedule. Finally, the third major theme is divided into six sub-themes: adaptability, confidence and readiness; changes in availability of support; lifestyle; communication; and technical. Conclusion: Undergraduate final-year dental students reported both facilitating and impeding learning experiences during the COVID-19 transitional period. Dental educators should tailor the current dental education and pedagogical structures to suit the needs and demands of dental students when the country has fully entered the endemic phase.
Objective: To determine the angiographic patterns and severity of coronary artery disease (CAD) in patients aged ≤50 years presenting with acute coronary syndrome (ACS) at a tertiary care hospital. Study Design: Hospital based cross sectional analytical study. Place and Duration of Study: Department of Cardiology, PAEC General Hospital, Islamabad, from January 1 and June 30, 2025. Materials and Methods: Consecutive patients aged 30–50 years presenting with STEMI, NSTEMI, or unstable angina who underwent coronary angiography were enrolled. Demographic characteristics, cardiovascular risk factors, and angiographic findings were recorded. Data were analyzed using SPSS version 26.0. Associations between risk factors and CAD severity were assessed using the chi-square test, with p <0.05 considered statistically significant. Results: Ninety patients were included (mean age 44.94 ± 3.94 years), with 67.8% males. STEMI was the most frequent presentation (74.4%), followed by unstable angina (16.7%) and NSTEMI (8.9%). After angiography single-vessel disease was observed in 37.8% of patients, double-vessel disease in 22.2%, triple-vessel disease in 11.1%, 28.9% had normal coronary arteries. Hypertension (55.6%) and smoking (40%) were the most prevalent risk factors. Conclusion: Among young adults presenting with ACS, STEMI is the predominant clinical presentation, and single-vessel CAD is the most frequent angiographic pattern. A considerable proportion had normal coronary arteries, highlighting the need for further evaluation of non-obstructive mechanisms in young ACS patients.
