Objective: To compare the outcome of inhaled salbutamol versus placebo, in addition to standard treatment, among neonates with TTN. Study Design and Setting: A cross-sectional study was conducted in the Neonatal Unit, Department of Pediatrics Medicine, Abbas Institute of Medical Sciences, Muzaffarabad, over six months (14-Feb-2025 to 13-August-2025). Methodology: The study included a total of 80 neonates who fulfilled the inclusion criteria. Neonates were divided into two groups in accordance with the treatment given to them as part of standard clinical treatment: inhaled salbutamol or nebulized normal saline. Descriptive analysis was performed using SPSS version 25. Quantitative variables were given as mean ± standard deviation, while qualitative variables were reported as frequencies and percentages. An independent sample t-test was conducted to compare outcomes between the two groups. Statistical significance was defined as p=0.05. Results: The duration of oxygen therapy was significantly shorter in the salbutamol group (32.75 ± 2.12 hours) compared to the control group (78.20 ± 2.77 hours; p = 0.001). Similarly, the mean length of hospital stay was significantly reduced in the salbutamol group (3.05 ± 1.15 days) compared to the control group (5.78 ± 1.00 days; p = 0.001). Conclusion: Inhaled salbutamol, in addition to standard treatment significantly reduced the length of oxygen withdrawal and length of hospital stay in neonates with TTN. It might therefore represent effective adjuvant therapy to enhance the outcome and lessen the burden on hospitals of infants with the condition
Objective: To compare the outcomes of monopolar electrocautery and ultrasonic gallbladder dissection from the gallbladder bed during laparoscopic cholecystectomy in term of gallbladder perforation. Study design and setting: This comparative, cross-sectional study conducted in the Department of Surgery, PAF Hospital Mushaf, Sargodha, from August 2021 to December 2022 after obtaining ethical committee approval. Methodology: A total 320 patients with cholelithiasis undergoing laparoscopic cholecystectomy were divided into two groups. In group A, the dissection of gallbladder from its bed was done with an ultrasonic device that is harmonic scalpel, while in group B, conventional monopolar electrocautery was used. Patients were assessed for gall bladder perforation. A p-value < 0.05 was considered statistically significant. Results: Out of 320 laparoscopic cholecystectomies, gallbladder perforation occurred in 7 (4.4%) patients in Group A and 28 (17.5%) patients in Group B, a difference that was statistically significant (p < 0.001). The mean age was 29.08 ± 8.09 years in Group A and 32.49 ± 9.36 years in Group B (range 20–45 years), with no statistically significant difference between the groups (p = 0.481). The male-to-female ratio was 1:4.5 in Group A and 1:7 in Group B, with no significant difference between the groups (p = 0.792). Conclusion: This study revealed that a significantly lower frequency of gall bladder perforation with ultrasonic dissection as compared to monopolar diathermy among patients undergoing laparoscopic cholecystectomy. This can ultimately reduce the early and long-term complications of bile spillage and stone loss in peritoneal cavity.
Objective: To compare Foveal Avascular Zone (FAZ) metrics comprising of FAZ area, perimeter and circularity between individuals afflicted with diabetic retinopathy and those exhibiting healthy, normal retinal profile by using built in algorithm of Optical coherence tomography angiography (OCT-A) Study Design and Setting: It was an observational study. Conducted at the Ophthalmology Department, PNS Shifa Hospital, Karachi from October 2023 to December 2024. Methodology: 60 patients participated which included 30 type 2 diabetics with mild to moderate non proliferative diabetic retinopathy (NPDR), without macular involvement and 30 non diabetics age matched normals. FAZ parameters of OCTAngio Optopol revo nx130 (Area, Circularity and Perimeter) were calculated and compared between two groups using automated built in software. FAZ parameters of mild and moderate NPDR were compared within diabetic group. Results: Mean age in diabetics was 55.33 ± 6.85 years and in non-diabetics 55.30± 4.94 years. On comparison of FAZ parameters the area and perimeter were statistically significantly enlarged as compared to non-diabetics FAZ parameters (p < 0.001). The circularity index was lower among diabetics as compared to non-diabetics (p < 0.001). Among the diabetic patients there was a statistically significant enlargement of FAZ area in moderate NPDR versus mild NPDR (p <0.001) and difference of FAZ perimeter (p = 0.07) and circularity index (p =0.60) were statistically insignificant. Conclusion: Diabetic patients with mild to moderate NPDR having clinically normal appearing maculae show deranged FAZ parameters on OCT-A as compared to age matched normal healthy retinae
Objective: To evaluate the association between carotid intima-media thickness (CIMT) with the extent of angiographically proven coronary artery disease (CAD). Study Design and Setting: A cross-sectional study was conducted at Khyber Teaching Hospital (KTH), Peshawar. Methodology: The study included 65 patients receiving diagnostic coronary angiography and was conducted from 1st April 2025 to 30th September 2025. Cardiovascular risk factors were among the baseline clinical and demographic features that were documented. High-resolution B-mode ultrasonography was used to measure CIMT. The degree of CAD was classified as either no CAD, single-vessel, two-vessel, or three-vessel disease, and its severity was measured using the Gensini score. Regression and correlation models were used to examine relationships between CIMT and angiographic results. The diagnostic accuracy of CIMT for predicting obstructive CAD was assessed using receiver operating characteristic (ROC) curve analysis. Results: The mean age of participants was 56.2 ± 9.8 years, with 64.6% males. Obstructive CAD was present in 75.4% of patients. CIMT increased progressively with the extent of CAD, from 0.68 ± 0.10 mm in patients without CAD to 1.02 ± 0.13 mm in those with three-vessel disease (p < 0.001). CIMT showed a strong positive correlation with the Gensini score (p < 0.001). ROC analysis demonstrated good diagnostic accuracy (AUC = 0.82). Conclusion: CIMT is a reliable, non-invasive marker that correlates with the severity of CAD and can aid in early risk stratification and clinical decision-making
n the modern age, humanity faces a profound paradox, while medical technology has advanced with unprecedented speed, the global burden of chronic diseases continues to climb. Conditions such as diabetes mellitus, cardiovascular disease, obesity, cancer and mental health disorders have reached epidemic proportions. According to the World Health Organization, non-communicable diseases account for 75% of all non-pandemic related deaths globally in the year 2021, many of which are preventable through modifications in behavior and environment.
Objectives: The comparative clinical and functional effectiveness of dynamic hip screw and proximal femoral nailing for fixation of intertrochanteric femoral fractures in Pakistan. Study Design and Setting: A hospital-based prospective analytical study was undertaken in a tertiary care hospital of Pakistan, where intertrochanteric fractures constitute a growing burden among older adults and both fixation techniques are routinely employed in resource-constrained clinical environments. Methodology: In this hospital-based prospective analytical study, 256 patients aged 40–80 years with intertrochanteric fractures were enrolled and allocated to DHS or PFNA groups (n=128 each). Functional outcomes were assessed using the Harris Hip Score (HHS) at six months. Biochemical, clinical, and demographic variables were recorded. Statistical tests included t-test, Mann–Whitney U, chi-square, and logistic regression using SPSS v26, with significance set at p<0.05. Results: PFNA fixation resulted in significantly higher HHS (84.6 ± 7.5 vs. 78.3 ± 8.2: p < 0.001), shorter operative time (65 [58–77] vs. 82 [70–94] min: p < 0.001), and fewer postoperative infections (5.1% vs. 13.9%: p = 0.047) than DHS. PFNA patients had shorter hospital stays and better pain and ambulation outcomes. Radiological union was more frequent in PFNA but not statistically significant (p = 0.124). Logistic regression identified PFNA as an independent predictor of good functional recovery (OR = 2.78: p = 0.003). Conclusion: PFNA was associated with superior short-term functional outcomes, reduced surgical morbidity, and fewer complications compared to DHS. These findings support its preferential use in intertrochanteric fracture management within low-resource settings.
Objective: To assess the accuracy of PRISM III score in predicating mortality in severely ill pediatric patients. Study Design and Settings: A cross sectional study was conducted in Pediatric ICU of BVH from 1st March 2021 to 28 Feb 2022. Methodology: Patients were enrolled after informed consent as per inclusion and exclusion criteria. Clinical details and lab data were collected within 4 hours of admission to ICU and documented on performa. Outcome was followed. Results were analyzed in spss 20. Results: Out of 34 patients 13 (38.2 %) were male and 21 (61.8 %) were females. Age ranges from 1 month to 14 years. Regarding diagnosis maximum patients were of pneumonia and Pyomeningitis, that were 5 each this makes 14. 7% of study population for each diagnosis. PRISM score ranges from 0 to 14 with mean of 4.3 and median of 3. Out of them 21 (61.8 %) had PRISM score 3 or less and 13 (38.2 %) had 4 or more. PRISM III score has Sensitivity of 71.4 %, specificity of 70.3 %, Positive predictive value of 38.4 %, negative predictive value 90.4% and diagnostic accuracy of 20.5 %. Conclusion: PRISM III score has clinical accuracy of 20.5 % in determining prognosis in severely ill pediatric patients
Neurofibromatosis (NF) is a hemartoneoplastic syndrome with up to eight possible variants. By far NF Type I is the most common presentation. A 74 years old gentleman present at our dermatology OPD with history of asymptomatic progressive nodular lesions appearing on his left arm only for past 4 years. The family history was insignificant and examination revealed soft pedunculated skin-colored nodules of varying sizes distributed primarily over flexor aspect of left arm. There were no associated pigmentary changes or lisch nodules. Excisional biopsy reveled a well-circumscribed nodular lesion in dermis composed of multiple spindle cells packed loosely in myxoid stroma with scattered mast cells. Late onset NF (NF-VII) and segmental NF (NF-V) are rare variants of this genetic disorder. We present a very unique case of late onset NF which presented with segmental distribution in his 7th decade of life representing an overlap of Type VII and type V sub-types.
Objective: To evaluate the results of the traditional thread ligation technique against the vessel sealing system employed in axillary dissection for breast cancer, focusing on the average postoperative drain output and the mean duration until drain removal. Study Design and Setting: This study was carried out at the Gujranwala Medical College/District Headquarters Hospital. A total of 120 patients were enrolled in this study following the inclusion criteria. A Non-probability consecutive sampling technique was used to divide patients into two groups. Results: In this study the mean age and BMI in Group A were 52.78 ± 10.06 years and 26.88 ± 3.94 kg/m² respectively. Similarly, the mean age and BMI in Group B were 50.27 ± 11.77 years and 29.08 ± 4.12 kg/m², respectively. In this study the mean drain removal days in the conventional group were 5.05 ± 0.81 and in the ligasure group were 4.75 ± 0.77, with the p-value being as significant as 0.040. Similarly, the mean drain fluid in the conventional group was 640.33 ± 59.80 ml and in the ligasure group was 487.83 ± 27.38 ml, p-value < 0.01. The stratification of the age with respect to drain fluid showed significant differences for all age groups, i.e., p-value < 0.01 except for age group 18-28 years, p-value 0.371. Conclusion: Axillary lymph node dissection utilising the results in a reduction in mean postoperative drain output and the average duration until drain removal compared to the traditional thread ligation technique
Objective: This study aimed to assess the diagnostic accuracy of CRP as a predictor of readmission for acute exacerbations of chronic obstructive pulmonary disease (AECOPD), with 30-day readmission as the gold standard. Study design and setting: A prospective observational study was carried out at the Institute of TB and Chest Medicine, Mayo Hospital, Lahore, over six months from April 2025 to September 2025. Methods: A total of 201 patients aged 40–70 years with a confirmed diagnosis of COPD, as per GOLD 2025 guidelines, and presenting with AECOPD were enrolled using a non-probability consecutive sampling technique. Serum CRP levels were measured on admission using the Spectra 1000 analyzer. Participants were followed for 30 days post-discharge to record readmissions. Data were analyzed using SPSS version 27.0. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CRP =15.8 mg/dl for predicting 30-day readmission were calculated. Results: The mean age of participants was 53.80 ± 8.99 years, with 56.7% males. The mean CRP level was 16.37 ± 19.46 mg/dl. Higher CRP levels were significantly associated with advanced GOLD stages (p < 0.001). Overall, 30.8% experienced 30-day readmission. CRP = 15.8 mg/dl predicted readmission with sensitivity 70.9%, specificity 75.5%, and diagnostic accuracy 74.1% (p < 0.001). Conclusion: Elevated CRP is significantly associated with COPD severity and early readmission, suggesting its role as a useful prognostic biomarker for AECOPD management. CRP could serve as a simple, inexpensive biomarker for identifying high-risk patients and guiding post-discharge management to reduce readmissions
Objective:To determine the fetal outcome after prophylactic therapy with low molecular weight hepain and aspirin in pregnant woman with recurrent pregnancy loss (antiphosholipid syndrome) Study Design and Setting: This is retrospective observational study conducted in Department of obstetrics and gynecology at Indus hospital Karachi from 20 December 2016 to 30 September2022. Methodology; The study group include 39 pregnant woman with antiphophospholipd syndrome (recurrent pregnancy loss) presented at Sheikh Saeed campus of Indus Hospital Karachi from 2016 to 2022. Patients were diagnosed with APLS on the basis of Sapporo clinical criteria for aPLS. All these patients were treated with prophylactic therapy with aspirin and low molecular weight heparin throughout pregnancy. The primary outcome was live birth. Statistical analysis was done through SPSS version 26. Result: Prophylactic therapy with low molecular weight heparin and aspirin in pregnant woman with recurrent pregnancy loss has a significant impact on the fetal outcome. 79.5% delivered alive babies. 12.8 % experienced miscarriage. 2.6 % had termination of pregnancy due to congenital malformation. 5.2% were unable to follow-up. Conclusion; Prophylactic therapy with low molecular weight heparin and aspirin has significantly improved live birth rate (79.5%) in patients with recurrent pregnancy loss with antiphospholipid syndrome
Objective: To compare the outcomes of topical phenytoin vs normal saline (NS) dressings to treat diabetic foot ulcer (DFU). Study Design and Setting: Quasi-experimental study conducted in the Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from January 2024 to June 2024. The study was carried out under standardized clinical protocols, and all patients were managed in a uniform hospital environment to minimize variability in treatment practices and ensure consistency in outcome assessment. Methodology: One hundred and ten (110) patients were segregated into two equal groups; (1) Phenytoin dressings group, (2) NS dressings group. Outcomes of these groups were compared. A statistical package for Social Sciences (SPSS) version 23 was utilized to assess the results. Data regarding demographic variables, clinical presentation, and wound characteristics were collected systematically using a structured proforma, and all patients were followed regularly to monitor progress and response to treatment. Results: One hundred and ten (n=110) patients were equally segregated into two groups. In the Phenytoin group, 50(90.90%) patients had improvement in wound (reduction in Wagner Grade) and in NS group 40(72.72%) patients had wound improvement (p-value 0.01). In the Phenytoin group, 2(3.63%) patients developed local complications and in NS group 7(12.72%) patients had local complications (p-value 0.08). In the Phenytoin group, 46(83.63%) patients had complete healing and in NS group 37(67.27%) patients had complete healing (p-value 0.04). Additionally, patient satisfaction was higher in the Phenytoin group, reflecting better overall acceptance of the treatment modality. Conclusion: Phenytoin dressings were found to be more effective as compared to NS dressings in promoting healing in DFU, with improved clinical outcomes and higher patient satisfaction
Objective: To compare the efficacy of combined treatment with Ketoconazole 2% Cream and Adapalene 0.1% Gel versus Ketoconazole 2% Cream monotherapy in Pityriasis Versicolor. Study design and Setting: Randomized Controlled Trial conducted at Dermatology Department of PNS Shifa, Karachi from 19th July 2024 to 30th July 2025. Methods: A randomized trial included 176 patients with Pityriasis Versicolor (88 per group). Group A received ketoconazole 2% cream twice daily plus Adapalene 0.1% gel nightly for 4 weeks, and Group B received ketoconazole alone. Efficacy at week 4 was defined by clinical improvement, negative Wood’s lamp, and KOH microscopy. Data were analyzed in SPSS v26 using chi-square test; Means and standard deviations were calculated for continuous variables (age, BMI, disease duration), while frequencies and percentages were reported for categorical variables (gender, efficacy). The chi-square test was used to compare efficacy between groups, p<0.05 was considered significant. Results: The mean age in Group A was 25.1 ± 4.0 years and in Group B was 25.8 ± 4.2 years. The majority of patients were male, and the distribution of types of pigmentation was comparable in both groups. The efficacy of combination therapy (Group A) was 89.8%, compared to 43.2% with monotherapy (Group B), demonstrating a statistically significant difference (p < 0.001). Conclusions: Combination therapy with ketoconazole and adapalene was significantly more effective than ketoconazole monotherapy in the treatment of Pityriasis Versicolor
Objectives: To evaluate liver function test abnormalities in patients with dengue infection and determine whether elevated alkaline phosphatase (ALP) levels are associated with mortality and adverse clinical outcomes. Study Design and Setting: A prospective, descriptive observational study conducted over four months, from April 2 to July 31, 2022, at PNS Shifa Hospital (BUHSC). Methodology: Demographic, clinical, and laboratory data of confirmed dengue patients were recorded using a structured proforma. Liver function parameters including alanine aminotransferase (ALT), alkaline phosphatase (ALP), and serum bilirubin were analyzed. Data were entered and analyzed using SPSS version 29. Results: The study included 135 patients with a mean age of 30.9 ± 12.1 years: the majority (60.7%) were under 30. Liver involvement was common, with 64 patients (48.8%) exhibiting liver function test abnormalities. Among these, 27 (42.2%) had elevated ALT, seven (10.9%) showed increased bilirubin, and 30 (46.9%) had elevated ALP. Most patients (83%) maintained normal bilirubin levels, with a mean bilirubin level of 11.7 ± 8.6 µmol/L. Mean ALT was 107 ± 240 IU/L, and mean ALP was 113.6 ± 59.9 IU/L, both above normal ranges. Among liver function parameters, elevated alkaline phosphatase (ALP) levels showed a statistically significant association with mortality (Pearson’s r = 0.282, p = 0.01), whereas ALT and bilirubin levels were not significantly associated with death. Conclusions: Hepatic dysfunction is a frequent finding in dengue patients, with elevated ALP positively correlating with mortality. Although ALT and bilirubin abnormalities are often observed, they do not significantly predict patient outcomes.
Objective: To compare uterine artery flow parameters in women with Recurrent Spontaneous Abortion (RSA) and a control group among females presenting at a tertiary care hospital. Study Design and Settings: The study was conducted at the Department of Obstetrics and Gynecology for uterine artery flow parameters in women with Recurrent Spontaneous Abortion (RSA) and a control group. Methodology: 100 participants were included, with 50 in each group. The case group comprised women with RSA, defined as three or more consecutive pregnancy losses before the 20th week of gestation, while the control group consisted of women with uncomplicated pregnancies and at least one child born at term. Data were collected on demographic and clinical variables, including age, parity, and BMI. Uterine artery flow parameters, including Pulsatility Index (PI) and Resistive Index (RI), were assessed via Doppler ultrasound, and the results were subjected to statistical analysis using SPSS. Results: The study revealed that mean age, BMI, and median parity were similar in both groups. However, the PI and RI were significantly higher in the RSA group. The receiver operating characteristic (ROC) curve analysis demonstrated high diagnostic accuracy, with an area under the curve (AUC) of 88.6% for PI and 79.4% for RI, further emphasizing their potential as predictors of RSA. Conclusion: Uterine artery blood parameters may serve as potential predictors for identifying women at risk of RSA
Meditation affects neuroplasticity through synaptic pathways, prefrontal–limbic regulation, autonomic and biochemical systems. Randomized or controlled meditation interventions with at least one neuroplasticity related outcome published from January 2018 to April 2025 were included. Data extraction and synthesis were performed independently and combined by random-effects model. Eight studies met criteria for quantitative pooling. Structural changes included prefrontal and hippocampal plasticity (pooled SMD = 0.40, 95% CI: 0.20–0.60). Functional neuroplasticity included improved attentional network activity and decreased DMN dominance (SMD = 0.48, 95% CI: 0.25–0.70). Physiological markers demonstrated a positive trend (SMD = 0.60, 95% CI: 0.35–0.85). Higher BDNF and lower inflammatory indices were noted (SMD = 0.55, 95% CI: 0.30–0.80). Psychological outcomes and cognitive functions improved (SMD = 0.50, 95% CI: 0.25–0.75). Global heterogeneity was high (I2 = 81.3%), Egger’s test showed weak publication bias (p = 0.039). Analysis concluded significant meditation related neuroplastic changes in all studied domains
Objective: To investigate the association between parental consanguinity and complications of type 2 diabetes mellitus in the Pakistani population. Study design & Setting: A cross- sectional study was carried out on the participants from the medical outpatient department at PNS Shifa hospital Karachi, diagnosed with type 2 diabetes mellitus of consanguineous and non-consanguineous family backgrounds from 25th August to 24th October 2025. Methodology: 423 participants were utilized to collect the information about their demographic data, clinical background, diabetes control indicators, complication status, and treatment strategies in the form of medication and lifestyle interventions. Pearson Chi-Square test was used to analyze the relationship between consanguinity, the onset, severity, and treatment outcomes of diabetes. Results: Participants born to non- consanguineous parents, 0.6% (1) were suffering from cardiovascular disease; 1.7% (3) had hypertension, 1.1% (2) had a visual problem, and 0.6% (1) were reported to have dyslipidemia. Among the progeny of consanguineous parents, 14.5 %( 35) were suffering from cardiovascular disease, 4.1% (10) suffered from chronic kidney disease, 21.5 %( 52) had hypertension, 38.0% (92) had problems related to vision, and 7.0 %( 17) were reported to have dyslipidemia after being diabetic. There is a strong significant association between diabetes and their complications in the offspring of consanguineous couples after being diagnosed as diabetics (p<0.01). Conclusion: Clarifying the role of consanguinity in the prevalence and progression of T2DM can promote understanding of genetic susceptibility among high-risk populations and guide culturally sensitive public health practice and genetic counseling policy in Pakistan
Objectives: To compare post-operative pain score between Lichtenstein’s repair versus laparoscopic trans-abdominal preperitoneal (TAPP) repair for inguinal hernia. Study Design and Setting: Comparative cross sectional study. “Combined Military Hospital, Lahore from July-2021 to July-2024”. Methodology: The current study was approved from the ethical committee of the hospital. For sample size calculation, Open Epi sample size calculator was used. Eighty patients who presented with inguinal hernia were included in the study. They were non-randomly assigned into two groups of 40 patients; group A (Lichtenstein’s repair) and B (TAPP repair). Diagnosis of inguinal hernia was made using clinical assessment and ultrasound. Patients were allocated “Lichtenstein group” and “TAPP group” in two phases. From July 2021 to January 2023, 40 patients underwent “Lichtenstein hernia repair” while in second phase from January 2023 to July 2024, remaining 40 patients underwent “TAPP repair”. the patients were assessed and compared for post-operative pain score. Data was analyzed using SPSS version 22. Results: In this study, 80 patients were included. Mean age was 48.10 ± 5.05 years. There were all 80 (100%) males. Median BMI was 27.00 (29.40 – 19.70) kg/m2. Median duration of hernia was 5.00 (12.00 – 2.00) months. Frequency of ASA status I was 29 (36.25%) and of ASA status II was 51 (63.75%). Median post-operative pain VAS in “Lichtenstein group” was 6.00 (6.00 – 5.00) while in “TAPP group” it was 4.00 (4.00 – 3.00), (p < 0.001). Conclusion: TAPP repair for inguinal hernia is associated with less postoperative pain as compared to Lichtenstein’s repair.
Objective: To determine and compare the diagnostic yield of acid-fast bacilli (AFB) smear microscopy and GeneXpert testing performed on bronchial washings in patients clinically suspected of pulmonary tuberculosis (PTB) but negative for both sputum AFB smear and GeneXpert. The study also aimed to evaluate the utility of bronchoscopic sampling as an adjunct diagnostic tool in sputum-negative PTB, where conventional methods often fail to confirm the diagnosis. Study Design and Setting: A descriptive cross-sectional study conducted at the Department of Pulmonology, Mayo Hospital, Lahore, from 7 March 2025 to 10 June 2025. Methods: Patients aged 18–65 years with clinical and radiological evidence suggestive of PTB but negative sputum AFB smear and GeneXpert results were included. Bronchial washings were obtained through fiber-optic bronchoscopy and analyzed using Ziehl–Neelsen staining and GeneXpert MTB assay. Statistical analysis was performed using SPSS version 27, and diagnostic yields were compared. Results: A total of 95 patients were enrolled, with a mean age of 35.49 ± 11.03 years. Of these, 53.7% were males and 65.3% were non-smokers. GeneXpert detected Mycobacterium tuberculosis in 85.3%, while AFB smear was positive in 56.8% of bronchial wash samples. GeneXpert showed a higher diagnostic yield compared to AFB smear in sputum-negative PTB cases. Conclusion: GeneXpert testing of bronchial washings markedly enhances the diagnostic yield for sputum-negative PTB and should be incorporated as a routine diagnostic tool in patients with strong clinical and radiological suspicion of tuberculosis despite negative sputum findings
Objectives: This study evaluates the outcomes of 25-gauge pars plana vitrectomy (25G PPV) for dense vitreous haemorrhage (VH) of diverse etiology Study Design and Settings: This is a prospective interventional study in which 25G PPV was performed for dense VH at a tertiary eye care centre. Eligible cases were selected from surgical retina clinic. Methodology: All the investigations to determine the cause of VH were performed. Preoperative best corrected visual acuity(BCVA) was measured and then 25G PPV was performed. All the surgeries were done by the same surgeon. BCVA measurements were performed at postoperative day 1(Day1), one-month(1M), and two-month(2M) visits. Visual outcome was categorized based on underlying cause of VH Results: The mean patient age was 51.4 years, with proliferative diabetic retinopathy (40.8%) being the most common aetiology, followed by central retinal vein occlusion (CRVO) and ocular trauma. Surgical intervention resulted in a significant and sustained improvement in visual acuity at all postoperative intervals (p < 0.001), with a mean gain of 0.530 logMAR at the two-month endpoint. The magnitude of improvement varied by aetiology; eyes with CRVO demonstrated the largest mean gain (0.784 logMAR), while trauma cases showed modest recovery (0.317 logMAR). The procedure demonstrated a favourable safety profile, with an overall complication rate of 14.3%, primarily consisting of recurrent VH (8.2%). Conclusion: These findings confirm that 25-gauge PPV is a highly effective and safe intervention for restoring visual function in patients with dense VH, with aetiology serving as a key determinant of the final visual outcome
