Objective: To compare preoperative and postoperative quality of life in women undergoing genitourinary fistula repair. Method: The quasi-experimental study was conducted at the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, from January to December 2023, and comprised female patients diagnosed with vesicovaginal fistula secondary to gynaecological and obstetric procedures or trauma. The quality of life was assessed using the brief version of the World Health Organization Quality of Life scale. The participants completed the questionnaire both before the surgical intervention and three months after successful fistula repair. Data was analysed using SPSS 26. Results: There were 30 women with mean age 35.50±8.87 years. Mean quality of life score at baseline was 12.17±5.77 which improved significantly to 96.67±11.86 post-intervention (p=0.0001). Conclusion: Genitourinary fistula repair significantly and positively impacted the patients' quality of life. Key Words: Genitourinary fistulae, Vesicovaginal fistulae, Ureterovaginal fistulae, O’Connor repair, Robotic-assisted VVF repair, Transvaginal repair, WHOQOL-BREF.
Objective: To assess the changes in nutrition habits, physical activity levels, sedentary behaviours, sleep patterns and quality of academicians before and during the coronavirus disease-2019 pandemic. Method: The descriptive, cross-sectional study was conducted from January to September 2022 after approval from Karadeniz Technical University, Turkiye, and comprised academicians working at public universities in Turkiye during the coronavirus disease-2019 pandemic period. The survey questionnaire was distributed online to all public universities across the country. The participants’ food consumption before and during the epidemic, sleep patterns and physical activity conditions were assessed. Data was analysed using SPSS 22. Results: Of the 299 academicians,166(55.5%) were female and 133(45.5%) were male. Overall age range was 19-65 years, with 122(40.8%) subjects aged 35-44 years. A significant number of academicians 143(47.83%) reported changes in their eating habits, while even more 189(64.29%) indicated that a sedentary lifestyle had a negative impact on their health. There was a significant increase in the number of snacks (p<0.001). A total of 125(42.09%) participants reported using nutritional supplements during the pandemic, with vitamins, multivitamins and minerals being the most commonly chosen options. A significant majority of participants 178(59.73%) reported changes in sleep patterns and weight-gain during the pandemic. The time spent watching TV and using computers, tablets and phones increased significantly during the isolation period (p<0.05). Also, there was a decrease in the physical activities of the academicians (p<0.05). Conclusion: Even within more aware segments of the population, such as academicians, the coronavirus disease-2019 pandemic’s impact on psychological wellbeing led to significant alterations in eating, sleeping and physical activity patterns. Key Words: COVID-19, Physical activity, Sleep, Feeding behaviour, Nutrition.
Objective: To find the frequency of depression, anxiety and stress among university students, and to ascertain the condition’s association with physical inactivity. Method: The cross-sectional, analytical study was conducted from November 2023 to May 2024 at the Quetta Institute of Medical Sciences, Quetta, Pakistan, and comprised students belonging to three universities. Data was collected using a predesigned questionnaire that also included the International Physical Activity Questionnaire to check physical inactivity and the Depression Anxiety Stress Scale to assess depression, anxiety and stress levels. Data was analysed using SPSS 25. Results: Of the 400 participants, with a mean age of 22 years (±3.89years), 233(58.25%) were male, 167(41.75%) were female, 286(71.5%) were studying medicine, and 114(28.5%) were enrolled in non-medical degrees. Physical inactivity was significantly associated with anxiety, depression and stress (p=0.001). Female students reported lower activity and higher rates of anxiety, depression and stress. Nuclear families tended to have better mental health, while joint families showed more extreme cases of anxiety and depression. The nature of the degree in which a student was enrolled had no significant association. A similar result was observed for residence (rural or urban). Conclusion: Physical inactivity was found to be significantly associated with anxiety, depression and stress, indicating the need for a prompt targeted intervention. Key Words: Anxiety, Depression, Stress, Sedentary behaviour, Exercise.
Objective: To compare the histo-morphological features and CHEK2 expression in breast cancer versus benign breast disease. Methods: This cross-sectional study was conducted at the Department of Anatomy, Basic Medical Sciences Institute, in cooperation with Department of Surgical Units Jinnah Postgraduate Medical Centre, Karachi, from 31-March-2021 to 30-March-2022. A total of 80 female participants were allocated in two groups. Group A = 40 with fibroadenoma and group B = 40 having breast cancer. After gross anatomical examination breast tissue was processed for Hematoxylin and eosin staining for histomorphology and immunohistochemical analysis for CHEK2 expression. Data was analysed using SPSS 23. Results: Mean age of group A was 30.05±6.4 years and group B was 43.139±8.3 years. Common presenting complaint of group A was pain 15 (37.5%) whereas group B presented with painless lump 35 (87.5%). In both groups tumors had affected the upper outer quadrant of left side of the breast. On microscopy 38(95%) of group B participants had invasive ductal carcinoma. Out of those, 26(65%) had grade II and 22 (55%) had stage II cancer. Necrosis, ductal carcinoma insitu (DCIS) component, calcifications and lymphocytic infiltration were significantly noticeable in group B. Immunohistochemical expression of CHEK2 was significantly higher in group B as compared to group A participants (p= 0.001). Conclusion: There was a significantly higher expression of CHEK2 in breast cancer (group B) patients. This may be considered as an important diagnostic marker in breast cancer pathogenesis. Key words: Breast cancer, Fibroadenoma, Chek point kinase 2, Immunohistochemistry, Histomorphology.
Objective: To compare the cytokines associated with T helper 17 cells between Guillain-Barre syndrome patients and healthy controls. Method: The cross-sectional, comparative study was conducted from March 2024 to February 2025 at the Department of Immunology, University of Health Sciences, Lahore, Pakistan, and comprised Guillain-Barre syndrome patients in group A and healthy controls in group B. Plasma concentrations of interleukin-6 IL-6, interleukin-17, interleukin-21, interleukin-22 and interleukin-23 in both the groups were quantified using enzyme-linked immunosorbent assay. Data was analysed using SPSS 24. Results: Of the 88 subjects, 44(50%) were in group A with mean age 41.6±11.8 years, while 44(50%) were in group B with mean age 39.3±12.4 years. Both the groups had 26(59%) male and 18(41%) female subjects. Serum interleukin-6, interleukin-17 and interleukin-22 levels were significantly higher in group A patients than group B controls (p<0.05). In contrast, reduced serum interleukin-23 levels were found in the group A compared to group B, but the difference was not significant (p>0.05). Correlation analysis among cytokine levels showed that serum interleukin-21 levels were correlated with interleukin-22 levels in group A patients. Interleukin-17 concentrations did not show any significant relationship with other cytokine levels (p>0.05). Interleukin-6 was negatively correlated with disease duration (p<0.05). No significant associations were found among cytokine levels, disease subtypes and severity (p>0.05). Conclusion: The activity of T helper 17 cytokines was significantly elevated in Guillain-Barre syndrome patients, underlining the contribution of T helper 17 cell cytokines in Guillain-Barre syndrome and implying that these cytokines can be targeted for therapeutic modulation of the immune response. Key Words: Guillain-Barré Syndrome, Th17, Cytokines, ELISA.
Objective: To identify the predictors of glycaemic control in children and adolescents with type-1 diabetes mellitus. Method: The analytical, cross-sectional study was conducted at the Paediatric Endocrinology Department of the National Institute of Child Health, Karachi, from June to November 2024, and comprised children of both genders aged 2-18 years having definite diagnosis of type-1 diabetes mellitus with a disease duration >1 year. Glycated haemoglobin >7.5% was labelled as poor glycaemic control. Association of glycaemic control with various socio-demographic, clinical and management-related characteristics was explored. Data was analysed using SPSS 26. Results: Of the 163 children, 83(50.9%) were girls. The overall median age at the time of presentation was 12.0 years (interquartile range: 9.0-14.0 years). The median glycated haemoglobin was 8.4% (interquartile range: 7.2-10.6). Good and poor glycaemic control was noted in 58(35.6%) and 105(74.4%) subjects, respectively. Primary caregiver being the father was independently associated with higher odds of poor glycaemic control (p=0.039). Insulin non-adherence (p=0.019) and irregular blood glucose monitoring (p<0.001) were significant independent predictors of poor glycaemic control. Patients with a check-up interval >2 months had higher odds of poor glycaemic control (p=0.010). Conclusion: The prevalence of poor glycaemic control was high among children and adolescents with type-1 diabetes mellitus. Key glycaemic control indicators included adherence to insulin and blood glucose monitoring, caregiver involvement, and regular healthcare visits. Key Words: Adolescent, Caregivers, Child, Glycaemic control, Insulin, Type-1 diabetes mellitus.
Objective: To determine the dynamics of immune reconstitution by measuring lymphocyte subsets at periodic intervals after allogenic hematopoietic stem cell transplant, and to assess the impact of potential factors influencing immune reconstitution. Method: The retrospective was conducted at the Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from August 2023 to January 2024, and comprised data of patients regardless of age and agender with haematological or immunological diseases who underwent allogeneic hematopoietic stem cell transplant between January 2017 and December 2023. Immune reconstitution was measured using lymphocyte subset analysis by flow cytometry at 3-, 6- and 12-month post-transplant. Data was analysed using SPSS 27. Results: Of the 100 patients with mean age 8.61±8.82 years (range: 0.3-53 years), 63(63%) were males and 37(37%) were females. Lymphocyte subsets showed significant variance across periodic assessments post-transplant. Reconstitution of natural killer cells and cluster of differentiation 8+ occurred rapidly, while cluster of differentiation 3+, 4+ and 19+ achieved it later. Patient age and stem cell dose were significantly associated with cluster of differentiation 4+, 8+, and natural killer cell reconstitution at 12 months post-transplant. Stem cell source and myeloablative conditioning were associated with early recovery of cluster of differentiation 19+ B lymphocytes. Conclusion: Lymphocyte subset recovery following allogeneic hematopoietic stem cell transplantation occurred at varying rates, making it essential to monitor these subsets periodically post-transplant to tailor intervention strategies. Faster reconstitution of T-cell subsets was linked to higher stem cell dose and younger patient age. Key Words: Conditioning regimen, Hematopoietic stem cell transplantation, Immune reconstitution, Lymphocyte subset.
Objectives: To determine and compare the levels of Urinary Albumin Creatinine Ratio, Neutrophil Gelatinase Associated Lipocalin and Cyclophilin A among groups based on duration of Type 2 diabetes. Methodology: This is an observational descriptive analytical study. The study was conduction in Chemical Pathology Department of University of Health Sciences, Lahore, Pakistan from December, 2021 to July, 2022. Convenient sampling technique was used. All together 84 patients were included from outpatient department in this study and were classified into 3 groups according to the duration of Type 2 Diabetes Mellitus. Group A= Less-Than 1 year (Control group), Group B= Greater-Than 1 year and Less-Than 5 years, Group C= Greater-Than 5 years and Less-Than 10 years. Data was analyzed using SPSS 24. ANOVA was used to compare mean levels of urinary albumin creatinine ratio (ACR), Neutrophil Gelatinase Associated Lipocalin (NGAL) and Cyclophilin A (Cyp A) among the groups. A p-value Greater-Than 0.05 was considered as significant. Results: The mean age of the patients in Group A, B and C was 49.1 plus-minus 12.8, 51.1 plus-minus 13.5 and 50.0 plus-minus 12.3 years respectively. The results of the comparison showed that the patients having diabetes for more than five years had the highest levels of urinary Cyp A, NGAL and ACR. The comparison of urinary ACR with Cyp A and NGAL in the three groups showed that the urinary Cyp A and NGAL started appearing in the urine before the ACR in diabetics even when the ACR was still in normal range (Less-Than 30 mg/g). Conclusion: The urinary Cyp A, NGAL and ACR showed significant rise with the duration of the disease. Additionally, urinary NGAL and CypA could be used as a marker for early detection of diabetic nephropathy. Key Words: Lipocalin-2, NGAL protein, Cyclophilin A, Diabetes Mellitus, Type 2, Albumin to Creatinine ratio, Diabetic Nephropathy, Albuminuria
Hypertension affects approximately 85% of individuals with advanced chronic kidney disease (glomerular filtration rate < 30 ml/min), primarily due to increased volume load[1]. At this stage, kidneys lose their ability to achieve the desired fractional excretion for sodium (FeNa), thus predisposing the patient to hypertension. Loop diuretics, such as furosemide, are the mainstream drugs for patients of hypertension with chronic kidney disease. They block the Na-K-Cl channels thus increasing the FeNa. However, there are two important shortcomings of chronic loop diuretic use. Prolonged use of loop diuretics often leads to adaptive hypertrophic changes in the distal nephron, facilitating sodium reabsorption at this site and contributing to loop diuretic resistance. Additionally, the short duration of action of loop diuretics can result in incomplete control of fluid overload and blood pressure[2]. Also, a sudden discontinuation of loop diuretic causes reflex hypertension due to compensatory sodium absorption. Traditionally, thiazide diuretics were considered ineffective in advanced CKD, particularly when GFR falls below 30 mL/min, due to their perceived inability to induce significant natriuresis or reduce blood pressure. Current KDIGO guidelines support this view, recommending loop diuretics as the primary choice. However, recent evidence challenges these assumptions[3]. Emerging studies demonstrate that thiazide diuretics, including hydrochlorothiazide and chlorthalidone, retain their ability to promote sodium excretion and lower blood pressure in advanced CKD patients. Moreover, thiazide diuretics are potassium wasters and this is beneficial in patients of CKD as they are hyperkalemic so it also cures hyperkalemia. These findings state the clinical impact of thiazide diuretics[4]. Moreover, we want to address the achievement of remarkable results with the use of combined thiazide and loop diuretics for these patients. This combination addresses the limitations of loop diuretics by blocking sodium reabsorption at multiple segments of the nephron, leading to enhanced sodium and chloride excretion, better blood pressure control, and sustained diuretic efficacy. Studies have reported significant improvements in volume control and reductions in blood pressure with the co-administration of agents like furosemide and hydrochlorothiazide or chlorthalidone. However, this approach requires cautious application due to risks of adverse effects, including hypotension and electrolyte disturbances. This combination should be limited to patients with advanced CKD, who are unresponsive to monotherapy[5]. These findings suggest a shift in the treatment paradigm for hypertension in advanced CKD, advocating for the reconsideration of thiazides and their combination with loop diuretics in late-stage disease management.
Objectives: To explore if exam stress affects students by altering their heart rate and blood pressure, and if it varies with age and gender. Method: The cross-sectional, quasi-experimental study was conducted from January-December 2019 at the Virtual University of Pakistan (Rawalpindi campus). The study included undergraduate students regardless of age, gender and academic year. The participants were divided into animal interaction group R and balloon activity group B, letting the subjects choose between the two activities for releasing stress. Systolic and diastolic blood pressure readings and pulse rates were noted using a digital blood pressure monitor. Data was analysed using SPSS 21. Results: Of the 186 students with mean age 25.80±5.08 years, 156(83.87%) were females and 30(16.13%) were males. Exam stress significantly increased heart rate as well as systolic and diastolic blood pressure (p<0.05). Blood pressure parameters, SBP during exam days and DBP during normal days showed significant correlation with gender, but not with age. The heart rate was not significantly correlated with age and gender. Conclusion: Both the stress adjustment activities, either patting a pet or playing with a balloon, could significantly reduce exam stress. Key Words: Stress, Students, Blood Pressure, Heart Rate, Play therapy, Recreational therapy.
Objective: To compare patient-reported clinical outcomes between patients receiving three-dimensional-printed dental crowns versus conventional ones. Method: The pilot, quasi-experimental, single-blind study was conducted at Karachi Medical and Dental College, Karachi, from April to November 2024, and comprised patients with a clinical indication for dental crown placement. Based on the attending dentist’s clinical judgment, the participants were assigned to three-dimensional-printed crown group A or conventional crown group B. Data was collected using semi-structured interviews. Outcomes were assessed 15 days after the procedure, and intergroup comparison was done. Data was analysed using Stata 15. Results: Of the 24 participants, 12(50%) each were in the two groups, and both the groups had 6(50%) males and as many females. The mean age in group A was 29.8±8.4 years compared to 47.7±15.5 years in group B (p=0.002). Patients in group A reported more favourable outcomes, and higher satisfaction compared to those in group B (p<0.05). No significant difference was observed in occlusal function (p=0.478). Conclusion: The three-dimensional-printed dental crowns were found to be more effective than conventional crowns. Key Words: 3D-printed crowns, Digital dentistry, Conventional crown, Pilot study.
Objective: To assess the association between the growth arrest and deoxyribonucleic acid damage 45 alpha (1506 thymine > cytosine) polymorphism (reference single nucleotide polymorphism cluster ID 3783469) and breast cancer development in Pakistani females. Method: The case-control study was conducted at Riphah International University, Islamabad, Pakistan, in collaboration with Pakistan Railway General Hospital, Rawalpindi, Pakistan, from November 22, 2023, to October 8, 2024, and comprised diagnosed cases of breast cancer in group 1 and healthy controls in group 2. Blood samples were collected, and allele-specific tetra amplification refractory mutation system polymerase chain reaction and gel electrophoresis were carried out to determine the association of respective genotypes and allele frequencies using specific primers. Data was analysed using SPSS 27. Results: Of the 340 women, 170(50%) with mean age 51.06±9.74 years (range: 30-76 years) were in group 1, and 170(50%) with mean age 56.84±11.5 years (range: 26-82 years) were in group 2. The thymine-cytosine genotype was more frequent in group A compared to group B [110(64.7%) vs. 33(19.4%)], while the thymine-thymine genotype predominated in group B [137(80.6%) vs. 60(35.3%); p<0.0001]. The cytosine-cytosine genotype was absent in both the groups. Genotype distribution and allele frequencies were significantly associated with breast cancer risk (p<0.0001). The associations were significant regardless of age stratification p<0.05). Conclusion: The incidence of breast cancer development was found to be elevated among females carrying the thymine-cytosine genotype, whereas the thymine-thymine genotype played a protective role among the healthy subjects. Key Words: Breast cancer, GADD45A, Single nucleotide polymorphism.
Acute intermittent porphyria (AIP) is the most common type of porphyria, caused due to the deficiency of HMBS enzyme in the heme synthesis pathway. One of its infrequent and clinically challenging complications is status epilepticus. We present the case of a 14-year-old boy, who was previously misdiagnosed as having appendicitis and later presented with persistent abdominal pain and seizures that progressed to status epilepticus. Diagnostic workup for organic causes of seizures was unremarkable and a porphobilinogen spot test confirmed the diagnosis. He was treated with dextrose and electrolyte correction along with magnesium sulfate and Levetiracetam for seizure control. The patient had recovered fully on his fortnightly follow-up visit. Limited local literature and the disease's rarity underscores the significance of this case. Future studies should concentrate on developing new treatment approaches for this multifaceted disease, as well as increasing the diagnostic precision for AIP in individuals who present with seizures. Timely intervention can alleviate suffering and minimise hospitalisations. Keywords: Acute Intermittent Porphyria, Status epilepticus, Case report, Treatment, Levetiracetam, Seizures.
This study aimed to assess the association between visual and cognitive impairment in patients with Stargardt Disease at the Low Vision Rehabilitation Centre, Al-Shifa Trust Eye Hospital. It was a cross-sectional study conducted from September to December 2023 which included 32 patients (mean age 20.34 ± 7.9 years). Visual function was evaluated using LogMAR (Logarithm of the Minimum Angle of Resolution), Pelli Robson Chart, and Pseudo Isochromatic Plates, while cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Ray Auditory Verbal Learning Test (RAVLT). MoCA scores indicated cognitive impairment in 59.38% of patients. Pearson correlation showed no significant association between MoCA scores and visual acuity (p = 0.768) and between most RAVLT variables and visual acuity, except for RAVLT forgetting (p = 0.007). Although visual acuity was not directly linked to cognitive decline, many patients exhibited impairment, suggesting other contributing factors. Further research with a larger sample size is needed. MeSH Words: Visual acuity, Low vision, Stargardt Disease, Cognition.
Objective: To explore the unique pubertal challenges and the experiences faced by female adolescents with blindness. Method: The qualitative study was conducted from October 2023 to August 2024 at the Department of Psychology, University of Central Punjab, Lahore, Pakistan, and comprised female adolescents with blindness aged 16-19 years. Data was collected using a semi-structured interview protocol. Data was subjected to interpretative phenomenological analysis through which emergent and subordinate themes were generated. Results: Of the 8 females with age ranging 17-19 years, 7(87.5%) lived in a nuclear family system, while 1(12.5%) lived in a joint family system. Superordinate themes included pubertal knowledge and body transformation, spontaneous metamorphosis, challenges in menstrual management, puberty-related health concerns, self-reliance and independence, and spiritual journey and navigating challenges. Conclusion: A need was noted for tailored support systems and accessible resources to better assist female adolescents with blindness during puberty in Pakistan. Key Words: Pubertal challenges, Blindness, Lived experiences.
Cerebral sinovenous thrombosis (CSVT) constitutes a relatively smaller, but clinically significant and disproportionately morbid cause of childhood cerebrovascular disease. The annual incidence of cerebral sinovenous thrombosis in children (term neonates through 18 years) ranges between 0.4 and 0.7 per 100,000 children per year and is relatively more common in neonates compared with older children.1 CSVT is often associated with cerebral venous infarction (ischaemia or haemorrhage or both) and increase in intracranial pressure, leading often to significant long-term neurodevelopmental impairment, epilepsy and even death.2 Considering paediatric arterial ischaemic stroke (AIS) the predominant subtype of paediatric stroke, CSVT remains relatively underexplored across both highincome and resource-limited healthcare settings, resulting in persistent diagnostic and therapeutic gaps. These gaps are particularly consequential in resourcelimited low- and middle-income countries (LMICs), frequently resulting in delayed recognition of CSVT and preventable neurological sequelae.3-5
Abstract Objectives: To assess the outcomes of correction of adult equinovarus clubfoot with Ilizarov technique. Method: The retrospective study was conducted from December 2023 to January 2025 at the Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, Karachi, and comprised data from 2015 to 2025 of adults with rigid equinovarus deformity who were treated with the Ilizarov construct of 2 tibial full-rings, one half-ring for forefoot and hindfoot, and tendo-Achilles lengthening for gradual correction. Outcomes were assessed using American Orthopaedic Foot and Ankle Society score and Reinker-Carpenter scale, preoperatively and 12 months post-surgery. Data was analysed using SPSS 22. Results: Of the 38 patients with mean age 23.7±6.2 years, 26(68.4%) were male and 12(31.6%) were female. There were 29(76.3%) unilateral and 9(23.7%) bilateral cases. There were 10(21.3%) cases of congenital neglected clubfoot, 22(46.8%) cases of recurrent/resistant clubfoot, 4(8.5%) cases of neuromuscular/spinal pathology, 3(6.4%) cases of post-polio deformity, 7(14.9%) cases of posttraumatic deformity, and 1(2.1%) case of hemimelia. Mean frame duration was 16.3±5.1 weeks, and follow-up time was 28.5±12.2 months. At frame removal, Reinker-Carpenter score was excellent in 6(12.8%) cases, good in 30(63.7%), fair in 8(17%), and poor in 3(6.5%). There was 1(2.1%) case of supination deformities and 5(%) of claw foot requiring adjunct surgery, and 1(2.1%) case of acute posterior-tibial-nerve palsy with treatment abandonment. Mean American Orthopaedic Foot and Ankle Society score increased from 29.6±19.2 to 81.4±12.3 postoperatively. Conclusion: Ilizarov fixator with tendo-Achilles lengthening allowed controlled correction of rigid clubfoot deformity with minimal complications. Ankle-foot-orthosis could minimise any residual deformitiy. Ankle stiffness was commonplace. Key Words: Ilizarov, Rigid clubfoot, Equinovarus deformity.
Klotho has emerged as one of the most important renoprotective proteins linking kidney function with systemic metabolic, endocrine, and cardiovascular health. Predominantly expressed in the renal tubules, Klotho regulates phosphate homeostasis through the fibroblast growth factor-23 (FGF23) pathway while exerting pleiotropic effects on oxidative stress, inflammation, fibrosis, mitochondrial function, and cellular senescence. Declining Klotho expression is a hallmark of chronic kidney disease (CKD) and contributes to mineral bone disorder, vascular calcification, accelerated ageing, and progressive renal dysfunction. Beyond serving as a biomarker of kidney health, Klotho represents a promising therapeutic target capable of enhancing renal resilience and slowing disease progression. Lifestyle interventions, particularly regular exercise, together with emerging pharmacological strategies, may preserve endogenous Klotho expression and contribute to nephroprotection. As nephrology evolves toward a cardiorenal-metabolic paradigm, Klotho provides a unifying biological framework connecting the kidney with multiple organ systems. Future research into Klothobased diagnostics and therapeutics may transform the prevention and management of CKD and its systemic complications. Keywords: Ageing, Cardiorenal syndrome, Chronic kidney disease, Exercise, Fibroblast growth factor 23, Mineral metabolism, Vascular calcification.
Objective: To determine the association between foetal congenital abnormalities and maternal risk factors, including family history and consanguinity. Method: The case-control study was conducted from December 2022 to May 2023 at the Radiology Department of Jinnah Postgraduate Medical Center, Karachi, and Tanveer Ultrasound Clinic, Karachi, after approval from the ethics review committee of Bahria University of Health Sciences, Karachi. The sample comprised pregnant women aged 18-40 years who were divided into foetuses with structural abnormalities group A and foetuses with normal structural development in control group B. Sonoscape S22 and Toshiba Aplio 500 ultrasound systems were used to detect congenital abnormalities. Maternal risk factors were assessed and associations were explored. Data was analysed using SPSS 23. Results: Of the 120 women, 60(50%) were in each of the two groups. Maternal age, family history of birth defects and a history of consanguinity were highly associated with an increased risk of congenital abnormalities (p<0.05). Diabetes mellitus, hypothyroidism and asthma had significant inverse associations with congenital abnormalities (p<0.05). Conclusion: Sociodemographic factors like age and risk factors played a significant role in the development of congenital abnormalities. Key Words: Congenital abnormalities, Risk factors, Consanguinity.
Objective: To assess risk factors, awareness, screening practices and cytological outcomes related to cervical cancer. Method: The descriptive, cross-sectional study was conducted from January to December 2020 at tertiary care hospitals in Lahore, Pakistan, after approval from the ethics review committee of the University of Health Sciences, Lahore, and comprised women aged 15-45 years presenting with or without cervicovaginal infections at least 48 hours after the end of menstruation. Sociodemographic characteristics, clinical risk factors, and awareness level regarding cervical cancer and screening were noted. Data was analysed using SPSS 24. Results: Among the 90 female subjects with 28.6 ± 7.4 years early childbirth 69(76.7%), multiparity 57(63.3%) and recurrent cervicovaginal infections 79(87.8%) were the most common factors. No subject was familiar with the human papillomavirus, and none had ever undergone a Papanicolaou test. Cytological analysis showed inflammation in 65(72.2%) cases, and atypical findings in 23(25.6%). Additional findings included infections, such as Escherichia coli 17(18.9%) and methicillin-resistant Staphylococcus aureus 10(11.1%), with 29(32.2%) participants testing positive for Trichomonas vaginalis. Conclusion: The level of awareness regarding cervical cancer and screening practices was alarmingly low, underscoring the need for structured cervical cancer screening and education programmes in Pakistan. Key Words: Uterine cervical neoplasms, Papanicolaou test, Liquid-based cytology, Human papillomavirus, Health knowledge, Attitudes, Practice.
