Objective: This study aimed to determine the effectiveness of extracorporeal Shock Wave Lithotripsy and retrograde Intrarenal Surgery on obtaining stone-free status for renal pelvic stones measuring 1-2 cm in diameter. Material & Methods: This quasi-experimental study was conducted at the Department of Urology, Khyber Teaching Hospital, Peshawar, where a total of 60 patients with renal pelvic stones measuring 1–2 cm were randomly assigned to two equal groups: ESWL (n = 30) and RIRS (n = 30). Stone clearance was assessed on the 7th postoperative day using ultrasound and X-ray KUB. Results: The mean age of participants in Group A (ESWL) increased to 41 years (SD = 10.67), while the mean in Group B (RIRS) increased to 42 years (SD = 9.09). For Group A (ESWL), the sample included 20 males and 10 females, representing 67% and 33%, respectively. For Group B (RIRS), 21 participants were males, and 9 were females, accounting for 70% and 30%, respectively. The Chi-square test results indicate no statistically significant difference between the two groups regarding gender ratio (p = 0.7813). The data indicated that the patients with renal pelvic stones of 1–2 cm were more likely to be stone-free after retrograde intrarenal surgery (RIRS) than after extracorporeal shock wave lithotripsy (ESWL). In the RIRS group, 73% were stone-free, while only 33% were stone-free in the ESWL group (p = 0.0019). Conclusion: The study finds that RIRS is more effective than ESWL for managing 1-2cm renal pelvic stones. RIRS achieves higher stone-free rates, especially when anatomical difficulties and challenges associated with ESWL are common, and it can precisely locate stones and utilize advanced laser treatment features.
Objective: This study aims to compare mini-percutaneous cystolithotripsy and transurethral cystolithotripsy in children with bladder stones at our hospital. Materials and Methods: A total of 84 patients were divided equally (42 in each group) into two groups (A and B) based on self-selection of stone size, and the type of management was decided by the researcher after clinical examination. Mini-percutaneous cystolithotripsy was performed on patients in Group A utilizing a mini-nephroscope and a 15 Fr access sheath. 4.5/6 Fr or 6/7.5 Fr pediatric ureteroscopes were used to treat transurethral cystolithotripsy in patients in Group B. A Holmium YAG laser was used to break apart the stone. Results: Patients in group A had an average age of 8.38 ± 3.48 months, while those in group B were 8.30 ± 3.23 months old. Of the 84 patients, 49 (58.33%) were male and 35 (41.67%) were female, with a male-to-female ratio of 1.4:1. In my study, the mean operative time for group A (mini-percutaneous cystolithotripsy) was 31.43 ± 5.43 minutes, and for group B (transurethral cystolithotripsy), it was 39.52 ± 7.31 minutes, with a p-value of 0.0001. Conclusion: PCCL allows for easier fragmentation, quicker extraction of larger bladder stone fragments, fewer urethral complications, and reduced operative time. Keywords: Urinary bladder calculi, Lithotripsy, Operative time.
Objective: To determine the diagnostic accuracy of Magnetic Resonance Imaging (MRI) in detecting anterior cruciate ligament (ACL) tears, using arthroscopy as the gold standard. Material And Methods: We conducted this cross-sectional validation study in the Orthopedics Department at Khyber Teaching Hospital, Peshawar. A total of 296 patients were enrolled. All participants underwent knee MRI and were compared with arthroscopic findings, which served as the reference standard. Diagnostic parameters and overall accuracy were calculated. Statistical analysis was performed using SPSS 25. Results: Of the 296 patients, MRI detected ACL tears in 172 (58.1%) cases, while arthroscopy confirmed tears in 197 (66.6%) cases. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI were 70.1%, 65.7%, 80.1%, and 52.4%, respectively, with an overall diagnostic accuracy of 68%. A statistically significant association was observed between MRI and arthroscopy findings (p< 0.01). The ROC curve demonstrated fair discriminative ability of MRI. Conclusion: MRI exhibits moderate diagnostic accuracy in detecting ACL tears, with a reliable predictive value when results are positive. However, its limited sensitivity and specificity in this context highlight the need for cautious interpretation, especially in MRI-negative cases. Arthroscopy remains the definitive diagnostic tool, particularly for ambiguous or complex injuries. Keywords: Anterior Cruciate Ligament Injuries, Magnetic Resonance Imaging, Arthroscopy
Objective: This study aimed to assess medical students' engagement levels and identify socio-demographic factors associated with participation. Materials and Methods: A cross-sectional study was performed at a single medical college using self-reported surveys to assess student engagement across different age groups, genders, and academic years. Data were analyzed to determine the prevalence of "Good," "Neutral," and "Poor" engagement levels, with P < 0.05 set as the cutoff for statistical significance. Results: Most students (63.75%) exhibited a neutral level of engagement, while 20% demonstrated high engagement and 16.25% reported low engagement. Significant correlations were found between engagement and demographic variables (P < 0.05); notably, high engagement was most common among 21-year-olds (47.7%) and third-year students (59.6%), whereas engagement decreased significantly in older students and those in their fourth year of MBBS. Female students also reported significantly higher "Good" engagement (36.9%) compared to their male counterparts (1.31%). Conclusion: Engagement levels notably decline as students advance through their medical education and age. Although the study is limited by its single-center, cross-sectional design, these findings highlight the importance of targeted interventions to sustain student motivation in the later stages of medical training. Keywords: Student engagement, Modular Teaching System, Impact of Assessment Weightage, student motivation
OBJECTIVE: To assess the prevalence of sensorineural impairment in patients with type 2 diabetes and to explore the relationship between hearing loss and variables such as age, gender, HbA1C, and duration of diabetes. MATERIALS AND METHODS: This cross-sectional study was conducted from April to August 2025 and included patients with type 2 diabetes mellitus. Data were collected using the Hearing Handicap Inventory for Adults (HHIA) to screen for diabetes among individuals with hearing impairment. A non-probability convenience sampling method was used. Pure-tone audiometry (PTA) was employed to assess hearing. SPSS Statistics version 20 was used for data analysis. The chi-square test was used to assess associations, with results presented as frequencies and percentages. RESULTS: The study included 195 patients with Type 2 Diabetes mellitus aged 25-65 years. Of these, 7.7% were found to have sensorineural hearing loss, which primarily affects higher frequencies (2-4 kHz) and is usually mild to moderate. Additionally, it was found that sensorineural hearing impairment was significantly (p<0.005) associated with diabetes duration, hypertension, poor glycemic control, and chronic kidney disease. CONCLUSION: In this study, SNHI was found in only a small portion of diabetic patients. HHIA responses showed that most participants faced minimal hearing-related issues, while a significant link was observed between SNI and the duration of diabetes, poor blood sugar control, hypertension, and chronic kidney disease. KEYWORDS: Pure Tone Audiometry, Sensorineural Hearing Impairment, and Diabetes Mellitus
