Introduction Poisoning is a major global health concern and remains a leading cause of preventable injury-related mortality worldwide. According to the World Health Organization, poisoning accounted for approximately 84,000 deaths globally in 2019. In Pakistan and other LMICs, poisoning continues to be a significant public health burden, with unintentional exposure contributing substantially to mortality. Self-poisoning is more prevalent in LMICs due to pesticide availability, socioeconomic stressors, and limited access to emergency toxicology services. In contrast, high-income countries report drug overdoses as the leading cause of poisoning-related deaths.1,2 Initial management of suspected poisoning in emergency settings includes gastrointestinal decontamination strategies such as gastric lavage, activated charcoal administration, and supportive care.3 Gastric lavage is most effective when performed within one hour of ingestion; beyond this period, systemic absorption reduces its efficacy.4 Although the clinical use of gastric lavage has declined, gastric content analysis continues to provide valuable diagnostic and forensic information in selected cases. However, its role in modern toxicology remains under discussion due to methodological and economic limitations.
Background: Premature rupture of membranes (PROM) and meconium-stained liquor (MSL) are important obstetric conditions and may increase the risk of neonatal complications, including meconium aspiration syndrome (MAS), necessitating timely assessment and appropriate labor management. Objective: To compare the severity of MSL between two doses of misoprostol (25 µg vs. 50 µg) used for labor induction in patients with PROM. Methods: This observational study was conducted from July 2024 to September 2024 at Kohi Goth Women's Hospital, Karachi, Pakistan. A total of 100 confirmed PROM women underwent labor induction either immediately or after expectant management for up to 24 hours were categorized into two groups according to the misoprostol dose received. The primary outcome was severity of MSL (Grade I–III). Secondary outcomes included mode of delivery and number of doses required. Results: Mean age was 27.10±4.10 years in the 25 µg group and 26.68±4.47 years in the 50 µg group. The 50 µg group had a higher proportion of women requiring only one dose (44% vs. 30%, p =0.107); however, the difference was not significant. The rate of spontaneous vaginal delivery was higher in the 25 µg group (86%) compared with 52% in the 50 µg group, where the rate of cesarean section was 48% (p <0.001). There was also a significant difference in the severity of MSL (p <0.001), which was considerably greater in the 50 µg group. Conclusion: The 25 µg dosage i.e. lower-dose regimen was associated with less severe MSL and a higher proportion of spontaneous ............
Background: Obesity among children impairs academic performance, increases healthcare costs, and increases risk for chronic diseases in adulthood. Objective: To determine the prevalence of overweight and obesity, and their associated factors, among adolescents attending public and private high schools in Peshawar. Methods: A cross-sectional study was conducted among students attending public and private high schools in the Peshawar district by the Department of Endocrinology, Lady Reading Hospital, Peshawar in collaboration with the Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar. A total of 800 students were selected from public and private high schools of district Peshawar using multistage stratified random sampling. Data were collected on socio-demographic profile, dietary and nutrition-related information, health-related QOL, and physical activity. Data were analyzed using Stata version 14.0; chi-square tests and logistic regression analyses were performed, with a p-value < 0.05 considered statistically significant. Results Among respondents, 62.88% were male and 28.88% were aged 15 years. Approximately one-third of the students (33.3%) had low physical activity, while 21.4% were overweight and 18.3% were obese. Age, gender, father's occupation, and grade were significantly associated with BMI (p <0.05). Physical activity showed weaker correlations with health-related quality-of-life domains among overweight/obese respondents. Female sex was independently associated with lower odds of overweight or obesity, while belonging to a low-income household and being in the 9th grade increased these odds. Conclusion: High overweight and obesity prevalence was observed among Peshawar adolescents, independently associated with male sex, lower household income, and 9th grade, highlighting the need ........
Background: The etiological spectrum varies across different populations due to geographic, socioeconomic, and disease-related factors. However, data describing the underlying causes of cytopenias in the local Pakistani population remain limited, making it difficult to establish region-specific diagnostic priorities. Objective: To determine the etiological spectrum of pancytopenia and bicytopenia in patients undergoing bone marrow biopsy at a tertiary care hospital. Methods: This retrospective study was conducted at the Civil Hospital, Karachi, Pakistan. We reviewed the bone marrow biopsy records of patients presenting with bicytopenia and pancytopenia between January 2016 and June 2024. A total of 200 cases were included in this study. Cytopenias were defined as hemoglobin <10 g/dL, a total leukocyte count <4,000/mm³ and a platelet count <150 × 10⁹/L. Data were analyzed using SPSS version 24.0 and summarized using descriptive statistics. Results: Out of 200 patients, 172 (86%) had bicytopenia and 28 (14%) had pancytopenia, with a male predominance. The mean age was 24.8 years. Males were more frequently affected, and the male-to-female ratio was 1.04. Fever, 131 (65.5%), Pallor, 35 (17.5%), bleeding, 33 (16.5%), and splenomegaly, 31(15.5%) were the most frequent presentations of bicytopenia and pancytopenia. The etiological spectrum showed that aplastic anemia was present in 43 (21.5%) of the cases, followed by acute leukemia in 26 (13.0%) and megaloblastic anemia in 21 (10.5%). Conclusion: The most common cause of cytopenia was found to be aplastic anemia, followed by acute leukemia and megaloblastic anemia.
The rapid development of genomics has transformed the biomedical research and healthcare. Advances in next-generation sequencing (NGS), bioinformatics and computational biology have made it possible to generate and analyze genomic information at a scale that was difficult to imagine only a few decades ago. Genomic technologies are increasingly contributing to the diagnosis of rare diseases, understanding disease susceptibility, infectious disease surveillance, pharmacogenomics and precision medicine.1,2 For Pakistan, where inherited disorders and other complex health conditions represent important public-health challenges, genomics offers considerable opportunities for improving disease prevention, diagnosis and treatment. However, the increasing ability to generate genomic information has created a corresponding need to consider how such data should be governed. Unlike many conventional health records, genomic information is inherently sensitive and connected not only to biological relatives but in some conditions to a wider group of population. Genomic data may retain a potential for re-identification when combined with other datasets even after removal of direct identifiers.3 Sharing of genomic data across institutional and national borders adds more complexity to these challenges. International collaboration and access to global genomic data is important for research progression, especially for the populations that are less represented in genomic studies, but at the same time, it raises questions regarding informed consent, data access, use of secondary data, data security, benefit sharing and the responsibilities of researchers and institutions receiving the data.4 The ethical question therefore is not sharing of genomic data, but under what conditions they should be shared responsibly? In 2024, the World Health Organization (WHO) issued guidance establishing principles for the collection, access, use and sharing of human genome data.5 Similarly, the Global Alliance for Genomics and Health (GA4GH) have also emphasized the appropriate sharing of genomic and health-related data by governance structures that balance scientific usefulness with human and social needs. A major phase in this approach is set to begin in Pakistan. The Ministry of National Health Services, Regulations and Coordination (MNHSR&C) conducted a national consultation on Pakistan's proposed National Genomic Policy in June 2026, reflecting the increasing recognition of genomics as a crucial element of precision medicine, health security, and disease prevention.6 The National Genomic Surveillance Strategy (Pakistan) 2026 has also been incorporated into national plans by the National Institutes of Health (NIH). These achievements demonstrate the growing importance of genomic capacity in Pakistan's health policy. Additionally, they turn genetic data governance from a distant issue to an urgent governmental concern. However, developing a national genomic policy and boosting sequencing capacity are only two aspects of Pakistan's readiness for the demands of the genomic age. Additionally, a strong local ethical and legal framework is required.7 The National Bioethics Committee (NBC) of Pakistan took a major step toward building this infrastructure as it started registering institutional Review Boards (IRBs) and Ethical Review Committees (ERCs) with the NBC in July 2026. The effort aims to increase institutional ethical monitoring as part of the national research governance framework.8 The notion is especially important to genetic research, where ethical issues may affect families, communities, and populations beyond individuals. But rather than being an objective in itself, registration should be seen as a starting point. Appropriately formed committees, standardized protocols, ongoing training in cutting-edge fields like genomic data and secondary usage, quality control, and efficient coordination between institutional ethical committees and national oversight mechanisms are all necessary for sustainable supervision. The NBC has published several national guidelines and frameworks including those on human biological materials (HBM), stem cells, human organ transplants, ethical review (NBC-ERC), and ethical healthcare decision-making during outbreaks covering areas such as the collection, use, storage, and transfer of biological materials.9,10 These frameworks offer a key foundation for creating more specialized governance systems for biological materials and genetic data. The objective should not be to create unnecessary barriers to scientific collaboration. Excessively restrictive systems may limit research and disproportionately disadvantage researchers and populations in resource-constrained settings. Inversely, unrestricted sharing of data without appropriate safety measures may weaken the public trust. Responsible governance should therefore seek an appropriate balance between scientific openness and protection of rights. Pakistan now has an opportunity to establish a framework based on the principle of responsible genomic data sharing. The future of genomic medicine in Pakistan will depend not only on our ability to sequence genomes, but also on our ability to govern the information generated from them. Strengthening institutional ethics oversight alongside national genomic policy and data-governance mechanisms can enable Pakistan to participate more effectively in international genomic research while protecting the privacy, dignity, rights and interests of its population.
