Journal of Population Therapeutics and Clinical Pharmacology
The JPTCP is an international peer-reviewed journal publishing Editorials, Reviews, Full-text articles, Brief Communications and Case Reports in the field of medical and pharmacological practice.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
SOLVING DIAGNOSTIC CHALLENGES IN PEDIATRIC SMALL ROUND CELL TUMORS WITH IMMUNOHISTOCHEMISTRY
BACKGROUND: Pediatric small round cell tumors (SRCTs) are a group of aggressive cancers that look very similar under the microscope, making them difficult to tell apart based on appearance alone. An accurate diagnosis is critical because each type requires different treatment. AIM: This study aimed to test how effective a standard panel of immunohistochemistry (IHC) stains is at providing a definitive diagnosis for these challenging tumors. METHODS: We conducted a prospective study of 100 children with SRCTs. After an initial review under the microscope, all cases were tested with a targeted IHC panel designed to identify different tumor lineages (including CD99, myogenin, CD45, and synaptophysin). RESULTS: Initial microscopic examination failed to provide a specific diagnosis in 71% of cases, labelling them only as "undifferentiated." The IHC panel successfully resolved 99% of all cases, providing a specific diagnosis. The Ewing sarcoma family (50%) was the most common tumor, followed by embryonal rhabdomyosarcoma (17%). CONCLUSION: A systematic IHC panel is a highly effective and essential tool for diagnosing pediatric SRCTs. It resolves the vast majority of ambiguous cases, ensuring that children receive the correct diagnosis as the crucial first step towards appropriate therapy.
Pediatric Small Round Cell Tumors; Immunohistochemistry; Diagnostic Accuracy; Ewing Sarcoma; Rhabdomyosarcoma; Pathology
Copyright (c) 2025 Journal of Population Therapeutics and Clinical Pharmacology http://creativecommons.org/licenses/by-nc/4.0
MOLECULAR AND CLINICOPATHOLOGIC HETEROGENEITY OF IGM-NEGATIVE LYMPHOPLASMACYTIC LYMPHOMA: INSIGHTS FROM A PAKISTANI MULTICENTER STUDY
: Lymphoplasmacytic lymphoma (LPL) is diagnostically and therapeutically defined by its association with Waldenström Macroglobulinemia (WM) and an IgM paraprotein. The IgM-negative LPL variant is a rare and poorly characterized entity, with limited data on its molecular drivers and clinical behavior, particularly in non-Western populations. Aims & Objectives: This study aimed to define the clinicopathologic and molecular profile of IgM-negative LPL and compare it with classic IgM-positive WM in a Pakistani multicenter cohort. Methodology: A total of 92 patients diagnosed between March 2024 and July 2025 were enrolled from across three major healthcare institutions in Pakistan: Sheikh Zayed Hospital, both campuses Lahore & Rahim Yar Khan; and Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore. 47 with IgM-negative LPL and 45 with WM. Clinicopathologic data were collected retrospectively and prospectively. Centralized pathological review and molecular analysis for MYD88 L265P (by allele-specific PCR and Sanger sequencing) and CXCR4 mutations (by Sanger sequencing) were performed. Results & Findings: The IgM-negative cohort exhibited a significantly more aggressive phenotype, with higher rates of splenomegaly (48.9% vs. 26.7%, p=0.025), lower platelet counts (median 165 vs. 212 x 10⁹/L, p=0.008), and higher serum creatinine (median 1.4 vs. 1.0 mg/dL, p=0.003). The MYD88 L265P mutation was significantly less prevalent in IgM-negative LPL (63.8%) compared to WM (95.6%, p<0.001). Within the IgM-negative group, MYD88 wild-type status was associated with worse cytopenias and renal impairment. With a median follow-up of 14 months, overall survival was significantly inferior for IgM-negative patients (12-month OS 85% vs. 98%, p=0.013). Conclusion: IgM-negative LPL represents a distinct, more aggressive subtype of LPL characterized by a high burden of extramedullary disease, cytopenias, renal impairment, a lower frequency of MYD88 mutations, and inferior survival. These findings advocate for the integration of immunoglobulin isotype and molecular profiling into the diagnostic and prognostic stratification of LPL to guide personalized therapy.
Lymphoplasmacytic lymphoma, Waldenström Macroglobulinemia, IgM-negative, MYD88, Pakistan, Clinicopathologic heterogeneity.
MORPHOLOGICAL PATTERNS OF ANEMIA AND TREATMENT APPROACHES IN PATIENTS WITH LIVER CIRRHOSIS ADMITTED TO A TERTIARY CARE MEDICAL UNIT
Anemia is a common complication associated with liver cirrhosis; however, it is also a complication that is often underestimated. Several factors contribute to this issue, including malnutrition, chronic inflammatory processes, hypersplenism, and reduced activity of bone marrow. It is crucial to appreciate the variety of patterns of morphological manifestations of anemia present in this cohort of patients to ensure it is diagnosed in a timely manner, and to make sure the appropriate management can be instituted. Methodology: This descriptive cross-sectional study was conducted in the Medical Unit of Gomal Medical College, Dera Ismail Khan, from January 2024 to January 2025. 72 adults with documented liver cirrhosis were included through consecutive sampling. Demographic data, clinical data, complete blood counts, and data from peripheral smears were collected. Anemia was classified as normocytic, microcytic, macrocytic, or dimorphic according to red cell indices and smear variables. Therapeutic measures administered during the patients' hospital stays were also documented. Results: Normocytic anemia emerged as the most common morphological type, followed by microcytic and macrocytic patterns, while dimorphic anemia was observed in a smaller proportion. Associations between anemia patterns and selected laboratory parameters showed significant variation, with lower hemoglobin and albumin levels more frequently seen in patients with microcytic and dimorphic anemia. These findings highlight the multifactorial nature of anemia in cirrhosis and its relationship with disease severity. Conclusion: The findings of the research are such that among cirrhotic patients, normocytic anemia is of primary concern, although the microcytic and macrocytic patterns also play a considerable role. These patterns serve a purpose in guiding the clinician toward nutritional deficit recognition, occult blood loss, or bone marrow suppression, in a timely manner for more directives to be managed. Assessing the anemia pattern in cirrhosis is of great importance in aiding the medical professional in improving the clinical decision, more so, the overall patient's condition.
Liver cirrhosis, Anemia, Morphological patterns, Normocytic anemia, Microcytic anemia, Peripheral smear, Hematological abnormalities.
ADVERSE DRUG REACTIONS OF SELECTIVE SEROTONIN REUPTAKE INHIBITORS IN GENERALIZED ANXIETY DISORDER: A PROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN RURAL INDIA
Background: Generalized anxiety disorder (GAD) affects approximately 6% of the population globally, with selective serotonin reuptake inhibitors (SSRIs) representing first-line pharmacotherapy. However, adverse drug reaction (ADR) profiles in real-world settings, particularly in rural Indian populations with GAD, remain inadequately documented. Methods: This prospective observational study was conducted over 12 months in the psychiatry outpatient department. Forty-five drug-naïve adult patients with newly diagnosed GAD (ICD-10 criteria) prescribed SSRI monotherapy were enrolled using systematic random sampling. ADRs were monitored using structured proformas and assessed using WHO-UMC causality scale, modified Hartwig and Siegel severity scale, and Schumock and Thornton preventability criteria. Data were analyzed using descriptive statistics and chi-square tests. Results: Among 45 GAD patients (mean age 36.0 ± 1.92 years; M:F = 0.95:1), 88 ADRs were reported. Escitalopram was most frequently implicated (53.3%), followed by paroxetine (28.9%). Central nervous system ADRs predominated (50%), with headache (11.4%), dizziness (10.2%), and drowsiness (9.1%) being most common. Gastrointestinal ADRs accounted for 33%. Most ADRs were mild (88.6%) and non-preventable (90.9%). All ADRs were classified as "possible" by causality assessment. Tobacco use showed significant association with multiple ADR occurrence (p=0.035). Conclusion: SSRIs demonstrate an acceptable safety profile in GAD management with predominantly mild, manageable ADRs. Enhanced pharmacovigilance, patient education regarding lifestyle modifications, and routine cognitive monitoring may optimize therapeutic outcomes in rural populations.
Generalized anxiety disorder; Selective serotonin reuptake inhibitors; Adverse drug reactions; Pharmacovigilance; Montreal Cognitive Assessment; Rural India.
COMPARATIVE OUTCOMES OF LAP VS OPEN APPENDECTOMY IN ACUTE APPENDICITIS
Acute appendicitis is considered to be one of the most frequent surgical emergencies in the world. The laparoscopic appendectomy (LA) versus open appendectomy (OA) is an issue that is still subject to debate, particularly regarding the length of the operation time, post-surgery complications, and recovery. Objective: To compare the clinical outcomes, postoperative complications, and recovery rates of laparoscopic and open appendectomies in patients with acute appendicitis in DHQ Hospital Abbottabad, KPK, Pakistan. Methods: The research design was a cross-sectional study, which was conducted at DHQ Hospital Abbottabad, KPK, Pakistan from August, 2024 to July, 2025, and covered 120 patients with acute appendicitis. The study participants were divided equally into two groups: laparoscopic appendectomy (n=60) and open appendectomy (n=60). Data were analyzed using SPSS to calculate the time of operation, length of stay, postoperative pain, complications, and recovery to normal. Results: The mean time of operation in the LA (61.5 ± 10.2 min) was higher than that in OA (54.7 ± 9.4 min; p=0.001). Nevertheless, patients had significantly shorter stay in hospital (1.8 ± 0.6 vs 3.6 ± 1.2 days; p<0.001), wound infection (5% vs 16.7%; p=0.04), and normal activities (4.2 ± 1.1 vs 7.8 ± 1.5 days; p<0.001). The patients were also more content with the laparoscopic group. Conclusion: Laparoscopic appendectomy is superior to open appendectomy, which is less painful to the patient postoperatively, has less hospitalization, fewer complications, and a shortened recovery period despite slightly longer operating time. It should be taken as the suggested surgical procedure in uncomplicated cases of acute appendicitis in tertiary care hospitals where adequate skills and materials are available
EFFECTIVENESS OF CORE STABILIZATION EXERCISES IN REDUCING CHRONIC LOW BACK PAIN AMONG ADULTS: A RANDOMIZED CONTROLLED TRIAL
Chronic low back pain (CLBP) is a common musculoskeletal disorder that causes pain, functional limitation, and reduced quality of life. Core stabilization exercises have been proposed as a targeted intervention to improve spinal stability, reduce pain, and enhance functional outcomes. This study aimed to evaluate the effectiveness of core stabilization exercises in adults with chronic low back pain. Methodology: A randomized controlled trial was conducted on 80 adults aged 25–55 years with chronic low back pain lasting more than 12 weeks. Participants were randomly assigned to either the intervention group, which received a supervised core stabilization exercise program, or the control group, which underwent conventional physiotherapy. Both interventions were delivered three times per week for eight weeks. Pain intensity was measured using the Visual Analog Scale (VAS), and functional disability was assessed using the Oswestry Disability Index (ODI) at baseline, week 4, and week 8. Data were analyzed using paired and independent t-tests with a significance level of p < 0.05. Results: Both groups demonstrated significant improvements in pain and functional disability (p < 0.05). However, the core stabilization group showed a greater reduction in mean VAS scores (6.8 ± 1.2 to 2.3 ± 0.9) compared to the control group (6.7 ± 1.3 to 4.8 ± 1.1, p < 0.001). Similarly, ODI scores decreased more substantially in the intervention group (48.5 ± 7.2 to 22.1 ± 5.3) than in the control group (47.9 ± 6.9 to 35.6 ± 6.1, p < 0.001). Conclusion: Core stabilization exercises are more effective than conventional physiotherapy in reducing pain and improving functional outcomes in adults with chronic low back pain. These exercises should be incorporated into rehabilitation programs to enhance spinal stability and promote long-term functional recovery.
Chronic low back pain, core stabilization exercises, physiotherapy, Visual Analog Scale, Oswestry Disability Index
ADVERSE DRUG REACTIONS OF SELECTIVE SEROTONIN REUPTAKE INHIBITORS IN PATIENTS WITH DEPRESSION: A PROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CARE HOSPITAL IN RURAL INDIA
Background: Selective serotonin reuptake inhibitors (SSRIs) are widely used as first-line treatment for depression; however, their adverse drug reaction (ADR) profile in rural Indian populations remains underreported. Understanding real-world safety patterns is crucial for optimizing therapeutic outcomes and strengthening pharmacovigilance in resource-limited settings. Methods: This 12-month prospective observational study included drug-naïve adults with newly diagnosed depression attending a tertiary care hospital in rural Haryana. Patients prescribed SSRI monotherapy were followed at 3 and 6 weeks to identify ADRs using structured questionnaires and patient interviews. ADRs were evaluated using the WHO-UMC causality scale, Modified Hartwig and Siegel severity scale, and Schumock and Thornton preventability criteria. Data were analyzed using descriptive statistics and chi-square tests. Results: Among 51 patients (mean age: 34.8 ± 11.2 years), Escitalopram was the most frequently prescribed SSRI (60.8%) and accounted for the highest proportion of ADRs (57.1%). A total of 119 ADRs were reported, predominantly affecting the central nervous system (52.1%), followed by gastrointestinal manifestations (32.8%). The most common ADRs were headache (12.6%), dizziness (11.7%), nausea (10.9%), dry mouth (9.2%), and drowsiness (8.4%). All ADRs were categorized as “possible” on causality assessment. Most ADRs were mild (74.8%) and non-preventable (79.8%), while 25.2% were moderate and 20.2% were probably preventable. Tobacco use (p = 0.047) and tobacco/paan consumption (p = 0.032) showed significant associations with multiple ADR occurrence, whereas age, gender, BMI, and marital status showed no significant associations. Conclusion: SSRIs demonstrated a favorable and largely manageable safety profile in this rural cohort, with predominantly mild central nervous system and gastrointestinal ADRs. The association of tobacco use with increased ADR frequency highlights the need for integrated lifestyle counseling. Strengthened patient education and enhanced pharmacovigilance practices may further improve treatment adherence and safety in rural Indian settings.
Adverse drug reactions; SSRIs; Depression; Escitalopram; Pharmacovigilance; Rural India.
FREQUENCY OF SECONDARY HEMORRHAGE AFTER ELECTROCAUTERY TONSILLECTOMY" IN THE DEPARTMENT OF ENT
Tonsillectomy is a surgical intervention that is one of the most common in the field of otolaryngology, and along with the modernization of the surgical process, postoperative bleeding, especially secondary bleeding, is a severe and potentially fatal complication. Electrocautery tonsillectomy provides better hemostasis during the operation, but delayed bleeding as a result of thermal injury and sloughing of the eschar remains a major clinical problem. Objective: The frequency of secondary hemorrhage following electrocautery tonsillectomy and to determine the risk factors among patients who underwent electrocautery tonsillectomy at the Department of ENT, the MTI-HMC, Peshawar. Methods: The descriptive case series was performed between 21st September, 2020 and 21st March, 2021 in the Department of ENT, MTI-HMC Peshawar. One hundred and twenty patients who are aged 5-40 years with electrocautery tonsillectomy were selected. Information was gathered regarding age, gender, time and treatment of hemorrhage. Secondary bleeding was observed by following patients 14 days after their operations. Results: Secondary hemorrhage developed in 18 (15%) patients out of 120. Most of them (55.6%) took place during the 5th-7th postoperative days. The majority of the cases were treated conservatively (55.6 percent), and only 33.3 percent had to be re-cauterized with general anesthesia. No mortality was reported. Conclusion: Secondary hemorrhage post-electrocautery tonsillectomy is a well-researched postoperative complication, with most of the incidences occurring within the first week of the operating procedure. Risk minimization should be through preventive measures such as careful surgical practice, infection prevention, and close follow-up of the patient. Early detection and timely treatment guarantee good results and improve patient safety in tonsillectomy.
Electrocautery, Tonsillectomy, Secondary Hemorrhage, ENT Surgery, Postoperative Complications.
Copyright (c) 2023 Journal of Population Therapeutics and Clinical Pharmacology http://creativecommons.org/licenses/by-nc/4.0
“URINARY TRACT INFECTION RATES AMONG PATIENTS WITH COMPLEX KIDNEY STONES”
: Urinary tract infections (UTIs) are common postoperative complications in patients with complex kidney stones undergoing percutaneous nephrolithotomy (PCNL). Despite advancements in surgical techniques, infection control remains a significant challenge, particularly in high-risk populations. Objective: To determine the prevalence, causative organisms, and associated risk factors of UTIs among patients with complex kidney stones treated at the Institute of Kidney Diseases Hayatabad Peshawar, KPK, Pakistan. Methods: This cross-sectional study was conducted at Institute of Kidney Diseases Hayatabad Peshawar, KPK in the duration from February 2025 to July 2025, involving 180 patients with complex renal calculi who underwent PCNL. Preoperative and postoperative urine cultures were obtained. Demographic, clinical, and microbiological data were analyzed using SPSS version 26. Chi-square and logistic regression tests were Institute of Kidney Diseases Hayatabad Peshawar, KPK. Results: Among 180 patients, 51 (28.3%) developed postoperative UTIs. The infection rate was significantly higher in females (38.9%) than males (21.3%) (p = 0.02). Escherichia coli (47%) was the most common pathogen, followed by Klebsiella pneumoniae (23%) and Pseudomonas aeruginosa (15%). High antibiotic resistance was noted against fluoroquinolones (68%) and cephalosporins (62%). Larger stone size (>2 cm) and prolonged operative time (>90 minutes) were significantly associated with infection (p < 0.05). Conclusion: UTIs remain prevalent among patients with complex kidney stones after PCNL at Institute of Kidney Diseases Hayatabad Peshawar, KPK. Female gender, stone complexity, and extended operative duration are major predictors. Strengthened infection control measures, antibiotic stewardship, and early microbiological screening are essential to reduce postoperative complications and enhance patient outcomes.
Kidney stones, urinary tract infection, PCNL, E. coli, infection control, Institute of Kidney Diseases Hayatabad Peshawar, KPK, Pakistan
"ANATOMICAL VARIATIONS OF THE SCIATIC NERVE AND THEIR RELEVANCE IN HIP ARTHROPLASTY"
Background: The sciatic nerve is the largest peripheral nerve of the lower limb, and its anatomical course in relation to the piriformis muscle and posterior hip structures is clinically significant in hip arthroplasty. Although the classical description places the sciatic nerve emerging inferior to the piriformis muscle, multiple anatomical variations have been documented, including high division, accessory bundles, and atypical relationships with surrounding musculature. These variations may increase the risk of iatrogenic nerve injury, postoperative neuropathy, altered surgical exposure, and variable response to regional anesthesia. Understanding these variations is essential for orthopedic surgeons performing hip arthroplasty through posterior, anterolateral, or minimally invasive approaches. Objective: To determine the anatomical variations of the sciatic nerve in patients undergoing hip arthroplasty and to assess their clinical relevance regarding surgical exposure, intraoperative nerve protection, and postoperative neurological outcomes Methodology: An observational descriptive study was conducted in the Orthopedic Surgery Department Sughra Shafi Medical Complex Narowal over a period of one year from 1st January to 31st December 2024. A total of 50 patients undergoing primary hip arthroplasty for osteoarthritis, femoral neck fractures, or avascular necrosis were selected through consecutive sampling. Intraoperative exploration was performed using standard posterior or anterolateral approaches to document the sciatic nerve course, bifurcation pattern, and relationship with the piriformis muscle. Variants were classified according to Beaton and Anson’s anatomical classification. Postoperative neurological assessment was conducted on day 1, day 7, and at 6-week follow-up. Data were analyzed descriptively, and associations between anatomical variation and postoperative nerve deficits were assessed using chi-square testing. Results: Sciatic nerve anatomical variations were found in 18% (n = 9) of patients. The most common variant was high division of the tibial and common peroneal components above the piriformis (10%), followed by the peroneal component passing through the piriformis muscle (6%). A rare pattern with both divisions emerging above the piriformis was observed in 2% of cases. Patients with nerve variations showed higher rates of transient postoperative neuropraxia (11.1%) compared to those with classical anatomy (4.8%). The posterior surgical approach demonstrated greater intraoperative difficulty in nerve identification among variation cases. No permanent nerve deficits were observed. High bifurcation and intrapiriformis course were significantly associated with increased risk of temporary nerve irritation (p < 0.05).
Sciatic nerve, Anatomical variations, Hip arthroplasty, Piriformis muscle, Postoperative neuropraxia, Orthopedic surgery
ANTI-INFLAMMATORY, ANTI-DIABETIC AND LARVICIDAL ACTIVITY OF ETHYL ACETATE FRACTION OF LEAVES AND STEM OF VIBURNUM COTINIFOLIUM D.DON.
Vibernum cotinifolium is a deciduous shrub growing up to 3.5 m. The plant is traditionally used for many treatments. Viburnum cotinifolium is well known in folk medicine for sedative, spasmolytic, antioxidants, antibacterial, astringent and anti-asthematic properties. In current study the Larvicidal, anti-inflammatory and anti-diabetic activity of the ethyl acetate fraction of stem and leaves of Vibernum cotinifolium has been explored. In larvicidal activity the extracts were tested against Adies larvae and showed moderate to high toxic effect on Adies larvae after 72 hours of exposure at 300ppm concentration, while maximum inhibition (80%) was observed in ethyl acetate fraction of leaves of V. cotinifolium with LC50 value of 187.5 ppm. In stem ethyl acetate fraction the maximum inhibition was 71.7 percent after 72 hours of exposure at the concentration of 300ppm. In carragenan-induced paw edema model each fraction was supplied at a dose of 100 mg/kg, 200 mg/kg and 300 mg/kg. At 300 mg/kg the ethyl acetate fraction of leaves showed 54.83 % inhibition. While the stem fraction showed 49.82% inhibition. In anti-diabetic activity results were well comparable with the standard drug glibenclamide. The stem fraction was more effective as compared to standard drug with 86.07 percent inhibition. In all the three bioassays the plant showed potent inhibition which ensure its uses as cure for these diseases.
Larvicidal, anti-inflammatory, anti-diabetic, ethyl acetate.
Copyright (c) 2024 Journal of Population Therapeutics and Clinical Pharmacology http://creativecommons.org/licenses/by-nc/4.0
AN OBSERVATIONAL STUDY ON ULTRASOUND AND MAGNETIC RESONANCE IMAGING CORRELATION OF ANKLE AND FOOT PAIN WITH MAGNETIC RESONANCE IMAGING AS GOLD STANDARD IN THE DEPARTMENT OF RADIODIAGNOSIS, SMS MEDICAL COLLEGE AND HOSPITAL, JAIPUR
Musculoskeletal conditions involving the foot and ankle present a considerable public health challenge due to their increasing prevalence and significant effects on patients' quality of life. Materials & Methods: his hospital-based cross-sectional study, conducted in the Radiodiagnosis Department at SMS Medical College, Jaipur, employed a descriptive observational design. Data collection involved 70 patients referred for Ultrasound (US) and Magnetic Resonance Imaging (MRI) of the ankle and foot, selected according to specific inclusion criteria. Patients underwent a high-frequency ultrasound examination followed by MRI to confirm diagnoses, with MRI as the reference standard. The MRI protocol included axial, sagittal, and coronal views in various imaging sequences tailored to evaluate specific foot and ankle regions. Result : Ultrasound (USG) identified 64.29% of ankle tendon pathologies compared to MRI’s 77.14%, with Achilles tendinosis as the most common finding. USG exhibited high specificity and positive predictive value (PPV) for most tendon conditions, though sensitivity varied, performing well for Achilles tendinitis but less so for partial tears. For ligament pathologies, USG identified 18.57% of cases versus MRI’s 22.86%, detecting common injuries like ATFL tears with high sensitivity, specificity, PPV, and NPV but struggled with deltoid ligament tears. In posterior impingement syndrome and osseous lesions, MRI outperformed USG in sensitivity, capturing conditions like calcaneal lipoma and OCD of the talar dome, which USG missed. MRI also proved superior in detecting entrapment neuropathies. For foot lesions, USG showed perfect agreement with MRI in conditions like plantar fasciitis. Conclusion: Overall, USG and MRI demonstrated complementary strengths, with MRI providing enhanced sensitivity for certain complex pathologies and USG excelling in targeted diagnoses, underscoring their combined diagnostic value.
ULTRASOUND, MAGNETIC RESONANCE IMAGING, ANKLE AND FOOT PAIN
SALIVARY BIOMARKERS OF INFLAMMATION IN RESPONSE TO DENTAL MATERIALS IN ORAL PRECANCEROUS CONDITIONS IN AFGHAN POPULATION
: Salivary biomarkers are non-invasive, cost-effective means to assess inflammatory responses and identify precancerous lesions in the oral cavity. The dental materials that are used may have an impact on local inflammation, altering the course of the disease and the state of the mucosa. Objective: The primary purpose of the study was to measure the salivary biomarkers of inflammation (IL-1β, IL-6, and IL-8) generated in response to dental materials in patients with oral precancerous conditions in Afghan population. Methods: A study was performed during the period September, 2024 to February, 2025 at National Stomatology Curative and Specialty Hospital, Kabul, Afghanistan. The study comprised 40 patients with oral precancerous lesions, who were randomly assigned to two groups: composite resin and amalgam. Results: Significant increases in IL-1β, IL-6, and IL-8 were observed at 1-week post-treatment, especially in the composite resin group, followed by a gradual decline over two months. Conclusion: Dental materials trigger transient inflammatory responses; salivary biomarkers can effectively monitor oral inflammation.
Saliva, Biomarkers, Inflammation, Dental materials, Oral precancerous conditions, Cytokines.
EFFECTIVENESS OF THERMAL BALLOON ENDOMETRIAL ABLATION IN THE MANAGEMENT OF ABNORMAL UTERINE BLEEDING UNRESPONSIVE TO MEDICAL THERAPY: A PROSPECTIVE OBSERVATIONAL STUDY
Background: Abnormal uterine bleeding (AUB) is a prevalent gynecological condition that significantly impairs quality of life, particularly among perimenopausal women. While medical therapy is the first-line treatment, a substantial proportion of women fail to achieve adequate symptom control and require minimally invasive alternatives. Thermal balloon endometrial ablation (TBEA) has emerged as a safe and effective uterus-preserving option for such cases. Objectives: To evaluate the clinical efficacy, hematological improvement, and safety profile of thermal balloon endometrial ablation in women with AUB refractory to medical management. Methods: This prospective observational study included 30 women aged 35–50 years with AUB persisting despite at least six months of medical therapy. Baseline assessments included PBAC scoring, pelvic examination, Pap smear, endometrial biopsy, ultrasound evaluation, and hemoglobin estimation. All participants underwent TBEA under anesthesia. Follow-up was conducted at 10 days, 1 month, and 3 months, assessing menstrual outcomes, PBAC score, endometrial thickness, hemoglobin level, and postoperative complications. Results: The mean pre-treatment PBAC score significantly reduced from 740.0 ± 108.8 to 142.8 ± 189.6 at three months, corresponding to an 80.7% reduction (p < 0.001). Endometrial thickness decreased from 9.24 ± 1.26 mm to 5.55 ± 0.47 mm, a 40% reduction (p < 0.001). Hemoglobin levels showed a significant improvement from 9.43 ± 1.13 g/dL to 9.87 ± 0.76 g/dL (p = 0.027). No major intraoperative or postoperative complications were observed, and patient satisfaction was high at follow-up. Conclusion: Thermal balloon endometrial ablation is a highly effective and safe treatment modality for AUB refractory to medical therapy. It offers substantial reduction in menstrual blood loss, normalization of endometrial thickness, improvement in hemoglobin levels, and excellent patient satisfaction. TBEA represents a valuable minimally invasive alternative to hysterectomy, particularly in resource-limited settings.
Abnormal uterine bleeding; Thermal balloon endometrial ablation; Endometrial thickness; PBAC score; Minimally invasive gynecology; Refractory AUB; Menorrhagia.
A PROSPECTIVE STUDY TO EVALUATE CLINICO-RADIOLOGICAL AND HISTOPATHOLOGICAL FEATURES, SURGICAL OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH SUPRATENTORIAL GLIOMAS
Background: Supratentorial gliomas are a major form of primary brain tumor, which are located in the cerebral hemispheres, and cause a substantial proportion of central nervous system malignancies in adults. All these tumours are developed by glial cells, mainly, astrocytes and oligodendrocytes and they have varied histopathological characteristics which determine the clinical presentation, treatment and prognosis. Diagnosis and grading require radiological imaging, especially MRI and histopathological analysis. Surgical intervention, coupled with other prognostic variables, has a huge influence on patient outcome. Methods: The study took place at the Department of Neurosurgery, J.A. Group of Hospitals and G.R. Medical College, Gwalior, India, between 2023 and 2025 as a prospective observational study. One hundred and ten patients aged 14 years and above who had supratentorial gliomas were involved. Data regarding clinical, radiological, surgical and histopathological were gathered. The analysis of postoperative outcomes and complications was performed, as well as the prognostic factors and the statistical analysis including chi-square and logistic regression were used to discuss the relationship between variables. Results: It was found that the highest incidence of glioma was highest in patients aged 41-60 years and male patients made up 60 per cent of the cohort. The presenting symptoms were seizures (68.2%), and headache (50.9%). The most common histopathological observation (40.91%), and Grade II astrocytomas (27.27) were the most common. A gross total resection was obtained in 61.8% and the rate of postoperative complication 30 with a mortality rate of 3.6. Advanced age (>50 years), low preoperative Karnofsky Performance Score (KPS < 70), high-grade gliomas (WHO Grade III-IV), and postoperative complications were significant prognostic factors that were associated with poor outcomes. Conclusion: The study shows that supratentorial gliomas occur more often in middle-aged men and the most frequent symptom is the seizures. The outcomes are strongly dependent on tumor grade and preoperative functional status. Gross total resection is an important variable to enhance prognosis. The results report that early diagnosis, aggressive surgical treatment, and a meticulous approach to prognostic variables in the course of treatment are critical issues.
Supratentorial gliomas, Glioblastoma, Surgery, Prognostic factors, Seizures, Tumor grade.
A REVIEW ON CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL THERAPY: A PARADIGM SHIFT IN CANCER IMMUNOTHERAPY
Chimeric Antigen Receptor (CAR) T-cell therapy has become one of the greatest breakthroughs in cancer immunotherapy, with the ability to cure patients with leukemias and lymphomas, thus changing the entire approach. The procedure made it possible to overcome the drawbacks of an ordinary T-cell response by turning it into an MHC-independent targeted, cytotoxicity with a patient’s T-cells that are genetically engineered to recognize and eliminate cancer-specific antigens. This review is about CAR-T cell therapy, describing its biological groundwork, the series of CAR constructs, the making process, action mechanism, and present-day FDA-approved clinical use, showing a vast range of information concerning CAR-T therapy. The investigation into the therapeutic advances in the treatment of leukemia, lymphoma, and multiple myeloma is illustrated along with the difficulties presented in the treatment of solid tumors, which are tumor heterogeneity, the problem of immunosuppressive microenvironments, antigen escape, and limited trafficking. The important toxicities of cytokine release syndrome and neurotoxicity are discussed with a major focus on grading, management strategies, and recent safety-improving developments. Innovations such as dual-target CARs, armored CAR-T cells, allogeneic “off-the-shelf” products, gene-edited CAR-T platforms, and the merging with checkpoint inhibitors point to the rapidly evolving future of this therapy. Finally, CAR-T cell therapy is a game changer in the oncology field, and if continued research expands its application to a greater number of tumors, it will be one of the most personalized, long-lasting, and powerful cancer treatment methods.
CAR-T cell therapy; Chimeric Antigen Receptor; cancer immunotherapy; adoptive cell transfer; hematologic malignancies; targeted therapy; cytokine release syndrome; ICANS; tumor microenvironment; engineered T-cells; personalized medicine.
LEVERAGING AI AND CRISPR IN BIOTECHNOLOGY TO COMBAT HPV-INDUCED CERVICAL CANCER: CURRENT ADVANCES AND FUTURE PERSPECTIVES
This review explores the synergistic integration of artificial intelligence (AI) and CRISPR-Cas9 technologies in biotechnology to address human papillomavirus (HPV)-induced cervical cancer, a major global health challenge. By targeting HPV oncogenes i.e. E6 and E7, CRISPR offers a precision oncology approach to restore tumour suppressor functions, while AI enhances the design and optimization of these therapies. We synthesize recent advancements, including clinical trials, AI-driven guide RNA design, and biotechnological applications, while addressing challenges like off-target effects and ethical concerns. This review highlights the transformative potential of these technologies in virology and oncology, with a focus on future directions for personalized cancer treatments.
ANTIBACTERIAL EFFICACY OF MORINGA OLEIFERA LATEX EXTRACT AGAINST PYOGENIC BACTERIA
Effective management of biofilm-related oral infectious diseases and increased resistance to antimicrobial agents and elevated virulence is now leading as a global challenge. Streptococcus pyogenes has been reported to be one of the most common and influential aerobic bacteria associated with leading cause of uncomplicated bacterial pharyngitis and tonsillitis. Due to prevailing use of antibiotics has been raising a real alarming issue, hence one alternative to overcome these problems is to use natural ingredients such as materials from plant extract such as Moringa oleifera latex. In the past, researchers paid only a little attention towards the plant extract which acts effectively against oral infection by latex. This study is aimed to evaluate the antibacterial activity of the latex of Moringa oleifera against Streptococcus pyogenes from the provided pure cultured master plate. Latex ( 2gm latex – 2ml DMSO-Dimethyl sulfoxide) is given to dissolved with DMSO within 48 hrs of collection left undisturbed overnight. DMSO is previously tested for negative control. Antibacterial Assay of Latex were calculated based on the inhibition zones using the Mueller–Hinton agar diffusion method (19.5–23.4 mm and 12–15 mm) , minimum inhibitory concentration (MIC) using Mueller–Hinton broth in a microdilution method ( 100% - 25%), and minimum bactericidal concentration (MBC) using nutrient broth and nutrient agar( 100%and 50%) . On witnessing the inhibitory results of M. oleifera latex can be considered one of the new infection-fighting strategies in controlling pyogenic bacteria responsible for oral infections, but further in vivo research and discovery of the mode of its action are immediately required to shed the light on the effects of latex against infection in buccal cavity instead of taking antibiotic pills, which might save the world from drug resistant bacterial pathogen
Moringa oleifera, Streptococcus pyogenes, pharyngitis, tonsillitis.
ASSOCIATION OF DOOR TO DIURETIC TIME ON MORTALITY AND MORBIDITY IN ACUTE HEART FAILURE
This study was prospective, observational study of patients hospitalized for acute heart failure (AHF). All patients were followed up for six months after the index hospitalization. Early group (n = 137) received IV diuretics within 90 minutes while as Delayed group (n = 293) received IV diuretics after 90 minutes. Demographic parameters like age, gender and comorbid illness was compared in patients in Early Group and Delayed Group and the association was found to be statistically insignificant (p >0.05). Insignificant statistical difference was observed when smoking status was compared between two study groups. There were 21.9% smokers in Early Group compared to 17.4% smokers in Delayed Group. On echocardiography, heart failure with preserved ejection fraction (HFpEF) was observed in 48.1% patients, heart failure with reduced ejection fraction (HFrEF) was seen in 39.1% patients and 12.8% patients had heart failure with midrange ejection fraction (HFmrEF). In-hospital mortality was higher in Delayed Group (12.3%) compared to Early Group (5.1%) with significant statistical difference (p < 0.05). Mean length of hospitalization was shorter in Early Group (14.7 days) compared to 17.3 days in Delayed Group (P < 0.05). Readmission at 1 month in two study groups was found to be statistically insignificant (p>0.05) with 13.9% in Early Group compared to 16.4% in Delayed Group. Readmission at 6 month was again higher in Delayed Group 12.3% versus 9.5% in Early Group with an insignificant statistical association (p > 0.05). At one month significantly higher mortality was observed in Delayed Group (14.3%) compared to 7.3% in Early Group (p<0.05). At 6 month, there was higher mortality in Delayed Group (22.9%) compared to 13.1% in Early Group with a statistically significant association between (p <0.05).
acute heart failure, reduced ejection fraction, preserved ejection fraction, readmission, mortality
A STUDY OF THE ROLE OF SERUM ALBUMIN LEVELS AND BLOOD UREA NITROGEN/ALBUMIN RATIO IN PREDICTING OF THE PROGNOSIS OF COMMUNITY ACQUIRED PNEUMONIA
Community-acquired pneumonia (CAP) remains a significant cause of morbidity and mortality worldwide. Although commonly used scoring systems such as CURB-65 and the Pneumonia Severity Index (PSI) help assess disease severity, their predictive accuracy for mortality and the need for intensive care unit (ICU) admission is remains limited. Recent studies have indicated that low serum albumin levels are associated with poorer outcomes in CAP, while elevated blood urea nitrogen (BUN) levels and decreased albumin levels correlate with higher mortality. The present study aimed to evaluate the role of serum albumin levels and the BUN/Albumin (BUN/Alb) ratio in predicting disease severity, complications, ICU requirements, and one-month mortality in patients with CAP. Materials This study included 121 patients aged above 18 years who were diagnosed with community-acquired pneumonia. Laboratory investigations included complete blood counts, serum albumin levels, and BUN levels, from which the BUN/Alb ratio was calculated. The CURB-65 and PSI scores were also determined for each patient. Individuals with immunocompromised states, chronic liver disease, chronic renal failure, or those receiving immunosuppressive therapy were excluded from the study. Results A total of 121 patients were enrolled. Patients requiring ICU admission demonstrated significantly higher BUN/Alb ratios (p<0.001) and higher mortality rates (p<0.001). Thirteen patients required ICU care. These patients had higher CURB-65 (≥2) and PSI (≥3) scores and lower serum albumin levels. Low serum albumin was a significant risk factor for ICU admission (p<0.001). Mean BUN levels were higher among ICU patients (23.76 ± 5.54, p<0.001), as was the BUN/Alb ratio (mean 7.1, p<0.001). The optimal BUN/Alb ratio cut-off for predicting ICU admission was 5.78, with a sensitivity of 89.1% and a specificity of 67.7%. Conclusion Patients with CAP who exhibit higher BUN/Albumin ratios are at greater risk of requiring ICU admission. Low serum albumin levels are significant predictors of disease severity and the need for ICU admissions in pneumonia.
Community-Acquired Pneumonia; BUN, Serum Albumin, BUN/Albumin Ratio, CURB-65, PSI.
DEVELOPMENT AND CHARACTERIZATION OF ANTIMICROBIAL DENTAL GEL FOR ORAL HEALTH FROM HERBAL SOURCE
This study focuses on the development and characterization of an antimicrobial dental gel using natural ingredients, including neem extract, clove oil, honey, and vitamin E. Three gel formulations (F1, F2, and F3) were prepared with varying concentrations of these ingredients and evaluated for their antimicrobial activity, pH, viscosity, spreadability, and skin irritation potential. The results showed that all formulations exhibited antimicrobial activity against Streptococcus mutans, with F3 demonstrating the most significant activity. F3 had a pH of 7.0, viscosity of 9632 cps, and spreadability of 26.08. The study suggests that the F3 formulation holds potential for development as a natural, plant-based oral gel for managing and preventing oral infections.
Neem extract, Clove oil, Antimicrobial dental gel, Natural oral care, Streptococcus mutans, Oral infections and Herbal formulation.
PREVALENCE AND ASSOCIATED FACTORS OF THYROID DYSFUNCTION AMONG WOMEN OF REPRODUCTIVE AGE IN AN URBAN RESETTLEMENT: A CROSS-SECTIONAL STUDY
Thyroid dysfunction is a common endocrine disorder, particularly among women of reproductive age, impacting fertility, pregnancy outcomes, and overall health. There is a paucity of community-based data on its prevalence in vulnerable populations, such as urban resettlement colonies in India. We conducted this study to determine the prevalence of thyroid dysfunction and identify its associated sociodemographic and dietary factors among women of reproductive age in an urban resettlement colony of Delhi. Methods: A community-based, cross-sectional study was conducted from January to December 2021 in Gokul puri, Delhi. We selected women of reproductive age group using systematic random sampling. Data were collected using a pre-tested, semi-structured questionnaire covering sociodemographics, clinical history, and dietary practices. Venous blood samples were analysed for thyroid-stimulating hormone (TSH), free T3 (fT3), and free T4 (fT4) using electrochemiluminescence immunoassay (eCLISA). Data were analysed using SPSS v25, with Chi-square and Fisher’s exact tests used for associations. Results: We collected data from 180 females. The mean age of participants was 36.3 ± 9.1 years. The overall prevalence of thyroid dysfunction was 28.3% (n=51). Hypothyroidism was present in 25.6% (n=46) of participants, with the majority being previously undiagnosed. 16.7% (n=30) had subclinical hypothyroidism and 5.6% (n=10) had overt hypothyroidism. Known cases of hypothyroidism comprised 3.3% (n=6). Hyperthyroidism was found in 2.7% (n=5) of participants (2.2% subclinical, 0.5% overt). Significant associations with thyroid dysfunction were found for marital status (p=0.02), frequent consumption of cabbage/cauliflower (p=0.00), a family history of thyroid disorder (p=0.00), being overweight or obese (BMI > 23 kg/m², p=0.03), and a history of adverse pregnancy outcomes (p=0.00). Conclusion: This study reveals a high, predominantly hidden burden of thyroid dysfunction, particularly subclinical hypothyroidism, in this urban community. The strong association with goitrogenic dietary preferences, family history, obesity, and adverse pregnancy outcomes highlights an urgent need for targeted community-based screening, health education, and public health interventions for women of reproductive age.
TRIMESTER-BASED ASSESSMENT OF HEMORRHOIDS AND ANAL FISSURES DURING PREGNANCY AND POSTPARTUM: A PROSPECTIVE STUDY AMONG WOMEN"
: Hemorrhoids and anal fissures are among the most frequent anorectal disorders affecting pregnant and postpartum women. Physiological, hormonal, and mechanical changes during gestation increase susceptibility to perianal pathology. Aim and Objective: This prospective study aimed to assess prevalence, trimester-wise distribution, and associated risk factors for hemorrhoids and anal fissures among pregnant women across tertiary care centres in North India. Material and Methods: A total of 510 pregnant women were enrolled from three tertiary care centres between April 2024 and September 2025. Each participant underwent clinical evaluation at four intervals—first trimester, third trimester, immediate postpartum, and one month postpartum. Women with gastrointestinal, inflammatory bowel, or malignancy-related conditions were excluded. Data were analyzed using SPSS v26 with logistic regression. Results: Out of 510 women, 252 (49.4%) developed perianal disorders. The majority occurred in the third trimester (n = 173; 68.6%), followed by the second trimester (n = 54; 21.4%) and postpartum period (n = 25; 9.9%). Hemorrhoids alone were present in 180 (71.4%) cases, while 72 (28.6%) had both hemorrhoids and fissures. Constipation (64.2%), prolonged second stage of labour, and birth weight >3900 g were key risk factors (p < 0.05). Vaginal delivery was observed in 414 (81.2%) and cesarean section in 96 (18.8%). Conclusion: Perianal disorders remain a common maternal morbidity during late pregnancy and postpartum, predominantly driven by constipation, high fetal weight, and prolonged labour. Early antenatal screening and preventive measures are critical for reducing incidence and improving quality of life.
Pregnancy, postpartum, hemorrhoids, anal fissures, constipation, perianal disorders, multicentric study
IMMUNEBOOSTING HERBS TRADITIONALLY USED IN HOUSEHOLDS
The mammalian immune system is vital for defending the body against infectious diseases and harmful pathogens. This paper reviews various herbs traditionally used for their immune-boosting properties. Specifically, it explores ginger, black pepper, turmeric, Tulsi , fenugreek, and ashwagandha, highlighting their active constituents and health benefits. These herbs exhibit immunomodulatory, anti-inflammatory, and antioxidant properties, making them effective in enhancing both innate and adaptive immunity. With their rich phytochemistry, they provide natural alternatives to synthetic drugs, offering holistic immune support with fewer side effects. The use of these herbs, prominent in traditional medicine systems like Ayurveda, holds promise for both preventive health and therapeutic applications. The findings emphasize the importance of incorporating these herbs into daily routines to strengthen the immune system, particularly in the face of emerging diseases.
: Immune-boosting hearbs , traditionally used , fewer side effect , alternative to synthetic one .
ASSOCIATION BETWEEN SERUM 25-HYDROXYVITAMIN D LEVELS AND CHRONIC URTICARIA IN PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN NORTH INDIA: A CASE-CONTROL STUDY
Chronic urticaria (CU) is a prevalent and often debilitating inflammatory dermatosis characterized by recurrent wheals and/or angioedema persisting for six weeks or longer. The underlying pathology involves mast cell activation and immune system dysregulation. Vitamin D, specifically its circulating form 25-hydroxyvitamin D, is recognized as a powerful immunomodulator necessary for maintaining immune homeostasis and stabilizing mast cell function. Given the high endemic prevalence of Vitamin D deficiency (VDD) reported across North India, including the Haryana region, a localized investigation into its association with CU is clinically necessary. Objectives: The primary objective was to determine the strength of the association, quantified by the Odds Ratio (OR), between VDD (serum 25(OH)D ng/mL) and the diagnosis of Chronic Urticaria in patients attending the M M Institute of Medical Sciences and Research (MMIMSR). Secondary objectives included comparing mean 25(OH)D levels between cases and matched controls and assessing the correlation between 25(OH)D concentration and objective disease severity, as measured by the Urticaria Activity Score over 7 days (UAS7). Methodology: This hospital-based, age- and sex-matched case-control study was conducted at MMIMSR, Mullana, Ambala, Haryana, from June 2022 to December 2022. A total of 200 participants, comprising 100 consecutive CU cases ( weeks duration) and 100 healthy controls, were enrolled. Serum 25(OH)D quantification utilized the highly accurate Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) technique. Descriptive and inferential statistics, including Chi-square tests and Odds Ratio calculation, were performed using IBM SPSS Statistics software. Results (Simulated): The mean serum 25(OH)D level was significantly lower in the CU case group ( ng/mL) compared to the control group ( ng/mL; P ). The prevalence of VDD ( ng/mL) was 78.0% among cases compared to 28.0% among controls. The calculated Odds Ratio for the association between VDD and CU was 8.25 (95% CI: 4.60–14.79; P ). Furthermore, a statistically significant negative correlation was found between 25(OH)D levels and UAS7 scores (, P). Conclusion: Vitamin D deficiency is strongly associated with a significantly increased risk and greater severity of chronic urticaria in this North Indian tertiary care population. The findings support the integration of routine 25(OH)D screening and supplementation as a valuable and affordable adjunct therapy in the management protocol for CU.
ANTIMICROBIAL SUSCEPTIBILITY PATTERNS OF ESCHERICHIA COLI ISOLATED FROM PATIENTS IN CALCUTTA SCHOOL OF TROPICAL MEDICINE
This study aimed to determine the prevalence and antimicrobial susceptibility patterns of Escherichia coli (E. coli) isolated from clinical samples, primarily urine, at the Calcutta School of Tropical Medicine. Increasing rates of antimicrobial resistance in E. coli, particularly the emergence of Extended Spectrum Beta-Lactamases (ESBLs), pose a growing worldwide concern in treating infections like Urinary Tract Infections (UTIs), which E. coli is the leading cause of. OBJECTIVE: The aim of this study is to determine the prevalence and antimicrobial susceptibility of E. coli from clinical samples. Methodology A retrospective review was conducted on results from urine cultures, and data on E. coli isolates and their antimicrobial susceptibility were collected. Isolates were identified using MacConkey agar culture (showing pink-red colonies), Gram staining, and a panel of biochemical tests (Citrate, Urease, SIM, and TSI). Antimicrobial susceptibility was evaluated using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results and Conclusion Of the 487 urine samples analyzed between June and July 2022, 12.3% yielded E. coli isolates, with the highest isolation rate observed in urine specimens. The study found a significantly high overall resistance of E. coli to certain groups of antibiotics, with resistance rates for Ampicillin being the highest (>60%) and for Cephalosporins being high (around <50% >). Ampicillin is no longer recommended for the empirical treatment of UTIs due to this high resistance. High resistance was also observed for Co-trimoxazole (55%) and Ciprofloxacin (53.44%). Conversely, the isolates showed high susceptibility to certain antibiotics. Fosfomycin (resistance rate <5%) and Amikacin (resistance rate 5.17%) were found to be highly active. The emergence of resistance among uropathogenic E. coli to penicillin, cephalosporin, quinolone, fluoroquinolones, and sulfonamides limits their use as first-line UTI treatments. The study concludes that fosfomycin and nitrofurantoin could be considered appropriate antimicrobials for empirical therapy of UTIs due to their high susceptibility. Regular and continuous monitoring of antibiotic susceptibility is vital to guide and optimize empirical treatment.
Copyright (c) 2022 Journal of Population Therapeutics and Clinical Pharmacology http://creativecommons.org/licenses/by-nc/4.0
MAPPING THE MENTAL FORAMEN: MORPHOMETRIC VARIABILITY AND SURGICAL SIGNIFICANCE IN THE NORTH INDIAN POPULATION
The mental foramen (MF) is a key anatomical landmark that plays a vital role in various clinical and surgical procedures involving the mandible, including the administration of local anaesthesia and other invasive interventions. A clear understanding of its shape, position, and relationship to nearby structures is essential to reduce the risk of complications. This study aims to provide detailed anatomical insights into the location, morphological variations, and prevalence of both the mental foramen and any accessory mental foramina. Materials and Methods: Fifty-five dry adult human mandibles of unknown sex were examined to determine the number, shape, and position of the mental foramina. Measurements were taken using digital vernier callipers, and the collected data were statistically analysed to calculate mean values and standard deviations (SD). Results: All 55 mandibles showed bilateral presence of the mental foramen. Accessory mental foramina (AMF) were identified in 16 mandibles, representing a prevalence of 29.1%. The majority of the foramina (64.5%) had an oval shape. In most cases, the MF aligned with the long axis of the second premolar—62% on the right and 72% on the left. Bilateral measurements from standard anatomical landmarks were recorded, offering a comprehensive morphometric profile of the MF. Conclusion: The MF demonstrates notable morphological and morphometric variations across populations. Knowledge of its exact position and dimensions is crucial for clinicians to ensure precise surgical planning, effective administration of anaesthesia, and the prevention of mental nerve injury.
Mandible, Mental foramen, Anatomical variation, Accessory mental foramina, Morphometry
CHILD SAFETY COGNIZANCE AND TUTELAGE - A MIXED STYLE.
Background: “Children are a heritage” according to the biblical scripture. Worldwide, safety mishaps claim the lives of one in five children . Objective: This study was intended to answer the research problem ,“What are the Child Safety perspectives among mothers with toddlers?”. Since information has always had an impact on parental knowledge, a session of tutoring was believed to reform the parental apprehension. Methods: A mixed method research employing Exploratory Sequential Design included an in-depth interview among 5 mothers which aided in preparation of the educational material and there after a “child safety session” among 60 mothers of toddlers between 1-3 years of age . Samples were selected using non-probability methods. The study was conducted at Institute of Child Health and Hospital for Children, Chennai . A self-structured questionnaire with 17 questions was used . The approval of the institutional ethical committee has been obtained prior to commencement of the study. Results: Three themes emerged at the end of the thematic analysis such as, Monitoring, Knowledge and Fear. The mothers had significant increase in knowledge scores, before and after the sessions . Significant association (p>0.05) of knowledge with mother’s age, working status and Mother’s education was similar as some Asian studies. Conclusion: Safety precautions and remaining knowledgeable about child safety helps prevention of domestic accidents among children . Implication : Health care professionals should insist the awareness and sensitization programs on supporting domestic child safety.
METABOLIC DIFFERENCES BETWEEN ELDERLY PRIMIGRAVIDAE AND MULTIGRAVIDAE: A CROSS-SECTIONAL STUDY FROM BALUCHISTAN
Background: Western industrialized countries are seeing a steadily rising trend in pregnancies at advanced maternal age (AMA, i.e. from age 35 upwards), and same goes true for developing countries. At present, AMA has long been looked askance at because of its linkage with the high incidence rate of pregnancy complications. However, whether maternal age leads to concomitant changes in metabolic characteristics during pregnancy is still unknown. Moreover, no materials have yet been reported from Baluchistan area of Pakistan where the present study was carried out. Objective: To compare the serum cholesterol levels, blood glucose, and BMI between elderly primigravidae (the first pregnancy) or multigravidae in mid second trimester. Method: This cross-sectional study was carried out from January to April 2023 at three hospitals in Turbat, Baluchistan. Subjects for the investigation included 272 pregnant women aged 35 years and over (132 primigravidae and 140 multigravidae). Sociodemographic data, obstetric history and mid-second trimester laboratory findings (serum lipids, HbA1c, and BMI) were collected and analyzed. Results: Average age was 36. 8 ± 1.7 years for primigravidae and 37.5 ± 2.1 years for multigravidae. Hypertension and diabetes were more prevalent among multigravidae (22.1% and 18.6%) than primigravidae (16.7% and 12.1%). Multigravidae had higher mean BMI (27.3 ± 3.5 kg /m² vs. 26.1 ± 3. 2 kg/m²), total cholesterol (217.8 ± 31.4 mg/dL vs. 205.5 ± 28.3 mg/dL), LDL (134.7 ± 25.1 mg/dL vs. 126.4 ± 22.6 mg/dL), triglycerides (175.5 ± 34.1 mg/dL vs. 162.1 ± 30.6 mg/dL) and HbA1c (5.9% ± 0.8 vs. 5. 6% ± 0.7), but lower HDL. Hemoglobin levels were also slightly lower for multigravidae. Conclusion: Aging multigravidae have a worse obesity-adjusted metabolic profile than primigravidae s. Elderly women with kids must be carefully monitored and educated, as shown by the findings with senescence underscored in pregnancy.
Serum Cholesterol, Blood Glucose, Body Mass Index, Primigravida, Multigravida
URINARY TRACT INFECTION AND ITS ASSOCIATED RISK FACTORS AMONG PREGNANT FEMALES OF BALUCHISTAN
During pregnancy, leg cramps are a common problem. The specific sorts and dimensions of the review of literature included a relative low-quality paper. After all, no data are available about urinary tract infections in pregnant women living in Wadi Addawser, so there isn't anything on how to take definite steps on specific management procedures let alone avoid the adverse results from it. The purpose of this study was to evaluate the prevalence of bacteriologically verified urinary tract infection in pregnant women who attended maternity ward ，its risk factors and the most common antibacterial which infected pregnant women use. The article reports on an observation of 303 pregnant women from one county hospital clinic and what they recalled about certain aspects of their obstetric history. The sample was then collected using head-to-foot questioning. 53.5 % of the pregnant women in the sample had positive pathogens in their urine, the study results show. In total, E. coli (37%) accounted for the largest proportion and Klebsiella pneumoniae (27%) followed closely behind it. Antimicrobial agents used by infected women: amoxicillin and cefoxitin, respectively (40.1% & 21.6%) are the most commonly used antibiotics, while fusidic acid is used by few pregnant women (5.6%). Women with clinical symptoms including frequent urination, wetting oneself by mistake, lower abdominal pain, the color of urine changes, painful burning micturition and incomplete bladder evacuation accounted for nearly all the infected. Identifying the cause of symptoms is a good way to prevent and quickly respond to problems of urinary tract infection in pregnancy, so pathogens should be screened early on and infected cases treated promptly.
An antibacterial agent; Pregnant women; Urinary tract infection