Assessment of Self-Reported Metabolic Parameters Among Pakistani Doctors

Objective: To determine the frequency of self-reported metabolic syndrome (MetS) and its components in Pakistani. Methodology: This cross-sectional, descriptive study was conducted at Shifa International Hospital, Islamabad from August to November 2025. 360 licensed doctors (house officers, post graduate trainees, medical officers, and consultants) aged between 25 to 65 years of age completed a self-reported questionnaire on anthropometric measurements, blood pressure, fasting glucose, lipid profile, and lifestyle factors; cut-off values provided by the AHA/NHLBI for the definition of MetS were applied using ethnic and age-specific cut-off values for the Asian population. Descriptive statistics and chi-square tests were performed to evaluate associations. Results: The participants had a mean age of 28.9±5.4 years, and 60.6% of the participants were male. The mean BMI for the sample was 27.3±4.2 kg/m²; 66.1% of the participants were classified as overweight, and 7.8% were classified as obese according to BMI. From the total sample, 26.1% of the participants self-reported having MetS;the percentage of males (29.4%) was higher than that of females (21.1%);Poor physical activity levels (33% vs. 18.1%) and current smoking status (34.2% vs. 23.9%) were both associated with a greater incidence of MetS. Conclusion: Many Pakistani doctors having self-reported metabolic syndrome and its associated components. The MetS is typified by central obesity, dyslipidemia, and hypertension. The prevalence of lifestyle variables and the risk of developing metabolic diseases (lack of exercise and smoking) highlight the importance of screening and prevention among this cohort

Comparison of Diode Laser Tonsillectomy and Bipolar Cauterization Tonsillectomy

Objectives: To compare the outcomes of diode laser tonsillectomy and bipolar cauterization tonsillectomy in terms of intraoperative efficiency, postoperative recovery, and complications. Methodology: This  prospective comparative study carried out at Rawal Institute of Health Sciences (RIHS), Islamabad from January 2023 to December 2023. A total of 100 patients were randomly selected for the diode laser tonsillectomy procedure and bipolar cauterization tonsillectomy. Various details such as intraoperative parameters, postoperative pain, time to start a normal diet, and the complication/s that ensued were documented and compared. Results: The mean age of the patients was 26.5±5.2 years, with gender distribution was 50% male and 50% females. Diode laser tonsillectomy resulted in shorter operating time (25.0±5.0 min), decreased blood loss (5.0±2.0 ml), reduced pain score at day 7 (1.5±0.5 points) and faster postoperative recovery than bipolar cauterization (p < 0.001). The frequency of secondary haemorrhage in the diode laser patients (2%) was also noticeably less. Conclusion: Diode laser tonsillectomy is characterized by fewer post-operative complications, shorter time of treatment, and faster healing compared to classical methods of tonsillectomy due to high cost it is not popular

Altered Sleep Pattern in Patients of Acute Myocardial Infarction at Cardiology Ward of Liaquat University of Medical & Health Sciences

Objective: To determine the frequency of altered sleep patterns among patients with acute myocardial infarction admitted to the cardiology ward of Liaquat University of Medical & Health Sciences. Methodology: This prospective observational study was conducted in the Department of Cardiology, Liaquat University Hospital (LUMHS), from September 2023 to March 2024. Patients of both genders, aged 20–65 years, presenting with acute myocardial infarction were included. Sleep patterns were assessed using both open- and close-ended questions, and any deviation from the normal sleep pattern was considered abnormal. Associations between altered sleep patterns and baseline as well as clinical parameters were evaluated, with a p-value < 0.05 considered statistically significant. Results: The overall mean age of the patients was 54.04 ± 8.82 years. Male patients constituted a higher proportion compared with females (62.82% vs. 37.28%). The overall frequency of altered sleep patterns among patients admitted with acute myocardial infarction was 40.69%. A higher prevalence of altered sleep patterns was observed among males, married individuals, urban residents, housewives, patients belonging to the middle socioeconomic class, those with normal body mass index, non-smokers, patients presenting with typical chest pain, and those diagnosed with non–ST-elevation myocardial infarction (NSTEMI); however, these associations were not statistically significant (p > 0.05). Depression was the only variable that showed a statistically significant association with altered sleep patterns among patients with acute myocardial infarction (p = 0.04). Conclusion: The prevalence of altered sleep patterns was notably high among patients admitted with acute myocardial infarction. However, depression was the only factor significantly associated with sleep deviation in this population

Role of tranexamic acid in terms of reducing perioperative blood loss and post operative transfusion requirement in fractures of proximal femur

Objectives: To assess the effect of perioperative intravenous tranexamic acid (TXA) on the amount of blood lost postoperatively, as well as the requirement of blood transfusions in patients who underwent surgery for proximal femur fractures. Methodology: A comparative study was conducted at the Department of Orthopedics, Pakistan Air Force (PAF) Hospital, Islamabad, from November 2025 to January 2026. A total of 180 patients aged 18 to 65 years with proximal femur fractures (ASA I to II classification) were included in this study, divided into control and TXA groups. The control group (n = 90) patients who received no TXA, and the TXA group (n = 90) patients who received intravenous TXA perioperatively. Blood loss was measured based on hemoglobin drop and 24-hour drain output. Blood transfusion requirements were recorded according to institutional guidelines. The statistical analysis of the results was performed using SPSS version 25. Results: The mean postoperative drain output in the TXA group was significantly less than that in the control group (312 ± 74 mL vs. 468 ± 96 mL; p < 0.001). Patients receiving TXA also had a lower mean postoperative hemoglobin drop (1.2 ± 0.5 g/dL vs. 2.1 ± 0.6 g/dL; p < 0.001). The TXA group had a significantly lower mean number of transfused units per patient (0.38 ± 0.72 vs. 0.89 ± 1.03; p = 0.001) and fewer patients needed postoperative blood transfusions (18.9% vs. 38.9%; p = 0.004). Thromboembolic or wound-related complications did not differ significantly. Conclusion: The routine use of perioperative intravenous TXA in clinical practice is supported by the fact that it successfully lowers postoperative blood loss and transfusion requirements in proximal femur fracture surgery without increasing adverse events

Efficacy of Dexamethasone in preventing post spinal hypotension in elderly patients undergoing orthopedic surgery; A Randomized Control Trial at a tertiary care hospital

Objective: To compare the efficacy of single pre-operative dose of intravenous Dexamethasone vs placebo in elderly patients undergoing orthopedic surgeries in spinal anesthesia in terms of number of hypotensive episodes. Methodology: After ethical approval and clinical trial registration (NCT07052864), study was carried out at Department of Anesthesiology and Critical Care Medicine, PIMS Hospital, Islamabad from 30th June 2025 to 30th August 2025. A total of 134 patients were enrolled who were 50 years to 100 years belonging to ASA I & II. Group A patients were given single preoperative dose of dexamethasone 8?mg IV in 100?ml normal saline 1 hour before induction of spinal anesthesia in the pre-operative area while group B patients were given placebo. Results: The incidence of intra operative hypotension was significantly higher in group B than group A. The incidence in group B was 70% and in group A it was 45% with p value being 0.003. Similarly intraoperative phenylephrine consumption was 0.00 (50.00) in group A while in group B it was 50.00 (200.00) with p value being 0.02. Conclusion: Prophylactic administration of Intravenous Dexamethasone is effective in preventing post spinal hypotension and reducing intraoperative vasopressor requirements among elderly patients undergoing lower limb orthopedic surgeries

Efficacy of Ligasure use in Total Thyroidectomy at a tertiary care Hospital

Objective: To evaluate the effectiveness of the ligasure small jaw (LSW) device in achieving hemostasis during total thyroidectomy. Methodology: This study is conducted as a retrospective observational study at Akbar Niazi Teaching Hospital, Islamabad. Eighty-six patients underwent thyroidectomy using LSW between April 2021 till April 2024 were studied. Liga Sure is an advanced bipolar vessel-sealing device that uses a combination of controlled pressure and radiofrequency energy to permanently seal blood vessels up to 7 mm in diameter, providing effective hemostasis with minimal thermal spread. Parameters including per operative findings of intraoperative bleeding and operative time and postoperative findings of voice change and hospital stay were assessed. After approval from the ethical board, data was collected as a qualitative research study and entered on standard SPSS sheet version 26. Results: A total of 86 patients were observed during the study period. Per operative findings of intraoperative bleeding measured by the visual gauze method showed 6ml gauze blood in 39.5% and more than 6ml gauze blood in 26.8% and rest of the patients were having 3ml-6ml gauze blood. The mean surgery time noted was 92.07±6.34 minutes.64% of the patients had hospital stay of 1-2 days. Only 1 patient had voice hoarseness which was improved after giving stat dose of steroid. The use of Liga Sure demonstrated effective hemostasis, acceptable operative time, short hospital stays, and a low complication rate in patients undergoing total thyroidectomy. Conclusion: The results demonstrated that LSW effectively minimized intraoperative bleeding, reduced operative time, and preserved recurrent laryngeal nerve function, with minimal complications. Comparative analysis with traditional ligation techniques, diathermy or bipolar devices confirmed the efficiency and safety of LSW

Efficacy of PECS Block In Perioperative Period For Pain Management In Patients Undergoing Elective Breast Surgery

Objective: To evaluate the effectiveness of intraoperatively performed, non-ultrasound-guided pectoral nerve (PECS) block compared to no regional block in controlling postoperative pain and opioid consumption in patients undergoing elective breast surgery. Methodology: This randomized controlled trial was conducted from October 2024 to March 2025 at Pakistan Institute of Medical Sciences, Islamabad. Sixty female patients (ASA I–III) scheduled for modified radical mastectomy or simple mastectomy were randomly allocated into two groups: Group P (PECS block under direct vision) and Group C (control, no block). The primary outcome was postoperative analgesic requirement. Secondary outcomes included total opioid consumption within 24 hours, time to first rescue analgesia, and Visual Analogue Scale (VAS) pain scores. Results: The mean time to first rescue analgesia was longer in the PECS group but not statistically significant (70.04 ± 44.01 vs. 54.44 ± 31.01 minutes; p = 0.118). Intraoperative and postoperative tramadol consumption was comparable between groups (p > 0.05). The proportion of patients requiring rescue analgesia was also similar. VAS pain scores at 1, 2, 4, 6, 12, and 24 hours postoperatively showed no statistically significant differences between groups, although consistently lower trends were observed in the PECS group. Conclusion: Non-ultrasound-guided PECS block is a safe and feasible adjunct to general anesthesia but did not demonstrate statistically significant improvement in postoperative pain control or opioid consumption. However, modest clinical benefits suggest potential utility in resource-limited settings. Larger studies with ultrasound guidance are recommended to better define its efficacy

Establishing a Prediction Model for Successfully Planned Endotracheal Extubation in Preterm Neonates: An Answer to Many Questions

Objective: To establish the prediction model for successfully planned endotracheal extubation in preterm neonates. Study Design: Prospective cohort studyPlace and Duration of Study: This study was conducted at Neonatal ICUs of Fatima Memorial Hospital Lahore, from February 2023 to October 2024.Methodology: The study included 255 preterm neonates (28–35 weeks gestation) intubated <7 days and extubated for the first time before 30 days of age. Successful extubation was labeled as no need for reintubation within 72 hours following extubation. Demographics, prenatal, and peri-extubation data were collected analyzed using multivariate logistic regression to identify independent predictors. Receiver operating characteristic (ROC) analysis assessed model discrimination, and a nomogram was constructed for individualized prediction.  

Cytoprotective Role of Co-Enzyme Q10 on the Spleen of Immunosuppressed Female Albino Wistar Rats

Objective: To assess the effects of Co-enzyme Q10 supplementation on the histology of the spleen in immunocompromised female Albino Wistar rats. Methodology: A quasi-experimental study was conducted between July 2021 and December 2021 at the Anatomy Department of Isra University Hyderabad. Forty female adult Albino Wistar rats (n=10/group) were included in the present study, divided into 4 groups where A was kept as vehicle control, B as experimental group, C as pre-treatment group, and D was kept as post-treatment. All drugs were administered through the intraperitoneal route. On Day 09, animals were sacrificed through cervical dislocation and dissected. Spleen was carefully dissected from each animal and washed thoroughly with distilled water, and tissue was fixed in 10% formalin and processed for light microscopy. Results: On the histopathological findings, the moderate and severe white pulp atrophy was significantly higher in group B (p-0.001). All the animals of control group A were without haemorrhagic findings, while mild haemorrhage was seen in 3 animals of group b, 3 animals in group C and 3 animals of group D. Moderate haemorrhage was seen in 5 animals of group B and 2 animals of group D, while severe haemorrhage was seen only in 2 animals of group B. The moderate and severe haemorrhage was significantly higher in group B (p-0.001). Furthermore, the moderate and severe necrosis was significantly higher in group B (p-0.001). Conclusion: The histological changes, including white pulp atrophy, haemorrhage, and necrosis, were most frequently observed in the spleens of immunosuppressed female rats treated with cyclophosphamide. A significant cytoprotective effect of Coenzyme Q10 was noted in these rats, as spleen histology showed marked improvement in those treated with Coenzyme Q10 alongside cyclophosphamide, regardless of whether Coenzyme Q10 was administered before or after the start of cyclophosphamide treatment