Coronectomy of Impacted Lower Third Molar in Close Proximity to Inferior Alveolar Nerve: Evaluation of Outcomes and Complications After One-Year Follow-Up

Objectives: This current study was performed to evaluate the outcome after coronectomy of mandibular third molars in terms of complications met during or after the procedure, IAN injury, root migration and need for re operation. Methodology: This present clinical study was conducted in Oral and Maxillofacial Surgery Department of private dental hospital of Islamabad for 02 years from June 2022 to June 2024. Forty-five mandibular third molars of patients having high risk of IAN injury between the age group of 18 to 45 years, were involved in the study. Preoperatively the lower third molars were assessed clinically and radio graphically. Coronectomy was done and primary closure was achieved. Patients were evaluated postoperatively at 01 week, 06 months and 01 year. Post-operative pain, IAN and lingual nerve injury or any other complications were observed and recorded. Results: Not a single patient had IAN and lingual nerve injury. Although 03 patients had infection at the coronectomy site after few months and required another surgical removal. However, 3 of our patients were categorized as failed coronectomy due to intra operative mobilization of roots, which were were removed. Conclusion: The procedure of Coronectomy is effective in avoiding inferior alveolar nerve injury following removal of lower third molars in high risk cases with very low prevalence of complications

Perinatal Outcomes in Women with History of Chronic Hypertension but Controlled Blood Pressure Before 20 Weeks Gestation

Objective: To determine the perinatal outcome in women with prior history of chronic hypertension but controlled BP before 20 weeks of gestation. Methodology: A descriptive cross-sectional study was conducted at the Department of Gynaecology, Sheikh Zayed Medical College, Rahim Yar Khan, from November 2019, to May 2020, on patients aged 20 to 40 years old with singleton pregnancy of 20 weeks or more with previous history of hypertension but currently on no treatment for last one month or more and with normal blood pressure irrespective of parity. After taking demographic and clinical information the patients were followed every month to look for small for gestational age (SGA), pre-eclampsia and pre-term birth. Data was entered and analysed using SPSS-version 26.0. Results: Overall mean age was 28.1 ± 3.2 years. Out of all cases, 22% had fetuses small for gestational age, 21% developed pre-eclampsia, and 23% had urinary protein levels below 300 mg/24 hours, while 77% had raised levels. FSGA was most common at ages 26–30 (50%) and pre-eclampsia at 31–40 years (41.9%), both significantly associated with age and parity (p=0.031, p=0.0497), but not with previous cesarean (p>0.05). Preterm birth was more frequent in ages 26–40 and higher parity, while statistically insignificant (p>0.05). Conclusion: Women with a history of chronic hypertension, even when blood pressure is controlled before 20 weeks of gestation, remain at increased risk for adverse perinatal outcomes

Effect of Hemodynamic Management Using the Trend of Perfusion Index in Patients Admitted to the Paediatric Intensive Care Unit

Objective: To determine the effect of hemodynamic management using the trend of perfusion index admitted in Paediatrics intensive care unit.Methodology: A prospective observational study was conducted at Paediatrics Intensive Care unit, Indus Hospital, Karachi. Children admitted in PICU with shock, aged between 2 months to 14 years and both genders were included. A questionnaire was utilized to collect data, including patient baseline demographics and clinical information. Hemodynamic management typically employed for patients with low peripheral perfusion or shock, involved fluid resuscitation and/or inotropic support. The perfusion index, derived from pulse oximetry, measures peripheral perfusion noninvasively by calculating the ratio of pulsatile to non-pulsatile blood flow in peripheral tissues. Statistical package for the social sciences (SPSS v. 26) was used for data entry and analysis.Results: A total of 80 patients were studies with a overall mean age of 6.34+3.23 years. The primary causes of admission were respiratory failure 41.7% and septic shock 33.3%, and others 16.7%. Patients showed a significant improvement in PI(from 0.8 ± 0.3 to 1.5 ± 0.4, p = 0.001 after management, along with stabilization of systolic and diastolic BP and decrease in heart rate (p = 0.001). Mortality was highest among patients admitted for septic shock 30% compared to other causative factors40%, while those with respiratory failure had better outcomes 91.7% discharged. Correlation analysis revealed a strong positive relationship between improvements in PI and survival (p=0.001).Conclusion: Study revealed that the hemodynamic treatment involving resuscitation and inotropic support among patients in PICU. It played a pivotal role in stabilizing vital signs, as reflected in the significant improvements in perfusion index, blood pressure, and heart rate. The interventions were particularly beneficial in patients with respiratory failure, who showed the highest survival rates, while patients with septic shock and cardiac arrest, required more intensive support, had higher mortality rates

Frequency of the Factors Leading to Amblyopia in Children

Objective: To determine the factors that influence the distribution of amblyopia in children based on their referral pattern, refractive problems, strabismus, and visual deprivation. Methodology: This cross-sectional study was conducted at the Ophthalmology Department, Hayatabad Medical Complex, Peshawar. from January 2023 - May 2024 after obtaining approval from the Ethical Committee. 287 Children of either Gender with unilateral amblyopia and their age ranged from 5-15 years were included in the study. Performa were used to gather data and the variables were analyzed using SPSS version 22. Results: A total of 287 children were evaluated, revealing a slight male predilection, with 51.9% of the affected individuals being male. Refractive errors were identified as the leading causes of amblyopia, with hypermetropia accounting for 36.9% of cases and myopia for 29.6%. Other contributing factors included astigmatism 12.5%, strabismus 11.5%, and visual deprivation 9.4%. Conclusion: The study shows that refractive errors played a very crucial part in children developing amblyopia. This implies therefore that the above factors need to be detected and addressed early to prevent the adverse effects on the vision. These findings suggest that screening for amblyopia must be performed regularly within the pediatric populations to achieve optimum outcomes for amblyopia intervention

In-Vitro Analysis of the Anti-Diabetic Potential of Acetone and n-Hexane Extracts of Delonix regia (Gul Mohar) Leaves

Objective: To assess the anti-diabetic activity of leaves extract of D. regia in acetone and n-hexane through in vitro analysis. Methodology: The preclinical study was conducted in the Department of Pharmacology and Therapeutics at Baqai Medical College/University of Karachi, in November 2022. Freshly harvested D. regia leaves were collected identified, and authenticated by the herbarium of the botany department at Karachi University. The extract was concentrated in rotary vacuum evaporator and kept in a desiccator to maintain their integrity and suitability for further applications. In vitro, anti-hyperglycemic studies were conducted using ?-amylase and ?-glucosidase inhibition assays. Results: D. regia leaves extract revealed distinct inhibitory activity of ?-amylase and ?-glucosidase. Acetone extract (25 mg/ml) showed 7.8% and 2.5% inhibition, respectively; while the n-hexane extract (25 mg/ml) demonstrated lower activities, 1.4% and 2.0%, respectively. Conclusion: The present study concludes that polar solvent (acetone) extract of D. regia exhibits more inhibitory potential for ?-amylase and ?-glucosidase as compares to non-polar solvent emphasizing solvent polarity's role in extracting active compounds

An Investigation of Clinical Features of Head and Neck Cancers in a Tertiary Care Hospital

Objective: To investigate the clinical features of individuals with head and neck cancer at a tertiary care hospital. Methodology: A retrospective cross-sectional analysis was conducted at the Histopathology Department of Combined Military Hospital (CMH) in Lahore, Pakistan, duration from August 2019 to September 2024. Total 250 cases, confirmed through histopathological analysis and above 20 years of age, were included in the study. The cancer sites encompassed the nasopharynx, oral cavity, oropharynx (specifically lip, tongue, tonsil, mouth floor, gingiva, and retromolar trigone), larynx, pharynx, salivary glands, and sinonasal region. The outcomes were to investigate the tumor site in HNC, assess the histological HNC frequency, analyze the HNC stages of tumor node metastasis, and explore the etiological factors contributing to HNC. Failure rates were documented with regard to the type of recurrence, whether it was local, systemic, or distant. Results: Among the cases, majority (85.2%) were male, and 14.8% were female. The patients mean age was 55.0±20.2 years. The most prevalent age was 40–59 years, representing 55.2% of the cases. The oral cavity was the frequent primary tumor site, observed in 35.2%, followed by the nasopharynx in 20%. Squamous cell carcinoma was the most prevalent type of HNC, observed in 75.2%. The frequency of HNC varied across TNM stages, ranging from stage 0 to stage 4, with 65.2% of cases classified as stage 4. Smoking alone was identified as the most prevalent risk factor for cancer, primarily in the oral cavity, followed by the larynx. Conclusion: The increasing incidence of HNC has led to high morbidity and mortality in the Pakistani, primarily due to risk factors such as smoking, tobacco use in various forms, and alcohol consumption

Frequency of Iron Deficiency Anemia in 6–60 Months Old Children Presenting with Febrile Seizure

Objective: To determine the proportion of iron deficiency anemia (IDA) among children aged 6–60 months presenting with febrile seizures. Methodology: This cross-sectional study was conducted in the Department of Pediatrics, Ayub Teaching Hospital, Abbottabad, Pakistan, from Jan to December, 2024. Children with febrile seizures were evaluated for IDA using hemoglobin (Hb), mean corpuscular volume (MCV), and serum ferritin levels. Data were collected after obtaining informed written consent from parents/guardians. Results: Among 116 children with febrile seizures, 60 (51.7%) were aged 6–30 months and 56 (48.3%) were 31–60 months, with a mean age of 28 ± 17.01 months. The mean Hb level was 8 ± 1.46 g/dL, mean MCV was 65 ± 11.13 fL, and mean serum ferritin was 21 ± 2.87 ng/mL. Of the total participants, 68 (58.6%) were males and 48 (41.4%) were females. Iron deficiency was observed in 77 children (66.4%). Conclusion: This study demonstrates a strong association between iron deficiency anemia and febrile seizures in children. Early detection and management through iron supplementation and dietary modifications may help reduce the incidence of febrile seizures, as IDA is a modifiable risk factor

Role of Probiotic and Racecadotril as an Adjuvant Therapy in Management of Acute Watery Diarrhea in Children

Objective: To see the role of nonspecific antidiarrheal agents as Probiotics and Racecadotril as an adjuvant therapy among children presenting with acute watery diarrhea Methodology: This cross-sectional comparative study was conducted in Pediatric Department Fatima Memorial Hospital Lahore from July 2023 to December 2023. One hundred and sixty children were included in this study and were equally divided in two study groups. Probiotics was given in Group A and Racecadotril treatment was given in Group B (1.5 mg/kg every eight hours). The effect of both agents was evaluated at 24 hours and 48 hours after admission in terms of improvement in the stool consistency. Results: Out of 160 children, 97 (60.6%) were male. The mean age was 15.73 ± 9.75 months. The average duration of diarrhea before starting treatment was 2.51 ± 1.21 days, with an average of 13.56 ± 3.85 stools per day. The average number of episodes was significantly lower with Racecadotril (8.08 ± 2.97 on day 1 and 3.68 ± 1.98 on day 2) compared to Probiotics (10.01 ± 3.79 on day 1 and 7.45 ± 2.92 on day 2) with p value 0.000 on both day 1 and day 2 comparison. The result showed that Racecadotril demonstrated better efficacy compared to probiotics with significant improvement in stool grades on the first and second day of treatment (p value 0.000 and 0.001, respectively). Conclusion: We concluded that Racecadotril is significantly more effective in treating acute watery diarrhea in children

Prevalence of Fatty Liver Disease in Patients Presenting to General Medicine Clinic with Abdominal Pain and Deranged Liver Function Tests at Tertiary Care Hospital Islamabad

Objective: To determine the frequency of fatty liver disease in patients presenting with abdominal pain and deranged liver function tests at a tertiary care hospital in Islamabad. Methodology: This cross-sectional study was conducted using a non-probability sampling technique in the Department of General Medicine, Rawal Institute of Health Sciences, Islamabad, over a period of eight months from March 2023 to October 2023. Adult male and female patients presenting with upper abdominal pain and deranged liver function tests (LFTs) were included. Baseline demographic and clinical data were collected and analyzed using SPSS version 26.0. Results: A total of 512 patients were screened, out of which 199 (38.86%) were diagnosed with fatty liver disease. Patients with fatty liver were significantly older (mean age: 40.22 ± 6.84 years), had a higher body mass index (BMI: 26.81 ± 2.34 kg/m²), and elevated alanine aminotransferase (ALT: 63.18 ± 29.33 mg/dL). Comorbidities were also more prevalent: diabetes mellitus (n = 63, 31.65%), hypertension (n = 74, 37.18%), and current smoking (n = 41, 20.60%)—all statistically significant (p < 0.05). Conclusion: The study demonstrates a significant association between fatty liver disease and patients presenting with abdominal pain and deranged LFTs. Advanced age, elevated ALT levels, hypertension, diabetes mellitus, and smoking were found to be important risk factors

Antioxidant Potential Calotropis Procera leaves, flowers, and latex, Zanthoxylum Armatum Dried Seeds, and Syzygium Aromaticum Dried Flower Buds

Objectives: This study evaluates the antioxidant potential of Calotropis procera leaves, flowers, and latex, Zanthoxylum armatum dried seeds, and Syzygium aromaticum dried flower buds. Methodology: The extracts were prepared using methanol, acetone, and chloroform as solvents. Antioxidant activity was assessed using the DPPH (1,1-Diphenyl-2-picryl-hydrazyl) free radical scavenging method, with ascorbic acid serving as the standard. Phytochemical screening identified secondary metabolites such as flavonoids, terpenoids, glycosides, and more. Results: The results revealed that C. procera leaves and flowers exhibited the highest antioxidant activities, with Methanolic extracts showing the most significant radical scavenging potential. Methanolic extracts of S. aromaticum dried flower buds also demonstrated substantial antioxidant activity. Conclusion: This comparative analysis underscores the therapeutic potential of these plants in managing oxidative stress-related diseases. Keywords:Antioxidant potential, Calotropis Procera Leaves, Dried Flower Buds