Omega-3 Fatty Acids Ameliorate Sleep Deprivation-Induced Histomorphological Alterations in the Rat Prostate

Objective: The primary objective of this study was to observe the impact of chronic sleep deprivation on the histomorphological features of the rat prostate gland and to evaluate the potential protective effects of omega-3 fatty acid supplementation. Materials & Methods: Thirty male Sprague-Dawley rats (200-300g) were randomly divided into three groups (n=10 per group): Group A (control, maintained on a normal sleep-wake cycle), Group B (sleep deprivation, subjected to 16 hours of sleep deprivation followed by an 8-hour sleep opportunity daily for 60 days), and Group C (sleep deprivation + omega-3, subjected to the same sleep deprivation regimen as Group B, supplemented with 260 mg/kg/day omega-3 fatty acid via oral gavage). Post-euthanasia and after dissection, prostate tissues were processed for histological observation using H&E and Masson's trichrome staining to assess epithelial apoptosis, collagen deposition, and smooth muscle architecture. Statistical analyses were performed using SPSS software version 21, with p<0.05 considered statistically significant. Results: Group A (control) showed normal histological structure. Group B (sleep deprivation) exhibited a significantly higher frequency of epithelial apoptosis (p<0.05), increased interacting collagen deposition (p<0.001), and marked irregularities in the smooth muscle layer surrounding the acini (p=0.002). Group C (sleep deprivation + omega-3) demonstrated reduced epithelial apoptosis, collagen deposition, and smooth muscle distortion relative to Group B. Conclusion: The present study observed that sleep deprivation caused significant changes in the histomorphology of the rat prostate gland, including epithelial apoptosis, collagen fibre deposition in the interacting space, and irregular arrangement of the smooth muscle fibres around the acini. Additionally, omega-3 fatty acid supplementation had an ameliorative effect on these histomorphological alterations induced by sleep deprivation

Lifestyle Medicine Assessment Among The General Population Of District Sialkot, Pakistan: A Comparative Study

Objective: To assess the lifestyle medicine among the general population of the district of Sialkot, Pakistan.  Methods: A comparative cross-sectional study was conducted in 4 Tehsils of District Sialkot, from April to September 2024. A calculated sample of 400 healthy individuals was selected by a non-probability consecutive sampling technique, and data were collected through a modified version of the lifestyle assessment short form questionnaire Results: The average age of participants was 33.58 ±13.06 years, with a predominant representation of males (60%). The majority of the respondents were young (93.5%) and graduates or post-graduates (55.4%). The mean lifestyle medicine score was 38±4.41. Only 40%of the participants had a favourable lifestyle medicine score above the mean. Education of the participants showed a significant association with lifestyle medicine score(p=0.027), while age, area of residence and social class revealed a non-significant association. Conclusion: Most of the study participants had unfavourable lifestyle medicine scores below mean indicating poorer adherence to recommended lifestyle medicine practices.                                                                                Similarly for individual life style medicine domains, score was below the mean except for smoking and substance abuse domain

Biochemical Markers, Medications, and COVID-19 Complications in Vaccinated Versus Unvaccinated Pakistani Patients

Objective This study aimed to explore the association between COVID-19 vaccination and prolonged post-COVID symptoms (long COVID) in adults reporting this condition. Material and Methods This is a cross-sectional design of the study design. With the consent, the data were collected through questionnaire questionnaires from patients (N=308) who visited OPD or were admitted to the hospital with COVID-19 infection. The patient demographic details, vaccination status, type of complications, and haematological and pathological blood tests including complete blood count (CBC), D-dimer, white blood cells (WBC), and platelet count along with medication details the patient used. Patients used either Group I medicines (Panadol and Azomax) or Group 2 (Azomax, Surbex-Z, Loprine, Multivitamin, Ivermectin, and anti-allergy). Using. The data was analyzed using characteristics and inferential statistics such as chi-square and Fischer’s exact tests.  Results A significant association is observed between the duration of infections and the type of medication used (group 1 & group 2). For infection duration of more than a week with group 1 medications 65.9% (p<0.001) and for two weeks or more with group II medications 87.9% (p<0.001). Data analysis showed no correlation between vaccination status and POST-Covid-19 complications. A significant association was observed when WBC count was compared with neuro-psychological and cardiovascular complications at the 0.05 significance level (p-values <0.001 & 0.008). No significant association was observed between neutrophil count and the type of vaccination used.     Conclusion: Biochemical and haematological diagnostic markers, such as blood CBC, platelet count, and neutrophil count, exhibit a correlation with the type of medication used in managing COVID-19 complications, highlighting differences between vaccinated and unvaccinated patients. Keywords: Blood CBC, Neutrophil count, Platelet count, COVID-19, Hypertensio

Dengue Fever With Shigellemia: A Case Report

Shigella mostly causes gastroenteritis and rarely causes sepsis. Mostly malnourished children and elderly immunocompromised population at high risk of blood stream infection. Here, we are presenting a case of a male, aged 73 years. He was a known case of diabetes, hypertension, and ischemic heart disease (history of angioplasty twice) who came into the emergency department on 16th October 2024. The presenting with of loose bloody stools for 5 days, with shortness of breath. Initially, the patient was managed on the line of viral haemorrhagic fever with secondary bacterial infection of the Gastrointestinal tract, including Shigella. The patient was improving with symptomatic treatment and on antibiotics. This case highlights the rarity of and generates awareness among health care workers and physicians to direct their approach considering patient risk factors and clinical deteriorating conditions and early diagnosis of secondary bacterial infections in viral and immunocompromised patients. This approach reduces the hospital stay and cost, risk of treatment failure and mortality rate

Gaza Students at RMU; Bridging Education Beyond Borders

The academic year 2024–2025 has been an important and moving chapter for Rawalpindi Medical University (RMU). During this period RMU had the privilege to host 38 medical students from Al-Azhar University, Gaza, whose campus and homes were destroyed in the war. This initiative was provided by RMU on voluntary and humanitarian grounds to help students who had lost their institutions, families, and in some cases parents. Our purpose was to give them safe continuity of education, and the professional training required to become physicians. The Government of Punjab and Pakistan Medical & Dental Council played a vital role in registration and facilitation of these students.The arrival of these students strengthened our academic community. Their determination and personal stories of loss and resilience created learning opportunities beyond the formal curriculum. They joined RMU not only as learners but also as members of our academic family. From the first day we sought to provide a secure, welcoming, and academically stimulating environment that acknowledged both their educational needs and their personal hardships. A hybrid curriculum was designed in collaboration with Al Azhar University, Gaza specifically for these students.The academic session formally began with a welcome ceremony held on 30 October 2024 at the New Teaching Block. At that event the students were introduced to faculty, department heads and peers. This marked the formal start of the year and prepared the ground for teaching, clinical placements and collegial interaction. Following the ceremony an orientation programme was conducted in which deans of all departments presented their departments and expectations. At the outset the students underwent baseline academic, physical and psychological assessment so that bespoke support plans could be made. A foundation week was organised to address gaps in basic sciences and to align prior learning with RMU’s curriculum.In addition to formal teaching we focused on students’ well-being and social integration. RMU organised a night gala that combined sports, cultural activities and community celebration. The university dedicated the newly renovated Sports Complex to these students; the complex had been refurbished with donations and was formally inaugurated by one of the Gaza students. Over the twelve months the Gaza students participated actively in clinical rotations across multiple specialties. These attachments provided supervised, hands-on experience and helped refine clinical reasoning, procedural skills and professional conduct. Faculty members offered regular feedback and targeted mentoring to help each student meet learning objectives. Continuous evaluation was used to monitor progress and to tailor remediation where needed.The academic year also emphasised peer support and community engagement. RMU students, staff and the visiting group took part in joint academic sessions, journal clubs and community outreach activities. These interactions fostered intercultural understanding and helped the Gaza students rebuild academic networks that are essential for their future careers.As the academic year comes to an end, we warmly celebrate the students’ hard work and progress. Their perseverance and steady academic improvement have shown, in a simple and clear way, how education can heal pain and bring people closer. RMU will continue to support them until they complete their training and return home as licensed doctors prepared to serve their communities.In short, the year 2024–2025 reminded us that medical education is more than teaching facts. It is also a duty of care and solidarity. When institutions act with compassion and responsibility they help keep learning alive for those affected by conflict and displacement. For RMU this is a moral obligation, and we are determined to continue this support in the coming years

Role of Aspartate Aminotransferase to Platelet Ratio Index as a non-invasive predictor of variceal etiology.

 Objective: To determine the diagnostic accuracy of the aspartate aminotransferase to Platelet ratio index as an indicator of upper gastrointestinal bleeding, taking endoscopy as the gold standard. Methodology: The cross-sectional validation study was conducted in the Department of Medicine Unit I, Benazir Bhutto Hospital, Rawalpindi, from 25th September 2022 to 24th March 2023. A total of 350 patients aged 16-75 years, both genders, diagnosed with cirrhosis were included. Then a blood sample was taken in a 3cc disposable syringe. Reports were assessed, and APRI was calculated. The patient was labelled as positive or negative. Then the patient underwent upper gastrointestinal endoscopy within 24 hours of admission, and the patient was labelled as positive or negative based on endoscopy findings. Results: Aspartate aminotransferase - Platelet Ratio Index overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy as a predictor of upper gastrointestinal bleeding requiring endoscopy were 93.24%, 91.60%, 94.15%, 90.34%, and 92.57%, respectively. Conclusion: The Aspartate Aminotransferase Platelet Ratio Index (APRI) has a fairly high diagnostic accuracy for variceal bleeds

Seven-Year Trend Analysis Of Dyslipidemia Among Patients Reporting To Tertiary Care Hospital In Rawalpindi, Pakistan

Objective: Dyslipidemia is a noticeable cause of morbidity and mortality. The purpose of the study was to analyse the cholesterol and triglyceride levels of patients presenting for lipid profile. Methods: A total of 9989 participants presenting to Benazir Bhutto Hospital, Rawalpindi, for the Lipid profile assessment were enrolled in this study. The participants were included irrespective of age and gender. Data was retrieved from HMIS for the last 7 years (2015-2022). Enzymatic colourimetric techniques were used to examine the serum levels of total cholesterol and triglycerides. Dyslipidemia was defined based on standard guidelines by the National Cholesterol Education Program Adult Treatment Panel III. Results: Out of the total of 9989 presented with signs and symptoms of dyslipidemia, 401(4%) were subjects under 19 years of age. Among the adult patients, 4283(44 .7%) were males and 5305 (55.3%) were females.  Females have significantly high concentrations of cholesterol median (min-max), 203.25(48-1157) as compared to males, 196.95 (2-924). Mann Whitney, p value= 0.0001. Significant. difference was not observed for the concentrations of triglycerides in both genders (p=0.761) Substantial difference  in concentrations of cholesterol and triglycerides was observed in different age groups  Kruskal Wallise H 145.09 p –value 0.0001,  Kruskal Wallise H 171 51 .09 p –value 0.0001 , respectively. Conclusion: Highest number of patient with dyslipidemia were observed in age group between 40-52 years. Mean cholesterol level in females were significantly higher as compared to males. Prevalence of isolated hypercholesterolemia and isolated hypertriglyceridemia in our study was 50.3% and 59.9% respectively

Improving Endometrial Carcinoma Prognosis: A Case Report on Synergistic Moringa Treatment

Endometrial adenocarcinoma is the most common gynecologic malignancy worldwide, particularly affecting postmenopausal women. While standard treatments include surgery, chemotherapy, and radiotherapy, there is growing interest in complementary therapies to improve prognosis. This case report presents a 62-year-old female diagnosed with stage II endometrial adenocarcinoma, who underwent standard chemotherapy and radiotherapy while incorporating Moringa Oleifera supplementation. Over six months, the patient demonstrated improved tolerance to treatment, reduced inflammation markers (CRP: 18 mg/L to 5 mg/L), and enhanced immune function (increase in CD4+/CD8+ ratio). Tumor regression was confirmed via imaging, showing a 40% reduction in lesion size post-treatment. The patient also reported improved energy levels and reduced chemotherapy-related side effects. This case highlights the potential of Moringa Oleifera as a synergistic adjunct to conventional therapy in endometrial carcinoma. Further clinical studies are needed to validate these findings

Impact Of Modifiable Risk Factors On Outcome In Patients With Perforated Peptic Ulcers: A Local Experience

Objective: This study aims to determine the impact of modifiable factors in perforated peptic ulceration on reducing mortality at our local setting of Benazir Bhutto Hospital, Rawalpindi, over two years. Methods: All the patients who were admitted and managed for perforated duodenal ulcer at the emergency department of the Surgical Unit 1 at Benazir Bhutto Hospital, Rawalpindi, from 01-11-2021 to 31-10-2023 were included in the study. The possible causes, co-morbidities, and complications were noted, and data were recorded on a specified proforma. Results: Among thirty-two patients of perforated duodenal ulcers, 63% were smokers, a history of NSAIDs use was present in 37.5% patients, and co-morbidities were present in 25.00% patients. All patients underwent exploratory laparotomy and repair of perforation. The average hospital stay was 5 days, with a range of 1-15 days. The mortality rate in our study was 28.12%. Conclusion: Perforation is still a prevalent complication of peptic ulcer disease. Smoking, increased NSAIDs use, and stressful life play an important role in such cases. Mortality rate is very high in perforated duodenal ulcer cases despite increased understanding of post-operative care

Safety And Efficacy Of Drug-Coated Balloon In Large Coronary Artery Disease

Introduction: Coronary artery disease is one of the leading causes of death worldwide for which various therapeutic interventions have been proposed. The use of drug-coated balloons (DCBs). DCBs have gained attention as a promising tool for the treatment of large coronary artery disease. This study aims to see the efficacy and clinical outcomes of DCB therapy in large coronary artery disease. Methods: This prospective observational study involving 60 patients of CAD, was conducted in the Department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi. The patients with large coronary artery disease were included and treated with DCB therapy.  The effectiveness of DCB as the primary outcome in terms of target lesion revascularization was observed over time. Similarly secondary (adverse outcomes) were also assessed and represented as frequencies and percentages. Analysis was done by SPSS.V.26. Results: In our study, the mean age was 55.217±9.814 and the mean diameter of the target vessel was 3.1 ± 0.249 mm while that of the lesions was 25.25 ± 8.1 mm.  On follow-up, target lesion revascularization was noted in only 8 (13.3 %), similarly, the adverse outcomes like MI in 4 (6.7%), target vessel thrombosis in 5 (8.3%), dyspnea in 8 (13.3%), effort angina in 10 (16.7%), and death was reported in just 2 (3.3%) of the patients. Conclusion: The use of DCB therapy resulted in a significant reduction in the proportion of patients requiring target lesion revascularization, which was the primary outcome measure. Furthermore, the secondary (adverse) outcomes exhibited a notable decrease in patients who received DCB therapy, thus demonstrating the efficacy of DCB therapy in individuals with large coronary artery disease