Gender-based analysis of antibiotic prescribing trends for pediatric patients with respiratory tract infections admitted to a tertiary care hospital in Lahore

Respiratory tract infections (RTIs), caused by microorganisms such as bacteria and viruses, are a leading cause of morbidity and mortality in children worldwide. Antibiotic resistance is a serious concern, and proper prescribing practices are necessary to avoid life-threatening situations. Thus, this study aims to conduct a gender-based analysis and compare antibiotic prescribing patterns for pediatric patients with respiratory tract infections admitted to a tertiary care hospital in Lahore. This comparative cross-sectional study was conducted at Children’s Hospital in Lahore, Pakistan, for three months and enrolled 250 pediatric patients who met the inclusion criteria, including 155 males and 95 females. Data were collected through face-to-face interviews and reviewing hospital records. The results of the study showed that the average number of drugs per prescription was 3.06 ± 1.29 (male) and 3.12 ± 1.5 (female), while the average number of antibiotics per prescription was 2.25 ± 0.60 (male) and 2.17 ± 0.58 (female). The most prevalent medical conditions were bronchopneumonia (53.55% males and 58.95% females), followed by respiratory distress (20.00% males) and pneumonia (16.13% males and 16.84% females). The most commonly prescribed drugs were J01DD04: Ceftriaxone (78.71% males and 71.58% females), J01CR02: Amoxicillin/Clavulanate (59.35% males and 56.84% females), and J01GB06: Amikacin (41.29% males and 45.26% females). A low percentage of prescriptions had major drug‒drug interactions (8.39% males and 10.53% females), while most prescriptions had no drug‒drug interactions (81.94% males and 84.21% females). There was no significant difference between male and female patients for caregiver, indications for antibiotic prescriptions, the class of active agent prescribed, and drug interactions. Our study findings indicate that most male and female patients admitted to the hospital with lower respiratory tract infections were prescribed antibiotics alongside analgesics and antipyretics. Furthermore, our analysis revealed minimal drug interactions among the prescribed medications. Importantly, we observed a similar antibiotic prescribing trend among male and female pediatric patients, highlighting the consistency in treatment approaches

The impact of passive screen time on early childhood speech and language development: parental perspectives and behavioral correlates

Excessive and early exposure to digital screens has raised growing concerns about its implications for children’s speech and language development. This study investigated the associations between passive screen exposure and speech and language delays in children aged 5–8 years, focusing on behavioral and clinical risk factors such as screen-use duration, content type, contextual usage, parental awareness, and screen-time mediation strategies. A descriptive cross-sectional study was conducted with 203 parent‒child dyads via a structured questionnaire. Most children were exposed to screens before age two, with more than 57% exceeding two hours of daily screen time. Social media and entertainment content were the most frequently consumed, while only 47.3% engaged with educational content. Parental mediation practices were inconsistent, and only 28.6% reported frequent supervision. Language delay severity was high, with 62.1% classified as having severe delays. Chi-square analysis revealed a significant association between average daily screen time and language delay status (p = 0.001). Binary logistic regression revealed that greater screen time increased the odds of delay (AOR = 2.67, p < 0.001), whereas greater parental awareness [adjusted odds ratio (AOR) = 0.45, p = 0.002], educational content consumption (AOR = 0.40, p = 0.041), and active mediation (AOR = 0.35, p = 0.048) were protective. A modest but significant negative correlation was observed between parental awareness and language delay severity (r = -0.183, p = 0.009). This study revealed that excessive and early screen exposure is strongly linked to speech and language delays in children aged 5–8 years, whereas greater parental awareness, a preference for educational content, and engaged mediation practices are associated with reduced risk. These findings emphasize the pivotal role of parents in shaping digital environments and highlight the need for early, targeted interventions to enhance parental digital engagement, promote content supervision, and guide balanced screen use. Public health efforts and pediatric counseling should collaboratively support families in promoting healthy language development amid evolving digital habits

Air quality, governance, and agricultural productivity: a comparative study of South Asia and Southern Europe with implications for social and public health resilience

Agricultural productivity plays a vital role in ensuring food security, rural livelihoods, and environmental sustainability, particularly in regions facing ecological stress and institutional variation. This study offers a comparative analysis of South Asian and Southern European countries from 2000–2022, investigating how environmental quality, economic investment, and governance influence agricultural output. Using secondary panel data and the Driscoll–Kraay (DSK) estimator, the analysis addresses the challenges of cross-sectional dependence (CSD), heteroskedasticity, and autocorrelation. The findings show that in South Asia, gross fixed capital formation (GFCF) (β = 0.577, p < 0.01) and fertilizer use (β = 0.113, p < 0.01) are significant drivers of productivity. Crop residue burning (CRB), despite its environmental drawbacks, also has a positive association with productivity (β = 0.227, p < 0.01). However, stricter air quality regulations appear to constrain productivity (β = –0.228, p < 0.01), likely due to disruptions in conventional farming practices. Governance and surface air temperature (SAT) were not statistically significant in this region. In Southern Europe, productivity is positively linked with GFCF (β = 0.362, p < 0.01), fertilizer use (β = 0.203, p < 0.10), and SAT (β = 0.238, p < 0.05), suggesting a potential benefit from moderate warming. No significant effects were observed for governance, air quality performance (AQP), or crop burning, likely reflecting stronger institutions and regulatory stability. The model explains a greater proportion of the productivity variation in South Asia (R² = 0.8744) than in Southern Europe (R² = 0.1456). These results highlight the importance of region-specific strategies. South Asia requires policies that reconcile environmental regulation with agricultural output, whereas Southern Europe should prioritize climate adaptation and ecological safeguards. Aligning agricultural policy with public health, governance, and sustainability goals is essential for resilient food systems

Genderwise comparison of barriers to accessing oral healthcare facilities in peri-urban communities of Sargodha, Pakistan

Oral health is one of the significant indicators determining the population’s overall health and well-being status. Good oral health is a fundamental human right irrespective of demographic differences. Therefore, this study compared the barriers to accessing oral healthcare facilities among males and females living in peri-urban communities. This comparative cross-sectional study was conducted in the peri-urban communities of Sargodha. Using the random number method, this study used a simple random sampling technique to identify 320 houses; 160 males and 160 females who met the inclusion and exclusion criteria were interviewed. Data were analyzed using descriptive statistics and a chi-square test. The results showed that more males (78.13%) were users of dental services than females (53.75%); however, a meagre number of both genders were making regular visits to oral healthcare facilities. Expensive treatment was one of the significant barriers to visiting oral healthcare facilities for males (85.00%) and females (75.63%). Moreover, time shortage was a significant barrier, mainly reported by almost three-fourths of the males (72.50%), but fewer females (20.63%) considered it a vital barrier (p < 0.05). Furthermore, for both genders, various barriers varied widely, including fear of the dentist, avoiding treatment, lack of awareness, family pressure to avoid visiting clinics, and reliance on home remedies (p < 0.05). Therefore, this study concluded that more males than females visit oral healthcare services. However, most males and females do not visit oral healthcare facilities for regular checkups but for any oral health problem ailment. Both males and females make out-of-pocket expenditures to afford oral health services. Males preferred private oral healthcare facilities, whereas females preferred public healthcare facilities to provide oral healthcare services. Males and females observed the cost of treatment for oral healthcare issues, shortage of time, and fear as the key barriers to accessing oral healthcare facilities

Demographic influences on perception of aging, appearance-related consciousness, and negative self-perception among young and middle-aged adult women

With global life expectancy increasing, societal views on aging—especially its negative impact on women's self-image, intensified by social media—demand urgent attention. These norms affect self-perception and overall well-being. Therefore, this demographic study was conducted with the objective of exploring the relationships between age perceptions, appearance-related social media consciousness (ASMC), and self-perception. This pilot study, carried out in Lahore, Pakistan, involved 100 women either engaged in academic or professional work who were selected through purposive sampling. The data were collected via face-to-face interviews utilizing a questionnaire in English, comprising the Brief Aging Perceptions Questionnaire (B-APQ), the ASMC scale, and the Rosenberg Self-Esteem Scale (RSES), to evaluate the participants’ perceptions and self-view. Our study revealed a significant positive correlation between perceptions of aging and negative self-perception (r = 0.98, p < 0.01), indicating that concerns about aging contribute to more negative self-views, a trend mainly attributed to middle-aged women. Moreover, marital status notably affected appearance-related consciousness, with married women exhibiting greater concerns (p = 0.03). The findings underscore the nuanced effect of education on appearance concerns—postgraduates showed greater concern (mean = 57.24 ± 16.45) than those with lower educational levels (mean = 47.94 ± 19.73, p = 0.04). Despite this, education did not significantly impact perceptions of aging or overall negative self-perception, indicating its selective influence on aspects of self-perception. Our study reveals the multifaceted relationship between perceptions of aging, appearance consciousness, and self-perception in women, emphasizing the substantial role of social media. It shows that social media exposure and engagement intensify appearance concerns and aging anxieties, especially among middle-aged and married women, concluding in more pronounced negative self-views. While the influence of educational background remains mixed, the findings support initiatives for educational and awareness campaigns to redefine aging and appearance perceptions, advocating for diverse beauty representations to improve women's self-image and counteract negative stereotypes

Nutritional status and postoperative outcomes in patients undergoing major resection for gastrointestinal cancer: a prospective cohort study

Malnutrition is highly prevalent among patients with gastrointestinal (GI) cancers and has a significant effect on surgical outcomes. Despite the growing recognition of this relationship, standardized nutritional assessment and intervention protocols remain inconsistent across healthcare settings. A prospective cohort study was carried out over a one-year period (June 2023–June 2024) to determine the associations between preoperative nutritional status and postoperative outcomes in patients undergoing major resection for GI malignancies. Consecutive patients who underwent elective major GI cancer resection were enrolled. The study utilized validated tools to assess nutritional status, including serum albumin (ALB), body mass index (BMI), and the Patient-Generated Subjective Global Assessment (PG-SGA). The principal outcomes were major postoperative complications (Clavien–Dindo grade ≥3), length of hospital stay, and thirty-day mortality. Among 294 patients, 128 (43.5%) were identified as nutritionally at risk preoperatively. Patients classified as malnourished experienced significantly higher 30-day mortality, with a rate of 12.5% versus 4.2% in well-nourished patients (p = 0.008). They also had a greater incidence of major postoperative complications, occurring in 35.9% of cases versus 18.1% among their well-nourished counterparts (p < 0.001). In addition, the median length of hospital stay was notably longer in malnourished individuals (14 days) than in those with adequate nutritional status (9 days; p < 0.001). Multivariate analysis revealed severe malnutrition as an independent risk factor for adverse postoperative outcomes, with an odds ratio (OR) of 2.84, a 95% confidence interval (CI) ranging from 1.52 – 5.31, and a p value of 0.001. These findings demonstrate that preoperative malnutrition significantly increases perioperative morbidity and mortality among patients undergoing GI cancer surgery. These findings advocate the integration of routine nutritional screening and tailored interventions into the perioperative care pathway

Comparison of teledentistry and on-site clinical diagnosis using the International Caries Detection and Assessment System (ICDAS) in Rawalpindi and Islamabad: a validation study

Dental caries significantly impact global health, particularly in Pakistan, where the prevalence is notably high. This study assessed the diagnostic accuracy of mobile teledentistry in Islamabad and Rawalpindi by employing the International Caries Detection and Assessment System (ICDAS) as a benchmark. This cross-sectional validation study was conducted from July to September 2022 in nine private dental clinics involving 460 participants proficient in basic Android smartphone functions. The diagnostic procedure comprised initial in-person evaluations by dentists, subsequent remote assessments using images captured by smartphones based on verbal instructions, and validations by a third independent dentist. Statistical analyses were performed using sensitivity, specificity, Matthew’s correlation coefficient, and receiver operating characteristic (ROC) curves. Teledentistry achieved a specificity of 89% and a sensitivity of 70%. The positive and negative predictive values were 74.6% and 86%, respectively. The ROC curve analysis, with an area under the curve greater than 0.7, confirmed the high diagnostic efficacy of the method. The Cohen’s kappa statistic reached 0.814, demonstrating substantial interrater reliability, while the diagnostic odds ratio was 18, indicating strong discriminative power. This study confirmed that teledentistry, enabled by the use of smartphone cameras, serves as a reliable method for detecting dental caries, with efficacy comparable to that of conventional clinical examination methods. It significantly extends dental care accessibility, particularly in geographically remote or economically underserved regions, effectively mitigating the logistical challenges associated with traditional dental visits. The findings support the broader implementation of teledentistry, highlighting its potential to enhance mass screening efforts, improve oral health outcomes, and alleviate pressures on healthcare systems across diverse demographic landscapes

Road traffic accidents in Pakistan: unveiling the emergency service challenge

We address the critical issue of road traffic accidents (RTAs) that significantly impact global mortality and morbidity. Annually, RTAs cause nearly 1.35 million deaths worldwide, making them one of the top ten leading causes of death, exceeding rates of tuberculosis and diarrheal diseases. In Pakistan, the situation is particularly dire due to its vast population and extensive road network. The increasing number of vehicles combined with rapid urbanization intensifies RTA occurrences. Inadequate enforcement of traffic laws leads to high-risk driving behaviors. Most victims are young adults, with motorcyclists, cyclists, and pedestrians being the most vulnerable groups. This highlights a pressing need for comprehensive reforms to enhance road safety practices, improve emergency response systems, and implement effective public health education to mitigate the devastating impact of RTAs

Assessment of acute kidney injury associated with the concomitant use of piperacillin/tazobactam and vancomycin in pediatric cancer patients

This study aimed to evaluate the renal safety of concomitant piperacillin/tazobactam (Pip-Taz) and vancomycin in pediatric cancer patients by assessing changes in the serum creatinine (SCr) and blood urea nitrogen (BUN) levels. The hospital information system at Shaukat Khanum Memorial Cancer Hospital and Research Centre was used to extract the required information, and laboratory test results were collected for 100 randomly selected patients in whom both Pip-Taz and vancomycin were used. Patients were randomly selected using a computer-generated list to minimize selection bias. The data obtained were statistically analyzed using the Friedman test. Most patients who received Pip-Taz and vancomycin suffered from pre-B lymphocytic leukemia. The Friedman test revealed significant within-group differences in SCr and BUN over time (χ² = 299.945, p < 0.001 for males; χ² = 170.162, p < 0.001 for females), but all posttherapy values remained within normal physiological ranges. Posttherapy, vancomycin-treated patients had slightly lower SCr and BUN levels than did those receiving Pip-Taz, although all values remained within normal ranges. A similar trend was observed in females. These findings suggest that concomitant Pip-Taz and vancomycin did not result in significant nephrotoxicity, as all renal biomarker changes remained within normal ranges. No patients met the acute kidney injury (AKI) criteria during therapy. However, vancomycin-treated patients presented slightly greater reductions in creatinine and BUN levels than did Pip-Taz-treated patients, although this does not indicate improved renal function. Despite these findings, vancomycin’s potential for nephrotoxicity remains an important consideration in pediatric treatment decisions

Beyond transmission: exploring the knowledge of risk factors and myths of Hepatitis B and C among undergraduate medical students

Hepatitis B virus (HBV) and hepatitis C virus (HCV) have significant impacts on global public health, necessitating a deep understanding of their transmission dynamics and risk factors. Given the high prevalence in Pakistan and the critical role of healthcare education, this study aimed to assess medical students’ knowledge of transmission risk factors and common myths and misconceptions about HBV and HCV. An exploratory study was conducted in May 2022 at Rai Medical College, Sargodha, Pakistan. A total of 376 undergraduate medical students were recruited using a convenient sampling technique. Participants completed self-administered questionnaires to assess their knowledge of HBV and HCV transmission risk factors and associated myths and misconceptions. The data were analyzed for frequencies and percentages with SPSS version 25.00. The majority of students accurately identified traditional transmission pathways for HBV, with 78.72% recognizing transmission during pregnancy and 73.14% during delivery. However, knowledge about nontraditional transmission routes and household practices was less robust, with only 60.64% acknowledging the risks of sharing nail cutters. For HCV, knowledge was generally lower, with 62.77% recognizing the risk associated with tattooing. Misconceptions were also prevalent; for instance, 53.99% of students mistakenly believed that HBV could be transmitted through the home care of patients. This study highlights significant knowledge gaps and pervasive misconceptions among medical students regarding HBV and HCV transmission. Despite a good grasp of traditional risk factors, the widespread misunderstanding of nonbloodborne transmission routes underscores the urgent need for enhanced educational interventions. The findings suggest that targeted improvements in curriculum design could better equip future healthcare providers to combat hepatitis effectively