Evaluating Risk Factors and the Burden of Silent Myocardial Ischemia Among Diabetic Patients.

Introduction: Silent myocardial ischemia (SMI) is a significant concern for diabetic patients, often remaining undetected until severe complications arise. Prolonged hyperglycemia, poor glycemic control, and lifestyle factors contribute to its risk, with older adults and those with long-standing diabetes particularly vulnerable.

Objective: To assess the prevalence and predictors of SMI in adults with diabetes, emphasizing long-term management and monitoring.

Efficacy and Safety of Stem Cell Therapy for Orthopedic Conditions, Including Osteoarthritis and Bone Defects.

Introduction: Orthopedic conditions like osteoarthritis and bone defects pose significant challenges due to their impact on individuals' quality of life. Traditional treatments often provide only symptomatic relief, necessitating alternative therapies for long-term management. Stem cell therapy has grabbed attention for its regenerative and immunomodulatory properties, offering potential for tissue repair and functional restoration.

A pancreatic pseudocyst sitting in the mediastinum-A case report of an unusual occurrence.

Pancreatitis can produce several complications such as pseudocyst, which can happen in acute and chronic pancreatitides. Pseudocysts are typically found in the abdomen but can rarely extend into the mediastinum. Atypical symptoms such as dyspnea, dysphagia, coughing, vomiting, abdominal or chest pain, and hemoptysis are usually the notable complaints.

In vitro analysis of PI3K pathway activation genes for exploring novel biomarkers and therapeutic targets in clear cell renal carcinoma.

Objectives: The regulation of various cellular functions such as growth, proliferation, metabolism, and angiogenesis, is dependent on the PI3K pathway. Recent evidence has indicated that kidney renal clear cell carcinoma (KIRC) can be triggered by the deregulation of this pathway. The objective of this research was to investigate 25 genes associated with activation of the PI3K pathway in KIRC and control samples to identify four hub genes that might serve as novel molecular biomarkers and therapeutic targets for treating KIRC.

Frequency Of Primigravida In Patients With Eclampsia.

Background: Pregnancy-induced hypertension (PIH) occurs in about 5% of pregnancies and is a major cause of high perinatal and maternal morbidity and mortality. In several international studies, primigravidas were associated with a significantly higher incidence of eclampsia. The local studies so far have a small sample size and mainly focus on preeclampsia in all pregnant women.

Frequency Of Stone Clearance After Transurethral Fragmentation Of Large Urinary Bladder Calculi Using Pneumatic Swiss Lithoclast.

Background: Vesical calculi refer to stones in the urinary bladder. The causes of bladder stones include bladder outlet obstruction, neurogenic voiding dysfunction, infection, or foreign bodies. Very rarely, these vesical calculi may reach very large sizes and the largest dimension can sometimes reach 13 centimetres.

Career Aspirations Of Junior Doctors In Pakistan: Exploring Reasons Behind The Brain Drain.

Background: Mass medical migration from Pakistan to more developed counties pose a threat to the professional resources of Pakistan. The aim of our study is to assess magnitude of the brain drain and to assess reasons behind it.

Methods: A Cross-sectional study, using convenience non-probability sampling, with sample of 201 Ayub Medical College graduates.

MRI Changes Among Patients Of Eclampsia And Preeclampsia With Associated Neurological Symptom Analysis.

Background: Pregnancy poses some stress on normal homeostasis of the human body and brings changes in the body which predisposes the individual towards various pathological conditions as well.

Objective: Objective of the study was to determine the magnetic resonance imaging (MRI) changes and clinical symptoms associated with these changes among patients of eclampsia and preeclampsia managed at tertiary care unit. It was a cross-sectional study, conducted at Gynaecology and obstetrics department Pak Emirates Military Hospital (PEMH) Rawalpindi.

Outcome Of Open Interlocking Nailing In Closed Fracture Shaft Of Femur.

Background: Various treatment modalities have been used in treating femoral shaft fractures, i.e., open intramedullary nailing, plating and external fixators but these does not always produce stable fixation and there is increased risk of infection, closed locked intramedullary nailing technique has being the gold standard and is a routine procedure but it requires proper orthopedic operation table with traction apparatus and the use of image intensifier.

Surgical Attitudes And Preferences Regarding Choice Of Anaesthesia Amongst Orthopaedic Surgeons.

Background: Regional anaesthesia is choice of anaesthesia for orthopaedic surgery due to lower side effects such as nausea, vomiting, postoperative pain and early mobilization. Despite of this, some orthopaedic patients refuse this modality. This study was conducted to interrogate the surgeons about their choice of anaesthesia in order to gain some insights into the concerns of surgeons and to change their minds and choose a safer mode of anaesthesia.

Comparison Of Lumbar Drain Insertion And Conservative Management In The Treatment Of Traumatic CSF Rhinorrhoea.

Background: Conservative management of traumatic CSF rhinorrhoea is associated with a greater risk of developing meningitis in the presence of active CSF leak. Lumbar drains have been reported to be better than conservative management alone in stopping CSF leaks following traumatic brain injury.

Methods: This randomized controlled trial enrolled 60 patients with CSF rhinorrhoea and divided them into two groups.

Non-Contrast Enhanced Multi-Slice Ct-Kub In Renal Colic: Spectrum Of Abnormalities Detected On Ct Kub And Assessment Of Referral Patterns.

Background: Renal colic is a common problem and significant number of patients presenting to ER, ED are suffering from acute or chronic renal colic. The conventional methods of investigating patients with renal colic are urine routine examination, plain radiograph for KUB (kidneys, ureters and bladder) and ultrasound followed by intravenous urography. Now a days non contrast enhanced computed tomography of kidneys, ureters and bladder is the first line investigation in suspected upper urinary tract obstruction.

Role Of Choledochoduodenostomy Revisited In The Era Of Minimal Invasive Procedures.

Background: Present era of endoscopic and laparoscopic approaches have revolutionized surgical management of Common Bile Duct (CBD) stones. Open procedures like Choledochoduodenostomy (CDD) have become a rarity but are not completely obsolete. It may be considered a relatively safe alternative when dealing with recurrent, too large or impacted stones, a failed ERCP, and CBD stricture with stones.

Procedural Outcomes Of Primary Percutaneous Coronary Intervention In Elderly Patients With Stemi.

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide, and coronary artery disease (CAD) is the most prevalent manifestation associated with high mortality and morbidity. Older age is independent predictor of cardiovascular mortality and death. Elderly may experience high rates of complications following acute STEMI.

Role Of Tuberculin Test As A Diagnostic Tool For Tuberculosis.

Background: Childhood Tuberculosis remains one of the major public health concerns in developing countries like Pakistan and is responsible for high rates of morbidity and mortality in children. Although tuberculin skin test is very commonly used by physicians all over the world, its interpretation always remains difficult and challenging. The objective of this study was to determine the frequency of positive tuberculin skin test in vaccinated and unvaccinated children suffering from tuberculosis.

Plant derived anticancer agents: A green approach towards skin cancers.

Plants have been used as medicinal agents since the origin of mankind. High cost and severe side effects associated with conventional chemotherapy has limited their general acceptability and fuel up the search for alternate options. The alternative treatment options like phytochemicals have come up with ease of availability and cost effectiveness.

Ultrasound And Supine Chest Radiograph In Road Traffic Accident Patients: A Reliable And Convenient Way To Diagnose Pleural Effusion.

Background: Portable bed side ultrasound and supine chest radiograph of 80 traumatic patients excluding very clinically unstable patients who subsequently underwent CT scan chest was done for traumatic effusion showing that ultrasound had a higher sensitivity than CXR, 88.23% and 77.94%, respectively, and a similar specificity of 100% and 100%, respectively.

Out Come Of Trial Of Scar In Patients With Previous Caesarean Section.

Background: Patients who had one caesarean section were previously not given a trial of scar due to fear of increased morbidity. However, recently there has been a trend to give a trial of labour to patients with a previous caesarean section for a non-recurrent cause. Medical evidence indicates that 60-80% of women can achieve vaginal delivery after a previous lower segment caesarean section.

Giant Cementoblastoma Of Left Maxilla Involving A Deciduous Molar.

Cementoblastoma is a relatively rare benign tumour. The clinicopathologic features, radiological findings, treatment and prognosis are reported here in a 10-year-old girl who presented to us from Afghanistan. The tumor was managed surgically and the histopathology confirmed the diagnosis of cementoblastoma.

Histological Pattern Of Endometrial Samples In Postmenopausal Women With Abnormal Uterine Bleeding.

Background: Abnormal uterine bleeding is one of the most common clinical problems in gynaecological practice and is an indicator of various underlying disorders. An endometrial biopsy should be done in all women over 35 years with AUB to rule out endometrial cancer or pre-malignant lesion and to initiate treatment. However, wide range of histological patterns on endometrial biopsy offer a diagnostic challenge to practicing pathologists.

Efficacy of endoscopic third ventriculostomy in non-communicating hydrocephalus.

Background: Hydrocephalus is common problem requiring either extra-cranial (shunts) or intracranial (ventriculostomy) diversion of cerebrospinal fluid. Endoscopic third ventriculostomy obviates all the complications of shunts and has been accepted as the procedure of choice for the treatment of obstructed hydrocephalus in adults and children because of the minimally invasive nature. This study was conducted to determine the efficacy of endoscopic third ventriculostomy in the treatment of non-communicating hydrocephalus.

Aetiology and types of neonatal seizures presenting at Ayub Teaching Hospital Abbottabad.

Background: Neonatal seizures (NS) affect approximately 1% of neonates. Clonic, tonic, myoclonic and subtle seizures are the common types. Birth asphyxia, sepsis, metabolic derangements, intracranial bleed, kernicterus, tetanus and 5th day fits are the common aetiologies.

Evaluation of modified Alvarado score for frequency of negative appendicectomies.

Background: Appendicitis being the commonest surgical emergency is primarily diagnosed clinically but posses diagnostic difficulty usually, especially to junior surgeons, demanding the need for tool/scoring system that can be easily applicable, accurate & reproducible in the diagnosis of appendicitis, with low negative Appendicectomy rate. This study is designed to assess one such scoring system, i.e.

Outcome of intramedullary spinal cord tumours: experience with 18 patients operated at Ayub Teaching Hospital, Abbottabad.

Background: Intramedullary spinal cord tumours (IMSCT) are among the uncommon lesions at spinal cord. They can present with a vast array of symptoms and cause severe neurological deficits. With advent and frequent use of MRI more and more patients with IMSCT are picked up.