ADVANCES IN BASIC MEDICAL SCIENCES

Short-term functional outcomes of partial meniscectomy among middle-aged patients

2025-02-17T08:34:39+00:00

Objective: The focus of this investigation was to examine functional recovery patterns in middle-aged individuals following arthroscopic paral meniscectomy, a minimally invasive surgical procedure involving paral excision of the knee meniscus in the early postoperative period.

Methods: The current prospective interventional study was conducted at Afridi Medical Complex and Teaching Hospital, Peshawar, from August 2023 to July 2024, including 87 patients with knee meniscal tears who underwent arthroscopic partial meniscectomy. Visual Analogue Scale score and Lysholm Knee Functional Score were used to evaluate improvement postoperatively, pain, and the functional outcome, respectively. Data analysis was done through Excel software version 2003.

Results: The VAS score for knee pain improved from 7.023±0.816 preoperatively to 2.518±1.065 at 12^thweeks postoperatively (p-value < .001). Lysholm knee score for functional outcomes improved from 48.41±6.327 preoperatively to 81.8±10 at 12^th week postoperatively (p-value < .001). Functional outcome of partial meniscectomy was excellent, good, fair, and poor outcomes were noted in 9.42%, 60%, 20%, and 10.59% of patients, respectively. Gender, BMI status, and type of meniscal tears had no effect on the functional outcome of partial meniscectomy for meniscal tears.

Conclusion: Meniscal tears in adults afflict the male gender more than the female gender, and they are more likely to be degenerative than traumatic. Most of the patients had less knee discomfort at 12 weeks after an arthroscopic partial meniscectomy. At 12 weeks, over fifty percent of the patients demonstrated better short-term functional results following arthroscopic partial meniscectomy. Gender, body mass index, and meniscal tear type had no significant impact on outcome.

A Comparison of conservative management versus appendectomy in uncomplicated acute appendicitis in pediatric age

2024-11-19T06:44:24+00:00

OBJECTIVE: The objective of this study was to compare the outcome of conservative management (CM) of acute appendicitis (AA) versus appendectomy in uncomplicated appendicitis in the pediatric age group regarding resolution of symptoms and hospital stay.

METHODS: This randomized controlled trial was conducted after IRB approval. A total of 122 patients were registered in this study and were randomly assigned into two groups by a ballot method (61 patients in each group): In group A, children were managed conservatively with antibiotics, and in group B, Patients underwent appendectomy. After treatment in both groups, the outcome was measured in terms of resolution of symptoms and hospital stay.

RESULTS: Overall, there was a male predominance in the study population, with 58.2% males and 41.8% females. Both groups were comparable concerning the age of presentation (Group A: 111.4 ± 24.38 months vs Group B: 112.4 ± 30.3 months, p-value=0.883). In terms of hospital stay, Group A had a mean stay of 2.655 ± 0.834 days and Group B had a mean stay of 1.967 ± 0.682 days, with a p-value of 0.001. Among the patients in the conservative group, 85.2 %( n=52/61) showed resolution of symptoms, while 14.8% (9/61) had treatment failure. The rate of histologically confirmed negative appendectomy was 11.5% (7/61) in the appendectomy group, which was confirmed histologically. The histology of the nine individuals in the conservative group who underwent appendectomy was positive. On follow-up, one patient (1.85%) in the conservative management group presented with recurrence. While in the appendectomy group, 4 cases of wound infection and one case of prolonged ileus were presented (overall complication rate 8.2%).

CONCLUSION: for suspected acute appendicitis, antibiotics are safe and effective and may avoid unnecessary appendectomy, decreasing the operation rate and surgical hazards.

Exploring COVID-19 Vaccine Hesitancy and associated factors among Medical College Students

2025-02-17T08:41:13+00:00

OBJECTIVE: This study aimed to assess the frequency of COVID-19 vaccine hesitancy among medical college students. In response to the COVID-19 pandemic, the scientific and regulatory communities swiftly developed and approved vaccines to combat the highly contagious SARS-CoV-2 virus. However, the expedited processes to address the public health crisis led to limited time for thorough safety testing of these vaccines, resulting in doubts among the general, academic, health professionals, and scientific communities. Additionally, reports of side effects more severe than the disease itself have contributed to vaccine hesitancy among the public. Given their role in disseminating accurate information and administering vaccinations, understanding medical science students' vaccine hesitancy is essential to the COVID-19 response.

METHODS: A cross-sectional survey using online forms observed the level of COVID-19 vaccine hesitancy in 299 medical college students of both genders from January 20 to February 20, 2023. The study was conducted at Jinnah Medical College after ethical approval was obtained from the institutional ethical review board.

RESULTS: A total of 299 (65.2% male and 34.8% female) medical students (MBBS) participated in the study. Most of the students, 274 (91.6%) marked themselves as vaccinated, whereas 25 (8.4%) were not vaccinated. A series of questions was asked to determine the causes of hesitancy. Despite the 91.6% vaccination rate, the initial vaccine acceptance rate was 71.9% among the participants. Most of the initially hesitant students changed their minds and got vaccinated. The side effects observed ranged from 28.6 to 45.1%, and no prominent impact of psychological factors was observed on the side effects.

CONCLUSION: The vaccine acceptance and vaccination rates were high among the students. About half of the students observed side effects that were not correlated with the psychological impact of COVID-19.

The Early Maternal Skin-to-Skin Contact and Its Role in Reducing Neonatal Sepsis: A Prospective Cohort Study

2025-05-08T15:46:31+00:00

OBJECTIVE: To assess the impact of maternal-newborn skin-to-skin contact on the incidence of neonatal sepsis by the 28th day of life among mothers delivering at hospitals in Baluchistan and Karachi.

METHODOLOGY: This prospective cohort study was conducted from December to April 2022, including 237 mothers and their neonates from two sites: Civil Hospital Hub, Lasbela District, Baluchistan (SSC/KMC group) and Civil Hospital Karachi (conventional care group). Participants were selected using purposive sampling. Data collected through a structured, pretested questionnaire and by observation from delivery until the 28th day of life to determine the occurrence of neonatal sepsis in both groups. Data were entered into SPSS version 22 and analyzed using binary logistic regression. Variables showing a p-value less than 0.25 in the bivariate analysis were entered into the multivariate logistic regression model to account for potential confounding factors. Statistical significance in the multivariate model was determined at a p-value threshold of <0.05.

RESULTS: Among the 237 neonates, 18.5% developed early-onset sepsis (0–7 days), and 4.2% developed late-onset sepsis (8–28 days), yielding an overall sepsis rate of 22.6%. Significant associations were found between neonatal sepsis and factors such as maternal age, ethnicity, low birth weight, lack of SSC, and delayed initiation of breastfeeding. Attributable risk analysis revealed that 18.76% of sepsis cases in the non-SSC group could have been prevented by early skin-to-skin contact (SSC). Furthermore, 58.26% of the sepsis burden in neonates without SSC was potentially preventable through timely SSC intervention.

CONCLUSION: Early SSC and breastfeeding initiation are simple, cost-effective interventions that significantly reduce neonatal sepsis, morbidity, and mortality. Promoting antenatal and postnatal care awareness, ensuring skilled birth attendance, and adhering to infection prevention protocols are critical steps towards improving neonatal outcomes.

Pattern of dento-alveolar fracture in children

2025-05-17T10:15:25+00:00

OBJECTIVE: Dento-alveolar fractures are a significant concern in pediatric dentistry, often resulting from falls, sports-related injuries, and motor vehicle accidents. Understanding their epidemiology, etiology, and treatment outcomes is crucial for improving preventive and therapeutic strategies.

METHODOLOGY: This retrospective study analyzed 185 pediatric patients (≤18 years) with dento-alveolar fractures. Data on demographic characteristics, etiology, fracture types, radiographic findings, and treatment modalities were evaluated using descriptive and inferential statistical analyses.

RESULTS: The mean age of patients was 10.4 ± 3.2 years, with a male predominance (68%). Falls (42%) were the most common cause of injury, followed by sports-related trauma (28%) and motor vehicle accidents (18%). Maxillary anterior teeth were the most frequently affected site (52%), particularly the central incisors (38%). Soft tissue injuries accompanied 74% of cases, with lacerations (55%) and gingival bleeding (45%) being the most frequent. Uncomplicated crown fractures (Ellis Class I: 48%; Ellis Class II: 32%) were most prevalent, while luxation injuries (20%) and avulsions (8%) were less common. Significant associations were found between gender and fracture type (p = 0.012), as well as between motor vehicle accidents and mandibular fractures (p < 0.001). Younger children (≤10 years) and sports-related injuries were independent predictors of treatment failure (p < 0.05).

CONCLUSION: Pediatric dento-alveolar fractures predominantly affect young boys, with falls and sports injuries being the leading causes. The maxillary anterior region, particularly the central incisors, is the most vulnerable. Findings highlight the need for age-specific and gender-targeted preventive measures, including school-based safety programs and the promotion of protective gear in contact sports.

Determinants of Absenteeism Among Undergraduate Medical Students: A Cross-Sectional Study from a Public Medical College in Pakistan

2025-05-04T11:17:30+00:00

OBJECTIVE: To identify the determinants of absenteeism among undergraduate medical students at a public medical college in Pakistan, focusing on academic, psychological, and social factors.

METHODOLOGY: This cross-sectional study was conducted at Bacha Khan Medical College (BKMC), Mardan, from December 2024 to March 2025. A total of 200 MBBS students with attendance below 75% were enrolled through convenience sampling. Data were collected using a validated, self-administered questionnaire that covered academic stress, mental health, teaching satisfaction, learning engagement, and social influences. Statistical analysis included descriptive statistics, chi-square tests, and binary logistic regression.

RESULTS: Key contributors to absenteeism included academic stress (78%), dissatisfaction with teaching methods (70%), mental health issues (65%), low engagement (60%), and social factors (52%). Logistic regression identified academic stress (OR = 2.78, p < 0.001), low engagement (OR = 2.43, p = 0.001), mental health issues (OR = 1.94, p = 0.018), dissatisfaction with teaching (OR = 1.88, p = 0.021), and social influences (OR = 1.67, p = 0.045) as significant predictors. No significant associations were found with gender or academic year.

CONCLUSION: Absenteeism among medical students in public-sector institutions in Pakistan is influenced by multiple interrelated factors, particularly academic stress and disengagement. Addressing these issues through institutional reforms, enhanced teaching methods, and mental health support could improve student attendance and overall academic performance.

In vitro synergistic cytotoxic activity of oral hypoglycemic agent (Metformin) with Methotrexate against cancerous cells

2025-05-23T11:54:53+00:00

OBJECTIVE: Evaluation of synergistic cytotoxic effects of add-on therapy of Metformin with Methotrexate in different cancerous cells.

METHODOLOGY: This interventional study was undertaken at BMSI, JPMC, in conjunction with PCMD. The trial lasted three months. To appraise the Cytotoxic activity of metformin only and in combination with methotrexate, we employed cells from breast cancer (MCF-7 and MDA-MB-231), vaginal cancer (Hela), and colorectal adenocarcinoma (HT-29 cell line). We employed the most appropriate MTT tests to assess cytotoxic effects.

RESULTS: When the percentage viabilities of the examined cell lines were compared, it was discovered that combination therapies of Metformin and Methotrexate dramatically lowered the percentage viabilities and had synergistic cytotoxic effects. There was a significant difference in the percent viability of cells representing breast cancer (MCF-7, MDA-MB-231), colorectal carcinoma (HT-29), and vaginal carcinoma representative cells (Hela cell lines) as assessed by MTT assay between Metformin alone and Metformin with Methotrexate. CDI values of each cell line for combination therapy were 0.702 ± 0.034, 0.67 ± 0.019, 0.69 ± 0.019, and 0.73 ± 0.040 for MDA-231, Hela, MCF-7, and HT-29 cells, respectively.

CONCLUSION: This research showed that Metformin also has synergistic effects with Methotrexate, in addition to having antiproliferative effects on the studied cancer cell lines.

Bias in AI-driven diagnostic tool in Dentistry

2024-11-13T09:13:20+00:00

Artificial intelligence (AI) is transforming the landscape of dentistry by enhancing the accuracy and efficiency of diagnostic processes. Through technologies such as machine learning and natural language processing, AI is increasingly being used to interpret radiographs, predict disease progression, and identify patients at risk of developing dental conditions. However, while AI offers immense promise, its integration into healthcare, particularly dentistry, also raises critical concerns about bias embedded in data and algorithms. These biases can perpetuate existing disparities, especially among marginalized and underserved communities.¹