Pakistan Journal of Medicine and Dentistry

A Rare Presentation: Leptomeningeal Disease Involving the Left Cerebellar Hemisphere and Lumbosacral Region in Breast Cancer

Rida Aziz, Arifa Shahzadi, Hamza Tanzeel, Ayesha Siddiqa, Areeba Aziz — Tue, 16 Apr 2024 00:00:00 +0500

Leptomeningeal disease (LMD) is a rare condition that occurs in fewer than 5% of breast cancer patients. In certain instances, individuals exhibit symptoms of LMD when initially diagnosed. We present a case involving a 48-year-old female who experienced a sudden onset of weakness in her left upper and lower limbs, leading to an extensive LMD diagnosis. A series of investigations were initiated to uncover the root cause of LMD. Subsequent MRI scans covering both the entire brain and the spinal cord confirmed the presence of metastatic breast carcinoma, thus providing insight into the origin of her condition. Following this, the patient underwent a regimen of radiation therapy to address the metastases and then started a comprehensive neuro-rehabilitation program aimed at improving her overall well-being and quality of life.

Co-existence of Systemic Lupus Erythematosus and Celiac Disease: A Case Report

Nauman Ismat Butt, Muhammad Sohail Ajmal Ghoauri — Tue, 16 Apr 2024 00:00:00 +0500

Systemic Lupus Erythematosus (SLE) is an autoimmune multisystem disease usually affecting mucocutaneous, hematologic, and renal organs. Whereas, Celiac Disease is a chronic digestive and immune disorder of the small intestine leading to diarrhea and malnutrition. We report the case of an 18-year-old girl with chronic diarrhea for 1 year with bilateral feet swelling, photosensitive skin rash over sun-exposed areas, recurrent oral ulcers, marked hair fall, generalized lethargy, and fatigue. On examination, she was underweight having malar butterfly rash, oral ulcers, alopecia, conjunctival pallor, and bilateral pitting pedal edema. Investigations revealed raised ESR, microcytic anemia due to iron deficiency, and low serum albumin. Duodenal biopsy showed villous atrophy, lamina propria inflammation, and intraepithelial lymphocytosis. The autoimmune profile revealed positive anti-tissue transglutaminase (tTG-IgA and tTG-IgG), ANA, anti-DsDNA, and Anti-Sm antibodies with low serum C3 and serum C4 levels. A diagnosis of co-existing Celiac Disease and SLE was made and was managed with a gluten-free diet, steroids, and hydroxychloroquine.

A Case Report on Reverse Tokotsubo Cardiomyopathy: Diagnosis and Path toward Treatment

Tue, 16 Apr 2024 00:00:00 +0500

Reverse takotsubo cardiomyopathy (rTTC), also known as inverted takotsubo syndrome, is an acute cardiac syndrome that mimics myocardial infarction and accounts for a smaller proportion of cases compared to the classic takotsubo syndrome. While the exact prevalence is not well-established, studies suggest that the proportion of patients with the rTTC variant out of all Takotsubo Cardiomyopathy (TTC) according to different literature ranges from 1-23%. This variant of TTC is characterized by basal and/or mid-akinesis/hypokinesis associated with apical hyperkinesis that resolves spontaneously. We report a case of a 30-year-old male patient who presented with complaints of sudden crushing chest pain and shortness of breath. After conducting a thorough examination, the patient's diagnostic workup confirmed reverse takotsubo cardiomyopathy, elucidating the underlying cardiac pathology.

Comparative Analysis: Global Rating Scale vs. Checklist in Teaching and Assessing Skill Competence

Somia Saghir, Bushra Sultan, Farhana — Tue, 16 Apr 2024 00:00:00 +0500

This study compared the effectiveness of the Global Rating Scale (GRS) versus the checklist for teaching and evaluating nursing students on two skills; nasogastric tube (NGT) and subcutaneous injection. Using a census sample, 100 students of 2^nd year Bachelor of Science in Nursing (BSN) were enrolled and divided into two groups. The control group was taught and evaluated on the traditional checklist, whereas the experimental group through the GRS. The results showed students in the experimental group obtained a higher mean score (NGT 9.41, subcutaneous injection 9.27) than the control group (NGT 7.2, subcutaneous injection 7.6). Likewise, critical point scores were also notably higher in the experimental group (NGT 9.6, subcutaneous injection 9.8) than in the control group (NGT 1.7, subcutaneous injection 2.4). GRS is recommended for teaching and evaluating nursing students’ psychomotor skills. Educator training is essential for effective GRS utilization, enhancing performance evaluation, ensuring competence, and aligning with study program objectives for enhanced patient safety.

Exploring The Legacy: The Biological Interactions of Bis Schiff Bases and Their Coordinated Azomethine Derivatives Over Time

Zahid Khan, Muhammad Asad Khan Tanoli — Tue, 16 Apr 2024 00:00:00 +0500

Schiff base class of compounds has a double bond between carbon and nitrogen. They form a carbonyl molecule, like an aldehyde or ketone, when combined with a primary amine. A Schiff base is structurally an aldehyde or ketone's nitrogen counterpart where the carbonyl group (CO) has been replaced with an imine or azomethine group. Schiff bases are a significant class of organic compounds with potential applications in many biological fields. They are best recognized for their capacity to generate transition metal complexes. Schiff-base ligands are easily produced and can form complexes with almost any metal ion. The main focus of this review is on the bis Schiff bases, a subclass of Schiff bases identified by the occurrence of two azomethine groups in their structures. These azomethine groups are major contributors to the activity of these compounds, along with substituent effects on key positions. For scientists interested in learning about these particular compounds' potential for specific biological uses, this article provides literature examples of the compounds in question and their biological action processes. A review focusing on the biological applications of Schiff base-derived ligands and their complexes is essential due to the numerous recent publications detailing their antibacterial, antioxidant, and enzyme-inhibitory activities.

AI-Enhanced Predictive Analytics in Optimizing Patient Outcomes within Pakistan's Healthcare System

Sidra Abid, Humna Rafiq, Maha Zehra — Tue, 16 Apr 2024 00:00:00 +0500

Dear Editor,

AI integration in healthcare, particularly in low- and middle-income countries such as Pakistan, offers revolutionary opportunities by automating processes, analyzing data, and improving healthcare efficiency while addressing staffing and financial resource challenges. Pakistan's health and disease burden is in the bottom 25% of the world in terms of predictive analytics on outcomes for patients. The country is witnessing an increase in innovative healthcare projects that use artificial intelligence and statistical analysis to anticipate the effects on patients, influencing the future of healthcare delivery and therapeutic approaches.

A Paucity of Acupuncture-Based Rehabilitation for Cerebral Palsy Patients in Pakistan

Ammara Rafique, Sana Subhan, Syeda Amna Iqbal — Tue, 16 Apr 2024 00:00:00 +0500

Dear Editor,

Cerebral Palsy (CP) is a neurological disorder that primarily affects motor functions along with cognitive, hearing, speech, and oral health functions^1,2. Morbidity data has shown that CP is more common in males in Karachi, Pakistan³. CP management often requires many interventions including anticonvulsant medications, bimanual training, botulinum toxins, castings, context-focused therapy, home-based therapy, occupational therapy, physiotherapy, and even surgeries in extreme cases⁴. Apart from these interventions, acupuncture is an effective and widely used method of rehabilitation to treat addiction, asthma, cancer pain, carpal tunnel syndrome, chronic prostatitis, CP, depression, dental pain, fibromyalgia, headaches, infertility, irritable bowel syndrome, labor pain, menstrual cramps, myofascial pain, osteoarthritis, post-operative pain, sciatica, urinary incontinence, and many more.

Preference Level for Robusta Green Coffee Bean Extract Toothpaste among Students at the University of Jember, Indonesia

Desi Sandra Sari, Shabrina Tuhva Chaliqi, Yuliana Mahdiyah Da’at Arina — Tue, 16 Apr 2024 00:00:00 +0500

Background: Robusta green coffee bean extract toothpaste was an alternative product for preventing caries and periodontal disease. As a product, a hedonic test to determine consumer acceptance and satisfaction was needed. This research assessed the preference level for Robusta green coffee bean extract toothpaste among students at the University of Jember, Indonesia.

Methods: This is an experimental and analytical observational study. The Robusta green coffee bean was extracted using the maceration method with 96% ethanol. The toothpaste was made by mixing placebo paste ingredients with Robusta green coffee bean extract at concentrations of 0.0625%, 0.125%, 0.25%, and 0.5%. The hedonic test included color, aroma, and texture parameters with a Likert scale and was carried out in the period August-November 2023 by 30 students from the Faculty of Dentistry, University of Jember, who were healthy, without allergies, and did not smoke SPSS vr26 was used and the mean score was calculated as the level of preference. Statistical test with Kruskal Wallis followed by Mann Whitney with p-value<0.05 significant.

Results: The cut-off value of the mean score was 3-5 for the highest level of preference with 4.00±1.174 for color parameters and 3.73±0.907 for texture parameters, shown by 0.5% concentration of Robusta green coffee bean extract toothpaste, while for aroma parameters was 4.13±0.681, shown by 0.25% concentration of toothpaste. Overall, the highest level of all parameter’s preference was 3.93±0.691 shown by 0.5% concentration of toothpaste but there was no significant difference with 0.25% concentration (p>0.05).

Conclusion: Robusta green coffee bean extract toothpaste with concentrations of 0.25% and 0.5% were preferred by consumers.

Mucin-2 Expression in Primary and Recurrent Cases of Pleomorphic Adenoma in Tertiary Care Hospitals of Peshawar

Samar Ashfaq, Sadaf Alam, Muhammad Mumtaz Khan, Sabeen Nasir — Tue, 16 Apr 2024 00:00:00 +0500

Background: Pleomorphic adenoma (PA) is a benign tumor, with a high recurrence rate. This study aimed to compare the Mucin-2 (MUC2) expression in primary and recurrent cases of PA in tertiary care hospitals of Peshawar.

Methods: In this study, there were 60 PA cases, 51 being primary lesions and 9 recurrent lesions. Formalin-fixed and paraffin-embedded (FFPE) blocks of the two groups were examined for the immunohistochemical expression of MUC2. The clinicopathological parameters were also examined. This study was conducted at the Pathology Department, Pakistan Institute of Medical Sciences (PIMS), Peshawar, between January 2019 to January 2021. A nonprobability sampling technique was used while collecting the samples. SPSS version 21 was used and p-value<0.05 was considered significant.

Results: The mean age was 32.3±8 years for both primary and recurrent PA cases. Out of the total, there were 30 (50%) females with 21 (35%) males, while all the recurrent cases were females 9 (15%). Most common microscopic features evaluated by H&E-staining showed Myxoid and chondroid stroma along with sheets of epithelioid and basaloid cells. Among 51 cases of primary PA, 17 (33%) showed positive MUC2 expressions and 34 (66.6%) showed negative expressions while all cases of recurrent PA showed positive MUC2 expression with a p-value of 0.05. In primary PA, only a single (1.66%) case showed a strong stain, while there were 5(55.3%) cases in the recurrent PA.

Conclusion: The expression of MUC2 is a useful marker to predict recurrence and there was a significant difference in the expression of MUC2 in primary and recurrent cases of PA.

Maternal Morbidity and Mortality in Higher Order Caesarean section

Shazia Iffet, Ayesha Arif , Sadaf Moin, Samia Ghulam, Nazia Mushtaq, Amera Tariq — Tue, 16 Apr 2024 00:00:00 +0500

Background: The persistently rising cesarean section rate in Pakistan is largely driven by cultural preferences for larger families, primary cesarean sections, induction of labor, and the desire to avoid litigation. These practices have resulted in numerous complications, posing significant challenges for obstetricians worldwide. This study aimed to determine the maternal morbidity and mortality associated with multiple repeat cesarean sections.

Methods: This cross-sectional study was carried out at the Department of Gynecology and Obstetrics, at a tertiary care hospital, Abbottabad. Patients (106), with four or more previous cesarean sections, (elective or emergency repeat CS), over 6 months (October 2022 to March 2023), were selected. The primary outcome including uterine scar dehiscence (USD), scar rupture, bladder injury, bowel injury, grade 2 adhesions, morbidly adherent placenta (MAP), obstetrical hysterectomy, intensive care admission, blood transfusion, prolonged hospital admission, and maternal mortality, were recorded through follow-up four weeks postpartum. Data was analyzed using SPSS vr20.

Results: Cesareans performed were 798, and HOCS 106 (13.2%). Out of these, 95 (89.6%) had their fourth, 9(8.5%) fifth, and 2(1.8%) sixth CS. Abdominopelvic adhesions were seen in 53(50%), USD in 23(21.6%), MAP in 5.6% leading to obstetrical hysterectomy in 6(5.6 %), bladder & bowel injury occur in 2(1.9%). No maternal death was recorded.

Conclusion: HOCS pose significant challenges. Reducing primary and elective repeat CS rates by promoting alternative delivery methods and trial of labor after one CS. Proper counseling and education on the risks of multiple cesarean sections and the use of modern contraceptive techniques are essential.

Carvacrol Silver Nanoparticles - An Effective Antibacterial Against Carbapenem-Resistant Acinetobacter Isolates Unaided and With Meropenem

Tue, 16 Apr 2024 00:00:00 +0500

Background: Acinetobacter species are a serious clinical challenge owing to their established resistance to carbapenems. This study aimed to explore Carvacrol silver nanoparticles' activity against carbapenem-resistant Acinetobacter and their interaction with meropenem to develop effectual treatment.

Methods: An in-vitro experimental study was conducted from February 2021 to January 2022. The minimum inhibitory concentration (MIC) of Carvacrol silver nanoparticles was checked using the broth macrodilution method. The results were further corroborated by performing the agar well diffusion method on 50 isolates of carbapenem-resistant Acinetobacter to observe the zone of inhibition (ZOI). The interaction of Carvacrol silver nanoparticles with meropenem (synergistic/additive/antagonistic) was assessed by checkerboard assay. SPSS vr24 was used. Kruskal-Wallis ANOVA with pair-wise comparison analysis was applied to compare different groups. p-value<0.05 was considered significant.

Results: The study showed that older males were mostly affected and the majority of the isolates were from the tracheal secretions and collected from the Medical ICU. MIC of Carvacrol silver nanoparticles was found to be 0.04-0.16mg/ml. On agar well diffusion, the ZOI of Carvacrol silver nanoparticles was in the range of 0-20mm compared to meropenem (0) and colistin (0-14mm) with a p-value of 0.00. Checkerboard assay revealed additive interaction between Carvacrol silver nanoparticles and meropenem as the Fractional inhibitory concentration was calculated to be 1.25.

Conclusion: Carvacrol silver nanoparticles have shown the potential ability to combat carbapenem-resistant Acinetobacter and may prove as an effective antibacterial agent in the future. Furthermore, the additive interaction of Carvacrol silver nanoparticles with meropenem points toward the possible revival of carbapenems against Acinetobacter.

Delay in Management of Acute Peritonitis and Its Effect on 30-Day Mortality

Tue, 16 Apr 2024 00:00:00 +0500

Background: Peritonitis is a grievous surgical emergency, characterized by the inflammation of the peritoneum and a major cause of morbidity and mortality in surgical situations. This study investigated the delayed presentation impact on 30-day mortality in emergency laparotomies for peritonitis patients in Karachi.

Methods: This longitudinal study was employed on 148 peritonitis patients at Jinnah Postgraduate Medical Centre, selected through non-probability convenient sampling. The study included secondary peritonitis-diagnosed patients of all ages and genders admitted from December 2022 to August 2023. Data encompassed pre-hospital experiences, care received at our center, and previous medical consultations. National Exploratory Laparotomy Audit (NELA) score estimated the 30-day mortality rate. SPSS version 26.0 was used, with qualitative variables presented as percentages and frequencies, considering p<0.05 significant.

Results: The majority of our patients were male 106(71.6%) with ages 19-30(41.2%). Among admitted patients, 59(40.3%) had primary education while 41(28%) had none, indicating educational disparities. Financial constraints were evident, with 45(30.2%) earning less than 15,000PKR monthly. The mean delay in presenting to the first practitioner was 2.98 days. Local general practitioners were consulted by 59.1% before reaching our facility. Total delay time correlated significantly with the NELA score (p<0.001). Extended travel distances (72.4% traveled far) correlated with delayed presentation (p=0.019). Differences in systolic blood pressure and respiratory rate were noted between mortality and non-mortality groups (p-value<0.05).

Conclusion: The study underscores the substantial contribution of delayed presentation to mortality in peritonitis patients undergoing emergency laparotomy. Addressing such issues could potentially enhance patient outcomes and reduce mortality in emergency surgeries.

The Effect of Curcuma Longa on Respiratory Tract Isolates: A Potential Natural Therapeutic Agent

Tue, 16 Apr 2024 00:00:00 +0500

Background: Extensive use of antibiotics has led to emergence of antimicrobial resistance (AMR), hence, challenging the treatment of clinical bacterial isolates. Herbal agents like Curcuma longa (Turmeric) have gained prominence for their wide-ranging effects. This study aimed to identify antibacterial and cytotoxic potential of pure and processed Curcuma longa on respiratory tract bacterial isolates to develop an effective and sustainable treatment option.

Methods: This study was conducted from March to October 2023 at Medical Technology Laboratory, Ziauddin University. The antibacterial activity of pure and processed Curcuma longa ethanolic extracts against Moraxella catarrhalis, Klebsiella pneumoniae, Streptococcus pyogenes, and Haemophilus influenzae was checked by agar well diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined through microdilution method. Phytochemical composition was qualitatively analyzed and cytotoxic potentials of Curcuma longa were tested through MTS assay. Mean values of turmeric extracts were compared by student’s t-test through SPSS version 17. p-value<0.05 is considered significant.

Results: Comparable antibacterial activity was observed for pure and processed Curcuma longa extract against tested bacterial organisms. Among them, Moraxella catarrhalis showed maximum zones of inhibition (20mm) when treated with pure Curcuma longa extract. Furthermore, MIC was achieved at 25mg/ml and 50mg/ml against tested isolates with the bactericidal mode of action. Enhanced phytochemical composition and 98% cell viability against NIH 3T3 mouse fibroblast cell lines were observed for pure Curcuma longa.

Conclusion: This study revealed effective antibacterial potential of Curcuma longa and prefers the use of pure Curcuma longa due to its better phytochemical composition and safety profile for cellular systems.

Association of Infraorbital Nerve Injury with Zygomaticomaxillary Complex Fractures at a Tertiary Care Hospital, Karachi

Tue, 16 Apr 2024 00:00:00 +0500

Background: The zygomatic region stands out as the most prominent facial portion, and zygomatic complex fractures (ZMC) are the second most prevalent facial fractures in the lateral mid-face area. This study investigated the associations between fractures in the ZMC and injuries to the infraorbital nerve at a tertiary care hospital.

Methods: This cross-sectional study was conducted among 72 patients from September 2021 to March 2022, at the Oral and Maxillofacial Surgery Department, Jinnah Post Graduate Medical Centre, Karachi. Patients aged between 16 to 65 years, recently diagnosed with zygomatic bone fractures, were included in the study through consecutive non-probability sampling. Comprehensive patient histories, including demographic information, gender, age and residential status, obesity, and the identification of infraorbital nerve injuries diagnosed through clinical examinations and radiographic assessments. SPSS vr20 was used and the Chi-Square test was utilized to explore associations between categorical variables.

Results: Among the 72 cases, 45(62.5%) were male, while 27(37.5%) were females. The average age was 37.43 ± 11.04 years, with ages ranging from 16 to 65 years. Within this cohort, 47(65.3%) individuals were residents of urban areas, whereas 25(34.7%) hailed from rural regions. Notably, positive infraorbital nerve injuries were detected in 54 patients (p=0.02), constituting 75.0% of the total injuries. Among those with ZMC fractures, 25(34.7%) (p=0.02) also had infraorbital injuries, while 20(27.8%) (p=0.03) did not exhibited such injuries.

Conclusion: our study highlights a noteworthy correlation between ZMC fractures and infraorbital injuries. These results underscore the reciprocal relevance of assessing infraorbital injuries in ZMC fracture cases and vice versa, enhancing the comprehensive understanding and management of such injuries in clinical practice.

Safety and Efficacy of Pre-Cytoreduction Prior to Definitive Multi-Agent Chemotherapy in Aggressive Lymphoma

Reena Kumari Sunil, Tariq Siddique, Sunil Kumar, Samina Shamim — Tue, 16 Apr 2024 00:00:00 +0500

Background: Pre-cytoreduction refers to the administration of initial chemotherapy to reduce tumor burden prior to initiating definitive multi-agent chemotherapy. This study assessed the safety and efficacy of pre-cytoreduction prior to definitive multi-agent chemotherapy in aggressive lymphomas.

Methods: A prospective cohort study was done at Ziauddin Hospital, Karachi for six months. Patients of either gender, aged between 18-80 years diagnosed with aggressive lymphoma (Stage II-IV) were included. Patients having stage-I lymphoma, primary CNS lymphoma, HIV-linked Diffuse Large B Cell Lymphoma (DLBCL) transformed lymphoma, and other malignancies were excluded. The pre-cytoreduction group received a low dose of chemotherapeutic drug on the −6^th day and prednisolone 100mg daily for 7 days (−6^th day to day 0) followed by standard chemotherapy on day 1. Non-pre-cytoreduction group received chemotherapy without pre-cytoreduction. After chemotherapy's first cycle, follow-up was done for 30 days. Anxiety assessment was done using the Hamilton Anxiety Rating Scale (HAM-A). For data analysis, SPSS v27 was used.

Results: From 120 patients, 27(22.5%) were diagnosed with Burkitt Lymphoma while 93(77.5%) with DLBCL. Pre-cytoreduction included prednisone, in 17(14.2%) patients, while 12(10%), 13(11%), and 10(8%) were given Vincristine, Prednisolone (VP), Cyclophosphamide, Prednisolone (CP) and Cyclophosphamide, Vincristine, and Prednisolone (CVP) respectively. There was a significant difference between both groups’ tumor lysis syndrome, bone marrow suppression, ECOG PS (Eastern Cooperative Oncology Group Performance Status), and other post-treatment complications (p<0.001).

Conclusion: Pre-cytoreduction was reported to be slightly better than conventional therapy in terms of compliance, with pre-cytoreduction improving patients’ performance status, decreased hospital emergency visits, febrile neutropenia risk, and improved treatment response rates.

Frequency of Endometriosis on Diagnostic Laparoscopy in Females with Secondary Infertility

Tue, 16 Apr 2024 00:00:00 +0500

Background: For endometriosis, one of the most common chronic diseases encountered in gynecological outdoors, laparoscopy, is considered as a gold-standard diagnostic tool because direct visualization of endometriotic lesions enables the medical practitioner to provide recommendations for future therapy. This study aimed to determine the frequency of endometriosis on diagnostic laparoscopy in females with secondary infertility.

Methods: A cross-sectional study among 92 females was conducted at the Department of Obstetrics & Gynecology, Sir Ganga Ram Hospital, Lahore, from December 2022 to June 2023. Females aged 20-45 years, presenting with secondary infertility and subjected to diagnostic laparoscopy were analyzed using a non-probability, consecutive sampling technique. Data regarding the age, BMI, residence, parity, duration of infertility, and menstrual cycle were recorded. The findings of laparoscopic diagnosis regarding endometriosis were labeled. SPSS vr26 was used. The chi-square test was used to see the impact of effect modifiers on the frequency of endometriosis, taking p≤0.05 as significant.

Results: Out of a total of 92 females, (mean age 36.66±5.41years), 65 (70.7%) females were aged between 35-45 years. The mean BMI was 24.6±3.2 kg/m2 and the secondary infertility mean duration was 22.05±6.04 months while the mean parity was 2.09±0.82. Endometriosis was diagnosed among 28 (30.4%) females, in which 16 (57.1%) had a duration of infertility above 2 years (p=0.013) with parity <3 (p=0.761).

Conclusion: Using diagnostic laparoscopy, the frequency of endometriosis was found significant among females having secondary infertility. Laparoscopic evaluation can be helpful in the timely diagnosis and management of secondary infertility.

ASPECTS and Functional Outcomes in Left versus Right Hemisphere Strokes: A Prospective Cohort Study

Tue, 16 Apr 2024 00:00:00 +0500

Background: Stroke presents as the second most prominent factor contributing to global mortality. Immediate brain imaging can be valuable for assessing functional recovery potential. This study investigated the association between Alberta Stroke Program Early CT Score (ASPECTS) and functional outcomes in patients with left and right-hemisphere strokes.

Methods: A prospective cohort study was conducted in July-Dec2 022, at a tertiary care hospital in Karachi including patients of either gender presenting within 2 days of stroke while excluding posterior circulation strokes, TIA & unwilling patients using a non-probability consecutive sampling technique. A total of 152 patients with acute ischemic stroke involving anterior circulation were analyzed and patients were categorized into two groups: the left hemisphere group (n=76) and the right hemisphere group (n=76) accordingly. ASPECTS scores were calculated from brain CT scans, while functional outcomes were measured using the modified Rankin Scale (mRS) at the three-month mark. Descriptive analysis and chi-square test were applied using SPSS vr25.

Results: Patients (n=152) had a mean age of 61.75 ± 13 years, with males comprising 67% of the cohort. ASPECTS scores were notably higher in left hemisphere strokes (median 9, IQR 2) than right hemisphere strokes (median 8, IQR 3) (p=0.036). Higher ASPECTS scores (≥7) correlated with improved outcomes (mRS ≤2) in both hemispheres. There was no statistically significant difference in both groups’ functional outcomes (p=0.182).

Conclusion: ASPECTS predicts functional outcomes in acute ischemic strokes equally well regardless of the affected hemisphere.

Influence of Social Media on the Perception of Dentofacial Aesthetics: A Cross-Sectional Study

Tue, 16 Apr 2024 00:00:00 +0500

Background: Social media has become an influential tool with its usage increasing immensely in recent years. This study aimed to assess the impact of social media on the perception of dentofacial aesthetics and its gender-wise comparison among general population of Pakistan.

Methods: This cross-sectional study was conducted from November 2022 to March 2023 using an online questionnaire developed on Google Forms, distributed among 500 participants via WhatsApp and Facebook groups among males and females with 18 years or above operating any social media account, using non-probability convenience sampling. SPSS version 25 was used, and categorical variables were compared using Chi-Square Test. p< 0.05 was significant.

Results: Out of a total of 455 people who responded, 125 (27.5%) were male, and 330 (72.5%) were female. Females were very frequent (n=244, 53.6%) users of social media (p=0.029), spending 4 to 6 hours every day (p=0.01). There was a significant gender disparity in social media usage, with females predominantly using Instagram (n=308, 93.3%) (p<0.001), Snapchat (n=170, 51.5%) (p=0.012), and TikTok (n=76, 23%) (p=0.042). Furthermore, smile is a key aesthetic element, according to most respondents (n=425, 93.4%). Four out of ten (n=169, 37.1%) followed aesthetic surgeons on social media, and around one-half (236, 51.9%) were influenced by social media beauty standards.

Conclusion: The impact of social media on the Pakistani population can be considered as high. People nowadays are influenced by social media applications and are seeking aesthetic treatment as an outcome. It is the responsibility of dentists to educate patients about the best treatment options.

Dental Students and the AI Revolution: Exploring Awareness and Perception

Rabia Arshad, Zunaira Khalid, Rehan Ahmad, Nimra Qaiser — Tue, 16 Apr 2024 00:00:00 +0500

Background: Artificial intelligence (AI) implies a machine's overall capacity to carry out tasks that require human intelligence. AI's active role in medical and dental practices has resulted in the advancement of patient care systems with enhancement in the healthcare industry. This research aimed to assess dental students’ awareness and perception of the use of AI and its potential application in the prospects of dentistry.

Methods: This cross-sectional, survey-based research was carried out using an electronic questionnaire at Altamash Institute of Dental Medicine Karachi, from July to August 2022. With convenience sampling, a total of 160 students were selected, questionnaire was divided into three sections demographic details, general awareness, and perception of students for AI. They were directed to rate their responses for each statement on a 5-point Likert scale. Using SPSS version 26, the data was evaluated for descriptive and inferential statistics.

Results: The majority of the students 128 (80%), were aware of AI, with about 105 (65.6%) of them recognizing its use in dentistry. The mean of responses for awareness (1.86) and perception (2.01) sections falls in the range of “agree” (1.81-2.60) to the statements. There was no significant difference present regarding gender and all four years of BDS education for the concept and utilization of AI.

Conclusion: Dental students are well aware of the advantages and utilization of AI tools in dentistry, with a strong perception that some aspect of AI should be added to the undergraduate dental curriculum and clinical training.

Revolutionizing Healthcare: The Proteomics Paradigm in Molecular Medicine

Yamna Khurshid — Tue, 16 Apr 2024 00:00:00 +0500

Proteomics, the comprehensive study of function, composition, structures, and interactions of proteins in biological systems, has emerged as a revolutionary force in the field of molecular medicine. Over the last few decades, this rapidly developing field has played a decisive role in decoding the complex molecular mechanisms underpinning health and disease. In this editorial, we explore the crucial role that proteomics plays in the field of molecular medicine, emphasizing how it has transformed diagnostic/prognostic biomarker discovery, therapeutics, and our basic knowledge of the human body.