Journal of Pharmaceutical Negative Results
The main aim of the Journal of Pharmaceutical Negative Results to publish the negative results so that newer generation of researchers should not waste their time and money repeating the same studies and finding the same unpublishable results. Most of the journals have published only the positive results and findings. However they do not publish negative results. We believe negative results are also a part of quality research. Research papers: Original research work will be considered under this section depending on the volume and quality of work. Methods: Articles on new methods/procedures on drug evaluation, testing and analyses will be published. Innovative studies on established methodologies and their modification will also be considered. The articles must be supported by data. Rapid communication: An article will be accepted for rapid communication if it merits priority publication. The decision of acceptance or otherwise will be communicated within 4 weeks of receipt of the manuscript and accepted articles will be published in the following issue. Research letters: Preliminary work with hard data can be published as a Letter. Brief research communications will also be accepted under this section. Correspondence: Comment(s) on previously published articles, items of current interest and articles of general interest and views can be submitted for this section. Note : Journal Publishes articles both Positive and Negative results
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“Correlation Between Thermal Stability AND Kinetic Parameters OF Metal Complexes”
Metal complexes are significant in most fields such as catalysis, biology and materials science. Thermal stability and kinetic parameters of the complexes are the key determinants of the structural integrity and reactivity of such complexes. In this paper, the relationship between thermal stability and kinetic values of the selected transition metal complexes has been discussed. The thermal analysis was performed by thermogravimetric analysis (TGA) and differential thermal analysis (DTA) and the calculation of the kinetic parameters (activation energy (Ea)) and (frequency factor (A) and entropy of activation (ΔS)) using Coats-Redfern and Horowitz-Metzker methods. The results indicate the positive relationship that is high between thermal stability and activation energy are high which means that complexes with high activation energy have higher thermal resistance. These findings contribute to the limited literature of correlation between stability and kinetics which plays a crucial role in the development of thermally stable metallic complex to be employed in industries and pharmaceutical market.
Holistic Ayurvedic Approach In Prameha Janya Kuṣṭha With Uncontrolled Type 2 Diabetes Mellitus: A Clinical Case Report
Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from impaired insulin secretion or action. Dermatological manifestations such as pruritus, discoloration, and inflammation are common in uncontrolled diabetes and indicate systemic metabolic derangement. In Ayurveda, such conditions correspond to Prameha Janya Kuṣṭha, arising from vitiation of Kapha and Meda Dhātus leading to Agnimāndya and Srotorodha. The present case demonstrates the successful management of Prameha Janya Kuṣṭha through Ayurvedic intervention emphasizing Agnidīpana, Raktaprasādana, and Srotoshodhana principles. Methodology (Case Presentation): A 52-year-old female, a known case of Type 2 Diabetes Mellitus since 14 years, presented with Tvak Vaivarnya (skin discoloration), Tvak Kandu (itching), and Duṣṭi Pradeśī Vedanā (localized burning and pain). Laboratory investigations revealed uncontrolled diabetes (HbA1c: 9.2%; FBS: 141.2 mg/dL; PPBS: 359.8 mg/dL). The diagnosis of Prameha Janya Kuṣṭha was made based on clinical and Ayurvedic assessment. Treatment included Ghycohub Granules (5 g daily, empty stomach), Kandughna Mahākāṣāya Vaṭi (1 BID), Phaltrikādi Kaṣāya Siddha Jala as drinking water, and a combination of Pramehagaḍakesarī, Vasant Kusumākara Rasa, Gudūcī Satva, Rasna, Viśvā, and Trivanga Bhasma. External therapies included Avagāha Sveda with Nimba–Triphala–Kandughna Kaṣāya and Vraṇaśodhana Taila application. Results: After one month of treatment, the patient reported complete relief in itching, discoloration, and pain. Blood sugar levels normalized (FBS: 99.2 mg/dL; PPBS: 138.3 mg/dL), and HbA1c reduced to 6.8%, indicating significant metabolic improvement. Discussion and Conclusion: This case illustrates that Ayurvedic therapy based on Doṣha–Dhātu–Mala balance effectively addresses both glycemic dysregulation and skin pathology in Prameha Janya Kuṣṭha. The outcome underscores the potential of integrative Ayurvedic management in diabetic dermatoses and warrants further controlled studies.
Financial Security In Education Sector: Introducing Affordable Health Insurance System For Students At The University Of Delhi
Vision of the paper: The vision of this research paper is to provide a comprehensive framework for integrating affordable health insurance programs into the fee structures of colleges under the University of Delhi. By doing so, it aims to enhance the financial and health security of students, ensuring they have access to essential medical services without the burden of significant out-of-pocket expenses. This initiative envisions a holistic approach where health insurance becomes an integral part of the educational ecosystem, promoting a healthier student body that can focus on academic and personal growth without the constant worry of medical costs. By meticulously analyzing existing government schemes, private insurance offerings, and student preferences, this research aims to develop practical recommendations that are both economically viable and widely accepted by the student community. The ultimate goal is to create a sustainable model that can be replicated across other universities in India, thereby setting a precedent for prioritizing student well-being in higher education policy and administration.
Comparative Effects Of A Four-Week Mountaineering Training Program On Red Blood Cell Count At Medium And High Altitudes
This study investigated the influence of a four-week mountaineering training program on red blood cell (RBC) count among selected trainees at two different altitudes: medium altitude (2050 m) and high altitude (2700 m). Twenty trainees from Himachal Pradesh of the age group 18-25 years, were selected, and exposed to four-week training at two different high altitude training centres namely; Atal Bihari Vajpayee Institute of Mountaineering and Allied sports, Manali (2050 m) and Atal Bihari Vajpayee Institute of Mountaineering and Allied sports, Narkanda (2700 m) in Himachal Pradesh. These trainees were divided equally into two groups and assessed at three intervals i.e. pre-test (Day 0), mid-test (Day 14), and post-test (Day 28). Descriptive statistics, repeated measures ANOVA, and trend analyses were employed to examine within-subject and between-group differences. The results revealed no statistically significant changes in RBC counts over time or between altitude groups. Linear and quadratic trends were also found to be non-significant. These findings suggest that altitude-related physiological adaptations in RBC count may require longer training durations or more extreme environmental stimuli. Future research should explore longer-duration interventions and include additional haematological markers.
Impact Of A 12-Week Circuit And Conventional Training On Core Strength Among High School Boys
The present study aimed to investigate the effect of a 12-week circuit and conventional training program on abdominal strength among high school male students aged 14 to 16 years. Abdominal strength, a crucial component of core fitness, plays a significant role in postural stability, athletic performance, and injury prevention. A total of 60 students were randomly assigned into two groups: The Circuit Training Group (CTG) and the Conventional Training Group (CVTG), each comprising 30 participants further categorized by age (14, 15, and 16 years). Both groups underwent age-appropriate training protocols, with CTG following a structured circuit regimen twice a week and CVTG engaging in traditional training exercises six days a week. Abdominal strength was assessed at various time points: pre-test, mid-test (every two weeks), and post-test using the standardized AAHPER Youth Fitness Test (1957). The data were analyzed using one-way repeated measures ANOVA and post hoc test to assess within-group and between-group differences across time. Results revealed that both training methods significantly improved abdominal strength over the 12-week period. However, the circuit training group demonstrated superior gains compared to the conventional training group across all age categories. The findings suggest that circuit training is a more effective and time-efficient method for enhancing abdominal strength among adolescent boys, supporting its inclusion in school-based physical education programs.
Haematological Characteristics, Body Metabolites, Electrolytes And Enzymes As Predictors Of Physical Fitness Variable Explosive Leg Strength Among Hockey Players
This study aimed to investigate the predictive capacity of haematological characteristics, body metabolites, electrolytes and enzymes on physical fitness variable explosive leg strength among sub-junior male hockey players in Himachal Pradesh. Twenty players aged 14-16 years, who had participated in Sub-Junior National Level Championships during 2022-2024, were assessed. The study employed a non-experimental, correlational research design to analyze the relationships and predictive strength of 25 physiological markers with the physical fitness component explosive leg strength. The data was collected using SAI Physical Fitness Tests and laboratory blood analyses. Pearson correlation and regression analyses were conducted. The findings revealed that red blood cells (RBCs) and haemoglobin exhibited a significant positive relationship with explosive leg strength, while white blood cells (WBCs) showed a non-significant negative association. Among body metabolites, no significant correlations were found. Potassium demonstrated a significant negative relationship among electrolytes, contributing meaningfully to the regression model. None of the enzymes studied significantly correlated with explosive leg strength. The regression models confirmed that haematological traits and electrolytes, particularly RBCs and potassium, were significant predictors of explosive leg strength, accounting for 60.5% and 67.5% variance respectively. These insights emphasize the role of internal physiological factors, especially blood and electrolyte markers, in determining physical fitness characteristics important for athletic performance in hockey.
Pathophysiology And Management Of Sickle Cell Disease: New Therapeutic Approaches And Disease-Modifying Treatments
Background: The genetic disorder sickle cell disease results in the production of abnormal HbS and causes changes in red blood cell shape, alongside vaso-occlusion, breakdown, and continuous inflammation. People who have SCD experience severe health problems and death risks because of medical conditions such as pain emergencies together with strokes, and organ tissue deterioration. The treatment landscape now focuses on altering disease advancement patterns while enhancing patient quality of care. Objectives: Evaluating innovative SCD therapeutic and disease-modifying treatments requires measuring their effects on clinical aspects, as well as VOC frequency and red blood cell haemoglobin levels in SCD patients. Study design: A prospective cohort study. Place and duration of study. Department of Microbiology Nowshera Medical College Nowsher,Kpk-Pakistan From jan 2019 to jan 2020 Methods: 50 SCD patients for twelve months by analyzing their standard treatments in combination with hydroxyurea, voxelotor, crizanlizumab and gene therapy protocols. Scientists monitored SCD patients throughout 12 months through assessments of haemoglobin measurements and VOC incidents, along with tests of biomarkers linked to hemolysis. Mean comparison tests, along with standard deviation (SD) measurements, allowed researchers to verify significant results through p-values representing the determined parameters. Doctors verified that patients aged 12 to 50 years old with confirmed SCD would be included in the study. The research enrolled 50 patients (mean age: 26.4 ± 6.2 years) and excluded individuals with various blood diseases. The voxelotor group experienced a significant elevation in their haemoglobin levels, as indicated by p=0.03, whereas therapeutic effects became visible through decreased VOC counts in crizanlizumab recipients (p=0.02). The sustained expression of HbF as a result of gene therapy reduced the markers indicating hemolysis. Hydroxyurea treatment led to better blood test results; however, it produced inconsistent results regarding the decrease in VOC events. Conclusion: Available disease-modifying drugs show the potential to lower the morbidity related to SCD. Crizanlizumab succeeds in minimising VOC occurrences, while voxelotor stabilises haemoglobin structures, and gene therapy presents a possible cure for the disease. Longitudinal research must continue to prove both the long-term effectiveness and security rates authentically. SDC management could see revolutionary changes through the incorporation of these therapies into clinical settings.
The Role Of Pathology In Personalized Medicine
Background: The study of personalized medicine involves developing customized medical interventions through integrating DNA components with individual patient histories as well as ecological and personal behaviors. Targeted therapies receive guidance through molecular and histopathological insights which Pathology delivers to patients. New advances in genomic sequencing together with biomarker detection and digital pathology technology have improved both diagnostic preciseness and treatment outcome measurements. Objectives: to evaluates the use of pathological analysis in personalized medicine through a study of molecular markers accompanied by histopathological features together with patient results from targeted therapeutic strategies. Study design: A retrospective cohort study Place and duration of study. Department of Microbiology Nowshera Medical College Nowsher,Kpk-Pakistan From july 2019 to july 2020 Methods: A Medical experts analyzed 200 patients from different malignancy backgrounds through a retrospective study. Next-generation sequencing analysis and immunohistochemistry assays determined tumor biological composition after histopathology assessments of medical samples. The research used statistical methods to determine associations between therapeutic results and biomarker detection in patients. Statistical evaluations using mean age and standard deviation along with p-values determined the importance of research results. Results: The study involved a participant sample of 200 patients with an average age of 58.4 years (±10.2). The study of genetic mutations through molecular profiling revealed actionability in 62 percent of patients. Patients who received treatment according to molecular diagnostic findings of disease-specific targets achieved longer disease remission by 45% in comparison to standard therapies (p = 0.003). Checkpoint inhibitor response rates showed a substantial correlation with PD-L1 expression according to immunohistochemical results (p = 0.002). The treatment response from monoclonal antibody therapy was better among patients showing HER2 protein overexpression (p = 0.001). The research proves pathology plays an essential part in developing optimal precision medicine strategies for therapy selection. Conclusion: The implementation of pathology forms an essential foundation for personalized medicine because it provides necessary data for selecting precise therapies as well as patient care decisions. Results of molecular and histopathological examinations enhance treatment effectiveness which produces better results for patients. Medicine will experience continuous progress in pathology-based diagnostic methods which will drive treatment accuracy towards better healthcare standards.
Skilled Regulatory Affairs Expert With A Focus On Global Standards
Regulatory affairs professionals specializing in global standards play a crucial role in ensuring compliance across the pharmaceutical, biotechnology, and medical device industries. These experts possess specialized knowledge of international regulatory frameworks, making them instrumental in facilitating market access and ensuring the safety and efficacy of products. This article explores the competencies, responsibilities, and challenges faced by regulatory affairs professionals. It also discusses the global trends in regulatory harmonization, the adoption of digital technologies, and the critical role of these experts in navigating the increasingly complex regulatory landscape. The importance of a comprehensive understanding of global regulations, such as those set by the FDA, EMA, and WHO, is emphasized as being essential for successful product approval and market entry. Moreover, the article highlights the need for these professionals to manage cross-functional teams and collaborate with local regulatory bodies across various regions. It also addresses the challenges faced, including regulatory complexity, varying standards across regions, and the dynamic nature of regulatory frameworks. With the adoption of digital tools like electronic submissions (eCTD) and regulatory intelligence systems, the role of regulatory affairs experts continues to evolve. These advancements help streamline approval processes, reduce delays, and enhance efficiency. As the global regulatory environment grows more intricate, regulatory affairs experts are pivotal in ensuring product compliance and mitigating risks associated with non-compliance, such as fines and reputational damage. The article underscores the indispensable nature of regulatory affairs experts in achieving faster market access, reducing regulatory delays, and promoting a patient-centric regulatory approach. It concludes that these professionals will continue to be at the forefront of global regulatory strategies, ensuring that products meet the highest standards of quality and safety.
Statistical Distribution To Distinguish Noise In Magnetic Resonance Images
Fisher's test in statistics is one of the statistical tests that is used to test hypotheses, in order to ascertain whether the differences between two samples or groups are equal or unequal. In this test, the data follows a Fisher distribution, and the q test is used to compare one variance with another by partitioning. The F test can be one-tailed or two-tailed, depending on the data and parameters of the problem to be solved. The F value is obtained after conducting the test, and then it is used in conducting a one-way ANOVA test. In this article, we will talk more about the Fisher test in statistics, how to conduct the test on hypotheses, and explain the steps for conducting the test manually. The analysis method is added to the image testing and noise determination. The distorted parts of the laboratory images are improved by adding the nonlinear filter method, which is suitable for these cases. The nonlinear median filter demonstrates a convenient method for replacing degraded pixels. The filter is not applied to the undetected portions of the image, preserving them intact and avoiding distortion of fine image details and important edges. Experimental results have improved this architecture compared to traditional noise reduction architectures.
Uttarbasti: A Therapeutic Modality In Ayurvedic Gynecology – Principles, Practice, And Clinical Significance
Ayurveda, the ancient science of life, emphasizes Panchakarma therapies for disease management, with Basti Chikitsa being regarded as "half of the total treatment." Among its specialized forms, Uttarbasti is a unique procedure primarily indicated for genitourinary disorders, especially in gynecological conditions. This review explores the principles, classifications, instruments, procedural techniques, and modern applications of Uttarbasti. The therapy, administered through the urinary or vaginal route, plays a vital role in conditions such as infertility, dysmenorrhea, amenorrhea, and uterine disorders. Its mechanism of action is understood through Ayurvedic and modern pharmacokinetic perspectives, highlighting its efficacy in local drug absorption and systemic benefits. The review also discusses its indications, contraindications, and procedural advancements. Uttarbasti, when performed with proper pre- and post-procedural care, emerges as a significant therapeutic intervention in Ayurvedic gynecology, warranting further clinical validation in contemporary healthcare settings.
Histopathological Examination Of Thyroid Tissue In Patients With Thyroid Disorders In Iraq
Thyroid disorders are prevalent worldwide, with significant variations in histopathological findings across different populations. This study aimed to evaluate the histopathological features of thyroid tissue in Iraqi patients with thyroid disorders. A retrospective analysis was conducted on 300 thyroidectomy specimens obtained from patients diagnosed with thyroid disorders between January 2018 and December 2022. The specimens were examined for histopathological features, including nodular hyperplasia, thyroiditis, follicular adenoma, papillary carcinoma, and follicular carcinoma. The results revealed that nodular hyperplasia was the most common finding (45%), followed by papillary carcinoma (25%), thyroiditis (15%), follicular adenoma (10%), and follicular carcinoma (5%). The study highlights the importance of histopathological examination in accurately diagnosing and managing thyroid disorders in Iraq. The findings provide valuable insights into the prevalence and distribution of thyroid pathologies in the Iraqi population, which can aid in the development of targeted diagnostic and therapeutic strategies.
Prehabilitation Programs To Optimize Surgical Outcomes
Background: The method of prehabilitation provides a new approach which boosts surgical patients' operational ability ahead of surgery to produce better results during recovery. A multiple-specialty team addresses preoperative patient care through physical exercise with diet optimization and mental support. Prehabilitation enhances patients before surgery to prevent complications while decreasing hospitalization periods and speeding up recovery which results in superior surgical results. Objectives: The main goal of this research was to understand how structured preoperative rehabilitation treats patients before surgeries to enhance their procedural outcomes. The research investigated how preoperative intervention affected surgical complications and maintenance of hospital stay duration. Study design: This was a prospective study. Place and duration of study. Department of Surgery QHAMC, Nowshera Medical college ,Nowshera from jan 2021 to june 2021 Methods: Two hundred patients undergoing elective major surgery participated in this study. Two groups of patients participated in this study with 100 participants enrolled in each group where 100 patients received standard preoperative care while the other 100 patients experienced prehabilitation. A preoperative program spanning four weeks provided patients with physical exercise supervision alongside specific nutrition guidance as well as psychological support. The research evaluated two major outcomes such as postoperative complications together with hospital stay duration and postoperative functional status recovery. The statistical analysis through SPSS software adopted p < 0.05 as the determination of significance. Results: Two hundred patients participated in the study whose mean age stood at 62.4 years with SD = 10.2. The patients who received prehabilitation suffered fewer postoperative complications than the control participants with 18% versus 30% (p = 0.03). Prehabilitation patients experienced reduced hospitalization duration of 6.2 ± 1.5 days compared to control patients who stayed for 8.1 ± 2.0 days (p < 0.01). Patients in the prehabilitation group achieved better functional recovery results based on the results of the 6-minute walk test (420 ± 50 meters vs. 380 ± 55 meters, p = 0.02). The prehabilitation intervention caused no negative side effects. Conclusion: Designing structured preoperative exercises creates better postoperative results for surgical patients through decreased medical complications and shortened hospital recovery periods. Clinical practice should implement preoperative interventions because such measures enhance functional recovery in surgical patients. Data from this study confirms prehabilitation must become a standard part of preoperative care mainly for patients at high surgical risk because it streamlines recovery and improves their general health state.
Fazal Ghani, Kamran Ahmad, Kamran Hakeem Khan, Shafiq Ur Rahman, Khalil Ur Rehman, Aurangzeb Shaikh
Surgical Management Of Obesity Comparative Outcomes Of Bariatric Procedueres
Background: That is why obesity as a condition has become one of the major threats to human health for people living in different countries. Bariatric surgery can be ultimately recommended for weight loss as well as for the improvement of obesity associated limited morbidity in case the conservative therapies are ineffective. Objectives: The various bariatric surgeries performed include the Laparoscopic adjustable gastric band, Laparoscopic sleeve gastrectomy, Laparoscopic roux-en-Y gastric bypass, Open roux-en-Y gastric bypass and Biliopancreatic diversion with duodenal switch, in order to assess the efficacy, the complications involved and the weight loss and obesity comorbidities’ alteration from one procedure to another. Study design: This was a observational study. Place and duration of study. Department of Surgery QHAMC, Nowshera Medical college ,Nowshera from jan 2020 to jan 2021 Methods: : The various bariatric surgeries performed include the Laparoscopic adjustable gastric band, Laparoscopic sleeve gastrectomy, Laparoscopic roux-en-Y gastric bypass, Open roux-en-Y gastric bypass and Biliopancreatic diversion with duodenal switch, in order to assess the efficacy, the complications involved and the weight loss and obesity comorbidities’ alteration from one procedure to another. Results: Mean patient age was 42.3 years old (SD=8.5). RYGB experienced the highest weight loss, but when comparing the weight loss to SG and AGB, there was a statistically significant difference (p < 0.01). Among all the variables, SG demonstrated moderate utility within the organization and AGB had the least impression. RYGB also had better comorbidity management (for example diabetes, hypertension). Conclusion: In the management of obesity, bariatric surgery proven as beneficial, and RYGB yields the maximum benefits concerning weight loss and comorbidity treatment. Carrying through individualized approach to the choice of the procedure and subsequent Superovulation monitoring is critical.
Assessment And Comparison Of Laparoscopic Hernia & Open Lichtenstein Repair A Retrospective Study
Objective: Laparoscopic hernia repair (LH) is widely practiced, yet the available evidence regarding its superiority over Lichtenstein open hernia repair (OH) is still inconclusive. So, we compare the safety and effectiveness of LH and OH in this study. Study Design and Setting: A retrospective comparative cross-sectional study was done in Civil Hospital Karachi and Bantva Memon Hospital Karachi for four years (Jan 2014- Dec 2017) using a non-probability consecutive sampling method. Methodology: 84 patients were included, with 52 (62%) undergoing OH repair (Group A) and 32 (38%) undergoing LH (TAPP) repair (Group B). The mean operative time, complications, and duration of hospital stay were compared between the two groups. Results: Our results showed that the mean operative time was significantly longer in Group B than in Group A (52±15 minutes’ vs 34±10 minutes, respectively). The incidence of scrotal hematoma was significantly lower in Group B than in Group A (1% versus 8%, respectively). The postoperative pain score was significantly higher in Group A than in Group B (P>0.01), and the recovery time and time to return to work were significantly longer in the OH repair group, wound infection was observed in 6% of patients in Group A. The mean hospital stay was significantly shorter in Group B than in Group A (1±0.025 days versus 2±0.5 days, respectively). Conclusion: Our study demonstrated that LH is a safe and effective technique associated with fewer complications compared to OH. These findings suggest that LH could be considered as a preferred method over LH.
Rubab Nafees, Summaya Saeed, Kumar D, Khalil ur Rehman, Aurangzeb Shaikh, Rauf Shaikh
Debates In Hernia Repair Open Vs Minimally Invasive Approaches
Background: Hernia repair surgery occurs frequently as medical practitioners perform traditional and minimally invasive open procedures. Traditional open surgery is the conventional technique, but laparoscopic and robotic procedures provide patients with diminished Pain and accelerated healing times. The surgical approach selection depends on the hernia type, patient attributes, and the surgeon's experience. Objectives: The study analyzes clinical outcome differences between open and minimally invasive hernia repair operations regarding recovery duration, complication rates, and extended effectiveness. Study design: A Retrospective Study. Place and duration of study. Department of Surgery QHAMC, Nowshera Medical college ,Nowshera from jan 2021 to june 2021 Methods: 100 patients who received hernia repair surgery from 2022 to 2024. The research designed two groups for analysis: open Repair with 50 patients and minimally invasive Repair with 50 additional patients. Surgical research gathered information about patient demographics, surgical results, complication frequency, and recovery duration. The study utilized mean values, standard deviation measurements, and p-values to understand significant group differences. Results: Patients participated in the study with an average age of 52.6 years (±10.2 standard deviation). Patients receiving open repair surgery had an average age of 54.1 years with a standard deviation (±9.8), yet the minimally invasive group demonstrated an average age of 51.2 years (±10.6). The study results showed a postoperative complication frequency of 15% in the open repair patients, while minimally invasive patients experienced complications at an 8% rate (p=0.042). The minimally invasive group required a mean recovery time of 10.2 days, which proved significantly shorter than the 16.4 days patients in the open group needed for recovery (p<0.001). A higher percentage of open repair patients experienced chronic Pain at 10% versus only 4% of the minimally invasive surgery patients (p=0.031). Conclusion: Minimal invasive hernia repair achieved better study that produced shorter recovery time intervals, reduced chronic Pain, and presented fewer complications than open hernia repair. The study results indicate that minimally invasive surgical methods should be used by preference because they yield better results in patients who qualify for laparoscopic or robotic surgical interventions.
Comparative Study Between Ultrasonic And Fluoroscopic Guided PCNL In Blood Loss And Stone-Free Rate
Objective: This study aimed to compare the effectiveness of ultrasound-guided and fluoroscopy-guided percutaneous nephrolithotomy (PCNL) in terms of stone-free rates and blood loss, as well as secondary outcomes such as operative time, hospital stay, and complication rates. Methods: One hundred patients with renal stones scheduled for PCNL were divided into two groups. Group A (50) underwent ultrasound-guided PCNL, while Group B (50) underwent fluoroscopy-guided PCNL. The same surgeon performed all procedures in the prone position, using 30 Fr Amplatz sheaths for access. Doppler ultrasound was employed in Group A to minimize vascular injury. Results: Stone-free rate was 80 percent in Group A (ultrasound) and 90 percent in Group B (fluoroscopy), slightly better for fluoroscopy. Mean blood loss was less in Group A (250± 80 mL) than in Group B (310 90 mL). Moreover, there was no decline in hemoglobin either in the ultrasound-guided (1.2 ±0.4 g/dL) or the fluoroscopy group (1.5 ± 0.5 g/dL). A patient in Group A and two in Group B needed blood transfusions. Secondary results showed a shorter operative time for Group B (70 ±10 minutes) than for Group A (85± 12 minutes). Meanwhile, the hospital stay was similar for each group (2.2± 0.6 days for ultrasound; 2.1 ± 0.5 days for fluoroscopy). Complication rates were similar: 6 cases (12%) of Grade I/II complications per group in Group A and 7 cases (14%) in Group B. Conclusion: Ultrasound- and fluoroscopy-based PCNL are viable treatments for renal stones, but they have different strengths. Ultrasound-guided blood loss and hemoglobin loss were minimized, while fluoroscopy guided a slightly higher stone-free rate and shorter operative time. Given similar safety profiles, ultrasound-guided PCNL might be an alternative to fluoroscopy if eliminating radiation and bleeding offsets the benefits.
Advancements IN Eeg Technology: A New Frontier IN Real-Time Mental Health Monitoring AND Intervention
Objective: This study evaluated the effectiveness of recent advancements in electroencephalography (EEG) technology for real-time mental health monitoring and intervention, specifically focusing on the impact of portable, AI-enhanced EEG devices in detecting and managing symptoms of anxiety and depression. Methods: The group consisted of 100 patients with generalized anxiety disorder or major depressive disorder who were randomly assigned to the experimental group (modern EEG monitoring with AI support) or control group (old-school EEG monitoring without real-time backing). Over 6 weeks, we measured each group’s mental health regarding symptom reduction, engagement, and detection accuracy. Changes in mental health were measured with the GAD-7 and PHQ-9 scales, and EEG data were analyzed for biomarkers. Results: Compared with the control group, the experimental group's symptoms were significantly reduced by 30%, which is an extremely strong sign that feedback in real-time is good. The cutting-edge EEG system detected 87% of mental health biomarkers, far greater than the 60% of standard EEG recording. Participants in the experimental group were more engaged and satisfied thanks to the live feedback received by AI-enabled EEG machines. Conclusion: The evidence confirms that high-throughput EEG technology with real-time functions is better at monitoring and intervening in mental health. These systems can be applied to clinical practice with AI-enhanced accuracy and real-time symptom treatment, which would likely revolutionize mental health care through proactive and personalized treatment approaches.
Implementation Of War Fund Schemes During The First World War In The Madras Presidency
The intensification of war demands in 1917 introduced many firsts in India's financial history. Government announced the ‘gift’ of 100 million pounds towards Britain’s war expenses and launched the first of two Indian War Loans to meet this sum on that year. This cast the colonial regime in the role of debtor to a subject population over which it had to reproduce its standing and authority. War loan propaganda could never be too strident, lest Indians conclude that Britain was bankrupt and losing the war. Peasants viewed the war loan as just another oppressive exaction. However, in appealing to the figure of the ‘small investor’, war loan propaganda opened up a space for the conversation with the people from Indian middle classes. During those process, it added fuel to the demand for home rule.
Renal Physiology In Chronic Kidney Disease: Insights Into Glomerular And Tubular Dysfunction
Background: Chronic Kidney Disease (CKD) is a slowdown in renal outputs which begins with glomerular and extends to tubular impairment. Disorders of these components are pivotal in the development of progression of kidney pathology and its morbidity including hypertension, proteinuria, and electrolyte imbalance. Renal physiology in the context of CKD must therefore be better understood in order that diagnosis and treatment may be enhanced. Objectives: To assess the glomerular and tubular function abnormalities in CKD patients and understand its clinical relevance in CKD kidney function and progression. Study design: A Prospective Cohort Study Place and duration of study: Northwest General Hospital Peshawar from July 2021 to Sep 2021 Methods: The study involved a group, for which 50 patients with the CKD diagnosis was assessed. The global clearance rate of the native protein was assessed by determination of GFR, proteinuria, and tubular function tests. Simple regression correlation test was used to analyse the relationship between glomerular and tubular dysfunctions. Patients were also split according to their CKD status; comparisons of results were made concerning stage. Results: Patients were 50 with the average age of 58.5 years old of them 12.3 SD together. An abnormality of greater than 30 dB was found in 38 patients with a p-value of < 0.05 for glomerular function. Thus, the degree of tubular dysfunction was highest in patients with the lowest GFR values (p < 0.01). Again we noted a positive correlation between proteinuria and tubular dysfunction (p < 0.001) implying advanced CKD stages. Conclusion: glomerular and tubular disorder in CKD progression. If both deficiencies and dysfunctions are addressed earlier on, the course of the disease may be altered, along with the prognosis of affected patients.
Tooba Khan,Susan Kakakhel,Jaleel Kamran , Nighat Ghafoor,Madiha Khattak
Radiological Assessment Of Interstitial Lung Diseases: A Comparative Analysis Of Hrct And Mri Techniques
Background: systemic cop & interstitial lung diseases (ilds) are broadly defined subgroups of inflammatory and fibrotic lung disorders. before the development of uip pattern, the gold-standard test for the evaluation of ILD has been the High-Resolution Computed Tomography (HRCT), which allows detailed imaging of the lung tissue. However, MRI seems to be a radiation-free technique that is gradually gaining patronage to offer complementary functional and structural information. It is crucial to look for the best approaches and make some comparisons between the two so as to ensure that the patients get the right diagnosis as well as avoiding their compromise. Objectives: In order to define the place of HRCT and MRI in diagnosing interstitial lung diseases with regard to the image quality, sensitivity, and safety of patients. Study design: A retrospective study. Place and duration of study. Department of pulmonology MTI lady reading hospital Peshawar from jan 2022 to March 2022 Methods: For this analysis the patient records of 200 ILD patients were reviewed in the retrospective manner. In this regard, the diagnostic accuracy and image quality, as well as lesion characterization, of HRCT and MRI scans were assessed by two radiologists. Intra and interobserver reliability was calculated by using Intraclass Correlation Coefficient with 95% confidence intervals for continuous variables and Mc Nemar’s test for categorical variables while diagnostic results were compared using Student t test for parametric and Chi square test for non parametric variables. Results: The study included 200 patients (mean age: 55.4 years, SD: ±12.7). For fibrotic patterns HRCT revealed better spatial resolution compared with the DLCO (p<0.001). MRI was more useful in depict functional imaging required and also depicted vascular abnormalities more comprehensively. Interobserver variance co-efficient for HRCT scan was 0.87 and for MRI was 0.80. Accuracy on a per lesion basis for HRCT was 93% sensitivity and 90% specificity The MRI achieved 85% sensitivity and 88% specificity. MRIs were preferred by patients because no radiation was used in the procedure. Conclusion: While for the structural evaluation in ILD, there is no better modality than the HRCT and for functional evaluation MRI does not expose to radiation. Coordination of these approaches may increase the reliability of differential diagnostics and minimize risks in the treatment of ILD.
Muhammad Umar, sher Ali, zafar Iqbal, Sajjad Naseer, Erum habib
Advancements In AI-Assisted Imaging For Early Detection Of Pulmonary Nodules In High-Risk Populations: A Retrospective Study
Background : Pulmonary nodules are critical indicators of early-stage lung cancer, particularly in high-risk populations. Advancements in imaging technologies, including low-dose computed tomography (LDCT) and artificial intelligence (AI), have enhanced the accuracy and timeliness of detection, offering improved patient outcomes. This study evaluates imaging techniques and their diagnostic impact in high-risk individuals. Study Design : A Retrospective Study. Place and duration of study: pulmonology MTI lady reading hospital Peshawar from July 2021 to Dec 2021 Objectives : To assess the efficacy of advanced imaging modalities, including LDCT and AI-driven analysis, in detecting pulmonary nodules in high-risk populations, and to evaluate patient outcomes and diagnostic accuracy. Methods : This retrospective cohort study analyzed 150 patients from high-risk groups undergoing LDCT screening between 2015 and 2020. AI-assisted analysis was used for nodule characterization. Data on patient demographics, nodule size, malignancy likelihood, and follow-up outcomes were collected. Statistical analysis included mean age, standard deviation, and p-values to assess diagnostic efficiency and patient outcomes. Results: Among 150 patients, 65% were male. The mean age was 62.4 years (SD ± 8.1). Nodules were detected in 38% of patients, with 12% confirmed malignant. LDCT combined with AI showed a sensitivity of 94% for detecting malignant nodules. Significant differences were noted between malignant and benign nodules (p < 0.01). AI analysis reduced false positives by 25% compared to manual radiological review, enhancing specificity. Early-stage lung cancer diagnoses increased by 18% in high-risk patients screened with LDCT. Conclusion : Advanced imaging techniques, particularly LDCT with AI integration, significantly improve pulmonary nodule detection in high-risk populations, leading to earlier lung cancer diagnoses and better patient outcomes. The study underscores the importance of adopting these technologies in routine screening programs. Continued research is necessary to optimize protocols and address cost-effectiveness and accessibility challenges.
Sher Ali, Muhammad umar,Sajjad Naseer, Erum habib , Zia ullah
Evaluation Of Thyroid Function Tests In Cancer Patients Treated In The Oncology Unit, Hayatabad Medical Complex, Peshawar
Background: Hypothyroidism is a well-known side effect of cancer management through chemotherapy, radiotherapy, and molecular-target therapy. Thyroid function assessment is crucial for the prevention of dysfunction and improvement of the therapeutic effect. In the context of Hayatabad Medical Complex, this study targets on evaluating the thyroid function disorders in the oncology unit cancer patients receiving treatment. Objectives: to determining the frequency and forms of thyroid dysfunction among oncological patients receiving treatment at the Oncology Unit Hayatabad Medical Complex and to describe the association between thyroid function and cancer therapy regimens. Study design: : A cross-sectional study. Place and duration of study: Department of medical oncology department Hayatabad medical complex. Peshawar January 2019 to December 2019 Methods: on this cross-sectional research design was conducted on 100 cancer patients, attending the oncology unit. TSH, FT4, FT3 levels were evaluated, as were patient’s sex/age/intake of various treatments. The basic quantitative descriptive analyses such as mean, standard deviation, and p-value were used to determine the relationship between the variables. Specific abnormal conditions of the thyroid were not tested, if the patient previously had such, to minimize the influence of the illness on the treatment outcomes. Results: 50.6 years (SD ±12.3) one hundred patients with cancer had thyroid dysfunction prevalence ranging at 42 percent. Hypothyroid state was commonest (28%) followed by subclinical hypothyroidisms (10% and hyperthyroidisms (4%). The results further showed that overall thyroid dysfunction was more common in patients received radiotherapy in the head and neck region (p-value < 0.05). In the present study no statistical differences in thyroid dysfunction in male and female patients were found. Here mild subclinical hypothyroidism was observed in 18% of cases related to chemotherapy. Targeted therapy, the patient population that exhibited autoimmune thyroiditis was significantly different (Chi-square = 4.00; p-value < 0.05). The implication of the findings is that thyroid function should be monitored frequently when a patient with cancer is receiving treatment. Conclusion: Thyroid dysfunction is common in cancer patients, particularly those undergoing radiation and targeted therapies. Regular monitoring of thyroid function tests is essential for early detection and management. The study highlights the significance of thyroid screening in improving patient outcomes and minimizing treatment-related complications. Integrating thyroid care into cancer management protocols is recommended for comprehensive patient care at Hayatabad Medical Complex.
Understanding And Management Of Thyroid Cancer Genomics
Background: Thyroid cancer is a rather heterogeneous disease with regard to the molecular characteristics of tumors. Major achievements have been accorded to genomics diagnosis, risk assessment for the disease, and even the treatment that is accorded to the disorder. Molecular changes such as BRAF, RAS, RET, and TERT promoter gene mutations define the disease process in thyroid cancer. Implementation of genomic data into a practice results in accurate handling in a clinical practice hence improving the performance of a patient. Objectives: To explore the diagnostic, predictive or prognostic impact of genomic changes in thyroid cancer and to determine whether such changes can guide therapies for the metastatic disease to enhance the patients’ outcomes. Study design: A cross-sectional study Place and duration of study. Department of medical oncology department Hayatabad medical complex. Peshawar January 2017 to December 2021 Methods: A study of 200 Thyroid cancer patients was reviewed retrospectively. Molecular characterization was performed by targeted sequencing for hotspot mutations (BRAF, RAS, RET/PTC fusions). The results of molecular tests were compared with clinical information on Age, Tumor type and sensitivity to treatment. Descriptive analysis used mean age and standard deviation in the patients, and prognostic differences were assessed for statistical significance by p-values. Results: The cross-sectional study assessed 200 patients with mean age of 48.6 years (SD ± 12.4) years. At present, BRAF V600E mutation was found in 52% cases of papillary thyroid carcinoma associated with advanced disease stage (p = 0.02). RET/PTC rearrangements were identified in 18 % patients with increased frequency in younger individuals (p = 0.03). Newly arising TERT promoter mutations were associated with near survival in 26 % of anaplastic subjects ( p < 0.01 ). Personalized treatments were found to show increased PFS in patients with actionable mutations. Conclusion: Analysis of thyroid cancer genomic characteristics is considered useful to individualized approach. BRAF/ TERT roadmaps have been discovered as key main features of prognosis and therapeutic stratification. Individualized therapies improve patient care and fashion the practice of the various therapeutic modalities.
Outcomes Of Emergency Surgery Of Complicated Diverticulites
Background: Advanced complicated diverticulitis, particularly when involving perforation, abscess or peritonitis, presents a management dilemma in emergency surgery. Its management sometimes includes doing procedures such as Hartmann’s or primary anastomosis. However the reality is that emergency surgeries are much more risky compared to elective surgeries even with all the development that has happened in the field. Knowledge of outcomes and predictors condition basic knowledge in regard to surgical interventions and patient management. Objectives: To assess the safety and efficacy of emergency surgery for complicated diverticular disease; patients’ demographics, operative complications and factors affecting morbidity/ mortality and postoperative recovery to inform future practice and policy. Study design: A Retrospective study. Place and duration of study. Department of General Surgery MTI Lady Reading hospital Peshawar from jan 2021 to july 2021 Methods: 50 emergency surgical patients with complicated diverticulitis in a single institution from January 2015 to December 2020. Information collected were patients’ characteristics, intra operative details and other variables in form of complications recorded after the surgery. The opinions of the respondents were analyzed with reference to mean age, standard deviation t-test. In comparing mortality and complication rates between subgroups, the P values were calculated. Analytic work was done using the Statistical Package for the Social Sciences Version 17 and a significance level of 0.05 was used. Results: The study targeted fifty patients their mean age was 67.5 ± 12.3 years. Hartmann’s procedure was conducted in 60% of patients, and primary anastomosis in the rest 40% of cases. A postoperative complication rate of 45 percent as marked by wound infections at 20 percent, anastomotic leaks at 5 percent. The mortality rate was 15%. Mortality rates were higher in patients older than 70 years: 27.8 % versus 18.2 % (p = 0.03). Hinchey classification demonstrated that prolonged length of stay connected with Hinchey degree III and IV (p = 0.02). We also divided both patients with sepsis and those receiving primary anastomosis based on surgical treatment; primary anastomosis had shorter recovery time with higher leakages among the septic group (p = 0.04). Conclusion: Emergency surgery for complicated diverticulitis remains a high-risk procedure, especially among elderly patients and those presenting severe disease features. Although Hartmann’s procedure is the standard management in critically ill patients, primary anastomosis is possible in occasionally stable patients. The care of such patients demands that surgery should be tailored for each of the patients and the perioperative period should be managed optimally. Thus future trials are required to minimize the mortality rate and refine indications for surgical management in emergencies.
Ahmad Faraz, Fazal Ghani, Muhammad Javed khan, Muhammad Ali khan, Huma shafi
Assessment Of Knowledge, Attitude,Self Reported Practice And It’s Association With Sociodemographic Factors Among College Students Of District Mansehra , Pakistan
Background.Oral health is an utmost component of one’s general health and over all well-being. Many systemic diseases have oral manifestations . Oral diseases are common occurrence across the world wide and required community based prevention to improve oral health at community level. Knowledge , attitude and practice (KAP) survey is an important for the evaluation and detection of needs before launching community based oral health promotion programs. Objective: to assess oral health knowledge , attitude, self – reported practices and it’s association with sociodemographic factors among college students of college students of district Mansehra , Pakistan . Study Design : A Cross Sectional Study. Place and Duration of study. Department of Community Dentistry Bacha Khan College of Dentistry Mardan from jan 2020 to dec 2020 Methodology :It was a cross sectional study conducted on 203 college students in district Mansehra. Data was collected by using a modified structure questionnaire and analyzed using SPSS software. Result: Oral health knowledge of the participants about specific oral diseases was not satisfactory , but overall oral health knowledge was good . Regular dental check-up was uncommon( only 37.93%) . Most of the participants(191/203) were reported to brush their teeth with toothpaste 145 (71.43%),Miswak 43(21.18%) .Female students have more knowledge than male students( P= 0.0001 which is statisticaly significant) . Conclusion: Oral health knowledge about oral diseases not satisfactory and most of the students didn’t know about proper brushing method and oral hygiene aid , there by requiring awareness campaigns , seminars and oral health programs to improve oral hygiene and health.
Muhammad Naeem, Raham Zaman ,MuhammadAnas ,Muhammad Usman sultan
Polycystic Kidney Disease Genetic Basism Diagnosis And Management A Descriptive Cross-Sectional Study
Background: PKD is a disease depending on genetics with cyst growth in the kidneys that gives rise to renal malfunction. It is caused by mutation in PKD1, PKD2 and PKHD1 genes. Screening and specific management plans are however key to enhancing patient survival and prevention of growth to ESRD. Objectives: Clinical research questions: To compare the genetic and diagnostic characteristics of PKD, and to compare the efficacy of novel therapeutic interventions in decreasing clinical progression in patients with the disease. Study Design : A descriptive cross-sectional study. Place and duration of study. Department of Urology MTI BKMC/MMC Mardan Pakistan from jan 2022 to july 2022 Methods: The present study is a descriptive cross-sectional study conducted from January to December 2022 in which 150 patients of PKD participated. Medical genetic testing, radiological scans, and physical examinations as well as laboratory tests were used to confirm the diagnoses. The demographic characteristics, symptoms, estimated glomerular filtration rate and dialysis prescriptions were recorded. Data was analyzed using SPSS Software Version 24.0, differences as measured by mean ± SD and P value were determined.. Results: Of 150 patients (mean age: 42.3 ± 9.6 years-old), PKD1 mutations were identified in 65%, PKD2 in 30% and PKHD1 in all 8 ARPKD cases. The majority of the patients had hypertension (78%) and flank pain (62%). In the current study, the mean eGFR was 52 ± 10 mL/min/1.73m². AVPRA inhibitors also decreased the rate of disease progression (trend level <= 0.001), but neither dual management nor conventional anti hypertensive therapy brought patients’ BP into the target range in 72% patients. Conclusion: PKD has also been linked with PKD1, PKD2 and PKHD1 genes mutations. Although imaging and genetics help in early detection of the disease, vasopressin receptor antagonists hold great potential in treating the disease and reversing the condition. Targeted therapy enhances disease prognosis in PKD.
Zafar Ahmad Khan,Rahmat Ali Khan, Najmuddin,Atta Mohmmand Khan,Shah Fahad,Shahid Rizwan Safir
Emerging Therapies In Chronic Kidney Disease A Cross-Sectional Study
Background:CKD is a highly prevalent ailment worldwide that is typified by gradual deterioration of kidney function and many complications. Just in the last decades, there has been progress in the management and the effectiveness of therapy with special reference to the pharmacological use. Objectives: To assess the effectiveness of novel treatments and treatment strategies in CKD in terms of renal prognosis, cardiovascular risk and patients’ quality of life. Study Desgin: A Cross-Sectional Study. Place and Duration of study. January 2022 and july 2022 in a Urology MTI BKMC/MMC Mardan Pakistan Methods: This study was a cross-sectional Study of 150 Patient with CKD at different stages of the disease. Participants were given conventional interventions with newly developed treatments such as SGLT2 inhibitors and fresh anti-inflammatory drugs. In the present study, we focused on collecting clinical data of the participants with eGFR, proteinuria and cardiovascular data over six months. Descriptive statistics using SD, comparison of the means and p-values for prevalence was used to determine the statistical significance for the data analyzed. Results:SGLT2 inhibitors led to an enhancement of eGFR levels from 12% in 150 patients (mean age, 58.4 ± 6.2 years), (p < 0.01). The albuminuria was decreased over time in studied patient means 1.2 ± 0.4 g/day; p = 0.03; Experience of better cardiovascular result was observed. Renal benefits following the use of anti-inflammatory agents were subtle, hence figures were higher compared to placebo (p = 0.06). Conclusion: antidiuretic drugs particularly SGLT2 inhibitors, have been shown to reduce CKD progression in patients with T2DM and, therefore, should play a vital function in CKD treatment. Further experimental studies will be important to determine ideal treatment approaches and other requirements still unmet.
Zafar Ahmad Khan,Rahmat Ali Khan, Najmuddin,Atta Mohmmand Khan,Zahid ullah khan,Shahid Rizwan Safir
To Determine The Frequency Of Iron Deficiency Anemia As A Risk Factor For Simple Febrile Seizures Presenting To The Department Of Pediatrics, Gomal Medical College, D.I. Khan
Background: In children Febrile Seizures one of the most common pediatric emergency.Iron deficiency anemia is one of the risk factors for febrile seizures.Iron deficiency anemia is a treatable and preventable disease.This study will acquaint local researchers in managing both these diseases in a much pragmatic manner at the local level. OBJECTIVE:To determine the frequency of Iron deficiency anemia as a risk factor for simple febrile seizures in children presenting to Gomal Medical College, D.I. Khan. Study Design : A Descriptive Cross sectional study. Place and Duration of Study. Pediatric department Gomal Medical College, D.I. Khan after approval from institutional ethical review board from 01 Nov 2020-01 Apr 2021 SUBJECTS AND METHODS: This Descriptive cross sectional study was carried out in Pediatric department Gomal Medical College, D.I. Khan after approval from institutional ethical review board from 01 Nov 2020-01 Apr 2021.Total 185 children suffering from febrile seizures with ages between 6months-6 years from both gender were enrolled after informed consent from parents and guardians.Purposive sampling was done to measure hemoglobin, MCHC, MCV and serum ferritin and Iron Deficiency Anemia was diagnosed as per operational definition.Data was collected on pre-designed structured performa and was analyzed using SPSS version 23. RESULTS: As per frequencies and percentages for iron deficiency anemia in patients presented with febrile seizures, 70 (37.8%) patients were recorded with iron deficiency anemia. CONCLUSION:This study found that iron deficiency is a major risk factor for simple febrile seizures in children under the age of three.
Palwasha Hayat Burki, Sadia Mahmood Ahmad, Nusrat Bashir