Journal of Women Medical and Dental College
Prevalence and Comparison of Dental Caries Experience Among Government and Private School Children in Abbottabad: A Community Dental Outreach-Based Study
The present study was conducted to assess the prevalence of dental caries and to compare the components of the Decayed, Missing, and Filled Teeth (DMFT) index among school children studying in government and private schools in Abbottabad. Differences according to gender and age groups were also explored using data obtained from community-based dental awareness programs conducted in 2025. A descriptive cross-sectional study was carried out from June to August 2025 as part of school oral-health awareness activities organized by the Department of Community Dentistry, Women Dental College, Abbottabad. Dental examinations were performed using the WHO-recommended DMFT index. Schools were categorized into government and private institutions, and demographic information including age and gender was recorded. Non-probability convenience sampling technique was used, and the collected data were analyzed using IBM SPSS version 24. Descriptive statistics were calculated, while chi-square and independent t-tests were used to examine differences in caries prevalence and mean DMFT components across groups. Results were considered statistically significant when p-value was less than 0.05. A total of 1,615 schoolchildren were included in the final analysis, with a mean age of 15.8±1.9 years. Among these 52.4% were female and 47.6% were male. The prevalence of dental caries (DMFT>0) was observed to be 47.3%. The mean scores for individual DMFT components were 1.19 for decayed teeth, 0.19 for missing teeth, and 0.03 for filled teeth. A higher prevalence of dental caries was observed in private schools (60.9%) as compared to those in government schools which was (36.9%). Female students exhibited greater prevalence as compared to male students. Furthermore, a gradual increase in mean DMFT scores was seen with increasing age among adolescents. Dental Caries remain the most common oral health concern among school children in Abbottabad. the finding suggests a comparatively higher burden among private schools’ students and female adolescents. Strengthening school based preventive strategies, including oral health education, routine dental visits and dietary counseling, may help to reduce the burden of dental caries in this population.
Copyright (c) 2026 Journal of Women Medical and Dental College
Socioeconomic Status and Educational Level as a Barrier to Accessing Maternal Healthcare in Abbottabad, Pakistan: A Cross-Sectional Study
In low- and middle-income countries, such as Pakistan, maternal health outcomes remain a significant public health concern. Decreased access to prenatal, intranatal, and postnatal care is strongly linked to socioeconomic inequality and female educational levels. To design equitable healthcare interventions, it is necessary to understand the barriers to healthcare access. This was a hospital-based cross-sectional survey with a sample size of 349 undergoing maternity treatment at Women and Children Hospital, Jinnah International Hospital, and Ayub Medical Complex in Abbottabad, and convenience sampling was used. A self-structured questionnaire was designed to collect the required information on the variables. SPSS version 20 was used to analyze the data to determine how these factors related to one another, and Chi-square tests were used; p-values <0.05 were considered statistically significant. Most of the participants were from rural areas, joint households, and were aged between 25 and 29 years. About 28.9% of them were uneducated, while 71.6% were from low-income families. Only 36.7% of women completed the four antenatal care visits, while 16.6% attended at least one visit. In addition, 93.2% of the women gave birth in government and private clinics. Only 38% of them received postnatal check-ups after six weeks. There is a strong association between a woman's educational level and her use of maternal health services. Women with higher educational levels are likely to seek prenatal health care at an earlier gestational age. In addition, we established a strong association between women's chances of receiving postnatal check-ups and household income. Women are likely to face financial constraints due to a lack of funds (67.9%) and the distance to health facilities (14.9%). In Abbottabad, socioeconomic status and educational level are key barriers to maternal health care, and this is evident through our research. These are the fundamental issues that need to be addressed to effectively improve maternal and child health.
Bruton’s Tyrosine Kinase Inhibitors in Chronic Spontaneous Urticaria: Unraveling Mechanisms, Clinical Efficacy, and Future Perspectives
Chronic spontaneous urticaria (CSU) is an inflammatory process that is mediated by mast cells, and that is characterized by the presence of recurrent wheals or angioedema or both over a period of more than six weeks. Antihistamines and biologic agents, including Omalizumab, have been available, but still a certain number of patients turn out to be resistant, and that is why it is necessary to find new targeted therapies. A promising target is Bruton tyrosine kinase (BTK), a central mediator of Fc5 receptor (Fc 5) signaling in mast cells and basophils. This narrative review included a collection of evidence about BTK inhibitors in CSU. PubMed and Google Scholar were searched in a structured manner covering up to February 2026. Randomized controlled trials, early-phase clinical trials, observational studies, and mechanistic studies evaluating the BTK inhibitors in CSU were all included in the search. Compilation of the results was done in a descriptive manner lacking a risk-of-bias evaluation. Preliminary clinical trials have demonstrated that specific BTK inhibitors, including remibrutinib and rilzabrutinib, cause quick decreases in the urticaria activity rating, enhance the symptoms and have favorable safety profiles in the short-term. BTK inhibition has been confirmed as a useful treatment in mechanistic studies to inhibit mast cell and basophil cell activation, thus preventing IgE-mediated and autoantibody-driven pathways that cause CSU. Initial findings suggest that there is a significant improvement in the patients who are antihistamine-resistant, but the long-term safety and maintenance of the response rates remain to be explored. BTK inhibitors are an encouraging new therapy in the treatment of CSU. Phase III trials and real-world investigations in the future will assist to establish their long-term effectiveness, safety, and place in the present treatment guidelines. This Review sets out to incorporate the current literature on the use of Bruton tyrosine kinase inhibitors in chronic spontaneous urticarcia.
Nanomaterials and Nanotechnology: An Overview on Synthesis, Characterization and Application
Nanomaterials have significant large surface area relative to their volume which makes them unique regarding the physical and chemical characteristics. They have notable optical, electrical, magnetic, mechanical, and catalytic properties and these brings the new scientific era- nanotechnology. Ball milling, lithography, sputtering, and laser ablation are commonly used ‘Top-down’ method where larger materials are broken down to the nanoscale. However, ‘Bottom-up’ methods, such as chemical vapor deposition (CVD), sol-gel processes and hydrothermal processes build nanoparticles from atoms or molecules with controlled modulation of shape and composition. Researchers of late have focused on green nanotechnology by producing the metal nanoparticles from plants, algae, and microorganisms. This could be a potential era for biotechnologists to explore more to find the environmental friendly and less expensive biological approach. X-ray diffraction (XRD), scanning and transmission electron microscopy (SEM, TEM), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS) are widely used surface characterization of nanomaterials. From environmental remediation to modern electronic devices, nanotechnology has kept his impactful footprint along with food and medicine disciplines. This review summarizes the synthesis, characterization, and application of nanotechnology in recent research fields, guiding future contributors in the innovation of nanotechnology.
Menstrual Health and Hygiene Practices Among Adolescent School Girls in Nowshera: Insights and Impacts
Menstrual Health Management (MHM) is an important aspect of adolescent health and gender equality that is underserved. Cultural taboos and socioeconomic barriers frequently jeopardize the health and education of young girls in Pakistan. The practices of menstrual hygiene, awareness levels, and socioeconomic obstacles faced by adolescent schoolgirls in District Nowshera, Khyber Pakhtunkhwa, are the subjects of this study. In five schools in Nowshera, 200 adolescent girls between the ages of (14± 2, grades 8-10) participated in a quantitative descriptive study. A 15-item, structured, and translated into Urdu questionnaire was used to gather information about awareness, product use, and the impact of menstruation on school attendance. Both parental consent and ethical approval were obtained. A notable lack of preparedness was observed, as 22% of participants said that they had no confidence in their knowledge of menstruation (P < 0.001). Economic issues were also observed, as 68% of participants admitted to borrowing sanitary pads from others, which is a risky practice in terms of hygiene, and 58% used cloth pads. Sixty percent of participants from this group were absent from their classes due to their menstrual cycle, which was a remarkable number of school absenteeism (P < 0.001). Although 87% relied on their mothers, only 7% were "very satisfied" with education from schools. Moreover, 68.5 percent of misconceptions were due to cultural issues rather than medical facts, such as taking a bath or using cold water. The research emphasizes a critical MHM situation that exists in Nowshera, characterized by institutional failure and "period poverty". Specific policy interventions are necessary, including the integration of MHM into the national school curriculum and the provision of government subsidies for sanitary products to address the 60% absenteeism rate and the risky sharing of menstrual resource. In order to ensure that adolescent girls are able to manage their health in a dignified manner and continue with education, the recommendations suggest that MHM should be incorporated into the curriculum, sanitary items should be subsidized, and "period-friendly" school infrastructures should be developed.
Patient Satisfaction with Health Care Services in Tertiary Hospitals: A Comparison of Government and Private Hospitals of Abbottabad, KPK
In a healthcare system patients are the main users of facilities and their satisfaction with these facilities is very important factor that tells how effectively the care is being provided. Patient satisfaction is now considered an important indicator of hospital performance. For any hospital to perform well, it must understand what patients’ expectations from a healthcare system are and how they perceive quality care. Also, continuous and regular evaluation of patient satisfaction can positively affect the patient’s interaction with the healthcare system and their trust in the institution. The objective to assess patient experiences in tertiary healthcare settings, such as staff attitudes, communication, accessibility, waiting times, and general quality of care. To see differences in patient satisfaction level in government and private hospitals. Therefore, this study aims to assess patient experiences in tertiary healthcare settings, such as staff attitudes, communication, accessibility, waiting times, and general quality of care and to see differences in patient satisfaction level in government and private hospitals. Cross-sectional study was carried out over eight months (March–October 2024). A non-probability convenience sampling method was used. Based on the WHO calculator, the required sample size at a 95% confidence interval was 258. Of these, 129 participants were taken from government hospitals and 129 from private hospitals in Abbottabad. All the patients present in mentioned tertiary care setting admitted in the wards and visiting OPDs of tertiary care hospital. Patients who were not interested were excluded. Data were processed and analyzed using SPSS version 20. The survey of 258 participants revealed mostly female 131(50.8%) with an average age of 38.5 years. 96% of private and 82% of public hospital patients appreciated the calm environment. Affordability of medications was acknowledged by 61% of private and 51% of public patients. Positive interactions with staff were reported by 97% of private and 88% of public hospital patients. Additionally, 89% of private and 80% of public patients found waiting times reasonable. Our study shows that there is significant difference in patient satisfaction level between public and private sector hospitals. As far as provision of facilities like clean environment, bathroom facilities, treatment affordability, attitude of doctors and nurses/paramedics and waiting time are concerned patient showed more satisfaction with the facilities provided in private hospital than those provided in public Hospitals as they were much better in private sectors as compared to public hospitals.
Copyright (c) 2025 Journal of Women Medical and Dental College
Revolutionizing Insulin Initiation: Integrating Digital Health and Clinical Insight in Diabetes Care
Insulin therapy initiation in diabetes treatment is often delayed, which leads to poor blood sugar control and a higher chance of developing medical complications. Digital health technologies that use artificial intelligence through their decision-support systems show potential to decrease treatment delays while enhancing patient health outcomes. The research used mixed methods to analyze electronic medical records from 1,000 diabetes patients who received treatment at three tertiary-care hospitals while conducting a structured survey among 250 endocrinologists and diabetologists, and diabetes nurses. The AI-assisted clinical decision tool determined optimal insulin initiation timing through evaluation of HbA1c level, fasting plasma glucose, and unsatisfactory oral therapy outcomes. The researchers used SPSS version 28 for statistical analysis, which established p < 0.05 as the threshold for statistical significance. The AI decision support system implementation reduced insulin initiation time by 3.5 months, which resulted in a decrease from 9.2 months to 5.7 months (p = 0.001). The percentage of patients following their treatment plan increased from 62% to 88% while the average HbA1c level decreased from 1.4% to 2.2% during six months. The clinicians experienced better treatment initiation certainty while they could more effectively incorporate their work processes. The combination of AI decision support systems with clinician knowledge results in better insulin initiation speed, patient treatment compliance, and blood sugar control. Digital-clinical collaboration represents a promising pathway to reduce therapeutic inertia. The practice enhances patient-centered diabetes care delivery.
Discovery and Analysis of Novel Phage DSI29 with Potent Activity Against Escherichia coli
Escherichia coli is a common foodborne pathogen that can result in life-threatening diseases and represents a serious burden to food safety management. With the advent of the post-antibiotic era, bacteriophages have generated great attention as promising biocontrol agents for their selective action against bacteria and lysis them. Here, we describe the isolation and charcaterization of a new E. coli-infecting phage DSI29, isolated from a freshwater sample in Joypurhat, Bangladesh. DSI29 phage has a wide host range and a lytic performance to E. coli, implying that the phage is applicable for food safety. Subsequent work revealed its stability to different pH and temperatures, rendering it appropriate for a broad range of environments. Because of its pure lytic lifestyle and powerful bacteriolytic activity, the DSI29 has promising potential as a biocontrol agent in food manufacturing systems. These results reveal the potential of phage therapies in controlling E. coli contamination, a sustainable alternative to conventional antibiotics.
Teachers at Risk: Exploring Hoarseness of Voice and the Effectiveness of Self-Report Screening Tools Vocal Handicap Index (VHI) & Voice Symptom Scale (VoiSS) in a Saudi Population
Teachers who use their voices for extended periods of time in less than ideal environments are more likely to develop voice disorders like hoarseness. Preventing long term vocal impairment requires early detection with validated screening instruments. To compare the diagnostic performance of the Voice Handicap Index (VHI) and the Voice Symptom Scale (VoiSS) as screening instruments. A cross-sectional study was conducted among 101 randomly selected school teachers from 15 schools in Bisha, Asir Region. Data were collected using a validated, self-administered questionnaire, including VHI and VoiSS. Statistical analysis was performed using SPSS version 27. The gold standard was a speech language pathologist's clinical voice evaluation. To assess the diagnostic precision of VHI and VoiSS, sensitivity, specificity, and Receiver Operating Characteristic (ROC) curves were computed. ROC analysis demonstrated high diagnostic accuracy for both tools, with AUCs of 0.86 (VHI) and 0.89 (VoiSS). At optimal cut-off scores, the VoiSS showed higher sensitivity (88.9%) and specificity (81.3%) than the VHI (84.4% and 78.7%, respectively).Hoarseness of voice is very common among school teachers. While both VoiSS and VHI are useful screening tools, VoiSS performs marginally better in terms of diagnosis. In educational settings, routine use of these tools may help with early diagnosis and treatment of voice disorders.
Prevalence and Determinants of Hoarseness of Voice in School Teachers: Implications for Occupational Vocal Health
Hoarseness of voice is a common occupational hazard among school teachers, often resulting from prolonged vocal use in challenging classroom environments. Despite its substantial impact on teachers’ quality of life and job performance, there is limited data on the prevalence and contributing factors of voice disorders in Saudi Arabia. To evaluate the burden of hoarseness of voice and explore its associated risk factors among school teachers in Bisha, Saudi Arabia, using the Voice Handicap Index (VHI). A cross-sectional study was conducted among 101 randomly selected school teachers from 15 schools in Bisha, Asir Region. Data were collected using a validated, self-administered questionnaire, including socio-demographic variables, voice usage and perception, lifestyle factors, and the VHI. Statistical analysis was performed using SPSS version 27. Descriptive and bivariate analyses were conducted to explore associations between hoarseness of voice and independent variables. Among the 101 participants, 71.3% reported mild, 21.8% moderate, and 6.9% severe voice handicap based on the VHI. Hoarseness of voice was significantly associated with higher income (P=0.043), longer teaching experience (P=0.05), raising voice during teaching (P=0.034), and coffee consumption (P=0.04). Although older age and female gender were linked with increased voice handicap, these associations were not statistically significant. The findings reveal a high prevalence of hoarseness of voice among school teachers in Bisha, influenced by several modifiable risk factors. Implementation of preventive strategies such as vocal hygiene education, voice amplification devices, and routine medical evaluations is essential. Further longitudinal and clinically validated studies are needed to establish causality and improve voice health among educators.
Voice Disorders in Teachers: A Quantitative Assessment Using the Voice Symptom Scale in a Saudi Arabian Town
The human voice is an essential tool for communication, particularly in teaching, one of the most vocally demanding professions. Persistent voice use can lead to vocal strain and hoarseness, impacting teachers’ professional performance and quality of life. This study aimed to assess the prevalence of hoarseness of voice and identify associated risk factors among school teachers in Bisha, Saudi Arabia, using the Voice Symptom Scale (VoiSS).A cross-sectional study was conducted in 15 schools across Bisha, in Saudi Arabia involving 101 randomly selected school teachers. Data were collected using a pre-tested, validated questionnaire that included demographic details, voice usage patterns, lifestyle habits, and the VoiSS. Descriptive and bivariate analyses were conducted using SPSS version 27 to identify associations between hoarseness and various risk factors. The prevalence of hoarseness of voice among participants was 63.4%. Female teachers and those with less than 20 years of teaching experience were significantly more affected (P = 0.003). Coffee consumption showed a statistically significant association with increased VoiSS scores (P = 0.041), while other factors such as age, smoking, and voice amplification usage were not significantly associated. Hoarseness of voice is highly prevalent among school teachers in Bisha, particularly among females and those with shorter teaching experience. Lifestyle factors such as coffee intake may exacerbate voice symptoms. These findings underscore the need for preventive measures, including vocal health education, voice amplification tools, and access to medical care, to reduce the burden of voice disorders in educators.
Medical Students’ Perception Regarding Ways to Enhance Efficacy of Online Practical Teaching
Online education has become increasingly important in modern medical education due to its accessibility and scalability. It gained significant traction during the COVID-19 pandemic. However, teaching practical skills virtually presents specific challenges. This study aims to assess medical students’ perceptions of online practical sessions and gather strategies to improve virtual skill acquisition. A descriptive cross-sectional study was conducted at Women Medical and Dental College from March to May 2021. A total of 200 medical students from first and second year MBBS/BDS participated. Data were collected via a structured questionnaire distributed through Microsoft Office Forms, using non-probability convenience sampling. Among the 200 respondents, 68% reported difficulty in learning practical skills online. About 76% expressed concern over potential negative impacts on future clinical competence. Multimedia tools (audio, video, graphic) were preferred by 61%. Additionally, 78% of students recommended teachers take breaks to assess understanding, and 98% supported repetition of key points. The DEDICT (Demonstrate, Explain, demonstrate, Imitate, Coach, Test) teaching method was rated effective by 83%, and 80% preferred receiving pre-session demonstration videos Peer interaction was seen as beneficial by 82% of students, and 55% preferred wanted practical method of teaching over live sessions. A blended learning model was favored by 66%. Students strongly support a blended approach for teaching practical skills. Key strategies include the use of visual aids, repeated content, interactive teaching, and student engagement. These methods can enhance the effectiveness of online practical education.
Medical Camp in Rural Area (Bara Hotar) of Abbottabad District
To present the demographics, medical diagnoses, and treatments provided to attendees of the free medical camp in the Abbottabad district's Bara Hotar area. Cross sectional descriptive study. A medical camp of one day duration was established in BaraHotar area of District Abbottabad in August 2024. Camp was staffed by doctors, nurses and assistants of Women Medical College, Abbottabad. At the entrance, the attending patients' details were noted, and at the dispensary where the medications were administered, diagnoses and the medications were noted. The medical camp was attended by 72 patients. The patients' ages ranged from 2 months to 80 years, with a mean age of 27.19 years. 68.1% (49) of the patients were male. The most common complaints were related to the gastrointestinal system (20.8%), musculoskeletal system (18.1%), teeth (20.8%), and visual acuity (5.4%). Additional frequent concerns were associated with obstetrics, dermatology, and ENT (ear, nose, and throat). Of the 72 prescriptions that were documented, the most frequently prescribed medications were anthelminthics (15.3%), multivitamins (5.6%), analgesics (4.2%), and antibiotics (38.9%). The majority of Abbottabad's rural residents suffer from gastrointestinal, musculoskeletal, and dental conditions. These camps are advised until a sufficiently affordable healthcare system is established to serve remote rural communities.
Pediatric Mandibular Langerhans Cell Histiocytosis with Maxillary Recurrence: A Case Highlighting Multidisciplinary Management
Histiocytosis X used to be a common name for a diverse group of rare clinicopathologic conditions. Histologic analysis shows these conditions have histiocyte-like cells and different amounts of eosinophils, lymphocytes, plasma cells, and multinucleated giant cells. The histiocytic cells in these lesions are Langerhans cells, so the disease is now called Langerhans cell histiocytosis. This report describes a four-year-old girl who was previously healthy. She was taken to the hospital with a nonhealing ulcer on her mandible. A distinct lytic lesion on her jaw was discovered by radiographic examination. Histopathology and immunohistochemistry are used to confirm the disease. At first, curettage was the only procedure carried out. Two months later, the disease returned in the maxilla, necessitating a second operation and systemic chemotherapy. The patient had no negative side effects from taking the medication as directed. Six months after surgery, imaging and clinical evaluations showed total remission. This case highlights the importance of early diagnosis, careful follow-up, and teamwork in treating pediatric LCH with jaw involvement.
Prevalence and Association of Risk Factors in Premature Coronary Artery Disease among Patients of Abbottabad
To determine the frequency and analyze the association of various risk factors, such as hypertension, hyperlipidemia, smoking, diabetes, and stress, with premature coronary artery disease (PCAD) among patients of Abbottabad. This cross-sectional study was conducted to identify common risk factors associated with premature coronary artery disease (PCAD) among 246 patients in Abbottabad. Participants were selected through Purposive non-probability sampling from individuals either admitted or attending the outpatient departments (OPD) of District Headquarters Hospital (DHQ) and Ayub Teaching Hospital (ATH) between 1st January to 30th June 2024. The sample size of 246 was calculated using the OpenEpi calculator with a 95% confidence interval and 5% absolute precision. Data was collected using a self-structured questionnaire covering demographic details and clinical risk factors, including hypertension, diabetes mellitus, hyperlipidemia, and smoking. To assess psychosocial and lifestyle factors, the Perceived Stress Scale and Rapid Assessment of Physical Activity Scale were used. Data were analyzed using SPSS version 22.0, and associations between categorical variables were evaluated using the chi-square test. In our study, PCAD males were 125 whereas PCAD females were 119. The frequency of risk factors was cholesterol (33.3%), Family history (56.5%), Hypertension (69.5%), Diabetes (33.3%) and Smoking (32.1%). Hypertension, mental stress, and smoking were the significant risk factors with p-value 0.001,0.001 and 0.000 respectively with a notable gender disparity. The physical inactivity and poor dietary habits also contributed being unconventional risk factors. This study offers significant understanding about the prevalence of risk factors associated with premature coronary artery disease (PCAD) among patients in Abbottabad, Pakistan. We identified hypertension, smoking, and stress as significant contributors to PCAD. The findings underscore the necessity for targeted interventions and public health strategies to address these risk factors, especially considering the gender discrepancies observed. Furthermore, the study highlights the often-overlooked roles of stress and physical activity in the development of PCAD, suggesting that comprehensive lifestyle modifications could play a fundamental role in prevention.
The Current Cesarean Section Rate and Factors Associated with it among Women Attending The Tertiary Care Hospital in Hazara Division
The recent global upsurge in the trend of cesarean section rates presents a major health problem, especially for underdeveloped countries like Pakistan. The increasing cesarean section rate is a dilemma for the present world. This study, conducted at Ayub Teaching Hospital Abbottabad from June to November 2024, aims to analyze the C-section rate, assess contributing factors, and explore potential associations between these factors and their indications. This research seeks to provide valuable data and insights to the existing body of research on cesarean section rates and factors influencing delivery decisions. By sharing the findings, the study aims to foster a better understanding of C/S rates and promote improved practices in obstetric care in ATH and beyond.This cross-sectional study was conducted in the Department of Gynaecology at Ayub Teaching Hospital Abbottabad over a period of six months, from 1st June to 30th November 2024. It was based on a sample of 249 patients selected through a purposive non-probability sampling technique. Data were collected using a self-devised structured questionnaire. For data analysis, frequencies and percentages were calculated for categorical variables.The study reveals a 40.3% cesarean section rate, which is significantly higher than WHO recommendations, raising concerns about potential overuse and associated health risks. The most important and notable indication for cesarean section is “Previous CS” (26.9%), which shows a significant association with obstetrical hysterectomy, emphasizing the importance of previous C-section history. Malpresentation of the baby accounts for 6.0%, with associated risks in decision-making during childbirth. Placenta previa is another significant indication (2.4%), leading to a notable increase in emergency C-sections. “Fetal distress” (10.0%) and “Preeclampsia + PIH” (8.8%) also contribute to the C-section rate, with significant associations found between patient age and specific indications for C-section.“Elective C-section” is more common in cases of “Previous C-section” and “Malpresentation of the baby,” while “Emergency C-section” is more often associated with indications such as “Fetal distress,” “Preeclampsia + PIH,” “Obstructed labor,” and “Placenta previa and abruption.” Parity shows a strong association with cesarean indications, with multiparas having a higher frequency due to previous C-sections, while primiparas exhibit a higher occurrence related to breech presentation.The four main factors responsible for significant associations with cesarean indications were age (p = 0.019), family income (p = 0.043), type of cesarean section, and parity (p = 0.006). Positive trends are also observed in BMI, comorbidities, and lifestyle. “Previous CS” remains the major indication at 26.9%, while others include fetal distress, malpresentation, obstructed labour, etc. This study paves the way for further research to comprehensively understand and address the upsurge in C-section trends for improved maternal and neonatal health outcomes.
Prevalence of Depressions and Its Association with Symptoms among Convicted Male Inmates at District Jail Attock
Depressive disorders are characterized by sadness, loss of interest, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. Mental disorders, including depression, are prevalent globally, particularly in prison populations, where conditions exacerbate existing issues. This study aims to assess the level of depression among convicted male prisoners aged 18-50 years in Attock prison using the Beck Depression Inventory (BDI).The primary objective is to find out the prevalence of depression and examine the association between depression and somatic symptoms and sociodemographic variables. A cross-sectional survey was conducted with 109 prisoner samples calculated through Open-Epi and selected through Convenience Sampling with random selection technique. A validated structured questionnaire was prepared which contains three sections i.e. demographic data, somatic symptoms of depression, and BDI. SPSS version 29 was used for data analysis where Chi-square, phi, and p-values were calculated to assess the statistical significance of the association between depression and various factors. A level of p < 0.05 was used to assess significance. The prevalence of depression was Normal (11.9%), Mild-mood disturbance (19.3%), Border-line depression (22.9%), Moderate depression (35.8%), Severe depression (7.3%), and Extreme depression (2.8%).Changes in appetite, lethargy, suicidal thoughts, mood changes, and sleep disturbances were strongly correlated with the severity of depression scores p < 0.05 while others like loss of interest and use of drugs/alcohol show only moderate association. Thus, study findings reveal also that 68.8% of inmates suffer from depression with 22.9% falling in the range of borderline clinical depression. There is an urgent need for targeted interventions to reduce depression rates among prisoners for societal well-being. The BDI proves to be an effective tool for measuring depression in this population.
Copyright (c) 2024 Journal of Women Medical and Dental College
Brief Overview of Myeloid and Lymphoid Neoplasia: A Review Article
Bone marrow neoplasia is a wide and diverse topic. Especially lymphoid and myeloid neoplasia, there is potential for confusion between them and their subtypes. This article aims to provides educational clarity and differentiation between lymphoid and myeloid neoplasia along with some of their subtypes. I searched databases like PubMed and Web of sciences along with the help of a reference book, Robins Basic pathology to achieve this goal. Articles were selected using a convenience sampling method without strict inclusion or exclusion criteria.
Comparison of Pregnant Ladies with and without Antenatal Care Booking and its Effect on Maternal and Fetal outcome
Early Antenatal Care (ANC) introduction and frequent visits lead to favorable mother and fetal outcomes. Pregnant women who attend ANC experience much lower morbidity and mortality rates than those who do not. A cross-sectional study was conducted among women in an age group of 20-40 years who delivered at Jinnah International and Women and Children Hospital Abbottabad from March till August 2024. Women were selected through convenience sampling and interviewed through a self-structured questionnaire. 100 women were recruited with a mean age group of 20-40 years. Out of which 57% of the women received ANC while 43% did not. Antenatal care was significantly associated with better maternal and fetal outcome (p=0.015 and p=0.000) respectively. There was no statistical association between age (p=0.239) and mother’s education (p=0.128) on maternal outcome while iron/folic acid intake (p=0.000) and pregnancy complications (p=0.013) showed a positive association with maternal outcome. In the case of fetal outcome, decreased fetal movements (p=0.003) showed an association with poor outcome while time of delivery (p=0.015) and availability of transport (p=0.000) showed an association with poor fetal outcome. It was concluded that un-booked pregnant females are at a greater risk of adverse fetal and maternal outcomes due to poor antenatal care and late coming of subjects with complications that can result in higher fetal and maternal mortality and morbidity than booked females.
Exploring Gut Phages as a Defense Mechanism Against Drug-Resistant Bacterial Infections
The human gut microbiota is a complex and dynamic ecosystem consisting of various microorganisms, including bacteria, viruses, fungi, and protozoa, that contribute to overall health. Among these, bacteriophages (phages) are viruses that specifically target and infect bacteria, playing a critical role in regulating microbial balance within the gut. In recent years, the rise of antibiotic-resistant bacterial infections has become a major global health challenge, largely attributed to the overuse and misuse of antibiotics. As a result, there has been growing interest in phages as a promising alternative to conventional antibiotics, particularly in combating drug-resistant infections. Phages offer several advantages, including their ability to selectively target specific bacteria, their rapid replication in the presence of host bacteria, and their potential to minimize disruption to the beneficial gut microbiota. Furthermore, phages may serve as a natural mechanism to restore microbial equilibrium in the gut, providing a novel strategy for treating infections that are difficult to manage with antibiotics. This manuscript examines recent research on gut phages, exploring their potential therapeutic applications, the mechanisms behind their bactericidal action, and their broader implications for human health, particularly in the context of rising antimicrobial resistance.
The Trend of Modifiable Risk Factors of Ischemic Heart Disease in Pakistan from 2000 To 2022
Ischemic Heart Disease is the leading cause of mortality in Pakistan. It is cause by myocardial ischemia. Most cases of myocardial ischemia are as a result of coronary artery atherosclerosis. There are Modifiable and nonmodifiable risk factors of atherosclerosis. Here we discuss the trend of modifiable risk factors in Pakistan from 2000 to 2022. A Secondary analysis was conducted to find the trend of Modifiable risk factors and its relation with ischemic heart disease in Pakistan from 2000 to 2022. For this purpose, Literature review was performed using google scholar and PubMed, Data on trends of these risk factors was obtained from WHO Pakistan website. The trend of modifiable factors of ischemic heart disease, namely Tobacco smoking, Obesity, Alcohol consumption and Hypertension has been increasing in Pakistan, except for Tobacco smoking. Proper preventive measures must be taken to counter this specific death rate. This may include mass Health education, Health promotion, Dietary changes, and lifestyle changes.
Examining the Autoimmune, Genetic, Environmental, and Microbial Aspects of the Complex Etiology of Inflammatory Bowel Diseases: A Comprehensive Review and Comparative Analysis
Inflammatory Bowel Disease is an autoimmune disease of the Colon and or ileum. The exact cause of the disease is unknown but there are many factors that may predispose a person, worsen or improve the condition of the patient. These include genetic, environmental, autoimmune and bacterial factors. Here we briefly discus each one of these factors. We used databases including PubMed, Google Scholar, Scopus, and Web of Science to conduct a thorough literature search for our analysis of Inflammatory Bowel Disease (IBD). Screening researches, reviews, and meta-analyses from the previous two decades was part of our methodology. Articles that provided substantial new insights into the etiology, clinical presentation, and treatment approaches of IBD were the main focus of our inclusion criteria. In order to compile the state of knowledge and new directions in IBD research, we also carefully gathered data from citations and cross-referenced them to locate more pertinent studies. Inflammatory bowel disease is an autoimmune condition the exact cause of which is still unknown. This highlights the intricate relationship that exists between the immune system, environment, and gut microbiota, as well as the need for advancements in the field to identify the precise cause of the illness under consideration and develop a treatment plan for it.
Stigma as a Barrier to Seeking Treatment for Dysmenorrhea - A Review
Painful menstruation, or dysmenorrhea, is a common gynecological state. It could be secondary to a uterine illness or primary, meaning it wouldn't have any linked illnesses. Menstruating individuals' quality of life is adversely affected by it. About half of all women who are menstruating suffer from dysmenorrhea, which leads to serious issues with personal and public health, significant rates of absenteeism from work and school, and substantial financial loss. Despite being fairly common, dysmenorrhea is frequently mistreated and ignored by medical professionals, pain experts, and even women themselves due to shame and menstrual stigma. The impact and repercussions of the stigma associated with menstruation are the main topic of this review. It also draws attention to the obstacles it presents to a proper diagnosis and course of therapy for dysmenorrhea.
Exploring Menstrual Hygiene Education and Awareness among Medical Students: A Cross-Sectional Study
Menstrual hygiene education is crucial for promoting women's health, yet misconceptions and cultural taboos persist, even among medical students. This cross-sectional study assessed menstrual hygiene knowledge, attitudes, and practices among 312 female MBBS students at Quaid-e-Azam Medical College (QAMC), Bahawalpur, to identify gaps and develop targeted educational interventions. Data was collected using a self-administered survey from February to March 2024. Results showed that 58% (n=181) of students had pre-menarche knowledge, primarily from mothers (74.7%, n=233). Sanitary pad usage was high (96.5%, n=301), but only 1.6% (n=5) used vaginal wash daily. Significant associations were found between the year of study and frequency of changing menstrual products (p = 0.019), menstrual cycle regularity (p = 0.004), and awareness of menstrual myths (p = 0.027). Awareness of myths was high (74.7%, n=233), yet 45.5% (n=142) of students faced menstrual restrictions. The findings highlight the need for enhanced menstrual hygiene education and resources to equip future healthcare providers with accurate knowledge and positive attitudes towards menstruation.
The Severity of Tooth Surface Loss in Adult Patients Presenting to a Private Dental Hospital
This study aimed to assess the severity of tooth surface loss (TSL) in adult patients at a private dental hospital for 6 months. This research explored the severity of TSL using the Smith and Knight Tooth wear index (TWI). Study participants underwent intraoral examination in dental chairs with adequate lighting using a mouth mirror. Prior to examination, sterile cotton swab was used to clean and dry the teeth and to eliminate any plaque residue. Each tooth surface (buccal, lingual, cervical and occlusal/incisal) were evaluated using the TWI and documented on the research proforma. Only the most affected teeth and teeth surfaces were noted in a patient. A total of 320 patients were observed between ages (18-40 years), out of which 140 had tooth wear according to TWI. The male patient had a ratio of 40.91% while female were 50.08%. The mandibular anterior teeth had score 2 in 97.1% of the patients and maxillary premolars had score 1 and 2 which were 96.4% and 92.9% respectively. The occlusal surface was involved in 58% of maxillary teeth and 100% in mandibular teeth. Our study indicates that the mandibular anterior occlusal surfaces are particularly susceptible to the impacts of tooth wear. This may lead to aesthetic concerns, exposure of pulp with advanced wear and occlusal imbalance, which will require extensive treatment. Hence, it is imperative to raise awareness among individuals regarding the early indicators and symptoms of tooth wear.
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Frequency of Refractive Errors in the Students of Khawaja Fareed University of Engineering and Information Technology, Rahim Yar Khan Punjab Pakistan
The purpose of this study was to find out the frequency of refractive errors in the students of Khawaja Fareed University of Engineering & Information Technology (KFUEIT), Rahim Yar Khan. A Cross-sectional university-based study was carried out from March 1, 2023, to May 19, 2023, at KFUEIT. All enrolled students from various disciplines at KFUEIT were included, except those who were not KFUEIT students or had undergone ocular surgery, or had preexisting other eye diseases, systemic diseases, or syndromes. Out of a total of 623 students representing various disciplines who participated in the study, 603 met the predefined inclusion criteria. Visual acuity testing, non-cycloplegic objective refraction, and subjective verification were performed to evaluate refractive error measurements. Data analysis was carried out using SPSS version 21, employing descriptive statistics, frequency calculations, and cross-tabulations. According to the results of the study, 179 students out of the 603, which is approximately 29.7%, had refractive errors. Myopia emerged as the most prevalent refractive error, affecting 25.2% of students, followed by astigmatism (3.0%) and hyperopia (1.5%). Gender analysis demonstrated a slightly higher prevalence of myopia among male students compared to females. Moderate myopia was the most prevalent severity level observed. Male students predominantly exhibited compound myopic astigmatism, while simple myopic astigmatism was more prevalent in females. Conclusion: Our study at KFUEIT found that 29.7% of the 603 students had refractive errors. These findings can guide interventions and policies for a visually healthy environment at KFUEIT.
Revolutionizing Prosthodontics with Artificial Intelligence: A Narrative review
The revolutionary impact of artificial intelligence (Al) on prosthodontics is addressed in this narrative review with focus on how it has changed the way patients are examined. Additionally, machine learning is used which aids in greater accuracy and customization when creating a treatment plan for the patient. Artificial intelligence (AI)-driven technologies are essential in the creation and manufacturing of prostheses and has improved computer-aided design (CAD) systems, making it easier to create customized, anatomically accurate prosthetic limbs. Apart from its practical uses Artificial Intelligence fosters an Ongoing investigation and advancement in the field of prosthodontics, as new materials, techniques, and treatment approaches are developed, Al system continuously incorporate lessons from real patient experiences, pushing the boundaries of what is possible in the field. To address the inherent difficulties in traditional approaches this paper explores a convincing case for using Al in decision making and treatment planning in prosthodontics. Through use of unique patient data to support evidence-based decisions treatment planning can become more precise and personalized by leveraging Al analytical powers. Furthermore, the incorporation of Al-powered technologies including CAD and 3D printing is being investigated as a way to optimize manufacturing process of different of prostheses. Al is playing a crucial role in molding the future of the discipline as highlighted by the ongoing research element. This article highlights the revolutionary potential of artificial intelligence (Al) in prosthodontics, providing a state of and patient-centered approach to dental care.
Correlation between Inter Canine Width and Skeletal Patterns in Orthodontic Patients
Dental arches vary among people according to tooth size, tooth position, pattern of craniofacial growth and by many genetic and environmental factors. The relationships between craniofacial morphology and malocclusion have long been of interest to orthodontists. The objective of this study was to assess how skeletal characteristics in orthodontic patients relate to intercanine width. The sample consisted of hundred good qualities lateral cephalogram and dental casts. Obtaining ethical approval from the research committee of Women Medical and Dental College demonstrates a commitment to conducting research in a responsible and ethical manner. This step ensures that the study respects accepted ethical standards and protects the rights and welfare of the participants Pre-treatment lateral cephalogram and manual study model with complete permanent dentition except third molars were used to record the measurements. Test subjects between the ages of 14 to 27 were chosen for conducting this study. The mean age of the participants coming out to be 19.62 ± 4.54 years. After running the correlation analysis, a very insignificant and weak although positive correlation was found between the UICW and N⊥A (p=0.705, ρ=0.038), and also between UICW and N⊥Pog (p=0.946, ρ=0.094). Inferring from the results of the study, it is concluded that the correlation between N⊥A and UICW, N⊥Pog and LICW is not a very significant one.
Pattern of Mandibular Third Molar Impaction in Patients from Twin Cities of Pakistan
When a tooth fails to erupt within its expected time window, it is called as impaction. Impaction of tooth can be due to multiple local and generalized reasons. Generalized factors are associated with multiple systematic disorders and syndromes including cleidocranial dysostosis, Down’s syndrome, amelogenesis imperfecta, osteopetrosis and achondroplasia. Local factors involved in the failure of eruption include lack of space, supernumerary teeth, odontogenic cysts and tumors, odontoma, ankylosis, existence of alveolar cleft and idiopathic factors such as primary failure of eruption. Mechanical obstruction are most frequently associated with the failure of eruption of permanent teeth. Most common impacted tooth is mandibular third molar which makes 98% of all types of impacted teeth1 followed be maxillary third molar, maxillary canine and mandibular second premolars. Mandibular third molars removal is performed due to multiple reasons including pain, swelling and other complications during and after eruption. Its extraction requires proper planning according to the angulation and position to avoid post-operative complication. The goal of the present study is to estimate patterns of mandibular impaction in patients from twin cities of Pakistan. So that surgeons can plan the surgery according to the patterns of impactions. A prospective survey was executed on patients visiting oral surgery section of Islamic International Dental Hospital, Islamabad from April 2018 to Feb 2019. Sample size was of 50 patients. Chosen Classifications were Pell and Gregory and Winters classification. Data examination was done through SPSS 23. The most frequent type of impaction is mesioangular in patients of twin cities. Third molar impaction is a public health concern. The most predominant category of impaction was level B and class 2, mesioangular impaction with a slight male prediction in twin cities of Pakistan. This study can help surgeons plan according to data and avoid complications.
The Evolving Landscape of Biosafety and Biosecurity: A Review of International Guidelines and Best Practices
Biosafety and biosecurity encompass the intersection of bioengineering and biotechnology, along with the evaluation and control of risks to human, animal health, and the environment. This link encompasses the danger created by research and its use, as well as research and application to reduce risk via bioengineering and biotechnology. High-level biosafety laboratories provide a secure and reliable setting, integrating robust containment measures, well-educated staff, and precise biosafety protocols to safeguard scientists from infections while working with microbial pathogens. Simultaneously, they prevent the accidental release of these pathogens into the surrounding environment. In recent decades, there has been the construction and operation of labs with different tiers of protection, the establishment of legal regulations and a laboratory biosafety management system, and these functional labs have played a crucial role in addressing newly emerging and recurring infectious diseases. This review article offers useful insights into the complicated environment of biosafety and biosecurity at both the national and international levels. It advocates for more international cooperation among states, organizations, and stakeholders to ensure the effective implementation of biosafety and biosecurity measures, fostering a safer and more secure global biotechnology landscape.