The Health Sciences AUS is a monthly, peer-reviewed, open-access academic journal founded in 2024, dedicated to advancing the fields of medicine and health sciences. Serving as an essential platform for the dissemination of innovative research and advancements, Health Science aims to enhance the understanding and application of medical and dental practices. With a commitment to evidence-based methodologies, the journal publishes original research articles, review papers, case reports, and clinical studies that contribute to healthcare knowledge at both local and global levels. Health Science fosters interdisciplinary collaboration, encouraging innovative solutions to contemporary health challenges. The journal provides a dynamic forum for academics, practitioners, and healthcare professionals to exchange ideas, stay informed about the latest developments, and actively contribute to improved healthcare outcomes. Upholding rigorous ethical standards in research and publication, Health Science ensures that all content is of the highest quality and relevance. By supporting both established and emerging scholars, Health Science seeks to promote the growth of medical and dental knowledge in Australia and beyond, making a significant impact on public health.
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Divergent Paths: A Comparison of Magnification Practices
Objective: This study was to compare the dental magnification practices and preferences of restorative and endodontic dentists. It aimed to measure how often different clinical procedures were used. The study also sought to determine the most popular kinds of magnification equipment. Lastly, it evaluated how clinical results and musculoskeletal health were thought to be affected by magnification. Method: From September 2024 to September 2025, a cross-sectional study was carried out at the Dr. Ishrat ul Ibad Khan Institute of Oral Health Sciences. A selected sample of certified endodontists and restorative dentists received a validated questionnaire. We gathered information on preferences, therapeutic applications, device usage, and demographics. Descriptive and inferential statistics were used in the statistical analysis conducted with SPSS version 26.0. Result: Restorative dentists employed loupes more frequently, mainly for operations like crack diagnosis and caries eradication. In complicated procedures like canal obturation and perforation repair, the use of magnification was a significant factor (p<0.05) determining reported outcomes. Additionally, there was a significant favorable association found between the usage of magnification and a decrease in musculoskeletal pain. Conclusion: Endodontists use high-magnification tools, such as the microscope, more frequently. In order to improve accuracy and ergonomics, magnification must be widely used. The results support the inclusion of integrated magnification training in postgraduate programs in order to standardize high-quality care.Due to procedural requirements, there is a significant difference in the two specialties' magnification procedures.
Endodontics, restorative dentistry, dental magnification, surgical loupes, dental operating microscopes,clinical procedures.
Copyright (c) 2025 mudasar shah (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Gender Disparity in Medical Specializations: The Overrepresentation of Female Doctors in Gynecology and the Need for Diversification in Pakistan: Review Study
In Pakistan, particularly in Khyber Pakhtunkhwa (KPK), cultural and religious norms often restrict women from seeking medical treatment from male doctors, especially in sensitive specialties. Despite this, a disproportionate number of female doctors choose gynecology over other critical fields such as surgery, diabetology, hematology, orthopedics, and urology. This paper examines the factors driving this trend, including societal expectations, institutional biases, and lack of mentorship in non-traditional specialties. A mixed-methods approach was used, combining surveys of female medical students and practitioners with an analysis of specialization trends in KPK hospitals. The findings reveal that while cultural restrictions necessitate more female doctors in all specialties, systemic barriers discourage women from pursuing non-gynecological fields. Policy recommendations include targeted scholarships, mentorship programs, and awareness campaigns to encourage female doctors to diversify their specializations.
Female doctors, medical specialization, gender disparity, gynecology, Pakistan, KPK
Copyright (c) 2025 shabana tahir (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Intralesional Triamcinolone Acetonide in the Management of Acne Keloidalis Nuchae
Background: Acne keloidalis nuchae (AKN) is a chronic, scarring folliculitis that predominantly affects the occipital scalp and posterior neck, leading to significant cosmetic and psychological morbidity. Current treatment remains challenging, and recurrence is common. Objective: This article reviews the efficacy and safety of intralesional triamcinolone acetonide (ILTA) in AKN and presents clinical insights into its application as a practical, cost-effective therapy. Methods: A comprehensive review of the literature was undertaken using PubMed, Google Scholar, and regional databases. In addition, case experiences from patients treated with ILTA injections at a dermatology practice in Pakistan are highlighted. Results: ILTA demonstrates significant efficacy in reducing inflammation, pruritus, and lesion size, with high patient satisfaction. Side effects such as atrophy and hypopigmentation are rare when administered at appropriate concentrations. Combination approaches (ILTA with antibiotics, laser, or surgery) further improve long-term outcomes. Conclusion: ILTA is a cornerstone therapy for AKN, offering a safe and effective treatment option when delivered using proper technique and dosage.
Acne keloidalis nuchae; Intralesional triamcinolone; Keloid; Corticosteroid injection; Dermatology
Acne keloidalis nuchae; Intralesional corticosteroids; Triamcin
Dermatology; Clinical Medicine; Pharmacology; Surgery; Aesthetic Medicine
Copyright (c) 2025 Dr. Annas Sani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
S Rahba “Empowering Parents of Children with Cerebral Palsy: Impact of the Fav-Words Framework in Pakistan”
Childhood disability in Pakistan exists within a complex socio-cultural matrix where stigma, silence, and misperception often overshadow the actual needs and potential of children with developmental disorders, such as cerebral palsy. In such contexts, parental understanding tends to be shaped by deficit-based perspectives emphasizing what the child cannot do rather than recognizing inherent abilities or future possibilities. This study set out to challenge these perceptions by introducing parents to the F-words for Child Development framework, a strengths-based approach grounded in the ICF model, which centers on Function, Family, Fitness, Fun, Friends, and Future. Through a structured intervention that included awareness sessions and pre- and post-intervention interviews, the research illuminated a profound shift in how parents began to perceive their children’s disabilities. Thematic analysis revealed that the F-words framework not only reframed disability as an opportunity for growth and participation but also encouraged families to reimagine their caregiving roles. From initial expressions of grief, guilt, and helplessness, many parents evolved toward a language of empowerment, agency, and hope placing the child’s strengths and aspirations at the heart of caregiving narratives. These findings underscore the transformative potential of contextually sensitive interventions that focus on capacity rather than limitation. By engaging with the F-words framework, parents were not simply informed; they were inspired. Their narratives moved from silence to advocacy, from marginalization to inclusion. This change was not just cognitive it was deeply emotional and relational, fostering a renewed sense of purpose and possibility within the family system. In a country where cultural beliefs and limited rehabilitative infrastructure often hinder progress, this study affirms that transformative change can begin with something as fundamental as a shift in perspective. When families are given the tools to reframe disability through a lens of dignity, strength, and potential, the ripple effects extend beyond the child to society at large. The F-words framework, thus, emerges as a powerful catalyst for inclusive thinking one that challenges stigma and builds pathways toward holistic well-being.
F-words, disability, cerebral palsy, Pakistan, parental empowerment, family-centered care, qualitative research, inclusion, child development, thematic analysis
Parental Empowerment, Strength-Based Perspective , Cultural Reframing, Hope for the Future, Therapy Beyond Clinics.
Copyright (c) 2025 rahba sani (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
ADVANCEMENTS IN MINIMALLY INVASIVE TECHNIQUES: REVOLUTIONIZING POSTOPERATIVE RECOVERY IN COLORECTAL SURGERY
OBJECTIVE: This study evaluates advancements in minimally invasive techniques (MITs) and their impact on postoperative recovery in colorectal surgery patients METHOD: A retrospective cohort study was conducted at Khyber Teaching Hospital, Peshawar, from January 2024 to December 2024. Patients undergoing MITs were compared to those treated with conventional methods regarding postoperative outcomes, focusing on recovery times, complication rates, and patient satisfaction. RESULT: A total of 200 patients were analyzed. MITs showed a significant reduction in recovery times and complication rates compared to conventional methods. Key metrics, such as satisfaction scores and pain relief levels, indicated superior outcomes for MITs. CONCLUSION: MITs represent a revolution in colorectal surgery, enhancing postoperative recovery and reducing complications. Continued adoption and refinement of these techniques are essential for improving patient care
Copyright (c) 2025 dr fazliwadud (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Future of Doctors in Pakistan: Healthcare Corruption and Underdevelopment Crisis
Pakistan's healthcare system faces a severe crisis due to systemic corruption, underfunding, and brain drain of medical professionals. Doctors, who are essential for national health security, struggle with inadequate infrastructure, political interference, and unethical practices that compromise patient care. This paper examines the impact of corruption on medical practice, the challenges faced by doctors, and the future of healthcare in an underdeveloped system. Using a mixed-methods approach, including surveys of physicians and analysis of healthcare policies, this study highlights how corruption worsens health inequities and forces skilled doctors to emigrate. Recommendations include anti-corruption reforms, increased healthcare funding, and incentives to retain medical talent.
Healthcare corruption, medical brain drain, Pakistan health crisis, doctor’s future, underdevelopment
Copyright (c) 2025 Muhammad danyal khan (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Adverse Reactions to Ringer’s Lactate Infusion: The Role of Poor Dietary Habits in Fast-Food-Dependent Populations
Ringer’s lactate (RL) is a widely administered crystalloid solution for fluid resuscitation and maintenance therapy. Although generally considered safe, emerging case reports document adverse reactions, including metabolic disturbances and electrolyte imbalances. This study investigates the potential link between RL-related complications and poor dietary habits, particularly high fast-food consumption and inadequate vegetable intake. We present three clinical cases demonstrating RL-induced hyperkalemia, metabolic alkalosis, and lactate intolerance in patients with nutritionally deficient diets. Our findings suggest that chronic fast-food dependence—characterized by excessive sodium, low potassium, and micronutrient deficiencies—may predispose individuals to RL-associated complications. Clinicians should evaluate dietary history when selecting intravenous fluids, particularly in metabolically vulnerable patients. Further research is needed to establish dietary guidelines for fluid therapy in high-risk populations.
Ringer’s lactate, adverse drug reactions, fast food, metabolic alkalosis, hyperkalemia, malnutrition
Human Rights Violations and the Future of Doctors in Pakistan: A Case Study of Land Mafia and Institutional Corruption
This paper presents a comprehensive examination of systemic human rights violations in Pakistan, focusing on two critical issues: illegal land occupation by politically powerful elites and the deteriorating state of the healthcare system. Through a personal case study involving the illegal seizure of ancestral property by a sitting senator and subsequent police inaction, this study reveals deep-rooted institutional corruption. Parallel to this, the paper analyzes the crisis facing medical professionals in Pakistan, where unemployment among doctors coexists with severe shortages in public healthcare facilities. The study employs a mixed-methods approach, combining personal narrative with analysis of legal frameworks, statistical data, and comparative studies. Findings demonstrate how weak governance, judicial inefficiency, and elite capture have created a system where fundamental rights are routinely violated, and professionals face diminishing opportunities. The paper concludes with policy recommendations aimed at land reform, judicial restructuring, and healthcare system revitalization.
Human rights, institutional corruption, land mafia, healthcare crisis, judicial reform, Pakistan
Clinical Hematology in Khyber Pakhtunkhwa, Pakistan: A Crisis of Workforce, Infrastructure, and Ethics
Khyber Pakhtunkhwa (KPK) faces a dire hematology crisis with only 3 specialists for 40 million people—0.075 hematologists per million, 85% below WHO standards. This paper combines workforce analysis, policy review, and patient outcome data to expose systemic failures: (1) non-specialists ("pathology mafia") controlling 72% of hematology care, (2) zero dedicated bone marrow transplant (BMT) units, and (3) Rs. 0 allocated for hematology in KPK's 2019 health plan. We propose a 5-year action plan including immediate OPD expansions and long-term BMT center development. Keywords: Hematology workforce, Pakistan healthcare corruption, thalassemia care, health policy reform
Hematology workforce, Pakistan healthcare corruption, thalassemia care, health policy reform
Copyright (c) 2025 Irsa Hidayat (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Joint Liver-Kidney Transplantation for Primary Hyperoxaluria and Other Metabolic Conditions
Combined liver-kidney transplantation (CLKT) represents a pivotal therapeutic advancement in the management of metabolic disorders, particularly primary hyperoxaluria type I (PH-I), a rare autosomal recessive condition resulting in systemic oxalosis and end-stage renal disease (ESRD). This review synthesizes clinical evidence from key studies, including the University of Kansas Medical Center and international registries, to assess the efficacy, outcomes, and current management strategies associated with CLKT in PH-I and other metabolic diseases. CLKT effectively corrects the underlying hepatic enzymatic deficiency and restores renal function, significantly improving patient and graft survival rates compared to kidney-alone transplantation, which is often compromised by recurrent oxalate deposition. The review outlines perioperative management strategies such as intensive dialysis, high-volume diuresis, and pyridoxine therapy, and highlights critical considerations like timing of transplantation, oxalate mobilization, and immunosuppressive regimens. Despite ongoing challenges, including persistent post-transplant hyperoxaluria and risk of graft rejection, CLKT remains the gold standard for pyridoxine-unresponsive PH-I. Emerging approaches such as gene therapy, improved diagnostic tools, and personalized treatment protocols offer promising avenues for future care.
Copyright (c) 2025 Abdullah Ishtiaq (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
KPK physicians' contentment with their jobs
Assess physician and student burnout and job satisfaction among KPK physicians. Analyse the differences in workplace barriers according to designation and gender. Identify the systemic factors affecting career opportunities and mental wellbeing. Method: 218 participants in a cross-sectional research study conducted at kpk from January to May 2025. Employed validated surveys on job satisfaction, burnout, and worries. Furthermore, this Data was analysed using ANOVA (SPSS v26) and t-tests with a significance level of p<0.05. Result: Males were more inclined to remain in Pakistan (p=0.027), whereas females felt less workplace security (p=0.002). Burnout (1.47±0.50) and anxiety about unemployment were highest among medical students (p=0.009). Salary discontent did not differ by gender (p=0.566). Conclusion: At KPK, hierarchy and gender greatly influence job satisfaction. Workplace safety precautions and mental health support are urgently needed. The results are consistent with issues related to physician well-being in resource-constrained environments worldwide.
Physician burnout, Gender disparities, Workplace security, Job anxiety, Pakistan healthcare
Copyright (c) 2025 abdullah khan (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The impact of hospital admissions for infected diabetic foot ulcers at Hayatabad Medical Complex
.Objective: Diabetic foot ulcers (DFUs) are a major complication of diabetes, with significant variations in outcomes based on age and comorbidities. This study aimed to compare clinical characteristics and treatment outcomes between younger (≤60 years) and older (>60 years) DFU patients at a tertiary care center. Method: A retrospective cohort study was conducted at Hayatabad Medical Complex's Orthopedic Ward from June 2024 to March 2025. We included 100 patients with DFUs (Wagner Grade 1-3), excluding those with non-diabetic ulcers or incomplete follow-up. Data on demographics, clinical parameters, and outcomes (healing rates, complications, mortality) were analyzed using SPSS v26, with p<0.05 considered significant. Result: The cohort (mean age 65±9.5 years, 60% male) showed significant differences between age groups. Older patients had higher BMI (31.4 vs 26.7 kg/m², p<0.01) and mortality (7.5% vs 1.7%, p=0.05). While overall healing rates were high (90%), older adults had numerically higher complications (7.5% vs 3.3%, p=0.23) and rehospitalization rates (10% vs 6.7%, p=0.55). Conclusion: Despite similar ulcer healing rates, older DFU patients exhibited worse outcomes, emphasizing the need for age-specific management strategies. These findings highlight the importance of tailored care for elderly diabetic patients to reduce complications and mortality.
Copyright (c) 2025 dr rashid khan (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Role of Vitamin D Supplementation in orthopedic trauma patients
This randomized controlled trial evaluated the effects of vitamin D supplementation on disease activity in trauma patients with baseline vitamin D deficiency at Hayatabad Medical Complex's Orthopedic Ward from July 2024 to March 2025. A total of 150 patients with bike trauma, firearm trauma, or history of falls were equally divided into supplemented (n=75) and control (n=75) groups. The supplemented group received 50,000 IU vitamin D3 weekly for 8 weeks followed by 2000 IU/day maintenance, while controls received standard care. Results demonstrated significantly greater reductions in disease activity scores in supplemented patients across all trauma types: bike trauma (2.4 vs 1.0, p=0.04), firearm trauma (1.6 vs 0.7, p=0.03), and history of falls (1.1 vs 0.5, p=0.05). The supplemented group also showed more stable outcomes (SD=0.7) compared to controls (SD=0.9) and achieved substantial increases in vitamin D levels (14 to 46 ng/mL) versus minimal change in controls (16 to 17 ng/mL). These findings indicate that vitamin D supplementation significantly improves disease activity and reduces clinical variability in trauma patients, supporting its potential role in orthopedic rehabilitation protocols for vitamin D-deficient individuals.
Vitamin D supplementation, trauma patients, disease activity, orthopedic rehabilitation
Copyright (c) 2025 dr inzimam chughtai (Author); Dr Muhammad Abbas (Translator) https://creativecommons.org/licenses/by-nc-nd/4.0
Evaluating the Role of Automated Fact-Checking (AI) in Combating Health Misinformation and Strengthening Policy Effectiveness: A Comparative Study of Government Hospitals in Australia and Pakistan
Health misinformation poses a significant threat to public health, particularly during crises such as pandemics. Automated fact-checking systems powered by artificial intelligence (AI) have emerged as vital tools in detecting and countering false health claims. This study evaluates the role of AI-driven fact-checking in combating health misinformation, comparing its implementation and effectiveness in government hospitals in Australia and Pakistan. While Australia has integrated AI into its national health communication strategies, Pakistan faces challenges due to limited digital infrastructure and policy gaps. Through a comparative analysis, this article assesses the strengths, limitations, and policy implications of AI fact-checking in these two contrasting healthcare systems. The findings suggest that while AI can significantly reduce misinformation, its success depends on governmental support, digital literacy, and healthcare infrastructure. Policy recommendations are provided to optimize AI fact-checking in diverse healthcare settings.
Artificial Intelligence, Fact-Checking, Health Misinformation, Public Health Policy, Australia, Pakistan
Copyright (c) 2025 dr saad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
"Involvement of Paranasal Sinuses in Patients with Bilateral Nasal Polyps: A cross-sectional descriptive Study "
Objective: To determine the frequency of paranasal sinus involvement in patients with bilateral nasal polyps aged 20–50 years using a validated self-structured questionnaire and radiological imaging. Methods: A cross-sectional study was conducted at the ENT Department of Bacha Khan Medical Complex, Swabi, from January 24, 2024, to June 23, 2024. A sample size of 50 patients was selected using a convenient sampling technique. Data were collected using a pre-tested, validated questionnaire, and sinus involvement was assessed via CT scans. Descriptive statistics were analyzed using SPSS version 26. Results: Among 50 patients, 72% (n=36) were male, and 28% (n=14) were female. The 20–25 age group constituted 30% (n=15) of the sample. Maxillary sinus involvement was most common (36%), followed by ethmoid (26%), frontal (26%), and sphenoid sinuses (18%). Bilateral maxillary sinus involvement was observed in 40% of patients. Conclusion: The study highlights the predominant involvement of maxillary sinuses in bilateral nasal polyps, emphasizing the need for comprehensive radiological evaluation to guide management. The findings align with existing literature but underscore the need for larger, randomized studies to improve generalizability.
Bilateral nasal polyps, maxillary sinuses, ethmoid sinuses, frontal sinuses, sphenoid sinuses, CT scan
The Role of Vitamin D Supplementation in Managing Autoimmune Disorders in Women Implications for Gynecological Health.
Background: The function of vitamin D in the human body was found to be critical for immune regulation, and the deficiency in vitamin D has been seen to cause several autoimmune diseases; most gynecological conditions often affect women. Thus, growing evidence shows that vitamin D might be effective for immunological disorders including SLE, RA and thyroid autoimmune diseases. This paper focuses on the impact of vitamin D administration on inflammation in autoimmune disease female patients to better understand better patient outcomes as well as gynecological implications. Objectives: To assess the effect of vitamin D on disease activity in female autoimmune disease patients and to establish possible advantages of vitamin D in managing gynecologic health extenuated autoimmune complications. Study design: A Cross sectional study. Duration and place of study. The department of Obs & Gynae and Surgical Unit from jan 2023 to Dec 2023 Methods: 150 women of childrearing age with a doctor’s diagnosis of an autoimmune disease: SLE, RA, or autoimmune thyroid disease. Participants were divided into two groups: One group of patients was given 1000 IU of vitamin D daily while the others were not. DAS at 28 and vitamin D at baseline and after One Year of intervention were compared. Scoring systems were used according to SLEDAI for SLE and DAS28 for RA; results were analyzed by SPSS version 24.0. Results: 150 women consumers of vitamin D had lower disease activity scores than the control group. The mean SLEDAI score reduction for SLE was 2.3 ± 0.7 in the supplemented group, and 1.0 ± 0.6 in the controls (p=0.03). DAS28 was reduced in RA patients at the end of supplementation 1.5 ± 0.3 in the supplemented group compared with controls 0.7 ± 0.4 (p = 0.02). The level of standard deviation for disease activity was relatively low, 0.6 in the supplemented group and 0.8 in the control group, indicating that vitamin D helps to reduce the variability of the disease. Conclusion: vitamin D supplementation modulated autoimmune disease activity: implications for gynecologic disorders. It is important to learn how to maintain normal serum vitamin D concentrations in order to better treat autoimmune diseases, enhance the patient’s quality of life and strengthen the immune response. This indicates that predicting and attending to the needs of vitamin D could turn out to be a routine for females with auto-immune diseases.
Calcium-D-vitamin, autoimmunpatologi, gynecology, supplementvoeding
" Neurosurgical Emergencies in mardan medical complex: A Cross-Sectional Study"
Objective: To analyze the age-related variations in neurological emergencies, including spinal cord injury, epidural hematoma, subdural hematoma, and traumatic brain injury, and to assess their clinical significance across different age groups. Method: A retrospective analysis was conducted on patients with neurological emergencies, categorized into three age groups: 17–25, 25–35, and 35–42 years. The frequency of spinal cord injury, epidural hematoma, subdural hematoma, and traumatic brain injury was compared across age groups using statistical analysis, with significance determined by p-values. Result: Spinal cord injury was most common in the 25–35 age group (73.4%), but no significant difference was observed between age groups (p = 0.99). Epidural hematoma and subdural hematoma showed significant age-related differences (p = 0.001 and p = 0.016, respectively), with increasing prevalence in older age groups. Traumatic brain injury was most frequent in the 17–25 age group (17.5%), absent in the 25–35 age group, and reemerged in the 35–42 age group (13.3%) (p = 0.001). Conclusion: The study highlights significant age-related variations in neurological emergencies, with older individuals being more susceptible to epidural and subdural hematomas, while younger individuals have a higher incidence of traumatic brain injuries. Spinal cord injuries showed no significant difference across age groups. These findings emphasize the need for targeted prevention and age-specific management strategies to improve clinical outcomes.
Neurological emergencies, spinal cord injury, epidural hematoma, subdural hematoma, traumatic brain injury, age-related variations, neurotrauma management.
OUTCOME OF PROCEDURE AT SPINE WITH THEIR COMPLICATIONS
Objective: To evaluate the outcomes and complications associated with corpectomy procedures for spinal pathologies, focusing on neurological improvement, levels of disease involvement, and postoperative complications in patients treated at the Neurosurgery Ward, Mardan Medical Complex. Method: This retrospective observational study was conducted at the Neurosurgery Ward of Mardan Medical Complex. Patients undergoing corpectomy for spinal pathologies involving the thoracic spine (D4-D12) were included. Data were collected on demographic characteristics, preoperative and postoperative neurological status (Frankle grading), surgical procedures performed, and associated complications such as CSF leaks, mortality, and neurological deficits. Surgical procedures included corpectomy with cage fixation, corpectomy with bone graft fixation, and corpectomy without fusion. Patients with prior spinal surgeries or incomplete follow-up records were excluded. The primary outcomes measured were postoperative Frankle grading, procedure types, and complications. Result: A total of 39 patients were included in the study, with disease distribution at D4-D8 (43.8%) and D9-D12 (56.2%). The most common procedure performed was corpectomy with cage fixation (90.47%). Postoperative outcomes demonstrated significant neurological improvements, with Frankle A grading reducing from 5.3% preoperatively to 0.25% postoperatively, and Frankle E improving from 7.8% to 18.4%. However, complications included CSF leaks (8.3%), one mortality (4.26%), and one case of severe neurological deficit (2.63%). Conclusion: Corpectomy with cage fixation is a highly effective procedure for managing thoracic spine pathologies, leading to substantial neurological improvement and structural stability. Despite the low rates of severe complications, vigilance in perioperative management and advanced surgical techniques are essential to further reduce risks and optimize patient outcomes.
corpectomy, cage fixation, Frankle grading, CSF leak, spinal surgery complications, neurological improvement.
Surgical Site Infections Following Orthopaedic Trauma Surgery
Objecticve: To evaluate the impact of age, diabetes, hypertension, and surgical site infection (SSI) on postoperative complications in surgical patients. Method: A retrospective analysis of surgical patients was conducted, assessing age, diabetes, hypertension, and SSI as potential risk factors for postoperative complications. Data were analyzed using statistical tests to determine significance levels. Result: The study found that SSI was significantly associated with surgical complications (p<0.001), whereas age, diabetes, and hypertension did not show statistically significant associations. Younger patients (20-39 years) had a higher complication rate (24%) compared to older patients (>40 years, 12.3%), though this was not significant (p=0.101). Conclusion: Surgical site infection is a critical determinant of postoperative complications, emphasizing the need for stringent infection control measures. While age, diabetes, and hypertension did not show significant associations, targeted interventions for infection prevention remain crucial. Future research should explore antimicrobial strategies and optimized perioperative care to reduce SSI-related complications.
Surgical site infection, postoperative complications, diabetes, hypertension, antimicrobial strategies, perioperative management.
Risk Factors For Deep Surgical Site Infections Following Orthopaedic Trauma Surgery
Background: Surgical site infections (SSIs) represent a major concern in orthopedic surgery, leading to prolonged hospital stays, increased healthcare costs, and potentially life-threatening complications. SSIs are particularly common in patients with severe fractures, such as those classified by the Cauchoix grading system, where the risk of infection is heightened due to the complexity of the injury and the surgical intervention required. Factors such as nutritional status, diabetes, smoking, and the use of external fixators contribute to the development of SSIs. This study, conducted at Bacha Khan Medical Complex, Mardan, seeks to identify the clinical and laboratory markers that can predict SSIs in patients undergoing orthopedic fracture management, thereby helping to reduce the incidence and severity of these infections. Method: This prospective cohort study was conducted from January 2024 to December 2024 at the orthopedic ward of Bacha Khan Medical Complex, Mardan. A total of 207 patients who underwent surgery for fractures were included in the study. Inclusion criteria were patients over the age of 18 years undergoing orthopedic fracture surgery. Exclusion criteria included patients with pre-existing infections, immunocompromised conditions, or those who underwent emergency surgeries. Data was collected on patient demographics, fracture grade (Cauchoix classification), laboratory markers (hemoglobin, lactate levels, creatinine, glycemia, and arterial oxygen levels), and the use of external fixators. Statistical analysis was performed using SPSS, and predictive models for SSI development were created based on these parameters. Result: Fractures classified as Cauchoix grade 3 were associated with a higher incidence of SSIs (47%). Polymicrobial infections were found in 64% of the SSI cases, with gram-positive cocci, including Staphylococcus aureus, being the most common pathogens (72%). A predictive model with an AUC of 0.80 and a negative predictive value of 95.9% was developed. The significant risk factors for SSI development included low hemoglobin, maximum lactate levels, minimum arterial oxygen levels, and high glycemia levels. The use of external fixators was linked to a higher risk of infection in 38% of the SSI cases. Conclusion: Cauchoix grade 3, and laboratory markers such as lactate levels and glycemia were strongly associated with an increased risk of infection. The developed predictive model with high sensitivity and specificity could aid in early identification of at-risk patients, allowing for targeted preventive measures and potentially reducing the incidence of SSIs in orthopedic trauma care. Future research should focus on refining this model and assessing the effectiveness of preventive strategies based on these predictive factors.
Surgical Site Infection (SSI), Orthopedic Surgery, Fracture Classification, Cauchoix Grade 3, Predictive Model, Risk Factors, External Fixator, Polymicrobial Infection, Gram-positive Cocci, Lactate Levels, Glycemia, Hospital Mortality, Bacha Khan Medical Complex.
Copyright (c) 2025 dr Abdus Samad (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Advantages Of Skin Closure With Staples In Orthopedic Surgery At Mardan Medical Complex
Background: Wound closure is a fundamental aspect of surgery that impacts recovery, cosmetic outcomes, and postoperative complications. Among various closure techniques, sutures and staples are widely used, each with distinct advantages and limitations. Sutures offer precision and adaptability, while staples are valued for faster application and reduced surgical time. Despite their widespread use, comparative studies evaluating their effectiveness in orthopedic surgeries remain limited. Previous research highlights variability in outcomes such as infection rates, wound healing, and patient satisfaction across surgical settings, emphasizing the need for specialty-specific data. This study focuses on orthopedic wound closure, aiming to provide evidence-based insights for optimizing patient care. Method: This prospective observational study was conducted in the orthopedic ward of Bacha Khan Medical College, Mardan, from January 2024 to December 2024. A total of 120 patients undergoing surgical wound closure with either sutures or staples were included. Patients aged 22–60 years were eligible, while those with pre-existing wound infections, immune deficiencies, or incomplete medical records were excluded. Data collection involved demographic details, clinical outcomes, and postoperative follow-ups. Key parameters included skin closure time, infection rates, wound discharge, necrosis, hypertrophic scar formation, and cosmetic outcomes. Statistical analyses were performed to compare outcomes between the two groups, with a p-value of <0.05 considered significant. Result: A total of 120 patients (mean age: 42 years; 68 males, 52 females) were evaluated. The mean skin closure time was significantly shorter with staples (5.2 ± 0.9 minutes) compared to sutures (12.6 ± 1.5 minutes; p < 0.0001). Complication rates, including wound infections (6.6% in sutures vs. 3.3% in staples; p = 0.647), wound discharge (3.3% in both groups; p = 1.000), and hypertrophic scar formation (3.3% in sutures vs. 1.6% in staples; p = 1.002), were comparable. Wound necrosis occurred in 1.6% of suture cases but was absent in the staples group (p = 1.000). These findings indicate that staples offer faster skin closure without increasing complication rates. Conclusion: Staples demonstrated a significant advantage in reducing skin closure time compared to sutures while maintaining comparable rates of complications such as infections and wound discharge. These results suggest that staples may be a preferable option for orthopedic wound closure, particularly in scenarios prioritizing efficiency. However, further studies are warranted to evaluate long-term outcomes and patient satisfaction comprehensively.
Orthopedic wound closure, sutures, staples, postoperative outcomes, skin closure time, wound complications, infection rates, cosmetic results.
ADVANCES IN NON-SURGICAL INTERVENTIONS FOR UTERINE FIBROIDS: PATIENT-CENTERED OUTCOMES AT MARDAN MEDICAL COMPLEX
OBJECTIVE: Uterine fibroids significantly affect the quality of life of women, with symptoms including excessive bleeding, pain, and infertility. Non-surgical interventions have emerged as effective alternatives to invasive procedures like hysterectomy.To evaluate the outcomes of non-surgical interventions for uterine fibroids, including symptom severity, fibroid size reduction, and patient satisfaction, at Mardan Medical Complex, with a focus on patient-centered outcomes. METHOD: this study was conducted after ethical aproval at gynea b ward mardan medical complex.the study assessed demographic data, clinical characteristics, and treatment outcomes, including symptom relief and quality-of-life measures. data were statistically analyzed using descriptive and inferential methods, with significance determined at p < 0.05. RESULT: This study analyzed data from 150 patients receiving uterine artery embolization (UAE), focused ultrasound surgery (FUS), and pharmacological therapy. UAE showed the highest symptom reduction (60%), followed by FUS (50%) and pharmacological therapy (40%). Size reduction was consistent across all modalities, with no statistically significant differences observed (p>0.05). CONCLUSION:Non-surgical approaches such as UAE and FUS are effective and patient-centered alternatives for managing uterine fibroids. Tailored treatments are critical for optimizing patient satisfaction and clinical outcomes.
Uterine fibroids, Non-surgical interventions, Uterine artery embolization, Focused ultrasound surgery, Patient outcomes
Copyright (c) 2025 dr hemasa gul (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
The Role of Artificial Intelligence in Diagnosing and Managing Chronic Diseases: A Paradigm Shift
BACKGROUND: To evaluate the impact of artificial intelligence (AI) on diagnosing and managing chronic diseases, focusing on its efficacy in improving patient outcomes and reducing healthcare burdens. METHOD: This observational study was conducted at Mardan Medical Complex from January 2024 to December 2024. Data analysis incorporated patient characteristics, diagnostic accuracy, and management outcomes facilitated by AI, comparing AI-based and conventional approaches. RESULT: AI diagnostic systems showed a mean improvement in diagnostic accuracy (65 ± 9.5) compared to traditional methods (55 ± 4.8), with significant reductions in symptom severity scores (AI: 28.5 ± 4.3, Traditional: 31.4 ± 4.6; p < 0.01). Treatment satisfaction rates were higher in AI-supported interventions (70%) compared to manual methods (67%, p = 0.45). CONCLUSION: AI represents a transformative approach in chronic disease management, enhancing diagnostic precision, symptom relief, and patient satisfaction. Its integration into healthcare systems heralds a paradigm shift toward personalized medicine.
Artificial Intelligence, Chronic Disease, Diagnostics, Management, Healthcare Technology
Outcome of surgical site infection following inguinal hernia closure
Objective: This study's goal is to look into how inguinal hernia surgery patients respond to surgical site infections (SSIs). The purpose of the study is to examine the association between the prevalence of SSIs and demographic factors such as age, body mass index (BMI), habitation type (urban/rural), presence of diabetes mellitus and hypertension, degree of education, length of hospital stay, and length of surgery. Methods: Patients who underwent inguinal hernia closure surgeries were included in this retrospective analysis, which was carried out in a medical facility. A patient's demographics, BMI, type of habitation, diabetes and hypertension status, education level, length of hospital stay, length of operation, and presence or absence of surgical site infections were all collected from their medical records. To evaluate the patient population's characteristics and the prevalence of SSIs, data analytic techniques included frequency distribution and percentage calculation. In order to identify correlations between factors and the occurrence of SSI, statistical tests were run. Results: The study involved all of the patients. The age distribution displayed 35.1% in the 20–30 age, 21.1% in the 40–50 age, and 43.9 % in the 40–50 age. BMI categories were revealed with BMIs of 20–23, 23–25, and 25–28. Participants who lived in cities made up 22(29.7%) of the group, whereas participants who lived in rural areas made up 35.1 %. Diabetes mellitus was more common than hypertension 23 (20.2%) vs. 17(14.9%). The distribution of education levels was as follows: 17(14.9 %) with no education, 46 (40.4%) with SSC-level education and 51(44.7%) with HSSC or higher education. Hospital stays lasting 1-3 days in 55 (48.2%) of cases and 3-6 days in 59 (51.8%) of cases, respectively. There were two categories for operation length: 1-3 months 59(51.8%) and 3-6 months 55 (48.2%). 22 (19.3%) of cases had surgical site infections, while 92 (80.7%) of cases had no infections at all. Conclusion: The results of surgical site infections after inguinal hernia closure are clarified by this investigation. The frequency of SSIs highlights the significance of strict infection control procedures. Further investigation is required to determine the association between demographic factors and the prevalence of SSI. These findings have implications for post-operative care plans and surgical protocols that aim to reduce the risk of SSIs and improve patient outcomes. To fully comprehend the multifactorial nature of SSIs in inguinal hernia closure surgeries, additional study is required.
inguinal hernia, surgical site infection, diabetes, hypertension, age
Copyright (c) 2024 dr fazliwadud (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Audit, Transparency, and Future Directions for the Sehat Card Plus Program: Insights and Recommendations
The Sehat Card Plus program in Khyber Pakhtunkhwa (KP), Pakistan, launched to provide free healthcare services, has faced growing demand as it now extends from inpatient (IPD) to outpatient (OPD) services. Despite its transformative potential, the program struggles with transparency, resource allocation, and accountability issues that compromise service delivery and patient outcomes. This study critically examines the program’s operational challenges using data from various healthcare facilities across KP, highlighting significant shortages in medical equipment, inadequate fund distribution, and inefficiencies within the program’s administrative processes. Recommendations for stricter audit protocols and improvements in operational transparency are provided to enhance the program’s effectiveness
Copyright (c) 2024 Ammad Ali, Dr Saad Ali, Dr Isra Hidayat (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Editorial: The Future of Family Medicine as a Specialty in Pakistan
Globally, family medicine is considered the foundation of primary healthcare systems, and its significance is becoming more widely acknowledged in Pakistan. Pakistan's healthcare system is under a lot of strain due to the country's fast expanding population, diverse healthcare system, and new public health issues. Given this, family medicine is a profession with great potential to address numerous systemic problems, increase access to healthcare, and promote the patient-centered care movement. But there are many obstacles facing family medicine in Pakistan, and lawmakers, educators, and medical professionals must work together to overcome them. Family medicine as a specialty focuses on the continuous, comprehensive care of patients of all ages and genders, incorporating social, mental, and physical health into treatment regimens. (1) Family medicine stresses the full range of healthcare, including preventive, curative, and rehabilitative treatments, in contrast to specialty medicine, which sometimes concentrates on a limited field. Better patient outcomes and increased satisfaction with healthcare services are the results of fostering long-term connections between patients and healthcare providers. Family medicine is more important than ever in Pakistan. Alongside the persistent problems caused by infectious diseases, the nation is seeing a rise in the prevalence of chronic conditions like diabetes, high blood pressure, and cardiovascular disorders. (2) Because of this dual burden of disease, family medicine may offer a comprehensive approach to healthcare. Family doctors are qualified to treat both acute and chronic illnesses, providing the continuity of care required to manage diseases over the long term, lowering hospitalization rates, and relieving the burden on specialized care.
Copyright (c) 2024 dr ihtisham kakakheel (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
CONCERNS AND RECOMMENDATIONS FOR OPD SERVICES UNDER THE BENAZIR INCOME SUPPORT PROGRAM
The program proposes an annual allocation of €11–€3 (approximately PKR 900) per family, paid quarterly to hospitals managing 4,000 families each. This approach excludes vital specialty care, investigations, and hospital admissions, which are essential for managing severe communicable diseases (e.g., dengue, acute hepatitis, and pneumonia) and chronic non-communicable diseases (e.g., diabetes mellitus, coronary artery disease, and stroke). These limitations significantly undermine the initiative's potential to deliver comprehensive and quality healthcare. Furthermore, reimbursing hospitals regardless of actual service provision raises ethical concerns about transparency and accountability
Copyright (c) 2024 https://creativecommons.org/licenses/by-nc-nd/4.0
Outcome of Breast feeding mothers with infants under 6 months admitted to Kohat district hospital
BACKGROUND: Exclusive breastfeeding within the first six months of infancy is one of the main goals of global public health.There is evidence linking early breastfeeding termination to several factors, including the reasons given by women for quitting. The purpose of this study was to describe the actual nursing practices and the stated intentions of women to breastfeed, as well as to examine the correlations between different parameters at Lady Reading Hospital. METHODOLGY: the study subject to the greatest extent possible by using this convergent design "to obtain different but complementary data on same topic." At Kohat District Hospital's Peads OPD & Ward, a cross-sectional study was carried out with ethical approval. RESULT: The age group under 35 had the highest percentage, at 151 (69%). 118 people, or 54%, had primary level education, which was more than other factors. There was a lower employment ratio among working mothers (87, 40%). The store milk had the highest percentage of respondents not answering (19), but everyone had the same opinion about breast milk as the first food after birth. For water utilization, 22 moms gave the same response. Thirty-three women did not respond, 89 were safe, and 97 mothers had depression. 137 babies received colostrum, whereas 107 (48%) of them received hand washing as part of their hygiene routine. Thirty-one moms, or eighteen percent, utilized medication for lactation. CONCLUSION: For the mother and the child, proper hygiene is crucial. Education and support are beneficial after the initial delivery. Health care professionals should visit all expectant moms to provide education and advice on sanitary care, as well as to monitor postpartum depression.
breast feeding, infant, mothers, education, hygiene care, traditions and culture
Copyright (c) 2024 dr zakir ullah (Author) https://creativecommons.org/licenses/by-nc-nd/4.0
Outcome of Manifestation and sign of pneumonia in children under five years of age
Objective: Acute infectious diseases such as pneumonia can be brought on by bacteria, viruses, or fungi and harm the lung parenchyma. It continues to be the world's top cause of death for children under five. Immunizations, a balanced diet, and a reduction in environmental stressors can all help with prevention. Early discovery, appropriate care, and prompt hospital admission are essential for treating this illness with low-tech, accessible therapies. Methods: With ethical consent, a case series study was carried out in the pediatric department of District Kohat Hospital from August 2023 to February 2024. Informed consent was obtained from the parents of 139 study participants. SPSS version 24 was used for the data analysis process. Results: Lethargy was the most prevalent clinical symptom (23.74%), while cyanosis was the least common (2.87%). Men experienced greater effects than women (59% vs. 41%). The vaccination rate for the first dosage was the lowest (28%) and the non-vaccination rate was the highest (44%). Conclusion: Health planners must emphasize filling in the gaps in the EPI schedule by using media like radio, television, and newspapers.
pneumonia, education, health, presentation, Kohat , age.
IMPACT OF DIABETES ON TUBERCULOSIS TREATMENT OUTCOMES: EDITORIAL PERSPECTIVE
Diabetes mellitus (DM) significantly alters tuberculosis (TB) treatment outcomes due to immune dysfunction, drug interactions, and limited access to integrated care. The coexistence of these conditions exacerbates global health disparities, particularly in low-resource settings. Diabetic patients with TB frequently exhibit delayed sputum conversion, higher relapse rates, and poorer cure outcomes than non-diabetic counterparts. Addressing these challenges requires an interdisciplinary approach combining better glycemic control, robust healthcare integration, and patient education. This editorial evaluates the interplay between DM and TB, discusses barriers to effective treatment, and highlights strategies to improve cure rates, advocating for targeted interventions to reduce the dual disease burden globally.
Copyright (c) 2024 dr danyal (Author) https://creativecommons.org/licenses/by-nc-nd/4.0