Pioneer Journal of Biostatistics and Medical Research
Pioneer Journal of Biostatistics and Medical Research (Pioneer J Biostat Med Res) is one of the first dedicated journals in the field of biostatistics and medical statistics, published quarterly. The journal aims to empower health researchers by promoting the application of purpose-driven and innovative statistical techniques that yield meaningful insights and guide evidence-based solutions to real-world health challenges. Pioneer J Biostat Med Res welcomes contributions from a wide range of professionals, including clinicians, public health experts, epidemiologists, pharmacists, biostatisticians, statisticians, and other researchers across the life and health sciences domains. Our commitment lies in promoting interdisciplinary dialogue that enhances statistical thinking in healthcare research. Fees and Funding Pioneer J Biostat Med Res is a no-fee, open-access journal. We do not charge any article processing or publication fees. The journal operates independently, without reliance on external funding or sponsorship. This ensures equitable access for authors worldwide and reflects our commitment to academic integrity and open science.
Medical Research and Statistical Consultancy Training Centre (MRSCTC)
Exploring Cytomegalovirus Infection in Renal Transplant Recipients: A Comprehensive Literature Review
Background: Complication in kidneys the cytomegalovirus (CMV) infection still important in transplantation, due to un favoring effects on grafts survival and general patient result, the role in energizing acute or chronic allograft injury, good recognize but the CMV linked nephritis is regularly undiagnosed, emphasizing about of timely heading and its management. Objective: The review aims to combine between current knowledge on CMV nephritis in the kidney transplant recipients emphasizing its fundamental mechanisms, diagnostic methods with therapeutic plans. Methods: This literature review was conducted counting 15 peer-reviewed articles published in 2010 to 2022, databases searched are PubMed, Google Scholar, Cochrane Library, and Mendeley, with the keywords of “CMV kidney transplant” & “cytomegalovirus nephritis.” The data covered with patients’ clinical presentation, risk factors, histopathology, demographics and outcomes. Results: The comprised studies were on transplant recipients aged rage between 38 to 62 years, representation of numerous ethnic groups and sexes showed with hypertension (HTN) and diabetes mellitus (DM) are common comorbidities, cases with multifaceted CMV-seronegative recipients with grafts due to seropositive donors. In the clinical look characteristically looked between 5 to12 weeks post-transplant having fever, fatigue, weakened graft function and raised serum creatinine (S/Crt), in histological investigation showed tubulointerstitial nephritis with characteristic CMV insertions in tubular epithelial cells. Therapeutic management mainly be subject to Valganciclovir, with immunosuppressive therapy like mycophenolate mofetil or tacrolimus. In the clinical results mixed, complete recovery 6 studies, partial recovery 5 studies, stable function 4 studies and graft lost 2 studies. Conclusion: CMV nephritis had a stealth complication can threats graft survivals and the management have a high index of doubt at-risk patients and histological confirmation. Accurate diagnosis is a essential to get the damaging effects of misdirected anti-rejection therapy like FK to reservation long-term graft function.
Copyright (c) 2025 Muhammad Ajmal Dina Dina, Asifa Karamat, Muhammad Bilal, Muhammad Shakeel Basit, Muhammad Akram Butta, Zar Nigar , Shazia Siddique (Author) https://creativecommons.org/licenses/by/4.0
Comparison of conventional care and kangaroo mother care on very low birth weight babies
Background: In 1978, the concept of kangaroo mother care (KMC) emerged as a compassionate alternative for the care of low birth weight (LBW) infants. In this study, we present the initial findings from a randomized, controlled trial assessing the early outcomes of KMC compared to conventional care methods. Objective: To compare Conventional Care Vs Kangaroo Mother Care on very Low-Birth Weight Babies. Methods: This study employed a randomized controlled trial conducted in the Paediatrics department unit 1 newborn nursery and intensive care unit Services Hospital Lahore. With a duration of 9 months, 104 neonates, 52 in each group, participated based on previous research indicating mean weights at two weeks for kangaroo mother care and conventional care groups. Nonprobability purposive sampling was used. Inclusion criteria encompassed neonates with very low birth weight (<1500 gm), excluding those needing critical care interventions or having congenital anomalies without maternal consent. Data collection involved temperature monitoring and weight measurements, analyzed using SPSS version 26 with significance set at 0.05. Results: Notably, participants in the Conventional Care (CC) group exhibited a significantly longer mean hospital stay (16.1 days) compared to the Kangaroo Mother Care (KMC) group (10.8 days). Moreover, the comparison of weight gain in grams from Day 1 to Day 5 between the Conventional Care (CC) and Kangaroo Mother Care (KMC) groups indicates statistically significant differences across all days. Participants in the KMC group showed higher mean weight gain throughout the observation period, with Day 1 demonstrating a mean weight gain of 1489.6 grams compared to 1461.2 grams in the CC group (p = 0.04). Conclusion: Kangaroo Mother Care (KMC) demonstrates effectiveness in promoting daily weight gain compared to the CC group. Additionally, KMC proves beneficial in shielding neonates from hypothermia. However, insufficient evidence exists to establish a discernible disparity in the incidence of apnea and hospital stay duration between the two groups.
Copyright (c) 2025 Hafiz Ahma Kamal, Kanwal Bibi (Author) https://creativecommons.org/licenses/by/4.0
Cost-effectiveness of treating Febrile neutropenia in Children with Cancer in Resource-limited settings
Background: Febrile neutropenia in children on intensive chemotherapy is very frequent requiring urgent evaluation and management, imposing a significant strain on the already available limited resources in low-middle-income countries (LMIC) Objectives: To evaluate the need of cost-effectiveness in managing in-hospital FN and explore the mechanisms to implement in public sector LMIC to pave the way for cost-minimization Methodology: Prospective extraction of patient level costs from hospital records to evaluate the costing of injectable antimicrobial and inotropes provided by the hospital management free of cost as part of the comprehensive childhood cancer care Results: A total of 250 FN episodes were analyzed, all of them managed in the inpatient unit, complete cost data were extracted for these FN episodes. The analysis revealed that despite subsidized purchase of antimicrobials and supportive care materials FN has a huge burden on the public sector hospital resources whereas length of hospital stays, blood products, laboratory tests and staff consultations were excluded. Majority of these patients were of acute leukemia, having the last session of chemotherapy in a week time in 87% and majority on intensive chemotherapy and suffered from respiratory tract infections and mucositis. More than half had severe derangements of Laboratory parameters and gram-negative septicemia among positive cultures. The mean estimated cost per FN episode was around 15,000 PKR. Conclusion: Febrile neutropenia exerts a huge burden on childhood cancer care services emphasizing the need to explore the cost-effectiveness in FN management by different mechanisms including parents’ health literacy to promote early seeking behavior, emergency management, shared care therapy and social support and standardized de-escalation of therapy to minimize the costs.
Copyright (c) 2025 Alia Ahmad, Mahvish Hussain, Asma Mushtaq, Amber Goraya, Naima Mehdi, Safwan Ahmed, Fauzia Shafi Khan (Author) https://creativecommons.org/licenses/by/4.0
Temporal trends and sex disparities in live and stillbirths: A five-year study at ring road general hospital, Ibadan, Nigeria
Background: Stillbirth remains a critical indicator of maternal and perinatal health, with global disparities influenced by time, season, and fetal sex. Understanding localized patterns is essential to evaluate the impact of health interventions. This five-year retrospective study examined temporal trends and sex-related disparities in live births and stillbirths at Ring Road General Hospital, Ibadan, Nigeria (2020–2024), in the context of targeted maternal care improvements. Objective: To assess temporal and seasonal trends in birth outcomes and evaluate sex-based disparities in stillbirth risk over a five-year period. Method: A retrospective analysis of 4,294 birth records (live and stillbirths) was conducted from January 2020 to December 2024. Time-series analysis was used to identify seasonal and annual trends. Kruskal-Wallis and chi-square goodness-of-fit tests assessed differences in outcomes across time and sex. Logistic regression was employed to examine the association between fetal sex and stillbirth risk. Results: Live births showed significant seasonal variation, with peaks in the first and second quarters of each year. Stillbirth rates declined substantially from 21.38 to 2.99 per 1,000 births over the study period (p < 0.05), suggesting improved outcomes. The sex ratio remained stable for both live births (1.07 male-to-female) and stillbirths (1.00), with no significant deviation from expected norms. Male fetuses had 22.6% higher odds of stillbirth compared to females, though this difference was not statistically significant (OR = 1.226, p = 0.159). Conclusion: This study revealed a marked reduction in stillbirth rates over five years, likely reflecting the success of maternal health interventions and enhanced data surveillance. The consistent sex ratios and lack of significant sex-based disparity in stillbirth risk diverge from global patterns, indicating equitable maternal and neonatal care practices within the study setting.
Copyright (c) 2025 Alfred Ayo Ayenigba, Olutunde Michael Ajao, Oluwafunmilayo E. ADETONA (Author) https://creativecommons.org/licenses/by/4.0
Risk factors of hyperuricemia in type II diabetes mellitus patients
Background: Pakistan has an increased incidence of type II diabetes mellitus, a serious national health problem. Hyperuricemia, which is marked by increased Serum Uric Acid (SUA) levels, often goes along with diabetes mellitus type II and raises the threat of Kidney disease, BMI, dietary intake, and other comorbid diseases all contribute significantly to hyperuricemia. The research on hyperuricemia among Pakistani diabetic type II patients is very little. Objectives: To identify the associated risk factors of hyperuricemia in type II diabetes mellitus. Method: An Analytical Cross-Sectional Study was conducted at Government Kot Khwaja Saeed Teaching Hospital Lahore, involving 362 participants recruited through convenient sampling over 9 months. Patients aged 30–60 with type II diabetes mellitus for at least one year were included, while those with type I or gestational diabetes, known patient of hyperuricemia, relevant medication use, or unwillingness to participate were excluded. Results: Key results show that 69.6% of patients had no hyperuricaemia levels, while 30.4% had hyperuricemia. The mean uric acid level ranged from 2.90 to 9.30 mg/dL, with an average of 5.60 ± 0.75 mg/dL. Female gender is the strongest indicator of hyperuricemia, while BMI, diabetes duration, glycemic control, and comorbidities showed no correlations. Hyperuricemia was highly prevalent among housewives, indicating potential lifestyle factors. These findings stress the need for focused treatments, especially for women, to reduce hyperuricemia risks in TDM II female patients. Conclusion: This study reveals that female gender, height, housewives, low saturated fat foods and eating of the lean meats (poultry, fish, eggs etc.,) are the strongest predictor of hyperuricemia, with higher prevalence and odds. Factors like duration of diabetes mellitus in years, glycemic control, BMI and comorbidities showed no significant associations. Housewives exhibited a higher prevalence, suggesting lifestyle-related influences. These findings emphasize the need for targeted measures among females to reduce hyperuricemia risks and complications.
Copyright (c) 2025 Muhammad Kashif Shahzad Virk, Muhammad Yaqoob (Author) https://creativecommons.org/licenses/by/4.0
Risk Assessment of chronic venous insufficiency and varicose veins Among Teachers: Prevalence, Patterns, and Perspectives in Sahiwal Division, Pakistan
Background: The prevalence of varicose veins in the legs is commonly observed across the global population. However, the specific prevalence of varicose veins and the associated risk factors within the Sahiwal division are not clearly known. Objectives: This study aimed at clarifying the risk factors for varicose veins among teachers in Sahiwal division. This study's objective was to evaluate the risk of varicose veins among teachers Sahiwal division, Pakistan. Methodology: Distributions of frequency and percentage were used to summarize the data. The t-test and chi-square test were used to assess statistical significance. This cross-sectional survey was carried out during February to April 2025 among teachers of both genders working in Sahiwal division's Primary, elementary, and high schools. Results: Mean age of both gender were 42.2 ± 2.06 years, 306 (51%) of the 600 participating instructors were male, while the remaining teachers were female. Pain in the legs increase especially during work (20.5%). The majority of participants (31.0%) had been employed for more than 15 years, and (41.0%) had been standing for fewer than five hours each day. Spider leg-shaped veins were the most noticeable symptom (24.2%). Swelling in the leg or ankle, was the common indicator (40.5%). 179 instructors in all had a family history of varicose veins; 84 of them (14.0%) had already received a varicose vein diagnosis. Conclusion: Obesity, family history, more than five hours standing is associated risk factor of chronic venous insufficiency and varicose veins among teachers that are above 45 years old. In summary, female educators who have a family history of varicose veins are at a higher risk of chronic venous insufficiency and varicose veins disease. Teachers in the Sahiwal division have a significant prevalence of varicose veins. This study indicates that teachers are far more likely to develop the disorder because of the way they work, which accelerates the condition's advancement.
Copyright (c) 2025 Ansar Ali Faraz, Waqas Makhdoom (Author) https://creativecommons.org/licenses/by/4.0
The Spectrum of Socio-Economic Barriers of Families of Children with Cancer during Cross-Border Care: A Paediatric Tertiary Care Hospital Experience
Background: Childhood cancer care needs timely access to diagnostic, treatment, and follow-up services for better survival of these children. Unfortunately, there is a lack of established comprehensive childhood cancer centers in Afghanistan, so these children with cancer and blood disorders consult healthcare providers working cross-border to seek specialized care. The research to explore the distress linked with childhood cancer and associated socioeconomic hurdles is lacking in low-middle-income LMIC countries. Objective: To evaluate the challenges faced by these families while their children with cancer are being managed cross-border in Pakistan. Methodology: This is a cross-sectional study done at Children’s Hospital Lahore, Pakistan, from 1st January 2023 to 31st March 2023. The study involved families with twenty-four children. We interviewed the Afghan families of these children to understand the challenges they faced during this ordeal. Results: The study included children with a mean age of 7.4 years; only 21% were females. They spoke Pushto and Dari languages. Twenty-five percent did not understand Urdu, finding communication exceedingly difficult in 50% of families. Only 4 families had the facility of a translator. Sixty-seven percent were diagnosed with acute lymphoblastic leukemia, and the rest with solid malignancies. The monthly family income was meager. In 85% of cases, the remaining family was sponsored by loans or charity, and 75% were escorted by one or both parents. Ninety-five percent took loans and had a significant effect on siblings education and emotional well-being. Eighty-five percent declared the economic difficulties more disturbing than communication and logistic challenges. Conclusion: During cross-border care, immense challenges were faced by them, requiring efficient socioeconomic support and parental support groups.
Copyright (c) 2025 Alia Ahmad, Laeeq Ur Rehman, Asma Mushtaq, Amber Goraya, Aysha Akram, Mahvish Hussain (Author) https://creativecommons.org/licenses/by/4.0
Case report on preferential use of surgical management for treating cesarean scar pregnancy
Cesarean scar pregnancy( CSP/ Cesarean scar ectopic pregna) although rare ( 1 in 1800- 2500 pregnancies) is continually on the rise due to rising cesarean section rate. It contributes to maternal morbidity and mortality due to placenta accrreta and uterine rupture.This issue is addressed by early diagnosis and definitive management to enhance quality of life.CSP case of woman with previous two cesarean sections and no alive issue is presented where various management options have been tried leading to ultimate recovery with surgical management.
Copyright (c) 2025 Mehwish Ayyaz, Abida Sajid, Saba Irshad (Author) https://creativecommons.org/licenses/by/4.0
Risk factors of maternal near miss among females: A Systemic Review
Background: Maternal near-miss (MNM) is a critical indicator for evaluating maternal healthcare quality, reflecting cases where women survive life-threatening obstetric complications. This review aimed to identify the leading risk factors associated with MNM based on recent global observational studies. Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2020 and 2024. Observational studies assessing maternal near-miss and its risk factors using WHO or similar criteria were included. A total of 30 studies were reviewed from diverse settings, including low-, middle-, and high-income countries. Results: Hypertensive disorders (n=25 studies), obstetric hemorrhage (n=21), lack of antenatal care (n=18), and socio-demographic disadvantages such as rural residence and poor education (n=15) emerged as the most frequent risk factors. Additional contributors included anemia (n=14), previous cesarean section (n=12), and delays in accessing care. Protective factors identified were timely antenatal visits, spontaneous labor, and quality hospital-based multidisciplinary care. Conclusion: MNM remains highly prevalent, especially in LMICs, with preventable factors playing a dominant role. Targeted public health interventions to improve antenatal care coverage, early risk identification, and emergency obstetric services are essential to reduce the burden of MNM and improve maternal outcomes.
Copyright (c) 2025 Kiran Saeed, Nimra Abid, Syeda Tahira Sherazi, Sadaf Fayyaz, Sariya Tul Tahira (Author) https://creativecommons.org/licenses/by/4.0
Effectiveness and side effects of Syanapress (subcutaneous depot medroxyprogesterone) in females of reproductive age groups
Background: Sayana Press® (injectable contraceptive) is associated with a high level of contraceptive efficacy. It is fascinating that the effectiveness of Sayana Press is sustained even if the time of injection is prolonged from the usual three to four months. Objective: To study the effectiveness and side effects of Sayana Press in females of reproductive age to change existing contraceptive practices. Methodology: This descriptive case series was done in a six-month duration (01-04-2023 to 30-09-2023) at the department of obstetrics and gynecology at Lady Aitchison Hospital, which enrolled 96 females after informed consent and followed up for the study duration. We obtained ethical approval and informed consent prior to conducting the study. We used SPSS-v26 for data analysis. Results: We selected 96 females of reproductive age for this study. The mean age of the patients was 31.95±5.06 years. Among 96 patients, 22 (22.9%) were nulliparous, 35 (36.5%) were primiparous, and 39 (40.6%) were multiparous. According to the efficacy of Sayana Press, it was efficacious in 66 (68.7%) patients, and 30 (31.3%) had side effects. Conclusion: The findings of the study revealed that Sayana Press was deemed satisfactory by the women within our specific demographic. The information provided by this study is of importance as it provides significant perception to the government and serves as a pivotal milestone towards the potential implementation of Sayana Press.
Copyright (c) 2025 Arooj Fatima, Mehwish Ayyaz, Aun Ali (Author) https://creativecommons.org/licenses/by/4.0
Comparison of hematological parameters of JAK2 positive and JAK2 negative patients of polycythemia vera: A mini-review
Polycythemia vera (PV) is a malignant disorder with a different frequency based upon age and population. The present review aimed to determine the frequency of Janus Kinase-2 (JAK2) positive and JAK2 negative patients with PV and compare the hematological parameters. Operating polymerase chain reaction (PCR), studies found that mutations in the patients of JAK-2 V617F gene with low serum erythropoietin (EPO) and bone marrow depicted hypercellularity with increased red cell mass. PV is a subtype of myeloproliferative neoplasms (MPN), causing hyperviscosity and thrombotic complications. It’s symptoms include fatigue, headache and pruritus. It’s incidence ranges from 0.02 to 2.8 per 100,000. The JAK-STAT pathway mainly encompasses normal blood cell production and function, but irregularities can lead to disease conditions.
Copyright (c) 2025 Adnan Khan, Afshan Nosheen, Fahad Ur Rehman, Muhammad Maaz Arif (Author) https://creativecommons.org/licenses/by/4.0
Life style medicine: An Emerging Healthier Future
Life style medicine bridges this gap by intervening in daily life habits and behaviors. Life style medicine is an evidence-based approach that works mainly in 6 domains of life style. These domains include nutrition, physical activity, stress management, avoidance of harmful substances, positive socialization and sleep hygiene. Interventions in life style of these domains help in preventing underlying causes of non-communicable diseases.
Copyright (c) 2025 Dr. Rabiah Mahwish (Author) https://creativecommons.org/licenses/by/4.0
The Importance of Hand Hygiene in the Era of Antimicrobial Stewardship
The importance of hand hygiene cannot be overstated in the fight against antimicrobial resistance. By improving hand hygiene practices, we can reduce the spread of infectious diseases, limit the use of unnecessary antibiotics, and slow the emergence of antimicrobial resistance.
Copyright (c) 2025 Muhammad Faheem Afzal (Author) https://creativecommons.org/licenses/by/4.0
Energy bar from a composite of unripe banana, sesame, and semolina flours: Development, sensory evaluation, proximate analysis, and keeping quality evaluation
Background: Globally, the popularity and market for energy bars steadily increases, especially with increasing urbanisation. Fresh bananas suffer much postharvest losses mainly due to their short green life. Semolina, a by-product of wheat is usually destined to waste despite its nutritional profile. Objective: The present study aimed at developing an energy bar from a composite of unripe banana (Musa accuminata), sesame (Sesanum indicum) and semolina flours, assessing the consumer acceptability and determining the nutrient plus keeping quality of the most accepted formulation. Methodology: A total of five energy bars from different composite flour formulations namely; A (20:20:60), B (20:10:70), C (10:10:80), D (30:30:40), and E (10:30:60) for unripe banana flour: sesame flour: semolina flour respectively were developed and tested for consumer acceptability using a nine-point hedonic scale. The most accepted energy bar formulation was further profiled for its proximate composition, selected minerals’ content, and keeping quality using standard AOAC protocols. Results: Formulation D provided the most accepted energy bar regarding the texture, taste, plus overall acceptability, whereas the least accepted sample for most sensory attributes was from formulation A. No significant difference existed in colour for all the formulations. The most accepted energy bar contained 5.72% moisture, 1.02% ash, 5.39% crude protein, 2.94% crude fat, and 4.33% dietary fibre.This energy bar provided a high percentage of carbohydrates and energy value i.e. 72.98% and 1440 KJ/100g (360 calories) respectively. Its mineral analysis revealed 110.51mg/100g of calcium, 38.407 mg/100g of iron, and 399.291 mg/100g of potassium. Indices for the keeping quality of the most accepted energy bar showed a peroxide value of 1.87 and a free fatty acids content of 0.33. Conclusion: This study developed a calories-rich energy bar which can be quickly utilised to fuel plus replenish the body in periods of high energy demand or as an energy-dense snack for people who dont have enough time for meal preparation, manifested in its high carbohydrate content and energy value obtained. Other than increasing the accessibility to cheap high-energy food sources, the present study showed potential of reducing post harvest losses of unripe bananas.
Copyright (c) 2025 Masuma Yaseen, Nakyinsige Khadijah, Babirye Babirye, Abbas Kisambira, Aqsa Abid (Author) https://creativecommons.org/licenses/by/4.0
Mechanistic Pathways Linking Posttraumatic Stress Disorder, Sleep Dysregulation, and Cardiovascular Disease: An Integrative Review
Emerging longitudinal studies establish posttraumatic stress disorder (PTSD) as a significant predictor of cardiovascular disease (CVD). The association is determined by a complex interplay of physiological and behavioral mechanisms. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system dysfunction with chronic systemic inflammation are key contributors. Behavioral factors like physical inactivity, smoking, and poor dietary habits further elevate CVD risk. The review highlights that sleep disturbances as a critical, modifiable risk factor linking PTSD and CVD. Sleep dysregulation is a hallmark symptom of PTSD and a well-established risk factor for CVD. Exposure to trauma often leads to persistent sleep problems, including insomnia, nightmares, and sleep fragmentation, these disturbances have direct Cardiotoxic effects like increased sympathetic activation, endothelial dysfunction, and elevated inflammation. Although, even with clear connections, research examining sleep as a mediator in the PTSD-CVD relationship remains limited. Addressing these gaps is essential for understanding the internal mechanisms and developing targeted interventions. Sleep-focused interventions could potentially mitigate CVD risk in trauma exposed individuals with PTSD. Furthermore, integrating sleep assessment into routine PTSD care could improve risk stratification. Behavioral medicine models should prioritize sleep health as a modifiable target for CVD prevention, by addressing sleep disturbances in PTSD populations and advanced precision-based strategies to reduce CVD risk. This approach will not only enhance our understanding of the PTSD-CVD link but will also offer practical solutions for improving long-term health outcomes in trauma survivors.
Copyright (c) 2025 Muhammad Ajmal Dina, Anam Arshed, Arifa Jabeen, Khalid Pervaiz, Mahnoor Khan, Duaa Fatima Rana (Author) https://creativecommons.org/licenses/by/4.0
Global Health and the Role of Artificial Intelligence
Artificial intelligence (AI) is revolutionizing global health by providing novel solutions to enduring concerns. AI has shown significant promise in enhancing diagnosis and treatment accuracy, as well as in advancing healthcare delivery in low- and middle-income countries (LMICs). Technologies such as machine learning and natural language processing are now used across several medical professions, improving results and diminishing inequities. However, challenges like as ethical quandaries, insufficient infrastructure and data related biases should be addressed to provide impartial access. By promoting the collaboration, prioritizing ethical practices and investing in capacity building AI can substantially support in achieving the global health provision and many of the United Nations' Sustainable Development Goals (SDGs). As AI progresses, its integration into the healthcare systems has great potential to create more inclusive, efficient, and impactful global health framework.
Copyright (c) 2024 Asif Hanif (Author) https://creativecommons.org/licenses/by/4.0
Sociodemographic profile of females with in vitro fertilization failure
Background: Infertility affects many of the couples worldwide, bringing along enormous psychological, and physical, challenges for individuals facing it. In vitro fertilization (IVF) stands out as the most popular form of treatment available, yet the success rates of IVF depend on various factors. Objective: To explore sociodemographic profile of females with IVF failure. Methods: We designed a retrospective cohort study with the aim to identify the sociodemographic profile of females associated with pregnancy failure in infertile patients undergoing IVF. A total of 50 women patients who had unsuccessful IVF cycles were enrolled via non-probability consecutive sampling. Results: The mean age was 34.5 years with a standard deviation of 7.6 years. The mean height and weight were 156.9 cm with a standard deviation of 7.6 cm., 62.4 kg with a standard deviation of 9.2 kg, respectively. The mean BMI (kg/m²) and monthly household income (Pkr) were 23.6 kg/m² and 130,000 PKR; having standard deviation of 5.3 kg/m² and 79,600 PKR, respectively. 55% of participants were housewives, and 45% were employed in various jobs. 56.2% of participants resided in urban areas, while 43.8% lived in rural areas. Lastly, 43.8% of participants have education up to primary or matriculation level, 30% have an intermediate or undergraduate education, 13.8% hold a master's or PhD degree, and 12.5% are uneducated. Conclusion: The study concluded that factors like maternal age, BMI, educational level, occupation, household income, and place of residence have significant implications for the success of IVF. These factors must be taken into consideration before planning a successful IVF and avoid unexpected failure. Keywords: Socioeconomic Factors, Age Factors, Educational Status, Marital Status, Employment, Ethnicity
Copyright (c) 2024 Shamroz Aslam (Author) https://creativecommons.org/licenses/by/4.0
Inflammatory Breast Cancer the hidden threat in oncology: A Narrative review
The understanding of inflammatory breast cancer (IBC) has advanced significantly since Dr. Haagensen established the initial diagnostic criteria in 1956 in the United States. Inflammatory breast cancer (IBC) is a rare and high destructive subtype of breast cancer, representing 1% to 6% of all breast cancer identifies, marked with rapid progression and an important tendency for metastasis, the manifesting with inflammatory symptoms in the breast that can lead to misdiagnosis as situations like mastitis. In clinically, diagnosis is based on physical signs like edema, erythema and along with histopathological evidence like dermal lymph vascular tumor emboli, and aggressive nature of IBC is evident in its poor prognosis, with survival rate five-year considerably lower than that of other breast cancer types, due to late-stage diagnosis when patients presents in advanced disease, recent progresses in the considerate of IBC have underscored the implication of its molecular characteristics in shaping treatment approaches, the embattled therapies, for HER2-positive cases, have demonstrated potential in enhancing patient outcomes when used in conjunction with neoadjuvant chemotherapy. But, the absence of standardized treatment procedures when tailored for IBC poses an important challenge, awareness of IBC increases, collaborative efforts across discipline are very important to improve early detection, and refine treatment strategies, ultimately to boost survival rates for those who are affected.
Copyright (c) 2024 Anam Arshad, Muhammad Ajmal Dina (Author) https://creativecommons.org/licenses/by/4.0
Diagnostic accuracy of 50 g glucose challenge test for screening of the gestational diabetes mellitus using 75 g oral glucose tolerance test as reference standard
Background: Gestational diabetes mellitus (GDM) is a common causative factor of grave maternal and fetal consequences. Prompt and precise diagnosis of GDM can aid in lessening the likelihood of these unfavorable outcomes. Objective: To find the diagnostic accuracy of 50 g GCT (glucose challenge test) for detecting GDM, using 75 g OGTT (oral glucose tolerance test) as the reference standard and to find complications of GDM were also reported. Methodology: A diagnostic cross-sectional study was executed at the outdoor patient department of gynecology unit, Lahore General Hospital, Lahore. It comprised of 285 pregnant females aged ≥ 18 years who were screened for GDM. All participants undertook 50 g GCT, followed by 75 g OGTT. Result was considered true positive if GDM was reported on both tests. A 2x2 table was made to estimate the sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV) and diagnostic accuracy of GCT using OGTT as gold standard. Results: Mean age of patients was 26.28±4.183 years. According to GCT, 39 (13.68%) cases were positive for GDM. On the other hand, 42 (14.74%) tested positive for GDM using 75 g OGTT. We found Sensitivity = 85.71%, Specificity = 98.77% of 50 g GCT and PPV = 92.31 % NPV = 97.56% and overall diagnostic accuracy was found as 96.84%. A total of 86(30.17%) participants reported gestational hypertension whereas Hydramnios was reported in 26 (9.12%) participants. 94(32.98%) patients underwent cesarean section due to cephalopelvic disproportion. Macrosomia, shoulder dystocia and neonatal hypoglycemia was reported in 36(12.63%), 14(4.91%) and 84(29.47%) cases, respectively. Conclusion: 50g GCT provided significantly high sensitivity and specficity for diagnosing GDM. As it is a cost-effective and provides reasonably accurate results, it can be used as an alternate to 75 g OGTT. This could aid in minimizing the maternal and fetal consequences by timely identification of the condition.
Copyright (c) 2024 Surayya Batul (Author) https://creativecommons.org/licenses/by/4.0
Frequency and risk factors associated with musculoskeletal discomfort among prolonged standing workers at the University
Background: Due to the mobility of the legs and the high degree of freedom, standing can be regarded as a diverse position. Workplace musculoskeletal discomforts (MSDs) can have serious consequences for both the affected employees and their companies. From a personal standpoint, MSDs can cause pain, discomfort, and functional restrictions, which can impair a worker's capacity to effectively carry out their job duties. Objective: To assess frequency of musculoskeletal discomfort and to evaluate the risk factors related to musculoskeletal discomfort, e.g. age, sex, body mass index (BMI), marital status, number of children, shoe preferences, profession, working experience, and standing hours. Methodology: An analytical cross-sectional study was conducted by administering a pre-designed questionnaire to two hundred and fifty-four prolonged standing workers (security guards n = 109, sweepers n = 80, messengers n = 37, and chefs n = 28) selected from The University of Lahore. The outcome variable, Musculoskeletal Disorder (MSD), was evaluated using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), which categorized MSD scores into three levels of discomfort: mild, moderate, and severe. The data collected were analyzed by using Statistical Package for Social Sciences (SPSS) version 22. Results: MSD was most common in the foot 42.2%, lower legs 29.1%, lower back 11.4%, and hip 10.0%, according to the CMDQ tool. More than half (51.9%) of the participants reported no musculoskeletal discomfort, while the remaining participants reported varying levels of discomfort. The prevalence of discomfort was 25.5% mild, 11.9% moderate, and 10.7% severe. Gender, occupation, age, standing hours, daily working hours, weekly working hours, and shoe preference were directly associated with MSDs. Logistic regression analysis revealed that gender, age, profession, and break time were significant predictors of WRMSDs in workers. Conclusion: This study found a high prevalence of musculoskeletal disorders (MSDs) among prolonged standing workers, with lower back and foot pain being the most common complaints. Male workers, older workers, and those with less frequent breaks were more likely to experience MSDs. Implementing regular breaks and ergonomic training may help reduce the risk of MSDs among prolonged standing workers.
Copyright (c) 2024 Zubia Yaqoot, Iqra Hamid Khan, Iqra Yaqoot (Author) https://creativecommons.org/licenses/by/4.0
Effectiveness of a picture exchange communication system (PECS) on dental plaque and oral health of children with autism
Background: Children with autism spectrum disorder (ASD) often face challenges in communication and social interaction, impacting their oral health. The Picture Exchange Communication System (PECS) has shown promise in improving communication skills in individuals with ASD. This study aims to investigate the effectiveness of PECS in reducing dental plaque and improving oral health outcomes in children with ASD. Objective: To evaluate the effectiveness of Picture exchange communication system as an intervention strategy on dental plaque and oral health in children with autism spectrum disorder. Methodology: This was a quasi-experimental study. Using PECS as a pictures/cards series showing a structured tooth brushing method, 30 children with ASD and their parents/caregivers were trained on tooth-brushing twice, 2 weeks apart. Data collected after examinations (baseline, 3 months follow up) included gingival and plaque indices (GI, PI) and DMFT score. Results: The mean pre-intervention PI score was 2.32 ± 0.44, which decreased to 1.67 ± 0.42 post-intervention phase. The mean difference in PI was 0.65 ± 0.26. The paired t-test result was 13.794, with a p-value of <0.0001, indicating a highly significant reduction in PI scores post-intervention. The mean pre-intervention GI score was 1.18 ± 0.49, which decreased to 0.85 ± 0.50 post-intervention. The mean difference in GI was 0.33 ± 0.32. The paired t-test result was 5.634, with a p-value of <0.0001, indicating a highly significant reduction in GI scores post-intervention The mean pre-intervention DMFT score was 3.17 ± 3.51, which slightly decreased to 3.13 ± 3.51 post-intervention. The mean difference in DMFT was 0.03 ± 0.18. The z-test (Wilcoxon Signed Ranks Test) result was -1.000, with a p-value of 0.317, indicating no significant change in DMFT scores post-intervention. Conclusion: PECS was useful in improving teeth brushing practices, oral health and gingival and plague indices, indicating improvement in gingival health in children with ASD.
Picture Exchange Communication System (PECS)
Copyright (c) 2024 Noor ul Ain Munawar, Babar Orangzaib Wattoo (Author) https://creativecommons.org/licenses/by/4.0
The impact of maternal health literacy on pregnancy outcomes: A systematic review
Background: A good level of maternal health literacy is important for pregnancy outcomes. The concept comprises the knowledge, use, and decision-making aspects that a woman possesses to manage health related information that impacts prenatal care, self-management of diseases, and other managerial health solutions. Low HL is predictive of complications during pregnancy and the common indicator of premature birth and low birth weight. Objective: The purpose of this research is to quantify the effects of maternal health literacy on preterm birth, birth weight, and maternal morbidity so as to quantify the correlation coefficients. Methodology: Study design : A systematic review. Duration and place of study : The study was done in 3 months at AJK Medical College. Data collection methods: This systematic review has expanded from 25 studies identified through PubMed, Scopus, and Web of Science that target maternal health literacy and pregnancy outcomes. Quantitative aspects were reported as mean age, standard deviation, and p-values were obtained and cross-compared across the different studies. Selection criteria concerned female subjects aged 18-45 with no comorbidities that would affect their pregnancy outcomes. Results: The study sample comprised the 1,200 patients, with a mean age of 29.4 years (±5.8 years). Statistical analysis revealed that maternal health literacy was to some extent predictive of birth outcomes. Maternal health literacy showed a significant negative correlation both to preterm birth (Z = -2.569, p <0.05) and low birth weight (Z = -3.246, p <0.01 ). A study highlighted higher maternal morbidity where clients with higher health literacy levels recorded lesser gestational diabetes than those with low health literacy levels (p < 0.05). Other utilisation-focused health literacy interventions improved the receiver’s compliance with antenatal clinic attendance and even healthier delivery outcomes. Conclusion: The present research is to describe and explain changes in maternal health literacy and its impact on pregnancy outcomes regarding preterm births, low birth weight, and maternal morbidity. Health literacy should form part of prenatal care, especially for females who have low access to quality care, in order to enhance the overall maternal and neonatal health. Keywords: Health knowledge, pregnancy outcomes, premature delivery, antenatal care.
Copyright (c) 2024 Parsa Ahsan (Author) https://creativecommons.org/licenses/by/4.0
Comparative effects of home-based stabilization and Kegel exercises on low back pain, disability and quality of life in postnatal females
Background: Lower back pain is the most common musculoskeletal postnatal problem and effects the quality of life in postnatal women. Hormonal changes occur in pregnant females and due to which they experience hormonal induced hyper-mobility which results low back pain and decrease joint stability. The optimal biomechanics restoration is amongst goal of physiotherapy of lower back pain in postnatal women. Objective: To find out the comparative effects of home based stabilization and kegel exercises on low back pain, disability and quality of life in postnatal females. Methods: This randomized clinical trial was conducted at the Family Hospital in Lahore. 22 postpartum mothers were divided into two groups ; Home-based stabilization exercises and kegel exercises. For six months, each exercise was done three times daily with 10 repetitions and a holding period of 5 to 10 seconds. The outcome was assessed using the Oswestry Disability Index for pain-related disability and the visual analogue scale for lower back pain and life's quality of life using the Short Form 36. Before and after the treatment's first six weeks, all results were evaluated. The data was examined using SPSS 21. Results: According to the study, the statistically significant p value for the pretreatment session of the two groups' visual analogue scales was 0.762, which was higher than the statistically significant p value for the post treatment session, which was 0.384 for both groups' pain intensity. Pretreatment session for both groups' Oswestry disability indices had a statistically significant p value of 0.805, which was higher than post treatment session's statistically significant p value of 0.719 for both groups' disabilities. The statistically significant value for both groups' SF36 pretreatment sessions was 0.620, which was lower than the value for both groups' SF36 post treatment sessions, which was 0.894. Conclusion: The results of the current study showed that while both regimens were equally successful in reducing low back pain and pain-related impairment, there was no discernible difference in quality of life.
Copyright (c) 2024 Mehak Hassan, Hina Gul, Mehwish Fatima, Amina Batool (Author) https://creativecommons.org/licenses/by/4.0
The Role of medical statistics in Pandemic response and Preparedness
Applying medical statistics, we can solve public health issues more effectively and efficiently, which offers an evidence-based framework for managing infectious diseases or pandemics. Biostatistics will continue to play its important and critical role in protecting global health challenges as long as pandemics are a point of concern.
A cross‐sectional study of emotional exhaustion among parents of autistic children in Pakistan
Background: Emotional exhaustion is globally renowned terminology and described as feeling of being emotionally overstretched, or drained of one's emotional and physical resources. Parenting an autistic child has severe consequences for not only the autistic child but the parents as well. Most of the parents go through stress, phases of skepticism, suspicions, highly grief and despair, self-accusation and guiltiness, while remaining go through the feeling of inability to help and persistent shock. Objective: This study was designed to find out the level of Emotional Exhaustion in the parents of autistic children. Methodology: The study used an exploratory cross-sectional study design. The sample size was N=60 out of which 30 were mother and 30 were fathers. The sample consisted of parents (both Gender), with at least one autistic child, parents’ Age range of was 18 years to 50 years, Divorced and Widowed family was excluded, Family with husband having more than one wife were excluded, Age of the autistic Child/Children range between 4 year- 26 years. Parental Burnout Assessment sub-scale (Emotional Exhaustion) was partially used as a survey questionnaire for data collection. Results: There was substantial variance found in the mean of emotional exhaustion in fathers was 13.73±9.80 and mean score in mothers was 18.46±13.61. 68% parents were less emotionally exhausted, 15% were moderately exhausted and 21% were high at emotional exhaustion. Conclusion: The current study conclusively showed that mothers were more emotionally exhausted than fathers.
Emotional Exhaustion, Burnout, Autism- spectrum disorder, Autism, Parents
Copyright (c) 2024 Muhammad Yahya Qureshi, Asma Zafar, Umber Nawaz (Author) https://creativecommons.org/licenses/by/4.0
Emotional regulation among parents of autistic children: a descriptive study in Pakistani population
Background: Emotional Regulation may help to prevent parents of children with disabilities from psychological anguish and to support their child's healthy development. Objective: To identify the variables that influence parents of Autistic children to employ both adaptive and maladaptive ER techniques. Methodology: It was a cross-sectional survey design in nature because the research collected the data from the respondents at a single point of time, the researcher adopted non-probability purposive sampling technique due to being an unknown percentage of Autistic population in Pakistan. The sample size was 57. By adding 20% of drop out the estimated sample size was 70. Parents with at-least 1 autistic child, Age range was 20 years to 50 years, Divorced and Widowed was excluded. Data was collected on a structured questionnaire IIPB protocol. The questionnaire was already pilot tested and had been used in almost 60 countries across the world. Results: Among 70 parents, out of which 35(50%) were Fathers and 35(50%) were Mothers. The Mean Age of participants was 34.5±5.69. Emotional Regulation in parents was found out to be 39.24±16.79. The minimum emotional regulation was 7.00 and maximum score was 66.00. One of the sub-types of Emotional regulation, Reappraisal had a mean score of 23.40±10.35 with minimum score 4.00 and maximum score was 40.00. Suppression was another sub-domain of emotional regulation with mean score of 15.84±7.13 minimum score was 2.00 and maximum score was 27.00. Conclusion: It was concluded that reappraisal and emotional regulation was more frequently employed by both parents.
Autism, Autism- Spectrum disorder, Emotional Regulation, Emotional Intelligence, Suppression, Re-appraisal.
Copyright (c) 2025 Umber Nawaz, Muhammad Yahya Qureshi, Asma Zafar (Author) https://creativecommons.org/licenses/by/4.0
Comparison of central corneal thickness and intraocular pressure in third trimester pregnant females with and without gestational diabetes mellitus
Background: In pregnancy, like other body changes, changes also occur in eyes. During third trimester of pregnancy, central corneal thickness (CCT) increases and intraocular pressure (IOP) decreases as compared to other trimesters. There were only few studies which publish the data regarding CCT and IOP in gestational diabetes mellitus during third trimester. Objective: To compare the central corneal thickness and intraocular pressure in third trimester pregnant females with and without gestational diabetes mellitus. Methodology: A case-control study was done in this research. Total 90 pregnant females having third trimester were included in this study, in which 45 were cases and 45 were controls. Age group of 18-45 is included in this study. HbA1c less than 6% was taken. Complete eye examination was done in all females. CCT was measured by corneal topography method and IOP was measured by air-puff tonometer without using any local anesthesia. Both eyes were included in this study. Results: Results showed that third trimester pregnant females had major affects on eyes, as central corneal thickness increase and intraocular pressure decrease in third trimester, but gestational diabetes mellitus changed the whole scenerio. Sociodemographic data also played an important role in this context. Independent sample t-test was applied. Significant difference was present between the values of both study groups. Conclusion: It was concluded that pregnancy had affect the values of central corneal thickness and intraocular pressure especially in third trimester. Pregnant females with gestational diabetes mellitus showed tremendous increase in values as compared to non-gestational diabetes mellitus pregnant females.
Gestational and non-gestational diabetes mellitus, central corneal thickness, intraocular pressure and pregnant females.
Copyright (c) 2024 Rabia Basri Khan (Author) https://creativecommons.org/licenses/by/4.0
The use of data analytics in transforming contemporary medical practices
The data analytics has become a potent force in contemporary healthcare, profoundly impacting the methods of medical treatments and enhancing patient results. Data analytics will have a growing significance in driving progress and enhancing the efficacy and efficiency of medical operations as the healthcare industry continues to undergo transformation.
Retrospective study of multi-Infection agents among children attending to Pediatric teaching hospital in the holy city of Karbala, Iraq
Background: Globally, infectious diseases continue to be significant contributors to both morbidity and mortality, particularly in nations with limited resources. The present study aimed to identify the most important of multi-Infection causal factors for children admitted to the Children's Teaching Hospital in the holy city of Karbala- Iraq. Methodology and Results: A total of 5089 cases (2940 male and 2149 female) children aged between few months to 15 years of age with positive different clinical manifestations checked by specialist physicians. At Al-Hussein Teaching Hospital for Children by a cross- sectional retrospective study during the period from first of January 2023 until 31st of December 2024. The data were gathered by using specific formula sheet. Results: The study shows relationship between gender and pathogenic agents (2888 male than 1826 female) cases p=.000. Also, 2487 cases under one year, followed by 1871 cases for 1-4 years of age with highly significant difference between age p=.000. On the other hands, bacteria was the high incidence with p-value was (p=.000) between gender. Conclusion: There was high significant relationship between age group and gender with the many pathogens causes illness to children, especially bacterial infection from the Pneumonia species.
Multi infection, Parasite infection, Pneumonia.
Copyright (c) 2024 Ahmed Khesbak, Balqees Jasim, maytham AL-Nasrawii (Author) https://creativecommons.org/licenses/by/4.0
Mean duration of labor after Drotaverine hydrochloride injection in the primigravid women presenting in the active phase of labor
Background: The process of hastening labor involves stimulating the uterus to enhance the frequency, duration, and intensity of contractions once active phase of labor has begun. Drotaverine is an effective drug for treating spasms of the smooth muscles. However, its efficacy in shortening the duration of labor in primigravidas is not well-established in the local settings. Objective: Determining the mean duration of labor after Drotaverine hydrochloride injection in primigravid women presenting in the active phase of labor at a tertiary care hospital. Methodology: This case-series study was undertaken from Feb 2023 till Dec 2023, at department of Obs and Gyne Swat Medical College Saidu Shareef Swat. The study included 150 patients who were already in the active phase of labor with cervical dilation of 3 to 5 cm with 2 to 3 uterine contractions lasting for at least 30 seconds every 10 minutes. All patients received a 40 mg injection of Drotaverine hydrochloride intramuscularly at 3 to 5 cm dilation. Then, patients were monitored until delivery, and the duration of labor from the time of injection until delivery was noted. Results: The mean age of the patients was 23.67 + 3.23 years. The mean length of first, second, and third stage of labor was 4.34±0.094 hours, 22.07±4.25 minutes, and 10.42±3.35 minutes, respectively. The total duration of labor was 4.94±0.33 hours. Conclusion: Drotaverine hydrochloride effectively reduced the average length of labor in the primigravidas presented in the active phase of labor. Therefore, it can be administered to alleviate spasms and accelerate cervical dilatation, thereby facilitating safe and prompt delivery, and reducing the incidence of feto-maternal complications.
Copyright (c) 2024 Zulfiqar Ali Khan, Shumaila Khawaja Khail, Mohammad Usman (Author) https://creativecommons.org/licenses/by/4.0