Life and Science

Rapid Surge of Chikungunya in Pakistan Demands Urgent Action

Wasim Alamgir, Deeba Amraiz — Fri, 10 Jan 2025 00:00:00 +0500

Chikungunya virus infection is a vector-borne disease that has emerged as a serious public health concern around the world over the past two decades. The disease is associated with a significant morbidity rate with an increased risk of lifelong impairment along with psychological and economic consequences. Although severe complications are uncommon, chikungunya virus disease (CHIKVD) causes debilitating and persistent joint pain, neurological symptoms, inflammation in the heart muscle, liver damage as well as multiple organ failure in severe cases, which can be life threatening mostly in infants and elderly population.¹ The first Chikungunya vaccine approved by the Food and Drug Administration (FDA) in 2023 is currently licensed in the United States, however, there is no vaccine available in the endemic countries.²

CHIKV was first identified in Pakistan in 1983 to be circulating in rodents with a limited number of human infections. Since 2015, outbreaks of CHIKV in human population have become more frequent primarily during dengue epidemics.³ The local transmission was confirmed by February 28, 2016 and according to National Institute of Health, Pakistan, a total of 8,521 laboratory confirmed cases were reported from December 2016 till March 2018, with Sindh and Balochistan accounting for the majority of reported cases.⁴ According to the European Centre for Disease Prevention and Control, as of November 30 2024, around 480,000 cases of CHIKVD have been reported worldwide, with over 200 deaths in 2024. Pakistan is among the 23 countries reporting the CHIKVD with approximately 5,726 cases confirmed during the latest outbreak in 2024.⁵

Pakistan being a subtropical country, is becoming more vulnerable to the transmission of chikungunya and other vector-borne diseases including dengue, malaria and leishmaniasis due to changes in the climate patterns such as longer summers, shorter milder winters, and an increased frequency of unpredictable and severe weather events. The CHIKVD appears to have overlapping symptoms (fever and severe joint pains) with other viral illnesses such as dengue, which often leads to misdiagnosis resulting in the mistreatment of both illnesses causing serious challenges for healthcare professionals. In addition, an underestimated disease burden is reported. The mosquito vectors responsible for Chikungunya virus transmission are Aedes aegypti and Aedes albopictus, species prevalent in Pakistan during and after the monsoon season and the same species also transmit dengue and Zika viruses.⁶ All of these factors including the upcoming monsoons are likely to contribute to the endemicity of the CHIKVD in Pakistan over the coming year.

In Pakistan, the overall impact of the CHIKVD is multifaceted with ambiguous consequences due to an underestimated disease burden. The increasing prevalence associated with Chikungunya alongside other vector-borne infections underscores an urgent need for further scientific exploration and public health interventions to alleviate the effects of this emerging infectious

disease. The impact of Chikungunya on human health can be overwhelming, particularly in countries like Pakistan already burdened by dengue and malaria outbreaks. This emphasizes an immediate and rigorous strategy, including public health campaigns, to be prepared and implemented by the coordinated actions of various health departments including the Ministry of National Health Services Regulations and Coordination (NHSR&C), National Institute of Health (NIH) Pakistan, Pakistan Meteorological Department (PMD) and other related divisions.

Editor-in-Chief

How to cite this: Alamgir W, Amraiz D. Rapid Surge of Chikungunya in Pakistan Demands Urgent Action. Life and Science. 2025; 6(1): 1-2. doi: http://doi.org/10.37185/LnS.1.1.875

Predictor Response of Monotherapy with Methotrexate with Triple DMARDS Therapy in Patients of Rheumatoid Arthritis

Babar Ejaz, Amer Fakhr, Adnan Manzar, Waqar Anwar, Zahid Hussain — Fri, 10 Jan 2025 00:00:00 +0500

Objective: To compare Monotherapy with Methotrexate with Triple Therapy (Methotrexate, Sulfasalazine, and Hydroxychloroquine) in patients of Rheumatoid Arthritis.
Study Design: Quasi-experimental study.
Place and Duration of Study: This study was conducted at the Department of Rheumatology, Pak Emirates Military Hospital (PEMH) Rawalpindi, Pakistan, from November 2021 to April 2022.
Methods: A total of 106 patients were enrolled in this study as per defined inclusion and exclusion criteria. These patients were divided into two groups. Group A was given monotherapy methotrexate, and in Group B triple therapy was given. Patients were followed up till 12 weeks, and outcome variables were measured to see disease activity in both treatment groups. Data entry and analysis were done with the help of the statistical package for Social Sciences version 26.
Results: Mean DAS score for Groups A and B was 4.24±0.22 and 4.30±0.23, respectively. For pain assessment, we used a visual analogue scale. The mean visual analogue scale score for Group-A and Group-B patients was 3.58±1.16 and 3.05±1.09, respectively. The efficacy of treatment was based on the DAS score. As per the DAS score criteria, the efficacy of Group-B treatment was significantly higher than that of Group A. i.e. Good response (Group-A: 49.06% vs. Group-B: 71.70%, P-value=0.051). The most frequent side effect experienced by patients in both treatment groups was gastrointestinal problems followed by fatigue and headache.
Conclusion: The results of this study demonstrate that combination triple therapy is more effective than monotherapy of methotrexate for treating patients with rheumatoid arthritis.

How to cite this: Ijaz B, Fakher A, Manzor A, Anwer W, Hussain Z. Predictor Response of Monotherapy with Methotrexate with Triple DMARDS Therapy in Patients of Rheumatoid Arthritis. Life and Science. 2025; 6(1): 3-9. doi: http://doi.org/10.37185/LnS.1.1.501

Frequency to Anti-HBS Antibody Sero-Positivity (> 10 mIU/ml) in Children Aged 5-10 Years after Hepatitis B Vaccination in Infancy

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To determine the frequency of anti-Hepatitis B Surface antibody (anti-HBS antibody) seropositivity (> 10 mIU/ml) in 5-10 years old children after hepatitis B vaccination during infancy.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted in the Pediatrics Department, Combined Military Hospital (CMH) Rawalpindi, Pakistan, from 16^th May 2020 to 16^th November 2020.
Methods: Patients aged 5-10 years, irrespective of gender, and who completed vaccination of hepatitis B during infancy were included in this study. Parents of patients who refused to consent and were without complete immunization of hepatitis B during infancy were excluded. Blood samples were taken for anti-HBS antibody titer. Patients with anti-HBS antibody levels > 10 mIU/ml were considered to have a positive response to vaccination. The patients whose anti-HBS titer was < 10 mIU/ml were considered to have the negative response to immunization against hepatitis B. Data were entered using the proforma.
Results: A total of 343 cases were enrolled. The mean age was 7.46 ± 1.80 years (minimum was five and maximum was 10 years). About 47.8 % of cases had titer less than 10, 43.1 % had equal to or more than 10, and 9 % had Titer equal to or more than 100. 52.2 % had immune status positive, and 47.8 had negative status.
Conclusion: Although the majority of our cases were immune to HBV infection, the difference was only minor compared to the numbers in the non-immune group. After EPI vaccination, the immune status was found to be more retained in the females than in the males.

How to cite this: Aziz A, Tabussam S, Iqbal A, Jabbar G, Hussain S, Shahid H. Frequency to Anti-HBS Antibody Sero-Positivity (> 10 mIU/ml) in Children Aged 5-10 Years after Hepatitis B Vaccination in Infancy. Life and Science. 2025; 6(1): 10-14. doi: http://doi.org/10.37185/LnS.1.1.496

Correlation of Total Leucocyte Count, Neutrophil to Lymphocyte Ratio and Platelet Count with Duration of Hospital Stay in Dengue Fever

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To assess the correlation of total leucocyte count (TLC), neutrophil to lymphocyte ratio (NLR), and platelet count with the duration of hospital stay in dengue patients.
Study Design: A cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Haematology and Dengue Ward, Pak Emirates Military Hospital (PEMH) Rawalpindi, Pakistan from January 2023 to February 2023.
Methods: Comprised 136 confirmed dengue-positive patients who were admitted to PEMH with symptoms of fever. All the participants were requested for their informed consent before their enrolment in the study. A 3 ml venous sample was taken, and complete blood counts were determined by Sysmex XN-3000.TLC, Hematocrit, platelet count, and differentials were measured while Neutrophil the neutrophil-to-lymphocyte ratio was calculated. Patients were followed in hospital and their total hospital stay was noted. Correlation of total leucocyte count, neutrophil to lymphocyte ratio, and platelet count in dengue patients with duration of hospital stay was noted.
Results: TLC and the neutrophil-to-lymphocyte ratio did not show any significant correlation with hospital stay in dengue patients. However, platelet count was found to be negatively correlated with hospital stay duration (r = -0.864, P = 0.00).
Conclusion: Platelet count has a significant negative correlation with hospital stay in dengue patients and is found to be a good predicting factor for indoor stay of dengue patients.

How to cite this: Sajjad Z, Tashfeen S, Shahid S, Bibi A, Irfan R, Naeem U, Butt MN. Correlation of Total Leucocyte Count, Neutrophil to Lymphocyte Ratio and Platelet Count with Duration of Hospital Stay in Dengue Fever. Life and Science. 2025; 6(1): 15-20. doi: http://doi.org/10.37185/LnS.1.1.466

Assessing Emotional Intelligence Among Future Health Care Professionals; A Cross-Sectional Study in Sialkot, Pakistan

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To assess emotional intelligence among future healthcare professionals.
Study Design: Descriptive cross-sectional.
Place and Duration of Study: This study was conducted at the Department of Community Medicine, Sialkot Medical College Sialkot, Pakistan, from 23^rd August 2023 to 23^rd November 2023.
Methods: The study was carried out in Sialkot Medical College. A convenient sampling technique was employed to select participants. The inclusion criteria were students enrolled in the first through the final year of the MBBS program. The exclusion criteria were any medical students who had been diagnosed with anxiety or depression disorders, as these conditions could potentially influence their emotional intelligence scores. Data was collected through an Emotional intelligence scale questionnaire disseminated via Google Forms. SPSS Version 23 was used to analyze data; P-value of less than 0.05 is considered statistically significant.
Results: This study enrolled 298 medical students, with a mean age of 20.4 ± 1.77 years, comprising 143 (48%) males and 155 (52%) females. In the emotional awareness domain, females scored higher (29.9 ± 3.3) than males (24.4 ± 2.9), with a significant difference (P = 0.042). Conversely, in emotional management, males scored higher (32.8 ± 3.1) than females (26.6 ± 2.9), also significant (P = 0.002).
Conclusion: This study revealed gender-specific differences in specific domains of emotional intelligence among medical students, yet found consistent levels of overall emotional intelligence across both genders and throughout different academic years. These findings suggest the need for targeted interventions to address these disparities and underscore the stability of emotional intelligence in the medical education context.

How to cite this: Salahuddin H, Rehman S, Zaheer S, Yahya N, Irum S, Ain Q. Assessing Emotional Intelligence Among Future Health Care Professionals; A Cross-Sectional Study in Sialkot, Pakistan. Life and Science. 2025; 6(1): 21-27. doi: http://doi.org/10.37185/LnS.1.1.769

Impact of Pre-Pregnancy BMI On Short-Term Maternal and Perinatal Outcomes: A Cross-Sectional Study at Lahore

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To compare short-term maternal and perinatal outcomes in women with normal BMI (<25 kg/m²) and high BMI (>25 kg/m²).
Study Design: Analytical cross-sectional study.
Place and Duration of Study: This study was conducted in the Department of Obstetrics and Gynecology at CMH Lahore from April 2023 to February 2024.
Methods: The women’s BMI at the first antenatal visit was noted by patient records, and they were categorized first antenatal visit noted from patient records, and they were categorized as having a normal BMI (<25 kg/m²) and high BMI (>25 kg/m²). Maternal outcomes considered were pre-eclampsia, gestational hypertension, gestational diabetes, fever, prolonged surgery time, and postpartum hemorrhage. Perinatal outcomes considered were the mode of delivery, gestational age at delivery, duration of labor, APGAR score at 1 minute and 5 minutes, birth weight, birth condition, admission in neonatal ICU, neonatal mortality, and hypoglycemia. For data analysis, SPSS version 26.0 was used. The chi-square test was applied to evaluate the significance of the association between the variables.
Results: Out of 151 women, 102 (67.5%) had normal BMI and 49 (32.5%) had a high BMI on their first antenatal visit. Increased frequency of gestational hypertension (P = 0.021), pre-eclampsia (P = 0.0003), prolonged surgery time (P = 0.022), and macrosomia (P = 0.009) were found to be associated with high pre-pregnancy BMI.
Conclusion: The study emphasizes a strong association between maternal pre-pregnancy BMI with gestational hypertension, pre-eclampsia, birth weight, and surgery time. It also calls attention to the need for increased prenatal and perinatal care so that appropriate protocol can be established for women with high pre-pregnancy BMI.

How to cite this: Impact of Pre-Pregnancy BMI On Short-Term Maternal and Perinatal Outcomes: A Cross-Sectional Study at Lahore. Life and Science. 2025; 6(1): 28-35. doi: http://doi.org/10.37185/LnS.1.1.844

Protective Effects of Withania Somnifera Against Cisplatin-Induced Acute Kidney Injury in Rats: A Histomorphometric Analysis

Fri, 10 Jan 2025 00:00:00 +0500

Objective: This research aims to analyze the toxic effects of cisplatin and its amelioration by the root extract of Withania Somnifera on acute kidney injury in rat models through histomorphometric parameters.
Study Design: Experimental study.
Place and Duration of Study: The study was conducted at the Department of Anatomy and Animal House, Baqai Medical University Karachi, Pakistan, from November 2018 to February 2019.
Methods: 80 adult male Albino Wistar rats split evenly into four groups for study purposes. No intervention was administered to Group A (control group), and Group B (treatment group) was given intraperitoneal injections of Cisplatin at 1mg/kg daily for 7 days. Group C (protected group) received ethanolic extract of Withania somnifera roots in an oral dose of 500mg/kg for 15 days before cisplatin treatment and continued with it till 22^nd day. Group D (positive control group) was exclusively given Withania somnifera root extract 500mg/kg orally for 22 days’ duration. Group B was anesthetized & sacrificed on the 8^th day of study, while groups A, C, and D at the 23^rd day. Kidneys from all sacrificed animals were carefully dissected and harvested for subsequent histomorphological analysis. This included analysis of Proximal convoluted tubule (PCT) count & PCT cell count under a microscope. Data were analyzed using SPSS version 22. One-way ANOVA was performed to compare groups, followed by post-hoc Tukey's test to assess the group differences.
Results: The final kidney weight of rats in cisplatin-treated group B showed a significant increase (P<0.05) as compared to groups C & D. However, no statistically significant differences in kidney weight were observed among the other groups (P>0.05). Microscopic examination of Group B kidneys revealed significant (P<0.05) histopathological changes in renal parenchyma. There was a decrease in the mean Proximal convoluted tubule count and Proximal convoluted tubule cell count of Cisplatin treated group. In contrast, Group C displayed preserved renal architecture (P>0.05).
Conclusion: This study concluded that pretreatment with Withania Somnifera root extract attenuates cisplatin-induced acute kidney injury, mediated by its antioxidant and anti-inflammatory properties. Histomorphological analysis revealed significant improvements in proximal tubule (PCT) count & PCT Cell count per reticule. Withania Somnifera also reduced kidney weight, which was increased due to renal parenchymal edema associated with cisplatin-induced inflammation.

How to cite this: Rasheed A, Younus N, Jamshed N, Faisal L, Waseem N, Zeeshan RM, Shamim O. Protective Effects of Withania Somnifera Against Cisplatin-Induced Acute Kidney Injury in Rats: A Histomorphometric Analysis. Life and Science. 2025; 6(1): 36-43. doi: http://doi.org/10.37185/LnS.1.1.661

Navigating Adolescent Health and Aesthetic Imperative: A Qualitative Study of Adolescence in Islamabad

Warda Waheed, Abdul Qadar — Fri, 10 Jan 2025 00:00:00 +0500

Objective: This paper aims to understand the relationship between adolescence, aesthetic imperative, and health in the larger socio-cultural context of Islamabad, a representative urban area of Pakistan.
Study Design: Qualitative research design comprises participant observation, unstructured interviewing and focus group discussions.
Place and Duration of Study: The study was conducted among the adults of Islamabad from August 2022 to November 2022. Places of participant observation, interviews and focus group discussions vary from neighborhoods of a gated community of Islamabad, university cafeteria, and classrooms of the National University of Medical Science Rawalpindi, Pakistan.
Methods: Overall, a qualitative research framework has been designed for data collection through unstructured interviews (stretching from somewhat formal interviews to normal conversation in the form of jokes, etc.), focus group discussions, and participant observation, yielded emic perspectives and subjective experiences of adolescents of Islamabad. The argument has been established on the basis of thematic analysis of the empirical evidence leading to the conceptualization of the themes.
Results: It is found that adolescence is considered a crucial phase of life because it shapes the trajectory of life in significant ways. Adolescents refer to the numerous physical and cognitive changes shaping their individual experiences as a period of stress and storm, resulting in high susceptibility to health hazards for adolescents. However, many of these hazards are based on sociocultural grounds that necessitate medical regimens among adolescents. One of the important dimensions of medicalization, which is found prevalent among this age group, is aestheticization as a part of the modern aestheticized culture influenced mainly by the contemporary media landscape.
Conclusion: The narratives present a mix of intrinsic factors and dimensions of socialization that impels them to resort to an aesthetic imperative.

How to cite this: Waheed W, Qadar A. Navigating Adolescent Health and Aesthetic Imperative: A Qualitative Study of Adolescence in Islamabad. Life and Science. 2025; 6(1): 44-50. doi: http://doi.org/10.37185/LnS.1.1.457

Dysfunctional AV Fistula in End-Stage Renal Disease Patients at Tertiary Care Hospitals of Lahore and Peshawar

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To determine the frequency of dysfunctional arteriovenous fistula utilizing Doppler ultrasound in End stage renal disease patients receiving maintenance hemodialysis.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted at the Dialysis Unit, Sir Ganga Ram Hospital Lahore, Pakistan, and Department of Nephrology, Lady Reading Hospital Peshawar, Pakistan, from July 2019 to January 2021.
Methods: One hundred and seventy-seven (177) people receiving continuous hemodialysis for end-stage renal disease, fulfilling selection criteria, were included in the study. Their medical record was assessed, the clinical examination findings and Doppler ultrasound findings of dysfunctional arteriovenous fistula were recorded
Results: In this study, 177 patients who had end-stage renal disease and were on maintenance hemodialysis, fulfilling selection criteria, were included. Among these patients, 124 (70.1%) were male and 53 (29.9%) were females. The patients' average age was 48±13.29 years. In our local population, the frequency of a dysfunctional arteriovenous fistula is 30.5% on physical examination and 44.6% on Doppler ultrasound among patients on thrice weekly maintenance hemodialysis.
Conclusion: We concluded that upon physical inspection, 30.5% of individuals receiving thrice-weekly maintenance hemodialysis had dysfunctional arteriovenous fistulas and 44.6% on Doppler ultrasound in our population. Arteriovenous fistula with normal physical examination findings may be dysfunctional on Doppler ultrasonography and Doppler ultrasonography further confirm the findings of physical examination.

How to cite this: Kifayat S, Muhammad N, Fawad M, Burki A, Khan MW, Khan MU. Dysfunctional AV Fistula in End-Stage Renal Disease Patients at Tertiary Care Hospitals of Lahore and Peshawar. Life and Science. 2025; 6(1): 51-57. doi: http://doi.org/10.37185/LnS.1.1.689

Correlation of Ultrasonographic Findings in Renal Parenchymal Disease with Creatinine Levels at a Tertiary Care Setting in Rawalpindi

Fri, 10 Jan 2025 00:00:00 +0500

Objective: The study aims to determine the correlation of ultrasonic measurements in assessing renal parenchymal disease (RPD) with the results of creatinine levels in serum to support or oppose the findings.
Study Design: Cross-sectional and descriptive study.
Place and Duration of Study: This study was conducted at the Department of Radiology, Armed Forces Institute of Radiology and Imaging (AFIRI) Rawalpindi, Pakistan, from September 2022 to February 2023.
Methods: Two diagnostic tools were used, i.e., ultrasound and serum creatinine levels. All the patients reporting at a tertiary care hospital for Abdomen and Kidney Ureter Bladder (KUB) ultrasound were included. All the results were finalized under the supervision of a Classified Radiologist. Those patients who hadn’t had their serum creatinine levels checked beforehand were asked to get it done and provide the results later on. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 26. Pearson’s correlation was done to find the relationship of serum creatinine with different ultrasound parameters.
Results: A positive correlation that was statistically significant was found to exist between serum creatinine and echogenicity grades (r = 0.418, P < 0.0001), renal length (r = 0.220, P < 0.0001), corticomedullary differentiation (r = 0.354, P < 0.0001) and parenchymal echogenicity (r = 0.261, P <0.001) in right kidney. Similarly, in the left kidney, a significant positive relationship that was confirmed through statistical analysis was found between serum creatinine and echogenicity grades (r = 0.435, P <0.0001), renal length (r = 0.169, P = 0.003), corticomedullary differentiation (r = 0.338, P < 0.0001) and parenchymal echogenicity (r = 0.294, P <0.001).
Conclusion: The results produced a significant correlation through statistical analysis between sonographic findings and serum creatinine levels paving the way for the use of ultrasonography as an early diagnostic tool for the timely diagnosis of renal parenchymal disease.

How to cite this: Zahid L, Ali MZ, Khan SA, Ahmed N, Akram A, Ibrahim F. Correlation of Ultrasonographic Findings in Renal Parenchymal Disease with Creatinine Levels at a Tertiary Care Setting in Rawalpindi. Life and Science. 2025; 6(1): 58-64. doi: http://doi.org/10.37185/LnS.1.1.694

Predicting Maternal Morbidity in Peripartum Period: Validity of Modified Early Obstetric Warning System

Rubaba Abid Naqvi, Irsa Batool, Shagufta Parveen, Nabila Iram — Fri, 10 Jan 2025 00:00:00 +0500

Objective: To determine the effectiveness of a modified early obstetric warning system (MEOWS) in determining the probability of maternal morbidity during the Peripartum Period.
Study Design: Cross-sectional observational study.
Place and Duration of Study: This Study was conducted at the Department of Obstetrics and Gynecology, District Headquarters Hospital (DHQ) Rawalpindi, Pakistan from October 2022 to October 2023.
Methods: The study sample consisted of pregnant women, 127 each in 3 high-risk categories of postpartum hemorrhage, pre-eclampsia/eclampsia, and sepsis, detained in the high dependency area for observation on the risk of developing maternal deterioration from the 26^th week onwards to delivery and discharge from hospital. The modified early obstetric warning signs (vital signs, i.e., temperature, blood pressure, heart rate, respiratory rate, oxygen saturation, and consciousness level) were used to measure the risk of deterioration. The data was collected on a pre-structured study proforma. The study outcome was assessed as the diagnostic accuracy of modified early obstetric warning system (MEOWS) in predicting peripartum maternal morbidity.
Results: The mean age (years) of the women was 31.76+8.58, and the range was from 18 to 42 years. The frequency and percentages of maternal morbidities include postpartum hemorrhage 73 (57.5%), preeclampsia 76 (59.8%), and sepsis 80 (63%). The sensitivity of MEOWS in detecting postpartum hemorrhage, pre-eclampsia, and sepsis is 89.86 % 80.52%, and, 87.37 % respectively.
Conclusion: The study indicates that during the peripartum period (labor and the early postpartum period), the modified early obstetric warning system (MEOWS) can efficiently detect women at risk of developing obstetric complications like postpartum hemorrhage, pre-eclampsia, and sepsis and hence initiate timely intervention.

How to cite this: Naqvi RA, Batool I, Parveen S, Iram N. Predicting Maternal Morbidity in Peripartum Period: Validity of Modified Early Obstetric Warning System. Life and Science. 2025; 6(1): 65-70. doi: http://doi.org/10.37185/LnS.1.1.564

Response of Capecitabine and Oxaliplatin Chemotherapy in Metastatic Colorectal Carcinoma

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To evaluate the frequency of objective response of Capecitabine and Oxaliplatin (CAPOX) in patients with metastatic colorectal cancer.
Study Design: A descriptive case study.
Place and Duration of Study: The Study was conducted at the Oncology Department, Hameed Lateef Hospital Lahore, Pakistan from 17^th July 2019 to 16^th January 2020.
Methods: A total of 80 participants aged 20-80 who were diagnosed with metastatic colorectal carcinoma were selected for the study. After baseline investigations and examination, all the patients were advised chemotherapy comprising oral capecitabine and oxaliplatin for 6 cycles. For assessment of the response, CT scans were done by the radiological department and reported after chemotherapy.
Results: 3 (3.8%) showed complete response, 32 (40%) showed partial response, 26 (32.5%) showed no response, and 19 (23.8%) patients showed disease progression after six cycles of chemotherapy. (43.8%) patients had objective responses, and 45 (56.2%) patients showed no objective response.
Conclusion: chemotherapy yields promising activity for treating metastatic colorectal cancer.

How to cite this: Rashid AA, Zafar A, Jafar A, Iqbal R, Siddiqi H, Ismail Z. Response of Capecitabine and Oxaliplatin Chemotherapy in Metastatic Colorectal Carcinoma. Life and Science. 2025; 6(1): 71-75. doi: http://doi.org/10.37185/LnS.1.1.528

Determining the Dental Hygiene of Removable Prostheses from the Patient’s Perspective

Saima ., Muhammad Sartaj Khan; Muhammad Raza — Fri, 10 Jan 2025 00:00:00 +0500

Objective: To evaluate the hygiene of removable dental prostheses from the patient's perspective and to assess patient knowledge about denture care and maintenance. This study would be helpful for the dentist to educate patients on cleaning their prostheses.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Prosthodontics, Peshawar Dental College Peshawar, Pakistan, from March 2023 to August 2023.
Methods: This questionnaire-based study was conducted in the Prosthodontics department. After informed consent, each patient completed a Performa. The aim of the study was to help the patient understand the importance of dentures and oral hygiene and maintenance. The patients were assured that their data would be kept confidential. The study sample consisted of 150 subjects with removable dental prostheses.
SPSS statistics version 26.0 was used to analyze the data with Chi-square test at P <0.05. Data was calculated for categorical and numerical variables.
Results: The sample had an age range of 33-70 years (mean 50 years) and a standard deviation of 10.22 with 65% males (n=97) and 35% females. The majority of the dentures in the study had been in use for more than 1 year; 37% of subjects reported cleaning their prosthesis once a day, and 90% of the subjects (n=135) reported cleaning their dentures with toothbrushes using water. The majority (92%) of the subjects recalled the hygiene instructions given by the treating practitioners. About 65% stated that verbal instructions were given, and the majority of the subjects (78.7%) removed their dentures at night.
Conclusion: The majority of patients removed their dentures at night and used brushing techniques for stain removal. Almost two-thirds of patients remembered verbal instruction on hygiene maintenance.

How to cite this: Saima, Khan MS, Raza M. Determination of The Dental Hygiene of Removable Prosthesis from Patient Perspective. Life and Science. 2025; 6(1): 76-80. doi: http://doi.org/10.37185/LnS.1.1.638

Frequency of Helicobacter Pylori Infections and Its Association with Immune Thrombocytopenia in Patients Presenting with Dyspepsia in Tertiary Care Setting, Islamabad

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To determine the frequency of Helicobacter Pylori (H. Pylori) infection and its association with immune thrombocytopenia in patients presenting with dyspepsia symptoms.
Study Design: Cross-sectional study.
Place and Duration of Study. The study was conducted at the Department of General Medicine, Gastroenterology and Hematology, PIMS Islamabad, Pakistan, from 20^th October 2019 to 20^th April 2020.
Methods. A total of 275 patients with the symptoms of dyspepsia were enrolled. All patients of either sex or any age with the signs and symptoms of dyspepsia presenting through Gastro/Medicine OPD, wards, and emergency and admitted to hospital were included in the study. Those addicted to alcohol, on drugs (NSAIDS, Steroids) without PPI cover, chronic renal failure, and pregnancy were excluded from the study. The primary outcome was to determine frequency of helicobacter pylori infection in dyspeptic patients in our local settings.
Results: In this study, out of a total of 275 cases, females presented in dominance with 61% proportion. The average age of patients was 40 years, ranging from 44 to 95 years. The main presenting complaints were retrosternal burning (74.4%), bloating (65%), pain in the upper abdomen (49.6%), and water brash (37.9%). The frequency of helicobacter pylori infection confirmed on stool for helicobacter pylori antigen was (64.2%). 30.5% of patients have immune thrombocytopenia among those with stool for helicobacter pylori antigen positive.
Conclusion: Our findings validate previous reports on the association of helicobacter pylori infection with dyspepsia. In our study a high proportion of patients (64.2%) were having helicobacter pylori infection.

How to cite this: Mujtaba MA, khan HS, Azhar R, Zulfiqar A, Bukhari SH, Yousaf A. Frequency of Helicobacter Pylori Infections and Its Association with Immune Thrombocytopenia in Patients Presenting with Dyspepsia in Tertiary Care Setting, Islamabad. Life and Science. 2025; 6(1): 81-86. doi: http://doi.org/10.37185/LnS.1.1.630

Effects of Mobilization with Movement Versus Static Stretching Among Patients with Stroke, Hyderabad, Sindh Province, Pakistan

Fri, 10 Jan 2025 00:00:00 +0500

Objective: The study aims to evaluate the effects of mobilization with movement versus static muscle stretching in stroke patients.
Study Design: A multicenter interventional study.
Place and Duration of Study: This Study was conducted at Three different hospitals named Majee Hospital, Surgi Care Hospital, and St. Elizabeth Hospital Hyderabad, Sindh-Pakistan, from January 2022 to June 2022.
Methods: Purposive sampling was used to investigate the effects of two mobilization techniques, Mobilization with Movement and Static Muscle Stretching, on post-stroke gait. Ethical approval was obtained. Standardized rehabilitation therapy (30 min/session) combined with either technique (3x/week) was delivered for 4 weeks. Ankle Dorsiflexion Passive Range of Motion, Berg Balance score, cadence, and speed were assessed pre-and post-intervention. Data analysis utilized SPSS version 25.0.
Results: The total Sample size was 70 (45.7%), equally divided into two groups. The Mobilization group showed significant improvement in all outcome measures compared with baseline (P<0.05). Including Ankle Dorsiflexion Passive Range of Motion (0.011), Berg Balance Score (0.000), Gait Speed (0.000) and Cadence (0.005). Gait speed and cadence showed more improvement than other parameters.
Conclusion: The study reveals that Mobilization training, combined with standard rehabilitation, significantly improves Ankle Flexion Passive Range of Motion, Berg Balance Score, gait speed, and cadence in post-stoke patients or patients in the recovering stage.

How to cite this: Qazi D, Lata P, Fahim MF, Yousuf A, Memon SA, Tasneem S. Effects of Mobilization with Movement Versus Static Stretching Among Patients with Stroke, Hyderabad, Sindh Province, Pakistan. Life and Science. 2025; 6(1): 87-94. doi: http://doi.org/10.37185/LnS.1.1.713

Correlation Between Liver Function Test and Severity of Dengue Fever at a Tertiary Care Hospital, Rawalpindi

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To evaluate the correlation between changes in serum liver function tests and the severity of dengue fever.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Medicine, Pak Emirates Military Hospital, from 1^st May 2023 till 30^th October 2023.
Methods: Patients aged 18 years and above who had dengue NS1 rapid test assay or dengue IgM/IgG rapid test positive were included in the study using convenience sampling. Participants with pre-existing liver conditions, chronic kidney disease, pregnant women, and those with concurrent infectious illness were excluded. The World Health Organization classification system was used to classify the patient’s disease severity into Dengue Fever and Severe dengue.
Results: One hundred and seventy-one patients, including 131 (76.61%) males, had a mean age of 35.91±12.86 years. Severe dengue was observed in 15 (8.8%), while 156 (91.2%) had dengue fever. The dengue NS1 protein assay was positive in 169 (98.8%) and dengue serology was positive only in 2 (1.2%). All liver enzymes, including serum alanine transaminase, serum alkaline phosphatase, serum albumin, and serum bilirubin, had significant relation amongst the dengue disease severity groups. The severity of hepatic impairment was also significantly related to the World Health Organization classification (P = 0.02).
Conclusion: Dengue fever severity can be predicted early by derangements in liver function tests as they statistically correlate with the severity of the disease.

How to cite this: Rehman W, Ali MZ, Arshad AR, Iqbal M, Karim N, Abbas M, Ahmed Z. Correlation Between Liver Function Test and Severity of Dengue Fever at a Tertiary Care Hospital, Rawalpindi. Life and Science. 2025; 6(1): 95-101. doi: http://doi.org/10.37185/LnS.1.1.709

Prevalence of Anemia in Pregnant Women Attending a Healthcare Facility in Multan: A Cross-Sectional Study

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To assess the prevalence of anemia among pregnant women attending a healthcare facility in Multan and identify its associated sociodemographic determinants.
Study Design: A cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Obstetrics and Gynecology and Department of Medicine, Bakhtawar Amin Trust Hospital Multan, Pakistan, from January 2021 to January 2022.
Methods: The study included 250 pregnant women selected by consecutive sampling. The sample size was calculated by keeping the estimated incidence of anemia at 40%, 5% margin of error and a 95% confidence interval. The data was collected through a structured questionnaire, which included questions about demographic data (age, educational status, occupation, and eating habits) and the obstetric history of women. Complete blood picture of all the participants was recorded. Women with hemoglobin levels < 11 g/dL were considered anemic. SPSS version 23 was used for data analysis. Binary logistic regression analysis was used to determine the association between factors. P-value <0.05 was considered statistically significant.
Results: Of 250, 112 (45%) had anemia. Anemia had a higher prevalence in women aged 36 to 40 years. Regarding risk factors, women in the first trimester had a significantly higher risk of anemia than those in the second or third trimester (P <.0001). Moreover, women who had > 4 pregnancies had a higher risk of anemia (P<.0001). Nutrition counseling and healthy dietary habits significantly decreased the risk of anemia (P< .0001).
Conclusion: Anemia is a significant health concern in pregnant women, with the highest prevalence during the first trimester. Low socioeconomic background, poor dietary habits, and more than four pregnancies are significantly associated with the development of anemia during pregnancy.

How to cite this: Hussain I, Rasheeq T, Gardezi A, Mukhtar S, Tahir M, Siddiqui HN. Prevalence of Anemia in Pregnant Women Attending a Healthcare Facility in Multan: A Cross-Sectional Study. Life and Science. 2025; 6(1): 102-108. doi: http://doi.org/10.37185/LnS.1.1.533

Retrospective Evaluation of the Outcomes of Splenectomy in Patients with β-Thalassemia: Insights from a Tertiary Care Center in Bahawalpur

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To evaluate outcomes of splenectomy in patients with β-thalassemia major.
Study Design: A retrospective study.
Place and Duration of Study: The study was conducted at the Department of Hematology, Bahawal Victoria Hospital Bahawalpur, Pakistan, from June 2022 to June 2023.
Methods: A total of 80 patients with β-thalassemia were included. Participants were divided into Group A (n=40), including patients who had undergone splenectomy, and Group B (n=40), including patients with no splenectomy. The medical records of all participants were reviewed. Complete blood count, serum ferritin, and liver function tests were recorded. Flow cytometry was used to assess lymphocyte populations. Patients in Group A were evaluated 2 years after the splenectomy.
Results: Mean platelet and white blood cell count after splenectomy were 645.700/mm³ and 16.480/mm3 respectively. Splenectomy resulted in a significant increase in RBC indices, hematocrit, RBC count, and mean hemoglobin level. However, splenectomy did not decrease iron burden, and more patients required iron chelation. Group B had significantly higher total and indirect bilirubin compared to Group A. Splenectomy resulted in a significant increase in total and B lymphocytes. However, Group A had lower IgM Memory B lymphocytes than Group B. CD4 helper T lymphocytes, in total T lymphocytes, CD4+/CD8+ ratio and CD8 cytotoxic T lymphocytes did not differ significantly between both groups.
Conclusion: Splenectomy is associated with the risk of thrombocytosis in the long term. It improves anemia but does not impact blood transfusion requirement or iron burden. Preoperative vaccination can reduce the risk of overwhelming post splenectomy infections.

How to cite this: Khan MI, Abid F, Malik H, Younas NS, Sarfaraz A, Malik N, Khan HI. Retrospective Evaluation of the Outcomes of Splenectomy in Patients with β-Thalassemia: Insights from a Tertiary Care Center in Bahawalpur. Life and Science. 2025; 6(1): 109-115. doi: http://doi.org/10.37185/LnS.1.1.555

The Safety and Effectiveness of 0.03% Tacrolimus in Pediatric Patients Presenting with Vernal Keratoconjunctivitis in Children Hospital, Multan

Fri, 10 Jan 2025 00:00:00 +0500

Objective: This study evaluated the safety and effectiveness of tacrolimus (0.03%) ointment in treating pediatric patients with vernal keratoconjunctivitis.
Study Design: A prospective, interventional study.
Place and Duration of Study: The study was conducted at the Department of Pediatrics, The Children's Hospital and The Institute of Child Health Multan, Pakistan over one year from February 2021 to February 2022.
Methods: The research involved sixty pediatric patients who had bilateral vernal keratoconjunctivitis. Patients in the tacrolimus cohort were treated with 0.03 percent tacrolimus ointment two times daily for 60 days, followed by a single application daily for 60 days, and once on alternate days for the next two months. The control group got topical fluorometholone 0.1% drops in their eyes for two weeks, after which the amount given was gradually lowered for another two weeks. During the subsequent follow-up time frame, both groups received topical olopatadine 0.1% drops for the eyes twice daily. Modifications to symptoms and signs were documented among the groups to measure the success of therapy, and their severity was rated using a four-point scale.
Results: During the follow-up period, 60 children with bilateral VKC were observed, and the mean age of both groups was similar. Papillary hypertrophy and conjunctival hyperemia were the most common signs, while itching was the most frequently reported symptom. After treatment, Symptoms and signs decreased significantly in both of the groups. However, at three and six months, the group treated with 0.03 percent tacrolimus ointment showed a more notable improvement in symptom and sign scores. The tacrolimus group tolerated the treatment well, with only a few complaining of a stinging sensation. The control group experienced one incidence of elevated intraocular pressure.
Conclusion: 0.03% tacrolimus ointment is an effective and secure therapy for vernal keratoconjunctivitis in young individuals. This different treatment technique may help and lower the likelihood of steroid-related problems in patients with chronic VKC.

How to cite this: Chaudhary MA, Ullah MS, Tahir MY, Khan R, Haider SM. The Safety and Effectiveness of 0.03% Tacrolimus in Pediatric Patients Presenting with Vernal Keratoconjunctivitis in Children Hospital, Multan. Life and Science. 2025; 6(1): 116-121. doi: http://doi.org/10.37185/LnS.1.1.650

Mechanism of Narcotic Addictions and Its Treatment by Medicinal Plants: A Detailed Review

Fri, 10 Jan 2025 00:00:00 +0500

Drugs such as heroin, methamphetamine, cocaine, cannabis, alcohol, and opioids are examples of substances that have the potential to cause substance abuse and addiction. This is since each of these chemicals has a distinct mechanism of action to increase levels of dopamine and produce euphoria. To battle the effects of these narcotics, the primary focus of this review is on medicinal herbs that offer anti-narcotic qualities. The utilization of medicinal plants as a method for the treatment of substance abuse disorders has been a component of traditional medicine for some centuries. These natural antinarcotic compounds have the potential to be employed in an effective and risk-free manner to treat addiction. A class of substances known as phytochemicals has the potential to be utilized in the treatment of addiction. The development of appropriate treatment solutions that are effective over the long term is getting more challenging as a result of the fact that there is still a lack of study on the neurobiology of addiction.

How to cite this: Aftab M, Ullah F, Javed F, Shah NA, Hamid ZA. Mechanism of Narcotic Addictions and Its Treatment by Medicinal Plants: A Detailed Review. Life and Science. 2025; 6(1): 122-132. doi: http://doi.org/10.37185/LnS.1.1.448

Multidisciplinary Strategies for Early Diagnosis and Treatment of Sternoclavicular Joint Infection: Enhancing Outcomes and Reducing Mortality

Muhammad Umair, Muhammad Umer Farooq, Tarique Ahmed Maka — Fri, 10 Jan 2025 00:00:00 +0500

Osteomyelitis is an infection involving bones. It may present in any part of the body but vertebral involvement is most common. After vertebral osteomyelitis, the most common site involved in hematogenous osteomyelitis is the flat bones of the axial skeletal system, such as the sternoclavicular and pelvic bones. Drug users are particularly at risk. It is most caused by Staphylococcus aureus and typically presents with localized pain, swelling, and erythema in the sternoclavicular region. We present a case of an 85-year-old male who is a known case of diabetes mellitus, ischemic heart disease, and hypertension who presented with sudden onset, high-grade fever, severe pain, difficulty in swallowing, and swelling over the Left sternoclavicular joint. Imaging studies revealed emphysematous osteomyelitis with abscess formation and subcutaneous emphysema. The patient underwent surgical drainage and was initiated on empirical intravenous antibiotics as blood for culture and sensitivity reports were awaited. The patient showed some improvement after the drainage and anti-biotics treatment, but after 3 days’ the patient stopped responding to treatment. Follow-up imaging showed no resolution of the abscess, and clinical examination showed a freely mobile clavicle and increased pain. The patient died 10 days after the diagnosis of sternoclavicular joint emphysematous osteomyelitis and initiation of treatment due to extensive sepsis. Sternoclavicular joint osteomyelitis requires prompt diagnosis and a multidisciplinary approach involving infectious disease specialists and surgeons. Early surgical intervention combined with appropriate antibiotic therapy is crucial for successful management and prevention of complications. The rarity of this pathology with increased mortality prompted the case report.

How to cite this: Umair M, Farooq MU, Maka TA. A Multidisciplinary Approach to Sternoclavicular Joint Infection for Early Diagnosis and Treatment to Improve Disease Outcomes and Reduce Mortality. Life and Science. 2025; 6(1): 133-137. doi: http://doi.org/10.37185/LnS.1.1.553

Assessment of Compliance of Hand Hygiene Practices amongst Healthcare Care Workers in Tertiary Care Hospital, Multan

Nadia Khan, Abdul Hakim, Muhammad Sohail Zahid — Fri, 10 Jan 2025 00:00:00 +0500

Objective: To assess hand hygiene practices compliance among health care workers in military hospitals.
Study Design: Cross-sectional descriptive study.
Place and Duration of Study: The study was conducted in Emergency Rooms (ERs), Intensive Therapeutic Care (ITCs), High Dependency Units (HDUs), and Wards of Combined Military Hospital (CMH) Multan, Pakistan, from 8^th March 2023 to 7^th April 2023.
Methods: The statistics presented here were compiled using the World Health Organization's "Hand Hygiene Knowledge Questionnaire for Healthcare Workers." The survey was distributed in hard copy to the medical staff on duty at the various facilities during the data collection period. Participants were given time to complete it privately and then collected it after work.
Results: There were 26 (52%) doctors, including army and civil medical practitioners; 14 (28%) included AFNS/nurses and paramedical staff, and 10 (20%) were from housekeeping staff, including sweepers, janitors and building cleaners. All the participants, 50 (100%), in the study knew that hand hygiene is important for health. 49 (98%) respondents believed that hand hygiene is effective in preventing health care-associated infections, and only 1 (2%) didn’t know whether hand hygiene is effective in preventing healthcare-associated infections or not. 45 (90%) respondents said that hand-cleaning products were readily available for staff and patient use, whereas 5 (10%) said that hand-cleaning products were not available for patients and staff to use. 31 (62%) of the respondents were satisfied with their hand hygiene practices, 11 (22%) were not satisfied. In contrast, 8 (16%) thought that there was still room for improvement in these practices.
Conclusion: It is necessary to encourage hand hygiene practices and educate health care workers according to WHO guidelines. This will not only reduce mortality and morbidity due to hospital-acquired infections but also improve and promote health at all levels.

How to cite this: Khan N, Hakim A, Zahid MS. Assessment of Compliance of Hand Hygiene Practices amongst Healthcare Care Workers in Tertiary Care Hospital, Multan. Life and Science. 2025; 6(1): 138-144. doi: http://doi.org/10.37185/LnS.1.1.472

Changes in Oral and Salivary Contents in Patients with Chronic Kidney Disease

Fri, 10 Jan 2025 00:00:00 +0500

Objective: To analyze oral manifestations and changes in salivary contents in patients with chronic kidney disease (CKD).
Study Design: A comparative study.
Place and Duration of Study: This study was conducted at the Nephrology Department of Ibne-Sina Hospital Multan, Pakistan from January 2021 to the Nephrology January 2023.
Methods: Patients diagnosed with chronic kidney disease were included in the study after giving informed consent. The study was conducted on 100 subjects: 50 were chronic kidney disease (patients (study group), and 50 were period on tally and systematically healthy participants (control group). Saliva samples of all participants were collected and sent to a laboratory for detailed analysis.
Results: The chronic kidney disease (CKD) patients had significantly reduced salivary flow compared to the healthy controls (P<0.001). The major oral manifestation in the study group was the the study group was the paleness of mucosa followed by calculus formation and bleeding of gums. The salivary sodium level in healthy controls was 13.4 ± 8.6, while in dialysis patients, it was 34.1 ± 19.3; this difference was statistically significant (P<0.001). Potassium level in control group was 19.2 ± 3.8 and in the study group was 22.5 ± 3.1 (P<0.001). The calcium level in the control group was 6.6 ± 2.1, and in the study group was 4.32 ± 4.55 (P<0.001). The Phosphorus level in control group was 5.5 ± 3.8 and study in study group was 27 ± 4.45 (P<0.001).
Conclusion: Salivary calcium, phosphorus, urea, sodium, and potassium levels in chronic kidney disease are significantly higher than those in normal individuals. These increased levels are correlated with the severity of renal disease. Decreased salivary flow rate and calculus deposition reflect increased salivary urea and renal disorder.

How to cite this: Farooq B, Jaffar A, Qureshi ZH, Yasmeen N, Rehman R. Changes in Oral and Salivary Contents in Patients with Chronic Kidney Disease. Life and Science.2025; 6(1): 145-149. doi: http://doi.org/10.37185/LnS.1.1.514