Year 2024, Volume 40 - Issue 2

University of Health Sciences (UHS), Lahore stands as the sole representative from Punjab province alongside Sindh (Agha Khan Medical University, and Dow University of Health Sciences Karachi) to secure its position among the top 800 medical universities of the world in 2024 QS World Subject Rankings. The absence of most Pakistani medical universities from these rankings underscores a broader issue within the country's higher education system. Factors contributing to this include insufficient research output, lack of international collaboration, inadequate funding, and limited focus on innovation and academic reputation. To address this issue, the research and development (R&D) in medical sciences require substantial investment, which is currently lacking especially within the public sector medical universities. Without significant funding, universities cannot support high-quality research projects or attract top-tier faculty. Secondly, there is a dire need for enhancing the quality and quantity of research publications. Pakistani universities often lag in producing high-impact research papers, a crucial criterion for international rankings. Thirdly, international collaboration and partnerships are limited, reducing the global visibility and impact of Pakistani research. Furthermore, improving the overall academic environment by attracting and retaining high-caliber faculty, modernizing curricula, and fostering a culture of alumni exchange and engagements will contribute to better rankings.

Background and Objective: Zygomatico-maxillary complex (ZMC) fractures and associated infraorbital nerve paresthesia are the most prevalent features of facial trauma associated with road traffic accidents, accidental falls, and violent assaults. The objective of this study was to assess the recovery time of the infraorbital nerve functional status in individuals with paresthesia after open and closed reduction of ZMC fractures.

Method: A comparative cohort study was conducted in the Oral and Maxillofacial Surgery Department of Mayo Hospital in Lahore. The study comprised 100 patients with unilateral isolated en bloc ZMC fractures and post-traumatic paresthesia. Patients were equally divided into two groups: Group A comprised of patients who underwent closed reduction while patients of Group B had open reduction with micro plate osteosynthesis. Demographic information, infraorbital nerve healing, post-op complications, and patients’ satisfaction were documented. To compare the outcomes of the two groups, statistical analyses were done and p-value <0.05 was taken as statistically significant.

Results: The age distribution revealed a mean age of 37.43 ± 11.06 years, with 72% of the participants being males. In 63% of patients, there was overall functional nerve recovery. After 6 weeks, 74% of those in Group A (closed reduction) had functional nerve recovery, as compared to 52% of those in Group B (open reduction) (p = 0.023). Age subgroup analysis revealed no significant differences in the recovery rates. When compared to Group-A, patients in Group-B showed faster sensory improvement and better satisfaction levels. Complication rates were equal for both approaches.

Conclusion: In ZMC fractures with paresthesia, both open and closed reduction procedures yielded good results in recovering infraorbital nerve function; however, the open reduction technique demonstrated quicker sensory recovery and more patient satisfaction.

Background and Objective: Vitamin D deficiency emerges as a significant player in shaping reproductive health challenges including the ones with conception and fertility. The present study aims to ascertain the prevalence of vitamin D deficiency in the context of female infertility in the local population.

Methods: This cross-sectional study was conducted in the Obstetrics and Gynecology Department at Services Hospital Lahore, Pakistan, from May 30, 2021, to November 30, 2021. A total of 96 sub-fertile females, 20-40 years of age were recruited for the study after taking detailed history followed by clinical examination, and transvaginal ultrasound. The required information regarding body mass index (BMI), type of infertility, and socio-economic status were correlated with the laboratory assessment of serum vitamin D levels. Data were analyzed statistically using the chi-square test keeping p-value <0.05 as significant.

Results: The mean age of the patients was 29.43 ± 3.35 years, and the mean vitamin D level recorded was 19.03 ± 14.30 ng/ml. Notably, 97.9% of primary infertile females compared to 29.2% of secondary infertile patients exhibited vitamin D deficiency (p-value = 0.003). The deficient levels of Vitamin D were associated with the age, BMI, and socioeconomic status of these females.

Conclusion: Females with primary infertility have a notable Vitamin D deficiency compared to the ones with secondary infertility. Additional studies are pressingly needed to confirm a causal relationship and to investigate the potential therapeutic benefits of vitamin D supplementation.

The research highlights the rich heritage of dentistry in the Indian subcontinent and the diverse influences that have shaped its evolution. The roots of dentistry can be traced back to the inhabitants of the Indo-Pak subcontinent at Mehrgarh where the earliest evidence of dental practices was found. By analyzing the methods of the primitive “tooth-pullers” to those of modern-day specialists, this study delves deep into the influence of Ayurveda, Unani medicine, colonialism, and global exchanges on the field of dentistry.The study begins with the analysis of Ayurvedic records which document early dental procedures and the use of herbal remedies for oral diseases followed by the exploration of colonialism and the effect of Western medicine on shaping oral health practices. The dual system of healthcare prevailed due to the incorporation of traditional and modern medicine. Furthermore, the key milestones are discussed. Alongside the developments, the study also discusses the challenges faced in achieving those developments and the initiatives launched that aimed at improving the quality of care provided. Patterns that led to the development of dentistry can be recognized which will help in further improvement.In conclusion, the transition of dentistry from primitive practices to modern procedures is mainly due to the interaction between tradition and modernization. The findings of the paper underscore the need for improvement in research standards and a greater focus on public health by adopting both, traditional and modern-day medicine.

Background and Objective: In surgical procedures, accurate intraoperative diagnosis is essential for guiding surgical management. Two common techniques employed for rapid intraoperative diagnosis are touch imprint cytology (TIC) and frozen section (FS). However, their diagnostic accuracy as compared to histopathology remains under debate. This study therefore aims to evaluate the diagnostic precision of FSs and TIC taking histopathology as a gold standard in oropharyngeal squamous cell carcinoma (OPSCC) biopsies.

Methods: A total of 122 biopsies of OPSCC were received for FS analysis at the Histopathology Department of the University College of Medicine and Dentistry Lahore, Pakistan. Touch imprints were taken from the surgical margins of the same biopsies and FSs were cut and stained with rapid Hematoxylin and Eosin stain following standard protocols. Paraffin-embedded histopathology sections were later made from the same tissues for comparison and diagnostic accuracy studies.

Results: Comparison of FS with histopathology showed a sensitivity of 60%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 95%, and overall diagnostic accuracy of 95%. On comparison of TIC with histopathology, sensitivity was 86.6%, specificity was 100%, PPV was 100%, NPV was 98.2%, and accuracy was 98.3%.

Conclusion: In comparison to histopathology, TIC and FS examination have promising utility as well as certain limitations for the evaluation of the margin status of OPSCC specimens. Thus, with careful consideration, these techniques may provide valuable insights for clinical practice in local settings with both time and cost-effective approaches.

Background and Objective: With the high prevalence of dental caries among children in Pakistan and the limited availability of pediatric dentists, dental care is provided majorly by general dentists. This study aims to determine the preventive dental care provided to pediatric dental patients by general dentists in private practice settings in Lahore.

Methods: This cross-sectional study was conducted among 185 general dentists working in private dental clinics in Lahore, utilizing an online validated questionnaire designed by the authors and distributed through email and WhatsApp using a purposive sampling technique. Data were analyzed using statistical software, and p-value of 0.05 was taken as significant.

Results: Most respondents (73.5%) reported the unavailability of pediatric dentists in their clinics. About one-third of the respondents always chose to refer their child to a pediatric dentist. About 48.1% of the general dentists were “somewhat aware” of the behavioral management techniques. Pediatric-specific dental treatment services were more frequently provided in clinics where a pediatric dentist was available. Fillings were the most frequent (90.8%) treatment services, along with extractions (79.5%), pulpectomies (69.2%), and pulpotomies (65.9%). Notably, 74.1% of the general dentists had not attended any workshop or course in pediatric dentistry.

Conclusion: General dentists in private practices provide minimal dental treatment to pediatric patients, with a significant number lacking formal training in pediatric dentistry. This highlights the need for formal training programs to improve the quality of pediatric dental care.

Background and Objective: The world has already seen a massive pandemic of COVID-19. Medical professionals are the first line of defense in this pandemic. In this regard knowing about the spread of Monkeypox and then its preventive measure could save us from another pandemic. This study was therefore designed to determine the knowledge and awareness of medical students regarding the spread and prevention of monkeypox viral disease.

Methods: It was a cross-sectional study comprising of 406 medical students from first to final year MBBS of a private medical college in Lahore were enrolled through convenient sampling. The data were collected through a structured and validated questionnaire designed through Google Forms and administered by the researchers through WhatsApp groups. The data regarding the mode of spread and prevention was analyzed statistically with a p-value < 0.05 as significant.

Results: A total of 406 responses were collected. The mean age of the participants was 22 ± 2 SD years. Regarding modes of spread of monkeypox, the medical students had significant knowledge about different routes; 359 (88.4%) respondents were aware of human-to[1]human transmission through respiratory secretions and vertical transmission (p < 0.001), while 298 (73.4%) respondents also regarded fomites as one of the modes (p < 0.001).Regarding the prevention of spread, 359 (88.4%) respondents picked each of the options of wearing masks, smallpox vaccination, and prior infection with chickenpox or smallpox while 329 (81%) and 309 (76.1%) respondents regarded the use of antivirals and isolation of affected person respectively as protective against Monkeypox (p < 0.001).

Conclusion: The knowledge of medical students regarding the spread and prevention of monkeypox seems satisfactory. This can be attributed to the inclusion of the disease in their curriculum and its status as an emerging global outbreak, with extensive information readily available through social media platforms.

Background and Objective: Dietary habits are one of the most important factors that play a significant role in maintaining optimal health and body mass index (BMI). The objective of this study was to investigate and determine how changes in dietary pattern of medical and dental students can impact their BMI and quality of life.

Method: This cross-sectional study included 190 medical and dental students from a local private medical and dental college in Lahore, Pakistan. All participants filled out a validated online questionnaire having 30 questions divided into four sections. The responses were scaled in three tiers and the data was collected and analysed using statistical software.

Results: A total of 32.6% of students rated their quality of life as good with respect to dietary habits while 81.6% rated physical environment as moderately healthy with very many difficulties in concentrating (19.5%) and poor physical energy levels (31.1%). A notable percentage (12.6) reported not to have enough financial stability to meet their dietary needs. Satisfaction levels regarding their own health status varied with mixed responses. Negative feelings were frequent (70.5%), and a majority noted changes in eating habits and observed an increase in weight relating to BMI.

Conclusion: Most of the medical and dental students after enrolling into their respective colleges face adverse changes in dietary habits. Taking educational stress and managing one’s daily activities show a limited balance with resultantly lower quality of life and a higher BMI.