Year 2025, Volume 41 - Issue 1

The University of Health Sciences (UHS), Lahore, has undertaken transformative curriculum reforms through the Modular Integrated MBBS Curriculum 2K23, shifting from discipline‑based teaching to a competency‑driven, integrated model. Emphasizing spiral learning, early clinical exposure, and the “Seven‑Star Doctor” concept, UHS has mandated life‑saving emergency skills training for over 20,000 annual graduates across health disciplines. Reforms extend to nursing and allied health sciences, promoting interprofessional education, digital integration, and sustainability through continuous feedback, faculty development, and research. By embedding global standards within local relevance, UHS positions itself as a leader in socially accountable, future‑ready healthcare education, fostering a collaborative culture of excellence.

Background and Objective: Understanding the prevalence is essential for developing guidelines for screening and managing hepatitis B virus in patients with rheumatoid arthritis (RA), particularly in settings like Peshawar, where the burden of both diseases is likely to be high and viral infectivity may rise because of immunosuppression induced by anti-rheumatoid therapy. Therefore, this study was conducted to determine the frequency of hepatitis B virus (HBV) infection among patients with RA presenting at a tertiary care hospital in Peshawar.

Methods: A cross-sectional study was conducted on 231 patients diagnosed with RA. Diagnosis was confirmed using clinical assessment and laboratory investigations, including rheumatoid factor and anti-CCP. All laboratory tests were performed in a single hospital laboratory under the supervision of a senior pathologist. HBV infection was confirmed using a third-generation ELISA for HBsAg with a cut-off value of 2.0. An independent t-test was applied keeping p < 0.05 as statistically significant.

Results: The age range of patients was 18-60 years with 43% males and 57% females. The use of DMARDs was reported by 58% patients, while steroid alone was used by 66% patients. HBV testing revealed that only 4% patients had positive and active hepatitis B virus infection. No statistical significance (p > 0.05) was observed between HBV infection and age, gender, or type of treatment.

Conclusion: The frequency of RA patients infected with hepatitis B was very low in population from Peshawar. However, there is a need to screen hepatitis B virus in all patients undergoing anti-arthritic therapy for improving early diagnosis and management in such cases.

Background and objective: Diabetes mellitus (DM) is a major public health concern worldwide, with ocular complications being a leading cause of preventable vision loss among adults. Early detection through regular ophthalmic screening is critical to prevent irreversible vision loss. The study was designed to determine the frequency of ocular complications of DM in patients with diabetes presenting to Munawwar Memorial Hospital Chakwal, for their first eye consultation.

Methods: A cross-sectional observational study was conducted at the monthly Medical Retina Clinic of Munawwar Memorial Hospital Chakwal from September 2022 to November 2022. Detailed clinical assessment and regular ophthalmic examination of 60 diabetic patients, aged 30-90 years, was done to determine the presentation patterns of diabetic eye disease. An optometrist performed refraction and slit lamp examination to evaluate the anterior and posterior segments. A full retinal examination was performed using a 78-diopter lens. The findings were then validated by the attending ophthalmologist.

Results: The mean age of patients was 57.5 + 13.5 years, with 45% females and 55% males. Diabetic retinopathy (DR) was found in 62%
of diabetes patients with recurring vision loss. 62.5% and 34% patients presented with non-proliferative and proliferative DR. Cataract was seen in 28% patients. Other ocular complications included dry eyes, keratitis, and glaucoma. Age and duration of diabetes were significantly associated (p < 0.05) with the progression to proliferative diabetic retinopathy.

Conclusion: A high burden of advanced ocular disease, in particular diabetic retinopathy, was observed at first presentation along with other complications such as cataracts, glaucoma, and corneal disease. These findings underscore the urgent need for community-based screening, early referral pathways, and public awareness campaigns to facilitate timely detection and intervention in diabetic eye disease.

Background and objective: Conventional disease-modifying anti-rheumatic drugs (DMARDs) used for the treatment of rheumatoid arthritis are known for their steady onset of action and multiple adverse effects. The objective of this study is to evaluate the anti-arthritic activity of ethanolic extract of Solanum nigrum in Complete Freund’s adjuvant-induced arthritic rat model.

Methods: 30 male Wistar albino rats were used in a 4-week pre-clinical experimental study. The animals were divided into 5 groups; Group-I Negative (healthy) control (0.9% normal saline), Group-II positive (diseased) control (0.9% normal saline), Group-III Standard group (Methotrexate 1.5mg/kg), Group-IV (Solanum nigrum 100mg/kg), Group-V (Solanum nigrum 200mg/kg). To develop arthritis, 0.1mL of Complete Freund’s Adjuvant (CFA) was administered intraarticularly in the right knee joints of all groups except Group-I at day 0. Knee joint circumference was assessed by using a Vernier calliper once weekly for 4 weeks. For euthanasia, 100mg/kg pentobarbital was injected intraperitoneally in all animals on the 29^th day for the assessment of histopathological changes in knee joints. SPSS version 22 was used to analyse the results and ANOVA was applied for intergroup and intragroup comparisons. A P-value less than 0.05 was considered significant at a 95% confidence interval.

Results: Edema in the positive controls (group-II) increased continuously throughout the study duration. While group-III (MTX) showed initial increase in edema but slight reduction was observed in the last two weeks. Group-V (SN200) with higher dose of herbal extract showed maximum reduction in edema. Histological assessment showed maximum arthritic score (3) in group-II. While 66% of animals in group-III (MTX) and group-IV (SN100) showed mild scoring exhibiting scattered inflammatory cells. Group-V showed maximum improvement in the histopathological changes and 66% of animals showed normal scoring while 33% animals showed few inflammatory cells.

Conclusion: Ethanolic extract of Solanum nigrum has decreased knee joint edema and improved histopathological outcomes.

Background and Objective: Metabolic syndrome poses a significant public health challenge in developing nations and accounts for the highest mortality and morbidity rates globally. It is associated with an increased risk of developing cardiovascular diseases in individuals of all age groups. This study assessed the risk factors and frequency of metabolic syndrome among adults at Mirpur Khas, Sindh.

Methods: The current cross-sectional study was conducted at the Department of Biochemistry, Bhitai Medical and Dental College, Mirpur Khas, Sindh. A total of 1,000 subjects with clinically suspected metabolic syndrome were enrolled, and their anthropometric measurements, including weight and height, serial blood pressure estimation, blood sugar, cholesterol, high-density lipoprotein (HDL), LDL , and triglyceride levels were taken. The logistic regression was used to establish the correlation between the metabolic syndrome and risk variables.

Results: There were 550 (55%) male and 450 (35%) female participants. The mean age was 43.0 ± 11.2 years. Metabolic syndrome was present in 350 (35%) participants. In our study, we found that obese individuals had an odds ratio (OR) of 15.01, individuals aged ≥ 51 years or older had an OR of 5.91, and overweight participants had an OR of 5.91. These findings indicate that these groups are at a much higher risk of developing metabolic syndrome.

Conclusion: Our findings show that metabolic syndrome is common in our community, with a higher prevalence in females. Key contributing factors include hyperglycemia, hypertension, abdominal obesity, elevated triglycerides, and low HDL levels.

Background and Objective: Repairing composite restorations is a conservative alternative to replacement, and bond strength is influenced by both the composite type and surface treatment. This study compared the shear bond strength of microhybrid and bulk-fill composites repaired with bulk-fill composite using different surface treatment protocols.

Methods: This experimental study, conducted from July 2023 to February 2024, included 120 samples: 60 microhybrid composites and 60 bulk-fill composites. The samples were divided into a control group with no further treatment and an experimental group with additional surface treatments. The samples were prepared in Teflon moulds, cured, aged in deionized water, and exposed to thermal cycling as per ISO standard/TR 11405 (2003). The surface treatments included roughening, application of a universal adhesive (iBOND Universal), sandblasting with alumina, and a silane coupling agent (bis-Silane, BISCO Inc.). The repair composites were applied and cured, followed by
shear bond strength testing using a universal testing machine.

Results: Specific post-hoc comparisons revealed that control groups generally exhibited the lowest bond strengths, with varying mean values: 11.98 ± 3.83 MPa, 23.01 ± 7.46 MPa, and 12.90 ± 3.03 MPa for different controls. Conversely, specimens treated with bulk-fill material consistently showed higher shear bond strength, especially those undergoing sandblasting, which recorded the highest bond strengths among all the groups tested (p < 0.01). Additionally, the failure analysis under a stereo light microscope revealed a transition in rupture types from “adhesive interface” to “cohesive in composite” in aged specimens, after thermal cycling, indicating a reduction in the cohesive strength over time.

Conclusion: Sandblasting notably improved the repair effectiveness, emphasizing the importance of surface preparation in dental composite repairs. These findings underscore the need for careful selection of surface treatment techniques to optimize repair outcomes in dental restorations.

Background and Objective: Access to oral health care is vital for overall well-being, yet it is influenced by a complex interplay of social, cultural, economic, structural, and geographic factors. This study aimed to identify and analyze the socio-demographic characteristics and attitudes affecting access to dental care among residents of the Sheikh Zayed Hospital residential colony in Lahore, Pakistan.

Methods: A cross-sectional survey was conducted using a mixed-methods approach, incorporating both qualitative and quantitative data collection techniques. A questionnaire based on Andersen and Aday’s behavioral model of health care service use was developed and pretested through cognitive interviews to ensure clarity and relevance. Convenience sampling was employed to select 125 participants from the residential colony. Data collection involved door-to-door household surveys, demographic information gathering, and questionnaire responses. Statistical analysis was performed using SPSS, focusing on descriptive statistics for categorical variables.

Results: The study included 125 respondents, with a majority being female (70.4%) and a mean age of 38.98 years. Educational attainment varied, with 6.4% uneducated, 44% having less than 12 years of education, and 49.6% with more than 12 years. Most respondents (61.6%) had a monthly income of ≤ 40,000 PKR. Perceived oral health was reported as good by 53.6%. Brushing twice or more daily was practised by 57.6% of participants. Although 90.4% preferred dental care, only 52.8% had visited a dentist in the past year. Key barriers to accessing dental care included work overload (43.2%), the time for dentist availability (85.6%), dependency on family members (28%), dental anxiety
(19.2%), and dissatisfaction with service quality (17.6%).

Conclusion: Despite free dental services, psycho-social barriers limit access to care in the study population. Improving clinic availability, extending hours, and enhancing service quality could increase utilization and improve oral health outcomes.

Background and Objective: Dental laboratory surfaces are contaminated by various microorganisms that can cause infections among staff and students. This observational study aimed to identify different types of microbial flora present on different surfaces of dental laboratories and determine the antibiotic sensitivity of the isolates.

Methods: This cross-sectional observational study was conducted in the dental laboratory of a dental school in Pakistan from April 2023 to April 2024. Eleven samples were collected from randomly selected surface areas in the dental laboratory during working hours of the day without any prior disinfection using Amies agar gel transport swabs and transferred to the laboratory for culture and sensitivity testing. Visible growth was observed on all culture plates. Colonies grown on blood and MacConkey agar plates were tested using standard microbiological methods.

Results: Analysis of swabs taken from the dental laboratory surfaces showed microbial contamination with Acinetobacter baumannii (63%), Klebsiella pneumoniae (36%), and Staphylococcus hominis (27%), with the absence of any fungal growth. These microorganisms showed variable resistance to various antibiotics, including Ampicillin, Co-amoxiclav, Co-trimoxazole, Meropenem, Ciprofloxacin, Cefotaxamine, and Levofloxacin.

Conclusion: This study found pathogenic microorganisms resistant to most antibiotics, highlighting the need to update disinfection practices commonly used in our dental laboratories.

Background and Objective:  MI causes morbidity and mortality worldwide and is linked to oxidative stress and metabolic markers. This study examines how many oxidative stress markers predict myocardial infarction and its effects. Our ultimate goal is to create prognostic markers for early MI diagnosis and therapy.

Method: The University of Lahore Institute of Molecular Biology and Biotechnology researcher did a cross-sectional study. 405 clinically proven MI patients aged 20–90 were studied. The study excluded autoimmune disease and post-diagnosis surgical participants. Biochemical marker concentrations were determined using standardized ELISA kits on Lahore Teaching Hospital blood samples containing VSMCs. The study examined markers such as lipid peroxidation (DT, MDA, THB, 8-OHdG, 4-HNE, NT, IsoP-F2α) and antioxidants (SOD, Catalase).

Results:  All variables demonstrated a statistically significant difference between MI patients and controls. Serum MDA levels in MI patients were higher than the control group (4.56±1.09 vs. 0.932±0.056 nmol/ml, p=0.022). In the MI group, serum oxidative stress levels (8-OHdG, 4-HNE, IsoP-F2α) were greater than in the non-MI group. Patients with MI had reduced SOD, CAT, GSH, Vitamin D, C, and E levels. 60% of MI patients smoked, 85.43% had hypertension, and 75.55% had high LDL. The group had 59% obesity and 73.82% diabetes.

Conclusion: In conclusion, oxidative stress and antioxidant enzyme levels predict myocardial infarction outcomes. Low vitamin and antioxidant levels and high MDA 4-HNE and isoprostanes levels indicate MI. The annotations show early patterns and treatment options for heart disease patients' oxidative stress.