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Psychiatric disorders are some of the major challenges facing treatment in as much as response rates and recoveries are concerned because these mental disorders are acknowledged for their devastating effects. Another area explored in this research looks into the functioning of liberal motives in the glutamatergic system, immunologic system, and neuroinflammation as specifications that could be utilized for managing psychiatric disorders with the help of medications. Two main strategies are; regulation of the release of glutamate and immune reactions, and neuroinflammation. The efficacy of such systems has been demonstrated from preclinical and clinical trials, mainly in the enhancement of mental symptoms. Though, questions arise like: Is it feasible to develop the target? Do the emitting pole and the receiving pole indicate that the treatment is the best one? On what basis should the patients be grouped? Assessing such priceless information concerning these novel targets will enable the identification of the course towards the personal and appropriate medication for patients with psychiatric ailments. The discoveries in this article will shed light on the new potential therapeutic targets for the psychiatric diseases, which will point towards the potential new directions for the treatment for the mental health disorders that may revolutionise the treatment outcomes for the psychiatric patients and force the changes in the mental healthcare system.

Background and Objective: Evaluation of intraoperative frozen section (FS) in central nervous system (CNS) lesions  is an invaluable tool to ensure adequacy of tissue obtained to establish the diagnosis and is consistently practiced for rapid assessment and ancillary studies. The objective of this study was to determine the diagnostic concordance between frozen section for the pediatric CNS lesions considering Histopathology as a gold standard in the local pediatric population with respect to age and gender.

Methods: This cross-sectional study was conducted at the Department of Histopathology, University of Child Health Sciences & The Children’s Hospital, Lahore, Pakistan. The biopsy specimens from 35 pediatric patients with CNS tumors were sent fresh frozen and in formalin, both, for analysis of the diagnostic accuracy of FS while taking formalin fixed paraffin embedded (FFPE) tissues as gold standard. 
The data was analyzed by using statistical tests of significance.

Results: Comparing FS with FFPE tissues,  77.1 % cases showed complete concordance,  17% were partially concordant while only 5.7% cases were discordant. Male patients demonstrated higher (10.5%) discordance as compared to females (0%) (p= 0.251). Across age groups, concordance rates vary with no statistically significant differences.

Conclusion: The diagnostic concordance of frozen sections  is quite higher in CNS lesions in comparison to formalin fixed paraffin embedded tissues with certain limitations occurring in different tumors. Histopathological review and clinical correlation is mandatory for reaching a conclusive diagnosis in challenging cases. 

Background and Objective: Urinary tract infections (UTIs) are a major public health disease after upper respiratory tract infections,  affecting more than 150 million people worldwide  The study was aimed to identify the effects of probiotics in preventing recurrent UTIs in pregnant women.

Methods: This randomized controlled trial was conducted on pregnant females (1st and 2nd trimester), aged between 18 and 40 years presenting with UTIs. A total of 60 participants were equally and randomly allocated into two groups, i.e., Group A, who received probiotics along with conventional treatment, and Group B which acted as a control and received the placebo along with the conventional treatment. Urine D-R evaluations were performed pre and post intervention. The pre-post analysis was performed using a paired t-test as the data were normally distributed. To compare analysis among groups, an independent sample t test was applied. p (<0.05) was considered as statistically significant.

Results: Group-A (Probiotic) showed greater improvement among variables where the Leukocyte count improved from 15.2 ± 4.3 (cells/HPF) to 10.5 ± 3.1 (cells/HPF) (p = 0.001), and the level of nitrites improved from 0.8 ± 0.2 to 0.5 ± 0.1μmol/ml (p = 0.02) as compared to Group-B (p = 0.05).

Conclusion: The addition of probiotics in the conventional treatment regimen in pregnant females with recurrent UTIs leads to earlier recovery as depicted by the clinico-pathological assessment. 

Background and Objective: Benign prostatic hyperplasia (BPH) is the commonest disorder involving the male reproductive tract. Surgical biopsy is the key to diagnosis in correlation with serum hormone levels. This study was designed to determine the frequency of sexual dysfunction (SD) after transurethral resection of the prostate (TURP) in male patients presenting with BPH. 

Methods: This descriptive study was conducted at the Institute of Kidney Diseases, Peshawar. A total of 82 male patients of 40 to 60 years of age with BPH having lower urinary tract symptoms (LUTSs) were included. Detailed history, examination, and investigations like full blood count, coagulation profile, and ultrasound with pre and post-void residual urine were performed on every patient. Preoperative erectile function was assessed by using the international index of erectile function (IIEF-5). All patients underwent TURP using monopolar diathermy and were managed according to the standard protocol till discharge from the hospital. Post TURP erectile function was assessed after six months using the same IIEF-5. Any increase or decrease in the score was noted and analyzed using statistical tests of association.

Results: The mean age of the patients was 50.71 ± 5.72 years. The mean duration of LUTS was 5.26 ± 1.77 months. The mean preoperative IIEF-5 score was 22.41 ± 2.30 while the mean postoperative IIEF-5 score was 22.41 ± 3.68. The frequency of sexual (erectile) dysfunction (ED) in our study was 9.8%. Among these, 4.9% of patients had mild ED while 2.4% each of patients presented with moderate and severe ED. 

Conclusion: The frequency of SD after TURP for BPH is higher in patients of younger age in our population. 

Background and Objective: Thyroid lesions stand as the predominant endocrine disorders witnessing a substantial global surge in the incidence over recent decades. This study was designed to assess the frequency of neoplastic and non-neoplastic thyroid lesions, focusing on variations across age groups and genders within two tertiary care hospitals in Lahore, Pakistan.

Methods: This retrospective cross-sectional study was conducted at the Pathology Departments of Combined Military Hospital Lahore and Sheikh Zayed Hospital Lahore from the year 2017 to 2021. Histopathological data of 1,217 patients was assessed, with 333 patients having thyroid lesions. The lesions were classified into neoplastic and non-neoplastic. Statistical analysis was performed using the Chi-square test.

Results: Among the 1,217 patients, 333 (27.3%) were diagnosed with thyroid-related lesions, of which 303 (90.9%) were neoplastic and 30 (9.0%) were non neoplastic. Neoplastic lesions included multinodular goiter (41.4%), adenomatous colloid goiter (32.7%), papillary carcinoma (10.2%), and follicular adenoma (6.6%). Non-neoplastic lesions comprised Hashimoto’s thyroiditis (8.1%) and thyroglossal cysts (0.9%). The frequency of thyroid lesions was significantly higher in males (56.6%) (p = 0.001). There was a statistically significant variation in the distribution of lesion types across different age groups (p < 0.001).

Conclusion: Papillary carcinoma emerged as the sole malignant thyroid lesion identified, highlighting its prominence within the study population. These findings underscore the necessity for region-specific epidemiological research to better understand thyroid pathology and inform targeted screening and management strategies.

Background and Objective: Manifestation and the law of attraction are new age practices. Different age groups view and practice these differently since their beliefs are influenced by their peers, families, cultures, traditions, and technology. This study compares the perceptions, interpretations, and interactions of Generation Z and Millennials in order to better understand the intricacies of the manifestation phenomenon.

Methods: It was a cross-sectional survey conducted at a private medical college in Lahore, Pakistan. A total of 266 subjects were divided into two groups according to their ages, i.e., Generation Z (born between 1997 and 2012) and Millennials (born between 1981 and 1996) generation. Data were collected using a survey proforma created on Google Forms and statistical analysis was done using relevant tests of significance. 

Results: Generation Z had better knowledge (p = 0.045) of the concept of manifestation and how it works. Both generations believe that practicing intentional manifestation and trusting your positive beliefs can help in achieving goals (p-value = 0.811). Both generations are somewhat affected by cultural and spiritual beliefs and technology, including social media; however, the difference in the influence between the generations (p = 0.427 and p = 0.698) is not significant.

Conclusion: The study underscores the influence of generational experiences and cultural context on the adoption and interpretation of 
new age practices with respect to the manifestation phenomenon.