Background and Objective: Pneumothorax, an accumulation of air between the pleural layers, can occur spontaneously or post-traumatically. Thoracocentesis, a common procedure for aspirating pleural fluid, is a known cause of iatrogenic pneumothorax, with a prevalence of 13-19%. Despite ultrasound guidance reducing the incidence, complications persist, especially with large fluid volumes. Prior studies offer conflicting evidence on the link between aspirated fluid volume and pneumothorax risk. This study aims to determine pneumothorax frequency in patients undergoing ultrasound-guided thoracocentesis and assess the relationship between pneumothorax and fluid volumes of ≤1000 ml and >1000 ml. Methods: A cross-sectional study was conducted at Memon Medical Institute Hospital, Karachi, from February to August 2024. Patients aged 20-60 years with pleural effusion undergoing ultrasound-guided thoracocentesis were included, excluding those with pre-existing pneumothorax or significant lung disease. The sample size was 266. Patients were divided into Group A (≤1000 ml) and Group B (>1000 ml), with Group... Continue Reading

Background and Objective: Oral potentially malignant disorders (OPMDs) are a group of oral mucosal abnormalities with an increased risk of malignant transformation. Their high prevalence, especially in Asia, poses a significant public health concern. Beyond disease control, understanding the impact of OPMDs on patients’ health-related quality of life (HRQoL) is essential for guiding treatment decisions and optimizing care. This study aimed to identify factors that could affect HRQoL in patients with oral potentially malignant disorders in the local population. Methods: A cross-sectional study was conducted over 8 months at Ziauddin University and Abbasi Shaheed Hospitals, enrolling 83 patients aged >20 years with clinically and histologically confirmed Oral Potentially Malignant Disorders. Patients with other medical conditions or prior treatments were excluded. Written informed consent was obtained. HRQoL was assessed using the SF-36 questionnaire across eight domains. ANOVA was used to compare HRQoL domains, and Pearson’s correlation tested associations between variables. A... Continue Reading

Background and Objective: Chronic osteomyelitis of the tibia is a persistent bone infection that, if inadequately managed, can cause significant disability. Antibiotic-loaded intramedullary nails (ALIN) and antibiotic-loaded beads (ALB) are commonly used for infection control and limb preservation, yet their comparative effectiveness remains unclear. This study aimed to compare functional outcomes, pain control, reinfection rates, quality of life (QoL), and complications between ALIN and ALB in managing chronic tibial osteomyelitis in local patients. Methods: In this randomized comparative study, 60 patients with chronic tibial osteomyelitis were allocated into the Nail Group (n  =  30) receiving ALIN or the Bead Group (n  =  30) receiving ALB. Pain was assessed using the Visual Analog Scale (VAS), limb function via the American Orthopaedic Foot and Ankle Society (AOFAS) score, and QoL with the SF-36 questionnaire. Reinfection was assessed clinically, and complications were recorded. Follow‑up was conducted over 12 months. Independent t-test was used for... Continue Reading

Background and Objective: Endoscopy is considered the gold standard for evaluating and managing gastrointestinal (GI) disorders. It serves both diagnostic and therapeutic purposes in patients presenting with upper GI symptoms. This study aimed to audit the common indications for upper GI endoscopy and their associated endoscopic findings at Dr. Akbar Niazi Teaching Hospital, Islamabad, Pakistan. Methods: This cross-sectional study was conducted on 374 patients presenting with upper GI symptoms (including dyspepsia, dysphagia, epigastric pain, and hematemesis) between January 2021 and April 2024. Patients were recruited from both inpatient and outpatient settings. Demographic and clinical data were recorded. Endoscopic findings were documented and categorized according to indication. Descriptive statistics were applied for frequency distribution. The chi-square test was used to assess associations between presenting symptoms and endoscopic findings, with a p-value <0.05 considered statistically significant. Results: Of the 374 patients, 62% were male and 38% female. Common indications included dysphagia (29%),... Continue Reading

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute hyperglycemic complication of diabetes mellitus. Thalassemia major predisposes to diabetes mellitus due to pancreatic dysfunction from iron overload, yet DKA is uncommon in these patients. We report the case of an 18-year-old female with thalassemia major and secondary hemochromatosis who presented with acute shortness of breath, drowsiness, and confusion following one day of diarrhea. On examination, she was profoundly hypotensive (BP 54/21 mmHg), tachycardic (PR 131 bpm), hypoxic (SpO₂ 89%), and exhibited acidotic breathing, pallor, bronze skin pigmentation, and cold extremities. Laboratory evaluation revealed severe anemia, marked leukocytosis (>30,000/mm³), metabolic acidosis with hypokalemia, hyperglycemia, and markedly elevated ferritin (>1,650 ng/l). The patient was treated with insulin infusion, electrolyte correction, blood transfusion, iron chelation therapy, and supportive measures. She improved clinically, achieved metabolic stabilization, and was discharged in stable condition. This case underscores that thalassemia-related iron overload can precipitate disturbances in glucose metabolism and rarely present... Continue Reading

Background and Objective: Bone marrow examinations are typically safe procedures. Even though complications are uncommon, they can occur and may include significant bleeding in individuals with low platelet counts and infections, usually at the skin puncture site, particularly in immunocompromised patients. The conditions examined include bone disorders, as well as both hematologic and nonhematologic malignancies in the bone marrow. Methods: This study analysed the retrospective data from Department of Pathology, Allama Iqbal Medical College/Jinnah Hospital, Lahore, including 373 patients who underwent bone marrow trephine biopsy between January 2023 and June 2024. Patient records were reviewed for demographic and diagnostic data. Statistical analysis was performed using the chi-square test, with p < 0.05 considered significant. Results: Of the 373 patients, 206 (55.2%) were male and 167 (44.8%) were female, yielding a male-to-female ratio of 1.2:1. The most common age group was 21-30 years, comprising 68 cases. Bone marrow aspiration was most... Continue Reading