Armed Forces Institute of Pathology

Background: The mandibular symphysis (MS) is a critical anatomical structure influencing facial aesthetics, orthodontic diagnosis, and treatment planning. Variations in MS morphology may reflect underlying sagittal and vertical skeletal discrepancies, thereby affecting orthodontic biomechanics and treatment limits. Objective: To compare mandibular symphysis dimensions among different sagittal and vertical skeletal patterns in non-growing adults, with additional consideration of gender-based differences. Methodology: A comparative cross-sectional study was conducted at the Armed Forces Institute of Dentistry, Rawalpindi. Lateral cephalograms of 230 non-growing adult patients aged 16–40 years with skeletal Class I, II, or III malocclusions were analyzed. Sagittal skeletal relationships were determined using the ANB angle with Wits appraisal as an adjunct, while vertical skeletal patterns were classified using the SN–mandibular plane angle. Mandibular symphysis parameters assessed included dentoalveolar length, skeletal symphysis length, chin length, total symphysis length, vertical symphysis dimension, symphysis convexity, and symphysis concavity. Results: Females comprised 53.04% of the sample and males 46.96%. Significant differences in mandibular symphysis dimensions were observed across vertical skeletal patterns. High vertical patterns demonstrated significantly greater skeletal symphysis length, total symphysis length, and vertical symphysis dimensions (p < 0.001), along with a shorter chin length (p = 0.008) and increased symphysis concavity angle (p = 0.002). Sagittal skeletal patterns showed no significant differences in most symphysis parameters, except for symphysis convexity, which was significantly greater in skeletal Class II subjects (p = 0.02). Gender-specific analysis revealed distinct morphological variations, particularly in high vertical patterns. Conclusion: Mandibular symphysis morphology is significantly influenced by vertical skeletal pattern, whereas sagittal skeletal relationship has a limited effect, except on symphysis convexity. These findings underscore the importance of vertical growth assessment in orthodontic diagnosis and treatment planning. Keywords: Cephalometry, Facial Skeleton, Mandibular Symphysis, Malocclusion, Orthodontics.

An Experiment to study the “impact of integrated use of NPK fertilizers and moringa leaf extract (MLE) for the growth and yield of mungbean (Vigna radiata L. cv. AEM-96)” was carried out during two consecutive 'Kharif' seasons in four replicated randomized complete block design (RCBD) with a single factor arrangement and six treatments. It aims to compare integrated NPK + MLE treatments and determine the optimal number of foliar MLE applications for maximizing mungbean productivity. The Experiment comprised six treatments including: T1 = Control (without MLE and NPK fertilizer), T2 = Recommended dose of fertilizer (RDF) NPK @ 25: 50: 25 (kg ha-1), T3 = NPK + 1 (one) foliar spray of Moringa Leaf Extract (MLE) 10 DAS, T4 = NPK + 2 (two) foliar spray of Moringa Leaf Extract (MLE) 10 DAS and 20 DAS, T5 = NPK + 3 (three) foliar spray of Moringa Leaf Extract (MLE) 10 DAS, 20 DAS and 30 DAS and T6 = NPK + 4 (four) foliar spray of Moringa Leaf Extract (MLE) 10 DAS, 20 DAS, 30 DAS and 40 DAS, alongside a control (without MLE) and recommended dose of fertilizer (RDF) NPK @ 25: 50: 25 (kg ha-1) was applied in all plots to evaluate their effects on crop performance. Throughout the Experiment, the study aimed to evaluate the measurements included soil Physio-chemical properties, Agronomic traits, Physiological attributes, Meteorological observations, Grain nutrient status, and Economic returns. Statistical analysis was performed using Statistix-8.1 software with the HSD test to compare treatment effects, while the Regression and Pearson correlation analysis tested relationships among variables. The results evaluated that combined effect of NPK fertilizers and moringa leaf extract (MLE) significantly enhanced mungbean performance (P ≤ 0.05) across both years. The statistical analysis (ANOVA) revealed that combining NPK + 4 (four) foliar spray of (MLE) treatment T6, gave the highest seed yield SY 1935 (kg ha⁻¹), plant height PH (83.33 cm), days to first seed germination DFSG (5.25 days). In contrast, the results of regression and correlation analyses, the results revealed that regression analysis showed a strong model fit (R² = 0.8413; F = 19.099; p < 0.0001). Moreover, Pearson’s correlation analysis (r > 0.99) showed extremely strong positive relationships between seed yield SY (kg ha-1) and key traits: (PH cm), (HI %), (LAI1 m-2 21 DAS), (LAI2 m-2 52 DAS), (PC %) with the highest economic return benefit-cost-ratio (BCR = 3.94). Overall, MLE, especially at 100% concentration and 200 L ha⁻¹, proved an eco-friendly bio-stimulant that boosts yield and reduces reliance on synthetic fertilizers when applied at key growth stages. Overall, the study recommends foliar application of MLE (NPK + 4 (four) foliar spray of (MLE)) @ (200 L ha⁻¹) at critical crop growth stages (germination, flowering and pod development), ideally combined with NPK, as an eco-friendly, high-efficiency bio-stimulant for mungbean cultivation.

Background: Ischemic heart disease is a leading cause of heart failure worldwide. Coronary revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) restores myocardial perfusion and may improve electrical stability in patients with ischemic left ventricular dysfunction. Corrected QT interval and heart rate variability are established predictors of arrhythmic risk and mortality. Objectives: To evaluate the effect of coronary revascularization on cardiac electrical activity using surface ECG and 24-hour Holter monitoring in patients with ischemic left ventricular dysfunction. Methods: In this prospective, non-randomized study, 80 patients with EF <50% were allocated to a revascularization group (PCI or CABG; n=40) or a medical therapy group (n=40). ECG and 24-hour Holter monitoring were performed at baseline and one month post-intervention. Results: Revascularization significantly reduced corrected QT interval (432.4 ± 23.9 ms vs. 427.3 ± 23.1 ms; P = 0.003) and QT dispersion, with a greater decrease than medical therapy (P < 0.001 vs. P = 0.035). Heart rate variability improved markedly after revascularization (P < 0.001). Non-sustained ventricular tachycardia observed at baseline resolved completely in all affected patients (P = 0.024). Conclusions: Revascularization was associated with improvements in ECG markers of electrical stability, including corrected QT interval (P = 0.003), QT dispersion (P < 0.001), and heart rate variability (P < 0.001), with complete resolution of NSVT (P = 0.024). These findings suggest enhanced myocardial electrical stability; however, medication adjustments and residual ischemia may have influenced outcomes. Further studies are needed to clarify causal relationships and long-term prognostic impact

Objective: To assess the prevalence and pattern of psychiatric disorders in individuals presenting to the psychiatry department of CMH Skardu and to examine their relationship with routine laboratory measurements, age, marital status and educational level. Materials and Methods: This cross-sectional study was conducted in Skardu from September 2021 to February 2022. A total of 100 adults aged 21–40 years who provided written informed consent were enrolled. Participants underwent clinical evaluation by a consultant psychiatrist, medical specialist, and gynecologist, and diagnoses were made according to ICD-10 criteria. Blood samples were analyzed for complete blood counts and liver and renal function tests using standard methods. Statistical analysis assessed associations between demographic characteristics, laboratory findings, and psychiatric diagnoses. Results: Among the 100 participants, 81% were married and 19% single, with a mean age of 26.94 ± 4.35 years. Depressive episodes were most common (44%), followed by adjustment disorder (30%), anxiety disorder (12%), dissociative disorder (9%), and mood disorder (5%). All participants had mild anemia (mean hemoglobin 12.37 ± 1.35 g/dL) and mildly elevated ALT levels (mean 42.30 ± 15.25 U/L). No significant differences in laboratory parameters were found across diagnostic groups (p &gt; 0.05). Conclusion: Depressive disorders 44% and adjustment disorders 30% were the leading psychiatric conditions at high altitude. Apart from mild anemia and marginal elevation in alanine aminotransferase levels baseline hematological and biochemical findings were largely comparable across diagnostic categories. Keywords: Adjustment disorder, Depression, High altitude ICD 10, Psychiatric disorders.

Article Development and validation of the manual disease activity score (MDAS) for rheumatoid arthritis was published on December 1, 2025 in the journal Rheumatology and Immunology Research (volume 6, issue 4).

Rosuvastatin is considered as the cornerstone therapy for primary and secondary prevention of cardiovascular diseases. Although clinical efficacy of rosuvastatin is well established, but wide inter-individual variations have been observed in its plasma levels, lipid lowering efficacy and adverse effects. So the current study was undertaken to evaluate the impact of genetic polymorphism of rosuvastatin efflux transporters on variable bioavailability, clinical efficacy and adverse effects. For this study, three hundred and eightyfour hyperlipidemic patients with low density lipoprotein more than 130 mg/dl and serum creatine phosphokinase level within normal range > 190 U/L were enrolled. Study design was quasi experimental and non-probability purposive sampling was done for recruitment of patients. It was conducted from June 2022 to December 2023 in two tertiary care hospitals of Pakistan. All the enrolled patients were treated with rosuvastatin (10 mg) once daily for 12 weeks. Fasting lipid profile, serum creatine phosphokinase, liver and renal function tests were measured at the start of study. After 12 weeks of intervention with rosuvastatin, biochemical tests, genotyping and plasma rosuvastatin levels were determined. Frequency of ABCG2 34 C > T polymorphism for wild type CC, heterozygous mutant CT and homozygous mutant TT genotypes were 55.2, 35.9 and 8.9% respectively. Patients with TT and CT have significantly higher plasma levels of rosuvastatin with mean value of 30.37 ± 6.4 ng/mL and 22.27 ± 4.68 ng/mL respectively as compared to CC genotypes 15.57 ± 8.94 ng/mL (p = < 0.001) which ultimately has improved lipid lowering efficacy. After 12 weeks of intervention, rosuvastatin significantly reduced total cholesterol (mean % decrease: CC 23.04 ± 10.05%, CT 37.43 ± 7.64%, TT 41.32 ± 6.97%, p = < 0.001), low density lipoprotein (mean % decrease: CC 31.11 ± 11.6% CT 47.27 ± 8.22% TT 53.29 ± 8.03%, p = < 0.001), very low density lipoprotein (mean% decrease: CC 36.23 ± 13.27%, CT 44.41 ± 10.29%, TT 54.5 ± 9.63%, p = < 0.001), triglycerides (mean% decrease: CC 24.34 ± 12.66%, TC 35.2 ± 10.47%, TT35.94 ± 8.6%, p = < 0.001) and high density lipoproteins (mean% increase: CC 9.19 ± 10.29%, CT 16.51 ± 9.33%, TT 23.10 ± 8.32%, p = < 0.001). Patients with TT and CT genotype has greater improvement in lipid profile compared with CC genotypes. Frequency of myopathy and hepatotoxicity in study population was 5.2 and 3.13% respectively. We conclude that rosuvastatin 10 mg is highly efficacious and well tolerated by most of the patients, however genotype profiling should be done before initiating rosuvastatin therapy to reduce the risk of adverse effects and to improve the compliance.

Background: Coronary artery bypass grafting (CABG) is a standard procedure for patients with coronary artery disease, particularly those with low ejection fraction (EF). The optimal surgical approach—on-pump or off-pump—remains debated for this high-risk group. Objective: To compare the mean intensive care unit (ICU) stay in patients with low EF undergoing off-pump versus on-pump CABG. Methodology: This randomized controlled trial was conducted at the Department of Cardiac Surgery, Peshawar Institute of Cardiology, from July 2023 to January 2024. A total of 188 patients with EF ≤35% were randomized equally into on-pump (Group A) and off-pump (Group B) CABG groups. ICU stay duration was recorded, and data were analyzed using SPSS 25, applying independent t-tests with p &lt; 0.05 as significant. Results: The mean age was 52.23 ± 0.12 years, with 59% males. Off-pump CABG showed a significantly shorter ICU stay (36.87 ± 2.42 h) than on-pump CABG (49.62 ± 4.29 h; p &lt; 0.0001). The difference remained consistent across all demographic and clinical subgroups. Conclusion: Off-pump CABG markedly reduces ICU stay in patients with low EF, indicating faster recovery and more efficient postoperative care. Keywords: CABG, ICU stay, Low ejection fraction, Off-pump, On-pump.