Farooq Hospital

Background: Childhood malnutrition remains a major public health challenge and contributes substantially to morbidity and mortality among children under five years of age. Nurses play a critical role in the early identification, assessment, and management of severe acute malnutrition in pediatric care settings. Adequate knowledge of evidence-based management protocols is therefore essential to ensure timely treatment and improved clinical outcomes. However, deficiencies in knowledge among healthcare providers may limit effective care for malnourished children. Objective: To assess nurses’ knowledge regarding the management of malnutrition in children under five years of age in pediatric care settings. Study Design: Descriptive cross-sectional study. Settings: Pediatric wards, nutrition stabilization centers, and child health units of tertiary care healthcare facilities. Duration of Study: January to June 2025. Methods: A total of 153 nurses and healthcare providers involved in the care of severely malnourished children were recruited using non-probability convenience sampling. Data were collected through a structured self-administered questionnaire that included demographic characteristics and knowledge-based items related to the management of severe acute malnutrition. Key domains included identification of complications, treatment of hypoglycemia, feeding practices, monitoring of hypothermia, dehydration management, and electrolyte imbalance. Data were analyzed using SPSS version 25. Descriptive statistics were applied, and results were presented as frequencies and percentages. Results: Among the 153 participants, most were aged 21–30 years (54.9%), female (91.5%), and held a nursing diploma (55.6%). Regarding initial management priorities, 27.5% identified treatment or prevention of dehydration as the first step, and 27.5% identified treatment of hypoglycemia as the first step, while 24.8% selected correction of electrolyte imbalance. Hypothermia with dehydration and dehydration with hypoglycemia were the most frequently recognized coexisting conditions (28.1% each). Only 28.1% correctly identified the recommended feeding frequency for hypoglycemia management. Correct identification of hypothermia thresholds was reported by 38.6% of participants, and 28.8% reported appropriate temperature monitoring during treatment. In dehydration management, 37.3% selected replacement of stool losses with oral rehydration solution. A majority (81.7%) correctly recognized sodium imbalance as the electrolyte disturbance associated with edema in severely malnourished children. Conclusion: The findings suggest important knowledge gaps among nurses in several critical aspects of severe acute malnutrition management, particularly treatment prioritization, feeding practices, hypothermia monitoring, and dehydration management. Targeted training and continuing professional education may strengthen nurses’ competencies and support improved management of malnourished children in pediatric healthcare settings.

Acute flaccid paralysis is a potentially life- threatening presentation necessitating prompt and precise diagnosis. Guillain-Barre’ Syndrome (GBS) is often the first consideration due to its prevalence and severity. However, non-neurological conditions, particularly metabolic disturbances such as hypokalemia, can clinically and electrophysiologically mimic GBS. Hypokalemic paralysis, albeit rare, represents a reversible etiology of acute limb weakness. It may present with symptoms indistinguishable from GBS, including areflexia and ascending limb paralysis, resulting in a diagnostic dilemma. A misdiagnosis can delay appropriate treatment and subject the patient to unnecessary interventions. This case report elucidates a patient who exhibited classic features of GBS but was ultimately diagnosed with severe hypokalaemia. It underscores the imperative of good clinical assessments including correctly identifying serum electrolytes abnormalities in all patients presenting with acute neuromuscular weakness.

Background: Allergic asthma is a chronic inflammatory disorder driven by Th2-type immune responses. Current treatments include corticosteroids and bronchodilators, which are effective but often associated with systemic side effects. This study investigates the anti-inflammatory effect of Foeniculum vulgare methanolic seed extract (FME) in an ovalbumin (OVA)-induced allergic airway inflammation model in BALB/c mice. Methods: Forty mice were randomly divided into five groups (n=8): normal control, disease control (OVA-sensitized), standard treatment (OVA + dexamethasone), and two test groups treated with 200 mg/kg and 300 mg/kg FME. All treatments were given orally for 7 days prior to final OVA challenge. Blood was collected to assess total leukocyte count (TLC), eosinophil, lymphocyte, and neutrophil percentages. Data were analyzed via one-way ANOVA followed by Tukey’s post-hoc test (p<0.05). Results: Disease control group exhibited significantly elevated TLC and eosinophils (p<0.001). Both FME-treated groups showed significant reduction in TLC and eosinophil count. Lymphocyte levels also declined, while neutrophils remained statistically unchanged. Effects were comparable to dexamethasone. Conclusions: FME demonstrated potent anti-inflammatory activity, particularly in reducing eosinophilia and total leukocytes, highlighting its potential as a safe plant-based alternative in asthma management. Keywords: Foeniculum vulgare, asthma, eosinophils, ovalbumin, inflammation, BALB/c mice

Background: The term "placental abruption" refers to a condition in which the fetus remains within the uterus beyond the 20th week of pregnancy, and the placenta separates from the uterine wall, either completely or partially. Placenta abruption is associated with worse fetal outcomes. Objectives: To determine the feto-maternal consequences in pregnant females presenting with placental abruption in terms of fetal death, preterm delivery, postpartum hemorrhage, and uterine atony. Methods: One hundred females with placental abruption were included from emergency of a tertiary care hospital in Lahore, Pakistan. Females were screened for maternal anemia, and HELLP syndrome was noted. Females were also observed for intrauterine death, mode of delivery, preterm delivery, stillbirth, postpartum hemorrhage and uterine atony were noted. Total hospital stay was also noted. All this data was recorded on proforma and analyzed in SPSS v23. Results: The average age of the female participants in this research was 31.51 ± 7.70 years. The symptoms of abruption lasted 5.16 ± 1.48 days on average. Anemia accounted for 36 (36%), followed by pregnancy-induced hypertension (33%) and abnormal amniotic fluid index (28%) and trauma (3%). Anemia was the leading cause of abruption. Upon doing a clinical examination, it was found that 15 (15%) of the female patients had HELLP syndrome, 4 (4%) had intrauterine death, 56 (56%), had preterm delivery, 8 (8%) had stillbirths, 40 (40%) had postpartum hemorrhage, and 17 (17%) had unborn children. Conclusion: The chances of feto-maternal consequences of placental abruption are high, especially preterm delivery and post-partum hemorrhage.

Background: Acute poisoning is a major emergency care burden in low- and middle-income countries, and frontline nurses frequently manage the earliest and most time-sensitive phases of assessment and stabilization; however, evidence indicates substantial competency gaps that may compromise early care quality (1–5). Objective: To evaluate the effectiveness of a structured educational session in improving nurses’ knowledge and self-reported practices regarding acute poisoning management in tertiary-care emergency departments in Peshawar, Pakistan. Methods: A quasi-experimental pre–post intervention study was conducted among 125 registered nurses working in accident and emergency departments of three public tertiary care hospitals. Outcomes were measured using a validated questionnaire assessing poisoning-related knowledge (15 items) and practice (35 items) (2). Participants completed baseline assessment, attended a one-hour educational session (lecture plus practical demonstration), and completed post-intervention assessment one week later. Paired-sample t-tests compared pre- and post-intervention scores with statistical significance set at p<0.05. Results: Knowledge increased from 7.08±0.78 to 14.47±0.75 (mean difference 7.39, 95% CI 7.19–7.59, p<0.001), and practice increased from 12.81±3.19 to 33.63±1.56 (mean difference 20.82, 95% CI 20.16–21.48, p<0.001). Conclusion: A brief structured educational session produced large, precise improvements in nurses’ poisoning management knowledge and reported practices, supporting protocol-focused training as a practical continuing professional development strategy in emergency settings.

Objective:To synthesize recent advancements in metastatic spinal cord compression (MSCC) treatment, evaluating their efficacy in improving neurological function, pain relief, survival, and quality of life.Background:MSCC is an oncologic emergency caused by the progression of cancer to the spine and is prevalent in approximately 3–5% of all cancer patients, with a relatively higher incidence of breast, prostate, and lung cancers. MSCC can lead to irreversible paralysis due to loss of vital sensory and motor functions, thus requiring an immediate diagnosis and treatment.Methods:A systematic PubMed search identified studies published over the past 5 years focusing on advancements in MSCC treatment. Applying the PICO criteria, 132 articles were retrieved, of which 38 met the inclusion criteria after rigorous screening.Result:Effective care of MSCC includes high-dose corticosteroids, surgery, and radiation therapy. Advancements such as robot-assisted and minimally invasive surgeries enhance surgical outcomes. Emerging technologies, including deep learning models for early detection and automated MRI analysis, improve diagnostic accuracy. Personalized medicine techniques, such as next-generation sequencing, enable the development of customized therapies tailored to individual tumor characteristics. Innovations such as bioengineered implants provide better imaging compatibility and reduce radiation scattering. Proton therapy delivers targeted radiation with minimal harm to adjacent tissues.Conclusion:Prompt, multimodal treatment is necessary, including corticosteroids, surgery, and radiation therapy to reduce symptoms and enhance patient outcomes. Despite advancements, challenges such as delayed diagnosis and limited access to specialized treatments persist. Precision medicine, artificial intelligence–based diagnostics, and easier access to clinical trials should be the main areas of future development. Preventing irreparable neurological impairments and improving patient quality of life requires a focus on palliative care and early intervention. Integrating innovative therapies with comprehensive supportive care in a patient-centered study is essential for enhancing neurological function, pain control, and overall quality of life.

Abstract Disclosure: R. Elangovan: None. K. Elangovan: None. J.R. Sethuraj: None. E. Krishnan: None. G. Palaniswamy: None. S. Nanduri: None. K. Sakalabaktula: None. U. Qureshi: None. F. Rahman: None. Z. Baloch: None. Z. Ahmed: None. S. Biswas: None. R. Muralidhar: None. C. Robert: None. K.J. Patel: None. G. Rajamani: None. N. Vora: None. S. Malapati: None. K. Noor: None. M. Kaur: None. A.S. Agrawal: None. A. Franklin Johnson: None. P. Uvaraj: None. T. Dontulwar: None. F. Madhumithaa Jagannathan: None. P.C. Sirait: None. M. Amro Alrouh: None. S. Tamma: None. S.S. Bhurchandi: None. S.K. Bhurchandi: None. Introduction: Endocrine cancers present critical challenges due to their systemic hormonal effects and intricate diagnostic profiles. With nearly 10 million cancer-related deaths annually, innovative solutions are imperative. Artificial intelligence (AI) is revolutionizing endocrinology by achieving unparalleled diagnostic precision in endocrine malignancies, offering scalable tools to reduce diagnostic errors and improve outcomes. AIM: This study aimed to develop and validate cutting-edge AI models for endocrine tumor evaluation, using multimodal data, ensuring their global generalizability, and deployment feasibility through a privacy-preserving, universally accessible application to promote equitable cancer care. Methods: Advanced deep learning architectures (EfficientNets and ResNets) were rigorously tested on anonymized multimodal datasets (CT, MRI, ultrasonography, cytopathology, and histopathology) from endocrine tumors in the thyroid, pancreas, pituitary gland, adrenal glands, and ovaries. Internal evaluations ensured model reliability, while external testing across diverse datasets from six continents validated generalizability. An online platform was developed, enabling users to test the models with their own data locally. Real-world applicability was confirmed through independent assessments by healthcare professionals worldwide. Results:EfficientNets and ResNets achieved exceptional diagnostic performance across multiple endocrine tumors (AUROC >99%) and robust generalizability. EfficientNetB0 excelled in treatment response monitoring (>97%). When deployed in an online application, EfficientNetB0 exhibited superior computational efficiency, while maintaining rapid processing speeds (<1 second/image) and diagnostic accuracy. Multi-national healthcare professionals validated the online platform’s reliability and usability, underscoring its global applicability. Conclusion: This study demonstrates the transformative impact of AI in endocrine oncology. Our findings illustrate a paradigm shift in biomedical AI, where minimal computational resources yield maximal diagnostic performance. This highlights the potential of AI-driven approaches to optimize diagnostic workflows, even with minimal computational resources, revolutionizing biomedical AI applications in cancer care. APPLICATION: The AI-powered application provides a privacy-preserving, scalable solution for endocrine tumor detection, classification, treatment monitoring, and advanced clinical decision-making. Validated multi-nationally by healthcare professionals, it ensures robust real-world applicability, fostering equitable cancer care globally. Its adaptability across platforms positions it as a universal tool for cancer care worldwide. Presentation: Sunday, July 13, 2025

Background: Antenatal care (ANC) is essential for reducing maternal and neonatal morbidity and mortality. However, in rural areas of South Punjab, Pakistan, ANC utilization remains markedly low despite the availability of public health services. Nurses, being the first-line providers of maternal healthcare in rural settings, are uniquely positioned to identify barriers affecting ANC uptake. Objective: To explore the socio-cultural, economic, and health system barriers influencing ANC utilization in rural tehsils of South Punjab from the nursing perspective. Methods: A qualitative descriptive study was conducted from March to July 2025 in three rural tehsils, Lodhran, Muzaffargarh, and Layyah. Using purposive sampling, 20 registered nurses working in Basic Health Units (BHUs) and Rural Health Centers (RHCs) with at least one year of ANC experience were interviewed through semi-structured, in-depth interviews. Data were transcribed verbatim and analyzed thematically using Braun and Clarke’s six-step framework to identify emerging patterns and themes. Results: Four major themes and ten subthemes emerged: (1) Socio-cultural barriers including restricted female autonomy, cultural misconceptions, and privacy concerns; (2) Economic and geographic constraints such as poverty, long distances, and lack of transport; (3) Health system limitations including staff shortages, infrastructure deficiencies, medicine unavailability, and negative staff attitudes; and (4) Knowledge and awareness gaps highlighting low literacy, reliance on traditional birth attendants, and minimal male involvement in maternal health decisions. Nurses emphasized that these interconnected factors collectively restrict women’s access to consistent ANC and contribute to delayed care-seeking behaviors. Conclusion: Barriers to ANC utilization in rural South Punjab are multifactorial, rooted in gender norms, economic hardship, and systemic inadequacies. From a nursing perspective, improving ANC uptake requires culturally sensitive health education, community-based awareness programs, stronger nurse-patient communication, and facility-level reforms to ensure privacy and supply consistency. Nurse empowerment and male-inclusive community interventions can play a pivotal role in enhancing maternal health outcomes in rural Pakistan.

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder with significant public health implications. Social media platforms like Instagram have emerged as influential tools for health communication, yet the quality and reliability of content remain variable. This study aimed to systematically evaluate the nature, accuracy, reliability, and overall educational quality of AD-related content disseminated on Instagram, to determine whether the information provided is evidence-based, appropriately sourced, and suitable for public health education.A cross-sectional observational study was conducted over 20 days in January 2025, analyzing posts from six popular Alzheimer’s-related hashtags. A total of 600 posts were screened, of which 288 met the inclusion criteria. Posts were assessed for type, uploader category, content category, factual accuracy, Global Quality Score (GQS), and Reliability Score. Statistical comparisons were made between two groups of posts based on content accuracy and quality.Among the 288 posts analyzed, 162 (56.25%) were images and 126 (43.75%) were videos. Doctors (90, 30.94%) and researchers (82, 28.47%) were the most common uploaders. The majority of posts focused on etiology (66, 22.19%), prevention (60, 20.88%), and symptoms (60, 20.88%). Only 120 (51.9%) posts in Group A were factually accurate, compared to 22 (38.59%) in Group B (P < 0.000001). The mean GQS and Reliability Score were significantly higher in Group A (2.28 ± 1.04 and 2.29 ± 1.21) than in Group B (1.93 ± 1.10 and 1.72 ± 1.09), indicating better quality and trustworthiness of content.Instagram serves as a widely used platform for disseminating Alzheimer’s-related information. However, the overall quality and reliability of content are suboptimal, with less than half of the posts being factually accurate. Healthcare professionals and researchers tend to produce more credible content, while posts from patients and non-medical users are less reliable. There is a pressing need to promote the creation and amplification of evidence-based, high-quality content to enhance public understanding and support for AD.