Indus Hospital

Background: Postpartum depression (PPD) is a serious mental health condition that affects women after childbirth. Early recognition of PPD is crucial for preventing worsening of maternal mental health. Objectives: This study aimed to investigate the knowledge and attitudes about PPD among women in Pakistan. Methodology: A descriptive, multicenter, cross-sectional study was conducted for 3 months in 3 public and 3 private sector hospitals in Lahore to collect data from 330 pregnant females at any gestational age, those with routine checkups 40 days after delivery, or those who came for treatment of PPD. Data were entered and analyzed using SPSS. Descriptive statistics were used to compute frequencies, and regression analysis was applied to determine factors influencing knowledge about PPD. Results: Knowledge about PPD was low, with a common misconception that it only exists with suicidal thoughts (57.3%) and occurs in females with previous psychological issues (64.3%). The majority of females (90%) had poor attitudes, believing that PPD would resolve on its own. Statistical analysis revealed a significant association between age and knowledge about PPD. Univariate analysis revealed that participants aged 31–35 (OR 2.09; p = 0.05) and >35 years (OR 2.26; p = 0.04) were more likely to have good knowledge than those aged <25 years. Educational level, family income, and area of residence did not significantly influence knowledge of PPD. Conclusion: The study revealed low levels of knowledge regarding PPD. Increasing educational awareness is crucial for improving PPD recognition and management.

Background: Major Depressive Disorder (MDD) is a leading cause of disability worldwide, characterized by heterogeneous treatment outcomes. Predicting antidepressant response remains a persistent clinical challenge, often resulting in prolonged trial-and-error approaches. Advances in artificial intelligence (AI) and biomarker research now offer opportunities to forecast treatment outcomes more accurately through the integration of multimodal data. Objective: To develop and evaluate an AI model capable of forecasting antidepressant treatment response in patients with MDD using combined clinical, neuroimaging, genetic, and digital biomarker datasets. Methods: A descriptive study was conducted over four months at a tertiary psychiatric center in Lahore, including 68 participants aged 18–55 years diagnosed with MDD according to DSM-5 criteria. Clinical severity was assessed using the Hamilton Depression Rating Scale (HDRS-17) and the Montgomery–Åsberg Depression Rating Scale (MADRS) at baseline and after eight weeks of antidepressant therapy. Neuroimaging, genetic, and digital biomarkers were collected and analyzed. Data integration and model training employed random forest and support vector machine algorithms, with 10-fold cross-validation to ensure reliability. Results: Significant reductions were observed in HDRS-17 and MADRS scores post-treatment (p < 0.001). Responders demonstrated higher cortical thickness, greater gray matter volume, and stronger functional connectivity. The random forest model achieved superior predictive accuracy (86.8%) compared with the support vector machine (83.2%), with an AUC-ROC of 0.91. These findings indicated that integrating multimodal biomarkers improved the precision of treatment response prediction in MDD. Conclusion: The study demonstrated that AI-based multimodal modeling can accurately forecast antidepressant response, supporting the potential of precision psychiatry in optimizing individualized treatment strategies for MDD.

Objective: To determine the frequency of factors responsible for allergic airway disease in children <2 years of age. Methodology: This descriptive cross-sectional study was conducted at the Department of Pediatrics, LUMHS, Jamshoro, from October 2022 to April 2023. Children under 2 years of age diagnosed with allergic airway disease were included in the study. Both boys and girls with a disease duration of at least 3 months were enrolled. The assessed factors included family history of asthma, cow’s milk protein allergy, allergic rhinitis, low socioeconomic status, maternal education level, respiratory tract infection, and prematurity. All collected data were entered into Microsoft Excel and subsequently analyzed using SPSS version 23. Results: The patients’ ages ranged from 5 to 24 months (mean: 12.28 ± 3.40 months). Of the total participants, 84 (69.4%) were male and 37 (30.6%) were female. The contributing factors identified were family history of asthma in 21 (17.4%) patients, cow’s milk protein allergy in 59 (48.8%), allergic rhinitis in 53 (43.8%), low socioeconomic status in 28 (23.1%), primary-level maternal education in 56 (46.3%), matric-level education in 50 (41.3%), above-matric education in 15 (12.4%), respiratory tract infection in 49 (40.5%), and prematurity in 31 (25.6%). Conclusion: Cow’s milk protein allergy and allergic rhinitis were the most common contributing factors to allergic airway disease in children under 2 years of age, exceeding the contribution of respiratory tract infections and prematurity.

Background: Rectal foreign bodies are a rare but serious surgical emergency that can lead to serious problems if they aren't diagnosed or treated right away. Early evaluation and the right action are necessary to avoid illness. Case Presentation: We present a patient who arrived at the emergency department with rectal discomfort after the insertion of a foreign body per rectum. The patient was stable in terms of blood flow and had no signs of peritonitis. A plain abdominal X-ray showed a foreign body that was not visible on the X-ray and was in the rectum, but there was no sign of a bowel perforation. The foreign object was successfully taken out through the anus while the patient was under general anaesthesia, so there was no need for surgery. There were no problems during or after the surgery. Conclusion: This case shows that early diagnosis, the right imaging, and timely trans anal extraction under general anaesthesia can all lead to successful non-operative management of rectal foreign bodies. A structured and multidisciplinary approach is important because it makes sure that the patient is relaxed enough for the surgery to be safe and lowers the risk of iatrogenic injury.

Late recurrence of osteosarcoma after a prolonged disease-free interval is an uncommon but significant clinical challenge, representing a failure of primary therapy to eradicate microscopic residual disease. We present the case of a 19-year-old male diagnosed with chondroblastic osteosarcoma of the proximal tibia who was treated with standard multimodal therapy, including neoadjuvant chemotherapy and limb-salvage surgery. He achieved wide (R0) surgical margins and an excellent (Huvos Grade IV, > 95% necrosis) pathological response. After a 3-year disease-free interval, he presented with an aggressive and extensive local recurrence in the residual tibia, which ultimately necessitated a below-knee amputation for local control. This case demonstrates that an excellent initial pathological response and wide surgical margins do not preclude the risk of a delayed and highly aggressive relapse in osteosarcoma. It serves as a critical reminder that a "cure" is provisional and underscores the absolute necessity of indefinite, long-term oncologic surveillance for all survivors. The phenomenon of late recurrence highlights the urgent need for research into tumor dormancy and the development of surveillance tools capable of detecting minimal residual disease.

This quantitative study evaluated the diagnostic accuracy, clinical impact, and role of Point-of-Care Ultrasound (POCUS) in rapid decision-making within emergency and trauma care settings. A prospective observational design was conducted in the emergency department and critical care units of a tertiary-level hospital, involving a consecutive sample of 120 adult patients presenting with traumatic injuries or critical medical conditions. POCUS examinations were performed by trained clinicians using standardized protocols, and findings were compared with reference standards including computed tomography, surgical findings, or definitive clinical diagnoses. Diagnostic accuracy was assessed using sensitivity, specificity, positive predictive value, and negative predictive value, while chi-square and independent samples t tests were applied for statistical analysis. Results demonstrated high diagnostic accuracy of POCUS, with sensitivity of 92.9% and specificity of 83.3% (p < .001). Patients assessed with POCUS experienced significantly reduced clinical decision-making time compared to those managed without POCUS (p < .001). Additionally, POCUS-guided management was significantly associated with improved early patient stabilization outcomes (p < .001). These findings support the effectiveness of POCUS as a reliable bedside diagnostic tool that enhances rapid clinical decision-making and improves short-term outcomes in emergency and trauma care settings.

Significant disparities remain in prenatal care utilization across countries, the specific socioeconomic and systemic factors contributing to these gaps have not been consistently synthesized. This review evaluates the gap by comparing barriers to timely and adequate prenatal care between high and low resource settings by focusing on the factors affecting prenatal service utilization through socioeconomic status and geography cultural barriers and system-related factors. The systematic review explored databases such as PubMed, Google Scholar, Scopus, Web of Science, and ScienceDirect. The recent studies from 2014 up to 2024 underwent evaluation based on Boolean operators combined with indexed keywords. Eligible studies included quantitative study designs examining barriers to prenatal care among women of reproductive age. Screening was conducted by two reviewers independently by following PRISMA guidelines. A total of 20 studies were included as per the eligibility criteria. Due to heterogeneity in study design, a structured narrative review synthesis was conducted. The main barriers identified were Socioeconomic limitations because of low income and insufficient insurance coverage and the challenges of distance to healthcare facilities and inadequate transportation combined with cultural barriers such as traditional gender roles and stigmatization and traditional beliefs. The barriers identified in high-income settings were that immigrant and refugee women faced challenges due to their status uncertainties, difficulties with language and unfamiliarity with healthcare systems. Depression along with abuse and multiple caregiving duties emerged as a major psychological factor that prevented women from accessing healthcare. System-related factors like Long waiting times and inadequate medical personnel along with insufficient respect from healthcare providers were the major identified factors. The utilization of prenatal care is influenced by a multifaceted interplay of the individual, cultural, socioeconomic, and systems factors. It is important to strengthen these community-based measures, including financial and structural assistance, to enhance equitable, timely, and sufficient prenatal care across diverse settings.

The COVID-19 pandemic posed unprecedented challenges to public health surveillance frameworks. In response, the Provincial Public Health Laboratory (PPHL), Sindh, contributed to early detection, large-scale diagnostic testing, and genomic surveillance from February 2020 to June 2025. This study reviews five years of PPHL's role in COVID-19 diagnosis, variant tracking, and public health response in Sindh. Diagnostic data included positive cases, while genomic epidemiology was assessed using commercial RT-PCR kits and in-house S-gene dropout assays as proxy tools for variant detection, supplemented by whole genome sequencing (WGS). A total of 194,415 specimens were tested, with five major peaks observed: wild-type (33.3%), Alpha (26.9%), Delta (22.0%), and Omicron (23.1%). WGS was performed on 124 selected samples, which identified Delta (AY.127, B.1.617.2), Omicron (BA.1, BA.5.2, XBB.1.9.1), and, more recently, JN.1, BA.2.86.1, and XEC lineages in May 2025. Reports of NB.1.8.1 from neighboring countries were noted, but this lineage was not detected in Karachi samples. While study limitations like low portion of sequenced samples and potential bias toward low Ct specimens exist, these findings still highlight the value of sustained laboratory-based surveillance in documenting SARS-CoV-2 evolution and supporting public health decision-making in Sindh.