Khawaja Farid Social Security Hospital

Introduction: Oncology treatments affect blood health; this study highlights nutrition’s role in reducing side effects and enhancing well-being. This study assesses chemotherapy’s impact on nutrition, quality of life, and the benefits of dietary adherence in breast cancer. Methods: This longitudinal hospital study spanned two chemotherapy cycles with triweekly followups. A total of 61 female breast cancer patients aged 24-71 years undergoing treatment with either Doxorubicin-Cyclophosphamide or Paclitaxel were enrolled. Anthropometric assessments (including weight, height, and BMI), clinical evaluations, laboratory tests (such as hemoglobin and PDW), and dietary assessments were recorded at both baseline and follow-up. BMI, Ideal Body Weight (IBW), and Total Energy Expenditure (TEE) were calculated. A dietary intervention chart was developed and offered to all participants; 20 patients adhered to the plan. Paired Student's t-tests were used for prepost comparisons, with significance set at p <0.05. Results: The cohort included patients at Stage 1 (1.6%), Stage 2 (21.3%), Stage 3 (26.2%), Stage 4 (14.7%), and undefined stage (36%). Mean BMI was 27.62 ± 5.51, IBW was 47.78 ± 5.59 kg, and TEE was 1484.9 ± 198.74 kcal. Discussion: Standard chemotherapy side effects included diarrhea, constipation, nausea, vomiting, dry mouth, anorexia, and cachexia. Among the 20 patients who adhered to the dietary plan, hemoglobin levels increased significantly from a baseline mean of 10.5 g/dL to 11.4 g/dL at follow-up (p = 0.01), and PDW improved significantly (p = 0.04). Adherent patients reported fewer gastrointestinal and systemic side effects than non-adherent patients. Conclusion: Following a balanced, nutrient-rich diet during chemotherapy reduces side effects, improves blood parameters, and enhances breast cancer patients' quality of life. conclusion: A healthy diet can reduce chemotherapy side effects and enhance the quality of life for patients.

Low-light imaging presents significant challenges for both human perception and computer vision systems, often resulting in underexposed or overexposed images that hinder analysis. In this paper, we introduce a novel Multi-Stage Image Enhancement and Correction (MSIEC) framework that effectively addresses these issues through a robust, four-stage processing pipeline. The proposed framework incorporates gamma correction in the HSV color space to achieve precise luminance adjustment, adaptive sharpening for edge preservation, localized contrast enhancement using CLAHE(Contrast Limited Adaptive Histogram Equalization), and discrete wavelet transform-based multi-channel fusion for the final output. We demonstrate the versatility of MSIEC across various domains. Comprehensive experiments were conducted on a diverse set of 18,443 images from benchmark datasets such as LOL, ExDark, DarkFace, and a random selection of other images. Performance metrics, including PSNR, NIQE, ILNIQU, and SSEQ, were employed for rigorous evaluation. A detailed comparison with eight SOTA (state-of-the-art) methods demonstrates that the proposed MSIEC framework outperforms existing techniques, providing enhanced image quality and preserving structural integrity even under challenging illumination conditions.

In recent years, the integration of ethical values into higher education has gained substantial recognition. This study investigated the relationship between ethical values and academic achievement among university students, focusing on six core dimensions: trustworthiness, respect, responsibility, fairness, caring, and citizenship. Data were collected using self-assessment and peer-assessment instruments and analyzed through a quantitative survey design. Descriptive statistics revealed a moderate to high prevalence of ethical values from both self-perceived and peer-reported perspectives. Independent samples t-test results indicated significant differences between self and peer assessments for trustworthiness, respect, and responsibility, while no significant differences emerged for fairness, caring, and citizenship. Regression analysis further identified responsibility and caring as significant predictors of academic achievement. These findings underscore the pivotal role of students’ ethical self-concept—particularly in terms of responsibility and empathy—in fostering academic success. The study recommends embedding character education into higher education curricula and adopting pedagogical frameworks that promote both cognitive excellence and ethical development.

Objectives: To determine the frequency of anatomical variations of osteomeatal complex in patients presenting with chronic rhinosinusitis. Study design: Descriptive cross-sectional study. Date and place of study: Department of Diagnostic Radiology, Combined Military Hospital, Multan, from Nov, 2024 to Apr, 2025. Methods: A total of 125 patients aged 18–65 years, clinically diagnosed with chronic rhinosinusitis (persistent symptoms lasting at least 12 weeks despite medication), and referred for CT scans of the paranasal sinuses were included in this study. A consultant radiologist identified anatomical variations of the osteomeatal complex. Descriptive statistics was applied to present the frequency and types of these variations. Results: The mean age of patients was 35.4 ± 11.2 years (range: 18–65 years). There were 59% males and 41% females. Anatomical variations of the osteomeatal complex were found in 112 (89.6%) patients. Most frequent variations were deviated nasal septum 82 (65.6%), concha bullosa 71 (56.8%), agger nasi cells 49 (39.2%), haller cells 34 (27.2%), pneumatized uncinate process 28 (22.4%), uncinate process deviation 25 (20%) and paradoxical middle turbinate 15 (12%). Conclusion: Anatomical variations of the osteomeatal complex are highly prevalent in patients diagnosed with chronic rhinosinusitis, with deviated nasal septum and concha bullosa being the most frequent variations observed in our population.

Bilateral thalamic infarcts represent an uncommon manifestation of acute ischemic stroke, often resulting from occlusion of the artery of Percheron (AOP). Thereby, we report the case of an 86‐year‐old female with a background of multiple comorbidities who presented with sudden-onset unresponsiveness. Her Glasgow coma scale (GCS) score on admission was 10/15. Non-contrast computed tomography (NCCT) of the head ruled out intracranial hemorrhage. While being empirically managed for a suspected meningitis, the patient’s admission was complicated by a marked reduction in her GCS (5/15) along with new-onset left-sided facial weakness and ptosis. On admission day 6, a diffusion‐weighted magnetic resonance imaging sequence (DWI‐MRI) revealed acute ischemic changes in the midbrain and bilateral thalami, which were consistent with the occlusion of AOP. The patient deteriorated very quickly and passed away during the same admission. This case illustrates the elusive clinical presentation of AOP infarction and underscores the urgent need for adequate neuroimaging to avoid any unwarranted medical treatment.

Introduction Breast cancer is the most common type of cancer in women worldwide, and early detection plays a key role in improving survival and treatment outcomes. National breast screening programs help identify both invasive and non-invasive cancers, such as ductal carcinoma in situ (DCIS). This study aimed to compare the one-year outcomes of screen-detected invasive breast cancer and DCIS in women diagnosed through a regional screening program. Methods A retrospective cohort study was conducted at our tertiary center in the UK. Patients diagnosed with screen-detected breast cancers from January 1, 2023, to December 31, 2024, were followed for one year post-surgery. A total of 216 patients were included: 108 with invasive breast cancer (Group A) and 108 with DCIS (Group B). Data on demographics, tumor characteristics, surgical procedures, postoperative complications, and oncological outcomes were collected using electronic records. Comparative statistical analyses were performed using SPSS version 26 (IBM Corp., Armonk, USA). Chi-square and independent t-tests were used for categorical and continuous variables, and odds ratios (ORs) with 95% confidence intervals were calculated to assess the strength of associations. Statistical significance was set at p < 0.05. Results The mean age was similar between groups (Group A: 57.6 ± 10.8 years; Group B: 58.1 ± 11.5 years). Estrogen and progesterone receptor (ER/PR)positivity was high in both groups (70.4% vs. 75%, p = 0.431). Human epidermal growth factor receptor 2 (HER2) positivity was more frequent in Group A (17.6% vs 11.1%, p = 0.173). Multifocality (24.1% vs 13%, p = 0.038), positive margins (17.6% vs 6.5%, p = 0.015), and nodal involvement (23.1% vs 0%, p < 0.001) were significantly more common in invasive cancers. Postoperative complications (hematoma, wound infection, seroma, flap necrosis) were similar in both groups. However, local recurrence was higher in Group A (9.3% vs 2.8%, p = 0.044), and one-year disease-free survival was lower (85.2% vs 97.2%, p = 0.002). Chemotherapy was given only to patients in Group A (59.3%). Conclusion In our study, we found that screen-detected in situ breast cancer had better short-term outcomes than invasive cancer, with fewer recurrences and higher one-year disease-free survival. Both groups were similar in demographics, but invasive cancer had more multifocality and required more aggressive surgery. Re-excision was more common in the in situ group. The results suggest avoiding overtreatment of DCIS and using risk tools to balance treatment with quality of life. Improving patient education, collaboration, and standardizing surgical decisions is important. The study highlights the need for evidence-based approaches in treatment planning.

Objective: To compare the outcome of Perianal block versus Saddle block in the treatment of anal fissure using lateral sphincterotomy procedure. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Multan Pakistan, from Jun 2022 to Mar 2023. Methodology: The sample of 60 patients with anal fissures were randomly divided in two equal Groups (Group-A and B) by lottery method. Group-A patients underwent perianal block while Group-B patients received Saddle block. Both the Groups underwent lateral sphincterotomy procedure for the treatment of anal fissure. Pain assessment was done every hour for first 6 hours and then after 2 hours for the next 24 hours, and total pain-free period was defined as the mean time taken from administration of block till the time the patient required rescue analgesia (75 mg diclofenac sodium intramuscularly). Results: Males were (38)63.3%, whereas (22)36.7% were females. Mean age of these patients was 36.73±9.19 years (range; 22–58 years), and (43)71.7% were aged up to 40 years. Mean time taken for rescue analgesia in Group-A was 288.17±58.13 minutes versus 117.50±18.18 minutes in Group-B (p&lt;0.001). Conclusion: Mean time taken for rescue analgesia was significantly higher in perianal block as compared with saddle block. Hence, the use of a perianal block reduces additional use of analgesic drugs.

The conventional criteria of Intrusion Detection Systems (IDS) need to evolve because they fail to detect modern cyber security threats adequately. The advantages of machine learning (ML) and deep learning (DL) models in IDS functionality are limited by the inability to provide explanations which prevents cybersecurity professionals from validating decisions. The research analyzes DL-based IDS performance and interpretability standards through the examination of the NSL-KDD dataset. A screening process identified models that combined high reliability and accuracy numbers as selection candidates. feedforward neural networks (FNN), convolutional neural networks (CNN), and recurrent neural networks (RNN)—findings revealed that CNN achieved the greatest accuracy of 94.2% along with an AUC of 0.97 exempting FNN (91.3%) and RNN (93.8%). The effective extraction of spatial features from network traffic data by CNN models leads to its higher performance. The "black-box" nature of CNNs within DL models makes them difficult to understand because they remain concealed from users. The research integrated local interpretable model-agnostic explanations (LIME) and Shapley additive explanations (SHAP) to interpret decisions at the feature level. The implemented methods did not result in substantial accuracy improvements yet they made classification decisions more trustworthy and understandable by indicating the important features involved. Furthermore, in these developments there exist technical obstacles associated with high processing expenses and performance versus deployment speed balancing requirements. Research initiatives should focus on developing explainability techniques that maintain high-performance rates and excellent interpretability in IDS systems.

Microcephaly affects 1 in 2,500 babies per year. Primary microcephaly results from aberrant neurogenesis leading to a small brain at birth. This is due to altered patterns of proliferation and/or early differentiation of neurons. Premature differentiation of neurons is associated with defects in the centrosome and/or primary cilia. In this study, we report on the first patients identified with NUBP2 -deficiency and utilize a conditional mouse model to ascertain the molecular mechanisms associated with NUBP2 -deficient primary microcephaly. We identified homozygous NUBP2 variants in these patients who displayed profound primary microcephaly in addition to intrauterine growth restriction, cervical kyphosis, severe contractures of joints, and facial dysmorphia. We then generated a mouse model using Emx1-Cre to ablate Nubp2 from the forebrain. The mice presented with severe microcephaly starting at E18.5. Neurospheres generated from the forebrain of Emx1-Cre; Nubp2 flox/flox conditional deletion mice were used to support the pathogenicity of the patient variants. We show that loss of Nubp2 increases both canonical and non-canonical cell death, but that loss of p53 fails to rescue microcephaly in the mouse model. Examination of neurogenesis in Emx1-Cre; Nubp2 flox/flox mice revealed distinct alterations in proliferation and cellular migration accompanied by supernumerary centrosomes and cilia. We therefore propose that NUBP2 is a novel primary microcephaly-related gene and that the role of Nubp2 in centrosome and cilia regulation is crucial for proper neurogenesis.

Respiratory tract infections (RTIs) are a significant global health concern, particularly with the rise of antimicrobial resistance (AMR). This study aimed to investigate the prevalence of bacterial pathogens, resistance patterns, and gender-specific differences among patients with RTIs admitted to a tertiary-level hospital in South Punjab, Pakistan. The retrospective study, which lasted from September 2023 to February 2024, included 194 patients with bacterial RTIs. Demographic data, clinical characteristics, and bacterial isolates were analyzed. The antibiotic susceptibility of 194 bacterial isolates was assessed using the disc diffusion method. Bacteria were classified as extensively drug-resistant (XDR), multidrug-resistant (MDR), or pan-drug-resistant (PDR) based on standard criteria. The impact of bacterial resistance on mortality and ICU admissions was examined using multivariate Cox regression analysis. The study cohort had a mean age of 66.5 ± 10.8 years, with 76.4% being male. ICU admissions were higher among males (25%) than females (9%). Pseudomonas aeruginosa (12.89% in males; 15.46% in females) and Klebsiella pneumoniae (3.61% in males; 9.79% in females) were the most prevalent Gram-negative bacteria, whereas Streptococcus spp. and Moraxella catarrhalis were the most common Gram-positive bacteria. A higher mortality rate was observed among MDR-infected patients (12.22%) compared to those with non-resistant strains (4.89%). Resistance to beta-lactams, fluoroquinolones, and macrolides was particularly pronounced in ICU patients. Gender-specific differences in bacterial prevalence and resistance patterns were noted, with females exhibiting higher rates of P. aeruginosa and MRSA infections. The study underscores the growing burden of antimicrobial resistance in RTIs, with significant gender-based disparities. The high prevalence of MDR bacteria highlights the urgent need for targeted antibiotic stewardship programs and infection control measures to mitigate the impact of drug-resistant respiratory infections.