Pakistan Atomic Energy Commission

Objective: To determine the need for routine histopathological analysis of gallbladder specimens post-cholecystectomy in Pakistan, focusing on detecting unexpected pathologies. Methodology: This descriptive cross-sectional study was conducted at Islamabad Medical Complex, NESCOM, 1st august 2022 to 31st October 2023, involving 534 patients who were diagnosed with gallstones-induced acute or chronic cholecystitis, while excluding those with clinical or radiological indications of gallbladder carcinoma. All surgical specimens were carefully submitted for histopathological analysis, and the collected data were systematically evaluated using SPSS 26 version. Results: Overall 534 mean age of patients was 49.03 +15.02 years. The chronic cholecystitis was the most frequent histopathological finding (85.0%), followed by acute on chronic cholecystitis (13.5%), while rare lesions included gallbladder polyps (0.7%) and mucinous adenocarcinoma (0.7%). Additionally, the distribution of histopathological outcomes across different age groups (p = 0.527) and between genders (p = 0.988) showed no statistically significant differences. Conclusion: Study revealed that most gallbladder specimens following elective cholecystectomy for gallstones showed benign pathology, predominantly chronic cholecystitis, with only rare lesions such as gallbladder polyps or mucinous adenocarcinoma, and although incidental malignancy was uncommon, which indicating that the routine histopathological examination remains essential and justified to ensure early detection of unexpected neoplastic changes that could be missed on gross examination.

Background: Undiagnosed type 2 diabetes is increasingly recognised as a critical driver of preventable morbidity in low-income urban settings where constrained access to screening and limited health literacy impede early detection. Middle-aged adults in informal settlements may be particularly vulnerable due to cumulative exposure to behavioural and social risk factors. Objective: To estimate the prevalence of undiagnosed type 2 diabetes among middle-aged adults living in urban slums in Pakistan and to identify key socio-behavioural predictors. Methods: A community-based cross-sectional study was conducted among adults aged 35–60 years selected through multistage sampling. Sociodemographic, behavioural, and anthropometric data were collected using a structured questionnaire, and fasting blood glucose was measured using calibrated glucometers. Undiagnosed diabetes was defined as fasting glucose ≥126 mg/dL in individuals without prior diagnosis. Logistic regression was used to identify independent predictors. Results: Of 326 participants, 14.7% had undiagnosed diabetes. Prevalence was higher in adults ≥51 years, individuals with obesity, those who were physically inactive, and those with low educational attainment. In multivariable models, age (AOR 1.08), obesity (AOR 2.91), physical inactivity (AOR 2.43), low education (AOR 2.57), and family history (AOR 2.12) were independent predictors. Conclusion: Undiagnosed diabetes is common among adults in urban informal settlements and is shaped by metabolic, behavioural, and social determinants. Community-based screening and targeted prevention strategies are essential to address detection gaps in these high-risk populations.

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: Prolonged and frequent use of high-heeled footwear has been associated with musculoskeletal maladaptation and impairments. These include calf tightness, reduced ankle dorsiflexion range of motion (ROM), and altered gait mechanics. Over time, these changes may compromise the functional mobility of the lower extremity. Objective: to compare the instrument-assisted soft tissue mobilization and dynamic oscillatory stretch technique on ankle ROM and Lower Extremity Functions among high-heeled users. Method: This single-blinded, randomized Controlled Trial was carried out at Begam Akhtar Memorial Trust Safari Hospital from August 2023 to January 2024. A total of n=54 females aged between 20-40 years with &lt;17 degrees dorsiflexion, wearing high heels of at least 2 inches, for 5 hours/day, for more than 3 days/week, and &gt; one year included in the study. The sample was divided into group A, which received Graston mobilization (IASTM), and group B received the dynamic oscillatory stretch technique (DOST) for gastrocnemius and soleus muscles. For lower limb functions, ankle ROM goniometer and Pain were assessed through lower extremity functional status, goniometer, and numeric pain rating scale.at baseline and after the 12th session. Results: The Results showed significant improvement (p&lt;0.001) in the IASTM group as compared to the DOST group with respect to ankle ROM, pain reduction, and LEFS showed equal (p=0.303) improvements for both groups. Conclusions: IASTM is more effective than DOST in improving ankle ROMs and decreasing pain in female high heel users. However, both techniques showed similar improvements in lower extremity functional status. Clinical trial registry: NCT06086600

Underwater wireless optical sensor networks require high-speed, long-range, and scalable underwater wireless optical communication/ultra-wideband hybrid links to enable real-time data transmission and reliable communication between sensors and surface stations. Such hybrid links can provide seamless connectivity, adaptability to changing underwater environments, and support for various applications including ocean exploration, monitoring, and surveillance. We report an underwater wireless optical communication/ultra-wideband converged transmission link for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="m1"><mml:mrow><mml:mn>5</mml:mn><mml:mo>×</mml:mo><mml:mn>1.5</mml:mn></mml:mrow></mml:math> Gb/s underwater wireless optical sensor networks. The directly-modulated lasers are used to modulate and transmit the sensors’ data over underwater wireless optical communication channels towards floating optical base station having radio-access units where multiple ultra-wideband signals are generated employing optical delay line technique. Intensity modulation/direct detection scheme based upon On-off keying modulation is employed in this work. The performance of the sensors is examined taking into account various water bodies and turbulence regimes using metrics of Bit-error rate, Quality factor, and Error-vector magnitude utilizing Gamma-Gamma statistical channel model. The simulation results obtained indicate that forward-error correction target Bit-error rate of <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="m2"><mml:mrow><mml:mn>3.8</mml:mn><mml:mo>×</mml:mo><mml:mn>1</mml:mn><mml:msup><mml:mrow><mml:mn>0</mml:mn></mml:mrow><mml:mrow><mml:mo>−</mml:mo><mml:mn>3</mml:mn></mml:mrow></mml:msup></mml:mrow></mml:math> is successfully achieved for sensors considering different water bodies and turbulence regimes. The proposed system is potentially scalable, accommodating increased sensors, and supporting higher rates while efficiently generating and processing ultra-wideband signals.

Objective: This study aimed to assess the correlation between radiological imaging findings and cerebrospinal fluid (CSF) parameters in adult patients with bacterial and tuberculous meningitis, to identify distinct diagnostic patterns that could enhance differentiation and improve clinical management. Materials and Methods: A total of 97 cases, comprising individuals aged fourteen years and above, were retrospectively examined over a twelve-month timeframe following a confirmed diagnosis of meningitis. Data included clinical presentation, CSF analysis, and imaging findings from MRI and CT scans. Statistical tests, including chi-square, were used to evaluate the association between radiological and CSF patterns. Results: Tuberculomas were exclusively associated with tuberculous meningitis (p = 0.013), while infarcts were more prevalent in bacterial cases (p = 0.002). Hydrocephalus was observed more frequently in bacterial meningitis, but it was not statistically significant (p = 0.155). CSF profiles highlighted elevated protein levels and lymphocyte dominance in tuberculous cases, contrasting with neutrophilic inflammation and variable glucose levels in bacterial meningitis. The integration of radiological and biochemical data enhanced diagnostic precision. Conclusion: This study highlights the importance of combining radiological imaging with CSF analysis in diagnosing meningitis. The findings provide valuable insights into local patterns, improving differential diagnosis and patient outcomes. Prospective studies are recommended to validate these findings and refine therapeutic protocols.

Background: Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide, with significant implications for long-term child health. Among the various maternal risk factors, vitamin D deficiency has gained attention for its potential role in adverse pregnancy outcomes, including preterm delivery. However, the current literature presents inconsistent findings, necessitating a comprehensive evaluation of existing evidence to clarify this association. Objective: This systematic review aims to assess the relationship between maternal vitamin D deficiency during pregnancy and the risk of preterm birth. Methods: A systematic review was conducted following PRISMA guidelines. Databases including PubMed, Scopus, Web of Science, and the Cochrane Library were searched for studies published between 2019 and 2024. Inclusion criteria encompassed observational studies and randomized controlled trials examining maternal 25(OH)D levels and preterm birth outcomes. Studies involving animals, non-English publications, and lacking full-text access were excluded. Two independent reviewers conducted screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool. Results: Eight studies involving 15,392 pregnant women were included, comprising five cohort and three case-control studies. All studies reported a statistically significant association between maternal vitamin D deficiency (commonly defined as &lt;20 ng/mL) and increased risk of preterm birth. Adjusted odds ratios and risk ratios across studies indicated a consistent trend, with p-values ranging from &lt;0.05 to &lt;0.001. Risk of bias was generally low to moderate. Conclusion: Maternal vitamin D deficiency is significantly associated with an elevated risk of preterm birth. These findings support the clinical relevance of monitoring and managing vitamin D levels during pregnancy. Nonetheless, further large-scale randomized trials are needed to confirm causality and define optimal intervention strategies.

Background: Influenza vaccination remains a vital preventive strategy, particularly in populations with comorbidities, yet its uptake is variable across different demographic groups. Understanding factors influencing vaccination can guide public health interventions. Objective: To assess the influenza vaccination coverage rates in high-risk patient groups. Methodology: This descriptive cross-sectional study was conducted among 190 adult participants. Data were collected using a structured questionnaire assessing demographic characteristics, comorbidities, vaccination status, and knowledge about influenza vaccination. Knowledge scores were categorized as poor (0–3), moderate (4–6), and good (7–9). Statistical analyses were performed using Chi-square tests, with a p-value ≤ 0.05 considered significant. Results: The mean age of participants was 54.6 ± 14.2 years, with 56.8% males. Most participants were married (75.8%), unemployed/retired (62.1%), and resided in urban areas (63.7%). Knowledge assessment revealed that 28.4% had poor knowledge, 48.4% moderate knowledge, and 23.2% good knowledge, with an overall mean score of 4.9 ± 2.1. Influenza vaccination was significantly associated with diabetes mellitus (p = 0.027), while higher vaccination rates were observed among individuals ≥50 years (p = 0.018), those with higher education (p = 0.004), and employed participants (p = 0.042). Gender did not show a significant association with vaccination status. Conclusion: Despite moderate knowledge levels, influenza vaccination coverage remains suboptimal. Comorbid conditions, education, age, and employment significantly influenced uptake. Targeted health education and vaccination campaigns are recommended to improve coverage, particularly among high-risk groups.

Prediabetes is an intermediate metabolic state of elevated blood glucose levels that fall below the threshold for diabetes diagnosis. Often asymptomatic, it serves as an early warning sign for the future development of type 2 diabetes. Objective: To determine the frequency of prediabetes and evaluate associated demographic and lifestyle risk factors among patients attending routine outpatient checkups. Methods: This cross-sectional study was conducted at the Department of Medicine, PAEC General Hospital, Islamabad, from December 2024 to May 2025. A total of 201 patients aged 20–70 years, attending for routine checkups, were included through non-probability consecutive sampling. HbA1c was measured to assess glycemic status. Prediabetes was defined as HbA1c levels between 5.7% and 6.4%. Results: Prediabetes was detected in 26 out of 201 patients (12.9%). A statistically significant association was found between prediabetes and both BMI ≥30 (p = 0.03) and sedentary lifestyle (p = 0.048). No significant associations were observed with gender, age, smoking status, place of residence, or income. Logistic regression analysis confirmed obesity and physical inactivity as independent predictors of prediabetes. Conclusion: It is concluded that the frequency of undiagnosed prediabetes is substantial in patients presenting for routine OPD checkups. Obesity and sedentary lifestyle were key risk factors. Routine HbA1c screening should be integrated into outpatient settings to enable early detection and preventive care.