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Introduction: Myocardial steatosis, a poorly documented pathology, is characterized by the accumulation of abnormal amounts of triglycerides in the cardiomyocytes. Myocardial steatosis is generally asymptomatic, but it can be the cause of heart failure. It is primarily of hypoxic or metabolic origin. Case Report: We report a case of postmortem diagnosis in a 53-year-old male patient, without known his pathological history, who was a victim of sudden death from abdominal pain. The autopsy revealed diffuse atheromatous cardiac, aortic, and hepatic lesions. Conclusion: It is very common for myocardial steatosis to be diagnosed postmortem due to its nonspecific symptomatology. The risk of mortality and morbidity could be reduced through a healthy lifestyle and regular biological examination to identify risk factors.

This review article examines the use of seductive details in nursing education activities. Seductive details are irrelevant images that are placed into educational material. Although seductive details may be found in any type of educational material and at any academic level, this article focuses on the placement of seductive details in electronic slide presentations used in nursing education activities. Educators optimistically place seductive details in educational material to engage learners or provide a momentary break from the presentation. Although engaging the learner is important, educators must use methods that do not derail how the learner's brain remembers information. Added visuals should be relevant to the material needed to be understood. Using seductive details may adversely affect learning by overloading the working memory with extraneous cognitive information, affecting the ability of the learner to create a coherent mental model needed to store a long-term memory. Evidence-based information about seductive detail use is nonexistent in nursing education literature. Professional nurse educators must carefully consider the use of seductive details in electronic slide presentations. [ J Contin Educ Nurs. 2023;54(6):261–267.]

Nanotechnology becomes the most interesting area for researchers from last two decades. There are several methods to synthesis nanoparticles but the use of green method for synthesis reduces or eliminates the generation of hazardous byproducts. Green synthesis method is environment friendly alternative to conventional synthesis techniques. Green chemistry is about reducing risk, energy, environmental impact, hazard, cost, materials and waste. The green method or biological method involves the use of microorganisms, plants etc. for synthesis of nanoparticles. In our present research work we use Murraya koenigii leaves powder extract as reducing and capping agent. Plant sources containing the phytoconstituents viz., Tannins, Alkaloids, Polyphenols, Flavonoids, Citric acid etc. Metallic and metal oxides nanoparticles of various shapes, sizes, contents and physicochemical properties can be synthesized using green synthesis method. The synthesized Iron oxide Nanoparticles were characterized be different analytical techniques. The surface morphology revealed by SEM, elemental composition by EDX, Different functional groups revealed by FTIR spectroscopy and particle size measured by particle size analyzer.

Background: Graduate nurses are known to experience transition shock when they enter the workforce. Graduate nurse programs are designed to alleviate aspects of transition shock. Method: Best practice in development and delivery of transition programs is currently limited in the literature, and there are few examples focusing on curriculum design that can be adapted by health services to develop and support new nurses. Results: An inquiry-based learning approach was used as the underlying andragogy to frame a contemporary transition curriculum to support graduate nurses. Conclusion: Inquiry-based learning can be used to support graduate nurses to improve critical thinking, confidence, and job satisfaction during the most challenging years of their professional lives. [ J Contin Educ Nurs. 2023;54(6):268–274.]

Failure to rescue is prevalent among patients with traumatic injury who are admitted to medical-surgical units. These units are traditionally staffed by new graduate nurses who require mentorship and ongoing continuing education. The coronavirus disease 2019 (COVID-19) pandemic prompted nurse educators to develop and implement new methods of providing routine and just-in-time education in the hospital setting. This article describes a trauma-focused educational program with live sessions and online educational activities created with survey software. [ J Contin Educ Nurs . 2023;54(6):275–280.]

Background: Nurses, regardless of experience, sometimes wait for the Modified Early Warning Score to indicate physiological decline before initiating the hospital's Rapid Response Team (RRT). The goal of this quality improvement initiative was to reduce nurse hesitancy to call the RRT, as indicated by the monthly number of proactive calls before the Modified Early Warning Score increased and triggered an automated page. Method: Education, planned handoff communication, debriefing, and good catch emails were the educational strategies used in the implementation of the quality improvement initiatives, encouraging RRT calls sooner. Increasing RRT knowledge and communication is an evidence-based practice strategy to reduce nurse reluctance to call the RRT. Results: After implementation, monthly proactive RRT calls increased (χ 2 [1, n = 1,964] = 14.6085, p = .000159). Bedside interventions, unscheduled transfers, and Acute Physiologic and Chronic Health Evaluation scores did not differ. Conclusion: Education, structured handoff communication, and acknowledging good catches reduced nurses' reluctance to call the RRT proactively. [ J Contin Educ Nurs. 2023;54(6):281–288.]

Background: Although mental health symptoms increased during the coronavirus disease 2019 (COVID-19) pandemic, little is known about the associations between nursing students' perceived risk of contracting COVID-19 and their academic and psychological well-being. This study examined associations between perceived COVID-19 risk, likelihood of completing nursing education, and mental health factors of nursing students. Method: A total of 979 nursing students completed self-report measures of perceived COVID-19 risk, anticipated academic completion, anxiety and depressive symptoms, stress, coping self-efficacy, hope, and social support. Results: Students with higher perceived COVID-19 risk reported increased anxiety and depression as well as decreased likelihood of graduating, coping self-efficacy, and levels of social support. Conclusion: Findings indicate the need for increased mental health support for nursing students for successful completion of their programs. Educators should increase support and proactively strengthen positive psychology factors to mitigate the effects of COVID-19 and other crises on nursing students' well-being. [ J Nurs Educ . 2022;61(11):641–645.]

The nurse residency program (NRP) was developed as a recruitment strategy for new graduate registered nurses (NGRNs). The 2020 COVID-19 pandemic impacted health care in many ways, including causing a decline in NGRN retention rates. Post-pandemic, the NRP needed to incorporate strategies that would promote nursing retention. Effective collaboration and innovative strategies were found to be key elements in promoting successful NGRN retention. [ J Contin Educ Nurs . 2023;54(6):245–247.]

A virtual learning center is the hub for storing enterprise teaching material where the information is immediately accessible and available to staff. Building and maintaining a virtual learning center requires collaboration with information technology staff, creative leaders, and tech-savvy nursing professional development specialists willing to innovate. Outcomes include cost savings, more standardized practice, and improved patient outcomes. [ J Contin Educ Nurs . 2023;54(6):250–252.]

Background: When it comes to protecting patients' rights and ensuring the quality of healthcare, medical ethics are of the utmost importance. Clinical specialists need a solid understanding of clinical morals to adhere to moral guidelines in the delivery of medical care. Objective: The study aims to determine, how well doctors in Lahore, Pakistan, are aware of medical ethics in health practices and their comprehension of healthcare ethical principles, guidelines, and decision-making processes knowledge and contribution. Methods: A cross-sectional review was conducted in Lahore with 350 health professionals from various medical services settings. The survey had unconditional and different decision inquiries to evaluate the comprehension specialists might interpret clinical morals using Medical Ethics Attitude Scale (MEAS). Results The findings of this analysis suggest that the opinions of medical professionals regarding how they adhere to medical ethics vary significantly. The professional respondents' mean score of 2.01 indicates a moderate level of agreement regarding medical ethics. To determine the significance of the differences in the assessment scores, an analysis of variance (ANOVA) was conducted. The ANOVA test resulted in an F-value of 69.87, indicating a highly significant association between the assessment scores and the variables related to knowledge of medical ethics practice.

Mesocyclopus scrassus is an insect predatory with an environmentally favourable profile. Although malaria is in control in India, there is a possible risk of spread from malarial infected people coming from other endemic countries. The probability of mosquito vectors in several parts of India, necessitates the identification of effective and innovative control methods. The present study focused on identifying an effective biological control method for the 3rd instar of anopheline larvae using Mesocyclops scrassus under laboratory and field conditions to prevent malaria. So, we investigated its potency against Anopheles larvae.

To examine influence of total quality management on perceived quality services, to identify how training and knowledge sharing impact as moderating variables and mediated by organizational culture. Non-probability convenience sampling strategy was utilized for sampling. Cross sectional study design for data collection from doctors, nurses, administrative employees and others of tertiary care hospital in Karachi. It was determined that positive outcomes of TQM in SQ in the Pakistani health sector with the aid of OC mediation demonstrate that if businesses successfully adopt TQM practices, it will improve SQ score even in private hospitals. while top-management commitment and support from the government are essential for achieving ambitious objectives. In our research, the private sector's moderation effects based on training in quality management are excellent, though knowledge sharing may serve us less in both sectors. The research can be used to understanding how specialist training projects in public and private hospitals can promote TQM adoption can be influenced by dedicated training programs in public and private hospitals.

Enhancing the administration of primary healthcare facilities might be a significant step toward achieving the quality improvement goal. The purpose of this research was to determine whether or not improvements in healthcare performance lead to improvements in the overall quality of decision-making in Medina, Saudi Arabia. In order to determine the impact that increased information security has on the quality of decision-making, the researcher used the use of a questionnaire. Our findings revealed a high level of the quality, accepting and implementing and timeliness and administrative decision-making, and this suggests that health facilities have a high degree of competence to make administrative choices in all three of their dimensions. In addition, we mentioned a high level of performance of health facilities, and this suggests that the health facilities that were investigated had a high level of performance. We found that administrative decision-making had a statistically significant influence on the performance of healthcare facilities, and we found that for every 1% rise in the level of administrative decision-making, the performance of healthcare facilities improved by 0.853%.

TV repairing is the process of fixing problems with television sets in order to restore their functionality. This can involve diagnosing the issue, sourcing replacement parts, and performing the necessary repairs to fix the problem. Some common issues that require repair include broken screens, power problems, faulty components, and audio issues. TV repairing is typically performed by trained technicians, who use specialized tools and equipment to diagnose and repair the issue. The future of TV repairing will be shaped by advancements in technology, changes in consumer behavior, and the growing demand for more convenient and efficient repair services. Television repair is the process of troubleshooting and fixing issues with malfunctioning televisions. The process of repairing a TV involves a range of skills and expertise, including knowledge of electronic circuitry, digital signal processing, and mechanical repairs. To begin the process of repairing a TV, a technician will first need to diagnose the problem with the device, which may involve running tests and examining the circuitry. Once the problem has been identified, the technician will need to source the necessary parts and components and perform the required repairs. The repair process may involve replacing faulty components, repairing broken connections, or updating software to fix bugs or glitches. With the right skills and experience, many common TV problems can be resolved quickly and effectively, restoring the device to full functionality. TVs are an essential appliance in modern households, and like any other electronic device, they can malfunction and require repair.

Artificial intelligence (AI) 's rapid advancement in dentistry has brought numerous benefits, such as improved diagnosis, treatment planning, and patient care. However, the implementation of AI in this field raises significant ethical and privacy concerns. This study aims to explore AI’s ethical and privacy implications in dentistry and analyze the perspectives of dental professionals and patients. To achieve this, a quantitative research methods approach was employed. A survey was administered to 50 Dentists, Dental Professionals, AI Developers, and Dental Patients. A survey questionnaire was administered to a larger sample of dental patients. Study was conducted in Karachi, Pakistan. The survey assessed their awareness and perceptions of AI use in dentistry, as well as their concerns regarding ethical and privacy issues. The sample size for the survey was 50 patients, randomly selected from dental clinics. The findings of this study contribute to the growing body of knowledge on the ethical and privacy implications of AI in dentistry. It provided valuable insights for dental professionals, policymakers, and regulatory bodies in developing guidelines and safeguards to ensure responsible AI integration while protecting patient privacy and upholding ethical standards in dental practice.

Background: The need for a trustworthy Trauma Registry (TR) to enhance patient care and direct trauma prevention strategies has been recognized for a very long time. Objectives: This research sought to establish, develop, and assess Pakistan's first Digital TR at SMBB Institute of Trauma. Methods: Using U.S. DIv5 TR model as starting point, locally adapted digital TR was developed, and several methodologies were used to analyze prevalence, characters, and first-aid care of trauma, as well as the feasibility of establishing a national TR. The research was conducted at SMBBIT for the period from November 2016 to December 2022. Results: Majority of patients suffering trauma were youthful 46% and predominantly male 86%, according to the demographic analysis. Direct admission from the accident scene was common 68%, and the preponderance of incidents involved 59% road accidents. In the majority of cases, 64% family members provided primary care. The leading causes of injury were 75% blunt force trauma and 59% automobile collisions. Orthopedic 35%, neurosurgical 22%, and oro-maxillofacial 12% injuries were the most common. In terms of assault-related injuries, gunshot wounds were a prominent cause of trauma.

Background: This study aimed to investigate the long-term effect of Type 2 diabetes on the quality of life of 100 patients in the Department of Diabetes and Endocrinology at the Hayatabad Medical Complex in Peshawar, Pakistan. The patients’ demographic information, medical history and associated comorbidities, and quality of life were collected and recorded. The quality of life was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) tool. The results showed that Type 2 diabetes had a significant negative impact on the physical, psychological, and social domains of the patients’ quality of life. There were significant differences between males and females in terms of physical health, psychological health, and social relationships. In addition, elderly patients reported lower scores on general health and physical activities than younger participants. These results demonstrate that Type 2 diabetes has a long-term negative effect on the quality of life of those affected and should be taken into consideration when developing treatment and prevention strategies. Objectives: The main objective of this study was to investigate the long-term effect of Type 2 diabetes on the quality of life of 100 patients in the Department of Diabetes and Endocrinology at the Hayatabad Medical Complex in Peshawar, Pakistan.

Background and Aim: Restless legs syndrome (RLS) is a prevalent neurological disease that is frequently misdiagnosed due to comparable signs and symptoms to other disorders such as diabetes, migraine, and cardiovascular disease. RLS may deteriorate with age, and it is more frequent in women than in males. The incidence of RLS varies from 6.6% to 80% in the general population. The present study aimed to assess the RLS in patients on hemodialysis. Patients and Methods: A questionnaire based study was conducted on 116 consecutive hemodialysis patients in the Department of Neurology and Nephrology of Institute of Kidney Diseases Hayatabad, Peshawar and PAF Hospital, Islamabad for the Duration from June 2022 to December 2022. Patients’ history included a history of drug, predialysis duration, and hemodialysis duration. Data was obtained using a standardized questionnaire that includes demographic variables such as personal history, family history, disease history, and smoking history.

Background: This study aimed to investigate the role of air quality and pollution in pulmonary diseases exacerbation among 100 patients with type 2 diabetes. The study included data on air quality parameters such as PM10 and SO2 concentrations, disease comorbidities such as COPD, respiratory tract infection, and asthma collected over a period of 12 months from January 2020 to January 2021. The results of the study indicated that the prevalence of exacerbations of pulmonary diseases was significantly higher in patients with poor air quality (P

Background: Infection susceptibility during anesthesia administration and surgical procedures continues to be a primary cause of morbidity and mortality, despite the advent of prophylactic antibiotics and advanced technology. During surgery, nosocomial infections frequently result in sepsis, highlighting the importance of Operation Theatre (OT) sanitation. Objectives: To evaluate the hygienic practices of anesthesiologists operating in teaching hospitals in Sindh, Pakistan. Methods: Using cross-sectional design, six-month survey of consultant anesthetists in Sindh's numerous educational institutions was conducted. A thorough, self-administered questionnaire was used to collect data on aspects of sanitation practices including knowledge of infection control, existing practices, perceived obstacles, and adherence to guidelines. Utilizing a sequential sampling procedure, participants meeting specific eligibility criteria were selected to represent a wide range of demographics, socioeconomic statuses, and healthcare delivery contexts. Results: The study contributed to closing the disparity between global standards and actual practices, thereby aligning with the global initiative to improve anesthesia hygiene practices. A total of 83 consultants were approached, but 18 declined, culminating in the analysis of data from 65 participants. Their mean age was 49.27+11.17 years. Participants were predominantly employed in private institutions (n=43) and had an average of 13.97 (SD=10.24) years of experience (p> 0.05).

Objective: The study aimed to compare the procedural time (wire crossing time) of primary percutaneous coronary intervention (PPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) using the radial approach versus the femoral approach. Study Design: A single-center, observational, retrospective cohort study was conducted. Setting: The study was carried out in the Cardiology Department of Saidu Group of Teaching Hospital (SGTH) in the period from July, 2022 TO December, 2022. Methods: Medical records of patients with acute STEMI who underwent PPCI using either the radial or femoral approach were retrospectively reviewed. Demographic, clinical, and procedural data were collected, and the primary outcome was the procedural time (wire crossing time) for each approach. Results: A total of 276 patients were included in the study, with 137 in the radial approach group and 139 in the femoral approach group. The mean procedural time (wire crossing time) was significantly longer in the radial approach group (29.6 ± 7.3 minutes) compared to the femoral approach group (24.2 ± 6.5 minutes), p

Background: The term "upper gastrointestinal bleeding" refers to bleeding from the gastrointestinal system that occurs above the Treitz ligament. It is one of the gastroenterological problems that is seen most often in clinical settings by gastroenterologists. Objective: To assess the frequency of gastric Varices amongst patients with upper gastrointestinal bleeding. Methodology: Our study was descriptive-cross sectional study, carried out at the Gastroenterology Department…….hospital Peshawar for duration of six months from August 2022 to January 2023. A careful upper-gastrointestinal endoscopy was carried out. Endoscopic findings of gastric varices in patients were recorded on a designed proforma for our research. All the documented data was analyzed by using 23. Results: In our current study a total of 120 patients were included. The male were 67 (55.83%) whereas female patients were 53 (44.17%). The mean age (SD) was 36 (9.11) years. The overall frequency of gastric varices amongst patients with gastrointestinal bleeding was 24 (20%). Conclusion: Our study concludes that frequency of gastric varices amongst patients with upper-gastrointestinal bleeding is very high. Multiple centre studies with large sample size should be conducted to get better results.

Background: In this research, premenopausal women with HR-HPV infections and atypical cervical smears were compared by age. Materials and method: 200 regularly screened women between the ages of 36 and 60 had a cervical smear and HPV detection. Demographic, behavioral, and medical data were gathered by telephone surveys. Descriptive analysis was used to look at the connection between HR-HPV infections and cervical aberrations by age. Results: Age significantly decreased the number of cases of cervical abnormalities, HR-HPV, and human papillomavirus, as well as the correlation among these disorders. In younger females with abnormalities, HR-HPV detection was 60%; however, it steadily decreased to 30% in "50-54-year-old" women, without abnormalities found in 55-60 years old females. Different relationships between HR-HPV infection and anomalies remained found in females over 45, a pattern not observed in females who were young by age. Conclusion: Age had no effect on several kinds of low-grade and severe anomalies, but we saw a decline in the agreement among cytological results and HR-HPV tests.

Introduction: Anatomy-based drug dosing strategies have emerged as a personalized approach to medication administration in surgical patients. In a sample of 150 patients who had major abdominal surgery, the purpose of this research was to assess the efficacy of this strategy. Methods: The anatomy-based dosage group and the control group were separated into two groups of patients. In the anatomy-based dosing group, medication doses were calculated based on individual body composition and organ function, while in the control group, medication doses were calculated based on standard weight-based dosing. The primary outcomes evaluated were the incidence of adverse drug reactions, pain scores, and time to postoperative recovery. Results: When compared to the control group's rate of adverse medication responses (30%), the incidence in the anatomy-based dosage group was much lower (14.3%). With a mean score of 3.8 compared to 4.4 in the control group, pain levels were also considerably lower in the anatomy-based dosage group. The mean postoperative recovery time was 8.2 days for the anatomy-based dosage group and 8.5 days for the control group, which is comparable between the two groups.

Cavities are the most common indication of dental caries, a contagious condition that leads to the deterioration of the tooth's structure. Dental caries has been identified as one of the most common oral health issue. This research has been conducted to identify them early, owing to the discomfort and high expense of treatment. Artificial intelligence has been utilized in recent years to create models which can forecast the risk of dental caries due to restrictions in medical research in oral healthcare, such as the high costs and lengthy requirements. Data for our study were collected from Khyber College of Dentistry and Hospital. On this data, a number of Deep Learning algorithms were implemented, and their performances were evaluated using recall, precision, F1-score, and accuracy. In comparison to CNN, LeNet and AlexNet deep learning techniques, VGG16 has the best performance, scoring accuracy of 98.99%, F1-score of 0.96% with precision of 0.95%, and a recall of 0.97%. This suggested paper demonstrated that DL is strongly advised for dental professionals to use in helping them make decisions for the early diagnosis and treatment of dental caries.

An observation study was undertaken at Department of Otorhinolaryngology, AIMSR fromJan 2021 – Aug 2022. The aim of my study the efficiency of use of autologous platelet rich fibrin membrane along with temporalis fascia in closure of tympanic membrane perforation during tympanopasty. All the patients attending ENT OPD at AIMSR within the age group of 11-60 years, irrespective of sex with tubotympanic CSOM either unilateral or bilateral were included in this study. In our study of 50 patients, 42 patients had graft uptake and 8 had failure of graft. Through this study we concluded that. The outcome of tympanoplasty does not depend on age and sex, dry ear of more than 6 month has a better graft.

Background: Rhinosinusitis (RS) poses a major health problem, substantially affecting quality of life, productivity, and finances. Materials & methods: The study was conducted in the Department of Otorhinolaryngology, Adesh Institute of Medical Science and Research, Bathinda on admitted patients of chronic rhinosinusitis suspected with fungal sinusitis. The specimen obtained during surgery was sent for fungal culture. All the results were analyzed by Microsoft excel software. Results: Fungal sinusitis was present in 50 percent of the patients. Mean age of the patients belonged to the age group of 39.76 years. 58 percent of the patients were males while the remaining 42 percent of the patients were females. Nasal obstruction, nasal discharge and headache were present in 44 percent, 40 percent and 38 percent of the patients. Aspergillus niger and Aspergillus fumigates was present in 32 percent and 24 percent of the patients. Mucormycosis was present in 12 percent of the patients while Candida albicans was present in 14 percent of the patients respectively.

Background: Acute inferior ST-elevation myocardial infarction (STEMI) is medical emergency entailing immediate intervention to restore blood flow and mitigate myocardial damage. Primary percutaneous coronary intervention (PCI) has replaced thrombolytic therapy as preferred treatment strategy for having superior outcomes. Objectives: To develop a risk stratification model incorporating the identified predictors to estimate the individual risk of complete AV block in patients undergoing primary PCI for acute inferior STEMI. Methods: This study enrolled 139 patients diagnosed with acute inferior STEMI who underwent primary PCI at the hospital. They were divided into two groups, i.e. pre-operative and post-operative carrying 54 and 85 patients, respectively. On admission, demographic, clinical data and peak values of cardiac biomarkers were obtained and the complications associated with PCI were elaborated. Results: Mean age of patients was 59.81+8.19 years, and comprised significantly more male (97) than female (42) patients (p

Background and Aims: Hepatitis C infection is one of leading causes of liver cirrhosis and a considerable proportion of hepatocellular carcinoma worldwide. Despite the very high efficacy of Directly Acting Viral Agents (DAAs) on clearance of hepatitis C their role remains controversial on development of Hepatocellular Carcinoma. The Aim of this study is to analyze hepatocellular occurrence in hepatitis C patients after achieving Sustained virologic response on directly acting viral agent. Methods and Material: It is prospective study conducted on outpatients in the Hepato-gastroenterology department of Asian Institute of Medical Science Hospital Hyderabad from 21-10-2018 to 20-04-2019. All patients who fulfilled the criteria were enrolled, their baseline demographic characteristics, Child Pugh Class, MELD score, alpha-fetoprotein level and Ultrasound liver before and after treatment collected. Duration of DAAs treatment and type of DAAs used also noted. Hepatocellular carcinoma labelled when Triphasic CT scan liver shows typical characters of hepatocellular carcinoma i.e. arterial phase hyperenhancement and delayed washout on portal and venous phase or ultrasound liver shows focal liver lesion with alpha-fetoprotein level more than 300ng/ml. Results: One hundred fifty-seven patients of chronic hepatitis C enrolled in the study after exclusion criteria.

The current research design was descriptive-correlation research. The statistical population of the research includes all the children of the witness families living in the border provinces of Iraq, which was selected based on Morgan's table, a sample of 250 people was available. The data were collected using the social support scale, flexibility of emotion regulation strategies and post-traumatic growth scale and were tested and analyzed using the Pearson correlation method and structural equation model in SPSS24 and AMOS24 software. The results showed, there was a direct and significant relationship between social support and resilience with post-traumatic growth. Also, emotion regulation strategies indirectly mediated the effects of resilience and social support on post-traumatic growth. It is suggested to pay attention to resilience training, emotion regulation and support for people who have experienced trauma.

Introduction: The purpose of this research was to examine how a very low-calorie ketogenic diet affected body composition and metabolic rate in overweight and obese people. Method: A 12-week weight loss program using a ketogenic diet that had only a few hundred calories per day was offered to 80 participants at the Hayatabad Medical Complex in Peshawar. Participants consumed 800-1000 calories each day and were instructed to maintain a state of ketosis. Data on body composition, metabolic rate, and appetite hormones were collected at baseline and after the intervention. Results: The study's findings demonstrated that a ketogenic diet consisting of extremely few calories helped people lose a considerable amount of weight and improved their body composition and metabolic rate. Participants' weight, fat percentage, and circumference of the waist all decreased, as well as an increase in lean body mass. The metabolic rate of the participants increased, suggesting that the ketogenic diet may help with weight reduction and metabolic health. Conclusion: This research shows that an exceedingly low-calorie ketogenic diet may help those who are overweight or obese, especially those who have insulin resistance, lose weight.

The current study is describing the main degrading scums in bromazepam, diazepam, Cefixime trihydrate, cefazolin sodium, simvastatin, and lovastatin, among other materials and manufactured items. HPLC was used to characterize pharmaceutical substance scums by comparing their retention lengths to reference standards. Before deciding, they sorted all the material from its main scums. Scums fell between 1.23 to 20.57 min, and parent compounds had try values between 2.71 and 9.22. Thus, isolating and identifying these compounds takes 20 minutes. This study identified parent compounds and degradation products using HPLC after confirming the European Pharmacopeial methodology. HPLC method validation for parent pharmaceuticals and degradation scums examined specificity, linearity, precision, and accuracy. The process can be applied to commodities and waste products using each compound's values for these qualities. 98%–102% of parent and scum materials are recovered. The experimental technique repeats within 3%. In compliance with pharmacopeial and regulatory norms, scums above 0.1% must be determined for pharmaceutical safety, efficacy, and quality. It's vital due to the effects of packaging, transit, storage, and manufacturer synthetic pathways. Adjuvants may cause degradation scums. The selected drugs' raw material and finished product levels of their main degrading scums were examined, and a concentration range was provided.

Background: Obesity is a major public health problem in both developed and developing countries and it became an important public health problem in developing countries like Sudan. Study purpose: The purpose of this study was to identify obesity and overweight and determine factors that contribute to obesity and overweight among young adults. Methods: A descriptive quantitative study was conducted in Sudan, Khartoum. The sample size was amounted to 180 collected with convenient techniques and selected according to criteria. Data was obtained through a self-administered questionnaire and was analyzed by (SPSS) version 22.0, descriptive statistics, cross tabulation were made. Results: 103 (57.2%) of participants were females and 77 (42.8%) were males. Most of the participants' 90(50.0%) ages ranged from 18–23 years. More than half of participants, 104 (57.7%) with university and post-university education, and 54.4% had an average monthly income. Obesity and obesity were 13.9% and 22.2%, respectively. Obesity was insignificantly high among females (15.5%), and overweight was higher among males (23.4%), a p-value of 0.860. Obesity and overweight are caused by a variety of factors, including hereditary and eating foods containing fat, cholesterol, and sodium.

Background: ST-elevation myocardial infarction (STEMI) is life-threatening condition requiring prompt medical attention. The diagonal branches are a group of blood vessels that supply blood to the front of the heart, and their involvement in anterior STEMI can result in worse outcomes. Early diagnosis and intervention are essential for enhancing patient outcomes. Objectives: This study's objective is to assess the efficacy of early angiography and intervention in the treatment of anterior STEMI involving diagonal branches. Methods: We conducted cross-sectional investigation of patients admitted to Medical Training Institute, Lady Reading Hospital, Peshawar, Pakistan during 2022-23, with anterior STEMI involving diagonal branches, including 250 patients whom underwent early angiography and intervention within 12 hours of symptom onset. Medical records were mined for clinical data, including demographics, medical history, electrocardiogram (ECG) findings, hematological laboratory results, and treatment modalities. The primary outcome measure was all-cause mortality at 30 days following hospitalization. Results: Mean age of STEMI patients was 61.91+8.71 years, and 68.8% were males. Median time between onset of symptoms and hospitalization was 3.50+0.78 hours. The 30-day mortality rate was 10.8% overall (27/250). Our results indicated that early intervention improved mortality outcomes, whereas late intervention increased the number of cases requiring revascularization.

Background: Acute myocardial infarction (AMI) can result in severe left ventricular dysfunction (LVD) and cardiac failure, increasing risk of complications like stroke, thrombo-embolism, and recurrent AMI. Appropriate anticoagulation strategies are crucial for mitigating adverse events. The risk stratification of these patients involves evaluating their propensity for thrombotic and hemorrhagic events. Objectives: The study determined risk stratification and anticoagulation strategies for AMI patients with severe LVD post-PCI. Methods: At a tertiary hospital in Peshawar Pakistan, an investigation was conducted on 300 patients who presented with anterior AMI and 40% LVEF upon admission. Group A received anticoagulant therapy as part of their post-PCI management, whereas Group B received standard post-PCI management without anticoagulant therapy. Various risk scores, including CHA2DS2-VASc and HAS-BLED score, and major adverse cardiovascular events, were used in assessing patient's risk of thrombosis events of bleeding through risk stratification. Results: Mean age of patients was 63.47+8.19 years, mean BMI was 28.76+3.0 and 193/300 (64.33%) were females. Hypertension, hyperlipidemia and diabetes were the prevailing comorbidities (p

Background: It is observed that HIV infected people are facing multidimensional stigma, discrimination, blames, restrictions, ban, loathing and hateful behavior by their own families, community members, neighbors, and many more people who comes in daily contact with them. The objective of the study was to determine the problems of changing social relations that HIV/AIDS patients experiences in the families and communities. Materials and Methods: The study was qualitative and cross-sectional in nature. The participants of the study were HIV infected people registered with Punjab AIDS Control Programme and enrolled at Public Hospitals and their key informants i.e. family members and medical practitioners. Purposive sampling technique was used to select the representative sample. A sample of 50 HIV infected people, 50 family members and 20 medical practitioners were interviewed. In-depth interviews were conducted with HIV infected people, family members and medical practitioners. The collected in-depth and enrich information was analyzed thematic analysis. Results: The diagnose of HIV reshape the identity of individual in the family and community. The social relations of HIV infected people change with the family and friends.

Background and Aim: Non-carious cervical lesions (NCCLs) are defined as any deterioration of the tooth tissue in terms of abrasion, composition, and erosion during normal and/or pathological function. The present study aimed to assess different etiological causes of cervical lesions among patients without caries in the population of Lahore, Pakistan. Materials and Methods: A cross-sectional analytical study was carried out on 62 patients aged 16-60 years in the Department of Dentistry of a Tertiary Care Hospital of Lahore, Pakistan from July 2022 to December 2022. Patients were categorized into two groups: Group-I (Non-carious dental lesions patients) and Group-II (without non-carious dental lesions patients). All the patients underwent clinical examinations and answered a questionnaire which included inquiries related to oral hygiene, personal impressions, eating habits, teeth appearance and functionality, and it also emphasized on the different etiologies of non-carious dental lesions.Results: Out of the total 62 patients, the study and the control groups consisted of 38 (61.3%) and 24 (38.7%) patients respectively. Age-wise distribution of the patients was as follows: 19 (30.6%) in 16-30 years, 12 (19.4%) in 31-45 years, and 31 (50%) in 46-60 years.

Background: Globally, teenage girls undergo challenges with their menstrual cycle, including managing hygiene, fatigue, physical and psychological stigma, and absenteeism from school. Methodology: Teenage girls were included in this qualitative study, with five focus groups (three sessions each) with a researcher note. A thematic approach was adopted, and the criteria of reports on the qualitative study have been adhered to: Two major concepts of themes evolved from the collected data. 1. Dysmenorrhea and 2. Physical and psychological changes. Focus groups used a diary to document the conversations. Results: The girls reported that menstrual pain limits their everyday activities and causes less confidence. They are also more likely to feel mentally low, and it hurts their outfits. Conclusions: The research explores the significance of the data from a qualitative study in uncrating teenage girls’ perception of menstrual pain and changes in their body images.

Osteoarthritis (OA) of the knee is a relatively prevalent disorder, and prevalence rises with age. Total knee replacement surgery (TKA) is a frequent operation that has significantly improved the quality of life for millions of people with symptomatic knee OA. TKA postoperative care has been discussed regarding the utility of CPM; it has been shown to speed up the recovery of full range of motion, shorten hospital stays, lessen discomfort, speed up wound healing, and lower the risk of DVT. The current study was conducted to compare Effectiveness of CPM protocol as an adjunct to Standard Physiotherapy protocol in Post-operative Rehabilitation of TKA cases. From July to December 2021, three affiliated hospitals hosted the randomised controlled study, which included patients who had complete knee arthroplasty surgery. After surgery, patients were randomly allocated to one of two groups: From the first surgical day till discharge, Group A got twice daily PT and continuous passive motion (CPM), while Group B only received the usual physiotherapy programme from the first postoperative day. Evaluation of the results took place the day after discharge. The participants in the 2 groups' baseline outcome measurement characteristics were comparable.

Background: There is a need for RNs to be skilled at coordinating care and improving transitions within and across a wide variety of clinical settings and in diverse populations. A care coordination and transition management (CCTM) course was developed to address this growing need. Method: The course was designed to promote enhanced clinical reasoning as well as synthesis and application of CCTM concepts while focusing on the patient and family perspectives. Learning activities incorporated individual writing assignments, discussion board assignments, and a group project. Results: Students demonstrated the application of CCTM concepts in individual and group assignments and used prior and current clinical experiences to connect theory to practice. Conclusion: This course helped prelicensure students learn and apply CCTM concepts. Learning activities within the CCTM course could be adapted to be effective in all forms of undergraduate programs as well as graduate nursing programs. [ J Nurs Educ . 2023;62(X):XXX–XXX.]

Extraordinary nourishing significance of milk as well as comparative lower price related to other diets containing protein made it a particular portion of dietetics amongst the inhabitants around the globe. Conversely, the amplified demand of milk globally made it disposed to gigantic intensities of deceitful actions. It is a highly risky product for falsified deeds for getting economic gains where culprits can intensify nutrition protection threats and reduce nutritious worth by deliberated contamination along with the deficiency of maintenance, negligence in deprived cleanliness circumstances, no refrigeration conveniences. Current study was directed to expose the causes, harmful consequences and solutions for the prevention of this menace. For this purpose, 60 respondents from supply chain conveniently and 150 respondents from consumer chain systematically. Due to adulteration in milk, it became considerably low nutritious levels which also be lethal for community well-being exposed through current milk adulteration outrages which caused risky issues related to socio-economic conditions in addition to psychological and serious health concerns related to stomach, eye sight, cardiac, renal, and lever failure due to hazardous additives used as adulterants in milk.

Objectives: To determine the periodontal health of pregnant women by using Community periodontal index of treatment needs (CPITN). To determine the oral health knowledge of pregnant women during pregnancy. To determine the correlation of knowledge and oral hygiene practices with periodontal health in pregnant women. To compare periodontal health, oral health knowledge and practices in different social classes during pregnancy. Methods and materials: A Cross-sectional study was carried out on 384 pregnant patients visiting gynea OPDs of Mercy, Kuwait, prime teaching hospitals and dental OPD of Peshawar dental hospital following inclusion and exclusion criteria and written consent was taken. Closed ended questionnaire was used consisting of 5 parts i-e age, trimester, oral health assessment (CPITN), oral health knowledge, oral hygiene practices and socioeconomic status. Results: Out of 384 patients 222 (57.8%) had healthy Periodontal status, followed by 75 (19.5%) having pocket depth between 3.5 to 5.5, calculus having 66 (17.2%), bleeding on probing were only 21 (5.5%) patients, whereas no patients were having pocket more than 5.5. 22(5.7%) had good oral health knowledge, 350 (91.1%) had satisfactory and 12 (3.1%) had poor oral health knowledge.

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder that requires a multifaceted approach to manage the disease, including lifestyle changes, medication, and monitoring blood glucose levels. Zinc is an essential micronutrient that plays a critical role in regulating insulin secretion, glucose metabolism, and immune function. Zinc supplementation may improve glycemic control and reduce oxidative stress in people with type 2 DM. Objectives: To determine whether zinc supplementation can enhance glycemic control in type 2 diabetic patients by investigating the relationship between serum zinc levels and glycemic control. Methodology: 100 participants with type 2 DM were recruited from local DM clinics and hospitals to participate in the study. Fifty participants were assigned to the zinc supplementation group and fifty to the placebo group. At the beginning and conclusion of the 12-week study period, serum zinc, HbA1c, and fasting plasma glucose levels were measured using blood samples. Using the t-test and regression analysis, SPSS (version 23.0) was used to conduct statistical analysis. Results: The mean age of the participants was 58.2 years, and the majority had a BMI greater than 25. There were no significant differences between the two categories in terms of participant characteristics.

Aim: To study of the morphology and the morphometry of renal artery and its variations in the branching pattern of the renal artery in the cadavers. Introduction: The kidneys are pair of essential excretory organs which elaborate urine and eliminate nitrogenous waste products of protein metabolism from the blood and maintain electrolyte and water balance of the body. Each kidney is situated retroperitoneally in the posterior abdominal wall by the side of the vertebral column, extends from T12 to L3 vertebra. Right kidney is slightly lower than the left kidney due to the presence of liver. The structures passing through renal hilum antero posteriorly are renal vein, renal artery and renal pelvis. Variations in renal vessels are mainly due to various developmental positions of the kidneys. Renal artery variations are becoming more important due to the gradual increase in interventional radiological procedures, urological and vascular operations, and renal transplantation. Methods: The present study was carried out in 50 specimens obtained from formalin preserved human cadavers, and studied by dissection method. The Renal arteries were and their branching pattern were noted then, photographed, and numbered the abnormalities if any were noted.