Journal of Bahria University Medical and Dental College
Click here for Old Users. The Journal of Bahria University Medical and Dental College (JBUMDC) is a peer-reviewed, multidisciplinary biomedical Journal of Basic and Clinical Health Sciences (Print ISSN: 2220-7562 and Online ISSN:2617-9482 CODEN: JBUMB7). It was established in 2011 with the main aim to promote and disseminate high-quality research papers among the healthcare research community. It is published quarterly in January, April, July, and October. It is recognized by Pakistan Medical and Dental Council (PM&DC) IP/0072 It is recognized by Higher Education Commission of Pakistan (HEC) for Year 2021-22 (Sr. No 27859) for Year 2022-23 (Sr. No 29081) for Year 2023-24 (Sr. No 29036) for Year 2024-25 There are no processing and publication charges for article processing and publication.
Bahria University Medical and Dental College
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0
Diagnostic Accuracy of C-Reactive Protein as a Predictor of Readmission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Objective: This study aimed to assess the diagnostic accuracy of CRP as a predictor of readmission for acute exacerbations of chronic obstructive pulmonary disease (AECOPD), with 30-day readmission as the gold standard. Study design and setting: A prospective observational study was carried out at the Institute of TB and Chest Medicine, Mayo Hospital, Lahore, over six months from April 2025 to September 2025. Methods: A total of 201 patients aged 40–70 years with a confirmed diagnosis of COPD, as per GOLD 2025 guidelines, and presenting with AECOPD were enrolled using a non-probability consecutive sampling technique. Serum CRP levels were measured on admission using the Spectra 1000 analyzer. Participants were followed for 30 days post-discharge to record readmissions. Data were analyzed using SPSS version 27.0. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CRP =15.8 mg/dl for predicting 30-day readmission were calculated. Results: The mean age of participants was 53.80 ± 8.99 years, with 56.7% males. The mean CRP level was 16.37 ± 19.46 mg/dl. Higher CRP levels were significantly associated with advanced GOLD stages (p < 0.001). Overall, 30.8% experienced 30-day readmission. CRP = 15.8 mg/dl predicted readmission with sensitivity 70.9%, specificity 75.5%, and diagnostic accuracy 74.1% (p < 0.001). Conclusion: Elevated CRP is significantly associated with COPD severity and early readmission, suggesting its role as a useful prognostic biomarker for AECOPD management. CRP could serve as a simple, inexpensive biomarker for identifying high-risk patients and guiding post-discharge management to reduce readmissions
Acute disease, Biomarker, C-reative protein (CRP), Chronic obstructive pulmonary disease (COPD)
Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
Comparison of Axillary Lymph Node Dissection by Using Vessel Sealing System versus Conventional Thread Ligation in Patients Undergoing Modified Radical Mastectomy for Carcinoma of Breast
Objective: To evaluate the results of the traditional thread ligation technique against the vessel sealing system employed in axillary dissection for breast cancer, focusing on the average postoperative drain output and the mean duration until drain removal. Study Design and Setting: This study was carried out at the Gujranwala Medical College/District Headquarters Hospital. A total of 120 patients were enrolled in this study following the inclusion criteria. A Non-probability consecutive sampling technique was used to divide patients into two groups. Results: In this study the mean age and BMI in Group A were 52.78 ± 10.06 years and 26.88 ± 3.94 kg/m² respectively. Similarly, the mean age and BMI in Group B were 50.27 ± 11.77 years and 29.08 ± 4.12 kg/m², respectively. In this study the mean drain removal days in the conventional group were 5.05 ± 0.81 and in the ligasure group were 4.75 ± 0.77, with the p-value being as significant as 0.040. Similarly, the mean drain fluid in the conventional group was 640.33 ± 59.80 ml and in the ligasure group was 487.83 ± 27.38 ml, p-value < 0.01. The stratification of the age with respect to drain fluid showed significant differences for all age groups, i.e., p-value < 0.01 except for age group 18-28 years, p-value 0.371. Conclusion: Axillary lymph node dissection utilising the results in a reduction in mean postoperative drain output and the average duration until drain removal compared to the traditional thread ligation technique.
Axillary Lymph Node, Carcinoma, Conventional, Dissection, Mastectomy
Late Onset neurofibromatosis (NF-VII) presenting with segmental distribution of lesions: A novel case report
Neurofibromatosis (NF) is a hemartoneoplastic syndrome with up to eight possible variants. By far NF Type I is the most common presentation. A 74 years old gentleman present at our dermatology OPD with history of asymptomatic progressive nodular lesions appearing on his left arm only for past 4 years. The family history was insignificant and examination revealed soft pedunculated skin-colored nodules of varying sizes distributed primarily over flexor aspect of left arm. There were no associated pigmentary changes or lisch nodules. Excisional biopsy reveled a well-circumscribed nodular lesion in dermis composed of multiple spindle cells packed loosely in myxoid stroma with scattered mast cells.
Late onset, Neurofibromatosis, Segmental
Meditation's Impact on Neuroplasticity: Unveiling the Anatomical, Physiological and Clinical Changes- A Meta-Analysis
Meditation affects neuroplasticity through synaptic pathways, prefrontal–limbic regulation, autonomic and biochemical systems. Randomized or controlled meditation interventions with at least one neuroplasticity related outcome published from January 2018 to April 2025 were included. Data extraction and synthesis were performed independently and combined by random-effects model. Eight studies met criteria for quantitative pooling. Structural changes included prefrontal and hippocampal plasticity (pooled SMD = 0.40, 95% CI: 0.20–0.60). Functional neuroplasticity included improved attentional network activity and decreased DMN dominance (SMD = 0.48, 95% CI: 0.25–0.70). Physiological markers demonstrated a positive trend (SMD = 0.60, 95% CI: 0.35–0.85). Higher BDNF and lower inflammatory indices were noted (SMD = 0.55, 95% CI: 0.30–0.80). Psychological outcomes and cognitive functions improved (SMD = 0.50, 95% CI: 0.25–0.75). Global heterogeneity was high (I2 = 81.3%), Egger’s test showed weak publication bias (p = 0.039). Analysis concluded significant meditation related neuroplastic changes in all studied domains
Cognition, Neuroplasticity, Meditation, Mindfulness
Copyright (c) 2026 Afshan Iftikhar, Shandana Qazi, Madeeha Sadiq, Sana Azwar, Maham Khalid, Marina Ihsan, Numan Majeed (Author) https://creativecommons.org/licenses/by-nc/4.0
Estimation of the Aortic Valve Annular Size Measured by Pre-Operative Echocardiogram Validated Against Intra Operative Measurement by Standard Valve Sizers in Patient Undergoing Aortic Valve Replacement Open Heart Surgery
Objective: This study was carried out to determine the diagnostic accuracy of transthoracic echocardiography (TTE) for preoperative sizing of the aortic annulus. It was done by comparing its measurements against the reference standard of direct intraoperative valve sizer measurement in patients who were undergoing surgical aortic valve replacement (SAVR). Methodology: This cross-sectional was conducted at the Department of Cardiac Surgery, Hayatabad Medical Complex, Peshawar. from January 2023 to June 2023. Total 194 consecutive patients who were scheduled for SAVR were enrolled. Preoperative TTE measurements of the aortic annulus were performed in the parasternal long-axis view. The primary outcome was the agreement between TTE and sizer measurements. For this the concordance was defined as a difference of ±1 mm. After data collection the statistical analysis was performed using SPSS version 20. Results: The mean age of our study population was found to be 66.8 ± 10.5 years, with 63.4% males. The TTE and sizer measurement showed a very strong positive correlation (r = 0.978, p<0.001). However, TTE systematically underestimated the annular diameter with a mean bias of -1.41 mm. The range of Bland-Altman limits of agreement was from -2.31 mm to -0.50 mm. The clinical concordance rate within ±1 mm was 81.4%. while analyzing the subgroups based on gender or valve morphology, they showed no significant differences in measurement discrepancy (p>0.05). Conclusion: The TTE establishes a very strong correlation with direct intraoperative sizing, but it also exhibits a consistent underestimation bias
Aortic Valve, Aortic Valve Stenosis, Diagnostic Accuracy, Echocardiography, Heart Valve Prosthesis Implantation, Intraoperative Care
Prospective Evaluation of Reinforced Laryngeal Mask Airway Use in Ambulatory Facial Aesthetic Surgery: A Clinician-Led Innovation in Airway Management
Objective: To prospectively evaluate the safety, ergonomic advantages, and team-centred workflow impact of the reinforced laryngeal mask airway in ambulatory facial aesthetic surgery. Study Design and Setting: A single-centre prospective observational study conducted at Care Medical Centre, Riyadh, Saudi Arabia, from 1st July–31st December 2025. Methodology: One hundred and ten ASA I–II adult patients undergoing elective facial aesthetic procedures (submental liposuction, blepharoplasty, lip lift) were managed with reinforced laryngeal mask airway under general anaesthesia without neuromuscular blockade. Primary outcomes included RLMA placement success, need for intraoperative airway adjustment, and airway-related adverse events. Secondary outcomes included recovery time and structured surgical-team satisfaction using a 5-point Likert scale.. Results: Reinforced laryngeal mask airway placement succeeded on the first attempt in 100% of cases. Minor repositioning was required in 14 patients (12.7%). No hypoxia (SpO2 <94%), laryngospasm, regurgitation, or aspiration occurred. No conversion to endotracheal intubation was necessary. Mean discharge time from post anaesthesia care unit was 2.3 ± 0.4 hours. Staff satisfaction scores were high: surgical access (4.7/5), airway stability (4.6/5), and workflow facilitation (4.5/5). Conclusion: The reinforced laryngeal mask airway is a safe, highly effective, and workflow-enhancing airway choice for ambulatory facial cosmetic surgery. Its flexible design ensures unobstructed surgical access without the need for neuromuscular blockade. This prospective cohort provides systematic evidence supporting the use of RLMA in selected facial aesthetic procedures and highlights the value of clinician-led innovation in perioperative care
Ambulatory Surgical Procedures; Airway Management; Anaesthesia, General; Laryngeal Masks; Patient Satisfaction; Post-anaesthesia Care Units
Efficacy and Safety of Percutaneous Nephrolithotomy in Patients with and without Previous Renal Stone Surgery
Objective: To determine the efficacy and Safety of Percutaneous Nephrolithotomy in Patients with and without Previous Renal Stone Surgery Study design and setting: This descriptive comparative study was carried out at the Department of Urology, Sindh Institute of Urology & Transplantation (SIUT) in Karachi, Pakistan from April 2023 to October 2023. Methodology: In the current study we included 151 patients in the age group of 18-65 years of either gender who underwent a PCNL in a prone position for renal stone of size ranging from 2-3 cm. Sample size was determined by the WHO sample size calculator at 95% confidence interval and a 5% margin of error. PCNL was done with general anaesthesia using universal techniques. Follow-up arrived at four weeks postoperatively. All the data was analyzed by using SPSS version 24. Results: Participants were 45.1±9.3 years old, with males being dominant (69.5%). In 91.4% of cases, concrete stones were cleared. These were reducing in hemoglobin 19.2%, pneumothorax 6.0%, colon injury 3.3%, and postoperative fever 12.6%. Renal patients with no previous history of renal surgery also had significantly higher stone clearance rates of 77.5% & 13.9% (p=0.005) and lower complications rates p < 0.001. Conclusion: Our study concludes that PCNL is a very efficient technique for the stone clearance with an efficiency rate of over 90%. But when patients have a previous history of renal surgery, they have lower clearance rates of stones and higher complication rates.
PCNL, kidney stones, stone removal, complications, urology
Efficacy of Topical Phenytoin vs Normal Saline Dressing in Management of Diabetic Ulcers
Objective: To compare the outcomes of topical phenytoin vs normal saline (NS) dressings to treat diabetic foot ulcer (DFU). Study Design and Setting: Quasi-experimental study conducted in the Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from January 2024 to June 2024. The study was carried out under standardized clinical protocols, and all patients were managed in a uniform hospital environment to minimize variability in treatment practices and ensure consistency in outcome assessment. Methodology: One hundred and ten (110) patients were segregated into two equal groups; (1) Phenytoin dressings group, (2) NS dressings group. Outcomes of these groups were compared. A statistical package for Social Sciences (SPSS) version 23 was utilized to assess the results. Data regarding demographic variables, clinical presentation, and wound characteristics were collected systematically using a structured proforma, and all patients were followed regularly to monitor progress and response to treatment. Results: One hundred and ten (n=110) patients were equally segregated into two groups. In the Phenytoin group, 50(90.90%) patients had improvement in wound (reduction in Wagner Grade) and in NS group 40(72.72%) patients had wound improvement (p-value 0.01). In the Phenytoin group, 2(3.63%) patients developed local complications and in NS group 7(12.72%) patients had local complications (p-value 0.08). In the Phenytoin group, 46(83.63%) patients had complete healing and in NS group 37(67.27%) patients had complete healing (p-value 0.04). Additionally, patient satisfaction was higher in the Phenytoin group, reflecting better overall acceptance of the treatment modality. Conclusion: Phenytoin dressings were found to be more effective as compared to NS dressings in promoting healing in DFU, with improved clinical outcomes and higher patient satisfaction.
Diabetic foot ulcers, Healing, Normal saline dressings, Outcomes, Phenytoin dressings
Association of TP53 rs1042522 Polymorphism with Clinicopathological Features of Breast Cancer in Patients from a Tertiary Care Center in Pakistan
Objective: Breast cancer (BC) is the most common cancer among women worldwide and a leading cause of cancer-related mortality; Pakistan has one of the highest incidence rates in Asia, highlighting its significant public health burden. Mutations in a tumor suppressor gene TP53 have attracted much interest. Therefore, the aim of this study was to evaluate the association between clinicopathological characteristics of breast cancer patients and TP53 rs1042522 polymorphism. Study Design & Setting: This cross-sectional study used non-probability consecutive sampling, including cases with adequate FFPE tissue and complete clinicopathological data. Collected variables comprised age at diagnosis, tumor laterality, histological type, tumor grade, pathological stage, and hormone receptor status, recorded according to standardized pathology reporting criteria. Genomic DNA was extracted from FFPE blocks using the Quick-DNA™ FFPE MiniPrep Kit, and DNA concentration and quality were assessed by spectrophotometry. Methodology: Formalin-fixed paraffin-embedded (FFPE) tissue samples and clinical records of 48 histologically diagnosed breast carcinoma cases were analyzed. TP53 rs1042522 genotyping was performed using tetra-amplification refractory mutation system polymerase chain reaction (T-ARMS-PCR). Associations between genotypes and clinicopathological variables were analyzed using Chi-square. Results: Total of 48 female breast cancer patients were included. Invasive ductal carcinoma was the predominant histological subtype. TP53 rs1042522 genotypes were variably distributed across tumor grades, stages, and hormone receptor status and the results showed no statistically significant association (p > 0.05). Conclusion: Study concluded with statement that, TP53 rs1042522 polymorphism showed variable distribution without significant association with clinicopathological features, suggesting a descriptive rather than predictive role in this population
Breast Neoplasms, TP53 Protein, Polymorphism, Genetic, Polymerase Chain Reaction, Receptor
Comparison of Clinical Outcomes and Union Rates Between Proximal Femoral Nail and Gamma Nail in Intertrochanteric Fractures
Objective: To compare the efficacy and outcomes of two different surgical procedures, the PFN and the GAMA nail, in the treatment of intertrochanteric femur fractures. Study Design and Settings: It was a comparative study. From 1 July 2024 to 1 Feb 2024, 35 patients with intertrochanteric fractures treated with PFN or GAMMA Nail at Shifa International Hospital's Department of Orthopaedics were part of this prospective study. Results: In this study the mean age of the cases in Group A was 69.27 ± 19.44 and in Group B was 62.15 ± 23.52. Greater tip apex at 6 weeks and 6 months is associated with higher leg length discrepancies as the pearson correlation showed significant p-value 0.000. For the PFN group (n = 13), there was a significant positive correlation between tip-apex distance and leg length discrepancy (r = 0.634, p = 0.020). Similarly, for the Gamma Nail group (n = 22), a significant positive correlation was observed (r = 0.560, p = 0.007). Conclusion: Our study showed that both gamma nail and proximal femoral nail are trusted devices for intertrochanteric fracture (boyd and griffin type ii) treated by PFN vs Gamaa nail. The comparison of union rate at 6 weeks and 6 months showed and pain score showed comparative results. Moreover, the results showed that Greater tip apex at 6 weeks and 6 months is associated with higher leg length discrepancies as the pearson correlation showed significant p-value 0.000.
Boyd and Griffin, Gamaa Nail, Intertrochanteric Fracture, PFN, Union Rate
Comparison of Postoperative Pain between Lichtenstein’s Repair and Laparoscopic Transabdominal Preperitoneal (TAPP) Repair of Inguinal Hernia
Objectives: To compare post-operative pain score between Lichtenstein’s repair versus laparoscopic trans-abdominal preperitoneal (TAPP) repair for inguinal hernia. Study Design and Setting: Comparative cross sectional study. “Combined Military Hospital, Lahore from July-2021 to July-2024”. Methodology: The current study was approved from the ethical committee of the hospital. For sample size calculation, Open Epi sample size calculator was used. Eighty patients who presented with inguinal hernia were included in the study. They were non-randomly assigned into two groups of 40 patients; group A (Lichtenstein’s repair) and B (TAPP repair). Diagnosis of inguinal hernia was made using clinical assessment and ultrasound. Patients were allocated “Lichtenstein group” and “TAPP group” in two phases. From July 2021 to January 2023, 40 patients underwent “Lichtenstein hernia repair” while in second phase from January 2023 to July 2024, remaining 40 patients underwent “TAPP repair”. the patients were assessed and compared for post-operative pain score. Data was analyzed using SPSS version 22. Results: In this study, 80 patients were included. Mean age was 48.10 ± 5.05 years. There were all 80 (100%) males. Median BMI was 27.00 (29.40 – 19.70) kg/m2. Median duration of hernia was 5.00 (12.00 – 2.00) months. Frequency of ASA status I was 29 (36.25%) and of ASA status II was 51 (63.75%). Median post-operative pain VAS in “Lichtenstein group” was 6.00 (6.00 – 5.00) while in “TAPP group” it was 4.00 (4.00 – 3.00), (p < 0.001). Conclusion: TAPP repair for inguinal hernia is associated with less postoperative pain as compared to Lichtenstein’s repair
Inguinal Canal, Inguinal Hernia, Laparoscopy, Postoperative Pain, TAPP, Visual Analogue Scale.
Comparison of Mean Post-Operative Pain after Nerve Preservation versus Prophylactic Ilioinguinal Neurectomy in Lichtenstein Tension free Meshplasty for Inguinal Hernia Repair
Objective: To compare the mean post-operative pain of nerve preservation and prophylactic ilioinguinal neurectomy in patients undergoing Lichtenstein tension free meshplasty. Study Design and Setting: This is a prospective comparative study that was conducted at the University of Lahore Teaching Hospital over the given period from November 2024 to May 2025. Methodology: The study sample was 134 people between the ages of 18 and 60 who were diagnosed with inguinal hernia. The participants were randomly allocated into two different groups - Group-A in which the nerve preservation was performed and Group-B in which prophylactic ilioinguinal neurectomy was done. Post-operational pain levels were checked on the third day after the surgery on a numerical analogue scale from 0 to 10. Statistical analysis was done by software package of the statistical programme and data analysis (SPSS) version 25. The results of this study were analysed by independent student t-test which p<=0.05. Results: A total of 134 patients were included, with 67 patients in each group. The majority of patients in both groups were male and belonged to the age group above 45 years, with comparable baseline characteristics between the groups. The mean post-operative pain score at 72 hours was significantly lower in the neurectomy group (2.12±1.17) compared to the nerve preservation group (3.07±1.10) (p=0.001), indicating better pain control with prophylactic ilioinguinal neurectomy. Conclusion: Prophylactic ilioinguinal neurectomy decreased the pain experienced after surgery compared to nerve preservation in patients undergoing Lichtenstein tension-free meshplasty for inguinal hernia repair.
Inguinal Hernia, Ilioinguinal Neurectomy, Lichtenstein Meshplasty, Nerve Preservation, Post-Operative Pain
Clinical Outcomes and Safety of 25-Gauge Pars Plana Vitrectomy in Vitreous Haemorrhage
ABSTRACT Objectives: This study evaluates the outcomes of 25-gauge pars plana vitrectomy (25G PPV) for dense vitreous haemorrhage (VH) of diverse etiology Study Design and Settings: This is a prospective interventional study in which 25G PPV was performed for dense VH at a tertiary eye care centre. Eligible cases were selected from surgical retina clinic. Methodology: All the investigations to determine the cause of VH were performed. Preoperative best corrected visual acuity(BCVA) was measured and then 25G PPV was performed. All the surgeries were done by the same surgeon. BCVA measurements were performed at postoperative day 1(Day1), one-month(1M), and two-month(2M) visits. Visual outcome was categorized based on underlying cause of VH Results: The mean patient age was 51.4 years, with proliferative diabetic retinopathy (40.8%) being the most common aetiology, followed by central retinal vein occlusion (CRVO) and ocular trauma. Surgical intervention resulted in a significant and sustained improvement in visual acuity at all postoperative intervals (p < 0.001), with a mean gain of 0.530 logMAR at the two-month endpoint. The magnitude of improvement varied by aetiology; eyes with CRVO demonstrated the largest mean gain (0.784 logMAR), while trauma cases showed modest recovery (0.317 logMAR). The procedure demonstrated a favourable safety profile, with an overall complication rate of 14.3%, primarily consisting of recurrent VH (8.2%). Conclusion: These findings confirm that 25-gauge PPV is a highly effective and safe intervention for restoring visual function in patients with dense VH, with aetiology serving as a key determinant of the final visual outcome Keywords: Vitreous Haemorrhage; Diabetic Retinopathy; Central Retinal Vein Occlusion (CRVO); Pars Plana Vitrectomy
Vitreous Haemorrhage; Diabetic Retinopathy; Central Retinal Vein Occlusion (CRVO); Pars Plana Vitrectomy
Effect of Inhaled Salbutamol on outcome of Transient Tachypnea of Newborn (TTN) in Neonatal Care Unit at AIMS Muzaffarabad
Objective: To compare the outcome of inhaled salbutamol versus placebo, in addition to standard treatment, among neonates with TTN. Study Design and Setting: A cross-sectional study was conducted in the Neonatal Unit, Department of Pediatrics Medicine, Abbas Institute of Medical Sciences, Muzaffarabad, over six months (14-Feb-2025 to 13-August-2025). Methodology: The study included a total of 80 neonates who fulfilled the inclusion criteria. Neonates were divided into two groups in accordance with the treatment given to them as part of standard clinical treatment: inhaled salbutamol or nebulized normal saline. Descriptive analysis was performed using SPSS version 25. Quantitative variables were given as mean ± standard deviation, while qualitative variables were reported as frequencies and percentages. An independent sample t-test was conducted to compare outcomes between the two groups. Statistical significance was defined as p=0.05. Results: The duration of oxygen therapy was significantly shorter in the salbutamol group (32.75 ± 2.12 hours) compared to the control group (78.20 ± 2.77 hours; p = 0.001). Similarly, the mean length of hospital stay was significantly reduced in the salbutamol group (3.05 ± 1.15 days) compared to the control group (5.78 ± 1.00 days; p = 0.001). Conclusion: Inhaled salbutamol, in addition to standard treatment significantly reduced the length of oxygen withdrawal and length of hospital stay in neonates with TTN. It might therefore represent effective adjuvant therapy to enhance the outcome and lessen the burden on hospitals of infants with the condition
B2-Agonist, Neonatal Respiratory Distress, Salbutamol, Transient Tachypnea of the Newborn
Association of Carotid Intima Media Thickness with the Extent of Angiographically Proven Coronary Artery Disease
Objective: To evaluate the association between carotid intima-media thickness (CIMT) with the extent of angiographically proven coronary artery disease (CAD). Study Design and Setting: A cross-sectional study was conducted at Khyber Teaching Hospital (KTH), Peshawar. Methodology: The study included 65 patients receiving diagnostic coronary angiography and was conducted from 1st April 2025 to 30th September 2025. Cardiovascular risk factors were among the baseline clinical and demographic features that were documented. High-resolution B-mode ultrasonography was used to measure CIMT. The degree of CAD was classified as either no CAD, single-vessel, two-vessel, or three-vessel disease, and its severity was measured using the Gensini score. Regression and correlation models were used to examine relationships between CIMT and angiographic results. The diagnostic accuracy of CIMT for predicting obstructive CAD was assessed using receiver operating characteristic (ROC) curve analysis. Results: The mean age of participants was 56.2 ± 9.8 years, with 64.6% males. Obstructive CAD was present in 75.4% of patients. CIMT increased progressively with the extent of CAD, from 0.68 ± 0.10 mm in patients without CAD to 1.02 ± 0.13 mm in those with three-vessel disease (p < 0.001). CIMT showed a strong positive correlation with the Gensini score (p < 0.001). ROC analysis demonstrated good diagnostic accuracy (AUC = 0.82). Conclusion: CIMT is a reliable, non-invasive marker that correlates with the severity of CAD and can aid in early risk stratification and clinical decision-making.
Carotid Intima-Media Thickness; Coronary Angiography; Coronary Artery Disease; Gensini Score; Risk Factors; Ultrasonography
Early Response Evaluation of Hepatocellular Carcinoma After Transarterial Chemoembolization Using Triphasic Computed Tomography
Objective: To aim of this study was to evaluate the early tumor response of hepatocellular carcinoma (HCC) to transarterial chemoembolization (TACE) using triphasic computed tomography (CT). Study Design and Setting: This was a retrospective study conducted at Indus Hospital & Health Network, Karachi. Methodology: A total of 102 patients were included for six months study between 1st February 2025 and 31st July 2025. Tumor response was assessed 6 weeks post-TACE according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) and categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). The Chi-square test was applied to test statistical significance of differences across response categories, with a pvalue of <0.05 considered statistically significant. Results: CR was observed in 36% and PR in 32% of patients, giving an overall response rate of 68%. SD was seen in 20% and PD in 12%. Triphasic CT demonstrated a diagnostic accuracy of 88%, with sensitivity of 85% and specificity of 90%. Inter-rater agreement was substantial (ê = 0.82, p < 0.001). Patients with Child-Pugh class A liver function showed higher response rates (76%) compared to Child-Pugh class B (50%), though this was not statistically significant (p = 0.09). Conclusion: Triphasic CT is a reliable and reproducible imaging modality for early assessment of tumor response following TACE in HCC. It provides high diagnostic accuracy and can guide treatment decisions.
Carcinoma, Hepatocellular; Contrast Media; Liver Function Tests; Reproducibility of Results; Tomography, X-Ray Computed
Marriage within Bloodline: Assessing the Impact of Consanguinity on Type 2 Diabetes in Karachi, Pakistan
Abstract Objective: To investigate the association between parental consanguinity and complications of type 2 diabetes mellitus in the Pakistani population. Study design & Setting: A cross- sectional study was carried out on the participants from the medical outpatient department at PNS Shifa hospital Karachi, diagnosed with type 2 diabetes mellitus of consanguineous and non-consanguineous family backgrounds from 25th August to 24th October 2025. Methodology: 423 participants were utilized to collect the information about their demographic data, clinical background, diabetes control indicators, complication status, and treatment strategies in the form of medication and lifestyle interventions. Pearson Chi-Square test was used to analyze the relationship between consanguinity, the onset, severity, and treatment outcomes of diabetes. Results: Participants born to non- consanguineous parents, 0.6% (1) were suffering from cardiovascular disease; 1.7% (3) had hypertension, 1.1% (2) had a visual problem, and 0.6% (1) were reported to have dyslipidemia. Among the progeny of consanguineous parents, 14.5 %( 35) were suffering from cardiovascular disease, 4.1% (10) suffered from chronic kidney disease, 21.5 %( 52) had hypertension, 38.0% (92) had problems related to vision, and 7.0 %( 17) were reported to have dyslipidemia after being diabetic. There is a strong significant association between diabetes and their complications in the offspring of consanguineous couples after being diagnosed as diabetics (p<0.01). Conclusion: Clarifying the role of consanguinity in the prevalence and progression of T2DM can promote understanding of genetic susceptibility among high-risk populations and guide culturally sensitive public health practice and genetic counseling policy in Pakistan
Consanguinity, Type 2 Diabetes Mellitus, Genetic predisposition, Public health.
Association of Obesity-Induced Systemic Inflammation with Severity and Radiological Progression of Osteoarthropathy in Adult Patients
Abstract Objective: To determine the association of obesity-induced systemic inflammation with the severity and radiological progression of osteoarthropathy in adult patients. Study Design and Setting: A cross-sectional analytical study was conducted at the Department of Orthopedic Surgery, Federal Government Polyclinic Postgraduate Medical Institute (PGMI), Islamabad, over two years, from August 2023 to August 2025. Methodology: Non-probability consecutive sampling was used to enroll 387 adult participants aged 18–65 years. Anthropometric measurements were obtained, including body mass index (BMI) and waist circumference. Standard assays were used to measure laboratory parameters, including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), fasting glucose, and lipid profile. The radiological severity was determined using the Kellgren–Lawrence (KL) grading system. Results: The mean ± standard deviation (SD) age was 51.4 ± 8.8 years. Obese participants (n = 193) had significantly higher BMI (29.6 ± 3.4 kg/m²) than non-obese participants (23.5 ± 2.8 kg/m², p < 0.001). The median (interquartile range, IQR) hs-CRP was 4.8 (3.1–6.9) mg/L in obese participants and 2.1 (1.3–3.4) mg/L in non-obese participants (p < 0.001). Severe radiographic osteoarthropathy (KL grade 3–4) occurred in 42.3% of obese participants versus 24.7% of non-obese participants (÷² = 13.91, p < 0.001). Conclusion: These results indicate that systemic inflammation, rather than mechanical loading, leads to disease pathology. Early detection could facilitate preventive and individualized approaches for obese patients in orthopedics.
C-reactive protein; Interleukin-6; Obesity; Osteoarthropathy; Radiographic progression; Systemic inflammation
Relationship between Preoperative Risk Factors and Need for Blood Transfusion in Transurethral Resection Of The Prostate (TURP)
Objective: To assess the incidence of blood transfusion after transurethral resection of the prostate (TURP) and to examine the relationship between preoperative risk factors and need for blood transfusion. Study design and Setting: Descriptive study conducted in the Department of Urology, The Indus Hospital and health network, Karachi from 1st Sep’ 2024 to 28th Feb’ 2025. Methodology: Sixty patients who underwent TURP after approval by the IRB. Patients with bleeding diatheses, anticoagulant use within the previous 2 weeks prior to surgery or preoperative treatment with 5-alpha reductase inhibitors were excluded. The data was written on predesigned proforma and analyzed by using SPSS V.26. Risk factors were evaluated in patients who needed transfusion. Univariate analysis was performed by descriptive statistics and Chi-square or Fischer’s exact test as appropriate, the level of significance adopted being p<0.05. Results: Sixty patients were enrolled with a mean age of 67 ± 7.29 years. Hemoglobin and hematocrit decreased from 13.1 ± 1.42 g/dl and 39.7 ± 4.27% preoperatively to 12.3 ± 1.61 g/dl and 37.1 ± 4.68% postoperatively, with median reductions of 0.7 g/dl and 2.35%, respectively. Hypertension (28.2%) and diabetes (15.4%) were the most common comorbidities; 39.7% had none. Only one patient (1.7%) required transfusion, associated with indwelling catheter, prior TURP, short symptom duration, and prostate size of 40–60 g. No significant association between risk factors and transfusion was observed. Conclusions: The rate of transfusion after TURP was low, Universal cross-matching and prearrangement of blood in all patients are probably not indicated
Aged; Blood Transfusion; Hemoglobin; Prostatic Hyperplasia; Transurethral Resection of Prostat
Clinical Accuracy of PRISM III Score in determining mortality in severely ill Pediatric patients in Pediatric ICU
Objective: To assess the accuracy of PRISM III score in predicating mortality in severely ill pediatric patients. Study Design and Settings: A cross sectional study was conducted in Pediatric ICU of BVH from 1st March 2021 to 28 Feb 2022. Methodology: Patients were enrolled after informed consent as per inclusion and exclusion criteria. Clinical details and lab data were collected within 4 hours of admission to ICU and documented on performa. Outcome was followed. Results were analyzed in spss 20. Results: Out of 34 patients 13 (38.2 %) were male and 21 (61.8 %) were females. Age ranges from 1 month to 14 years. Regarding diagnosis maximum patients were of pneumonia and Pyomeningitis, that were 5 each this makes 14. 7% of study population for each diagnosis. PRISM score ranges from 0 to 14 with mean of 4.3 and median of 3. Out of them 21 (61.8 %) had PRISM score 3 or less and 13 (38.2 %) had 4 or more. PRISM III score has Sensitivity of 71.4 %, specificity of 70.3 %, Positive predictive value of 38.4 %, negative predictive value 90.4% and diagnostic accuracy of 20.5 %. Conclusion: PRISM III score has clinical accuracy of 20.5 % in determining prognosis in severely ill pediatric patients. Keyword Index: Mortality, PRISM III score, Pediatric ICU
Mortality, PRISM III score, Pediatric ICU
Efficacy of combined treatment with Ketoconazole 2% Cream and Adapalene 0.1% Gel vs. Ketoconazole 2% Cream monotherapy in Pityriasis Versicolor
Objective: To compare the efficacy of combined treatment with Ketoconazole 2% Cream and Adapalene 0.1% Gel versus Ketoconazole 2% Cream monotherapy in Pityriasis Versicolor. Study design and Setting: Randomized Controlled Trial conducted at Dermatology Department of PNS Shifa, Karachi from 19th July 2024 to 30th July 2025. Methods: A randomized trial included 176 patients with Pityriasis Versicolor (88 per group). Group A received ketoconazole 2% cream twice daily plus Adapalene 0.1% gel nightly for 4 weeks, and Group B received ketoconazole alone. Efficacy at week 4 was defined by clinical improvement, negative Wood’s lamp, and KOH microscopy. Data were analyzed in SPSS v26 using chi-square test; Means and standard deviations were calculated for continuous variables (age, BMI, disease duration), while frequencies and percentages were reported for categorical variables (gender, efficacy). The chi-square test was used to compare efficacy between groups, p<0.05 was considered significant. Results: The mean age in Group A was 25.1 ± 4.0 years and in Group B was 25.8 ± 4.2 years. The majority of patients were male, and the distribution of types of pigmentation was comparable in both groups. The efficacy of combination therapy (Group A) was 89.8%, compared to 43.2% with monotherapy (Group B), demonstrating a statistically significant difference (p < 0.001). Conclusions: Combination therapy with ketoconazole and adapalene was significantly more effective than ketoconazole monotherapy in the treatment of Pityriasis Versicolor Keywords: Adapalene, Combination treatment, Efficacy, Ketoconazole
Diagnostic Yield of AFB smear and GeneXpert on Bronchial Washings with Fiber-Optic Bronchoscope in Patients with Sputum-Negative Pulmonary Tuberculosis
Objective: To determine and compare the diagnostic yield of acid-fast bacilli (AFB) smear microscopy and GeneXpert testing performed on bronchial washings in patients clinically suspected of pulmonary tuberculosis (PTB) but negative for both sputum AFB smear and GeneXpert. The study also aimed to evaluate the utility of bronchoscopic sampling as an adjunct diagnostic tool in sputum-negative PTB, where conventional methods often fail to confirm the diagnosis. Study Design and Setting: A descriptive cross-sectional study conducted at the Department of Pulmonology, Mayo Hospital, Lahore, from 7 March 2025 to 10 June 2025. Methods: Patients aged 18–65 years with clinical and radiological evidence suggestive of PTB but negative sputum AFB smear and GeneXpert results were included. Bronchial washings were obtained through fiber-optic bronchoscopy and analyzed using Ziehl–Neelsen staining and GeneXpert MTB assay. Statistical analysis was performed using SPSS version 27, and diagnostic yields were compared. Results: A total of 95 patients were enrolled, with a mean age of 35.49 ± 11.03 years. Of these, 53.7% were males and 65.3% were non-smokers. GeneXpert detected Mycobacterium tuberculosis in 85.3%, while AFB smear was positive in 56.8% of bronchial wash samples. GeneXpert showed a higher diagnostic yield compared to AFB smear in sputum-negative PTB cases. Conclusion: GeneXpert testing of bronchial washings markedly enhances the diagnostic yield for sputum-negative PTB and should be incorporated as a routine diagnostic tool in patients with strong clinical and radiological suspicion of tuberculosis despite negative sputum findings. Keywords: Bronchoscopy, Bronchial lavage, Pulmonary tuberculosis, Sputum
Cognitive Disorders in Patients with Chronic Kidney Disease
Objective: To asses and identify prevalence and severity of cognitive disorders through cognitive screening test in patients with Chronic Kidney Disease (CKD). Study Design and Setting: This observational cross-sectional study was conducted in Nephrology Department at PNS Shifa hospital Karachi from February 01, 2025 to July 31, 2025. Methodology: Total of 201 patients who either visited OPD or came in dialysis center were included in study. All adult patients with CKD, aged above 18 years, either gender, with or without comorbids were enrolled after informed consent both verbal and written. A set questionnaire was used for data collection, subsequently was analyzed by using SPSS version 25. Results: Cognitive impairment (CI) has been found in 122 (60.69%) patients suffering from CKD while 79 (30.3%) were devoid of such presentation. Significant point of note among cognitively impaired persons was that greater proportion had mild form of disease, i-e: 79 (64.75%) otherwise 28 (22.9%) patients had revealed moderate form and 8 (6.5%) patients had severe form of cognitive disorder. It was also evident that moderate and severe form of CI were more pronounced in patients who were on maintenance hemodialysis. Conclusion: CKD patients particularly those who are on maintenance hemodialysis are prone to suffer from cognitive disorders, an overlooked complication. It is necessary to make physicians/ Nephrologists aware of this complication so that all patients with CKD maybe screened for CI and early application of required therapy be initiated to curb further deterioration. Key Words: Chronic Kidney Disease: Cognitive disorders: Cognitive Screening Test
Comparative Analysis of Clinical and Functional Outcomes of Dynamic Hip Screw Versus Proximal Femoral Nail Antirotation (PFNA) in Intertrochanteric Femur Fracture Fixation
Objectives: The comparative clinical and functional effectiveness of dynamic hip screw and proximal femoral nailing for fixation of intertrochanteric femoral fractures in Pakistan. Study Design and Setting: A hospital-based prospective analytical study was undertaken in a tertiary care hospital of Pakistan, where intertrochanteric fractures constitute a growing burden among older adults and both fixation techniques are routinely employed in resource-constrained clinical environments. Methodology: In this hospital-based prospective analytical study, 256 patients aged 40–80 years with intertrochanteric fractures were enrolled and allocated to DHS or PFNA groups (n=128 each). Functional outcomes were assessed using the Harris Hip Score (HHS) at six months. Biochemical, clinical, and demographic variables were recorded. Statistical tests included t-test, Mann–Whitney U, chi-square, and logistic regression using SPSS v26, with significance set at p<0.05. Results: PFNA fixation resulted in significantly higher HHS (84.6 ± 7.5 vs. 78.3 ± 8.2: p < 0.001), shorter operative time (65 [58–77] vs. 82 [70–94] min: p < 0.001), and fewer postoperative infections (5.1% vs. 13.9%: p = 0.047) than DHS. PFNA patients had shorter hospital stays and better pain and ambulation outcomes. Radiological union was more frequent in PFNA but not statistically significant (p = 0.124). Logistic regression identified PFNA as an independent predictor of good functional recovery (OR = 2.78: p = 0.003). Conclusion: PFNA was associated with superior short-term functional outcomes, reduced surgical morbidity, and fewer complications compared to DHS. These findings support its preferential use in intertrochanteric fracture management within low-resource settings.
Clinical outcomes, Dynamic hip screw, Intertrochanteric femur fracture, Proximal femoral nailing
Complications of Trans-Rectal Ultrasound-Guided Prostate Biopsy: A Single-Centre Experience from Sindh Institute of Urology and Transplantation
Objective: To evaluate the frequency, severity, and types of complications associated with TRUS-guided prostate biopsy in patients at the Sindh Institute of Urology and Transplantation (SIUT) over an 18-month period. Study Design and Setting: This observational study included 302 male patients who underwent TRUS-guided prostate biopsy between January 2023 and June 2024. Methodology: Pain severity was measured using the Visual Analog Scale (VAS). Complications such as haematuria, urinary tract infections, hematospermia, rectal bleeding, acute urinary retention, and epididymo-orchitis were documented. Descriptive statistics were used for data analysis. Results: Acute urinary retention (6,2%) , urinary tract infection (6.2%) , visible haematuria (8.5%)and probe-related pain (VAS 9= 11.8%) were observed in patient underwent TRUS-guided biopsy. Hematospermia and epididymo-orchitis were seen in 10.2% and 15.8% of cases. Rectal bleeding was least common (3.3%). Conclusion: TRUS-guided prostate biopsy is associated with significant procedural discomfort and a notable incidence of post-procedure complications. Enhanced pain management protocols and infection prevention strategies are essential to improve patient outcomes and procedural safety. Keywords: Trans rectal ultrasound guided prostate biopsy, Infection, Acute urinary retention
Lisa vs Insure in the Treatment of Respiratory Distress Syndrome in Preterm Infants
ABSTRACT Objectives: To compare the outcome of Less Invasive Surfactant Administration (LISA) versus Intubation–Surfactant–Extubation (INSURE) for treatment of respiratory distress syndrome in preterm infants Study design and Setting: Randomized controlled trial, Department of Pediatric, Fauji Foundation Hospital Rawalpindi. March 27, 2022 till September 26, 2022 Subjects: Total 70 neonates aged 1 to 24 hours of life having gestational age of 32-36 weeks of either gender having respiratory distress syndrome were enrolled using non- probability consecutive sampling technique. Methodology: Study was conducted after approval of hospital ethical committee and written informed consent of parents. Neonates were enrolled in LISA group A and INSURE group B using lottery method. In LISA group surfactant was given using 6Fr nasogastric tube and in INSURE group neonates were intubated and surfactant was given. Frequency of need for mechanical ventilation in both groups was noted. Data was entered and analyzed using SPSS 21. Results: In our study total 70 patients were enrolled, 35 patients in each group. Mean age was 7.8±6.6 hours in group A and 6.6±5.9 in group B. There were 40% males in group A and 57.1% in group B. females were 60% in group A and 42.9% in group B. In LISA group 28.6% needed mechanical ventilation while in INSURE group 60% needed mechanical ventilation, p-value 0.008 Conclusion: LISA is more effective in preventing need for mechanical ventilation after surfactant administration in preterm neonates
Intubate-surfactant-extubate: Less invasive surfactant administration: Preterm: Respiratory distress syndrome: Surfactant.
Assessing the Predictive Value of Uterine Artery Flow Parameters in Patients with Recurrent Spontaneous Abortion
Objective: To compare uterine artery flow parameters in women with Recurrent Spontaneous Abortion (RSA) and a control group among females presenting at a tertiary care hospital. Study Design and Settings: The study was conducted at the Department of Obstetrics and Gynecology for uterine artery flow parameters in women with Recurrent Spontaneous Abortion (RSA) and a control group. Methodology: 100 participants were included, with 50 in each group. The case group comprised women with RSA, defined as three or more consecutive pregnancy losses before the 20th week of gestation, while the control group consisted of women with uncomplicated pregnancies and at least one child born at term. Data were collected on demographic and clinical variables, including age, parity, and BMI. Uterine artery flow parameters, including Pulsatility Index (PI) and Resistive Index (RI), were assessed via Doppler ultrasound, and the results were subjected to statistical analysis using SPSS. Results: The study revealed that mean age, BMI, and median parity were similar in both groups. However, the PI and RI were significantly higher in the RSA group. The receiver operating characteristic (ROC) curve analysis demonstrated high diagnostic accuracy, with an area under the curve (AUC) of 88.6% for PI and 79.4% for RI, further emphasizing their potential as predictors of RSA. Conclusion: Uterine artery blood parameters may serve as potential predictors for identifying women at risk of RSA.
Abortion, Miscarriages, Pregnancy Loss, Pulsatility Index, Resistive Index, Uterine artery flow parameters.
Comparison of Foveal Avascular Zone Parameters in Diabetic Retinopathy and Normal Retina on Optical Coherence Tomography Angiography Using Automated Software
Objective: To compare Foveal Avascular Zone (FAZ) metrics comprising of FAZ area, perimeter and circularity between individuals afflicted with diabetic retinopathy and those exhibiting healthy, normal retinal profile by using built in algorithm of Optical coherence tomography angiography (OCT-A) Study Design and Setting: It was an observational study. Conducted at the Ophthalmology Department, PNS Shifa Hospital, Karachi from October 2023 to December 2024. Methodology: 60 patients participated which included 30 type 2 diabetics with mild to moderate non proliferative diabetic retinopathy (NPDR), without macular involvement and 30 non diabetics age matched normals. FAZ parameters of OCTAngio Optopol revo nx130 (Area, Circularity and Perimeter) were calculated and compared between two groups using automated built in software. FAZ parameters of mild and moderate NPDR were compared within diabetic group. Results: Mean age in diabetics was 55.33 ± 6.85 years and in non-diabetics 55.30± 4.94 years. On comparison of FAZ parameters the area and perimeter were statistically significantly enlarged as compared to non-diabetics FAZ parameters (p < 0.001). The circularity index was lower among diabetics as compared to non-diabetics (p < 0.001). Among the diabetic patients there was a statistically significant enlargement of FAZ area in moderate NPDR versus mild NPDR (p <0.001) and difference of FAZ perimeter (p = 0.07) and circularity index (p =0.60) were statistically insignificant. Conclusion: Diabetic patients with mild to moderate NPDR having clinically normal appearing maculae show deranged FAZ parameters on OCT-A as compared to age matched normal healthy retinae
Angiography, Diabetic retinopathy, Optical coherence tomography
Evaluation of Liver Function Tests and Clinical Outcomes in Dengue Patients: Elevated Alkaline Phosphatase Levels as a Predictor of Mortality
Objectives: To evaluate liver function test abnormalities in patients with dengue infection and determine whether elevated alkaline phosphatase (ALP) levels are associated with mortality and adverse clinical outcomes. Study Design and Setting: A prospective, descriptive observational study conducted over four months, from April 2 to July 31, 2022, at PNS Shifa Hospital (BUHSC). Methodology: Demographic, clinical, and laboratory data of confirmed dengue patients were recorded using a structured proforma. Liver function parameters including alanine aminotransferase (ALT), alkaline phosphatase (ALP), and serum bilirubin were analyzed. Data were entered and analyzed using SPSS version 29. Results: The study included 135 patients with a mean age of 30.9 ± 12.1 years: the majority (60.7%) were under 30. Liver involvement was common, with 64 patients (48.8%) exhibiting liver function test abnormalities. Among these, 27 (42.2%) had elevated ALT, seven (10.9%) showed increased bilirubin, and 30 (46.9%) had elevated ALP. Most patients (83%) maintained normal bilirubin levels, with a mean bilirubin level of 11.7 ± 8.6 µmol/L. Mean ALT was 107 ± 240 IU/L, and mean ALP was 113.6 ± 59.9 IU/L, both above normal ranges. Among liver function parameters, elevated alkaline phosphatase (ALP) levels showed a statistically significant association with mortality (Pearson’s r = 0.282, p = 0.01), whereas ALT and bilirubin levels were not significantly associated with death. Conclusions: Hepatic dysfunction is a frequent finding in dengue patients, with elevated ALP positively correlating with mortality. Although ALT and bilirubin abnormalities are often observed, they do not significantly predict patient outcomes.
Alkaline Phosphatase, Dengue, Dengue Hemorrhagic Fever, Hepatic Insufficiency, Liver Function Tests
Impact of Monoploar Electrocautery Versus Ultrasonic Dissection On Gallbladder Perforation In Laparoscopic Cholecystectomy
Objective: To compare the outcomes of monopolar electrocautery and ultrasonic gallbladder dissection from the gallbladder bed during laparoscopic cholecystectomy in term of gallbladder perforation. Study design and setting: This comparative, cross-sectional study conducted in the Department of Surgery, PAF Hospital Mushaf, Sargodha, from August 2021 to December 2022 after obtaining ethical committee approval. Methodology: A total 320 patients with cholelithiasis undergoing laparoscopic cholecystectomy were divided into two groups. In group A, the dissection of gallbladder from its bed was done with an ultrasonic device that is harmonic scalpel, while in group B, conventional monopolar electrocautery was used. Patients were assessed for gall bladder perforation. A p-value < 0.05 was considered statistically significant. Results: Out of 320 laparoscopic cholecystectomies, gallbladder perforation occurred in 7 (4.4%) patients in Group A and 28 (17.5%) patients in Group B, a difference that was statistically significant (p < 0.001). The mean age was 29.08 ± 8.09 years in Group A and 32.49 ± 9.36 years in Group B (range 20–45 years), with no statistically significant difference between the groups (p = 0.481). The male-to-female ratio was 1:4.5 in Group A and 1:7 in Group B, with no significant difference between the groups (p = 0.792). Conclusion: This study revealed that a significantly lower frequency of gall bladder perforation with ultrasonic dissection as compared to monopolar diathermy among patients undergoing laparoscopic cholecystectomy. This can ultimately reduce the early and long-term complications of bile spillage and stone loss in peritoneal cavity.
Cholelithiasis, Gallbladder perforation, Laparoscopic cholecystectomy, Monopolar electrocautery,