Exploring Body Image Satisfaction in Post-Mastectomy Female Breast Cancer Patients.

Objective: Mastectomy is a widely used surgical intervention for breast cancer in Pakistan, where late-stage diagnoses are common and breast-conserving options are often limited. While effective oncologically, mastectomy can significantly affect a woman's body image, emotional well-being, and social relationships. In Pakistan, sociocultural norms and limited reconstructive services further shape the post-mastectomy experience.

Role of Serum Magnesium Deficiency in Insulin Resistance Among Overweight and Obese Children: A Meta-Analysis.

Magnesium is an essential micronutrient that plays a critical role in insulin signaling, glucose metabolism, and energy balance. With the growing global burden of childhood obesity and metabolic dysfunction, serum magnesium deficiency has emerged as a potential modifiable factor in the development of insulin resistance. This meta-analysis aimed to evaluate the association between serum magnesium levels and insulin resistance among overweight and obese children.

Combinatorial induction with valproic acid and fibroblast growth factor-9 enhances neural differentiation and cell fate commitment in adipose tissue-derived mesenchymal stem cells.

Recent advances in neural differentiation have unveiled new possibilities that could potentially be applied to the development of human-relevant non-animal models, for use in fields such as biomedical research and drug screening. Thus, the directed differentiation of tissue stem cells toward neural progenitor cells or neural stem cells, by small molecules and growth factors without the need for genetic manipulation, has attracted great attention. The generation of neural progenitor cells, and their proliferation and lineage commitment are regulated by signaling pathways activated by small molecules and growth factor families, including various fibroblast growth factors (FGFs).

Impact of low-level pretransplant donor-specific antibodies detected by the Luminex platform on acute rejection and long-term graft survival.

Background: The Luminex platform, where beads are coated with single human leukocyte antigens (HLA), detects HLA antibodies with higher sensitivity and specificity compared to complement-dependent cytotoxicity (CDC) assay and flow cross-match (FCXM). The clinical significance of donor-specific antibodies (DSAs) detected by this method is still under investigation.

Aim: To report the impact of low-level pretransplant DSAs detected by the Luminex platform on the rates of acute rejection (AR), allograft function, and long-term graft survival.

Developing Congenital Cardiac CT Services in Low-Resource Settings: A Quality Improvement Approach.

Cardiac computed tomography (CCT) is increasingly used to evaluate congenital heart disease (CHD), but remains underutilized in low and middle-income countries (LMICs) due to training and system level barriers. Structured quality improvement (QI) strategies for safe implementation are limited. This initiative aimed to implement a high-quality congenital CCT service in a resource-limited public hospital through structured QI methods, multidisciplinary collaboration across cardiology, anesthesia, radiology, and surgery, and innovative training approaches including virtual mentorship without requiring new capital equipment.

Psychological Impact and Quality of Life in Patients With Intestinal Stoma in Resource-Limited Settings: A Cross-Sectional Study From Pakistan.

Background: Intestinal stoma formation alters patient lifestyle and psychological well-being, especially in resource-limited settings lacking perioperative support. This study assessed the quality of life (QoL) and prevalence of depression in Pakistani patients with stomas, identifying key demographic and clinical correlates.

Methods: A descriptive cross-sectional study was conducted among 136 patients with intestinal stomas at a tertiary care surgical clinic in Karachi.

Association of Anti-SS-A Antibodies with Lupus Nephritis in Patients with Glomerulonephritis.

Introduction: Anti-SS-A antibodies (anti-SS-A) are the most prevalent anti-extractable nuclear antibody (ENA). Glomerulonephritis (GN), characterized by intraglomerular inflammation and cellular proliferation, is the leading cause of end-stage renal failure. The association of anti- SS-A in various types of GN is not well established in the literature.

Mediastinal lymphadenopathy: Causes, symptoms and factors predicting good yield of endoscopic ultrasound-guided biopsy.

Background: Mediastinal lymph nodes (MLNs) can be enlarged due to various benign or malignant causes. Endoscopic ultrasound (EUS) is often employed for the acquisition of tissue specimens of the enlarged MLN (EMLN).

Aim: To determine the causes, document the symptoms, and determine factors predicting good yield of EUS-guided EMLN biopsy.

Colorenal fistulae: A rare but fatal presentation of renal tuberculosis in a paediatric patient.

Genitourinary Tuberculosis (GUTB) primarily occurs due to haematogenous infection and represents the most prevalent form of extra-pulmonary tuberculosis. It typically presents with non-specific symptoms and is rare in children, making diagnosis challenging and, potentially, leading to complications such as renal failure, pyonephrosis, nephrocutaneous fistulae, and sepsis. We describe a unique case involving a four-year-old male child who developed renal tuberculosis secondary to a renal stone, resulting in pyonephrosis and colorenal fistulae.

Evaluating postoperative complications in radical cystectomy and ileal conduit for bladder cancer using the clavien-dindo grading system.

Objective: To determine the frequency of postoperative complications after radical cystectomy with ileal conduit surgery in patients diagnosed with urinary bladder cancer.

Methods: This prospective observational study was conducted at the Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, from 30TH December 2019 to 30TH June 2020, following approval from the SIUT Ethics Review Board. The study comprised patients aged 25-70 years diagnosed with urinary bladder cancer who underwent elective radical cystectomy with ileal conduit.

A Comparative Study of Transurethral Resection of the Prostate (TURP) Versus Transurethral Incision of the Prostate (TUIP) in Small-Sized Prostate Glands With Benign Prostatic Hyperplasia.

Introduction And Aim: Benign prostatic hyperplasia (BPH) is a prevalent condition in aging males, often leading to lower urinary tract symptoms (LUTS). While transurethral resection of the prostate (TURP) is the gold standard for surgical management, transurethral incision of the prostate (TUIP) is a less invasive alternative for small prostate volumes. This study aims to compare the efficacy and safety of TURP and TUIP in patients with small prostate glands (<30 mL) suffering from BPH.

Assessing quality of life before and after transurethral resection of the prostate in benign prostatic hyperplasia patients.

Objective: To compare quality of life scores before and after transurethral resection of the prostate in patients with benign prostatic hyperplasia.

Methods: The prospective, observational study was conducted at the Urology Department of the Sindh Institute of Urology and Transplantation, Karachi, from September 24, 2021, to March 30, 2022, and comprised consecutive patients who were eligible to undergo transurethral resection of the prostate for benign prostatic hyperplasia. Prior to undergoing definitive surgical therapy, all the patients were evaluated using standardised questionnaires, specifically the International Prostate Symptom Score and a disease-specific quality of life score.

Comparison of Intravesical Bacillus Calmette-Guérin (BCG) and Mitomycin C for the Treatment of Non-Muscle-Invasive Bladder Cancer.

Background Bacillus Calmette-Guérin (BCG) and mitomycin C (MMC) are the two most commonly used intravesical therapies for non-muscle-invasive bladder cancer (NMIBC), yet variability in treatment outcomes and tolerability continues to challenge clinical decision-making. Updated comparisons reflecting current treatment protocols and adherence patterns are needed to inform practice. Objective The objective of this study is to evaluate and compare the efficacy and safety of intravesical BCG versus MMC in the contemporary treatment of NMIBC, focusing on recurrence, progression, and adverse effects over a 24-month follow-up.

Platinum chemotherapeutic-induced oxidative stress affects the transcriptional response of DNA repair genes in murine mesenchymal stem cells.

Unlabelled: Cisplatin and oxaliplatin are among the most extensively used anti-cancer drugs in the treatment of various types of cancer. However, the cytotoxicity associated with these drugs in normal and adult stem cells is a major concern.

Objectives: This study aimed to determine the oxidative stress induced by platinum drugs in murine mesenchymal stem cells (mMSCs).

Preoperative nutrition status in children with congenital heart disease and its impact on postoperative outcomes: a systematic review and meta-analysis.

Despite the significant advancement in congenital heart disease (CHD) surgery over the years, the mortality and morbidity rate in children undergoing CHD surgery is substantial, especially in lower-middle-income countries. Evidence shows that malnutrition contributes to morbidity and mortality in these children, with a negative impact on their surgical outcomes. The aim of this systematic review and meta-analysis was to assess the impact of preoperative nutritional status on postoperative outcomes among patients with CHD.

Fatty Liver Disease in the Diabetic Population: A Cross-Sectional Study From Pakistan.

Introduction Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disorder, particularly among patients with type 2 diabetes mellitus (T2DM). The association between NAFLD and diabetes is bidirectional, with NAFLD increasing the risk of diabetes and vice versa. Therefore, this study aimed to determine the prevalence of NAFLD in diabetic individuals and evaluate the impact of metabolic and cardiovascular factors, along with the role of anti-diabetic medications in NAFLD progression.

Frequency of Gallstones in Patients With Non-alcoholic Fatty Liver Disease.

Introduction Non-alcoholic fatty liver disease (NAFLD) is a metabolically related liver disease that is becoming increasingly prevalent globally, due to rising obesity, diabetes, and sedentary lifestyles. Concurrently, gallstone disease is a prevalent biliary disease and shares similar risk factors to NAFLD, such as dyslipidemia, insulin resistance, and obesity. In Pakistan, due to a paradigm shift toward urbanization and sedentary lifestyles in recent times, the data are scarce regarding the coexistence of gallstones in the NAFLD population.

Solid pancreatic lesions: etiology, morphology and utility of macroscopic on-site evaluation in predicting good yield of endoscopic ultrasound-guided biopsy.

Introduction: Solid pancreatic lesions (SPL)s can be due to various etiologies, and their management depends on the histologic diagnosis.

Aim: The aim of this study was to document the etiology, morphology, and utility of macroscopic on-site evaluation (MOSE) in predicting good yield of endoscopic ultrasound (EUS)-guided biopsy.

Material And Methods: All patients with SPLs referred for EUS-guided biopsy were included in the study.

Predictors of Gallstones in Patients With Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD).

Introduction Metabolic dysfunction-associated fatty liver disease (MAFLD) has become the most prevalent chronic liver disease worldwide, particularly in South Asian countries like Pakistan. Gallstone disease (GSD), often associated with metabolic abnormalities, shares several risk factors with MAFLD, such as obesity, diabetes, and dyslipidemia. Despite international evidence supporting an association between MAFLD and GSD, there is a hdlscarcity of local data in this regard.

Utility and Comparative Efficacy of Lok Score, Splenic Stiffness, EVendo Score, and Liaoning Score in Predicting Esophageal Varices in the Pakistani Population.

Background Esophageal varices (EV) are a critical complication of portal hypertension in cirrhotic patients, with variceal bleeding contributing significantly to morbidity and mortality. Endoscopy remains the gold standard for diagnosis, but its invasive nature and limited availability in low-resource settings necessitate the validation of non-invasive predictive tools. This study aims to compare the diagnostic performance of four non-invasive models, Lok score, splenic stiffness (SS), EVendo score, and Liaoning score, for predicting EV in Pakistani patients with chronic liver disease (CLD).

Standardizing The Biochemical Tests for Chronic Kidney Disease (CKD): Where Do We Stand? A National Survey of Laboratories Across Pakistan.

Introduction: CKD affects 8.6% of the global population, with South Asian countries seeing prevalence rates between 10.6% and 23.

Clinicopathological characteristics and long-term outcomes of adult patients with proliferative lupus nephritis.

Background: Proliferative lupus nephritis (PLN) is the most severe form of lupus nephritis (LN). There are limited data available on renal outcomes of PLN from developing countries.

Aim: To determine the clinicopathological characteristics and long-term outcomes in terms of remission, requirement of kidney replacement therapy (KRT), and patient survival.