Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University
type: channel
description: The Annals of Pakistan Institute of Medical Sciences (APIMS) is the official quarterly and open access journal of Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Pakistan. Previously, two separate medical journals of this institute were being published, namely, JPIMS started in 1990 and the Journal of Surgery in 1991. They were officially merged into one journal, APIMS, in 2005. The Annals of PIMS is recognized by the Pakistan Medical and Dental Council (PMDC), the Higher Education Commission of Pakistan ( Y category), and the CPSP (https://www.cpsp.edu.pk/files/news_notifications/cpsp-sec-2020-338.pdf) It is indexed in WHO-IMEMR, & Base from Germany.
publisher: Shaheed Zulfiqar Ali Bhutto Medical University
language: en-US
publication name: Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University
issn: 1815-2287
copyright: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons. org/licenses/by-nc/4.0/.) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
items: Role of Structured Infection Prevention and Control Training Program in Reducing Surface Contamination and hospital acquired infections: A Single Centre Study
items: Prevalence of Hyponatremia in Patients With Moderate to Severe Bronchiolitis
items: Comparison of treatment outcomes in childhood pneumonia with or without rickets Introduction
items: The Diagnostic Significance of Cytokeratin 13 & 17 Expression in Oral Mucosal Biopsies by Immunohistochemical Technique
items: Resolution of Type 2 Diabetes After Sleeve Gastrectomy
items: Enhanced post total knee replacement recovery by using intraarticular intraoperative cocktail injections
items: Efficacy of Dexamethasone in preventing post spinal hypotension in elderly patients undergoing orthopedic surgery; A Randomized Control Trial at a tertiary care hospital
items: Altered Sleep Pattern in Patients of Acute Myocardial Infarction at Cardiology Ward of Liaquat University of Medical & Health Sciences
items: Comparison of Endothelial Cell Density Post- Phacoemulsification between Diabetic and Non- Diabetic Patients
items: Popliteal Artery Injuries in Motorcycle Accidents Following Posterior Knee Dislocation: Surgical Outcomes of Saphenous Vein Graft Repair — A Single-Center Case Series from Nishtar Hospital, Multan
items: Maternal and fetal outcomes in pregnant women Presenting with burn injuries at PIMS Islamabad
items: Vitamin D Deficiency in General Paediatric Population Presented in Combined Military Hospital, Malir
items: Establishing a Prediction Model for Successfully Planned Endotracheal Extubation in Preterm Neonates: An Answer to Many Questions
items: Oral Health Care Status and Barriers to Accessing Oral Health Care Services in Geriatric Population
items: Comparison of Diode Laser Tonsillectomy and Bipolar Cauterization Tonsillectomy
items: Assessment of the Anti-hyperglycemic Effects of Rosemary (Salvia Rosmarinus) Compared to Glimepiride in Alloxan induced Diabetic Rabbits
items: Efficacy of Ligasure use in Total Thyroidectomy at a tertiary care Hospital
items: Cost Out-of-Pocket Expenses with Cardiovascular Diseases at PMCH Nawabshah – COUP Study
items: Evaluation Of Postoperative Pain With Resin Based Sealer vs Zinc Oxide Eugenol Based Sealer After Single Visit Endodontic.
items: Predictors of Allergic Airway Disease in Children Under Two Years of Age
items: Efficacy of PECS Block In Perioperative Period For Pain Management In Patients Undergoing Elective Breast Surgery
items: Beyond the Virus: Tracheal Stenosis as a Sequela of Severe COVID-19 – A Case Report

Role of Structured Infection Prevention and Control Training Program in Reducing Surface Contamination and hospital acquired infections: A Single Centre Study
type: item
description: Objective: To assess the impact of a structured IPC training program on reducing surface contamination and the frequency of HAIs. The findings aim to support effective infection control strategies and improved outcomes in healthcare settings. Methodology: Retrospective interpreted time series (ITS) analysis of monthly environmental cultures from six critical areas of Tertiary care teaching hospital (June 2022 to Dec 2023) was conducted. Surface culture reports and HAI records were analyzed before and after IPC training implementation. Descriptive statistics and chi-square tests assessed the changes in surface contamination and HAI rates. Results: Among 619 environmental samples from six critical areas, 32 (5.1%) showed microbial growth. Positive cultures rates declined significantly across study period from 11.9% to 3.1% and 1.7% following IPC program implementation (df = 2, p < 0.001). ICUs had highest contamination, predominantly Gram-positive cocci, including coagulase-negative Staphylococci. Hospital-acquired infections decreased in critical areas, with a significant shift after IPC implementation ( df = 3, p = 0.019). Conclusion: There is a significant impact of implementation of infection prevention and control policies followed by regular and structured training sessions of healthcare professionals on surface bacterial contamination of critical areas and hospital associated infections in a tertiary care hospital.
creator: Aliya Batool
creator: Zholdasbekova Ainur
creator: Sadaf Khalid
creator: Naghmi Asif
creator: Mohsin Ali Malik
creator: Khalid Hassan
rights: Copyright (c) 2026 Aliya Batool https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 1
ending page: 7
doi: 10.48036/apims.v22i1.1626

Prevalence of Hyponatremia in Patients With Moderate to Severe Bronchiolitis
type: item
description: Objective: To estimate the frequency and severity of hyponatremia in infants hospitalized with moderate–severe bronchiolitis and to assess its association with the severity of disease and length of stay (LOS). Methodology: It was a single-centre cross-sectional study of consecutive infants with moderate–severe bronchiolitis conducted at Pediatric Medicine Department, Federal Government Polyclinic (FGPC) Hospital, Islamabad, from 01-11-2023 to 30-04-2024. Patients were selected by clinical diagnosis using Pediatric Respiratory Severity Score (PRESS) at presentation. Serum sodium was measured and hyponatremia categorized by standard thresholds. Associations with clinical severity and LOS were tested with chi-square and correlation analyses. Multivariable logistic regression was applied to adjust for confounding variables like age and gender. SPSS version 27 was used for analysis and a P<0.05 was considered significant. Results: Data of total of n=135 eligible infants were analysed. Hyponatremia was found in 62.2% of cases (mild 63.1%, moderate 36.9%, severe 0%) and was significantly associated with bronchiolitis severity (P<0.001) and longer durations of hospital stay (P<0.001). Serum sodium showed a strong negative correlation with PRESS (r=-0.712; P<0.001) and LOS (r=-0.594); P<0.001). In multivariable adjusted models, severe (vs moderate) bronchiolitis carried markedly greater odds of a higher hyponatremia category (aOR 6.27; 95% CI 2.25–17.45; P<0.001). Conclusions: In infants with bronchiolitis, a low admission serum sodium levels track with higher PRESS and longer LOS. An admission sodium check is recommended along with PRESS-based triage. This will help in identifying children who need closer observation.
creator: Tayyeba Rasheed Malik
creator: Sidra Nisar
creator: Shahzad Munir
creator: Shehreen Iqbal
creator: Naveed Ashraf
rights: Copyright (c) 2025 Dr. Tayyeba Rasheed Malik, Dr Sidra Nisar, Dr Shahzad Munir, Dr Shehreen Iqbal, Dr Naveed Ashraf https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 8
ending page: 13
doi: 10.48036/apims.v22i1.1566

Comparison of treatment outcomes in childhood pneumonia with or without rickets Introduction
type: item
description: Objective: To compare the treatment outcomes among children with pneumonia with or without rickets presentation. Methods: This comparative study was conducted on 190 children diagnosed with pneumonia, who were divided into two equal groups: 95 children with rickets and 95 without rickets. Study was done at Department of Pediatric Medicine, Recep Tayyip Erdogan Hospital Muzaffargarh. The rickets was diagnosed based on clinical features and radiological and biochemical findings. Patients received standard pneumonia management according to institutional guidelines. Treatment outcomes were assessed in terms of duration of fever, need for oxygen therapy, length of hospital stay, and treatment failure, across the groups. Data were analyzed using appropriate statistical tests, and a p-value &lt; 0.05 was considered statistically significant. Results: Paediatric patients with rickets showed a significantly longer duration of fever (p=0.001) and prolonged stay in Hospital stay p=0.001 compared to non-rickets patients. Failure of treatment was more frequent in the rickets group (22.1 % vs 9.5 %) p = 0.018. The severe pneumonia and oxygen requirement were significantly higher in children with rickets in contrast to non-rickets patients (31.6 % vs 15.8 %) and (48.4 % vs 27.4 %), p= 0.004 respectively. Average clinical recovery time was also significantly delayed in children with rickets. Additionally, the rate of complications also being significantly higher among children with rickets, while the mortality rate was low and almost similar across the p=0.05). Conclusion: The childhood pneumonia with rickets was observed with significantly poor treatment outcomes, and these patients required more intensive supportive care and showed higher rates of treatment failure compared to those without rickets. Key words: Pneumonia, Rickets, Children, Treatment failure, Mortality
creator: Noor ul Huda
creator: Masood Mazhar Sahu
rights: Copyright (c) 2026 Noor ul Huda, Masood Mazhar Sahu https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1

The Diagnostic Significance of Cytokeratin 13 & 17 Expression in Oral Mucosal Biopsies by Immunohistochemical Technique
type: item
description: Objective: To find out immunohistochemical (IHC) profile of cytokeratin 13 and 17 expression in oral premalignant and malignant epithelial lesions. Methodology: This descriptive cross-sectional study was conducted at, pathology department of Liaquat University of medical and health science Jamshoro from January 2017 to June 2019. Excisional biopsy samples of patients of all age groups, both gender with complain of oral mucosal epithelial lesions were enrolled. Oral mucosal biopsies were fixed in 10% formalin, routinely processed, and stained with H&E for histopathological diagnosis. Immunohistochemistry for Cytokeratin 13 and 17 was performed on paraffin sections after deparaffinization and blocking of endogenous peroxidase activity. Tissue sections were kept moist throughout the procedure and mounted on FLEX IHC slides. All the relevant pathological and clinical data were recorded using study proforma and analyzed by SPSS version 20. Results: Patient’s mean age was 40.45+11.94 years and males were in majority 63.4%. Buccal mucosa, cheek and tongue were most common sites of biopsy, 32.8%, 21.6% and 31.3% respectively. CK13 was positive among 73 cases. CK17 was positive among 96 cases. Leukoplakia, sub mucous fibrosis, ulcers were significantly associated with CK13 p=0.003, while leukoplakia and squamous cell carcinoma were significantly associated with CK 17 p=0.001. Results: A total of 139 cases were included. The mean age of patients was 40.45 ± 11.94 years. Males constituted the majority (63.4%). The most common biopsy sites were buccal mucosa (32.8%), cheek (21.6%), and tongue (31.3%). Most patients (78.4%) reported symptoms for 1 to 3 months. Leukoplakia was the most frequent oral lesion, observed in 22.3% of cases. CK13 positivity was observed in 73 cases, while CK17 was positive in 96 cases. CK13 expression was significantly associated with leukoplakia, submucous fibrosis, and ulcers (p = 0.003). CK17 expression showed significant association with leukoplakia…
creator: Kiran Aqeel
creator: Ferzana Memon
creator: Tanveer Shaikh
creator: Naila Shaikh
creator: Aneela Faisal
creator: Maria Jawed
rights: Copyright (c) 2025 Kiran Aqeel, Ferzana Memon, Tanveer Shaikh https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 18
ending page: 22
doi: 10.48036/apims.v22i1.1555

Resolution of Type 2 Diabetes After Sleeve Gastrectomy
type: item
description: Objective: To determine the resolution of type-II diabetes mellitus (DM) after sleeve gastrectomy (SG) among patients by evaluating glycemic control, medication use, and weight loss. Methodology: A prospective observational study was done at the Nescom hospital, Islamabad, from August 2022 to September 2023. Both male and female individuals aged 18 years old or above, morbidly obese with BMI greater than35 kg/m and with diagnosis of type –II DM undergoing laparoscopic sleeve gastrectomy were included. Laparoscopic sleeve gastrectomy was done using a standardized four-port technique. A possible large curvature of the stomach was resected, starting 6 cm proximal to the pylorus up to the angle of His. The 36-Fr bougie was used to calibrate the sleeve. Postoperative care started with a liquid diet and structured follow-up at POD3, 2 weeks, and 6 months. At each visit, BMI, fasting glucose, and HbA1c were recorded. Data were documented on a study proforma and analyzed using SPSS version 26. Results: Overall mean age of the individuals was 47 ± 8 years with 63.3% being female and 36.7% males. Before the surgeries, 66.7% required hypoglycemic drugs and 53.3% were on insulin. Average HbA1c decreased significantly from 8.9% preoperatively to 8.2% on POD3, 7.1% at 2 weeks, and 5.9% at 6 months (p < 0.001). The plasma glucose levels declined from 202.7 mg/dL (POD3) to 138.4 mg/dL at 2 weeks and 100.8 mg/dL at 6 months (p < 0.001). Additionally, the excess weight loss was improved steadily, from 4.1% at POD3 to 11.7% at 2 weeks and 35.1% at 6 months (p < 0.001). However, there were no significant gender-based differences were observed in HbA1c, plasma glucose, excess weight loss, or BMI (all p > 0.05). Conclusion: LSG is an effective intervention for achieving significant weight loss, improving glycemic control, and reducing plasma glucose levels in Pakistani patients with T2D. These findings support the use of LSG as a valuable tool for managing obesity-related T2D in diverse …
creator: Natasha Maryam
creator: Amna Batool
creator: Aroob Farhan
creator: Tabassum Hameed
rights: Copyright (c) 2024 Natasha Maryam, Summera ambreen https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 23
ending page: 27
doi: 10.48036/apims.v22i1.1071

Enhanced post total knee replacement recovery by using intraarticular intraoperative cocktail injections
type: item
description: Objective: To assess the advantages of a specific cocktail combination in TKR patients, focusing on postoperative pain relief and enhanced recovery of knee mobility. Methodology: This prospective, double-blinded, placebo-controlled study was conducted at Akbar Niazi Teaching Hospital, Islamabad, from January 2022 to December 2024. Sixty consecutive patients underwent unilateral TKR were enrolled, with 30 receiving an intraoperative intraarticular cocktail injection (intervention) and 30 receiving normal saline (control). Postoperative pain for each knee was assessed using visual analog scale (VAS), and time required to attain 90° of knee flexion was recorded for both groups. The collected data were analyzed utilizing SPSS v 23. Changes in pain scores within the groups across follow-up periods were analyzed using repeated measures ANOVA Results: The patients were between 55 and 85 years old (mean was 63.2±9.2 years), and males were 66.7%. Patients who received the cocktail injection experienced significantly less pain than the control group during the first 48 hours and achieved 90° of knee flexion in a significantly shorter time. Conclusion: Intraoperative intraarticular cocktail injection significantly alleviates early postoperative pain and enhances early knee mobility.
creator: Muhammad Hanif
creator: Obaid ur Rehman
creator: Naveed Gul
creator: Junaid Hassan
creator: Muhammad Rehman
creator: Naveed Arshad
rights: Copyright (c) 2026 Muhammad Hanif, Obaid ur Rehman, Naveed Gul, Junaid Hassan, Muhammad Rehman, Naveed Arshad https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-02
publication date: 2026-02-02
volume: 22
number: 1
starting page: 28
ending page: 32
doi: 10.48036/apims.v22i1.1491

Efficacy of Dexamethasone in preventing post spinal hypotension in elderly patients undergoing orthopedic surgery; A Randomized Control Trial at a tertiary care hospital
type: item
description: Objective: To compare the efficacy of single pre-operative dose of intravenous Dexamethasone vs placebo in elderly patients undergoing orthopedic surgeries in spinal anesthesia in terms of number of hypotensive episodes. Methodology: After ethical approval and clinical trial registration (NCT07052864), study was carried out at Department of Anesthesiology and Critical Care Medicine, PIMS Hospital, Islamabad from 30th June 2025 to 30th August 2025. A total of 134 patients were enrolled who were 50 years to 100 years belonging to ASA I & II. Group A patients were given single preoperative dose of dexamethasone 8?mg IV in 100?ml normal saline 1 hour before induction of spinal anesthesia in the pre-operative area while group B patients were given placebo. Results: The incidence of intra operative hypotension was significantly higher in group B than group A. The incidence in group B was 70% and in group A it was 45% with p value being 0.003. Similarly intraoperative phenylephrine consumption was 0.00 (50.00) in group A while in group B it was 50.00 (200.00) with p value being 0.02. Conclusion: Prophylactic administration of Intravenous Dexamethasone is effective in preventing post spinal hypotension and reducing intraoperative vasopressor requirements among elderly patients undergoing lower limb orthopedic surgeries.
creator: Sadia Saleem
creator: Muhammad Haroon Anwar
creator: Naheed Fatima
creator: Asad Niazi
rights: Copyright (c) 2026 Sadia Saleem https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 33
ending page: 37
doi: 10.48036/apims.v22i1.1576

Altered Sleep Pattern in Patients of Acute Myocardial Infarction at Cardiology Ward of Liaquat University of Medical & Health Sciences
type: item
description: Objective: To determine the frequency of altered sleep patterns among patients with acute myocardial infarction admitted to the cardiology ward of Liaquat University of Medical & Health Sciences. Methodology: This prospective observational study was conducted in the Department of Cardiology, Liaquat University Hospital (LUMHS), from September 2023 to March 2024. Patients of both genders, aged 20–65 years, presenting with acute myocardial infarction were included. Sleep patterns were assessed using both open- and close-ended questions, and any deviation from the normal sleep pattern was considered abnormal. Associations between altered sleep patterns and baseline as well as clinical parameters were evaluated, with a p-value < 0.05 considered statistically significant. Results: The overall mean age of the patients was 54.04 ± 8.82 years. Male patients constituted a higher proportion compared with females (62.82% vs. 37.28%). The overall frequency of altered sleep patterns among patients admitted with acute myocardial infarction was 40.69%. A higher prevalence of altered sleep patterns was observed among males, married individuals, urban residents, housewives, patients belonging to the middle socioeconomic class, those with normal body mass index, non-smokers, patients presenting with typical chest pain, and those diagnosed with non–ST-elevation myocardial infarction (NSTEMI); however, these associations were not statistically significant (p > 0.05). Depression was the only variable that showed a statistically significant association with altered sleep patterns among patients with acute myocardial infarction (p = 0.04). Conclusion: The prevalence of altered sleep patterns was notably high among patients admitted with acute myocardial infarction. However, depression was the only factor significantly associated with sleep deviation in this population.
creator: Shahim Ali Bhurgri
creator: Shahbaz Ali Shaikh
creator: Jaweria Amjad
creator: Faraz Farooq Memon
creator: Shahid Hussain Memon
creator: Shadab Sahato
rights: Copyright (c) 2026 Shahim Ali Bhurgri, Shahbaz Ali Shaikh, Jaweria Amjad, Faraz Farooq Memon, Shahid Hussain Memon, Shadab Sahato https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 38
ending page: 43
doi: 10.48036/apims.v22i1.1373

Comparison of Endothelial Cell Density Post- Phacoemulsification between Diabetic and Non- Diabetic Patients
type: item
description: Objective: To compare the corneal endothelial cell density (CED) after phacoemulsification for cataract surgery between type II diabetic patients and non-diabetic patients. Methodology: This comparative cross-sectional study was conducted at Sindh Institute of Ophthalmology and Visual Sciences, Hyderabad, from August 2021 to January 2022. Patients aged between 35 and 60 years, both genders presented with cataract of any duration and undergoing uneventful phacoemulsification cataract surgery were included. One day before phacoemulsification, CED was measured using by Topcon SP 3000P Specular Microscope. During surgery, total operative time, pre-operative CED and post- operative CED were measured. Patients were reviewed postoperatively to measure CED after 1 week through a pre-designed proforma. Results: There were 279 patients enrolled in the study. The mean corneal endothelial cell density pre- operatively was noted 2522.22 ± 181.59 cells/mm2 which was post significantly decreased as 1702.00 ± 73.56 cells/mm2 (p=0.001). Most importantly, the mean post-operative CED was significantly lower among diabetes patients (1671.96 ± 48.64 cells/mm²) compared to non-diabetics (1840.09 ± 81.91 cells/mm²), (p = 0.001), indicating significant more endothelial cell loss after surgery, among diabetic patients. Conclusion: Diabetic patients observed with significantly more CED loss following phacoemulsification compared to non-diabetic cases, expected due to the prolonged structural and metabolic alterations in the corneal endothelium resulting from chronic hyperglycemia.
creator: Sandeep Kumar
creator: Mariya Nazish Memon
creator: Neelam Nizamani
creator: Narain Das
creator: Jai Kumar
creator: Asma Shams
rights: Copyright (c) 2024 Zille Huma, Abid Farooque, Chahat Hussain, Asif Younas, Muhammad Faizan, Mehwish Saba https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 44
ending page: 48
doi: 10.48036/apims.v22i1.1033

Popliteal Artery Injuries in Motorcycle Accidents Following Posterior Knee Dislocation: Surgical Outcomes of Saphenous Vein Graft Repair — A Single-Center Case Series from Nishtar Hospital, Multan
type: item
description: Objective: To assess the surgical outcomes and early functional recovery of patients undergoing great saphenous vein graft repair for popliteal artery injuries following posterior knee dislocations caused by motorcycle accidents. Study Design: Descriptive case series. Place and Duration of Study: Plastic Surgery and General Surgery Departments, Nishtar Hospital, Multan, from January 2021 to December 2024. Methodology: This study included 21 male patients aged 12 years and older who sustained posterior knee dislocations due to motorcycle-related trauma. All patients had intraoperatively confirmed injuries to the popliteal artery and underwent arterial reconstruction using reversed autologous great saphenous vein grafts. Fasciotomy and orthopedic stabilization were performed as required. Patients who presented more than 12 hours after trauma with non-viable limbs or incomplete follow-up data were excluded. Graft patency was evaluated with Doppler ultrasonography on days 2 and 7, and with CT angiography at six months. Functional outcomes were assessed at 12 weeks using the Lower Extremity Functional Scale (LEFS). Results: All patients achieved limb salvage, with no amputations recorded. Graft patency at six months was confirmed in all cases. The mean LEFS score was 65.0 ± 4.1, with 18 patients (85.7%) achieving scores of 60 or higher, reflecting satisfactory recovery. Postoperative complications occurred in 5 patients (23.8%) and included wound infection, early graft thrombosis, seroma, and wound dehiscence—all managed conservatively. Conclusion: Timely revascularization using reversed saphenous vein grafts offers excellent outcomes in terms of limb salvage, graft durability, and early functional recovery in patients with motorcycle-related popliteal artery injuries.
creator: Muhammad Naveed Shahzad
creator: Muhammad Jamil Zahid
creator: Ahsan ur Rehman Khan
rights: Copyright (c) 2026 Muhammad Naveed Shahzad, Muhammad Jamil Zahid, Ahsan ur Rehman Khan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 49
ending page: 55
doi: 10.48036/apims.v22i1.1634

Maternal and fetal outcomes in pregnant women Presenting with burn injuries at PIMS Islamabad
type: item
description: Objective: To evaluate the clinical characteristics, trimester-wise presentation, and fetomaternal outcomes of pregnant women presenting with burn injuries at Pakistan Institute of Medical Sciences (PIMS), Islamabad. Methodology: This retrospective cohort study was conducted in collaboration between the Burn Center and Maternal and Child Health (MCH) Department at PIMS from May 2008 to October 2024. A total of 33 pregnant women with burn injuries were included after ethical approval and informed consent. Data regarding age, gestational age, total body surface area (TBSA), type and mode of burn, trimester-wise obstetrical management, and maternal and fetal outcomes were collected using a structured questionnaire. Burn severity was calculated using the Wallace Rule of Nines. Data were analyzed using SPSS version 25. Primary outcomes included maternal and fetal survival, while secondary outcomes assessed the impact of TBSA and management strategies on outcomes. Results: The majority of patients were aged 21–30 years (63.6%). Distribution across trimesters was comparable. Flame burns were most common (75.8%), and 97% were accidental. Maternal survival was 39.4%, while fetal survival was 30.3%. Mortality strongly correlated with TBSA (p < 0.001), with 100% fetal mortality observed in burns exceeding 70% TBSA. Outcomes improved significantly over time (p = 0.007) with multidisciplinary care. Supportive therapy yielded better maternal survival in first and second trimesters, while delivery in the third trimester resulted in improved fetal survival. No-intervention management was associated with the poorest outcomes. Conclusion: Burn severity is the strongest predictor of fetomaternal mortality. Early multidisciplinary management and trimester-specific obstetrical strategies significantly improve survival outcomes in pregnant burn patients.
creator: Sara Usman
creator: Zeenat usman
creator: Ahaifa Khan
creator: Aashar Khalid
creator: Faryal Ali
creator: Nosheela Javed
rights: Copyright (c) 2025 Sara Usman, Zeenat usman, Ahaifa Khan, Ashir Khalid, Faryal Ali, Nosheela Javed https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 56
ending page: 61
doi: 10.48036/apims.v22i1.1589

Vitamin D Deficiency in General Paediatric Population Presented in Combined Military Hospital, Malir
type: item
description: Objective: To determine the frequency of vitamin D deficiency in paediatric population presented at combined military Hospital, Malir. Methodology: This descriptive cross-sectional designed study was conducted at the Pediatric Outpatient Department (OPD) at combined military Hospital, Malir, from July to November 2021. Children aged 6 months to 12 years, both boys and girls presented to the pediatric department for routine care, nutritional concerns, or nonspecific symptoms potentially related to micronutrient deficiency were included. A 3–5 mL sample of venous blood was collected aseptically from each participant for biochemical assessment of the vitamin D and vitamin D (25-hydroxyvitamin D) level <20 ng/mL was considered deficient. All the relevant information was entered and analyzed using SPSS version 26. Results: Out of all 54.5% were female and 45.5% were male. Most children (47.7%) were 1–5 years old. Around half (50%) children were found to have vitamin D deficiency, while 31.8% had insufficient levels, and only 18.2% had sufficient. Sunlight exposure, type of dairy product intake, fish and meat intake, and socioeconomic status had significant associations with serum vitamin D levels p <0.05. Conclusion: A higher prevalence observed of vitamin D deficiency among children, and found to be strongly linked to inadequate sunlight exposure, poor dietary intake, and low socioeconomic status.
creator: Ayesha Asif
creator: Syed Taqi Hassan Zaidi
creator: Wasif Shujaat Ali
creator: Muhammad Hanif
creator: Komil
creator: Tasneem Kousar
rights: Copyright (c) 2025 Ayesha Asif, Syed Taqi Hassan Zaidi, Wasif Shujaat Ali, Muhammad Hanif, Komil, Tasneem Kousar https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 62
ending page: 66
doi: 10.48036/apims.v22i1.1594

Establishing a Prediction Model for Successfully Planned Endotracheal Extubation in Preterm Neonates: An Answer to Many Questions
type: item
description: Objective: To establish the prediction model for successfully planned endotracheal extubation in preterm neonates. Study Design: Prospective cohort study Place and Duration of Study: This study was conducted at Neonatal ICUs of Fatima Memorial Hospital Lahore, from February 2023 to October 2024. Methodology: The study included 255 preterm neonates (28–35 weeks gestation) intubated <7 days and extubated for the first time before 30 days of age. Successful extubation was labeled as no need for reintubation within 72 hours following extubation. Demographics, prenatal, and peri-extubation data were collected analyzed using multivariate logistic regression to identify independent predictors. Receiver operating characteristic (ROC) analysis assessed model discrimination, and a nomogram was constructed for individualized prediction.
creator: Rafia Gul
creator: Aimen Tahir
creator: Samer Fatima
creator: Muhammad Usman
creator: Lubna Asghar
creator: Tahir Mahmood Butt
creator: Irshad Hussain
rights: Copyright (c) 2025 Rafia Gul, Aimen Tahir, Samer Fatima, Muhammad Usman, Lubna Asghar, Tahir Mahmood Butt, Irshad Hussain https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 67
ending page: 74
doi: 10.48036/apims.v22i1.1553

Oral Health Care Status and Barriers to Accessing Oral Health Care Services in Geriatric Population
type: item
description: Objective: To evaluate the oral health status and identify major barriers to accessing dental care among the geriatric population. Methodology: This descriptive cross-sectional study was conducted at Institute of Health Management and Research Sciences from November 2024 to May 2025, on elderly individuals aged 60 and above attending the dental OPD of LUMHS. Overall 150 elderly individuals aged >60 years, both genders, who were able to respond the study questionnaires were included. After taking demographic information, oral health status and barriers to accessing dental care were evaluated. SPSS version 26 was used for data analysis. Results: Average age of individuals was 63.9+3.99 years. Males were in majority 56.0%. Oral health was note fair or poor, with half not using any dental prosthetics. Financial barriers (58.7%) and fear of dental visits (56%) were the main barriers. Only 41.3% visited dentists regularly, and preventive services were underutilized (8%). Cost and lack of awareness were key reasons for avoiding dental care. Despite 49.3% considered oral health very important and 82.7% were satisfied with available services. Conclusion: Most of the elderly individuals observed with poor oral health, with limited access due to financial, social, and awareness-related barriers despite high satisfaction among those receiving care.
creator: Sadaf Ujjan
creator: Muhammad Ilyas Siddiqui
creator: Rafaina Shah
creator: Allah Wadhayo Kalo
creator: Pirah Zardari
creator: Partab Puri
rights: Copyright (c) 2024 Faizan Sadiq https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 75
ending page: 80
doi: 10.48036/apims.v22i1.832

Comparison of Diode Laser Tonsillectomy and Bipolar Cauterization Tonsillectomy
type: item
description: Objectives: To compare the outcomes of diode laser tonsillectomy and bipolar cauterization tonsillectomy in terms of intraoperative efficiency, postoperative recovery, and complications. Methodology: This prospective comparative study carried out at Rawal Institute of Health Sciences (RIHS), Islamabad from January 2023 to December 2023. A total of 100 patients were randomly selected for the diode laser tonsillectomy procedure and bipolar cauterization tonsillectomy. Various details such as intraoperative parameters, postoperative pain, time to start a normal diet, and the complication/s that ensued were documented and compared. Results: The mean age of the patients was 26.5±5.2 years, with gender distribution was 50% male and 50% females. Diode laser tonsillectomy resulted in shorter operating time (25.0±5.0 min), decreased blood loss (5.0±2.0 ml), reduced pain score at day 7 (1.5±0.5 points) and faster postoperative recovery than bipolar cauterization (p < 0.001). The frequency of secondary haemorrhage in the diode laser patients (2%) was also noticeably less. Conclusion: Diode laser tonsillectomy is characterized by fewer post-operative complications, shorter time of treatment, and faster healing compared to classical methods of tonsillectomy due to high cost it is not popular.
creator: Mirza Nasheed Baig
creator: Farhan Ahmed
creator: Mumtaz Ahmad Umar
creator: Muhammad Yasir Khan
creator: Ayesha Jawad
creator: Saira Iftikhar
rights: Copyright (c) 2026 Mirza Nasheed Baig, Farhan Ahmed, Mumtaz Ahmad Umar, Muhammad Yasir Khan, Ayesha Jawad, Saira Iftikhar https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 81
ending page: 85
doi: 10.48036/apims.v22i1.1489

Assessment of the Anti-hyperglycemic Effects of Rosemary (Salvia Rosmarinus) Compared to Glimepiride in Alloxan induced Diabetic Rabbits
type: item
description: Objectives: To observe the antihyperglycemic effect of rosemary (Salvia rosmarinus) in alloxan-induced diabetic rabbits. Methodology: This experimental study was conducted at the Department of Pharmacology and Therapeutics, Liaquat University of Medical and Health Sciences (LUMHS), in collaboration with the Animal House of the Agriculture University, Tando Jam, from November 2023 to April 2024. A total of 24 adult healthy male rabbits weighing between 1.5 and 2.5 kg were included. The rabbits were divided into four groups: Group A (normal control) and Group B (diabetic-induced control) received 0.9% NaCl, while Group C (diabetic-induced) received Rosmarinus officinalis 250 mg/kg, and Group D (diabetic-induced) received glimepiride 2.5 mg/kg. Leaves of Rosmarinus officinalis were dried, powdered, and prepared as an ethanolic extract. After the experiment, blood samples were collected from the femoral vein, centrifuged, and analyzed for serum glucose levels. Hyperglycemia was defined as a blood glucose level above 200 mg/dL. Data were entered and analyzed using SPSS version 26. Results: Fasting blood sugar (FBS) levels showed a significant reduction in Groups C and D compared with Group B by day 28. Specifically, in Group C, FBS decreased from 252.8±2.5 to 181.3±2.3 mg/dL, and in Group D from 255±1.8 to 197.16±2.5 mg/dL (p<0.05), indicating significant efficacy of Rosmarinus officinalis in improving FBS levels in diabetic rabbits. Conclusion: Rosmarinus officinalis effectively reduced glycemic concentrations in alloxan-induced diabetic rabbits.
creator: Soobia Pathan
creator: Mujtaba shah
creator: Anwar Ali Jamali
creator: Madiha Niamat
creator: Amjad Mahmood Khan
creator: Farheen Malik
rights: Copyright (c) 2026 Soobia Pathan, Mujtaba shah, Aziz, Madiha Niamat, Amjad Mahmood Khan, Shujaullah https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 86
ending page: 90
doi: 10.48036/apims.v22i1.1375

Efficacy of Ligasure use in Total Thyroidectomy at a tertiary care Hospital
type: item
description: Objective: To evaluate the effectiveness of the ligasure small jaw (LSW) device in achieving hemostasis during total thyroidectomy. Methodology: This study is conducted as a retrospective observational study at Akbar Niazi Teaching Hospital, Islamabad. Eighty-six patients underwent thyroidectomy using LSW between April 2021 till April 2024 were studied. Liga Sure is an advanced bipolar vessel-sealing device that uses a combination of controlled pressure and radiofrequency energy to permanently seal blood vessels up to 7 mm in diameter, providing effective hemostasis with minimal thermal spread. Parameters including per operative findings of intraoperative bleeding and operative time and postoperative findings of voice change and hospital stay were assessed. After approval from the ethical board, data was collected as a qualitative research study and entered on standard SPSS sheet version 26. Results: A total of 86 patients were observed during the study period. Per operative findings of intraoperative bleeding measured by the visual gauze method showed 6ml gauze blood in 39.5% and more than 6ml gauze blood in 26.8% and rest of the patients were having 3ml-6ml gauze blood. The mean surgery time noted was 92.07±6.34 minutes.64% of the patients had hospital stay of 1-2 days. Only 1 patient had voice hoarseness which was improved after giving stat dose of steroid. The use of Liga Sure demonstrated effective hemostasis, acceptable operative time, short hospital stays, and a low complication rate in patients undergoing total thyroidectomy. Conclusion: The results demonstrated that LSW effectively minimized intraoperative bleeding, reduced operative time, and preserved recurrent laryngeal nerve function, with minimal complications. Comparative analysis with traditional ligation techniques, diathermy or bipolar devices confirmed the efficiency and safety of LSW.
creator: Ahmad Raza
creator: Hira Saleem
creator: Sabah Ali Chaudhary
creator: Nausheen Nawaz
creator: Sidra Ahmad
creator: Misbah Arif
creator: Kaynat Mustafa
creator: Muhammad Hassan Farooq
rights: Copyright (c) 2026 Dr Ahmad Raza, Hira Saleem, Dr Sabah Ali Chaudhary, Dr Nausheen Nawaz, Dr Sidra Ahmad, Dr Misbah Arif, Dr Kaynat Mustafa, Dr Muhammad Hassan Farooq https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 91
ending page: 95
doi: 10.48036/apims.v22i1.1558

Cost Out-of-Pocket Expenses with Cardiovascular Diseases at PMCH Nawabshah – COUP Study
type: item
description: Objectives: To evaluate out-of-pocket (OOP) healthcare expenditures and associated factors among patients with cardiovascular diseases (CVDs) presenting at PUMHS Nawabshah. Methodology: This cross-sectional study was conducted among 200 diagnosed CVD patients attending inpatient and outpatient cardiology services at PUMHS SBA from October 2023 to March 2024. All adult patients of both genders presenting with any cardiovascular disease at the cardiology department were enrolled. Patients were assessed for sociodemographic characteristics, type of cardiovascular disease, duration of illness, and direct medical and non-medical expenses, including consultation fees, medications, diagnostic tests, transportation, and hospital stay. Descriptive statistics were used to calculate the mean and median OOP costs. Appropriate statistical tests were applied using SPSS version 23, with a p-value of <0.05 considered statistically significant. Results: The overall mean age of participants was 59.3 ± 14.36 years, and the majority were males (67.6%). The mean annual medication cost was 117,735.31 PKR. Patients were hospitalized an average of 2.02 times per year, with a mean total of 9.63 inpatient days annually, incurring a mean annual hospitalization cost of 68,191.50 PKR. Yearly transportation-related expenses averaged 35,946.04 PKR. Collectively, the overall mean annual out-of-pocket expenditure per patient was 259,908.06 PKR. Out-of-pocket spending exceeding 10% of household income was observed in all patients, indicating that every participant in the study faced financially catastrophic healthcare costs. Additionally, a significant majority of patients (97.2%) reported borrowing money to meet their treatment expenses, and 73.8% were compelled to sell household assets to finance their care. Conclusion: Individuals with CVDs faced a considerable out-of-pocket financial burden, primarily driven by medication and diagnostic costs, which adversely influenced treatment adherence and h…
creator: Qurban Ali Rahu
creator: Ghulam Fareed
creator: Jagdesh Kumar
creator: Mashooque Ali Dasti
creator: Imran Elahi Soomro
creator: Shahnawaz Panhwar
rights: Copyright (c) 2026 Qurban Ali Rahu, Ghulam Fareed, Jagdesh Kumar, Mashooque Ali Dasti, Imran Elahi Soomro, Dr Shahnawaz Panhwar https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 96
ending page: 101
doi: 10.48036/apims.v22i1.1140

Evaluation Of Postoperative Pain With Resin Based Sealer vs Zinc Oxide Eugenol Based Sealer After Single Visit Endodontic.
type: item
description: Objective: The aim of this study is to compare the postoperative pain after single visit endodontics using zinc-oxide eugenol sealer and resin-based sealer. Introduction: Complete root canal system obturation and disinfection, as well as periradicular tissue healing, are the objectives of root canal therapy. One of the key concerns of endodontic practice is pain management both during and after root canal therapy. Methodology: A prospective, randomized, double-blind clinical trial was conducted at school of dentistry from June 2023 to November 2023 on 180 patients. The study included patients aged 18-60, ASA Class 1 or 2, with single-rooted teeth suffering from symptomatic irreversible pulpitis. Exclusions were made for ASA Class 3-5 patients, those with immature apices, severe periodontal issues, recent analgesic use, and those needing root canal treatment on multiple teeth. Single visit RCT was planned in single rooted teeth as per presentation and these patients were divided in to two groups, in Group A patients zinc oxide eugenol-based sealer was used and in group B resin based sealer was used. Per-operative, postoperative at 24H and 48H pain perception was calculated through VAS. Data was analyzed through SPSS software v20.0. Results: The mean age of Group A was 32.38±8.28 and Group B was 32.14±8.58. Around 51% of from Group A were male as compare to 34.4% male patients in group B. Majority (53%) of Group A patients have Mild pain as compare to 42% in Group B patients. P value was significant at post-operative pain after 24H and 48H of treatment in either group. Conclusion: in this investigation found that, between 24 and 48 hours after endodontic therapy, zinc oxide eugenol-based sealers have a slightly higher incidence of discomfort than resin-based sealers.
creator: Ahsen Amin
creator: Prof Dr Nouman Noor
creator: Dr Sheejia Asif
creator: Dr Abeera Maqbool
creator: Mor khan Shar
rights: Copyright (c) 2025 Ahsen Amin, Nouman Noor, Almas Sarfraz , Sheejia Asif, Abeera Maqbool, Mor khan Shar https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 102
ending page: 107
doi: 10.48036/apims.v22i1.1241

Predictors of Allergic Airway Disease in Children Under Two Years of Age
type: item
description: Objective: To determine the frequency of factors responsible for allergic airway disease in children <2 years of age. Methodology: This descriptive cross-sectional study was conducted at the Department of Pediatrics, LUMHS, Jamshoro, from October 2022 to April 2023. Children under 2 years of age diagnosed with allergic airway disease were included in the study. Both boys and girls with a disease duration of at least 3 months were enrolled. The assessed factors included family history of asthma, cow’s milk protein allergy, allergic rhinitis, low socioeconomic status, maternal education level, respiratory tract infection, and prematurity. All collected data were entered into Microsoft Excel and subsequently analyzed using SPSS version 23. Results: The patients’ ages ranged from 5 to 24 months (mean: 12.28 ± 3.40 months). Of the total participants, 84 (69.4%) were male and 37 (30.6%) were female. The contributing factors identified were family history of asthma in 21 (17.4%) patients, cow’s milk protein allergy in 59 (48.8%), allergic rhinitis in 53 (43.8%), low socioeconomic status in 28 (23.1%), primary-level maternal education in 56 (46.3%), matric-level education in 50 (41.3%), above-matric education in 15 (12.4%), respiratory tract infection in 49 (40.5%), and prematurity in 31 (25.6%). Conclusion: Cow’s milk protein allergy and allergic rhinitis were the most common contributing factors to allergic airway disease in children under 2 years of age, exceeding the contribution of respiratory tract infections and prematurity.
creator: Komal
creator: Roomana Qureshi
creator: Muhammad Hanif
creator: Asadullah Memon
creator: Sher Muhammad Nuhrio
creator: Sadaf Ujjan
rights: Copyright (c) 2026 Komal, Roomana Qureshi, Muhammad Hanif, Asadullah Memon, Sher Muhammad Nuhrio, Sadaf Ujjan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-02
publication date: 2026-02-02
volume: 22
number: 1
doi: 10.48036/apims.v22i1.1464

Efficacy of PECS Block In Perioperative Period For Pain Management In Patients Undergoing Elective Breast Surgery
type: item
description: Objective: To compare the effectiveness of intraoperatively performed PECS block (without the ultrasound guidance) and no regional blocks in controlling postoperative pain and opioid use among patients undergoing elective modified radical mastectomy (MRM) and Mastectomy. Methodology: Study Design: Randomised controlled trial. Duration and Place of Study: This study was conducted from Oct 2024 to march 2025 in Pakistan Institute of Medical Sciences, Islamabad. A randomized, controlled prospective study will be a study of 60 female (ASA I- II) patients who are to undergo MRM and Mastectomy. The patients were randomized into two groups, Group P (PEC group): Received PECS block intraoperatively under direct view (surgeon assisted) and Group C (Control group): Received standard general anesthesia without block. Primary outcome: Requirement of Analgesia. Secondary outcomes: Total Opioid use in 24 hours, Mean time to first rescue analgesic request,Visual Analogue Scale (VAS). Results : The average time to first rescue analgesia was similar between the PECS block group and control group (70.04 + 44.01 vs. 54.44 + 31.01 minutes; p =0.118). There was no significant difference in the total intraoperative tramadol intake (104.14 ± 15.02 mg vs. 96.82 ± 30.62 mg; p = 0.244). The Tramadol requirement postoperative rescue analgesia and the percentage of the patients rescued by the analgesia remained similar in the groups (p &gt; 0.05). The mean VAS pain scores of the two groups in all the time points assessed (1, 2, 4, 6, 12, and 24 hours after the operations) were significantly lower and no differing VAS pain scores between the two groups were found to be statistically significant. Conclusion: PECS block, when used intraoperatively, is safe and effective as a supplement to general anesthesia among patients that undergo elective modified radical mastectomy. It was proven to be more effective in terms of postoperative pain scores measured with the Visual Analog Scale (VAS) at pre-sp…
creator: Hira Bajwa
creator: Erum Majeed
creator: Aatif Inam Shami
rights: Copyright (c) 2026 Hira Bajwa, Erum Majeed, Aatif Inam Shami https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
doi: 10.48036/apims.v22i1.1568

Beyond the Virus: Tracheal Stenosis as a Sequela of Severe COVID-19 – A Case Report
type: item
description: INTRODUCTION: The COVID-19 pandemic has haunted the globe with its wide array of presentations, for over 2 years now. We present a case of tracheal narrowing – a presentation that may have an association with the pathology of the causative virus. CASE REPORT: A 57 year old female, known case of congestive heart failure and hypertension, presented with increasing shortness of breath. She had a history of recent hospital admission for congestive heart failure exacerbation, which included several days of intubation. Diagnosed with COVID-19 pneumonia, the patient was admitted and a CT scan ordered, which revealed bilateral ground glass opacities – a finding characteristic of the disease. In addition, the trachea was found to be narrowed. This was confirmed and treated with rigid bronchoscopy, which greatly improved the patient’s condition. CONCLUSION: Diagnostic testing modalities are limited in their abilities to identify COVID-19. This may affect management protocols. We propose establishing a scoring system, using a combination of symptoms and laboratory investigations as scoring criteria, to help not only identify patients in need of therapy but also to stratify disease severity. Our case represents a unique and rather rare finding, which may possibly hint towards COVID-19.
creator: Muhammad Osama Muslim
creator: Muhammad Abdullah
creator: Aiman Balouch
creator: Abdurrahman Mir Khan
creator: Alina Tariq
creator: Syeda Gul E Zahra
creator: Sania Muslim
rights: Copyright (c) 2026 Muhammad Abdullah, Muhammad Osama Muslim MD, Aiman Balouch, Abdurrahman Mir Khan, Alina Tariq, Syeda Gul E Zahra, Sania Muslim https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 22
number: 1
starting page: 118
ending page: 120
doi: 10.48036/apims.v22i1.1547