Life and Science

Editorial

2025-08-28T13:28:51+05:00

Educational institutions have benefited from the implementation of artificial intelligence (AI), which has
optimized and improved their tasks. Utilizing educational tools, AI-driven instructors, and cutting-edge
technology that supports independent study, educational institutions are becoming more accessible and
customized to meet the unique needs of students.¹ Artificial intelligence has the potential to transform how
individuals learn at educational institutions around the world. The rapid pace of development has provided
individuals with increased options and improved their capacity to utilize technology more effectively. The
established standards, especially those of an ethical nature, face challenges from emerging possibilities that
necessitate careful scrutiny.

AI can assist educators in improving the skills of every student by facilitating the modification of course difficulty
levels. They can now observe the engagement and performance of their students in real time. As a result,
instructors are equipped to assist each student more effectively.¹ Language translators, virtual assistants, and
educational chatbots serve as prime examples of AI systems that assist students who are unable to attend
school or encounter difficulties in language communication. This advanced technology offers significant
advantages to individuals from various backgrounds. However, some individuals argue that this has reduced
the importance of educational attainment in comparison to earlier times.

While taking the importance of AI into consideration, there is also much hue and cry about the adverse effects
of its use. As sole reliance on AI can affect one's creativity and memory as well as critical thinking. Risko and
Gilbert proposed that cognitive offloading can be achieved via using an external tool, and this can free up
memory, but it can also lead to decline in skill development and cognitive activities.² Similarly, Sparrow et al
concluded that using search engines for information can affect processing of information and memory.³ Thus,
continuous use and sole reliance on AI will make human dependent on AI and in turn will result in reducing
cognitive abilities.

AI has the potential to revolutionize the way we acquire knowledge in every aspect. When utilizing this
advanced tool, it is essential to exercise the highest level of caution. This initiative should support educators in
improving their effectiveness in their professional roles, rather than replacing them. Legislators and educators
must consider the ethical, social, and technological implications of utilizing artificial intelligence to improve the
equity, accessibility, and human-centered approach of educational institutions. The ability of AI to demonstrate
creativity and empathy will determine its effectiveness in educational settings.⁴

AI has enormous potential to support educational environments; however, it should be utilized thoughtfully
and with care.⁵ The extent to which AI in education harmonizes innovation with human values will ultimately
determine whether it simplifies or complicates the learning process, and how it influences individuals' capacity
for meaningful engagement. It is crucial for us, as leaders in education, to carefully observe the implementation
of AI in our universities.

Editor-in-Chief

How to cite this: Alamgir W, Haider A. AI in Education: The Double-Edged Sword. Life and Science. 2025; 6(3): 308-309. doi: http://doi.org/10.37185/LnS.1.1.1003

Comparison of Quantitative C-Reactive Protein with Blood Lactate Levels as Septic Markers in Neonatal Sepsis: A Cross-Sectional Study in a Tertiary Care Setting, Rawalpindi

2025-08-28T13:28:52+05:00

Objective: To find the relationship between the quantitative C-reactive protein and lactate as septic markers in
neonatal sepsis.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the Neonatal Intensive Care Unit of Combined
Military Hospital (CMH), Peshawar, Pakistan from March 2024 to August 2024.
Methods: Neonates (age 1 day–28 days) diagnosed with sepsis were enrolled. Patients were categorized into
two groups: Group I (Survivors) and Group II (Non-survivors). Patient's demographic details, blood cultures,
serum C-reactive protein, neutrophil counts, plasma Lactate, and outcome in terms of hospital discharge were
assessed and recorded. Data analysis was done using SPSS version 26.
Results: Of the total 136 neonates, there were 76 (55.9%) male and 60 (44.1%) female. The overall mean age
was 14.56±7.82 days. Group I had 92 (67.6%) survivors and Group II had 44 (32.4%) non-survivors. The median
value of Lactate (millimole/Liter) and C-reactive protein (milligram/deciliter) was 2.3 (IQR 1.4-5.3) and 2.1 (IQR
0.15-8.7), respectively. Survivor group (Group-I) had lower Lactate (1.9 millimole/Liter [1.2–9] than the nonsurvivor group (4.5 millimole/Liter [2.15–7.4]), P < 0.05. The prevalence of multiple organ dysfunction was
significantly higher in Group-II 82 (89.1%) than in Group-I 16 (36.4%). Based on organism causing infections
among 136 neonatal sepsis cases, the incidence of Group B Streptococcus, Escherichia coli, Listeria
monocytogenes, Coagulase-Negative Staphylococci, Staphylococcus aureus, Enterococcus species, Klebsiella
species, and Pseudomonas aeruginosa was 58 (43%), 32 (24%), 9 (7%), 7 (5%), 4 (3%), 14 (10%), 10 (7%), and 2
(1%), respectively.
Conclusion: Lactate is superior to C-reactive protein in predicting prognosis and mortality in neonatal sepsis in
the Neonatal intensive care unit. Elevated levels of lactate and C-reactive protein are primarily associated with
increased severity of neonatal sepsis, including the progression to multiple organ dysfunction syndrome
(MODS), septic shock, and poor clinical outcomes.

How to cite this: Ali F, Aqib AR, Ahmad N, Ibrahim S, Rehman M, Usman A. Comparison of Quantitative C-Reactive Protein with Blood Lactate Levels as Septic Markers in Neonatal Sepsis: A Cross-Sectional Study in a Tertiary Care Setting, Rawalpindi. Life and Science. 2025; 6(3): 310-316. doi: http://doi.org/10.37185/LnS.1.1.740

A Comparative Study on Ventral Dartos Flap Vs Tunica Vaginalis Flap in Hypospadias Repair, Decreasing the Incidence of Fistula Formation

2025-08-28T13:28:54+05:00

Objective: To compare the effectiveness of the Tunica Vaginalis Flap (TVF) and the Ventral Dartos Flap (VDF) in
reducing fistula formation following distal hypospadias repair in pediatric patients.
Study Design: Quasi-experimental study.
Place and Duration of Study: This study was conducted at the Department of Paediatric Surgery, Pak Emirates
Military Hospital (PEMH), Rawalpindi, Pakistan from January 2023 to December 2024.
Methods: A total of 100 patients under eight years of age with distal hypospadias were recruited. Patients were
randomly divided equally into two groups (TVF vs VDF), using a random numbers table. Data was analyzed using
SPSS version 27, with chi-square tests for categorical variables and independent t-tests for continuous variables
with significance set at P < 0.05.
Results: The mean age of all patients was 2.46±1.210 years, while the mean weight was 11.47 ± 3.115 kg, and
were comparable between groups. During the 6 months follow-up, a total of 25% (N=25 out of 100) patients
developed Urethro Cutaneous Fistula (UCF), with 13% (N=8) in the TVF group and 34% (N=17) in the VDF group,
indicating a statistically significant reduction in fistula formation with tunica vaginalis flap (P=0.038). The
superior vascularity and independent blood supply of TVF likely contributed to improved wound healing and
fewer UCF.
Conclusion: In this study, TVF provides a more trustworthy neourethral coverage than VDF in distal hypospadias
repair, particularly lowering UCF incidence. These results justify the preferred use of TVF for neourethral
coverage to improve surgical outcomes. However, the choice between the two techniques may depend upon
the operating surgeon's preferences and patient-specific factors. Further large-scale studies with extended
follow-up are recommended to validate these results.

How to cite this: Ahmed R, Ashraf Y, Ahmed A, Jabbar MS, Rehman MH, Jarral S. A Comparative Study on Ventral Dartos Flap Vs Tunica Vaginalis Flap in Hypospadias Repair, Decreasing the Incidence of Fistula Formation. Life and Science. 2025; 6(3): 317-323. doi: http://doi.org/10.37185/LnS.1.1.927

Association of Coronary Artery Dominance with Post-Primary Percutaneous Coronary Intervention Complication in ST-Segment Elevation Myocardial Infarction: Retrospective Observational Study, Rawalpindi

2025-08-28T13:28:55+05:00

Objective: To examine the relationship between coronary artery dominance and complications after primary
percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI).
Study Design: Retrospective observational study.
Place and Duration of Study: This study was conducted at the Armed Forces Institute of Cardiology (AFIC) and
the National Institute of Heart Diseases (NIHD), Rawalpindi, Pakistan from February 2023 to January 2024.
Methods: Coronary artery dominance and complications following initial percutaneous coronary intervention
(PCI) in ST-segment elevation myocardial infarction patients were examined in this retrospective observational
study. The Armed Forces Institute of Cardiology and National Institute of Heart Diseases in Rawalpindi,
Pakistan, conducted this investigation. From February 2023 to January 2024, 85 consecutive STEMI patients
had primary percutaneous coronary intervention (PCI) at the study centers. Patients who had CABG, significant
coronary anomalies, or inadequate medical data were excluded from the research. Electronic medical records
and angiographic databases included demographics, medical history, angiographic results, procedure details,
and post-PCI issues.
Results: The study comprised 85 patients diagnosed with STEMI at an average age of 59.4 years. The group was
mostly made up of male patients, accounting for 76.5% of the total. Comorbidities such as hypertension
(52.9%) and diabetes mellitus (35.3%) were prevalent. Left dominance was seen in 47.1% of instances, whereas
right dominance was noted in 35.3%. Co-dominance was detected in 17.6% of cases. Myocardial reperfusion
injury, no-reflow phenomenon, and distal embolization occurred in 17.6%, 23.5%, and 11.8% of patients,
respectively.
Conclusion: According to our results, STEMI post-PCI morbidity may not be affected by coronary artery
dominance. However, patient demographics, comorbidities, lesion characteristics, and procedures may alter
PCI outcomes.

How to cite this: Gul SJ, Nadeem A, Samore NA, Gul SF, Bilal A, Hasan F. Association of Coronary Artery Dominance with Post-Primary Percutaneous Coronary Intervention Complication in ST-Segment Elevation Myocardial Infarction: Retrospective Observational Study, Rawalpindi. Life and Science. 2025; 6(3): 324-330. doi: http://doi.org/10.37185/LnS.1.1.717

A Cross-Sectional Study on the Accuracy of Volume Assessment of Pleural Effusion by Ultrasonography with Pleural Tap as the Gold Standard in Tertiary Care Setting, Rawalpindi

2025-08-28T13:28:57+05:00

Objective: To determine the accuracy of three-dimensional ultrasound for volume estimation of pleural
effusion, keeping the volume obtained by pleural tap as the gold standard.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Radiology, Combined Military
Hospital (CMH), Rawalpindi, Pakistan, from 1^st January 2023 to 30^th June 2023.
Methods: A total of 219 patients who fulfilled the selection criteria were included in the study. After detailed
history and clinical examination, all patients underwent volume estimation of pleural effusion by ultrasound
using a three-dimensional approach, i.e., anteroposterior, transverse, and craniocaudal. Subsequently, all
participants underwent a pleural tap to drain fluid in order to estimate the actual volume. All findings were
noted down on a predesigned proforma and accuracy of ultrasonography was assessed.
Results: The mean age of the patients was 42.62±12.96 years, with 112 (51.14%) males. The mean estimated
volume of pleural effusion on USG was 668.94 (312 – 963) ml while on thoracentesis was 641.95 (310 - 999) ml.
Pneumonia 93 (42.47%) was the leading cause, followed by hemothorax 37(16.89%). 89 (40.64%) had mild,
while 11(5.02%) had severe pleural effusion, and the rest had moderate pleural effusion. The sensitivity,
specificity, and accuracy of ultrasonography for mild pleural effusion (estimated volume was >10 to <500 ml)
was 82.29%, 91.86% and 87.67%, for moderate pleural effusion (estimated volume was >500 to <1500 ml) was
86.95%, 81.73% and 84.47% and for severe pleural effusion (estimated volume was >1500 ml) it was 85.71%,
97.64% and 97.26%, respectively.
Conclusion: Volume estimation by three-dimensional ultrasound had a high sensitivity, specificity, and
accuracy for varying severity of pleural effusion, keeping pleural tap as the gold standard.

How to cite this: Bakhtyar A, Dildar N, Amir H, Awais A, Iqbal M, Zahid A. A Cross-Sectional Study on the Accuracy of Volume Assessment of Pleural Effusion by Ultrasonography with Pleural Tap as the Gold Standard in Tertiary Care Setting, Rawalpindi. Life and Science. 2025; 6(3): 331-337. doi: http://doi.org/10.37185/LnS.1.1.558

Prevalence of Olfactory Fossa Variants and Their Association with Age and Gender: A CT-Based Observational Study using Keros Classification

2025-08-28T13:29:04+05:00

Objective: To determine the prevalence of olfactory fossa variants based on Keros classification and to assess
their association with age and gender using computed tomography.
Study Design: Retrospective observational study.
Place and Duration of Study: This study was conducted at the Department of Radiology, Pakistan Ordinance
Factory (POF) Hospital, Wah Cantt, Pakistan from January 2022 to January 2024.
Methods: Patients of either gender above 10 years were included in the study who had undergone CT PNS. A
qualified radiologist measured the olfactory fossa depth using reference landmarks. Both descriptive and
inferential statistical techniques were utilized in the examination of the Keros type distribution among the
patients. Inferential statistics, particularly chi-square tests, were employed to examine the relationships
between categorical variables such as gender and age groups and the distribution of Keros types. P-values were
used to assess the statistical significance of these correlations.
Results: A Total of 123 patients were included in the study, including 69 females (56.1%) and 54 males (43.9%).
Minimum age was 10 year and maximum age was 87 years. The results show type II Keros fossa is the most
prevalent type, followed by type I, while type III is rare. A symmetrical olfactory fossa is more common than
asymmetrical. Age groups and Keros Type on both sides do not significantly correlate, according to the chi square test.
Conclusion: Chronic sinusitis and nasal polyps are prevalent conditions, and their treatment has been
transformed with the advent of advanced surgical procedures, notably Functional Endoscopic Sinus Surgery.
The depth of the olfactory fossa varies, making the Keros classification particularly important because it
assesses the variations in olfactory fossa depth and symmetry, which is important for surgeons to avoid
iatrogenic injuries.

How to cite this: Madiha, Raza SJ, Mukhtar R, Ajmal A, Akbar F, Maka TA. Prevalence of Olfactory Fossa Variants and Their Association with Age and Gender: A CT-Based Observational Study using Keros Classification. Life and Science. 2025; 6(3): 338-343. doi: http://doi.org/10.37185/LnS.1.1.787

Evaluating Non-Alcoholic Fatty Liver Disease in Individuals with and without Type 2 Diabetes Comparative Cross-Sectional Study using Ultrasound Imaging

2025-08-28T13:29:11+05:00

Objective: Non-Alcoholic Fatty Liver Disease (NAFLD) is a significant health concern globally, particularly in
individuals with Type 2 Diabetes Mellitus (T2DM). This study aims to evaluate the frequency and severity of
NAFLD among diabetic and non-diabetic populations using ultrasound imaging, focusing on its implications in
Pakistan.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Medicine, Ibn-e-Siena Hospital &
Research Institute, Multan, Pakistan from 17^th September 2018 to 16^th March 2019.
Methods: A total of 324 participants were enrolled, including 162 patients diagnosed with type 2 diabetes
mellitus and 162 age- and gender-matched non-diabetic controls. The study included male and female patients
aged 30-60 years, diagnosed with type 2 diabetes and on oral hypoglycemic agents or insulin for at least one
year. Patients with suspected autoimmune hepatitis, viral hepatitis, chronic liver disease, excessive alcohol
consumption, or those unwilling to participate were excluded. Abdominal ultrasonography was employed to
assess liver echogenicity and grade hepatic steatosis. Statistical analysis was carried out using SPSS version
26.0. Categorical variables were analyzed using the chi-square test, while continuous variables were assessed
using the independent t-test. A P-value <0.05 was considered statistically significant.
Results: The frequency of NAFLD was significantly higher in the diabetic group (76%) compared to nondiabetics
(48%) (P < 0.001). Moreover, moderate to severe NAFLD was more frequent in diabetics (54%) than in
non-diabetics (20%). NAFLD severity showed a significant correlation with increasing age (≥50 years), obesity
(BMI ≥30 kg/m²), and poor glycemic control (HbA1c ≥7%).
Conclusion: Non-alcoholic fatty liver disease (NAFLD) is more prevalent and severe in type 2 diabetics
compared to non-diabetics, as assessed through ultrasound imaging anatomy.

How to cite this: Iqbal MZ, Irfan A, Ejaz M, Gardazi A, HBS Syed, Ali A. Evaluating Non-Alcoholic Fatty Liver Disease in Individuals with and without Type 2 Diabetes Comparative Cross-Sectional Study using Ultrasound Imaging. Life and Science. 2025; 6(3): 344-349. doi: http://doi.org/10.37185/LnS.1.1.772

A Cross-Sectional Study on Visceral Fat Estimation by Computed Tomography and Its Relationship to Diabetes and Coronary Artery Disease at Shalamar Hospital, Lahore

2025-08-28T13:29:13+05:00

Objective: This study aimed to estimate visceral abdominal fat using computed tomography (CT scan) and its
relationship with two major metabolic conditions diabetes mellitus (DM) and coronary artery disease (CAD).
Study Design: A cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Cardiology, Shalamar Hospital,
Lahore, Pakistan from 4^th May 2024 to 10^th August 2024.
Methods: A total of 68 adult patients, including both males and females diagnosed with either diabetes, CAD,
or both, were recruited for the study. Abdominal CT scans were performed following standard hospital imaging
protocols. Axial two-dimensional (2D) CT images were analyzed to quantify visceral adipose tissue (VAT) area in
square centimeters (cm²). The scans were interpreted by a trained radiologist to ensure accuracy and
consistency in VAT estimation.
Results: Results showed that the mean age was approximately 51.88 years in females and 55.24 years in males.
Mean visceral adipose tissue (VAT) was 179.63 cm2 in the patients suffering from diabetes or coronary artery
disease (CAD), and their visceral fat percentage was much higher than the VAT threshold. A statistically
significant association was found between elevated visceral fat and the presence of diabetes mellitus.
Additionally, male participants demonstrated a higher prevalence and quantity of visceral abdominal fat
compared to females.
Conclusion: This study highlights a strong association between increased visceral adiposity and the presence of
diabetes and coronary artery disease. These findings underscore the clinical importance of incorporating VAT
assessment into routine screening protocols for at-risk individuals. Early identification and targeted
management of excess visceral fat could play a crucial role in both the primary and secondary prevention of
metabolic and cardiovascular diseases.

How to cite this: Kazmi T, Tahir M, Farhat S, Hameed Z, Yousaf A. A Cross-Sectional Study on Visceral Fat Estimation by Computed Tomography and Its Relationship to Diabetes and Coronary Artery Disease at Shalamar Hospital, Lahore. Life and Science. 2025; 6(3): 350-355. doi: http://doi.org/10.37185/LnS.1.1.775

Incidence of Nephropathy After Spontaneous Bacterial Peritonitis in Decompensated Liver Cirrhosis at Muhammad Teaching Hospital, Peshawar: A Single Institution Descriptive Cross-Sectional Study

2025-08-28T13:29:15+05:00

Objective: To determine the incidence of nephropathy after spontaneous bacterial peritonitis in patients with
decompensated liver cirrhosis.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Medicine, Muhammad Teaching
Hospital (MTH), Peshawar, Pakistan from November 1^st, 2024, to April 30^th 2025.
Methods: A total of one hundred and ten (110) patients were part of the current study. This sample size was
obtained by using the WHO sample size calculator, for which a reference study was considered having a
frequency of renal impairment in about 83.3% of patients who had developed decompensated liver cirrhosis
followed by spontaneous bacterial peritonitis. Consecutive, non-probability sampling technique was used. The
confidence interval was equal to 95% while error margin was equal to 6% to calculate the size.
Results: Participants of the study were adults, and the minimum age was 18, whereas the oldest was 60 years,
with a mean of 46.436 ± 6.81 years. As chronic liver disease patients were selected, they had a prolonged
history of decompensated cirrhosis of the liver (mean duration was 8.845 ± 2.38 months). Gender classification
of 110 participants was done, in which males were 91 (82.7%) and females were 19 (17.3%). Nephropathy
(Renal impairment) was observed in 33 (30%) of patients after spontaneous bacterial peritonitis in
decompensated liver cirrhosis.
Conclusion: In this study, the results showed that overall, there was 30% renal impairment in the observed
cases. They were more prominent in Child's Pugh C cirrhosis liver compared to Class A or B cirrhosis liver
because of the development of ascites.

How to cite this: Alam S, Ayaz M, Kausar SAZ, Ullah R, Imran A, Khan MS. Incidence of Nephropathy After Spontaneous Bacterial Peritonitis in Decompensated Liver Cirrhosis at Muhammad Teaching Hospital, Peshawar: A Single Institution Descriptive Cross-Sectional Study. Life and Science. 2025; 6(3): 356-361. doi: http://doi.org/10.37185/LnS.1.1.942

Outcome of Obstetric Patients with Valvular Heart Diseases: Results of a Cohort Study from Tertiary Care Hospital, Multan, Pakistan

2025-08-28T13:29:17+05:00

Objective: To determine the outcomes of obstetric patients with valvular heart diseases in a tertiary care
hospital.
Study Design: Cohort study.
Place and Duration of Study: This study was conducted at the Department of Gynaecology and Obstetrics,
Combined Military Hospital (CMH), Multan, Pakistan, from 1^st May 2023 to 30^th April 2024.
Methods: A total of 110 pregnant women diagnosed with valvular heart disease, as confirmed by
echocardiographic evaluation, were included in this study through consecutive sampling. The maternal, fetal,
and neonatal outcomes, especially linked to cardiology and obstetrics, were recorded. Descriptive analysis of
the study outcomes was done by applying frequency and percentages.
Results: The Mean± SD of age in this study was 27.83±5.25 years with an age range of 21-39 years. Mitral
stenosis was the most frequent valvular heart disease observed in 66 (60%) and 58 (52.73%) patients, who
belonged to NYHA class I. The maternal outcomes showed the mean gestational age of 37.58±1.75 weeks, with
34.55 % of the patients suffering from any type of maternal complications. Cesarean section (25.45 %), anemia
(8.18%), atrial fibrillation (7.27%), cardiac arrhythmia (7.27%), and onset/worsening of heart failure (5.45%)
were the most frequently recorded maternal complications. Data regarding fetal and neonatal outcomes
showed that complications were present in 33.64% of cases. Preterm delivery (23.64%), low birth weight (20%),
low APGAR (Appearance, Pulse, Grimace, Activity, Respiration) score at 5 minutes (7.27%), and stillbirth
(6.36%) were the most common complications.
Conclusion: Adverse maternal, fetal, and neonatal outcomes are frequently reported in obstetric patients with
valvular heart disease.

How to cite this: Hashmi Z, Sheen IN, Batool S, Azam R, Wajid H, Bushra. Outcome of Obstetric Patients with Valvular Heart Diseases: Results of a Cohort Study from Tertiary Care Hospital, Multan, Pakistan. Life and Science. 2025; 6(3): 362-367. doi: http://doi.org/10.37185/LnS.1.1.767

Evaluation of Analgesic and Anesthetic Efficacy of Magnesium Sulphate in Regional Blocks: Quasi-Experimental Study

2025-08-28T13:29:26+05:00

Objective: To evaluate the anesthetic and analgesic efficacy of magnesium sulphate as an adjunct to local
anesthesia in Regional Blocks.
Study Design: A quasi-experimental study.
Place and Duration of Study: This study was conducted at the main operating theatre (OT), Combined Military
Hospital (CMH), Lahore, Pakistan from 3^rd November 2022 to 5^th September 2023.
Methods: A total of 70 patients (35 in each group), aged 18-45 years of either gender, American Society of
Anesthesiology Status I or II, undergoing ophthalmological surgeries under regional blocks were enrolled in the
study. Patients were divided into two groups: Group A - Magnesium Sulphate (N = 35) and Group B - Placebo (N =35). The peribulbar block was performed with 0.5% bupivacaine and 2 % lignocaine without adrenaline in a 10
ml syringe in equivalent proportions. In this compound of local anaesthetic, 1ml of 0.9% normal saline was
added to Group B members as a placebo treatment, while in Group A, 50 mg magnesium sulphate was added.
Lid and globe akinesia were evaluated at 1, 5, and 15 minutes, and the duration of lid and globe akinesia was
recorded. The analgesia requirement at the first and third hours was also recorded as per the visual analogue
score.
Results: Mean age of participants was 39.1 ± 5.2 years. Duration of Lid Akinesia in A and B was 115 ±7.9 minutes
and 135 ± 5.9 minutes, respectively; whereas, duration of Globe Akinesia in A and B was 180.5±7.9 minutes and
225 ± 6.5 minutes, respectively. Visual Analogue Score at 1st hour in A was 1.4 ± 0.50 and B 2.5 ± 0.50 (P<.001). At the 3^rd hour, results were 3.4 ± 1.1 and 4.5 ± 1.1 in groups A and B, respectively (^P<.001). Onset of Lid Akinesia at 1 minute in A was among 18 (51.4%) patients, whereas in B, in 3 (8.6%) (P<.001).
Conclusion: Magnesium sulphate as an adjunct to local anesthetic in regional blocks can promote earlier
inception and prolonged duration with pronounced analgesic prospects.

How to cite this: Ameer K, Ali M, Abbas MA, Kashif S, Sharif MH. Evaluation of Analgesic and Anesthetic Efficacy of Magnesium Sulphate in Regional Blocks: Quasi-Experimental Study. Life and Science. 2025; 6(2): 368-374. doi: http://doi.org/10.37185/LnS.1.1.557

A Cross-Sectional Study on Psychiatric Assessment in Patients with Uncertain ENT Symptoms in the Hospital Outpatient Department, Bahawalpur

2025-08-28T13:29:34+05:00

Objective: To detect psychiatric symptoms presenting with ear, nose, and throat manifestations by using a
simple screening tool like the General Health Questionnaire (GHQ)-12 shortened version and then refer them
to the psychiatric outpatient department for further evaluation and management. Mental health issues are
very common nowadays, and understanding their clinical manifestations is crucial.
Study Design: A cross-sectional study.
Place and Duration of Study: The study was conducted in the Ear, Nose, and Throat (ENT) Outpatient
Department, Combined Military Hospital (CMH), Bahawalpur, Pakistan from August 2020 to January 2021.
Methods: A Total of 455 patients presented in the outpatient department with ENT CMH Bahawalpur
symptoms were considered in this study. GHQ-12 questionnaire was applied to detect psychiatric symptoms in
patients who were not explained on detailed history and physical examination, and in those having positive
symptoms related to ear, nose, or throat problems. Chi-square test was applied as a statistical tool.
Results: Among 455 patients who reported ENT OPD during 06 months, 36 patients did not have physical
findings on detailed examination, 59 were positive for psychiatric symptoms, and they were guided to go to
psychiatric OPD for further evaluation and mental state examination.
Conclusion: Psychiatric symptoms can be identified by taking a detailed history from patients presenting in the
outdoor patient department and applying different screening tools. Medical health professionals at all levels
need to be trained and sensitized to identify such cases. The absence of physical disease gives an important clue to recognize psychiatric illnesses.

How to cite this: Saeed I, Rafique U, Malik KZ, Ali A, Mahar R. A Cross-Sectional Study on Psychiatric Assessment in Patients with Uncertain ENT Symptoms in the Hospital Outpatient Department, Bahawalpur. Life and Science. 2025; 6(3): 375-380. doi: http://doi.org/10.37185/LnS.1.1.808

Case-Control Study of Corneal Endothelial Cell Density in Primary Open-Angle Glaucoma Patients Versus Normal Population Using Specular Microscopy in Rawalpindi, Pakistan

2025-08-28T13:29:36+05:00

Objective: To assess Endothelial cell counts in the corneas of patients with primary open-angle glaucoma
(POAG) as compared to age-matched healthy individuals using Corneal Specular Microscopy.
Study Design: Case-control study.
Place and Duration of Study: This study was conducted at the Armed Forces Institute of Ophthalmology (AFIO),
Rawalpindi, Pakistan from December 2023 to May 2024.
Methods: A total of 50 individuals were recruited, including 25 phakic Primary Open Angle Glaucoma patients
on antiglaucoma medications for at least five consecutive years. They were compared with 25 healthy phakic
individuals as controls. All the individuals were aged 50-60 years. Intraocular pressure (IOP) was recorded using
Goldmann Applanation Tonometry (GAT). Endothelial cell density was measured using Indirect Specular
Microscopy SP-3000P® in both groups after thorough ophthalmological examination. SPSS 25 was used for
statistical analysis. Age was stratified into 3-year intervals from 50 to 60 years. Paired sample t-test was
employed to assess the mean difference, and a P-value <0.05 was considered statistically significant.
Results: Among included participants ( N=50), 26 (52%) were males and 24 (48%) were females. Participants
had a mean age of 55.08 ± 2.48 years. The mean endothelial cell count in Primary Open Angle Glaucoma
patients was 2067±155 cells/mm² compared to controls 2715±315 cells/mm² (P=0.0001). There was no
statistically significant difference in endothelial cell counts (in cells/mm²) between males and females or across
stratified age groups. (P > 0.05)
Conclusion: Primary Open Angle Glaucoma patients exhibit significantly reduced endothelial cell density
compared to healthy individuals. Chronic intraocular pressure elevation and long-term exposure to antiglaucoma medications may contribute to endothelial loss of cells.

How to cite this: Sajjad S, Rauf A, Haider MK, Zahra SM, Naseer MS, Zahra F. Case-Control Study of Corneal Endothelial Cell Density in Primary Open-Angle Glaucoma Patients Versus Normal Population Using Specular Microscopy in Rawalpindi, Pakistan. Life and Science. 2025; 6(3): 381-386. doi: http://doi.org/10.37185/LnS.1.1.887

An Observational Study on Prevalence and Risk Factors of Hepatitis B and C in Pregnant Women at Bakhtawar Amin Trust Hospital

2025-08-28T13:29:37+05:00

Objective: To evaluate the prevalence and associated risk factors of Hepatitis B and C in pregnant women.
Study Design: An observational study.
Place and Duration of Study: This study was conducted at the Department of Gynecology and Obstetrics,
Bakhtawar Amin Trust Hospital, Multan, Pakistan from September 2022 to September 2023.
Methods: A total of 500 pregnant women who were in their 1st trimester and tested positive for chorionic
gonadotropin hormone were selected for the study by consecutive sampling. A 5ml blood sample was drawn
from all women, and serum samples were separated, stored, and then processed by enzyme-linked
immunosorbent assay (ELISA). Hepatitis B antigen was identified in each serum sample using ELISA. ELISA kits
were used to test the anti-HCV antibodies. Patients were also tested for human immunodeficiency virus (HIV)
by HIV1/2 STAT PACK and ARBON.
Results: The prevalence of Hepatitis B and Hepatitis C was 25 (5%) and 10 (2%), respectively. Only one subject
was infected with both viruses (2.8%). Eight of the women infected with the Hepatitis B virus were also positive
for HIV. HBV showed high prevalence in rural residents (5%), patients who had undergone blood transfusion
(20%), and those with sexually transmitted diseases (20%). Women with HIV were twice the risk of infection
(OR: 2.1 (2-6.3)). Women with sexually transmitted diseases were eightfold more at risk (OR: 8.5), and women
who had undergone blood transfusion were seven times more susceptible to infection (OR: 7.3 (3.2-17.1)).
Women aged between 17 and 25 were at threefold more risk of Hepatitis C infection than older women (OR: 3.5
(1.5-9.2)). A high prevalence was noted in women with sexually transmitted diseases (13.3%)
Conclusion: The prevalence of Hepatitis B and C infection in first-trimester pregnant women was 5% and 2%.
The prevalence of viral hepatitis was associated with young age (25 years or younger), which suggested the
importance of early antenatal screening and hepatitis vaccine to reduce the risk of mother-to-child
transmission.

How to cite this: Qureshi HZ, Khan B, Iftikhar A, Imran H Iqbal MA. An Observational Study on Prevalence and Risk Factors of Hepatitis B and C in Pregnant Women at Bakhtawar Amin Trust Hospital. Life and Science. 2025; 6(3): 387-393. doi: http://doi.org/10.37185/LnS.1.1.569

Effectiveness of Ultrasonography in Detecting Metacarpal Fractures at Al-Nafees Medical Hospital, Islamabad: A Cross-Sectional Study

2025-08-28T13:29:38+05:00

Objective: To compare the effectiveness of ultrasound and direct radiography on the detection and
management of metacarpal fractures.
Study Design: A cross-sectional Study.
Place and Duration of Study: This study was conducted at the Department of Emergency, Al-Nafees Medical
Hospital, Islamabad, Pakistan from August 2022 to August 2023.
Methods: The study was conducted on 60 patients suspected of metacarpal fracture. All patients underwent
point-of-care ultrasonography and direct radiography. Data, including swelling, point tenderness, crepitus,
ecchymosis, deformity, neurovascular injury, or range of motion, was recorded.
Results: The results showed that direct radiograph detected fractures in 32 (53.3%) patients, while point-ofcare
ultrasonography detected fractures in 34 (56.6%) patients. Compared to direct radiograph, the sensitivity,
specificity, positive predictive value, and negative predictive value of point of care ultrasonography for fracture
detection were 92%, 87%, 89% and 90% respectively. point-of-care ultrasonography detected all adjacent bone
fractures. The 5th metacarpal neck was the most common site of fracture. Compared to direct radiograph, the
sensitivity, specificity, positive predictive value, and negative predictive value of point of care ultrasonography
for fracture localization were 92%, 87%, 89% and 89% respectively. With point-of-care ultrasonography,
angulation was detected in 41 (68.3%) patients and step-off in 14 (24%) patients. With direct radiograph,
angulation was detected in 40 (66.6%) patients and step off in 13 (21.6%) patients. Point-of-care
ultrasonography detected intramuscular hematoma in 9 (15%) patients. Based on the evaluation of physicians
who performed direct radiograph and point-of-care ultrasonography, 17 (28.3%) patients required an elastic
bandage, and 2 (3.3%) required surgery.
Conclusion: Point-of-care ultrasound is an effective tool for diagnosing metacarpal fractures and can be used as
an alternative to radiography.

How to cite this: Asim A, Abbasi SH, Sarfraz M, Bashir MA, Kanwal S, Imtiaz H. Effectiveness of Ultrasonography in Detecting Metacarpal Fractures at Al-Nafees Medical Hospital, Islamabad: A Cross-Sectional Study. Life and Science. 2025; 6(3): 394-398. doi: http://doi.org/10.37185/LnS.1.1.556

Association of Erythrocyte Sedimentation Rate with Treatment Outcome in Patients Suffering from Pulmonary Tuberculosis: A Cross-Sectional Study in Islamabad

2025-08-28T13:29:40+05:00

Objective: To assess the association of erythrocyte sedimentation rate with treatment outcome in patients
suffering from pulmonary tuberculosis.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Medicine, Margalla General
Hospital, Islamabad, Pakistan from July 2022 to January 2023.
Methods: Patients who were diagnosed with pulmonary tuberculosis by a consultant pulmonologist based on
clinical and radiological criteria were included in the study. They underwent all baseline investigations,
including erythrocyte sedimentation rate, at the time of diagnosis. Patients were started on the usual
treatment of pulmonary tuberculosis and followed up for three months. At the end of three months, clinical
outcome was determined along with repetition of erythrocyte sedimentation rate, and the association
between both parameters was assessed.
Results: A total of eighty-seven patients with pulmonary tuberculosis were included in the final analysis after
application of inclusion/exclusion criteria. AT the end of three months, 70 (80.4%) patients had significant
clinical improvement, while 17 (19.6%) did not show significant clinical improvement. 77 (88.5%) patients had
an Erythrocyte sedimentation rate less than 50mm/h while 10 (11.5%) had more than 50mm/h. Chi-square
analysis showed that reduced levels of Erythrocyte sedimentation rate had a statistically significant relationship
with the presence of clinical improvement at the end of three months of treatment (P-value<0.001).
Conclusion: Reduction in Erythrocyte sedimentation rate was found to be associated with clinical improvement
at the end of three months of treatment in patients suffering from pulmonary tuberculosis. As a cost-effective
biochemical marker associated with clinical improvement, it can be effectively incorporated into patient
management plans.

How to cite this: Afzal M, Hassan Z, Afzal S, Azhar R, Quershi H, Hassan S. Association of Erythrocyte Sedimentation Rate with Treatment Outcome in Patients Suffering from Pulmonary Tuberculosis: A Cross-Sectional Study in Islamabad. Life and Science. 2025; 6(3): 399-404. doi: http://doi.org/10.37185/LnS.1.1.605

Sensitivity of Amoxicillin-Clavulanic Acid in Diabetic Foot Ulcers: A Cross-Sectional Study from Khyber Teaching Hospital, Peshawar

2025-08-28T13:29:41+05:00

Objective: This study aimed to determine the sensitivity of amoxicillin-clavulanic acid in Diabetic Foot Ulcer
patients admitted to the Department of Medicine, Khyber Teaching Hospital, Peshawar.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the Department of Medicine, Khyber Teaching
Hospital, Peshawar, Pakistan from November 27, 2021, to May 26, 2022.
Methods: A total of 141 patients (aged 35–80 years) with type 2 diabetes and Diabetic Foot Ulcer of at least 2
weeks' duration were enrolled using a non-probability consecutive sampling technique. After obtaining ethical
committee approval and informed consent, culture specimens were collected from the ulcers and processed in
the hospital laboratory for culture and sensitivity testing. Data were analyzed using Statistical Package for Social
Sciences (SPSS) version 22.
Results: The study population had a mean age of 56.56 ± 15 years, with 59.6% males and 40.4% females. The
mean ulcer duration was 3.71 ± 2.8 weeks, and the mean HbA1c was 7.91 ± 1.9%. A majority (72.3%) of the
patients were classified as having long-standing diabetes. The most isolated organisms were Pseudomonas spp.
40 (28.4%), Staphylococcus aureus 38 (27%), Escherichia coli 30 (21.35%), Klebsiella spp. 15 (12.8%), and mixed
growth 8 (10.6%). Overall, sensitivity to amoxicillin-clavulanic acid was observed in 63.8% of the isolates.
Conclusion: Amoxicillin-clavulanic acid demonstrated moderate sensitivity against the microbial isolates from
DFUs in our cohort. These findings may assist clinicians in selecting appropriate empirical antibiotic therapy for
DFU management. Further studies are warranted to monitor changing microbial patterns and to assess the
clinical outcomes associated with antibiotic therapy.

How to cite this: Khan I, Alam I, Khan Z, Wazir ZM, Khalil A, Ullah I. Sensitivity of Amoxicillin-Clavulanic Acid in Diabetic Foot Ulcers: A Cross-Sectional Study from Khyber Teaching Hospital, Peshawar. Life and Science. 2025; 6(3): 405-410. doi: http://doi.org/10.37185/LnS.1.1.923

Therapeutic Options for Treating Cefotaxime-Resistant Escherichia coli & Klebsiella Species in Resource-Limited Tertiary Care Setup of Rawalpindi: A Retrospective Observational Study

2025-08-28T13:29:43+05:00

Objective: This study aimed to assess potential therapeutic options for Klebsiella pneumoniae and Escherichia
coli isolates resistant to third-generation Cephalosporins.
Study Design: Retrospective observational study.
Place and Duration of Study: This study was conducted at the Department of Pathology, Pakistan Railway
Hospital, Rawalpindi, Pakistan from January 2021 to December 2021.
Methods: Patient samples were congregated from the specified study period and processed in the
microbiology laboratory using standard protocols. Pathogens were identified through Gram staining,
biochemical tests, and antibiotic susceptibility tests via the disk diffusion method following Clinical and
Laboratory Standards Institute (CLSI) guidelines. Data scrutiny was accomplished using Statistical Package for
Social Sciences (SPSS) version 24.
Results: Out of 1,128 clinical specimens, Escherichia coli was recognized as the most recurrently isolated
pathogen (34.66%, N=391), followed by Klebsiella pneumoniae (21.89%, N=247), with Enterococcus faecalis
being the least common (3.10%). Escherichia coli exhibited notable decreased sensitivity to ampicillin (58%),
amoxicillin-clavulanate (34%), cefotaxime (43%), ciprofloxacin (31%), and co-trimoxazole (24%). Similarly,
Klebsiella pneumoniae showed resistance to amoxicillin-clavulanate (58.7%), cefotaxime (49%), and cotrimoxazole (24%). However, both pathogens remained susceptible to Carbapenems, ceftazidime,
Cefoperazone-Sulbactam, tetracycline, Cloxacillin, erythromycin, Aztreonam, Nitrofurantoin, Fosfomycin,
amoxicillin-clavulanate, and chloramphenicol.
Conclusion: The rising resistance of Escherichia coli and Klebsiella pneumoniae to third-generation
Cephalosporins 92 (24%) and 89 (36%), respectively, has been revealed in the present study. Moreover,
quinolones also present significant treatment challenges by showing high resistance among collected isolates.
In contrast, Carbapenems, β-lactam/β-lactamase inhibitor combinations (Piperacillin–Tazobactam) (TZP),
Ceftazidime, Cefoperazone-Sulbactam (SCF), Tetracycline, and Fosfomycin are found as effective alternatives to
combat cefotaxime-resistant pathogens.

How to cite this: Mussarat U, Taj S, Zahra A, Tariq N, Naval A, Bano S. Therapeutic Options for Treating Cefotaxime-Resistant Escherichia coli & Klebsiella Species in Resource-Limited Tertiary Care Setup of Rawalpindi: A Retrospective Observational Study. Life and Science. 2025; 6(3): 411-418. doi: http://doi.org/10.37185/LnS.1.1.871

A Novel Mutation in The GLA Gene Leading to Fabry Disease - A Case Report from Islamabad, Pakistan

2025-08-28T13:29:44+05:00

Fabry disease (OMIM #301500) is a rare X-linked lysosomal storage disease. Generally, lysosomal storage
disease is identified by inappropriate lipid storage in lysosomes due to specific enzyme deficiencies. In case of
Fabry disease, the defective enzyme is Alpha-Galactosidase A (Enzyme Commission No- 3.2.1.22). Alpha-
Galactosidase A enzyme is involved in the hydrolysis of terminal, non-reducing Alpha-D-galactose residues in
Alpha-D-galactosides, including galactose oligosaccharides, galactomannans, and galacto-lipids. The defect in
the enzyme is usually due to pathogenic variants in the GLA gene, present on Human X chromosome
(chrX:101397803-101407925, hg38). A mutation in the Alpha-Galactosidase A gene results in the accumulation
of globotriaosylceramide and its derivatives throughout lysosomes in the body. A pathogenic, hemizygous
Alpha-Galactosidase A variant identified through genetic testing usually confirms the diagnosis in male
patients. In contrast, the presence of a heterozygous pathogenic variant may establish the diagnosis in female
patients, as heterozygous females may be as severely affected as males or asymptomatic throughout a normal
life span. To our knowledge, Fabry disease has not been reported from Pakistan. We report the first case of
Fabry disease in a 13-year-old boy presenting with bilateral lower limb acroparesthesia and anhidrosis from
Pakistan. At present, he does not have any additional symptoms, including cardiac and renal. Genetic testing
through targeted panel sequencing revealed a novel pathogenic hemizygous mutation in the Alpha-
Galactosidase A gene (c.779G>A, p.Gly260Glu) in this male patient. This variant is present in exon 5 of the
Alpha-Galactosidase A gene, which comprises of 429 amino acids. We advised Injection Agalsidase beta, 1
mg/kg, I/V infusion every 2 weeks, which is a lifelong enzyme replacement therapy.

How to cite this: Malick AA, Hasan MJ, Ahmad A. A Novel Mutation in The GLA Gene Leading to Fabry Disease - A Case Report from Islamabad, Pakistan. Life and Science. 2025; 6(3): 419-423. doi: http://doi.org/10.37185/LnS.1.1.913