Journal of Aziz Fatimah Medical & Dental College

Editorial Faith-Based Counseling in Subfertility: Opportunities and Challenges in Modern Practice

2025-03-22T15:34:33+00:00

Subfertility presents not only medical challenges but also deep emotional and psychosocial burdens, particularly in culturally and religiously rooted societies like Pakistan. This editorial explores the emerging role of faith-based counseling in supporting individuals and couples navigating subfertility. Faith can offer a powerful source of resilience, acceptance, and emotional strength, yet its clinical application requires sensitivity, inclusivity, and ethical vigilance. The article discusses potential benefits, highlights implementation challenges—including clinician training, risk of bias, and need for religious literacy—and emphasizes the importance of integrating faith-based support with evidence-based care. It calls for the development of culturally sensitive guidelines and multidisciplinary collaboration to offer holistic, patient-centered fertility care. By bridging spiritual and clinical domains, healthcare providers can foster healing that honors both the science of medicine and the humanity of belief.

Evaluation of Non-Invasive Prenatal Testing and Early Ultrasound Findings in Fetuses with Raised Nuchal Translucency

2026-01-28T11:33:01+00:00

Objective: To assess the association between non-invasive prenatal testing (NIPT) results and first-trimester ultrasound findings in pregnancies with increased nuchal translucency (NT) and their ability to predict adverse fetal outcomes.
Methodology: A retrospective analytical cohort study was carried out at the Combined Military Hospital (CMH), Kharian, Pakistan, between January 2022 and December 2025. The study included 180 singleton pregnancies showing an NT measurement of 3.0 mm or more on first-trimester ultrasound. Findings from NIPT were compared with ultrasound results and verified through invasive diagnostic procedures or postnatal outcomes. Diagnostic accuracy was assessed by calculating sensitivity, specificity, predictive values, and the area under the ROC curve (AUC).
Results: The mean maternal age was 31.2±4.6 years, and the mean gestational age at ultrasound was 12.4±0.6 weeks. Among 180 pregnant women, 54 (30%) had adverse pregnancy outcomes, including chromosomal abnormalities, major structural anomalies, or pregnancy loss. NIPT demonstrated a sensitivity of 95.4%, specificity of 98.6%, and area under the curve (AUC) of 0.97 for detecting aneuploidy. First-trimester ultrasound alone showed an AUC of 0.83, while the combined approach achieved an AUC of 0.99, yielding superior diagnostic accuracy.
Conclusion: Increased NT remains a critical early marker of adverse fetal outcomes. NIPT provides excellent detection of common aneuploidies; however, combining it with detailed first-trimester ultrasound significantly enhances diagnostic and prognostic accuracy.

Association of Expression Patterns of ER, PR, HER-2/neu and Ki67 with Nottingham Tumor Grade in Breast Cancer Biopsies

2026-03-01T05:01:40+00:00

Objective: To examine the association of expression patterns of ER, PR, HER-2/neu, and Ki-67 with Nottingham tumor grade in breast cancer biopsies. Methodology: This was a cross-sectional study, which included 876 histologically confirmed breast carcinoma cases at Meezan Lab, Faisalabad, from January 2020 to December 2024. The Nottingham (modified Scarff-Bloom-Richardson) grading system was used to grade tumors. ER, PR, HER-2/neu, and Ki-67 were all subjected to immunohistochemistry. Pearson correlation and chi-square tests were performed, with p-values <0.05 considered statistically significant.

Results: The majority of patients were in the 40–50-year age range. The most frequent histological subtype was invasive ductal carcinoma (91.2%), and the most common tumors were Grade II (50.7%), followed by Grade III tumors (48.7%). The positivity rates of ER and PR were 50.9% and 35.5%, respectively, while that of HER-2/neu was 51.6%. A high Ki-67 proliferation index was mostly found in higher-grade (grade III) tumors. Nottingham grade had a significant positive association with ER (p<0.001), PR (p<0.001), HER-2/neu (p=0.013), and Ki-67 (p<0.001). Ki-67 had the strongest association with tumor grade.
KEYWORDS: Breast cancer; Estrogen receptor; HER-2/neu; Immunohistochemistry; Ki-67; Nottingham grade; Progesterone receptor

Outcomes in Patients with Mild Traumatic Brain Injury with No Significant Radiological Findings

2026-01-06T07:24:26+00:00

Objective: To determine the functional outcomes in patients presenting with mild traumatic brain injury (mTBI) without significant radiological findings and to assess symptom improvement at follow-up.
Methodology: A prospective observational study was conducted in the Emergency and Neurosurgery Department of Shaheed Mohtarma Benazir Bhutto Trauma Center (SMBBIT), Karachi, Pakistan, from June to November 2025. A total of 264 patients aged 18–50 years with mTBI, no significant CT findings, and presentation within 24 hours of injury were enrolled using non-probability sampling. Demographic and clinical data, including mechanism of injury, comorbidities, medications, and work absence, were recorded. Functional outcomes were assessed using the Extended Glasgow Outcome Scale (eGOS). Follow-up at 2 and 6 weeks was stratified by initial eGOS score. Chi-square and Fisher’s exact tests were applied, p value less than 0.05 was marked as significant.
Results: The mean age of patients was 37 years, and males accounted for 82.2% of cases. The median eGOS score was 7, and 70.8% of patients had mild disability. At 2-week follow-up, headache (97%), absence from work (73%), and vomiting (39%) were common symptoms. At 6 weeks, 72% of patients reported difficulty concentrating.
Conclusion: Functional outcomes in mTBI patients were generally favorable; however, persistent symptoms, including headache, vomiting, and concentration difficulties, persisted during follow-up.

Public Knowledge Regarding Childhood Epilepsy Attending a Tertiary Care Hospital

2025-08-25T15:34:49+00:00

Objective: To evaluate the knowledge of the public regarding epilepsy in children.
Methodology: This was a cross-sectional study, conducted at the department of pediatrics, Madinah Teaching Hospital, Faisalabad, from October 2024 to December 2024. A total of 384 individuals (Parents/guardians/attendants) aged 20-60 years were included in the study after taking consent from the participants. Health care professionals and attendants of epileptics, or parents who themselves had epilepsy were excluded to exclude bias. Participants’ knowledge about epilepsy was assessed, using a questionnaire, comprising of nine knowledge-based questions related to epilepsy. Knowledge was classified into 3 categories, viz. poor, moderate or good. Chi-square analysis was conducted to compare knowledge against education level and socio-economic status. P-value of <0.05 was considered significant.
Results: Overall, our population showed 34.4% with good; 51.3% with moderate and 14.3% with poor knowledge regarding epilepsy. Results of our study also showed that there was a significant association between socioeconomic status and extent of knowledge (p=0.01). Similarly, significant association was reported between education and extent of knowledge (p=0.01) and it was observed that knowledge decreased with increasing age.
Conclusion: Majority of our public has inadequate knowledge about epilepsy and the contributory factors can be the low literacy level according to our study or due to certain cultural and religious beliefs that need to be evaluated further. It is crucial to educate our society about epilepsy, empowering them to make informed decisions about treatment, without the burden of stigma and misconceptions.

Virtual Online Consultation: Advantages and Limitations from Patients’ Perspectives

2026-04-14T06:25:44+00:00

Objectives: To assess patient satisfaction with virtual online consultation (VOC) in the general population and determine sociodemographic factors related to the level of satisfaction.
Methodology: The cross-sectional study was conducted between January and December 2024 and included 377 participants. A questionnaire based on demographic profile, use of information channels, and experience of VOC was given out. The frequencies, percentages, means, and standard deviations were determined. Chi-square tests were used to assess the relationship between demographic variables and satisfaction, and binary logistic regression was used to determine independent predictors of satisfaction.
Results: A total of 377 participants were included, with most being young adults and students. The VOC satisfaction scale showed good internal consistency (Cronbach’s alpha = 0.874). Most of the respondents (82.8%, n=312) were rated highly satisfied with a mean total score of 45.55 + 6.13. The relational aspects of VOC, such as provider understanding (81.2%), respectful treatment (78.0%), were rated best. The only statistically significant bivariate correlation was found between ethnicity and satisfaction (chi-square = 11.305, p = 0.023). Logistic regression showed that none of the demographic variables was significantly predicted to be satisfied independently (Nagelkerke R2 = 0.019).
Conclusion: Most participants were very satisfied with VOC especially in terms of communication and interaction with providers. The areas of privacy and comfort still need improvement. The only sociodemographic factor that was related to satisfaction was ethnicity, but this did not hold in the multivariate analysis.

Radiological Assessment of Lumbar Spine Degeneration: Correlation with Age and Lumbar Level in Pakistani population

2025-08-30T12:49:40+00:00

Objective: To evaluate the utility of X-rays in grading lumbar spine degeneration and its correlation with age and lumbar levels in the local Pakistani population to enhance diagnostic accuracy and management of low back pain

Methodology: This study examined 59 lumbar motion segments (L1-L5) from 13 male human cadavers aged 21-80 years. Ethical approval was obtained, and only segments without deformities, fractures, infections, or metastasis were included. Radiological degeneration scores were assigned based on osteophytes, sclerosis and disc height from X-rays.

Results: Radiological findings showed increased sclerosis and osteophyte formation with advancing age, while Schmorl’s nodes were observed in 16% of cases. Mean overall degeneration scores, along with sclerosis and osteophyte scores, correlated positively with both age and spinal level. Mean overall degeneration scores showed significant associations with age (p<0.001) and spinal level (p=0.001). Spearman’s rank correlation revealed significant increases in overall degeneration and osteophyte scores with age (p<0.001), whereas sclerosis showed a positive but non-significant association (Rho=0.7). A strong positive correlation was also found between spinal level and overall degeneration (p=0.01) as well as sclerosis scores (p=0.04). Osteophyte scores increased with spinal level (Rho=0.82) but without statistical significance (p=0.089).

Conclusion: Lumbar spine degeneration increased with age, with L5 most affected, while sclerosis and osteophytes progressed independently. Findings support X-rays as a reliable diagnostic tool, aligning with global studies and highlighting the need for further research on Modic changes and ethnic variations.

Comparative Study of Clinical Profile in Patients with Solitary Versus Multiple Gallstones

2026-02-10T18:45:56+00:00

Objective: To compare the clinical profile of patients with solitary gallstones versus those with multiple gallstones.
Methodology: This cross-sectional comparative study was conducted at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from March 2023 to February 2024 and evaluated 127 patients diagnosed with gallstones via convenience sampling. Demographic information, clinical presentations, including detailed pain characteristics and preoperative ultrasound findings, were recorded. The patients were categorized into two groups based on the number of stones in the gallbladder: Group A (solitary stone) and Group B (multiple stones). Descriptive analysis was done using SPSS version 25.
Results: The mean age was 47.10±14.11 years, with a female predominance (79.5% females vs 20.5% males). Gallstones were more common in patients aged 30 to 45 years. Preoperative ultrasound showed a solitary stone in 29 patients (22.8%) and multiple stones in 98 (77.2%). Group A demonstrated a higher proportion of thick-walled gallbladders and stone impactions. Group A patients predominantly reported colicky pain localized to the right hypochondrium, whereas Group B patients experienced dull or constant pain in the epigastrium. Secondary symptoms, like dyspepsia, vomiting, and fever, showed no significant differences.
Conclusion: The clinical profiles are similar between groups except for the site and nature of pain. Distinct variations exist in preoperative ultrasound findings, with solitary stones showing a higher proportion of thick-walled gallbladders and neck impactions.

Socio-Demographic Determinants of Non-Communicable Disease Risk Factors Among Adolescents in Rawalpindi Pakistan

2026-04-14T19:35:04+00:00

Objective: To determine the frequency of major non-communicable disease (NCD) risk factors among adolescents aged 13–17 years in public and private schools of Rawalpindi, and to assess the association of socio-demographic factors with these risk factors.
Methodology: A cross-sectional study among 400 adolescents aged 13–17 years from one public and one private secondary school in Rawalpindi was conducted. Two-stage stratified random sampling was used with equal numbers from grades VII to X. Data was collected using WHO Global School-Based Student Health Survey (GSHS). Categorical variables were presented as frequencies and percentages. Associations were measured using chi-square test, followed by logistic regression.
Results: Of 400 participants (mean age 14.9 ± 1.4 years), 49.8% were male. Dietary risk (364, 91.0%), physical inactivity (351, 87.8%), and sedentary behavior (215, 53.7%) were the most prevalent NCD risk factors. Older age (AOR 14.67; 95% CI 3.88–55.47) and private school attendance (AOR 12.56; 95% CI 3.60–43.84) were the strongest predictors of dietary and physical inactivity risk (p < 0.001 for both). Higher grade level was independently associated with increased sedentary behavior (AOR 1.44; 95% CI 1.17–1.79; p = 0.001).
Conclusion: School type and older age predicted dietary risk and physical inactivity, while sedentary behavior rose with grade level. Interventions should target screen time, affordable nutrition, and physical activity promotion.
KEYWORDS: Adolescent, cross-sectional study, dietary