Frontier in Medical & Health Research {FMHR} | ISSN (E) 3007-1607 (P) 3007-1593 | is a HEC & CPSP approved journal. FMHR is an open-access, quarterly, and double-blind peer-reviewed journal covering all areas of medical and health sciences from basic research to clinical and experimental work. The FMHR is committed to completing the double-blind peer-review process within one month and informing the author(s) accordingly. The FMHR is published by the Institute for Excellence in Education and Research (IEER), duly registered with the Securities and Exchange Commission of Pakistan (SECP) under registration number 0224595.
Institute for Excellence in Education & Research
COMPARATIVE STUDY OF SERUM TSH AND LIPID PROFILE AMONG PREMENOPAUSAL AND POSTMENOPAUSAL WOMEN
Background:Due to reducing ovarian follicular function and lower estrogen synthesis, menopause is a usual physiological change in women characterized by the lasting end of menstruation, which reasons major hormonal and metabolic changes. These hormonal variations have the possible to impact lipid metabolism also thyroid function, which can increase the risk of metabolic diseases and heart disease. Objective:The recent research aimed to study the relationship between menopausal position and serum thyroid-stimulating hormone (TSH) amounts as well as lipid profile measures in premenopausal and postmenopausal women. Methods:Ethical permission was acquired before this cross-sectional research remained was conducted Novo Care International Hospital in Sargodha for a period of three months. Based on their menstrual history, 301 women were selected using non-random convenience sampling and separated into premenopausal and postmenopausal groups. Age, body mass index (BMI), height, weight, and medical history were among the population characteristics that were collected. Lipid profile indicator, such as total cholesterol, triglycerides, LDL, and VLDL, as well as serum TSH levels, were analyzed by obtaining blood samples. Regression examination using standardized coefficients, one-way ANOVA, and descriptive numerically were used to statistically analyze the relationship between biochemical factors and menopausal status. Results:The connection between menopause and increasing age was clear, associate the notion that menopause is a biological change connected with age. Differences in thyroid function during reproductive aging were presented by a sturdy correlation between serum TSH levels and menopausal state. Menopausal metabolic changes are multifactorial, as proved by the restricted independent statistical role of differences in lipid profile parameters between groups within the regression model. Conclusion: The outcomes expose that menopause is related to major hormonal and metabolic changes that capacity makes women more liable to thyroid disorders and cardiovascular disease. For the early identification of metabolic irregularities and the implementation of preventative healthcare involvements to enhance long-term health outcomes and excellence of life among aging women, routine monitoring of serum TSH and lipid profile during menopause is advised
TSH, Lipid-profile, Menopause, Pré-menopause, Total Cholesterol, Cardiovascular Disease, Aging, Metabolic Abnormalities, Perimenopau
LATENT MODIFIABLE RISK FACTORS FOR CORONARY ARTERY DISEASE: QUALITY AND QUANTITY OF SLEEP?
Objective: Earlier research has indicated that insufficient sleep has harmful impacts on multiple systems, with observable alterations in metabolic, endocrine, and immune processes. Both brief and extended sleep durations are linked to a higher risk of diabetes and hypertension. Nevertheless, the connection between sleep duration, sleep quality, and Coronary Artery Disease (CAD) remains unclear among the Pakistani population. We investigated the notion that sleep length (relative to <6 h) and sleep quality (PSQI > 5) are contributors to CAD risk. Methods: A controlled and retrospective study was performed involving 354 adults (>18 yrs) participants (177 controls and 177 cases, 60% male, average age M = 51 ± 9.38). The quality and duration of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Low sleep quality and inadequate sleep duration were characterized as PSQI >5 and total sleep time <6.0 h, respectively. Patients with OSA were not included in the study. The primary outcome of interest was the occurrence of any CAD (n = 177), which included MI, angina, and stroke. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined through Multivariate Logistic Regression analysis. Results: We identified that both inadequate sleep quality and reduced sleep duration were independently linked to CAD. In comparison to a total sleep duration of 6.0 hours, the multivariate odds ratio (95% confidence interval) for CAD was 3.81 (1.69 to 8.58), while for poor sleep quality (PSQI > 5), it was found to be 16.62 (9.13 to 30.28). Conclusion: A positive correlation was found between both brief sleep duration and inadequate sleep quality with CAD in a chosen group of Pakistani adults. These findings indicate that inadequate sleep quality and limited sleep duration could be significant changeable CAD risk factors within the Pakistani population
ARTERY DISEASE: QUALITY AND QUANTITY OF SLEEP
FREQUENCY OF ASYMPTOMATIC BACTERIURIA IN CHRONIC KIDNEY DISEASE AND ASSOCIATED RISK FACTORS
Objective: To determine the frequency of asymptomatic bacteriuria (ASB) in patients with chronic kidney disease (CKD) and identify associated risk factors. Design: Cross-sectional study. Place and Duration of Study: The study took place at the Outpatient Nephrology Department, Indus Hospital & Health Network, Karachi, Pakistan for six months. Methodology: A total of 214 adult patients aged 18–80 years with diagnosed CKD were enrolled using consecutive sampling. Demographic data, comorbidities, CKD stage, laboratory findings, and ultrasonographic parameters were recorded. Midstream urine samples were collected for culture. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which is widely used for staging CKD and assessing renal function. ASB was defined as growth of ≥10⁵ colony-forming units/mL of a single organism without urinary symptoms. Data were analyzed using SPSS version 26. Chi-square and independent t-tests were applied. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Among 214 patients, 49 (22.9%) had asymptomatic bacteriuria, while 11 (5.1%) had symptomatic urinary tract infection. Female gender (OR=4.20, p<0.001), diabetes mellitus (OR=2.40, p=0.008), significant post-void residual volume (OR=2.90, p=0.006), and serum creatinine rise ≥30% (OR=2.39, p=0.044) were significantly associated with ASB. The highest prevalence (34.4%) was observed in CKD stage 4. Conclusion: Asymptomatic bacteriuria is common among CKD patients, particularly in females and those with advanced CKD. Targeted screening in high-risk groups may be beneficial.
Chronic Kidney Disease; Asymptomatic Bacteriuria; Urinary Tract Infection; Diabetes Mellitus; Risk Factors; Pakistan
IMPACT OF HUMOR STYLES AND MINDFULNESS ON QUALITY OF LIFE AMONG PATIENTS WITH CARDIOVASCULAR DISEASE. MEDIATING ROLE OF RELATIONSHIP SATISFACTION
Cardiovascular diseases (CVD) are world's most common reason of death and are responsible for quality of life (QOL) impairment. The current research was carried out to study the impact of humor styles and mindfulness on quality of life among cardiovascular disease patients. The mediating role of relationship satisfaction was also being studied. Sample of 160 patients were recruited (83 males and 77 females) with an age range of 35 to 65 will be taken from Armed Force Institute of Cardiology (AFIC) Rawalpindi. The study was quantitative in nature. Humor and Mindfulness was measured using Humor Styles Questionnaire (Martin, 2003) and Mindfulness Attention Awareness Scale (Brown & Ryan 2003) respectively. Quality of Life and Relationship Satisfaction was measured using The World Health Organization Quality of Life Questionnaire (WHOQOL Group, 1997) and Couples Satisfaction Index (Funk & Rogge, 2007) respectively. The data was analyzed using SPSS and Process macro. Results showed significant positive relationship between humor styles, mindfulness and quality of life among patients with cardiovascular diseases. Relationship satisfaction emerges as significant mediator on relationship between humor, mindfulness and quality of life among cardiovascular diseases patients The study will contribute to the existing literature and will be helpful to create awareness among people about humor and mindfulness as coping techniques. Humor, mindfulness and relationship satisfaction may enhance the positive psychological functioning and restructure CVD patient’s negative attitudes and behaviors related to health.
Humor styles, mindfulness, quality of life, relationship satisfaction, cardiovascular diseases.
FREQUENCY OF LOSS OF RADIAL PULSE IN PATIENTS UNDERGOING TRANSRADIAL CORONARY CATHETERIZATION
Background: The transradial approach (TRA) has become the preferred method for coronary catheterization due to its lower bleeding risk and enhanced patient comfort. However, radial artery occlusion (RAO), often presenting as loss of radial pulse, remains a common complication that may limit future vascular access. Objective: To determine the frequency of loss of radial pulse in patients undergoing transradial coronary catheterization. Methods: This descriptive study was conducted at the Department of Cardiology, Lady Reading Hospital, Peshawar, over a six-month period. A total of 113 patients with coronary artery disease, aged 25–70 years, who met inclusion criteria, underwent transradial coronary catheterization. Post-procedural loss of radial pulse was assessed at 24 hours using the Reverse Barbeau Test and confirmed via Doppler ultrasound. Data were analyzed using SPSS v26, with p ≤ 0.05 considered statistically significant. Results: The mean age of participants was 56.3 ± 8.9 years; 60.2% were male. Loss of radial pulse occurred in 13 patients (11.5%). Significant associations were found between RAO and diabetes mellitus (p = 0.044), elevated BMI > 27 kg/m² (p = 0.038), and previous radial artery cannulation (p = 0.031). No statistically significant associations were found with gender, age, or hypertension. Conclusion: The frequency of radial pulse loss post-transradial coronary catheterization was 11.5%, in line with global findings. Diabetes, obesity, and prior radial access were identified as significant risk factors. Pre-procedural risk stratification and post-procedural patency assessment are essential to minimize RAO and preserve future vascular access.
Transradial coronary catheterization, radial artery occlusion, radial pulse loss, vascular access, coronary artery disease, Reverse Barbeau Test, Doppler ultrasound.
FREQUENCY OF MODIFIABLE RISK FACTORS FOR CHRONIC KIDNEY DISEASE IN A TERTIARY CARE HOSPITAL OF KHYBER PAKHTUNKHWA
OBJECTIVE: To determine the frequency of modifiable risk factors for chronic kidney disease in a tertiary care hospital of Khyber Pakhtunkhwa. Materials and Methods: This cross-sectional study was carried out in the Department of Nephrology at Lady Reading Hospital, Peshawar, between January and June 2025. Patients were enrolled consecutively over six months using a non-probability sampling method. A total of 104 participants were included, with the sample size determined through OpenEpi using a 5% margin of error. Adult patients (≥18 years), of either gender, with CKD at any stage were eligible for inclusion. Results: The study enrolled 104 CKD patients, including 51 males (48.1%) and 53 females (51.9%), with a mean age of 50.9 ± 14.9 years and a median eGFR of 23 ml/min/1.73 m², indicating advanced disease. Long-standing hypertension was observed in 80 patients (76.9%) and diabetes mellitus in 75 (72.1%). Other risk factors included dyslipidemia in 48 (46.2%), prolonged herbal medication use in 44 (42.3%), smoking in 34 (32.7%), chronic obstructive uropathy in 25 (24.0%), and recurrent renal stones in 22 (21.2%). Conclusion: This study demonstrates a high burden of modifiable risk factors, especially diabetes, hypertension, and herbal medication use, among CKD patients, emphasizing the importance of early detection, targeted interventions, and public health strategies to prevent disease progression
Chronic kidney disease; Modifiable risk factors; Diabetes mellitus; Hypertension; Herbal medication use
FREQUENCY OF HYPOGLYCEMIA IN PATIENTS WITH LIVER CIRRHOSIS PRESENTING AT TERTIARY CARE HOSPITAL
Background Liver cirrhosis is associated with profound metabolic derangements due to impaired hepatic glucose regulation. Hypoglycemia has an underappreciated complication, although it has the potential clinical consequences, while hyperglycemia and diabetes are well known. Data, particularly from developing countries, regarding the burden of hypoglycemia among patients of liver cirrhosis, is limited. Objective To determine the frequency of hypoglycemia among patients with liver cirrhosis presenting to a tertiary care hospital. Methods This cross-sectional observational study was conducted on adult patients presenting to a tertiary care hospital aged 28 to 70 years old with clinically, biochemically, and radiologically confirmed liver cirrhosis in the Department of General Medicine at Medical Teaching Institution Mardan Medical Complex, over a time period of six months. Blood glucose levels were tested immediately at presentation or measured within 24 hours of admission by using standardized methods. Blood glucose level below from70 mg/dL were defined as Hypoglycemia. Child–Pugh class and MELD score. The Demographic and clinical variables were also recorded during the study. Descriptive statistics were used to summarize results, and chi-square tests were applied to find the relation between hypoglycemia and selected clinical variables. All the data were analyzed using SPSS version 27. Results A total of 151 patients with confirmed liver cirrhosis were included, with a mean age of 51.3 ± 9.4 years; 36.8% female and 64.2% were male. In 77 patients with the overall frequency of 51.0% hypoglycemia was observed in 77. The rise in percentage of hypoglycemia is observed with advancing liver disease severity, occurring more commonly in Child–Pugh class C compared with classes A and B; but this association had no statistical significance (p = 0.232). No prominent linkage was found between hypoglycemia and residential background, sex or diabetes mellitus status. Conclusion Hypoglycemia affected almost half of the studied population and was recognized as a common metabolic abnormality among confirmed liver cirrhosis patients presented to the Medical Teaching Institution, Mardan Medical Complex. Hypoglycemia occurred across all stages of cirrhosis, with which it was more common in advanced liver disease. These study findings highlight the significance of regular glucose measurement in patients with liver cirrhosis to promote early diagnosis in patients and appropriate clinical management.
Liver cirrhosis; Hypoglycemia; Glucose metabolism; Child–Pugh classification; Chronic liver disease; Pakistan
FREQUENCY OF SILENT CAROTID ARTERY STENOSIS AMONG PATIENTS WITH DIABETES PRESENTING AT MARDAN MEDICAL COMPLEX: A CROSS-SECTIONAL STUDY
Objective: To determine the frequency of silent carotid artery stenosis (CAS) among patients with type 2 diabetes mellitus and to assess its association with demographic and clinical factors. Study Design and Setting: Cross-sectional study conducted at the Department of General Medicine, Mardan Medical Complex, Khyber Pakhtunkhwa, Pakistan. Methodology: A total of 187 patients aged 27–70 years with type 2 diabetes mellitus were enrolled using non-probability consecutive sampling over six months. All participants underwent bilateral carotid Doppler ultrasonography. Silent CAS was defined as ≥50% stenosis without neurological symptoms. Data were analyzed using SPSS version 27, and associations were assessed using the Chi-square test, with p <0.05 considered statistically significant. Results: The mean age of participants was 51.7 ± 8.3 years, with 53.5% males. Hypertension and smoking were present in 57.8% and 21.9% of patients, respectively. The overall frequency of silent CAS was 15.0%. Right-sided stenosis was observed in 8.0%, left-sided in 1.6%, and bilateral stenosis in 5.3% of patients. No significant association was found between silent CAS and age, gender, BMI, duration of diabetes, hypertension, smoking, socioeconomic status, education, or occupation (p >0.05). A significant association was observed with place of residence, with higher prevalence among urban residents (19.6% vs. 8.0%, p = 0.029). Conclusion: Silent carotid artery stenosis is present in a notable proportion of asymptomatic diabetic patients. Urban residence was significantly associated with CAS. Targeted screening may help in early detection and prevention of cerebrovascular complications.
Atherosclerosis; Carotid artery stenosis; Diabetes mellitus; Doppler ultrasonography; Stroke prevention
RENAL DIMENSIONS IN MALNOURISHED CHILDREN: A COMPARATIVE ULTRASONOGRAPHIC ANALYSIS OF KIDNEY SIZE AND ITS ANTHROPOMETRIC CORRELATES: A HOSPITAL-BASED CROSS-SECTIONAL STUDY
Background: Malnutrition remains the most critical public health crisis in low- and middle-income countries, particularly in South Asia. Its systemic effects extend beyond anthropometric deficits to impair organ-level development, including renal growth. Kidney size, measurable non-invasively by ultrasonography, represents a sensitive marker of somatic growth and nephron endowment. Objectives: To compare kidney dimensions between malnourished and healthy children aged 6–60 months and to assess the correlation between renal parameters and anthropometric variables including age, weight, height, and body surface area (BSA). Methods: A hospital-based cross-sectional study enrolled 41 malnourished children (cases) and 40 healthy age-matched controls. Bilateral kidney dimensions (length and width) were assessed via B-mode ultrasonography. Anthropometric data were collected, and severity of malnutrition was classified using WHO weight-for-height z-scores (WHZ), mid-upper arm circumference (MUAC), and the presence of bilateral pitting oedema. Statistical analysis included Mann-Whitney U tests for group comparisons and Spearman's rank correlation for anthropometric associations. Results: Malnourished children demonstrated significantly reduced bilateral kidney lengths compared to healthy controls (left: 6.0 cm vs. 6.55 cm, p<0.001; right: 5.9 cm vs. 6.5 cm, p=0.001), while kidney widths did not differ significantly. Malnourished children weighed 40% less, were 16% shorter, and had 30% reduced BSA compared to controls (all p<0.001). In healthy children, kidney length correlated significantly with age, weight, height, and BSA. In malnourished children, correlations were reduced and age lost its predictive significance for renal length, with weight and BSA emerging as the dominant anthropometric correlates. Conclusion: Malnutrition is associated with significantly smaller kidney lengths, reflecting compromised renal growth and potentially reduced nephron endowment. The decoupling of age from renal length in malnourished children suggests nutritional status, rather than chronological age, governs renal growth trajectories in this population. These findings have important implications for long-term cardiorenal risk in nutritionally vulnerable paediatric populations
Malnutrition; kidney size; renal growth; ultrasonography; anthropometry; nephron endowment; paediatric nephrology; Pakistan
BIOTECHNOLOGICAL EVALUATION OF COFFEE WASTE-BASED COMPOST FOR ENHANCED OYSTER MUSHROOM PRODUCTION AND NUTRITIONAL QUALITY
This study evaluated the effect of coffee waste compost supplementation on the growth, yield, biological efficiency, and nutritional composition of oyster mushroom (Pleurotus ostreatus) cultivated on wheat straw substrate. Four substrate treatments were prepared: T0 (100% wheat straw as control), T1 (25% coffee waste compost + 75% wheat straw), T2 (50% coffee waste compost + 50% wheat straw), and T3 (75% coffee waste compost + 25% wheat straw). Results showed that moderate incorporation of coffee waste compost significantly improved mushroom growth and productivity. The shortest spawn running time (15.2 ± 0.3 days), earliest pinhead initiation (20.1 ± 0.4 days), highest number of fruiting bodies (38.6 ± 1.2 per bag), maximum fresh yield (1.84 ± 0.03 kg/bag), and highest biological efficiency (92.4%) were recorded in Treatment T2. In contrast, Treatment T3 showed delayed mycelial growth, reduced yield, and lower biological efficiency, likely due to excessive concentrations of caffeine and phenolic compounds that inhibited fungal development. Nutritional analysis further revealed that mushrooms cultivated on coffee waste-amended substrates had improved protein, crude fiber, ash, and fat contents, with T2 showing the highest crude protein content (27.2%). The findings indicate that moderate supplementation of coffee waste compost enhances substrate utilization, mushroom productivity, and nutritional quality, while excessive supplementation negatively affects fungal growth. Therefore, the use of 50% coffee waste compost with wheat straw is recommended as an effective and sustainable substrate formulation for oyster mushroom cultivation
T-CELL RECEPTOR REPERTOIRE POLYCLONALITY SUPPRESSES MATURE T-CELL LYMPHOMA THROUGH HOMEOSTATIC CLONAL COMPETITION: A SEVEN-MODULE ARTIFICIAL INTELLIGENCE FRAMEWORK FOR RISK PREDICTION AND GENE THERAPY SAFETY SURVEILLANCE
Background: Mature T-cell lymphomas (MTCLs) are considered rare and comprise a small percentage of all lymphomas, with varying incidence rates globally. T-cell receptor (TCR) repertoire polyclonality may be an innate tumor-suppressive mechanism functioning via homeostatic clonal competition of antigen-presenting cell (APC) niches. However, the application of computational models to formalize the principle of clonal competition for lymphoma risk prediction or gene therapy safety monitoring has been limited. Objective: To suggest and analytically benchmark a seven-module AI/ML framework that puts the clonal competition results into perspective and extrapolates them to TCR repertoire-based lymphoma risk prediction, competitive dynamics simulation, integration site oncogenicity scoring, automated ALCL histopathology classification, and a regulatory-grade gene therapy safety index. Framework: Seven AI/ML modules are suggested: (1) DeepTCR/BERT-based TCR diversity scorer with an AUROC ≥0.93; (2) a reinforcement learning agent-based model (RL-ABM) with an index of tipping-point polyclonality (PI ≈ 0.30); (3) a graph neural network TCR-MHC niche affinity predictor; (4) an XGBoost transformation susceptibility classifier (F1 ≥0.93, MCC ≥0.84); (5) a CNN-based retroviral integration site oncogenicity predictor; (6) a Vision Transformer ALCL histopathology classifier (AUROC ≥0.97); and (7) a multi-modal ensemble Gene Therapy Safety Index (AUROC ≥0.98, F1 ≥0.96) that generates RED/AMBER/GREEN surveillance alerts. Conclusion: The suggested framework will convert TCR diversity-mediated lymphoma suppression into a quantitative, predictive AI pipeline with direct regulatory implications to safe design of adoptive TCR therapy and CAR-T cell products.
TECHNICIANS 4.0: ROLE OF PHARMACY TECHNICIANS IN SMART HOSPITALS IN PAKISTAN
Introduction: Pakistan's evolving healthcare infrastructure makes the integration of smart technologies in hospital pharmacies both an opportunity and a challenge for the pharmacy workforce. Aims and objectives: To review the dynamic role of pharmacy technicians within smart hospital settings in Pakistan and to present a conceptual framework, Pharmacy Technician 4.0 Methodology: A cross-sectional survey was done quantitatively on pharmacy technicians in five governments, privately operated non-profit tertiary hospitals in Karachi, Pakistan. Descriptive statistics and Chi-square tests were used to analyze data based on 150 respondents and the statistical significance was set at p < 0.05. Results: The degree of automation was found to differ among the hospitals, with some having simple manual systems in place and others having partially automated dispensing and inventory management systems. Technicians in the partially automated hospitals showed a decrease in dispensing time (12 to 7 minutes per prescription), a decrease in medication errors (8–3%), and an improvement in patient adherence (65% to 78%). Mean scores demonstrated a moderately positive attitude towards automation, with the highest agreement that AI and robotics positively impact technician roles (mean = 3.81 ± 1.28). The Chi-square test showed a significant difference in the distribution of responses (χ2 = 282.7, p < 0.0001), which indicated overall acceptance of sophisticated technologies. Conclusion: Pharmacy technicians in Pakistan are showing willingness to be transformed to a Technician 4.0 figure in smart hospital systems
Pharmacy technician 4.0, Smart hospitals, Automation, Artificial intelligence, Medication safety
DIAGNOSTIC ACCURACY OF GLYCOSYLATED HAEMOGLOBIN (HBA1C) FOR THE DETECTION OF GESTATIONAL DIABETES MELLITUS AMONG PREGNANT FEMALES ATTENDING A TERTIARY CARE OBSTETRIC OUTPATIENT DEPARTMENT
Background: Gestational diabetes mellitus (GDM) is among the most common metabolic complications of pregnancy, affecting between 5% and 14% of pregnancies worldwide. Early and accurate diagnosis is essential to reduce adverse maternal and fetal outcomes. Although the 2-hour oral glucose tolerance test (OGTT) remains the diagnostic gold standard, it is cumbersome, time-consuming, and poorly tolerated by many pregnant women. Objective: To determine the diagnostic accuracy of glycosylated haemoglobin (HbA1c) for detecting GDM among pregnant females at 18 to 24 weeks of gestation, using the OGTT as the reference standard. Methods: A comparative cross-sectional study was conducted at Jinnah Hospital, Lahore, enrolling 168 consecutive pregnant women aged 18–40 years at 18–24 weeks of gestation. All participants underwent concurrent HbA1c measurement and a 2-hour 75 g OGTT. Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal diagnostic threshold, and standard diagnostic accuracy metrics were computed. Results: The true prevalence of GDM in this cohort was 31.5%. HbA1c demonstrated outstanding overall discriminatory capacity, with an area under the ROC curve (AUC) of 0.980 (95% CI: 0.962–0.997; p < 0.001). An HbA1c threshold of 5.3% was identified as the optimal cut-off, yielding a sensitivity of 94.3%, specificity of 96.5%, positive predictive value (PPV) of 92.6%, and negative predictive value (NPV) of 97.4%. Conclusion: HbA1c at a threshold of 5.3% demonstrates excellent diagnostic accuracy for GDM screening in this South Asian obstetric population, offering a reliable, patient-friendly alternative to support primary metabolic triage and reduce over-reliance on the OGTT
Gestational diabetes mellitus; HbA1c; glycosylated haemoglobin; oral glucose tolerance test; diagnostic accuracy; South Asia; pregnancy screening
KNOWLEDGE, ATTITUDE, AND AWARENESS REGARDINCHILDHOOD VACCINATION AMONG PARENTS OF UNDER-FIVE CHILDREN IN DISTRICT KURRAM: A SURVEY-BASED STUDY
Background: Childhood vaccination is recognized as one of the most effective and economical public health strategies for reducing morbidity and mortality associated with vaccine-preventable diseases. In Pakistan, immunization services are provided free of cost through the Expanded Programme on Immunization (EPI); however, vaccination coverage among children remains inadequate, particularly in rural and underserved communities. Parents’ knowledge, awareness, and attitudes toward immunization significantly influence the completion of childhood vaccination schedules. In District Kurram, limited evidence is available regarding parental perceptions and practices related to childhood immunization. Objective: To assess the knowledge, attitudes, and awareness regarding childhood vaccination among parents of under-five children in District Kurram. Materials and Methods: A descriptive cross-sectional survey-based study was conducted in District Kurram, Khyber Pakhtunkhwa, Pakistan, over a four-month period from December 2025 to March 2026. A total of 220 parents/caregivers of under-five children were included through a community-based survey approach. Data were collected using a structured and pre-tested questionnaire adapted from WHO and UNICEF guidelines. The questionnaire gathered information regarding socio-demographic characteristics as well as parental knowledge, attitudes, and awareness about childhood vaccination. Data were entered and analyzed using SPSS version 24. Descriptive statistics, including frequencies and percentages, were used to present the findings. Results: A total of 220 parents/caregivers participated in the study. The majority of respondents were between 26–35 years of age (43.6%), while females constituted 53.6% of the participants. Most respondents had secondary or higher secondary education and belonged to rural areas. Overall awareness regarding childhood vaccination was found to be satisfactory, with 70.9% of participants reporting awareness of vaccines and 95.0% acknowledging the availability of vaccination services in their area. Regarding knowledge, 54.1% correctly identified the recommended age for routine immunization, and 90.9% knew that vaccination should begin at birth. However, notable gaps were identified in knowledge related to the total number of vaccine doses, multiple-dose vaccination schedules, and the importance of the EPI vaccination card. Attitudes toward childhood vaccination were generally positive, as the majority of parents considered vaccination essential for child health and expressed confidence in healthcare providers. Conclusion: The study findings demonstrate that parents in District Kurram generally possess positive attitudes toward childhood vaccination and satisfactory overall awareness. Nevertheless, important deficiencies remain in detailed knowledge regarding immunization schedules and vaccine-preventable diseases. Strengthening community-based awareness campaigns and health education initiatives may improve parental understanding and contribute to higher vaccination coverage and complete immunization among under-five children
Childhood vaccination, immunization, parental knowledge, vaccine awareness, under-five children, District Kurram.
COMPARATIVE ANALYSIS OF ANAEMIA STATUS AND ITS MANAGEMENT IN HAEMODIALYSIS AND PERITONEAL DIALYSIS
OBJECTIVE: To compare the prevalence, severity, management of anemia between patients undergoing haemodialysis (HD) and peritoneal dialysis (PD) in a tertiary care setting. STUDY DESIGN: Prospective cohort study. PLACE AND DURATION OF STUDY: The study took place at the Nephrology Department, The Indus Hospital, Karachi, Pakistan For six months. METHODOLOGY: A total of 102 adult patients with end stage renal disease were enrolled and equally divided into HD (n=80) and PD (n=80) groups. Haemoglobin levels, anaemia severity, erythropoiesis-stimulating agent (ESA) use, iron supplementation, and transfusion requirements were assessed according to KDIGO guidelines. Statistical analysis was performed using SPSS Vol 25, applying independent t-test and chi-square test to test significance at the level of <0.05. RESULTS: Mean haemoglobin levels were significantly higher in PD patients compared to HD patients (10.6 ± 1.4 vs. 9.8 ± 1.5 g/dL; p=0.001). Anaemia prevalence was higher in the HD group (52.5% vs. 32.5%; p=0.011), with severe anaemia more frequent in HD patients (16.7% vs. 3.8%; p=0.043). Although ESA use was comparable, HD patients required significantly higher doses (195.2 ± 72.3 vs. 153.1 ± 58.4 IU/kg/week; p=0.001). Iron supplementation and blood transfusion rates were also significantly higher in the HD group. CONCLUSION: Peritoneal dialysis is associated with better anaemia control and lower treatment burden compared to haemodialysis. Dialysis modality should be considered an important factor in anaemia management strategies in resource-limited settings.
Anaemia, Haemodialysis, Peritoneal Dialysis, ESRD, Erythropoiesis-Stimulating Agents.
IMMUNOTHERAPY VERSUS CHEMOTHERAPY IN ADVANCED NON-SMALL CELL LUNG CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS OF SURVIVAL OUTCOMES AND ADVERSE EVENTS
Background: Non-small cell lung cancer (NSCLC) is the predominant type of lung cancer and a leading cause of cancer death worldwide. For long, chemotherapy has proved the most appropriate treatment although the advent of immunotherapy, particularly immune checkpoint inhibitors directed against PD-1/PD-L1, marked a turning point in the treatment paradigm for advanced NSCLC. The purpose of this systematic review and meta-analysis is to compare survival outcomes and safety profiles of immunotherapy versus chemotherapy in patients with advanced NSCLC. Methods: A systematic search was performed in PubMed, Embase, and Cochrane Library databases from 2014-2025 to identify relevant studies. Fifteen studies met predefined inclusion criteria. Hazard ratios (HRs) of overall survival (OS) and progression-free survival (PFS), odds ratios (ORs), and adverse event (AE) rates were pooled by random-effects models. We conducted subsequent subgroup analysis of age and PDL1 expression levels. Egger’s test and I² statistic were applied to assess publication bias and study heterogeneity, respectively. Results: As compared with chemotherapy, immunotherapy was related to significantly better survival. Hazard ratios for OS and PFS favored immunotherapy in all the 15 included studies. Patients >65 years and with PD-L1 expression ≥50% had the greatest survival advantages. The immunotherapy arm also had less grade 3–5 AEs and fewer treatment discontinuations. Moderate studies heterogeneity and minimal publication bias was found. Sensitivity analyses supported the robustness of the findings. Conclusion: Immunotherapy confers a better clinical benefit compared to chemotherapy for advanced NSCLC, especially in elderly and high-PD-L1 expression patients. These results contribute to the evolving trend of immunotherapy as first-line therapy and underscore the need for biomarker-driven patient selection. More long-term research is needed to confirm these results and to determine the best combination plan
non-small cell lung cancer, immunotherapy, chemotherapy, meta-analysis, overall survival, PD-L1 expression, adverse events Introduction Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related death worldwide.
PHYTOCHEMICAL ANALYSIS AND ANTIMICROBIAL ACTIVITY OF AERIAL PARTS OF THE ACHILLEA MILLEFOLIUM
The work presented in this paper consists of “Phytochemical analysis and antimicrobial activity of aerial parts of the Achillea millefolium”. Achillea millefolium is widely recognized for its many uses and lengthy history in conventional medicine worldwide. Since ancient times, the herb has been used to treat a variety of illnesses in Balochistan. Methanol was used at room temperature to extract the aerial portion of Achillea millefolium for this study. A qualitative phytochemical analysis and biological tests (antimicrobial activity against four gram-positive and gram-negative bacteria) were conducted prior to the extract. The results illustrated that the plant extract shows fine acti-bacterial properties and is rich in secondary metabolites
Achillea millefolium, Aerial part, Methanolic extract, Phytochemical screening, antimicrobial activity
PSYCHOSOCIAL FACTORS OF TREATMENT SATISFACTION IN INDIVIDUALS WITH MIGRAINE: A COMPARATIVE STUDY OF MEDICATION AND ACUPUNCTURE TREATMENT GROUPS
A correlational cross-sectional research design was conducted to examine the extent to which psychosocial factors, including Migraine Interictal Burden, Pain Perception, Perceived Stress, and Doctor-patient relationship, differ in the level of treatment satisfaction in medication and acupuncture treatment groups. The sample comprised (n= 30) MTG, (M = 25.53, SD = 2.93) and (n=30) ATG, (M = 27.7, SD =2.86) recruited through convenience and snowball sampling strategy from private hospitals and clinics. Data was collected using standardized measures, including Migraine Interictal Burden Scale (MIBS-4), Pain Belief and Perception Inventory (PBPI), Perceived Stress scale (PSS-10), Patient-Doctor Relationship Questionnaire (PDRQ) and Functional Assessment of Chronic Illness Therapy Treatment Satisfaction General (FACIT-TS-G). The findings revealed that the acupuncture treatment group reported comparatively higher treatment satisfaction than the Medication Treatment Group. It was found that among both groups, individuals who reported higher Migraine interictal burden perceive their pain as permanent, who believe that their pain is mysterious, also believe that pain is permanent and constant, and who believe pain is permanent also believe that it’s constant, and a healthy DPR tends to increase the treatment satisfaction. However, the findings of the MTG are that individuals who reported higher Migraine interictal burden perceive their pain as mysterious, who believe that pain is permanent and constant, reported decreased treatment satisfaction. Furthermore, the findings of the ATG are that individual who reported higher Migraine interictal burden perceive their pain as constant, who believe that their pain is mysterious, also report more perceived stress and blame themselves more for their pain, and who believe that pain is permanent and constant report higher perceived stress. Regression analysis indicated that psychological factors were not found to be non-significant predictors of treatment satisfaction in both cohorts. However, the doctor-patient relationship was a significant predictor of treatment satisfaction in the ATG. The doctor-patient relationship was found to be a non-significant mediator in both cohorts, suggesting it’s a significant factor, but not as a mediator. Meaningful differences emerged across sociodemographic and clinical factors. Women reported higher treatment satisfaction in MTG. On the other hand, the women reported pain as more mysterious in ATG. Individuals who have migraine with aura perceive their pain as more permanent and constant in MTG. The finding underscores the importance of addressing psychosocial determinants and sociodemographic variations, raises awareness about the efficacy of acupuncture treatment, and calls for better policies to allow more practice of acupuncture for effective treatment outcomes
Migraine interictal burden, Treatment satisfaction, Pain Perception, Acupuncture
EVALUATION OF PRE- AND POST-OPERATIVE COAGULATION PARAMETERS IN PATIENTS UNDERGOING MAJOR SURGERIES
The issue of coagulation abnormality is a critical problem among patients who undergo major surgical operations since this may aggravate the chances of perioperative bleeding and thrombotic events. Hemostatic mechanisms can change due to surgical trauma, anesthesia, and related physiological stress, with an observable change in coagulation parameters. It will be critical to track such changes to timely identify and treat any possible complications. Prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR) are common laboratory indicators that are widely used to evaluate the coagulation and inform clinical decision-making in patients undergoing surgery. Study Rationales: The current research was carried out to compare and contrast the pre- and post-operative coagulation parameters (PT, APTT and INR) in patients who undergo major surgeries. It also sought to establish the level of alterations in coagulation profile post-surgical and evaluate the possibility of the occurrence of abnormal coagulation during the perioperative phase. Methodology: This cross-sectional but comparative study was conducted on 30 patients aged over 18 years having undergone major surgical operations. Aseptic conditions were observed in the collection of blood samples prior to surgery and in a specified post-operative period. Standard laboratory techniques were used to analyze the samples in order to ascertain PT, APTT and INR values. Appropriate demographic and clinical information were also taken. The mean values of the preoperative and postoperative coagulation parameters were compared to conduct a statistical analysis and assess significant differences. Results: The results of the study revealed that the values of the PT, APTT, and INR in the post-operative period were altered with respect to their previous values, which indicated the change of the coagulation status after a major surgical intervention. There was a tendency to longer coagulation times in some of the patients, which indicated a higher risk of bleeding during the period right after the operation. Conclusion: The findings emphasized the need to regularly check the coagulation parameters in patients with major surgery. Timely intervention and prevention of complications can be achieved by early detection of coagulation abnormalities by simple and reliable laboratory tests, thus enhancing patient outcomes. This research highlighted the importance of appropriate perioperative laboratory evaluation in the provision of safe surgical management and efficient care of patients.
EVALUATION OF RFTS IN DIABETIC VS NON-DIABETIC PATIENTS
Diabetes mellitus is considered to be one of the most prevalent chronic metabolic diseases in the world and is identified by the persistent hyperglycemia caused by the defects of insulin secretion, insulin action or both. Uncontrolled long-term diabetes is linked with a series of microvascular and macrovascular complications which pose a high risk of morbidity and mortality. Of these complications, diabetic nephropathy is believed to be one of the most common causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Renal impairment in diabetic patients can progress slowly and can be asymptomatic in the initial stages, so it is crucial to make renal impairment diagnosis as early as possible. Thus, routine checks of renal functionalities with simple, reliable, cost-effective biochemical tests like serum urea and serum creatinine, also known as renal function tests (RFTs) are important to prevent irreversible renal impairment. Purpose of the Study: The targeted study compared and contrasted the parameters of renal function tests in diabetic and non-diabetic people. It further attempted to establish the prevalence of renal failure in patients with diabetes, evaluated how length of diabetes affected renal functioning status, and found early biochemical predictors of diabetic nephropathy. Methodology: This comparative cross-sectional research was carried out on adult patients of age 18 years and above till 90 years. The patients were separated into two groups: diabetic and non-diabetic controls. The serum samples taken under normal aseptic condition were tested using a fully automated biochemistry analyzer. The estimation of parameters such as serum urea and serum creatinine were determined by the conventional laboratory procedures. Demographic and clinical information (age, gender, duration of diabetes, etc.) was also taken. The statistical comparison of the mean values of renal parameters in the two groups was conducted and the significant associations was established. Results: It was expected that the level of serum urea and serum creatinine would be very high among diabetic patients compared to non-diabetic individuals signifying a decreased renal function. Moreover, the patients that had a higher duration of diabetes were anticipated to exhibit more changes in the renal parameters, which indicated progressive nephropathy with the duration of chronic disease. Conclusion: The research results of the current study are likely to highlight the need of regular renal function check-ups in diabetic patients to help in early detection of nephropathy. Simple biochemical tests are also capable of early screening and various interventions can be initiated promptly and delay the onset of chronic kidney disease and patient outcomes. The research also gives baseline information on the renal dysfunction of the diabetic groups and reinforces the importance of proper laboratory practices in the effective management of healthcare.
THE ADDICTION OF SOCIAL MEDIA AND ITS IMPACT ON THE ACADEMIC PERFORMANCE AMONG UNDERGRADUATE NURSING STUDENTS: A CROSS-SECTIONAL STUDY
Background: The rapid advancement of technology and internet accessibility in contemporary education system has significantly increased the use of social media worldwide. Especially among young people social media use is more common, nursing students also use social media on daily basis. Despite having beneficial use of social media excessive and addictive use may affect students’ academic performance. Objectives: The study aims to determine the impact of social media addiction on the academic performance of undergraduate nursing students and identify the association between social media addiction and academic achievement. Methodology: An analytic cross-sectional study design was conducted at a private nursing college. A sample of 167 nursing students were selected using stratified random sampling with proportional allocation. Data was collected using 5-point Likert scale. Data was analyzed using SPSS 29. Descriptive statistics mean standard deviation and percentages are used to describe the population. Results: The result findings showed a moderate level of social media addiction among students (Mean = 3.59 ± 0.69). Spearman correlation analysis revealed a weak but statistically significant positive association between social media addiction and academic performance (r = 0.234, p = 0.002). Most participants reported using more than three social media platforms, with Instagram being the most commonly used application, and many students spent more than four hours daily on social media. Conclusion: The study concluded that social media addiction significantly affects the academic performance of nursing students. Although social media provides educational benefits and improves communication and learning access, excessive use may negatively influence study habits and concentration. The findings indicate that balanced use of SM is important for maintaining better academic performance among nursing students.
Social Media Addiction (SMA), Academic Performance, Nursing Students, Social Networking Sites (SNS), Undergraduate Students, Digital Addiction, Social Media Usage.
Humor styles, mindfulness, quality of life, relationship satisfaction, cardiovascular diseases
ASSESSING FACULTY PERCEPTION OF POTENTIAL BENEFITS, LIMITATIONS, AND CONCERNS REGARDING ADOPTION OF AI CHATBOTS IN NURSING EDUCATION
Objectives: Artificial Intelligence (AI) chatbots have the capacity to transform nursing educational practice through increasing accessibility, personalizing learning, and reducing workload. However, understanding faculty perceptions is critical for successful adoption. The focus of this study is to assess the perceptions of nursing faculty in Sindh, Pakistan, regarding the benefits, limitations, and usage patterns of AI chatbots in nursing education. Methods: A descriptive cross-sectional survey was implemented among 85 nursing faculty members, recruited through Purposive sampling. Data were gathered via a structured online questionnaire, and data were analyzed using descriptive statistics (mean, standard deviation, frequency, and percentage) . Results: The faculty demonstrated a generally favorable perception of AI chatbot integration, particularly recognizing its educational benefits, such as enhanced learning support and teaching efficiency (Mean = 46.36). Nevertheless, concerns regarding personalization, adaptability, and misinformation persisted. ChatGPT was the most familiar (40.6%) and frequently used chatbot (69.0%), mainly for self-academic purposes rather than for teaching. Conclusion: While faculty are receptive to AI chatbot adoption, their concerns should be considered to promote both effective and ethical implementation. Institutional efforts should focus on training, support, and policy development to foster accountable AI integration in nursing education.
Artificial Intelligence, Chatbots, Nursing Education, Faculty Perception, Technology Adoption, Educational Technology
NURSE’S BURNOUT AND TURNOVER INTENTION ASSOCIATED WITH WORKLOAD IN A TERTIARY PRIVATE HOSPITAL, LAHORE
Background: Turnover intension in nursing profession continuously increases because of workload and burnout. Nurses constantly dealing with physical and psychological stress, diminish mental health, anxiety, depression and exhaustion because of these efforts nurses are frequently quitting their jobs and professions. Increase turnover causes shortage of staff in hospitals and it directly impacts on the mental health of nurse, reducing professional productivity. Nurses are burdened because of multiple elements, including long shift hours, organizational requirement, shortage of staff and shift tasks. These factors may lead to physical tiredness and psychological exhaustion, which can cause burnout and raises turnover. Methodology: A cross-sectional quantitative study was conducted to collect data from 114 registered nurses self-administered questionnaires were used to collect data. The data were summarized in terms of descriptive statistics like frequencies, percentages, means and standard deviations and inferential statistics like chi-square test and Pearson correlation were used to establish associations and relationships between variables. Results: A total of 114 nursing participants were surveyed, and the key academic outcomes are, the nursing workforce surveyed was mainly female (73.7%, n=84), and male (26.3%, n=30). 71.9% of the nurses in the hospital were experiencing moderate level of Burnout and 11.4% were under high level of Burnout. Likewise, 64.9% have moderate level of intentions to leave their jobs. Conclusion: The results indicate that job-related burnout and turnover intentions are the crucial challenges among nurses of private healthcare units. The factual data exposed that considerable fraction of nurses are experiencing moderate to high grade emotional exhaustion. Approaches to minimize job-related burnout and intentions of turnover, such as by reducing or managing workload and promoting cooperative work environment, should be given precedence by healthcare organizations or institutes to ensure the delivery of excellent patient care
nurses’ burnout, turnover intentions and workload
COMPUTATIONAL DRUG TARGET IDENTIFICATION IN MONKEYPOX VIRUS: COMPARATIVE INSIGHTS INTO NATURAL PRODUCTS AND REPURPOSED ANTIVIRALS
The global re-emergence of the Monkeypox Virus (MPXV) has sparked renewed efforts to identify effective antiviral treatments. In this study, we conducted an in silico docking analysis using CB Dock2 to evaluate natural products and repurposed antiviral drugs. We focused on key viral targets for inhibition, including VP39 2'-O Methyltransferase, viral topoisomerase-DNA complexes, and poxin. Physalin A, Sitoindoside IX, Withanolide, Shatavarin 1, Kutkoside, and Berberine HCl were among the natural substances that our research identified as possible inhibitors. Furthermore, the most successful repurposed antiviral was found to be tecovirimat. Based on their Vina scores and binding affinities, the natural compounds Withanolide, Sitoindoside IX, and Physalin A showed encouraging inhibitory potential, providing hope for alternative treatment approaches. But among all examined targets, tecovirimat continued to be the most effective inhibitor, highlighting its ongoing significance in the battle against MPXV.
Monkeypox Virus, Methyltransferase, viral topoisomerase-DNA complexes, Physalin A,
COMPARISON OF CSF ASPIRATION AND CONVENTIONAL POPPING METHODS USING 25-GAUGE SPINAL NEEDLE IN PATIENTS UNDERGOING SPINAL ANESTHESIA
Background: Performing spinal anesthesia with a thin gauge needle is technically difficult due to the flexibility of the needle and minimal pop sensation. In this study, we implemented a newly introduced technique of spinal anesthesia, that is the cerebrospinal fluid aspiration method, and compared it with the conventional popping method while using a 25-gauge Quincke type spinal needle. Objective: The study compared the total procedural time, success rate of the first attempt to perform dura puncture, number of attempts, and incidence of post-Dural puncture headache using either CSF aspiration method or the conventional popping method in patients undergoing spinal anesthesia. Design:Prospective, randomized, single-blinded controlled trial. Participants:60 patients between 19 to 65 years of age, with American Society of Anesthesiologists physical status 1 or 2, undergoing surgeries below umbilical region under spinal anesthesia were enrolled in this study. Method:The patients were randomly assigned to one of the two groups: 1) Patients receiving spinal anesthesia using the CSF aspiration method, in which the spinal needle is advanced with continuous aspiration. 2) The conventional popping method, in which a Dural pop or click is sensed by the anesthesiologist. The primary outcome measure was the total procedural time and success rate of the first attempt to perform Dural puncture. Number of attempts, time to complete motor block, withdrawal cases, and post-Dural puncture headache were also recorded. Result:60 patients were included in this study. In the aspiration group, the total procedure time was significantly shorter than in popping group [P=0.039]. Moreover, In the popping group, the number of attempts was significantly higher than in the aspiration group [P = 0.018], whereas the success rate of the first attempt for Dural puncture was 93.3% compared to 70% in the popping group [P=0.020]. In the popping group, 4 withdrawal cases were reported, compared to aspiration group which had only one withdrawal case. There was no significant difference between the number of passages and PDPH incidence between the two groups. However, 2 out of 60 cases of PDPH were reported, both belonging to the popping group. Conclusion:The CSF aspiration method has several clinical benefits over conventional popping method for spinal anesthesia using 25-gauge Quincke-type spinal needle.
IN PATIENTS UNDERGOING SPINAL ANESTHESIA
ASSESS KNOWLEDGE AND PRACTICE REGARDING TRIAGE AMONG NURSES IN EMERGENCY DEPARTMENT AT PUBLIC TERTIARY CARE HOSPITAL PESHAWAR
Triage is essential in emergency care for prioritizing patients based on the severity of their condition. This study aimed to assess the knowledge, practice, and associated factors related to triage among nurses working in the emergency departments of three public tertiary care hospitals in Peshawar: Khyber Teaching Hospital, Hayatabad Medical Complex, and Lady Reading Hospital. A cross-sectional design was used, and data were collected from 100 nurses selected through convenient sampling, using a structured questionnaire. Knowledge was measured through topic-related questions, while practice was assessed through performance-based items. The findings will provide insight into the current understanding and application of triage protocols and support hospital administrations and policymakers in improving emergency care quality through targeted training and standardized guidelines.
AN INTEGRATED YOLOV8N-CRNN-DEEPSORT FRAMEWORK FOR AUTOMATIC NUMBER PLATE RECOGNITION
Automatic Number Plate Recognition (ANPR) supports traffic monitoring, access control, parking management and intelligent transportation analytics. A reliable ANPR system must localize plates, transcribe characters, associate repeated detections across frames and store audit-ready records. This paper presents a compact and reproducible ANPR framework that integrates YOLOv8n for plate detection, a Convolutional Recurrent Neural Network with Connectionist Temporal Classification (CRNN-CTC) for sequence recognition, EasyOCR for pseudo-labeling and fallback recognition, and DeepSORT for multi-frame association. YOLOv8n was trained as a one-class detector using 640-pixel images. Detected plate crops were passed to the CRNN recognizer. EasyOCR generated pseudo-labels where manually verified crop text was unavailable and was retained as a fallback recognizer for short CRNN outputs. DeepSORT linked detections across frames for vehicle-level logging. YOLOv8n validation produced precision of 0.980, recall of 0.943, mAP@0.50 of 0.971 and mAP@0.50:0.95 of 0.686 on 2,048 validation images containing 2,195 plate instances. A separate IoU-matched inference evaluation produced 92.32% detection accuracy/ACR, 97.46% precision, 94.58% recall and 96.00% F1 score. The CRNN recognizer achieved 86.61% exact-match training accuracy and 97.58% character-level F1 against EasyOCR pseudo-labels. The proposed workflow demonstrates a practical ANPR pipeline for research-grade intelligent transportation studies. Tracking accuracy is not claimed because temporal identity ground truth was not available.
automatic number plate recognition; license plate recognition; YOLOv8n; CRNN; CTC loss; EasyOCR; DeepSORT; computer vision; intelligent transportation systems.
EFFECT OF WORKING HOURS ON DEPRESSION AND MENTAL WELLBEING AMONG HEALTHCARE PROVIDERS OF OPERATION THEATER OF MULTIPLE TERTIARY CARE HOSPITALS OF KARACHI, PAKISTAN
BACKGROUND “Health is wealth” is a time-tested adage. Health becomes more relevant when it comes to professionals whose job is to provide people with services that maintain an optimum state of mental, physical, and social well-being. Healthcare professionals (HCP) differ from general population regarding the nature of their work, stress, burnout etc. We initiated this study to see how working hours effect on depression and mental wellbeing of operation theater Workers. METHODS The study included 346 participants who work in Operation Theater of multiple hospitals of Karachi. An Analytical Cross-sectional study was used and stratified random sampling technique was used to collect the sample. Questionnaires had administered directly to the operation theater participant after their consent Warwick Edinburg Mental Wellbeing Scale (WEMWBS) was used to assess depression and mental wellbeing. RESULT There were 67.9 % male and 32.5% female participant in the study. The mean age of the participant was 35.53 ± SD 10.51 with a range of 23 to 69 years. The prevalence of stress related to long working hours was 48.26%. The mean score of WEMWBS was 44.69 ±SD 9.213. Probable clinical depression, mild depression and normal mental wellbeing was 33.8%,17.1% and 49.1% respectively. Data has analyses by SPSS software version 24. CONCLUSION Most of the participants of the study were working average 8 to 9 hours per day so my study does not show significant association between working hours and depression however after applying correlation test with multiple independent variables showed significant relationship with depression.
Working hours, Operation Theater Workers, Depression, mental wellbeing and WEMWBS Score.