Journal of Rawalpindi Medical College
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ENT Diseases Among Children Presenting To A Teaching Hospital In Sargodha: A Cross-Sectional Analysis
Full text linkObjective: This study aimed to determine the frequency of commonly prevalent pediatric ear, nose, and throat (ENT) disorders presenting in the outpatient department of a teaching hospital in Sargodha, Pakistan.
Methods: This cross-sectional study was conducted at the Department of Otorhinolaryngology, Niazi Welfare Foundation Teaching Hospital, from October 1, 2024, to April 30th, 2025. A total of 380 children aged 0–15 years were enrolled via consecutive sampling, after obtaining informed consent from their primary caregivers. SPSS 21 was used for statistical analysis, including the Chi-square test to identify the statistical significance of various study variables.
Results: Out of 380 participants, the majority (53.2%) were male and 82.6% lived in rural areas. The most frequently diagnosed disorders were tonsillitis (20.3%), acute suppurative otitis media (9.2%), epistaxis (7.9%), adenotonsillitis (7.9%), and pharyngitis (3.4%). A significant statistical association was found between ENT disorders and age (Contingency Coefficient = 0.927, p < 0.001). Parental education (p<0.001) and smoking exposure (p=0.003) influenced the disease chronicity. Parental inclination towards unverified health care providers was influenced by the education level of both parents (p<0.001), the mother’s occupation (p=0.046) and the father’s occupation (p<0.001).
Conclusion: ENT disorders, particularly tonsillitis, are commonly prevalent among children in Sargodha. Low parental education level and exposure to second-hand smoking significantly contribute to disease recurrence. Region-specific, multicenter data collection is essential to provide evidence-based figures for policymakers to plan the provision of healthcare strategies, especially in underserved areas.
Keywords: Adenoids, Chronic Otitis media, Epistaxis, Paediatrics, Pharyngitis, Tonsilliti
To determine the frequency of necrotizing enterocolitis in preterm infants treated with prophylactic probiotics versus controls
Full text linkObjective: To determine the frequency of necrotising enterocolitis in preterm infants treated with prophylactic probiotics versus controls.
Methodology: This was a Quasi experminet, conducted in Holy Family Hospital Rawalpindi, Department of Paediatrics from Jan 2020 to Dec 2020. A total of 170 preterm neonates (gestational age 30–35 weeks, birth weight <1500 g) were enrolled and randomly divided into two groups: Group A received prophylactic probiotics, while Group B received routine management without probiotics. Both groups followed standard feeding protocols using expressed breast milk or preterm formula, gradually advancing feeds as tolerated. NEC was monitored clinically and radiologically and confirmed by pneumatosis intestinalis. The study endpoints included NEC incidence with follow-up until 10 days of life or discharge. Data were analysed using SPSS 23, with chi-square tests applied post-stratification for variables such as gestational age, gender, and weight. A p-value of <0.05 was considered statistically significant.
Results: Comparison of frequency of necrotising enterocolitis in preterm infants treated with prophylactic probiotics versus controls shows 4.71%(n=4) NEC in Group A and 18.82%(n=16) in Group B.
Conclusion: The frequency of necrotizing enterocolitis in preterm infants treated with prophylactic probiotics is lower when compared with controls
Keywords: Preterm, probiotics, necrotising enterocoliti
A Chronic Sialolithiasis of the submandibular gland with a gigantic collection of stones - A Case Report
Full text linkSialolithiasis, characterized by the accumulation of calcium salt deposits known as sialoliths, often affects the submandibular gland nestled within the submandibular triangle. This disorder primarily impacts the submandibular gland due to the lower positioning of Wharton's duct, facilitating retrograde infection by oral flora. The alkaline saliva produced by the gland actively promotes the precipitation of calcium salts, consequently fostering the formation of sialoliths.
This case study showcases a 35-year-old male patient who developed a huge sialolith and persistent sialadenitis after recurring submandibular swelling and pain. The patient revealed a ten-year history of recurrent painful, persistent swelling and a gradual increase of dysphagia during his last seven-month illness. Chronic sialolithiasis was diagnosed when imaging revealed a large sialolith collection. A contrast-enhanced neck CT confirmed a massive intra-parenchymal stone aggregate and an enlarged gland. Following submandibular sialoadenectomy, unusually shaped stones weighing 189 grams were discovered. A histopathological study confirmed the presence of squamous and mucinous metaplasia together with persistent sialadenitis, ruling out cancer. At the three-month follow-up, the patient showed favorable healing and improved speech.
The objective is to highlight a gigantic collection of stones with unusual presentation in submandibular sialolithiasis, clinical features, diagnostic techniques, and treatment options.
Highlighting the complexities of submandibular sialolithiasis, this case report emphasizes the need for early and easy access to timely healthcare provision in getting precise diagnoses and tailored treatment plans and avoiding complications related to delayed and unreachable healthcare. Successfully performing a submandibular sialoadenectomy led to significant relief of symptoms, demonstrating the effectiveness of surgical approaches in managing chronic sialadenitis with large sialoliths
Comparison Of Parenteral Iron Sucrose And Oral Iron Therapy In Managing Iron Deficiency Anemia In The Post-Partum Period
Full text linkOBJECTIVE
The goal of this study is to assess the effectiveness of parenteral iron sucrose therapy vs oral iron supplements in the treatment of iron deficiency anaemia (IDA) in the postpartum period.
METHODOLOGY:
This study is conducted in the OBS and Gynae department of PAF Hospital Islamabad. This is a randomized control trial (RCT). A total of 130 women, 65 in each group were recruited who were diagnosed with iron deficiency anaemia (as per operational definition ), 48hrs after delivery. In group A females were prescribed intravenous iron sucrose therapy according to post-delivery hemoglobin level by using the formula (2.4 × (target Hb-actual Hb) × post-pregnancy weight (kg)) + 1000 mg every alternate day. In group B females were prescribed daily oral iron supplements along with folic acid. Follow-up of both groups was done after 4 weeks in OPD.
RESULTS:
The mean age was 29 years ± 2.688 in group A, while in group B it was 30 years with SD ±2.422. In group A (Intravenous iron sucrose therapy) mean ferritin level was 140.94 ± 3.292 and the mean hemoglobin level was 11.11 ± 0.710. In group B (Oral iron supplements) mean serum ferritin level was 125.34 ± 6.551 and the mean Hemoglobin level was 10.65 ± 0.623 after treatment.
CONCLUSION
Our study concludes that there is no significant difference in treatment between intravenous iron sucrose therapy and oral iron supplements for iron deficiency anaemia in the post-partum period
Improving Endometrial Carcinoma Prognosis: A Case Report on Synergistic Moringa Treatment
Full text linkEndometrial adenocarcinoma is the most common gynecologic malignancy worldwide, particularly affecting postmenopausal women. While standard treatments include surgery, chemotherapy, and radiotherapy, there is growing interest in complementary therapies to improve prognosis.
This case report presents a 62-year-old female diagnosed with stage II endometrial adenocarcinoma, who underwent standard chemotherapy and radiotherapy while incorporating Moringa Oleifera supplementation. Over six months, the patient demonstrated improved tolerance to treatment, reduced inflammation markers (CRP: 18 mg/L to 5 mg/L), and enhanced immune function (increase in CD4+/CD8+ ratio). Tumor regression was confirmed via imaging, showing a 40% reduction in lesion size post-treatment. The patient also reported improved energy levels and reduced chemotherapy-related side effects.
This case highlights the potential of Moringa Oleifera as a synergistic adjunct to conventional therapy in endometrial carcinoma. Further clinical studies are needed to validate these findings
Comparison Of Endothelial Cell Count Before And After Phacoemulsification In Grade 2 Nuclear Sclerosis Cataract Versus Grade 4 Nuclear Sclerosis Cataract In Tertiary Care Hospital In Pakistan
No full textObjective: During Phacoemulsification, hardness of the lens opacity has definitive impact on corneal endothelial cells. In our study we provided comparative data for endothelial cell count by comparing Phacoemulsification procedure in grade 2 versus grade 4 cataract.
Methods: Our study included 90 patients after taking approval from the Ethical Review Committee from 1st May 2024 to 31st October 2024. Technique of Non-Probability Purposive sampling was used. Patients were selected for the data collection process in the Eye Outpatient Department at the Institute of Ophthalmology, Allied Hospital, Faisalabad. Slit lamp examination was performed on all patients to diagnose cataract. Specular microscopy was done to examine the endothelial cell count before and after phacoemulsification in grade 2 versus grade 4 nuclear sclerosis cataract. Patients were divided into two groups based on the grade of nuclear sclerosis cataract: Group A (patients with grade 2 nuclear sclerosis cataract) and Group B (patients with grade 4 nuclear sclerosis cataract).
Results: The mean age of patients was 61.311±3.97 years in Group A and 62.400±3.58 years in Group B. The mean ± SD of baseline endothelial cell count in Group A was 2248.022 ± 132.05 mm2, while in Group B it was 1977.488 ± 180.90 mm2 (p-value <0.05). The mean ± SD of postoperative endothelial cell count after 6 weeks in Group A was 1935.622 ± 165.57 mm2 (mean cell loss), and Group B was 1535.955 ± 177.37 mm2 (mean cell loss; p-value <0.05). Endothelial cell loss% increased from 13.89% in grade 2 nuclear sclerosis cataract to 22.32% in grade 4 nuclear sclerosis cataract.
Conclusion: Endothelial cell loss was higher with high grade of nuclear sclerosis cataract ranging from 13.89% in grade 2 to 22.32% in grade 4 cataract
Gaza Students at RMU; Bridging Education Beyond Borders
No full textThe academic year 2024–2025 has been an important and moving chapter for Rawalpindi Medical University (RMU). During this period RMU had the privilege to host 38 medical students from Al-Azhar University, Gaza, whose campus and homes were destroyed in the war. This initiative was provided by RMU on voluntary and humanitarian grounds to help students who had lost their institutions, families, and in some cases parents. Our purpose was to give them safe continuity of education, and the professional training required to become physicians. The Government of Punjab and Pakistan Medical & Dental Council played a vital role in registration and facilitation of these students.The arrival of these students strengthened our academic community. Their determination and personal stories of loss and resilience created learning opportunities beyond the formal curriculum. They joined RMU not only as learners but also as members of our academic family. From the first day we sought to provide a secure, welcoming, and academically stimulating environment that acknowledged both their educational needs and their personal hardships. A hybrid curriculum was designed in collaboration with Al Azhar University, Gaza specifically for these students.The academic session formally began with a welcome ceremony held on 30 October 2024 at the New Teaching Block. At that event the students were introduced to faculty, department heads and peers. This marked the formal start of the year and prepared the ground for teaching, clinical placements and collegial interaction. Following the ceremony an orientation programme was conducted in which deans of all departments presented their departments and expectations. At the outset the students underwent baseline academic, physical and psychological assessment so that bespoke support plans could be made. A foundation week was organised to address gaps in basic sciences and to align prior learning with RMU’s curriculum.In addition to formal teaching we focused on students’ well-being and social integration. RMU organised a night gala that combined sports, cultural activities and community celebration. The university dedicated the newly renovated Sports Complex to these students; the complex had been refurbished with donations and was formally inaugurated by one of the Gaza students. Over the twelve months the Gaza students participated actively in clinical rotations across multiple specialties. These attachments provided supervised, hands-on experience and helped refine clinical reasoning, procedural skills and professional conduct. Faculty members offered regular feedback and targeted mentoring to help each student meet learning objectives. Continuous evaluation was used to monitor progress and to tailor remediation where needed.The academic year also emphasised peer support and community engagement. RMU students, staff and the visiting group took part in joint academic sessions, journal clubs and community outreach activities. These interactions fostered intercultural understanding and helped the Gaza students rebuild academic networks that are essential for their future careers.As the academic year comes to an end, we warmly celebrate the students’ hard work and progress. Their perseverance and steady academic improvement have shown, in a simple and clear way, how education can heal pain and bring people closer. RMU will continue to support them until they complete their training and return home as licensed doctors prepared to serve their communities.In short, the year 2024–2025 reminded us that medical education is more than teaching facts. It is also a duty of care and solidarity. When institutions act with compassion and responsibility they help keep learning alive for those affected by conflict and displacement. For RMU this is a moral obligation, and we are determined to continue this support in the coming years
Fathers' Knowledge and Role in Child Health: A Cross-Sectional Study in Urban Settings of Rawalpindi
Full text linkObjective: Child health is a crucial aspect of global public health, with millions of children under five dying each year from preventable diseases and malnutrition. Fathers play a pivotal role in children's health by providing emotional support, assisting with healthcare decisions, and promoting a healthy environment. This study assesses the role of men in child health care, focusing on their knowledge and practices.
Materials & Methods: This cross-sectional study was conducted in the Allied Hospitals of Rawalpindi Medical University from March to August 2024. A sample size of 366 married men with children under five was interviewed using a structured questionnaire via purposive sampling. Married men living in the study area with at least one child below 5 years were included. Descriptive and inferential statistics were carried out on SPSS 27.
Results: Findings revealed significant male involvement and knowledge in child health. Most men exhibited good knowledge (77.0%) and high involvement (78.7%) in child health. Key barriers included lack of funds (69.4%), lack of time (57.9%), location of the hospital (15.3%), and the attitude of health workers (16.1%). The study underscores the importance of male participation in improving child health outcomes.
Conclusion: Male involvement in child health is essential for improving outcomes. Addressing barriers to their participation can enhance the effectiveness of child health interventions
Assessment Of Efficacy Of Intralesional Vitamin D3 Injection In The Treatment Of Recalcitrant Warts
Full text linkObjectiveTo assess the efficacy of intralesional vitamin D3 injection as a treatment modality for recalcitrant warts in a tertiary care setting in Pakistan.
Materials and MethodsThis quasi-experimental study was carried out in the Department of Dermatology, CMH Lahore, over six months from March 16 to September 16, 2021. After obtaining approval from the hospital's ethical and research committee, 139 patients aged 18–60 years, presenting with recalcitrant warts fulfilling the inclusion criteria, were recruited. Intralesional vitamin D3 (600,000 IU/mL), 0.5ml was injected into the base of up to four warts per session, with injections repeated every two weeks for a maximum of four sessions. Efficacy was defined as the complete resolution of all warts. Adverse events were monitored, and data were stratified by age, gender, and wart characteristics.
ResultsThe study population had a mean age of 30.3 ± 6.8 years, with a male predominance (57.6%). The average wart duration was 6.5 ± 1.5 months. Complete resolution was achieved in 89.9% of patients. While no statistically significant differences in efficacy were observed across stratified subgroups (p > 0.05), patients with shorter wart durations (3–6 months) demonstrated the highest success rate (98.7%), whereas those with warts lasting longer than 6 months showed the lowest response (79.0%). Adverse effects were minimal and resolved on their own, with 15% of patients experiencing injection site pain and 10% reporting temporary erythema.
ConclusionIntralesional vitamin D3 injections have demonstrated significant efficacy and a favorable safety profile, positioning it as a promising and novel treatment for recalcitrant warts. However, to strengthen the evidence and better understand its long-term benefits, additional randomized controlled trials are essential.
Correlation of Radiological and Pathological Cervical Lymph Node Involvement in Oral Cavity Cancer
No full textObjective: This study aims to detect and correlate enlarged lymph nodes radiologically with their pathological status, specifically identifying reactive and positive nodes.
Methods: This retrospective observational study was performed at Dr. Ziauddin Hospital, Karachi, Pakistan. All patients with biopsy-proven surgically resectable oral cavity cancer from January 2021 to December 2021 were included in this study. Data were gathered, including radiological and histopathological reports. The diagnostic accuracy of the scans was calculated using final histopathology as the gold standard. Data was analysed using SPSS v.26.0.
Results: 222 patients’ data were reviewed, and 89 patients satisfied the inclusion criteria. The sensitivity and specificity of the CT scan were 82.98% and 38.04%, respectively. The positive predictive value was 60%, whereas the negative predictive value was 66.67%. We found that the overall accuracy of the CT scan was 61.8%.
Conclusion: We conclude that contrast-enhanced CT scans in lower-middle-income countries remain a viable radiological approach for cervical lymph node assessment that can significantly influence decisions regarding neck dissection, impacting patient survival outcomes and improving quality of life