ZU Journal System (Ziauddin University)
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Effect of Peri-Implant Mucositis on Long-Term Implant Survival: A Cross-Sectional Study
No full textBackground: An inflammatory disorder of the soft tissues surrounding dental implants, peri-implant mucositis (PIM) can impair stability and functionality. The purpose of this study was to assess how PIM affected peri-implant clinical parameters and implant survival.
Methods: A cross-sectional observational data study (September 2023 to March 2024) included 120 patients with 210 implants for over 24 months. Clinical evaluations included marginal bone loss, plaque index (PI), bleeding on probing (BOP), implant stability (ISQ), and probing depth (PD). BOP was used to diagnose PIM without radiographic bone loss. SPSS version 26 was used to analyze the data. Using chi-square and independent t-tests, p < 0.05 was deemed significant.
Results: PIM was found in 78 implants (37.1%). When compared to healthy implants, PIM implants had significantly higher PI (1.62 ± 0.41 vs. 0.82 ± 0.34), BOP (28 (21.2%) vs. 54 (69.2%)), PD (3.5 ± 0.7 mm vs. 2.1 ± 0.6 mm), and bone loss (1.24 ± 0.32 mm vs. 0.45 ± 0.19 mm), as well as lower ISQ values (68.3 ± 3.9 vs. 72.8 ± 4.1; all p < 0.001). Poor dental hygiene and smoking were strongly linked to PIM. Overall, 96.2% of implants survived, and there were moderately negative correlations (r = -0.41 to -0.48, p < 0.001) between the severity of mucositis and survival indicators.
Conclusion: Higher levels of plaque accumulation, increased bleeding, deeper probing depths, and decreased implant stability are all linked to peri-implant mucositis. PIM might jeopardize the health of the peri-implant tissue, even though overall implant survival is still high.
Keywords: Dental Implants, Peri-implant Mucositis, Implant Survival, Probing Depth, Bleeding on Probing, Plaque Index, Marginal Bone Loss
Significance of Physiotherapy Management in Vestibular Disorders
No full textVestibular system is important in the detection of head position in space as well as with reference to gravity hence ensuring gaze stabilization, posture control, upright stability, spatial orientation and navigation. The inner ear sends sensory information to the central nervous system via the inner ear and is combined with the visual and somatosensory information. The imbalance of this process causes the appearance of the conflicting sensory signals that cause the emergence of the following symptoms dizziness, vertigo, nausea, headache, postural instability, and deterioration in functional performance. Chronic vestibular impairment may greatly limit everyday functionality, lead to fatigue, as well as adversely impact the quality of life.1 Among the elderly Vestibular dizziness and imbalance are frequent but poorly characterized clinical manifestations. The current epidemiology shows that vestibular dysfunction occurs in almost one-third of all patients above 60 years of age and the prevalence rates are higher than 50.2, 3 where the etiology of the condition is multifactorial and may involve peripheral or central vestibular pathology, neuromuscular impairment, cardiovascular, medication-induced dizziness, or psychosocial causes. In spite of these complications, it is still vital to establish which system is predominant to provide proper management and prevent the needless investigations or a long period of using pharmacological therapy.
Efficacy of Spencer Technique and Scapular Mobilization in the Management of Adhesive Capsulitis: A Narrative Review: Spencer Technique and Scapular Mobilization for Adhesive Capsulitis
No full textAdhesive capsulitis is characterized by the thickening and tightening of shoulder capsule, resulting in its sticking to the humeral head. It is described by a sudden occurrence of pain and discomfort with gradual loss in the active and passive shoulder movements resulting from long-term inflammation of the synovial membrane, which leads to increasing hardening and tightening of the GH joint capsule. This article provides an overview of existing evidence on the effects of Spencer technique and scapular mobilization in adhesive capsulitis patients. An extensive review of databases such as PubMed, Pedro and Google Scholar identified 16 articles regarding the impact of the Spencer Technique and Scapular Mobilization on individuals diagnosed with adhesive capsulitis released between 2021 and 2025. Both techniques demonstrate significant benefits in managing Adhesive Capsulitis. The findings of study will help the healthcare practitioners to integrate evidence-based approaches into rehabilitation regimes in order to improve quality of life. This review is limited by small sample size and heterogeneous study designs. By integrating these techniques into care strategies, healthcare professionals will be able to speed up recovery and enhance quality of life. This research critically evaluates the recent evidence, identify the gaps in literature and highlights the benefits of both techniques in rehabilitation of patients with Adhesive Capsulitis. The Spencer technique along with scapular mobilization appear to be effective treatment methods for adhesive capsulitis, in terms of increase in range of motion and function.
Keywords: Adhesive Capsulitis, Frozen Shoulder, Scapular mobilization, Spencer Technique, Range of Motion, Mobilization Techniques.
To cite this article: Sarwar N, Eisha-Tur-Razzia, Siddique S, Jawa R. Efficacy of Spencer Technique and Scapular Mobilization in the management of Adhesive Capsulitis. A Narrative Review. Pakistan Journal of Rehabilitation. 2026; 15(1):5-8
The Anti-Diabetic, Anti-Oxidative And Hepatorenal Protective Effects of Citrullus Lanatus Seed Oil Against Toxicity Caused by Alloxan in Wistar Rats: Anti-Diabetic and Organ-Protective Effects of C. Lanatus Seed Oil
No full textBackground: Diabetes Mellitus (DM) is a disorder of metabolism represented by persistent hyperglycaemia due to the non-secretion or insensitivity of insulin. Pancreatic beta cells are responsible to release insulin and maintain blood glucose level. Alloxan is a cytotoxic glucose analogue that is experimentally used to damage pancreatic beta cells of rats for the creation of pancreatitis, oxidative stress and Diabetes. Watermelon seed oil (WMSO) is a reservoir of antioxidants and has been shown to produce defence against oxidative damage. Since oxidative stress is the primary cause of alloxan-induced pancreatic beta cell damage therefore the purpose of this study was to determine the anti-diabetic, anti-oxidative, and hepatorenal protective activities of WMSO on rats with alloxan-induced pancreatic beta cell damage.
Methodology: In this experimental study, eighteen healthy age-matched male Wistar rats of 150-200g were used and randomly allotted into three experimental groups (n=6). A-Group: (control-untreated), B-Group: (Alloxan-treated), C-Group: (Alloxan + WMSO treated) each containing Six rats. Following overnight fasting, an intra-peritoneal-injection of Alloxan 120mg/kg dissolved within 0.9% saline was given in group B & C rats whereas WMSO was additionally provided to group C rats in a dose of 2.5gm/kg daily via oral gavage for 21-days. Bodyweights were observed weekly and on 22nd-day, animals were sacrificed for biochemical assessments.
Results: The bodyweights were well maintained in group A whereas reduced in group B & C. Alloxan treatment in group B has been shown to cause beta cell damage evidenced by hyperglycaemia and decreased serum insulin levels. Alloxan also has caused impaired renal and hepatic functions in group B and indicated by significantly higher (p<0.05) levels of AST, ALT, ALP, urea, creatinine and BUN whereas significantly lower (p<0.05) levels of antioxidant enzymes SOD, CAT, and GSH in comparison to group A. WMSO treatment in group C rats along with alloxan resulted in drop of hepatorenal and oxidative stress markers as endorsed by a significant (p<0.05) decline in AST, ALT, ALP, urea, creatinine and BUN while increase (p<0.05) in antioxidant enzymes SOD, CAT, and GSH when compared with group B.
Conclusion: The study proves ameliorative effects of WMSO against alloxan induced pancreatic beta cell damage in rats. WMSO also has been shown promising hepatorenal protective effects via reducing oxidative stress thereby endorsing its anti-diabetic and antioxidant potential. Keywords: Diabetes mellitus (DM), Hepatorenal, Hyperglycaemia, Oxidative stress, Water melon seed oil (WMSO).
To cite this article: Nasir I, Naz L, Mughal MA, Nisar M. The Anti-Diabetic, Anti-Oxidative and Hepatorenal Protective Effects of Citrullus Lanatus Seed Oil against Toxicity caused by Alloxan in Wistar Rats. Pakistan Journal of Rehabilitation. 2026; 15(1):9-13.
Evaluation of a Fixed-Dose Combination Antihypertensive Therapy versus Monotherapy on Medication Adherence and Blood Pressure Control: A Prospective Cohort Study
No full textBackground: Suboptimal medication adherence represents a critical obstacle to achieving target blood pressure levels in hypertensive patients globally. Fixed-dose combination (FDC) formulations have demonstrated potential for enhancing therapeutic compliance through streamlined dosing protocols and reduced medication complexity. To evaluate comparative effectiveness of fixed-dose combination antihypertensive regimens versus conventional monotherapy and free-combination approaches regarding medication adherence patterns and blood pressure management outcomes.
Methods: This 6-month prospective observational cohort study recruited 1,248 treatment-naïve adults (ages 35-75) with newly diagnosed essential hypertension from three metropolitan primary care centers in Hyderabad, Pakistan between January and July 2025. Primary endpoint assessed medication adherence via proportion of days covered (PDC) methodology. Secondary endpoints included blood pressure target achievement rates, time-to-control intervals, and major adverse cardiovascular events.
Results: FDC recipients (n=624) exhibited substantially superior medication adherence versus control participants (n=624), with mean PDC values of 82.4% compared to 64.7% (p<0.001). Target blood pressure achievement (<140/90 mmHg) at 6 months occurred in 73.1% of FDC patients versus 54.8% of controls (p<0.001). Median time-to-target was significantly reduced in the FDC cohort (8.2 weeks vs. 12.6 weeks, p<0.001).
Conclusions: Single-pill combination antihypertensive strategies demonstrate marked superiority in medication adherence and blood pressure control metrics compared to traditional therapeutic approaches, supporting their prioritization in contemporary hypertension management protocols
Surgical Site Infection following Gallbladder Extraction during Laparoscopic Cholecystectomy – Umbilical versus Epigastric Ports
No full textBackground: The most effective treatment for symptomatic gallstones is laparoscopic cholecystectomy (LC); nevertheless, surgical site infection (SSI) is still a frequent postoperative concern. Due to variations in wound exposure and the risk of bacterial contamination, the location of gallbladder extraction—through the umbilical or epigastric port—may affect the incidence of SSI. Thus study compared the incidence of SSI after laparoscopic cholecystectomy gallbladder extraction via the umbilical versus epigastric port.
Methodology: This prospective cohort study was consisted of two groups of 80 patients (N=160) undergoing elective LC, Group A (umbilical port extraction) and Group B (epigastric port extraction). Consultant surgeons performed all procedures according to standardized aseptic and operative protocols to ensure consistency and reduce bias. The Southampton classification was used to assess postoperative wounds. SPSS version 25.0 was used in statistical analysis with p-value less than 0.05 as statistically significant.
Results: From the 160 patients, 17 (10.6%) experienced SSI development. There was a statistically significant difference (p = 0.04) in the incidence between the groups with umbilical ports (12 patients, 15.0%) and epigastric ports (5 patients, 6.3%). Group A and Group B experienced mean postoperative hospital stays of 1.8 ± 0.6 and 1.6 ± 0.5 days, respectively (p = 0.13).
Conclusion: Gallbladder extraction using the umbilical port is associated with a significantly increased risk of surgical site infection. After a laparoscopic cholecystectomy, using epigastric port extraction may lessen postoperative wound complications
Laparoscopic Subtotal Cholecystectomy Versus Open Conversion as a Bailout Strategy in Complicated Laparoscopic Cholecystectomy
No full textBackground: Difficult laparoscopic cholecystectomy (LC), due to inflammation or unclear anatomy, increases complication risk, such as bile duct injury. In such scenarios, surgeons adopt bailout strategies—either laparoscopic subtotal cholecystectomy (LSC) or conversion to open cholecystectomy (OC). In resource-limited settings, evidence comparing these options remains scarce. This study aimed to compare the postoperative outcomes of LSC and OC as bailout strategies for difficult LC in a resource-constrained tertiary care setting in Pakistan.
Methods: A comparative cross-sectional study was conducted at Benazir Bhutto Hospital, Rawalpindi, enrolling 34 patients who underwent either LSC (n=28) or OC (n=6) between January 2022 and December 2024. Patients were selected based on intraoperative difficulty criteria. Primary outcome was procedural success; secondary outcomes included bile leakage, surgical site infections, 30-day mortality, and length of hospital stay. Statistical analysis included t-tests and chi-square tests with a 95% confidence interval.
Results: Both groups achieved 100% procedural success. No bile leakage, organ space infections, or 30-day mortality occurred in either group. LSC demonstrated significantly shorter operative time (78.4±15.2 min vs. 102.5±18.7 min, p=0.01) and slightly shorter hospital stay. Superficial surgical site infections were fewer in the LSC group but not statistically significant.
Conclusion: In resource-limited settings, both LSC and OC offer comparable safety and efficacy. LSC may offer advantages in operative time and invasiveness. Surgeon expertise and intraoperative judgment should guide strategy selection
Ventral Abdominal Wall Hernioplasty: Insights into Intraperitoneal Onlay Mesh Vs Sublay Technique, A Retrospective Cross-Sectional Study
No full textBackground: Ventral abdominal wall hernia represents a common surgical problem that is linked to morbidity, prolonged recovery duration, and high costs of healthcare. The purpose of this study was to compare the outcome of perioperative, postoperative pain, and complication rate in open sublay versus laparoscopic IPOM repair in a tertiary care hospital.
Methods: This retrospective cross-sectional study (March to November 2025) comprised of 120 patients underwent ventral hernia repair, were divided into two groups (Group A (open sublay, n=60), and Group B (laparoscopic/IPOM, n=60)). Demographic data, comorbid data, operative data, mesh size, use of analgesics and antibiotics, drain data, hospitalization, Visual Analogue Scale (VAS) pain scores and postoperative complications were recorded. Independent t-tests and the Fisher exact test were used as statistical tests, with the p-value of less than 0.05 being regarded as significant.
Results: Laparoscopic/IPOM group demonstrated better results in the time spent in operations (46.35 ± 5.7 vs. 59.53 ± 8.4 min, p=0.001) and days in the hospital (3.0 ± 1.0 vs. 5.0 ± 2.0 days, p<0.001). The levels of postoperative pain were also reduced and 86% of the patients had mild pain (VAS <3), as compared to 33% in the open group (p=0.0001). There were also less analgesics and drain requirements in the laparoscopic group.
Conclusion: Laparoscopic/IPOM repair is the most effective in terms of faster recovery, less postoperative pain, less perioperative burden, and safety equivalent than that of open sublay repair. These results promote laparoscopy repair as a convenient method in the management of ventral hernias