International Journal of Pharmacy Research & Technology (IJPRT)

Comparative Analysis of Early Versus Late Laparoscopic Cholecystectomy Following Endoscopic Retrograde Cholangiopancreatography in Cases of Cholelithiasis with Choledocholithiasis

2026-01-01T08:28:28+03:00

Background: The optimal timing of laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis remains debated. While early LC (≤72 hours) may reduce operative difficulty and hospital stay, late LC (>6 weeks) has traditionally been practiced to allow inflammation to subside.

Methods: A prospective comparative study was conducted on 60 patients with cholelithiasis and choledocholithiasis who underwent successful ERCP for common bile duct clearance at a tertiary care hospital. Patients were randomized into early LC (within 72 hours; n=30) and late LC (>6 weeks; n=30) groups. Demographic, operative, and postoperative parameters including operative time, adhesion grading, conversion to open surgery, complications, and hospital stay were analyzed using standard statistical tests.

Results: Both groups were comparable in terms of age, sex, and comorbidities. Mean operative time was significantly shorter in the early LC group (56.2 ± 8.5 min vs. 77.4 ± 9.1 min; p<0.001). Severe adhesions were more frequent in late LC (40% vs. 10%; p=0.01). The mean length of hospital stay was reduced in the early LC group (2.9 ± 0.7 vs. 4.3 ± 1.2 days; p=0.002). Conversion to open surgery (1 vs. 2 cases) and postoperative complications (6.7% vs. 10%) were not statistically different.

Conclusions: Early LC within 72 hours of ERCP is safe and associated with shorter operative time, less operative difficulty, and reduced hospital stay without increasing complication rates. These findings support early cholecystectomy as the preferred strategy in patients with cholelithiasis and choledocholithiasis.

A CLINICAL STUDY OF TRAUMATIC BRAIN INJURY COMPARING FULL OUTLINE UNRESPONSIVE SCORE (FOUR SCORE) AND GLASGOW COMA SCALE SCORE (GCS SCORE) IN PREDICTING THE IN-HOSPITAL MORTALITY IN EMERGENCY DEPARTMENT OF TERTIARY CARE HOSPITAL

2026-01-05T14:00:38+03:00

Objective: To compare and predict themortality in patients with TBI, by using FullOutline of Unresponsiveness (FOUR) scoreand the Glasgow Coma Scale (GCS) in Emergency department.

PREVALENCE OF HYPOTHYROIDISM IN PATIENTS WITH GALL STONE DISEASE IN A RURAL TERTIARY CARE HOSPITAL

2026-01-05T14:05:35+03:00

Background: Gallstone disease is aprevalent condition, with increasingevidence suggesting a link tohypothyroidism. However, the exact
relationship between thyroid abnormalities and gallstone disease is notwellestablished

Diagnostic Accuracy of Symphysio-Fundal Height in Detection of FGR by Taking Ultrasound as a Standard

2026-01-06T11:27:59+03:00

Objectives: To measure the diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard.

Study Design: validation study

Settings: Department of Obstetrics and Gynaecology, BBH, Rawalpindi.

Study Duration: 5th April 2022 to 4th October 2022.

Materials & Methods: A total of 225 women with singleton pregnancies between 28 and 36 weeks of gestation, aged 18 to 40, were enrolled. We excluded patients with fetal cardiac activity, congenital abnormalities, and polyhydroamnios. A researcher measured the fundal height every two weeks between weeks 28 and 38 at prenatal clinic visits. The distance between the uterine fundus and the top of the symphysis pubis was measured using a non-stretchable tape that came into touch with the skin of the abdominal wall. The researcher was facing the inch side of the tape to avoid bias. The inspecting hand's palm applied light pressure at a straight angle to the abdomen wall to delineate the fundus. Plotting of the measurements onto the normogram was done after they were measured in centimeters (to the nearest 0.5 cm). A radiologist performed an ultrasound to confirm FGR if it did not match gestational age.

Results: Overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of symphysio-fundal height in detection of fetal growth restriction by taking ultrasound as a gold standard was 92.08%, 88.37%, 92.76%, 87.36% and 90.67% respectively. Conclusion: This study concluded that symphysio-fundal height is a highly sensitive and accurate parameter for detecting fetal growth restriction.

Comparing the Diagnostic Precision of the RMI and ADNEX Models in Identifying the Ovarian Tumor

2026-01-06T12:20:34+03:00

Objectives: To assess the diagnostic precision of the ADNEX and RMI models in distinguishing between benign and malignant ovarian tumors while taking histopathology as the gold standard.

Study type: Validation study.

Study duration: 5th April 2022 to 4th October 2022 Settings: Department of Obstetrics & Gynecology, Benazir Bhutto hospital Rawalpindi.

Materials & Methods: 165 patients between the ages of 14 and 65 who had at least one ovarian, para-ovarian, or tubal adnexal mass with a smallest diameter > 3 cm on ultrasound examination were included. Patients who had undergone bilateral adnexectomy or who had an adnexal mass under follow-up prior to the study's commencement were not included. The RMI/ADNEX score was computed. The patient was categorized as either low risk or high risk. To determine the predictive value of both models, the values were correlated with the histology report following surgery. Histopathological analysis of removed tissue serves as the foundation for the reference standard.

Results: The RMI model's diagnostic accuracy, sensitivity, specificity, PPV, and NPV in telling the difference between benign and malignant ovarian masses were 90.11%, 85.14%, 88.17%, 87.50%, and 87.88%, respectively. ADNEX showed sensitivity of 85.56%, a specificity of 81.33%, a PPV of 84.62%, an NPV of 82.43%, and a diagnostic accuracy of 83.64%. Conclusion: This study concluded that diagnostic accuracy of RMI model in differentiation of benign and malignant ovarian masses is better than ADNEX model.

Evaluation of Novel Biomarkers for Early Detection of Acute Myocardial Infarction

2026-01-10T10:22:53+03:00

Background: Early diagnosis of acute myocardialinfarction (AMI) is time-critical, yet initial ECGfindings may be non-diagnostic, and highsensitivity troponin can be negative or borderline in very early presenters. Objective: To evaluatethe diagnostic performance

Diagnostic Accuracy of Triple Assessment in Breast Cancer: A Comprehensive Clinical Evaluation with Statistical Analysis

2026-01-12T08:53:46+03:00

Background: Triple assessment combining clinical breast examination, radiological imaging, and fine needle aspiration cytology represents the systematic diagnostic approach for evaluating breast masses and determining malignancy probability. Despite widespread utilization, comprehensive analysis of individual component performance and concordance patterns with statistical significance remains incompletely characterized in contemporary literature.

Methods: This retrospective study evaluated 340 consecutive women presenting with palpable breast lumps undergoing complete triple assessment evaluation. Clinical breast examination, diagnostic mammography with BI-RADS categorization (0–6 scale representing <2% to >95% malignancy risk), and ultrasound-guided fine needle aspiration cytology (classified as C1–C5 according to National Health Service Breast Screening Programme criteria) were performed. All patients underwent histopathological examination as the gold standard reference. Diagnostic accuracy metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. Statistical significance was assessed using chi-square analysis and McNemar's test with significance threshold of p<0.05.

Results: Combined triple assessment achieved 99.1% diagnostic accuracy (sensitivity 99.0%, specificity 99.3%, p<0.001). Individual modality sensitivities were clinical examination 76.9% (p<0.001), mammography 94.9% (p<0.001), and FNAC 94.7% (p<0.001). Concordant findings (80% of cases, n=272) demonstrated 100% sensitivity and 99.4% specificity. Discordant cases (20%, n=68) showed elevated malignancy risk of 86.8% (59 of 68 cases, p<0.001), with FNAC-driven discordance demonstrating 92.9% malignancy detection versus 11.1% for isolated clinical examination concerns (p<0.001).

Conclusion: Triple assessment achieves exceptional diagnostic reliability when all components are concordant, supporting clinical decision-making without additional biopsy in appropriately selected cases. Discordant presentations mandate heightened investigation, with FNAC demonstrating superior prognostic weighting. Triple assessment represents the gold-standard diagnostic paradigm for breast mass characterization and malignancy stratification.

Comparative Study of Oxidative Stress Markers in Hemodialysis (HD) versus Peritoneal Dialysis (PD) Patients

2026-01-12T09:35:23+03:00

Introduction: Chronic kidney disease (CKD) patients on dialysis frequently develop anemia due to iron deficiency, blood loss, and chronic inflammation. Hemodialysis (HD) often involves intravenous iron therapy, which can elevate ferritin, while peritoneal dialysis (PD) patients may experience iron depletion through peritoneal losses. Ferritin, transferrin saturation (TSAT), and total iron binding capacity (TIBC) are key markers of iron status, but their interpretation is complicated by inflammation. Interleukin 6 (IL 6), a pro inflammatory cytokine, further influences iron metabolism and anemia. Comparing these parameters in HD and PD patients is essential for tailoring iron management strategies.

Aim: To compare iron and inflammatory markers between hemodialysis (HD) and peritoneal dialysis (PD) patients, and assess correlations with age and gender.

Methods: A cross sectional study of 70 ESRD patients (35 HD, 35 PD) was conducted. Serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT), ferritin, and interleukin 6 (IL 6) were measured using standard biochemical and ELISA methods. Statistical comparisons were made using Student’s t test, and correlations were assessed with Pearson’s coefficient.

Results: IL 6, serum iron, and TIBC did not differ significantly between HD and PD (p> 0.05). Serum ferritin was significantly higher in HD (574.05 ± 341.04 ng/ml) compared to PD (370.91 ± 292.38 ng/ml, p = 0.009). Age showed a weak negative correlation with ferritin, while females had higher ferritin than males.

Conclusion: HD patients exhibit elevated ferritin levels, likely reflecting iron supplementation and inflammation. Ferritin should be interpreted cautiously, and iron management strategies tailored to dialysis modality, age, and gender.

Evaluating the Impact of Workforce Burnout in Emergency Departments Considering Staff Performance and Patient Safety in Quetta: A Systematic Literature Review

2026-01-12T09:42:32+03:00

The problem of burnout among emergency department healthcare professionals affects worldwide healthcare systems most severely in limited-resource environments especially in Quetta Pakistan. This research analyzes the effect of working burnout on emergency department staff performance and patient protection in Pakistani medical units through PEO (Population, Exposure, Outcome) methodology with PRISMA analysis. A total of five research-based studies appeared in the timeframe from 2016 to 2024 and underwent theme-based analysis. Research evidence reveals significant emotional exhaustion and depersonalization together with psychological distress within the ED workforce while showing their connection to diminished job performance and workforce dissatisfaction and inferior patient safety operations. Multiple studies showed that work-related challenges and insufficient support systems and societal discrimination regarding mental health together fueled this problem. This review demonstrates the importance of immediate policy changes and institution-based mental health aids to reduce burnout and increase healthcare effectiveness across Quetta's medical facilities.

Effects of Intermittent Fasting on Metabolic, Hemodynamic, and Cardiovascular Risk Parameters in Adult Subjects

2026-01-12T11:32:14+03:00

Intermittent fasting has emerged as a popular dietary intervention with potential metabolicand cardiovascular effects. The present study was conducted to evaluate the impact of onemonth of intermittent fasting on anthropometric indices, glycemic parameters, lipid profile, inflammatory markers, and hemodynamic variables

Chronic Prostatitis and Causative Organisms

2026-01-12T11:45:03+03:00

Background: Chronic prostatitis is a frequently encountered urological condition with a heterogeneous etiology. While gram-negative bacteria remain the predominant causative agents, atypical and sexually transmitted organisms contribute significantly to disease burden, particularly in sexually active men.

Objective: To identify the spectrum of causative organisms in patients diagnosed with chronic bacterial prostatitis using conventional culture and nucleic acid amplification tests (NAAT).

Materials and Methods: This prospective observational study was conducted between March 2023 and November 2025 at a tertiary care hospital. Men aged 20–50 years presenting with recurrent urinary tract infection and genitourinary symptoms suggestive of chronic prostatitis were included. Patients with acute prostatitis or without identifiable organisms were excluded. All patients underwent detailed clinical evaluation, urine culture, expressed prostatic secretion analysis, and NAAT for sexually transmitted pathogens when indicated.

Results: A total of 146 patients were diagnosed with chronic bacterial prostatitis. Escherichia coli was the most common organism isolated on conventional culture (41%). NAAT identified atypical and sexually transmitted organisms in 10.9% of cases, predominantly Chlamydia trachomatis. Patients with multiple sexual partners showed a higher prevalence of atypical organisms.

Conclusion: Chronic prostatitis has a diverse microbiological profile. Along with conventional urine culture, NAAT improves detection of atypical and sexually transmitted pathogens and should be incorporated into diagnostic protocols for appropriate management.

A HISTOLOGICAL OBSERVATION ON DEVELOPMENT OF HUMAN FETAL LUNG -A RETROSPECTIVE FETAL AUTOPSY STUDY

2026-01-12T17:02:09+03:00

Background: This paper focuses on Lung histogenesis study in normal human foetuses ranging from11 to 40 weeks of gestation age. The process of histogenesis is nothing but a series of events thatoccur during the development of a tissue. In this process undifferentiated cells attain full functional maturity.

ANATOMICAL VARIATIONS IN PELVIC PART OF SCIATIC NERVE, A CADAVERIC STUDY AND ITS CLINICAL IMPLICATIONS

2026-01-12T17:21:15+03:00

Background: Sciatic nerve is the largest and widest nerve in the human body. It is also called asthe ischiatic nerve or ischial nerve. It is the main continuation sacral plexus. It supplies posteriorcompartment thigh, leg and foot. Understanding the anatomical variations of the sciatic nerve is essential for clinicians and surgeons

Triple-Arm Randomized Trial of Intraperitoneal Levobupivacaine, Dexmedetomidine, and Placebo for Analgesia After Laparoscopic Cholecystectomy

2026-01-12T17:29:52+03:00

Background: Pain after laparoscopic cholecystectomy is still a major clinical issue. The use ofanalgesic agents through intraperitoneal instillation may lead to better multimodal analgesia.The current research was aimed at comparing the analgesic effects of levobupivacaine and dexmedetomidine against placebo

Effects of a 12-Week Strength and Circuit Training Programme on Explosive Power and Cardiorespiratory Endurance in College-Level Football Players

2026-01-13T08:56:23+03:00

Background: Football performance depends heavily on the integration of neuromuscular power and cardiorespiratory efficiency. Late adolescence and early adulthood represents a critical period during which targeted training interventions may induce favorable physiological adaptations.

Objective: The present study aimed to evaluate and compare the effects of strength training and circuit training on explosive power and cardiorespiratory endurance in college-level football players.

Methods: Sixty male football players aged 18–21 years were randomly assigned to a strength training group, a circuit training group, or a control group (n = 20 each). The experimental groups underwent a structured 12-week training programme, while the control group continued routine physical activity. Explosive power was assessed using the standing broad jump test, and cardiorespiratory endurance was evaluated using the 12-minute run/walk test. Data were analyzed using analysis of covariance (ANCOVA) at a 0.05 level of significance.

Results: Both strength training and circuit training produced significant improvements in explosive power and cardiorespiratory endurance compared to the control group (p < 0.05). Circuit training resulted in greater enhancement of explosive power, whereas strength training elicited superior improvements in cardiorespiratory endurance.

Conclusion: The findings suggest that both training modalities induce meaningful physiological adaptations in college-level football players. Incorporating strength and circuit training within youth conditioning programmes may optimize neuromuscular performance and cardiovascular efficiency essential for football performance.