Muhammad Farrukh Habib

Background: Physical health factors, notably physical activity and sleep quality, play a crucial role in adolescents' academic performance. Regular physical activity has been associated with enhanced cognitive functions, including improved concentration and memory, as well as better mood regulation. Adequate sleep, typically 8–10 hours per night for teenagers, is essential for processes such as memory consolidation and maintaining attention. Insufficient sleep and physical inactivity have been linked to diminished academic outcomes and increased absenteeism. Objective: This study aimed to assess the levels of physical activity and sleep patterns among secondary school teenagers and to evaluate their academic performance. Methods: A descriptive cross-sectional study was conducted among 384 students from private secondary schools in Bahawalnagar. Participants were selected using a census sampling technique. Data collection instruments included the International Physical Activity Questionnaire (IPAQ) to measure physical activity levels, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, and the Academic Performance Scale (APS) to evaluate academic outcomes. Descriptive statistics, including means, standard deviations, frequencies, and percentages, were calculated using SPSS version 27. Results: Among the participants, 32.8% exhibited low to moderate levels of physical activity. Regarding sleep quality, 37.2% reported good sleep, while 60% experienced disturbed sleep patterns. Despite these physical health challenges, 65.6% of the students achieved excellent academic performance. The analysis indicated that both physical activity levels and sleep quality had a substantial impact on academic outcomes. Conclusion: The findings suggest that a significant portion of secondary school teenagers have suboptimal physical activity levels and sleep patterns. Nonetheless, a majority attained excellent academic performance, indicating that additional factors may contribute to academic success. Interventions aimed at improving physical activity and sleep quality could potentially enhance academic outcomes.

Background: Postoperative pain is a common concern following dental procedures, affecting patient comfort and recovery. Effective pain management is crucial, with irrigating solutions playing a key role in endodontic treatments. Among these, 2% chlorhexidine and 5.25% sodium hypochlorite are widely used due to their antimicrobial and tissue-clearing properties, respectively. While chlorhexidine is known for its lower cytotoxicity, sodium hypochlorite offers stronger antibacterial effects but may increase pain. This study aims to compare the effectiveness of these two solutions in reducing postoperative pain, helping clinicians make informed choices to improve patient outcomes. Objective: To determine the efficacy of 2%chlorhexidine and 5.25% Sodium Hypochlorite irrigating solution on post operative pain Methods: This quasi-experimental interventional study was conducted at Sandeman Provincial Hospital Quetta from October 2021 to October 2023. A total of 312 patients experiencing postoperative pain were randomly assigned to two groups, each with 156 participants. Group A received 2% chlorhexidine as the irrigating solution, while Group B was treated with 5.25% sodium hypochlorite. Postoperative pain, the primary outcome measure, was assessed using the Visual Analog Scale (VAS) at baseline, on the 3rd day, the 7th day, and at a 2-week follow-up. Data were collected, entered, and analysed using SPSS version 26.0, with the chi-square test applied to assess group differences, considering p < 0.05 as statistically significant. Results: Out of 312 patients, with 160 males (51.3%) and 152 females (48.7%). Patients were divided into 2 groups. Group A (2% chlorhexidine) reporting a mean VAS score of 6.3 (±1.2) and Group B (5.25% sodium hypochlorite) showing a mean score of 6.5 (±1.3). By the 2-week follow-up, both groups reported reductions in pain scores. Group A had a mean VAS score of 1.5 (±1.1), and Group B had a mean score of 2.8 (±1.4). A p-value of < 0.05 was considered statistically significant, which affirmed the effectiveness of 2% chlorhexidine over 5.25% sodium hypochlorite in managing postoperative pain. Conclusion: 2% chlorhexidine is significantly more effective than 5.25% sodium hypochlorite in reducing postoperative pain following non-surgical root canal treatment

Background: Surgical site infections (SSIs) are among the most common complications following abdominal surgeries, including hernia repairs. These infections significantly contribute to patient morbidity and healthcare burden, especially in resource-limited settings. Preoperative skin antisepsis is a critical factor in SSI prevention, with agents such as povidone iodine (PI) and chlorhexidine alcohol (CA) frequently used. However, their comparative efficacy in reducing SSI rates remains an area of clinical interest, necessitating further exploration. Objective: To compare the prevalence of SSIs in patients undergoing preoperative skin preparation with povidone iodine versus chlorhexidine alcohol during abdominal hernia repair. Methods: This comparative non-randomized controlled trial was conducted at CMH, Rawalpindi, from May 2022 to February 2023. A total of 300 patients scheduled for hernia repair were enrolled and divided equally into two groups: group A (PI) and group B (CA). Group allocation was performed using a single-blinded technique to minimize bias. Preoperative skin preparation was conducted with a 10% PI solution for group A and a CA solution (2% chlorhexidine in 70% alcohol) for group B. Patients were followed up for 30 days post-surgery to evaluate the presence of SSIs, defined as purulent discharge, fever, elevated white blood cell count, swelling, or erythema at the surgical site. Data were analyzed using SPSS version 22, with statistical significance set at p ≤ 0.05. Results: The study included 300 patients with a mean age of 40.42 ± 8.71 years, of whom 124 (41.30%) were male and 176 (58.70%) were female. The overall SSI frequency was 69 (23.00%). SSI was significantly higher in the PI group compared to the CA group, with rates of 34.00% (51/150) versus 12.00% (18/150), respectively (p < 0.001). Conclusion: Chlorhexidine alcohol is significantly more effective than povidone iodine in reducing the prevalence of SSIs in abdominal hernia surgeries. Its use should be preferred for preoperative skin antisepsis to improve surgical outcomes.

Background: Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyneuropathy that often follows infections, characterized by varying degrees of motor weakness, sensory impairment, and autonomic dysfunction. The disease has multiple subtypes, including Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) and Acute Motor Axonal Neuropathy (AMAN), with diverse functional outcomes. Plasma exchange (PLEX) has emerged as a cost-effective and efficient therapeutic option in resource-limited settings, but its impact on various subtypes and functional outcomes requires further exploration. Objective: To evaluate the effectiveness of plasma exchange (PLEX) as a treatment for GBS and to prospectively analyze the clinical and functional outcomes of patients aged 16 and above across different subtypes of GBS. Methods: This prospective observational study was conducted over six months at a tertiary care hospital in Rawalpindi. Participants aged 16 and older, meeting inclusion criteria, underwent detailed history taking, clinical examination, and electrophysiological studies, including Forced Vital Capacity (FVC) and EMG, to categorize GBS subtypes. Functional disability was assessed using the Hughes GBS Disability Scale. All patients received five sessions of PLEX initiated on the day of admission. Outcomes were evaluated on the seventh day. Data analysis was performed using SPSS, with quantitative variables presented as means and qualitative variables as percentages. Results: A total of 40 participants were included, with a mean age of 38.97 ± 5.4 years. Males constituted 63% (n = 25) and females 37% (n = 15). Participants were categorized by Hughes GBS Disability Score into Group 1 (n = 5, Score 2), Group 2 (n = 12, Score 3), Group 3 (n = 20, Score 4), and Group 4 (n = 3, Score 5). Based on EMG findings, 57.5% (n = 23) had AIDP, 30% (n = 12) had AMAN, and 12.5% (n = 5) had AMSAN. After seven days of treatment, 80% of patients in Groups 1 and 2 showed significant improvement, while 75% in Group 3 and 33% in Group 4 demonstrated partial recovery. AIDP had the best response to PLEX, with 24 patients showing improvement, compared to 1 patient with AMAN and 2 with AMSAN. Conclusion: Patients with GBS exhibit varying functional disabilities and outcomes across different subtypes. PLEX demonstrated significant improvement, particularly in patients with lower initial disability scores and the AIDP subtype. Early intervention and subtype-specific management are critical for optimizing outcomes.

Background: Asthma is one of the most common chronic respiratory diseases in children and adolescents, and is associated with inflammation and hyper-responsiveness of the airways. Multiple studies have suggested a potential link between lower levels of vitamin D and increased severity & frequency of asthma exacerbations. Objective: To find out the incidence of low vitamin D in children with signs of acute exacerbation. Methods: This was a cross-sectional study conducted at the Pediatrics department of PAEC General Hospital, Islamabad from January, 2023 to March, 2024. 94 pediatric patients aged 5 – 16 years, with clinical diagnosis of asthma according to the Global Initiative for Asthma (GINA) guidelines, and admission with an acute exacerbation of asthma were included into the study. Blood samples were taken for serum vitamin D levels and levels <20ng/ml was considered vitamin D deficiency. Results: Mean age was 10.5 ± 3.2 years. Male and female patients were 58.5% and 41.5%, respectively. The hospitalization rate was slightly higher (60.3%) but the difference was not statistically significant (p=0.18). Mean 25(OH)D levels were significantly lower in patients with severe asthma (12.7 ± 3.5 ng/mL). Vitamin D deficient patients were 58 (61.7%) and insufficient were 25 (26.6%). Conclusion: The findings of this study highlight the importance of vitamin D in pediatric asthma severity and clinical outcomes in children, and role of vitamin D supplementation for prevention of acute episodes.

Background: Exclusive breastfeeding for the first six months is crucial for optimal infant health and development. However, various maternal, neonatal, and environmental factors can influence breastfeeding practices, leading to suboptimal outcomes. Objective: To identify and assess the impact of maternal, pregnancy, birth, and infant factors on exclusive breastfeeding among children under two years of age. Methods: A case-control study was conducted at the Department of Paediatrics, Combined Military Hospital, Kharian, from July 2022 to March 2023. The study included 150 mothers and their children aged over two years. Exclusion criteria encompassed mothers with a history of breast trauma, surgery, irradiation, contraindications to breastfeeding, and neonates with anatomical facial defects. Data were collected on maternal demographics, pregnancy and birth details, infant characteristics, and breastfeeding practices. Statistical analyses, including calculation of adjusted odds ratios (OR) with 95% confidence intervals (CI), were performed to determine associations between various factors and exclusive breastfeeding. Results: The study identified several factors associated with increased odds of not providing exclusive breastfeeding. Premature birth was significantly associated with higher odds (OR: 12.5; 95% CI: 3.3–45.1; p<0.001). Maternal obesity also contributed to increased odds (OR: 3.6; 95% CI: 1.0–12.5; p=0.046). Additionally, maternal depression was linked to higher odds (OR: 18.5; 95% CI: 2.6–134.2; p=0.004). A maternal perception of inadequate milk supply was associated with increased odds (OR: 9.1; 95% CI: 2.4–35.2; p=0.001). Lastly, a non-supportive breastfeeding environment was significantly associated with higher odds (OR: 13.5; 95% CI: 4.2–43.0; p<0.001). Conclusion: Premature birth, maternal obesity, depression, perceived insufficient milk supply, and lack of a supportive environment are significant barriers to exclusive breastfeeding. Addressing these factors through targeted interventions is essential to improve breastfeeding practices and, consequently, infant health outcomes.

Background: Type-II Diabetes Mellitus (T2DM) is a chronic metabolic disorder associated with insulin resistance and hyperglycemia, leading to significant complications. Diabetes Distress, a psychological stressor, negatively impacts self-management and glycemic control in T2DM patients. Cognitive Behavioral Therapy (CBT) has been recognized for its effectiveness in managing psychological issues but its impact on Diabetes Distress and glycemic control remains under-researched.Objective: To evaluate the effect of CBT on Diabetes Distress Score and glycemic control (HbA1c) in patients with T2DM.Methods: This prospective case-control study included 82 patients with T2DM (CBT group = 40, Control group = 42). The CBT group underwent a 10-session structured CBT intervention, while the control group received standard care. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up using Diabetes Distress Scale (DDS) and HbA1c levels. Data were analyzed using repeated measures ANOVA and t-tests.Results: The CBT group showed a significant reduction in DDS (-0.8 ± 0.4, p < 0.001) compared to the control group (-0.2 ± 0.3, p = 0.078). HbA1c levels decreased significantly in the CBT group (-0.7 ± 0.3, p < 0.01) versus the control group (-0.2 ± 0.2, p = 0.083).Conclusion: CBT effectively reduces Diabetes Distress and improves glycemic control in T2DM patients, supporting its integration into routine diabetes management.

Background: Iron deficiency anaemia (IDA) is a prevalent global health problem associated with significant morbidity. Traditional oral iron therapy is often limited by gastrointestinal side effects and poor absorption. Intravenous (IV) iron may provide a faster and more effective alternative.Objective: This study aims to compare the efficacy and safety of IV iron replacement with oral iron supplementation in patients with IDA.Methods: A randomized, single-centre, prospective interventional study was conducted with 200 adult patients diagnosed with IDA. Patients were randomized into two groups: IV iron (ferric carboxymaltose) or oral iron (ferrous sulphate) for 12 weeks. Haemoglobin and ferritin levels were measured at baseline, 6 weeks, and 12 weeks. Treatment adherence and adverse effects were also monitored.Results: The IV iron group showed a significantly higher mean increase in haemoglobin (4.3 ± 1.1 g/dL) compared to the oral iron group (2.7 ± 1.4 g/dL, p < 0.001). Ferritin levels improved by 69.6 ± 14.2 ng/mL in the IV group versus 29.5 ± 10.8 ng/mL in the oral group (p < 0.001).Conclusion: IV iron is more effective and better tolerated than oral iron for IDA management, particularly in scenarios requiring rapid correction.

Background: Stroke is a leading cause of death and long-term disability worldwide, placing a significant burden on healthcare systems. Nurses play a critical role in stroke care, particularly in educating patients post-stroke to prevent recurrence and complications.Objective: To assess the level of knowledge nurses possess regarding patient education after stroke at a tertiary care hospital.Methods: A descriptive, cross-sectional study was conducted from May to July 2024. A total of 249 nurses from various departments at Allied Hospital Faisalabad were included. Data were collected using a structured questionnaire that evaluated nurses' knowledge of stroke definitions, causes, risk factors, and post-stroke interventions. SPSS version 25 was used for data analysis, including descriptive statistics and one-way ANOVA.Results: Of the 249 participants, 98% were female, and 56.2% held a bachelor's degree. Most nurses (81.5%) correctly defined stroke, and 95.6% knew the types of strokes. A significant association was found between higher education levels and knowledge (p = 0.013). However, gaps in knowledge regarding stroke causes and interventions were identified.Conclusion: Nurses demonstrated moderate to high knowledge of post-stroke education, with formal education being a significant predictor. Further training is needed to address knowledge gaps

Background: Dyslipidemia, characterized by elevated total cholesterol, LDL-C, triglycerides, and low HDL-C, is a significant risk factor for cardiovascular disease. Smoking exacerbates these lipid abnormalities, increasing cardiovascular risk, yet the disparities in lipid profiles between smokers and non-smokers are not well defined.Objective: To compare the lipid profiles of smokers and non-smokers and evaluate the extent of dyslipidemia associated with smoking.Methods: A cross-sectional study was conducted with 500 participants (250 smokers, 250 non-smokers) from an urban hospital. Fasting serum samples were collected and analyzed for total cholesterol, LDL-C, HDL-C, and triglycerides. Smoking status was self-reported and validated by cotinine levels. Statistical analysis included ANOVA and multiple regression to assess lipid differences between groups, adjusting for confounders.Results: Smokers had significantly higher total cholesterol (213.4 ± 42.1 mg/dL vs. 197.2 ± 38.7 mg/dL, p < 0.001) and LDL-C (142.7 ± 35.4 mg/dL vs. 126.3 ± 31.6 mg/dL, p < 0.001) and lower HDL-C (44.3 ± 11.2 mg/dL vs. 53.7 ± 12.9 mg/dL, p < 0.001) compared to non-smokers.Conclusion: Smoking significantly worsens dyslipidemia, highlighting the need for targeted smoking cessation interventions to reduce cardiovascular risk