Journal of University Medical & Dental College

Surviving a Rare Brain Cancer Without a Safety Net: The Burden of Glioblastoma on Families in Pakistan

Maha Maqbool — 2026-03-30

Exploring medical students' perceptions of the flipped classroom model: A cross- sectional study

Aakash kumar — 2026-03-30

BACKGROUND AND OBJECTIVE: The flipped classroom model in medical education is gaining more attention as an innovative way to enhance engagement and active learning. Therefore, this study explores medical students' perceptions of the flipped classroom model and investigates whether preferences change across different years of study at a medical college in Karachi, Pakistan. To explore medical students' perceptions of the flipped classroom model in a medical college in Karachi, Pakistan.

METHODOLOGY: This cross-sectional study, conducted at Bahria University Health Sciences Campus, Karachi, included 298 randomly sampled students. Structured questionnaires were used to collect data, and SPSS 23 was used for analysis. Associations (p < 0.05) were evaluated using the Fisher test. All participants provided their informed permission, and ethical approval was obtained.

RESULTS: Most students rated their knowledge of the flipped classroom model as average to limited, with significant variations across years of study (p = 0.001). Preferences varied, with 38% of favoring a blended teaching approach, while a traditional lecture-style was more popular among year students. Screen-based educational activities were frequently engaged in by 43.9% of students, and online resources were the preferred choice for tackling challenging topics, especially among (76%).

CONCLUSION: The flipped classroom is perceived differently by medical students over time, according to research, which highlights the need for flexible teaching strategies that combine traditional and flipped methods to improve academic performance and student engagement.

Chest trauma management; An experience at trauma center, postgraduate medical institute, Quetta

Muhammad Arif Khan — 2026-03-30

BACKGROUND & OBJECTIVE: Chest trauma is a leading cause of global morbidity and mortality, especially among young adults. The rising incidence in Pakistan underscores the need for local research to inform effective management. The objective of the current study is to determine the variety of chest trauma and its associated factors among patients admitted to the Trauma Centre, Postgraduate Medical Institute (PGMI), Quetta.

METHODOLOGY: A cross-sectional quantitative study was conducted at Trauma Centre PGMI Quetta from March 1, 2024, to August 31, 2024, after obtaining ethical approval (PGMIQ/ERC/16/2024). We reviewed 200 chest trauma patients, admitted to the surgical unit of the trauma centre and analyzed the data. Fisher tests analyzed the relationship between management approaches and patient status upon arrival, as well as thoracotomy findings and initial management approaches.

RESULTS: Of the 200 patients, 167 (83.5%) were male, and 33 (16.5%) were female. Most (69.5%) had injuries from road traffic accidents or falls. Rib fractures occurred in 75 (37.5%) patients, with 40 (20%) on the left side and 35 (17.5%) on the right. Fisher’s Exact test revealed significant associations between management approach and patient arrival status (p = 0.013) and between management approach and thoracotomy findings (p = 0.000), respectively.

CONCLUSION: Chest trauma is a significant health concern, particularly among young males, often caused by road accidents and falls. While most cases involve blunt trauma and can be managed conservatively, thoracotomy is typically required for hemothorax cases with vascular or pulmonary injuries.

Frequency of Hyponatremia and Its Effect on Complications in Decompensated Chronic Liver Disease (DCLD)

Toqeer Ahmad — 2026-03-31

BACKGROUND & OBJECTIVE: Hyponatremia, an electrolyte imbalance, is prevalent in decompensated chronic liver disease (DCLD) and is linked to an increased risk of complications, including hepatic encephalopathy, ascites, hepatorenal syndrome, and variceal bleeding. The study aims to assess the frequency of hyponatremia and its impact on various complications in patients with DCLD.

METHODOLOGY: A cross-sectional study was conducted on 120 DCLD patients aged 15-75 years at Allama Iqbal Memorial Teaching Hospital from January to June 2023. The sample size of 120 patients was stratified using the Child-Pugh classification, and complications were assessed, including ascites, hepatic encephalopathy, hepatorenal syndrome, variceal bleeding, and spontaneous bacterial peritonitis. The data analysis was conducted using SPSS version 23. Chi-square test was applied, and a p-value of ≤ 0.05 was considered statistically significant.

RESULTS: The frequency of hyponatremia was 40%, with 48 patients affected. Complications were more common in patients with hyponatremia, including ascites (80.6% in males, p = 0.000; 94.1% in females, p = 0.005), hepatic encephalopathy (45.2% in males, p = 0.026), and hepatorenal syndrome (9.7% in males, p = 0.016). Variceal bleeding was significantly associated with hyponatremia (22.6% in males, p = 0.004).

CONCLUSION: Hyponatremia is a frequent and clinically significant complication in DCLD, associated with higher morbidity and mortality. Early detection and management are crucial for improving patient outcomes.

From Hidden to Highlighted: Students' Perceptions of the PERLs Module in Undergraduate Medical Education in Pakistan

Noor-i-Kiran Naeem — 2026-03-31

BACKGROUND &OBJECTIVE: In Pakistan's undergraduate medical education context, the PERLs (Professionalism, Ethics, Research, and Leadership) module has been introduced to align with modern integrated curricula. This study aimed to explore students' perceptions of the PERLs module and its influence on professional development and clinical practice within a private medical college in Pakistan.

METHODOLOGY: A mixed-method sequential explanatory study comprised a cross-sectional survey of 78 medical students, followed by in-depth interviews of 8 participants to gain richer qualitative insights. Survey data were analyzed using descriptive statistics, while interview transcripts underwent thematic analysis.

RESULTS: Survey findings demonstrated strong student agreement on the relevance and applicability of the PERLs module to medical practice, with mean ratings ranging from 4.077 to 4.462(out of 5). Students acknowledged the module’s role in preparing them for ethical challenges, enhancing clinical practice skills, and advancing professional development. Qualitative themes reinforced these outcomes, highlighting the module’s practical utility in addressing real-world ethical dilemmas, strengthening research and clinical reasoning, and cultivating teamwork, communication, and leadership. Suggestions for improvement emphasized the need for more accessible resources, expanded practical exposure, and improved time allocation within the module.

CONCLUSION: Students viewed the PERLs module as an effective bridge between theory and practice, supporting their growth as competent and ethical future physicians. With targeted enhancements to resources, practical engagement, and time management, the module has strong potential to advance professional identity formation in medical education.

Vascular risk assessment in female migraineurs

Aysha Zaheer — 2026-03-31

BACKGROUND & OBJECTIVES: Migraine is the most common disabling neurological disorder twice as common in females as compared to males. It has been associated to increased vascular risk leading to cardiovascular disease and stroke. The underlying pathophysiology is not yet clear as the results are inconsistent. This study was designed to see if migraine alone, excluding traditional risk factors, is a predictable cause of untoward vascular events.

METHODOLOGY: A cross-sectional comparative study was conducted on female migraineurs with a history of varying migraine duration, compared to controls. Participants were divided into three groups of 28 subjects each. Serum homocysteine, highly sensitive C-Reactive Protein and total cholesterol were measured. Data was analyzed with SPSS version 17.0.

RESULTS: Median with interquartile range was calculated. Comparison of the groups using the Kruskal-Wallis ANOVA revealed no significant difference among the three groups. The estimated p-value for Hcy, hsCRP and total cholesterol was 0.479, 0.819 and 0.978, respectively.

Levels of Hcy, hsCRP, and total cholesterol were also categorised as normal, moderately elevated, and highly elevated. A non-significant difference was observed among the groups.

CONCLUSION: The vascular risk profile of migraineurs does not differ from that of healthy females, even if the migraine is present for a longer duration.

Comparison of CT findings between pyogenic meningitis and tuberculosis meningitis at a tertiary care Hospital

Asim khan — 2026-04-11

BACKGROUND & OBJECTIVES: Early detection and management of tuberculous meningitis can improve its prognosis. TBM and pyogenic meningitis (PM) have overlapping clinical presentations. The objective of this study was to determine the frequency of TBM and PM among children with meningitis and to compare their CT findings.

METHODOLOGY: This study was conducted in the Department of Paediatrics, The Children’s Hospital, Lahore, from 1^st January to 31^st June 2025. A total of 94 children aged 4 months to 14 years who fulfilled the diagnostic criteria for TBM or PM were included. After informed consent, contrast-enhanced CT scans were performed and assessed for basal enhancement, hydrocephalus, infarction, and intracranial tuberculoma. Data were analyzed using SPSS version 20. Chi-square test was applied, with p < 0.05 considered significant.

RESULTS: Among the study population, 49 children (52.1%) had PM and 45 (47.9%) had TBM. Basal enhancement was more frequent in TBM (77.8% vs 51.0%, p = 0.020). Hydrocephalus (55.6% vs 32.7%, p = 0.012), infarction (42.2% vs 22.4%, p = 0.018), and intracranial tuberculomas (35.6% vs 10.2%, p = 0.001) were also significantly higher in TBM.

CONCLUSION: CT imaging is a useful tool to differentiate TBM from PM in children. Findings such as basal cisternal enhancement, hydrocephalus, infarction, and tuberculomas support the diagnosis of TBM and can facilitate early recognition and treatment in resource-limited environments.

We rely on transcutaneous bilirubin in fast paced NICU as compared to serum total bilirubin

Maryam — 2026-04-11

BACKGROUND & OBJECTIVE: Neonatal hyperbilirubinemia is common and requires timely detection to prevent bilirubin-induced neurological dysfunction. Serum total bilirubin (STB) is the diagnostic gold standard but is invasive and time-consuming, whereas transcutaneous bilirubin (TcB) offers a rapid, non-invasive screening alternative. To evaluate the correlation and agreement between TcB and STB in late preterm and term neonates and to assess the reliability of TcB as a NICU screening tool.

METHODOLOGY:It is a Cross-sectional analytical study. A study was conducted at the Neonatal ICU, Combined Military Hospital Kharian, Pakistan, from June to August 2025. A total of 159 jaundiced neonates (35–37 weeks) were included. TcB values obtained with the Dräger JM-105 were compared with simultaneous STB measurements. Data were stratified by gestational and postnatal age. Statistical tests included Shapiro–Wilk, Pearson/Spearman correlation, Intraclass Correlation Coefficient (ICC), and Bland–Altman analysis.

RESULTS: Mean TcB was 267.14 ± 77.84 µmol/L, and STB was 276.78 ± 80.12 µmol/L. All subgroups showed strong positive correlations (r/ρ > 0.78, p < 0.01). ICC values ranged from 0.757 to 0.952. Bland–Altman analysis showed a mean bias of –9.64 µmol/L, with limits of agreement from –49.1 to +29.8 µmol/L.

CONCLUSIon: TcB demonstrates strong correlation and good agreement with STB and can serve as a reliable screening tool in resource-limited NICUs. However, consistent underestimation and wide limits of agreement limit its use as a stand-alone diagnostic test. STB confirmation is recommended when values approach treatment thresholds.

Comparison of retention of posterior class i composite resin fillings done by two different incremental and bulk fill techniques

Abdul Manan — 2026-04-13

BACKGROUND AND OBJECTIVES: Use of Composite fillings is a common and preferred practice in dentistry. Dental surgeons use various techniques to get maximum retention and better aesthetics using composite resins. The purpose of our study was to compare the retention of posterior class I fillings of composite resin fillings using increments and single-placement techniques.

METHODOLOGY: This randomized control trial study (No. #3336-R-A25) was conducted at the Restorative Department of Frontier Medical and Dental College, Abbottabad, from 10th July 2024 to 10th January. 2025. It consisted of 104 participants with occlusal class I cavities of at least 3mm deep. The Filtek Z250 (3M, ESPE) filling material was used in two restorative techniques (incremental and single-fill). Patients were divided into two groups, A and B, each of 52 participants. In Group A, the incremental filling technique was used; in Group B, the single filling technique was used. After 6 months, filling retentions were evaluated. Data was analyzed by using SPSS version 23.

RESULTS: After 6 months, 90.4% retention, 9.6% non-retention, and 0% partial loss in the incremental group, whereas 84.6% retention, 9.6% non-retention, and about 5.8% partial loss in the single-fill group were observed (Figure I). It showed no statistically significant difference in retention between the two groups using two different techniques (p > 0.374).

CONCLUSION: This study showed that the retention of incremental fill composite is almost equal to that of the single fill resin in class I fillings of posterior teeth. It is mainly the skill of a dental surgeon in performing composite fillings with perfection, following the protocol and the manufacturer’s instructions.

Both Perimenopausal Vasomotor Symptoms and associated anxiety disorder be managed with Escitalopram : An experience at a tertiary care Hospital

Muhammad Mohsin Rana — 2026-04-11

BACKGROUND & OBJECTIVE:
Perimenopausal vasomotor symptoms (VMS) are distressing and often trigger mood disorders. Selective Serotonin Reuptake Inhibitors (SSRIs) may improve both. This study evaluated the incidence and severity of anxiety in menopausal women with VMS and assessed the efficacy of Escitalopram in managing both conditions.

METHODOLOGY:
An interventional, multicenter, observational study was conducted from January to July 2023 at Rai Medical College, Sargodha, and private clinics. Women aged 30–75 years with VMS (per STRAW staging) and anxiety were included. Exclusions were HRT, prior SSRIs/NSRIs, hypersensitivity, certain neurological/psychiatric disorders, malignancy, and major systemic diseases. The Vasomotor domain of the MENQOL questionnaire was used for the Composite Symptoms Severity Index (CSSI), and anxiety was measured using the GAD-7 scale. Patients with GAD >4 or CSSI >50 received Escitalopram 10 mg daily. Scores were reassessed at 8 and 12 weeks. Data were analyzed using SPSS 25, chi-square, and Fisher’s exact test.

RESULTS:
A total of 346 patients were enrolled in the study. Baseline anxiety (minimal, mild, moderate, severe) varied across CSSI groups. By week 12, the proportion with minimal anxiety increased markedly (e.g., from 36% to 75% in one group), while moderate and severe anxiety declined across all groups. CSSI scores also showed consistent improvement from 8 to 12 weeks.

CONCLUSION:
Escitalopram significantly reduced both anxiety and vasomotor symptom severity in perimenopausal women, with improvements evident by week 8 and sustained through week 12.