Pakistan Armed Forces Medical Journal
type: channel
description: Pakistan Armed Forces Medical Journal (PAFMJ) is bi - monthly medical journal published by Army Medical College, Rawalpindi, Pakistan. The Pakistan Armed Forces Medical Journal follows "CC BY NC creative commons" licensing https://creativecommons. org/licenses/by-nc/4.0/. PAFMJ is an open access journal and is included in Directory of Open Access Journals (DOAJ). Online ISSN : 2411-8842 Print ISSN : 0030-9648 The journal is recognised by Higher Education Commission (HEC) and PM&DC of Pakistan and is Indexed and abstracted in Scopus. Covered by: Google Scholar
publisher: Army Medical Corps
language: en
publication name: Pakistan Armed Forces Medical Journal
issn: 0030-9648
items: Prof. Brig. Munir Ahmed Cheema (Late)
items: Student-Centered Assessment - Contentions, Reticence and the Way Forward
items: Post-Flood Mental Health Crisis:: Neglected Consequences of Natural Disasters
items: Pioneers of Medical Profession in Pakistan: Contributions of Armed Forces Doctors
items: Genomics and Molecular Services in Developing Economies: a Suggested Road Map to Incorporate Technology in Parallel to the Emerging Landscape of Genetic Service Provision AI AI-Driven Arena
items: Ultrasonographic Measurement of Optic Nerve Sheath Diameter for Detection of Raised Intracranial Pressure in Critically Ill Patients; A Novell, Non-Invasive and Point of Care Test
items: New Dimensions of Pelviperineology:: Integral Theory and Nattive Tissue Repair in Pelvic Floor Disorders
items: Outcome of Distal Humeral Fractures: An Experience to Evolve
items: Clairvoyance in the Perspective of Modern Science
items: A Participatory Approach to Develop Ethical Guidelines for Generative Artificial Intelligence
items: Innovative Surgical Strategies for Morbidly Adherent Placenta: Optimizing Outcomes and Minimizing Maternal Morbidity
items: Telecardiology and Digital Health Innovations for Cardiovascular Care
items: https://pafmj.org/PAFMJ/article/view/13519
items: Barriers to Continuing Medical Education Among Doctors in Tertiary Care Hospitals of Pakistan: a Descriptive Cross-Sectional Study
items: The Scalpel and the Algorithm: Navigating the Ethical Landscape of AI in Medical Writing
items: Efficacy of Progressive Muscle Relaxation in Reducing Psychological Distress and Improving Quality of Life Among Nursing Students: A Feasibility Trial from Pakistan
items: Saphenous Vein Graft vs. Radial Artery Graft: Searching for the Best Second Conduit in Coronary Artery Bypass Grafting
items: The High Cost of a Medicalized Death: Are We Heading in the Right Direction or Is It Time for a Change?
items: Factors Affecting Adherence to Iron-Folic Acid Supplementation During Pregnancy in Rawalpindi
items: The Outcome of Pregnancy in Women with Normal V/S High Salt Intake Presenting in a Hospital of Northern Region of Pakistan
items: Opportunistic Infection in HIV Patients at Tertiary Care Hospital in Rawalpindi
items: Workplace Challenges and their Impact on Quality of Life Among Women in Midlife and Beyond
items: https://pafmj.org/PAFMJ/article/view/13276
items: Frequency and Distribution of Mount-Hume Classification Among Patients Requiring Root Canal Treatment at Armed Forces Institute of Dentistr
items: Enhancing Operative Dentistry and Endodontics Education Through Telehealth: Integrating Digital Learning with Hands-On Training
items: Lifelong Learning and Adaptive Expertise in Faculty Development Programs
items: Crosslinking Salivary Diagnosis with Non-Invasive Insights to Oral Pathology: Novel Systematic Insights to Personalized Medicine in Disease Management
items: Open AccessOriginal Article Anesthetic Efficacy of Supplemental Buccal Infiltration as Compared to Intraligamentary Injection in Treating Mandibular Second Molars with Irreversible Pulpitis
items: Comparison of Metformin and Myoinositol In Improving Insulin Sensitivity of Women with Polycystic Ovarian Syndrome
items: CRP/Albumin Ratio: A Promising Marker of Bacteremia in Neonatal Sepsis in a Tertiary-Care Hospital in Pakistan

Prof. Brig. Munir Ahmed Cheema (Late)
type: item
description: We deeply regret to announce that Prof. Brig. Munir Ahmed Cheema passed away in Rawalpindi due to heart failure. Born in Punjab, Prof. Cheema earned his MBBS from King Edward Medical College, Lahore. He completed a house job in Surgery at Mayo Hospital, then pursued postgraduate and Fellowship training in Orthopaedic Surgery in the UK, followed by advanced training in the USA. Upon his return to Pakistan, Prof. Cheema joined the Pakistan Armed Forces Medical Services on 22nd June 1967. He served as an Orthopaedic Surgeon at various Army and Air Force hospitals. He developed Orthopaedic Departments at several Military Hospitals across the country and significantly advanced orthopaedic care within the Armed Forces.
subject: Obituary
  topic: section
creator: Prof Mahmud Ahmad Akhtar
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-10-31
publication date: 2025-10-31
starting page: 1038
ending page: 1038
doi: 10.51253/pafmj.v75i5.14006

Student-Centered Assessment - Contentions, Reticence and the Way Forward
type: item
description: There is probably more bad practice and ignorance of significant issues in the area of assessment than in any other aspect of higher education. This would not be so bad if it were not for the fact that the effects of bad practice are far more potent than they are for any aspect of teaching. Students can, with difficulty, escape from the effects of poor teaching, they cannot (by definition if they want to graduate) escape the effects of poor assessment”. 1 The last hundred years have witnessed milestone developments in the domain of curriculum development and teaching - learning in medical education The focus of medical education has shifted from the teacher-centeredness to student-centeredness. However, this focus has yet to include assessment practices. Assessment has always been and will remain to be the most critical component of medical education in terms of its impact on the student, the system of education and the regulatory requirements. Learning, being the central outcome of any educational programme, is the main purpose of all educational interventions. Assessment not only authenticates, quantifies and certifies learning but it also evaluates the teachers, educational programme, the systems that are designed to actualize learning and the impact of learning. Therefore, if assessment is not focused on learning it loses its purpose. There is no doubt that assessment drives learning but if it does not follow the purpose for which it was designed, it can disrupt learning with lifelong consequences for the student, the system and the end-user of health care– the patient. 2
subject: Editorial
  topic: section
creator: Ayesha S. Abdullah
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-10-31
publication date: 2025-10-31
starting page: 833
ending page: 835
doi: 10.51253/pafmj.v75i5.14005

Post-Flood Mental Health Crisis:: Neglected Consequences of Natural Disasters
type: item
description: Floods are often put into perspective within the frame of visible destruction, such as houses and agricultural lands ruined, and damaged infrastructure. Still, the psychological damage that they cause to the victims is no less terrible and is left in them even when the water subsides. Research conducted globally has indicated that floods cause recovery booms of depression, anxiety, and post-traumatic stress disorder (PTSD) in societies that are already poor and have weak health systems. Psychological consequences of natural disasters are a crisis to be considered and be included in the disaster preparedness and disaster recovery policies. The systematic review of the consequences of flooding found a linear association with large levels of depression and PTSD particularly among individuals who were displaced or had their means of livelihood destroyed.1 Greater evidence exists on natural disasters confirming the same trends: exposure to natural disasters is a major risk of mood and anxiety disorders and the impact of disasters on mental health is also likely to be long-term over the years.2 Longitudinal support of this image includes one study, which monitored participants both prior to and following floods, and found sharp rises in distress, anxiety, and PTSD symptoms during the post-disaster period.3 It was found that the exposure to disasters enhances prevalence rates of common mental disorders across all settings, but the extent and duration of the impact varies with vulnerability factors.4 However, interventions remain a few. A meta-analysis of prevention strategies found very little evidence of support of psychosocial interventions in the aftermath of natural hazards and stated that there was much to be desired on scalable mental health responses to the flood-affected population.5
subject: Editorial
  topic: section
creator: Haseeb Khaliq
creator: Amna Batool
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S826
ending page: S827
doi: 10.51253/pafmj.v75iSUPPL-6.13898

Pioneers of Medical Profession in Pakistan: Contributions of Armed Forces Doctors
type: item
description: It is nice to remember the pioneers of the medical profession in Pakistan. In the Civil setup, the Armed Forces personnel are generally not well known, and their contributions are often overlooked in published articles. In this article, the contributions of the Armed Forces doctors as pioneers and their role in developing the medical profession in the early period of Pakistan are described. At independence, the Pakistan Armed Forces inherited well-developed psychiatric units at major Military Hospitals with both indoor and outdoor facilities. Military Hospital Rawalpindi had a major psychiatric unit, which also trained postgraduates. Maj M. Shoaib (later Maj Gen) was the Head of the unit. He was trained in psychiatry before the partition and was the first to acquire D.P.M. (Lond) from Pakistan (at that time, it was the major qualification in psychiatry). CMH Lahore had a well-known psychiatrist, Maj Thaker Das. Later, Major General Ishrat Hussain and Brigadier Fazle-Haq made contributions. In the civil institutions, psychiatric units emerged decades later.
subject: Short Communication
  topic: section
creator: Mahmud Ahmed Akhtar
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-08-30
publication date: 2025-08-30
starting page: 824
ending page: 829
doi: 10.51253/pafmj.v75i4.13792

Genomics and Molecular Services in Developing Economies: a Suggested Road Map to Incorporate Technology in Parallel to the Emerging Landscape of Genetic Service Provision AI AI-Driven Arena
type: item
description: 1. Science has never stayed static but has been evolving, revolutionizing, and opening out in 360 degrees. From the prehistoric invention of the wheel to the development of the “James Webb Telescope,” it was all hard work, allowing headway towards the envisioned redefinition of scientific discovery, which has led to the current day scientific boom. What we learn over time is that ‘change’ is the only constant in any human development and discovery. Recent landmark innovations of biotechnology and ambitious exploration of the human genome have allowed mining of the intricate ‘cellular life’ to enlighten our species with DNA and RNA world illuminating us with a tsunami of newer diagnostics and possibly therapeutics.1 Molecular sciences and genomics over recent decades to replace the conventional in clinical science with the potential to emerge as definitive medical tools for diagnostics. It can be an easy deduction to foresee that the genomics era has ushered in fast with more robustness to muscle much-needed depth now needed in clinical diagnostic care.2 The swarming growth of diagnostic markers has steadily entered the clinical corridors, necessitating a nationwide need for ‘standard of care in Molecular Pathology. 3
subject: Editorial
  topic: section
creator: Sikandar Hayat Khan
creator: Muhammad Qaiser Alam Khan
creator: Asma Hayat
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-08-30
publication date: 2025-08-30
starting page: 621
ending page: 621
doi: 10.51253/pafmj.v75i4.13789

Ultrasonographic Measurement of Optic Nerve Sheath Diameter for Detection of Raised Intracranial Pressure in Critically Ill Patients; A Novell, Non-Invasive and Point of Care Test
type: item
description: Objective: To determine the diagnostic accuracy of bedside Ultrasonographic measurement of Optic Nerve Sheath Diameter for detection of raised Intracranial Pressure in critically ill patients in comparison with CT scan brain. Study Design: Prospective longitudinal study Place and Duration of Study: Department of Anesthesia and Critical Care Medicine, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University Islamabad, Pakistan from Jun to Nov 2019. Methodology: Patients with clinical suspicion of raised ICP underwent Ultrasonographic measurement of ONSD by Principal Investigator within one hour prior to shifting of the patients to Radiology suite for CT scan brain to prevent diagnosis bias. The Ultrasonographic measured ONSD value of 5.0 mm was the cutoff limit for detecting raised ICP in our study. The CT scan brain reports were considered positive if findings suggested radiological features of raised ICP like Cerebral edema/effacement of ventricle or cisterns, midline shift or sub arachnoid haemorrhage. The diagnostic accuracy of Ultrasonographic measurement of ONSD for detection of raised ICP was then determined by comparing the results with radiological diagnosis of raised ICP by CT scan brain. Results: We enrolled total 120 patients in this study. The patients included in our study were suffering from different diseases like Traumatic Brain Injury (TBI), Meningitis, Encephalitis, Space Occupying Lesions (SOLs), Eclampsia, Stroke and Metabolic encephalopathy with different percentages. The ultrasonographic measured ONSD value range was from minimum 4.7 to maximum 6.9 with mean value of 6.1 mm. The sensitivity was 95.5%, specificity 91.3%, positive predictive value 93.2%, negative predictive value 98.5% where ultrasonographic measured ONSD value of 5.0 mm was taken as a cutoff limit. In our study ultrasonographic measured ONSD values showed good diagnostic accuracy for raised ICP detection in comparison with CT scan brain. Conclusion:…
subject: Original Articles
  topic: section
subject: Intra Cranial Pressure
  topic: keywords
subject: Optic Nerve sheath diameter
  topic: keywords
subject: Traumatic Brain Injury
  topic: keywords
creator: Rahmat Ullah Khan
creator: Rana Imran Sikandar
creator: Najma Khurshid
creator: Salman Shafi
creator: Abdul Bari
creator: Muhammad Iqbal Memon
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-07-31
publication date: 2025-07-31
starting page: S817
ending page: S821
doi: 10.51253/pafmj.v75iSUPPL-5.13704

New Dimensions of Pelviperineology:: Integral Theory and Nattive Tissue Repair in Pelvic Floor Disorders
type: item
description: Pelviperineology is evolving rapidly, propelled by ground breaking conceptual frameworks and innovative surgical techniques that reshape our understanding and management of pelvic floor disorders. Among these, the Integral Theory— pioneered by Professor Peter Petros—stands out as a transformative paradigm that offers a comprehensive, biomechanical explanation for conditions like anterior and posterior vaginal prolapse, as well as urinary incontinence.1 The Integral Theory fundamentally redefines pelvic floor dysfunction as a consequence of ligamentous and fascial laxity, disrupting the intricate balance of forces required for normal pelvic organ support and function.1,2 The ligament-based system offers a new way forward. It is a different way of thinking. In contrast to previous thinking; the ligament-based system aims primarily to treat the pelvic symptoms even if prolapse is minimal. This is because even a slightly altered anatomy can cause severe symptoms.
subject: Editorial
  topic: section
creator: Nazli Hameed
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-07-31
publication date: 2025-07-31
starting page: S639
ending page: S640
doi: 10.51253/pafmj.v75iSUPPL-5.13703

Outcome of Distal Humeral Fractures: An Experience to Evolve
type: item
description: Objective: To evaluate the functional outcomes of distal humerus fracture fixation using locking plates and screws, focusing on fracture reduction, fixation stability, and post-operative recovery as measured by the Mayo Elbow Performance Score (MEPS). Study Design: Cross sectional study. Place and Duration of Study: Pakistan Navy Station Shifa Hospital, Karachi Pakistan, from Jan 2019 to 30 Jun 2021. Methodology: A total of 19 patients aged 18-65 with closed distal humerus fractures were included in the study. All patients underwent open reduction and internal fixation (ORIF) using locking plates. The primary outcome was functional recovery assessed using the Mayo Elbow Performance Score (MEPS) at 3 and 6 months post-operatively. Secondary outcomes included complication rates, time to union, and patient adherence to post-operative rehabilitation. Results: At 6 months, the mean MEPS score was 72.37±8.39, with significant improvement from the 3-month follow-up. Males showed better recovery than females (p=0.032). Two patients (10.5%) experienced mild surgical site infections, and one patient (5.3%) had delayed union. Notably, 89.5% of patients missed regular rehabilitation sessions, which negatively impacted their functional outcomes. Fracture union occurred in an average of 20 weeks. Conclusion: Locking plate fixation provides stable fracture fixation and satisfactory functional outcomes for distal humerus fractures. Gender and compliance with rehabilitation were significant factors influencing the outcomes in this study.
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Elbow Joint, Fracture Fixation, Humeral Fractures, Outcome Assessment.
  topic: keywords
creator: Syed Faraz Anwar
creator: Syed Sheheryar Anwar
creator: Shahid Iqbal
creator: Syeda Lyba Onaiz
rights: Copyright (c) 2025 Syed Faraz Anwar, Syed Sheheryar Anwar, Shahid Iqbal, Syeda Lyba Onaiz https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S828
ending page: S831
doi: 10.51253/pafmj.v75iSUPPL-6.13587

Clairvoyance in the Perspective of Modern Science
type: item
description: Man has been fascinated by the phenomenon of “Clairvoyance” since ages. Whether one believes in its reality or not, one is still attracted to the possibility of seeing beyond the physical senses and obtaining help from unconventional and supernatural powers. The term “clairvoyance” comes from a combination of two French words; “Clair” meaning clear and “voyant” meaning vision. In other words, it refers to one’s ability to sense information without using any known sensory medium, hence the terms extrasensory perception (ESP), “sixth sense” etc. Clairvoyance or “Paranormal beliefs” relate to experiences that have not been scientifically analyzed or proven.1 A poll conducted in 2005 in United States of America, having a sample size of 1002, found that 55% subjects had faith in spiritual healing of the body through mind, 41% believed in ESP and 31% believed in the existence of mental telepathy.2
subject: Editorial
  topic: section
creator: Palvasha Waheed
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-06-30
publication date: 2025-06-30
starting page: 428
ending page: 429
doi: 10.51253/pafmj.v75i3.13610

A Participatory Approach to Develop Ethical Guidelines for Generative Artificial Intelligence
type: item
description: Objective: To explore the perceptions of supervisors and postgraduate students on the ethical use of Artificial Intelligence (AI) in thesis writing. Study Design: Qualitative Exploratory Study. Place and Duration of Study: Riphah International University Rawalpindi, Pakistan from Jan to Jun 2024. Methodology: Focus group discussions were employed to gather data from 20 participants, consisting of university supervisors and postgraduate students. Thematic analysis was performed using ATLAS.ti 9 to identify recurring themes related to the ethical use of AI in thesis writing. Results: Five key themes emerged from the analysis: transparency, academic integrity, personal development, data privacy, and supervision. Both students and supervisors expressed concerns about the ethical use of AI, particularly around issues like plagiarism, over-reliance, and data security. Supervisors also emphasized the need for institutional policies to regulate AI usage, while students perceived AI as a tool for enhancing their academic skills. Conclusion: There is a critical need for comprehensive ethical guidelines to govern the use of AI in academic research, particularly in thesis writing. Engagement of key stakeholder including academic supervisors, students, and institutional authorities in the formulation of these guidelines provided a balanced approach in identifying the benefits of AI while addressing concerns related to academic integrity, transparency, and data privacy.
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Artificial Intelligence, Ethical Guidelines, Supervisors' Perceptions, Students' Perceptions
  topic: keywords
creator: Fatima Shaukat
creator: Zainab Kamal
creator: Rehan Ahmed Khan
creator: Madiha Sajjad
creator: Irum Tassaduq
creator: Salma Ambreen
rights: Copyright (c) 2025 Fatima Shaukat, Zainab Kamal, Rehan Ahmed Khan, Madiha Sajjad, Irum Tassaduq, Salma Ambreen https://creativecommons.org/licenses/by-nc/4.0
date: 2025-10-31
publication date: 2025-10-31
starting page: 1029
ending page: 1034
doi: 10.51253/pafmj.v75i5.13606

Innovative Surgical Strategies for Morbidly Adherent Placenta: Optimizing Outcomes and Minimizing Maternal Morbidity
type: item
description: Objective: To analyze maternal outcomes associated with different surgical approaches during cesarean section for morbidly adherent placenta. Study Design: Prospective longitudinal study. Place and Duration of Study: Obstetrics & Gynecology Departments of Combined Military Hospital Sialkot, Quetta, Kharian, Rawalpindi, Pakistan from Jan 2015 to Dec 2024. Methodology: This study analyzed 252 women. Patients underwent five types of surgical intervention at time of cesarean section: bilateral internal iliac artery ligation followed by hysterectomy, hysterectomy followed by bilateral internal iliac ligation, hysterectomy alone, placenta left in situ followed by Injection Methotrexate and bilateral internal iliac ligation followed by myometrial resection. Outcomes assessed included the operative time, number of transfusions, duration of hospital stay, incidence of re-laparotomy and postoperative sepsis. Results: A total of 252 patients were included. Age group ranged between 26 to 40 years (Mean 34.4±3.3), the gestational age was between 34 to 37 weeks (Mean 35.6±0.94) and the mean BMI was 29.6 Kg/m2±1.9. Bilateral internal iliac ligation followed by hysterectomy was done in 138(54.8%), hysterectomy followed by Bilateral internal iliac ligation in 71(28.2%), hysterectomy in 27(10.7%), placenta left in situ in 2(0.8%) and myometrial resection in 14(5.6%) patients. The median hospital stay was 5 days, patients who did not undergo internal iliac ligation required more transfusions as compared to other surgical approaches (p<0.001) Conclusion: There is variability in clinical outcomes with different surgical approaches for morbidly adherent placenta during cesarean section. The surgical procedures incorporating bilateral internal iliac artery ligation were associated with reduced intraoperative blood loss and improved outcomes.
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Blood transfusion, Hysterectomy, Hemorrhage, Morbidly adherent placenta
  topic: keywords
creator: Saira Saeed
creator: Uzma Gul
creator: Uzma Urooj
creator: Sumaira Khan
rights: Copyright (c) 2025 Saira Saeed, Uzma Gul, Uzma Urooj, Sumaira Khan https://creativecommons.org/licenses/by-nc/4.0
date: 2025-10-31
publication date: 2025-10-31
starting page: 1023
ending page: 1028
doi: 10.51253/pafmj.v75i5.13604

Telecardiology and Digital Health Innovations for Cardiovascular Care
type: item
description: Cardiovascular disease remains the leading global health concern,1 with remote populations often facing barriers to timely and specialized cardiac care.2 Every 36 seconds, a life is lost to cardiovascular disease (CVD)—yet for more than 6 billion people, accessing specialized cardiac care remains a distant hope. Telecardiology, a transformative technology, integrates telemedicine with wearable sensors and Al analytics to remotely diagnose and manage heart conditions.3 This approach aims to enhance medical excellence and operational readiness within cardiovascular healthcare systems.
subject: Editorial
  topic: section
creator: Naseer Ahmed Samore
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-05-30
publication date: 2025-05-30
starting page: S382
ending page: S383
doi: 10.51253/pafmj.v75iSUPPL-3.13520

https://pafmj.org/PAFMJ/article/view/13519
type: item
title: Unlocking Potentials: Exploring Awareness, Utilization, and Perceptions related to Benefits and Challenges of Artificial Intelligence in Research - A Study amongst Aspiring Healthcare Professionals of Islamabad
description: Objective: To assess level of awareness, utilization pattern, and perceptions regarding benefits and challenges of artificial intelligence in research among aspiring healthcare professionals in Islamabad. Study Design: Cross Sectional Analytical study Place and Duration of Study: Foundation University School of Health Sciences (FUSH), Islamabad from 25th May to 25th September 2024 Methodology: A stratified random sample of 355 students was surveyed after ethical approval using structured Google Form. After informed consent, data were collected on demographics, AI awareness, utilization, benefits, challenges and training needs, and analyzed using SPSS v25. Chi-square, t-tests, correlation, and regression were applied (p ≤ 0.05). Results: Of 355, 327 responded, among these, 236 (72.2%) were generally aware of AI in research, though 209 (88.5%) had no formal AI training. The mean awareness score 10.44±3.19, with 174 (73.7%) showing adequate awareness. However, only 75 (31.8%) showed sufficient AI tool utilization (mean score 6.4±4.29). Popular AI platforms included ChatGPT, Grammarly, and Mendeley. A majority (68.2%) agreed that AI improves research efficiency. Key barriers included lack of training (54.6%), limited technological access (46.2%), 93.6% expressed willingness to use AI in future research. Significant associations were found between awareness, utilization, and demographic variables. Conclusion: Aspiring healthcare professionals in Islamabad showed high AI awareness but low utilization, with limited formal training. Positive perceptions prevailed despite concerns over plagiarism, data security, and technical understanding. Formal AI training remains essential for developing responsible, effective, and ethical use of AI in research
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Artificial Intelligence, Awareness, Challenges, Research, Utilization.
  topic: keywords
creator: Tahira Amjad
creator: Owais Mahmood Ikram
creator: Murtaza Akif
creator: Hafza Sajid
creator: Rikza Sadiq
rights: Copyright (c) 2025 Tahira Amjad, Owais Mahmood Ikram, Murtaza Akif, Hafza Sajid, Rikza Sadiq https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S1033
ending page: S1038
doi: 10.51253/pafmj.v75iSUPPL-6.13519

Barriers to Continuing Medical Education Among Doctors in Tertiary Care Hospitals of Pakistan: a Descriptive Cross-Sectional Study
type: item
description: Objective: To assess the barriers to Continuing Medical Education (CME) among doctors in tertiary care hospitals of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Public and private tertiary care hospitals of Rawalpindi and Islamabad, Pakistan, from Feb 2025 to Apr 2025. Methodology: This study was conducted on doctors working in tertiary care hospitals of Rawalpindi and Islamabad using a structured, self-administered questionnaire. A total of 417 responses were collected through online and paper-based surveys. Results: Out of 417 respondents, only 43.2% had attended a CME activity in the past year. The primary barriers identified were lack of time due to heavy workload (63%), high cost of participation (34%), and limited local access to CME programs (26%). To address time constraints, the most preferred solution was integrating CME into work hours (42.9%), followed by shorter or flexible sessions (29%) and online programs (25.4%). For financial barriers, employer-sponsored programs (33.3%), lower registration fees (27.6%), and free online options (27.3%) were the top recommendations. Workshops and hands-on training were the most favored CME formats (59%), and opinions on mandatory CME for license renewal were nearly evenly split. Conclusion: CME participation among doctors is hindered primarily by time and financial constraints. Institutional support through work-integrated CME, financial assistance, and flexible delivery formats can significantly enhance participation. Policy-level interventions are needed to ensure equitable access and sustained professional development.
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Continuing, Education, Medical, Physicians
  topic: keywords
creator: Amna Ahmed
creator: Mehwish Abbas
creator: Saba Khurshid
rights: Copyright (c) 2025 Amna Ahmed, Mehwish Abbas, Saba Khurshid https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S1027
ending page: S1032
doi: 10.51253/pafmj.v75iSUPPL-6.13492

The Scalpel and the Algorithm: Navigating the Ethical Landscape of AI in Medical Writing
type: item
description: The rapid advancement of artificial intelligence (AI), particularly large language models (LLMs) like ChatGPT, has sparked excitement and apprehension within the medical community. While the allure of automated medical writing is undeniable, we must proceed cautiously, acknowledging the ethical implications of integrating these powerful tools into our practice. LLMs offer enticing possibilities, from streamlining literature reviews to drafting manuscripts, but their limitations and potential pitfalls demand careful consideration. As Fingerhut and Winter aptly warn, "AI in medical writing has limitations and dangers. The medical community must be aware of them."1 One of the most significant concerns is the potential erosion of critical thinking. LLMs, trained on vast datasets, excel at mimicking human language and generating seemingly coherent text. However, they lack the nuanced understanding and contextual awareness crucial for scientific reasoning. As Sharma et al. points out, "AI tools cannot understand new information, generate insights, or perform deep analysis, which are essential for meaningful scientific discourse."2 Over-reliance on these tools can lead to cognitive offloading, where individuals delegate critical thinking tasks to the algorithm, potentially hindering the development of essential analytical skills.4 This is particularly concerning for trainees and early-career professionals, who may become overly dependent on AI, bypassing the rigorous process of independent learning and critical evaluation.1-3
subject: Editorial
  topic: section
creator: Shams-un-Nisa Sadia
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-04-29
publication date: 2025-04-29
starting page: 229
ending page: 230
doi: 10.51253/pafmj.v75i2.13441

Efficacy of Progressive Muscle Relaxation in Reducing Psychological Distress and Improving Quality of Life Among Nursing Students: A Feasibility Trial from Pakistan
type: item
description: Objective: To assess the level of psychological distress and evaluate the efficacy of Progressive Muscle Relaxation on psychological distress (stress, depression, anxiety) and quality of life among nursing students. Study Design: Mixed-methods Study. Place and Duration of Study: College of Nursing, Armed Forces Post Graduate Medical Institute, Rawalpindi Pakistan, from Jun to Aug 2024. Methodology: Phase I of the study includes the assessment of psychological distress, in which a total of 28 nursing students reported significant psychological distress based on the Depression Anxiety Stress Scale (DASS-21) and participated in testing the efficacy of PMR intervention. In phase II, a single session of PMR was used along with pre- and post-testing for study variables through DASS21, the World Health Organization Quality of Life Scale (WHOQOL-BREF), and a Demographic Information sheet (DIS) in a group setting. Result: We present initial evidence of the intervention's fidelity, with good inter-rater reliability (r=0.80), high acceptability through qualitative feedback analysis, and the feasibility of running a randomized controlled trial. Further, results revealed that after the intervention, depression scores significantly reduced with a moderate effect size (Cohen’s d=0.314). Qualitative assessment from acceptability feedback interviews complemented the findings. Conclusions: We support using PMR intervention to manage psychological distress and enhance the quality of life among nursing students in Pakistan.
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Anxiety, Depression, Mental Health, Nursing Students, Progressive Muscle Relaxation
  topic: keywords
creator: Shakeel Ahmed
creator: Nazia Mustafa
creator: Abid Aftab
creator: Sophia Rashid Khan
rights: Copyright (c) 2025 Shakeel Ahmed , Nazia Mustafa, Abid Aftab, Sophia Rashid Khan https://creativecommons.org/licenses/by-nc/4.0
date: 2025-08-30
publication date: 2025-08-30
starting page: 812
ending page: 818
doi: 10.51253/pafmj.v75i4.13357

Saphenous Vein Graft vs. Radial Artery Graft: Searching for the Best Second Conduit in Coronary Artery Bypass Grafting
type: item
description: Objective: To compare early in hospital outcomes between Radial Artery (RA) graft and saphenous vein grafts (SVG) in patients undergoing Coronary Artery Bypass Graft (CABG) surgery. Study Design: Quasi Experimental study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Oct 2021-Nov 2024. Methodology: Three hundred and ninety-one patients with over age of 18 years, regardless of gender who underwent isolated On-pump CABG were recruited through non probability consecutive sampling. Patients were non-randomly allocated into two groups; Group-A (LIMA+VG) and Group-B (LIMA+RA+VG). Data on demographic, preoperative, intraoperative, and postoperative characteristics was collected using a structured proforma from adult cardiac surgery database. In-hospital outcomes and post-operative complications were compared between the study groups. Results: Out of 391 patients, 76(19.4%) were females and 315(80.6%) were males with median age of 59.00(52.00-65.01) years. Group-A and Group-B had 182(46.5%) and 209(53.5%) patients respectively. Group-A had longer ICU stay duration compared to Group-B [45.50(22.00-91.00) vs. 29.00(21.00-61.00) hours; p<0.01]. In patients receiving three grafts, Group-A showed significantly higher chest tube drainage than Group-B [550.00(380.00-990.00ml) vs. 400.00(250.00-650.00ml); p=0.013]. The OR for type of graft was 2.03 (95% CI: 0.98-4.19; p=0.05), manifesting the borderline but significant impact on the postoperative complications. Conclusion: RA grafts showed potential advantages over SVG as the second conduit in CABG surgery, especially in improving early in-hospital outcomes. Our findings emphasize the potential of RA graft use and support its frequent adoption in clinical practice particularly in younger population.
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Complication, Conduit, In-hospital outcome, Radial artery, Graft patency.
  topic: keywords
creator: Imtiaz Ahmed Chaudhry
creator: Naser Ali Khan
rights: Copyright (c) 2025 Imtiaz Ahmed Chaudhry, Naser Ali Khan https://creativecommons.org/licenses/by-nc/4.0
date: 2025-05-30
publication date: 2025-05-30
starting page: S426
ending page: S433
doi: 10.51253/pafmj.v75iSUPPL-3.13033

The High Cost of a Medicalized Death: Are We Heading in the Right Direction or Is It Time for a Change?
type: item
description: The medicalization of death refers to the process by which dying is increasingly viewed and treated as a medical issue, often leading to interventions that may not align with patients' desires or values.1 This phenomenon has been shaped by historical, cultural, and systemic factors, resulting in a healthcare model that prioritizes hospital-based care at the end of life.2,3 Every year, millions of people spend their final days in hospitals, hooked to machines and surrounded by strangers, rather than at home with loved ones. This is the reality of medicalized death—a phenomenon that prioritizes aggressive interventions over patient autonomy and dignity. Some people have argued that medicalization can provide necessary support and pain management for patients at the end of life, ensuring comfort and dignity. This perspective emphasizes the role of medical professionals in facilitating a "good death" through appropriate interventions.4 This editorial highlight the issue of medicalization in context of a developing country like Pakistan with limited resources and some possible solutions.
subject: Editorial
  topic: section
creator: Imran Ahmad
creator: Farooq Azam Rathore
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-03-25
publication date: 2025-03-25
starting page: S137
ending page: S139
doi: 10.51253/pafmj.v75iSUPPL-2.13327

Factors Affecting Adherence to Iron-Folic Acid Supplementation During Pregnancy in Rawalpindi
type: item
description: Objectives: To determine frequency of adherence to Iron Folic Acid supplementation (IFAS) and to identify determinants of adherence to IFAS in pregnant women of Rawalpindi. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynecology and Obstetrics, Fauji Foundation Hospital, Rawalpindi, Pakistan, from Oct 2021 to Mar 2022. Methodology: Three hundred and ninety-nine pregnant women in their second and third trimesters of pregnancy meeting our inclusion criteria were recruited. A pre-validated, open-access questionnaire, including informed consent, demographic information, and items related to IFAS adherence, including reasons for non-adherence, counselling by healthcare provider, polypharmacy, family support, and whether or not the pregnancy was planned, was administered. Results: Forgetfulness (23.7%), abdominal pain (13.4%), nausea (14.4%), and unpleasant taste (11.3%) were main reasons reported for non-adherence. There was a significant association between education (p=0.001), monthly income (p=0.03), area of residence (p=0.001), planned pregnancy (p=0.001), husband’s support (p< 0.001), counseling by healthcare provider regarding the importance of IFAS (p=0.003), availability (p< 0.001), accessibility (p< 0.001) and affordability (p< 0.001) of IFAS supplements and adherence. Conclusion: The majority of women reported adherence to the prescribed IFAS supplementation. Higher education, planned pregnancy, urban residence, husband’s support, counselling by healthcare provider, affordability, availability and accessibility were associated with adherence. For those who reported non-adherence, forgetfulness and side effects were main reasons reported for non-adherence. Training of healthcare professionals to provide better counseling to women and their husbands during Antenatal care is recommended.
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Folic Acid, Iron-deficiency Anemia, Medication Adherence, Pregnancy.
  topic: keywords
creator: Fatima Ali Raza Mughal
creator: Naila Azam
creator: Raima Asif
creator: Najam us Saqib Khan
creator: Mehwish Riaz
rights: Copyright (c) 2025 Fatima Ali Raza Mughal, Naila Azam, Raima Asif, Najam us Saqib Khan, Mehwish Riaz https://creativecommons.org/licenses/by-nc/4.0
date: 2025-06-30
publication date: 2025-06-30
starting page: 430
ending page: 435
doi: 10.51253/pafmj.v75i3.13326

The Outcome of Pregnancy in Women with Normal V/S High Salt Intake Presenting in a Hospital of Northern Region of Pakistan
type: item
description: Objective: To compare the outcome of pregnancy in women with normal versus high salt intake presenting in a hospital of northern region Pakistan. study design: quasi experimental study. Place and Duration of Study: Department of Gynecology and Obstetrics, Combined Military Hospital, Gilgit Pakistan, from Feb 2023 to Feb 2024. Methodology: This study was conducted on the pregnant women attending the department for antenatal checkup in these study dates. Daily salt intake was calculated with the help of dietician by calculating the overall consumption of sodium chloride in different forms during the day. Women were divided into two groups on this basis as having normal or high salt intake. Both the groups were followed up till the time of delivery for any maternal or fetal complications. Results: A total of 1000 pregnant women were included in the final analysis who were followed up till delivery. Mean age of the study participants was 26.66±5.15 years. Out of the babies born, 527(52.7%) were males and 473(47.3%) were females. Out of 1000 women, 450(45%) were classed as having normal salt intake while 550(55%) were classed as having high salt intake. Statistical analysis showed that intrauterine growth retardation, oligohydramnios, pregnancy induced hypertension and preeclampsia were found significantly more in women who had high salt intake (p-value<0.01). Conclusion: A significant number of pregnant women in Gilgit and surrounding areas were having high salt intake. Both maternal and fetal complications studies were found significantly more in women with high salt intake as compared to women with ...
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Fetal growth retardation; Infant; Pregnancy; Sodium Chloride; Preeclampsia; Oligohydramnios
  topic: keywords
creator: Reema Gul
creator: Ayisha Raja
creator: Munnaza Andleeb
creator: Faria Memon
creator: Fareeha Zaheer
creator: Umber Imtiaz Khan
rights: Copyright (c) 2025 Reema Gul, Ayisha Raja, Munnaza Andleeb, Faria Memon, Fareeha Zaheer, Umber Imtiaz Khan https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S956
ending page: S959
doi: 10.51253/pafmj.v75iSUPPL-6.12871

Opportunistic Infection in HIV Patients at Tertiary Care Hospital in Rawalpindi
type: item
description: Objective: To determine the spectrum of opportunistic infection in human immunodeficiency virus patients at tertiary care hospital. Study Design: Cross-sectional study. Place and Duration of Study: Department of Infectious Diseases, Pak Emirates Military Hospital, Rawalpindi, Pakistan from Jan 2024 to Sep 2024. Methodology: The confirmed cases of human immunodeficiency virus infection of both genders between the age of 18-65 years were included. Patients having any infection before the diagnosis of human immunodeficiency virus infection were excluded from the study. Moreover, those who were not willing to participate and unable to comprehend questions were also excluded. All participants willing to participate were interviewed for demographic details and the clinical examination was done afterwards. Laboratory investigations for the suspected opportunistic infections were done. Results: Of these eighty-one (n=81) patients 74(91.36%) were males and 7(8.64%) were females with a median age of 29.00 (44.00-35.00) years. The median HIV RNA PCR value was 33000.00 (1529.00 - 903341.00) IU/ml while median CD4 counts were 213.00 (71.00-381.00) cell/mm3. The most common opportunistic infection was pulmonary tuberculosis 20(24.69%) followed by Cytomegalovirus infection 18(22.22%) and Toxoplasmosis 17(20.99%). Syphilis was seen in 7(8.64%) while Cryptococcal Meningitis was seen in 3(3.70%). The least common infections were hepatitis B and Ebstein Bar virus infection having a frequency of 1(1.23%). Conclusion: Pulmonary tuberculosis, cytomegalovirus infection and toxoplasmosis were the most common infections observed in individuals with human immunodeficiency virus infection.
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Autoimmune deficiency Syndrome, Human immunodeficiency infection, Opportunistic Infection, Tuberculosis.
  topic: keywords
creator: Mirza Waseem Javed
creator: Shazia Nisar
creator: Ejaz Ahmad
creator: Muhammad Iqbal
creator: Muhammad Anwar
creator: Syed Yasir Abbas
rights: Copyright (c) 2025 Mirza Waseem Javed, Shazia Nisar, Ejaz Ahmad, Muhammad Iqbal, Muhammad Anwar, Syed Yasir Abbas https://creativecommons.org/licenses/by-nc/4.0
date: 2025-07-31
publication date: 2025-07-31
starting page: S780
ending page: S783
doi: 10.51253/pafmj.v75iSUPPL-5.12973

Workplace Challenges and their Impact on Quality of Life Among Women in Midlife and Beyond
type: item
description: Objective: To identify workplace challenges experienced by women in midlife and beyond and determine the impact of these challenges on their Quality of Life. Study Design: Analytical cross-sectional study. Place and Duration of Study: Islamabad, Pakistan, from March to December 2023. Methodology: This study included working women between the ages of 45 to 65 years, who were invited to participate in an online survey hosted on Google Forms. The survey was a structed and validated questionnaire, comprising demographic details and questions related to time utilization, job satisfaction and facing workplace challenges. Results: The researchers enrolled 282 female participants from Islamabad, Pakistan, majority (160, 56.7%) of whom were between the ages of 45-50 years and reported having full-time employment (162, 57.4%). While most participants felt that they did not face organizational discrimination in their workplace (192, 68.1%), a lot of participants also responded that they had faced employment rejection due to being in midlife (176, 62.4%) and had taken extra efforts to maintain their appearance (149, 52.8%). Statistical tests were applied where p-value ≤0.05 was considered significant. Conclusion: Majority women reported no organizational discrimination at work, experienced no economic challenges and feared no age-related job threats. Participants who reported occasionally taking time off work for themselves and spent time frequently with family and friends felt no need to take early retirement indicating high job satisfaction.
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Job Satisfaction, Occupational Stress, Quality of Life, Working Women, Work-Life Balance.
  topic: keywords
creator: Nabia Tariq
creator: Anum Shahid
creator: Asmara Ahmed Malik
creator: Najm us Saqib Khan
rights: Copyright (c) 2025 Nabia Tariq, Anum Shahid, Asmara Ahmed Malik, Najm us Saqib Khan https://creativecommons.org/licenses/by-nc/4.0
date: 2025-07-31
publication date: 2025-07-31
starting page: S724
ending page: S729
doi: 10.51253/pafmj.v75iSUPPL-5.13273

https://pafmj.org/PAFMJ/article/view/13276
type: item
title: Association Between Door to Balloon Time and Reperfusion with Left Ventricular Function and Heart Failure in Patients With ST Segment Elevated Myocardial Infarction Treated with Primary Percutaneous Intervention
description: Objective: To determine the association between prolonged D2B time and heart failure in patients with STEMI treated with primary PCI. Study Design: Prospective longitudinal study Place and Duration of Study: Cardiology department of Punjab Institute of Cardiology, Lahore Pakistan, from Oct 2024 to Feb 2025. Methodology: This study was carried out on 120 patients diagnosed with acute STEMI undergoing primary PCI after taking informed consent. Data was collected using pre-designed proforma. Patients were categorized into two groups based on door-to-balloon time, to compare the incidence of heart failure at 48 hours post-PCI. Relative risk was calculated, and data analysis was performed using SPSS version 26, with p-value <0.05 considered significant. Results: Heart failure was observed in 23% exposed patients vs. 15% non-exposed patients, relative risk of heart failure in exposed group was 1.556 (95% CI: 0.730–3.317). Conclusion: This study suggests that prolonged door-to-balloon time is linked to higher frequency of heart failure in patients with STEMI undergoing primary PCI, with relative risk indicating increased likelihood of heart failure in those with delayed intervention.
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Door to balloon time, heart failure, STEMI.
  topic: keywords
creator: Muhammad Taha
creator: Sajjad Ahmad
creator: Muhammad Javeed
creator: Muhammad Kamran
creator: Hamayon .
creator: Syed Jalal Ud Din
rights: Copyright (c) 2025 Muhammad Taha, Sajjad Ahmad, Muhammad Javeed, Muhammad Kamran, Hamayon ., Syed Jalal Ud Din https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S1021
ending page: S1026
doi: 10.51253/pafmj.v75iSUPPL-6.13276

Frequency and Distribution of Mount-Hume Classification Among Patients Requiring Root Canal Treatment at Armed Forces Institute of Dentistr
type: item
description: Objective: To assess the frequency and distribution of Mount-Hume classification in patients requiring root canal treatment. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from Jan 2024 to Jan 2025. Methodology: Patients visiting operative department of AFID requiring root canal treatment were included in this study. Mount-Hume classification was used for categorizing patients depending upon the lesion site and size of it. Data including demographics, tooth type, lesion site, lesion size and etiology was recorded. Results: A total of 280 teeth from 254 patients were endodontically treated with greater female (58.27%) compared to male (41.73%) patients. Caries was the predominant etiological factor presenting in 264(94.29%) cases. Molars were the most affected tooth type in 167(59.64%) cases, followed by 77(27.5%) premolars and 36(12.86%) anteriors. Significant associations between tooth type and etiology (p<0.001), tooth type and lesion site (p<0.001), and tooth type and size of lesion (p<0.001) were observed. While, site of lesion was found to be significantly associated with etiology (p<0.001), but not with lesion size (p=0.280) Conclusion: Caries was the most common etiology behind root canal treatments, with molars predominantly affected tooth. Advanced diagnostic tools and preventive interventions are needed to mitigate the burden of carious lesions requiring root canal therapy.
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Dental Caries, Endodontics, Root Canal Therapy, Tooth Loss.
  topic: keywords
creator: Talha Khurshid
creator: Nadeem Ahmad Rana
creator: Muzammil Hussain Shah
creator: Hafiz Rabbi Ul Ehsan
creator: Shan e Haider Naqvi
creator: Ahmed Abdullah
rights: Copyright (c) 2025 Talha Khurshid, Nadeem Ahmad Rana, Muzammil Hussain Shah, Hafiz Rabbi Ul Ehsan, Shan e Haider Naqvi, Ahmed Abdullah https://creativecommons.org/licenses/by-nc/4.0
date: 2025-08-30
publication date: 2025-08-30
starting page: 807
ending page: 811
doi: 10.51253/pafmj.v75i4.13269

Enhancing Operative Dentistry and Endodontics Education Through Telehealth: Integrating Digital Learning with Hands-On Training
type: item
description: Objective: To evaluate the effectiveness of telehealth in dental education by identifying training gaps and proposing a blended learning model integrating digital education with hands-on clinical experience. Study Design: Quasi-experimental study (Pre-post interventional study) Place and Duration of Study: Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry Rawalpindi, Pakistan, from Apr to Oct 2024. Methodology: A total of 80 dental professionals, postgraduate students and practicing dentists participated in a structured telehealth-based workshop covering diagnostic skills, case-based learning, and treatment planning. The Telehealth Educational Environment Measurement Tool (THEEM) assessed participants’ perceptions, while pre- and post-intervention knowledge was measured using structured assessments. Paired t-tests were used to evaluate learning gains. Results: The mean age of our participants was 32.52±4.69 years, with 61.25% males. Median THEEM scores showed domain-specific variation: Platform Usability remained stable, Internet Connectivity and Learning Engagement improved, while Instructor Support declined. Overall knowledge about THEEM significantly increased, with median pre-intervention scores of 114.25 (IQR 99.25–135.75) rising to 128.00 (IQR 110.00–147.50; p<0.001). Findings highlight notable gains in learning engagement and knowledge acquisition through telehealth. Conclusion: Telehealth intervention significantly enhanced knowledge acquisition, confidence, and engagement in dental education. However, for clinical skill development, a hybrid model combining telehealth with hands-on training is essential. Addressing technical infrastructure and faculty training can further strengthen telehealth integration into dental curricula.
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Clinical Competency, Dental Education, Digital Health Training, Learning, Telehealth
  topic: keywords
creator: Hafiz Rabbi Ul Ehsan
creator: Nadeem Ahmad Rana
creator: Marium Arif
creator: Syed Shan E Haider Naqvi
creator: Muhammad Atae Mustafa Mahayyudin
creator: Shumaila Maryum
rights: Copyright (c) 2025 Hafiz Rabbi Ul Ehsan, Nadeem Ahmad Rana, Marium Arif, Syed Shan E Haider Naqvi, Muhammad Atae Mustafa Mahayyudin, Shumaila Maryum https://creativecommons.org/licenses/by-nc/4.0
date: 2025-10-31
publication date: 2025-10-31
starting page: 949
ending page: 953
doi: 10.51253/pafmj.v75i5.13255

Lifelong Learning and Adaptive Expertise in Faculty Development Programs
type: item
description: Medical knowledge doubles every year, meaning that much of what was learned during formal education will eventually become outdated. It is important for faculty to continue to update their own expertise to reflect current best evidence-based practices and technologies. Embedding these principles keep educators versatile, creative, and successful throughout their careers. This lifelong learning commitment by faculty fosters a similar mindset among students, which is an important part of navigating a profession where learning is a lifetime process. Faculty are more than sources of information; they represent role models for the next generation. The institutions have an important role in supporting the faculty by recognizing and rewarding their professional growth. Understanding those faculties who attend conferences, certification, or contribute to medical education research will create an enabling environment. Learning communities or journal clubs focusing on innovations in medical education also advance collaboration and learning.
subject: Editorial
  topic: section
creator: Khadija Qamar
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by-nc/4.0
date: 2025-02-28
publication date: 2025-02-28
starting page: 1
ending page: 2
doi: 10.51253/pafmj.v75i1.13244

Crosslinking Salivary Diagnosis with Non-Invasive Insights to Oral Pathology: Novel Systematic Insights to Personalized Medicine in Disease Management
type: item
description: Objective: To explore the integration of salivary biomarkers, histopathological validation, and advanced imaging for precision diagnosis and management of oral diseases. Methodology: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Relevant studies from PubMed, Scopus, and Google Scholar were analyzed, with a focus on biomarker discovery, validation, and non-invasive diagnostic modalities in oral pathology. Data extraction emphasized study design, salivary biomarker specificity, imaging correlations, and clinical utility. The risk of bias was assessed using the QUADAS-2 tool, and the GRADE criteria were used to determine the evidence quality. Results: Among the 15 studies included, 6 investigated salivary biomarkers for oral cancer detection, five evaluated non-invasive imaging modalities, and four explored molecular diagnostics in disease progression. Salivary biomarkers (e.g., IL-6, miRNA-21) demonstrated high specificity (AUC >0.85) in distinguishing between malignant and benign lesions. Non-invasive imaging enhanced diagnostic accuracy by 37% (p<0.001). Combined approaches improved early detection and treatment personalization. Conclusion: Salivary diagnostics offer a powerful, non-invasive tool for personalized disease management in oral pathology. Integrating molecular biomarkers and imaging could revolutionize early detection, reducing the need for invasive procedures and enhancing patient outcomes. Further research is needed to validate biomarker-driven precision medicine strategies.
subject: Review Articles
  topic: section
subject: Fast Track
  topic: category
subject: Biomarkers, Disease Progression, Histopathology, Molecular Diagnostics, Non-Invasive Imaging, Oral Cancer Personalized Medicine, Oral Pathology.
  topic: keywords
creator: Rehana Kausar
creator: Attia Batool
creator: Ashfaq Ahmad Shah Bukhari
creator: Abdul Rehman Khalil Shaikh
creator: Abdul Aleem
creator: Madeeha Minhas
creator: Muhammad Hussain
rights: Copyright (c) 2025 Rehana Kausar, Attia Batool, Ashfaq Ahmad Shah Bukhari, Abdul Rehman Khalil Shaikh, Abdul Aleem, Madeeha Minhas, Muhammad Hussain https://creativecommons.org/licenses/by-nc/4.0
date: 2025-06-30
publication date: 2025-06-30
starting page: 611
ending page: 616
doi: 10.51253/pafmj.v75i3.13199

Open AccessOriginal Article Anesthetic Efficacy of Supplemental Buccal Infiltration as Compared to Intraligamentary Injection in Treating Mandibular Second Molars with Irreversible Pulpitis
type: item
description: Objective: To compare the anesthetic efficacy of supplemental buccal infiltration (BI) and intraligamentary (IL) injections in treating mandibular second molars with irreversible pulpitis in the Pakistani population. Study Design: Quasi experimental study. Place and Duration: Department of Operative Dentistry and Endodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from Apr 2024 to Oct 2024. Methodology: This study included 100 participants (median age: 30 years) divided into two groups: IL group and BI group. Patients received standardized local anesthesia protocols, and pain levels were recorded using the Visual Analog Scale (VAS). Pain levels were classified as mild, moderate, or severe, and the success rate of anesthesia was evaluated. Results: The IL group showed significantly lower pain levels (median VAS: 38.00(31.00–41.00)) compared to the BI group (median VAS: 65.50(40.00–87.00)). Severe pain was reported by 21(42.0%) participants in the BI group versus none in the IL group (p<0.001). The IL technique had a higher success rate of 45(90.0%) compared to 22(44.0%) in the BI group (p<0.001), indicating its superior efficacy. Conclusion: Intraligamentary injections with 4% Articaine provide more effective anesthesia and higher success rates compared to buccal infiltrations for mandibular second molars with irreversible pulpitis. These findings suggest that IL injections are a preferable supplemental technique for profound anesthesia in such cases. Further studies are recommended to validate these findings.
subject: Original Articles
  topic: section
subject: Fast Track
  topic: category
subject: Anesthetic efficacy, Buccal infiltration, Intraligamentary injection, Irreversible pulpitis, Mandibular molars, Visual Analogue Scale.
  topic: keywords
creator: Syed Shan E Haider Naqvi
creator: Nadeem Ahmad Rana
creator: Hafiz Rabbi ul Ehsan
creator: Shumaila Maryum
creator: Talha Khurshid
creator: Naseem Azad
rights: Copyright (c) 2025 Syed Shan E Haider Naqvi, Nadeem Ahmad Rana, Hafiz Rabbi ul Ehsan, Shumaila Maryum, Talha Khurshid, Naseem Azad https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S960
ending page: S965
doi: 10.51253/pafmj.v75iSUPPL-6.13193

Comparison of Metformin and Myoinositol In Improving Insulin Sensitivity of Women with Polycystic Ovarian Syndrome
type: item
description: Objective: To determine the outcome of Metformin versus Myoinositol in women with polycystic ovarian syndrome.” Study Design: Quasi-experimental study Place and Duration of Study: Department of Obstetrics & Gynecology, Avicenna Medical Hospital Lahore for 06 months (Oct-2022 to March-2023). Methodology: One hundred patients were enrolled and divided in two Groups. In Group A, females were given Myo-inositol. In Group B, females were given Metformin. After 24 weeks, blood sample was taken for assessment of HOMA-IR. Reports were assessed and HOMA-IR level was recorded. Reduction in HOMA-IR in blood after 24 weeks of treatment was calculated. Information was recorded in proforma and analyzed in SPSS 23. Results: The mean age of females in Myoinositol Group was 29.76±9.11 years while the mean age of females in Metformin Group was 32.52±8.81 years. In Myoinositol Group, 13(26%) had primary infertility and 25(50%) had secondary infertility. In Metformin Group, 7(14%) had primary infertility and 28(56%) had secondary infertility. In Myoinositol Group, the mean HOMA-IR at baseline was recorded as 27.59±19.10 that was reduced to 21.28±15.38. In Metformin Group, the mean HOMA-IR at baseline was recorded as 24.13±12.32 that was changed to 16.55±7.56. The difference in both Groups at baseline was insignificant as well as after 24 weeks, however the HOMA-IR was less in Metformin Group (p-value >0.05). Conclusion: Thus there is no difference in the HOMA-IR level whether Metformin is prescribed or Myoinositol is prescribed
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Blood Glucose, Blood Insulin, HOMA-IR, Metformin, Myoinositol, Polycystic ovarian syndrome
  topic: keywords
creator: Sadia Awan
creator: Gulfreen Waheed
creator: Sana Navid
rights: Copyright (c) 2025 Sadia Awan, Gulfreen Waheed, Sana Navid https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S1009
ending page: S1014
doi: 10.51253/pafmj.v75iSUPPL-6.13185

CRP/Albumin Ratio: A Promising Marker of Bacteremia in Neonatal Sepsis in a Tertiary-Care Hospital in Pakistan
type: item
description: Objective: This study evaluated the CRP/albumin ratio as a potential indicator of bacteremia in neonatal sepsis among neonates admitted to a tertiary care hospital in Pakistan. Study Design: Cross-Sectional Study. Place and Duration of Study: Neonatal Intensive Care Unit (NICU), Department of Pediatrics and Neonatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2024. Methodology: This study investigated a total of 192 neonates with neonatal sepsis, and data were collected using a proforma. Laboratory tests were performed to measure C-reactive protein (CRP) and albumin levels, and statistical analyses were performed using SPSS version 23. Results: Our study analyzed 192 neonates with sepsis to evaluate the CRP/Albumin ratio as a potential biomarker. All variables exhibited non-normal distributions (Shapiro-Wilk p<0.001). Neonates had a mean age of 10.74±7.31 days (IQR =9) and birthweight of 2.676±0.63 kg, with elevated leukocyte counts (17,102.08±13,132.49 cells/mm³, IQR =27,500) confirming sepsis. Hypoalbuminemia (3.066±0.61 g/dL, IQR =0.90) and high CRP (12.87±8.89, IQR =10.20) were observed. Hospital stays averaged 2.85±1.52 days (IQR =3). The CRP/Albumin ratio (4.36±3.17, IQR =14.4) demonstrated significant variability, suggesting its potential as a severity marker in neonatal sepsis. 152(79.2%) tested positive for bacteremia. Clinical symptoms included fever in 148(77%) neonates, respiratory distress in 119(62%), and feeding intolerance in 108(56%). No significant association was found between CAR and variables such as type of sepsis onset or sex. Conclusion: CRP/albumin ratio is a promising marker for neonatal sepsis. However, our study did not find a statistically significant relationship between CRP/albumin ratio and late-onset neonatal sepsis.
subject: Original Articles
  topic: section
subject: Normal Track
  topic: category
subject: Albumin, Blood Culture, C-Reactive Protein, C-Reactive Protein/Albumin Ratio, Neonatal Sepsis, Neonate, NICU
  topic: keywords
creator: Muhammad Haroon Khan
creator: Arshad Khushdil
creator: Sajid Ali Shah
creator: Uzma Naeem
creator: Syed Zubair Shah
creator: Bilal Afzal
rights: Copyright (c) 2025 Muhammad Haroon Khan, Arshad Khushdil, Sajid Ali Shah, Uzma Naeem, Syed Zubair Shah, Bilal Afzal https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-30
publication date: 2025-09-30
starting page: S1015
ending page: S1020
doi: 10.51253/pafmj.v75iSUPPL-6.13063