LIAQUAT MEDICAL RESEARCH JOURNAL

Lamotrigine Overdose: A Case Report

Shafiq Ur Rahman — 2025-03-31

Lamotrigine is a second-generation anticonvulsant and mood stabilizer commonly used to treat epilepsy and bipolar disorder. Although generally well tolerated, overdoses can cause significant toxicity affecting the central nervous and cardiovascular systems. We report a case of a 34-year-old female with conversion disorder who ingested 1000 mg of lamotrigine following an emotional distress episode. She presented with slurred speech, tachycardia, and lethargy but remained hemodynamically stable. Management included gastric lavage, activated charcoal, and supportive care, resulting in a favorable outcome without complications. This case highlights the importance of early intervention in lamotrigine toxicity and the need for psychiatric evaluation in at-risk patients.

Plant extracts for drug development: Is it economical?

Binafsha Manzoor Syed — 2025-03-31

Plants have been in use for medicinal purposes for centuries. A number of drugs have been developed from plant extracts and are currently in clinical practice. There are still a number of diseases where there is no specific treatment available such as dengue fever or only synthetic molecules are there with a number of side effects. Thus considering plants for development of new drugs would be a viable option, however it’s a time consuming and rigorious process. However when compared to the synthetic molecules the initial cost incurred upon extraction and identification of the molecules from plant is much lower, the remaining clinical trial and quality control checks remain the same.

Current trends in acute leukemia: A cross-sectional survey of adult acute leukemia cases

Sorath Bhutto — 2025-03-31

Acute Leukemia (AL) is one of the cancer on rise globally, there is dearth of regional information in particular gender pattern of the disease among adult population from Pakistan. Therefore, this cross-sectional study was designed and conducted at Medical Oncology department at Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan. The said department receives cancer patients all over from the province of Sindh as well as other provinces. A total of 130 adult patients presenting at Oncology OPD with diagnosis of acute leukemia and included in this study. Participants were selected using non-probability convenient sampling technique. Data was collected using a structured questionnaire and analyzed using SPSS version 24.0. The median age of male AL patients was significantly higher as compared to female AL patients i.e. 30 years ; IQR =18 versus 24 years; IQR=21.25 years (p-value= <0.05). The study found male: female ratio of AL was 1.8:1. No statistically significant differences were observed in the socio-demographic and disease-related characteristics among male and female AL patients. The current study concludes that acute leukemias has male predominance whereas the average age of presentation was comparatively lower among females as compared to males.

B- Lynch suturing in postpartum haemorrhage management and maternal outcome

Aysha Jamil — 2025-03-31

Surgical care of atonic Postpartum Hemorrhage (PPH) following medically unsuccessful treatment has recently been documented, involving the application of uterine compression sutures over the whole thickness of both uterine walls. In both developing and developed nations, PPH continues to rank among the top 5 causes of maternal death, out of the reported cases 75% to 90% are caused by uterine atony. This study was aimed to monitor the B Lynch suture's effectiveness in treating PPH. A total of 104 females between age of 20 and 45 years who were experiencing PPH and were between 36 and 42 weeks’ gestation were included in the study. Patients with any bleeding disorders, genital hematomas, conception retirements, ruptured uteruses, and genital injuries were not included. Success criteria were tracked, such as bleeding control within 15 minutes of the surgery. The mean age of females was 27.69 ± 3.68 years. There were two different mean gestational ages: 39.98 ± 1.57 weeks and 40.04 ± 1.68 weeks, with 92.30% success rates. Over 104 women who had postpartum hemorrhages during cesarean sections and who did not respond to conservative treatment were treated with B Lynch suturing, there were only eight (7.69%) patients who failed to respond to this approach and underwent hysterectomy. There were no reported cases of uterine necrosis. Furthermore, two patients were reopened for an abdomen rupture. The results showed that the B-Lynch suture had a good success rate in controlling PPH and improving maternal outcomes. When treating unmanageable postpartum bleeding, B-lynch sutures are a simple, safe, easy, and fertility-preserving procedure.

Comparative analysis of aerobic exercise protocols on depression in post-myocardial infarction rehabilitation

Muhammad Jawaid — 2025-03-31

Depression is common among patients recovering from myocardial infarction (MI) and is reportedly associated with poor outcomes. Aerobic exercise has been proposed as a beneficial intervention for improving both cardiovascular health and mental well-being. This study investigated the effects of different aerobic exercise protocols on depressive symptoms in MI patients during their recovery and determine the most effective approach. A randomized controlled trial design was employed, enrolling 120 patients recovering from MI. Participants were randomly assigned to one of the three exercise groups: low-intensity aerobic exercise, moderate-intensity aerobic exercise, and high-intensity interval training (HIIT). Depressive symptoms were assessed using the Beck Depression Inventory (BDI) at baseline, 6 weeks, and 12 weeks post-intervention. Exercise adherence and safety were monitored throughout the study. Significant reductions in depressive symptoms were observed in all exercise groups, with the HIIT interval training group showing the greatest improvement in depression scores compared to the low and moderate-intensity groups. Exercise adherence rates were highest in the moderate-intensity group, while HIIT demonstrated the most significant physiological improvements in cardiovascular fitness. Aerobic exercise, particularly high-intensity interval training, appears to be an effective intervention for reducing depressive symptoms in patients recovering from myocardial infarction. These findings suggest that incorporating structured aerobic exercise into recovery programs may enhance both psychological and physical health outcomes.

Association of exercise-related injuries with body composition and aerobic capacity in amateur athletes

Shahzadi Moeeza Humayun — 2025-03-31

This study was conducted to evaluate the association of exercise-related injuries with body composition and aerobic capacity in amateur athletes. In this cross-sectional study 374 participants were recruited including both male and female amateur athletes; from Shoaib Akhtar and Abdul Qadir Cricket Academy, Lahore Pakistan. The study duration was four months, from September 2024 to January 2025. The participants of the study were recruited by using a non-probability convenient sampling technique. Participants' hip and waist dimensions were measured and Cooper’s test assessed their aerobic capacity values. Additionally, responses for injury incidence rate and psychological readiness values were derived from their respective questionnaires. The study showed that males had a slightly higher waist-to-hip ratio (W/H ratio) than females (0.906 versus 0.896), while females showed better aerobic fitness compared to males (Cooper value: 12.89 versus 12.33). Muscle cramps were the most common injury, followed by fractures and concussions. Weak negative correlations were found between injury incidence and both aerobic fitness and W/H ratio. Injury incidence also showed a slight inverse relationship with age. However, no strong relationships were established between BMI, fitness levels, or demographic factors and injury incidence. The study concluded that as the injury incidence rate increases, aerobic capacity decreases. Waist-to-hip ratio and age had a slight inverse relationship with injury incidence rate while BMI and psychological readiness didn’t have a significant correlation with injury incidence rate.

Association between histologic grades and Ki67 score in breast cancer

Dr Shumaila Nawaz Khan Khan — 2025-03-31

Ki 67 is a key proliferative marker in breast cancer, often associated with tumor aggressiveness and grade. Despite its established role, the correlation between Ki 67 and histological grade remains inconsistent across studies. This study aimed to explore the association between Ki 67 expression and tumor grades in breast cancer patients. This was a cross-sectional study conducted at the Department of Medical Oncology, Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan over six months period (January 2024- June 2024). A sample of 78 breast cancer patients was included, divided into groups based on Ki 67 protein expression (Positive defined as >21% of positive cells). Histological grading was assessed by using the Elston-Ellis modification of Scarff-Bloom-Richardson grading system, while demographic and clinical data, including age, marital status, and BMI, were collected. High Ki-67 expression was observed predominantly in Grade 3 tumors (n=33, 91.7%) compared to Grade 2 (n=52, 66.7%) and Grade 1 (n=3, 50%) (p-value =0.008). No significant associations were found between Ki 67 and other variables, including tumor size, axillary lymph node involvement, and TNM stage. This study demonstrates a strong association between higher Ki 67 and advanced histological grades in breast cancer, suggesting that Ki 67 may serve as a valuable prognostic indicator. However, further research is needed to clarify its role in predicting clinical outcomes across diverse patient populations.

The assessment of the douepia tortuosa and horsetail (equisetum arvense) comparative and combine antioxidant potential

Fazilat Noureen — 2025-03-31

Superoxide anions, hydrogen peroxide, and hydroxyl radicals are all members of the family of reactive oxygen species (ROS) known as free radicals. They can react with proteins, lipids, and DNA to cause cancer and other chronic diseases. The antioxidant capacity of Douepia tortuosa, (D. tortuosa) is substantial. This study evaluated scavenging capacity of 23%, 65% and 78% at different concentrations of D. tortuosa, including 100µg/ml, 500µg/ml, and 1000µg/ml respectively. The common horsetail (Equisetum arvense) is a silica-rich rhizomatous annual herbaceous plant with a number of biological traits, such as antioxidants, diuretics that act as immunological barrier, and antimicrobial, antibacterial, and anti-inflammatory properties which is reportedly protect the heart and the nervous system. This study showed that horsetail (Equisetum arvense) has antioxidant capacities of 26%, 42%, and 47%. Furthermore, the combine plants extract antioxidant potential which was found to be 41%, 61% and 80%. Further in vivo and in vitro studies are needed to elucidate the biochemical composition of combine plant extract and explore their therapeutic potential.

Roxadustat in CKD and transplant patients: A new era in anemia management

Muhammad Tassaduq Khan — 2025-03-31

The aim of this study was to evaluate the efficacy and safety of Roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), for the management of anemia in patients with chronic kidney disease (CKD), including hemodialysis-dependent (HDD), non-dialysis-dependent (NDD), and renal transplant recipients (RTRs). This was a prospective cross-sectional study was conducted at Dow University of Health Sciences, Karachi, Pakistan, from August 2024 to January 2025. A total of 55 patients were enrolled and treated with Roxadustat, beginning with a dose of 100 mg thrice weekly for the initial 4 weeks, followed by 70 mg thrice weekly. The primary outcome was the achievement of a hemoglobin (Hb) target of ?10 g/dL within 6 weeks. The safety profile was assessed by monitoring adverse events, including myocardial infarction. A total of 55 patients were recruited in the study. Of these, 19 were hemodialysis-dependent (HDD), 31 were non-dialysis-dependent (NDD), and 5 were renal transplant recipients (RTRs). The hemoglobin target of 10 g/dL within 6 weeks was achieved in 48 patients (87.3%). Among the successful cases, 18 were HDD patients, 26 were NDD patients, and 3 were RTRs. The remaining 7 patients (12.7%) did not achieve the target hemoglobin level within the specified timeframe. Adverse events were observed in 3 patients (5.4%), all of whom experienced myocardial infarction. This included 2 HDD patients and 1 NDD patient. No adverse events were reported in the RTR group. Overall, Roxadustat was well-tolerated, with a structured dose adjustment from 100 mg thrice weekly to 70 mg thrice weekly ensuring sustained hemoglobin levels. Roxadustat appears to be an effective and generally safe therapeutic option for managing anemia in CKD patients, including those who are HDD, NDD, or RTRs. However, monitoring for cardiovascular events, such as myocardial infarction, is essential in these patients.