Pakistan BioMedical Journal

Association Between Guyon’s Canal Syndrome and Hypothenar Muscle Weakness Among Call Center Agents: A Cross-Sectional Study

Fatima Mazhar — 2025-09-30

Guyon’s Canal Syndrome is an ulnar nerve entrapment often caused by repetitive wrist use and poor ergonomics. Objectives: To investigate the association between Guyon’s Canal Syndrome and hypothenar muscle weakness among call center agents. Methods: This cross-sectional study was conducted on 56 participants using convenience sampling. The study was completed within six months. Data were collected from call center agents in Lahore using Tinel’s sign to assess ulnar nerve irritation, and testing of the hypothenar muscles, abductor digiti minimi, and opponens digiti minimi was performed using Manual Muscle Testing (MMT). Results: A positive Tinel test was noted in 83.9% of subjects. MMT revealed that 60.7% exhibited grade 4 and 35.7% displayed grade 5 strength in the abductor digiti minimi, while 66.1% showed grade 4 and 28.6% demonstrated grade 5 strength in the opponens digiti minimi. A notable negative correlation emerged between Tinel test outcomes and abductor digiti minimi strength (r=–0.442, p<0.001), whereas the correlation with opponens digiti minimi strength was not statistically significant (r=–0.190, p=0.064). Conclusions: The study found a significant negative correlation between Tinel test results and abductor digiti minimi strength.

Prevalence of Genu Varum and Genu Valgum in Osteoarthritis, Association with BMI, Age, Gender and Grade 3, 4 of Osteoarthritis

Erum Ghaffar — 2025-09-30

A joint disease known as osteoarthritis is a degenerative disease in which cartilage breakdown, leading to pain, stiffness, and reduced joint function, especially in weight-bearing joints like the knees. Skeletal deformities, such as bandy leg and knock-knees, can worsen the symptoms and limitations of OA in the lower extremities. Objective: To evaluate the relationship between angular deformities (Genu Varum and Genu Valgum) and osteoarthritis (OA) in individuals between the ages of 35 and 80, with an emphasis on OA grade, age, and BMI. Methods: A cross-sectional survey of 163 male and female patients with grade 3 and 4 OA from different hospitals in Lahore, ranging in age from 35 to 80 years, was conducted. Intercondylar and intermalleolar distances were measured with a scale, and the Q angle was determined with a goniometer using non-probability convenient sampling. The BMI was computed by dividing weight by the square of height in meters. Results: In this study out of 163 individuals, genu varum and valgum were diagnosed by Q angle, intercondylar distance, and intermalleolar distance. Data analysis using SPSS 27 revealed 52% of OA patients had genu valgum and 47% had genu varum. A strong association was found between these deformities and OA, particularly with increasing age and advanced OA grades. Conclusions: The study indicated that individuals aged 40 to 60 with grade 3 OA are at higher risk of developing genu valgum than genu varum. A significant association between these deformities and OA was found, with a p-value of less than 0.05. A strong correlation between age and angular deformities shown, while BMI and gender were less correlated

Workplace Politics and Its Effect on Postgraduate Obstetrics and Gynecology Training: An Exploratory Study

Qudsia Nawaz — 2025-09-30

Power, favoritism, and informal influence are the hallmark features of workplace politics, which can have significant implications on postgraduate medical education. Objectives: To investigate the effects of these dynamics on learning, morale, and professional growth among obstetrics and gynecology fellowship trainees in two tertiary care hospitals in Pakistan. Methods: Qualitative exploratory study using thematic analysis of semi-structured interviews and open-ended survey responses. Sixteen female obstetrics and gynecology fellows from two different teaching hospitals of Pakistan responded; the names of these hospitals are being kept anonymous. Data were collected via anonymous online questionnaires with quantitative Likert items and open-ended questions, followed by in-depth semi-structured interviews. Responses underwent inductive coding to identify recurrent themes around politics, mentorship, bullying, and workplace culture. Results: Six themes emerged: (1) favoritism affecting access to surgical cases and evaluations, (2) lack of supervisory accountability, (3) isolation and reduced self-confidence among non-favored trainees, (4) impaired team cohesion, (5) normalization of political behavior, and (6) absence of formal grievance mechanisms. Quantitatively, 75% of trainees reported that workplace politics substantially hindered their learning, including limited clinical exposure, delayed skill acquisition, and reduced participation in teaching sessions. Additionally, 87.5% felt uncomfortable reporting bias or bullying, highlighting a lack of psychological safety in the training environment. Conclusions: Workplace politics in postgraduate obstetrics and gynecology training negatively impact learning outcomes by restricting access to practical training, reducing self-efficacy, and undermining collaborative learning. Implementing transparent case allocation, ethical leadership training, anonymous reporting mechanisms, and structured audits is essential to foster an equitable and supportive educational environment.

Exploring Sleep Quality as a Modifiable Risk Factor for Suicidal Ideation among Young Students

Manahl Imran — 2025-09-30

Sleep quality is a key modifiable factor that can influence suicidal ideation. While poor sleep is linked to suicidal thoughts, there is limited research on its effects in non-clinical young Students. Objectives: To examine how sleep disturbances, influenced by environmental factors such as living conditions and lifestyle, are related to suicidal ideation among students. Methods: A cross-sectional survey was conducted at the University of Punjab, Lahore, Pakistan, from March to June 2025. A total of 150 Young Students aged 15-30 years were recruited through purposive sampling. Participants completed the 13-item Sleep–Suicide Ideation Rating Scale (S-SIRS), a self-developed questionnaire designed to assess sleep quality and its perceived impact on suicidal thoughts. The S-SIRS was validated through reliability testing (Cronbach’s α = 0.748) and expert evaluation for content validity. Data analysis included Spearman’s correlation to explore the relationship between sleep disturbances and suicidal ideation, non-parametric tests for group comparisons, and Firth’s penalized-likelihood logistic regression to identify key predictors and address class imbalance. Results: A significant positive correlation was found between sleep disturbances and suicidal ideation (ρ=0.402, p<0.001). Hostel residents and female reported higher levels of both sleep disturbances and suicidal ideation. Sleep impairment was the strongest predictor, with each unit increase in sleep disturbance raising the odds of suicidal ideation by 23.3% (OR = 1.233, p<0.001). Conclusions: Sleep disturbances are strongly linked to suicidal ideation among students, with environmental factors influencing this relationship.

Navigating Challenges Evaluating Health System Responses to Burn Injuries in Quetta, Balochistan

Zarak Khan — 2025-09-30

Burns are a significant health issue in the population of low- and middle-income countries such as Pakistan. This is especially acute in the resource-strained province of Balochistan, where the healthcare system in terms of assisting burn victims in Quetta, is compromised due to a great number of systemic flaws. Objectives: To assess the effectiveness of the healthcare system to treat burn injuries in Quetta, Balochistan, in terms of analyzing the primary barriers to care, such as infrastructural inadequacy, the lack of staff, and sociocultural issues. Methods: The qualitative research design of semi-structured interviews was ascertained by the 24 interviewees in the semi-structured interviews with the professionals in the field of burn care who could reflect the patients, givers, and policymakers. Primary data were collected at the different health facilities of Quetta. Thematic analysis was able to reduce the wide categories and problems in burn care. Results: The financial aspect was a great concern, and the treatment was prohibitive expensive. Moreover, an increase in the number of delays in seeking care was caused by sociocultural factors, including gender-based decision-making. All these results indicate the existence of significant barriers, which are founded on insufficient investments, the absence of highly qualified staff, and ineffective infrastructure, which lead to the need to establish the overall changes in the treatment of burns. Conclusions: An interdisciplinary Burn Care strategy should be more preoccupied with changes in infrastructure, education of medical workers, and community involvement.

Serum Electrolytes and Their Combined Effect on Hyperuricemia among Type 2 Diabetic Patients

Nasreen Begum — 2025-09-30

Hyperuricemia (HU) is a metabolic and kidney dysfunction that is rapidly prevailing. To compare the diabetic, gender, and age-based response of magnesium and potassium in patients with diabetes mellitus (DM) type 2. Objectives: To compare the diabetic, gender, and age-based response of magnesium and potassium in patients with diabetes mellitus (DM) type 2. Methods: It was a randomized controlled trial (single-blinded) conducted on 290 patients. Four groups were formed: T1 (control), T2 (Magnesium), T3 (Potassium), and T4 (Magnesium + Potassium). Supplements were given for a period of two months. Blood samples from subjects were taken before (phase I) and after (phase II) the supplements. Unpaired t-test and multivariate Analysis of Variance (MANOVA) were applied. Results: Among 290 participants, 195 were female (67.2%) and 95 male (32.7%), with 159 (54.8%) of all participants in the age range of 46-65 years. The mean uric acid levels dropped from 5.5 mg/dL to 4.6 mg/dL after medication intervention. Significant differences in BSF/R, HbA1c, and uric acid levels were reported between phase I and phase II; p-values <0.001, 0.0025, and 0.04, respectively. MANOVA determined that T3 was highly significant with respect to gender (0.005) and T4 with respect to age (0.01). While the control group showed the largest absolute drop in uric acid, potassium supplementation (T3) demonstrated a consistent and statistically significant reduction relative to baseline and across gender groups. Conclusions: Potassium substantially plays an effective role in lowering the BSF/R and uric acid levels of T2DM patients and is controlled by gender.

Assessment of Occupation-Related Lower Limb Venous Disorders Using Doppler Ultrasonography: A Cross-Sectional Study

Warda Kiran — 2025-09-30

The lower limb contains the hip, femur, knee joint, tibia, fibula, and foot. Some common abnormalities of lower limbs are varicose veins, followed by deep vein thrombosis, fractures, tumors, etc. Objectives: To evaluate lower limb venous abnormalities in patients related to their occupation using Doppler ultrasonography. Methods: This was a descriptive cross-sectional study conducted within the Radiology Department. A high-frequency linear probe, a TOSHIBA ultrasound machine, and the patient table were used in the equipment for this study. The patients were included after written consent. A sample size of 117 patients was considered using a convenience sampling technique. All patients with lower limb pain, swelling, tortuous veins, and tenderness were included in the study. The data were entered and analyzed using SPSS version 26.0. Results: Lower limb abnormalities are most common at the age of 41-50 years, 46 (39.3%). There were 75 (64.1%) male in the study and 42 (35.9%) female in the study. Most of the patients, 41 (35.0%), were housewives, followed by businessmen, 4 (20.5%). Superficial femoral vein 55 (47.0%) was involved in most patients. The most common diagnosis was varicose veins, 71 (60.7%), followed by deep vein thrombosis (DVT), 32 (27.4%). Lower limb venous abnormalities are seen to be more common in male than in female. These abnormalities are common at the age of 41-50 years. Conclusions: In conclusion, the most common occupation is seen to be housewives. The most common venous abnormality was left-sided varicose veins, followed by Deep Vein Thrombosis.

Smoking in Pregnancy: An Invisible Threat to the Developing Brain

Anna Maria Lavezzi — 2025-09-30

Cigarette smoking during pregnancy is a widely recognized public health issue, with a growing body of evidence documenting its harmful effects on the health of the unborn child [1]. While long-term consequences such as low birth weight and respiratory problems are now well-known, the impact on the particularly vulnerable developing nervous system deserves specific and urgent attention. Prenatal exposure to toxic substances from smoking can leave a lasting imprint, compromising the complex neuronal architecture and future cognitive functions. Nicotine, the most well-known component in cigarette smoke, not only easily crosses the placental barrier but is also one of the few lipid-soluble substances capable of passing through the blood-brain barrier by passive diffusion, thus acting directly on the expression of genes and transmitter systems essential for the development of the nervous system [2-4].

In particular, it can act as an agonist on acetylcholine receptors, crucial for neuronal proliferation, differentiation, synaptogenesis, and above all, it can interfere with the development of nerve centers essential for coordinating the vital functions of the fetus. Furthermore, it should be noted that smoke is not just nicotine. Cigarette smoke is a complex mixture of over 7,000 chemical substances, many of which are neurotoxic. Carbon monoxide, for example, reduces the availability of oxygen for the fetus, creating a condition of hypoxia that can irreversibly damage brain cells. Epidemiological studies have consistently shown a correlation between maternal smoking and an increased risk of neurobehavioral and developmental disorders in the child. A higher incidence of Attention Deficit/Hyperactivity Disorder (ADHD), autism spectrum disorders, and cognitive delays is observed in children exposed to smoke in utero [5]. These problems are not simply transient; they often persist into adolescence and adulthood, affecting school performance, social relationships, and overall quality of life.

On the cellular and molecular level, studies have demonstrated the accepted mechanisms of these effects. Exposure to smoke during pregnancy has the capacity to distort the expression of genes governing signal pathways, specifically impairing myelination, which is required to transmit impulses efficiently [6]. Moreover, it has been learned that smoking can cause oxidative stress and inflammation in the fetal brain tissue, which are some of the reasons that lead to cell death and deterioration of the neurons. The problem is not related to the active smoking of the mother alone. Prenatal exposure to secondhand smoke can also be regarded as a major risk factor. There is a need to make sure that the awareness of this problem is conveyed not only to the expectant mothers but also to the partners and all other people who spend time in the same home, so that the atmosphere of the place is totally smoke-free and the fetus can be well taken care of.

In summary, it is not only an ethical and scientific requirement but also scientific to protect the fetal nervous system against exposure to smoke. Each cigarette smoked by a pregnant woman is not only a threat to the pulmonary or cardiac system of the unborn child, but also a potential strike to the wholeness of their brain and the likelihood of delivery without health complications. This should be targeted in information campaigns and health policies, where women and their families are given help that will enable them to stop smoking and give their child the best possible start in life, and a neuro-cognitive future.