Journal of Islamic International Medical College (JIIMC)

EDITORIAL: The Silent Burden of Communication Disorders: Artificial Intelligence for Transforming Recognition, Informed Decisions and Outcomes

Prof. Dr. Humaira Shamim Kiyani — Thu, 03 Sep 2026 00:00:00 +0000

Communication is a fundamental human right and the cornerstone of learning, employment, social participation and overall well-being. Communication disorders including speech, language, voice, fluency, hearing, and cognitive abilities, affect hundreds of millions of people worldwide. The World Health Organization (WHO) reported that more than 430 million people have hearing loss that is incapacitating, while millions more experience acquired and developmental communication disorders associated with autism spectrum disorder, stroke, traumatic brain injury, Parkinson's disease, dementia and other neurological conditions.

Due to a lack of epidemiological data, underreporting, insufficient screening programs and a shortage of speech-language pathologists the actual prevalence in Pakistan is still unknown. Consequently, many people remain undiagnosed or only receive intervention after the most effective period for recovery has been lost. Communication disorders represent a silent burden, making them one of the most overlooked health challenges. In contrast to physical disabilities, communication difficulties such as problems with speaking, understanding, reading, writing, or social communication often go unrecognized which can result in delayed diagnosis, poor academic performance, unemployment, social isolation, psychological distress, and a lower quality of life. The nature of these impairments can make early recognition difficult, complicating clinical assessment and delaying informed decision-making.

Artificial intelligence (AI) offers an unprecedented opportunity to make invisible burden visible by identifying early or subtle changes in speech language, and communication abilities that may not be readily observed during traditional clinical assessment. Progress in speech analytics, natural language processing, machine learning, and digital biomarkers can generate objective data to supplement traditional evaluation methods and support more accurate and timely clinical decision making................................

Evaluation of Neonatal Factors on 17 Alpha Hydroxyprogesterone Level in Neonates- An Experience in Tertiary Care Setting

Humaira Javed, Ghazanfar Abbas, Muhammad Aamir, Muhammad Omar, Masooma Fatima — Thu, 03 Sep 2026 00:00:00 +0000

Objective: This study aimed to determine the effect of various neonatal factors on the serum 17 alpha hydroxyprogesterone (17α-OHP) levels in neonates.
Study Design: An observational analytical study.
Place and Duration of Study: This study was conducted at the Department of Chemical Pathology of Shifa International Hospital Islamabad, Pakistan from 29th January 2026 to 30thJune 2026.
Materials and Methods: The study was conducted on 132 study participants that included healthy neonates as controls and sick neonates as cases. The sample size was calculated using the WHO sample size calculator. Non-probability consecutive sampling techniques were employed. Clinical data of all neonates were collected using a structured data sheet and their serum 17 alpha hydroxyprogesterone levels were measured using a chemiluminescence-based auto analyzer (Maglumi X3, Snibe Diagnostics, China). Statistical analysis was performed on IBM SPSS Software version 26, with the Mann–Whitney U test applied for comparison of continuous variables to determine statistical significance.
Results: A total of 132 neonates were included in the study, of which 92 (69.7%) were full-term and 40 (30.3%) were preterm. Among them, 44 (33.3%) were sick and 88 (66.7%) were healthy. 17α-OHP levels were significantly higher in preterm compared to term neonates (p < 0.05), in sick compared to healthy (p < 0.05).
Conclusion: The present study supports existing evidence that several neonatal factors are associated with elevated 17α-OHP levels. Therefore, these neonatal factors should be taken into account when interpreting 17α-OHP levels in the neonates.

Maternal Knowledge, Attitudes, and Cultural-Religious Perceptions Regarding Human Milk Donation and Human Milk Banking: A Cross-Sectional Study among Postpartum Mothers at a Tertiary Care Hospital

Thu, 03 Sep 2026 00:00:00 +0000

Objective: To assess maternal knowledge, attitudes, and cultural-religious perceptions regarding human milk donation and acceptance of donor human milk among postpartum mothers at a tertiary care hospital in Karachi, Pakistan.
Study Design: It was a descriptive cross-sectional study.
Place and Duration of Study: Over the course of six months, October 1, 2025, to March 30, 2026, this study was carried out at Pakistan Naval Ship (PNS) Shifa Hospital in Karachi.
Materials and Methods: A total of 375 postpartum mothers with infants younger than six months were enrolled using non-probability consecutive sampling. Data were collected using a standardized intervieweradministered questionnaire covering sociodemographic characteristics, obstetric history, knowledge, attitudes, and cultural-religious perceptions regarding human milk donation and milk banking. Descriptive statistics and Chi-square test were used for data analysis, with p<0.05 considered statistically significant.
Results: A total of 375 postpartum mothers participated in the study, with a mean age of 28.73 ± 4.43 years. Awareness of human milk banks was reported by 169 (45.1%) mothers, while 209 (55.7%) believed donor human milk was more nutritious than formula milk. Most participants (321; 85.6%) expressed concerns regarding infection transmission through donor milk, and 342 (91.3%) were aware of the concept of milk kinship (Rada'a). Only 82 (21.9%) mothers were willing to donate breast milk, and 49 (13.1%) were willing to receive donor human milk for their infants, indicating low acceptance despite moderate awareness.
Conclusion: Despite moderate awareness of human milk banking, willingness to donate or receive donor human milk remained low among postpartum mothers. Fears of infection and cultural-religious concerns were the principal barriers to acceptance.

Head and Neck Cancers in a Tertiary Care Setting: A Retrospective Analysis

Palwasha Faiz Khattak, Noor Ul Huda, Mirza Khizar Hameed, Mahum Khizar — Thu, 03 Sep 2026 00:00:00 +0000

Objective: To determine the site-distribution and relative frequency of head and neck cancers and to study their age and gender distribution and histological types across different anatomical subsites.
Study Design: A Retrospective cross-sectional record-based descriptive study.
Place and Duration of Study: This study was conducted from July 01, 2020, to December 31, 2024, in the ENT Department, Fauji Foundation Hospital Rawalpindi.
Materials and Methods: The record of 305 patients, with age range of 14-79 years, and histologically confirmed cases of head and neck cancers, was reviewed over a period of four and a half years. Data on tumour sites, type, age, and gender were extracted and analyzed using SPSS v26. Descriptive statistics (frequencies and percentages) were calculated for each tumour category, and age was recorded as a range across the study population.
Results: Out of total 305 patients, 211 (69.2%) were males, while 94 (30.8%) were females. Oral cavity tumours were the most common, found in 76 cases (24.9%), followed by hypopharyngeal carcinomas, 51 cases (16.7%), oropharyngeal cancers, 47 cases (15.4%), nasal/paranasal carcinomas, 29 cases (9.5%) nasopharyngeal cancers, 27 cases (8.9%), laryngeal cancers, 23 cases (7.5%), salivary carcinomas in 18 cases (5.9%), thyroid carcinomas and neck tumours with unknown primary each 15 cases (4.9%) and aural cancers in 4 cases (1.4%).
Conclusion: Head and neck cancers predominantly involved the oral cavity, hypopharynx, and oropharynx, together accounting for nearly two-thirds of all cases. An overall male predominance was observed, consistent with reported regional patterns. However, the near-equal gender distribution of hypopharyngeal cancers among males and females was a noteworthy finding and warrants further investigations through larger multicentre studies to explore potential regional demographic, environmental, and risk factor influences.

Do Professional Attitudes Align with Academic Performance? A Cluster Analysis of Physical Therapy Students

Thu, 03 Sep 2026 00:00:00 +0000

Objective: To identify professional attitudes among physical therapy graduates and to find patterns of professional attitudes in relation to academic performance using cluster analysis.
Study Design: An analytical cross-sectional study.
Place and Duration of Study: Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Thailand between March 01, 2025 to September 30, 2025.
Materials and Methods: The study included 65 physical therapy graduates. Participants completed an adapted questionnaire assessing professional attitudes across four domains. Grade point averages (GPAs) were obtained from official academic records. K-means cluster analysis was used to identify clusters based on GPA and professional attitude scores. Cluster characteristics were summarized descriptively, followed by exploratory comparisons using the Kruskal–Wallis test with post-hoc Mann–Whitney U tests.
Results: Overall, participants reported favourable attitudes toward the physical therapy profession. Three distinct profiles emerged. The profiles were characterized by lower relative GPA with high attitude scores, higher GPA with high attitude scores, and intermediate GPA with comparatively lower attitude scores. These profiles illustrate that academic performance, and professional attitudes do not necessarily align.
Conclusion: The findings indicate variation in professional attitudes across levels of academic performance among physical therapy graduates. These findings highlight the importance of considering professional attitudes alongside academic performance in physical therapy education.

Prevalence of Selected Cardiovascular Risk Factors among Patients with Chronic Kidney Disease Receiving Maintenance Hemodialysis at a Tertiary Care Hospital in Islamabad

Muhammad Ali Riaz, Saima Bashir, Mobina Zafar, Bibi Taseer Fatima, Riaz — Thu, 03 Sep 2026 00:00:00 +0000

Objective: To determine the prevalence of selected traditional cardiovascular risk factors and CKD-related cardiovascular risk-associated abnormalities among patients with chronic kidney disease receiving maintenance hemodialysis.
Study Design:Descriptive cross-sectional study.
Place and Duration of Study: Department of Nephrology, Shifa International Hospital, Islamabad, from 15 September 2020 to 14 March 2021.
Materials and Methods: A total of 150 patients with CKD on maintenance hemodialysis, aged 18–70 years, were recruited using consecutive sampling. Patients with congenital or rheumatic heart disease, chronic liver disease or malignancy were excluded. Demographic and clinical data were collected, and laboratory investigations included complete blood count, serum calcium, phosphate, and HbA1C. Data were analyzed using SPSS version 22.Continuous variables were presented as mean ± standard deviation, and categorical variables as frequencies and percentages. Associations were assessed using chi-square tests, with p ≤0.05
considered statistically significant.
Results: The mean age of participants was 51.2 ± 8.4 years; 103 (68.7%) were male and 47 (31.3%) female participants. Hypertension was present in 64.0% of patients, diabetes mellitus in 38.0%, hypocalcemia in 64.7%, hyperphosphatemia in 50.0%, and anemia in 72.0%. Anemia was slightly more prevalent in females (78.7%) than males (68.9%). Diabetes mellitus was significantly more common in males (44.7%) than females (23.4%) (p=0.013). Other risk factors did not show statistically significant sex or age differences.
Conclusion: Traditional cardiovascular risk factors and CKD-related abnormalities associated with cardiovascular risk were highly prevalent among patients receiving maintenance hemodialysis. Anemia was the most prevalent CKD-related cardiovascular risk-associated abnormality, followed by hypocalcemia, hypertension, hyperphosphatemia, and type 2 diabetes mellitus.

Evaluation Of Phenotypic and Genotypic Methods for Detection of Multidrug Resistant Tuberculosis in Pakistan

Thu, 03 Sep 2026 00:00:00 +0000

Objective: To evaluate the phenotypic and genotypic approaches for the diagnosis of drug-resistant Mycobacterium Tuberculosis.
Study Design: A cross-sectional study.
Place and Duration of Study: This multicenter study was conducted over a period of six months, from April 01, 2025, to September 30, 2025, in collaboration with several healthcare and academic institutions across Pakistan. The study activities were carried out in the Biosafety Level 3 (BSL-3) Laboratory at the Department of Microbiology, Health and Population Department, Lahore; Tehsil Headquarters (THQ) Hospital Jand, district Attock; Health Services Academy, Islamabad; Islamabad Medical and Dental College, Barakaho; Metropole Laboratories, Islamabad; and Sindh Medical College, Karachi.
Materials and Methods: Eighty-Seven culture-positive samples of Mycobacterium Tuberculosis (MTB) isolates were evaluated for susceptibility to first-line anti-tuberculosis medications such streptomycin, isoniazid, ethambutol, and rifampicin, by using the Mycobacteria Growth Indicator Tube (MGIT) 960 system. The GeneXpert for MTB was used for its rapid detection and rifampicin resistance. Multiplex polymerase chain reaction (PCR) assays were optimized to amplify mutations in the rpoB gene associated with rifampicin
resistance, the katG gene associated with isoniazid resistance, and the embB gene associated with ethambutol resistance. The amplified PCR products were analyzed by agarose gel electrophoresis to determine the banding patterns associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) MTB isolates.
Results: Among the 84 MTB isolates, 30 samples were single-drug resistance (SDR), while 4 samples were identified as MDR. Among the SDR isolates, resistance to isoniazid was the most common (n = 24), followed by7 ethambutol (n = 3) and rifampicin (n = 2). Three non-MTB samples (negative, positive, and normal controls) were included as controls. Additionally, 50 samples were identified as Mycobacteria Other Than Tuberculosis (MOTT).
Multiplex PCR analysis included the following diagnostic performance parameters for MDR: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (DA) and it demonstrated 66.67%, 100%, 33.33%, 71.43%, and 80% for multidrug resistance; 66.67%, 100%, 50%, 75%, and 85.71% for isoniazid resistance; 80%, 96%, 50%, 84.50%, and 100% for rifampicin resistance; and 50%, 75%, 100%, 80%, and 80% for ethambutol resistance, respectively.
Conclusion: Genotypic methods for diagnosing drug-resistant MTB were faster than phenotypic methods to address important public health challenges in countries like Pakistan.

Comparative Analysis of Dyslipidemia and Atherogenic Indices among Controlled and Uncontrolled Diabetes Mellitus Patients at a Tertiary Care Center

Thu, 03 Sep 2026 00:00:00 +0000

Objective: To compare the prevalence, patterns, and atherogenic indices associated with dyslipidemia among patients with controlled and uncontrolled diabetes mellitus.
Study Design: Cross-sectional observational study.
Place and Duration of Study: The study was conducted at the Punjab Institute of Cardiology, Lahore, from October 2 to December 29, 2025.
Materials and Methods: Fasting blood samples of 503 eligible patients were analyzed for their lipid profiles and HbA1c levels. Participants were grouped into controlled and uncontrolled diabetes groups based on ADA criteria, while dyslipidemia classification was made using NCEP ATP III cutoffs. Clinical characteristics, lipid profile parameters, and atherogenic indices were compared between the two groups using independent t-test for parametric variables while Mann-Whitney U test was employed for non-parametric variables. Logistic regression analysis was used to assess the association of specific dyslipidemia phenotypes with glycemic
control status.
Results: The overall prevalence of dyslipidemia in the study population was 87.3%, which was significantly higher in the uncontrolled group (89.5% vs. 82.8%, χ²=4.510, p=0.034). Patients with uncontrolled diabetes showed significantly higher median values of HbA1c, triglycerides, duration of diabetes, Castelli Risk Index I and II, atherogenic coefficient, and cardiometabolic index, while HDL-C levels were lower. Uncontrolled diabetes was a strong, independent predictor of the combined dyslipidemia phenotype (OR: 3.43, 95% CI: 1.61–7.31, p=0.001), while LDL-C did not differ significantly between groups.
Conclusion: Uncontrolled diabetes mellitus is strongly associated with a more atherogenic lipid profile. Atherogenic indices should be incorporated into routine lipid profile along with a detailed assessment of dyslipidemia patterns, especially in the diabetic population.

Frequency and Antimicrobial Susceptibility Patterns of ESBL-Producing Uropathogens in Culture-Confirmed Pediatric Urinary Tract Infections

Sidra Tul Muntaha,Muhammad Ibrahim — Thu, 03 Sep 2026 00:00:00 +0000

Objective: To determine the frequency of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae isolated from culture-confirmed pediatric urinary tract infections and to evaluate their antimicrobial susceptibility patterns according to age and sex.
Study Design: Analytical cross-sectional study employing consecutive sampling.
Place and Duration of Study: Holy Family Hospital, Department of Pediatrics from 1st April 2023 to 1st April 2024.
Materials and Methods: Children aged 1 month to 12 years with clinical features of urinary tract infection and a positive urine culture were recruited. Urine specimens were processed for bacterial identification, antimicrobial susceptibility testing and confirmation of ESBL production. Age, sex, isolated organism, ESBL status and antimicrobial susceptibility findings were recorded and analyzed.
Results: Among 384 children, 236 (61.5%) were female and 148 (38.5%) were male. Escherichia Coli was the most frequently isolated organism, accounting for 284 (74.0%) cases, followed by Klebsiella Pneumoniae in 62 (16.1%) cases. Of 346 Enterobacteriaceae isolates, 208 (60.1%) produced ESBL. ESBL production was detected in 162 (57.0%) Escherichia coli isolates and 46 (74.2%) Klebsiella pneumoniae isolates. Infections were more frequent among children aged 1 month to <5 years and among females. Resistance was highest to ampicillin,
co-amoxiclav and ciprofloxacin, whereas meropenem and fosfomycin retained complete antimicrobial activity.
Conclusion: Extended-spectrum beta-lactamase producing Enterobacteriaceae were common among children with urinary tract infections, particularly in younger children and females. The high resistance to commonly prescribed antibiotics supports regular antimicrobial surveillance and culture guided treatment. Routine urine culture and antimicrobial susceptibility testing should be encouraged before initiation of definitive therapy to
optimize antibiotic stewardship.

Optimizing Platelet Transfusion Practices: A Comprehensive Analysis of Adherence to Guidelines in a Tertiary Care Hospital

Thu, 03 Sep 2026 00:00:00 +0000

Objective: To evaluate adherence of platelet transfusion practices to British Society for Haematology (BSH) guidelines – 2024 and identify patterns of non-compliance across clinical settings.
Study Design: A descriptive cross-sectional study.
Place and Duration of Study: Department of Haematology and Blood Bank, Fauji Foundation Hospital, Rawalpindi, from July 01, 2025 to December 31, 2025.
Materials and Methods: A total of 260 patients who received platelet transfusions during the study period were included. Demographic details, clinical diagnoses, indications for transfusion, and requesting departments were recorded. The appropriateness of platelet transfusion practices was assessed in accordance with the 2024 BSH platelet transfusion guidelines. Data were analyzed using SPSS v29. Guideline adherence was classified as adherent or non-adherent, and associations between diagnosis and adherence were assessed
using the Chi-square test.
Results: Adults constituted 56.2% of study population, whereas paediatric patients accounted for 43.8%. Females constituted 66.5% of the study population. Most platelet transfusions were administered in the NICU (18.1%), followed by oncology units (15.4%), ICU (14.2%), Medical wards (14.2%), paediatric wards (14.2%) and others (23.9%). Overall, 161 platelet transfusions (61.9%) were found to be compliant with the recommended transfusion guidelines, whereas 99 transfusions (38.1%) were identified as non-compliant.
Conclusion: Despite reasonable overall compliance, a substantial proportion of platelet transfusions were inappropriate, particularly in non-haematology settings. These findings highlight the need to strengthen transfusion management, to improve guideline adherence, enhance patient safety and optimize platelet utilization.

MEDICAL EDUCATION: Perspectives of Undergraduate Medical Students Towards Electronic Portfolios: A Mixed-Methods Study from Pakistan

Rida Hassan, Ayesha Aleem — Thu, 03 Sep 2026 00:00:00 +0000

Objective: To explore undergraduate medical students' perspectives on the adoption of electronic portfolios (e-portfolios), focusing on perceived benefits, challenges, and influence on learning and professional growth.
Study Design: A convergent mixed-methods design was employed.
Place and Duration of Study: Bahria University College of Medicine, Bahria University Health Sciences Campus, Islamabad, Pakistan, from May 27, 2025 to January 30, 2026.
Materials and Methods: All 100 first-year MBBS students were invited through census sampling and all participated. A structured questionnaire assessed awareness, perceptions, perceived benefits, and barriers to e-portfolio use. Semi-structured interviews with 21 purposively selected students explored these experiences in greater depth. Quantitative data were analysed using descriptive and inferential statistics; qualitative data underwent thematic analysis.
Results: Only 8% of students used the institutional e-portfolio. Educational background was not associated with use (Fisher's Exact Test, p = 1.000). Overall perceptions were positive (mean composite score 23.84 of 30): 63% high, 36% moderate, and 1% low. Female students scored higher than male students on the Mann- Whitney U test (p = 0.042), although this should be interpreted cautiously because the parametric analysis was not significant (Welch's t-test, p = 0.069). Lack of awareness (42.4%) was the commonest barrier, followed by
perceived irrelevance to undergraduate education (19.0%) and uncertainty regarding expected use (12.9%).p Greater support and guidance (46.8%) and evidence of educational benefit (26.0%) were the measures most often endorsed to encourage future use. Thematic analysis generated four themes: Knowledge Acquisition and Self-Awareness, Skill Development and Reflective Practice, Learning from Mistakes and Growth Mindset, and
Necessary Support Structures.
Conclusion: Medical undergraduates held predominantly positive perceptions of e-portfolios despite limited experience of their use. Improving awareness, structured orientation, faculty support, and curricular integration may enhance meaningful adoption in undergraduate medical education.