ISSN(Print) 2076-2860 ISSN(Online) 2958-5945 Email: Editorial@jaimc.org Phone: +924299231453 PMDC & UHS (IP-0043)
Submission Open for Upcoming Vol. 24, Issue 2 ( April 2026- june 2026)
National and International Authors are invited to submit their research articles, case studies and review papers for the possible publication in VOL.24, Issue No.2, April 2026- June 2026, Journal of JAIMC.
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For Vol 23 Issue 3,
Dr Fatima Saed,
Assistant Professor, Pathology, AIMC
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CURRENT ISSUE
April 2026 – June 2026
VOL. 24, ISSUE NO. 2
EDITORIAL
Vaccine Hesitancy —Stretch Marks: An Overlooked and Therapeutically Recalcitrant Cutaneous Condition with Substantial Psychosocial Consequences Threat to global immunization gains
Muhammad Auns Faisal, Dayyan Ahmad Muazzam,Amber Arshad
https://doi.org/10.59058/jaimc.2026.24.1.1
ORIGINAL ARTICLES
Comparison of Post-Episiotomy Pain Relief with Diclofenac Suppositories and Oral Indomethacin: A Comparative Study
Saira Fayyaz, Samar, Aqsa Arshad, Amna Ahsan Cheema, Humayun Wasif Ahmad
https://doi.org/10.59058/jaimc.2026.24.1.1
ABSTRACT
Background & Objective: Perineal pain is a common morbidity following episiotomy, often hindering early maternal
mobility, newborn care, and overall recovery. Oral indomethacin has traditionally been used for post-episiotomy pain
relief, but gastrointestinal side effects limit its tolerability. Rectal diclofenac suppositories have been suggested as an
alternative with potential advantages in efficacy and safety.The objective of this study was to compare the efficacy of
rectal diclofenac suppositories with oral indomethacin for relief of post-episiotomy pain in primiparous women.
Methodology: In this comparative study, 70 primigravid women (aged 18–45 years, gestational age ≥37 weeks)
undergoing episiotomy at Lahore General Hospital, Lahore, were enrolled through non-probability consecutive
sampling. Participants were randomly allocated by balloting to receive either rectal diclofenac suppositories (100 mg
every 12 hours) or oral indomethacin (25 mg every 8 hours). Pain intensity was assessed 24 hours postpartum using the
Visual Analogue Scale (VAS). Subgroup analyses were performed based on age, body mass index (BMI), and gestational
age.
Results: Baseline demographic and clinical characteristics were comparable between groups. Mean VAS pain score at
24 hours was significantly lower in the diclofenac group compared with the indomethacin group (1.86 ± 0.81 vs. 3.26 ±
1.36; p < 0.001). Subgroup analyses confirmed the superiority of diclofenac across all age groups, BMI categories, and
gestational age strata. No adverse effects were reported.
Conclusion: Rectal diclofenac suppositories provide superior analgesia compared with oral indomethacin for postepisiotomy pain management, without variation across demographic or clinical subgroups. These findings support the
routine use of diclofenac suppositories for post-episiotomy pain relief in obstetric practice.
KEY WORDS: Episiotomy, Perineal pain, Diclofenac suppository, Indomethacin
Frequency of Need for Induction of Labour among Pregnant Women with Anterior Placenta Presenting: A Tertiary Care Experience
Alisha Pasha, Shamsa Arshad Butt, Kiran Iqbal, Nabiha Iqbal, Sadia Ilyas, Iram Iqbal
https://doi.org/10.59058/jaimc.2026.24.1.1
ABSTRACT
Background & Objective: The placenta, which is typically found at the fundus, anterior, or posterior uterine wall, is an
essential organ that supports fetal growth during pregnancy. An anterior placenta is typically regarded as a normal
placental position when detected by ultrasound. It may affect the onset of labor, but obstetric complications are not
typically caused by it.
The objective of this study was to determine the frequency of need for induction of labour among pregnant women
with an anterior placenta presenting at a tertiary care hospital.
Methodology: This retrospective analysis was conducted in the Department of Obstetrics and Gynaecology over a
period of six months from 1st May 2024 to 30th October 2024. Pregnant women with ultrasound-confirmed anterior
placenta, fulfilling the inclusion criteria, were enrolled after ethical approval and informed consent. Baseline
investigations and ultrasound examinations were performed to confirm placental location. Patients were assessed at
40 weeks of gestation for the onset of spontaneous labour. Data regarding maternal age, parity, body mass index (BMI),
need for induction of labour, and mode of delivery were recorded using a predefined proforma. Data were analyzed
using SPSS version 22. Ap-value <0.05 was considered statistically significant.
Results: The mean maternal age was 27.77 ± 4.15 years (range: 18–40 years). The mean BMI was 32.09 ± 3.45 kg/m²,
and the mean parity was 2.06 ± 1.46. Vaginal delivery occurred in 74.4% of cases, while 25.6% underwent caesarean
section. Induction of labour was required in 24.4% of women, whereas 75.6% experienced a spontaneous onset of
labour.
Conclusion: Anterior placental location is associated with a lower requirement for induction of labour, as the majority
of women with an anterior placenta achieved spontaneous onset of labour at term.
KEY WORDS: Induction of labour, term pregnancy, anterior placenta, onset of labour, mode of delivery
Antibiotic Susceptibility Patterns of Salmonella Isolates from Pediatric Blood Cultures at UCMD-Affiliated Teaching Hospitals
Anum Tahir, Muhammad Naveed, Mahwish Ejaz, Sehr Syed, Sara Maqsood, Ammara Gul
https://doi.org/10.59058/jaimc.2026.24.1.1
ABSTRACT
BACKGROUND & OBJECTIVE: Antibiotic resistance is a global public health threat and the emergence of multidrugresistant and extensively drug-resistant strains has significantly complicated treatment, resulting in increased
morbidity, mortality, healthcare costs and prolonged hospital stays. The objective of this study is to evaluate the
patterns of antibiotic susceptibility in Salmonella Typhi and Salmonella Paratyphi A isolates from pediatric blood
culture samples.
Methodology: It is a retrospective observational study conducted on 369 pediatric patients aged 1-15 years with
positive blood cultures for Salmonella species. Data were analyzed using SPSS software, with Chi-square test was
applied to compare resistance patterns between S. Typhi and S. Paratyphi A against different classes of antibiotics.
The study conducted in hospitals affiliated with the University College of Medicine and dentistry Lahore, from January
2022 till June 2024.
Results: Among 369 pediatric patients (mean age 10.3±3.6years; 66.7% male), 39% of Salmonella Typhi isolates
were sensitive to both first-line drugs and third-generation cephalosporins, 52.6% were multidrug-resistant, and 0%
were extensively drug-resistant. ESBL positivity was observed in 29.3% of isolates, while azithromycin and meropenem
retained high activity.
Conclusion: The results demonstrated that Salmonella Typhi showed higher resistance as compared S. Paratyphi A
(52.6% multidrug-resistant isolates and no extensively drug-resistant strains). It is pertinent to note the decrease in
cases of extensively drug-resistant strains in the present study after the introduction of TCV in the region. The study
highlights the need for continuous surveillance and rational antibiotic use.
KEY WORDS: Typhoid Fever, Salmonella Typhi, Drug Resistance, Multiple, Bacterial Drug Resistance, TyphoidParatyphoid Vaccine
Prevalence And Factors Associated With Depression Among Medical Students
Huda Abbas, Sundas Hamna
https://doi.org/10.59058/jaimc.2026.24.1.1
ABSTRACT
BACKGROUND & OBJECTIVE: Depression is a mental disorder in which low mood usually accompanies the low selfesteem, loss of interest, low energy or insomnia. Among medical students it is a growing problem worldwide and has far
reaching effects upon the students and the healthcare system. Higher suicide rates are associated with depression
among medical students than in the general population, more common among females.The study aims to determine to
determine prevalence of depression and associated factors among the medical students of Quaid-e-Azam Medical
College, Bahawalpur.
Methodology: It was a descriptive cross-sectional study conducted Quaid-e-Azam medical college, Bahawalpur during
April 2024 to September 2024. The sample Size was 280 calculated by Raosoft calculator. After obtaining informed
consent data was collected using a preformed online questionnaire using Phq 9 scale. Data was analyzed using SPSS
software version 26. The frequencies were calculated and tables and figures were made. Chi square test of significance
was applied.
Results: Among 280 students, 35.7% had mild depression, 30.7% minimal depression. Moderate depression was 25%,
while moderately severe and severe depression were 10% and 7% respectively. Females had higher levels of moderate
and severe depression. The final year students suffered the highest levels of depression and significant associations
between depression and gender, family history, higher use of social media were found (p<0.05).
Conclusion: Most of the students had mild depression, more prevalent among females and final year students.
Depression was significantly related to gender, family history, higher use of social media.
KEY WORDS: Depression, Academic Stress, Family History
Knowledge and Use of Preconception and Antenatal Folic Acid Supplementation in Women with Pre-Existing Diabetes: A cross-Sectional Study from Lahore, Pakistan
Atif Munir, Sidra Anwar, Saniya Umer Draz, Aijaz Zeeshan Khan Chachar, Najeeb Ullah, Asma Afzal Khan
https://doi.org/10.59058/jaimc.2026.24.1.1
ABSTRACT
BACKGROUND & OBJECTIVES: Pre-existing diabetes is a well-established risk factor for adverse fetal outcomes,
including congenital anomalies such as neural tube defects. Preconception and periconception folic acid
supplementation represent an evidence-based strategy for reducing these risks.
The objective of this study was to enhance awareness among both the general population and healthcare practitioners
is essential to ensure the timely and appropriate use of folic acid for preventive purposes.
Methodology: This study aimed to assess the level of awareness, understanding, and utilization of folic acid among
pregnant women with diabetes attending antenatal care, as well as its integration into routine clinical practice.
Results: Of the 50 participants, 14% were aware of folic acid supplements, 8% were familiar with the impact of folic
acid supplements on birth defects. 2% of participants reported that their doctors had discussed the effects of diabetes
on pregnancy with them. 46% of respondents reported currently taking folic acid supplements. 92% of participants
were unaware of the role of folic acid in the prevention of neural tube defects in pregnancy with diabetes and the fact
that diabetes increases the risk of neural tube defects in babies.
Conclusion: The findings underscore a significant need to strengthen awareness and educational initiatives targeting
both the public and healthcare professionals, in order to optimize folic acid use and reduce the risk of adverse
pregnancy outcomes associated with diabetes.
KEY WORDS: Folic Acid, Pre-Existing Diabetes, Knowledge
Aortic dissection: An Updated Review of Pathogenesis, Diagnosis and Management
https://doi.org/10.59058/jaimc.2026.24.1.1
Zain Nasiri,Sunnia Khalid
ABSTRACT
BACKGROUND & OBJECTIVE: Aortic dissection is a cardiovascular emergency requiring urgent attention and is
associated with severe complications and an increased risk of death. Early diagnosis and timely management are
critical for improving patient outcomes. This review aims to summarise the current understanding of the pathogenesis,
classification, diagnosis, and management of aortic dissection.
Methodology: Relevant English-language studies available up to 2025 were identified through searches of PubMed,
Google Scholar, and ScienceDirect. Keywords included “aortic dissection,” “pathophysiology,” “classification,”
“diagnosis,” and “management.” Peer-reviewed articles, clinical studies, and guideline papers published in English
were included. Data were extracted and synthesised qualitatively.
Results: Aortic dissection occurs when a tear in the intimal layer allows blood to form a false lumen. Important risk
factors include hypertension and connective tissue disorders. The Stanford classification remains the standard for
guiding management choices. Diagnosis is primarily based on imaging, especially computed tomography angiography,
with biomarkers such as D-dimer providing supportive information. Stanford Type A dissections require immediate
surgical intervention, while Stanford Type B dissections are usually managed medically or with endovascular
techniques.
Conclusion: Aortic dissection is a complex condition and demands swift identification and collaborative management.
While advancements in imaging modalities, biomarker discovery, and endovascular interventions have enhanced
diagnostic precision and patient prognoses, further investigation is essential to refine therapeutic approaches.
KEY WORDS: Aortic Dissection; Stanford Classification; D-Dimer; Diagnosis; Computed Tomography Angiography
Primary Cutaneous Mucormycosis Caused by Apophysomyces elegans in an Immunocompetent Child: A Rare Pediatric Case Report
Kokab Jabeen, Faiqa Arshad, Muhammad Suliman Sajid
https://doi.org/10.59058/jaimc.2026.24.1.1
ABSTRACT
BACKGROUND & OBJECTIVE: Primary cutaneous mucormycosis is an uncommon invasive fungal infection that typically
occurs in immunocompromised persons. Apophysomyces elegans is a member of order Mucorales and is an emerging
pathogen that can cause severe soft tissue infections in immunocompetent individuals following minor trauma.
Pediatric cases in immunocompetent children are exceedingly rare.
CASE PRESENTATION: We describe a healthy boy aged 9 years who presented with a progressive painful swelling and
black discoloration of the right lower limb after a minor incident outdoors. The first treatment with oral antibiotics
didn't work. On examination, it was found that there was necrotic eschar with surrounding erythema and tenderness.
Laboratory exams were normal and HIV testing was negative. MRI showed soft tissue involvement in the absence of
bone invasion. Direct potassium hydroxide (KOH) mount showed broad aseptate hyphae and fungal culture produced
the growth of Apophysomyces elegans. Urgent surgical debridement and intravenous (IV) liposomal amphotericin B
were performed. He improved markedly clinically and was discharged on oral posaconazole for 6 weeks. At 3-month
follow-up, there were no recurrences.
CONCLUSION: This case illustrates that invasive fungal infections can be encountered even in immunocompetent
children after minor trauma. Prompt and aggressive combined medical-surgical management and early suspicion is
vital to survival.
KEY WORDS: Pediatrics, mucormycosis, immunocompetent .
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