LIAQUAT MEDICAL RESEARCH JOURNAL

Anterior Mediastinal Mass Leading to Superior Vena Cava Obstruction- A case report

Rizwan Shah — 2026-03-31

Anterior mediastinal masses are uncommon but potentially life-threatening, particularly when they cause vascular compromise such as superior vena cava (SVC) obstruction. Thymoma is the most frequently encountered anterior mediastinal tumour in adults and may produce critical complications including complete SVC occlusion, haematological toxicity, and post-treatment pulmonary sequelae.

CASE PRESENTATION: A 53-year-old woman from Gilgit Baltistan presented with a 20-day history of fever and cough. Contrast-enhanced computed tomography of the chest revealed a large infiltrative anterior mediastinal mass encasing the great vessels and causing complete SVC obstruction with significant collateral venous formation. She was treated with concurrent chemoradiotherapy (CCRT), with serial imaging demonstrating partial tumour regression. However, persistent SVC obstruction, post-radiation pulmonary fibrosis, and progressive haematological toxicity — including dimorphic anaemia, leucopenia, and thrombocytopenia — developed as sequelae of treatment. This case highlights the importance of early imaging evaluation, a multidisciplinary treatment approach, and diligent haematological surveillance in patients with anterior mediastinal masses complicated by SVC obstruction. Holistic nursing care addressing both the physical and psychosocial burden of long-term malignancy is equally essential to optimise patient outcomes.

Are randomized controlled trials as gold standard for high level evidence a pragmatic approach in the era of precision medicine and real-world evidence

Binafsha Manzoor Syed — 2026-03-31

Randomized controlled trials (RCTs) have been considered as the gold standard for evaluating medical interventions due to their robust methodology, limited introduction of bias, and strength in establishing strong evidence to show better effect of a treatment option. However, the evolving landscape of healthcare—marked by precision medicine, digital health technologies, and expanding access to real-world data—has exposed important limitations in the traditional dominance of RCTs. These include issues of generalizability, cost, ethical constraints, and limited applicability in heterogeneous patient populations, particularly in low- and middle-income countries. Concurrently, the emergence of real-world evidence, pragmatic trials, and adaptive designs has introduced complementary paradigms that challenge the exclusivity of RCTs in evidence hierarchies. This editorial provides a critical and expanded appraisal of the role of RCTs in contemporary medicine, examining their enduring strengths alongside their limitations, and highlighting the need for an integrated, context-sensitive approach to evidence generation.

Perception and Awareness of Physiotherapy in Migraine and Its association with Quality of Life among Migraine Sufferers

Qurat-ul-ain Mustafa — 2026-03-31

This study was design to assess awareness and perception of physiotherapy among migraine sufferers and to examine its association with health-related quality of life among university students. This was a cross-sectional study including 132 university students aged 18–30 years with migraine, selected through convenience sampling. Migraine diagnosis was confirmed using the ICHD-3 criteria or a positive ID-Migraine screening test. Data were collected using the MINDS questionnaire, the Migraine Disability Assessment Scale (MIDAS), and the SF-36 health survey. Statistical analysis was performed using SPSS version 30, applying descriptive statistics and Pearson correlation analysis. Pearson correlation analysis showed statistically significant weak negative associations between SF-36 total scores and migraine characteristics. Quality of life was negatively correlated with the number of migraine attacks (r = ?0.205, p = 0.009), attack intensity (r = ?0.205, p = 0.009), medication intake (r = ?0.185, p = 0.017), and headache-related disability (r = ?0.155, p = 0.038). This study concludes that physiotherapy is significantly associated with improvement in migraine symptoms and overall quality of life among migraine sufferers.

The Effects of apple cider vinegar on VEGF165 and glucose level in Diabetic Mellitus type-II patients

Muhammad Asif Memon — 2026-03-31

Background/Aims: The purpose of clinical trial to evaluate the effect of apple cider vinegar on VEGF₁₆₅ and glucose level in type-II diabetes Mellitus (DM) patients.

Methods: A clinical randomized trial with non-probability convenient sampling technique study was conducted on 110 eligible types-II diabetes Mellitus patients who were failed to control their glucose level and they were suggested for cataract (senile) surgery. 15-20 ml apple cider vinegar in 200 ml water before sleep at night for 6 months (follow-up after each 3 months). HbA1C, Fasting Blood Sugar, VEGF₁₆₅ tests were performed Pre and Post operatively and analyzed using SPSS version 21.

Result: Total 110 diabetic type-II patients who were (NPDR) in both eyes, high ration of age between 51-60 about 54.4%, females were 61.5% and majority were illiterate about 37.2%. about 58.2% patients strictly follow their medication, about 53.1% patients strictly follow their diet plane and about 48.2% patients strictly intake apple cider vinegar daily. Significant mean changes were found in VEGF₁₆₅ (p<0.002), HbA1C (p<0.023), blood sugar fasting (p<0.012).

Conclusion: Apple cider vinegar regularly is most effective in controlling diabetes and unusual production of VEGF₁₆₅ (protein) of retina in DM type-II patient and control the worse condition of the eye moreover ophthalmologist can easily operate the cataract surgery and remove the dense cataract of the eye.

Effectiveness of arm ability training with biofeedback techniques to improve neuroplasticity, dexterity and quality of life among subacute stroke survivors

MYTHILI D — 2026-03-31

One of the main causes of physical disability is stroke, and 80% of stroke survivors suffer upper extremity dysfunction characterized by reduced muscle strength and functional limitation in muscle control and life quality. Arm ability training with biofeedback techniques is reported to enhance the functional recovery of the upper limb by improving the dexterity of the upper limb and life quality. An experimental study to find out the effects of Arm Ability Training with Biofeedback techniques on upper limb dexterity, functional ability, and quality of life in sub-acute stroke survivors. Sixty participants were chosen and randomly allocated to two groups. Group A received Arm ability training with biofeedback techniques, and Group B received conventional therapy for 60 minutes, 5 days/week for 3-4 weeks. The outcome measures were Modified standardized nine-hole peg test (mS-NHPT), Fugl-Meyer Assessment Upper Extremity, 12-item stroke-specific quality of life scale, and Wolf Motor Function Test. The mean completion time for the m-S NHPT decreased (from 113.78 ± 3.14 to 88.36 ± 2.49), and the FMA-UL increased (from 79.08 ± 2.54 to 90.52 ± 2.92). SS-QOL-12 (19.76 ± 0.99 to 40.12 ± 1.24), WMFT (Functional Ability) (from 46.76 ± 1.47 to 56.92 ± 2.03), and the time score improved (from 478.64 ± 2.9 to 435.16 ± 2.22). The variables indicates a statistical significance (p < 0.05). The above result statistically shows significant improvements in dexterity, functional ability, and life quality of sub-acute stroke subjects.

Bridging Healthcare and Community by Expanding the Scope of Medical Social Work in Public Health Care in Sindh, Pakistan: Challenges and Solutions

Faisal Hyder Shah Syed — 2026-03-31

This research study aimed to bridge healthcare and community and to expand the scope of medical social work in public health care, specifically in Sindh, Pakistan, by identifying challenges and proposing solutions within this context. Using qualitative semi-structured interviews with a sample of 18 participants (or respondents), our study explored the opinions of psychiatric social workers who provide professional help to patients with psycho issues through their service delivery in mental care hospitals, clinics, and community centers. However, our research findings explored many challenges, as expressed by participants during qualitative interviews, including the role ambiguity of health social workers among communities, resource scarcity, community-public power imbalances, the shortage of physical infrastructure, prevalent diseases, cultural barriers to treatment, people with disabilities, the impact of public organizational culture on their service delivery, and patients’ education and poverty. Our research suggests that health policymakers in Sindh address those challenges as solutions, thereby effectively enhancing the role and responsibilities of social workers in public health care at the provincial level.

Frequency of Renal Stones in Patients Diagnosed with Chronic Kidney Disease

Abeera Munir — 2026-03-31

This study was conducted to determine the frequency of renal stones in patients diagnosed with chronic kidney disease. A total of 226 participants aged 18–60 years of both genders with CKD were enrolled using consecutive sampling. Renal stones were diagnosed using ultrasonography. Data were analysed using SPSS v26 with Chi-square test; p ?0.05 indicated statistical significance. The mean age was 40.6 ± 12.2 years; among them, 144 (63.7%) were male. Renal stones were identified in 36 patients (15.9%) and were significantly associated with prior CKD history (83.3 vs 32.6%; p=0.001) and vitamin D supplementation (75.0 vs 37.9%; p=0.001). No significant associations were observed for age and gender (p >0.05). The current findings revealed that renal stones were present in patients with CKD and that the patient had significant associations with a prior history of kidney disease and vitamin D supplementation. Such demographic attributes as age, gender, and residential status did not have a significant association with stone formation. The results indicate the significance of specific clinical follow-ups and that further research is necessary to understand the potential origins and effective preventive interventions.

Silent Myocardial Infarction in Asymptomatic Patients With End-Stage Renal Disease on Maintenance Hemodialysis in a Resource-Poor Setting: A Cross-Sectional Study From a Single Dialysis Center in Pakistan

UZMA IBRAHIM — 2026-03-31

This descriptive cross-sectional study was conducted to determine the frequency of silent myocardial infarction (SMI) among asymptomatic end-stage renal disease (ESRD) patients on maintenance haemodialysis using routinely available electrocardiography and echocardiography in a resource-limited setting. The study was conducted at the Department of Nephrology, Dr. Ziauddin Hospital, Karachi, Pakistan, from April 2023 to October 2023. Medical records of 147 asymptomatic ESRD patients aged 18–70 years on maintenance haemodialysis for at least one year were reviewed. Patients with prior symptomatic ischaemic heart disease or coronary interventions were excluded. SMI was defined by pathological Q waves or major ST–T abnormalities on ECG (Minnesota Code) and/or regional wall motion abnormalities on echocardiography with left ventricular ejection fraction <50%, in the absence of ischaemic symptoms. Descriptive statistics, chi-square or Fisher’s exact tests, and multivariable logistic regression were applied. The mean age was 50.44 ± 13.55 years and 57.1% were male. SMI was identified in 19 patients (12.9%). Echocardiographic abnormalities were present in 43 patients (29.3%) and were not associated with SMI (p = 0.807). On multivariable analysis, haemodialysis duration greater than five years was independently associated with lower odds of SMI compared with one to five years (adjusted OR 0.11, 95% CI 0.01–0.84; p = 0.035). Silent myocardial infarction was identified in 12.9% of asymptomatic haemodialysis patients in this resource-limited setting. Routine ECG and echocardiography are feasible screening tools, particularly during the early dialysis period when cardiovascular risk appears greatest.