A healthcare system is one of the most essential pillars of any country. The primary role of a healthcare system is to ensure that all people get the best available health facilities in a timely, acceptable, affordable, and accessible manner. However, for a healthcare system to function as such, it requires proper infrastructure and financial support. To a large extent, the healthcare system in Pakistan is facing several challenges. There is a massive shortage of hospitals, doctors, nurses, and paramedical staff. Most life-saving medications are too expensive for people to afford. Now and then, there is a shortage of medicines in the market. Above all, there exists a lack of trust in the healthcare system, which gives way to the ever-increasing quackery in the country. Two parallel systems exist in the healthcare system of Pakistan. One consists of public hospitals, and the other consists of private hospitals. The former is short even of basic healthcare facilities, and the latter is too costly for the people of Pakistan to afford. Solutions to the stumbling and compromised healthcare system of Pakistan are adequate financial support and infrastructure development. Stakeholders need to invest in the healthcare system; otherwise, the healthcare system in Pakistan will continue fighting for its survival rather than improving and competing with the healthcare systems of other nations in the region.

Introduction: Routine medical checkup (RMC) is a screening and preventive technique that is implied to detect non-communicable diseases (NCDs). This study aims to assess the awareness in public regarding RMC, the association between education level and level of familiarity regarding RMC, and factors that prevent and encourage the practice of RMC by the public. Methods: This is a cross-sectional study carried out in Rawalpindi, Pakistan. Health professionals and individuals who refused to consent were excluded from the study. Data was collected using a mixed-mode questionnaire, and convenient sampling was used. The sample size was calculated to be 355 according to the WHO sample size calculator. A total of 356 individuals participated in this study after giving informed consent. Both male and female adults aged 18 or older and residents of Rawalpindi were included in the study. Individuals younger than 18 were excluded. Results: Among the 356 study participants, 160 (45%) were males, and 196 (55%) were females. The mean age was 27.57±10.027. Among the total participants, 33 (9.3%) individuals had primary-level education, 100 (28.1%) individuals had secondary-level education, and 233 (62.6%) had graduate-level education. A total of 329 (92.9%) participants knew that RMCs could help in early diagnosis and treatment. On the contrary, only 154 (43.3%) people knew that RMCs involve screening all body tissues. Only 329 (92.4%) participants said that they were aware that timely diagnosis through RMC can lead to early treatment. Graduates were generally more aware of different aspects of RMCs, especially in the domains of awareness regarding what an RMC is and that RMC can help in timely diagnosis compared to participants who had primary or secondary level of education (p<0.001). Females had a greater overall awareness of RMCs than males (p<0.001). Graduates were more likely to undergo RMCs than people educated till the primary or secondary level (p<0.001). The most common reason for undergoing RMC was “just concerned about health,” which was selected by 130 (36.5%) participants. The most common reason mentioned by participants for not having an RMC was ''heavy cost,'' mentioned by 104 (29.2%) participants. Conclusion: Most of the participants of this study were well educated and were students in terms of profession. The majority of the study population knew that RMCs could help in early diagnosis and treatment. Awareness regarding RMCs was linked to educational level. Females had overall better knowledge regarding RMCs than men. The most common reported reason to have an RMC was a health concern, and the most common reported reason for not having an RMC was its high cost.

Hepatitis is a major public health issue in Pakistan, with an estimated 11.55% prevalence of HCV infection in the adult population. The country ranks second globally in terms of hepatitis C virus (HCV) infections, with approximately one in every 20 Pakistanis already infected. The mortality rates due to HBV and HCV stand at 563,000 and 366,000 annually, respectively. However, the absence of a national registry or database system and the lack of coordination among provinces pose significant obstacles in combating this disease effectively. To address this issue, the establishment of a centralized national database registry is crucial, allowing comprehensive analysis, tracking of hepatitis prevalence, and identification of high-risk areas for targeted interventions. By fostering collaboration among provinces, the government, and non-governmental organizations, the registry would facilitate joint decision-making, minimize duplication of efforts, and address inconsistencies in diagnosis and treatment. Collaborating with student-run organizations and leveraging enhanced laboratory capacities post-COVID era can strengthen the hepatitis control program. The centralized approach and unified efforts are necessary to achieve the goal of a hepatitis-free Pakistan, where a healthier future can be realized.

Patients diagnosed with human epidermal growth factor receptor 2 (HER2)-positive breast cancer require treatment upfront because of the aggressive nature of this type of cancer. Patients with early-stage HER2-positive breast cancer are usually treated with neoadjuvant therapy. This neoadjuvant therapy comprises targeted therapy and chemotherapy. Targeted therapy is given with trastuzumab. Pertuzumab is either administered or not with trastuzumab as a targeted therapy. This systematic review and meta-analysis aim to find out and compare the benefit achieved in terms of pathologic complete response (pCR) by adding pertuzumab to the neoadjuvant treatment regimen for early-stage HER2-positive breast cancer patients. Various databases were searched to find out relevant clinical trials. After going through PubMed, Embase, and Cochrane, three clinical trials were shortlisted for this systematic review and meta-analysis. These three clinical trials were double-armed. Pertuzumab was present in one arm while being absent in one arm to assess the benefit of adding pertuzumab in terms of pCR achieved. Data were analyzed using RevMan Web (Cochrane, London, UK). The odds ratio and 95% confidence interval were calculated for the outcome. The Mantel-Haenszel method and random effect model were used for analysis. The risk of bias in studies was evaluated using the Cochrane risk of bias tool for randomized controlled trials (ROB2). The summary statistics showed that the incidence of pCR was more in the experimental group (having pertuzumab) as compared to the control group (without pertuzumab) with an odds ratio of 2.10 (95% CI: 1.56-2.83) with I2 = 0%. In three double-arm trials, there were 840 participants, 445 in the experimental group and 395 in the control group. A total of 203 (45%) patients out of 445 in the experimental group achieved pCR, whereas 127 (32%) patients out of 395 in the control group achieved pCR. Through the results of this study, it can be concluded that the rate of pCR achieved was higher in that arm in which pertuzumab was present compared to the study arm in which only trastuzumab was given as targeted therapy. Thus, it can be suggested that pertuzumab be added to the neoadjuvant regimen for early-stage HER2-positive breast cancer patients. This would result in achieving a better pCR. And by improving pCR rates, the survival outcomes of patients can be significantly improved.

Androgenetic alopecia (AGA) is a very common cause of noncicatricial alopecia, which negatively affects a person’s wellbeing. Although Food and Drug Administration (FDA)-approved drugs such as topical minoxidil result in an apparent improvement in this hair condition in a period of 4–6 months and have been used commonly as the first-line treatment of choice, another treatment modality that has gained popularity over the years is platelet-rich plasma (PRP) therapy. PRP is minimally invasive but much more cost-effective than restoration surgery. The FDA has not approved PRP as a treatment modality for AGA. We systematically reviewed the existing literature from Embase, Web of Science, CENTRAL and PubMed from inception to 2024, and included six clinical trials that compared these two commonly practised dermatological therapies for the treatment of AGA. Most studies used global photographic assessment of hair changes based on the investigator’s examination, which demonstrated statistically significant changes in hair density, terminal hair count and hair pull test. A few studies used subjective quantitative measures of hair parameters, such as patient satisfaction scores and improvement in hair quality. Topical minoxidil showed more improvement in terminal hair count and proportion of anagen hair. PRP showed more improvement in hair density and a negative hair pull test. All of the selected studies suggested that the efficacy of PRP is nearly comparable to that of topical minoxidil, with minimal adverse effects on long-term follow-up. Thus, PRP is a valuable treatment option either adjuvant to topical minoxidil or as a second-line treatment option for AGA.