Background:Organ transplantation provides a vital solution for patients with end-stage organ failure; however, deceased organ donation rates in South Asia remain critically low. Cultural taboos, religious misconceptions, ethical concerns about brain death, and systemic socioeconomic inequities hinder donation efforts. Public mistrust and policy inconsistencies further exacerbate the shortage of available organs. Objective:This research explores how ethics, religion, and policy intersect to influence organ donation practices in South Asia. It identifies key barriers and proposes culturally appropriate strategies to increase deceased donation rates while ensuring equitable, ethical, and sustainable transplantation systems. Methods:A qualitative study was conducted using semi-structured interviews, questionnaires, and document analysis involving transplant surgeons, medical students, NGOs, and transplant candidates. A thematic analysis identified recurrent ethical, religious, and policy-related challenges. Literature review, expert consultations, and examination of religious texts and regional policies informed the findings. Key findings:Organ donation in South Asia faces multifactorial barriers. Public misconceptions about brain death are widespread, often conflated with coma or vegetative states. Religious hesitancy persists despite theological endorsements for donation in Islam, Hinduism, and Jainism. Rural populations and low-income groups experience greater reluctance due to cultural beliefs about bodily integrity and systemic inequities in healthcare access. Policy gaps, inconsistent brain death criteria, and inadequate infrastructure hinder donor recruitment and transplantation logistics. Community distrust toward healthcare institutions impedes acceptance of deceased donation. Collaborative efforts between healthcare professionals and religious leaders, combined with public education and policy reforms, emerged as critical pathways for improvement. Conclusion & Recommendations:Transforming organ donation in South Asia requires a multifaceted approach integrating ethical governance, religious support, and technological innovation. Key recommendations include establishing standardized brain death criteria, implementing opt-out consent trials with religious leader support, appointing transplant coordinators, and creating AI-based organ matching systems. Development of regional organ-sharing networks, drone transport, blockchain donor registries, and green corridors can improve efficiency and transparency. Religious endorsement libraries, hospital chaplaincies, and culturally tailored education campaigns can foster trust and awareness. Equitable financial protections, anti-trafficking enforcement, and oversight of emerging transplantation technologies are essential to build sustainable, ethical organ donation systems across South Asia.

Background: Surgical site infections (SSIs) remain one of the most frequent postoperative complications, leading to significant morbidity, prolonged hospitalization, and increased healthcare costs. The risk of SSIs is strongly influenced by surgical urgency, patient comorbidities, and intraoperative aseptic practices. Objective: This study aimed to assess and compare the incidence, microbial spectrum, and risk factors associated with SSIs in emergency versus elective surgical procedures performed at tertiary care centers in Punjab, Pakistan. Methods: A cross-sectional observational study was conducted from January 2023 to March 2024 across multiple tertiary care hospitals. A total of 90 patients were enrolled—45 undergoing emergency and 45 undergoing elective surgeries. Patient demographics, comorbidities, wound class, duration of surgery, and antibiotic use were documented. Postoperative wounds were evaluated on days 3, 7, and 30 according to CDC criteria. Data were analyzed using SPSS version 26, and significance was set at p < 0.05. Results: The overall SSI rate was 25.6%, with a higher incidence in emergency surgeries (31.1%) compared to elective procedures (20.0%). The majority of infections were superficial incisional (56.5%), followed by deep (26.1%) and organ-space (17.4%) infections. Staphylococcus aureus (43.5%) was the predominant pathogen, followed by E. coli (26.1%) and Pseudomonas aeruginosa (17.4%). Prolonged operative duration, diabetes mellitus, and contaminated wounds were identified as significant risk factors. Conclusion: Emergency surgeries are associated with significantly higher SSI rates due to limited preoperative optimization and greater contamination risk. Strict adherence to aseptic techniques, timely antibiotic prophylaxis, and postoperative wound surveillance can substantially reduce infection-related morbidity. Surgical site infection, emergency surgery, elective surgery, postoperative complications, tertiary care, infection control, Staphylococcus aureus.

Introduction: Autoimmune polyglandular syndrome (APS) type 2 is a rare disease that makes the body produce insufficient hormones because more than one endocrine gland is targeted simultaneously. Case presentation: We present here a report of a 30-year-old man found to have both APS type 2 and involvement of multiple organs. He came to the outpatient department with symptoms that suggested his thyroid, adrenal glands, and pancreas could be involved. The blood tests all showed he had Hashimoto’s thyroiditis, Addison’s disease, and type 1 diabetes. Discussion: Schmidt syndrome or APS type 2 was first noticed in two patients with Addison’s disease and chronic thyroiditis, described by the clinician Schmidt. Afterward, doctors confirmed that, as a rule, Addison’s disease occurs along with type 1 diabetes. The disease is three times more common in females than in males. Conclusion: This case demonstrates the importance of diagnosing acute endocrine problems early and that young patients with autoimmune conditions should be assessed for problems in multiple organs.

Background: Myopia is a growing concern globally, particularly among school-aged children, leading to severe ocular complications if untreated. Objective: The purpose of this research was to determine the effectiveness of DIMS spectacle lenses in preventing myopia progression in Pakistani children. Methods: The current study was tested clinically for two years with two hundred myopic youngsters aged six to twelve years. The subjects were divided into two groups; the first group received DIMS lenses while the second group received single vision lenses. Biometry of the axial length was done using the IOL Master 500 (Carl Zeiss Meditec) and the cycloplegic autorefraction was done using the Topcon KR-800S. For monitoring the progression of myopia, axial length measurements and cycloplegic autorefraction were performed with an interval of six months. Quantitative data were analysed using independent t-tests and mixed-effects models in order to compare the results between the groups. Results: Comparing the DIMS group to the single vision lens group, the children in the former demonstrated slower myopia development. Whereas the control group's mean myopic shift was -0.67 ± 0.30 D/year, the DIMS groups was -0.32 ± 0.25 D/year (p < 0.001). Significantly less axial length changes (0.15 ± 0.10 mm/year) were seen in the DIMS group as compared to the control group (0.31 ± 0.12 mm/year) (p < 0.001). Conclusion: DIMS spectacle lenses are effective in preventing the progression of myopia in Pakistani children. Their use could be a viable approach to managing myopia in this population. However, the study is limited by its short follow-up period and the lack of data on long-term outcomes.