Pakistan Journal of Medical Sciences最新文献

Objective: To evaluate the effectiveness of the Schroth method combined with spinal manipulation treatment in patients with adolescent idiopathic scoliosis (AIS).

Methods: This was a single-center retrospective study performed between January 2023 and February 2024, in which 150 patients with AIS were treated with Schroth method with or without spinal manipulation at Wenzhou Traditional Chinese Medicine Hospital. Patients were classified into a study group and a control group with 50 patients in each group after screening. Intervention effects, maximum Cobb angle, clavicle angle before and after the treatment, trunk rotation angle, vertebral rotation angle, and lumbar range of motion (range of motion for lumbar extension and flexion) were compared between the two groups.

Results: The overall efficacy of intervention in the study group was higher than that in the control group (96.00% versus 84.00%) (P<0.05). After the treatment, the maximum Cobb angle, clavicle angle, angle of trunk rotation (ATR), and vertebral rotation angle of the two groups decreased compared to pretreatment levels and were significantly smaller in the study group compared to the control group (P<0.05). After the treatment, the degree of lumbar extension and flexion in both groups increased compared to before treatment and was markedly greater in the study group (P<0.05).

Conclusions: In patients with AIS, combining the Schroth method and spinal manipulation treatment was more effective in reducing the maximum Cobb and clavicle angles, trunk rotation angle, and vertebral rotation angle and restoring the lumbar range of motion compared to the Schroth method alone.

Objective: To determine the frequency and spectrum of different categories of Primary immunodeficiency disorders (PIDD).

Methodology: This was a prospective, observational analytical study, conducted in the Pediatric Medicine Department, University of Child Health Sciences (UCHS) from January 2021 to January 2023.We recruited 81 patients, initially suspected based on Jeffrey Modell Foundation(JMF) warning signs, followed by detailed evaluation. Descriptive statistics were applied.

Results: Male patients exceeded female (47: 31). Median age of presentation was 17 months. Median diagnostic delay was 10.5 months. Need of I/V antibiotics was the most frequent JMF warning sign (88.5%). Consanguinity, previous hospital admissions, family history and sibling death were present in 80%, 78%, 54%, 37% of cases respectively. The most conspicuous clinical feature was persistent or recurrent thrush (51%). Patients were categorized into six main groups: B-Cell defect (29.5%), SCID (24.4%), CID (14.1%), T-Cell defect (12.8 %), Phagocytic defect (11.5%) and NK deficiency (7.7%). Main bulk of patients 37 (47.4 %) were in age-group up to one year. Most common site of infection was recurrent pneumonia (76%) and the least was septic arthritis (5.1%).

Conclusion: PIDD should no longer be considered a rarity. B-Cell defect is the most common while earliest to diagnose are SCID and LAD. International health authorities should advocate EQUITABLE utilization of genetic testing across the globe.

Background & objective: Root canal infections are challenging to eradicate with conventional methods due to their complexity. Traditional chemical irrigants often fail to reach all bacterial colonies. Methylene blue (MB), used in photoactivated disinfection (PAD), generates reactive oxygen species (ROS) upon light activation, effectively killing bacteria. This study aimed to synthesize, characterize, and explore MB-functionalized reduced graphene oxide (MB/rGO) for enhanced photoactivated disinfection in root canal treatment.

Methods: This in-vitro study was conducted from April 2024 to September 2024 at Universiti Sains Malaysia and King Faisal University. Graphene oxide (GO) was reduced by dispersing GO in deionized water with sonication, followed by adding sodium hydroxide (NaOH) under vigorous stirring. The suspension obtained was centrifuged, washed, and dried to yield reduced graphene oxide (rGO). For functionalization, rGO was dispersed in ethanol and mixed with methylene blue (MB) solution, followed by stirring and drying to obtain MB-functionalized rGO. The antibacterial and antifungal activities of MB alone and in combination with rGO, with or without laser exposure, were tested using the agar well diffusion method. The paired sample t-test was used to compare the inhibition zones for different treatment groups of E. faecalis and C. albicans.

Results: FTIR analysis confirmed successful functionalization by identifying specific functional groups of rGO and MB. Similarly, Raman spectroscopy indicated that GO-MB had an intermediate level of defects, and SEM analysis confirmed slight morphological changes with MB molecules attached to the rGO surface. Moreover, the antimicrobial test revealed that MB/rGO with laser performed significantly better (p=0.042) than MB/rGO without laser and MB with laser group (p=0.034) against E. faecalis.

Conclusions: The functionalization of MB with rGO and its application with laser treatment significantly enhanced antimicrobial and antifungal activity, suggesting potential benefits for endodontic treatments and other dental applications.

Objective: Long-term mask use can trigger or exacerbate various health issues. This prospective experimental study evaluated the impact of protective face masks on masseter muscle activity and temporomandibular joint (TMJ) function reported by participants.

Methods: This prospective, experimental tudy was conducted to investigate the effect of face masks on TMJ function, we used surface electromyography to assess masseter muscle activity at rest, during maximum contraction of the masseter muscle, and while reading a text. We also evaluated the intensity of the masseter muscle pain using an algometer. The participants underwent these evaluations at the Istanbul Medipol University between July and October 2022.

Results: The study included 24 female participants with an average age of 28.5±5.40 years. After at least five hours of daily N95 mask use, a significant increase in masseter muscle activity was observed at rest and during speech (p=0.01; p=0.04, respectively). However, no significant changes in the maximum contraction of masseter muscle or pain threshold were observed (p>0.05).

Conclusion: This study found that the use of N95 mask is associated with restricted TMJ movements and discomfort, and an increase in its use is associated with restricted TMJ movements, discomfort, and increased masseter muscle activity. Questions regarding mask-wearing-related habits should be included in the routine lifestyle assessment of patients who report TMJ complaints.

Objective: The detection of anti-nuclear antibodies (ANA) is crucial in diagnosing systemic autoimmune rheumatic diseases (SARDs). The Dense Fine Speckled (DFS) nuclear pattern is one of the most common indirect immunofluorescence (IIF) patterns detected during routine ANA screening in patients with various clinical conditions. The aim of this study was to analyze the data of patients who were positive for DFS/antiDFS in our patient population and to show the possible clinical relationship.

Methods: In this retrospective study, 7406 patient serum samples sent to our laboratory for routine ANA screening between May 2022-2023 were evaluated for the presence of anti-DFS.

Results: In a group of patients referred for routine ANA screening using the indirect immunofluorescence method, the frequency of DFS pattern was found to be 4.55% (337/7406), with ANA positivity detected at a rate of 25.68% (1902/7406). Out of 221 patients with DFS pattern, 181 tested positive for anti-DFS antibodies in both the IIF-ANA and immunoblot (IB) tests. Additionally, 11 of these patients tested positive for other antibodies against different extractable nuclear antigens (anti-ENAs). Conversely, only seven out of the 40 patients who tested negative for anti-DFS antibodies showed positive results for other anti-ENAs.

Conclusion: The DFS pattern is often positive in individuals. In patients exhibiting this pattern, anti-DFS70 antibody may be detected alone or in combination with SARD-associated autoantibodies. Therefore, we propose that in this patient cohort, it would be more prudent to screen for additional concomitant autoantibodies with anti-ENA rather than confirming isolated anti-DFS.

Objective: To retrospectively evaluate β-thalassemias in the premarital hemoglobinopathy screening program in primary care.

Methods: The retrospective study was carried out in Bursa Uludag University Family Health Center in Turkey between 1-30 September 2023. In the study, the data of individuals who applied to the Family Health Center for premarital health examination within the four years between January 1, 2019, and December 31, 2022, were taken from the database and evaluated retrospectively. Family history of hemoglobinopathy, sociodemographic findings, existing diseases, allergies, cancer, and genetic disease conditions were obtained. Complete blood count, and high-performance liquid chromatography (HPLC) results were examined. P-values below 0.05 were considered statistically significant. Analyzes were made in the SPSS 25.0 program.

Results: A total of 327 people, 171 men (52.3%) and 156 (47.7%) women, participated in the study. It was determined that the age of the individuals was 30.17±6.16. The average Mentzer index levels were found to be 12.95±4.56. Places of birth are Mediterranean with 8.3% and other regions with 91.7%. β-thalassemia type detected in family medicine was suspected with a rate of 1.5% and carrier with a rate of 0.6%. The rate of patients referred to a hematologist was found to be 2.1%. The rate of patients with a definitive diagnosis was determined as 1.8%. It was determined that β-thalassemia definitive diagnosis rates were higher in groups whose place of birth was the Mediterranean region, with a family history of thalassemia, with a diagnosis of cancer, and with a genetic, allergic, and chronic disease diagnosis (p=0.01).

Conclusion: Although it is not located in the Mediterranean region, the high prevalence of β-thalassemia in our population and its relationship with diseases are important. We emphasize the importance of a premarital screening program for the diagnosis of β-thalassemia due to its increasing frequency and complications in the globalizing world.

Objective: To investigate the prevalence of Helicobacter pylori (Hp) infection, clarithromycin (CAM)-resistant genes and CYP2C19 gene polymorphisms in asymptomatic school-age children in Baigou New Town, Baoding City, Hebei Province, China.

Methods: This retrospective study recruited 1,068 primary school students from Baigou New Town, Baoding City, Hebei Province, China, in November 2023 to screen for Hp infection and detect clarithromycin-resistant genes using stool samples. Additionally, blood samples were collected for CYP2C19 gene polymorphism analysis.

Results: The stool antigen test for Hp yielded a positive rate of 18.4% (197/1,068). Among the 197 Hp-positive patients, 36.5% were resistant to CAM. The polymorphism analysis revealed that, in the 23S rRNA V region, the overall mutation rate was 62.5% for the A2143G site, 77.7% for T2182C, 50% for A2143G and T2182C, 2.7% for A2142C and 1.3% for A2142G. Moreover, the analysis classified the study participants into three CYP2C19 phenotypes (i.e., extensive, intermediate and poor metabolisers; extensive metabolisers (EM), intermediate metabolisers (IM) and poor metabolisers (PM), respectively), and the prevalence was 45.6%, 44.6% and 9.6% for EM, IM and PM, respectively.

Conclusion: The local area showed a high CAM resistance, indicating that CAM is not preferred for Hp eradication. CYP2C19 gene polymorphism analysis revealed that the EM phenotype was highly prevalent. Therefore, a comprehensive analysis of CYP2C19 gene polymorphisms is recommended to identify ideal proton-pump inhibitors for Hp eradication.

Objective: To investigate the effect of ablative fractional carbon dioxide laser (AFCO2L) combined with 1064 nm-Nd: YAG laser in treating hypertrophic scars (HTS) in burn patients.

Methods: This study retrospectively analyzed the medical records of 119 patients with postburn HTS admitted to The First People's Hospital of Changzhou from March 2021 to October 2023. According to the treatment method, patients who received 1064 nm-Nd: YAG laser treatment were included in the YAG group, while patients who were treated by a combination of 1064 nm-Nd: YAG laser and AFCO2L comprised the combined group. Treatment effects, skin properties, and patients' satisfaction with aesthetics were compared between the two groups.

Results: The total efficacy of the combination group was significantly higher than that of the YAG group (P<0.05). After the treatment, skin elasticity, skin moisture, and pigmentation scores of the combined group were significantly higher than those of the YAG group (P<0.05). The level of satisfaction with the aesthetics was significantly higher in patients who received the combined treatment than those treated with YAG alone (P<0.05).

Conclusions: A combination of AFCO2L and 1064 nm-Nd: YAG laser in the treatment of HTS is associated with a more significant effect, more significant improvement of skin properties, less pigmentation, and overall increased patient satisfaction with the aesthetics compared to the treatment with 1064 nm-Nd: YAG laser alone.

Gamification involves using gaming elements in education to capture learners' attention and motivate participation, offering innovative solutions to traditional teaching challenges. In various fields gamification enhances learning by fostering competition, collaboration and peer learning. In the realm of medical education, innovation is key to foster knowledge acquisition, critical thinking and skill development. Family physicians, dealing with comprehensive care, emphasize preventive measures like family planning and contraception. Effective contraceptive education is crucial not only for providing patient-centered reproductive healthcare but also to address the unique needs and preferences of a diverse patient population. To make learning more engaging we incorporated the board game "Snakes and Ladders" into a didactic session for family medicine trainees. Divided into teams, they solved case-based questions linked to game progression. Feedback indicated the session was more engaging and enjoyable compared to traditional lectures and they wish to see similar teaching methods in future academic sessions.

Objective: Although Vitamin-D (VD) deficiency in pregnancy continues to be an important public health problem, the effects of VD on fetal outcomes are not clear. VD can show its effects at the feto-maternal junction via nuclear factor-kB (NF-kB). This study was planned to determine the effect of changes in serum VD levels on amniotic fluid NF-kB levels.

Methods: Participants were selected among patients who applied to Samsun Medikalpark Hospital Gynecology and Obstetrics outpatient clinic between November 1, 2022 and November 1, 2023. Sixty patients whose serum VD measurements were performed at 24 weeks of gestation were included in the study. The pregnant women were divided into two equal groups according to their serum VD levels (n=30). The patients in Group-1 consisted of 30 patients with a VD level less than 20 ng/ml (VD deficienct group) and Group-2 consisted of 30 patients with a VD level higher than 20 ng/ml (VD sufficienct group). NF-kB levels were measured by ELISA in amniotic fluid samples taken during cesarean section from patients in both groups.

Results: The amniotic fluid NF-kB concentration of the VD sufficient group was found to be significantly lower than the VD deficient group. The amniotic fluid NF-kB levels of the VD deficient group were approximately two times higher than the VD sufficient group (6.36±2.12 ng/mL vs. 3.95±1.49 ng/mL, p< 0.01). After adjusting for gestational age, fetal birth weight, and parity, significant associations were found between VD and amniotic fluid NF-kB. The mean gestational ages at the time of cesarean section were similar in both groups.

Conclusion: Although VD insufficiency causes early inflammatory changes in fetal membranes by increasing amniotic fluid NF-kB levels, it does not lead to preterm delivery.