Pakistan Journal of Medical Sciences最新文献

Objective: To evaluate the effectiveness of Azadirachta indica based Herbal mouthwash to treat tooth sensitivity in patients.

Method: This single-blinded clinical trial was performed at School of dentistry, Shaheed Zulfiqar Ali Bhutto Medial University, Islamabad from 1st February, 2023 to 30th April, 2023. In this interventional study incorporated 120 participants with clinically visible signs of erosion, abrasion or recession. Visual Analog Scoring (VAS) Tool was used to investigate tooth sensitivity in these patients. Values of VAS for tooth sensitivity was calculated by exposing teeth of these patients to cold air blasting with triple syringe attached to dental unit at psi-30.0 pressure between 23±30ºC for duration of one second without using Azadirachta indica based Herbal mouthwash. Later on, these patients were provided with this Herbal mouthwash and its usage was recommended twice a day for one month. After One month, tooth sensitivity of patients was determined by VAS again. Data was analyzed by Paired T-test at 95% confidence and significance < 0.05.

Results: VAS mean value for tooth sensitivity of patients before using Azadirachta indica based Herbal mouthwash was higher and found to be 55.43% ± 12.04 whereas its mean value after using Herbal mouthwash for one month reduced to 35.38% ± 11.62 which was statistically significant (p value=0.001). Reduction in tooth sensitivity of patients was almost 20.05% just after one month.

Conclusion: Azadirachta indica based Herbal mouthwash was potent enough to reduce the tooth sensitivity in patients after one month of its usage.

Objective: This study aimed to evaluate the clinical effectiveness of ORIF versus Ilizarov for the management of Type C closed pilon fractures of the distal tibia at 12 months follow up.

Methods: This retrospective cross sectional study was conducted at Jinnah Postgraduate Medical Center (JPMC) between 29^th May 2015 and 27^th November 2019 that included patients 18 years and older diagnosed with open AO type C pilon fractures. The primary outcome was the patient-reported Disability Rating Index (DRI) months. While the secondary outcomes were quality of life assessment using the patient satisfaction form (SF-12) and AOFAS-Ankle Hindfoot Score. Radiographs were assessed for fracture healing, time to healing, and malalignment.

Results: Fifteen patients underwent ORIF, while 26 patients were treated with Ilizarov, there was no statistically significant difference in DRI scores at 12 months between the two groups. In terms of clinical outcomes, both groups had comparable results throughout the follow-up period. The number of unplanned surgical procedures was not statistically significant (p=0.73), 26.92% (n=7) in the Ilizarov as compared to 33.33% (n=5) in the ORIF group.

Conclusion: Among patients with an acute, displaced, intra-articular fracture of the distal tibia, neither external fixation nor locking plate fixation resulted in superior disability status at 12 months. Patient factors may need to be considered in deciding the optimal approach.

Objective: To compare and find out the relationship between psychological distress, general health and life satisfaction among children with thalassemia and children undergoing dialysis.

Method: The current study utilized cross sectional research design. A representative group of children with Thalassemia (n=60) and children undergoing dialysis (n=60) with ages ranging from 6-14 years were included in the sample. The sample was drawn from Children's Hospital and Sundas Foundation from February 2023 to August 2023 through a purposive sampling technique.

Results: Psychological distress significantly correlates negatively with general health (-.34**) and life satisfaction (-.44**) in Children with Thalassemia. A significant negative relationship is also observed between psychological distress and general health (-.43**) and life satisfaction (-.54**) in Children undergoing Hemodialysis. Children undergoing hemodialysis experience more psychological distress whereas children with thalassemia have better general health. However, no significant difference was found in life satisfaction. The findings of the present study will be helpful for healthcare professionals and clinical psychologists to develop strategies and training programs which can increase resilience among patients. Training the patients and caregivers regarding how to fight chronic illnesses will lead to an improvement in their quality of life.

Conclusion: Psychological distress is higher in children undergoing hemodialysis and general health is also not good but the level of satisfaction is almost equal between the two groups. This is justified that chronic illnesses do not preclude children from leading happy and satisfying lives.

Objective: Premature infants require special attention during nursing. This study aimed to explore the effects of baby touch on the growth, immunity, sleep and communication in premature infants.

Methods: This was a retrospective study. A total of 64 premature infants with a gestational age of 30-36 weeks were selected at Maternity & Child Care Center of Qinhuangdao from June 2022 to May 2023, and randomly divided into experimental group and control group. The control group received routine comprehensive nursing care for newborns, while the experimental group was additionally treated with touch intervention using the international standard touch method. The effects of the three months touch on the growth and development, immunological function, sleep quality, and emotional communication of the premature infants were observed.

Results: No statistically significant differences were found in gender, gestational age, birth weight, birth length, or head circumference at birth between the two groups (p> 0.05). In the third month, the increases in body weight, body length and head circumference were significantly more obvious, the immunological function indicators including CD³⁺, CD⁴⁺, CD⁸⁺, IgG, IgA and IgM were all significantly higher, the sleep time and sleep quality were both significantly superior, and the interaction time and intimacy with parents were significantly superior in the experimental group compared with the control group, with statistically significant differences (p< 0.05).

Conclusion: Baby touch can promote growth and development, strengthen immunological function, improve sleep quality and enhance the emotional communication abilities of premature infants, and help them better adapt to the environment and grow.

Objective: To compare the therapeutic efficacy of tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in patients with chronic Hepatitis-B (CHB).

Methods: This retrospective study included 110 patients with CHB who received treatment at The First People's Hospital of Linping District, Hangzhou from January 2021 to January 2023. Clinical data of the patients were reviewed and the patients were classified according to the treatment received: TDF group (n=53, patients received TDF treatment) and ETV group (n=57, patients received ETV treatment). Hepatitis-B virus deoxyribonucleic acid (HBV DNA) levels, liver function indicators, hepatitis-B e antigen (HBeAg) seroconversion rate, alanine transaminase (ALT) normalization rate, HBV DNA negative conversion rate, overall efficacy, and incidence of adverse reactions were compared.

Results: The total efficacy of the treatment in the TDF group was 94.33%, significantly higher than that in the ETV group (78.95%; P<0.05). After the treatment, the HBV DNA levels in both groups decreased compared to pretreatment levels, and were significantly lower in the TDF group compared to the ETV group (P<0.05). Both groups showed significant post-treatment improvement in liver function that was markedly better in the TDF group compared to the ETV group (P<0.05). The HBeAg seroconversion rate, ALT normalization rate, and HBV DNA conversion rate in the TDF group were significantly higher compared to the ETV group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups.

Conclusions: Compared with ETV, TDF has comparable adverse reaction profile but has more significant clinical effects in patients with CHB, improving HBeAg seroconversion rate, ALT normalization rate, and HBV DNA negative conversion rate. TDF is associated with lower HBV DNA levels after treatment and better improvements in liver function of patients.

Objective: To evaluate the results of the prostate-specific antigen (PSA) test used in prostate cancer screening.

Methods: This retrospective study was conducted on a total of 1106 male individuals, including 615 people (55.6%) aged 40-54, 379 people (34.3%) aged 55-69, and 112 individuals (10.1%) aged 70 and over. In the study, prostate-specific antigen (PSA) blood test results were performed on a total of 1106 male individuals aged 40 and over registered in the Uludag University Family Health Center, Bursa, Turkey during the 5-years between June 1, 2018, and May 31, 2023, were taken from the database and analyzed. Relationships with sociodemographic characteristics, comorbidities, and risk factors were examined. Data was analyzed using SPSS 25.

Results: About 15.5% of the participants were married, 78.4% were single, and 6% were separated from their spouses or widows. The PSA values of the patients referred to the urologist were found to be significantly different between the ages of 55 and 69. It was determined that the PSA levels of the patients with benign prostatic hypertrophy and prostate cancer were higher than the patients without any finding, and the mean was 6.81±4.39 (p=0.01).

Conclusion: In our study, it is important to diagnose benign prostatic hypertrophy or prostate cancer in patients aged 55-69 years, whose mean PSA levels were 6.81±4.39, and referred to a urologist. As a contribution to the discussions in the literature, we recommend that the patient with symptoms be referred to the urologist after the test request and the joint decision with the family physician.

Background and objective: Pakistan, a South Asian developing country, is experiencing a rapid increase in number of diabetes cases. High prevalence ratio of diabetes in Pakistani population and lack of genetic research studies prompted us to design this study. This present study investigated Pakistani Pashtun population for (known and novel SNPs) and its possible correlation with Type-2 Diabetes Mellitus (T2DM).

Methods: This two stage (discovery & validation stage), case-control association study included one thousand individuals (Patients with T2DM=500 & controls=500) from eight districts of Khyber Pakhtunkhwa Pakistan. The study duration/period was from March 2018 to January 2020. In the first stage (the discovery stage) the target population was screened for known and novel T2DM-associated genetic markers. In the validation stage, identified variants were confirmed for T2DM association using MassARRAY genotyping and association analysis.

Results: Exome sequencing detected eleven known and four novel/new genetic markers in the study population. Novel variants were preferred over the known for follow-up analysis/validation. Among the identified variants strong associations were confirmed for the following variants; rs1781133/ANKRD65 (OR=2.10, 95%Cl=1.06-3.08, P=0.003) rs2274791/TTLL10 (OR=1.97, 95%Cl=1.36-2.62, P=0.025), rs71628928/RNF223 (OR=1.82, 95%Cl=0.97-1.92, P=0.041), and rs609805/SCNN1D (OR=2.21, 95%Cl=1.92-3.09, P=0.001) with T2DM; other reported variants showed no noticeable association (having P>0.05) with T2DM.

Conclusion: This study reports new genetic risk variants for T2DM in Pashtun population providing valuable insights into the genetic basis of T2DM in this group.

Objective: To determine frequency of postoperative hyperglycemia in children who underwent repair of Congenital Cardiac Defects (CCDs) in a tertiary care hospital of Pakistan. The other objective was to compare outcomes in children with versus without postoperative hyperglycemia who underwent repair of CCDs in a tertiary care hospital of Pakistan.

Methods: A descriptive study was conducted at the Cardiac Intensive Care Unit (CICU), Aga Khan University Hospital (AKUH), Karachi, Pakistan from October 3, 2020, to April 2, 2021. A total of 185 patients aged one month-18 years admitted to CICU underwent elective surgical repair of CCDs meeting the eligibility criteria were included. Glucose monitoring was collected at immediate, 4^th and 8^th postoperative hours on the first day and once daily on postoperative days Two and Three to assess hyperglycemia. Data including age, weight, gender, pre-operative diagnosis, type of surgery and variables such as CICU stay, duration of hospital stay and duration of mechanical ventilation were recorded.

Results: The mean age of the patients was 40.40±48.63 months. Out of 185 patients, 115 (62.2%) were male while 70 (37.8%) were female. Hyperglycemia was found to be in 182 (98.4%) patients. Out of 182 hyperglycemic patients, 53 (28.6%) had moderate hyperglycemia while 129 (69.7%) had severe hyperglycemia. Mean duration of hospital stays was 9.24±7.45, mean duration of pediatric CICU stays was 141.61±169.02 hours and mean duration of mechanical ventilation was 80.59±98.54 hours.

Conclusion: Hyperglycemia is a frequent finding in children who underwent repair of CCDs, and it is not significantly associated with duration of mechanical ventilation, length of hospital and CICU stay.

Background & objectives: The relationship of Vitamin-D (VD) with Luteinizing Hormone (LH), Follicle stimulating Hormone (FSH) and Anti Mullerian Hormone (AMH) is recognized. This study was conducted to determine whether VD is a predictor of fertility and investigate its relationship with female reproductive hormones and markers of ovarian reserve in female population of Karachi.

Methods: A cross-sectional study was performed from July 2020 to June 2022 at the Aga Khan University Hospital (AKUH) with recruitment of 135 fertile and infertile subjects. VD, AMH, FSH and LH levels were estimated by 'Enzyme Linked Immunosorbent assay (ELISA)'. By applying binary logistic regression, variables with p-value < 0.25 in univariate analysis were used for multivariate regression model and adjusted odds ratios were computed. In multivariate analysis, significance was p-value ≤ 0.05.

Results: VD deficiency was observed in all infertile female subjects. In univariate regression analysis, FSH, LH, LH/FSH ratio and VD levels turned out to be significant. The Multivariate analysis represented that for every one ng/mL increase in VD level, the odds of fertility were expected to be 50.154 times higher with p-value < 0.001. The positive correlation of VD with FSH was significant.

Conclusion: VD deficiency was prevalent in all infertile female subjects. VD levels were strong predictor of fertility in the study population. The significant association of VD with FSH explained the indirect effect of VD on follicular development and ovarian functions however no relationship of VD with ovarian reserve was exhibited.

Objective: To evaluate the reliability and validity of the Chinese Version of the Spiritual Care-giving Scale (C-SCGS) in nursing undergraduates and its application.

Methods: This was a retrospective study. A questionnaire survey was conducted among 262 senior nursing undergraduates from Chengde Medical University, China from May to June, 2023 through convenience sampling method. The C-SCGS and the general demographic data table were employed to investigate the subjects.

Results: The C-SCGS retained 34 items, and four common factors were extracted by exploratory factor analysis, with a cumulative contribution rate of 65.15%. The I-CVI value of the scale was 0.88-1.0, and the S-CVI/Ave value was 0.94. The Cronbach's α coefficient of the total scale was 0.957, that of each dimension ranged from 0.850 to 0.944, with a split-half coefficient of 0.887.

Conclusion: The C-SCGS may be used to evaluate the spiritual cognition of Chinese nursing undergraduates by virtue of its good reliability and validity.