Shengwei Ji, Mingrong Hu, Chunjie Zhang, Maowei Pei
Objective: Recurrent laryngeal nerve (RLN) injury is a serious complication during thyroid reoperation. Intraoperative neuromonitoring (IONM) is one of the means to reduce RLN paralysis. However, the role of IONM during thyroidectomy is still controversial. The aim of this study was to assess whether the IONM could reduce the incidence of RLN injury during thyroid reoperation.
Methods: We performed a systematic review to identify studies in English language which were published between January 1, 2004, and March 25, 2023 from PubMed, EMBASE, and Cochrane Library, comparing the use of IONM and Visualization Alone (VA) during thyroid reoperation. The RLN injury rate was calculated in relation to the number of nerves at risk. All data were analyzed using Review Manger (version 5.3) software. The Cochran Q test (I2 test) was used to test for heterogeneity. Odds ratios were estimated by fixed effects model or random effects model, according to the heterogeneity level.
Results: Eleven studies (3655 at-risk nerves) met criteria for inclusion. Data presented as odds ratio(OR) and their 95% confidence intervals(CI). Incidence of overall, temporary, and permanent RLN injury in IONM group were, respectively, 4.67%, 4.17%, and 2.39%, whereas for the VA group, they were 8.30%, 6.27%, and 2.88%. The summary OR of overall, temporary, and permanent RLN injury compared using IONM and VA were, respectively, 0.68 (95%CI 0.4-1.14, p=0.14), 0.82 (95%CI 0.39-1.72, p=0.60), and 0.62 (95%CI 0.4-0.96, p=0.03).
Conclusions: The presented data showed benefits of reducing permanent RLN injury by using IONM, but without statistical significance for temporary RLN injury.
{"title":"Systematic review with meta-analysis of intraoperative neuromonitoring during thyroid reoperation.","authors":"Shengwei Ji, Mingrong Hu, Chunjie Zhang, Maowei Pei","doi":"10.12669/pjms.40.8.8241","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8241","url":null,"abstract":"<p><strong>Objective: </strong>Recurrent laryngeal nerve (RLN) injury is a serious complication during thyroid reoperation. Intraoperative neuromonitoring (IONM) is one of the means to reduce RLN paralysis. However, the role of IONM during thyroidectomy is still controversial. The aim of this study was to assess whether the IONM could reduce the incidence of RLN injury during thyroid reoperation.</p><p><strong>Methods: </strong>We performed a systematic review to identify studies in English language which were published between January 1, 2004, and March 25, 2023 from PubMed, EMBASE, and Cochrane Library, comparing the use of IONM and Visualization Alone (VA) during thyroid reoperation. The RLN injury rate was calculated in relation to the number of nerves at risk. All data were analyzed using Review Manger (version 5.3) software. The Cochran Q test (I<sup>2</sup> test) was used to test for heterogeneity. Odds ratios were estimated by fixed effects model or random effects model, according to the heterogeneity level.</p><p><strong>Results: </strong>Eleven studies (3655 at-risk nerves) met criteria for inclusion. Data presented as odds ratio(OR) and their 95% confidence intervals(CI). Incidence of overall, temporary, and permanent RLN injury in IONM group were, respectively, 4.67%, 4.17%, and 2.39%, whereas for the VA group, they were 8.30%, 6.27%, and 2.88%. The summary OR of overall, temporary, and permanent RLN injury compared using IONM and VA were, respectively, 0.68 (95%CI 0.4-1.14, p=0.14), 0.82 (95%CI 0.39-1.72, p=0.60), and 0.62 (95%CI 0.4-0.96, p=0.03).</p><p><strong>Conclusions: </strong>The presented data showed benefits of reducing permanent RLN injury by using IONM, but without statistical significance for temporary RLN injury.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saher Gul Ahdi, Javeria Raza Alvi, Azeem Ashfaq, Tipu Sultan
Objective: To unravel the clinical and genetic specifications of Neuronal ceroid lipofuscinosis (NCL).
Methods: This is a retrospective cross-sectional study conducted in the Department of Pediatric Neurology Children Hospital and University of Child Health Sciences, Lahore, Pakistan from March 2017 to March 2022. The primary outcome was to measure genotype-phenotype correlation by segregation of phenotypes according to genotype. The secondary outcomes included a correlation between genotype and distribution of age(s) of onset.
Results: One hundred fifty three patients clinically diagnosed with NCL underwent genetic testing and pathologic mutation was identified in 32.7% of patients. About 59.6% were male and 37.2% had an affected sibling. The median age was 5.46±1.95 years at the onset of the first symptom i.e., myoclonic seizures in 68%, and motor difficulty in 24%. Other features found were global developmental delay (56%), hypotonia (23%), visual impairment (80%), ataxia (22%), and disc pallor (56%). The most common type was CLN6 (Ceroid lipofuscinosis neuronal) (42%), CLN2 (16%) followed by CLN7 (12%). When 50 patients with recognized mutations were compared with 103 patients with no mutation, family history (p=0.049), early visual loss (p=0.016), hypotonia (p=0.001), white matter signals (p=0.026) and pan-atrophy(p=0.047) was statistically significant in the genetically confirmed NCL. Multiple pairwise comparisons indicated that the estimated age of onset for the CLN1 and CLN2 mutation group was significantly lower than other genotypes including CLN6 (p 0.012), CLN10 (p 0.007) and CLN12 (p 0.007).
Conclusion: Following a detailed review of NCL symptomatology, a clinically-oriented approach should be used for a rapid diagnosis with confirmation by targeted molecular testing for future genetic counseling.
{"title":"Pediatric onset neuronal ceroid lipofuscinoses: Unraveling clinical and genetic specifications.","authors":"Saher Gul Ahdi, Javeria Raza Alvi, Azeem Ashfaq, Tipu Sultan","doi":"10.12669/pjms.40.8.8006","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8006","url":null,"abstract":"<p><strong>Objective: </strong>To unravel the clinical and genetic specifications of Neuronal ceroid lipofuscinosis (NCL).</p><p><strong>Methods: </strong>This is a retrospective cross-sectional study conducted in the Department of Pediatric Neurology Children Hospital and University of Child Health Sciences, Lahore, Pakistan from March 2017 to March 2022. The primary outcome was to measure genotype-phenotype correlation by segregation of phenotypes according to genotype. The secondary outcomes included a correlation between genotype and distribution of age(s) of onset.</p><p><strong>Results: </strong>One hundred fifty three patients clinically diagnosed with NCL underwent genetic testing and pathologic mutation was identified in 32.7% of patients. About 59.6% were male and 37.2% had an affected sibling. The median age was 5.46±1.95 years at the onset of the first symptom i.e., myoclonic seizures in 68%, and motor difficulty in 24%. Other features found were global developmental delay (56%), hypotonia (23%), visual impairment (80%), ataxia (22%), and disc pallor (56%). The most common type was CLN6 (Ceroid lipofuscinosis neuronal) (42%), CLN2 (16%) followed by CLN7 (12%). When 50 patients with recognized mutations were compared with 103 patients with no mutation, family history (p=0.049), early visual loss (p=0.016), hypotonia (p=0.001), white matter signals (p=0.026) and pan-atrophy(p=0.047) was statistically significant in the genetically confirmed NCL. Multiple pairwise comparisons indicated that the estimated age of onset for the CLN1 and CLN2 mutation group was significantly lower than other genotypes including CLN6 (p 0.012), CLN10 (p 0.007) and CLN12 (p 0.007).</p><p><strong>Conclusion: </strong>Following a detailed review of NCL symptomatology, a clinically-oriented approach should be used for a rapid diagnosis with confirmation by targeted molecular testing for future genetic counseling.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: A report on the cross-cultural adaptation and validation process of the Rome IV Diagnostic Questionnaire for children aged four years and over into Saudi-Arabian Arabic for use in assessing the prevalence of functional gastrointestinal disorders in children in Saudi Arabia.
Method: A mixed-methods approach was used in translating the 60-item original English version of the questionnaire. The process included four steps followed by a cognitive debriefing and was guided by the Rome Foundation. The questionnaire was tested for practicability with 10 participants of children aged four years and older. The whole study took place between October 2020 and April 2021.
Results: The original questionnaire repeated information on areas of pain experienced by children, which did not show up in the backward, English, translation. The back-translated version occasionally provided medical expressions that were then explained between parentheses in plain English, for example, dyspepsia (burning feeling). The expert panel indicated that all questionnaire items reached the set 90% agreement level, confirming that the questionnaire is fully understandable and valid for use. Preliminary testing with 10 participants (four years and older) revealed functional constipation to have the highest prevalence among the participants (40%, n=4), followed by irritable bowel syndrome (20%) and abdominal migraine (20%).
Conclusion: This study provides a detailed report on the translation process of the tested ROME- IV Diagnostic Questionnaire for children aged four years and over into Saudi Arabic following Rome Foundation guidelines. The results of the preliminary test should encourage researchers and clinicians in Saudi Arabia to utilize the tool for non-invasive diagnosis of functional gastrointestinal disorders in children.
{"title":"Translation process of the tested Rome IV diagnostic questionnaire for functional gastrointestinal disorders into Saudi-Arabian Arabic: A mixed-methods approach.","authors":"Elham A Aljaaly, Mai A Khatib","doi":"10.12669/pjms.40.8.9126","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9126","url":null,"abstract":"<p><strong>Objective: </strong>A report on the cross-cultural adaptation and validation process of the Rome IV Diagnostic Questionnaire for children aged four years and over into Saudi-Arabian Arabic for use in assessing the prevalence of functional gastrointestinal disorders in children in Saudi Arabia.</p><p><strong>Method: </strong>A mixed-methods approach was used in translating the 60-item original English version of the questionnaire. The process included four steps followed by a cognitive debriefing and was guided by the Rome Foundation. The questionnaire was tested for practicability with 10 participants of children aged four years and older. The whole study took place between October 2020 and April 2021.</p><p><strong>Results: </strong>The original questionnaire repeated information on areas of pain experienced by children, which did not show up in the backward, English, translation. The back-translated version occasionally provided medical expressions that were then explained between parentheses in plain English, for example, dyspepsia (burning feeling). The expert panel indicated that all questionnaire items reached the set 90% agreement level, confirming that the questionnaire is fully understandable and valid for use. Preliminary testing with 10 participants (four years and older) revealed functional constipation to have the highest prevalence among the participants (40%, n=4), followed by irritable bowel syndrome (20%) and abdominal migraine (20%).</p><p><strong>Conclusion: </strong>This study provides a detailed report on the translation process of the tested ROME- IV Diagnostic Questionnaire for children aged four years and over into Saudi Arabic following Rome Foundation guidelines. The results of the preliminary test should encourage researchers and clinicians in Saudi Arabia to utilize the tool for non-invasive diagnosis of functional gastrointestinal disorders in children.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background & objectives: Ataxia is usually caused by cerebellar pathology or a decrease in vestibular or proprioceptive afferent input to the cerebellum. It is characterized by uncoordinated walking, truncal instability, body or head tremors, uncontrolled coordination of the hands, dysarthria, and aberrant eye movements. The objective of the current investigation was to identify the underlying genetic cause of the hereditary ataxia that affects the Pakistani population.
Methods: We studied numerous consanguineous Pakistani families whose members had ataxia-related clinical symptoms to varying degrees. The families were chosen from the Punjab province, and the neurophysician conducted a clinical examination. Peripheral blood samples from both sick and healthy members of the family were taken after obtaining informed consent. Genomic DNA was used to find potential variations in probands using whole exome sequencing. The study was carried out at the University Hospital of Tübingen, Germany, and Government College University in Faisalabad, Pakistan, during 2018-2023.
Results: The molecular analysis of these families identified different variants including SGCB: c.902C>T, c.668G>A, ATM: c.6196_6197insGAA, SPG11: c.5769del, SETX c.5525_5533del, and ATM: c.7969A>T. A noteworthy mutation in ATM and SETX was observed among them, and its symptoms were shown to cause ataxia in these families.
Conclusion: The current study broadens the mutation spectrum of several hereditary ataxia types and suggests the next generation sequencing in conjunction with clinical research for a more accurate diagnosis of overlapping phenotypes of this disorder in the Pakistani population.
背景和目的:共济失调通常是由小脑病变或小脑前庭或本体感觉传入减少引起的。共济失调的特征是行走不协调、躯干不稳定、身体或头部震颤、双手协调失控、构音障碍和眼球运动失常。本次调查的目的是找出影响巴基斯坦人群的遗传性共济失调的潜在遗传原因:我们研究了许多巴基斯坦近亲家庭,这些家庭的成员都有不同程度的共济失调相关临床症状。这些家庭选自旁遮普省,由神经物理学家进行临床检查。在获得知情同意后,采集了患病和健康家庭成员的外周血样本。使用基因组 DNA 进行全外显子测序,以发现潜在的变异。研究于 2018-2023 年期间在德国图宾根大学医院和巴基斯坦费萨拉巴德政府学院大学进行:对这些家族的分子分析发现了不同的变异,包括SGCB:c.902C>T、c.668G>A、ATM:c.6196_6197insGAA、SPG11:c.5769del、SETX c.5525_5533del和ATM:c.7969A>T。其中值得注意的是ATM和SETX的突变,其症状被证明会导致这些家庭出现共济失调:目前的研究拓宽了几种遗传性共济失调类型的突变谱,并建议将下一代测序与临床研究相结合,以更准确地诊断巴基斯坦人群中这种疾病的重叠表型。
{"title":"A novel mutation in <i>SETX</i> and <i>ATM</i> causes ataxia in consanguineous Pakistani families.","authors":"Rabia Akram, Shahid Mahmood Baig, Haseeb Anwar, Ghulam Hussain","doi":"10.12669/pjms.40.8.9246","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9246","url":null,"abstract":"<p><strong>Background & objectives: </strong>Ataxia is usually caused by cerebellar pathology or a decrease in vestibular or proprioceptive afferent input to the cerebellum. It is characterized by uncoordinated walking, truncal instability, body or head tremors, uncontrolled coordination of the hands, dysarthria, and aberrant eye movements. The objective of the current investigation was to identify the underlying genetic cause of the hereditary ataxia that affects the Pakistani population.</p><p><strong>Methods: </strong>We studied numerous consanguineous Pakistani families whose members had ataxia-related clinical symptoms to varying degrees. The families were chosen from the Punjab province, and the neurophysician conducted a clinical examination. Peripheral blood samples from both sick and healthy members of the family were taken after obtaining informed consent. Genomic DNA was used to find potential variations in probands using whole exome sequencing. The study was carried out at the University Hospital of Tübingen, Germany, and Government College University in Faisalabad, Pakistan, during 2018-2023.</p><p><strong>Results: </strong>The molecular analysis of these families identified different variants including <i>SGCB</i>: c.902C>T, c.668G>A, <i>ATM</i>: c.6196_6197insGAA, <i>SPG11</i>: c.5769del, <i>SETX</i> c.5525_5533del, and <i>ATM</i>: c.7969A>T. A noteworthy mutation in <i>ATM</i> and <i>SETX</i> was observed among them, and its symptoms were shown to cause ataxia in these families.</p><p><strong>Conclusion: </strong>The current study broadens the mutation spectrum of several hereditary ataxia types and suggests the next generation sequencing in conjunction with clinical research for a more accurate diagnosis of overlapping phenotypes of this disorder in the Pakistani population.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zara Amir, Jacob John, Mahmoud Danaee, Zamros Yuzadi Mohd Yusof
Objective: To validate and ascertain the reliability of the Orofacial Esthetic Scale specifically within the context of prosthodontic patients, aiming to establish it as a credible and standardized tool for evaluating orofacial esthetics in this specialized cohort.
Methods: The systematic analysis adhered to the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search using four databases PubMed /Medline, Web of Science, Scopus, Science Direct along with manual and grey literature (ProQuest and Google scholar) till 30 October 2023 was performed. The risk of biasness was assessed using Joanna Briggs Institute (JBI) critical appraisal checklist followed by validity analysis. For meta-analysis, psychometric values (Cronbach alpha and Intra class correlation coefficient) were used through MedCalc software.
Results: The overall ICC value was 0.95 (95% CI: 0.94 to 0.96) and the overall Cronbach alpha value was 0.94 (95% CI: 0.92 to 0.96). There was evidence of high heterogeneity and no publication bias among the studies included.
Conclusion: This study underscores the pivotal role of orofacial esthetics in prosthodontic care, introducing the Orofacial Esthetic Scale as a validated tool to quantitatively assess subjective perceptions. This will highlight its potential for tailored treatment planning and improved patient outcomes.
目的验证并确定口腔美学量表在口腔修复患者中的可靠性,旨在将其确立为在这一特殊群体中评估口腔美学的可靠且标准化的工具:系统分析遵循《系统综述和元分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)的指导方针。使用 PubMed /Medline、Web of Science、Scopus、Science Direct 四个数据库以及截至 2023 年 10 月 30 日的手工和灰色文献(ProQuest 和 Google scholar)进行了系统检索。采用乔安娜-布里格斯研究所(Joanna Briggs Institute,JBI)的批判性评估清单对偏倚风险进行评估,然后进行有效性分析。在进行荟萃分析时,通过 MedCalc 软件使用了心理测量值(Cronbach alpha 和类内相关系数):总体 ICC 值为 0.95(95% CI:0.94 至 0.96),总体 Cronbach alpha 值为 0.94(95% CI:0.92 至 0.96)。在纳入的研究中,有证据表明存在高度异质性,且无发表偏倚:本研究强调了口腔美学在修复治疗中的关键作用,并引入了口腔美学量表作为定量评估主观感受的有效工具。这将凸显其在量身定制治疗计划和改善患者疗效方面的潜力。
{"title":"Assessing Orofacial Esthetics in Prosthodontic Care: A Systematic Review and Meta-Analysis of Psychometric Properties.","authors":"Zara Amir, Jacob John, Mahmoud Danaee, Zamros Yuzadi Mohd Yusof","doi":"10.12669/pjms.40.8.9860","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9860","url":null,"abstract":"<p><strong>Objective: </strong>To validate and ascertain the reliability of the Orofacial Esthetic Scale specifically within the context of prosthodontic patients, aiming to establish it as a credible and standardized tool for evaluating orofacial esthetics in this specialized cohort.</p><p><strong>Methods: </strong>The systematic analysis adhered to the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search using four databases PubMed /Medline, Web of Science, Scopus, Science Direct along with manual and grey literature (ProQuest and Google scholar) till 30 October 2023 was performed. The risk of biasness was assessed using Joanna Briggs Institute (JBI) critical appraisal checklist followed by validity analysis. For meta-analysis, psychometric values (Cronbach alpha and Intra class correlation coefficient) were used through MedCalc software.</p><p><strong>Results: </strong>The overall ICC value was 0.95 (95% CI: 0.94 to 0.96) and the overall Cronbach alpha value was 0.94 (95% CI: 0.92 to 0.96). There was evidence of high heterogeneity and no publication bias among the studies included.</p><p><strong>Conclusion: </strong>This study underscores the pivotal role of orofacial esthetics in prosthodontic care, introducing the Orofacial Esthetic Scale as a validated tool to quantitatively assess subjective perceptions. This will highlight its potential for tailored treatment planning and improved patient outcomes.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rania M Al-Groom, Rand Raid Mahmoud Ali, Qasem M Abu Shaqra
Background & objectives: Genotypic identification of the etiologic agents of vaginal candidiasis (VC) is of significance in epidemiologic studies and in the establishment of adequate treatment protocol. The aim of this study was to determine the antifungal susceptibility and gene diversity of C. albicans isolated from a group of Jordanian women with VC.
Methods: A total of 312 isolates of candida species, recovered from women with vaginal candidiasis who attended gynecology clinics affiliated to three major private hospitals in Amman over a period of five months (July 2020 to December 2020) were included in this study. The isolated Candida were characterized by phenotypic and genotypic means. Genotypic studies were performed using specific PCR primers of the rDNA and RPS genes. Susceptibility testing of all C. albicans isolates was conducted following the National Committee for Clinical Laboratory Standards and E-test strips.
Results: Candida albicans was the most dominant Candida spp. that caused VC among the studied population. C. albicans isolates were found to be of three different subtypes at the 25S rDNA gene. All isolates belonged to genotypes A, B and C while genotypes D and E were not detected. The diversity of C. albicans was higher on the basis of RPS region where the use of two markers (P-I and P-II) resulted in the identification of nine distinct C. albicans subtypes. The sensitivity testing revealed variations in the susceptibility of various genotypes to different antifungal drugs. Genotype A isolates were more susceptible to fluconazole, flucytosine and ketoconazole than genotypes B and C.
Conclusion: Candida albicans incriminated as etiologic agents of vaginitis among Jordanian women exhibited relationship between various genotypes and antifungal drugs.
背景与目的:阴道念珠菌病(VC)病原体的基因型鉴定对于流行病学研究和制定适当的治疗方案具有重要意义。本研究旨在确定从约旦妇女阴道念珠菌病患者中分离出的白念珠菌的抗真菌敏感性和基因多样性:本研究从安曼三大私立医院附属妇科诊所就诊的阴道念珠菌病患者中分离出 312 株念珠菌,为期五个月(2020 年 7 月至 2020 年 12 月)。对分离出的念珠菌进行了表型和基因型鉴定。基因型研究使用 rDNA 和 RPS 基因的特定 PCR 引物进行。所有分离出的白色念珠菌均按照国家临床实验室标准委员会的要求进行了药敏试验,并使用了 E 测试条:结果:白念珠菌是研究人群中引起 VC 的最主要念珠菌属。白念珠菌分离株在 25S rDNA 基因上有三种不同的亚型。所有分离株都属于基因型 A、B 和 C,而没有发现基因型 D 和 E。根据 RPS 区域,白僵菌的多样性较高,使用两个标记(P-I 和 P-II)可鉴定出 9 个不同的白僵菌亚型。敏感性测试显示,不同基因型对不同抗真菌药物的敏感性存在差异。基因型 A 分离物对氟康唑、氟胞嘧啶和酮康唑的敏感性高于基因型 B 和 C:结论:约旦妇女阴道炎的病原体白色念珠菌显示出不同基因型与抗真菌药物之间的关系。
{"title":"Genotypes analysis and antifungal susceptibility of <i>Candida albicans</i> strains isolated from women with vaginal candidiasis in Jordan using PCR targeting 25SrDNA and ALT repeat sequences of the RPS.","authors":"Rania M Al-Groom, Rand Raid Mahmoud Ali, Qasem M Abu Shaqra","doi":"10.12669/pjms.40.8.9811","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9811","url":null,"abstract":"<p><strong>Background & objectives: </strong>Genotypic identification of the etiologic agents of vaginal candidiasis (VC) is of significance in epidemiologic studies and in the establishment of adequate treatment protocol. The aim of this study was to determine the antifungal susceptibility and gene diversity of <i>C. albicans</i> isolated from a group of Jordanian women with VC.</p><p><strong>Methods: </strong>A total of 312 isolates of candida species, recovered from women with vaginal candidiasis who attended gynecology clinics affiliated to three major private hospitals in Amman over a period of five months (July 2020 to December 2020) were included in this study. The isolated Candida were characterized by phenotypic and genotypic means. Genotypic studies were performed using specific PCR primers of the rDNA and RPS genes. Susceptibility testing of all <i>C. albicans</i> isolates was conducted following the National Committee for Clinical Laboratory Standards and E-test strips.</p><p><strong>Results: </strong><i>Candida albicans</i> was the most dominant <i>Candida spp</i>. that caused VC among the studied population. <i>C. albicans</i> isolates were found to be of three different subtypes at the 25S rDNA gene. All isolates belonged to genotypes A, B and C while genotypes D and E were not detected. The diversity of <i>C. albicans</i> was higher on the basis of RPS region where the use of two markers (P-I and P-II) resulted in the identification of nine distinct <i>C. albicans</i> subtypes. The sensitivity testing revealed variations in the susceptibility of various genotypes to different antifungal drugs. Genotype A isolates were more susceptible to fluconazole, flucytosine and ketoconazole than genotypes B and C.</p><p><strong>Conclusion: </strong><i>Candida albicans</i> incriminated as etiologic agents of vaginitis among Jordanian women exhibited relationship between various genotypes and antifungal drugs.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sultan Ayoub Meo, Mustafa A Salih, Joud Mohammed Alkhalifah, Abdulaziz Hassan Alsomali, Abdullah Abdulrahman Almushawah
Objectives: This study aimed to investigate the effect of Environmental Pollutants Particulate Matter PM2.5, PM10, Carbon Monoxide (CO), Nitrogen Dioxide (NO2), Sulfur Dioxide (SO2), and Ozone (O3) on lung airway inflammation by assessing the Fractional Exhaled Nitric Oxide (FeNO) in students studying in schools located in or away from air-polluted areas.
Methods: This matched case-control cross-sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia from August 2022 to July 2023. In this study, two schools were selected, one was located near a traffic-polluted area (School #1), and the second was located away from the traffic-polluted area (School #2). A total of 300 students were recruited, 150 (75 male and 75 female) students from the school located in a traffic-polluted area, and 150 students (75 male and 75 female) from the school located away from a traffic-polluted area. Environmental pollutants PM2.5, PM10, CO, NO2, O3, and SO2, were recorded. The Fractional Exhaled Nitric Oxide (FeNO) was measured using a Niox Mino.
Results: The mean concentration of PM2.5, PM10, CO, NO2, O3, and SO2 were 35.00±0.65 significantly higher in a school located in motor vehicle polluted area compared to a school located away from a motor vehicle-polluted area (29.95±0.32) (p=0.001). The mean values for FeNO were significantly higher (18.75±0.90) among students studying in a school located in the motor vehicle-polluted area compared to students studying in a school located away from the motor vehicle-polluted area (11.26±0.56) (p=0.001).
Conclusions: Environmental pollution can cause lung inflammation among students in schools located in traffic-polluted areas.
{"title":"Effect of Air Pollutants Particulate Matter PM<sub>2.5</sub>, PM<sub>10</sub>, Carbon Monoxide (CO), Nitrogen Dioxide (NO<sub>2</sub>), Sulfur Dioxide (SO<sub>2</sub>), and Ozone (O<sub>3</sub>) on Fractional Exhaled Nitric Oxide (FeNO).","authors":"Sultan Ayoub Meo, Mustafa A Salih, Joud Mohammed Alkhalifah, Abdulaziz Hassan Alsomali, Abdullah Abdulrahman Almushawah","doi":"10.12669/pjms.40.8.9630","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9630","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the effect of Environmental Pollutants Particulate Matter PM<sub>2.5</sub>, PM<sub>10</sub>, Carbon Monoxide (CO), Nitrogen Dioxide (NO<sub>2</sub>), Sulfur Dioxide (SO<sub>2</sub>), and Ozone (O<sub>3</sub>) on lung airway inflammation by assessing the Fractional Exhaled Nitric Oxide (FeNO) in students studying in schools located in or away from air-polluted areas.</p><p><strong>Methods: </strong>This matched case-control cross-sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia from August 2022 to July 2023. In this study, two schools were selected, one was located near a traffic-polluted area (School #1), and the second was located away from the traffic-polluted area (School #2). A total of 300 students were recruited, 150 (75 male and 75 female) students from the school located in a traffic-polluted area, and 150 students (75 male and 75 female) from the school located away from a traffic-polluted area. Environmental pollutants PM<sub>2.5</sub>, PM<sub>10</sub>, CO, NO<sub>2</sub>, O<sub>3</sub>, and SO<sub>2</sub>, were recorded. The Fractional Exhaled Nitric Oxide (FeNO) was measured using a Niox Mino.</p><p><strong>Results: </strong>The mean concentration of PM<sub>2.5</sub>, PM<sub>10</sub>, CO, NO<sub>2</sub>, O<sub>3</sub>, and SO<sub>2</sub> were 35.00±0.65 significantly higher in a school located in motor vehicle polluted area compared to a school located away from a motor vehicle-polluted area (29.95±0.32) (p=0.001). The mean values for FeNO were significantly higher (18.75±0.90) among students studying in a school located in the motor vehicle-polluted area compared to students studying in a school located away from the motor vehicle-polluted area (11.26±0.56) (p=0.001).</p><p><strong>Conclusions: </strong>Environmental pollution can cause lung inflammation among students in schools located in traffic-polluted areas.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wajiha Rizwan, Masood Sadiq, Mulazim Hussain Bukhari, Muqaddas Tasneem
Objective: To explore impact of flood on breastfeeding practices and identify barriers in continuation of breastfeeding among mothers residing in flood relief camps.
Methods: This exploratory observational study was conducted during visit of medical team of The University of Child Health Sciences, Children's Hospital at flood relief camps of Sindh (7th September to 12th September, 2022) and south-west of Punjab province (18th November to 20th November, 2022). The data was collected on structured questionnaire from 40 lactating mothers residing in flood relief camps. Purposive sampling technique was used in this regard.
Results: The mean age of breastfed children was 16.1±7.811 months. There was negative impact on breastfeeding practices (n=21, 52.5%) as frequency decreased in 18(45%) mothers and 3(7.5%) totally stopped breastfeeding. There was significant relation between pre-flood breastfeeding status and impact of flood on breastfeeding practices (p=0.001). The major barriers to appropriate breastfeeding were mother's perception of insufficient breast milk due to inadequate diet (n=6, 15%) or depression and anxiety (n=4, 10%), mother's illness (n=3, 7.5%), constant displacement (n=2, 5%) and provision of breast milk substitutes (n=2, 5%).
Conclusion: There has been significant negative impact of flood on breastfeeding practices among lactating mothers residing in flood relief camps. Perception of decreased milk production due to inadequate diet and stress are major barriers in continuation of breastfeeding. Breastfeeding supportive services need to be integral component of flood crisis management.
{"title":"Impact of Flood on Breastfeeding Practices at Flood Relief Camps of Pakistan.","authors":"Wajiha Rizwan, Masood Sadiq, Mulazim Hussain Bukhari, Muqaddas Tasneem","doi":"10.12669/pjms.40.8.8488","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8488","url":null,"abstract":"<p><strong>Objective: </strong>To explore impact of flood on breastfeeding practices and identify barriers in continuation of breastfeeding among mothers residing in flood relief camps.</p><p><strong>Methods: </strong>This exploratory observational study was conducted during visit of medical team of The University of Child Health Sciences, Children's Hospital at flood relief camps of Sindh (7<sup>th</sup> September to 12<sup>th</sup> September, 2022) and south-west of Punjab province (18<sup>th</sup> November to 20<sup>th</sup> November, 2022). The data was collected on structured questionnaire from 40 lactating mothers residing in flood relief camps. Purposive sampling technique was used in this regard.</p><p><strong>Results: </strong>The mean age of breastfed children was 16.1±7.811 months. There was negative impact on breastfeeding practices (n=21, 52.5%) as frequency decreased in 18(45%) mothers and 3(7.5%) totally stopped breastfeeding. There was significant relation between pre-flood breastfeeding status and impact of flood on breastfeeding practices (p=0.001). The major barriers to appropriate breastfeeding were mother's perception of insufficient breast milk due to inadequate diet (n=6, 15%) or depression and anxiety (n=4, 10%), mother's illness (n=3, 7.5%), constant displacement (n=2, 5%) and provision of breast milk substitutes (n=2, 5%).</p><p><strong>Conclusion: </strong>There has been significant negative impact of flood on breastfeeding practices among lactating mothers residing in flood relief camps. Perception of decreased milk production due to inadequate diet and stress are major barriers in continuation of breastfeeding. Breastfeeding supportive services need to be integral component of flood crisis management.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saffa Tareen, Mehwish Mooghal, Kulsoom Shaikh, Sana Zeeshan
This literature review explores breast cancer screening practices among transgender individuals globally, emphasizing the overlooked population in Pakistan. With an overview of intersex and transgender terminology, the study delves into screening guidelines for transfeminine and transmasculine patients, considering hormone therapy and surgery. Worldwide statistics on transgender and intersex populations are provided, highlighting the unique challenges they face, particularly in Pakistan, where societal discrimination and healthcare barriers persist. Databases searched included PubMed, Scopus, and Google Scholar from the Year 2000 till todate.The review synthesizes breast cancer screening recommendations in transgender population from ACR, WPATH, UCSF, and the Canadian Cancer Society, revealing variations in guidelines. It concludes with a call for tailored screening protocols for Pakistan's transgender community and recommends a comprehensive study due to the absence of data in Southeast Asia. The unstructured abstract underscores the need for nuanced, personalized screening strategies and emphasizes the critical gap in knowledge specific to breast cancer in this marginalized population.
{"title":"Breast Cancer Screening in Transgender Population: Review of literature.","authors":"Saffa Tareen, Mehwish Mooghal, Kulsoom Shaikh, Sana Zeeshan","doi":"10.12669/pjms.40.8.9132","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9132","url":null,"abstract":"<p><p>This literature review explores breast cancer screening practices among transgender individuals globally, emphasizing the overlooked population in Pakistan. With an overview of intersex and transgender terminology, the study delves into screening guidelines for transfeminine and transmasculine patients, considering hormone therapy and surgery. Worldwide statistics on transgender and intersex populations are provided, highlighting the unique challenges they face, particularly in Pakistan, where societal discrimination and healthcare barriers persist. Databases searched included PubMed, Scopus, and Google Scholar from the Year 2000 till todate.The review synthesizes breast cancer screening recommendations in transgender population from ACR, WPATH, UCSF, and the Canadian Cancer Society, revealing variations in guidelines. It concludes with a call for tailored screening protocols for Pakistan's transgender community and recommends a comprehensive study due to the absence of data in Southeast Asia. The unstructured abstract underscores the need for nuanced, personalized screening strategies and emphasizes the critical gap in knowledge specific to breast cancer in this marginalized population.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiangtao Ma, Yanli Zhao, Jing Li, Ying Zhang, Jie Chen
Objective: To analyze the characteristics of deliberate drug ingestion in adolescents and its related influencing factors.
Method: This was a retrospective study. A total of 158 cases of deliberate drug ingestion as observation group and 160 cases of other diseases in adolescents as control group were treated in the Emergency Department of Baoding Hospital of Beijing Children's Hospital Affiliated to Capital Medical University from January 2020 to December 2022. The clinical characteristics of adolescents who engaged in deliberate drug ingestion were analyzed, and various factors that could potentially influence deliberate drug ingestion in adolescents were subjected to both univariate and multivariate analysis.
Result: There was a progressive increase in the number of patients presenting with mental health issues year by year. Univariate analysis showed that family type, guardian's education level, place of residence, whether they were only children, parents' knowledge of medication, awareness of medication safety, depression/anxiety, negative life events, and social support were risk factors for deliberate drug ingestion in adolescents (all p<0.05). Logistic regression analysis showed that family type, parents' knowledge of medication, awareness of medication safety, whether they were depressed/anxious, negative life events, and social support were independent risk factors for deliberate drug ingestion in adolescents (p<0.05).
Conclusion: The incidence of deliberate drug ingestion in adolescents is increasing year by year, and their behavior is influenced by multiple factors. Interventions should be targeted at controllable influencing factors to prevent or reduce deliberate drug ingestion in adolescents.
{"title":"Clinical study on the characteristics and related influencing factors of deliberate drug ingestion in adolescents.","authors":"Jiangtao Ma, Yanli Zhao, Jing Li, Ying Zhang, Jie Chen","doi":"10.12669/pjms.40.8.8828","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8828","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the characteristics of deliberate drug ingestion in adolescents and its related influencing factors.</p><p><strong>Method: </strong>This was a retrospective study. A total of 158 cases of deliberate drug ingestion as observation group and 160 cases of other diseases in adolescents as control group were treated in the Emergency Department of Baoding Hospital of Beijing Children's Hospital Affiliated to Capital Medical University from January 2020 to December 2022. The clinical characteristics of adolescents who engaged in deliberate drug ingestion were analyzed, and various factors that could potentially influence deliberate drug ingestion in adolescents were subjected to both univariate and multivariate analysis.</p><p><strong>Result: </strong>There was a progressive increase in the number of patients presenting with mental health issues year by year. Univariate analysis showed that family type, guardian's education level, place of residence, whether they were only children, parents' knowledge of medication, awareness of medication safety, depression/anxiety, negative life events, and social support were risk factors for deliberate drug ingestion in adolescents (all p<0.05). Logistic regression analysis showed that family type, parents' knowledge of medication, awareness of medication safety, whether they were depressed/anxious, negative life events, and social support were independent risk factors for deliberate drug ingestion in adolescents (p<0.05).</p><p><strong>Conclusion: </strong>The incidence of deliberate drug ingestion in adolescents is increasing year by year, and their behavior is influenced by multiple factors. Interventions should be targeted at controllable influencing factors to prevent or reduce deliberate drug ingestion in adolescents.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}