Pakistan Journal of Medical Sciences最新文献

Objectives: To investigate the effects of a 12 weeks yoga program three times a week for one hour on blood pressure and sexual life among hypertensive women.

Methods: This study was a pre-post test randomized controlled trial (NCT06319365) performed in accordance with the CONSORT guidelines. This study was conducted in a public hospital in Turkey between June 15, 2022 and October 30, 2022. Data were collected by blood pressure measurements, Personal Information Form and Arizona Sexual Experience Scale. The sessions of the yoga group were conducted online for one hour three days a week for 12 weeks. The control group did not receive any intervention during the study. No side effects were recorded throughout the study.

Results: Participants in the yoga group had significantly lower systolic and diastolic blood pressure compared to the control group (p<0.001). In addition, women in the yoga group showed significant improvements in sexual activity, arousal, orgasm, lubrication and overall sexual function (p<0.05).

Conclusion: A 12-week, three times a week yoga program reduced blood pressure and positively affected sexual functioning.

Objective: This study sought to elucidate the potential association between serum cortisol level and clinical outcomes in patients diagnosed with Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PIICS).

Methods: This prospective observational study, initiated in January 2023 and concluded in July 2023 enrolled 42 patients diagnosed with PIICS admitted to the intensive care unit (ICU) at Training and Research Hospital. For the purpose of analysis, serum cortisol levels were categorized as low (<15 μg/dL) and high (>15 μdL). To facilitate data organization and subsequent analysis, measurements were categorized into three time intervals following ICU admission: T1 (days 14-21), T2 (days 21-28), and T3 (days >28). Statistical analysis was performed using IBM-SPSS 28. A significance level of p < 0.05 was set to determine statistically significant differences between groups.

Results: Cortisol measured at T3 were significantly lower (p < 0.05) compared to T2. In contrast, SOFA scores were significantly higher (p < 0.05). No statistically significant differences were observed between the low and high cortisol level groups at T1, T2 and T3 in terms of gender, APACHE-2 score, SOFA score, ICU length of stay (days), duration of mechanical ventilation (days), mortality rate, or mechanical ventilation requirement at discharge. Patients in the low cortisol group at T3 exhibited a significantly higher mean age compared to those in the high cortisol group (p < 0.05).

Conclusion: Cortisol levels in ICU patients may change over time. That cortisol levels tend to decrease as the length of stay increases, in older patients, and in PIICS patients with elevated SOFA scores.

Objective: The career choices of medical school graduates are extremely important because of their impact on a country's medical workforce planning. This study aimed to investigate the impact of medical students' level of professional commitment (PC) on their career plans.

Method: This cross-sectional study was conducted between April 15^th and November 15^th 2023, in a medical faculty in Erzincan Province in eastern Turkiye. A 16-question questionnaire and the medical students' PC scale were used. A total of 129 intern doctors (93.5%) participated in the study. The t test, Mann-Whitney U test, and Kruskal-Wallis test were used in the statistical analyses.

Results: Students who voluntarily chose medical school, aimed to become specialist doctors, selected specialties with higher occupational risks, and intended to work in Turkiye after obligatory service exhibited higher levels of PC. Notably, those inclined towards family practice specialty demonstrated lower levels of PC, whereas public health specialty, basic sciences, and certain clinical sciences were not preferred by any of the students.

Conclusion: The results obtained suggest that PC levels may influence the career plans of medical students. Further research into factors affecting changes in PC throughout medical education and their impact on future career goals will enhance understanding in this area.

Objective: Sequential therapy in traditional Chinese medicine (TCM) refers to a combination of internal and external treatment methods in a certain order based on syndrome differentiation and therapy. The aim of this study was to evaluate the efficacy of TCM sequential therapy that is given on the basis of conventional management in patients with non-alcoholic fatty liver disease (NAFLD).

Methods: Medical records of one hundred NAFLD patients who received treatment at Zhejiang Provincial Tongde Hospital between February 2023 and April 2024 were retrospectively analyzed. Of them, 48 patients received routine intervention (Control group), and 52 patients were additionally treated by sequential TCM therapy (TCM group). The levels of blood lipid indicators, liver function indicators, TCM syndrome efficacy, and quality of life (QOL) scores were compared between the two groups before and after the intervention.

Results: After the intervention, the levels of blood lipid and liver function indicators in both groups were significantly improved compared to preintervention and were considerably better in the TCM compared to the Control group (P<0.05). The overall efficacy was higher in the TCM group (94.23%) compared to the Control group (79.17%) (P<0.05). After the intervention, the QOL scores of both groups increased and were significantly higher in the TCM group than in the Control group (P<0.05).

Conclusions: For NAFLD patients, adopting TCM sequential therapy in addition to the routine disease management strategies can effectively regulate patients' blood lipid levels, restore liver function, improve disease treatment effectiveness, and improve the quality of life.

Background & objective: Dental caries remains a paramount public health concern among young children in Saudi Arabia. Vital pulp therapy is a vital component of regenerative endodontics that aims to maintain the vitality of the pulp. This study evaluates the teaching methods used for Vital pulp therapy (VPT) in undergraduate dental programs among Saudi Arabian dental schools.

Methods: This survey was conducted in fifteen dentistry colleges in Saudi Arabia, specifically targeting undergraduate institutions. The survey was administered through a Google form e-questionnaire. The colleges were classified according to their year of establishment. The study evaluated the implementation of VPT in lectures and pre-clinic/simulation sessions and identified the faculty members responsible for conducting these sessions.

Results: All surveyed colleges provided didactic teaching on VPT for permanent teeth. However, only 46.7% of the colleges included practical VPT training in their pre-clinic/simulation curriculum. Among colleges with founding years < 10 years, only 25% offered practical VPT training; however, established institutions over 20 years are more inclined to incorporate VPT into their pre-clinic/simulation sessions. The pre-clinical simulation sessions were mainly conducted by endodontists (85.7%), with a minor involvement from pedodontists (14.3%).

Conclusion: Saudi dental schools should standardize and enhance their VPT curricula to better prepare dental students for contemporary practice. Addressing current deficiencies and adopting the proposed changes will likely improve patient outcomes in vital pulp therapy.

Objectives: Intravitreal injections of Bevacizumab are widely used all over the world to treat Diabetic Retinopathy. However, there are thromboembolic events reported with its use. As blood coagulation is related with thromboembolism, the purpose of this study was to determine the effect of intravitreal injection of Bevacizumab on the coagulation profile of diabetic patients.

Methods: It was a quasi-experimental study, conducted at Department of Ophthalmology, Lahore General Hospital from January 2023 to August 2023. Patients with treatment naïve proliferative DR and diabetic macular edema were included and those with renal disease, hypertensive retinopathy, chronic liver disease, ischemic heart disease, previous history of stroke, retinal vascular occlusion, any malignancy, history of using anti coagulants and aspirin and the patients who lost to follow up and did not complete the blood work up after injection were excluded. Patients' Prothrombin time, bleeding time, clotting time, international normalized ratio and activated partial thromboplastin time were checked before and one week after intravitreal injection of Bevacizumab. Paired t test was used for analysis and p < 0.05 was set for significance.

Results: There were 138 patients who fulfilled the inclusion criteria (92 males and 46 females). The mean age was 55±8 years. There was statistically insignificant difference between the coagulation profile before and after intravitreal injection of Bevacizumab.

Conclusion: Coagulation profile is not affected after one intravitreal injection of Bevacizumab. Other factors must be taken into account while injecting Bevacizumab in patients with history of thromboembolic events.

Objective: To investigate the effect of perioperative care bundle in pediatric patients undergoing minimally invasive digestive endoscopy.

Methods: This was a retrospective study using clinical records of pediatric patients who underwent minimally invasive digestive endoscopy surgery at Hebei Children's Hospital from May 2020 to October 2023. Patients were divided into Care bundle group and Conventional care group based on the treatment received and matched for age, gender, and body mass index in 1:1 ratio. Perioperative vital signs, postoperative recovery, incidence of complications, and family members' satisfaction with nursing care were analyzed.

Results: A total of 98 pediatric patients were included, with 49 patients in each group. After surgery, diastolic blood pressure (DBP), systolic blood pressure (SBP), heart rate (HR), and mean arterial pressure (MAP) of both groups increased compared to preoperative values and were significantly lower in the Care bundle group compared to the Conventional care group (P<0.05). The time for anal exhaust, time for defecation, time to first out-of-bed activity, time to start eating after surgery, and length of hospital stay were shorter in the Care bundle than the Conventional care group (all P<0.05). The incidence of complications in the Care bundle group (4.08%) was lower than the Conventional care group (16.32%) (P<0.05). The overall family members' satisfaction with the nursing care was considerably higher in the Care bundle group (93.88%) compared to the Conventional care group (81.63%) (P<0.05).

Conclusions: Perioperative care bundle in pediatric patients undergoing minimally invasive digestive endoscopy was shown to be more efficacious than the conventional perioperative care.

Objective: To determine the association between children's autism spectrum disorder with parental anxiety and burnout in Karachi, Pakistan.

Methods: A cross-sectional study was conducted at Baqai Institute of Health Sciences, Baqai Medical University from December 2022, to November, 2023. Data collection was performed at three rehabilitation centers for autistic children in Karachi. The study population consisted of parents of autistic children. GAD-7 and Parental Burnout Assessment scales were used to assess the anxiety and burnout level among parents. Data were analyzed using SPSS version 21.

Results: The study results showed that 49 (24.5%) parents had moderate anxiety while 38 (19.0%) had severe anxiety. Besides, 36 (18.0%) of them were at risk of burnout while 8 (4.0%) were diagnosed with burnout. Furthermore, gender of child (p=0.01), father's age (p=0.015) and type of family (p=0.001) were significantly associated with the anxiety level whereas father's age (p=0.036), father's education (p=0.006) and type of family (p=0.046) were significantly associated with the burnout level of the parents.

Conclusion: This study results showed significant association of certain child and parental characteristics such as child's gender, father's age and type of family with parental anxiety level and of father's age, father's education and type of family with parental burnout.

Objective: To explore clinical efficacy of donepezil combined with nerve growth factor (NGF) in the treatment of Parkinson's disease dementia (PDD) and its potential impact on serum levels of adiponectin (APN) and soluble tumor necrosis factor receptor-1 (sTNFR-1).

Methods: Clinical data of 140 patients with PDD treated in Taizhou First People's Hospital from March 2021 to December 2023 were retrospectively analyzed. Patients were grouped based on the treatment received. Patients who received donepezil alone (n=68) comprised the Donepezil group, and patients who were treated with a combination of donepezil and NGF (n=72) were assigned into the Donepezil & NGF group. Treatment effects, symptom improvement before and after the treatment, APN and sTNFR-1 levels, and incidence of adverse reactions were compared between two groups.

Results: The overall efficacy of the combination therapy was higher than that of donepezil regimen alone (P<0.05). After treatment, symptom improvement in the Donepezil & NGF group was significantly better than that in the Donepezil group (P<0.05). Post-treatment serum levels of APN in the Donepezil & NGF group were significantly higher than that of Donepezil group, while the level of sTNFR-1 was significantly lower (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion: Combined regimen of donepezil and NGF is more effective than donepezil monotherapy in improving cognitive function, neurological function, and severity of the condition of patients with PDD, and is associated with the suppression of the inflammatory response without a significant increase in the incidence of adverse reactions. The study provides a basis for the clinical application of the combined regimen, but it still needs to be confirmed by more basic and clinical research.