Anwar Jamal Khan, Jabar Ali, S. Safi, Wasim Sajjad
Background: Patients presenting with ST-elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention (PCI) frequently face multivessel coronary artery disease (CAD). The optimal interventional approach remains debated. Objective: To systematically review and analyze the effectiveness and safety of drug-coated balloons (DCB) versus drug-eluting stents (DES) in multiculprit primary PCI through a randomized controlled trial. Methods: This prospective, single-center, randomized controlled trial included 100 patients with STEMI and multivessel CAD at Lady Reading Hospital Peshawar from April 2023 to March 2024. Patients aged 18 years or older requiring revascularization of two or more culprit lesions were randomized into two groups: one received DCBs and the other DES. Exclusions were based on contraindications to dual antiplatelet therapy, allergies to study drugs, bleeding disorders, or life expectancy under one year. Results: Each group comprised 50 patients. The prevalence of hypertension (56% in DCB vs. 60% in DES, p=0.68) and diabetes (36% in DCB vs. 40% in DES, p=0.72) was similar. TVR rates were 10% for DCB and 8% for DES (p=0.45). MACE rates were 14% for DCB and 12% for DES (p=0.37). Conclusion: The study supports the use of DCB as an alternative to DES in specific clinical scenarios, emphasizing the need for tailored treatment decisions based on individual patient and lesion characteristics.
{"title":"Drug Coated Balloon vs. Drug Eluting Stent in Multiculprit Primary Percutaneous Revascularization","authors":"Anwar Jamal Khan, Jabar Ali, S. Safi, Wasim Sajjad","doi":"10.61919/jhrr.v4i2.849","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.849","url":null,"abstract":"Background: Patients presenting with ST-elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention (PCI) frequently face multivessel coronary artery disease (CAD). The optimal interventional approach remains debated.\u0000Objective: To systematically review and analyze the effectiveness and safety of drug-coated balloons (DCB) versus drug-eluting stents (DES) in multiculprit primary PCI through a randomized controlled trial.\u0000Methods: This prospective, single-center, randomized controlled trial included 100 patients with STEMI and multivessel CAD at Lady Reading Hospital Peshawar from April 2023 to March 2024. Patients aged 18 years or older requiring revascularization of two or more culprit lesions were randomized into two groups: one received DCBs and the other DES. Exclusions were based on contraindications to dual antiplatelet therapy, allergies to study drugs, bleeding disorders, or life expectancy under one year.\u0000Results: Each group comprised 50 patients. The prevalence of hypertension (56% in DCB vs. 60% in DES, p=0.68) and diabetes (36% in DCB vs. 40% in DES, p=0.72) was similar. TVR rates were 10% for DCB and 8% for DES (p=0.45). MACE rates were 14% for DCB and 12% for DES (p=0.37).\u0000Conclusion: The study supports the use of DCB as an alternative to DES in specific clinical scenarios, emphasizing the need for tailored treatment decisions based on individual patient and lesion characteristics.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141012036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fahad Raja Khan, S. Memon, Samra Rehmat, Bahlool Khan
Background: Ischemic heart disease (IHD) is a significant health concern globally, with various risk factors affecting the outcomes of therapeutic interventions like percutaneous coronary interventions (PCIs) and coronary artery bypass grafting (CABG). The use of smokeless tobacco products such as SLT (snus, loose snuff) and Naswar is prevalent in South Asia and poses additional risks due to its cardiovascular implications. Objective: This study aims to assess the impact of smokeless tobacco (SLT/Naswar) use on the incidence of IHD following coronary interventions, highlighting the need for tailored healthcare strategies to address this modifiable risk factor. Methods: A prospective observational study was conducted from July 1, 2023, to January 1, 2024, involving 200 participants aged 18 to 80 years diagnosed with IHD. Data collection involved structured interviews and comprehensive reviews of health records. Statistical analyses included Chi-square tests and logistic regression to evaluate the association between SLT/Naswar usage and IHD incidence post-intervention, with SPSS software utilized for all computations. Results: Among the participants, 40.5% were users of SLT/Naswar. Post-coronary intervention, SLT/Naswar users showed a 66% incidence rate of IHD compared to 48% in non-users, with a statistically significant difference (P=0.032). Successful intervention rates were 62% in SLT/Naswar users versus 78% in non-users. Complication rates such as re-stenosis were higher in SLT/Naswar users (29% vs. 16%). Conclusion: The study demonstrates that SLT/Naswar use significantly impacts the outcomes of coronary interventions, with a higher incidence of IHD and complications among users. These findings underscore the importance of integrating smokeless tobacco cessation programs into cardiovascular care protocols.
{"title":"Incidence of Ischemic Heart Disease (IHD) in Smokeless Tobacco/Naswar Users Versus Non-Users Following Coronary Interventions","authors":"Fahad Raja Khan, S. Memon, Samra Rehmat, Bahlool Khan","doi":"10.61919/jhrr.v4i2.880","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.880","url":null,"abstract":"Background: Ischemic heart disease (IHD) is a significant health concern globally, with various risk factors affecting the outcomes of therapeutic interventions like percutaneous coronary interventions (PCIs) and coronary artery bypass grafting (CABG). The use of smokeless tobacco products such as SLT (snus, loose snuff) and Naswar is prevalent in South Asia and poses additional risks due to its cardiovascular implications.\u0000Objective: This study aims to assess the impact of smokeless tobacco (SLT/Naswar) use on the incidence of IHD following coronary interventions, highlighting the need for tailored healthcare strategies to address this modifiable risk factor.\u0000Methods: A prospective observational study was conducted from July 1, 2023, to January 1, 2024, involving 200 participants aged 18 to 80 years diagnosed with IHD. Data collection involved structured interviews and comprehensive reviews of health records. Statistical analyses included Chi-square tests and logistic regression to evaluate the association between SLT/Naswar usage and IHD incidence post-intervention, with SPSS software utilized for all computations.\u0000Results: Among the participants, 40.5% were users of SLT/Naswar. Post-coronary intervention, SLT/Naswar users showed a 66% incidence rate of IHD compared to 48% in non-users, with a statistically significant difference (P=0.032). Successful intervention rates were 62% in SLT/Naswar users versus 78% in non-users. Complication rates such as re-stenosis were higher in SLT/Naswar users (29% vs. 16%).\u0000Conclusion: The study demonstrates that SLT/Naswar use significantly impacts the outcomes of coronary interventions, with a higher incidence of IHD and complications among users. These findings underscore the importance of integrating smokeless tobacco cessation programs into cardiovascular care protocols.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141013997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Hepatocellular carcinoma (HCC) and liver metastases (LM) are often associated with significant symptoms such as pain and abdominal discomfort, impacting the quality of life (QoL) of affected patients. Current treatments vary in effectiveness and often leave a substantial unmet medical need in symptom management. Objective: This study aimed to assess the efficacy of external radiation therapy (ERT) in alleviating symptoms and improving the QoL in patients with HCC and LM, focusing on those presenting primarily with pain or abdominal discomfort. Methods: After institutional review board approval, patients with HCC or painful LM, not previously treated with tumor resection, radiofrequency ablation, or systemic therapy, were included. Eligible participants exhibited symptoms such as pain, nausea, and fatigue, and had a performance status of 0-2. A single fraction dose of ERT was administered, and symptom relief was evaluated using the Brief Pain Inventory (BPI) and QoL using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). Completion rates of these questionnaires were tracked at baseline, one week, and one month post-treatment. Results: Of the 43 patients enrolled (23 HCC, 20 LM), significant improvement in the FACT-G TOI was observed in 34% of patients at one month post-ERT. When focusing on those with pain or abdominal discomfort, 59% reported clinically significant symptom relief. However, QoL improvement was noted in only about one quarter of patients, with one third experiencing worsening QoL at one month. Questionnaire completion rates were high initially but decreased over time, reflecting the challenging nature of the patient population. Conclusion: ERT demonstrated potential benefits in symptom relief, particularly for pain and abdominal discomfort in patients with HCC and LM. Nonetheless, the impact on overall QoL was mixed, highlighting the need for further research into optimizing therapeutic strategies for this patient group.
{"title":"Role of Radiotherapy in Improving Quality of Life in Patients with Hepatocellular Carcinoma and Liver Metastasis","authors":"Saif ur Rehman, Shafaq Maqsood, Aneela Deevan","doi":"10.61919/jhrr.v4i2.872","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.872","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) and liver metastases (LM) are often associated with significant symptoms such as pain and abdominal discomfort, impacting the quality of life (QoL) of affected patients. Current treatments vary in effectiveness and often leave a substantial unmet medical need in symptom management.\u0000Objective: This study aimed to assess the efficacy of external radiation therapy (ERT) in alleviating symptoms and improving the QoL in patients with HCC and LM, focusing on those presenting primarily with pain or abdominal discomfort.\u0000Methods: After institutional review board approval, patients with HCC or painful LM, not previously treated with tumor resection, radiofrequency ablation, or systemic therapy, were included. Eligible participants exhibited symptoms such as pain, nausea, and fatigue, and had a performance status of 0-2. A single fraction dose of ERT was administered, and symptom relief was evaluated using the Brief Pain Inventory (BPI) and QoL using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). Completion rates of these questionnaires were tracked at baseline, one week, and one month post-treatment.\u0000Results: Of the 43 patients enrolled (23 HCC, 20 LM), significant improvement in the FACT-G TOI was observed in 34% of patients at one month post-ERT. When focusing on those with pain or abdominal discomfort, 59% reported clinically significant symptom relief. However, QoL improvement was noted in only about one quarter of patients, with one third experiencing worsening QoL at one month. Questionnaire completion rates were high initially but decreased over time, reflecting the challenging nature of the patient population.\u0000Conclusion: ERT demonstrated potential benefits in symptom relief, particularly for pain and abdominal discomfort in patients with HCC and LM. Nonetheless, the impact on overall QoL was mixed, highlighting the need for further research into optimizing therapeutic strategies for this patient group.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wajia Saba, Muhammad Faran, Javeria Sardar, Samra Ashraf
Background: Caregiver burden among those caring for patients with thalassemia major in Pakistan poses significant psychological challenges. The role of religious coping mechanisms in alleviating psychological distress and enhancing well-being among caregivers has been highlighted in prior research, suggesting a complex interplay between caregiver strain, coping strategies, and mental health outcomes. Objective: This study aims to investigate the relationships between caregiver burden, positive religious coping, and mental health outcomes, specifically psychological well-being and distress, among caregivers of thalassemia patients in the Twin cities of Islamabad and Rawalpindi. Methods: Employing a cross-sectional design, the study included 180 caregivers of thalassemia patients, recruited through non-probability purposive sampling from major thalassemia centers and hospitals in Islamabad and Rawalpindi. Data were collected using the Zarit Caregiver’s Burden Scale, the Brief Religious Coping Scale, and the Mental Health Inventory. Structural Equation Modeling (SEM) was utilized to analyze the data, using SPSS and AMOS software, with a focus on the mediating role of positive religious coping between caregiver burden and mental health outcomes. Results: The analysis revealed that caregiver burden significantly predicted the use of positive religious coping (β = .32, p < .001) and was negatively associated with psychological well-being (β = -.33, p < .001) while positively associated with psychological distress (β = .23, p < .01). Positive religious coping positively influenced psychological well-being (β = .28, p < .01) and negatively influenced psychological distress (β = -.21, p < .05). The model explained 38.2% of the variance in psychological well-being and 34.1% in psychological distress. Conclusion: The findings underscore the significant impact of caregiver burden on the mental health of caregivers, with positive religious coping serving as a beneficial mediating factor. Enhancing positive religious coping among caregivers may be a viable intervention strategy to improve their mental health outcomes.
{"title":"Caregivers' Burden and Mental Health of the Caregivers of β-Major Thalassemia Patients: Mediating Role of Religious Coping","authors":"Wajia Saba, Muhammad Faran, Javeria Sardar, Samra Ashraf","doi":"10.61919/jhrr.v4i2.831","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.831","url":null,"abstract":"Background: Caregiver burden among those caring for patients with thalassemia major in Pakistan poses significant psychological challenges. The role of religious coping mechanisms in alleviating psychological distress and enhancing well-being among caregivers has been highlighted in prior research, suggesting a complex interplay between caregiver strain, coping strategies, and mental health outcomes.\u0000Objective: This study aims to investigate the relationships between caregiver burden, positive religious coping, and mental health outcomes, specifically psychological well-being and distress, among caregivers of thalassemia patients in the Twin cities of Islamabad and Rawalpindi.\u0000Methods: Employing a cross-sectional design, the study included 180 caregivers of thalassemia patients, recruited through non-probability purposive sampling from major thalassemia centers and hospitals in Islamabad and Rawalpindi. Data were collected using the Zarit Caregiver’s Burden Scale, the Brief Religious Coping Scale, and the Mental Health Inventory. Structural Equation Modeling (SEM) was utilized to analyze the data, using SPSS and AMOS software, with a focus on the mediating role of positive religious coping between caregiver burden and mental health outcomes.\u0000Results: The analysis revealed that caregiver burden significantly predicted the use of positive religious coping (β = .32, p < .001) and was negatively associated with psychological well-being (β = -.33, p < .001) while positively associated with psychological distress (β = .23, p < .01). Positive religious coping positively influenced psychological well-being (β = .28, p < .01) and negatively influenced psychological distress (β = -.21, p < .05). The model explained 38.2% of the variance in psychological well-being and 34.1% in psychological distress.\u0000Conclusion: The findings underscore the significant impact of caregiver burden on the mental health of caregivers, with positive religious coping serving as a beneficial mediating factor. Enhancing positive religious coping among caregivers may be a viable intervention strategy to improve their mental health outcomes.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ammar Azam Cheema, Saleha Abbas, Muhammad Shahid, Moazama Shakeel Ahmed, Sauda Usmani, Syed Muhammad, Nayab Ali
Background: Percutaneous coronary intervention (PCI) is a primary treatment modality for coronary artery disease, particularly in complex cases involving multivessel disease, chronic total occlusions, or bifurcation lesions. The choice of vascular access site—radial versus femoral—can significantly impact patient outcomes and the incidence of vascular complications. Recent trends favor radial access due to its potential advantages in safety and recovery. Objective: To evaluate the impact of radial versus femoral access on vascular complications and patient outcomes in complex PCI. Methods: This randomized control trial was conducted at the Chaudhary Pervaiz Elahi Institute of Cardiology, Wazirabad, Pakistan, over a six-month period from September 2023 to February 2024. A total of 350 patients undergoing complex PCI were enrolled, with 210 assigned to radial access and 140 to femoral access. Baseline characteristics, including age, BMI, and prevalent comorbidities (dyslipidemia, hypertension, and diabetes mellitus), were recorded. Major outcomes measured included periprocedural myocardial infarction, in-hospital mortality, and stent thrombosis. Statistical analysis was performed using SPSS Version 26. Results: The mean age of participants was 52.90 ± 8.07 years. No significant differences were found in BMI and comorbid conditions between the groups. In-hospital mortality was 1.4% in the radial group compared to 4.3% in the femoral group (P=0.05). Rates of periprocedural myocardial infarction were similar between groups (0.5% radial vs 0.7% femoral, P=0.77). Stent thrombosis was observed in 0.5% of the radial group and was absent in the femoral group. Conclusion: Radial access in complex PCI was associated with lower in-hospital mortality compared to femoral access, with similar rates of myocardial infarction and stent thrombosis. These findings suggest that radial access may provide a safer alternative, supporting its increasing use in clinical practice.
{"title":"The Impact of Radial Vs Femoral Access on Vascular Complications and Patients Outcomes in Complex PCI","authors":"Ammar Azam Cheema, Saleha Abbas, Muhammad Shahid, Moazama Shakeel Ahmed, Sauda Usmani, Syed Muhammad, Nayab Ali","doi":"10.61919/jhrr.v4i2.876","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.876","url":null,"abstract":"Background: Percutaneous coronary intervention (PCI) is a primary treatment modality for coronary artery disease, particularly in complex cases involving multivessel disease, chronic total occlusions, or bifurcation lesions. The choice of vascular access site—radial versus femoral—can significantly impact patient outcomes and the incidence of vascular complications. Recent trends favor radial access due to its potential advantages in safety and recovery.\u0000Objective: To evaluate the impact of radial versus femoral access on vascular complications and patient outcomes in complex PCI.\u0000Methods: This randomized control trial was conducted at the Chaudhary Pervaiz Elahi Institute of Cardiology, Wazirabad, Pakistan, over a six-month period from September 2023 to February 2024. A total of 350 patients undergoing complex PCI were enrolled, with 210 assigned to radial access and 140 to femoral access. Baseline characteristics, including age, BMI, and prevalent comorbidities (dyslipidemia, hypertension, and diabetes mellitus), were recorded. Major outcomes measured included periprocedural myocardial infarction, in-hospital mortality, and stent thrombosis. Statistical analysis was performed using SPSS Version 26.\u0000Results: The mean age of participants was 52.90 ± 8.07 years. No significant differences were found in BMI and comorbid conditions between the groups. In-hospital mortality was 1.4% in the radial group compared to 4.3% in the femoral group (P=0.05). Rates of periprocedural myocardial infarction were similar between groups (0.5% radial vs 0.7% femoral, P=0.77). Stent thrombosis was observed in 0.5% of the radial group and was absent in the femoral group.\u0000Conclusion: Radial access in complex PCI was associated with lower in-hospital mortality compared to femoral access, with similar rates of myocardial infarction and stent thrombosis. These findings suggest that radial access may provide a safer alternative, supporting its increasing use in clinical practice.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pelvic radiotherapy is a primary treatment modality for organ-confined prostate cancer and early-stage endometrial cancer. While effective in improving survival rates and reducing recurrence, it is associated with a range of side effects that can impact patient quality of life. Objective: The study aimed to assess the incidence, management, and resolution of acute and chronic side effects of pelvic radiotherapy in prostate and endometrial cancer patients, focusing on bowel and bladder functions. Methods: This single-center, observational study included 50 patients diagnosed with prostate or endometrial cancer who underwent pelvic radiotherapy with a dose of 66-70 Gy using a four-field technique on a linear accelerator. Patients were assessed for bladder and bowel dysfunction, with follow-up at 6, 12, and 18 months post-treatment. Statistical analysis involved univariate weighted distribution of response frequencies and paired t-tests for ordinal scale scores, using SPSS version 25 for data analysis. Results: Of the participants, 22% experienced dysuria, 64% reported bladder outlet obstruction, and 20% had constipation. Acute bowel symptoms like diarrhea occurred in 32%, and chronic proctitis developed in 22% of patients. Urinary symptoms appeared by the third week and generally resolved within weeks; however, bowel symptoms persisted longer but returned to baseline by 18 months post-treatment. Approximately 70% of patients reported good tolerance to radiotherapy. Conclusion: Pelvic radiotherapy is effective in treating prostate and endometrial cancers but requires management of transient side effects to improve patient outcomes. Advanced radiotherapy techniques such as IMRT and 3D CRT have shown potential in reducing these side effects, emphasizing the need for continuous technological advancements and patient-centered care in radiotherapy.
{"title":"Radiotherapy Related Bowel and Bladder Toxicity after Prostate Cancer Irradiation","authors":"Saif ur Rehman, Shafaq Maqsood, Aneela Deevan","doi":"10.61919/jhrr.v4i2.874","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.874","url":null,"abstract":"Background: Pelvic radiotherapy is a primary treatment modality for organ-confined prostate cancer and early-stage endometrial cancer. While effective in improving survival rates and reducing recurrence, it is associated with a range of side effects that can impact patient quality of life.\u0000Objective: The study aimed to assess the incidence, management, and resolution of acute and chronic side effects of pelvic radiotherapy in prostate and endometrial cancer patients, focusing on bowel and bladder functions.\u0000Methods: This single-center, observational study included 50 patients diagnosed with prostate or endometrial cancer who underwent pelvic radiotherapy with a dose of 66-70 Gy using a four-field technique on a linear accelerator. Patients were assessed for bladder and bowel dysfunction, with follow-up at 6, 12, and 18 months post-treatment. Statistical analysis involved univariate weighted distribution of response frequencies and paired t-tests for ordinal scale scores, using SPSS version 25 for data analysis.\u0000Results: Of the participants, 22% experienced dysuria, 64% reported bladder outlet obstruction, and 20% had constipation. Acute bowel symptoms like diarrhea occurred in 32%, and chronic proctitis developed in 22% of patients. Urinary symptoms appeared by the third week and generally resolved within weeks; however, bowel symptoms persisted longer but returned to baseline by 18 months post-treatment. Approximately 70% of patients reported good tolerance to radiotherapy.\u0000Conclusion: Pelvic radiotherapy is effective in treating prostate and endometrial cancers but requires management of transient side effects to improve patient outcomes. Advanced radiotherapy techniques such as IMRT and 3D CRT have shown potential in reducing these side effects, emphasizing the need for continuous technological advancements and patient-centered care in radiotherapy.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141014702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Palliative radiation therapy (RT) is increasingly recognized as a crucial component of care for patients with advanced, incurable malignancies. In Pakistan, where patients often present at advanced stages due to socio-economic barriers and limited healthcare access, efficient and effective treatment protocols are essential. Objective: This study aimed to evaluate the efficacy of the Quad Shot hypo-fractionated RT protocol for pain palliation in elderly and frail patients with recurrent or metastatic non-osseous malignancies. Methods: A quasi-experimental study was conducted at the Oncology Department of Ganga Ram Hospital, Lahore. Forty-two elderly patients with histologically confirmed inoperable malignancies and a WHO Performance Status of 2 to 3 were enrolled. Patients with prior RT or a second cancer were excluded. RT was delivered using a Cobalt-60 beam, with a total dose of 14 Gy divided into four fractions over two consecutive days. Pain severity was assessed using a 10-point scale before and four weeks after treatment. Statistical analysis was performed using the Wilcoxon Sign Rank Test on SPSS version 25.0. Results: The study population comprised 52% males and 48% females, with the majority of primary tumors located in the head and neck (64%). Post-treatment, the mean pain score significantly decreased from 8.04 ± 1.22 to 4.32 ± 0.89 (p < 0.05). Conclusion: The Quad Shot hypo-fractionated RT protocol effectively reduces pain in elderly and frail patients with advanced malignancies, suggesting its suitability as a quick and effective palliative care option in resource-limited settings.
{"title":"Quad Shot Palliation, A Considerable Option for Non-Osseous Recurrent or Metastatic Malignancies in Elderly or Frail Patients.","authors":"Saif ur Rehman, Shafaq Maqsood, Aneela Deevan","doi":"10.61919/jhrr.v4i2.873","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.873","url":null,"abstract":"Background: Palliative radiation therapy (RT) is increasingly recognized as a crucial component of care for patients with advanced, incurable malignancies. In Pakistan, where patients often present at advanced stages due to socio-economic barriers and limited healthcare access, efficient and effective treatment protocols are essential.\u0000Objective: This study aimed to evaluate the efficacy of the Quad Shot hypo-fractionated RT protocol for pain palliation in elderly and frail patients with recurrent or metastatic non-osseous malignancies.\u0000Methods: A quasi-experimental study was conducted at the Oncology Department of Ganga Ram Hospital, Lahore. Forty-two elderly patients with histologically confirmed inoperable malignancies and a WHO Performance Status of 2 to 3 were enrolled. Patients with prior RT or a second cancer were excluded. RT was delivered using a Cobalt-60 beam, with a total dose of 14 Gy divided into four fractions over two consecutive days. Pain severity was assessed using a 10-point scale before and four weeks after treatment. Statistical analysis was performed using the Wilcoxon Sign Rank Test on SPSS version 25.0.\u0000Results: The study population comprised 52% males and 48% females, with the majority of primary tumors located in the head and neck (64%). Post-treatment, the mean pain score significantly decreased from 8.04 ± 1.22 to 4.32 ± 0.89 (p < 0.05).\u0000Conclusion: The Quad Shot hypo-fractionated RT protocol effectively reduces pain in elderly and frail patients with advanced malignancies, suggesting its suitability as a quick and effective palliative care option in resource-limited settings.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Tube thoracostomy (TT) is a prevalent procedure in the management of various thoracic conditions, including pneumothorax, pleural effusion, and chest trauma. Despite its widespread use, TT is associated with significant complications such as pain and impaired sleep quality, which can affect patient recovery and overall health outcomes. Objective: This study aims to explore the relationship between pain severity and sleep quality following tube thoracostomy and to assess the impact of pain management on postoperative recovery. Methods: A descriptive, prospective, cross-sectional study was conducted at Dr. Ruth K. M. Pfau Civil Hospital Karachi and Dow University of Health Sciences from September 28, 2022, to March 27, 2023. The study included adults aged 18 to 70 who underwent TT for any indication. Patients were excluded if they withheld consent, had a history of substance use, psychological disorders, or were victims of poly-trauma. Pain severity was assessed using a visual analogue scale (VAS) and sleep quality was evaluated using the Richards-Campbell Sleep Questionnaire (RCSQ). Data were analyzed using SPSS version 25, employing descriptive statistics and Spearman correlation tests. Results: The study involved 77 participants with a mean age of 28.33 ± 10.50 years. The mean pain scores on postoperative days 1, 2, and 3 were 8.08 ± 0.66, 6.92 ± 0.99, and 4.92 ± 1.37, respectively. Corresponding sleep quality scores were 17.50 ± 7.53, 36.67 ± 9.84, and 57.50 ± 10.55. A significant negative correlation was found between pain scores and sleep quality scores on day 3 (r = -0.744, p < 0.001). Conclusion: The findings suggest a significant association between lower pain scores and improved sleep quality among patients undergoing tube thoracostomy. Effective pain management may enhance sleep quality and facilitate recovery, highlighting the need for comprehensive postoperative care strategies in these patients.
{"title":"To Determine how the Severity of Pain Relates to the Quality of Sleep Following Tube Thoracostomy","authors":"Tehreem Ahmed, Mehreen Ansari, Sidrah Masoom, Saeed Ahmed, Rafia Haleem Shaikh, Sajida Qureshi","doi":"10.61919/jhrr.v4i2.818","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.818","url":null,"abstract":"Background: Tube thoracostomy (TT) is a prevalent procedure in the management of various thoracic conditions, including pneumothorax, pleural effusion, and chest trauma. Despite its widespread use, TT is associated with significant complications such as pain and impaired sleep quality, which can affect patient recovery and overall health outcomes.\u0000Objective: This study aims to explore the relationship between pain severity and sleep quality following tube thoracostomy and to assess the impact of pain management on postoperative recovery.\u0000Methods: A descriptive, prospective, cross-sectional study was conducted at Dr. Ruth K. M. Pfau Civil Hospital Karachi and Dow University of Health Sciences from September 28, 2022, to March 27, 2023. The study included adults aged 18 to 70 who underwent TT for any indication. Patients were excluded if they withheld consent, had a history of substance use, psychological disorders, or were victims of poly-trauma. Pain severity was assessed using a visual analogue scale (VAS) and sleep quality was evaluated using the Richards-Campbell Sleep Questionnaire (RCSQ). Data were analyzed using SPSS version 25, employing descriptive statistics and Spearman correlation tests.\u0000Results: The study involved 77 participants with a mean age of 28.33 ± 10.50 years. The mean pain scores on postoperative days 1, 2, and 3 were 8.08 ± 0.66, 6.92 ± 0.99, and 4.92 ± 1.37, respectively. Corresponding sleep quality scores were 17.50 ± 7.53, 36.67 ± 9.84, and 57.50 ± 10.55. A significant negative correlation was found between pain scores and sleep quality scores on day 3 (r = -0.744, p < 0.001).\u0000Conclusion: The findings suggest a significant association between lower pain scores and improved sleep quality among patients undergoing tube thoracostomy. Effective pain management may enhance sleep quality and facilitate recovery, highlighting the need for comprehensive postoperative care strategies in these patients.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141014918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abbas Raza, S. Tasleem, Nabi Ullah, Muhammad Dilshad, Amjad Ali Maitlo
Background: Industrial activities release significant amounts of heavy metals into the environment, contaminating soil and vegetation. This pollution poses severe risks to ecosystems and human health, making it a crucial area of study. Objective: To quantify the accumulation of heavy metals in soil and vegetation surrounding industrial areas and assess the ecological risks associated with this contamination. Methods: The study involved quantitative analysis of soil and plant samples from industrial and control areas. Heavy metals analyzed included lead, cadmium, mercury, arsenic, chromium, and nickel. Methods included atomic absorption spectroscopy for metal quantification, bioaccumulation factor (BAF) calculation for plants, and ecological risk assessment using the ecological risk index (ERI). Results: Soil samples from industrial zones showed significantly higher concentrations of lead (175 mg/kg), cadmium (8 mg/kg), and chromium (90 mg/kg) compared to control areas (lead: 30 mg/kg, cadmium: 2 mg/kg, chromium: 20 mg/kg). Plant tissues from these areas also revealed elevated levels of lead (12 mg/kg), cadmium (2 mg/kg), and nickel (8 mg/kg), against lower concentrations in control samples (lead: 3 mg/kg, cadmium: 0.5 mg/kg, nickel: 2 mg/kg). The ecological risk index underscored a high risk in industrial zones (ERI = 85) compared to control areas (ERI = 30). Conclusion: The study highlights the critical contamination of soil and vegetation with heavy metals near industrial zones and the consequent ecological risks. These findings emphasize the need for immediate remediation strategies and stricter regulatory frameworks to mitigate the impacts of this pollution.
{"title":"Quantifying Heavy Metal Accumulation in Soil and Vegetation Surrounding Industrial Areas: A Comprehensive Environmental Toxicology Study","authors":"Abbas Raza, S. Tasleem, Nabi Ullah, Muhammad Dilshad, Amjad Ali Maitlo","doi":"10.61919/jhrr.v4i2.864","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.864","url":null,"abstract":"Background: Industrial activities release significant amounts of heavy metals into the environment, contaminating soil and vegetation. This pollution poses severe risks to ecosystems and human health, making it a crucial area of study.\u0000Objective: To quantify the accumulation of heavy metals in soil and vegetation surrounding industrial areas and assess the ecological risks associated with this contamination.\u0000Methods: The study involved quantitative analysis of soil and plant samples from industrial and control areas. Heavy metals analyzed included lead, cadmium, mercury, arsenic, chromium, and nickel. Methods included atomic absorption spectroscopy for metal quantification, bioaccumulation factor (BAF) calculation for plants, and ecological risk assessment using the ecological risk index (ERI).\u0000Results: Soil samples from industrial zones showed significantly higher concentrations of lead (175 mg/kg), cadmium (8 mg/kg), and chromium (90 mg/kg) compared to control areas (lead: 30 mg/kg, cadmium: 2 mg/kg, chromium: 20 mg/kg). Plant tissues from these areas also revealed elevated levels of lead (12 mg/kg), cadmium (2 mg/kg), and nickel (8 mg/kg), against lower concentrations in control samples (lead: 3 mg/kg, cadmium: 0.5 mg/kg, nickel: 2 mg/kg). The ecological risk index underscored a high risk in industrial zones (ERI = 85) compared to control areas (ERI = 30).\u0000Conclusion: The study highlights the critical contamination of soil and vegetation with heavy metals near industrial zones and the consequent ecological risks. These findings emphasize the need for immediate remediation strategies and stricter regulatory frameworks to mitigate the impacts of this pollution.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Dental caries remains a significant public health issue globally, affecting both developed and developing nations. Studies have shown varying prevalence rates based on geographic, socioeconomic, and cultural factors, particularly among school-aged children. The city of Peshawar, with its diverse population, provides a unique setting to study these variables in relation to oral health outcomes among children. Objective: This study aimed to determine the prevalence of dental caries among school children aged 6 to 12 years in Peshawar, Pakistan, and to compare the rates between students from government and private schools. Additionally, the study sought to explore the association of dental caries with dietary habits, particularly the consumption of sweets, chocolates, and candies. Methods: A cross-sectional study was conducted involving 376 school children from both government and private schools in Peshawar. Participants underwent detailed oral examinations to assess for dental caries, and data on their dietary habits were collected through questionnaires. Informed consent was obtained from parents or guardians according to the Declaration of Helsinki. The Statistical Package for the Social Sciences (SPSS) Version 22 was used for data analysis, employing descriptive statistics to calculate frequencies, percentages, and mean values. Results: The overall prevalence of dental caries among the participants was 55.05%. Boys exhibited a slightly higher prevalence (53.2% in males compared to 62.7% in females). The consumption of sugary snacks was significantly associated with the presence of caries; 95.6% of carious children regularly consumed sweets, chocolates, or candies. There was no significant difference in caries prevalence between children from government (53.2%) and private schools (57.5%). Conclusion: The study highlights a high prevalence of dental caries among school-aged children in Peshawar, which correlates strongly with sugar consumption but not with the type of school attended. These findings underscore the need for targeted public health interventions to reduce sugar intake and improve oral hygiene among children.
{"title":"Prevalence and Comparison of Dental Caries of 6 to 12 Years Age in Government and Private School Children of Peshawar City, Pakistan","authors":"Zeeshan Ahmad Khan, Salma, Aqsa, Kay Enat Omar","doi":"10.61919/jhrr.v4i2.729","DOIUrl":"https://doi.org/10.61919/jhrr.v4i2.729","url":null,"abstract":"Background: Dental caries remains a significant public health issue globally, affecting both developed and developing nations. Studies have shown varying prevalence rates based on geographic, socioeconomic, and cultural factors, particularly among school-aged children. The city of Peshawar, with its diverse population, provides a unique setting to study these variables in relation to oral health outcomes among children.\u0000Objective: This study aimed to determine the prevalence of dental caries among school children aged 6 to 12 years in Peshawar, Pakistan, and to compare the rates between students from government and private schools. Additionally, the study sought to explore the association of dental caries with dietary habits, particularly the consumption of sweets, chocolates, and candies.\u0000Methods: A cross-sectional study was conducted involving 376 school children from both government and private schools in Peshawar. Participants underwent detailed oral examinations to assess for dental caries, and data on their dietary habits were collected through questionnaires. Informed consent was obtained from parents or guardians according to the Declaration of Helsinki. The Statistical Package for the Social Sciences (SPSS) Version 22 was used for data analysis, employing descriptive statistics to calculate frequencies, percentages, and mean values.\u0000Results: The overall prevalence of dental caries among the participants was 55.05%. Boys exhibited a slightly higher prevalence (53.2% in males compared to 62.7% in females). The consumption of sugary snacks was significantly associated with the presence of caries; 95.6% of carious children regularly consumed sweets, chocolates, or candies. There was no significant difference in caries prevalence between children from government (53.2%) and private schools (57.5%).\u0000Conclusion: The study highlights a high prevalence of dental caries among school-aged children in Peshawar, which correlates strongly with sugar consumption but not with the type of school attended. These findings underscore the need for targeted public health interventions to reduce sugar intake and improve oral hygiene among children.","PeriodicalId":507812,"journal":{"name":"Journal of Health and Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：