Journal of the Pakistan Medical Association最新文献

Objectives: To assess the relationship between light-emitting diode device usage and premature ageing.

Methods: The cross-sectional, descriptive study was conducted from October 2023 to May 2024 after approval from the ethics review committee of Pakistan Naval Ship Shifa Hospital, Karachi, and comprised individuals aged 27-40 years. Other than demographic characteristics, data was collected about light-emitting diode device usage and indicators of premature ageing based on self-reported and observed features. Data was analysed using SPSS 29.

Results: Of the 450 participants with mean age 32.4±3.7 years, 225(50%) each were males and females. Commonly used devices were mobile phones 400(88.9%), television 350(77.8%) and laptops 300(66.7%). Overall, 200(44.4%) subjects reported 5-7 hours of screen time, and 300(66.7%) did not use ultraviolet protection. Devices were used at a distance of 10- 20cm by 200(44.4%) subjects. In terms of premature ageing signs, the most common was dark circles 325(72.2%), while greying of hair was the least common 200(44.4%). All ageing variables showed a highly significant association with lightemitting diode usage (p<0.01), with the exception of greying of hair which demonstrated a significant association but at a lower level (p<0.05).

Conclusions: There was a significant link between light-emitting diode device usage and premature ageing.

Adolescent endocrinology is a fast-growing field of medicine. It is imperative for the clinicians to adopt a guided and a stepwise approach when it comes to history taking in adolescents. This best practice piece aims to guide health practitioners on how to approach the interview with these children and assess areas of risk or concern. The '3x3 S approach' mentioned in this manuscript will be helpful for clinicians as well as health workers in delivering adolescent sensitive, and adolescent friendly care services. It is a more pragmatic and practical version of the HEEADSSS acronym (Home, Education/ Employment, Eating, Activities, Drugs, Sexuality, Suicidal ideation and Safety) used to interview adolescents.

Objective: To evaluate the medical educational environment of an institution using integrated medical curriculum.

Methods: The cross-sectional study was conducted from September 1 to November 1, 2024, at Gujranwala Medical College, Gujranwala, Pakistan, and comprised of medical students regardless of age, gender and academic year. Data was collected using the validated Dundee Ready Education Environment Measure questionnaire, covering five domains of the educational environment. Data was analysed using SPSS 28.

Results: Of the 265 students, 88 (33.2%) were males and 177 (66.8%) were females. By year of study, 89 (33.6%) were first year, 77 (29.1%) second year, 32 (12.1%) third year, 34 (12.8%) fourth year, and [n=33 (12.5%)] final year. Regarding residence, 77 (29.1%) were day scholars and 188 (70.9%) were hostelites. The total mean DREEM score was 120.2±22.2 (60%), reflecting moderately positive perceptions. Subscale analysis revealed highest scores in Students' Perception of Learning (28.6±6.2) and lowest in Social Self-Perception (15.9±4.4). Significant differences across academic years were observed for all subscales (p<0.05). Regression analysis demonstrated that progression through academic years was significantly associated with declining scores in SPL, SASP, SPA, and SSSP (R²=0.06-0.15). No significant differences were noted by gender or residence status. Internal consistency was acceptable (Cronbach's alpha=0.86; standardized=0.89).

Conclusions: The evolving educational needs of students must be acknowledged through curricular adjustments to enhance student engagement, social support and professional competence.

Objective: To analyse the birth characteristics and maternal risk factors associated with preterm infants.

Methods: The retrospective study was conducted at the Jinshan Branch of Shanghai Sixth People's Hospital, China, and comprised data related to mothers and their preterm infants delivered between January 1, 2011, and December 31, 2020. Information on maternal age, pregnancy complications, number of births, gestational age at delivery and neonatal outcomes was collected from hospital records to assess risk factors for preterm birth. Data was analysed using SPSS 25.

Results: Among 9,953 total births, 454 (4.56%) were preterm. Of these, 57 (12.56%) were early preterm and 397 (87.44%) were late preterm. The mean gestational age was 34.97±1.60 weeks and the average birth weight was 2,596.87 ± 502.28 g. Independent risk factors included gestational hypertension 56 (12.30%), cholestasis 17 (3.74%), premature rupture of membranes (PROM) 134 (29.52%), hormone use during pregnancy 105 (23.13%), and twin pregnancies 80 (17.62%) (p<0.01).

Conclusion: Key maternal risk factors included gestational hypertension, intrahepatic cholestasis of pregnancy, premature rupture of membranes, and multiple gestations.

Objective: To determine the effect of nose form on linear and angular lip position on pre -treatment cephalometric soft tissue analysis.

Methods: The retrospective, cross-sectional, analytical study was conducted at the orthodontic department of Foundation University College of Dentistry and Hospital in Islamabad, and comprised data from October to December 2023 of patients aged 18-25 years presenting with no prior history of orthodontic treatment and craniofacial anomalies and syndromes. Pre-treatment lateral cephalograms were manually traced by a single experienced investigator. The sample was divided into two horizontal groups, using point A-nasion-point B angle. Comparisons were made based on gender and sagittal groups, and the effect of nasal profiles was assessed. Data was analysed using SPSS 23.

Results: Of the 131 patients, 96(73.2%) were females with mean age 22.70±3.97 years, and 35(26.7%) were males with mean age 20.97±3.21 years. There were 65(49.6%) subjects in sagittal Class I group, and 66(50.4%) in sagittal Class II group. A significant and inverse relationship was noted for columellar length with linear position of the upper and lower lips to E and S lines (p<0.05). Inclination of the nasal base had the most effect on the naso-labial angle (p<0.05).

Conclusion: Skeletal Class II had a prominent nose which created a relatively retrusive appearance of the upper and lower lips.

Objective: To evaluate the effect of a health education programme on changes in human papillomavirus knowledge, attitudes and intention to vaccinate among adolescent girls and their mothers.

Methods: The randomised controlled trial was conducted at two adolescent outpatient clinics from January to June 2019 after approval from the Medical Specialist Education Board, Ankara, Turkiye, and comprised girls aged 9-18 years and their mothers. The two clinics were randomised using the lottery method into intervention group A and control group B. The subjects in group A received two health education sessions in addition to standard care: the first session in the first week, and the second session in the fifth week after the first. The follow-up period lasted 12 weeks. Those in group B received standard care. Data was collected using the Human Papillomavirus Knowledge Scale and the Health Belief Model Scale. Data was analysed using SPSS 23.

Results: Of the 216 subjects, 108(50%) each were in groups A and B; 54(50%) mothers and as many daughters. There were significant post-intervention differences between the groups (p<0.05). Among group A mothers, the intention to vaccinate their daughters was higher compared to those in group B (p=0.001).

Conclusions: Health education regarding human papillomavirus infection and cervical cancer prevention was found to be effective in increasing knowledge and promoting positive health beliefs, attitudes and behaviours.

Rct registration: The study was registered at ClinicalTrials.gov (Trial #: NCT04113902 Date of Approval: April 15, 2019). Link: https://www.clinicaltrials.gov/study/NCT04113902.

Objective: To evaluate axial length, anterior chamber angle, anterior chamber depth, refractive errors and white-to-white corneal diameter, and to assess their inter-correlations with intraocular pressure among young individuals.

Methods: The prospective, cross-sectional study was conducted at the optometry clinics of King Saud University, Riyadh, Saudi Arabia, between January and April 2022, and comprised healthy subjects of either gender aged 8-37 years. Ocular parameters were noted, and the subjects were screened for ocular disorders with a slit lamp. The refractive error was assessed using an auto-refractometer. Data was analysed using SPSS 25.

Results: Of the 108 subjects, 61(56.5%) were females and 47(43.5%) were males. The overall mean age was 20.87±6.23 years. The mean anterior chamber angle was 39.26±5.04 degrees, mean anterior chamber depth was 3.06±0.30mm, mean white-to-white corneal diameter was 11.97±0.40mm, and mean intraocular pressure was 18.75±1.68mmHg. Intraocular pressure had a positive but non-significant correlation with myopia, anterior chamber angle, anterior chamber depth and axial length (p>0.05). Conversely, intraocular pressure had inverse but non-significant correlation with age, hyperopia and white-to-white corneal diameter (p>0.05).

Conclusions: Ocular biometric dimensions could be considered while assessing the risk factors for ocular hypertension.

Objective: To evaluate malnutrition's predictive potential and significance with respect to overall mortality related to heart failure with low ejection fraction.

Methods: The cross-sectional, prospective study was conducted from June to August 2022 at the Kahramanmaras Sutcu Imam University and the Osmaniye Duzici State Hospital, Turkiye, and comprised heart failure patients with low ejection fraction. Malnutrition status was evaluated using the Global Leadership Initiative on Malnutrition criteria. The patients were divided into malnutrition group A and healthy group B. Prognostic nutritional index and contro ling nutritional status scores were calculated and compared. All the patients were followed up either through telephone or clinic visits for up to one year. The number of hospitalisations and length of hospital stay within a year were recorded and compared. Data was analysed using SPSS 22.

Results: Of the 216 patients with mean age 67.10±5.59 years, 110(50.9%) were males and 106(49.1%) were females. There were 57(26.4%) subjects in group A and 159(73.6%) in group B. Malnutrition, length of hospital stay and increased neutrophils were independent predictors of death (p<0.05).

Conclusion: Malnutrition was found to be common among heart failure outpatients, and could significantly help identify those at increased mortality risk.