Journal of the Pakistan Medical Association最新文献

Restless leg syndrome (RLS) is a common yet frequently under-diagnosed condition. The exact pathophysiology is unknown, however multiple factors including genetic factors, brain iron deficiency and dysfunction of dopaminergic system are associated with RLS. It is a clinical diagnosis confirmed by International Restless Legs Syndrome Study Group (IRLSSG) consensus diagnostic criteria (2012). Several pharmacological and non - pharmacological management options are available for treatment of RLS. Non-pharmacological management options include lifestyle modifications, therapeutic exercises (aerobic training, resistance training and flexibility exercises), physical modalities (pneumatic compression, vibration therapy, and near-infrared light) and mind body approaches (yoga, cognitive behavioural therapy, acupuncture, massage, and mindfulness). Pharmacological management of RLS include drugs from various classes including gabapentinoids, dopamine agonists, opioids and iron therapy. Novel treatment options like peroneal nerve stimulation, botulinum toxin injection, transcranial magnetic stimulation, vagus nerve stimulation, spinal cord stimulation and deep brain stimulation are still in experimental phase.

Objective: To determine awareness score regarding the involvement of Artificial Intelligence (AI) to fight against Antimicrobial Resistance (AMR) among the HealthCare Workers of the South and Central Punjab, Pakistan by structured questionnaire to provide actionable educational initiatives and policy recommendations.

Methods: This descriptive cross-sectional survey was done among the HealthCare Workers of South and Central Punjab, Pakistan, between August 01, 2022 and January 31, 2023. The study was limited to Multan and Lahore cities of South and central Punjab, Pakistan was approved by the institutional ethics review board of Nishtar Medical University Multan. A selfcreated questionnaire was used for collecting data. Version VII of GraphPad Prism was used for the analytical analysis. An independent t-test and analysis of variance (ANOVA) were employed to verify significance among different parameters of study. A p-value of less than 0.05 was utilized to validate statistical significance.

Results: During the study, 401 participants completed the online survey. The data findings indicate that women 275 (68.6%) was majority of the respondents between the age group range 21 - 40. Most of the HealthCare Workers 200 (49.9%) had done post graduation and fall among the category of Certified Professional Doctors and Researchers. Moreover, majority of the partakers 225 (56.1%) lived in Lahore city. The significant correlation of Total Awareness Score (TAS) among Sociodemographic parameters was analyzed. Post graduate HealthCare Workers (p=0.0001) and cer tified professional doctors/researchers (p=0.0001) had higher awareness score. In comparison to two different cities, HealthCare Workers of City Lahore (p=0.0324) was observed higher awareness level.

Conclusion: Overall, majority of the HealthCare Workers have higher general awareness regarding the involvement of AI in combating antimicrobial resistance and also their implementation of that awareness is negligible.

Objective: To determine the association of post-phacoemulsification surgery corneal oedema between type 2 diabetic and non-diabetic patients in a tertiary care setting.

Methods: The prospective cohort study was conducted from November 2024 to February 2025 at the Ophthalmology Department of Dow University Hospital, Karachi, and comprised patients of either gender undergoing phacoemulsification. The patients were stratified into study group A comprising type 2 diabetics and the non-diabetic control group B. Standardised phacoemulsification was performed and postoperative evaluations were conducted on days 1, 7 and 30. Corneal oedema incidence and severity were compared between the groups. Data was analysed using SPSS 26.

Results: Of the 100 patients, 50(50%) were in group A; 28(56%) females and 22(44%) males with mean age 60.3±5.98 years. There were 50(50%) patients in group B; 34(68%) females and 16(32%) males with mean age 60.1±6.17 years (p>0.05). On postoperative day 1, corneal oedema was observed in 36(72%) patients in group A compared to 18(36%) in group B (p<0.001). Group A patients had a significantly higher incidence of severe corneal oedema on day 1 (p=0.003) and day 7 (p=0.009), with a 7.6-fold increased likelihood compared to non-diabetics (odds ratio: 7.6; 95% confidence interval: 1.8-30; p<0.01). In group A, oedema was more frequent in uncontrolled diabetics having glycated haemoglobin >7% (p<0.05). Uncorrected visual acuity (6/6-6/12) on postoperative day 1 was achieved in 16(32%) group A patients compared to 26(52%) in group B. By day 30, 62(62%) of all the patients achieved uncorrected visual acuity of 6/6.

Conclusion: The likelihood of post-phacoemulsification corneal oedema was greatly increased by type II diabetes, particularly when it was poorly controlled, and it also slowed vision recovery.

Objective: To assess the epidemiology of traumatic spinal cord injury survivors in Pakistan, and to investigate the level of functional dependence of patients on their caregivers.

Methods: The cross-sectional study was conducted from January 2021 to June 2023 after approval from the institutional ethics review board of the National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan, and comprised patients with spinal cord injury. Data was collected from spinal units of various public and private hospitals across the country. Demographic data, nature of injury, neurological level, aetiological factors of the injury, and functional dependence of patients were noted. Modified Barthel Index was used to measure the level of functional independence of the patients. Data was analysed using SPSS 26.

Results: Of the 205 patients, 121(59%) were males and 84(41%) were females. The overall mean age was 37.82±21.17 years, with 84(41%) being young adults, 50(26.3%) middle adults and 30(14.6%) adolescents. The most common cause was fall 74(36.1%), followed by road traffic accidents 64(30.2%), firearm injuries 40(19.5%) and sports injuries 11(5.4%). Majority of the patients had quadriplegic nature of injury 115(56.1%), involved cervical region 114(55.6%) and had American Spinal Injury Association neurological level A 152(74.1%). Total functional dependence was noted in 154(75.9%) cases.

Conclusions: In view of the specific epidemiology of spinal cord injury in Pakistani patients, it is crucial to develop a national registry for such patients.