bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution characteristics and influencing factors of homocyteine in an apparently healthy examined population
Authors: Bao Fang , Cui Ming , Shi Xiuying , Ju Shaoqing , Cong Hui
Published: September 2021

Background

Homocysteine (Hcy) is considered to be a risk factor for cardiovascular and cerebrovascular diseases. Few studies have evaluated the distribution of Hcy on a large-scale health examination. Accordingly, this study aimed to investigate the level and distribution of Hcy in the population with healthy physical examination and the correlation with other biomarkers, and analyzed for cardiovascular and other diseases.

Methods

Measurements of serum Hcy, TC, TG, LDL-c, HDL-c, ALT, ALP, γ-GT, TBIL, GLU, urea, Cr, UA, and related metabolic risk factors were selected for analysis from 8063 medical examination samples collected from February 2017 to April 2020. The relationship between Hcy and other biochemical indicators were evaluated with the multivariate regression model of age, gender, smoking, drinking, body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP).

Results

Among 8063 cases, the age, BMI, SBP, and DBP of the high-Hcy group were higher than those of the low-Hcy group, the difference was statistically significant (P < 0.001), and the proportion of males, smoking, and drinking were higher than the low-Hcy group, the difference was statistically significant (P < 0.001); Hcy of the abnormal GLU group is higher than the normal GLU group (P = 0.002) and the Hcy of abnormal TG and HDL is higher than that of the normal blood lipid group (P < 0.001); Hcy of people with abnormal UA and Urea was higher than that of people with normal renal function (P < 0.001, P = 0.007). In multivariate analysis, lnHDL-C was negatively correlated with lnHcy (β = − 0.038, SE = 0.016, P = 0.019), lnCr was positively correlated with lnHcy (β = 0.055, SE = 0.016, P < 0.001), lnUA and lnHcy were positive correlated (β = 0.043, SE = 0.019, P = 0.022).

Conclusion

Hcy is closely related to HDL-c, Cr, and UA, which indicates that Hcy may affect the metabolism of HDL-c and UA, and can also be used as an auxiliary diagnostic index for kidney injury.
COVID-19 hospitalizations in five California hospitals: a retrospective cohort study
Authors: Nuño Miriam , García Yury , Rajasekar Ganesh , Pinheiro Diego , Schmidt Alec J.
Published: September 2021

Background

The novel coronavirus pandemic has had a differential impact on communities of color across the US. The University of California hospital system serves a large population of people who are often underrepresented elsewhere. Data from hospital stays can provide much-needed localized information on risk factors for severe cases and/or death.

Methods

Patient-level retrospective case series of laboratory-confirmed COVID-19 hospital admissions at five UC hospitals (N = 4730). Odds ratios of ICU admission, death, and a composite of both outcomes were calculated with univariate and multivariate logistic regression based on patient characteristics, including sex, race/ethnicity, and select comorbidities. Associations between comorbidities were quantified and visualized with a correlation network.

Results

Overall mortality rate was 7.0% (329/4,730). ICU mortality rate was 18.8% (225/1,194). The rate of the composite outcome (ICU admission and/or death) was 27.4% (1298/4730). Comorbidity-controlled odds of a composite outcome were increased for age 75–84 (OR 1.47, 95% CI 1.11–1.93) and 85–59 (OR 1.39, 95% CI 1.04–1.87) compared to 18–34 year-olds, males (OR 1.39, 95% CI 1.21–1.59) vs. females, and patients identifying as Hispanic/Latino (OR 1.35, 95% CI 1.14–1.61) or Asian (OR 1.43, 95% CI 1.23–1.82) compared to White. Patients with 5 or more comorbidities were exceedingly likely to experience a composite outcome (OR 2.74, 95% CI 2.32–3.25).

Conclusions

Males, older patients, those with multiple pre-existing comorbidities, and those identifying as Hispanic/Latino or Asian experienced an increased risk of ICU admission and/or death. These results are consistent with reported risks among the Hispanic/Latino population elsewhere in the United States, and confirm multiple concerns about heightened risk among the Asian population in California.
Quality of inpatient care of small and sick newborns in Pakistan: perceptions of key stakeholders
Authors: Pradhan Nousheen Akber , Ali Ammarah , Roujani Sana , Ali Sumera Aziz , Rizwan Samia , Saleem Sarah , Siddiqi Sameen
Published: September 2021

Background

In LMICs including Pakistan, neonatal health and survival is a critical challenge, and therefore improving the quality of facility-based newborn care services is instrumental in averting newborn mortality. This paper presents the perceptions of the key stakeholders in the public sector to explore factors influencing the care of small and sick newborns and young infants in inpatient care settings across Pakistan.

Methods

This exploratory study was part of a larger study assessing the situation of newborn and young infant in-patient care provided across all four provinces and administrative regions of Pakistan. We conducted 43 interviews. Thirty interviews were conducted with the public sector health care providers involved in newborn and young infant care and 13 interviews were carried out with health planners and managers working at the provincial level. A semi-structured interview guide was used to explore participants’ perspectives on enablers and barriers to the quality of care provided to small and sick newborns at the facility level. The interviews were manually analyzed using thematic content analysis.

Findings

The study respondents identified multiple barriers contributing to the poor quality of small and sick newborn care at inpatient care settings. This includes an absence of neonatal care standards, inadequate infrastructure and equipment for the care of small and sick newborns, deficient workforce for neonatal case management, inadequate thermal care management for newborns, inadequate referral system, absence of multidisciplinary approach in neonatal case management and need to institute strong monitoring system to prevent neonatal deaths and stillbirths. The only potential enabling factor was the improved federal and provincial oversight for reproductive, maternal, and newborn care.

Conclusion

This qualitative study was insightful in identifying the challenges that influence the quality of inpatient care for small and sick newborns and the resources needed to fix these. There is a need to equip Sick Newborn Care Units with needed supplies, equipment and medicines, deployment of specialist staff, strengthening of in-service training and staff supervision, liaison with the neonatal experts in customizing neonatal care guidelines for inpatient care settings and to inculcate the culture for inter-disciplinary team meetings at inpatient care settings across the country.
Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana
Authors: Abukari Alhassan Sibdow , Acheampong Angela Kwartemaa
Published: September 2021

Background

Critically ill children require optimum feeding in the intensive care units for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units.

Methods

A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N = 42).

Results

The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral, and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children.

Conclusions

Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU are recommended to reduce possible infant and child mortality resulting from suboptimal feeding.
Incidence of hyperoxia in trauma patients receiving pre-hospital emergency anaesthesia: results of a 5-year retrospective analysis
Authors: Leitch P. , Hudson A. L. , Griggs J. E. , Stolmeijer R. , Lyon R. M. , ter Avest E. ,   Air Ambulance Kent Surrey Sussex
Published: September 2021

Background

Previous studies have demonstrated an association between hyperoxia and increased mortality in various patient groups. Critically unwell and injured patients are routinely given high concentration oxygen in the pre-hospital phase of care. We aim to investigate the incidence of hyperoxia in major trauma patients receiving pre-hospital emergency anesthesia (PHEA) in the pre-hospital setting and determine factors that may help guide clinicians with pre-hospital oxygen administration in these patients.

Methods

A retrospective cohort study was performed of all patients who received PHEA by a single helicopter emergency medical service (HEMS) between 1 October 2014 and 1 May 2019 and who were subsequently transferred to one major trauma centre (MTC). Patient and treatment factors were collected from the electronic patient records of the HEMS service and the MTC. Hyperoxia was defined as a PaO2 > 16 kPA on the first arterial blood gas analysis upon arrival in the MTC.

Results

On arrival in the MTC, the majority of the patients (90/147, 61.2%) had severe hyperoxia, whereas 30 patients (20.4%) had mild hyperoxia and 26 patients (19.7%) had normoxia. Only 1 patient (0.7%) had hypoxia. The median PaO2 on the first arterial blood gas analysis (ABGA) after HEMS handover was 36.7 [IQR 18.5–52.2] kPa, with a range of 7.0–86.0 kPa. SpO2 pulse oximetry readings before handover were independently associated with the presence of hyperoxia. An SpO2 ≥ 97% was associated with a significantly increased odds of hyperoxia (OR 3.99 [1.58–10.08]), and had a sensitivity of 86.7% [79.1–92.4], a specificity of 37.9% [20.7–57.8], a positive predictive value of 84.5% [70.2–87.9] and a negative predictive value of 42.3% [27.4–58.7] for the presence of hyperoxemia.

Conclusion

Trauma patients who have undergone PHEA often have profound hyperoxemia upon arrival at hospital. In the pre-hospital setting, where arterial blood gas analysis is not readily available a titrated approach to oxygen therapy should be considered to reduce the incidence of potentially harmful tissue hyperoxia.
Prenatal risk factors and neonatal DNA methylation in very preterm infants
Authors: Camerota Marie , Graw Stefan , Everson Todd M. , McGowan Elisabeth C. , Hofheimer Julie A. , O’Shea T. Michael , Carter Brian S. , Helderman Jennifer B. , Check Jennifer , Neal Charles R. , Pastyrnak Steven L. , Smith Lynne M. , Dansereau Lynne M. , DellaGrotta Sheri A. , Marsit Carmen J. , Lester Barry M.
Published: September 2021

Background

Prenatal risk factors are related to poor health and developmental outcomes for infants, potentially via epigenetic mechanisms. We tested associations between person-centered prenatal risk profiles, cumulative prenatal risk models, and epigenome-wide DNA methylation (DNAm) in very preterm neonates.

Methods

We studied 542 infants from a multi-center study of infants born < 30 weeks postmenstrual age. We assessed 24 prenatal risk factors via maternal report and medical record review. Latent class analysis was used to define prenatal risk profiles. DNAm was quantified from neonatal buccal cells using the Illumina MethylationEPIC Beadarray.

Results

We identified three latent profiles of women: a group with few risk factors (61%) and groups with elevated physical (26%) and psychological (13%) risk factors. Neonates born to women in higher risk subgroups had differential DNAm at 2 CpG sites. Higher cumulative prenatal risk was associated with methylation at 15 CpG sites, 12 of which were located in genes previously linked to physical and mental health and neurodevelopment.

Conclusion

We observed associations between prenatal risk factors and DNAm in very preterm infants using both person-centered and cumulative risk approaches. Epigenetics offers a potential biological indicator of prenatal risk exposure.
Best proximity point results and application to a system of integro-differential equations
Authors: Das Anupam , Nashine Hemant Kumar , Ibrahim Rabha W. , De la Sen Manuel
Published: September 2021

In this work, we solve the system of integro-differential equations (in terms of Caputo–Fabrizio calculus) using the concepts of the best proximity pair (point) and measure of noncompactness. We first introduce the concept of cyclic (noncyclic) Θ-condensing operator for a pair of sets using the measure of noncompactness and then establish results on the best proximity pair (point) on Banach spaces and strictly Banach spaces. In addition, we have illustrated the considered system of integro-differential equations by three examples and discussed the stability, efficiency, and accuracy of solutions.
Ontogeny of audible squeaks in yellow steppe lemming Eolagurus luteus: trend towards shorter and low-frequency calls is reminiscent of those in ultrasonic vocalization
Authors: Volodin Ilya A. , Yurlova Daria D. , Ilchenko Olga G. , Volodina Elena V.
Published: September 2021

Background

Rodents are thought to be produced their human-audible calls (AUDs, below 20 kHz) with phonation mechanism based on vibration of the vocal folds, whereas their ultrasonic vocalizations (USVs, over 20 kHz) are produced with aerodynamic whistle mechanism. Despite of different production mechanisms, the acoustic parameters (duration and fundamental frequency) of AUDs and USVs change in the same direction along ontogeny in collared lemming Dicrostonyx groenlandicus and fat-tailed gerbil Pachyuromys duprasi. We hypothesize that this unidirectional trend of AUDs and USVs is a common rule in rodents and test whether the AUDs of yellow steppe lemmings Eolagurus luteus would display the same ontogenetic trajectory (towards shorter and low-frequency calls) as their USVs, studied previously in the same laboratory colony.

Results

We examined for acoustic variables 1200 audible squeaks emitted during 480-s isolation-and-handling procedure by 120 individual yellow steppe lemmings (at 12 age classes from neonates to breeding adults, 10 individuals per age class, up to 10 calls per individual, each individual tested once). We found that the ontogenetic pathway of the audible squeaks, towards shorter and lower frequency calls, was the same as the pathway of USVs revealed during 120-s isolation procedure in a previous study in the same laboratory population. Developmental milestone for the appearance of mature patterns of the squeaks (coinciding with eyes opening at 9–12 days of age), was the same as previously documented for USVs. Similar with ontogeny of USVs, the chevron-like squeaks were prevalent in neonates whereas the squeaks with upward contour were prevalent after the eyes opening.

Conclusion

This study confirms a hypothesis of common ontogenetic trajectory of call duration and fundamental frequency for AUDs and USVs within species in rodents. This ontogenetic trajectory is not uniform across species.
Hydroxyapatite crystal deposition disease around the hip: a rare cause of piriformis syndrome and ischiofemoral impingement
Authors: Chua Elise , Shah Dhiren
Published: September 2021

Hydroxyapatite crystal deposition disease (HADD) around the hip is typically described involving the gluteal tendons. However, HADD can occur in any location and result in varied clinical presentations. Even with small deposits, symptoms can be significant and imaging findings may appear aggressive, mimicking infection and malignancy particularly when in an atypical location.

We illustrate cases of both common and rare locations of HADD around the hip, in particular presenting as greater trochanteric pain syndrome, piriformis syndrome and ischiofemoral impingement. The latter two manifestations have not been previously described in the literature.

Low signal deposits were identified on MRI at the greater trochanter (gluteus medius tendon), proximal piriformis (adjacent to the sciatic nerve), and quadratus femoris (in the ischiofemoral space), respectively. Associated inflammatory changes with tendinopathy, bursitis and oedema were also demonstrated. The patient with piriformis syndrome underwent steroid injections and shockwave therapy with significant symptom improvement.

HADD should be within the differential diagnosis for hip pain and nerve compression syndromes. Knowledge of tendon anatomy and correlation with radiographs or CT, even after MRI, is crucial in recognising unusual manifestations and preventing unnecessary investigation. Therefore, we review the spectrum of imaging features of HADD, as well as the current evidence on its management, to confidently diagnose this condition.
Analysis of the Clinical Characteristics of Tuberculosis Patients based on Multi-Constrained Computed Tomography (CT) Image Segmentation Algorithm
Authors: Zhu Feng , Zhang Bo
Published: September 2021

Objective: We used U-shaped convolutional neural network (U_Net) multi-constraint image segmentation method to compare the diagnosis and imaging characteristics of tuberculosis and tuberculosis with lung cancer patients with Computed Tomography (CT).

Methods: We selected 160 patients with tuberculosis from the severity scoring (SVR) task is provided by Image CLEF Tuberculosis 2019. According to the type of diagnosed disease, they were divided into tuberculosis combined with lung cancer group and others group, all patients were given chest CT scan, and the clinical manifestations, CT characteristics, and initial suspected diagnosis and missed diagnosis of different tumor diameters were observed and compared between the two groups.

Results: There were more patients with hemoptysis and hoarseness in pulmonary tuberculosis combined with lung cancer group than in the pulmonary others group (P<0.05), and the other symptoms were not significantly different (P>0.05). Tuberculosis combined with lung cancer group had fewer signs of calcification, streak shadow, speckle shadow, and cavitation than others group; however, tuberculosis combined with lung cancer group had more patients with mass shadow, lobular sign, spines sign, burr sign and vacuole sign than others group.

Conclusion: The symptoms of hemoptysis and hoarseness in pulmonary tuberculosis patients need to consider whether the disease has progressed and the possibility of lung cancer lesions. CT imaging of pulmonary tuberculosis patients with lung cancer usually shows mass shadows, lobular signs, spines signs, burr signs, and vacuoles signs. It can be used as the basis for its diagnosis. Simultaneously, the U-Net-based segmentation method can effectively segment the lung parenchymal region, and the algorithm is better than traditional algorithms.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4795

How to cite this:Zhu F, Zhang B. Analysis of the Clinical Characteristics of Tuberculosis Patients based on Multi-Constrained Computed Tomography (CT) Image Segmentation Algorithm. Pak J Med Sci. 2021;37(6):1705-1709. doi: https://doi.org/10.12669/pjms.37.6-WIT.4795

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Application of B-ultrasound information image in Renal Puncture Biopsy treatment and Nursing
Authors: Dong Linyan , Li Junhong , Zhao Mixia , Ren Jing
Published: September 2021

Objectives: This study was to explore the application value of B-ultrasound in guiding puncture biopsy of chronic kidney disease (CKD) and the clinical nursing effects under the guidance of B-ultrasound.

Methods: Pathological examination of kidney biopsy was performed on 94 patients with CKD under the guidance of ultrasound from August 2020 to December 2020.; patients were observed for symptoms such as low back pain, backache, hematuria, and subcapsular hematoma. Color Doppler ultrasonography was performed on the punctured patients on day 1, 2, and 3 to observe whether there was subrental hematoma. The pathological results were analyzed and the success rate of percutaneous renal biopsy under ultrasound guidance was analyzed. Before the patient was discharged, investigate the satisfaction with the nursing work.

Results: (1) After the puncture, 45 patients developed low back pain and low back pain symptoms, 12 cases developed subcapsular hematoma; 8 cases showed gross hematuria, 62 cases showed microscopic hematuria, and the rest had no obvious symptoms; (2) the nursing satisfaction rate of 94 cases was as high as 95.7%.

Conclusion: US-PRB is a safe and effective auxiliary examination method, which can improve the success rate of puncture and reduce postoperative complications. Effective nursing can reduce the incidence of postoperative complications and improve patient satisfaction.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4831

How to cite this:Dong L, Li J, Zhao M, Ren J. Application of B-ultrasound information image in Renal Puncture Biopsy treatment and Nursing. Pak J Med Sci. 2021;37(6):1564-1568. doi: https://doi.org/10.12669/pjms.37.6-WIT.4831

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Evaluation of left ventricular diastolic function of patients with coronary heart disease by ultrasound images on bilateral filtering image noise reduction algorithm combined with electrocardiogram
Authors: Li Wen
Published: September 2021

Objective: To explore the evaluation of left ventricular diastolic function (LVDF) in patients with coronary heart disease (CHD) using ultrasound images (UI) combined with electrocardiogram (ECG) on bilateral filtering image noise reduction algorithm (BFINRA).

Methods: A BFINRA was constructed, and 60 subjects who were investigated were divided into a control group (CG) from June 2019 to November 2019 in Taizhou People’s Hospital, a myocardial infarction group (MIG), and an angina pectoris group (APG). The patient’s LVDF was examined by two-dimensional electrophoresis (2DE) and real-time three-dimensional echocardiography (RT-3DE) combined with ECG. The results showed BFINRA could improve UI quality.

Results: Clinical data indicated there were no substantial differences in age, gender, and fasting blood glucose of all subjects. 2DE examination results showed the left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and early diastolic mitral blood flow velocity / early diastolic mitral annulus velocity (E/E’) of MIG were much higher than CG (P<0.05), while the left ventricular ejection fraction (LVEF), E / late diastolic mitral blood flow velocity (E/A) and E’ peak value were sharply decreased (P<0.05);LVESV and E/E’ of APG were increased dramatically (P<0.05), while E peak, E/A and E’ peak were decreased greatly. RT-3DE examination results indicated LVEDV and LVESV of MIG were considerably higher than CG (P<0.05), while LVEF and macrophage resistance factor (MRF) were enormously decreased (P<0.05);LVEDV and LVESV of APG were greatly increased (P<0.05). However, LVEF and MRF were not changed significantly (P>0.05). LVEDV had a remarkable difference (P<0.05), but LVESV and LVEF had no obvious differences (P>0.05). The electrocardiogram results illustrated the increase in QT dispersion (QTd) of MIG and APG was statistically significant (P<0.05) compared with CG, while the negative increase of P-wave terminal force in lead V1 (PTFV1) also had a statistical significance (P<0.05). Correlation analysis revealed that MRF and PTFV1 had positive correlation, while MRF and QTd showed a negative correlation.

Conclusion: The combination of UI and ECG could better assess LVDF in CHD patients.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4886

How to cite this:Li W. Evaluation of left ventricular diastolic function of patients with coronary heart disease by ultrasound images on bilateral filtering image noise reduction algorithm combined with electrocardiogram. Pak J Med Sci. 2021;37(6):1699-1704.  doi: https://doi.org/10.12669/pjms.37.6-WIT.4886

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Efficacy evaluation of Lattice Carbon Dioxide Laser Therapy in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence
Authors: Wu Ya-ru , Shen Dan , Zhang Yan-qiao , Cui Zhen-yu , Yang Wenzeng
Published: September 2021

Objectives: To investigate the efficacy and postoperative complications of lattice carbon dioxide laser in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence.

Methods: A total of 30 postmenopausal female patients with mild to moderate stress urinary incontinence, recruited from the Affiliated Hospital of Hebei University from September to November 2019, were selected as the study subjects and treated with lattice carbon dioxide laser therapy. Treatment was given at intervals of one month. The degree of urinary incontinence, the urinary incontinence questionnaire (ICI-Q-SF) score, and the urinary incontinence quality of life scale (I-QOL)) Score, surgical satisfaction, one hour pad test and postoperative complications before treatment and after each treatment of all patients were respectively recorded and compared.

Results: Compared with those before treatment, the grade of urinary incontinence and ICI-Q-SF scores of these 30 patients after each treatment were lower, and their I-QOL scores were higher. The difference of one hour urine pad test was statistically significant (P<0.05), but the follow-up data of three months after the third treatment was close to that of one month after the first treatment. The satisfaction rate of these 30 patients was 76.67% (23/30). After treatment, only one patient presented vaginal itching discomfort on the first day after surgery and the symptoms disappeared three days later. No obvious complications occurred in the other 29 patients.

Conclusion: The treatment of mild and moderate postmenopausal patients with stress urinary incontinence with lattice carbon dioxide laser can effectively reduce the incidence of incontinence and improve the quality of life.

doi: https://doi.org/10.12669/pjms.37.7.4077

How to cite this:Wu Y, Shen D, Zhang Y, Cui Z, Yang W. Efficacy evaluation of Lattice Carbon Dioxide Laser Therapy in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4077

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical effects of Apatinib combined with DOS neoadjuvant chemotherapy regimen in neoadjuvant chemotherapy for LAGC
Authors: Zhou Peng-zhe , Gao Lei , Wu Wei , Hao Ying-xia
Published: September 2021

Objective: To evaluate the clinical effects of apatinib combined with DOS regimen in the neoadjuvant chemotherapy for locally advanced gastric cancer (LAGC).

Methods: Eighty patients with LAGC admitted to Baoding first Central Hospital from January 2018 to October 2020 were randomly divided into two groups (n=40, respectively). The control group received DOS chemotherapy regimen alone. The experiment group additionally orally took apatinib mesylate tablets. The changes in CEA, CA19-9 and other tumor markers, RO resection rate, incidence of operative complications, adverse reactions, and other indicators were compared between the two groups.

Results: The overall response rate (ORR) of the experimental group was 72.5%, which was significantly better than that of the control group (50%) (p=0.03). After the treatment, the CEA and CA19-9 in the experiment group were significantly lower than those in the control group (p=0.00). The Ro resection rate was 77.5% in the experiment group and 57.5% in the control group (p=0.03). The operation time was shortened and amount of bleeding decreased in the experiment group, and the differences were statistically significant (p=0.00). The incidence of surgical complications in the experimental group was 17.5%, significantly lower than that in the control group (37.5%) (p=0.04).

Conclusion: Apatinib combined with DOS regimen is effective for patients with LAGC without significantly increasing adverse reactions. Meanwhile, tumor markers are reduced significantly. Besides, the Ro resection rate and the incidence of operative complications are obviously superior to the DOS neoadjuvant chemotherapy regimen alone.

doi: https://doi.org/10.12669/pjms.37.7.4265

How to cite this:Zhou P, Gao L, Wu W, Hao Y. Clinical effects of Apatinib combined with DOS neoadjuvant chemotherapy regimen in neoadjuvant chemotherapy for LAGC. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4265

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Residents’ perspective on the quality of postgraduate training programs in Pakistan – the good, the bad and the ugly
Authors: Alam Laima , Khan Jawad , Alam Mafaza , Faraid Varqa , Ajmal Fahad , Bahadur Laila
Published: September 2021

Objectives: To assess the satisfaction of trainees towards different attributes of their training programs.

Methods: This cross-sectional survey was carried out by enrolling trainee doctors currently working in Medical, Surgical, Dental and Allied specialties of the country by sending a validated and piloted questionnaire through email. Data collection was done from 1st to 31st January 2021 after taking ethical approval from the concerned authorities. Data was analysed using SPSS v. 19.0.

Results: A total of 516 completed responses were received from 15 major cities of the country. The overall perceived satisfaction towards clinical skills (42%), teaching skills (31.4%), personal growth and development (23.6%), research (21%) and supervisor’s role (44.2%) were considerably low with the most common causes for non-satisfaction being poor work-life balance (59%), financial instability (54.5%), poor research facilities (53%), poor career guidance (44%) and poor skill development (42.4%) in descending order. Senior years of residency, government and private set-ups, less than four and greater than 13 residents on average with less than three supervisors per department, excessive duty hours and financial instability in-lieu of not doing locums were statistically related to poor satisfaction across majority of the facets of residency as well the overall satisfaction towards training programs.

Conclusion: There is a tremendous scope for improvement in the recognized and partially acknowledged attributes of our training programs. Yearly feedback surveys involving residents is essential for enlightening the authorities and mitigating the trainees’ grievances.

doi: https://doi.org/10.12669/pjms.37.7.4297

How to cite this:Alam L, Khan J, Alam M, Faraid V, Ajmal F, Bahadur L. Residents’ perspective on the quality of postgraduate training programs in Pakistan – the good, the bad and the ugly. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4297

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Observations on the clinical efficacy of rhaFGF combined with Vitamin B complex for patients with Severe Recurrent Aphthous Ulcer
Authors: Sun Hui , Gao Jie , Li Dan , Li Bing
Published: September 2021

Objectives: To observe the therapeutic effect of rha FGF combined with vitamin B complex on severe recurrent aphthous ulcers (RAUs).

Methods: Ninety patients with severe RAU (grade III and IV) admitted to Chinese PLA General Hospital from May 2018 to May 2019 were selected and divided into two groups using a random number table, 45 patients/group. Patients in the control group gargled with a mixture of vitamin B complex (250 ml of 9% normal saline +250 ml of vitamin B complex +160,000 U of gentamicin +25 ml of lidocaine) after oral cleaning; patients in the observation group gargled with a mixture of the same ratio after oral cleaning and then sprayed rhaFGF on their oral ulcers. The clinical symptoms and treatment effects of the 2 groups within 1 week of medication were compared.

Results: The total effective rate of treatment was 97.78% in the observation group and 82.22% in the control group; the difference was statistically significant (P <0.05). The time to ulcer pain disappearance and eating recovery and the ulcer healing time in the observation group were significantly shorter than those in the control group (P <0.05).

Conclusion: rhaFGF combined with vitamin B complex has a significant therapeutic effect for patients with severe RAU; it can relieve pain and illness faster and shorten the healing time of ulcers.

doi: https://doi.org/10.12669/pjms.37.7.4364

How to cite this:Sun H, Gao J, Li D, Li B. Observations on the clinical efficacy of rhaFGF combined with Vitamin B complex for patients with Severe Recurrent Aphthous Ulcer. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4364

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Challenges of COVID-19 Vaccination Delivery in Pakistan
Authors: Tariq Shahan , Hamid Muhammad Ammar Bin
Published: September 2021

doi: https://doi.org/10.12669/pjms.37.7.4489

How to cite this: Hamid MAB, Tariq S. Challenges of COVID-19 Vaccination Delivery in Pakistan. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4489
Models of teaching medical errors
Authors: Gohal Gassem
Published: September 2021

Medical errors are relatively common causes of preventable iatrogenic adverse events. We have focused on teaching models in certain courses of study that have been reported to have significant positive impacts on the outcomes of teaching about medical errors. All healthcare organizations must establish suitable models of teaching about patient safety and medical errors as a preventive measure and as an early intervention strategy. Teaching undergraduate medical students and physicians in training how to manage and disclose medical errors helps them develop lifelong skills that can effectively reduce such errors.The literature search was conducted in international databases such as PubMed/MEDLINE and Google Scholar search engine using English equivalent keywords, from 1998 up to April, 2020. The search strategy used the following subject headings terms: “Medical error(s)” AND “Teaching”. Out of 40 Studies included, 6 studies were selected to have evaluated models of health care training and simulation based teaching of medical errors and patient safety in undergraduate and postgraduate medical education.

doi: https://doi.org/10.12669/pjms.37.7.4506

How to cite this:Gohal G. Models of teaching medical errors. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4506

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Spontaneous Detorsion of Sigmoid Volvulus in a patient with Nineteen-Volvulus episode history: A rare outcome of an extremely rare clinical entity
Authors: Atamanalp Sabri Selcuk , Disci Esra , Tatar Atamanalp Cansu , Atamanalp Refik Selim
Published: September 2021

Sigmoid volvulus (SV) recurrence more than 10 times is an extremely rare clinical entity and spontaneous detorsion is a rare outcome of SV. In this paper, we report a case with 19 previous SV attacks, in last of which spontaneous detorsion occurred. Such a multiple-episode history as well as an unexpected recovery was unique in a 1,036-case clinical profession of Ataturk University with SV over a 54.5-year period.

doi: https://doi.org/10.12669/pjms.37.7.4703

How to cite this:Atamanalp SS, Disci E, Tatar Atamanalp C, Atamanalp RS. Spontaneous Detorsion of Sigmoid Volvulus in a patient with Nineteen-Volvulus episode history: A rare outcome of an extremely rare clinical entity. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4703

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to Sell a Data Set? Pricing Policies for Data Monetization
Authors: Mehta Sameer , Dawande Milind , Janakiraman Ganesh , Mookerjee Vijay
Published: September 2021

The wide variety of pricing policies used in practice by data sellers suggests that there are significant challenges in pricing data sets. In this paper, we develop a utility framework that is appropriate for data buyers and the corresponding pricing of the data by the data seller. Buyers interested in purchasing a data set have private valuations in two aspects—their ideal record that they value the most, and the rate at which their valuation for the records in the data set decays as they differ from the buyers’ ideal record. The seller allows individual buyers to filter the data set and select the records that are of interest to them. The multidimensional private information of the buyers coupled with the endogenous selection of records makes the seller’s problem of optimally pricing the data set a challenging one. We formulate a tractable model and successfully exploit its special structure to obtain optimal and near-optimal data-selling mechanisms. Specifically, we provide insights into the conditions under which a commonly used mechanism—namely, a price-quantity schedule—is optimal for the data seller. When the conditions leading to the optimality of a price-quantity schedule do not hold, we show that the optimal price-quantity schedule offers an attractive worst-case guarantee relative to an optimal mechanism. Further, we numerically solve for the optimal mechanism and show that the actual performance of two simple and well-known price-quantity schedules—namely, two-part tariff and two-block tariff—is near optimal. We also quantify the value to the seller from allowing buyers to filter the data set.
Major Root and Tuber Crops Production in South Omo Zone, Southern Ethiopia
Authors: Kusse Kutoya
Published: September 2021

Increasing production and productivity of agriculture in general and root and tuber crops in particular require a strong linkage between the agricultural and non-agricultural sectors. The growing in agriculture sector does not occur without non-agricultural sectors. The major root and tuber crops production and productivity in South Omo Zone, Southern Ethiopia is very low in relation to the land coverage under the crops, due to poor and under recommended rate of improved agricultural technology utilization and low skill of management and related practices by the producers. To solve these root and tuber related problems and increase the production and productivity of the crops, strong and result based farmers training centers and interlinked research extension system are important and strongly interconnected . This study was conducted in five districts of South Omo Zone namely Debub Ari from agricultural based, Malle and Bena-Tsemay from agro-pastoral, Hammer, and Dasenech from pastoral. The districts are selected purposively based on root and tuber crop production potential. The result shows that the area coverage, production and productivity of the major root and tuber crops decreases from time to time and their diseases and pests increases thoroughly. Farmers in the study area should use disease resistance varieties and the production inputs at a recommended rate and time. The major root and tuber crops that are grown in the study area are sweet potato (Ipomoea batatas), potato (Solanum tuberosum), cassava (Manihot esculenta), taro (Colocasia esculenta), and enset (Ensete ventricosum).
Estimating the Productivity and Profitability of Rice and Pepper on Fields of the Irrigation Company Upper Region (ICOUR) in Ghana
Authors: Akolgo James Anaba
Published: September 2021

This study evaluates the Estimating the Productivity and Profitability of Rice and Pepper on the Project fields of the Irrigation Company Upper Region (ICOUR) in Ghana. Gross margin analysis was employed to estimate farm level profits at the two sites. Then, paired t-test (mean-comparison test) was applied to compare the productivity and profitability of rice and pepper farms at the two irrigation sites. Farm level data was collected from 113 (ie. 77 from Tono and 36 from Vea) crop farmers for the study. The finding shows that 0.53ha rice field and 0.34ha pepper field would yield averagely 1.6tons and 1.4tons of paddy rice and fresh pepper, respectively. This gives gross margins (profits) of Ghȼ1,041.06 and Ghȼ10,316.75 per hectare from the rice and pepper fields, respectively. The average productivity from the rice and pepper fields were 3.088Mt ha-1 and 4.286Mt ha-1, respectively. The study concludes that it is more productive and profitable to produce rice and pepper at Tono as compared to the Vea irrigation site. The gross margin was, however, higher on pepper fields as compared to the rice fields at both irrigation sites. The study recommends that crop farmers in the study areas should invest more on the production of pepper at both irrigation areas. Also, there is the need for the farmers to adopt yield-boosting practices such as the use of improved seeds, adopt good soil fertility management practices, efficient irrigation water delivery system and mechanisation services for optimum yields and higher income.
Enrichment of Restraint to Endmost Salinity and Outmost pH Circumstance in Common Bean (Phaseolus vulgaris L.) Nodulating Rhizobial Isolates from Eastern Hararghe Lowlands around Babile, Eastern Ethiopia, through Mutagenesis.
Authors: Mekonnen Mulugeta , Kebede Ameha
Published: September 2021

This study was committed to examining the symbiotic efficacy difference between wild and mutant rhizobial isolates from lowlands of eastern Ethiopia around Babile, and at the same time to appreciate the enrichment effect of mutagenesis on restraint of common bean (Phaseolus vulgaris L.) nodulating rhizobia to Endmost Salinity and Outmost pH Circumstance. A total of 50 wild rhizobia isolate, and 8 mutant isolates; after mutagenesis were selected based on their ability to endure endmost salt and outmost pH circumstances at laboratory condition. All of the mutants were found to be symbiotically effective. Among the observed rhizobium isolates, wild isolates HUCR (3D, 3A), HUCR 2D, and mutant isolate HUCRM 2D showed the highest symbiotic efficacy. Only the mutant isolates HUCRM2D (tolerated 12% NaCl, and pH4 and pH12), HUCRM5C (tolerated 12% NaCl and pH 4), HUCRM3B (tolerated 12% NaCl) and HUCRM9C (tolerated 11% NaCl) were growing effectively at the point out utmost conditions. Therefore, based on their restraint to utmost conditions and symbiotic efficacy, the above mentioned wild and mutant rhizobia isolates were suggested as nominees for the future development of common bean biofertilizer that grown under endmost saline and outmost pH conditions.
Eliciting public values on health inequalities: missing evidence for policy windows?
Authors: McHugh Neil
Published: September 2021

Background:

There is a widening health divide in the UK despite health inequalities being a longstanding subject of policy and research. New types of evidence are needed.

Key points for discussion:

Knowledge of public values for non-health policies and their associated (non-)health outcomes is currently missing from decision-making processes. Eliciting public values using stated preference techniques can provide insights on what the general public would be willing to give up for different distributions of (non-)health outcomes and the policies that can achieve them. To understand the role this evidence could have in decision-making processes, Kingdon’s multiple streams analysis (MSA) is used as a policy lens to explore how evidence of public values could affect policy processes for ways to tackle health inequalities.

Conclusions and implications:

This paper outlines how evidence of public values could be elicited through the use of stated preference techniques and suggests this could facilitate the creation of policy windows for tackling health inequalities. Additionally, Kingdon’s MSA helps make explicit six crosscutting issues when generating this new form of evidence. This suggests the need to explore reasons for public values and how decision makers would use such evidence. With an awareness of these issues, evidence on public values has the potential to support upstream policies to tackle health inequalities.
Introduction to the JOCN Special Issue on Advanced Monitoring and Telemetry in Optical Networks
Authors: Velasco Luis , Layec Patricia , Paolucci Francesco , Yoshikane Noboru
Published: September 2021

This special issue contains a collection of invited and contributed papers, including one review article and twelve research articles, on advanced monitoring and telemetry in optical networks.
Ultrasensitive temperature sensor and mode converter based on a modal interferometer in a two-mode fiber
Authors: Du Dawei , Xu Cheng , Yang Zuoxin , Zhang Kun , Dong Jiangli , Guan Heyuan , Qiu Wentao , Yu Jianhui , Chen Zhe , Lu Huihui
Published: September 2021

This paper presents an ultrasensitive temperature sensor and tunable mode converter based on an isopropanol-sealed modal interferometer in a two-mode fiber. The modal interferometer consists of a tapered two-mode fiber (TTMF) sandwiched between two single-mode fibers. The sensor provides high-sensitivity temperature sensing by taking advantages of TTMF, isopropanol and the Vernier-like effect. The TTMF provides a uniform modal interferometer with LP01 and LP11 modes as well as strong evanescent field on its surface. The temperature sensitivity of the sensor can be improved due to the high thermo-optic coefficient of isopropanol. The Vernier-like effect based on the overlap of two interference spectra is applied to magnify the sensing capabilities with a sensitivity magnification factor of 58.5. The temperature sensor is implemented by inserting the modal interferometer into an isopropanol-sealed capillary. The experimental and calculated results show the transmission spectrum exhibit blue shift with increasing ambient temperature. Experimental results show that the isopropanol-sealed modal interferometer provides a temperature sensitivity up to -140.5 nm/°C. The interference spectrum has multiple dips at which the input LP01 mode is converted to the LP11 mode. This modal interferometer acts as a tunable multi-channel mode converter. The mode converter that can be tuned by varying temperature and mode switch is realized.