bluuebunny/crossref_metadata_2025 huggingface dataset:
Urdu translation of Shoulder Pain and Disability Index (SPADI) and its validity and reliability on adhesive capsulitis patients
Authors: Munir Ammara , Ikram Mehwish , Rehman Syed Shakil Ur
Published: March 2022

Background

Excessive scar tissues around the shoulder are the results of shoulder pathologies that lead to pain and disability. The Shoulder pain and disability index (SPADI) is used to measure the level of pain and disability in patients with shoulder pathology. SPADI is translated into Urdu and its validity and reliability are measured on patients with adhesive capsulitis.

Objective

The study was aimed to translate the SPADI in Urdu and to evaluate its reliability and validity in patients with shoulder adhesive capsulitis.

Methods

Translation of SPADI in Urdu was conducted by applying the standardized process. Two forward translations in Urdu were made T1 and T2 by bilingual translators. Urdu version of SPADI was drafted after experts’ opinion. Two Backward English translations of Urdu SPADI were made BT1 and BT2 and the back translation was finalized by the consensus of all experts. After this process of reviewing by the professional experts, 3rd version of Urdu SPADI was drafted. The Final version was drafted after its application on 10 patients. Its reliability and validity were tested on 150 patients with shoulder adhesive capsulitis.

Results

Content Validity Index was good with values of each item > 0.85. For Test–retest reliability, the Intraclass correlation coefficient (ICC2,1) was measured with a value of 0.89 which showed good Test–retest reliability. The internal consistency and reliability of SPADI were calculated by Cronbach’s alpha for a total score with a value of 0.94. Construct validity and Concurrent validity were determined. In Construct validity, factor analysis of Urdu SPADI showed two factors and a cumulative variance of 75.443%.

Conclusion

It was concluded that the Urdu version of SPADI is a valuable translation that is a valid assessment tool for patients with shoulder adhesive capsulitis. It has good validity and test–retest reliability.
Retrospective analysis of risk factors for postoperative perineal hernia after endoscopic abdominoperineal excision for rectal cancer
Authors: Manabe Tatsuya , Mizuuchi Yusuke , Tsuru Yasuhiro , Kitagawa Hiroshi , Fujimoto Takaaki , Koga Yasuo , Nakamura Masafumi , Noshiro Hirokazu
Published: March 2022

Background

In contrast to open-surgery abdominoperineal excision (APE) for rectal cancer, postoperative perineal hernia (PPH) is reported to increase after extralevator APE and endoscopic surgery. In this study, therefore, we aimed to determine the risk factors for PPH after endoscopic APE.

Methods

A total 73 patients who underwent endoscopic APE for rectal cancer were collected from January 2009 to March 2020, and the risk factors for PPH were analyzed retrospectively.

Results

Nineteen patients (26%) developed PPH after endoscopic APE, and the diagnosis of PPH was made at 9–393 days (median: 183 days) after initial surgery. Logistic regression analysis showed that absence of pelvic peritoneal closure alone increased the incidence of PPH significantly (odds ratio; 13.76, 95% confidence interval; 1.48–1884.84, p = 0.004).

Conclusions

This preliminary study showed that pelvic peritoneal closure could prevent PPH after endoscopic APE.
The relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer: a cross-sectional study
Authors: Li Jiaojiao , Sun Di , Zhang Xu , Zhao Lihua , Zhang Yanling , Wang Hongmei , Ni Ni , Jiang Guichun
Published: March 2022

Background

Anticipatory grief has been shown to be highly prevalent among family caregivers of patients with advanced illness. Qualitative study suggests that illness uncertainty may be one of the core characteristics of anticipatory grief, but it has not been confirmed in quantitative studies. Therefore, the purpose of this study was to explore the relationship between anticipatory grief and illness uncertainty among Chinese family caregivers of patients with advanced lung cancer and to determine the factors influencing anticipatory grief.

Methods

This descriptive cross-sectional study used a convenience sampling method and recruited 254 inpatient family caregivers from the thoracic medicine ward of Liaoning Cancer Hospital & Institute in Shenyang, mainland China. Anticipatory grief (Anticipatory Grief Scale (AGS), illness uncertainty (Uncertainty in Illness Scale Family Caregiver Version) and sociodemographic information (Self-compiled general information questionnaire) were measured using validated self-report measures.

Results

Chinese family caregivers of patients with advanced lung cancer had high levels of anticipatory grief (73.5 ± 16.1). The results of the correlation analysis showed a positive association between anticipatory grief and illness uncertainty (r = 0.580, P < 0.001). The final linear regression model with anticipatory grief as the dependent variable included four variables: illness uncertainty (β = 0.674, P < 0.001), lack of informativeness (β =  − 0.168, P = 0.08), monthly income (β = 0.139, P = 0.006), and caregiving burden (β =  − 0.196, P < 0.001).

Conclusions

Illness uncertainty is probably an important factor affecting anticipatory grief. Excessive caregiving burden is associated with high levels of anticipatory grief. Improving illness uncertainty and caregiving burden may effectively reduce anticipatory grief among Chinese family caregivers.
Multimodal stress reduction and lifestyle modification program for patients with ulcerative colitis: a qualitative study
Authors: Schlee Christoph , Uecker Christine , Bauer Nina , Koch Anna K. , Langhorst Jost
Published: March 2022

Background

Over 2 million people in Europe are affected by ulcerative colitis, which often severely impacts the quality of life of those concerned. Among other factors, lifestyle and psychosocial factors seem to play an important role in pathogenesis and course of the disease and can be addressed as a complement to pharmacotherapy in comprehensive lifestyle modification programs.

Methods

This qualitative study as part of a mixed methods approach was carried out in the framework of a randomized controlled trial that examined the effect of a comprehensive lifestyle-modification-program (10-week-day clinic program) on quality of life in patients with ulcerative colitis. Qualitative interviews were conducted with 20 out of 47 patients of the intervention group after the program. The aim was to deepen, supplement, and expand the quantitative results of the trial, i.e. to examine individual perceptions of the intervention, including subjective changes and the extent to which elements of the program were integrated into everyday life. Qualitative content analysis techniques utilizing the software MAXQDA were used.

Results

Patients with ulcerative colitis in our sample often experienced multiple negative effects on different levels (physical, psychological, and social) and impaired quality of life because of their disease. They reported generally positively about the program itself, and emphasized perceived positive changes regarding their psychological and physical well-being. The interviews indicated a good implementation of elements learned during the intervention in everyday life.

Conclusions

Through participation in a comprehensive lifestyle modification program in the structure of a day clinic complementary to pharmacotherapy, patients with ulcerative colitis can reduce psychosocial stress and physical symptoms and thereby actively improve their well-being and general quality of life. This patient-centered, holistic approach was rated as useful in countering the complex disease manifestation as well as meeting the individual needs of the patients regarding their disease.

Trial registration

clinicaltrials.govNCT02721823
GlucoMedix®, an extract of Stevia rebaudiana and Uncaria tomentosa, reduces hyperglycemia, hyperlipidemia, and hypertension in rat models without toxicity: a treatment for metabolic syndrome
Authors: Villegas Vílchez León F. , Ascencios Julio Hidalgo , Dooley Thomas P.
Published: March 2022

Background

The objective of this in vivo study is to evaluate in five rat models the pharmacologic effects and toxicity of a commercial hydro-alcoholic extract, GlucoMedix®, derived from Stevia rebaudiana and the pentacyclic chemotype of Uncaria Tomentosa (Willd.) DC, for use as a treatment for metabolic syndrome. The extract contains phytochemicals of Stevia (e.g., steviol glycosides) and Uncaria (e.g., pentacyclic oxindole alkaloids, but lacks tetracyclic oxindole alkaloids).

Methods

The pharmacologic assessments in three rat models include reductions in chemically induced hyperglycemia, hyperlipidemia (cholesterol and triglycerides), and hypertension, all of which are comorbidities of metabolic syndrome. Acute toxicity and 28-day subacute toxicity were assessed in rat models at doses higher than those used in the efficacy models.

Results

The acute oral toxicity was evaluated in Holtzman rats and the extract did not produce acute toxic effects or lethality, with the LD50 > 5000 mg/kg (extract wet weight). Furthermore, subacute oral toxicity was evaluated in rats for 28 days at daily doses as high as 2000 mg/kg without toxicity or abnormal clinical chemistry or hematological effects. Daily oral doses of 250 - 1000 mg/kg were used to evaluate the treatment effects in hyperglycemic (alloxan-induced and glibenclamide-controlled), hyperlipidemic (cholesterol-induced and atorvastatin-controlled), and hypertensive (L-NAME-induced and enalapril-controlled) rat models. Alloxan-induced hyperglycemia was reduced in a dose-dependent manner within 28 days or less. Cholesterol-induced hyperlipidemic rats exhibited dose-dependent reductions in cholesterol and triglycerides at 21 days. Furthermore, GlucoMedix® produced a dose-dependent decrease in systolic and diastolic arterial blood pressure in L-NAME-induced hypertensive rats at 28 days.

Conclusions

The five in vivo rat models revealed that the all-natural phytotherapy GlucoMedix® is a safe and effective treatment for hyperglycemia, hyperlipidemia, and hypertension. This extract is expected to affect multiple comorbidities of metabolic syndrome, without any acute or subacute oral toxicity in humans. Although multiple prescription drugs are well known for the treatment of individual comorbidities of metabolic syndrome, no drug monotherapy concurrently treats all three comorbidities.
Gynura segetum-induced liver injury leading to acute liver failure: a case report and literature review
Authors: Zhang Zilong , Zou Haibo , Dai Zonglin , Shang Jin , Sure Shining , Lai Chunyou , Shi Ying , Yang Qinyan , Xiang Guangming , Yao Yutong , Feng Tianhang , Zhong Deyuan , Huang Xiaolun
Published: March 2022

Background

Gynura segetum (GS) is widely used in medical care and in community settings in China as the herbal remedy. It is widely thought to have antiphlogistic properties and pain relief in traditional Chinese medicine. It has been reported that GS can cause chronic drug-induced liver injury (DILI), manifested as hepatic sinusoid obstruction syndrome (HOSO). But case reports of acute DILI developing acute liver failure (ALF) due to GS are extremely rare.

Case presentation

We report a case of a 63-year-old female patient with hepatolithiasis for more than 6 years. There were no deterioration of liver function and no history of viral liver disease, autoimmune liver disease, blood transfusion or surgical allergy before operation. ALF and grade II liver encephalopathy occurred after partial hepatectomy. To follow up the medical history, the patient has been taking GS (Tusanqi) for a year and a half. The causality assessment was done by the updated Roussel Uclaf Causality Assessment Method, and the possibility of DILI caused by GS as highly probable for the score was 6 points. Excluding other causes, a diagnosis of DILI-associated ALF was established. After symptomatic support and artificial liver support system (ALSS) treatment, the clinical symptoms and signs of the patients were significantly improved. After discharge, the liver function of the patients returned to normal.

Conclusions

Based on this rare case of severe liver injury, we recommend that timely prevention, identification, and appropriate management of DILI is essential for patients with a history of taking GS and other hepatotoxic drugs, and careful monitoring of liver function for patients with DILI could avoid ALF as far as possible.
Impact of the COVID-19 pandemic on career intention amongst undergraduate medical students: a single-centre cross-sectional study conducted in Hubei Province
Authors: Wang Xue-lin , Liu Ming-xiu , Peng Shuai , Yang Lei , Lu Chen , Shou Shi-cong , Wang Jian-ru , Sun Jun-yi , Wang Jia-qi , Hu Yan , Zhao Jun , Duan Peng
Published: March 2022

Background

Undergraduate medical (UM) students faced the difficulties inherent in medical careers due to the coronavirus (COVID-19) outbreak. Thus, imperative containment measures might affect UM students’ career intentions. Information on the factors that may be associated with these students’ career change intentions is limited.

Methods

We conducted a cross-sectional survey in August 2020 to investigate the impact of the COVID-19 pandemic on career intention and the associated factors in UM students. Univariate analyses and logistic regression analysis were performed to identify said factors.

Results

A total of 2040 medical students from the Hubei University of Medicine were surveyed. Univariate analyses showed that grade, attitude towards healthcare, and the degree of the COVID-19 pandemic’s impact on the students’ lives were associated with changes in career choice (P<0.05). Logistic regression analysis showed that Grade 2, Grade 5, attitude towards a medical career, and having relatives with a medical background were associated with changes in career choice. The degree of the COVID-19 pandemic’s impact was a common and significant factor associated with career preference, career perspective, and ideal workplace.

Conclusions

Changes in career intentions were particularly influenced by grade, attitude towards being a health worker, and the degree of COVID-19’s impact on the participants’ lives. Treating large-scale public health emergencies rationally, setting up correct views of occupation choice, and building reasonable career planning may reduce the loss of medical talent.
The utilisation of regulated standardised care packages by Danish chiropractors: a mixed methods study
Authors: Jensen Rikke Krüger , Ris Inge , Linnebjerg Elisabeth , Christensen Henrik Wulff , Myburgh Corrie
Published: March 2022

Background

In Denmark, chiropractors in primary care work as independent private contractors regulated by the Danish National Health Authorities. The regulation includes partial reimbursement intended for standardised care packages for lumbar and cervical radiculopathy and lumbar spinal stenosis. Random checks have shown lower use than expected. This study aimed to describe and explore the utilisation of standardised chiropractic care packages and identify barriers to uptake.

Methods

A convergent mixed-method design was conceptualised. The use of standardised care packages was collected by register data. Potential determinants of difference in utilisation were assessed using a modified version of the Determinants of Implementation Behaviour Questionnaire (DIBQ) divided into 13 domains and sent to chiropractors in private clinics in Denmark in 2019. An open-ended question was added to the questionnaire, and thematic content analysis was applied. Qualitative findings were used to expand on the DIBQ data providing further insight into the clinicians’ perspective on standardised care packages. 

Results

Registry data of 244 included chiropractic clinics showed limited and inconsistent use of the standardised chiropractic care packages. A total of 269 chiropractors (44%) answered the DIBQ, and 45 provided data for the qualitative analyses. At least 60% of the clinicians answered ‘Strongly agree’ or ‘Agree’ in 10 out of 13 DIBQ domains suggesting a positive attitude towards using the standardised care packages. Three domains were identified as ‘problematic’ as more than 20% of clinicians disagreed or strongly disagreed: ‘Socio-political context’, ‘Goals’ and ‘Innovation’. Qualitative findings indicated that lack of usage of the standardised care packages was mainly related to the practical organization of standardised care, the chiropractor’s role when managing patients, and the patient population of interest to the clinic (e.g., children, athletes).

Conclusion

In general, Danish chiropractors displayed positive attitudes towards standardised packages of care. However, considerable variation in the use of the standardised care programs was observed. Low utilisation seemed mainly related to logistics, the chiropractor’s role, collaboration with GPs, and the patient population of interest to the clinic. These findings should be further explored in more extensive qualitative studies to inform implementation initiatives to increase and rectify utility.
Development and use of the PodEssential and Paeds‐PodEssential triage tools to define “essential” podiatry services. A Delphi survey, scoping review, and face validity testing study
Authors: Williams Cylie M. , James Alicia , Dars Sindhrani , Banwell Helen
Published: March 2022

Background

The coronavirus pandemic resulted in unique challenges for podiatrists in Australia. Podiatrists were tasked with having to make triage decisions about face‐to‐face care without clear guidelines. This research aimed to develop podiatry triage tools to understand individual risk for adults and children, and explore the face validity of both tools.

Methods

An online three‐round modified Delphi technique was used to elicit podiatrists' opinions on conditions, assessments and social factors that elevate risk. Additional elements of known foot and/or leg risk were informed by a synchronous scoping review. Australian podiatrists who held a clinical role treating patients or directly managing podiatrists treating patients within the past six months were recruited.

Where 70% of participants reported the same or similar theme in Round 1, statements were accepted with consensus. Where 50–69% of participants reported a similar theme, these were returned to participants to rate agreement using a four‐point Likert agreement scale. Statements identified in the scoping review were added at Round 2, if not already identified by participants. The final round presented participants with triage tools, and a series of mock patient scenarios.. Participants were asked to indicate if they would or would not provide face to face podiatry service based on these scenarios.

Results

There were 40 participants who responded to Round 1 (Adult presentations), of these, 23 participants also provided paediatric presentation responses. Participants developed and agreed upon 20 statements about risk in podiatry service delivery for both adults and children across Rounds 1 and 2. The PodEssential and Paed‐PodEssential were developed based on these statements indicating stand‐alone condition risk (tier 1), elements that should elevate risk (in the absence of a stand‐alone condition) (tier 2), and assessments results identifiying a limb at risk (tier 3) in adults and children respectively. Participants utilising these tools in Round 3 more frequently indicated face‐to‐face service when mock patient scenarios included a greater number elements, suggesting the tool can be useful in making triage decisions.

Conclusion

The PodEssential and Paeds‐PodEssential tools direct conditions requiring urgent attention as well as providing considered elements to a person's health status to assist in making triage decisions.
A neurodegenerative disease landscape of rare mutations in Colombia due to founder effects
Authors: Acosta-Uribe Juliana , Aguillón David , Cochran J. Nicholas , Giraldo Margarita , Madrigal Lucía , Killingsworth Bradley W. , Singhal Rijul , Labib Sarah , Alzate Diana , Velilla Lina , Moreno Sonia , García Gloria P. , Saldarriaga Amanda , Piedrahita Francisco , Hincapié Liliana , López Hugo E. , Perumal Nithesh , Morelo Leonilde , Vallejo Dionis , Solano Juan Marcos , Reiman Eric M. , Surace Ezequiel I. , Itzcovich Tatiana , Allegri Ricardo , Sánchez-Valle Raquel , Villegas-Lanau Andrés , White Charles L. , Matallana Diana , Myers Richard M. , Browning Sharon R. , Lopera Francisco , Kosik Kenneth S.
Published: March 2022

Background

The Colombian population, as well as those in other Latin American regions, arose from a recent tri-continental admixture among Native Americans, Spanish invaders, and enslaved Africans, all of whom passed through a population bottleneck due to widespread infectious diseases that left small isolated local settlements. As a result, the current population reflects multiple founder effects derived from diverse ancestries.

Methods

We characterized the role of admixture and founder effects on the origination of the mutational landscape that led to neurodegenerative disorders under these historical circumstances. Genomes from 900 Colombian individuals with Alzheimer’s disease (AD) [n = 376], frontotemporal lobar degeneration-motor neuron disease continuum (FTLD-MND) [n = 197], early-onset dementia not otherwise specified (EOD) [n = 73], and healthy participants [n = 254] were analyzed. We examined their global and local ancestry proportions and screened this cohort for deleterious variants in disease-causing and risk-conferring genes.

Results

We identified 21 pathogenic variants in AD-FTLD related genes, and PSEN1 harbored the majority (11 pathogenic variants). Variants were identified from all three continental ancestries. TREM2 heterozygous and homozygous variants were the most common among AD risk genes (102 carriers), a point of interest because the disease risk conferred by these variants differed according to ancestry. Several gene variants that have a known association with MND in European populations had FTLD phenotypes on a Native American haplotype. Consistent with founder effects, identity by descent among carriers of the same variant was frequent.

Conclusions

Colombian demography with multiple mini-bottlenecks probably enhanced the detection of founder events and left a proportionally higher frequency of rare variants derived from the ancestral populations. These findings demonstrate the role of genomically defined ancestry in phenotypic disease expression, a phenotypic range of different rare mutations in the same gene, and further emphasize the importance of inclusiveness in genetic studies.
Pathophysiological significance of increased α-synuclein deposition in sympathetic nerves in Parkinson’s disease: a post-mortem observational study
Authors: Isonaka Risa , Sullivan Patti , Goldstein David S.
Published: March 2022

Background

Parkinson’s disease (PD) is characterized by intra-neuronal deposition of the protein α-synuclein (α-syn) and by deficiencies of the catecholamines dopamine and norepinephrine (NE) in the brain and heart. Accumulation of α-syn in sympathetic noradrenergic nerves may provide a useful PD biomarker; however, whether α-syn buildup is pathophysiological has been unclear. If it were, one would expect associations of intra-neuronal α-syn deposition with catecholaminergic denervation and with decreased NE contents in the same samples.

Methods

We assayed immunoreactive α-syn and tyrosine hydroxylase (TH, a marker of catecholaminergic innervation) concurrently with catecholamines in coded post-mortem scalp skin, submandibular gland (SMG), and apical left ventricular myocardial tissue samples from 14 patients with autopsy-proven PD and 12 age-matched control subjects who did not have a neurodegenerative disease.

Results

The PD group had increased α-syn in sympathetic noradrenergically innervated arrector pili muscles (5.7 times control, P < 0.0001), SMG (35 times control, P = 0.0011), and myocardium (11 times control, P = 0.0011). Myocardial TH in the PD group was decreased by 65% compared to the control group (P = 0.0008), whereas the groups did not differ in TH in either arrector pili muscles or SMG. Similarly, myocardial NE was decreased by 92% in the PD group (P < 0.0001), but the groups did not differ in NE in either scalp skin or SMG.

Conclusions

PD entails increased α-syn in skin, SMG, and myocardial tissues. In skin and SMG, augmented α-syn deposition in sympathetic nerves does not seem to be pathogenic. The pathophysiological significance of intra-neuronal α-syn deposition appears to be organ-selective and prominent in the heart.
Improving outcomes among young adults with type 1 diabetes: the D1 Now pilot cluster randomised controlled trial
Authors: Morrissey Eimear C. , Byrne Molly , Casey Bláthín , Casey Dympna , Gillespie Paddy , Hobbins Anna , Lowry Michelle , McCarthy Elizabeth , Newell John , Roshan Davood , Sharma Shikha ,   The D1 Now Young Adult Panel, Dinneen Sean F.
Published: March 2022

Background

The D1 Now intervention is designed to improve outcomes in young adults living with type 1 diabetes. It consists of three components: an agenda-setting tool, an interactive messaging system and a support worker. The aim of the D1 Now pilot cluster randomised controlled trial (RCT) was to gather and analyse acceptability and feasibility data to allow (1) further refinement of the D1 Now intervention, and (2) determination of the feasibility of evaluating the D1 Now intervention in a future definitive RCT.

Methods

A pilot cluster RCT with two intervention arms and a control arm was conducted over 12 months. Quantitative data collection was based on a core outcome set and took place at baseline and 12 months. Semi-structured interviews with participants took place at 6, 9 and 12 months. Fidelity and health economic costings were also assessed.

Results

Four diabetes centres and 57 young adults living with type 1 diabetes took part. 50% of eligible young adults were recruited and total loss to follow-up was 12%. Fidelity, as measured on a study delivery checklist, was good but there were three minor processes that were not delivered as intended in the protocol. Overall, the qualitative data demonstrated that the intervention was considered acceptable and feasible, though this differed across intervention components. The agenda-setting tool and support worker intervention components were acceptable to both young adults and staff, but views on the interactive messaging system were mixed.

Conclusions

Some modifications are required to the D1 Now intervention components and research processes but with these in place progression to a definitive RCT is considered feasible.

Trial registration

ISRCTN (ref: ISRCTN74114336)
The use of cognitive task analysis in clinical and health services research — a systematic review
Authors: Swaby Lizzie , Shu Peiyao , Hind Daniel , Sutherland Katie
Published: March 2022

Background

At times, clinical case complexity and different types of uncertainty present challenges to less experienced clinicians or the naive application of clinical guidelines where this may not be appropriate. Cognitive task analysis (CTA) methods are used to elicit, document and transfer tacit knowledge about how experts make decisions.

Methods

We conducted a methodological review to describe the use of CTA methods in understanding expert clinical decision-making. We searched MEDLINE, EMBASE and PsycINFO from inception to 2019 for primary research studies which described the use of CTA methods to understand how qualified clinicians made clinical decisions in real-world clinical settings.

Results

We included 81 articles (80 unique studies) from 13 countries, published from 1993 to 2019, most commonly from surgical and critical care settings. The most common aims were to understand expert decision-making in particular clinical scenarios, using expert decision-making in the development of training programmes, understanding whether decision support tools were warranted and understanding procedural variability and error identification or reduction. Critical decision method (CDM) and CTA interviews were most frequently used, with hierarchical task analysis, task knowledge structures, think-aloud protocols and other methods less commonly used. Studies used interviews, observation, think-aloud exercises, surveys, focus groups and a range of more CTA-specific methodologies such as the systematic human error reduction and prediction approach. Researchers used CTA methods to investigate routine/typical (n = 64), challenging (n = 13) or more uncommon, rare events and anomalies (n = 3).

Conclusions

In conclusion, the elicitation of expert tacit knowledge using CTA has seen increasing use in clinical specialties working under challenging time pressures, complexity and uncertainty. CTA methods have great potential in the development, refinement, modification or adaptation of complex interventions, clinical protocols and practice guidelines.

Registration

PROSPERO ID CRD42019128418.
Association of FTO gene variants rs9939609 and rs1421085 with polycystic ovary syndrome
Authors: Alnafjan Alaa A. , Alkhuriji Afrah F. , Alobaid Hussah M. , Babay Zainb A. , Khalil Mahmoud I.
Published: March 2022

Background

Polycystic ovary syndrome (PCOS) is among the most common complex genetic endocrinopathy, and its etiology and pathophysiology remain controversial. FTO is a large highly polymorphic gene and was coined as the first locus associated with adiposity. The association of the intronic variant FTO rs9939609 or FTO rs1421085 with PCOS has been controversial and unclear, mainly due to ethnic differences among populations. The present study aims to investigate the association of FTO rs9939609 or FTO rs1421085 polymorphisms with PCOS in Saudi Arabian women.

Results

A total of 98 PCOS patients and 99 healthy females were included in this study. PCR and genotyping (TaqMan®SNP Genotyping Assay) were employed. For FTO rs9939609, the genotype TA and the recessive model (TA + AA) in PCOS patients were significantly different compared with control subjects (p = 0.008 and p = 0.007, respectively). The allele frequency of the FTO rs9939609 gene variant was associated significantly (p = 0.027) with PCOS, suggesting that the A allele is a risk factor for PCOS susceptibility. However, for the FTO rs1421085 variant, the genotype and allele distributions did not differ significantly between PCOS patients and controls (p > 0.05).

Conclusions

This is the first report to study the association of FTO rs9939609 and FTO rs1421085 with PCOS in Saudi women. Results suggest that the FTO rs9939609 gene variant could be a genetic predisposing factor for PCOS Saudi women.
Perforated Meckel’s diverticulum in neonates: a report of six cases and systematic review of the literature
Authors: Liaqat Naeem , Mahomed Anies , Nayyar Sajid Iqbal , Akhtar Nadeem , Ali Sajjad , Haider Naveed
Published: March 2022

Background

Perforation of Meckel Diverticulum (MD) is a rare cause of pneumoperitoneum in neonates. We hereby report six cases of perforation of MD in neonates, with addition of 53 cases from systematic review of the literature. A systematic review was performed using Mesh terms “Neonate, Meckel Diverticulum, Perforation, Pneumoperitoneum.” All reports of perforated MD in the English literature were identified. Details of our 6 cases were analyzed in similar fashion.

Results

A total of 3027 manuscripts were screened and 59 cases including 6 of our own were identified. The vast majority (78%) were female. Fifty patients (84.7%) presented in the newborn period. Half of the cases (52.5%) had associated anomalies and 13 neonates (22%) required oxygen supplementation including CPAP or ventilatory support before surgery. In 73% of the cases, a resection of gut was undertaken. Histopathological assessment in 44 cases (74.6%) revealed no ectopic gastric mucosa. Three cases demised prior to treatment. The outcome in the vast majority was excellent with 84.7% surviving and discharged well.

Conclusion

Perforated MD is an unusual cause of a pneumoperitoneum in the newborns. Diagnosis is established at laparotomy and it rare to find ectopic mucosa histopathologically. The overall outcome is excellent.
Infection control and the prevalence, management and outcomes of SARS-CoV-2 infections in mental health wards in London, UK: lessons learned from wave 1 to wave 2
Authors: Liu Kathy Y. , Kulatilake Anita , Kalafatis Chris , Smith Gareth , King Jacob D. , Serra-Mestres Jordi , Huzzey Lauren , Ng Nicola , Kandangwa Pooja , Elliott Thomas , Sommerlad Andrew , Marston Louise , Livingston Gill
Published: March 2022

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has high morbidity and mortality in older adults and people with dementia. Infection control and prevention measures potentially reduce transmission within hospitals.

Aims

We aimed to replicate our earlier study of London mental health in-patients to examine changes in clinical guidance and practice and associated COVID-19 prevalence and outcomes between COVID-19 waves 1 and 2 (1 March to 30 April 2020 and 14 December 2020 to 15 February 2021).

Method

We collected the 2 month period prevalence of wave 2 of COVID-19 in older (≥65 years) in-patients and those with dementia, as well as patients’ characteristics, management and outcomes, including vaccinations. We compared these results with those of our wave 1 study.

Results

Sites reported that routine testing and personal protective equipment were available, and routine patient isolation on admission occurred throughout wave 2. COVID-19 infection occurred in 91/358 (25%; 95% CI 21–30%) v. 131/344, (38%; 95% CI 33–43%) P < 0.001 in wave 1. Hospitals identified more asymptomatic carriers (26/91; 29% v. 16/130; 12%) and fewer deaths (12/91; 13% v. 19/131; 15%; odds ratio = 0.92; 0.37–1.81) compared with wave 1. The patient vaccination uptake rate was 49/58 (85%).

Conclusions

Patients in psychiatric in-patient settings, mostly admitted without known SARS-CoV-2 infection, had a high risk of infection compared with people in the community but lower than that during wave 1. Availability of infection control measures in line with a policy of parity of esteem between mental and physical health appears to have lowered within-hospital COVID-19 infections and deaths. Cautious management of vulnerable patient groups including mental health patients may reduce the future impact of COVID-19.
The prevalence, incidence, prognosis and risk factors for symptoms of depression and anxiety in a UK cohort during the COVID-19 pandemic
Authors: Jia Ru , Ayling Kieran , Chalder Trudie , Massey Adam , Gasteiger Norina , Broadbent Elizabeth , Coupland Carol , Vedhara Kavita
Published: March 2022

Background

The COVID-19 pandemic has had profound consequences for population mental health. However, it is less clear for whom these effects are sustained.

Aims

To investigate the prevalence, incidence, prognosis and risk factors for symptoms of depression and anxiety in a UK cohort over three distinct periods in the pandemic in 2020.

Method

An online survey was completed by a UK community cohort at three points (n = 3097 at baseline, n = 878 completed all surveys): April (baseline), July to September (time point 2) and November to December (time point 3). Participants completed validated measures of depression and anxiety on each occasion, and we prospectively explored the role of sociodemographic and psychological factors (loneliness, positive mood and perceived risk of and worry about COVID-19) as risk factors.

Results

Depression (Patient Health Questionnaire-9 means: baseline, 7.69; time point 2, 5.53; time point 3, 6.06) and anxiety scores (Generalised Anxiety Disorder-7 means: baseline, 6.59; time point 2, 4.60; time point 3, 4.98) were considerably greater than pre-pandemic population norms at all time points. Women reported greater depression and anxiety symptoms than men. Younger age, history of mental health disorder, more COVID-19-related negative life events, greater loneliness and lower positive mood at baseline were all significant predictors of poorer mental health at time point 3.

Conclusions

The negative impact of the COVID-19 pandemic on mental health has persisted to some degree. Younger people and individuals with prior mental health disorders are at greatest risk. Easing of restrictions and resumption of social interaction could mitigate the risk factors of loneliness and positive mood.
Van-Leo
Authors: Seif Ola
Published: March 2022

When the Art and Liberty group launched its activities in the late 1930s and early 1940s, the young Levon Boyadjian (later to become the famous Van-Leo) and his elder brother, Angelo, were jointly debuting their careers as photographers in Cairo. Van-Leo’s archive of photographic prints, negatives, and documents reveals much about the imaginative experimental channels he explored to crystallize his inner self. The artist’s self-portraiture—“auto-portraits,” as he called them—constituted the core of his surrealist production, and his photographic knowledge was enriched while he implemented these early self-portraits. Self-taught, he often returned to photography books, from which he learned techniques of double and triple exposure, juxtaposition, sandwiching, solarization, and cutouts and thus triggered his imagination and sense of exploration. This article traces the arc of Van-Leo’s early surrealist phase, which lasted about a decade that coincided with the beginning of his career in the 1940s. Other than the surrealist self-portraits, his photographic archive also contains a few hundred more works that are just as eccentric, although they rely more on disguise skills, shadows, and contrasts, or constitute false personifications of characters in society, rather than a surrealist approach. Although Van-Leo’s work was detached from what the Egyptian surrealist philosophies called for, he was, it seems, a surrealist by accident.
Comparison of Vonoprazan and Amoxicillin Dual Therapy with Standard Triple Therapy with Proton Pump Inhibitor for Helicobacter Pylori eradication: A Randomized Control Trial
Authors: Zuberi Bader Faiyaz , Ali Faiza Sadaqat , Rasheed Tazeen , Bader Nimrah , Hussain Sana Muhammad , Saleem Anoshia
Published: March 2022

Objectives: To compare the efficacy of Vonoprazan based dual treatment versus PPI based treatment for the eradication of Helicobacter pylori infection.

Methods: A randomized controlled trial was conducted in Department of Medicine/Gastroenterology Ruth KM Pfau Civil Hospital, DMC during the period of 22 June to 21 September 2021. Sample size was calculated as 96 in each Group. All patients of age 18-75 years with Helicobacter Pylori Infection were inducted and randomly allocated to two groups. Group-A: were given Capsule Amoxicillin 1 gm; Tablet Clarithromycin 500 mg; Capsule Omeprazole 20 mg all medications were given twice daily for two weeks. Group-B were given Capsule Amoxicillin 1 gm; Tablet Vonoprazan 20 mg (Vonozon©, m/s Getz Pharma, Pakistan) twice daily for two weeks. Confirmation of Hp eradication was done by stool Hp antigen test four weeks after completion of treatment. Nine and four patients were lost to follow-up in Group-A & B respectively. Analysis was conducted on 87 patients in Group-A and 92 patients in Group-B.

Results: Out of eighty-seven patients in Group-A and ninety-two patients in Group-B, 73 (83.9%) patients in Group-A and 86 (93.5%) patients in Group-B had negative H pylori result respectively after treatment (p = .042). Significantly higher frequencies of adverse events were observed in Group-A as compared to Group-B in nausea/vomiting (p = .035) and bloating (p = .045).

Conclusion: VA-dual provides an acceptable eradication rate with fewer adverse events.

doi: https://doi.org/10.12669/pjms.38.4.5436

How to cite this:Zuberi BF, Ali FS, Rasheed T, Bader N, Hussain SM, Saleem A. Comparison of Vonoprazan and Amoxicillin Dual Therapy with Standard Triple Therapy with Proton Pump Inhibitor for Helicobacter Pylori eradication: A Randomized Control Trial . Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.5436

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.
Ανάπτυξη μεθόδων προσδιορισμού δραστικών ουσιών σε καινοτόμες φαρμακομορφές για την από του στόματος χορήγηση
Authors: Συναρίδου Μαρία-Ευαγγελία
Published: March 2022

Σκοπός της παρούσας Διδακτορικής διατριβής ήταν η σύνθεση καινοτόμων στερεών φαρμακομορφών για τους μικρούς ασθενείς, στις οποίες η δυσάρεστη γεύση των δραστικών ουσιών καλύφθηκε επιτυχώς με τη χρήση πρωτότυπων βρώσιμων και εύγευστων συστατικών (εκδόχων), όπως για παράδειγμα η σοκολάτα, το μέλι, εκχύλισμα ροδιού, βασιλικός πολτός, φυστικοβούτυρο κ.λ.π. και η ανάπτυξη αναλυτικών μεθόδων για τον έλεγχο της ποιότητάς τους. Οι δραστικές ουσίες που χρησιμοποιήθηκαν στα σκευάσματα ήταν η ιβουπροφαίνη, η δεξαμεθαζόνη (νατριούχος φωσφορική) και η αμοξυκιλλίνη. Επιπλέον, παρασκευάστηκαν σκευάσματα/συμπληρώματα διατροφής για μικρούς αθλητές που περιείχαν βιταμίνες (λιποδιαλυτές βιταμίνες Α και Ε και υδατοδιαλυτές βιταμίνες C, B2, B3, B6, και B12) και αμινοξέα (L- ιστιδίνη, L- βαλίνη, β- αλανίνη, L- λευκίνη και L-ισολευκίνη) και είχαν ως στόχο την τόνωση του οργανισμού κατά τη διάρκεια της προπόνησης και την γρηγορότερη αποκατάστασή τους μετά από αυτή.Τα σκευάσματα υποβλήθηκαν σε κατάλληλη κατεργασία προκειμένου να παραληφθούν αμιγώς οι δραστικές τους και αναπτύχθηκαν (κατόπιν διερεύνησης) αξιόπιστες μέθοδοι ποσοτικού προσδιορισμού τους με χρωματογραφία υγρού (LC) συζευγμένη με ανιχνευτή συστοιχίας φωτοδιόδων (DAD), φθορισμομετρικό ή φασματόμετρο μάζας (ESI-Q/MS). Σε ορισμένες περιπτώσεις, προκειμένου να αυξηθεί η ευαισθησία της μεθόδου και να ελαχιστοποιηθούν τα όρια ανίχνευσής τους, τα δείγματα παραγωγοποιήθηκαν πριν την ανάλυσή τους. Ο πειραματικός σχεδιασμός χρησιμοποιήθηκε, όπου κρίθηκε απαραίτητο, τόσο για τη σύνθεση των σκευασμάτων (αναλογία εκδόχων), όσο και για τη βελτιστοποίηση των αναλυτικών μεθόδων. Τα πειράματα ολοκληρώθηκαν με τον έλεγχο σταθερότητας των δραστικών στα σκευάσματα (σε διάστημα έξι μηνών και/ή ενός χρόνου). Οι προτεινόμενες μέθοδοι, λόγω της χρηστικότητάς τους σε αναλύσεις ρουτίνας είναι εύχρηστες, οικονομικές και αξιόπιστες.Κατά την παραγωγική διαδικασία των σκευασμάτων αρχικά έγινε χαρακτηρισμός (ταυτοποίηση/καθορισμός ιδιοτήτων) των δραστικών ουσιών και των εκδόχων με τις τεχνικές, DSC (Differential scanning calorimetry) και FT-IR (Fourier-transform infrared spectroscopy). Ακολούθως οι ίδιες μετρήσεις επαναλήφθηκαν, μετά το στάδιο μορφοποίησης, σε σκευάσματα με και χωρίς δραστική ώστε να διεξαχθούν έμμεσα συμπεράσματα σταθερότητά τους.Παράλληλοι έλεγχοι που πραγματοποιήθηκαν στα σκευάσματα (ανά περίπτωση) ήταν ο έλεγχος των ποιοτικών χαρακτηριστικών (π.χ. σκληρότητα και ευθρυπτότητα δισκίων), ο έλεγχος ρυθμού αποδέσμευσης και διαλυτοποίησής τους, τόσο σε υπόστρωμα σιέλου, όσο και γαστρικών υγρών καθώς επίσης και ο έλεγχος διάλυσης και καταθρυμματισμού (dissolution & disintegration test).
Impact of AYUSH interventions on COVID-19: a protocol for a living systematic review and meta-analysis
Authors: Thakar Anup , Panara Kalpesh , Goyal Mandip , Kumari Ritu , Sungchol Kim
Published: March 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has created a great burden on governments and the medical fraternity globally. Many clinical studies from the Indian system of Traditional Medicines [Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH)] have been carried out to find appropriate solutions. Through a living systematic review and meta-analysis, this study aims to determine the effectiveness of the Traditional System of Indian Medicine (AYUSH system) in lowering the incidence, duration, and severity of COVID-19.

Methods: We will search the following databases: Pubmed; the Cochrane central register of controlled trials (CENTRAL); the Clinical Trials Registry - India (CTRI); Digital Helpline for Ayurveda Research Articles (DHARA); AYUSH research portal; Google scholar and World Health Organization (WHO) COVID-19 database. Clinical improvement, WHO ordinal scale, viral clearance, incidences of COVID-19 infection, and mortality will be considered as primary outcomes. Secondary outcomes will be use of O2 therapy or mechanical ventilator, admission to high dependency unit or emergency unit, duration of hospitalization, the time to symptom resolution, and adverse events. Data will be synthesized, with RevMan 5.4 tool and the risk of bias will be assessed with RoB 2 (for RCTs) and ROBINS I (for NRSIs). Certainty of evidence will be assessed through the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) tool. The review will be updated bi-monthly with two updates.

Conclusion: This living systematic review will be the first to address AYUSH interventions in COVID-19, synthesizing the full spectrum of Indian Traditional System of Medicine against COVID-19. It will facilitate professionals, guideline developers, and authorities with up to date synthesis on interventions periodically to make health-care decisions on AYUSH therapies in the management of COVID-19.
How Indian foreign policy negotiates federalism: a case study of the role of the constituent states
Authors: Chatterjee Shibashis , Maitra Sreya
Published: March 2022

India’s centre-heavy federalism suffered dual downturns in the 1990s, with the tides of globalization and economic liberalization challenging the sanctity of borders and the incidence of coalition politics increasing the salience of regional equations and demands. But Indian foreign policy in the 1990s remained the almost exclusive preserve of the Centre, ruled by several coalitions of political parties like the National Front (1989-1996), United Front (1996-1998). As Prime Minister Narendra Modi’s popular yet controversial regime is poised at the middle of its second term in 2022 (beginning in 2019), the continued showcasing of the Centre’s leadership in foreign policy decisions, high-profile bilateral and multilateral engagements, bold collisions with uneasy neighbours, are only matched with the unilateralism exhibited within the borders. Given the oft-reported instances of acute voices of assertions by the states on various issues ranging from illegal and forced migration, resource-sharing, or economic development involving neighbouring countries, a stock-taking is needed, to explore how genuinely federal is India’s foreign policy. In other words, the role of the constituent states in leveraging influence and bargaining for their due share of active involvement as stakeholders, merits critical academic intervention. When tested against real cases, two observations can be made. The dynamics shaping federalism and foreign policy may not just involve the Centre and the states but involve local/regional factors and influences from across international borders as well. Second, there is no causal link between the nature of the government in power at the Centre, Union-state political equations, and the imperatives across the borders between provinces and neighbouring countries. This study examines three case studies; West Bengal, Assam, and the Northeast, to reveal that foreign policy operates within the constitutionally designed structures of federalism in India by negotiating recurrent complexities of politics and deceives regional stakeholders or states with narratives of inclusiveness.