bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on the relationship between serum indoxyl sulfate concentration and iron dynamics index in patients with end-stage kidney disease: a cross-sectional study
Authors: Yoshida Takuya , Tsujimoto Masayuki , Kawakami Sachiyo , Fujioka Haruno , Irie Yuko , Nakatani Saki , Iso Ayako , Sugiyama Ayaka , Miyake Mizuho , Hirato Kazumi , Tanaka Rie , Oda Tomoko , Furukubo Taku , Izumi Satoshi , Yamakawa Tomoyuki , Minegaki Tetsuya , Nishiguchi Kohshi
Published: November 2022

Background

Chronic kidney disease (CKD) is frequently associated with renal anemia. Erythropoiesis-stimulating agent-hyporesponsive anemia is often caused by iron deficiency in patients with CKD. We hypothesized that high accumulation of indoxyl sulfate, a uremic toxin, accelerates iron deficiency in patients with CKD. The aim of this study was to clarify whether the accumulation of indoxyl sulfate is a cause of iron deficiency in patients with CKD. Therefore, we investigated the association between serum indoxyl sulfate concentration and iron dynamics in patients with end-stage kidney disease (ESKD).

Methods

We performed a cross-sectional study on 37 non-dialyzed patients with ESKD, who were hospitalized to undergo maintenance hemodialysis treatment at Shirasagi Hospital. Serum indoxyl sulfate concentration, iron dynamics parameters and other laboratory data were measured immediately before the initiation of hemodialysis treatment. Clinical characteristics were obtained from electronic medical records.

Results

The estimated glomerular filtration rate (eGFR) of 37 patients with ESKD was 5.08 (3.78–7.97) mL/min/1.73 m2(median [range]). Serum ferritin and transferrin saturation (TSAT) were 90 (10–419) ng/mL and 20 (8–59)% (median [range]), respectively. Serum indoxyl sulfate concentration was 62 (11–182) μM (median [range]). Serum indoxyl sulfate concentration was inversely correlated with serum ferritin level (ρ = − 0.422,p = 0.011), but not with TSAT, age, gender, eGFR and c-reactive protein (CRP) in 37 patients. In eight patients taking iron-containing agents, serum indoxyl sulfate concentration was strongly correlated with serum ferritin level (ρ = − 0.796,p = 0.037); however, in 29 patients not taking an iron-containing agent, this correlation was not observed (ρ = − 0.336,p = 0.076). In the multivariate analysis including age, gender, eGFR and CRP, the correlation between serum indoxyl sulfate concentration tended to be, but not significantly correlated with serum ferritin level in 37 patients (regression coefficient = − 54.343,p = 0.137).

Conclusion

Our study suggests that serum accumulation of indoxyl sulfate is one of causes not to increase serum ferritin level in patients with ESKD taking an iron-containing agent. Further clinical study is needed to reveal the appreciable relationship between serum ferritin and serum indoxyl sulfate.
Results of the 2018 Japan Society for Blood Purification in Critical Care survey: current status and outcomes
Authors: Abe Masanori , Shiga Hidetoshi , Tatsumi Hiroomi , Endo Yoshihiro , Kikuchi Yoshihiko , Suzuki Yasushi , Doi Kent , Nakada Taka-Aki , Nagafuchi Hiroyuki , Hattori Noriyuki , Hirohashi Nobuyuki , Moriguchi Takeshi , Yamaga Osamu , Nishida Osamu
Published: November 2022

Background

The Japan Society for Blood Purification in Critical Care (JSBPCC) has reported survey results on blood purification therapy (BPT) for critically ill patients in 2005, 2009, and 2013. To clarify the current clinical status, including details of the modes used, treated diseases, and survival rate, we conducted this cohort study using data from the nationwide JSBPCC registry in 2018.

Methods

We analyzed data of 2371 patients who underwent BPT in the intensive care units of 43 facilities to investigate patient characteristics, disease severity, modes of BPTs, including the dose of continuous renal replacement therapy (CRRT) and hemofilters, treated diseases, and the survival rate for each disease. Disease severity was assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores.

Results

BPT was performed 2867 times in the 2371 patients. Mean APACHE II and SOFA scores were 23.5 ± 9.4 and 10.0 ± 4.4, respectively. The most frequently used mode of BPT was CRRT (67.4%), followed by intermittent renal replacement therapy (19.1%) and direct hemoperfusion with the polymyxin B-immobilized fiber column (7.3%). The most commonly used anticoagulant was nafamostat mesilate (78.6%). Among all patients, the 28-day survival rate was 61.7%. CRRT was the most commonly used mode for many diseases, including acute kidney injury (AKI), multiple organ failure (MOF), and sepsis. The survival rate decreased according to the severity of AKI (P = 0.001). The survival rate was significantly lower in patients with multiple organ failure (MOF) (34.6%) compared with acute lung injury (ALI) (48.0%) and sepsis (58.0%). Multivariate logistic regression analysis revealed that sepsis, ALI, acute liver failure, cardiovascular hypotension, central nervous system disorders, and higher APACHE II scores were significant predictors of higher 28-day mortality.

Conclusion

This large-scale cohort study revealed the current status of BPT in Japan. It was found that CRRT was the most frequently used mode for critically ill patients in Japan and that 28-day survival was lower in those with MOF or sepsis. Further investigations are required to clarify the efficacy of BPT for critically ill patients.

Trial Registration: UMIN000027678.
Multiple sclerosis patients’ response to COVID-19 pandemic and vaccination in Egypt
Authors: Gad Adel Hassanein Elsayed , Ahmed Sandra Mohamed , Garadah Mostafa Yahya Abdelmohsen , Dahshan Ahmed
Published: November 2022

Background

On 11 March 2020, WHO declared COVID-19 has become a pandemic. This had an impact on everyday activity for every person. For special groups such as multiple sclerosis patients, the situation is a little bit confusing. In this study, COVID-19 infection impact on MS patients, willingness for vaccination, percentage of vaccinated patients and adverse effects of different vaccines were investigated. This cross-sectional descriptive study included 160 Egyptian MS patients. Demographic and clinical characteristics of all patients were extracted from their files MS unit archives. All these patients were contacted either by telephone and an oral informed consent was taken or in-person on their scheduled follow-up and informed written consent was taken to join this study. Patients were asked about: COVID-19 infection, severity of infection, and vaccination using a special questionnaire developed by the authors.

Results

Only 39 (24.3%) patients have had COVID-19 infection with confirmed diagnosis. Most of infected patients (84.6%) were treated at home with no need for hospital admission. Five patients (12.8%) reported symptom suggestive of relapses after COVID-19 infection. Sixty-five patients (40.6%) were vaccinated against COVID-19. Out of these vaccinated patients, 22 patients (33%) developed adverse events from vaccine. These adverse events were self-limiting and related to local injection site and general manifestations. MS relapse after vaccination was reported in 7.7% of the vaccinated group.

Conclusion

Prevalence of COVID-19 infection and severity of infection were equal to general population. Risk of relapse is low either with infection or vaccination. No severe adverse events were reported after vaccination.
Fasciola hepatica extract suppresses fibroblast-like synoviocytes in vitro and alleviates experimental arthritis
Authors: Dalmolin Suelen Pizzolatto , Pedó Renata Ternus , da Rosa Thales Hein , de Souza Silva Jordana Miranda , Farinon Mirian , Gasparini Maria Luísa , Chiela Eduardo Cremonese Filippi , Paz Ana Helena , Sehabiague Martín Pablo Cancela , Ferreira Henrique Bunselmeyer , do Espírito Santo Rafaela Cavalheiro , da Costa Gonçalves Fabiany , Xavier Ricardo Machado
Published: November 2022

Background

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial inflammation, fibroblast-like synoviocytes (FLS) activation and joint destruction. Fasciola hepatica is a platyhelminth that releases excretory-secretory immunomodulatory products capable of suppressing the Th1 immune response. Despite the effectiveness of available treatments for inducing disease remission, current options are not successful in all patients and may cause side effects. Thus, we evaluated the therapeutic potential of F. hepatica extract on FLS from RA patients and arthritis models.

Methods

FLS were isolated from synovial fluid of RA patients, cultured, and exposed to F. hepatica extract (60, 80, and 100 µg/ml) for different time points to assess cell viability, adherence, migration and invasion. For in vivo experiments, mice with antigen (AIA) and collagen (CIA) induced arthritis received a 200 µg/dose of F. hepatica extract daily. Statistical analysis was performed by ANOVA and Student's t-test using GraphPad Prism 6.0.

Results

In vitro assays showed that extract decreased FLS cell viability at concentration of 100 µg/ml (83.8% ± 5.0 extract vs. 100.0% ± 0.0 control; p < 0.05), adherence in 20% (92.0 cells ± 5.8 extract vs. 116.3 cells ± 7.9 control; p < 0.05), migratory potential (69.5% ± 17.6 extract vs. 100.0% control; p < 0.05), and cell invasiveness potential through the matrigel (76.0% ± 8.4 extract vs. 100.0% control; p < 0.01). The extract reduced leukocyte migration by 56% (40 × 104 leukocytes/knee ± 19.00) compared to control (90.90 × 104 leukocytes/knee ± 12.90) (p < 0.01) and nociception (6.37 g ± 0.99 extract vs. 3.81 g ± 1.44 control; p < 0.001) in AIA and delayed clinical onset of CIA (11.75 ± 2.96 extract vs. 14.00 ± 2.56 control; p = 0.126).

Conclusion

Our results point out a potential immunomodulatory effect of F. hepatica extract in RA models. Therefore, the characterization of promising new immunomodulatory molecules should be pursued, as they can promote the development of new therapies.

Trial registration Collection of synovial liquid and in vitro procedures were approved by the Ethics Committee with Certificate of Presentation of Ethical Appreciation in Plataforma Brasil (CAAE: 89044918.8.0000.5327; date of registration: 26/07/2018).
Reliability of cross-regional applications of global fire danger models: a Peruvian case study
Authors: Podschwit Harry , Jolly William , Alvarado Ernesto , Verma Satyam , Ponce Blanca , Markos Andrea , Aliaga-Nestares Vannia , Rodriguez-Zimmermann Diego
Published: November 2022

Background

Fire danger indexes (FDIs) are used as proxies for fire potential and are often developed for specific locations. For practical purposes, the extrapolation of the underlying calculations into novel locations is common, but it is generally uncertain if the relationships between FDIs and fire potential observed in the environment in which the index was developed are equally relevant in others. For example, although a topographically, ecologically, and climatologically complex country, f ire danger forecasts in Peru use a standard set of nationwide thresholds applied to the Fire Weather Index. In this study, we validate the underlying assumption that weather-fire relationships are spatially uniform within Peru by (1) making cross-regional comparisons of the statistical distributions of four FDIs—Burning Index, Energy Release Component, Fire Weather Index, and Keetch-Byram Drought Index, and (2) making cross-regional comparisons of the expected daily MODIS hotspot count percentiles conditioned on FDI values.

Results

Significant regional differences in the distributions of daily FDI values were observed in every pair of regions within Peru, and with the exception of a pair of regions within the Amazon, little data ($$<90$$<90days) were necessary to detect these differences. After controlling for FDI values and seasonal and annual effects with regressions, differences in predicted hotspot percentiles were common, differing by as much as 47 percentage points. Across the pairs of regions, the magnitude of these differences tended to decrease as climatic similarity increased, but some counterexamples were also apparent.

Conclusions

The noticeable differences in the distributions of daily FDI values suggest that a standard set of breakpoints may produce unreliable inferences regarding fire potential. We also find that even if the climatic conditions were similar across Peru, the same FDI values in two locations can produce substantially differing predictions of wildfire activity. This suggests that other factors besides FDI values can strongly mediate wildfire activity and that better fire potential predictions could be produced if these factors are accounted for.
Formulation development, optimization and characterization of Pemigatinib-loaded supersaturable self-nanoemulsifying drug delivery systems
Authors: Reddy Muthadi Radhika , Gubbiyappa Kumar Shiva
Published: November 2022

Background

Pemigatinib is a small molecule tyrosine kinase inhibitor of fibroblast growth factor receptor inhibitors. The oral bioavailability of Pemigatinib is constricted due to its limited solubility at physiological pH. It is essential to develop a novel formulation of Pemigatinib to improve the intrinsic solubility and to reduce the pharmacokinetic variability. Self-nanoemulsifying drug delivery system is an effective, smart and more adequate formulation approach for poorly soluble drugs. Different from conventional self-nanoemulsifying drug delivery system, a supersaturable self-nanoemulsifying drug delivery system of Pemigatinib was prepared by using a supersaturation promoter.

Results

Among all the oils, Captex® 300 have shown maximum solubility of Pemigatinib. Considering the solubilization potential and emulsification ability Kolliphor®RH 40 was selected as surfactant. Transcutol®HP was selected as co-surfactant. The composition of oil, surfactant and co-surfactant was identified using phase diagrams and further adjusted by simplex-lattice design. HPMC K4M as precipitation inhibitor at 5% concentration resulted in effective supersaturating with increased self-emulsification time. The droplet of sSNEDDS ranges from 166.78 ± 3.14 to 178.86 ± 1.24 nm with PDI 0.212 – 0.256, which is significantly smaller than that observed with plain SNEDDS. TEM images revealed the spherical shape of the nanodroplets. The final optimized formulation formed spontaneous nanoemulsion within 15 secs when added to physiological fluids. The percent transmittance of the diluted formulation was found to be 99.12 ± 0.46. The viscosity was found to be 574 ± 26 centipoises indicating the good flow ability. FTIR and DSC studies indicated the amorphization of the drug. The dissolution profile of sSNEDDS indicated the faster release of drug compared to both pure drug suspension and SNEDDS formulation. The drug release rate is directly proportional to the concentration of the drug. The drug release from the insoluble matrix is a square root of time-dependent Fickian diffusion process. The formulation was found to be stable and transparent at all pH values and the percent transmittance was more than 95%. Any kind of separation or precipitation was not observed at different temperatures cycles. No significant difference was observed with all the samples exposed at different storage conditions.

Conclusions

This study demonstrated the feasibility of stabilizing and improving the in-vitro performance of self-nanoemulsifying drug delivery systems of Pemigatinib by incorporating HPMC K4M as precipitation inhibitor.
Squamous cell carcinoma associated with an active cutaneous leishmaniasis in immunocompetent patient: case presentation of an unlikely association and literature—review
Authors: Ouattassi Naouar , Titou Anouar , Hammas Nawal , Kamal Dounia , El Alami Mohamed Nouredine El Amine
Published: November 2022

Background

Association between leishmaniasis and malignancy can be classified into four categories: leishmaniasis mimicking malignancy, leishmaniasis co-existing with malignancy, malignancy developing in patients with leishmaniasis scar, and leishmaniasis developing in patients with malignancy. In immunocompetent patients, the main form of association is cutaneous squamous cell carcinoma (cSCC) developing within cutaneous leishmaniasis scar years after cutaneous leishmaniasis is cured. Association of active cutaneous leishmaniasis and cSCC is exceptional, we are aware of two more cases.

Case presentation

A 30-year-old man presented with 2 years history of an unhealed wound on the dorsum nasi. As there still exist few sites of leishmaniasis in Morocco, systematic screening for leishmania was performed. Leishmania bodies were identified on slit skin smear by Giemsa staining. The patient received local antibiotic and on-site injections of 4 cc of meglumine antimonate for 2 months without any improvement. The lesion volume has increased significantly, a biopsy revealed an invasive squamous cell carcinoma. After staging assessment, the patient underwent a complete removal of the nasal tumor with a 1-cm margin, associated with right modified radical neck dissection. Histopathological examination confirmed the diagnosis of SCC with no lymph nodes metastasis. Nasal reconstruction was performed 2 weeks later using a frontal flap. Oncology meeting board advised adjuvant radiation on the tumor. The patient is followed up regularly and remains free of disease for a year now.

Conclusion

Although many cancers are related to infection (viral or parasitic), there is no proven link between leishmaniasis and malignancy. However, there are many etiopathogenic theories based on pathology finding that involve chronic inflammation inducing dysplasia, mitotic abnormalities, and expression of p53.
Addressing Osteonecrosis: A preventable catastrophe - A multi-center study
Authors: Alam Mafaza , Khan Zahid Mehmood , Alam Laima , Faraid Varqa , Khan Adnan
Published: November 2022

Objectives: To assess the knowledge of medical doctors about osteonecrosis who prescribe radiotherapy and bisphosphonates and dentists who receive these patients with such risk factors.

Methods: This cross sectional multicenter study was carried out from 15th October 2021 to 20th November 2021 in different set-ups of Pakistan. A validated and piloted questionnaire was sent to dental and non-dental doctors working in different set-ups of Pakistan through email. All data was analyzed in SPSS version 22 with p value <0.05 being significant.

Results: A total of 400 completed responses were received. Only 58% and 67% of the participants were actively educating their patients regarding the hazards of bisphosphonate and radiotherapy, respectively whereas only 45% of the medical doctors referred their patients to dentists before prescribing bisphosphonates and/or radiotherapy. Although the medical doctors had a statistically better knowledge of the definition of osteonecrosis, overall both the dental and non-dental doctors performed poorly regarding answering the questions pertaining to definition, clinical features and risk factors. The dental doctors also showed a poor performance for more technical and in depth questions that was statistically related to lesser work experience, working in a tertiary care facility and previous exposure to such patients.

Conclusion: The inadequate awareness of dentists and physicians about the prevention and management of osteonecrosis of jaw is alarming. Efforts should be undertaken to raise the knowledge of dentists and physicians in this regard.

doi: https://doi.org/10.12669/pjms.39.1.5985

How to cite this: Alam M, Khan ZM, Alam L, Faraid V, Khan A. Addressing Osteonecrosis: A preventable catastrophe - A multi-center study. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.5985

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.
Cardio protective effect of nicorandil in reperfusion injury among patients undergoing primary percutaneous coronary intervention
Authors: Ilyas Maria , Dr. Mudassar Noor  , Dr. Hamid Sharif Khan  , Dr. Sauleha Haroon  , Dr. Kulsoom Farhat  , Dr. Shabana Ali
Published: November 2022

Objectives: To evaluate the effect of nicorandil in prevention of reperfusion injury during primary percutaneous coronary intervention by thrombolysis in myocardial infarction flow grade scoring.

Methods: A total of 140 patients from Rawalpindi Institute of Cardiology were enrolled in this study conducted from 7th September to 10th of October 2021. These participants were allocated into two major groups. Control group received conventional acute coronary syndrome protocol regimen only whereas experimental group was given nicorandil along with conventional acute coronary syndrome protocol. During primary percutaneous coronary intervention, thrombolysis in myocardial infarction flow grade scoring was analyzed and compared.

Results: Majority of participants in nicorandil group achieved thrombolysis in myocardial infarction Grade-3 scoring which indicated reduced rate of no reflow phenomenon as compared to control group. A statistically significant difference was noted in score of both groups (p value = 0.001) signifying prophylactic use of nicorandil before primary percutaneous coronary intervention along with conventional acute coronary syndrome protocol is superior to only conventional acute coronary syndrome protocol regimen to cases in the control group.

Conclusion: Use of nicorandil in ST elevated myocardial infarction patients before primary percutaneous coronary intervention prevents reperfusion injury thus decreasing the risk of post percutaneous coronary intervention complications and reducing mortality rate in cardiac patients suggesting its significant cardio protective role.

doi: https://doi.org/10.12669/pjms.39.1.6034

How to cite this: Ilyas M, Noor M, Khan HS, Haroon S, Farhat K, Ali S. Cardio protective effect of nicorandil in reperfusion injury among patients undergoing primary percutaneous coronary intervention. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6034

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.
Posterior fossa epidural hematoma: A 6-year management experience
Authors: Sharafat Seema , Azam Farooq , Khan Zahid
Published: November 2022

Objective: Through this study, we sought to evaluate the management of posterior fossa extradural hematoma (PFEDH).

Methods: An observational study was conducted at the Neurosurgery Department of Lady Reading Hospital in Peshawar from January 2015 to December 2020. All patients who had a traumatic acute extradural hematoma (EDH) of the posterior fossa were included, irrespective of age and gender. The clinical predictors and outcomes were assessed, including the CT-scan findings and Glasgow Coma Scale (GCS) score.

Results: A total of 104 cases with posterior fossa extradural hematoma were identified from 1252 extradural hematoma patients admitted during the study period. The mean age of the enrolled patients was 18.17 ± 14.31 years. Most of the patients were male (65.39%) and belonged to the pediatric age group, i.e., < 15 years (60.6%). CT scan brain was done in all the cases for diagnosis. In 68.3% of cases, an associated occipital bone fracture was observed. Surgery was done in almost 71.2% of cases, and most of the patients experienced good recovery after surgery, as indicated by the GOS score. Linear regression model revealed that treatment (β=-0.20, p=0.038), time duration between surgery and trauma (β=0.43, p=0.000) and GCS category (β=-0.47, p=0.000) were significantly associated with PFEDH outcomes.

Conclusion: In conclusion, PFEDH was frequent among males and the pediatric age group. Serial CT brain is highly recommended in all suspected cases for early diagnosis.

doi: https://doi.org/10.12669/pjms.39.1.6408

How to cite this: Sharafat S, Azam F, Khan Z. Posterior fossa epidural hematoma: A 6-year management experience. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6408

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.
Serum procalcitonin, C-reactive protein, and neutrophil gelatinase-associated lipocalin in early diagnosis of acute kidney injury after upper urinary tract calculi
Authors: Hao Shirui , Guo Yin , Zhao Ruiyan , Wang Ting , Li Shujun
Published: November 2022

Objective: To investigate the value of serum procalcitonin(PCT), C-reactive protein(CRP), and neutrophil gelatinase-associated lipocalin(NGAL) in the early diagnosis of acute kidney injury(AKI) after upper urinary tract calculi(UUTC).

Methods: The clinical data of 86 patients who underwent UUTC surgery in our hospital from March 2020 to April 2021 were analyzed retrospectively(Approval number: 20211205L, Date: 2021-12-21). Patients were divided into an AKI group (AKI≥7 days after the operation) and a Non-AKI group. PCT, CRP, and NGAL concentrations were compared before and two hours after the operation. Multivariate logistic regression analysis was used to identify risk factors affecting the early occurrence of AKI post-operation. The receiver operating characteristic curve evaluated PCT, CRP, and NGAL in the early AKI diagnosis.

Results: A total of 86 patients (30 with AKI and 56 with Non-AKI) were included. Kidney injury molecule-1(KIM-1) and urinary microalbumin(mAlb) concentrations were significantly higher in the AKI group (P<0.05). PCT, CRP, and NGAL concentrations were significantly higher two hours after the operation than before the operation (P<0.05). KIM-1 levels and elevated PCT, CRP and NGAL concentrations affected the establishment of AKI after UUTC. The sensitivity of PCT, CRP, and NGAL in evaluating AKI after UUTC were 81.17%, 84.42%, and 79.02%; the specificity was 62.31%, 71.48%, and 73.32%; and the AUC was 0.812, 0.885 and 0.804 respectively.

Conclusions: PCT, CRP, and NGAL concentrations in patients with AKI after UUTC were significantly increased two hours after the operation, which can be used for the early diagnosis of AKI after UUTC operation.

doi: https://doi.org/10.12669/pjms.39.1.6694

How to cite this: Hao S, Guo Y, Zhao R, Wang T, Li S. Serum procalcitonin, C-reactive protein, and neutrophil gelatinase-associated lipocalin in early diagnosis of acute kidney injury after upper urinary tract calculi. Pak J Med Sci. 2023;39(1):---------.  doi: https://doi.org/10.12669/pjms.39.1.6694

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.
Factors affecting recurrence in sigmoid volvulus
Authors: Korkut Ercan , Peksoz Rifat , Disci Esra , Atamanalp Sabri Selcuk
Published: November 2022

Objectives: Recurrence is a relatively common outcome following endoscopic decompression in sigmoid volvulus (SV). This study aims to evaluate the factors affecting recurrence in SV.

Methods: In 434 patients with SV treated between June 1986 and January 2022, probable recurrence-affecting factors including age, age of SV onset, gender, dietary habit, defecation habit, altitude of living area, and SV attack count were analyzed in prospectively collected data.

Results: Of 434 patients, 111 (25.6%) had recurrent SV with mean 1.6 ± 2.3 of volvulus episodes (range: 1-21 attacks). SV recurrence demonstrated a significant linear increase with age (14.3%, 17.1%, 21.5%, and 29.9%, respectively, in young, middle aged, mature, and elderly patients, p < 0.001). Recurrent SV was also significantly higher in male gender (28.5% vs 12.7%, p = 0.004), high-fiber diet habit (32.9% vs 17.7%, p < 0.001), and living at high altitude (26.9% vs 12.5%, p = 0.047). Although SV recurrence was higher in patients with chronic constipation, the difference was not significant (36.7% vs. 20.3%, p = 0.594). When compared with that of the patients with mature onset or elderly onset patients, SV attack count was significantly higher in young-onset cases (1.3±0.9 and 1.1±0.3 vs 4.6±6.9, p < 0.001).Conclusion: Elderliness, early-onset, maleness, high-fiber diet habit, high altitude, and most likely chronic constipation may be the practical clinical parameters of recurrent SV. These parameters, as well as the presence of previous SV episode history, must be considered in the decision-making process in the elective treatment of SV.

doi: https://doi.org/10.12669/pjms.39.1.6882

How to cite this: Korkut E, Peksoz R, Disci E, Atamanalp SS. Factors affecting recurrence in sigmoid volvulus. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6882

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.
Improving the quality of Peer Review and accelerating the peer review process
Authors: Jawaid Shaukat Ali
Published: November 2022

doi: https://doi.org/10.12669/pjms.39.1.7236

How to cite this: Jawaid SA. Improving the quality of Peer Review and accelerating the peer review process. Pak J Med Sci. 2023;39(1):1-3.  doi: https://doi.org/10.12669/pjms.39.1.7236

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.
A brief guide to immunisation and the immunocompromised child or young person
Authors: Watson Chloe , Davies Barbara , Camara Claire
Published: November 2022

Immunisation in children with a compromised immune system is not straightforward. Children with autoimmune disorders are especially at risk of vaccine-preventable diseases due to their underlying disease and the immunosuppressive treatment that is often required for a long period. This article explores some of the complexities that need to be considered when planning individual vaccination programmes.
Assessment of motor limb strength by neuroscience nurses: variations in practice and associated challenges
Authors: Cook Neal F , Braine Mary E , O'Rourke Ciara , Nolan Siobhan
Published: November 2022

Background:

Limb strength is a central component of neurological assessment and monitoring in nursing practice, yet there is a lack of research examining the tools used by nurses or challenges nurses encounter when using these tools. The evidence base is lacking to inform effective practice and the underpinning educational approaches.

Aim:

To determine which tools are used by UK and Irish neuroscience nurses in the assessment of limb strength and the associated challenges and variations in practice.

Methods:

This study used an online self-reported survey design to ascertain which tools neuroscience nurses used and their experience of using these (n=160).

Findings:

Practices varied, with a dominance of two tools being used in practice: the Medical Research Council scale and the ‘normal power’ to ‘no movement’ scale found on the neurological observation chart. Most respondents used the same tool across all conditions.

Conclusion:

This study highlights variations in assessment practice and the absence of a sound evidence base behind choice of motor limb strength assessment tools used.
Supporting nursing, midwifery and allied health professional teams through restorative clinical supervision
Authors: Baldwin Sharin , Coyne Tracey , Kelly Patricia
Published: November 2022

The mental health and wellbeing of healthcare staff have been significantly affected by the demands resulting from the recent COVID-19 pandemic. Restorative supervision is a type of clinical supervision that supports reflective practice that can help build practitioners' resilience by focusing on the individual's experience, aiming to sustain their wellbeing and their motivation at work. This model has been shown to reduce stress and burnout and increase compassion satisfaction. This article discusses the implementation of a restorative clinical supervision programme used to support staff wellbeing in nursing, midwifery and allied health professional teams in a large London-based NHS trust.
Civility and kindness: not just niceties, but fundamental pillars of quality care
Authors: Foster Sam
Published: November 2022

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the areas for improvement arising from the latest Kirkup Report, in particular the importance of creating and sustaining kinder, more civil workplaces
Hypertrophic scar management
Authors: Edwards Jacky
Published: November 2022

Scarring has major psychological and physical repercussions. Scars are often considered trivial, but they can be disfiguring and aesthetically unpleasant and may cause severe itching, tenderness, pain, sleep disturbance, anxiety, depression and disruption of daily activities. It is more efficient to prevent hypertrophic scars than treat them; early diagnosis of a problem scar can considerably impact the overall outcome. Therefore, nurses need to be as knowledgeable about scar products as they are about wound products, and their responsibility should not end once the wound has healed. Appropriate management of the scar will ensure that the wound remains healed and that the patient is happy with the outcome. The nurse is ideally placed to ensure that scars are appropriately identified and treated as early as possible.
Use of ankle–brachial pressure index to assess patient suitability for lower limb compression
Authors: Cain Matthew , Ousey Karen , Atkin Leanne
Published: November 2022

Background:

Compression therapy is a safe, effective treatment for lower leg conditions such as lymphatic insufficiency and venous hypertension. The most common method of arterial assessment is the calculation of a patient's ankle–brachial pressure index (ABPI). The need for ABPI is highlighted in many best practice statement and local policies. ABPI compares the arterial flow of the arms and the legs, providing a ratio used to determine the presence and severity of peripheral artery disease and assess whether a patient is suitable for compression therapy.

Aim:

This study critically reviews and analyses findings from contemporary literature with the aim of evaluating the effectiveness of the ABPI screening tool.

Method:

A structured literature review using a narrative approach was carried out.

Results:

Four studies were identified for inclusion, which involved medical, nursing and allied health professional staff in primary and secondary care, with a total of 51 patients. Analysis generated eight themes: appropriateness of the ABPI tool; clinician education; referral process; access to appropriate equipment; lack of time to conduct the assessment; competence; associated costs; and role definition.

Conclusion:

It is important to undertake a holistic assessment of the patient, incorporating ABPI assessment where not contraindicated. Further research to explore patient experience and safety when assessing a patient's suitability for lower limb compression therapy is required.
‘Seasons of myths and hollow joylessness’
Authors: Allingham Sue
Published: November 2022

A few years ago I called one of my updates for this magazine ‘Season of myths and mellow fruitfulness’ with apologies to Keats. At the time I was writing about the myths that had built up around the Early Years Foundation Stage Profile. Sadly these persist, with many more being added. As I am actually writing this looking at some lovely Autumn trees, I am going to use the same quote slightly differently to address some myths that are currently increasingly common. So the Keats variation for this month is ‘Seasons of myths and hollow joylessness’. Again with apologies to Keats.
Supporting EAL students in an international school
Authors: Thorpe Sarah
Published: November 2022

Arriving in a school or setting where no one speaks your language can bring many challenges. It can be a very positive experience, however it can also be distressing. Through her own teaching experience, Sarah Thorpe discusses how students might feel and gives us insight into how international schools can support them.
Imagine a world without Ofsted
Authors: Mooney Donna
Published: November 2022

Donna Mooney has worked within the early childhood sector in both London and New York City. She explores the comparisons between regulatory bodies across the two countries.
What's in the balance?
Authors: Vollans Caroline
Published: November 2022

Work-life balance is a term we hear thrown around a lot. It is something that is good for us, indeed necessary. We all need a healthy work-life balance and should be striving for it. Or should we? Is it as simple as that?
STEM in early years
Authors: Celinska Angelica
Published: November 2022

Deborah Parfitt, nursery manager, shares with us insight into her journey and current role in a STEM based nursery, which I was fortunate enough to visit and experience the embedding of STEM learning throughout everything the children do.
Five ways early years professionals can protect their wellbeing
Authors: Wigdortz Brett
Published: November 2022

Burnout is a real risk in the early years sector. It's been a contributing factor, exacerbated by the pandemic, to the loss of some of our sector's brightest talents. Emotional capacity and energy levels can feel depleted after caring for young children all day.
An Efficient Solution to User Authorization Query Problem in RBAC Systems Using Hierarchical Clustering
Authors: Rao K. Rajesh , Kolpe Aditya , Pradhan Tribikram , Zarpelão Bruno Bogaz
Published: November 2022

Role Based Access Control (RBAC) systems face an essential issue related to systematic handling of users’ access requests known as the User Authentication Query (UAQ) Problem. In this paper, we show that the UAQ problem can be resolved using Unsupervised machine learning following the guaranteed access request and Dynamic Separation of Duty relations. The use of Agglomerative Hierarchical Clustering not only improves efficiency but also avoids disordered merging of existing roles to create new ones and steers clear of duplication. With a time complexity of  O(n^3), the algorithm proves to be one of the fastest and promising models in state-of-the-art. The proposed model has been compared with the existing models and experimentally evaluated.
A Privacy Preserving Framework to Protect Sensitive Data in Online Social Networks
Authors: Shetty Nisha P. , Muniyal Balachandra , Yagnik Niraj , Banerjee Tulika , Singh Angad
Published: November 2022

In this day and age, Internet has become an innate part of our existence. This virtual platform brings people together, facilitating information exchange, sharing photos, posts, etc. As interaction happens without any physical presence in the medium, trust is often compromised in all these platforms operating via the Internet. Although many of these sites provide their ingrained privacy settings, they are limited and do not cater to all users’ needs. The proposed work highlights the privacy risk associated with various personally identifiable information posted in online social networks (OSN). The work is three-facet, i.e. it first identifies the type of private information which is unwittingly revealed in social media tweets. To prevent unauthorized users from accessing private data, an anonymous mechanism is put forth that securely encodes the data. The information loss incurred due to anonymization is analyzed to check how much of privacy-utility trade-off is attained. The private data is then outsourced to a more secure server that only authorized people can access. Finally, to provide effective retrieval at the server-side, the traditional searchable encryption technique is modified, considering the typo errors observed in user searching behaviours. With all its constituents mentioned above, the purported approach aims to give more fine-grained control to the user to decide who can access their data and is the correct progression towards amputating privacy violation.
The migrant labour regime and labour market intermediaries in the Taiwanese semiconductor industry
Authors: Chen Tingchien , Schiller Daniel
Published: November 2022

This article aims at developing a conceptual framework of the migrant labour regime (MLR) to better understand the agency of migrants in the semiconductor industry and illustrates this by the example of Filipino migrant workers in the Taiwanese semiconductor industry. Based on semi-structured interviews with key persons in the semiconductor industry, the study demonstrates the different roles of actors and connections within the global production network (GPN). With regard to the theoretical contribution, this article develops a conceptual framework of the MLR and addresses three central actors in multi-scalar networks, that is, state, firms, and LMI. The framework proposed in this article offers more analytical clarity to the primary empirical contribution. Therefore, the article identifies three key factors of dynamics in GPNs. First, it emphasises the importance of the state and firms in shaping the MLR. Regulatory institutions at the national level hinder upward mobility of migrant workers and long-term employment relationships because working contracts do not allow employees to change job tasks or employers freely. Second, the coordination between contract manufacturers and lead firms in the GPN leads to a transformation of the workplace, for example, intensification and increased flexibility. Third, LMIs play a role in facilitating and mediating migrant labour in the transnational labour market.
Diagnostic yield, complications, pathology and anatomical features in CT-guided percutaneous needle biopsy of mediastinal tumours
Authors: Skretting Ingegjerd Kristina , Ruud Espen Asak , Ashraf Haseem
Published: November 2022

Objectives

This study presents the experiences of percutaneous CT-guided needle biopsy at a university hospital in Norway.

Methods

A retrospective examination of all mediastinal biopsy procedures between April 2015 and August 2019 was performed at Akershus University Hospital in Norway. We registered patient and procedure characteristics, along with lesion pathology and characteristics including localization according to anatomical and Felson mediastinal compartments.

Results

The study included 48 procedures, conducted in 45 patients (29 men and 16 women) with a mean age of 60,5 years. Pneumothorax occurred in 12 procedures (60% of the transpulmonary procedures) and pneumomediastinum in 18 procedures (38%). Pneumothorax was only seen in procedures with transpulmonal access. Four of the pneumothorax cases required pleural drainage. Diagnostic yield was 96%. We found significant (p = 0,006), moderate to high association between anatomical compartment localization and histopathological diagnosis (Cramér’s V = 0,49) for tumours selected for CT-guided percutaneous biopsy. Felson’s compartment division on the other hand, did not show any significant associations.

Conclusion

We found CT-guided percutaneous needle biopsy of mediastinal tumours to be an effective and safe procedure with a diagnostic yield of 96%. The main complications were pneumothorax and pnumomediastinum, with a relatively low chest drainage rate. Anatomical mediastinum compartment showed a significant, moderate to high association with the histopathological diagnosis for tumours selected for percutaneous CT-guided biopsies, where most malignancies were seen in the anterior compartment.
Consequences of exposure to pollutants on respiratory health: From genetic correlations to causal relationships
Authors: D’Antona Salvatore , Castiglioni Isabella , Porro Danilo , Cava Claudia
Published: November 2022

Modern society grew rapidly over the last few decades and this led to an alarming increase in air pollutants and a worsening of the human health, especially in relation to the respiratory system. Indeed, chronic respiratory diseases were the third main cause of death in 2017, with over 3 million of deaths. Furthermore, the pollution has considerable consequences both for burden medical expenses and environmental. However, the mechanisms linking pollutants to the onset of these diseases remain unclear. Thus, in this study we addressed this problem through the United Kingdom BioBank database, analyzing 170 genome-wide association studies (103 related to respiratory diseases and 67 related to pollutants). We analyzed the genetic correlations and causal relationships of these traits, leveraging the summary statistics and bioinformatics packages such as Linkage Disequilibrium Score Regression and Latent Causal Variable. We obtained 158 significant genetic correlations and subsequently we analyzed them through the Latent Causal Variable analysis, obtaining 20 significant causal relationships. The most significant were between "Workplace full of chemicals or other fumes: Sometimes" and “Condition that has ever been diagnosed by a doctor: Asthma” and between “Workplace very dusty: Sometimes” and “Condition that has ever been diagnosed by a doctor: Emphysema or chronic bronchitis”. Finally, we identified single nucleotide polymorphisms independently associated with sveral pollutants to analyze the genes and pathways that could be involved in the onset of the aforementioned respiratory system disorders and that could be useful clinical target. This study highlighted how crucial are the air condition of the working environments and the type of transport used in the onset of respiratory-related morbidity. Based on that, we also suggested some interventions, in order to improve quality life and develop new and eco-friendly society and life style, such as improving indoor air circulation, the use of public transport and urban reforestation.
Statisztika-e az útleírás?
Authors: Szász Géza
Published: November 2022

In the French philosophical works devoted to the theme of travel during the second half of the 18th century, we note the persistence of reflection on the questions to be asked of the inhabitants of the countries visited. Several times, models accompany him. This phenomenon is inseparable from the development of French statistical thought and the perceptible „exploratory fever” of the last years of the Ancien Régime. The study reconstructs the process going from Diderot’s propositions to Volney’s Statistical Questions and to the descriptive statistics initiatives of the Napoleonian era. As it turns out, lists of questions form the basis of observation and description each time. This provides us with a very important detail to understand the recognition processes of the turn of the 18th-19th centuries.