bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparisons of drug-eluting balloon versus drug-eluting stent for the treatment of cancer patients presenting with acute myocardial infarction
Authors: Yang Yi-Xing , Zhang Huai-Peng , Li Chuang , Fu Yuan , He Kui-Zheng , Liu Xin-Ming , Wang Hong-Jiang , Xia Kun , Xu Li , Zhong Jiu-Chang , Chen Mu-Lei , Wang Le-Feng
Published: September 2023

Background

Treatment for cancer patients presenting with acute myocardial infarction (AMI) remains challenging. The objective of the study was to investigate the safety and efficiency of drug eluting balloon (DEB) versus drug eluting stent (DES) in this high-risk group.

Methods

Between 1st January 2017 and 1st January 2022, cancer patients admitted to Beijing Chaoyang Hospital with AMI were retrospectively enrolled. The primary endpoint was major adverse cardiovascular event (MACE). The secondary endpoints included major bleeding events, heart failure and cardiac complications.

Results

A total of 164 cancer patients presenting with AMI were included in the final analysis. Patients treated with DEB had a numerically lower rate of MACE than those treated with DES during a median follow-up of 21.8 months (22.9% vs. 37.1%, p = 0.23). Patients treated with DEB had a trend towards lower rate of major bleeding events than patients treated with DES (6.3% vs. 18.1%, HR 2.96, 95% CI [0.88, 9.92], p = 0.08). There were no significant differences between the two groups with regards to the rate of heart failure (4.2% vs. 9.5%, p = 0.32) and cardiac complications (0.0% vs. 2.6%, p = 0.56).

Conclusions

The present study demonstrated that in cancer patients with AMI, DEB had a trend towards lower rate of major bleeding events and a numerically lower rate of MACE compared with DES.

Graphical Abstract
Causal relationship between sarcopenia and osteoarthritis: a bi-directional two-sample mendelian randomized study
Authors: Yang Jiyong , Liu Peng , Wang Shuai , Jiang Tao , Zhang Yilong , Liu Wengang
Published: September 2023

Background

Previous studies have shown that osteoarthritis (OA) and sarcopenia (SP) are closely related to each other, but the causal relationships between them have not been established. The aim of this study was to investigate the causal associations between OA and SP via a bi-directional Mendelian randomization (MR) approach.

Methods

A bi-directional two-sample MR was adopted to research the causal relationship between SP and OA. The instrumental variables for SP and four types of OA: KOA, HOA, total knee replacement (TKR) and total hip replacement (THR) were derived from published large genome-wide association studies (GWAS). The inverse variance weighted (IVW), MR-Egger and weighted median estimator (WME) methods were used to estimate bi-directional causal effects.

Results

Low grip strength (GS) did not have a causal effect on four types of OA (KOA: OR = 1.205, 95% CI 0.837–1.734, p = 0.316; HOA: OR = 1.090, 95% CI 0.924–1.609, p = 0.307; TKR: OR = 1.190, 95% CI 1.084–1.307, p = 0.058; THR: OR = 1.035, 95% CI 0.792–1.353, p = 0.798), while appendicular lean mass (ALM) had a causal effect on four types of OA (KOA: OR = 1.104, 95% CI 1.041–1.171, p = 0.001; HOA: OR = 1.151, 95% CI 1.071–1.237, p < 0.001; TKR: OR = 1.114, 95% CI 1.007–1.232, p < 0.001; THR: OR = 1.203, 95% CI 1.099–1.316, p < 0.001). In the reverse direction, KOA or HOA did not have a significant causal effect on both GS and ALM (KOA-GS: OR = 1.077, 95% CI 0.886–1.309, p = 0.458; KOA-ALM: Beta = 0.004, p = 0.892; HOA-GS: OR = 1.038, 95% CI 0.981–1.099, p = 0.209; HOA-ALM: Beta = − 0.017, p = 0.196; TKR-GS: OR = 0.999, 95% CI 0.739–1.351, p = 0.997; TKR-ALM: Beta = 0.018, p = 0.501; THR-GS: OR = 1.037, 95% CI 0.978–1.101, p = 0.222; THR-ALM: Beta = − 0.023, p = 0.081).

Conclusions

The present study suggests that SP may have a causal effect on OA through changes in muscle composition rather than muscle strength, while little evidence was provided for the causal effect of OA on SP.
Overexpression of glutathione synthetase gene improving redox homeostasis and chicken infectious bursal disease virus propagation in chicken embryo fibroblast DF-1
Authors: Lin Jia , Min Rui , Yi Xiaoping , Zhuang Yingping
Published: September 2023

Infectious bursal disease (IBD) of chickens is an acute, high-contact, lytic infectious disease caused by infectious bursal disease virus (IBDV). The attenuated inactivated vaccine produced by DF-1 cells is an effective control method, but the epidemic protection demands from the world poultry industry remain unfulfilled. To improve the IBDV vaccine production capacity and reduce the economic losses caused by IBDV in chicken, cellular metabolic engineering is performed on host cells. In this study, when analyzing the metabolomic after IBDV infection of DF-1 cells and the exogenous addition of reduced glutathione (GSH), we found that glutathione metabolism had an important role in the propagation of IBDV in DF-1 cells, and the glutathione synthetase gene (gss) could be a limiting regulator in glutathione metabolism. Therefore, three stable recombinant cell lines GSS-L, GSS-M, and GSS-H (gss gene overexpression with low, medium, and high mRNA levels) were screened. We found that the recombinant GSS-M cell line had the optimal regulatory effect with a 7.19 ± 0.93-fold increase in IBDV titer. We performed oxidative stress and redox status analysis on different recombinant cell lines, and found that the overexpression of gss gene significantly enhanced the ability of host cells to resist oxidative stress caused by IBDV infection. This study established a high-efficiency DF-1 cells system for IBDV vaccine production by regulating glutathione metabolism, and underscored the importance of moderate gene expression regulation on the virus reproduction providing a way for rational and precise cell engineering.

Graphical Abstract
Genotoxic effect of Tamiflu and Adamine on DNA content in male albino mice
Authors: El-Alfy Nagla Zaky Ibrahim , Sakr Samia Mohamed , Mahmoud Mahmoud Fathy , Omar Heba Ahmed
Published: September 2023

Background

Tamiflu (Oseltamivir) and Adamine (Amantadine HCl) are antiviral drugs which are used for prevention and treatment for influenza. The present study was carried out to evaluate the effect of Tamiflu and Adamine on DNA content of hepatocytes of adult male albino mice.

Results

The results of comet assay showed that treatment with Tamiflu and Adamine significantly increased (P < 0.005) the mean of DNA damage in hepatocytes of the treated mice in time dependent manner compared to control one. However qRT-PCR analysis showed the mRNA expression of BAX in mice liver of all treated groups with Adamine was significantly increased (P < 0.05) after ten days of treatment while the same gene was significantly decreased in Tamiflu treated group after ten days compared to control one, While the treatment of mice with both drugs simultaneously showed a significant increase (P < 0.05) in expression of BCL-2 gene and a decrease in expression of BAX gene after fifteen days of treatment.

Conclusion

Tamiflu and Adamine had produced deleterious impacts on DNA content of hepatocytes of treated mice. Whereas, the results of treatments with Adamine indicated pathogenic impacts more than that induced by Tamiflu.
Chemical characteristics and anti-Escherichia coli mechanism of water-soluble extracts from yeast cell walls
Authors: Liu Yana , Dou Baojing , Gong Fayuan , Hu Junpeng , Zhou Meifang , Pan Yuanhu , Wu Xiangyun , Huang Xin , Xie Zhiwen , Hao Haihong , Cheng Guyue , Liu Zhenli , Wang Yulian
Published: September 2023

Background

Antimicrobial resistance is a threat to global public health and requires the development of new antibiotic alternatives to treat bacterial infection. Infection with Escherichia coli (E. coli) is the most common cause of diarrhea in pigs, especially in weaning piglets. The objective of this study was to characterize chemical properties of water-soluble extract (WSE) obtained from yeast cell wall, and study its antibacterial activity and antimicrobial mechanisms against E. coli.

Results

WSE was extracted from yeast cell wall by hot water, followed by anhydrous ethanol precipitation and deproteinization by Sevag method to obtain water-soluble polysaccharides (WSP, accounting for 76.53 ± 5.91% by weight of WSE). WSP was purified by DEAE-52 cellulose column and Sephadex G-100 column to obtain three fractions of polysaccharides, WSNP, WSAP-1 and WSAP-2. Physicochemical properties of them were then characterized. The average molecular weights of WSNP, WSAP-1 and WSAP-2 were 105,130, 94,581 and 91,247 Da, respectively. WSNP was composed of glucosamine (GlcN), glucose (Glc), mannose (Man) and glucuronic acid (GlcA) in a molar ratio of 8.6:55.2:34.4:1.8, WSAP-1 was consisted of GlcN, Glc and Man in a molar ratio of 10.9:42.2:46.9, and WSAP-2 was consisted of GlcN, galactose (Gal), Glc and Man in a molar ratio of 9.0:1.0:55.1:34.9. Spectral analysis indicated that all three polysaccharides had pyran polysaccharides, triple-helix structure, α- and β-glycosidic bond. The minimum inhibitory concentrations of WSE and WSP on E.coli were 25 mg/mL and 100 mg/mL, respectively. WSE can not only disrupt the integrity of the cell wall and membrane of E.coli, but also increase the permeability of the outer membrane.

Conclusions

Our research elucidated chemical composition and structure of WSNP, WSAP-1 and WSAP-2. WSE exerted its bactericidal activity by damaging the bacterial cell wall and membrane and increasing outer membrane permeability. Yeast cell wall products have been recommended as a potential alternative to antibiotics. This work provides more information, regarding chemical properties and anti-E. coli mechanism of WSE, and facilitates the application of yeast cell wall products as a promising antibiotic alternative in animal feed.
Optic nerve sheath fenestration for salvaging acutely threatened vision in Idiopathic Intracranial Hypertension - A two-year completed follow up
Authors: LATIF SIDRAH , Rizwan Amna , Khan Asad Aslam , Zahra Summan
Published: September 2023

Objectives: To determine the efficacy and safety of Optic Nerve Sheath Fenestration (ONSF) for salvaging acutely threatened vision in patients of Idiopathic Intracranial Hypertension (IIH).

Methods: This retrospective, interventional case series study was performed at Institute of Ophthalmology Mayo Hospital Lahore from September 2017 to September 2019. Nine patients diagnosed with Idiopathic Intracranial Hypertension as per Modified Dandy Criteria, underwent medial trans-conjunctival ONSF. Pre-operative and 1st day, 1st week, 1st month, 1st year, and 2nd year postoperative best-corrected logMAR visual acuities (BCVA) were recorded. Mean BCVA were calculated and compared using paired t-test. P-value <0.05 was taken as significant.

Results: All nine patients were female with a mean age of 24 years. The average best-correctedpre-operative logMAR visual acuity (BCVA) in the better eye was 0.5 ± 0.28 and in the worse eye was 1.0 ± 0.57. After the worse eye ONSF, at 1st week mean BCVA in better eyes was 0.27 ± 0.32 (p-value=0.001), while it was 0.43 ± 0.63 (p-value=0.006) in the worse eyes. At 2nd year follow-up after optic nerve sheath fenestration mean BCVA in better eyes was 0.30 ± 0.30 (p-value=0.002) and in worse eyes was 0.44 ± 0.63 (p-value=0.007). Four patients (44.4%) had a subconjunctival hemorrhage, two patients (22.2%) had binocular diplopia, one patient (11.1%) pre-septal cellulitis, and one patient (11.1%) had no improvement in vision because of pre-operative secondary optic atrophy. All patients had unilateral fenestration and bilateral improvement, six patients (66.67%) reported improvement in headache and successful tapering of medical therapy.

Conclusion: Optic nerve sheath fenestration is effective as well as a safe surgical procedure to salvage acutely threatened vision in patients of Idiopathic Intracranial Hypertension on maximal medical treatment.

doi: https://doi.org/10.12669/pjms.39.6.6441

How to cite this: Latif S, Rizwan A, Khan AA, Zahra S. Optic nerve sheath fenestration for salvaging acutely threatened vision in Idiopathic Intracranial Hypertension - A two-year completed follow up. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.6441

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.
Effects of Butylphthalide Combined with Fasudil on Inflammatory Factors, Cognitive Function and Vascular Endothelial Function in Patients with Subarachnoid Hemorrhage Complicated with Cerebral Vasospasm
Authors: Tian Nan , Gan Ning , Song Chaoyan , Su Fei , Xie Jing , Zhang Yu
Published: September 2023

Objective: To investigate the effect of butylphthalide combined with fasudil in the treatment of subarachnoid hemorrhage (SAH) with cerebral vasospasm (CVS) on inflammatory factors, cognitive function and vascular endothelial function.

Methods: It is a retrospective study in which a total of 104 patients with SAH with CVS admitted to Baoding First Central Hospital from July 2020 to February 2022 were selected and randomly divided into two groups by drawing lots. Patients in the control group were treated with basic symptomatic treatment, while those in the observation group were treated with butylphthalide soft capsule combined with fasudil hydrochloride injection on the basis of the control group. Before and after treatment, serum neuron specific enolase (NSE), tumor necrosis factor-α(TNF-α), interleukin-8(IL-8), hypersensitive C-reactive protein (CRP), Birmingham Cognitive Screen test (BCoS) score, serum soluble intercellular adhesion molecule-1(ICAM-1), serum endothelin-1(ET-1), vascular endothelial growth factor (VEGF) levels, and endothelium-dependent vasodilation function (FMD) in the two groups were compared.

Results: After treatment, the expression levels of NSE, TNF-α, IL-8 and CRP in the two groups were significantly decreased, and the expression levels of all indicators in the observation group were lower than that in the control group (p<0.05). After treatment, the scores of orientations, attention, memory, language, practice and action in the two groups were significantly increased, and the scores of all dimensions in the observation group were higher than those in the control group (p<0.05). After treatment, S-ICAM-1, ET-1, VEGF, FMD decreased in both groups, and all indicators of the observation group were lower than those of the control group, with statistically significant differences (p<0.05).

Conclusion: Butylphthalide combined with fasudil therapy was found as effective in reducing inflammatory factors, ameliorating cognitive function and vascular endothelial function in patients with subarachnoid hemorrhage complicated with cerebral vasospasm.

doi: https://doi.org/10.12669/pjms.39.6.6768

How to cite this: Tian N, Gan N, Song C, Su F, Xie J, Zhang Y. Effects of Butylphthalide Combined with Fasudil on Inflammatory Factors, Cognitive Function and Vascular Endothelial Function in Patients with Subarachnoid Hemorrhage Complicated with Cerebral Vasospasm. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.6768

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.
MBBS admission criteria as predictor of academic performance in a medical college of Pakistan
Authors: Iftikhar Sundus , Khalid Mahmood Cheema  , Iqra Aziz
Published: September 2023

Objective: To determine the relationship between scores obtained by students in assessments considered as admission criteria (cognitive and non-cognitive) with their academic performance in medical college.

Method: This correlational study used the data of students who got admission in Shalamar Medical and Dental College (SMDC) in 2015. Spearman correlation and Multiple regression tests were carried out to determine the relationship between admission criteria (Matric, FSC, MDCAT and MMI) and academic performance in medical college (pre-clinical and clinical years).

Results: There was significant positive correlation between scores obtained in MDCAT and pre-clinical years. When combined, MDCAT and MMI scores showed a significant positive correlation with scores obtained by students in clinical years. Scores obtained by students in pre-clinical years strongly correlated with their performance in clinical years. While scores obtained by students in FSC showed negative correlation with clinical year scores, significantly.

Conclusion: It is concluded that the tools used for admission criteria should include both cognitive and non-cognitive elements. MDCAT is a good predictor of academic performance in pre-clinical years however it can only predict performance in clinical years when combined with MMI since MMI assesses the non-cognitive attributes (communication, empathy, ethics etc.) required in those years. FSC should not be given weightage as admission criteria owing to a lot of variability in the exams and scoring of different academic boards of the country.

doi: https://doi.org/10.12669/pjms.39.6.6839

How to cite this: Iftikhar S, Cheema KM, Aziz I. MBBS admission criteria as predictor of academic performance in a medical college of Pakistan. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.6839

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical effect of Lymph Node Dissection in the Lateral Neck for the treatment of Papillary Thyroid Carcinoma: Endoscopic Thyroidectomy versus Open Surgery
Authors: Wang Guangyu , Zhang Gang , Gao Xiaoming
Published: September 2023

Objective: To compare the clinical effect, safety, and cosmetic effect of lymph node dissection via endoscopic thyroidectomy and open surgery in the treatment of papillary thyroid carcinoma (PTC).

Methods: A retrospective analysis was performed on 86 patients with PTC admitted to Baoding No.1 Central Hospital from January 2020 to December 2021. The enrolled patients were divided into the endoscopic thyroidectomy (n = 34) and open surgery (n = 52) groups based on different surgical methods. Further comparison was conducted on the surgical indexes, postoperative complications, changes of oxidative stress indexes, numerical score system (NSS) score of postoperative cosmetic satisfaction, scar length, and recurrence rate between the two groups.

Results: The operation time was longer, and the intraoperative blood loss was lower for the endoscopic thyroidectomy group than those for the open surgery group (P < 0.05). The oxidative stress indexes of the endoscopic thyroidectomy group were significantly better than those of the open surgery group (P< 0.05). The postoperative complication rate of the endoscopic thyroidectomy group was lower than that of the open surgery group (P < 0.05). At six months after surgery, the scar length was shorter, and the NSS score was higher in the endoscopic thyroidectomy group than those in the open surgery group (P < 0.05).

Conclusion: Endoscopic thyroidectomy for PTC is safe and effective, with mild stress response, fewer postoperative complications, and good cosmetic effect.

doi: https://doi.org/10.12669/pjms.39.6.7156

How to cite this: Wang G, Zhang G, Gao X. Clinical effect of Lymph Node Dissection in the Lateral Neck for the treatment of Papillary Thyroid Carcinoma: Endoscopic Thyroidectomy versus Open Surgery. Pak J Med Sci. 2023;39(6):---------.  doi: https://doi.org/10.12669/pjms.39.6.7156

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.
Role of coronary arteries in patients with Acute Coronary Syndrome
Authors: Usman Muhammad , Qureshi Hareem Zahra , Zahid Kiran , Bukhari Syed Naseem
Published: September 2023

Objective: To assess the role of coronary arteries in acute coronary syndrome patients who have survived sudden cardiac arrest.

Method: A cross-sectional study was conducted in Department of Cardiology at Chaudhary Pervaiz Elahi Institute of Cardiology, Multan from 1st May 2021 to 1st October 2021. A total of 203 patients who were diagnosed with sudden cardiac arrest were included as subjects of the study. Baseline data of all patients including age, sex, body mass index, history of smoking, diabetes and hypertension was noted. Coronary angiography was performed in all patients within five days after admission in hospital due to SCA.

Results: The average age of patients was 52.61±11.09 years. There were 140 (68.97%) male and 63 (31.03%) female patients. There were 131 (64.53%) patients with STEMI and 72 (35.47%) patients with Non-STEMI. LMCAD were diagnosed in 29 (14.29%) patients, RCA in 88 (43.35%) patients, LAD in 174 (85.71%) Patients and LCX in 41 (20.20%) patients.

Conclusion: LAD has the most involvement among the coronary arteries (85.71%) in patients with sudden cardiac arrest.

doi: https://doi.org/10.12669/pjms.39.6.7173

How to cite this: Usman M, Qureshi HZ, Zahid K, Bukhari SN. Role of coronary arteries in patients with Acute Coronary Syndrome. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7173

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.
Analysis of clinical efficacy of comprehensive nursing intervention on elderly patients with hypertension combined with hyperuricemia
Authors: Lu Na , Liu Jing , Cai Pan
Published: September 2023

Objective: To evaluate the clinical efficacy of the comprehensive nursing intervention on elderly patients with hypertension combined with hyperuricemia.

Methods: This was a retrospective study. One hundred elderly patients with hypertension combined with hyperuricemia admitted to the Baoding No.1 Central Hospital from May 2019 to May 2020 were included and randomly divided into two groups. Patients in the control group were treated with conventional nursing intervention, while those in the experimental group were treated with comprehensive nursing intervention based on the therapy in the control group. The improvement of compliance behavior, clinical efficacy, quality of life and satisfaction with hypertension combined with hyperuricemia before and after treatment were compared and analyzed between the two groups. The proportion of patients in both groups who developed gout or renal insufficiency was recorded, and their long-term treatment outcomes were compared and analyzed.

Results: After the comprehensive nursing intervention, the number of cases of compliance behaviors in the experimental group was significantly higher than that in the control group(p<0.05). The systolic and diastolic blood pressure and uric acid levels were significantly lower in the experimental group compared to the control group after the intervention(p=0.00). The scores of physical function, psychological function, social function and material life status improved significantly in the experimental group compared to the control group after the intervention(p=0.00). The satisfaction rate of the experimental group was significantly higher than the control group(p=0.02). The proportion of patients in the experimental group who developed gout was significantly lower than that in the control group(p=0.03).

Conclusion: Comprehensive nursing intervention plays a vital role in the treatment and prognosis of hypertension combined with hyperuricemia.

doi: https://doi.org/10.12669/pjms.39.6.7233

How to cite this: Lu N, Liu J, Cai P. Analysis of clinical efficacy of comprehensive nursing intervention on elderly patients with hypertension combined with hyperuricemia. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7233

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.
Demographic and clinical variables in the dengue epidemic in Punjab, Pakistan
Authors: Saad Saira Mushtaq , Khan Malik Ihsan Ullah , Khan Muhammad Tahir , Husain Aamir
Published: September 2023

Objectives: To identify the latest trends in the clinical picture and severity of the disease, which will help better understand and manage dengue.

Methodology: It was a cross-sectional, hospital-based study performed in the tertiary care hospitals of Punjab from August 21 to December 2022, in which serologically and polymerase chain reaction (PCR) confirmed patients with dengue infection, were enrolled. Demographic and clinical variables were recorded on a pre-tested Performa, processed and presented in frequency and percentages, and graphs were generated. Mean and standard deviation was used to present continuous variables.

Results: Out of a total of 580 patients, 472 were diagnosed with Dengue Fever (DF) and 108 with Dengue Hemorrhagic Fever (DHF). About 79.31% of the patients were male and 20.69% were females. The mean age of patients was 32.5±9 years. Among the clinical features the percentage of high-grade fever, body aches, and vomiting were the highest. The liver function profile showed that serum bilirubin, Serum aspartate transaminase (AST), serum alanine transaminase (ALT,) and alkaline phosphatase (ALP) levels were markedly raised.

Conclusion: This study showed that with time the trends in the presentation of dengue are slowly shifting, which will help us better manage the disease burden in the future.

doi: https://doi.org/10.12669/pjms.39.6.7383

How to cite this: Mushtaq S, Khan MIU, Khan MT, Husain A. Demographic and clinical variables in the dengue epidemic in Punjab, Pakistan. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7383

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.
Effects of a Doula instrument combined with auricular acupuncture and acupoint application on numerical rating scale scores, labour time of puerperae with a natural delivery and Apgar scores of the newborns
Authors: Sun Bing , Ren Jing , Yang Ying , Yang Chunhong
Published: September 2023

Objective: To determine how a combination of auricular acupuncture, acupoint application and the Doula instrument affects numerical rating scale (NRS) scores, labour time of puerperae and the Apgar scores of newborns during natural delivery.

Methods: This is a retrospective study. From January 2021 to December 2022, clinical data were collected from 90 healthy primiparae who completed natural delivery at Baoding Maternal and Child Health Hospital. They were divided into two groups based on different perinatal intervention methods. While the Doula instrument was used for the control group’s perinatal intervention, the study group received a combination of auricular acupuncture, acupoint application and the Doula instrument during their perinatal period.

Results: The NRS score of the study group was lower than that of the control group, demonstrating that their intergroup difference is statistically significant (P < 0.05). The incubation period, the active phase of the first stage of labour and the time of the second and third stages of work are shorter in the study group than in the control group (P < 0.05). Intergroup comparison of their one and five minutes Apgar scores demonstrates no statistically significant differences (P > 0.05). Expression levels in the study group are higher than in the control group five minutes after delivery (P < 0.05).

Conclusions: In this case, a perinatal intervention comprising auricular acupuncture, acupoint application and the Doula instrument was used for puerperae undergoing natural delivery.

doi: https://doi.org/10.12669/pjms.39.6.7451

How to cite this: Sun B, Ren J, Yang Y, Yang C. Effects of a Doula instrument combined with auricular acupuncture and acupoint application on numerical rating scale scores, labour time of puerperae with a natural delivery and Apgar scores of the newborns. Pak J Med Sci. 2023;39(6):---------.  doi: https://doi.org/10.12669/pjms.39.6.7451

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.
The effect of Dapagliflozin on renal functions in hospitalized patients with Acute Heart Failure
Authors: Gilani Syedah Fauzia Fatima , Ali Dr. Shabana , Siddique Dr. Muhammad Bilal , Farhat Dr. Kulsoom , Noor Dr. Mudassar , Waqar Dr. Farzana
Published: September 2023

Objective: To evaluate the influence of dapagliflozin on renal functions and diuretics use in patients with acute heart failure (AHF).

Methods: This comparative analytical study was conducted at Armed Forces Institute of Cardiology, Rawalpindi from July 2022 to November 2022. Patients were distributed equally in two groups i.e. Dapagliflozin and Conventional Groups, where patients received dapagliflozin added to conventional therapy for AHF and, only conventional therapy for AHF respectively. Estimated glomerular filtration rate (eGFR), serum creatinine were measured and compared on admission, after 48 hours and on discharge. Weight loss during hospitalization, daily dose of furosemide and length of hospital stay was also recorded. Quantitative parameters were analyzed using t-test or Mann Whitney U test accordingly.

Results: There were no significant baseline differences in renal functions. A modest decline in eGFR was observed in both groups after 48 hours. However, the variation in values of eGFR remained similar among both groups after 48 hours (p-value 0.365) and on discharge (p-value 0.768). Whereas, patients subjected to dapagliflozin treatment exhibited a more profound diuretic response expressed as greater weight loss (p-value < 0.001), achieved at comparatively lower doses of loop diuretics. Moreover, they also had a shorter duration of hospital stay (six vs eight days, p-value <0.001).

Conclusion: Institution of dapagliflozin did not cause any significant deterioration of renal functions, whereas; it was associated with improved diuretic response as depicted by more pronounced weight loss at comparatively lower doses of loop diuretics.

doi: https://doi.org/10.12669/pjms.39.6.7525

How to cite this: Gilani SFF, Ali S, Siddique MB, Farhat K, Noor M, Waqar F. The effect of Dapagliflozin on renal functions in hospitalized patients with Acute Heart Failure. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7525

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.
Osteoarthritis knee and modifiable cardiovascular risk factors: play in tandem
Authors: Wagan Abrar Ahmed , Paras  , Bhutto Abdul Qadir , Asghar Ammad
Published: September 2023

Objective: To know the frequency of modifiable cardiovascular risk factors in knee osteoarthritis patients.

Method: Cross sectional study was done at Department of Rheumatology Indus Medical College, Tando Mohammad Khan from March 25, 2022 to November 24, 2022. Total 246 Osteoarthritis of knee cases with (Kellgren-Lawrence grad-II and above) on x-ray, were selected after demographic details, blood pressure, body mass index and physical examination was done, 5ml of venous blood was drawn by phlebotomist, sent for fasting blood sugar, serum lipids analysis and Framingham 10years risk score was calculated afterward for each participant.

Results: In this study males (126) and females (120). Overall (78%) had risk factors, Patients having one CVD risk factor were (22.8%), two risk factors in (21.1%), three in (21.5%), four (9.8%) and five factors in (1.6%) while frequency of modifiable cardiovascular risk shows obesity (45.5%) hypertension (40.2%) intermediate to high risk of framingham score (40%) diabetes mellitus (25%), smoking (17%), high low density lipoproteins (8.1%). In males obesity(54.2%), hypertension (47.5% ) and (45.8%) were on medication, diabetes mellitus(31.7%), smoker(31%), high risk FRS(39.2%), K-L grade-IV (58.4%) and in females: obesity (42%), hypertension (43.7%) and (40.5%) were on medication, diabetes mellitus in (19%), smoking (4%), high risk FRS (13.5%), K-L Grade-4 (42%), significant association of diabetes mellitus, smoking, FRS and K-L grades with gender (p<0.05).

Conclusion: In OA knee there is high prevalence of modifiable cardiovascular risk factors and together these imposes a major health risk for future cardiac events and disability.

doi: https://doi.org/10.12669/pjms.39.6.7596

How to cite this: Wagan AA, Surahyo P, Bhutto AQ, Asghar A. Osteoarthritis knee and modifiable cardiovascular risk factors: play in tandem. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7596

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.
Patient-reported outcomes of taste alterations and quality of life in patients with nasopharyngeal carcinoma
Authors: Li Jie , Shao Xiaoqian , Yu Rongling , Shi Lingyun , Xu Dejing , Yu Xiaoyan
Published: September 2023

Objective: To investigate patient-reported outcomes of taste alterations and quality of life (QoL) in patients with nasopharyngeal carcinoma (NPC).

Methods: In this single-center retrospective study medical records of 191 patients with NPC undergoing chemoradiotherapy (CRT) in the Department of Radiotherapy, Jiangsu Cancer Hospital, the Affiliated Cancer Hospital of Nanjing Medical University from January 2021 to December 2021 were reviewed. A total of 120 patients met eligibility criteria and were included. The taste alterations and QoL at multiple time points during radiotherapy (RT) were compared.

Results: There were significant differences in the intensity of taste, discomfort, phantogeusia and parageusia or overall taste alterations at multiple time points during CRT (p-Value<0.001). These four parameters were significantly higher two or four weeks after CRT, or at the end of CRT compared to before CRT (p-Value <0.001). The intensity of taste, discomfort, phantogeusia and parageusia or overall taste alterations were all significantly higher four weeks after CRT compared to two weeks after CRT (p-Value <0.001), and at the end of CRT compared to four weeks after CRT (p-Value <0.001). The chemotherapy-induced taste alteration scale (CiTAS) scores were highest at the end of CRT (p-Value <0.001). There were significant differences in QoL at multiple time points during CRT (p-Value <0.001), and each parameter differed significantly at various time points (p <0.05). The QoL of all areas at the end of CRT were significantly higher than those before CRT, or two or four weeks after CRT (p-Value <0.001).

Conclusions: In patients with NPC undergoing CRT, taste alterations increasingly worsen as treatment progresses, with poor QoL outcomes.

doi: https://doi.org/10.12669/pjms.39.6.7830

How to cite this: Li J, Shao X, Yu R, Shi L, Xu D, Yu X. Patient-reported outcomes of taste alterations and quality of life in patients with nasopharyngeal carcinoma. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7830

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.
Effect of single intravenous injection of esketamine on quality of recovery during early period after modified radical mastectomy for breast cancer: A retrospective study
Authors: Fei Guofang , Yan Wei , Yao Huaqi
Published: September 2023

Objective: To assess the impact of a single esketamine intravenous (IV) injection on the quality of recovery during early period after modified radical mastectomy for breast cancer.

Methods: This retrospective study included 80 patients who underwent modified radical mastectomy under general anesthesia in Huzhou Maternity & Child Health Care Hospital from March to October 2022. All patients were between 35 to 55 years, weighting between 45 and 70 kg and Grade-I or II according to the American Society of Anesthesiologists (ASA). Patients were grouped based on the type of pain management used. Patients (n=40) who were given 0.25 mg/kg esketamine single IV injection prior to completion of the surgery were assigned to Group-E, and patients (n=40) who were not treated with esketamine, comprised the control Group-C. Patients’ data, such as education years, operation time, blood loss, the 9-item Quality of Recovery (QoR-9) scores before the anesthesia induction (T0), one (T1) and two hours after the extubation (T2), the 40-item Quality of Recovery (QoR-40) scores one (D1) and two days after the surgery (D2), and the rate of adverse reactions were assessed in both groups.

Results: Compared with T0, the QoR-9 scores at T1 and T2 were markedly lower in all patients. Compared to Group-C, the QoR-9 scores at T1 and T2 in Group-E were considerably increased (P<0.05). Similarly, the QoR-40 scores on D1 and D2 in Group-E were significantly higher compared to Group-C (P<O.05).

Conclusion: Single intravenous injection of esketamine can improve the quality of the recovery of breast cancer patients during the early period after the modified radical mastectomy.

doi: https://doi.org/10.12669/pjms.39.6.8057

How to cite this: Fei G, Yan W, Yao H. Effect of single intravenous injection of esketamine on quality of recovery during early period after modified radical mastectomy for breast cancer: a retrospective study. Pak J Med Sci. 2023;39(6):---------.  doi: https://doi.org/10.12669/pjms.39.6.8057

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical effect of glucosamine hydrochloride combined with compound osteopeptide injection for knee osteoarthritis
Authors: Liu Mo Han , He Kang , Liu Fengxia
Published: September 2023

Objective: To investigate the clinical efficacy of glucosamine hydrochloride combined with compound osteopeptide injection for knee osteoarthritis (KOA).

Methods: We retrospectively collected clinical data of 82 patients with KOA admitted to Shandong Weifang People’s Hospital from April 2019 to September 2022. According to the treatment records, 35 patients received an intramuscular injection of compound osteopeptide (control group), and 47 patients received an injection of glucosamine hydrochloride combined with compound osteopeptide (observation group). We compared clinical efficacy, WOMAC scores, inflammatory factor and CD4+ and CD8+ levels, and the incidence of adverse reactions between the two groups.

Results: The observation group’s total efficacy (95.74%) was significantly higher than the control group’s (80.00%; P<0.05). Treatment led to a significant reduction in WOMAC scores in both groups. In addition, the levels of tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) in the observation group were significantly lower than those in the control group (P<0.05); while the levels of CD4+ and CD8+ were significantly higher in the observation group (P<0.05).

Conclusions: Compared with compound osteopeptide injection alone, glucosamine hydrochloride combined with compound osteopeptide injection is more effective for patients with KOA, with improved level of inflammatory factors and immune function.

doi: https://doi.org/10.12669/pjms.39.6.8151

How to cite this: Liu MH, He K, Liu F. Clinical effect of glucosamine hydrochloride combined with compound osteopeptide injection for knee osteoarthritis. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.8151

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Efficacy and safety of Telitacicept in patients with IgA nephropathy
Authors: Liang Dongrui , Li Xiaodong
Published: September 2023

doi: https://doi.org/10.12669/pjms.39.6.8393

How to cite this: Liang D, Li X. Efficacy and safety of Telitacicept in patients with IgA nephropathy. Pak J Med Sci. 2023;39(6):---------.  doi: https://doi.org/10.12669/pjms.39.6.8393
Operative vaginal deliveries – a relic of the past or a promising prospect?
Authors: Skotalczyk Magdalena , Łokczewska-Bojar Aleksandra , Kuziemkowska Daria , Łącka-Majcher Anna , Tarsa Grzegorz , Kępka Przemysław , Sudelska Katarzyna , Ben Rhaiem Rami , Kuźma Jan , Sawińska Zuzanna
Published: September 2023

Introduction: Growing development of obstetrics and gynecology was followed by a decrease in the frequency of operative vaginal deliveries. This occurrence has been observed over the years, coming hand in hand with an increasing popularity of caesarean sections. Operative vaginal deliveries include vacuum deliveries and forceps deliveries, which both may be an alternative to some cases of emergency caesarean sections.

 Aim of the study: The aim of our study was to depict the most important aspects of operative vaginal deliveries, analyze their complications, and to try to compare the consequences of mentioned techniques. Careful analysis of these issues can facilitate the decision-making process in obstetric practice.

Materials and methods: A review of the current literature was made in the accessible PubMed and Google Scholar database, using the keywords: „operative vaginal deliveries”, „forceps delivery”, „vacuum delivery”. Moreover, textbooks concerning obstetrics and gynecology were reviewed in terms of operative vaginal deliveries.

Conclusions: Both forceps and vacuum deliveries have variety of uses, especially in cases of slowed progress of the second stage of labor. They both have distinct differences, the analysis of which may help the obstetrician to choose the best possible method for each case. These techniques may prove to be a useful tool in preventing unnecessary caesarean sections and their complications, especially when performed by experienced doctors.
Pruritus. Pathomechanism, management and novel treatment
Authors: Józefiak Maciej , Kania Joanna , Sobkiewicz Piotr , Kania Krzysztof , Niekurzak Karolina , Jędrak Maciej
Published: September 2023

Introduction
Itching is an unpleasant sensation that is commonly experienced in the general population. It accompanies many diseases. This sensory experience is burdensome and significantly reduces the quality of life. The mechanism of itching is complex. It involves receptors, the histaminergic and non-histaminergic pathways, cytokines, neuropeptides, neurotransmitters, proteases, and enzymes. External factors such as temperature or capsaicin also influence itching.
Aim of the study
This review presents the current state of knowledge regarding therapy in the treatment of itching. Also aims to show that it is a complicated process. Pruritus is a very bothersome sensory sensation and is a common symptom. 
Material and methods
This review was based on scientific books on human physiology and dermatology were used, which are listed in the bibliography and available data collected in the PubMed and Google Scholar database. Using key words:  itch, management, pathogenesis, pathophysiology, pruritus, therapeutics, treatments.
Conclusion
The latest research on itching has led to a better understanding of this complex mechanism. As a result, there is a possibility of discovering new, innovative treatment methods that are targeted at specific elements of this process or work systemically. Understanding the broad etiology assists in identifying the cause and in implementing an appropriate therapeutic strategy. Further research will enable improvements in treatment and enhance patient comfort.
KRASG12C inhibitors in lung cancer therapy
Authors: Jędrak Maciej , Niekurzak Karolina , Kania Joanna , Józefiak Maciej , Sobkiewicz Piotr , Kania Krzysztof
Published: September 2023

Introduction:
Lung cancer is characterized by the highest mortality among cancers and is the second most frequently diagnosed type of cancer in the world.
Targeted therapies are a promising therapeutic option for patients with this disease, however, one of the most common and most malignant mutations (KRAS) remains a challenge.
Purpose:
The aim of this study is to bring closer the problem of the KRAS mutation, in particular KRASG12C, and to present the most important information about the compounds created for therapies targeted at it.For a better understanding of the issue, the study contains information about the mechanisms of both mutation and drugs, as well as the most important statistical data and research results.
Materials and methods:
The review was based on articles available in the PubMed database.
Conclusions:
Two drugs targeting KRASG12C (sotorasib and adagrasib) have proven their clinical effectiveness and represent a milestone in the development of targeted therapies for lung cancer with this mutation.
However, they are not without side effects, and the emerging resistance and presence of commutations that reduce drug potency continue to challenge the scientific community.
Research is underway to refine therapies using existing inhibitors as well as to develop further compounds targeting KRASG12C.
Pancreatic cancer - diagnosis, risk factors and treatment. Literature review
Authors: Olczyk Krzysztof
Published: September 2023

Pancreatic cancer is a highly aggressive tumor. Due to the lack of characteristic symptoms, it is usually detected in the advanced stage. Resection of the tumor is possible only in 10-20% of all patients, which significantly extends and improves the quality of their life.  Therefore, new diagnostic methods are sought to detect PCDA at an early stage. Biomarkers are also increasingly being used in the diagnosis of pancreatic cancer, as well as genetic testing to better identify those at risk and use screening among them. Despite the development of treatments for pancreatic cancer, it still has a low 5-year survival rate, so there is a constant need for research into more effective therapeutic modalities.