bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospice care self-efficacy among clinical medical staff working in the coronavirus disease 2019 (COVID-19) isolation wards of designated hospitals: a cross–sectional study
Authors: Zheng Ze-hong , Luo Zhong-chen , Zhang You , Chan Wallace Chi Ho , Li Jian-qiong , Pang Jin , Jia Yu-ling , Tang Jiao
Published: December 2020

Background

The COVID-19 pandemic has caused more than 462,417 deaths worldwide. A large number of patients with severe COVID-19 face death in hospital. Hospice care is truly a philosophy of care that delivers patient-centred care to the terminally ill and their families. Hospice care could provide many benefits for patients, families, and for hospice caregivers. The aim of this study is to investigate hospice care self-efficacy and identify its predictors among Chinese clinical medical staff in COVID-19 isolation wards of designated hospitals.

Methods

A cross-sectional design was used. The Hospice Care Self-Efficacy, Self-Competence in Death Work Scale, Positive Aspects of Caregiving, and Simplified Coping Style Questionnaires were administered between February and April 2020. A total of 281 eligible medical staff responded to the questionnaires, with a response rate of ≥78.9%.

Results

The mean score of hospice care self-efficacy was 47.04 (SD = 7.72). Self-efficacy was predicted by self-competence in death work (B = 0.433,P < 0.001), positive aspects of caregiving (B = 0.149,P = 0.027), positive coping (B = 0.219,P < 0.001), giving hospice care to dying or dead patients before fighting against COVID-19 (B = -1.487,P = 0.023), occupational exposure while fighting against COVID-19 (B = -5.244,P = 0.004), holding respect for life and professional sentiment as motivation in fighting against COVID-19 (B = 2.372,P = 0.031), and grade of hospital employment (B = -1.426,P = 0.024). The variables co-explained 58.7% variation of hospice care self-efficacy.

Conclusion

Clinical nurses and physicians fighting COVID-19 reported a moderate level of hospice care self-efficacy during this pandemic. Exploring the traditional Chinese philosophy of life to learn from its strengths and make up for its weaknesses and applying it to hospice care may provide a new framework for facing death and dying during the COVID-19 pandemic. Continuous hospice care education to improve self-competence in death work, taking effective measures to mobilize positive psychological resources, and providing safer practice environments to avoid occupational exposure are also essential for the improvement of the hospice care self-efficacy of clinical nurses and physicians. These measures help caregivers deal effectively with death and dying while fighting against the COVID-19 pandemic.
Preparing lifelong learners for delivering pharmaceutical care in an ever-changing world: a study of pharmacy students
Authors: Khamis Sarah , Abdi Abdikarim Mohamed , Basgut Bilgen
Published: December 2020

Background

Continuing professional development (CPD) continues to gain acceptance as a model for health care professionals to engage in lifelong learning (LLL). Many pharmacy schools have not adopted yet specific programs targeting the development of LLL skills, though LLL is widely accepted as an essential competence. This paper examines the effectiveness and utility of a longitudinal CPD training program.

Methods

A CPD simulation course was introduced to a cohort of fifth year students in Northern Cyprus in the 2018–2019 academic year. The program was delivered as an interactive orientation course in one semester; meanwhile, in the second semester, the students applied the CPD cycle and completed their portfolios during their final experiential practice. A mixed-methods approach was used to evaluate the outcomes of the intervention using students’ preparedness for lifelong learning (SPLLL) self-administered questionnaire delivered pre-post program, focus group sessions for students to reflect on the course experience, and instructors’ evaluations of portfolios.

Results

Following the implementation of the course, students’ assessment scores were significantly higher overall and for all scale domains, including “knowledge, skills, attitude and practice”, compared to the baseline assessment. Additionally, compared to fifth year students who responded to the second SPLLL questionnaire, the intervention group students’ assessment was significantly higher in knowledge, skills, and practice. The qualitative analysis reported high student satisfaction and achievement of the course objectives. Nineteen of the students scored high on their portfolios.

Conclusion

The CPD simulation course provided students with opportunities to practice and develop self-assessment and self-management skills that are all desirable for lifelong learning and prepared them for CPD.
Reducing the quality risk of elderly care services in government procurement from market-oriented private providers through ex ante policy design: lessons from the principal-agent theory analysis
Authors: Song Huan , Yu Sihang , Sun Tao
Published: December 2020

Background

Government procurement of elderly care services from market-oriented private providers has become an important way to respond to the growing demands of elderly care. However, the government cannot accurately identify the actual quality efforts of these providers, and the government pursues social benefits while the providers pursue economic interests. The existence of asymmetric information and goal divergence increases the quality risk of services. From the perspective of maximizing the government’s net benefits, this study aimed to analyze how to reduce the quality risk through ex ante policy design.

Methods

On the basis of the principal-agent theory, this study defined the asymmetric information of market-oriented private providers’ efforts on quality as a random variable, and constructed the theoretical model in the case of asymmetric information to compare with the one in the reference case of complete information, in both of which the government is the principal and market-oriented private providers are the agents. And the models also introduced several parameters to describe key factors that affect the contract results, including the physical health of the elderly, the spillover benefits to the government and market-oriented private providers, and the market risks.

Results

The optimal results of the models in the two cases were obtained respectively, and the validity of the theoretical models was verified in a numerical example. Taking the case of complete information as the basic frame of reference, the difference of the optimal results in both cases showed the extent of negative impacts of asymmetric information, and highlighted the role of ex ante policy design in minimizing asymmetric information and reducing its negative impacts. Some ex ante policies that can improve the supervision of market-oriented private providers and their quality efforts, as well as have positive effects on key factors, were also recommended.

Conclusions

The government should attach importance to ex ante policy design to reduce the quality risk of elderly care services supplied by market-oriented private providers in government procurement. Our study provides main framework and critical directions for ex ante policy design, which is conducive to the realization of real and sustained quality improvement.
Different impacts of the zero-markup drug policy on county general and traditional Chinese medicine hospitals: evidence from Shandong province, China
Authors: Jiang Xiaofeng , He Ping , Zhu Dawei , Shi Xuefeng , Meng Qingyue
Published: December 2020

Background

As a key part of the new round of health reform, the zero-markup drug policy (ZMDP) removed the profit margins of drug sales at public health care facilities, and had some effects to the operation of these institutions. This study aims to assess whether the ZMDP has different impacts between county general and traditional Chinese medicine (TCM) hospitals.

Methods

We obtained longitudinal data from all county general and TCM hospitals of Shandong province in 2007–2017. We used difference-in-difference (DID) method to identify the overall and dynamic effects of the ZMDP.

Results

On average, after the implementation of the ZMDP, the share of revenue from medicine sales reduced by 16.47 and 10.42%, the revenue from medicine sales reduced by 24.04 and 11.58%, in county general and TCM hospitals, respectively. The gross revenue reduced by 5.07% in county general hospitals. The number of annual outpatient visits reduced by 11.22% in county TCM hospitals. Government subsidies increased by 199.22 and 89.3% in county general and TCM hospitals, respectively. The ZMDP reform was not significantly associated with the revenue and expenditure surplus, the number of annual outpatient visits and the number of annual inpatient visits in county general hospitals, the gross revenue, the revenue and expenditure surplus and the number of annual inpatient visits in county TCM hospitals. In terms of dynamic effects, the share of revenue from medicine sales, revenue from medicine sales, and gross revenue decreased by 20.20, 32.58 and 6.08% respectively, and up to 28.53, 63.89 and 17.94% after adoption, while government subsidies increased by around 170 to 200% in county general hospitals. The number of annual outpatient visits decreased by 9.70% and up to 18.84% in county TCM hospitals.

Conclusion

The ZMDP achieved its some initial goals of removing the profits from western medicines in county hospitals’ revenue without disrupting the normal operation, and had different impacts between county general and TCM hospitals. Meanwhile, some unintended consequences were also recognized through the analysis, such as the decline of the utilization of the TCM.
Trends in inpatient discharges with drug or alcohol admission diagnoses to a skilled nursing facility among older adults, New York City 2008–2014
Authors: Han Benjamin H. , Tuazon Ellenie , Kunins Hillary V. , Paone Denise
Published: December 2020

Background

Recent research shows an increase in drug and alcohol-related hospitalizations in the USA, especially among older adults. However, no study examines trends in discharges to a skilled nursing facility (SNF) after a drug or alcohol-related hospitalization. Older adults are more likely to need post-hospital care in a SNF after a hospitalization due to an increased presence of chronic diseases and functional limitations. Therefore, the objective of this study was to estimate trends in drug or alcohol-related hospitalizations with discharge to a SNF among adults age 55 and older.

Methods

We analyzed data from New York State’s Statewide Planning and Research Cooperative System to calculate the number of cannabis, cocaine, opioid, and alcohol-related hospitalizations in New York City that resulted in discharge to a SNF from 2008 to 2014 among adults age 55 and older. Using New York City population estimates modified from US Census Bureau, we calculated age-specific rates per 100,000 adults. Trend tests were estimated using joinpoint regressions to calculate annual percentage change (APC) with 95% confidence intervals (CI) and stratified by adults age 55–64 and adults age 65 and older.

Results

During the study period, among adults age 55–64, there were significant increases in cocaine, cannabis, and opioid-related hospitalizations that resulted in discharge to a SNF. For adults ≥ 65 years, there were sharp increases across all substances with larger increases in opioids (APC of 10.66%) compared to adults 55–64 (APC of 6.49%). For both age groups and among the four substances, alcohol-related hospitalizations were the leading cause of discharge to a SNF.

Conclusions

We found an increase in hospital discharges to SNFs for patients age 55 and older admitted with alcohol or drug-related diagnoses. Post-acute and long-term care settings should prepare to care for an increase in older patients with substance use disorders by integrating a range of harm reduction interventions into their care settings.
Comparative analysis of clinical features of SARS-CoV-2 and adenovirus infection among children
Authors: Li Kuanrong , Li Ling , Wang Xianfeng , Li Hui , Chen Jun , Liu Lei , Shao Jianbo , Xu Yi , He Liya , Gong Sitang , Xia Huimin , Liang Huiying
Published: December 2020

Background

The new emerging coronavirus disease 2019 (COVID-19) overall shares similar symptoms with other common respiratory viral infections. We aimed in this study to compare COVID-19 and human adenovirus (HAdV) infections in pediatric patients regarding the frequencies of major clinical symptoms and the potential disparities in laboratory and imaging parameters.

Methods

Following a case–control-like design, we built 72 age-matched pediatric COVID-19 and HAdV patient pairs. Their early symptoms and laboratory and imaging characteristics were then retrieved and compared.

Results

Fever and cough were the most common symptoms for both infections but were seen more often in HAdV than in COVID-19 patients (92% vs. 66% and 60% vs. 18%, respectively). Compared with COVID-19 patients, children with HAdV infection had statistically significantly higher values of neutrophil count, neutrophil percentage, activated partial thromboplastin time, prothrombin time, lactate dehydrogenase, C-reactive protein, procalcitonin but lower values of lymphocyte percentage, total bilirubin, potassium and sodium. Thoracic computed tomography also revealed more anomalies in HAdV patients than in COVID-19 patients (95% vs. 67%).

Conclusions

COVID-19 is an overall less symptomatic and less severe infection at admission compared to HAdV respiratory infection in pediatric population.
The comparison between total hip arthroplasty and hemiarthroplasty in patients with femoral neck fractures: a systematic review and meta-analysis based on 25 randomized controlled trials
Authors: Tang Xiumei , Wang Duan , Liu Ying , Chen Jiali , Zhou Zongke , Li Peifang , Ning Ning
Published: December 2020

Background

We performed an updated systematic review and meta-analysis which enrolled 25 prospective randomized controlled trials (RCTs) to compare the outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in patients with femoral neck fractures (FNFs).

Methods

We searched English databases which included PubMed, Embase (vis OvidSP), The Cochrane Library, and Web of Science, and Chinese databases Chinese National Knowledge Infrastructure (CNKI), VIP, Wang Fang, and China Biology Medicine Disc (CBM) in July 2020. The quality of each study was assessed according to the Cochrane Collaboration’s Risk of Bias. Risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were pooled with random-effects models. Data regarding baseline characteristics, hospital and surgery outcomes, clinical outcomes, patients’ quality of life, common complications, prothesis-related complications, mortality, and costs were reported.

Results

A total of 25 RCTs involving 3223 patients (1568 THA and 1655 HA) were included. THA had longer hospital length (WMD = 0.721, P < 0.0001) and surgery time (WMD = 20.044, P < 0.0001), and more blood loss compared with HA (WMD = 69.109, P < 0.0001). THA showed better ratings in the Harris Hip Score during follow-up periods between 1 and 5 years while no differences within 6 months and after 9 years. THA was associated with higher quality-of-life EuroQol-5 Dimension (EQ-5D) scores after 2 years of surgery but no difference within 1 year. There was no difference in common complications. THA had significant higher rate of dislocation (WMD = 1.897, P = 0.002) and lower acetabular erosion (WMD = 0.030, P = 0.001). For mortality, there was no difference during all the follow-up periods except for slightly higher 2-year mortality after surgery.

Conclusion

This meta-analysis demonstrates that THA has better medium-term functional results and quality of life and lower acetabular erosion rate, while HA shows better in reducing hospital stay, surgery time, and blood loss and also has lower dislocation rate.
Stressors and mental health in Bangladesh: current situation and future hopes
Authors: Alam Faruq , Hossain Rubina , Ahmed Helal Uddin , Alam Mohammad Tariqul , Sarkar Mekhala , Halbreich Uriel
Published: December 2020

Bangladesh is a densely populated emerging country in South Asia. Since its harsh independence war, it has suffered from repeated floods and other natural and man-inflicted disasters. Internal migration from rural areas to the urban centres has increased crowdedness, pollution and social conflicts. Furthermore, in recent years, the country has absorbed close to a million refugees from Myanmar. These stressors have been associated with an increase in mental disorders and symptoms with which the country is struggling. Lack of resources and a shortage of human capital have weakened the national capacity to efficiently respond to situational stressors or disasters. For assessment of stress-related mental health issues, information available from the Ministry of Health and the National Institute of Mental Health was collected and supplemented by external reports. It is promising that the government's approach of responding to mental health needs only after the occurrence of a crisis has recently been replaced by the concept of total management through primary healthcare. There is a need for development of adequate infrastructure, logistics and workforce support, as well as establishment of multidisciplinary teams of management and clinical services. Collaboration of all related sectors of the government and an overall increase in government funding for mental health are essential.
Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study
Authors: Akalın Çağrı
Published: December 2020

Objective: To examine the long-term outcomes such as recurrence, foreign body feeling and chronic pain of titanium-coated mesh (TCM) versus standard polypropylene mesh (PM) after Lichtenstein repair (LR).

Methods: In this retrospective cohort study, patients who underwent TCM and PM in LR were evaluated between May 2014 and January 2018 at Ordu University Training and Research Hospital in Turkey. Primary outcomes (age, gender, body mass index, smoking habits, comorbid diseases, American Society of Anesthesiologists score, hernia type, side of hernia, duration of hernia presentation and operative time) and secondary outcomes (surgical site occurence, recurrence, foreign body feeling and chronic pain) were analyzed. Patients were divided into two groups according to the mesh elected (TCM and PM); titanium group (TG) and polypropylene group (PG), respectively.

Results: In this study, 221 patients were analyzed; TCM was used in 72 (32.6%) patients and PM was used in 149 (67.4%) patients. No difference was found between groups in terms of primary outcomes (p>0.05). In the analysis of secondary outcomes, surgical site occurence was similar in both groups (p>0.05). Recurrence was observed in 1.39% (n=1) of TG and 2.01% (n=3) of PG. No difference was found between groups in terms of recurrence (p=0.606). Foreign body feeling was observed in 15.3% (n=11) of TG and 27.5% (n=41) of PG. Chronic pain was observed in 4.2% (n=3) of TG and 12.8% (n=9) of PG. Significant differences were found between groups in terms of chronic pain and foreign body feeling (p=0.046 and p=0.044, respectively).

Conclusion: The result of this study shows that in LR, TCM leads to less foreign body feeling and chronic pain than PM. However, there was no difference in terms of recurrence between these meshes.

doi: https://doi.org/10.12669/pjms.37.1.2694

How to cite this:Akalin C. Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study. Pak J Med Sci. 2021;37(1):81-86. doi: https://doi.org/10.12669/pjms.37.1.2694

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.
Compliance of checking HbA1c in a tertiary care hospital of Pakistan
Authors: Aziz Abdul , Ahsan Ali Syed
Published: December 2020

Background and Objectives: The prevalence of diabetes mellitus worldwide was 171 million one and half decade ago, while the prediction is 366 million patients by 2030 and more than 640 million people by 2040. HbA1c value represents average blood glucose over the past 2-3 months and accounts for both pre-prandial and post-prandial blood glucose levels. A link between HbA1c and diabetic complications has been confirmed. In general, patients with controlled diabetes mellitus should have at least biannual testing, while patients with uncontrolled diabetes mellitus or unmet glycemic targets should be tested every three months. The objective was to see compliance of checking HbA1c in tertiary care hospital of a developing world.

Methods: This was a retrospective observational study done from 1st February 2019 to 31st March 2019 in the Department of Medicine and Surgery, The Aga Khan University Hospital, Karachi. All patients of age 18 years and above, admitted with a diagnosis of diabetes mellitus (DM) from 1st February 2019 to 31st March 2019 were included. If HbA1c was less than 7% the patients were labelled as having controlled DM, otherwise, uncontrolled DM. If HbA1c of patients with controlled DM was not checked in last six months and if HbA1c of patients with uncontrolled DM was not checked in last three months then it was labelled as non-compliance of checking HbA1c.

Results: Out of 1732 diabetic patients only 94 patients fulfilled inclusion criteria. Out of these 94 patients 43 (45.7%) were male. Mean HbA1c was 7.90% (1.4) and 69 (73.4%) patients had uncontrolled diabetes mellitus. Overall, the compliance of checking HbA1c was 58.5%. In uncontrolled diabetes mellitus patients, the compliance of checking HbA1c was 45% and in controlled diabetes mellitus patients the compliance was 96%.

Conclusion: The compliance of checking HbA1c is inadequate in diabetic inpatients. The considerable prevalence of diabetes and the benefits of timely interventions in diagnosed patients to prevent complications suggest the need for a comprehensive awareness among the doctors for checking HbA1c.

doi: https://doi.org/10.12669/pjms.37.1.2814

How to cite this:Aziz A, Ali SA. Compliance of checking HbA1c in a tertiary care hospital of Pakistan. Pak J Med Sci. 2021;37(1):142-145.  doi: https://doi.org/10.12669/pjms.37.1.2814

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.
Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques
Authors: Sharobaro Valentin , Alimova Sekina , Telnova Anna , Shamanaeva Liudmila
Published: December 2020

Objective: To develop a clinical technique for objective estimation of exact location and degree of participation of face and neck soft tissues in age-related deformations for determine effective mini-invasive treatment techniques.

Methods: Ultrasound examination was performed in 2017-2019 at 63 patients with age-related face changes. Examination was done in the vertical position for determine the role, exact location and participation degree of different soft tissues of the face and neck in age-related changes.

Results: Great diagnostic value of ultrasound examination of involutional changes in soft tissues of lower third of face and neck was noted to determine all causes of contour age-related deformities. These results were used to choose effective minimally invasive methods for correction.

Conclusion: Ultrasound examination is a non-invasive, harmless, clinically available, inexpensive examination that allows to determine exact localization and degree of participation of different soft tissues of face and neck in age-related changes. That is very important for planning and use different minimally invasive techniques for facial and neck rejuvenation.

doi: https://doi.org/10.12669/pjms.37.1.3034

How to cite this:Sharobaro V, Alimova S, Telnova A, Shamanaeva L. Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques. Pak J Med Sci. 2021;37(1):272-276. doi: https://doi.org/10.12669/pjms.37.1.3034

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.
Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem
Authors: Çarkçı Engin , Polat Ayse Esin , Öztürkmen Yusuf , Tüzüner Tolga
Published: December 2020

Objective: In this study we aimed to investigate the long-term clinical and radiological results, revision rates and causes, and the rate of implant survival in total hip arthroplasty performed using CLS® expansion cup and Spotorno® cementless femoral stem.

Methods: Clinical results of total hip arthroplasty performed on 131 hips of 114 patients in Istanbul Training and Research Hospital between 1993 and 2003 were retrospectively evaluated according to the Harris Hip Score. Revision rates were determined and implant survival rates were identified using the Kaplan-Meier estimator.

Results: Of the patients, 39 were males and 75 were females. The average age of the patients at surgery was 48.7±11.3 years. Patients were followed up for a mean period of 13.9±2.4 years. The mean Harris Hip Score was 34.35±6.09 preoperatively and 88.20±7.11 at the final follow-up (p<0.001). The Kaplan-Meier survivorship estimate for the cup at 13.9 years, taking revision for any reason as the end point was 95.6% (95% CI), while the 15th and 17th year survival rates were 90% and 85%, respectively.

Conclusion: In total hip arthroplasty using a cementless expansive acetabular cup, a 95.6% survival rate is achieved after an average of 14 years, whereas the rate decreases to 85% after 17 years. Even if the incidence of cup breakage is reduced with proper implantation, particle disease and periacetabular osteolysis remains a problem for the long-term survival.

doi: https://doi.org/10.12669/pjms.37.1.3089

How to cite this:Carkci E, Polat AE, Ozturkmen Y, Tuzuner T. Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem. Pak J Med Sci. 2021;37(1):52-58. doi: https://doi.org/10.12669/pjms.37.1.3089

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.
Reliability and validity test of VES-13 and analysis of influencing factors for the vulnerable condition of patients with advanced castration-resistant prostate cancer
Authors: Feng Jia , Sun Qian , Li Jing , Li Ting-ting
Published: December 2020

Objectives: To study the relationship between the reliability and validity of VES-13 and the influencing factors of the vulnerable condition of patients with advanced castration-resistant prostate cancer, so as to provide a reference for the health management and nursing of elderly inpatients.

Methods: By means of convenience sampling, 150 vulnerable patients with advanced castration-resistant prostate cancer who were admitted to the Department of Oncology of the Affiliated Hospital of Hebei University from April 2019 to March 2020 were selected. General data questionnaire, simple mental state checklist, anxiety self-assessment scale, and the vulnerable elders 13 survey (VES-13) were used in this study. The reliability and validity were tested by SPSS 20.0.

Results: For this group of patients, VES-13 Cronbach’s α was 0.832, living function was 0.778, body function was 0.846, and the correlation coefficient between items was between 0.401 and 0.823 (P<0.01); the retest reliability was 0.831 (P<0.05), and the correlation coefficient was0.504 (P<0.05). The average time to fill in each scale was 4.53±1.32 Minutes, and general indicators such as economic status and education level were significantly correlated with vulnerability. The clinical indicators of prostate-specific antigen levels, multiple bone metastases, and bone pain were significantly correlated with vulnerability.

Conclusion: VES-13 scale had high level of reliability and operability, and was straight forward to understand and use; it can be used as an effective tool for the assessment of vulnerability in patients with advanced prostate cancer. The vulnerability of patients with castration-resistant prostate cancer showed significant correlation with economic status, education level, prostate-specific antigen level, multiple bone metastases, bone pain and other indicators. Nursing staff should pay close attention to the relevant factors of inpatients and give targeted advance intervention measures to facilitate rapid recovery of elderly inpatients.

doi: https://doi.org/10.12669/pjms.37.1.3095

How to cite this:Feng J, Sun Q, Li J, Li TT. Reliability and validity test of VES-13 and analysis of influencing factors for the vulnerable condition of patients with advanced castration-resistant prostate cancer. Pak J Med Sci. 2021;37(1):137-141.  doi: https://doi.org/10.12669/pjms.37.1.3095

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.
Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years
Authors: Ahmad Hafiz Mahmood , Naumeri Fatima , Saud Usama , Butt Ghazala
Published: December 2020

Background & Objective: In children younger than two years, most surgeons perform the inguinal herniotomy superficially through the external ring, a technique known as Mitchell-Banks’ Herniotomy (MBH) while in older children, commonly Ferguson and Gross Herniotomy (FGH) is performed which involves opening of inguinal canal. Our aim was to compare the FGH and MBH in terms of recurrence in boys with inguinal hernia.

Methods: Boys with inguinal hernia presenting to Pediatric Surgery, Mayo Hospital Lahore from Dec 2016 to January 2018 were included in the study, if older than two years and younger than 14 years and without palpable deep ring (2 cm or more in width) or strangulation of inguinal hernia or malnutrition. They were randomly allocated in 2 groups after obtaining informed consent from parents, and underwent MBH (Group-A) and FGH (Group-B). Children were called for follow up after 1 week and at 6 months to assess for recurrence.

Results: Total 260 patients with inguinal hernia were enrolled (NCT:03392636). The mean age of boys in Group-A was 5.2±3.0 years and in Group-B was 5.9±3.1 years. Mean operating time in Group-A (26.65±3.22 minutes) was longer than Group-B (15.92±4.22 minutes), and scrotal oedema was noted in 38 (29.2%) cases in Group-A, while 7 (5.4%) cases in Group-B. Testicular atrophy was noted in one patient of Group-B. Recurrence occurred in 1(0.8%) patient in Group-A, and in 8(6.2%) patients in Group-B (p-value 0.018).

Conclusion: Mitchell-Banks’ herniotomy has lower recurrence rate than Ferguson and Gross Herniotomy in boys older than two years.

doi: https://doi.org/10.12669/pjms.37.1.3216

How to cite this:Ahmad HM, Naumeri F, Saud U, Butt G. Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years. Pak J Med Sci. 2021;37(1):40-44. doi: https://doi.org/10.12669/pjms.37.1.3216

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.
Spectral Domain – Optical Coherence Tomography findings in Triple-A Syndrome – A case series from Pakistan
Authors: Nasir Javeria , Javed Anum , Arshad Muhammad Owais , Chatni Muhammad Hanif
Published: December 2020

Triple A Syndrome is an autosomal recessive entity involving multiple systems usually characterized by adrenal insufficiency, alacrimia and achalasia. The disease features include variable degrees of neurological and neuro-ophthalmic manifestations. Protein ALADIN encoded by the AAAS gene is found to be defective in Triple A Syndrome. Here we discuss a case series of five patients diagnosed as Triple A Syndrome. Clinically there was variable degree of optic atrophy in all the cases, which was further confirmed with spectral domain Optical Coherence Tomography The aim of this study was to publish the OCT based ONFL graphs of these unique cases, so that being an ophthalmologist we can take a multidisciplinary approach and decisions accordingly.

doi: https://doi.org/10.12669/pjms.37.1.3310

How to cite this:Nasir J, Javed A, Arshad O, Chatni MH. Spectral Domain – Optical Coherence Tomography Findings in Triple-A Syndrome – A case series from Pakistan. Pak J Med Sci. 2021;37(1):267-271. doi: https://doi.org/10.12669/pjms.37.1.3310

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.
X-ray patterns of COVID-19 in patients presenting to Lady Reading Hospital, Peshawar, Pakistan
Authors: Nishtar Tahira , Noor Nosheen , Khan Shandana Latif
Published: December 2020

Objective: To determine the pattern of COVID-19 on chest radiograph in patients presenting to Lady Reading Hospital, Peshawar, Pakistan.

Methods: This prospective observational study was conducted on 178 consecutive swab positive COVID-19 patients presenting to Lady Reading Hospital, Peshawar, Pakistan from 15th March to 15th June 2020. Patients of all ages and both genders were included. Chest X-rays performed by portable radiography unit were viewed for different patterns by two consultant radiologists independently and results were analyzed using IBM SPSS 20.

Results: Out of 178 patients 134 were male. Mean age was 55.67 years. Radiographic patterns observed were ground glass haze without or with reticulation and/or consolidation (45.5 % and 33.2% respectively) and predominant consolidation either alone or in combination with ground glass haze or other findings (27.1% collectively). Peripheral distribution pattern was seen in 69.1% of patients with bilateral findings in 84.3%. Further categorization was based on pulmonary zonal demarcation with changes most commonly involving four zones (33.1%) i.e., the lower and mid zones bilaterally.

Conclusion: Portable chest radiography is an essential supporting tool for assessing different patterns in COVID-19 infection. The most common pattern observed is alveolar opacities with predominant peripheral distribution either unilateral or more frequently bilateral, starting from the lower and mid zones extending to the upper zones and becoming diffuse with disease progression.

doi: https://doi.org/10.12669/pjms.37.1.3435

How to cite this:Nishtar T, Noor N, Khan SL. X-ray patterns of COVID -19 in patients presenting to Lady Reading Hospital, Peshawar, Pakistan. Pak J Med Sci. 2021;37(1):28-33. doi: https://doi.org/10.12669/pjms.37.1.3435

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.
Influence of contemporary CAD-CAM milling systems on the fit and adaptation of partially stabilized Zirconia fixed partial dentures
Authors: Al Aali Khulud , Alhamdan Rana , Maawadh Ahmed M , Vohra Fahim , Abduljabbar Tariq
Published: December 2020

Objective: To evaluate marginal fit and internal adaptation of three-unit Zr frameworks fabricated from four Zr CAD/CAM milling systems.

Methods: Fixed partial denture models were replicated (40 stone models) using Polyvinyl Siloxane impression material (PVS) and type IV stone for Zr framework fabrication. FPDs were milled with four CAD/CAM systems, Group-II: LAVA™ Zirconia milled by LAVA™, Group-2: Vita In-Ceram YZ milled by Cerec®, Group-3: Zirconia milled by GM1000 and Group-4: Zirconia milled by DWX-50N. Twelve marginal gap measurements per framework were performed at pre-established points, with a metallurgical microscope (Zeiss, Germany) at 500X magnification. Eight measurements of cement space per section were performed for adaptation. Data was analyzed using ANOVA and Tukey post hoc test.

Results: Zirconia FPD frameworks exhibited gaps ranging from 16 to 50.1 µm for marginal fit and 26.8 to 102.5 µm for internal adaptation. Group-3 [20.8 (8.3) µm & 50.3 (11.4) µm] and Group-4 [16.0 (4.0) µm & 40.2 (8.8) µm] specimens showed significantly lower marginal fit and internal adaptation gaps compared to Group-I [50.1 (13.4) µm & 100.5 (16.7) µm] and Group-2 [38.9 (8.2) µm & 102.5 (13.4) µm] specimens respectively.

Conclusions: Different CAD-CAM systems for fabrication of Zr FPD frameworks displayed a significant influence on marginal fit and internal adaptation of restorations.

doi: https://doi.org/10.12669/pjms.37.1.3490

How to cite this:Al-Aali KA, Alhamdan RS, Maawadh AM, Vohra F, Abduljabbar T. Influence of contemporary CAD-CAM milling systems on the fit and adaptation of partially stabilized Zirconia fixed partial dentures. Pak J Med Sci. 2021;37(1):45-51.  doi: https://doi.org/10.12669/pjms.37.1.3490

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Challenges during Colonoscopy in Women with a Prior Hysterectomy
Authors: Kamani Lubna , Butt Nazish , Khemani Hanisha
Published: December 2020

doi: https://doi.org/10.12669/pjms.37.1.3856

How to cite this: Kamani L, Butt N, Khemani H. Challenges during Colonoscopy in Women with a Prior Hysterectomy. Pak J Med Sci. 2021;37(1):295. doi: https://doi.org/10.12669/pjms.37.1.3856
Una hermandad de olvidadas: “las otras” escritoras y editoras en lengua inglesa durante la Primera Guerra Mundial.
Authors: Morató Yolanda
Published: December 2020

Durante los años de la 1ª Guerra Mundial, un grupo de mujeres –editoras, escritoras y artistas– colaboraron en los distintos movimientos de vanguardia que se extendieron por Occidente. En Inglaterra, algunas de estas mujeres se reunieron en círculos más o menos afines a un ismo autóctono, el Vorticismo. En estas páginas se proponen y analizan tres de los condicionantes por las que muchas de ellas han caído en el olvido.
Sirenas que cantan la vida: el sujeto femenino moderno en Vida a vida (1932) de Concha Méndez.
Authors: de la Parra Fernández Laura
Published: December 2020

El presente artículo analiza el poemario Vida a vida (1932), de Concha Méndez, desde la perspectiva de la escritura femenina en la vanguardia española. Tras analizar la representación de temas como el amor o la existencia, se argumenta, siguiendo a Altamirano, Quance o Capdevila-Argüelles, que la poesía de Concha Méndez propone una revisión de las vanguardias a partir de la expresión del sujeto femenino moderno que emerge a principios del siglo XX.
Mary Shelley: il padre come ossessiva relazione.
Authors: Stefanuto Clelia
Published: December 2020

L’obiettivo di questo articolo è analizzare le difficili relazioni paterno-filiali in Frankenstein di Mary Shelley, contestualizzando l’opera nella narrativa dell’Ottocento nel quale si tenta di ridefinire il ruolo della figura del padre nella famiglia e nella società. Mary Shelley proietta nel mostro il suo rapporto conflittuale con Godwin creando un racconto obliquamente autobiografico e, allo stesso tempo, emblematico della ribellione delle figlie e scrittrici al criterio di autorità patriarcale.
David Foster Wallace’s democratic normality.
Authors: Bolaño Quintero Jesús
Published: December 2020

David Foster Wallace’s “E Unibus Pluram” is an account of the prevalence of destructive irony at the end of the twentieth century. Trying to break free from the solipsism brought about by postmodern relativism, Wallace embraced sincerity as the cornerstone of the zeitgeist of the new millennium. This article offers an analysis of two salient sources of influence that could be considered as inspiration for Wallace’s alternative to postmodern irony: American transcendentalism and Ludwig Wittgenstein’s Philosophical Investigations. It does so with the intention of furthering the understanding of the cultural significance of the work of the author for the generation of writers that followed in his wake, and to demonstrate how the recovery of Romantic ideals may be the key to map out the nature of the paradigm shift to post-postmodernism.
De la incapacidad temporal, su flexibilización y desfiguración en tiempos de coronavirus
Authors: Martínez-Gijón Machuca Miguel Ángel
Published: December 2020

La incapacidad temporal ha sido un recurso clave durante la pandemia por coronavirus que ha azotado España. Ha permitido la suspensión de los contratos de trabajo de los trabajadores contagiados o que debían quedar en obligatorio aislamiento por riesgo de contagiar o ser contagiados. El legislador de emergencia ha actuado con intensidad sobre esta prestación de la Seguridad Social, ampliando y alterando algunos de sus rasgos característicos con la finalidad de ofrecer una mayor protección social. El artículo que se presenta analiza con exhaustividad cuáles han sido esas modificaciones y plantea la cuestión de si desde el punto de vista de la técnica jurídica pueden ser calificadas como correctas. Asimismo, aborda otros aspectos que han podido ser menos visibles en relación con la prestación, como el funcionamiento interno de la prestación sanitaria y el subsidio económico, la protección de los datos médicos de los trabajadores de baja por coronavirus, el tránsito entre el desempleo y la incapacidad de los trabajadores en ERTE, así como la compatibilidad del subsidio por IT con otras prestaciones de Seguridad Social.
La protección de los trabajadores autónomos por cese de actividad durante el estado de alarma y la protección tras su finalización
Authors: Álvarez Cortés Juan Carlos
Published: December 2020

Se analiza el régimen jurídico y la evolución normativa de la protección extraordinaria por cese de actividad establecida en el artículo 17 del Real Decreto-Ley 8/2020 y las diversas modificaciones producidas a lo largo de Estado de Alarma de esta prestación. También se analiza, de un lado, la ampliación de la protección por cese de actividad producida por el Real Decreto-Ley 24/2020, para facilitar el reinicio en la actividad permitiendo compatibilizar la actividad con el cese de actividad previsto en la Ley General de la Seguridad Social y, de otro, la prestación extraordinaria de cese de actividad previsto para los autónomos de temporada. Finalmente, se apuntan las medidas adoptadas por el Real Decreto-Ley 30/2020, de 29 de septiembre, de medidas sociales en defensa del empleo referidas al cese de actividad.
Implementation of the remote activities of the Programa Academia da Cidade in times of COVID-19
Authors: Oliveira Gledson da Silva , Pajeú Raquel Bezerra , Lemos Emmanuelly Correia de , Tassitano Rafael Miranda , Santos Renan Wallacy Yvson dos , Silva Charles Barbosa Gomes da , Oliveira Danyelle de Cássia Ribeiro de , Holmes Tatiana Martins Ferraz , Souza Luiz Eduardo Nunes de , Silva Marcílio Paulo da , Campos Gabriela Maranhão Câmara , Silva Ricardo Augusto Menezes da
Published: December 2020

Due to the COVID-19 pandemic, the face-to-face interventions of the Academia da Cidade of Recife (PAC-REC) were suspended and a remote activity plan was elaborated. The aim of this study was to describe the implementation and results of remote PAC-REC activities during the COVID-19 pandemic. A quantitative and qualitative analysis was performed based on the PAC-REC online reports and the virtual platforms referring to the remote activities carried out, from April to July 2020. For the implementation of the remote activities, integrated and systematic planning and monitoring meetings among the professionals and the program management were made. The following material was produced: 14 livestreams of bodily practices and physical activities, 10 interviews, 70 videos with different themes, 85 infographics, among others specified by pole. It is concluded that the performance of remote activities of PAC-REC reached its objectives and some should be maintained after the return of face-to-face activities.
Disappointment Aversion, Term Structure, and Predictability Puzzles in Bond Markets
Authors: Augustin Patrick , Tédongap Roméo
Published: December 2020

We solve a dynamic equilibrium model with generalized disappointment-aversion preferences and continuous state-endowment dynamics. We apply the framework to the term structure of interest rates and show that the model generates an upward-sloping term structure of nominal interest rates and a downward-sloping term structure of real interest rates and that it accounts for the failure of the expectations hypothesis. The key ingredients are preferences with disappointment aversion, preference for early resolution of uncertainty, and an endowment economy with three state variables: time-varying macroeconomic uncertainty, time-varying expected inflation, and inflation uncertainty.

This paper was accepted by Karl Diether, finance.
Coletivo de mulheres universitárias: nova forma de fazer política feminista? Uma análise utilizando process-tracing sobre a criação dos coletivos universitários no contexto da PUC-rio.
Authors: Maria Elaine De Azevedo , Giacomini Sonia Maria
Published: December 2020

Este artigo tem como objetivo demonstrar a relação do coletivo de mulheres da PUC-Rio com a modificação na política acadêmica desta universidade e a criação de novos coletivos. A metodologia escolhida foi o process-tracing por ter estrutura de rastreamento causal que permite analisar, através da sequência dos acontecimentos, o processo de construção política do movimento acadêmico.
O Despertar Do Gigante: Reflexões Sobre O Poder De Agenda Do Presidente Em Períodos De Crise.
Authors: Panait Iani , Melo Robert George Otoni de
Published: December 2020

O presente artigo objetiva compreender a correlação de forças entre os poderes Executivo e Legislativo em momentos históricos de engessamento da vida política no país. Em períodos caracterizados por crise econômica e/ou política, a instabilidade da agenda pública leva à prevalência do Executivo Federal, em detrimento das discussões no seio do parlamento brasileiro, gerando certa instabilidade e agravando períodos de abalo institucional. Através do método qualitativo, o artigo revisará bibliografia para analisar a hipótese de hegemonia da agenda da Presidência da República em relação aos outros poderes, inclusive, através de seus mecanismos de veto, visando pautar o jogo político.
DIMENSÕES DE UM CONFLITO FICCIONAL: A RELAÇÃO ENTRE ESTADO E O INTERESSE PRIVADO A PARTIR DO SETOR ELÉTRICO, E DA CONSOLIDAÇÃO DA ESPÍRITO SANTO CENTRAIS ELÉTRICAS S/A.
Authors: Lopes Jayme K. R.
Published: December 2020

A construção de um setor de energia elétrica estatal e nacional, ocupou um papel especial na história do desenvolvimento do Estado brasileiro entre as décadas de 1940 e 1980. Neste contexto, o setor foi um dos lugares de busca por controle político sobre a administração pública, e de ganhos econômicos a partir um desenvolvimento industrial que se consolidava. Este artigo, utilizando um recorrido de dados históricos, teóricos e bibliográficos, se propõe esta conjuntura explorando o caso do Estado do Espírito Santo. Jogando luz, sobretudo, ao entrelaçamento das ações do Estado e do interesse privado na implementação de sua infraestrutura elétrica e no processo de consolidação da empresa estatal de energia elétrica, a ESCELSA (Espírito Santo Centrais Elétricas S/A).