bluuebunny/crossref_metadata_2025 huggingface dataset:
Health care provider reporting practices related to self-managed abortion
Authors: Roberts Sarah C. M. , Zaugg Claudia , Grossman Daniel
Published: March 2023

Background

Health care providers reporting patients to government authorities is a main way people attempting self-managed abortion (SMA) become exposed to legal risks. Little is known about health care provider decision-making regarding SMA reporting.

Methods

We conducted semi-structured interviews with 37 clinicians who provided care in hospital-based obstetrics or emergency departments (13 obstetricians/gynecologists, two advance practice registered nurses providing obstetrics care, 12 emergency medicine physicians, and 10 family medicine physicians) throughout the United States. The interview guide asked participants to describe one or more cases of caring for a patient who may have attempted SMA and about related reporting decisions. We coded responses to answer two questions: What comes to mind for health care providers when asked to think about experiences caring for a patient who may have attempted SMA? Based on health care provider experiences, how might people who providers suspect may have attempted SMA end up reported?

Results

About half of participants had cared for someone who may have attempted SMA for that pregnancy. Only two mentioned SMA with misoprostol. Most participants described cases where they were unsure whether the patient had attempted to end their pregnancy on purpose. In most instances, participants mentioned that that the possibility of reporting never occurred to them nor came up. In some cases, participants described a reporting “adjacent” practice – e.g. beginning processes that could lead to substance use, domestic violence, or self-injury/suicide-related reports – or considered reporting related to a perceived need to report abortion complications. In two cases, hospital staff reported to the police and/or Child Protective Services related to the SMA attempt. These involved passing of a fetus after 20 weeks outside the hospital and a domestic violence incident.

Conclusion

Reporting patients who may have attempted SMA may occur via provider perception of a need to report abortion complications and fetal demises, particularly at later gestations, and other reporting requirements (e.g. substance use, domestic violence, child maltreatment, suicide/self-harm).
Electroacupuncture for the management of symptom clusters in cancer patients and survivors (EAST)
Authors: Xie Lifang , Ng Ding Quan , Heshmatipour Matthew , Acharya Munjal , Coluzzi Paul , Guerrero Nerida , Lee Sanghoon , Malik Shaista , Parajuli Ritesh , Stark Craig , Tain Rongwen , Zabokrtsky Keri , Torno Lilibeth , Chan Alexandre
Published: March 2023

Background

Neuropsychiatric symptoms, comprising cognitive impairment, fatigue, insomnia, depression, and anxiety, are prevalent and may co-occur during and after chemotherapy treatment for cancer. Electroacupuncture (EA), which involves mild electrical stimulation with acupuncture, holds great potential in addressing the management of individual symptoms. However, there is a lack of studies evaluating if EA can manage concurrent neuropsychiatric symptoms in cancer (i.e., symptom cluster). Hence, we designed a trial to evaluate the efficacy, safety, and feasibility of administering EA as an intervention to mitigate neuropsychiatric symptom clusters amongst cancer patients and survivors.

Methods

The EAST study is a randomized, sham-controlled, patient- and assessor-blinded clinical trial. Sixty-four cancer patients and survivors with complaints of one or more neuropsychiatric symptom(s) in the seven days prior to enrollment are recruited from the University of California Irvine (UCI) and Children’s Hospital of Orange County (CHOC). Individuals with needle phobia, metastases, bleeding disorders, electronic implants, epilepsy, exposure to acupuncture in the three months prior to enrollment, and who are breastfeeding, pregnant, or planning to get pregnant during the duration of the study will be excluded. Screening for metal fragments and claustrophobia are performed prior to the optional neuroimaging procedures. Recruited patients will be randomized (1:1) in random blocks of four or six to receive either ten weekly verum EA (treatment arm, vEA) or weekly sham EA (control arm, sEA) treatment visits with a follow-up appointment four to twelve weeks after their last treatment visit. The treatment arm will receive EA at 13 acupuncture points (acupoints) chosen for their therapeutic effects, while the control arm receives minimal EA at 7 non-disease-related acupoints. Questionnaires and cognitive assessments are administered, and blood drawn to assess changes in symptom clusters and biomarkers, respectively.

Conclusion

The EAST study can provide insight into the efficacy of EA, an integrative medicine modality, in the management of cancer symptom clusters in routine clinical practice.

Trial registration

This trial is registered with clinicaltrials.gov NCT05283577.
Multiple mini-interviews is a predictor of students’ academic achievements in early undergraduate medical years: a retrospective study
Authors: Alam Faiza , Lim Ya Chee , Chaw Li Ling , Idris Fazean , Kok Kenneth Yuh Yen
Published: March 2023

Background

Our study determined Multiple Mini-Interview (MMI) effectiveness in evaluating specific skill sets based on medical students’ performances during the undergraduate years and compared the academic performances of medical students who appeared for onsite/online MMI.

Methods

A retrospective study of 140 undergraduate medical students between 2016 and 2020 included data on age, gender, pre-university results, MMI scores, and examination results. Appropriate non-parametric tests were applied to compare the students’ MMI and academic performances.

Results

Ninety-eight students from cohorts 12 to 15 had an overall MMI score of 69.0(IQR: 65.0—73.2)/100 and an overall Cumulative Grade Point Average(GPA) of 3.64 (3.42—3.78)/5.0. Spearman’s correlation revealed a significantly positive relationship between MMI and cGPA (rho = 0.23) and GPA from the first 2 semesters (GPA1 rho = 0.25, GPA2 rho = 0.27). This observation was similar to that for station A in the first year (cGPA rho = 0.28, GPA1 rho = 0.34, GPA2 rho = 0.24), and in station B (GPA4 rho = 0.25) and D (GPA3 rho = 0.28, GPA4 rho = 0.24) in the second year. Of twenty-nine cohort16 students, 17(58.6%) underwent online and 12(41.4%) offline modes of MMI assessment, respectively. The overall median MMI score was 66.6(IQR: 58.6—71.6)/100, and the overall median cGPA was 3.45 (3.23—3.58)/5.0. When comparing the median marks of cohort16 groups, the online group scored significantly higher marks for station D than the offline group (p = 0.040).

Conclusion

Correspondence between MMI scores and cGPA predicted MMI scoring during student selection and entry process might ensure the success of their academic performance in medical school.
Adult asthma associated with roadway density and housing in rural Appalachia: the Mountain Air Project (MAP)
Authors: Christian W. Jay , Flunker John , May Beverly , Westneat Susan , Sanderson Wayne T. , Schoenberg Nancy , Browning Steven R.
Published: March 2023

Background

Appalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied.

Objective

This manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults.

Methods

A cohort of residents, aged 21 and older, in two Kentucky counties, was enrolled in a community-based, cross-sectional study. Stratified cluster sampling was used to select small geographic areas denoted as 14-digit USGS hydrologic units (HUCs). Households were enumerated within selected HUCs. Community health workers collected in-person interviews. The proximity of nearby active and inactive coal mining operations, density of oil and gas operations, and density of roadways were characterized for all HUCs. Poisson regression analyses were used to estimate adjusted prevalence ratios.

Results

From 1,459 eligible households contacted, 1,190 individuals were recruited, and 972 persons completed the interviews. The prevalence of lifetime asthma was 22.8%; current asthma was 16.3%. Adjusting for covariates, roadway density was positively associated with current asthma in the second (aPR = 1.61; 95% CI 1.04–2.48) and third tertiles (aPR = 2.00; 95% CI 1.32–3.03). Increased risk of current asthma was associated with residence in public, multi-unit housing (aPR = 2.01; 95% CI 1.27–3.18) compared to a residence in a single-family home. There were no notable associations between proximity to coal mining and oil and gas operations and asthma prevalence.

Conclusions

This study suggests that residents in rural areas with higher roadway density and those residing in public housing units may be at increased risk for current asthma after accounting for other known risk factors. Confirming the role of traffic-related particulates in producing high asthma risk among adults in this study contributes to the understanding of the multiple environmental exposures that influence respiratory health in the Appalachia region.
McKeown esophagectomy for a thoracic esophageal carcinoma patient who has a history of definitive chemoradiotherapy for esophageal carcinoma and total pharyngolaryngectomy for hypopharyngeal cancer
Authors: Sugawara Kotaro , Fukuda Takashi , Kishimoto Yutaka , Oka Daiji , Shirakura Satoru , Kanda Hiroaki , Kawashima Yoshiyuki
Published: March 2023

A 64-year-old man, who had previously undergone definitive chemoradiotherapy (dCRT) and endoscopic resections for metachronous multiple esophageal squamous cell carcinoma (ESCC) and had also received total pharyngolaryngectomy (TPL) for hypopharyngeal cancer, was diagnosed with ESCC in the middle thoracic esophagus (cT3N0M0). Thoracoscopic McKeown esophagectomy was performed for the patient. Although the tumor was tightly adherent to the thoracic duct and both main bronchi, they were successfully mobilized. In order to maintain the blood supply to the trachea, we preserved the bilateral bronchial arteries and avoided prophylactic upper mediastinal lymph node dissection. Cervical end-to-side anastomosis between the jejunum and a gastric conduit was performed. Minor pneumothorax was managed conservatively, and the patient was discharged 44 days after the surgery. Overall, thoracoscopic McKeown esophagectomy was safely performed in a patient with a history of TPL and dCRT. Surgeons should be very careful to prevent tracheobronchial ischemia by optimizing the extent of lymph node dissection.
Antagonist activation exercises elicit similar post-activation performance enhancement as agonist activities on throwing performance
Authors: Pisz A. , Blazek D. , Jebavy R. , Kolinger D. , Wilk M. , Krzysztofik M. , Stastny P.
Published: March 2023

Background

This study aimed to determine the acute effect of agonist and antagonist conditioning activities (CA) on medicine ball throw performance among female softball players.

Methods

Thirteen national-level female softball players (age 22.2 ± 3.1 years; body mass 68.3 ± 11.3 kg; softball experience 7.3 ± 2.4 years) performed 3 medicine ball chest throws before conditioning activity (CA) and after CA respectively in 3rd, 6th, and 9th minute. CA was the bench press and bent-over barbell row with 2 sets of 4 repetitions at 60% and 80% of one-repetition maximum, and 2 sets of 4 repetition bodyweight push up.

Results

Two-way ANOVA revealed an increase in throwing distance (p < 0.001) after bent over barbell row and push-up exercise, and an increase in throwing speed (p < 0.001) after bench press and push-up. All performance increases were in moderate effect size (Cohen d 0.33–0.41), and no differences were found between the experimental CA.

Conclusions

We conclude that upper body throwing performance is similar after antagonist exercise and agonist CA, both agonist and antagonist CA increase muscle power. In the resistance training practice, we recommend the interchange of agonist and antagonist CA using bodyweight push-up or submaximal intensity (80% of 1RM) bench press and bent over barbell row to succeed post-activation performance enhancement in upper limbs.
The characteristics of extrachromosomal circular DNA in patients with end-stage renal disease
Authors: Peng Yue , Li Yixi , Zhang Wei , ShangGuan Yu , Xie Ting , Wang Kang , Qiu Jing , Pu Wenjun , Hu Biying , Zhang Xinzhou , Yin Lianghong , Tang Donge , Dai Yong
Published: March 2023

Background

End-stage renal disease (ESRD) is the final stage of chronic kidney disease (CKD). In addition to the structurally intact chromosome genomic DNA, there is a double-stranded circular DNA called extrachromosomal circular DNA (eccDNA), which is thought to be involved in the epigenetic regulation of human disease. However, the features of eccDNA in ESRD patients are barely known. In this study, we identified eccDNA from ESRD patients and healthy people, as well as revealed the characteristics of eccDNA in patients with ESRD.

Methods

Using the high-throughput Circle-Sequencing technique, we examined the eccDNA in peripheral blood mononuclear cells (PBMCs) from healthy people (NC) (n = 12) and ESRD patients (n = 16). We analyzed the length distribution, genome elements, and motifs feature of eccDNA in ESRD patients. Then, after identifying the specific eccDNA in ESRD patients, we explored the potential functions of the target genes of the specific eccDNA. Finally, we investigated the probable hub eccDNA using algorithms.

Results

In total, 14,431 and 11,324 eccDNAs were found in the ESRD and NC groups, respectively, with sizes ranging from 0.01 kb to 60 kb at most. Additionally, the ESRD group had a greater distribution of eccDNA on chromosomes 4, 11, 13, and 20. In two groups, we also discovered several motifs of specific eccDNAs. Furthermore, we identified 13,715 specific eccDNAs in the ESRD group and 10,585 specific eccDNAs in the NC group, both of which were largely annotated as mRNA catalog. Pathway studies using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) showed that the specific eccDNA in ESRD was markedly enriched in cell junction and communication pathways. Furthermore, we identified potentially 20 hub eccDNA-targeting genes from all ESRD-specific eccDNA-targeting genes. Also, we found that 39 eccDNA-targeting genes were associated with ESRD, and some of these eccDNAs may be related to the pathogenesis of ESRD.

Conclusions

Our findings revealed the characteristics of eccDNA in ESRD patients and discovered potentially hub and ESRD-relevant eccDNA-targeting genes, suggesting a novel probable mechanism of ESRD.
Perceived abusive supervision and graduate students’ suicidal ideation: from the perspective of interpersonal psychological theory of suicide
Authors: Yao Yingying , Dong Fangbai , Qiao Zhihong
Published: March 2023

Background

In recent years, the issue of suicide caused by the stress of a contradictory relationship between graduate students and academic supervisors has aroused heated discussion in society. Based on the interpersonal psychological theory of suicide, this study aims to examine the influence of the perceived abusive supervision on graduate students’ suicidal ideation and the parallel mediating roles of thwarted belongingness and perceived burdensomeness.

Methods

We conducted a cross-sectional online survey measuring perceived abusive supervision, interpersonal psychological needs and suicidal ideation among 232 Chinese graduate students. A structural equation model was constructed to test the hypothesis.

Results

The results showed that abusive supervision directly exacerbated suicidal ideation (β = 0.160, 95% CI = [0.038, 0.281], p = 0.009) and indirectly influenced suicidal ideation through thwarted belongingness (β = 0.059, 95% CI = [0.008, 0.110], p = 0.019) and perceived burdensomeness (β = 0.102, 95% CI = [0.013, 0.191], p = 0.018). The indirect effect accounted for 50.15% of the overall effect.

Conclusions

These findings enrich our understanding of the influence of supervisor–student relationship by integrating the literatures on educational and organizational behaviour, and provide practical insights for psychosocial interventions from the perspective of the interpersonal psychological theory of suicide.
Examining capabilities, opportunities, and motivations for healthy eating behaviors in Latin American restaurants: a quantitative application of the COM-B model to inform future interventions
Authors: Fuster Melissa , Santos Maria P. , Dimond Emily , Huang Terry T. K. , Handley Margaret A.
Published: March 2023

Background

Eating foods away from home has been associated with poor diet quality and adverse health outcomes. Research is needed to examine barriers and facilitators to making healthier eating choices in restaurant settings. We operationalized the Capability, Opportunity, and Motivation for Behavior Model (COM-B Model) to conduct a behavioral diagnosis for healthy eating behaviors at Latin American restaurants (LARs), an understudied yet increasingly important food environment with the potential to positively influence diets.

Methods

We conducted an online survey with adults in the United States that reported eating food from LARs at least once a month (n = 509) recruited via an online market research panel to examine capabilities – physical (e.g., skills) and psychological (e.g., knowledge), opportunities – social (e.g., norms) and physical (e.g., environmental), and motivations – reflective (e.g., self-conscious intentions) and automatic (e.g., emotions) associated with healthier choices at LARs. In a survey focused on LAR-associated behaviors, each COM-B domain was scored between 1–5, with scores ≥ 4 denoted as having high capability, opportunity, and motivation to eat healthfully at LARs (potential range of total score = 6–35). Regression analysis was used to examine the association between COM-B scores (total and by domain) and select demographic characteristics (age, gender, race, Latin heritage, income, education, marital status, and Latin majority state of residency).

Results

More than half of the participants (57.1%) were classified as having high physical capability, followed by psychological capability (43.9%) in the LAR environment. The proportions of participants with either high motivation or high opportunity were low, ranging from 37.3% (reflective motivation) to physical opportunity (15.6%). The overall mean COM-B total score was 19.8 ± 3.0. Higher total COM-B scores were associated with younger age, self-identifying as white, having Latin heritage, and having higher income (p < 0.05).

Conclusions

This study expands the application of the COM-B framework using quantitative inquiry to evaluate levels of capability, motivation, and opportunity for healthy eating in LAR settings and initial demographic associations with determinants for healthy eating in these settings. This work can aid in tailoring interventions and developing evaluation tools for LAR-related healthy eating interventions.
Usefulness of augmented reality in radiological protection education and training for interventional radiologists
Authors: Lima Thiago VM , Figueiredo Pohlmann Simões Rafael , Heinrich Mirjam , Kreienbühl Tobias , Wetzel Richard , Roos Justus E.
Published: March 2023

Objective:

The aim of this work is to evaluate the usefulness of using augmented reality (AR) to train medical professionals in radiological protection (RP) in fluoroscopy.

Methods:

A Microsoft HoloLens 2 device has been used to simulate a fluoroscopic device. The teaching scenario considers a Philips Azurion able to rotate to pre-defined gantry positions,a dorsal decubitus patient and a ceiling shield. Radiation exposures were simulated using the FLUKA Monte Carlo code. 11 radiologists were asked to reproduce their positioning as per a clinical procedure and to correctly position the ceiling shield. Then, they were presented with the radiation exposure of their choices and were able to further optimise it. After the session, they were asked to complete a questionnaire.

Results:

Users rated the AR educational approach as Intuitive and relevant to RP education (35%) and inspiring to deepen their knowledge (18%). Nevertheless, a negative aspect was mainly the difficulty in dealing with the system (58%). Although the participants were radiologists, a minority recognised themselves as having accurate knowledge of the RP (18%), indicating a relevant knowledge gap.

Conclusion:

The usefulness of using AR in RP education for radiologists has been shown. The visual aid of such technology is likely to improve the consolidation of practical knowledge.

Advances in knowledge:

The use of interactive teaching techniques has the possibility to both help radiology professionals consolidate their radiation protection training and confidence in their practices.
How different is the Learning Environment of Public and Private Sector Medical Colleges in Lahore, Pakistan?
Authors: Shahzad Saadia , Gohar Wajid
Published: March 2023

Background & Objective: Regular assessment of the Learning Environment (LE) of health professions education institutions is important for their continuous improvement and to keep the students motivated. Pakistan Medical & Dental Council (PM&DC) applies uniform standards of quality in all public and private sector medical colleges of the country. However, the learning environment of these colleges might be different due to differences in their geographic location, structure, utilization of resources, and modus operandi. This study was conducted to measure the learning environment in selected public and private sector medical colleges in the city of Lahore, Pakistan, using a pre validated instrument (Jhon Hopkins Learning Environment Scale).

Methods: This cross-sectional descriptive study was conducted on 3,400 medical students from six public and private sector medical colleges of Lahore, during November and December 2020. Data was collected through Google forms. Two stage cluster random sampling technique was used to draw the study sample. John Hopkins Learning Environment Scale (JHLES) was used for data collection.

Results: Overall JHLES mean score was 81.75 ±13.5. Public sector colleges had a significantly higher mean JHLES score (82.1) than private-sector colleges (81.1), with small effect size (0.083). Male students rated LE slightly higher than females (82.0 and 81.6 respectively).

Conclusion: JHLES a relatively simpler tool (28 items) than DREEM, can be used effectively in the context of Pakistani environment to measure the LE in medical colleges. Both, public and private sector colleges had high overall JHLES mean scores, with public sector colleges having a significantly higher score than private-sector colleges.

doi: https://doi.org/10.12669/pjms.39.3.6202

How to cite this: Shahzad S, Wajid G. How different is the Learning Environment of Public and Private Sector Medical Colleges in Lahore, Pakistan? Pak J Med Sci. 2023;39(3):757-763. doi: https://doi.org/10.12669/pjms.39.3.6202

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.
Genetic Polymorphism and serum levels of Insulin like Growth Factor-1 (Igf-1) in patients of rheumatoid arthritis
Authors: Fayyaz Iram , Khaliq Saba , Bano Farhat , Kaul Haiba
Published: March 2023

Objectives: Insulin like growth factor-1(IGF-1), is a modulator of immunity and inflammation, it promotes the anabolic role of growth hormone (GH) on bone and skeletal tissue. Genetic polymorphism in IGF-1 gene is reported to affect the transcriptional efficiency affecting its serum level. In this study we aim: 1) To study the presence of 192bp polymorphism of IGF-1 gene in patients of rheumatoid arthritis (RA), 2) To study the association of 192 bp polymorphism of IGF-1 gene with serum IGF-1 levels and disease severity in patients of RA.

Methods: A cross-sectional study was carried out at University of Health Sciences (UHS), Lahore. Diagnosed RA cases who fulfilled the American College of Rheumatology (ACR) criteria were recruited from Fatima Memorial Hospital (FMH) and Behbud Rheumatology Clinics, Lahore during 2018–2019. Serum IGF-1 levels were determined by ELISA in blood samples of 200 RA patients and 200 healthy individuals. DNA was extracted and genetic polymorphism was determined.

Results: The serum IGF-1 level in RA group was significantly lower compared to healthy group. Our study shows presence of 192bp allele of IGF-1in 77% of the studied population. Carriers of 192bp allele of IGF-1 had a significantly higher serum level of IGF-1 as compared to non-carriers in the RA patients. Rheumatoid factor (RF) positive patients had a higher number of 192bp carriers in comparison to RF negative patients. Significant difference was also seen in severity of disease between carrier and non-carriers of 192bp allele with the disease being more severe in male carriers.

Conclusions: There is an association of IGF-1gene polymorphism with variation in serum IGF-1 levels and severity of RA.

doi: https://doi.org/10.12669/pjms.39.3.6561

How to cite this: Fayyaz I, Khaliq S, Bano F, Kaul H. Genetic Polymorphism and serum levels of Insulin Like Growth Factor-1 (Igf-1) in patients of rheumatoid arthritis. Pak J Med Sci. 2023;39(3):764-768. doi: https://doi.org/10.12669/pjms.39.3.6561

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.
Exploring areas of improvement in postnatal care services in a tertiary care hospital in Lahore
Authors: Mahmood Atiya , Eusaph Amna Zia , Javed Ayesha , Muzaffar Arooj
Published: March 2023

Background and Objective: Poor postnatal care can increase morbidity and mortality. This study assessed the current deficiencies in quality of postnatal care provided to mothers in Lady Aitchison hospital, Lahore when compared to WHO standards and identifies the areas for quality improvement.

Methods: It is a descriptive cross-sectional study which employs quantitative method to collect and analyze the data. It was conducted to include ninety-six maternities attending the wards of Lady Aitchison Hospital, Lahore during January 2022 to February 2022. Consenting post-partum mothers were selected by random sampling and interviewed by using a structured proforma.

Results: Among 96 mothers, 56% were below 25 years of age, 39% had secondary education, with more than one child (71%) and 57% visited for the first time. Majority of mothers, were given medicine timely (82%) and found the attitude (85%) and information (83%) provided by the healthcare workers helpful. Their subjective satisfaction rate with staff was 90%. The main areas of concern were lack of proper examination guidelines and facilities, limited information to mothers regarding neonatal care and substandard interior of hospitals. The statistics on the detailed maternal and neonatal examination showed that it was left out in 30% to 50% patients. Information regarding the danger signs of mothers and neonates was not given in 69% and information on family planning was provided to only 28%. Contentment with the infrastructure of the hospital was subpar and it was suggested that the sanitary conditions of washrooms and the paraphernalia of the wards i.e., ACs and beds needed improvement.

Conclusions: This study suggests that in developing countries like Pakistan, majority of the patients were satisfied by the services of healthcare workers. The prime improvement area is the infra-structure of the hospital which can be upgraded to provide better quality facilities in terms of air-conditioning, washrooms and well-designed areas for extensive examination of breast, pelvis, abdomen and neonates. There is also need for introduction of standard guidelines for postnatal care.

doi: https://doi.org/10.12669/pjms.39.3.6780

How to cite this: Mahmood A, Eusaph AZ, Javed A, Muzaffar A. Exploring areas of improvement in postnatal care services in a tertiary care hospital in Lahore. Pak J Med Sci. 2023;39(3):732-736. doi: https://doi.org/10.12669/pjms.39.3.6780

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.
Natamycin versus natamycin combined with voriconazole in the treatment of fungal keratitis
Authors: Cai Jingjing , Yang Chengwen , Wei Qiuhong , Lian Huifang , An Lin , Zhang Rong
Published: March 2023

Objective: To observe the therapeutic effect of natamycin combined with voriconazole in the treatment of fungal keratitis (FK).

Methods: This is a retrospective study. The subjects of this study were 64 patients with FK who were admitted to Baoding No.1 Central Hospital from February 2019 to July 2022. The enrolled patients were divided into control group (n= 32) and study group (n= 32) by the random number table method. The control group was treated with natamycin alone, and the study group was treated with natamycin combined with voriconazole. The total efficacy, time of disappearance of ocular symptoms, visual acuity level, keratitis severity score, corneal ulcer area, tear fungus index and incidence of adverse reactions were compared between the two groups.

Results: The total efficacy,of the study group was significantly higher than that of the control group. The disappearance time of corneal ulcer, photophobia, foreign body sensation and hypopyon in the study group was shorter than those in the control group. Keratitis severity score and (1,3)-β-D-glucan level in the study group were lower than those in the control group. The corneal ulcer area was narrowed in the study group than that of the control group, and the visual acuity level in the former group was higher than that of the latter group. Besides, there was no significant difference in the frequency of adverse reactions between the two groups.

Conclusion: Natamycin combined with voriconazole is safe and effective in the treatment of FK.

doi: https://doi.org/10.12669/pjms.39.3.6908

How to cite this: Cai J, Yang C, Wei Q, Lian H, An L, Zhang R. Natamycin versus natamycin combined with voriconazole in the treatment of fungal keratitis. Pak J Med Sci. 2023;39(3):775-779. doi: https://doi.org/10.12669/pjms.39.3.6908

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 epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) targeted combined chemotherapy on immune function, tumor markers and oxidative stress in patients with stage IV lung adenocarcinoma
Authors: Kun Yanxiao , Wu Jian , Chen Shaomu
Published: March 2023

Objective: To investigate the effects of EGFR-TKI combined chemotherapy on immune function, tumor markers and oxidative stress in patients with stage-IV lung adenocarcinoma.

Methods: This retrospective observational study included 116 patients with stage-IV lung adenocarcinoma, treated in The First Affiliated Hospital of Soochow University from January 2021 to January 2022. According to the treatment records, 60 patients that received pemetrexed + cisplatin for four courses were set as a Control-group and 56 patients that received EGFR-TKI + pemetrexed + cisplatin for four courses were set as an Observation-group. Changes in immune function, tumor marker levels and oxidative stress level in the two groups were analyzed and compared.

Results: After the treatment, levels of CD3+, CD4+, IgG and IgM in the Control-group were significantly lower than those before the treatment. EGFR-TKI + pemetrexed + cisplatin resulted in levels of CD3+, CD4+, IgG and IgM higher than before the treatment, and compared to the Control-group (p<0.001). After the treatment, the levels of NSE, serum CEA, serum CA125, CYFEA21-1 in both groups were significantly lower than those before treatment, and lower in the Observation-group (p<0.001). After the treatment, VEGF and MMP9 levels in both groups were significantly lower than those before treatment, and markedly lower in the Observation-group (p<0.001).

Conclusion: Compared with systemic chemotherapy, EGFR-TKI targeted combined chemotherapy for stage-IV lung adenocarcinoma is associated with enhanced immune function of patients. It more effectively inhibits the growth and proliferation of tumor cells and reduces the level of oxidative stress.

doi: https://doi.org/10.12669/pjms.39.3.7397

How to cite this: Kun Y, Wu J, Chen S. Effects of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) targeted combined chemotherapy on immune function, tumor markers and oxidative stress in patients with stage IV lung adenocarcinoma. Pak J Med Sci. 2023;39(3):742-746. doi: https://doi.org/10.12669/pjms.39.3.7397

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.
Η αρχή της ηθικής απόδειξης
Authors: Παπουτσής Χρήστος
Published: March 2023

Η διατριβή διαρθρώνεται σε τρία μέρη. Το πρώτο μέρος εξετάζει τη διαχρονική λειτουργία της αρχής της ηθικής απόδειξης, και στο οποίο αναλύονται: α) η επίδραση των δικονομικών αρχών στο πεδίο της απόδειξης, β) η ιστορική αναδρομή της αρχής της ηθικής απόδειξης, γ) η συγκριτική επισκόπηση της ελεύθερης εκτίμησης των αποδείξεων στα ευρωπαϊκά κράτη, δ) η αναδειχθείσα διαφοροποίηση της ηθικής απόδειξης από την ελεύθερη εκτίμηση των αποδείξεων. Στο δεύτερο μέρος εξετάζεται το δικονομικό πλαίσιο εφαρμογής της ηθικής απόδειξης, και στο οποίο αναλύονται: α) ο λογικός σχηματισμός της δικανικής πεποίθησης, β) η αρχή της σχετικότητας των αποδεικτικών μέσων, γ) η ηθική απόδειξη υπό το φως της ολόπλευρης αναζήτησης της αλήθειας. Στο τρίτο μέρος εξετάζονται οι περιορισμοί της ηθικής απόδειξης και στο οποίο αναλύονται: α) το ζήτημα των αποδεικτικών περιορισμών a priori, β) η έγγραφη κατάθεση του απόντος μάρτυρα υπό το φως της ηθικής απόδειξης, γ) η εξ ακοής μαρτυρία υπό το φως της ηθικής απόδειξης, δ) η ανώνυμη μαρτυρία υπό το φως της ηθικής απόδειξης, ε) η μαρτυρία συγκατηγορουμένου υπό το φως της ηθικής απόδειξης. Βασικός στόχος της διατριβής είναι να καταδειχθεί ένας εφικτός τρόπος εφαρμογής της αρχής της ασφάλειας δικαίου κατά την εκτίμηση των αποδείξεων, ώστε να προωθηθεί η αναγκαία προβλεψιμότητα της εφαρμογής της ηθικής απόδειξης. Για να επιτευχθεί ο στόχος αυτός προβάλλεται η ανάγκη αφενός της δογματικής εναρμόνισης της ηθικής απόδειξης με τις αρχές της αμεσότητας και της δίκαιης δίκης, αφετέρου η αξιοποίηση της νομολογίας του Γερμανικού Ομοσπονδιακού Δικαστηρίου, ως προς τον αναιρετικό έλεγχο της εκτίμησης των αποδείξεων.
Polycystic Ovary Syndrome - increased risk of depression development. Links and risk factors
Authors: Szymańska Julia , Kapłon Kamil , Pawłocik Weronika , Wojtala Laura , Pawlak Weronika , Kojder Dominika , Kamińska Izabela , Grabowska Ewa , Musiał Lena , Możdżyńska Agnieszka
Published: March 2023

PCOS is a common endocrine disorder affecting up to 6-10% of women in reproductive age. Patients suffer from many manifestations of this disease including symptoms of hyperandrogenism (hirsutism, acne, androgenetic alopecia), ovulation disorders, infertility, overweight and obesity, glucose-insulin homeostasis disorders (insulin resistance, type 2 diabetes). Many studies emphasize the relationship between the presence of PCOS in patients and the appearance of depression. The median incidence of depression in women with this syndrome was 36.6%, while in the group of women without PCOS it was 14.2%. The exact mechanism of this relationship is still unknown, but many factors may play an important role in it, e.g. increased BMI, infertility, high cortisol levels, body image, vitamin D deficiency or elevated inflammation markers.
Search Register Login Posesja przy ulicy Krakowskiej pod numerem 30 na krakowskim Kazimierzu: Ponowne przedstawienie problematyki historycznej oraz rekonstrukcja zabudowy (od XVI do XVIII wieku)
Authors: Dryja Sławomir , Sławiński Stanisław
Published: March 2023

Książka przedstawia historię i przemiany budowlane mieszczańskiej kamienicy stojącej przy ul. Krakowskiej nr 30 – dawniej w obrębie miasta Kazimierz pod Krakowem, dziś w Krakowie. Kamienica reprezentowała typ bliski występującemu nagminnie w Krakowie i tamże ukształtowanemu w ciągu wieków XIV i XV domowi średniej szerokości („półkuryjnemu”), o głębokim rzucie. Dom nazwano kamienicą już w roku 1587, a pierwszy znany nam jej opis powstał w roku 1589. Druga połowa wieku XVII i wiek XVIII to epoka upadku kamienicy, którą jednak reparowano w miarę potrzeb i możliwości. Dzisiejszą modernistyczną kamienicę zbudowano w początku wieku XX. W dalszej części książki omówiono problematykę realności sąsiednich, tak samo jak Krakowska 30 wydzielonych z zaplecza pierwotnych działek przyrynkowych. Były to: kamienica – dziś nr 32, a obok niej niewielka kamieniczka, pierwotnie oficyna narożnej działki przyrynkowej – dziś odrębny dom przy ul. Krakowskiej nr 34. Monografia została przygotowana na podstawie badań podjętych w terenie oraz kwerendy archiwalnej w aktach miasta Kazimierza znajdujących się w Archiwum Narodowym w Krakowie. Należy podkreślić występujące w kazimierskich zapiskach źródłowych bogactwo szczegółów, z którego wynikła możliwość dokładnego datowania powstawania poszczególnych partii murów kamienicy.
Ateistyczne korzenie ponowoczesności
Authors: Rożdżeński Roman
Published: March 2023

SŁOWEM „PONOWOCZESNOŚĆ ” określa się zwykle ten najnowszy okres kultury Zachodu, w którym teraz żyjemy, a który nastąpił po jej nowoczesnym okresie, radykalnie mu się przeciwstawiając. Albowiem główną cechą ponowoczesności jest utrata wiary w nieograniczone możliwości ludzkiego rozumu i bezgraniczny postęp, ta zaś wiara była czymś typowym dla nowoczesnej mentalności, zainspirowanej oświeceniową ideologią. Okres ponowoczesności zaczął się w drugiej połowie XX wieku, gdy kręgi zachodniej lewicy uznały, że straszliwe zbrodnie sowieckich komunistów oznaczają klęskę nowoczesnego paradygmatu rewolucji, który wiązał się ze stosowaniem przemocy, terroru i doprowadził do ludobójstwa. Postawiło to przed zachodnią lewicą pytanie: w jaki sposób można by dokonać marksistowskiej rewolucji w krajach Zachodu bez przemocy i terroru? Odpowiedzi w tej kwestii udzielili zachodni marksistowscy intelektualiści, reprezentujący tzw. marksizm kulturowy. Według nich rewolucji w zachodnich krajach należy dokonywać w sposób pokojowy, zastępując stopniowo ich tradycyjną kulturę marksistowską ideologią. Od tamtego czasu szeroko rozumiana zachodnia lewica, kierując się ich wskazaniami, swoimi wieloletnimi działaniami kształtowała tę ponowoczesną postać kultury, która obecnie dominuje w krajach zachodnich.
The Effect of Government Policy Management on the Quality of Health Services
Authors: Rahmadhani Wulan , Laelatul Qomar Umi , Dorji Sangay
Published: March 2023

Background: Quality of health services is a tool to measure the patient’s satisfaction with medical services in accordance with standard operating procedures and medical service standards. It is based on the potential of available resources, facilities, and infrastructure of Pusat Kesehatan Masyarakat (Puskesmas) or hospitals that are efficient, effective, safe, and in accordance with norms, ethics, law, as well as the socio-cultural environment while respecting and adapting to the capabilities and limitations of the government and society. Good quality of services in a health service affects the health service. This research aims to analyze, synthesize, summarize, and compare the results of studies about the influence of government policy management on the quality of health services in Puskesmas. Method: This literature review was conducted by searching the literature in Google Scholar, Prayer, and Garuda with the keywords of Government Policy, Health Service Management, and Quality of Health Services. This study reviewed 6 articles as reference sources. Results: This study showed the influence of government policy management on the quality of health services at Puskesmas. Conclusion: Policy management in a health service greatly influences the quality of health services and good service quality results in high patient satisfaction.
Analysis of Air Pollution (SO2) at Some Point of Congestion in DKI Jakarta
Authors: Aji Tritamtama Kurnia , Sembiring Fred Erick Soaloan , Choiruddin Achmad , Patria Harry
Published: March 2023

Background: Air pollution is the entry or inclusion of energy substances from other components into the air by humans so that air quality drops to a certain level which causes the air to not meet the requirements. This study aims to determine concentration levels of particulates (PM10, PM25), sulfur dioxide (SO2), carbon monoxide (CO), ozone (O3), and nitrogen dioxide (NO2) at several congestion points in Daerah Khusus Ibukota (DKI) Jakarta. Method: The research location based on the purposive sampling method was carried out at 5 congestion points in DKI Jakarta namely Bundaran Hotel Indonesia (HI), Kelapa Gading, Jagakarsa, Lubang Buaya, and Kebon Jeruk. The data used in the process of forming the model using the Box-Jenkins method and analyzed manually, so this process can be done using ARIMA Forecasting. Results: Based on the time series of hourly data, which was calculated on average into daily data, the concentration of PM10, PM25, SO2, CO, O3, and NO2 from January to October 2021 has decreased from the previous months at several congestion points in DKI. Conclusion: The conclusion of this study is the decreased concentration of PM10, PM25, SO2, CO, O3, and NO2 at several points in DKI Jakarta, so it is recommended to the Government and the Community make efforts/activities to maintain the healthy air quality in DKI Jakarta.
Digital Health Literacy Competencies of Students in Faculty of Health Science
Authors: Haikal Haikal , Rachmani Enny , Setyo Nugroho Bayu Yoni , Iqbal Muhammad , Prasetya Jaka , Yudi Nugroho Syahifful
Published: March 2023

Background: Students are the most significant internet users in Indonesia. 49.52% of internet user groups in Indonesia are students. High internet users do not guarantee that digital health literacy is also high. Students at the Universitas Dian Nuswantoro health faculty are responsible for disseminating health information and transmitting digital health literacy interests. Health literacy skills are necessary for health students to sort out doubtful information. Good health literacy skills will impact students' ability to assess incoming data and make appropriate health decisions. This study aims to describe the digital health literacy skills possessed by students of the Faculty of Health. Universitas Dian Nuswantoro. Method: This descriptive study provides an overview/description of the digital health literacy skills possessed by students of the Faculty of Health. Universitas Dian Nuswantoro. The research population of health students is 1.642 people with the sample being 321 students. Data collection using Google Forms and distributed through class groups in WhatsApp (WA) and communicated privately. The statistical test used descriptive statistical analysis. Results: Faculty of Health Science at Universitas Dian Nuswantoro students had an "Advanced" or "Independent-Advanced" level of competence. The advanced level indicates that their digital competencies and health information skills are at their current status and without problems. Indicators that digital health literacy can improve our safety. Thus. students can improve methods for securing personal data. Conclusion: Digital health literacy is an ability needed in today's digital era. What needs to be improved is that students can choose the most appropriate method to protect personal data.
Revisión sobre los beneficios psicosociales que las personas receptoras obtienen del aprendizaje-servicio…
Authors: López-de-Arana Prado Elena , Vizcarra Morales María Teresa , Calle-Molina María Teresa
Published: March 2023

INTRODUCCIÓN. La investigación apunta a que las experiencias en aprendizaje-servicio (ApS) en actividad física y deportiva (AFyD) favorecen el desarrollo personal y social de las personas receptoras. El objetivo de este estudio es conocer qué se recoge en la literatura sobre los beneficios psicosociales que obtienen estas personas, para elaborar un instrumento que facilite recoger su voz, la voz de las personas receptoras que tan frecuentemente es ventrilocuada. MÉTODO. Se realizó una revisión sistemática de la literatura, donde se analizaron 300 manuscritos publicados entre 2005-2021. El software Nvivo permitió discriminar la información centrada en los beneficios psicosociales, encontrando 91 referencias con información vinculada a las personas receptoras. De la revisión sistemática de la literatura emergieron 4 categorías: autoconcepto y autoestima, autonomía, relaciones interpersonales y diversión. Los resultados de este análisis posibilitaron construir las 54 preguntas que podrían facilitar la recogida de información sobre dichos aspectos. RESULTADOS. La mayor parte de los textos revisados afirman que estas experiencias ayudan a los colectivos receptores a mejorar su autopercepción corporal, profundizar en su conocimiento personal, ganar confianza en sus capacidades, superar prejuicios, tener una menor dependencia, incrementar su capacidad para pedir ayuda, ser más emprendedores, trabajar en equipo y/o colaboración, mostrar aptitudes para la socialización pacífica, expandir su red social, incrementar el disfrute, experimentar la calma y sentirse cansados. DISCUSIÓN. Se puede concluir que este estudio, al igual que otros, evidencia la necesidad de evaluar e investigar las experiencias de ApS en AFyD a través de las propias voces de los colectivos receptores; pero, además, ofrece un instrumento para superar este reto que se plantea en la investigación sobre ApS en AFyD.
Translation and adaptation of the Gross Motor Function Measure-88 to the Croatian language
Authors: Husnjak Dunja , Gudlin Hrvoje , Novak-Pavlic Monika
Published: March 2023

The Gross Motor Function Measure-88 (GMFM-88) is a standardized observational instrument measuring gross motor function for children with cerebral palsy and Down syndrome. Clinicians in Croatia have been showing a growing interest in GMFM-88. However, only the English version of the measure was available, which possessed a barrier for its use in Croatia. The aim of this study was to translate the GMFM-88 test from English into Croatian and adapt it for use in clinical practice in Croatia. In this study, we followed the first five steps of the Sousa & Rojjanasrirat (2010) guideline for translation and adaptation. First, two authors independently did “forward” translation; a translation of the score sheet from English into Croatian. Then, the third author performed “backward” translation, which was checked and revised by the measure’s author. The pre-final version of the translated measure was tested through cognitive debriefing with seven clinicians. Participants pointed out the importance of the consistent use of terms and provided suggestions for improvement, such as changed word order or shortening of the translated items. Seventy two of 88 items were changed. With this study, we have initiated the adaptation of the GMFM-88 to Croatian. The next steps for fully validated GMFM-88 in the Croatian language is to do psychometric testing with children with cerebral palsy and Down syndrome in Croatia.