bluuebunny/crossref_metadata_2025_split huggingface dataset:
Amiodarone in the treatment of atrial fibrillation of patients with rheumatic heart disease after valve replacement
Authors: Chen Kebiao , Qin Li , Lu Xin , Xia Tao , Gu Qing 
Published: July 2019

Objectives: To explore the efficacy of amiodarone in the treatment of atrial fibrillation for patients with rheumatic heart disease after valve replacement.
Methods: Eighty-six patients with rheumatic heart disease who were hospitalized between June 2016 and June 2017 and developed atrial fibrillation after valvular heart valve replacement were randomly divided into a control group and an observation group, 42 cases in each group. The control group was treated with routine medical treatment, while the observation group was given amiodarone on the basis of routine treatment. The cardiac function of the two groups were observed and recorded. Postoperative atrial fibrillation conversion rate, sinus rhythm maintenance rate, intensive care unit (ICU) monitoring time and hospital stay were compared between the two groups.
Results: Compared with the control group, the improvement of cardiac function indexes of the observation group was better, and the difference was statistically significant (P<0.05). The atrial fibrillation conversion rate and the maintenance rate of sinus rhythm of the observation group were 76.2% and 47.6% respectively, which were significantly higher than 57.1% and 33.3% of the control group; the differences had statistical significance (P<0.05). The ICU monitoring time and hospitalization time of the patients in the observation group were (1.69±0.91) d and (10.24±1.11) d respectively, which were significantly shorter than (2.83±0.95) d and (14.07±1.17) d in the control group (P<0.05); the differences were statistically significant (P<0.05).
Conclusion: Amiodarone can effectively treat valve replacement associated atrial fibrillation of patients with rheumatic heart disease. It can significantly improve the heart function, prevent the recurrence of atrial fibrillation, maintain sinus rhythm after operation, and shorten the time of ICU monitoring and hospitalization.
doi: https://doi.org/10.12669/pjms.35.4.1298
How to cite this:Chen K, Qin L, Lu X, Xia T, Gu Q. Amiodarone in the treatment of atrial fibrillation of patients with rheumatic heart disease after valve replacement. Pak J Med Sci. 2019;35(4):918-922. doi: https://doi.org/10.12669/pjms.35.4.1298
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.
Diabetes in Pakistan: A systematic review and meta-analysis
Authors: Akhtar Sohail , Nasir Jamal Abdul , Abbas Tahir , Sarwar Aqsa 
Published: July 2019

Objective: The purpose of this study was assess the time trend of the prevalence of prediabetes and diabetes and risk factors associated with diabetes in Pakistan by using a systematic review and meta–analysis.
Methods: A systematic literature search of Embase, PubMed, and the Cochrane library was carried out between January 1, 1995 and August 30, 2018. Diabetes and prediabetes prevalence estimates were combined by the random–effects model. The existence of publication bias was tested by Egger regression. This systematic review was reported following the PRISMA guidelines.
Results: The search conceded a total of 635 studies, only 14 studies were considered for meta-analysis. The prevalence of diabetes in Pakistan was revealed 14.62% (10.651%–19.094%; 14 studies) based on 49,418 people using the inverse–variance random–effects model. The prevalence of prediabetes was 11.43% (8.26%–15.03%; 10 studies) based on a total sample of 26,999 people. The risk factors associated with diabetes were mean age (β = 0.48%, 95% CI: 0.21–0.78, p<0.001), the proportion of participants with a family history of diabetes (β = 0. 45%, 95% CI: 0.08–0.82, p =0.018, p<0.001), hypertension (β = 0.40%, 95% CI: 0.06–0.75, p = 0.022), weight (BMI) (β = 0.21%, 95% CI: 0.02–0.4, p=0.030).
Conclusions: There has been a continuous increase in the prevalence of prediabetes and diabetes in Pakistan. All parts of the country have been affected, with the highest in Sindh and lowest in Khyber Pakhtunkhwa. The main factors include growing age, family history, hypertension and obesity. A nationwide diabetes care survey on risk factors and prevention policy is highly recommended.
doi: https://doi.org/10.12669/pjms.35.4.194
How to cite this:Akhtar S, Nasir JA, Abbas T, Sarwar A. Diabetes in Pakistan: A systematic review and meta-analysis. Pak J Med Sci. 2019;35(4):1173-1178. doi: https://doi.org/10.12669/pjms.35.4.194
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.
Injection of immunoglobulin in the treatment process of children with severe pneumonia
Authors: Chen Liping , Qi Xuehai , Li Ruiying , Wang Xudong , Hi Baohai , Meng Qingmei 
Published: July 2019

Objective: To observe the effect of intravenous infusion of immune globulin in the treatment of children with severe pneumonia.
Methods: Ninety-eight children with severe pneumonia who received treatment in our hospital between April 2015 and December 2016 were selected, and they were grouped into a control group and an treatment group, 49 each group. The control group received conventional treatment. The treatment group was additionally treated with immune globulin on the basis of conventional treatment. The humoral immune indicators were detected using immunoturbidimetric assay, and the inflammatory reaction indicators were detected using enzyme-linked immunoabsorbent kit. The overall efficacy, clinical symptoms, humoral immunity and inflammatory response were compared between the two groups.
Results: The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05). The cough, rale and fever of the treatment group disappeared faster than those of the control group, the relief of cardiac failure was also faster in the treatment group (P<0.05). The immunoglobulin G (Ig G), Ig A and Ig M of patients in the two groups compared before treatment, and no significant difference was found (P>0.05). The Ig G level of the treatment group was higher than that of the control group after treatment (P<0.05). The comparison of Ig A and Ig M between the two groups indicated no significant difference (P>0.05). The two groups had no significant differences in the content of tumor necrosis factor (TNF)-α, C-reactive protein (CRP), soluble intercellular adhesion molecule (SICAM)-1 and interferon (IFN)-γ (P>0.05) before treatment, but the content of the treatment group was significantly higher than that of the control group (P<0.01).
Conclusion: Immunoglobulin was significantly effective in the adjuvant treatment of children with severe pneumonia, and it can rapidly improve the improvement of symptoms, enhance immune function and inhibit inflammatory reaction; therefore it is worth promotion.
doi: https://doi.org/10.12669/pjms.35.4.83
How to cite this:Chen L, Qi X, Li R, Wang X, Shi B, Meng Q. Injection of immunoglobulin in the treatment process of children with severe pneumonia. Pak J Med Sci. 2019;35(4):940-944. doi: https://doi.org/10.12669/pjms.35.4.83
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.
Accessing DMPA-SC through the public and private sectors in Nigeria: users’ characteristics and their experiences
Authors: Liu Jenny , Shen Jennifer , Schatzkin Eric , Adedeji Olanike , Kongnyuy Eugene , Onuoha Chidinma , Fajemisin Morenike , Ayodeji Kazeem , Omoluabi Elizabeth 
Published: July 2019

Background: Beginning in 2015, subcutaneous depot medroxyprogesterone acetate (DMPA-SC) was added to the contraceptive method mix in Nigeria, primarily through social marketing in the private sector and community-based distribution in the public sector. We compare user experiences in acquiring DMPA-SC across sectors during this national scale-up. Methods: From October 2017 to February 2018, 459 women (Npublic=235; Nprivate=224) completed a phone survey from a convenience sample of 1,444 women (Npublic=912; Nprivate=532) who obtained DMPA-SC from participating providers and agreed to be contacted. We examined the sociodemographic predictors of attending a public vs. private provider and analyzed differences in care-seeking across sectors (becoming aware of DMPA-SC, choosing a provider, choosing DMPA-SC, quality of care). Results: Respondents obtaining DMPA-SC from public providers were younger and less educated than those attending private providers. Both program respondents were comprised of similar percentages of new users of modern contraception (58.7-60.3%), although most respondents became aware of DMPA-SC through a friend/family member (43.1%) or a provider (41.5%). Relatively more public sector respondents also heard about DMPA-SC through community outreaches whereas relatively more private sector respondents became aware through media. Convenience was the most common reason for choosing a provider—43.8% among all respondents (higher among public sector respondents). Private sector respondents were also more likely to choose a past or usual provider. Having overall higher quality interactions were more likely among clients who attended private providers than public providers, but responses to individual quality item measures show specific areas of poor quality for providers in each sector. Conclusions: Training emphasizing technical thoroughness, sensitivity toward younger women, and client choice may help improve women’s experiences with obtaining DMPA-SC, ultimately contributing to accelerating demand for and uptake of DMPA-SC specifically and contraception in general.
Normative data and inter-examiner reliability of the upper quarter Y-balance test
Authors: Vaughan Brett , Theisinger Kane , Abels Luke , Bryan Luke , Duggan Sarah 
Published: July 2019

Background/Aims Physical performance measures, such as the lower quarter Y-balance test, can be used to determine performance ability or functional limitations. The aim of this study was to establish a normative data set for the upper quarter Y-balance test and evaluate inter-rater reliability. Methods Healthy participants, with no current upper extremity complaint or balance issues, were recruited. Participants undertook the upper quarter Y-balance test by reaching in three directions: medial; superolateral; and inferolateral. Each participant completed three reaches on each side. The mean of the second and third reach distances was used for the analysis and reach distance was normalised to limb length. Results Mean participant age was 24.3 (± 5.6) years. Statistically significant differences between males and females were observed for all reach directions (both raw and normalised data), with large to very large effect sizes (P<0.001, effect size (r)=0.82–1.92). Results showed statistically significant differences between left- and right-hand dominance with left inferolateral reach (P=0.038, z=−2.076, r=0.21). Inter-rater reliability was excellent, with an intraclass correlation coefficient (3,1) of 0.98. Conclusions The results suggest that males have a statistically significantly larger reach in all directions and that participants reach significantly further when testing the dominant arm versus the non-dominant arm. The data presented here provide researchers with a substantive normative data set that will allow for comparison with symptomatic populations.
Exercise using a foam bead bag improves balance and lower extremity strength in older adults
Authors: Siriphorn Akkradate , Siriphorn Siriporn Vongsaiyat , Sawatthuk Kittaphon , Temvorasub Kanjana , Auttawut Malinee 
Published: July 2019

Background/Aims Balance training using unstable support surfaces is widely used in clinics and research and can reduce the risk of falls in older people. This study aimed to investigate the effect of an exercise programme using a foam bead bag on older adults' ability to balance and the strength of their lower extremities and compare the effect with no exercise and foam pad exercise using the same programme. Methods A total of 24 older adults were allocated into one of three groups: control (n=8), foam pad exercise (n=8) and foam bead bag exercise (n=8). The foam pad exercise and foam bead bag exercise groups carried out a programme consisting of 30 minutes of exercise performed twice a week for 5 weeks. The control group did not participate in an exercise programme. Participants' balance abilities were measured using the Fullerton Advanced Balance Scale, the Timed Up and Go Test and the Single-Leg Stance Test. The strength of their lower extremities was measured using the 30-second sit-to-stand test. Results The Fullerton Advanced Balance scale and 30-second sit-to-stand scores significantly improved in the foam pad exercise and foam bead bag exercise groups. Both of these groups also demonstrated significant improvements in Timed Up and Go tests. The amount of time that participants were able to stand on one leg while unassisted significantly increased in the foam bead bag group only. No significant differences were found in balance ability or lower extremity strength in the control group. Conclusions A foam bead bag is a suitable alternative to a foam pad when performing exercises to improve balance and strength of the lower extremities in older adults.
Feasibility and acceptability of Otago Exercise Programme and Prevention of Falls for Adults with Intellectual Disability: a multiple case study design
Authors: Hale Leigh , Vollenhoven Emile , Caiman Lisa , Dryselius Alice , Buttery Yvette 
Published: July 2019

Background/AimsMany people with intellectual disability fall frequently. Understanding fall prevention intervention characteristics will assist efficacy trials to target appropriate people. An exploration of two exercise-based fall prevention interventions is reported, focusing on viability and acceptability.MethodsA multiple case study of adults with intellectual disability completing either the group Otago Exercise Programme or the Prevention of Falls for Adults with Intellectual Disability intervention was performed. Integrated data sources were used: semi-structured interviews with participants and support workers, observations, attendance/adherence, falls, adverse events and balance measures.ResultsIn total, seven adults with varying intellectual disability levels participated. Overall, three themes enabled understanding of suitability of people to each intervention: suitability of the exercises; role of the environment; and benefits to participants.ConclusionsEducating adults with intellectual disability and their support workers of the importance of regular exercise is key to participation. Both programmes required high levels of support and prioritisation to ensure exercises occurred and were carried out safely.
An Exploratory Pilot Study Into Undergraduate Physiotherapy Students' Perceptions Of Working With Patients With Mental Illness And Working Within The Mental Health Sector Of Health Care
Authors: McIver Samantha , Toms Jane 
Published: July 2019

Background/Aims Mental illness is widespread throughout the United Kingdom with increasing prevalence. As mental illness affects such a large proportion of the population, it is likely that healthcare professionals, including qualified and student physiotherapists, will work with patients in all areas of healthcare, who have mental illness alongside co-morbidities. Physiotherapy students are placed into a wide range of placements throughout an undergraduate degree to develop skills and autonomy in rehabilitation. Understanding students' perspective appears relatively unexplored and was stimulated by personal experience of the first author where patients' rehabilitation could be impacted by mental illness. The impact varied depending on the severity of their illness, as well as the understanding of that illness by the multidisciplinary team involved in their care. The aim of this phenomenological study was to: explore physiotherapy students' lived experiences and perceptions of working with patients with mental illness, despite no mental health specific placement and understand their views of working in the mental health sector of healthcare Methods Ethical approval was obtained from Coventry University Ethics and a qualitative methodology was applied. Purposeful sampling was used to recruit six participants, who were all Undergraduate physiotherapy students at Coventry University, and data were collected via a focus group. The focus group explored their lived experiences, opinions and perceptions. Results A number of themes were discovered from the data, with associated sub-themes: ‘Lack of clarity’ with sub-themes: ‘Definitions, Terminology and understanding’, ‘Mental illnesses’ and ‘Physiotherapist role’ ‘Emotional Roller-Coaster’ with sub-themes: ‘Negative reactions’ and ‘Positive sentiments’ ‘Transferable skills’ with sub-themes: ‘Core competencies’ and ‘Core skills to elevate’ ‘Everyone has a story to tell’ with sub-themes: ‘Job’, ‘Placement’ and ‘Personal experience’ The themes influenced their ‘curious intrigue’, which related to their views of working in the mental health sector of health care. Conclusions All participants in the study had experiences to discuss and found it challenging to provide effective rehabilitation, appropriate to the patients' needs. Discussing these experiences evoked a complex range of perceptions and emotions.
Dorsiflexion But Not Plantarflexion Force Declines At Lower Foot Skin Temperatures
Authors: Bieles Julie S , Bruce Stuart A , Newham Di J , Green David A 
Published: July 2019

Background/Aims Muscle maximum voluntary force declines at skin temperature <20°C, attributed to cold muscle, however large muscle deep fibres remain at >20°C. Large muscle maximum voluntary force decline is comparable to that in small superficial muscle where muscle temperature remains close to skin temperature. Therefore, factors in addition to temperature may contribute to large muscle maximum voluntary force decline. This study compares the effects of foot and/or shank skin temperature on dorsiflexion and plantarflexion maximum voluntary force with the hypotheses that: dorsiflexion maximum voluntary force>plantarflexion maximum voluntary force decline at lower skin temperature; and, plantarflexion and dorsiflexion maximum voluntary force will decline at lower shank skin temperature independent of foot skin temperature. Methods A total of 24 adults (15 females, 9 males, 29 ± 11.8 years, 170.1 ± 8.0 cm, 66.9 ± 9.3 kg [mean ± standard deviation]) gave informed consent to participate on three visits – cooling/warming of: foot only; foot and shank; and shank only. Foot and/or shank temperature was adjusted using Cryocuff™ sleeves filled with ~45°C or ~4°C water. Temperature, taken before each maximum voluntary force set, was monitored through thermocouples placed on the limb. Plantarflexion and dorsiflexion maximum voluntary force were measured with a KinCom isokinetic dynamometer, with subjects seated on a plinth with knee fully extended and neutral ankle. A general mixed model was used to evaluate the effects of skin temperature on maximum voluntary force. Fixed effects were skin temperature and condition, with subject as a random effect. The skin temperature*condition interaction was also modelled. P-values were obtained by likelihood ratio tests. Results Foot skin temperature <18.5°C resulted in a 10% (χ2(1)=5.479, P=0.019) dorsiflexion maximum voluntary force decline, with a skin temperature*condition interaction (χ2(2)=11.031, P=0.004), this decline was 12% (χ2(1)=13.18, P=0.0003) in foot only and 8% (χ2(1)=4.675, P=0.031) in foot and shank. Leg skin temperature did not affect (χ2(1)=2.849, P=0.091) dorsiflexion maximum voluntary force. Plantarflexion maximum voluntary force did not change with foot skin temperature (χ2(1)=0.04, P=0.841) or leg skin temperature (χ2(1)=0.082, P=0.929). Conclusions Dorsiflexion maximum voluntary force declines at lower foot skin temperature independently of shank skin temperature, whereas plantarflexion maximum voluntary force is unaffected by skin temperature, possibly because in this protocol the shank was insufficiently cooled. Therefore factors other than direct muscle cooling must contribute to dorsiflexion maximum voluntary force decline. One theory is a rightward shift in the force-length relationship, due to stiffer tendon, could result in dorsiflexions operating in the descending limb of the force-length relationship. This warrants further investigation.
Mobilisation And Tactile (Sensory) Stimulation For The Foot Post Stroke: Opinions And Perceptions Of Experienced Therapists
Authors: Aries Alison M , Cooke Lucy , Hunter Sue M 
Published: July 2019

Background/Aims Intensive proprioceptive stimulation applied to the paretic hand post-stroke, using a complex hands-on intervention known as mobilisation and tactile stimulation, has reduced motor impairment and improved hand function in sub-acute and chronic stroke. While, anecdotally, mobilisation and tactile stimulation is also applied to the paretic foot to prepare it for standing, its use in stroke rehabilitation and effects on standing and balance have not been evaluated. Therefore, expert clinicians' experiences, opinions and perceptions of using mobilisation and tactile stimulation in routine clinical practice were explored to inform a subsequent feasibility study of mobilisation and tactile stimulation for the paretic foot post-stroke. Methods Following ethical approval, focus groups were undertaken: using purposive sampling, physiotherapists and occupational therapists with >12 months experience of stroke rehabilitation were recruited from a regional special interest group. A pilot study (n=4) and main study (n=7) explored content and application of hands-on therapy for the paretic foot, and the perceived impact of sensory loss on lower limb function. Data were audio-taped and transcribed verbatim. Thematic analysis was undertaken. Results All 11 therapists had previous experience of using mobilisation and tactile stimulation for the foot post-stroke. Three main themes were identified: (1) therapeutic intervention (sub-themes: therapy content, sensation, adjuncts, the foot as an active base of support and preparation for function); (2) 24-hour care; and (3) analysis (sub-themes: outcome measures, response to treatment). The most common adjuncts to mobilisation and tactile stimulation were orthotics and task-specific training. The importance of mobilisation and tactile stimulation in restoring foot alignment, sensory feedback and progression of the patient towards weight bearing and ambulation in the clinical setting was highlighted. Conclusions Mobilisation and tactile stimulation is a complex intervention used in stroke rehabilitation to enhance weight bearing and ambulation post stroke. Further research into its effects on the foot and lower limb is warranted in order to evaluate it and determine its evidence base for inclusion in routine clinical practice. Alternative methods of applying proprioceptive stimulation should also be considered, for example use of textured insoles, and relative effectiveness of these explored in clinical trials.