Pakistan Journal of Medical Sciences最新文献

{"title":"Contraceptive implant continuation among postpartum women at tertiary care center.","authors":"Tayyiba Wasim, Natasha Bushra, Tahira Nasreen, Afshan Shahid","doi":"10.12669/pjms.42.1.12408","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12408","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the continuation rates and factors influencing the discontinuation of postpartum etonorgestrel contraceptive implants over a three-year period.</p><p><strong>Methodology: </strong>A prospective cohort study was conducted from November 2017 to December 2022 in the Department of Obstetrics and Gynecology, Services Hospital, Lahore, Pakistan. The patients coming to OPD and emergency were counselled for insertion of long-acting reversible contraception. Those who opted for postpartum etonorgestrel implants were enrolled after informed consent and implant was placed within 48 hours of birth. The patients were followed for three years post insertion. The primary outcome was the continuation rate at three years, and secondary outcomes included reasons for discontinuation. Statistical analysis was performed using SPSS version 23, and p-values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Of 424 participants the cumulative continuation rates for year 1,2 and 3 were 91.9%, 82.7% and 75% respectively and 106 (25%) removals at the end of year 3. Doctors counselling played role in choosing implant in 177(41.7%) patients. Continuation was higher among women with prior contraceptive knowledge AOR: 3.73; 95% CI (1.20-6.21), previous contraceptive use AOR: 8.1; 95%CI (4.2-31.1), and antenatal counselling AOR: 2.24; 95% CI (1.16-3.54). The most common reasons for discontinuation were side effects in 77(45.2%) and family pressure 55(32.3%) patients. Women with no side effects were 18 times more likely to continue AOR: 18.1; 95% CI (7.5-48).</p><p><strong>Conclusion: </strong>The postpartum insertion of etonorgestrel implant has high continuation rates. Side effects of bleeding irregularities and family pressure were main reasons for discontinuation.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"89-94"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of spleen aminopeptide combined with budesonide nebulization in the treatment of pediatric bronchial asthma and its impact on immune function and inflammatory cytokines.","authors":"Su He, Ning Ran, Xu Yang, Bing Zhu, Dan Zhou","doi":"10.12669/pjms.42.1.12488","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12488","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of spleen aminopeptide(SAP) combined with budesonide nebulization(BN) in the treatment of pediatric bronchial asthma, and its impact on the immune function and inflammatory cytokines of the affected population.</p><p><strong>Methodology: </strong>This was a retrospective study. A total of 120 children with bronchial asthma admitted to Baoding Hospital, Beijing Children's Hospital Affiliated to Capital Medical University from December 2022 to October 2024 were enrolled and randomly divided into the control group(received symptomatic treatment along with BN) and study group(received additional oral SAP based on the control group regimen), with 60 cases in each group. After treatment, the clinical efficacy, adverse drug reaction(ADR) rate, changes in immune markers, and inflammatory cytokines were compared between the two groups.</p><p><strong>Results: </strong>The overall response rate was 93% in the study group and 78% in the control group, with a statistically significant difference(<i>p</i>= 0.02). The ADR was 15% in the study group and 12% in the control group, with no significant difference between the groups(<i>p</i>= 0.60). After treatment, levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ ratio were significantly higher in the study group compared to the control group(p= 0.00, respectively). Additionally, post-treatment levels of TNF-α, CRP, and IL-6 were significantly lower in the study group than in the control group(<i>p</i> = 0.00, respectively).</p><p><strong>Conclusion: </strong>The combination therapy using SAP and BN demonstrates significant clinical efficacy in treating pediatric bronchial asthma. SAP plus BN can effectively enhance immune function and reduce levels of inflammatory cytokines without significantly increasing adverse reactions.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"46-51"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing selection of anesthesiology as a career specialty by residents in Postgraduate Medical Institute Quetta.","authors":"Muhammad Iqbal Khan, Ambareen Khan, Ambreen Usmani","doi":"10.12669/pjms.42.1.12256","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12256","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the factors influencing the selection of anesthesiology as a future career by the residents at Postgraduate Medical Institute Quetta (PGMIQ).</p><p><strong>Methodology: </strong>After obtaining ethical approval from Post Graduate Medical Institute (PGMI), Quetta this sequential mixed-method study was conducted for a period of six months from 1^st of January, 2024 to 30^th June, 2024, to investigate the factors influencing the selection of anesthesiology by Postgraduate residents. In the first phase 36 postgraduates were administered a questionnaire to quantify the influencing factors. Chi-square tests (p<0.05) assessed gender associations. This was followed by a second phase in which in-depth interviews were conducted to get the qualitative insight of the first quantitative phase.</p><p><strong>Results: </strong>Out of 36 residents of PGMIQ, 19 (53%) showed personal interest, 11 (31%) showed mentor influence as the primary motivating factor. As far as practice was concerned, 33(91%) preferred practice in academic facility and 26 (72%) were motivated to integrate research in their future practice. It was also noted that 33 (91.7%) were planning for specialization in subspecialities of anesthesia with significant gender association. The plan for future practice varied, 18(50%) were planning to pursue in same institution, 4(11%) wanted to move to different institutions but within the province, whereas 5(13.9%) intended to move to other provinces and 9(25%) wanted to leave for abroad. During Qualitative phase, four key themes were revealed. First theme was career motivation which was driven by global deficiency of anesthetists and lifesaving aspects of anesthesia during difficult procedures. Second theme emerged as the professional deterrent \"inequity & dependency\" which was supported by their response as poor remuneration, dependency on surgeon and stigmatized labels like \"نشے والا ڈاکٹر\". Thirdly, Systemic improvements were suggested, such as student mentorship and government support for subspecialties and equipment. Finally, Professional Standards emphasized the urgent need to ban unqualified practitioners to ensure patient safety and elevate the specialty.</p><p><strong>Conclusion: </strong>Analysis revealed that the primary driving factor in selecting anesthesiology as a specialty was the residents' intrinsic fascination with the field, coupled with their desire to pursue a career in research and academia.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"252-257"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of combined endodontic-orthodontic treatment on the recovery of masticatory function in patients with crown-root fractures of permanent maxillary anterior teeth.","authors":"Nana Zhang, Lei Mi, Na Jing","doi":"10.12669/pjms.42.1.12794","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12794","url":null,"abstract":"<p><strong>Objective: </strong>To explore the influence of combined endodontic-orthodontic treatment on the recovery of masticatory function in patients with crown-root fractures of permanent maxillary anterior teeth.</p><p><strong>Methodology: </strong>This retrospective analysis included clinical data of 118 patients with crown-root fractures of permanent maxillary anterior teeth admitted to Yulin First hospital from March 2020 to March 2024. Among them, 56 patients who received conventional restoration treatment were set as the control group, and 62 patients who received combined endodontic-orthodontic treatment were set as the study group. The treatment effects, oral-related indicators before and after treatment [gingival index (GI), periodontal probing depth (PPD), tooth mobility (TM)], bite force, masticatory efficiency, and subjective satisfaction were analyzed.</p><p><strong>Results: </strong>The total efficacy of the study group (95.16%) was higher than that of the control group (83.93%) (P < 0.05). After treatment, the levels of GI, PPD, and TM in both groups decreased compared to pre-treatment, and were considerably lower in the study group (P < 0.05). The excellent-good rate of bite force in the study group (93.55%) was higher than that in the control group (80.36%) (P < 0.05). Similarly, combined endodontic-orthodontic treatment was associated with a higher excellent-good rate of masticatory efficiency (93.55%) than that of the conventional restoration (78.57%) (P < 0.05). The subjective satisfaction in the study group (95.16%) was higher than that in the control group (82.14%) (P < 0.05).</p><p><strong>Conclusion: </strong>The combined endodontic-orthodontic treatment for crown-root fractures of permanent maxillary anterior teeth can effectively improve the oral condition, enhance the bite force and masticatory efficiency, with higher treatment effects and subjective satisfaction. This approach may represent a promising treatment option for patients with crown-root fractures of permanent maxillary anterior teeth, pending further validation through prospective and multicenter studies.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"258-265"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the clinical value of serum inflammatory mediators in assessing sepsis severity.","authors":"Xinghua Li, Shiwu Zhang","doi":"10.12669/pjms.42.1.12765","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12765","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical utility of serum inflammatory mediators in assessing the severity of sepsis and predicting patient prognosis.</p><p><strong>Methodology: </strong>A retrospective analysis was conducted on 72 patients diagnosed with sepsis and admitted to the Tianjin Union Medical Center between January 2024 to January 2025, who were stratified into three groups based on disease severity: sepsis(<i>n</i>= 24), severe sepsis(<i>n</i>= 24) and septic shock(<i>n</i>= 24). An additional 24 individuals without sepsis were recruited as the control group. Within 24 hours of hospital admission, serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10) and heparin-binding protein(HBP) were measured, analyzed for their correlation with Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores and their predictive performance for 28-day mortality.</p><p><strong>Results: </strong>Significant differences were observed in serum TNF-α, IL-10, HBP levels and APACHE-II scores across the four groups(all <i>P</i>< 0.05). All three sepsis subgroups showed significantly elevated levels of TNF-α, IL-10, HBP and higher APACHE-II scores compared with the control group (all <i>P</i> < 0.05). Moreover, a graded increase in these biomarkers and APACHE-II scores was observed across the sepsis subgroups, following the trend: septic shock > severe sepsis > sepsis, with all pairwise comparisons reaching statistical significance(P< 0.05, respectively). When stratified into survival and non-survival groups, the non-survivors exhibited significantly higher levels of TNF-α, IL-10, HBP and APACHE-II scores(<i>P</i>< 0.005, respectively).</p><p><strong>Conclusion: </strong>Serum levels of TNF-α, IL-10 and HBP are positively correlated with sepsis severity. The combined measurement of these inflammatory mediators can provide a robust and objective approach for evaluating disease severity and predicting prognosis in patients with sepsis.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"136-140"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphometric analysis of retroperitoneal organs in individuals with unilateral congenital renal agenesis and renal hypoplasia.","authors":"Tayfun Aygun, Nurullah Yucel, Meral Mese, Ridvan Dizman, Tamer Baysal","doi":"10.12669/pjms.42.1.13016","DOIUrl":"https://doi.org/10.12669/pjms.42.1.13016","url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to determine the changing anatomy of the retroperitoneal organs in the Unilateral Congenital Renal Agenesis (UCRA) and Renal Hypoplasia (RH) groups and to investigate the presence of morphological biomarkers by evaluating the functional capacity of the kidney in the patient groups.</p><p><strong>Methodology: </strong>The study was conducted retrospectively at Istanbul Dr. Lütfi Kırdar City Hospital, in collaboration with the Departments of Radiology, Nephrology and Anatomy. CT images of individuals with UCRA and RH followed in the nephrology clinic were retrospectively reviewed and anatomical-topographic evaluations were performed. Biomarkers indicating renal function were obtained from laboratory test results. Statistical significance was accepted as p<0.05.</p><p><strong>Results: </strong>The study included 18 individuals in the agenesis group, 30 in the hypoplasia group, and 25 in the control group. Compensatory hypertrophy was significantly observed in all renal morphometric measurements in the healthy side kidney. It was observed that the estimated glomerular filtration rate (eGFR) decreased from the control group to the agenesis group. The anteroposterior diameter of the inferior vena cava was narrower in individuals with CAKUT (n=48) than in controls (n=25) (CAKUT: 14.50±3.83, Control 17.10±3.80, p=0.007). Cortex thickness was positively correlated with eGFR and negatively correlated with creatinine in both the UCRA group and the HP group. The cortex thickness/mediolateral diameter ratio was negatively correlated with urea, uric acid, creatinine and positively correlated with eGFR.</p><p><strong>Conclusions: </strong>A narrowing of the VCI-AP diameter was notable in patients with CAKUT. Cortical thickness was considered important in the assessment of renal function, and the ratio of cortical thickness to mediolateral diameter (Cx/ML) could be used as a potential reference.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"102-108"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the CHA₂DS₂-VASc Score in predicting postoperative Atrial Fibrillation after pulmonary resection.","authors":"Hasan Ekrem Camas, Serap Yildirim, Suleyman Emre Akin, Bayram Ali Uysal","doi":"10.12669/pjms.42.1.12822","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12822","url":null,"abstract":"<p><strong>Objective: </strong>CHA₂DS₂-VASc is a validated scoring system used to calculate the risk of stroke and thrombus in atrial fibrillation (AF) conditions. In this study, we aimed to evaluate the relationship between the development of postoperative atrial fibrillation (PAF) and CHA₂DS₂-VASc score in patients undergoing elective anatomical lung resection.</p><p><strong>Methodology: </strong>In this retrospective cohort study, the records of patients who underwent elective anatomic lung resection at a single center between January 2015 to December 2024 were reviewed. The CHA₂DS₂-VASc score of all patients was calculated. Mann-Whitney U, Chi-square and ROC analyses, as well as binary logistic regression, were used for statistical analysis.</p><p><strong>Results: </strong>Among one hundred patients (80 males), the incidence of PAF was 11%. Patients with PAF had significantly higher CHA₂DS₂-VASc scores (p<0.001). ROC analysis showed an AUC of 0.797 (p<0.001), with a cut-off of 1.5 yielding 90.9% sensitivity and 34.8% specificity. Logistic regression identified the CHA₂DS₂-VASc score as a significant predictor of PAF (OR=4.33, p=0.039).</p><p><strong>Conclusion: </strong>The CHA₂DS₂-VASc score may be a valuable tool not only to assess thromboembolic risk but also to predict the development of PAF after thoracic surgery. With this scoring, high-risk patients can be identified in advance, appropriate prophylactic measures can be taken, and postoperative morbidity and mortality can be reduced.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"179-184"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraintestinal manifestations in ulcerative colitis patients with disease phenotype: insights from a Pakistani population.","authors":"Omar Idris, Ali Akbar, Nazish Butt, Abdul Samad Bhatti","doi":"10.12669/pjms.42.1.12456","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12456","url":null,"abstract":"<p><strong>Background & objective: </strong>Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) involving continuous colonic mucosal inflammation that leads to extraintestinal manifestations (EIMs) in many patients. Understanding the prevalence, patterns and factors associated with EIMs is vital for optimizing UC patient care, making this study essential for assessing EIM frequency, distribution and stratification.</p><p><strong>Methodology: </strong>This observational, cross-sectional study was conducted at Jinnah Postgraduate Medical Centre in Karachi from June 2022 to November 2024, involving 147 UC patients. Prospective data collection was used to assess disease severity using the standard criteria. EIMs were classified according to their type. Statistical analysis included descriptive and inferential methods using chi-square tests with p <0.05.</p><p><strong>Results: </strong>EIMs affected 53 (36.1%) patients, with musculoskeletal manifestations in 13(8.8%) and hepatobiliary issues in 12(8.2%). Ocular involvement was observed in 8(5.4%) patients, dermatological manifestations in 09 (6.1%), renal issues (nephrolithiasis) in 5(3.4%) and systemic problems in 6(4.1%). Gender, age and disease duration did not significantly correlate with the presence of EIM (p >0.05), but severity showed a significant association (p<0.05).</p><p><strong>Conclusion: </strong>Extra-intestinal manifestations, especially musculoskeletal and hepatobiliary manifestations, are commonly found in ulcerative colitis. EIMs are correlated with disease severity and are not related to gender and age.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"168-172"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of adverse feto-maternal outcomes in patient with placental abruption.","authors":"Uzma Kausar, Saima Khattak","doi":"10.12669/pjms.42.1.12261","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12261","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the frequency of adverse feto-maternal outcomes in patients with placental abruption.</p><p><strong>Methodology: </strong>This descriptive case series was a study carried out in the Department of Obstetrics and Gynecology, Lady Reading Hospital, Peshawar between January 26, 2022 and July 26, 2022. The sample size of the study was 136 patients who had placental abruption, who were aged between 18 and 40 years, and were more than 24 weeks of gestation and any parity. The feto-maternal outcomes of these patients were compared.</p><p><strong>Results: </strong>The mean age of the participants was 27.65 ± 6.27 years. The adverse maternal outcomes were acute tubular necrosis (8.8%), disseminated intravascular coagulation (19.1%), postpartum hemorrhage (27.9%), and maternal admission to ICU was detected in 7 (5.1%) patients. The maternal age was significant as associated with DIC (p < 0.05). Adverse fetal outcomes included intrauterine fetal death in 6 (4.4%), preterm birth in 30 (22.1%), low APGAR score in 33 (24.3%), stillbirth in 28 (20.6%), and admission to NICU in 29 (21.3%). The maternal demographic variables were significantly related to preterm birth (p = 0.03) and stillbirth (p < 0.05).</p><p><strong>Conclusion: </strong>Our study identified the frequency of adverse fetal and maternal outcomes in patients with placental abruption. The fetal outcomes were intrauterine fetal death, pre-term births, low APGAR score, and stillbirth. The acute tubular necrosis, disseminated intravascular coagulation and postpartum hemorrhage were maternal outcomes.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"77-82"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of body-weight supported treadmill training and electrical stimulation on functional ambulation and strength in patients with incomplete traumatic spinal cord injury: A randomized controlled trial.","authors":"Amir Zeb, Beenish Mehmood, Arif Shah, Shakil Ur Rehman, Muhammad Kashif","doi":"10.12669/pjms.42.1.12127","DOIUrl":"https://doi.org/10.12669/pjms.42.1.12127","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the efficacy of body weight-supported treadmill training (BWSTT) combined with electrical stimulation (ES) in enhancing functional ambulation and lower limb strength.</p><p><strong>Methodology: </strong>This single-center, multi-arm randomized controlled trial with a parallel group design was conducted from July 2024 to February 2025 at the Paraplegic Center Peshawar (PCP). Eighty-one patients with incomplete traumatic spinal cord injury (SCI) were randomized into three groups: (I) BWSTT + ES + Conventional Therapy (CT), (II) BWSTT + CT and (III) CT only. Interventions were conducted for 12 weeks, with assessments at baseline, 6 weeks and 12 weeks using Walking Index for Spinal Cord Injury (WISCI-II), 6-Minute Walk Test, 10-Meter Walk Test, lower extremity muscle strength (LEMS) and spinal cord independence measure (SCIM). Repeated-measures ANOVA and post-hoc analyses with Bonferroni adjustment were performed.</p><p><strong>Results: </strong>All groups showed significant improvements in walking ability (WISCI-II) and functional independence (SCIM) (p < 0.001), with BWSTT + ES + CT demonstrating the greatest gains. At 12 weeks, this group had significantly higher WISCI-II scores than BWSTT + CT (p = 0.030) and CT only (p = 0.005). Strength and endurance improvements were greatest in the BWSTT + ES + CT group, but between-group differences were not statistically significant. Overall, the effects on the 6MWT, 10MWT, LEMS, and strength (measured via dynamometer) were higher in the BWSTT + ES + CT group; however, no significant differences were observed between groups.</p><p><strong>Conclusion: </strong>All three groups demonstrated improvements in ambulatory function and functional independence over time, with the BWSTT + ES + CT group showing the greatest overall gains. . Combining BWSTT with ES and CT showed superior results in walking ability and functional independence in individuals with incomplete SCI, while strength and endurance improvements were similar across different rehabilitation approaches.<b>Registration No.</b> (Trial ID: 70844; IRCT ID: IRCT20230615058487N1).</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 1","pages":"213-220"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}