Pakistan Journal of Medical Sciences最新文献

{"title":"Frequency of seizures in post-cerebrovascular accident patients.","authors":"Mirza Raees, Sheraz Saleem, Muhammad Adnan, Areeba Mariam Mehmood","doi":"10.12669/pjms.42.9.16727","DOIUrl":"https://doi.org/10.12669/pjms.42.9.16727","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the frequency of seizures in patients following a cerebrovascular accident (CVA).</p><p><strong>Methodology: </strong>This prospective observational cohort study was carried out at the Department of Medicine, Faisal Masood Teaching Hospital, Sargodha, between July 2024 and April 2025. After ethical clearance and written consent, 73 adults of either gender, aged 20 to 70 years, who reached the hospital within 24 hours of an acute stroke were enrolled. Data were analyzed using SPSS version 26.0.</p><p><strong>Results: </strong>Mean age was 55.33 ± 14.32 years, with 43 men (58.9%) and 30 women (41.1%). Ischemic stroke was seen in 49 patients (67.12%) and hemorrhagic stroke in 24 (32.88%). The middle cerebral artery was the most common territory, with 30 cases (41.1%), followed by the anterior cerebral artery with 24 (32.88%), the posterior cerebral artery with 10 (13.7%), and the cortical area with 9 (12.33%). Post-stroke seizures developed in 40 patients (54.79%), with onset ranging from 2 to 49 days (mean 28.03 ± 14.66). Late-onset seizures occurred in 30 patients (41.1%) and early-onset seizures in 10 (13.7%). On binary logistic regression, anterior cerebral artery involvement was an independent predictor of seizures (OR 4.88, 95% CI 1.43-18.67, p = 0.014); all patients with posterior cerebral artery or cortical involvement developed seizures (complete separation, odds ratios not estimable), whereas age, gender, and stroke type were not significant (model AUC 0.84).</p><p><strong>Conclusion: </strong>Seizures developed in over half of the stroke patients, and a late-onset pattern was more common. Cortical and posterior cerebral artery involvement showed the strongest association with seizures, and anterior cerebral artery involvement was an independent predictor of seizure occurrence.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2533-2539"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113472","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":"Outcomes of thrombolytic therapy in prosthetic valve thrombosis; a single centre study.","authors":"Ikram Ahmed Rana, Fatina Munawar, Ayesha Mubasher, Muhammad Talha Bajwa","doi":"10.12669/pjms.42.9.13490","DOIUrl":"https://doi.org/10.12669/pjms.42.9.13490","url":null,"abstract":"<p><strong>Objective: </strong>To determine the outcomes of thrombolytic therapy in prosthetic valve thrombosis.</p><p><strong>Methodology: </strong>Data was taken from the hospital discharge database, of the Tahir Heart Institute, for patients admitted from January 01, 2016 to June 30, 2024. Definitive diagnosis was made with transthoracic echocardiography showing an obstructed prosthetic valve for patients presenting with new-onset dyspnea. Streptokinase infusion was given per ACC/AHA guidelines with twelve-hourly TTE for transvalvular gradient assessment. The primary outcome was successful thrombolysis with reduction in transvalvular gradients. Data was analyzed by Microsoft Excel. Patients were followed up over time.</p><p><strong>Results: </strong>Approximately 0.1% of total hospital admissions, i.e. twenty-seven cases, were found to have prosthetic valve thrombosis. Target gradients on TTE were achieved for 71% (n=17) of mitral and 100% (n=3) of aortic valves: thrombolysis was successful in 74% (n=20), partial success in 18.5% (n=5) and unsuccessful in 7.4% (n=2) of cases. Subsequent complications were: myocardial infarction 7.4% (n=2), embolic phenomena 14.8 % (n=4), coronary emboli 7.4% (n=2), brain emboli 7.4% (n=2), re-thromboses 7.4% (n=2) and in-hospital mortality 7.4% (n=2) of cases. The mean time for follow-up after discharge was 3.04 ± 2.07 years; one patient died a year after discharge.</p><p><strong>Conclusion: </strong>Thrombolytic therapy with streptokinase has been shown to be an effective and relatively safe method for managing prosthetic valve thrombosis.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2264-2268"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113497","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":"HPV positivity despite cytological negativity: Risk assessment with colposcopic and histopathological findings.","authors":"Aysegul Cakmak Madakbas","doi":"10.12669/pjms.42.9.14703","DOIUrl":"https://doi.org/10.12669/pjms.42.9.14703","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate agreement between colposcopy-directed histopathological findings and final histopathological diagnoses in women with negative cytology but positive high-risk human papillomavirus (HR-HPV), and to assess associations of HPV genotypes with concordance and recurrence.</p><p><strong>Methodology: </strong>This retrospective study included women aged ≥18 years with negative cytology and HR-HPV positivity who underwent colposcopy at a tertiary center between January 2020 and January 2025. Histopathological results were obtained from endocervical curettage (ECC), biopsy, or conization. Concordance was defined as agreement between colposcopy-directed histopathological findings and the final histopathological diagnosis. Patients were followed for at least 12 months, with recurrence defined as histopathological detection of LSIL/HSIL or re-detection of HR-HPV during follow-up.</p><p><strong>Results: </strong>A total of 222 women were included (median age: 44 years). Overall concordance was 53.2%. HPV16-positive women had lower concordance than HPV16-negative women (46.7% vs. 60.8%, p=0.036). HPV18, single-type, and multiple-type HR-HPV were not associated with concordance (all p>0.05). Recurrence occurred in 24.0% of patients with available follow-up data (n=125), with no significant association with HPV genotype.</p><p><strong>Conclusion: </strong>Colposcopy-directed histopathological assessment shows moderate agreement with final histopathology in cytology-negative, HR-HPV-positive women. HPV16 positivity may be associated with lower concordance, while HPV genotype was not associated with recurrence. Careful follow-up may be warranted, and larger prospective studies are needed to confirm these findings.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2393-2397"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113489","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":"Clinicopathological profile and outcomes of pediatric glomerular diseases: A tertiary care experience.","authors":"Bilquis Naeem, Lubna Aman, Hina Fatima, Shazia Soomro","doi":"10.12669/pjms.42.9.13794","DOIUrl":"https://doi.org/10.12669/pjms.42.9.13794","url":null,"abstract":"<p><strong>Background & objective: </strong>Glomerular diseases in children are significant cause of morbidity and mortality, causing significant burden on health care system. Data regarding the outcomes of paediatric patients with glomerular diseases in association with clinicopathological findings is critical to understand the management plan and prognosis. To determine clinical spectrum, histopathological findings and outcome of children with glomerular disease who underwent kidney biopsy.</p><p><strong>Methodology: </strong>Cross sectional retrospective study conducted at nephrology department of National Institute of Child Health from January 2016 to December 2020. All children aged one to 18 years who underwent percutaneous kidney biopsy were included. Data recorded from the files including demographics, clinical presentations, diagnosis, histopathological findings, post biopsy complications and their outcome at last follow-up were noted. Data were analyzed using SPSS version 23.</p><p><strong>Results: </strong>Seventy children with mean age of 6.85±3.54 were studied. Males were predominant (56.9%). Most common presentation was edema (95.8%) followed by oliguria (77.7%) and hypertension (44.4%). Most common indication for kidney biopsy was steroid resistant nephrotic syndrome (SRNS 56.9%) followed by rapid progressive glomerulonephritis (RPGN16.7%). Two most common histopathological findings were focal segmental glomerulosclerosis (FSGS 33%) and minimal change disease (MCD 26%). Biopsy complications were observed in 21%. Outcome of our study showed that majority (75.7%), had preserved renal functions whereas, 5.6 % developed chronic kidney disease.</p><p><strong>Conclusion: </strong>Common presentations were edema, oliguria and hypertension. SRNS and RPGN were common indications for kidney biopsy. FSGS and MCD were common histopathological findings. Outcome was normal kidney functions in majority and few developed chronic kidney disease.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2428-2432"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113611","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":"Real world lessons on tyrosine kinase inhibitor response and resistance in CML from a developing country Pakistan.","authors":"Sahrish Khan, Zafar Iqbal, Muhammad Usman Ghani, Muhammad Farooq Sabar","doi":"10.12669/pjms.42.9.16564","DOIUrl":"https://doi.org/10.12669/pjms.42.9.16564","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate treatment responses, resistance and molecular characteristics of CML patients on TKI therapies to identify factors associated with suboptimal outcomes.</p><p><strong>Methodology: </strong>A retrospective observational study was conducted between January 2022 to December 2025 on 209 CML patients recruited at Mayo Hospital Lahore. Patients who achieved DMR and MMR were included. Minimum required duration of DMR was three years.</p><p><strong>Results: </strong>A total of 209 patients; 187 (89.4%) were in chronic phase, 12 (5.7%) in accelerated phase, and 10 (4.7%) in blast crisis. The majority were between 30-50 years of age and commonly observed splenomegaly (81.3%) and hepatomegaly (68.4%). Imatinib was prescribed to 114 patients (54.5%); however, 22 required a switch to nilotinib due to resistance.Among CP-CML, 45 (24.0%) patients achieved deep molecular response (DMR) and 18 (9.6%) attained major molecular response (MMR), while one patient from accelerated phase exhibited MMR, leaving more than two-thirds with incomplete responses despite prolonged therapy.Mutation analysis revealed G250E in a blast-phase patient with fatal outcome; another blast case with nilotinib resistance exhibited E459K and expired, E459K in accelerated-phase patient resistant to nilotinib. JAK2 (V617F) in CP-CML/MPN overlap two cases whereas 10 patients remained negative for JAK2 mutation. Death of five out of 10 blast patients have been confirmed.</p><p><strong>Conclusions: </strong>These real-world findings highlight the effectiveness of TKI therapy to achieving molecular responses, particularly in a substantial percentage of CP patients. However, variability in treatment response and emerging of resistance-associated mutations in advanced phases, emphasize the personalized management strategy.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2512-2518"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113522","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":"Comparison of outcomes of extracorporeal shock wave lithotripsy versus retrograde intrarenal surgery in the management of renal calculi measuring one to two centimeters.","authors":"Muhammad Waqas Arshad, Atif Javed, Shafeullah Ahadi, Azhar Ghayoor Yousaf","doi":"10.12669/pjms.42.9.16588","DOIUrl":"https://doi.org/10.12669/pjms.42.9.16588","url":null,"abstract":"<p><strong>Objectives: </strong>To compare outcomes of extracorporeal shock wave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS) for renal stones measuring 1-2 cm, including stone clearance, hospital stay, hematuria, sepsis, postoperative pain, and retreatment.</p><p><strong>Methodology: </strong>Six months, single-center, open-label, parallel-group randomized controlled trial was conducted at the Department of Urology, Dr. Ziauddin Hospital, North Nazimabad, Karachi, from September 5, 2025 to March 4, 2026. Ninety-eight eligible adults were enrolled consecutively and randomized 1:1 to ESWL or RIRS by lottery method using concealed identical allocation slips. Non-contrast CT-KUB was performed at baseline and at 28 days. Pain was assessed by VAS at 24 hours. Data were analyzed using SPSS version 26, with p<0.05 considered significant.</p><p><strong>Results: </strong>Baseline characteristics were comparable between the treatment groups. Stone-free status after one session was 53.1% with ESWL and 85.7% with RIRS (RR 1.62, 95% CI 1.21 to 2.15; p<0.001), while 28-day stone clearance was 67.3% and 85.7%, respectively (RR 1.27, 95% CI 1.02 to 1.60; p=0.032). ESWL was associated with shorter hospital stay (p<0.001). Median VAS pain score at 24 hours was higher after ESWL [4 (IQR 3-4)] than RIRS [3 (IQR 2-4); p<0.001]. Retreatment was more frequent after ESWL (30.6% vs 10.2%; RR for RIRS vs ESWL 0.33, 95% CI 0.13 to 0.85; p=0.012), while gross hematuria and postoperative sepsis were comparable.</p><p><strong>Conclusion: </strong>RIRS provided higher clearance and lower retreatment and pain scores than ESWL, while ESWL was associated with shorter hospital stay. <b><i>Registration Number:</i></b> www. clinicaltrials.gov (NCT07261995).</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2581-2587"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113573","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":"Gamification in dental education: Role of Kahoot in enhancing student engagement, learning outcomes and knowledge retention.","authors":"Afsheen Mansoor, Fouzia Farrukh, Emaan Mansoor, Shabana Ali","doi":"10.12669/pjms.42.9.16319","DOIUrl":"https://doi.org/10.12669/pjms.42.9.16319","url":null,"abstract":"<p><strong>Objective: </strong>Digital technology in education has made a significant change in pedagogy where Gamification has become a novel approach of instruction involving competition, scoring, rewards and leaderboards that is capable of enhancing motivation and engagement of learners. Kahoot is the most widely used online game-based learning platform that not only create interactive quizzes but also conduct real-time testing which amplifies learning of educators. The objective of this narrative review was to assesses the effects of Kahoot in encouraging student engagement, enhancing learning and knowledge retention regarding dental education.</p><p><strong>Methodology: </strong>Literature search of major databases such as PubMed, Scopus, Web of Science and Google Scholar was carried out that focused on literature from 2020-2025. Keywords that were used in search included Kahoot, gamification, game-based learning, dental education and student engagement. Studies that investigated use of Kahoot or other gamified modes of learning in dental or in other contexts of health-profession education were included. Papers that did not include empirical evaluation or were not related to education were eliminated. First search brought about 312 records, upon eliminating duplicates, filtering titles and abstracts only. Seventy eight full-text articles were evaluated on their eligibility and 30 studies were finally selected as part of qualitative synthesis.</p><p><strong>Results: </strong>Synthesized evidence showed that classroom participation, active learning, motivation and engagement among students were improved with Kahoot. Various studies revealed significant positive changes in academic achievement and more conceptual level of understanding among participants. Kahoot supported formative assessment process because it depicted immediate instructor instant feedback that helped in identifying knowledge deficiencies during instructional process. Some drawbacks have been mentioned such as more reliance on technological infrastructure, lack of information regarding long-term results and non-utilization for summative assessment mechanisms.</p><p><strong>Conclusion: </strong>Kahoot is one of the most useful auxiliary learning tool in developing an interactive learning environment and enhancing retention of information for dental education. Further studies are required to determine its long-term effectiveness and overcome technological and pedagogical obstacles that can be encountered in its implementation.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2441-2448"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113435","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":"Leukocytosis in acute stroke: A prospective study from an emergency department setting.","authors":"Muhammad Abas Khan","doi":"10.12669/pjms.42.9.14805","DOIUrl":"https://doi.org/10.12669/pjms.42.9.14805","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the total leukocyte count (TLC) in patients with acute stroke and assess its association with stroke type and age.</p><p><strong>Methodology: </strong>This prospective observational study was conducted at the Department of Emergency Medicine, Lady Reading Hospital, Peshawar, from May to November 2025. Adult patients with acute ischemic or hemorrhagic stroke were enrolled by non-probability consecutive sampling. TLC was measured at presentation, and age and stroke subtype were recorded. Patients with active infections, inflammatory diseases, hematological disorders, or immunosuppressive therapy were excluded. Data were analyzed using SPSS version 23. A one sample <i>t-test</i> was applied to compare the mean TLC value of the study population with the international reference mean TLC value of 7×10⁹/L. Chi-square assessed the association between TLC category and stroke type. One-way ANOVA compared TLC across age groups (30-49, 50-69, ≥70 years), and Pearson correlation assessed the relationship between age and TLC. A p-value <0.05 was considered significant.</p><p><strong>Results: </strong>Ninety patients were included. Mean TLC was significantly higher than the reference value (11.95±4.62×10⁹/L; p<0.001). No significant association was found between TLC category and stroke type (p=0.399). TLC did not differ significantly across age groups (p=0.119), and no significant correlation was observed between age and TLC (r=-0.108; p=0.313).</p><p><strong>Conclusion: </strong>TLC was elevated in acute stroke but showed no significant association with stroke subtype or age. Although leukocytosis is common in acute stroke, TLC alone has limited value in differentiating stroke types. Larger studies are needed to evaluate its prognostic significance.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2284-2288"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113443","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":"Assessing patient and caregiver satisfaction with outpatient palliative care telemedicine service at a tertiary care hospital in Karachi, Pakistan.","authors":"Ismat Jabeen, Asra Qureshi, Sidra Assad, Uqba Qamar, M Atif Waqar","doi":"10.12669/pjms.42.9.15011","DOIUrl":"https://doi.org/10.12669/pjms.42.9.15011","url":null,"abstract":"<p><strong>Background and objectives: </strong>Telemedicine is a valuable tool for improving access to palliative care (PC) for patients with serious illness, particularly in settings with limited trained professionals and specialized services. However, its effectiveness in PC remains under-evaluated, highlighting the need for further research. This study aimed to assess patient and caregiver satisfaction with the telemedicine appointment system and palliative care team (PCT) during virtual outpatient PC consultations.</p><p><strong>Methodology: </strong>This cross-sectional study was conducted among participants (patients and caregivers) recruited through convenience sampling who attended adult PC telemedicine clinics between February 2020-March 2022 at a Oncology department of a tertiary care hospital. Patient satisfaction was measured using a self-designed, structured, and pretested questionnaire. Descriptive analysis was performed on all database entries.</p><p><strong>Results: </strong>A total of 130 patients participated, with a mean age of 63.2±12.7 years, 47% were male, and 53% were female. There were 58% initial visits and 41% follow-ups. 94% of participants agreed with healthcare access, 92% with quality of care, 92% with patient-physician interaction, 77% with convenience, 91% wanted to continue teleconsultation, and 88% found it cost-effective. Besides this, 46% of participants expressed concerns about a potential privacy breach.</p><p><strong>Conclusion: </strong>Telemedicine is an innovative approach. Participants find it accessible, cost-effective, convenient and of good quality. In future, it should be promoted as an effective patient care modality to address enormous unmet needs of patients with functional frailty or living in remote areas.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2243-2249"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113494","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":"Diode laser-activated sodium fluoride and galla chinensis extract as dentin biomodifiers: Effect on microhardness, resin tag length, and shear bond strength of universal adhesive to caries-affected dentin.","authors":"Saeed Awod Bin Hassan, Saleh Ali Alqahtani, Nada Ahmad Alamoudi","doi":"10.12669/pjms.42.9.16672","DOIUrl":"https://doi.org/10.12669/pjms.42.9.16672","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of dentin biomodifiers sodium fluoride (NaF), blue diode laser (DL) irradiated NaF, Galla chinensis extract (GCE), and bioactive glass nanoparticles (BAGNPs), on the microhardness (MH), shear bond strength (SBS), and resin tag length (RTL) of a self-etch (SE) universal adhesive system bonded to caries-affected dentin (CAD).</p><p><strong>Methodology: </strong>Eighty disinfected permanent molars were included in the study. The present in vitro study was approved by the Ethical Committee of King Khalid University IRB-KKU-COD-ETH-0531. The study duration was four months, from 15^th September 2025 to 15^th January 2026. CAD was confirmed through visual, tactile, and staining methods. Samples were randomly divided into five groups based on the type of surface modifier(n=16). Group-1: No biomodification, Group-2: NaF, Group-3: Blue DL irradiated NaF, Group-4: BAGNPs, and Group-5: GCE. Surface MH testing was conducted using a Vickers hardness tester (n=4). RTL was identified using a SEM (n=2). The universal adhesive was applied using the SE technique, followed by composite buildup (n=10). SBS testing was performed using a Universal Testing Machine. The fractured specimens were evaluated under a stereomicroscope. ANOVA and Tukey's post hoc test were used to compare the mean MH, RTL, and bond strength values (p<0.05).</p><p><strong>Results: </strong>Group-3 (DL-irradiated NaF) exhibited the highest MH, whereas the lowest MH was observed in Group-1. Group-5 (GCE) demonstrated the maximum RTL (67.02±3.76μm) and the highest SBS (10.27±0.44 MPa).</p><p><strong>Conclusion: </strong>Galla chinensis extract and diode laser-irradiated sodium fluoride, when used independently, each enhanced the SBS and RTL of the self-etch universal adhesive to caries-affected dentin. Only blue laser-irradiated sodium fluoride was effective in augmenting the MH of caries-affected dentin.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"42 9","pages":"2221-2226"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112997","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}