Journal of the Pakistan Medical Association最新文献

{"title":"Child domestic labour in Pakistan: a narrative review.","authors":"Raahim Salman Abdul Ghaffar, Kishwar Enam","doi":"10.47391/JPMA.21423","DOIUrl":"https://doi.org/10.47391/JPMA.21423","url":null,"abstract":"<p><p>Child domestic workers are children who are hired to work in households by the owners for household chores. In 1996, up to 8.3% of all child labour cases in Pakistan involved domestic chores. Poverty is one of the most common and significant factors for child domestic labour in Pakistan. Studies have shown that if the parents are uneducated or do not value education, there is a high likelihood of children being involved in child domestic labour. Girls make up a large portion of child domestic workers compared to boys, and are more affected by child domestic labour. The victims of child domestic labour have to bear physical, mental and sometimes sexual abuse from the employers. Given these conditions, child domestic labour can be considered a form of modern-day slavery, with victims being children who may not be aware of their rights.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"632-637"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of lumbar disc degeneration in young adults with low back pain on 3T magnetic resonance imaging machine.","authors":"Ramsha Saleem, Sara Khan, Atiq Ur Rehman Slehria, Hafsa Aquil, Aliya Halim","doi":"10.47391/JPMA.20613","DOIUrl":"https://doi.org/10.47391/JPMA.20613","url":null,"abstract":"<p><strong>Objective: </strong>To determine the frequency and patterns of lumbar disc degeneration in young adults with low back pain.</p><p><strong>Methods: </strong>The descriptive, cross-sectional study was conducted at the Armed Forces Institute of Radiology and Imaging, Rawalpindi, Pakistan, from August 16, 2023, to February 15, 2024, and comprised patients of either gender aged 18-35 years who presented with low back pain. The participants were subjected to examination using 3.0T magnetic resonance imaging machine. Lumbar disc degeneration was noted and its patterns were assessed. Lumbar disc degeneration was graded using Pfirmann grading. Data was analysed using SPSS 25.</p><p><strong>Results: </strong>Of the 146 patients with mean age 25.6±2.98 years, 103(70.5%) were males and 43(29.5%) were females. Lumbar disc degeneration was present in 85(58.2%) patients, and multilevel involvement was seen in 45(30.8%). The most common involvement was of L3-L4 12(8.2%), followed by L4-L5 11(7.5%). The most common lumbar disc degeneration grade was grade III 39(26.7%), followed by grade IV 25(17.1%).</p><p><strong>Conclusions: </strong>In more than half of the young adults with low back pain, lumbar disc degeneration was present because of either single or multiple level of vertebrae involvement.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"587-591"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of vibration therapy with routine physical therapy on pain, balance, and functional disability in diabetic neuropathy patients: a randomised controlled trial.","authors":"Sajawal Bashir, Ayesha Jamil, Sarwat Ali","doi":"10.47391/JPMA.20058","DOIUrl":"https://doi.org/10.47391/JPMA.20058","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of integrating vibration therapy with standard physical therapy on pain levels, balance, functional impairment, and overall patient satisfaction among individuals with diabetic neuropathy.</p><p><strong>Methods: </strong>The single-blind, randomised controlled trial was conducted from September 2022 to February 2023 at the Physiotherapy Department of Omar Hospital, Lahore, Pakistan, and comprised patients of either gender aged 40-75 years having diabetic peripheral neuropathy. The participants were randomised using computer-generated numbers into group A receiving routine physical therapy only, and group B receiving vibration therapy with routine physical therapy. Each intervention lasted 30 minutes and six sessions were given over 2 weeks. Assessment was done at baseline, and at end of 1st and 2nd week for pain, balance, functional disability and satisfaction level using standard tools. Data was analysed using SPSS 21.</p><p><strong>Results: </strong>Of the 72 patients with mean age 59.2±9.47 years and mean duration of diabetes 14.23±6.4 years, 40(56%) were males and 32(44%) were females. Each group had 36(50%) subjects. At the baseline, there were no significant differences between the groups (p>0.05). Intergroup comparison for pain, functional disability were significantly better in group A compared to group B (p<0.05), but balance and patient satisfaction were not significantly different post-intervention (p>0.05). Intragroup improvements post-intervention were significantly better compared to baseline values (p<0.05).</p><p><strong>Conclusions: </strong>Vibration therapy was found to be better than routine physical therapy in terms of addressing pain and functional disability.</p><p><strong>Rct registration: </strong>The study was registered at ClinicalTrials.gov (Trial #: NCT05580705 Date of Approval: October 14, 2022). Link: https://clinicaltrials.gov/study/NCT05580705.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"534-539"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to adherence of stroke rehabilitation: therapist and patient's perspective.","authors":"Taliha Hamid Tareen, Arshad Nawaz Malik, Saira Jahan","doi":"10.47391/JPMA.11551","DOIUrl":"https://doi.org/10.47391/JPMA.11551","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the perspectives of physiotherapists and patients regarding barriers to stroke rehabilitation.</p><p><strong>Methods: </strong>The qualitative, descriptive study was conducted from January to December 2022 after approval from the ethics review board of Riphah International Hospital, Islamabad, Pakistan, and comprised sub-acute and chronic stroke patients and physiotherapists having two years of clinical experience. The sample was raised using nonprobability purposive sampling technique from hospitals/clinics in Rawalpindi and Islamabad. Data was collected through semi-structured interviews. During the interviews, the patients were asked about their experiences with rehabilitation programmes and the factors affecting their rehabilitation. The therapists were asked to share their thoughts on the factors affecting the patients' adherence to stroke rehabilitation. Data was subjected to thematic analysis using ATLAS.ti 9.</p><p><strong>Results: </strong>Of the 30 subjects, 15(50%) were patients; 13(86.6%) females and 2(13.3%) males with mean age 49.5±5.6 years and mean treatment duration 6.3±1.2 months. The remaining 15(50%) subjects were physiotherapists; 13(86.6%) females and 2(13.3%) males, with 8(53.3%) having three years of experience. Four themes were identified from the data related to the physiotherapists: experience and requirements of stroke rehabilitation, barriers to adherence of stroke rehabilitation, suggestions to improve stroke-rehabilitation, and avoiding non-adherence, motivational factors. Also, four themes were identified from the data related to the patients: experience and quality of life after stroke, major and minor barriers in stroke rehabilitation, positive and negative aspects of rehabilitation, and suggestions and factors to enhance participation in rehabilitation programmes.</p><p><strong>Conclusion: </strong>Multiple patient-related barriers regarding adherence to rehabilitation were noted, including social and physical barriers and financial issues, while therapist-related barriers included time management issues and poor stroke rehabilitation infrastructure.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"569-577"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of patients presenting 6 to 12 hours after isolated vascular trauma in a tertiary care hospital of Pakistan.","authors":"Ahmed Siddique Ammar, Syed Asghar Naqi, Affifa Liaquat, Azwa Munim Janjua, Adeena Syed, Syeda Ifrah Ali","doi":"10.47391/JPMA.21033","DOIUrl":"https://doi.org/10.47391/JPMA.21033","url":null,"abstract":"<p><strong>Objective: </strong>To assess the outcome of vascular injuries in patients presenting 6-12 hours after isolated vascular trauma.</p><p><strong>Methods: </strong>The analytical cross-sectional study was conducted at East Surgical Ward of Mayo Hospital, Lahore, Pakistan, from July 1, 2020, to June 30, 2022 and comprised consecutive patients of either gender aged >13 years with isolated vascular trauma presenting 6-12 hours after vascular injury. Operative procedures included ligation, end-to-end repair and reverse venous graft of the injured vessels. Outcomes, including cause of amputation and mortality, were noted. Data was analysed using SPSS 26.</p><p><strong>Results: </strong>Of the 82 patients, 61(74.03%) were males and 21(25.06%) were females. The overall mean age was 33±5.41 years. Femoral artery was damaged more 54(65.85%) compared to brachial artery 28(34.14%) in all modes of injuries. Ligation of vessel was done in 35(42.68%) cases. Mortality was the outcome in 15(18.29%) patients, amputation in 29(35.36%) and discharge after successful vascular repair 38(46.34%).</p><p><strong>Conclusion: </strong>Ligation of the femoral or brachial artery was found to be a safe and lifesaving procedure in patients presenting 6-12 hours after isolated vascular trauma to the emergency department in a tertiary care setting.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"596-600"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Usual Suspects: Abdominal Wall Metastases in Prostate Cancer Diagnosed by 68Ga-PMSA PET/CT.","authors":"Sharjeel Usmani, Khulood Al Riyami, Anjali Jain, Zahida Niaz, Raza Sayani, Shah P Naumani","doi":"10.47391/JPMA.25-32","DOIUrl":"https://doi.org/10.47391/JPMA.25-32","url":null,"abstract":"<p><p>68Ga-PMSA PET imaging has revolutionized both diagnosis and radioligand therapy selection in patients with metastatic prostate cancer. We report the case of a 63-year-old man with prostate adenocarcinoma who underwent radical prostatectomy followed by radiation therapy and ADT. Found to have rising PSA levels and referred for 68Ga- PSMA PET/CT for restaging. 68Ga-PSMA PET/CT showed multiple suspicious 68Ga-PSMA PSMA avid mediastinal lymph nodes and an avid lesion in the right lower anterior abdominal wall; suspicious for metastasis. Ultrasonography guided biopsy showed metastatic prostate adenocarcinoma. In our cases, 68Ga-PSMA PET/CT identified the unexpected metastatic site which leads to change patient management and potentially improving patient outcome.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"669-670"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nandrolone (17-Nortestosterone) And Glucose Metabolism: From Ugly Duckling To Handsome Swan.","authors":"Sanjay Kalra, Atul Dhingra, Nitin Kapoor","doi":"10.47391/JPMA.25-27","DOIUrl":"https://doi.org/10.47391/JPMA.25-27","url":null,"abstract":"<p><p>Glucosarcopenia, or sarcopenia coexisting with diabetes, is a common condition. Caused by various factors, including poor glucose control, as well as some glucoselowering therapies, sarcopenia negatively impacts quality of life and long-term health. Nandrolone, or 19- nortestosterone, is a selective anabolic receptor modulator (SARM), classified as an anabolic-androgenic steroid (AAS). A review of its pharmacological properties suggests that it may be used as therapy for sarcopenia, along with medical nutrition therapy and resistance exercise training. This review suggests a practical and pragmatic approach towards ensuring safe and smart usage of nandrolone in glucosarcopenia management.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"654-656"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaping culture: An emerging epidemic and its impact.","authors":"Ayesha Javaid Baig, Maryam Shaukat","doi":"10.47391/JPMA.21748","DOIUrl":"https://doi.org/10.47391/JPMA.21748","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"695"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sapiopsychosocial triage in obesity care.","authors":"Sanjay Kalra, Madhur Verma, Atul Dhingra, Nitin Kapoor","doi":"10.47391/JPMA.25-29","DOIUrl":"https://doi.org/10.47391/JPMA.25-29","url":null,"abstract":"<p><p>With the increasing prevalence of obesity, a triage system is needed to prioritize access to obesity care services, as well as support efficient choice of education and counselling strategies. The sapiopsychosocial triage (SPST) system, based upon cognitive, psychological and social assessment of the person living with obesity, helps determine the style and strategy of obesity management. It can be used as a complement to the Edmonton Obesity Staging System. The SPST ensures person -centred delivery of chronic weight management, keeping the biopsychosocial triad of health in mind. It facilitates understanding of the myriad determinant causes and contributors, and dynamic confounders of weight gain. Thus, it serves as a learning and teaching tool for all health care professionals.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"659-661"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revealing the unspoken battle: limited awareness of PMDD and Its invisible consequences on women's well-being in Pakistan.","authors":"Muhammad Shahzad, Mahnoor Saeed, Farah Shahzad, Ali Hassan","doi":"10.47391/JPMA.20466","DOIUrl":"https://doi.org/10.47391/JPMA.20466","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 4","pages":"687-688"},"PeriodicalIF":0.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}