Journal of the Pakistan Medical Association最新文献

{"title":"Mpox outbreak: A new pandemic threat.","authors":"Muhammad Anas Faheem, Mehdi Raza Virani, Mirza Shaheer Hyder","doi":"10.47391/JPMA.22153","DOIUrl":"https://doi.org/10.47391/JPMA.22153","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1340-1341"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978769","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":"Comparison of clinical effects of aspherical monofocal and Tecnis ZMB00 multifocal intraocular lenses in patients with age-related cataract.","authors":"Dan Han, Xinli Ma, Jiayue Gao, Ziwei Xu, Ziwei Xu, Fa Liu","doi":"10.47391/JPMA.21014","DOIUrl":"https://doi.org/10.47391/JPMA.21014","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical effects and outcomes in patients implanted with aspheric monofocal and multifocal intraocular lens.</p><p><strong>Methods: </strong>This study was conducted from January 2020 to January 2023 at Harbin 242 Hospital in China, using a prospective randomized case-control design. The research subjects were hospitalized patients with age-related cataracts, randomly divided into a control group A receiving single focus intraocular lenses and an intervention group B receiving multi focus intraocular lenses. The visual acuity, visual quality, glasses independence rate, vision related quality of life, and incidence of complications were compared between the two groups. Data analysis was conducted using SPSS 25 software.</p><p><strong>Results: </strong>Of the 100 patients, 50(50%) were in group A; 28(56%) females and 22(44%) males with mean age 63.25±7.59 years. The other 50(50%) patients were in group B; 26(52%) females and 24(48%) males with mean age 62.03±6.74 years (p>0.05). Group B patients had higher uncorrected visual acuity at 1 week, 1 month and 3 months post-surgery (p<0.05), higher vision-related quality of life at 3 months post-surgery (p<0.05), and higher rate of spectacle independence (p<0.05) than group A. However, group B had lower modulation transfer function at 30 and 45 cycles per degree, and lower contrast sensitivity function at 3 and 6 cycles per degree than group A (p<0.05). The incidence of halo and glare in group B was higher than group A (p<0.05).</p><p><strong>Conclusions: </strong>The multifocal intraocular lens outperformed the aspherical monofocal intraocular lens in improving the vision-related quality of life and rate of spectacle independence. However, it had dark vision defects and optical side-effects.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1229-1234"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978793","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":"Current status of selective nonsteroidal anti-inflammatory drug-COX-2 inhibitor use in outpatients with low back pain and cardiovascular comorbidities: An Analysis of the NAMCS Database.","authors":"Yujian Liu, Jian Lu, Guangwu Liu","doi":"10.47391/JPMA.20611","DOIUrl":"https://doi.org/10.47391/JPMA.20611","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse prescribing patterns of cyclooxygenase-2 inhibitor for low-back pain patients with cardiovascular comorbidities in American outpatient settings.</p><p><strong>Methods: </strong>The data of this retrospective, cross-sectional study were from the 2007-2019 National Ambulatory Medical Care Survey except 2017 for which data were not available. Data related to low-back pain patients of either gender aged ≥20 years. Those having cardiovascular comorbidities were placed in group A, while those without such comorbidities were placed in group B. Descriptive statistics were employed to evaluate visit characteristics, stratified by cyclooxygenase-2 inhibitor use. Multivariable logistic regression analysis was utilised to assess factors associated with cyclooxygenase-2 inhibitor prescriptions. Data was analysed using R 4.1.2.</p><p><strong>Results: </strong>Of the 242.65 million patients with 107.19(44.2%) females, 76.83 million (31.7%) were in group A and 165.82 million (68.3%) in group B. Compared to group B patients, those in group A were older (62.0±14.1years vs 49.7±16.1 years, p<0.01) and had a higher prevalence of cyclooxygenase-2 inhibitor use (p=0.01). Overall, 5.2 million (2.14%) patients were prescribed cyclooxygenase-2 inhibitors. Those using cyclooxygenase-2 inhibitor exhibited a higher prevalence of cardiovascular comorbidities (p=0.01), especially hypertension (p=0.01), and were older in age (p<0.01). Older age (odds ratio = 1.019, 95% confidence interval: 1.003-1.035; p<0.05) and higher prevalence of cardiovascular comorbidities (odds ratio = 1.638, 95% CI: 1.017-2.637; p<0.05) were associated with increased likelihood of receiving cyclooxygenase-2 inhibitor prescriptions.</p><p><strong>Conclusions: </strong>Cyclooxygenase-2 inhibitor use was positively correlated with age and cardiovascular comorbidities among low-back pain patients in American ambulatory care, suggesting potential contradiction to current medication guidelines and heightened risk of adverse cardiovascular events.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1218-1223"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978809","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":"Differentiating and promoting palliative and hospice services in optimizing endof- life care.","authors":"Rida Inam, Asim Mehmood, Aqdas Kazi","doi":"10.47391/JPMA.22374","DOIUrl":"https://doi.org/10.47391/JPMA.22374","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1332-1333"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978836","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":"Detection Of Accessory Splenic Tissue On Liver/Spleen Colloid Scan - Another Marvel Of SPECT-CT.","authors":"Areeba Amin, Xain Touqeer, Mairah Razi","doi":"10.47391/JPMA.25-66","DOIUrl":"https://doi.org/10.47391/JPMA.25-66","url":null,"abstract":"<p><p>Accessory splenic tissue is common after surgical intervention relating to spleen. However, it can occur by birth and in cases of idiopathic thrombocytopenic purpura (ITP). In ITP, accessory spleen can recur after splenectomy. Imaging modalities like CT and ultrasound serve as convenient tools for diagnosis of hepatic and splenic pathologies; however, their role is limited. Hybrid nuclear imaging can solve the mystery as it gives anatomical and targetted functional information. 99mTc labelled liver/spleen colloid scan has vast applications from detecting focal nodular hyperplasia to splenic remnants. We describe the case of a patient where colloid scan localized of suspected accessory splenic tissue after repeated surgery.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1307-1308"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978827","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":"Comparison of effectiveness between two treatment methods for patients with anal fistula and their impact on serum IL-6 and SAA.","authors":"Yi Lu, Yazhu Han, Shichao Cheng, Xin Zhang","doi":"10.47391/JPMA.20663","DOIUrl":"10.47391/JPMA.20663","url":null,"abstract":"<p><strong>Objectives: </strong>Observation of the clinical effect of Jiedu Shengji ointment in treating anal fistula and its impact on serum interleukin-6 and serum amyloid A.</p><p><strong>Methods: </strong>The study is a retrospective cohort study. The clinical comparative study was conducted at Baoding NO.1 Central Hospital, China, between April 2023 to March 2024, and comprised patients diagnosed with anal fistula who underwent surgery. The participants were assigned to control group A and intervention group B according to the treatment method. Control group A was treated with Vaseline gauze dressing, while intervention group B was treated with Jiedu Shengji ointment combined with Vaseline gauze. Treatment outcomes between the groups were compared. Data was analysed using SPSS 20.</p><p><strong>Results: </strong>Of the 60 patients, 30(50%) were in group A; 20(66.6%) men and 10(33.3%) women with mean age 32.56±2.66 years (range: 22-43 years). There were 30(50%) patients in group B; 22(73.3%) men and 8(26.7%) women with mean age 32.14±2.35 years (range: 22-42 years). Total effective rate of treatment in group B was 26 (86.67%) compared to 19 (63.33%) in group A (p<0.05). After 7 and 14 days of treatment, the levels of interleukin-6 and serum amyloid A in group B were significantly better than those in group A (p<0.05). The wound bleeding score, wound healing time, and wound oedema score of group B were significantly better than those of group A (p<0.05). After treatment, the visual analogue scale and the Faecal Incontinence Severity Index scores of group B were significantly better than those of group A (p<0.05). After treatment, the levels of transforming growth factor-β and epidermal growth factor in group B were significantly better than those in group A (p<0.05).</p><p><strong>Conclusions: </strong>Jiedu Shengji ointment demonstrated remarkable therapeutic efficacy in patients with surgical treatment for anal fistula.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1224-1228"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978782","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":"Striking a delicate balance: ethical considerations and promising advances in timely diagnosis and patient safety for Hunter syndrome.","authors":"Najia Sadiq, Osaid Ahmed, Fareeha Ubaid","doi":"10.47391/JPMA.21006","DOIUrl":"https://doi.org/10.47391/JPMA.21006","url":null,"abstract":"<p><p>Hunter syndrome (HS) is a rare X-linked lysosomal storage disease that poses a significant challenge to affected individuals and healthcare professionals. HS is characterised by MRI scans that often show extensive white matter changes as well as dilated perivascular spaces, despite apparently normal intellectual skills. HS requires early diagnosis to initiate enzyme replacement therapy and potential improvements in patients' outcomes. However, using intrusive methods to diagnose patients has serious ethical problems. Seeking early diagnosis and effective treatment for HS necessitates a careful balancing act among the advancement of medical research, the prioritisation of patient safety, comfort, and resolving moral dilemmas. We can give these individuals hope and improved outcomes by creating non-invasive biomarkers, improving upon existing diagnostic methods, and looking into novel treatment approaches. Programmes that prioritise early identification and screening in underserved areas, raise awareness and ensure equitable treatment for all HS-affected individuals can also help close the gap.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1327-1329"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978783","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":"Investigation of enhanced external counter pulsation of blood pressureelevating effect on chronic heart failure patients with low blood pressure.","authors":"Chen Bingxu, Shi Jie, Qiu Quan, Jiang Wing, Gan Qinjing, Qiu Yuangang, Chen Jie","doi":"10.47391/JPMA.20550","DOIUrl":"https://doi.org/10.47391/JPMA.20550","url":null,"abstract":"<p><strong>Objectives: </strong>To explore and evaluate the clinical effect of enhanced external counter pulsation in the treatment of patients with chronic heart failure and low blood pressure.</p><p><strong>Methods: </strong>The retrospective study was conducted from January, 1, 2023, to January 31, 2024, at the Department of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, China, and comprised data from January to October 2023 of chronic heart failure in patients who also had low blood pressure. The patients were divided into two groups on the basis of the treatment received. Group A patients had been treated with enhanced external counter pulsation, while group B patients had been asked to do regular exercises. Both the groups had been treated for cumulatively 35 hours. The change in blood pressure was the main outcome measure, and it was measured at baseline and 24h after treatment. Data was analysed using SPSS 20.</p><p><strong>Results: </strong>Of the 111 patients, 61(55%) were in group A; 36(59%) females and 25(41%) males with mean age 59.33±9.01 years. There were 50(45%) patients in group B; 29(58%) females and 21(42%) males with mean age 56.47±11.23 years. Baseline systolic blood pressure was not significantly different between the groups (p>0.05). Post-intervention, both the groups showed significant increase in in systolic blood pressure (p<0.05), but the change from baseline was more significant in group A compared to group B (p<0.05).</p><p><strong>Conclusion: </strong>Enhanced external counter pulsation had a significantly better therapeutic effect in the treatment of patients with chronic heart failure and low blood pressure.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1213-1217"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978798","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":"Evaluation of the relationship between vitamin D deficiency and microalbuminuria, glycaemic control, lipid profile in patients with type 2 diabetes mellitus.","authors":"Zeyneb Irem Yuksel Salduz, Aclan Ozder","doi":"10.47391/JPMA.21055","DOIUrl":"https://doi.org/10.47391/JPMA.21055","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship of vitamin D deficiency with microalbuminuria, glycaemia and lipid profile in type 2 diabetes mellitus patients.</p><p><strong>Methods: </strong>The retrospective, clinical study was conducted at Family Medicine outpatient clinics of Istanbul Bezmialem Vakıf University, Faculty of Medicine Hospital, Turkey, and comprised data between July 1 and December 31, 2019 related to adult type 2 diabetes patients. Data was classified according to vitamin D levels; <20 ng/mL in group 1, and >20 ng/mL in group 2. Microalbuminuria, glycaemia and lipid parameters were compared between the groups. Data was analysed using SPSS 28.</p><p><strong>Results: </strong>Of the 148 patients with mean age 56.58±9.76 years, 78 (52.7%) were female and 70 (47.3%) were male. The mean vitamin D level was 22.81±17.85 ng/mL, with 76 patients in group 1 and 72 in group 2. The mean level of glycated haemoglobin was 7.57±1.66%. Total cholesterol, low-density lipoprotein cholesterol, lymphocyte and urine microalbumin/creatinine ratio as well as glycated haemoglobin levels were significantly higher in group 1 patients than those in group 2 (p<0.05). Vitamin D levels were significantly negatively associated with glycated haemoglobin and total cholesterol (p<0.05).</p><p><strong>Conclusions: </strong>Lower vitamin D levels were associated with poor glycaemic control, lipid dysregulation, and higher microalbuminuria, suggesting potential roles in glucose metabolism, inflammation and kidney function.</p>","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1235-1240"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978812","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":"Embracing Diverse Learners: Making Higher Education Inclusive and Effective.","authors":"Muhammad Shahid Shamim","doi":"10.47391/JPMA.25-60","DOIUrl":"https://doi.org/10.47391/JPMA.25-60","url":null,"abstract":"","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 8","pages":"1181-1182"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978815","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}