Journal of the Pakistan Medical Association最新文献_第5页

Optimizing Kidney Disease Management during Ramadan: Evidence-Based Risk Stratification and Tailored Strategies.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.25-21

Sourabh Sharma, Manisha Sahay, Mastakim Ahmed Mazumder, Sanjay Kalra

{"title":"Optimizing Kidney Disease Management during Ramadan: Evidence-Based Risk Stratification and Tailored Strategies.","authors":"Sourabh Sharma, Manisha Sahay, Mastakim Ahmed Mazumder, Sanjay Kalra","doi":"10.47391/JPMA.25-21","DOIUrl":"https://doi.org/10.47391/JPMA.25-21","url":null,"abstract":"Fasting during Ramadan poses distinct challenges for individuals with kidney disease, requiring a careful balance between spiritual commitments and health maintenance. This article combines insights from recent research and guidelines to offer a thorough framework for risk assessment. Patients are classified into low, moderate, and high-risk categories based on individual, environmental, and health-related factors. Management approaches are organized into four main areas: spiritual support, non-drug interventions, medication adjustments, and modifications to kidney replacement therapy (KRT). Evidence indicates that stable chronic kidney disease (CKD) patients, especially those in stages 1-3, and kidney transplant recipients with stable graft function can fast safely with careful supervision. Conversely, patients with advanced CKD, those on dialysis, and individuals with significant additional health issues are advised against fasting due to possible complications. Essential recommendations include optimizing hydration, customizing medication plans, conducting regular monitoring, and making dietary adjustments. By merging medical knowledge with cultural awareness, healthcare providers can facilitate safe fasting and enhance health outcomes during Ramadan.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"506-508"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722453","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}

引用次数: 0

Prone Lumbar Traction: An Underexplored Alternative for Lumbar Radiculopathy and Discogenic Low Back pain.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.25-24

Muhammad Osama, Sabah Afridi, Farooq Azam Rathore

{"title":"Prone Lumbar Traction: An Underexplored Alternative for Lumbar Radiculopathy and Discogenic Low Back pain.","authors":"Muhammad Osama, Sabah Afridi, Farooq Azam Rathore","doi":"10.47391/JPMA.25-24","DOIUrl":"https://doi.org/10.47391/JPMA.25-24","url":null,"abstract":"Lumbar disc disorders and herniation are leading causes of discogenic low back pain (DLBP) and lumbar radiculopathy, often resulting in spinal surgery. Lumbar traction is an effective conservative treatment for DLBP, shown to decrease pain, improve functional disability, and positively affect disc height and herniation index. While typically applied in the supine position, lumbar traction can also be administered prone. However, many practitioners are unaware of this alternative approach. Studies have demonstrated that prone lumbar traction can effectively alleviate pain and disability in persons with DLBP, lumbar disc herniation, and radiculopathy. Some research suggests it may be more effective than supine traction for certain subgroups. Despite these promising findings, additional research is needed to further explore the clinical and biomechanical effects of prone traction. Additionally, it is important to identify which patient subgroups are more likely to benefit from prone versus supine traction. This review explores the potential of prone lumbar traction as an underutilized yet promising alternative in the management of DLBP and lumbar radiculopathy.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"514-517"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722465","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}

引用次数: 0

Proton pump inhibitors and the risk of rhabdomyolysis: A call for judicious use in Pakistan.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.21299

Saqib Sattar, Rahman Tanveer, Khansa Sattar

引用次数: 0

The 6M Classification of Nutrients.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.25-19

Sanjay Kalra, Madhur Verma, Nitin Kapoor

引用次数: 0

Thoracic spinal thrust manipulation for shoulder impingement syndrome: A meta-analysis of pain relief and functional outcomes.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.11608

Bazal Bukhari, Sarwat Ali, Saba Afzal

{"title":"Thoracic spinal thrust manipulation for shoulder impingement syndrome: A meta-analysis of pain relief and functional outcomes.","authors":"Bazal Bukhari, Sarwat Ali, Saba Afzal","doi":"10.47391/JPMA.11608","DOIUrl":"https://doi.org/10.47391/JPMA.11608","url":null,"abstract":"Objective: To evaluate the effectiveness of thoracic spine thrust manipulation in managing shoulder impingement syndrome.Methods: The meta-analysis was conducted from April 25 to November 5, 2023, after approval from the ethics review board of the University of Lahore, Lahore, Pakistan, and comprised a comprehensive search on multiple databases, including Cochrane Central Register of Controlled Trials PubMed, PEDro and MEDLINE. Randomised controlled trials with patients of either gender aged 19-44 years who had been diagnosed with shoulder impingement syndrome were included. Data extraction was independently performed by two researchers, and meta-analysis was conducted using RevMan 5.2.Results: Of the 14 studies comprising 749 participants, 8(57.14%) studies comprising 410(54.73%) participants involved quantitative analysis. The fixed-effect model revealed minimal heterogeneity (I2=0%) and a standardised mean difference of -0.03 (95% confidence interval: -0.22-0.16), indicating no significant improvement in clinical outcomes following thoracic spinal thrust manipulation.Conclusions: The meta-analysis provided a more complex view of the efficacy of thoracic spinal thrust manipulation in treating shoulder impingement syndrome. Some researchers suggested that treatment by manipulation positively affected immediate changes in range of motion and pain, while others revealed no significant clinical changes. This indicates the need for the application of manipulation alongside other exercise therapies for functional changes to be observed clinically.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"456-461"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722500","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}

引用次数: 0

Potential hip fracture early death predictors - a retrospective analysis from prospective trauma registry.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-02-01 DOI: 10.47391/JPMA.20102

Tashfeen Ahmad, Zehra Abdul Muhammad

{"title":"Potential hip fracture early death predictors - a retrospective analysis from prospective trauma registry.","authors":"Tashfeen Ahmad, Zehra Abdul Muhammad","doi":"10.47391/JPMA.20102","DOIUrl":"https://doi.org/10.47391/JPMA.20102","url":null,"abstract":"Objective: To explore the blood pressure, fracture anatomical site, and age as potential predictors of death within 3 months after proximal femoral fracture management.Methods: The retrospective study was conducted from June 2015 and March 2020 at the Aga Khan University Hospital, Karachi and comprised orthopaedic trauma registry data of isolated proximal femur fracture patients managed between June 2015 and March 2020. Data of those who expired within 3 months of the management was pooled in group A, while data of those who survived >3 months post-treatment formed group B. Blood pressure at the time of hospital admission was considered normal at 90-120mmHg systolic and 60-80mmHg diastolic. Data was analysed using SPSS version 19.0.Results: Of the 242 patients, 9(3.7%) were in group A; 5(55.5%) males and 4(44.4%) females with median age 78 years (interquartile range: 7 years). There were 233(96.3%) patients in group B; 123(52.7%) females and 110(47.2%) males with median age 70 years (interquartile range: 17 years). In 12 months post-treatment, 16(6.6%) patients expired; 9(56.25%) in group A, and 7(43.75%) in group B. Age >75 years and femoral neck fractures had a significant positive relationship with death within 3 months of surgical management (p<0.05).Conclusion: Patients with femoral neck fracture and aged ≥75 years were found to be at the risk of death within 3 months post-management.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 2","pages":"249-254"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415962","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}

引用次数: 0

Toripalimab: A new age in fighting Nasopharyngeal Carcinoma.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-02-01 DOI: 10.47391/JPMA.20757

Taha Ahmad Siddiqui, Aamrah Wakil, Maham Imran

引用次数: 0

Short-term outcome of metabolic surgery versus intensive medical therapy among obese type 2 diabetics: a quasi-experimental study.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-02-01 DOI: 10.47391/JPMA.10425

Zahra Raza, Muhammad Burhan Ul Haq, Tashfeen Imtiaz, Muhammad Adnan Khokhar, Aatif Inam

{"title":"Short-term outcome of metabolic surgery versus intensive medical therapy among obese type 2 diabetics: a quasi-experimental study.","authors":"Zahra Raza, Muhammad Burhan Ul Haq, Tashfeen Imtiaz, Muhammad Adnan Khokhar, Aatif Inam","doi":"10.47391/JPMA.10425","DOIUrl":"https://doi.org/10.47391/JPMA.10425","url":null,"abstract":"Objective: To compare the short-term outcomes of metabolic surgery and intensive medical therapy in the management of diabetes mellitus among obese persons with type 2 diabetes mellitus.Methods: The quasi-experimental study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from March 2018 to February 2019, and comprised obese type 2 diabetes mellitus patients of either gender aged 20-65 years. Those undergoing metabolic and bariatric surgery were assigned group A, while those undergoing intensive medical therapy formed control group B. All patients were followed up for 6 months to monitor their metabolic profile, including body mass index, glycosylated haemoglobin and fasting plasma glucose. Data was analysed using SPSS 20.Results: Of the 72 patients, 36(50%) were in group A; 23(63.9%) females and 13(36.1%) males with mean age 41.2 ± 10.2 years. The remaining 36(50%) patients were in group B; 22(61.1%) males and 14(38.9%) females with mean age 42.5 ± 10.6 years (p>0.05). At 6 months, mean body mass index, glycosylated haemoglobin and fasting plasma glucose values were significantly lower in group A compared to group B (p<0.001). There were 33(91.7%) patients in group A with remission of diabetes compared to 1(2.8%) patients in group B (p<0.001).Conclusions: Bariatric surgery was found to produce a good early outcome in the management of diabetes in the obese population, leading to remission post-surgery.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 2","pages":"186-191"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416227","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}

引用次数: 0

Socionutrition: The science of socionutrients.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-02-01 DOI: 10.47391/JPMA.25-12

Sanjay Kalra, Bharti Kalra, Madhur Verma, Nitin Kapoor

引用次数: 0

Immunotherapy in Type 1 Diabetes: Emerging Therapies and Future Directions.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-02-01 DOI: 10.47391/JPMA.25-10

Simran Thakkar, Saptarshi Bhattacharya, Lakshmi Nagendra, Sanjay Kalra

引用次数: 0