Journal of the College of Physicians and Surgeons--Pakistan : JCPSP最新文献

{"title":"Specific Knockout of Notch-1 in Macrophages Modulate the Progression of Hepatic Insulin Resistance in HFD Fed Mice via Regulating IRE1α-XBP1 Signals.","authors":"Weiling Zhou, Shuguang Ren, Yonggang Lu, Yuan Wang, Lei Feng, Qian Gao","doi":"10.29271/jcpsp.2024.05.527","DOIUrl":"10.29271/jcpsp.2024.05.527","url":null,"abstract":"<p><strong>Objective: </strong>To develop an intervention based on Notch-1 signalling pathway blockade by investigating the potential application of the neurogenic locus notch homologue protein 1(Notch-1) signalling pathway as a key regulator of chronic inflammation and adipogenesis in the treatment of hepatic insulin resistance (HIR).</p><p><strong>Study design: </strong>Experimental study. Place and Duration of the Study: Animal Laboratory of the Fourth Hospital of Hebei Medical University, Shijiazhuang, China, from April 2021 to June 2022.</p><p><strong>Methodology: </strong>HIR models were established in Notch-1WT and Notch-1MAC-KO mice by high fat diet (HFD) for 16 weeks. Haematoxylin and eosin (HE) staining and oil red O (ORO) staining were used to detect inflammatory infiltration and lipid accumulation in each group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of TNF-α and IL-6. Free fatty acid (FFA) and total cholesterol (TC) were measured with relevant kits. Moreover, real-time quantitative polymerase chain reaction (PCR) was performed to detect the relative expressions of F4/80, Mcp1, and CD11b in hepatic tissues. Mass spectrometry was used to analyse the levels of triglyceride (TG), diacylglycerol (DAG) and conformite europeenne (CE) in liver tissue. Western blotting was used to detect the expression of related proteins.</p><p><strong>Results: </strong>Specific knockdown of Notch-1 in macrophages decreases the relative fluorescence intensity of CD68 and attenuates inflammatory infiltration and lipid degeneration. There was no difference in plasma levels of FFA and TG. Specific knockdown of Notch-1 in macrophages decreases the expression of F4/80, Mcp1, and CD11b, as well as the levels of TG, DAG, CE, IL-6, and TNF-α.</p><p><strong>Conclusion: </strong>Specific knockout of Notch-1 in macrophages may reduce HIR by inhibiting the IRE1α-XBP1 signalling pathway.</p><p><strong>Key words: </strong>Hepatic insulin resistance, Macrophages, Notch-1, IRE1α, XBP1.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selenium Supplementation and Gestational Diabetes: A Randomised Controlled Trial.","authors":"Ece Yigit, Ilknur Sayar","doi":"10.29271/jcpsp.2024.05.561","DOIUrl":"10.29271/jcpsp.2024.05.561","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effects of selenium supplementation on blood glucose levels in women with gestational diabetes mellitus (GDM).</p><p><strong>Study design: </strong>Randomised controlled trial. Place and Duration of the Study: Department of Internal Medicine, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkiye, from February to July 2023.</p><p><strong>Methodology: </strong>In the first phase of this study, the selenium levels of the pregnant women who routinely had an oral glucose tolerance test were measured, and in the second phase of the study, the pregnant women diagnosed with GDM were randomly divided into two groups that received 4-week interventions: Diet alone and diet plus selenium supplementation (200 µg/day).</p><p><strong>Results: </strong>Selenium level in pregnant women with GDM was significantly lower than in healthy pregnant women, and a selenium level less than 80 ng/ml predicted GDM diagnosis with a sensitivity of 58.59% and a specificity of 67.11%. Pregnant women with low selenium (<80 ng/ml) had a 2.709-fold higher risk for GDM compared to those with higher values. Fasting blood glucose levels decreased significantly in both groups after the respective interventions, but the decrease was greater in selenium recipients. Furthermore, fasting, 1st and 2nd hour blood glucose levels were lower in selenium recipients compared to those who only received diet.</p><p><strong>Conclusion: </strong>Selenium level in pregnant women with GDM was low compared to healthy pregnant women. Selenium supplementation had a beneficial impact (compared to diet only) on blood glucose levels in pregnant women with GDM.</p><p><strong>Key words: </strong>Pregnancy, Pregnancy outcome, Diabetes, Gestational, Dietary supplements, Selenium.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Difference of Burnout in Physicians Working in Tertiary Care Hospital: A Cross-Sectional Study.","authors":"Mariam Khan Qamar, Babar Tasneem Shaikh, Ramesh Kumar, Armaghana Khan Qamar","doi":"10.29271/jcpsp.2024.05.620","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.05.620","url":null,"abstract":"<p><p>Burnout and emotional exhaustion are becoming common among health workers in the busy teaching hospitals due to increased workload and the dearth of human resource. This study aimed to determine the causes of burnout among doctors and across gender differences. This was a descriptive cross-sectional study conducted in the Fauji Foundation Hospital, Rawalpindi, Pakistan, from 1st July to 30th September 2022. Two hundred and forty-five randomly recruited doctors who filled out self-administered questionnaires were included in the study. Independent samples t-test was used for comparison of the mean emotional burnout score. Female doctors felt more emotionally drained, more fatigued, and more worn out from work than male doctors (p < 0.05). Overall emotional exhaustion was also higher in female doctors (p < 0.05). This situation was more serious during the COVID-19 pandemic. Gender-sensitive environments, workplace policies, and necessary interventions will save physicians' burnout and brain drain. Emotional burnout is greater in female doctors as compared to their male counterparts. This evidence not only calls for prevention and treatment but also certain service-related reforms to facilitate female physicians to balance out their work and family lives more effectively. Key Words: Physicians, Emotional exhaustion, Burnout, Gender difference, Pakistan.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome and Factors Related to Isolated Liver Metastasis due to Breast Cancer.","authors":"Ebru Sen, Tolga Canbak, Ozgur Bostanci, Muharrem Battal","doi":"10.29271/jcpsp.2024.05.604","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.05.604","url":null,"abstract":"<p><strong>Objective: </strong>To determine the associated risk factors for isolated liver metastasis in breast cancer patients and to detect the prognostic factors related to survival.</p><p><strong>Study design: </strong>Analytical study. Place and Duration of the Study: Department of General Surgery, The University of Health Sciences, Istanbul, Turkiye, from January 2011 to November 2020.</p><p><strong>Methodology: </strong>Patients with breast cancer liver metastasis who experienced surgery were retrospectively analysed for breast cancer and metastases-related characteristics. Descriptive statistical methods were used in the evaluation of data. Survival analyses were estimated by the Kaplan-Meier method. Log-rank and univariable Cox regression tests were utilised to search for prognostic factors' impact on survival.</p><p><strong>Results: </strong>Out of 12 patients, 11 had recurrent disease after a median of 36 months of disease-free survival (DFS) and one patient had de novo metastasis. Grade 3 tumours and increased expression of Ki-67 had a negative effect on DFS. The median follow-up period was 66 months. Survival analysis showed 2- and 3-year progression-free survival (PFS); overall survival rates were 82%, 69%, 92%, and 82%, respectively. Development of liver metastasis in 3 years following breast cancer treatment was linked to worse PFS (p = 0.040).</p><p><strong>Conclusion: </strong> Long-term survival is possible for breast cancer survivors with liver metastasis. Disease-free interval is an important determinant. Longer progression-free survival was detected in patients who had developed metastasis after three years of breast cancer treatment.</p><p><strong>Key words: </strong>Breast cancer, Liver metastasis, Hepatic surgery.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular Rehabilitation: Intelligent or Traditional?","authors":"Dandan Zhao, Dandan Zhao, Hao Feng","doi":"10.29271/jcpsp.2024.05.625","DOIUrl":"10.29271/jcpsp.2024.05.625","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Geko Neuromuscular Stimulator on Preoperative Preparation in Ankle Fractures.","authors":"Xue Zhao, Jianzhong Zhang, Yujing Li, Zhihong Nie, Wei Wang, Yan Dong","doi":"10.29271/jcpsp.2024.05.568","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.05.568","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of the Geko neuromuscular stimulator on preoperative preparation in patients with ankle fractures.</p><p><strong>Study design: </strong>Quasi-experiment study. Place and Duration of the Study: Department of Foot and Ankle Surgery and Department of Orthopaedics, Beijing Tongren Hospital, Capital Medical University, Beijing, China, between December 2020 and 2021.</p><p><strong>Methodology: </strong>This quasi-experiment study included patients with ankle fractures treated with Geko neuromuscular stimulator before surgical fixation. The primary outcome was limb swelling at 24, 48, and 72 hours (h) after admission, and the secondary outcomes were pain according to visual analogue scale (VAS) at 12, 24, and 48 hours after admission, preoperative waiting time, and comfort 4 and 72 h after admission.</p><p><strong>Results: </strong>A total of 60 patients were included in the study; 30 in the conventional treatment group (mean age 41.16 ± 2.01 years) and 30 in the Geko group (mean age 40.22 ± 2.68 years). The limb swelling in patients was significantly different between the Geko and conventional treatment groups (p = 0.004). Besides, the swelling values at 48 (p < 0.001) and 72 (p < 0.001) hours were significantly lower than those at 24 hours. The pain in patients was significantly different between the Geko and conventional treatment groups (p = 0.007). Besides, the swelling values at 24 (p < 0.001) and 48 (p < 0.001) hours are significantly lower than those at 24 hours. Comfort was significantly higher at 4 h (69.54 ± 2.18 vs. 67.22 ± 3.14, p = 0.002) and 72 h [(88.50 (84.00 - 94.00) vs. 82.14 ± 3.08, p < 0.001)] after admission. The preoperative waiting time (3.52 ± 1.8 vs. 5.15 ± 2.1 hours, p = 0.002) was significantly shorter in the Geko group.</p><p><strong>Conclusion: </strong>The Geko neuromuscular stimulator is a useful option for preoperative preparation in patients with ankle fractures to reduce local swelling and pain and improve patients' comfort.</p><p><strong>Key words: </strong>Ankle fractures, Lower extremity, Neuromuscular stimulator, Peroneal nerve, Pain.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Tacrolimus Ointment Alone versus in Combination with Microneedling for Refractory Stable Vitiligo.","authors":"Afshan Kiran, Seemab Khan, Najia Ahmed, Maira Ali","doi":"10.29271/jcpsp.2024.05.514","DOIUrl":"10.29271/jcpsp.2024.05.514","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of microneedling in combination with topical tacrolimus ointment 0.1% versus topical tacrolimus ointment 0.1% for treatment of refractory stable vitiligo.</p><p><strong>Study design: </strong>Comparative cross-sectional study. Place and Duration of the Study: Department of Dermatology, PNS Shifa, Karachi, Pakistan, from December 2022 to May 2023.</p><p><strong>Methodology: </strong>The study included 30 clinically diagnosed individuals of either gender who had refractory symptoms and aged between 20 and 60 years. For every patient, two comparable lesions on two comparable limb regions were selected. Group A (right side) received treatment with both topical tacrolimus ointment 0.1% twice daily in addition to microneedling every two weeks, whereas, Group B (left side) was treated with topical tacrolimus ointment 0.1% only. Every lesion was investigated as a separate entity. Both groups were subsequently observed for a further six months.</p><p><strong>Results: </strong>When topical tacrolimus ointment 0.1% was combined with microneedling, the total re-pigmentation rate was substantially higher than the usage of tacrolimus ointment 0.1% alone. Fifty-three percent of lesions treated with topical tacrolimus ointment 0.1% alone and 76.7% of lesions treated with microneedling in conjunction with it showed a good-to-excellent response. No adverse negative effects were noted. During the follow-up period, no problems or recurrences were noted.</p><p><strong>Conclusion: </strong>Tacrolimus ointment combined with microneedling is a successful treatment for refractory stable vitiligo.</p><p><strong>Key words: </strong>Dermapen, Depigmentation, Microneedling, Tacrolimus ointment, Vitiligo.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to \"Acute Oral Mucositis During Hypo-Fractionated Radiation in Squamous Cell Carcinoma of Oral Cavity\".","authors":"Muhammad Shahid Iqbal, Josef Kovarik, Charles Kelly","doi":"10.29271/jcpsp.2024.05.629","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.05.629","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Revival of Essay-Type Questions in Medical Education: Harnessing Artificial Intelligence and Machine Learning.","authors":"Muhammad Shahid Shamim, Syed Jaffar Abbas Zaidi, Abdur Rehman","doi":"10.29271/jcpsp.2024.05.595","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.05.595","url":null,"abstract":"<p><strong>Objective: </strong>To analyse and compare the assessment and grading of human-written and machine-written formative essays.</p><p><strong>Study design: </strong>Quasi-experimental, qualitative cross-sectional study. Place and Duration of the Study: Department of Science of Dental Materials, Hamdard College of Medicine & Dentistry, Hamdard University, Karachi, from February to April 2023.</p><p><strong>Methodology: </strong>Ten short formative essays of final-year dental students were manually assessed and graded. These essays were then graded using ChatGPT version 3.5. The chatbot responses and prompts were recorded and matched with manually graded essays. Qualitative analysis of the chatbot responses was then performed.</p><p><strong>Results: </strong>Four different prompts were given to the artificial intelligence (AI) driven platform of ChatGPT to grade the summative essays. These were the chatbot's initial responses without grading, the chatbot's response to grading against criteria, the chatbot's response to criteria-wise grading, and the chatbot's response to questions for the difference in grading. Based on the results, four innovative ways of using AI and machine learning (ML) have been proposed for medical educators: Automated grading, content analysis, plagiarism detection, and formative assessment. ChatGPT provided a comprehensive report with feedback on writing skills, as opposed to manual grading of essays.</p><p><strong>Conclusion: </strong>The chatbot's responses were fascinating and thought-provoking. AI and ML technologies can potentially supplement human grading in the assessment of essays. Medical educators need to embrace AI and ML technology to enhance the standards and quality of medical education, particularly when assessing long and short essay-type questions. Further empirical research and evaluation are needed to confirm their effectiveness.</p><p><strong>Key words: </strong>Machine learning, Artificial intelligence, Essays, ChatGPT, Formative assessment.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Preoperative Subchondral Bone Marrow Oedema with Outcomes after Lateral Unicompartmental Knee Arthroplasty.","authors":"Qilong Jiang, Xinwen Bai, Yu Deng, Huan Xia","doi":"10.29271/jcpsp.2024.05.610","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.05.610","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the presence of preoperative subchondral bone marrow oedema (SBME) is associated with inferior outcomes after lateral unicompartmental knee arthroplasty (LUKA).</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Department of Orthopaedic Surgery, Chongqing Orthopaedic Hospital of Traditional Chinese Medicine, Chongqing, China, from January 2019 to June 2022.</p><p><strong>Methodology: </strong>Data on patients treated with LUKA were obtained from the Medical Registry Database. Two groups were made based on the presence and absence of SBME on preoperative magnetic resonance imaging (MRI). The visual analogue scale (VAS), American Knee Society Scores (AKSS), and rate of patient satisfaction were compared between the two groups.</p><p><strong>Results: </strong>A total of 20 patients treated with LUKA were reviewed. The SBME was present in 9 cases and absent in 11 cases. Patients with SBME had inferior scores at preoperative evaluation and at 1, 3, and 6 months postoperatively. However, there was no significant difference between the groups at the 12-month follow-up. Eight (88.9%) patients with SBME were satisfied with the LUKA surgery versus 9 (81.8%) patients without SBME, showing no significant differences between groups.</p><p><strong>Conclusion: </strong>Presence of preoperative SBME is associated with inferior functional outcomes after LUKA within six months of follow-up.</p><p><strong>Key words: </strong>Bone marrow, Oedema, Knee, Arthroplasty, Outcome, Patient satisfaction.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}