Displaying publications 41 - 56 of 56 in total

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  1. M NE, Aw N, Ml N
    Pak J Med Sci, 2022;38(8):2376-2379.
    PMID: 36415246 DOI: 10.12669/pjms.38.8.5688
    The incidence of primary hyperparathyroidism (PHPT) is increasing in trend due to more common practice of routine blood investigations especially in the elderly. Surgery is the only curative therapy in symptomatic patients. We present a case of a 63-year-old lady with generalised body weakness associated with occasional muscle cramps. Her biochemical results were consistent with PHPT. As a result of persistent severe hypercalcemia, surgery was planned. However, the pre-operative anatomical and functional radiological imaging (neck ultrasonography, 99mTc-MIBI and FDG-PET scans) failed to identify the abnormal parathyroid gland. Therefore, bilateral neck exploration with intra-operative parathyroid hormone (io-PTH) measurement was performed. The nodular left thyroid and adenomatous right superior parathyroid glands were removed. Possible causes of negative localization and incorporation of io-PTH in under-resourced countries to ensure successful surgery are discussed.
  2. Niazi FH, Qamar Z, Noushad M, Muhareb AKB
    Pak J Med Sci, 2022 1 18;38(1):34-39.
    PMID: 35035397 DOI: 10.12669/pjms.38.1.4780
    Objectives: To evaluate the effect of Rose Bengal (RB), methylene blue (MB) and curcumin used as a canal disinfectant on the extrusion bond strength (EBS) of FRCP (fiber reinforced composite resin) with canal dentin.

    Methods: The present invitro study was completed in 90 days approved by Riyadh Elm University. Forty premolars were extracted disinfected and decoronated. Mechanochemical preparation was done of canal space using 10k file widening canals sequentially with a 25K file with constant saline irrigation. Canal was dried condensed with gutta percha and sealer. Post space was prepared using peso reamer. Based on canal disinfection samples were divided into four groups. Group-1 MBP+17%EDTA, Group-2 RBP +17%EDTA, Group-3 Curcumin+17%EDTA and Group-4 5.25% NaOCl +17% EDTA. Following disinfection, the canal space of all specimens was washed with 17% EDTA for 120 sec. Post was cemented in canal space and cured. Specimens were placed on Universal testing machine (UTM) for EBS. The type of bond failure was evaluated using stereomicroscope. ANOVA and Tukey multiple comparison test was used to compare means.

    Results: Cervical third of Group-3 in which samples were disinfected with CP+17% EDTA displayed the maximum EBS (8.69±1.32 MPa). Whereas, the lowest EBS (3.30±0.54 MPa) was exhibited by the apical third of Group-4, where 5.25% NaOCl +17% EDTA was used as a canal disinfectant. The intragroup comparison demonstrated a declining trend of EBS from cervical to apical third in all investigated groups.

    Conclusion: Root canal dentin treated with different PS (MBP, CP, and RBP) demonstrated better EBS than the conventional disinfecting regime (NaOCl +17% EDTA). CP and RBP displayed better EBS than MBP.

  3. Abdulghani HM, Sattar K, Ahmad T, Halepoto DM, Akram A
    Pak J Med Sci, 2022 1 18;38(1):69-75.
    PMID: 35035403 DOI: 10.12669/pjms.38.1.4256
    Background and Objective: The Flipped Classroom (FC) approach has become increasingly predominant and popular in medical education. This study aimed to explore the usefulness and the scope of FC based on medical students' experience, with their adaptation challenges.

    Methods: The present study was a mixed-method accomplished during the academic years 2019-20, involving fourth-year students at the College of Medicine in Riyadh, Saudi Arabia. A self-administered questionnaire was used to seek their first experience and opinion of the FC.

    Results: A total of 234 questionnaires were distributed to the students, and 214 students completed the survey (response rate of 91.45%). Out of this total, 68.2 % were males and 31.8% were females. Most of the students agreed 156 (72.9%) that the flipped classroom was more engaging than the traditional lecture, among them 100 (68.5%) males and 56 (82.3) females agreed. Almost ~79% of students liked FC as it enabled them knowing the material in advance, and the class time was spent clarifying the facts and principles with active interaction, as commented during focus group discussion "More chance for discussing with the doctors, and I got the chance to answer" (St. 6).

    Conclusion: The results showed that the students like the FC more than the conventional classroom. Suggestions were given by students to improve the active learning sessions within the FC modality.

  4. Lim CTS, Lee SE
    Pak J Med Sci, 2017 10 27;33(4):1047-1049.
    PMID: 29067090 DOI: 10.12669/pjms.334.13112
    Ralstonia mannitolilytica is a gram negative soil bacterium. Ralstonia infection though rare, has become the emerging nosocomial pathogens in hospital settings. Various clinical manifestations had been described as well as the mode of transmission. Despite its low virulence factor, it is able to survive under harsh condition and this may potentially cause significant morbidity and mortality especially in immunocompromised patients. Outbreak of Ralstonia mannitolilytica infections in the hospital are typically associated with contaminated medical supplies or instruments. We described here a case of Ralstonia mannitolilytica infection in a dialysis patient that occurred during the municipal reservoir water contamination crisis. In this report, we will also describe the behaviour of Ralstonia genus and its 4 main species, namely R. pickettii, R. solanacearum, R. insidiosa, and R. mannitolilytica and the choices of antibiotic therapy based on literature review.
  5. Taqi M, Razak IA, Ab-Murat N
    Pak J Med Sci, 2017 Jul-Aug;33(4):948-952.
    PMID: 29067071 DOI: 10.12669/pjms.334.13106
    OBJECTIVE: To estimate the percentage of children with low, moderate and high caries risk; and to determine the predictors of caries risk amongst 11-12 year old Pakistani school children.

    METHODS: Subjects' caries risk was assessed using the Cariogram programme. The survey was done among school children in Bhakkar district of Punjab, Pakistan. Caries and plaque level were assessed using the DMFT and Sillnes and Loe indices respectively, while diet content and frequency were assessed using a three-day diet diary.

    RESULTS: A total of 226 children participated in this study, giving a response rate of 75%. Most subjects (39.8%) were in the low risk category with DMFT score of 0. The overall mean DMFT score was 1.49 (±0.63). Linear and multiple regressions were performed to evaluate the predictability of caries risk. Previous experience of dental caries was found to be the most relevant predictor of caries risk (40%).

    CONCLUSION: The levels of caries risk amongst Pakistani 11-12 year old school children were generally low. Past caries experience was the most significant factor in predicting future caries lesion in this sample population.
  6. Chien PF, Khan KS
    Pak J Med Sci, 2023;39(2):317-322.
    PMID: 36950392 DOI: 10.12669/pjms.39.2.7428
    Systematic reviews rank at the top of the evidence hierarchy. Concise writing implies drafting the systematic review article succinctly, i.e. using as few words to express as full an extent of the research effort as possible. Precise writing means drafting the text with accuracy especially with respect to the methodological and statistical aspects. The Abstract ought to be succinct and structured to allow for editors, peer reviewers and readers to get the gist of the key aspects of the systematic review with a quick read. The readership needs to be able to critically appraisal systematic reviews for their internal and external validity rapidly. The Abstract also needs to be standalone, representing an independent summary that can be fully understood without the need for reading the full paper. The standard structure of the main text of a scientific article called IMRaD (Introduction, Methods, Results and Discussion) applies equally to systematic reviews in the same way as it does to any other kinds of research manuscripts whether related to laboratory experiments or clinical trials. Restricting the word count limits to those imposed by journals may at first seem difficult, even unfair, to systematic reviewers. However, with the availability of online appendices to transparently and fully report the details of the methods, results and other aspects of the work undertaken allows for a succinct print or PDF article. Writing a shorter manuscript is more effortful than writing a longer report. This commentary is aimed at novice systematic reviewers to help them learn the written and unwritten writing rules in order to assist them in producing impactful publications to support evidence-based medicine.
  7. Mm R, Kk W, I I, Zz R, H A
    Pak J Med Sci, 2014 Sep;30(5):1068-71.
    PMID: 25225528 DOI: 10.12669/pjms.305.5224
    OBJECTIVE: Influenza is considered as an emerging disease until today. The present study was undertaken to determine the prevalent genotypes of Influenza A virus in Malaysia.

    METHODS: Influenza A virus was identified from respiratory specimens by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Phylogenetic analysis of the identified isolates was performed and genotypes were detected.

    RESULTS: A total number of 505 throat swabs and nasopharyngeal aspirates were examined by rRT-PCR at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in which 65(12.87%) were positive for influenza A. The identified isolates were successfully genotyped by phylogenetic analysis. The identified influenza A genotypes were: H1N1 (42), H3N2 (20) and H5N1 (3).

    CONCLUSION: The findings indicated that 3 genotypes were circulating in Malaysia during 2011 in which H1N1 was the predominant. RESULTS added new genotype (H5N1) identification record in Malaysia that may be added in data base of WHO and CDC.

  8. Zaheer N, Shabaz M, Zaheer U, Wyne AH
    Pak J Med Sci, 2024;40(3Part-II):421-426.
    PMID: 38356796 DOI: 10.12669/pjms.40.3.7997
    OBJECTIVE: This retrospective, cross-sectional analytical study investigated the incidence of tooth agenesis in cleft lip and palate (CLP) patients. Cone Beam Computed Tomography (CBCT) radiographs of the CLP children were examined for congenitally missing teeth.

    METHOD: This study was conducted at three radiology centers in Lahore, namely, the Pakistan Jinnah MRI and Body Scan Centre, the University of Lahore Radiology Centres, and Fatima Memorial Hospital, from September 2021 to August 2022. The CLP patients were divided into four groups based on the location of the cleft: Cleft Lip and Palate Right (CLPR), Cleft Lip and Palate Left (CLPL), Bilateral Cleft (CLPB), and Midline Cleft (CLPM), inside and outside the cleft region. Two-way ANOVA was employed to compare the means of agenesis. Tukey's test was utilized to ascertain where the difference lies. The significance level was set at p ≤ 0.05.

    RESULTS: Moreover, a significant number of missing teeth were found inside the cleft. This study observed the CLPL (42.3%) and CLPR (13.6%) types more in number. Maxillary first premolars were found more missing outside the cleft region in CLPL and CLPB types. Although CLPB and CLPM types revealed a pattern of missing teeth, only a few cases were found in this study. Moreover, mean tooth agenesis was highest (4.5 SD.71) in the CLPM group, followed up by CLPB (2.75 SD 2.49), CLPR (1.23 SD 1.27), and CLPL Group (1.15 SD 1.12).

    CONCLUSIONS: Unilateral cleft lip and palate patients reported significant agenesis patttern compared to bilateral and median cleft cases.

  9. Khan MAH, Reza MA, Sharaf IM, Alam MJ, Rahman MM, Chandra P, et al.
    Pak J Med Sci, 2023;39(4):1212-1215.
    PMID: 37492299 DOI: 10.12669/pjms.39.4.7437
    Lipoid proteinosis is a rare multisystem genodermatosis inherited as autosomal recessive trait. We report a case of lipoid proteinosis in a 10-year-old boy born to first-degree consanguineous parents presented with marked hoarseness of voice, accelerated photoaging appearance, enlarged and erythematous tongue with restricted movement and widespread dermatoses. Biopsy of oral mucosa revealed Periodic acid-Schiff (PAS)-positive amorphous eosinophilic hyaline deposits. Mutational analysis revealed a homozygous nonsense mutation with C to T substitution at nucleotide position 1246(c.1246C>T) in exon-8 of the extracellular matrix protein 1 gene leading to a stop codon. Both the parents were unaffected heterozygous carriers. To our knowledge, this is the first case report of lipoid proteinosis with evidence of a novel nonsense genetic mutation from Bangladesh.
  10. Naeem NI, Hadie SNH, Ismail IM, Yusoff MSB
    Pak J Med Sci, 2023;39(6):1573-1583.
    PMID: 37936768 DOI: 10.12669/pjms.39.6.8430
    OBJECTIVES: To develop and validate Digital Medical Education Environment (Digi-MEE) Instrument for measuring online learning environment in medical education.

    METHODS: This series of studies involved 696 participants from May 2022 to December 2022. Following scoping review, invited modified e-Delphi experts developed consensus on the components and related items for measuring online learning environments. A panel of content experts and a group of medical students carried out content and response-process validation to determine Content Validity Index (CVI) and Face Validity Index (FVI) respectively. This was followed by exploratory and confirmatory factor analysis and reliability analysis to determine Digi-MEE's factorial structure and internal consistency using SPSS version 26.0 and AMOS 26.0.

    RESULTS: Delphi experts agreed upon nine components with 73 items of initial Digi-MEE version. CVI of Digi-MEE 2.0 was more than 0.90. with FVI of Digi-MEE 3.0 of 0.87. Exploratory factor analysis yielded 46 items with 57.18% variance. Confirmatory factor analysis led to the final Digi-MEE version containing 28 items within nine components with acceptable levels of goodness of fit indices. Overall Cronbach alpha of the final Digi-MEE was more than 0.90, and for the nine components ranged between 0.62 and 0.76.

    CONCLUSION: Digi-MEE is a promising valid and reliable instrument to evaluate online education environment in medical education. Content, response-process, factorial structure, and internal consistency evidence support the validity of Digi-MEE. Medical schools can use Digi-MEE as an evaluation tool for the continuous quality improvement of online learning environments.

  11. Altaf B, Mohamed M, Jawed S, Ghazali WSW
    Pak J Med Sci, 2023;39(6):1875-1882.
    PMID: 37936729 DOI: 10.12669/pjms.39.6.7990
    OBJECTIVE: This review is aimed to study MAFLD responses of lifestyle modifications using Diet and Exercise.

    METHODS: The sources for this MAFLD review following PRISMA protocol were PubMed, Google scholar, Scopus and Science Direct. Quality of evidence was assessed by consistent results with previous studies. Assessment of quality was done by Joanna Briggs Institute criteria. Quality of evidence was assessed by GRADE approach tool.

    RESULTS: This review included 12 studies, from which five were qualitative and seven quantitative. The later showed poor dietary habits and sedentary lifestyle exhibiting MAFLD which eventually affect their quality of life. Further studies suggested that by introducing healthy lifestyle in MAFLD group using diet and exercise caused reduction in BMI, obesity levels, improved glycemic control and reversal of liver fat content with improved liver enzymes.

    CONCLUSION: Subjects with MAFLD experienced poor quality of life. Altering lifestyle by diet and exercise can improve their physical wellbeing.

  12. Zia N, Doss JG, John J, Panezai J
    Pak J Med Sci, 2024;40(1Part-I):233-241.
    PMID: 38196463 DOI: 10.12669/pjms.40.1.7606
    OBJECTIVE: Green dentistry is an emerging concept necessary to address the worsening climatic changes. It is essential to compile the existing literature on knowledge, attitude, and practice on green dentistry that can be accomplished by conducting a literature review. The objective of this literature review was to summarize and present the existing knowledge that dentists have regarding green dental practices, their attitude about this shift towards sustainability, and steps that they have taken in their personal practice to adhere towards an eco-friendlier dental approach.

    METHODS: Three months of effective research and review development from March 2022 to June 2022. Design using keywords, a literature search was performed in PubMed, Google scholar and Web of Science databases. A total of 13 articles of 45, fulfilling the inclusion criteria were selected, of which two were excluded as these were not in English.

    RESULTS: Dental practitioners have good knowledge about green dentistry and positive attitudes towards environment conservation, but implementation in their practice is not adequate. Most common themes of knowledge, attitude and practice assessment in green dentistry are amalgam management, radiographic management, infection control, waste management, water, and electricity management.

    CONCLUSION: The absence of adequate literature on eco-friendly practices in dentistry makes it difficult to validate the findings of most of these studies. Dental professionals are familiar with environmentally friendly dental practices and have a positive outlook on their role in environmental protection, but its application in practice is far from adequate.

  13. Arshed M, Mahmud AB, Umer MF, Mashhadi F, Kawish AB
    Pak J Med Sci, 2025 Jan;41(1):22-28.
    PMID: 39867791 DOI: 10.12669/pjms.41.1.9272
    BACKGROUND & OBJECTIVES: Poor medication adherence is an essential contributor to Pakistan's high prevalence of uncontrolled hypertension. This study will be aimed to assess the efficacy of a one-of-a-kind developed intervention in improving medication adherence and treatment outcomes in hypertension patients.

    METHODS: Twleve months duration long randomized controlled trial from January to December 2021 will be carried out at Shaikh Zayed Medical Complex (SZMC), Lahore. A total of 440 patients aged 18 years and older diagnosed with hypertension in the last month with non- adherence to antihypertensive therapy <80% of pills used in the last 30 days and have access to a smartphone will be randomized into either the intervention group (n=220) or the control group (n=220). For the intervention arm, a comprehensive intervention, the "Multi-Aid-Package," consisting of seven items: written, voice, and graphics messages, animated video, educational material, and a 24/7 help service, has been designed. Standard care will be provided to the control group. The primary outcome will be improved adherence to antihypertensive medication, while the secondary outcome will be an alteration in systolic blood pressure (SBP). The analysis will be intention to treat.

    CONCLUSION: According to this study, if the multifunctional Multi-Aid-Package proves to be a useful mobile health tool for improving hypertension patients' medication adherence, it will also significantly affect systolic blood pressure. In Pakistan and other comparable low- and middle-income countries LMICs, the Multi-Aid-Package ought to be taken into consideration as a means of enhancing adherence to medications among hypertension patients.

  14. Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM
    Pak J Med Sci, 2021;37(4):1221-1229.
    PMID: 34290812 DOI: 10.12669/pjms.37.4.4004
    BACKGROUND AND OBJECTIVES: Medical Professionalism (MP) establishes the trust between society and doctors. We aimed at finding frequently highlighted qualities of MP in the literature.

    METHODS: We searched PubMed and Scopus for attributes of MP, using terms, "Professionalism," "Medical Students," and "Undergraduate Medical Education". We included English language, original research articles with MP attributes from the perspective of undergraduate medical education, any nationality, race, gender, and age range, as the central topic of the article. Papers published from January 1st 1986 to 29th February 2020 were included.

    RESULTS: From 1349 identified articles, finally, 18 were included, authored in 10 countries, collectively contributing to answering the scoping review question. Two themes were identified: (1) Nurturing of MP, 11 (61.11%) out of 18 included articles, highlighted "respect" as the most dominant attribute as it appeared in 6 (54.55%) out of 11 reviews, "communication" 5 (45.45 %) studies and "honesty" and "integrity" 4 (36.36%). (2) Assessment of MP, 7 (38.89%) studies, and majority, 4 (57.14 %) assessed MP using American Board of Internal Medicine's elements of MP, viz, "altruism, accountability, excellence, duty, honor and integrity, respect for others."

    CONCLUSIONS: Themes exemplified MP's most discoursed issues. The attributes are frequently used worldwide. MP deliberates as a commitment toward the individual patient, society, and necessitates transforming from its present generic form to more explicit details.

  15. Jouhar R, Halim MS, Ahmed MA, Shah F, Quadri SA
    Pak J Med Sci, 2025 Feb;41(2):519-524.
    PMID: 39926673 DOI: 10.12669/pjms.41.2.11001
    BACKGROUND & OBJECTIVE: Root canal infections are challenging to eradicate with conventional methods due to their complexity. Traditional chemical irrigants often fail to reach all bacterial colonies. Methylene blue (MB), used in photoactivated disinfection (PAD), generates reactive oxygen species (ROS) upon light activation, effectively killing bacteria. This study aimed to synthesize, characterize, and explore MB-functionalized reduced graphene oxide (MB/rGO) for enhanced photoactivated disinfection in root canal treatment.

    METHODS: This in-vitro study was conducted from April 2024 to September 2024 at Universiti Sains Malaysia and King Faisal University. Graphene oxide (GO) was reduced by dispersing GO in deionized water with sonication, followed by adding sodium hydroxide (NaOH) under vigorous stirring. The suspension obtained was centrifuged, washed, and dried to yield reduced graphene oxide (rGO). For functionalization, rGO was dispersed in ethanol and mixed with methylene blue (MB) solution, followed by stirring and drying to obtain MB-functionalized rGO. The antibacterial and antifungal activities of MB alone and in combination with rGO, with or without laser exposure, were tested using the agar well diffusion method. The paired sample t-test was used to compare the inhibition zones for different treatment groups of E. faecalis and C. albicans.

    RESULTS: FTIR analysis confirmed successful functionalization by identifying specific functional groups of rGO and MB. Similarly, Raman spectroscopy indicated that GO-MB had an intermediate level of defects, and SEM analysis confirmed slight morphological changes with MB molecules attached to the rGO surface. Moreover, the antimicrobial test revealed that MB/rGO with laser performed significantly better (p=0.042) than MB/rGO without laser and MB with laser group (p=0.034) against E. faecalis.

    CONCLUSIONS: The functionalization of MB with rGO and its application with laser treatment significantly enhanced antimicrobial and antifungal activity, suggesting potential benefits for endodontic treatments and other dental applications.

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