ZU Journal System (Ziauddin University)
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Evaluation of Gingival Crevicular Interleukin-1β Levels in Patients Undergoing Clear Aligners vs. Fixed Orthodontic Therapy
No full textBackground: Tooth movements induced by orthodontic force cause an inflammatory response in the periodontium that is mediated by cytokines, including Interleukin-1beta (IL-1β). Fixed appliances produce different biomechanical forces, which have the potential to modulate GCF cytokines compared to clear aligners. The study aimed to determine the levels of gingival crevicular fluid (GCF) IL-1β in patients receiving clear aligner treatment compared to those receiving fixed appliances.
Methods: This cross-sectional analytical research was conducted at a tertiary care dental hospital between From February to June 2025. 100 (50 clear aligner patients and 50 fixed appliance patients), 18-30 years old participants were recruited. Samples of GCF were obtained as a baseline and 1 month after treatment. IL-1β levels were measured by Enzyme-Linked Immunosorbent Assay (ELISA). The significance level was set as p < 0.05.
Results: No significant difference was found between baseline IL-1 levels (54.7 ± 9.3 vs. 56.1 ± 10.1 pg/L, CI: 2.5-5.3, p = 0.47). At 1 month, IL-1β levels were significantly elevated in the non-MAR group (92.4 ± 12.6 vs. 71.8 ± 10.9 pg/L, CI: 16.3-24.9, p < 0.001). Increases within the group were noted in both groups (clear aligners: 17.1 ± 6.2; fixed appliances: 36.3 ± 7.8, both p < 0.001). The difference between the groups persisted after controlling for confounders (CI: 15.7-23.0, p < 0.001).
Conclusion: Both appliance systems increased GCF IL-1β levels, but fixed appliances produced a significantly larger inflammatory response than clear aligners, even after adjustment for potential confounders
TRANSLATION, CROSS-CULTURAL ADAPTATION AND PSYCHOMETRIC PROPERTIES OF URDU VERSION OF FALLS EFFICACY SCALE- INTERNATIONAL IN COMMUNITY DWELLING OLDER ADULTS
No full textBackground and Aim: The Fear of Falling Scale (FES-I) was created to investigate people\u27s concerns of falling. It has 16 elements that should be translated into comprehensible Language to avoid misperceptions. The purpose of this research was to provide an Urdu translation of the fall\u27s effectiveness scale-International and evaluate its psychometric characteristics.
Methodology: The FES-I was translated using Beaton standards. A final FES-I was produced once forward and backward translations were completed. Adults aged 60 and up from the community of Lahore\u27s old houses were recruited. Internal consistency and test re-test reliability were evaluated. The Urdu version of the FES-I was compared to the Berg Balance Scale and the Time Up and Go Test to determine its validity.
Results: With 100 respondents, the Urdu – FES-I shows a good test-retest reliability (ICC = 0.989). With a Cronbach\u27s alpha score of 0.989, FES-I-U has high internal consistency. The construct validity between the FES-I-U and Time Up and Go revealed a good positive correlation when Pearson\u27s correlation coefficient was calculated. There is a substantial negative correlation between the FES-I-U and the Berg Balance Scale.
Conclusion: The FES-I in Urdu is a clear, valid, and reliable instrument for measuring fear of falling among older Pakistani community
DESIGN AND DEVELOPMENT OF A STROKE REHABILITATION GLOVE FOR MEASURING AND MONITORING HAND MOTIONS
No full textMuscular weakness tends to increase very rapidly due to various medical illnesses such as stroke, paralysis, fibromyalgia, etc. In order to keep tracks of the rehabilitative progress of patients who are suffering from such diseases, it is necessary to acquire data pertaining to finger movements including flexion and extension. Along with range of motions of proximal interphalangeal (PIP), distal interphalangeal (DIP) and meta-capo phalangeal joints, pinching strength is also vital in assessing the progress of rehabilitative therapies. Hence, our objective is to develop an assistive technology in the form of a smart glove comprising of flex and force sensors for measuring flexion and extension movements as well as the pinching strength. To the best of author’s knowledge, commercially available rehabilitation gloves are expensive and have some limitations such as being non-portable, having an antenna mount on the gloves facing upward and so on. The smart glove was able to measure the flexion and extension of finger movements and pinch strength with low-power requirements and low cost associated with production. The flexion and extension of finger movements along with pinching strength of stroke survivors was measured with the aid of the glove and showed promising outcomes. Through the results achieved by our developed glove, we were able to analyze the rehabilitative progress of stroke survivors. Moreover, the data is monitored continuously through liquid crystal display for rehabilitation purposes. Notably, this low cost glove was designed with the aid of flex sensors and force sensors that enabled the effective measurement of flexion, extension and pinching strength of stroke survivors
EFFECTS OF HYDROTHERAPY ON PAIN, GRIP STRENGTH AND FUNCTIONAL OUTCOMES IN OSTEOARTHRITIS OF HAND
No full textBackground and aim: This study was conducted to find the effects of hydrotherapy and land-based exercises on pain, grip strength and functional status in hand osteoarthritis patients. Methodology: Eighty participants were randomized into two study groups i.e. hydrotherapy based exercise group or land based exercise group. Both groups were treated for 3 sessions per week for eight weeks and assessed after two months follow up. Numeric Pain Rating Scale (NPRS), Hand held dynamometer and Functional Index for Hand Osteoarthritis (FIHOA) were used to measure pain, grip strength and functional status of hand before and after treatment sessions for eight weeks and again assessed at two months of follow up. Results: Multivariate analysis of variance indicates a statistically significant group-by-time interaction (p=.00). Pain intensity was significantly reduced in both groups whereas Grip strength and functional outcomes were significantly improved in patients of group B (hydrotherapy based exercises) as compared to group A (land based exercises) (P=.02 and .00). Conclusion: Hydrotherapy based exercises prove to be more efficient in terms of improving functional outcomes of patients of hand osteoarthritis.
Extensively Drug-Resistant (XDR) Enteric Fever in Children
No full textBackground: Typhoid and paratyphoid fevers are caused by Salmonella enterica subspecies serovars typhi (Salmonella typhi and Paratyphi) and the term enteric fever is generally used to describe both. This study was done to determine the frequency of extensively drug-resistant (XDR) in children diagnosed with enteric fever at a tertiary care hospital.
Methods: This cross-sectional study was conducted at the Department of Pediatric Medicine, Liaquat National Hospital, Karachi, Pakistan, from April 2023 to September 2023. A total of 122 children aged between 2-12 years with an axillary body temperature >38.4 oC for at least 4 days were analyzed. Non-probability convenient sampling method was adopted. Venous blood (3-5 ml) was drawn and sent for confirmation of XDR enteric fever. Effect modifiers were stratified concerning the frequency of XDR enteric fever, and post-stratification, a chi-square test was applied to take p<0.05 as significant.
Results: Out of a total of 122 children, 67 (54.9%) were boys. The mean age was 6.14±2.82 years. Blood culture for was found positive for Salmonella typhi in 82 (67.2%) children. In a total of 82 patients with positive blood culture for enteric fever, XDR was identified in 43 (52.4%) children. Relatively higher duration of fever was significantly associated with positive blood culture cases for Salmonella typhi ((>14 days, p=0.020), and XDR cases (p=0.031). Comparison of mean length of hospital stay (7.27±1.68 vs. 7.77±2.2 days, p=0.103) did not reveal any significant differences among study participants.
Conclusion: A very high prevalence of XDR was found among children diagnosed with enteric fever.
Initial Treatment of Meningocele and Myelomeningocele Lesion in Children
No full textBackground: Myelomeningocele is a severe form of spina bifida. The disease significantly impacts survival and neurological outcomes in children. The purpose of this study is to investigate the effect of in-time assessment and surgical intervention on functional outcomes in children with MMC.
Methods: A retrospective study was conducted on medical records of 60 children who underwent MMC repair between January 2016 and December 2019. ERC/62/24/06 were categorized into six groups based on the timing of assessment and surgical intervention. The KA Bennett classification system was used for functional outcomes grading. A Kaplan-Meier and log-rank test was used to find survival rates.
Results: Survival analysis revealed that early surgical intervention significantly reduced mortality rates compared to conservative treatment (p<0.05). Children treated within 24 hours (Group C) had higher survival rates (94.4%) compared to those with delayed or no closure (Groups A and B). Functional improvements were noted across all groups, with the highest in groups undergoing early surgery. The presence of hydrocephalus negatively impacted survival, with early closure groups showing lower mortality (26%) compared to those with delayed closure (55.1%). Group E showed fewer cases of hydrocephalus (62%) and smaller thoracic lumbar lesions were excluded from comparisons due to its unique profile assessed on days 3-4 post-birth.
Conclusion: Early surgical intervention within the first 24 hours post-birth significantly improves survival and functional outcomes in children with MMC compared to delayed treatment or conservative management
Implication of Different Levels of Placental Insufficiency in Predicting Perinatal Outcome
No full textBackground: Placental insufficiency occurs when the placenta undergoes malfunctioning and cannot supply adequate oxygen and nutrients to the foetus, thus causing unfavourable effects. This study aimed to assess the perinatal outcomes in neonates born to mothers diagnosed with placenta insufficiency in the absence of comorbidities.
Methods: After the ethical approval from the institutional committee, the cross-sectional study was carried out at Combined military Hospital Abbottabad from 1st January 2024 to 31st March 2024. Through non-probability consecutive sampling, 80 singleton pregnant women between 36 and 41 weeks were included . Women with twins, essential hypertension, pregnancy-induced hypertension, gestational diabetes, severe anaemia, foetus with congenital abnormalities were excluded from the study. Demographic and clinical variables of all the participants were collected through the pre-designed proforma. The primary outcomes focused on the rates of IUD, stillbirth, and ENND. Data was analysed using SPSS version 26.
Results: The Majority of the perinatal (50%) 6 and antenatal (33.3%) 4 deaths were observed in the neonates born after 40 weeks of gestation age. The study found that 34% (13) of pregnancies had severe unfavourable results (" antenatal outcome-1"), 28%(9) of pregnancies had adverse labor outcomes (" labor outcome-2"), and 38%(12) of pregnancies had adverse newborn outcomes (" adverse neonatal outcome-3").
Conclusion: Perinatal hypoxia-related events are common in newborns with low birth weights but can occur across all birth weights. Most are due to diminished placental function, necessitating additional diagnostic methods to detect placental malfunction during late pregnancy
Chameleons of Multiple Sclerosis: A Case Series
No full textMultiple Sclerosis (MS) presents diagnostic conundrums due to its resemblance to various neurological conditions in young patients. In this case series, we described three cases highlighting the diagnostic challenges in differentiating neurological conditions that mimic MS in young patients. A 23-year-old female presented with blurred vision and bilateral lower limb weakness, initially suggestive of MS, but was later diagnosed with metastatic disease. Another young female with quadriplegia, initially misidentified as having transverse myelitis or ADEM vs. MS, was later found to have extensive medullary and spinal cord ischemia. A young male, initially diagnosed with MS, was later identified as having CNS vasculitis. These cases underscore the diverse spectrum of conditions that can mimic MS, emphasizing the need for comprehensive patient history, meticulous clinical examination, and relevant laboratory investigations to avoid misdiagnosis. Seemingly straightforward clinical scenarios can be deceptively challenging. Collaboration among experienced faculty members is crucial in reaching accurate diagnoses and providing appropriate treatment
Colorectal Cancer: Determinants of Delayed Diagnosis and Its Association with Survival in Pakistani Population
No full textBackground: New research indicates that Pakistan is seeing an increase in Colorectal cancer (CRC) cases among people older than 50. The main goal of this study is to find out the determinants of delayed diagnosis and its association with the survival of colorectal cancer patients in the Pakistani community.
Methods: A prospective, cohort study was conducted on biopsy-proven colorectal cancer patients, aged between 18-70 years old presenting at the surgery department of Al Tibri medical college and Hospital, Karachi from January 1st, 2023 till March 30th, 2024, with a sample size of 98 patients, follow up duration was 1 year. A purposive sampling technique was used. Statistical Package of Social Sciences (SPSS) version 22 was used to enter, sort, and analyze the data. Kaplain–Meier was generated for survival analysis for both colon and rectal carcinoma. A P-value of ≤ 0.05 was considered significant.
Results: Reasons for Delay in diagnosis were reported as misdiagnosis by a physician (OR 1.32, 0.24 – 2.16), poor knowledge of disease and symptoms (OR 2.48, 1.04 – 4.88), and herbal medication use to treat symptoms (OR 0.89, 0.047 – 1.89). Overall survival was reported as 74 (74.7%) for 1-year follow-up, however, Rectal cancer survival was 23 (23.7%) and colon cancer survival was 51 (51.3%) with a p-value of 0.365.
Conclusion: In conclusion, patients with colorectal cancer in Pakistan are often diagnosed at an advanced stage, with a dismal prognosis, due to a delay in presentation
Estimation of Heavy Metals in Pakistani and International Branded Canned Foods in the Markets of Peshawar, Khyber Pakhtunkhwa, Pakistan
No full textBackground: Heavy metals in food are an emerging public health issue in the modern food industry. The toxicity of heavy metals can have serious effects on human health. Therefore, the present study was conducted to measure the concentration of heavy metals in branded canned foods.
Methods: A cross-sectional analytical study was conducted from January 2021 to July 2022. A total of 60 samples consisting of 42 International and 18 Pakistani canned foods. Collected samples were analyzed by an Atomic absorption spectrometer present in the Public Health laboratory, Khyber Medical College, Peshawar. Data was analyzed using SPSS version 23 for Windows. The p-value less than 0.05 was taken as significant.
Results: Tested samples were selected from 4 food types; i.e., fruits 19, lentils and legumes 18, vegetables 17, and 6 fish cans. Eighteen were preserved in sugary syrup and 42 in brine. International branded cans had upper normal levels of Cd, Cr, and Cu. While Pakistani cans showed upper normal Pb levels in the recommended set point by FAO/WHO, i.e., 0.1 mg/L Cd, 1 mg/L Cr, 0.4mg/L Cu, and 0.5 mg/L Pb. Pb, Cd, Cu, and Cd levels in Pakistani canned food were in a range of 0.29-0.0183 mg/L, 0.001- 0.047 mg/L, 0.008-0.022mgL and -0.069-0.123mg/L. Metals in International branded cans were in the range of -0.001- 0.198 mg/L, 0.001-0.065mg/L, -0.00-0.049mg/L and -0.004-0.137mg/L. This study revealed the upper normal limit for Pb and exceeding Cd levels in the tested samples.
Conclusion: The present study concluded that heavy metal concentrations are well above the permissible level stated by the WHO. Therefore, canned food should be consumed consciously.