Gastric Electrical Stimulation for the Treatment of Gastroparesis or Gastroparesis-like Symptoms: A Systemic Review and Meta-analysis.

BACKGROUND: The effects of gastric electrical stimulation are not fully understood. We aimed to assess the efficacy of gastric electrical stimulation (GES) for patients with gastroparesis and gastroparesis-like symptoms. MATERIALS AND METHODS: We searched PubMed, Scopus, Cochrane, Web of Science, Embase, and Science Direct to identify controlled trials and cohort studies. We used random effects models to estimate pooled effects. A total of nine studies met the criteria and were included for the final qualitative synthesis and the quantitative analysis. We examined the mean absolute differences (MD) and 95% CIs. RESULTS: Nine studies (n = 730) met the criteria and were included for the final qualitative synthesis and the quantitative analysis. There was significant improvement in gastrointestinal (GI) total symptom score (TSS) with the GES group compared with controls during the randomized blind trials. This effect was sustained at 12 months after treatment compared with before treatment (MD = -6.07; 95% CI, -4.5 to -7.65; p < 0.00001). The pooled effect estimate showed a significant improvement in frequency of weekly vomiting episodes at 12 months compared with before treatment (MD = -15.59; 95% CI, -10.29 to -20.9; p < 0.00001). CONCLUSION: GES appears beneficial, with significant improvement in GI TSS, weekly vomiting frequency, gastric emptying study, and quality of life.

Genetic polymorphism of 15 autosomal short tandem repeats in Baloch population of Pakistan.

Allele frequencies and forensic statistical parameters of 15 autosomal short tandem repeats (STRs) were evaluated in 200 genetically unrelated individuals of the Baloch population of Pakistan. Total 155 alleles were observed with allele frequencies ranged from 0.003 to 0.425. Among the 15 STRs, D2S1338 was found to be the most polymorphic and discriminating locus while TPOX was the least polymorphic and discriminating locus. The combined power of discrimination (CPD), combined power of exclusion (CPE), and combined matching probability (CMP) were found to be 0.9999999999999999978, 0.999994252, and 2.14012 × 10-18, respectively. No significant deviation from Hardy-Weinberg Equilibrium (HWE) was observed except for locus D21S11. Additionally, a correlation between previously published data and Baloch population is also presented.

Association of burnout with doctor-patient relationship and common stressors among postgraduate trainees and house officers in Lahore-a cross-sectional study.

INTRODUCTION: Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor-patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor-patient relationship. METHODS: A descriptive, cross-sectional study design with convenience (non-probability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or "HOs" (recent graduates doing their 1 year long internship) and post-graduate trainees or "PGRs" (residents for 4-5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor-patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. RESULTS: A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P > 0.05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson's burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. CONCLUSION: Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor-patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced.

Genetic analysis of 15 autosomal STRs in Yousafzai population of Pakistan.

Yousafzai is a Pushto-speaking Pathan tribe inhabiting the northern province of Pakistan who claim to be descendants of the prophet Yousaf (Joseph). Forensic and genetic parameters were determined for 203 genetically unrelated individuals on 15 autosomal STRs. D2S1338 was the most discriminating locus whereas TPOX was the least. The combined matching probability (CMP) for all loci was 1.52458 × 10-18 while combined power of discrimination (CPD) and combined power of exclusion (CPE) was 0.9999999999999999984 and 0.999998628, respectively. The Yousafzai population was in Hardy-Weinberg equilibrium after Bonferroni correction except for loci D3S1358 and D19S433. Pairwise genetic distance analysis was carried out by comparing with various populations at local and global levels. The findings of this study are valuable for population genetics and forensics analysis.

Exosomes as Biomarker of Cancer

ABSTRACT Rapid advances in medicine and biotechnology resulted in the development of non-invasive diagnostic and prognostic biomarkers enabling convenient and accurate detection. Exosomes has recently emerged as non-invasive biomarker for a number of diseases including cancer. Exosomes are the small endosome originated membranous vesicles secreted in a number of biological fluids such as serum, saliva, urine, ascites, cerebrospinal fluid, etc. Exosomes contain microRNA proteins and mRNA which can be used as disease specific biomarkers. Here we reviewed recent advancement in the field of exosomes as diagnostic biomarker for cancer along with a brief overview of their biogenesis, function and isolation.