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Background@#No recent meta-analysis has holistically analyzed and summarized the efficacy and safety of omarigliptin in type 2 diabetes mellitus (T2DM). We conducted a meta-analysis to address this knowledge gap. @*Methods@#Electronic databases were searched to identify randomized controlled trials (RCTs) that included patients with T2DM who received omarigliptin in the intervention arm. The control arm consisted of either a placebo (passive control group [PCG]) or an active comparator (active control group [ACG]). The primary outcome assessed was changes in hemoglobin A1c (HbA1c), while secondary outcomes included variations in glucose levels, achievement of glycemic targets, adverse events (AEs), and hypoglycemic events. @*Results@#From 332 initially screened articles, data from 16 RCTs involving 8,804 subjects were analyzed. Omarigliptin demonstrated superiority over placebo in reducing HbA1c levels (mean difference, –0.58%; 95% confidence interval, –0.75 to –0.40; P<0.00001; I2=91%). Additionally, omarigliptin outperformed placebo in lowering fasting plasma glucose, 2-hour postprandial glucose, and in the percentage of participants achieving HbA1c levels below 7.0% and 6.5%. The glycemic efficacy of omarigliptin was similar to that of the ACG across all measures. Although the omarigliptin group experienced a higher incidence of hypoglycemic events compared to the PCG, the overall AEs, serious AEs, hypoglycemia, and severe hypoglycemia were comparable between the omarigliptin and control groups (PCG and ACG). @*Conclusion@#Omarigliptin has a favorable glycemic efficacy and safety profile for managing T2DM.
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ABSTRACT Objective: Sexual dysfunction among women with diabetes is a common but neglected health issue worldwide. The objective of the present study was to investigate the prevalence of sexual dysfunction and its associated factors among women with type 2 diabetes mellitus (T2DM). Subjects and methods: This cross-sectional comparative study comprises 150 women with diabetes and 100 healthy women without diabetes who visited the endocrinology outpatient department of Mymensingh Medical College Hospital (MMCH). The data were collected from July to December 2019. Sexual dysfunction was assessed by the 19-item Female Sexual Function Index (FSFI). Informed consent was obtained before participation. Collected data were analysed by SPSS 26. Results: More women with diabetes than control subjects reported sexual dysfunction (79% vs. 72%; p = 0.864). The global FSFI score was lower among the diabetes patients than among the healthy controls (20.8 ± 7.2 vs. 23.7 ± 4.8; p < 0.001). Patients with T2DM scored significantly lower in the domains of desire (p = 0.04), lubrication (p = 0.01), orgasm (p = 0.01), and satisfaction (p < 0.001), but not the domain of arousal (p = 0.09). A prolonged duration of diabetes was the primary contributor to orgasm problems (adjusted odds ratio, aOR 1.3, 95% CI 1.1-1.7) and painful intercourse (aOR 1.2, 95% CI 1.1-1.5). Conclusion: Sexual problems are frequent in women with diabetes. Inclusion of sexual health in comprehensive diabetes management is crucial to address this problem as well as to improve the quality of life of female diabetes patients.
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Objectives@#Users share valuable information through online smoking cessation communities (OSCCs), which help people maintain and improve smoking cessation behavior. Although OSCC utilization is common among smokers, limitations exist in identifying the smoking status of OSCC users (“quit” vs. “not quit”). Thus, the current study implicitly analyzed user-generated content (UGC) to identify individual users’ smoking status through advanced computational methods and real data from an OSCC. @*Methods@#Secondary data analysis was conducted using data from 3,833 users of BcomeAnEX.org. Domain experts reviewed posts and comments to determine the authors’ smoking status when they wrote them. Seven types of feature sets were extracted from UGC (textual, Doc2Vec, social influence, domain-specific, author-based, and thread-based features, as well as adjacent posts). @*Results@#Introducing novel features boosted smoking status recognition (quit vs. not quit) by 9.3% relative to the use of text-only post features. Furthermore, advanced computational methods outperformed baseline algorithms across all models and increased the smoking status prediction performance by up to 12%. @*Conclusions@#The results of this study suggest that the current research method provides a valuable platform for researchers involved in online cessation interventions and furnishes a framework for on-going machine learning applications. The results may help practitioners design a sustainable real-time intervention via personalized post recommendations in OSCCs. A major limitation is that only users’ smoking status was detected. Future research might involve programming machine learning classification methods to identify abstinence duration using larger datasets.
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Objectives@#Users share valuable information through online smoking cessation communities (OSCCs), which help people maintain and improve smoking cessation behavior. Although OSCC utilization is common among smokers, limitations exist in identifying the smoking status of OSCC users (“quit” vs. “not quit”). Thus, the current study implicitly analyzed user-generated content (UGC) to identify individual users’ smoking status through advanced computational methods and real data from an OSCC. @*Methods@#Secondary data analysis was conducted using data from 3,833 users of BcomeAnEX.org. Domain experts reviewed posts and comments to determine the authors’ smoking status when they wrote them. Seven types of feature sets were extracted from UGC (textual, Doc2Vec, social influence, domain-specific, author-based, and thread-based features, as well as adjacent posts). @*Results@#Introducing novel features boosted smoking status recognition (quit vs. not quit) by 9.3% relative to the use of text-only post features. Furthermore, advanced computational methods outperformed baseline algorithms across all models and increased the smoking status prediction performance by up to 12%. @*Conclusions@#The results of this study suggest that the current research method provides a valuable platform for researchers involved in online cessation interventions and furnishes a framework for on-going machine learning applications. The results may help practitioners design a sustainable real-time intervention via personalized post recommendations in OSCCs. A major limitation is that only users’ smoking status was detected. Future research might involve programming machine learning classification methods to identify abstinence duration using larger datasets.
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Background: Involvement of the peripheral and autonomic nervous systems is probably the most common complication of diabetes. The main symptoms of diabetic polyneuropathy include negative symptoms (those related to nerve fiber loss or dysfunction) such as numbness and weakness, and positive symptoms (those related to abnormal function of surviving nerve fibers) such as tingling and pain.Methods: This was a cross-sectional study held in diabetic clinic of Nishter hospital, Multan, Pakistan. The study included any diabetic patients showing symptoms of neuropathy.Results: There were total of 140 in this study. This study included 85% of male and 15% of female. Most common symptoms of diabetic neuropathy were pain (70%) and tingling (70%) followed by numbness in 65% of patients. There were 28 patients in 5 years duration of diabetes, 35 people in 6-10 years duration, 21 patients in 11-15 years duration, and 14 patients in 20+ years duration.Conclusions: Neuropathy due to diabetes is crippling especially when pain is the prominent symptoms. Autonomic symptoms like constipation and lightheadedness are discomforting for the patients. The most commonly used screening test is vibrating tuning fork test which is east to perform is clinical setting and is not time consuming. Diabetic patients need to take special care of.
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@# Introduction: Data on water and sugar sweetened beverages (SSB) intake among young adults in Malaysia is sparse. This study aimed at measuring the intake of plain water and SSB among undergraduate students in a Malaysian university and examine its association with body mass index (BMI). Methods: A total of 376 undergraduate students aged 18-30 years were recruited. A selfadministered questionnaire was used to determine the SSB consumption pattern. The questionnaire consisted of five sections that included the background of the participants, knowledge about SSB, SSB preferences, frequency and portion size. Results: 23.9% of subjects in this study were overweight. Almost all of the subjects took outside food (93.1%) and drink (74.2%). The highest daily consumption was plain water (92.3%), with a majority drinking more than two cups at each intake. Caffeinated drinks (coffee or tea) were the most popular SSB among the students (18.4%). Most students (79.7%) did not consume SSB on a daily basis. A significant association was found between the proportion of plain water consumption and BMI (p<0.05). Those who were overweight consumed a greater amount of plain water as compared to those underweight. Conclusion: Our findings of low plain water intake among the underweight may be used to tailor intervention efforts to increase its intake and reduce that of SSB, especially among underweight young adults.
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The present study was undertaken to find out the safety levels of fenbendazole in common peafowl. This bird, raised on aviaries and zoos, can be severely parasitized with Ascaridia galli [enteric worms] and Syngamus trachea [gapeworm] along with other parasitic worms. Fenbendazole is a highly effective benzimidazole-class anthelmintic in animals. The objective of this work was to provide target animal safety data in young peafowl and to demonstrate reproductive safety in adult birds. During the experimental study, diets containing fenbendazole at 0, 100, 200 and 300 ppm were fed for 21 days [three times the normal treatment duration]. Data for feed consumption, feed conversion rate, and body weights were recorded for each bird in each group. Drug concentrations in different tissues of birds were determined to correlate concentrations with clinical observations, clinical pathology, and histologic findings. There were no morbidities or mortalities after study day 21. Additionally, there were no statistically significant treatment-related differences among above mentioned parameters. Analysis of fenbendazole concentrations in kidney, liver, leg/thigh, and breast muscle and skin with associated fat revealed that, even at the highest dose level used and with no feed withdrawal, fenbendazole concentrations were relatively low in these tissues. These findings indicate that fenbendazole has a relatively wide margin of safety in young peafowl and that the proposed dose of 100 ppm in the feed for 7 consecutive days is well within the margin of safety. In the reproductive safety study, five breeder peafowl farms fed fendbendazole at 100ppm for 7 days and collected data on hatching percentage of peahen eggs before and after treatment. Reproductive performance in peahen was not adversely affected
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A renal artery pseudoaneurysm is a rare but important complication that can occur after renal trauma, renal biopsy, percutaneous nephrostomy, percutaneous nephrolithotomy [PCNL], and partial nephrectomy. The incidence of this potentially life-threatening complication is less than 1%, but is likely to increase with the increasing popularity of endoscopic renal procedures. We present a case of a 30-year female who underwent right PCNL for a right renal pelvic stone. Two weeks later, she presented with massive hematuria. Renal angiography revealed psuedoanurysm of interlobar artery which was successfully treated with coil embolization
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Humans , Female , Adult , Nephrolithotomy, Percutaneous/adverse effects , Renal Artery , Aneurysm, False/etiology , Kidney CalculiABSTRACT
The present study describes the synthesis, characterization of nano-particles from Periploca hyaspidis and their in vitro biological activity. The synthesis of AgNPs was confirmed by UV-Vis spectrophotometer and structure by atomic force microscope. The crystallite size and different functional groups was determined by X-ray diffraction and Fourier transformed infrared spectroscopy. Anti-microbial and anti-oxidant activity was carried out by disc diffusion and DPPH radical scavenging protocol respectively. Silver nano-particles [AgNPs] were synthesized by mixing 1mM AgNO3 solutions with plant boiled extract in 1:9. The color change from yellow to dark brown indicated the synthesis of the nano-particles. The AgNPs were more stable at 25 degree C to 45 degree C, 1mM concentration of the salt and neutral to slightly basic pH. The results revealed that aromatic amines were responsible for the synthesis of AgNPs. The crystallite size was 7.50 nm, cubic and in nanorgime. AgNPs showed good anti-oxidant activity and was effective against K. pnemoniae, E. coli, X. compestris, C. albicans and P. chrysogenum
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The aim of the present study was to investigate bioactive compounds in different solvent extracted samples from the stem tissues of P. hydaspidis using Gas Chromatography and Mass Spectroscopy techniques. GC-mass spectrum was compared with the data base of National Institute of Standards and Technology [NIST] containing more than 62000 patterns of the mass spectrum. During matching with NIST library the match factor greater than 700 was considered only for better and pure results. The results revealed that different solvent extracted samples analyzed through GC-MS contained appreciable quantities of different bioactive molecules including antibiotics, fatty acids and protein which have important pharmacological significance
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Aim and Objective: To determine the association of primary headache with age, sex, obesity and hypertension among patients received at medical Out-patient-department of Liaquat University Hospital, Hyderabad / Jamshoro
Study Design: It is a cross-sectional study conducted at Liaquat University Hospital Out-Patient Department, Hyderabad / Jamshoro, to determine the prevalence of primary headache in association with sex, age, obesity and hypertension
Place and Duration of Study: Out-Patient-Department of medicine in Liaquat University Hospital, Hyderabad / Jamshoro from 1[st] January 2015 to 1[st] June 2015
Methodology: This cross-sectional study was conducted with 200 patients [both male and female] from different age groups received in Out-Patient-Department of Liaquat University Hospital, Hyderabad. SPSS 20 version was used for analysis and results. Proforma questionnaires were used for patients including bio-data, history, blood pressure and BMI. Inclusion criteria: All adult patients, both males and females, over the age of 18 years, with presenting complaint of headache were included in the study after taking proper consent. Proper history taking, vital signs, neurological examination, eye examination, BMI, and random blood sugar level were performed. Exclusion criteria: Patients having stroke, hypoglycemia [blood sugar <60mg/dl], diabetic ketoacidosis, intracranial hypertension, eye problem, and Chronic Liver Disease were excluded from this study
Results: Out of a total number of 200 patients, 60% were female and 39% were male, while 1% was dropout during follow-up. Most of the patients were between the ages of 30-60 years. Our study determines 86% of patients have primary headache with normal blood pressure [normal BP 88%] and 13% have secondary headache mostly caused by hypertension [BP 10%], 1% patients was dropout during follow-up from study. Out of 200 patients, 48% were found to have a normal BMI [body mass index], whereas 39% were over weight and 11% had obesity and 2% came under category of morbid obesity
Conclusion: This study result determined that among the patients received at medical Out-Patient Department of Liaquat University Hospital, Hyderabad / Jamshoro, primary headache is more common in young females who have an increased body mass index and normal blood pressure. So it is prudent to spread awareness through media campaigns, seminars, and workshops etc, regarding prevention and proper treatment of primary headache in such patients
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Objective: To report the results in the surgical treatment of pancreatic and periampullary neoplasms with emphasis on surgical technique, short-term postoperative outcome and the lessons learnt
Study Design: Case series
Place and Duration of Study: This study was carried out at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, from October 2014 to May 2016
Methodology: Patients undergoing surgical treatment of pancreatic and periampullary neoplasms were selected. Patients' characteristics including demographics, surgical technique, and 30-day morbidity and mortality were recorded. International Study Group of Pancreatic Fistula [ISGPF] classification was used to define postoperative pancreatic fistula and Clavien-Dindo classification to grade complications
Results: A total number of 65 patients underwent the trial of dissection; 50 had pancreaticoduodenectomy and 15 patients underwent palliative bypass and were excluded from analysis. Sixty-four percent were males and 36% were females. The most common tumor was periampullary [n=29, 58%] followed by pancreatic head [14, 28%] and duodenal tumors [n=07, 14%]. Mean age was 52.92 +/- 13.27 years; mean operating time was 470 +/- 358.28 minutes and median blood loss was 400 [287-500] ml. Pancreaticogastrostomy [PG] was the preferred reconstruction technique in 37 [74%] verses pancreaticojejunostomy [PJ] in 13 [26%] patients. Four [08%] patients needed portal vein reconstruction and two [04%] replaced right hepatic artery resection and reconstruction due to tumor involvement. There were seven Grade A, and one Grade B and C pancreatic fistulae each. Three patients [06%] needed endoscopic therapy for gastrointestinal hemorrhage from pancreatic stump. There was one death in postoperative period
Conclusion: Pancreaticoduodenectomy is a safe procedure with excellent postoperative outcome, if carried out in a specialized hepato-pancreato-biliary unit. A PG reconstruction can be a safer alternative to PJ
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Premature ejaculation is one of the most common sexual disorders. A large number of treatment options have been used so far for the treatment of this dysfunction and still a large number of experts are doing research in this field. Here we have tried to research on the beneficial effects of levosulpiride in the treatment of PE. Eighty-eight patients form different areas of Hazara division suffering from PE were chosen. Sixty-four patients were given levosulpiride and the remaining 24 patients were given Placebo. Out of 64 patients who have been given levosulpiride, 30 patients showed very good improvement, 14 patients showed some improvement, 14 patients showed little and 06 patients showed no improvement. levosulpiride have very good beneficial effects in the treatment of PE
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Humans , Male , Sulpiride , Sulpiride/analogs & derivatives , Placebos , Treatment Outcome , Ejaculation/drug effectsABSTRACT
Frequent or complex patterns of ventricular ectopic activity, whether occurring during routine activity or induced by exercise, are often a marker for serious heart disease and a harbinger of sudden death. To find the prevalence, associated characteristics and prognostic significance of exercise induced non-sustained ventricular tachycardia [VT] in a representative population. This descriptive, analytical study was carried out in Nishtar Hospital, Multan during the period of one year. A total of 1000 patients were included in the study. Ten subjects, 7 men and 3 women, with exercise induced VT were identified, representing 1.1% of those tested; only 1 was young than 65 years. All episodes of VT were asymptomatic and non-sustained. In 9 of 10 subjects, VT developed at or near peak exercise. The longest run of VT was 6 beats; multiple runs of VT were present in 4 subjects. Two subjects had exercise induced ST segment depression, but subsequent exercise thallium scintigraphic results were negative in each. Compared with a group of age and sex matched control subjects, those with asymptomatic, non-sustained VT displayed no difference in exercise duration, maximal heart rate, or the prevalence of coronary risk factors or exercise induced ischemia as measured by electrocardiography and thallium scintigrahy. Over a mean follow period of 2 years, no subject has developed symptoms of heart disease or experienced syncope or sudden death. Thus, exercise induced VT in apparently healthy subjects occurs almost exclusively in the elderly, is limited to short, asymptomatic runs of 3 to 6 beats usually near peak exercise, and does not portend increased cardiovascular morbidity or mortality rates over a 2 year period of observation. Exercise induced VT in apparently healthy subjects occurs almost exclusively in the elderly, is limited to short, asymptomatic runs of 3 to 6 beats usually near peak exercise, and does not show increased cardiovascular morbidity or mortality rates over a 2 year period of observation
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Humans , Male , Female , Exercise , Prevalence , PrognosisABSTRACT
To assess the value of coronary events reflected by changes in R-wave amplitude after exercise. Nishtar Hospital, Multan. One year. Comparative study. Sample size 146 patients. Convenient probability sampling done. All patients were followed up for 6 months, during which time myocardial infarction and death of cardiovascular origin were considered endpoints. The incidence of events in patients in whom R-wave amplitude decreased [normal response] and in those in whom R-wave amplitude did not change or increase [abnormal response] was compared. The incidence of coronary events in patients with a normal response was 23% and in those with an abnormal response, 45.8% [p<0.01]. Correlating the results with several non invasive and angiographic variables, an abnormal R-wave response showed a significantly higher rate of events in the subsets of patients with prior myocardial infarction, absence of cardiomegaly, maximal functional capacity lower than 4 METs, maximal heart rate higher than 140 beats/min and abnormal left ventricular function. The changes in R-wave amplitude after exercise is a variable that should be taken into account when assessing the risk of future events in patients with coronary heart disease
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Humans , Male , Female , Electrocardiography , Exercise Test , Predictive Value of Tests , Risk Assessment , Ventricular Function , PrognosisABSTRACT
Frequent or complex patterns of ventricular ectopic activity, whether occurring during routine activity or induced by exercise, are often a marker for serious heart disease and a harbinger of sudden death. The detection of such arrhythmias is thus an important responsibility of the physician. To find the prevalence, associated characteristics and prognostic significance of exercise induced non-sustained VT in a representative population. Nishtar Hospital, Multan. 1000 patients. Two years. Descriptive, analytical study. Convenient probability sampling done. Ten subjects, 7 men and 3 women, with exercise induced VT were identified, representing 1.1% of those tested; only 1 was young than 65 years. All episodes of VT were asymptomatic and non-sustained. In 9 of 10 subjects, VT developed at or near peak exercise. The longest run of VT was 6 beats; multiple runs of VT were present in 4 subjects. Two subjects had exercise induced ST segment depression, but subsequent exercise thallium scintigraphic results were negative in each. Compared with a group of age and sex matched control subjects. those with asymptomatic, non-sustained VT displayed no difference in exercise duration, maximal heart rate, or the prevalence of coronary risk factors or exercise induced ischemia as measured by electrocardiography and thallium scintigrahy. Over a mean follow period of 2 years, no subject has developed symptoms of heart disease or experienced syncope or sudden death. Thus, exercise induced VT in apparently healthy subjects occurs almost exclusively in the elderly, is limited to short, asymptomatic runs of 3 to 6 beats usually near peak exercise, and does not portend increased cardiovascular morbidity or mortality rates over a 2 year period of observation. Exercise induced VT in apparently healthy subjects occurs almost exclusively in the elderly, is limited to short, asymptomatic runs of 3 to 6 beats usually near peak exercise, and does not show increased cardiovascular morbidity or mortality rates over a 2 year period of observation
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Humans , Male , Female , Prevalence , Prognosis , Arrhythmias, Cardiac , Death, Sudden , Exercise , Age Distribution , Radionuclide Imaging , ElectrocardiographyABSTRACT
The syndrome of variant angina occurs in patients with a wide spectrum of coronary artery obstructions, ranging from normal coronary arteries to severe 3-vessel coronary artery disease [CAD]. Treatment of these patients is, in large part, determined by the extent and severity of the underlying fixed coronary obstructions. To determine the clinical features of variant angina with and without fixed severe coronary artery disease. Nishtar Hospital, Multan. Two years. Descriptive, comparative analytical study. Sample size 108 patients. Sampling technique: Convenient probability sampling done. 43 patients with variant angina who had less than 50% fixed coronary luminal diameter narrowing [group-I] were compared with 65 patients with variant angina who had 70% or greater diameter narrowing [group-II]. Statistically significant differences were found in 3 clinical features between group-I and group-II i.e. [1] a more than 3 months history of angina at rest before diagnosis [80% vs 23%, P <0.001]; [2] an abnormal electrocardiogram at rest [19 vs 48%, P <0.01]. [3] an abnormal stress test [26% [8 of 30] vs 84% [15 of 18], P <0.01. However, these features were not clinically reliable in separating patients with variant angina with and without fixed severe obstructions because of overlap between the two groups. No difference was found between the 2 groups in age, sex, predominant symptoms at the time of catheterization, history of exertional angina, syncope with angina, prolonged angina, previous artery disease. Coronary arteriography should be performed to define the underlying coronary anatomy and to determine optimal therapy in patients with variant angina
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Humans , Male , Female , Coronary Artery DiseaseABSTRACT
Coronary heart disease [CHD] is the single most common cause of death in the developed world. The incidence rate, risk factors prevalence and mortality vary widely among the countries. To identify risk factors associated with clinical evidence of CHD. This retrospective study was carried out in Cardiology ward, Nishtar Hospital, Multan during the period from January 2004 to January 2005. A total number of 100 patients were included in the study, attending OPD and emergency. Out of these, 60 were male and 40 were females. Age range was 40-80 years. Out of 100 patients 45 [45%] were smoker and 55 [55%] were non-smoker. Diabetes mellitus was also a contributed risk factor for CHD, 75 [75%] patients were diabetic as shown in. hypertension was found in 65 [65%] of cases. Higher age, being male, heredity, family history of CHD, hyperlipidemia, and hypertension were associated with CHD
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Hyperlipidemia appears to be a risk factor for atherogenesis. Diabetic patients have increased platelet adhesiveness and response to aggregating agents. These changes are also likely to favour atherogenesis. Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart disease and ad higher incidence of myocardial infarction than the general population. To find out the incidence of IHD in patients with NIDDM and too evaluate the pattern of clinical presentation of IHD in diabetic patients like with typical/atypical symptoms, evidence of silent ischemia and myocardial infarction. This study was carried out in Nishtar Hospital, Multan from June 2004 to July 2005. A total of 100 patients were included in the study. Study design is non-probable purposes. The 100 patients selected for study were between 30-80 years old. Majority of them belonged to 30-45 years of age. Mean age was 48.7 +/- 11.2 years. History of disease duration was also noted and 100 patients included had disease from 1 month to 30 years. Out of 100 patients, 70 [70%] were male and 30 [30%] were female. Among these 17 had evidence of IHD. Typical symptoms of IHD were found in 6 patients. Majority of them had more than one symptom and in one patient, dyspnea was the only symptom. Moreover 5 patients [29.5%] of those who had IHD had dyspnea apart from other atypical symptoms. The incidence of IHD is higher in diabetic patients as compared to non-diabetics