College Of Medicine Research Articles

Hematological parameters of hypertensive patients in northeast Ethiopia: A comparative cross-sectional study

IntroductionHypertension has emerged as a significant public health concern, ranking among the leading causes of mortality in low- and middle-income countries. Moreover, it is closely associated with structural and functional alterations in hematopoietic cells. Therefore, this study aimed to evaluate the hematological parameters of hypertensive patients in Northeast Ethiopia. MethodsA comparative cross-sectional study was conducted from January to March 2023, involving 248 participants. This included 124 hypertensive patients and 124 apparently healthy controls selected using a systematic random sampling technique. Socio-demographic and clinical data were collected through a structured questionnaire, and anthropometric measurements were obtained following established guidelines. Ethical approval was obtained from the Ethical Review Committee of the College of Medicine and Health Sciences at Wollo University. After obtaining informed consent, approximately 5 ml of venous blood was drawn from each participant for complete blood count and fasting blood glucose analysis, performed using the Mindray BC-3000 Plus hematology analyzer and the DIRUI CS-T240 automated clinical chemistry analyzer, respectively. Data analysis involved independent t-tests, Mann-Whitney U-tests, correlation tests, and logistic regression. A p-value of <0.05 was considered statistically significant. ResultsThe study found that white blood cell count, platelet count, platelet distribution width, red cell distribution width, and mean platelet volume were significantly higher in hypertensive patients compared to the control group (p < 0.05). Conversely, red blood cell count, hematocrit, and hemoglobin levels were significantly higher in the control group than in hypertensive patients (p < 0.05). Additionally, white blood cells and platelets exhibited a positive correlation with systolic and diastolic blood pressure (p < 0.05), while red blood cell count, hematocrit, and hemoglobin demonstrated a negative correlation with blood pressure indices and body mass index. Anemia was observed in 20.2 % of hypertensive patients. Notably, an abnormal body mass index (AOR: 3.5, 95 % CI: 1.3–9.6, p = 0.011) and high systolic blood pressure (AOR: 4.6, 95 % CI: 1.3–15.5, p = 0.013) were significantly associated with anemia among hypertensive patients. ConclusionThis study identified significant differences in various hematological parameters between hypertensive patients and the control group. Routine assessments of hematological parameters should be considered to effectively manage hypertension-related complications in hypertensive patients.

Visualization Analysis of Shenkang Injection based on CiteSpace Study

Objective: To explore the current research status and trend of Shenkang injection in the treatment of chronic kidney disease (CKD). Methods: By using CiteSpace6.2.R6 software, we could visually analyze the literature on Shenkang injection in the treatment of chronic kidney disease on CNKI, such as the number of documents issued, authors, institutions, keywords, and emergent word system, in order to better understand the latest research progress in this field. Results: A total of 827 relevant articles were retrieved through analysis and screening, and 663 articles were finally included after screening according to the inclusion and exclusion criteria. Through the systematic analysis, it is concluded that the number of documents issued by relevant research in this research field generally presents a good upward trend, and forms a cooperative team of authors with different numbers of members. According to the author of the document, the top three are Yunhong Wang, Yujie Hao, Yanying Lv, Sudong Tong and so on. According to the number of documents issued, the top three were Qian'an People's Hospital of Hebei Province, Beijing University of Chinese Medicine and Hebei Medical University. After analysis, 342 keywords, 8 keyword clusters, and 14 emergent words were obtained. Through the analysis of emergent words, it is concluded that "renal function", "renal failure", "adverse reactions", "alprostadil", "extracellular matrix" and "therapeutic effect" have become the research hotspots of everyone in the past 5 years. Conclusion: The research hotspots of Shenkang injection mainly focus on improving renal function, clinical therapeutic effect, adverse drug reactions and integrated traditional Chinese and western medicine. Shenkang injection has a good development trend in the treatment of chronic kidney disease, but the cooperation and sharing between different institutions need to be strengthened.

Pancreatoduodenectomy with colon-last approach for advanced pancreatic head cancer.

Margin-negative surgery is very important in surgical oncology. Considering margin-negative pancreatectomy is known to be essential for cure of the pancreatic cancer, pancreatoduodenectomy with combined venous vascular or arterial resection can be a potential option for margin-negative resection, especially, in era of neoadjuvant treatment with potent systemic chemotherapy. To the contrary, special attention was not paid on combined colonic resection during PD. In this article, safe surgical technique for PD with combined colonic resection is introduced, under the name of PD with "colon-last" approach. At Severance Hospital (Yonsei University College of Medicine, Seoul, Republic of Korea), between 2014 and 2021, a total of six patients underwent PD with "colon-last" approach. The surgical technique and surgical outcome are reviewed. All patients recovered without major complications (Clavien-Dindo classification grade ≥ III) after surgery, and most of them recovered after conservative treatment with postoperative pancreatic fistula biochemical leak. None of the patients were readmitted. Only the first and second cases represent cancer-related mortality, and the other patients are still alive and are being followed up. It is hoped that the present technique, PD with colon-last approach, could be helpful enhance the procedural safety in treating advanced cancer requiring PD with combined colon resection. However, its technical safety and oncologic role should be validated by many pancreatic surgeons' collaborative studies in the near future.

Neuroprotective effect of ranolazine in mice's model of Alzheimer's disease

Background. Alzheimer's disease is a neurodegenerative disorder that worsens over time as more brain regions are affected and symptoms increase. It usually starts slowly and advances permanently. Ranolazine is a piperazine derivative used as a second-line treatment for people with chronic aortic stenosis who are unresponsive to other medications and have steady or ineffectively-managed angina pectoris. This study is intended to look into the possible neuroprotective effects of ranolazine scopolamine-induced Alzheimer's illness-like features in a mouse model. Methods. This is a randomized controlled animal study that has been carried out in Department of Pharmacology from College of Medicine of Al-Nahrain University. Mice were separated into five groups equally (each group with 10); a control group, and an induction group (mice were administered scopolamine 1 mg per kg intraperitoneally every 24 hr for seven days to induce features similar to Alzheimer's disease). The mice in the remaining three treatment groups were given tested medications prophylactically for 14 days, then the induction was carried out with scopolamine 1 mg/kg i.p. once daily while the tested medication dosages were continued for an additional 7 days; these treatment groups included: donepezil group (5 mg/Kg/d), ranolazine group (40 mg/Kg/d), and combination groups - donepezil (5 mg/Kg/d) with ranolazine (40 mg/Kg/d); all were administrated i.p. once daily. Behavioral parameters including the Y maze test and novel object recognition test were assessed for inflammatory cytokines and oxidative stress parameters. Result. Ranolazine exhibits significant improvement in behavior and memory, oxidative stress parameter level, as well as inflammatory cytokines. When the scopolamine induction group was compared to the control group, the spontaneous alteration considerably decreased (p ≤0.001). However, compared to the induction group, all three donepezil, ranolazine, and combination (donepezil + ranolazine) groups had a highly significant increase in the spontaneous alteration and when compared with the control group, there were no statistically significant changes (p &gt;0.05). In comparison with a control group, the scopolamine (induction group) revealed a highly significant reduction (p ≤0.001) in the recognition index. In contrast to the induction group, all three donepezil, ranolazine, and combination (donepezil + ranolazine) groups demonstrated a highly statistically significant improvement in the recognition index. When compared with the control group, there were no statistically significant changes (p &gt;0.05). Conclusion. The current investigation demonstrated ranolazine's neuroprotective action against scopolamine-induced AD-like characteristics in mouse models. The present work has demonstrated the considerable antioxidant and anti-inflammatory benefits of ranolazine, which may account for these positive results.

Adiponectin and TNFα in relation to glucometabolic control in patients with type 2 diabetes mellitus.

The correlation of adiponectin and serum tumor necrosis factor alpha (TNFα) with glucometabolic parameters in diabetes mellitus (DM) needs further studies. We aimed in this study to evaluate the relationship between adiponectin and TNFα with glucometabolic parameters in patients with type 2 DM (T2DM). We conducted a cross-sectional study in the Department of Physiology, College of Medicine, King Saud University, Saudi Arabia. The sample size was 117 from the diabetes clinic of King Abdul-Aziz University hospital through the convenience sampling technique. Subjects were grouped into control (healthy) subjects (53) with no chronic diseases and the diabetic group (64) with confirmed T2DM. Socio-demographic data were collected along with the serum blood sample to analyze the variables. Adiponectin was significantly high in healthy subjects compared to the diabetic group (control: 14.4 ± 4.3, T2DM: 11.0 ± 4.1, P = 0.000), while TNFα was higher in the T2DM group (7.8 ± 2.7) than in the control group (6.6 ± 2.9, P = 0.024). TNFα was negatively correlated with adiponectin in the control group (-0.279) and in diabetic subjects (-0.311) and positively correlated with HbA1c in the diabetic group (0.319) and triglycerides (0.252). Adiponectin was positively correlated with HDL in the control group (0.252) and in diabetic subjects (0.326). There was an inverse correlation between TNFα and adiponectin. Adiponectin is higher in healthy subjects than in diabetic patients, while TNFα is higher in diabetic patients. In addition, adiponectin is positively correlated with HDL in healthy as well as diabetic patients. TNFα is positively correlated with HbA1c and triglycerides.

Obesity in Saudi Medical Students and Alignment with Eating Disorders: A Stratified Random Cross-Sectional Investigation.

As a result of the increasing global incidence of obesity and related diseases, this study aims to investigate the prevalence of obesity and its correlation with eating disorder (ED) screening among medical students to develop effective prevention strategies and provide better outcomes for these students. We conducted a quantitative analytical cross-sectional study at the College of Medicine at King Saud University between November 2023 and February 2024. A stratified random sampling technique was utilized, enrolling a net number of 415 participants. Participants were asked several questions, including demographic information, weight, height, and past medical history, and were given a validated screening tool for EDs. Participants' mean age was 21.4 ± 1.67 years, and 17.6% were considered obese. The prevalence of positive screening for EDs was 27.7%; it was more common in females (p = 0.013) and those who earned more than 1000 SAR per month (p = 0.011). Female students also exhibited almost twice the odds of having EDs than males (AOR = 1.957; 95% CI = 1.218-3.146; p = 0.006). Furthermore, non-obese students showed decreased odds of having EDs compared with obese students by at least 48% (AOR = 0.517; 95% CI = 0.287-0.929; p = 0.027). Our study revealed a concerning prevalence of ED symptoms and obesity among medical students, suggesting profound implications. Therefore, multicenter studies are needed to assess the generalizability of the results and apply the findings to targeted national campaigns and interventions tailored specifically to medical students.

The fifth international hackathon for developing computational cloud-based tools and resources for pan-structural variation and genomics

Background The goal of the Fifth Annual Baylor College of Medicine &amp; DNAnexus Structural Variation Hackathon was to push forward the research on structural variants (SVs) by rapidly developing and deploying open-source software. The event took place in-person and virtually in August 2023, when 49 scientists from 14 countries and 8 U.S. states collaboratively worked on projects to address critical gaps in the field of genomics. The hackathon projects concentrated on developing bioinformatic workflows for the following challenges: RNA transcriptome comparison, simulation of mosaic variations, metagenomics, Mendelian variation, SVs in plant genomics, and assembly vs. mapping SV calling comparisons. Methods As a starting point we used publicly available data from state-of-the-art long- and short-read sequencing technologies. The workflows developed during the hackathon incorporated open-source software, as well as scripts written using Bash and Python. Moreover, we leveraged the advantages of Docker and Snakemake for workflow automation. Results The results of the hackathon consists of six prototype bioinformatic workflows that use open-source software for SV research. We made the workflows scalable and modular for usability and reproducibility. Furthermore, we tested the workflows on example public data to show that the workflows can work. The code and the data produced during the event have been made publicly available on GitHub (https://github.com/collaborativebioinformatics) to reproduce and built upon in the future. Conclusions The following sections describe the motivation, lessons learned, and software produced by teams during the hackathon. Here, we describe in detail the objectives, value propositions, implementation, and use cases for our workflows. In summary, the article reports the advancements in the development of software for SV detection made during the hackathon.

Acupuncture and Sleep Quality Among Patients With Parkinson Disease

Poor sleep quality greatly impairs quality of life and accelerates deterioration in patients with Parkinson disease (PD), but current remedies remain limited. Acupuncture, used as an adjunctive therapy with anti-Parkinson medications, has shown positive effects in patients with PD. However, high-quality clinical evidence to support the effectiveness of acupuncture for patients with PD and poor sleep quality is lacking. To assess the safety and efficacy of real acupuncture (RA) vs sham acupuncture (SA) as an adjunctive therapy for patients with PD who have poor sleep quality. This single-center randomized clinical trial was performed at The First Affiliated Hospital of Guangzhou University of Chinese Medicine in China from February 18, 2022, to February 18, 2023. Patients with PD and sleep complaints were recruited and randomized (1:1) to receive RA or SA treatment for 4 weeks. Data analysis was performed from April 12 to August 17, 2023. Treatment with RA or SA for 4 weeks. The main outcome was the change in Parkinson Disease Sleep Scale (PDSS) scores measured at baseline, after 4 weeks of treatment, and at 8 weeks of follow-up. Of the 83 participants enrolled, 78 (94.0%) completed the intervention and were included in the analysis. Their mean (SD) age was 64.1 (7.9) years; 41 (52.6%) were men and 37 (47.4%) were women. A significant increase in PDSS scores from baseline was observed for both the RA group (29.65 [95% CI, 24.65-34.65]; P < .001) and the SA group (10.47 [95% CI, 5.35-15.60]; P < .001). Compared with the SA group, the RA group had a significant increase in PDSS scores after 4 weeks of treatment (19.75 [95% CI, 11.02-28.49]; P < .001) and at 8 weeks of follow-up (20.24 [95% CI, 11.51-28.98]; P < .001). In this randomized clinical trial, acupuncture proved beneficial in improving sleep quality and quality of life among patients with PD. These findings suggest that the therapeutic effects of acupuncture could continue for up to 4 weeks. Chinese Clinical Trial Registry Identifier: ChiCTR2200060655.

Development of high-quality artificial intelligence for computer-aided diagnosis in determining subtypes of colorectal cancer.

There are no previous studies in which computer-aided diagnosis (CAD) diagnosed colorectal cancer (CRC) subtypes correctly. In this study, we developed an original CAD for the diagnosis of CRC subtypes. Pretraining for the CAD based on ResNet was performed using ImageNet and five open histopathological pretraining image datasets (HiPreD) containing 3 million images. In addition, sparse attention was introduced to improve the CAD compared to other attention networks. One thousand and seventy-two histopathological images from 29 early CRC cases at Kyoto Prefectural University of Medicine from 2019 to 2022 were collected (857 images for training and validation, 215 images for test). All images were annotated by a qualified histopathologist for segmentation of normal mucosa, adenoma, pure well-differentiated adenocarcinoma (PWDA), and moderately/poorly differentiated adenocarcinoma (MPDA). Diagnostic ability including dice sufficient coefficient (DSC) and diagnostic accuracy were evaluated. Our original CAD, named Colon-seg, with the pretraining of both HiPreD and ImageNET showed a better DSC (88.4%) compared to CAD without both pretraining (76.8%). Regarding the attentional mechanism, Colon-seg with sparse attention showed a better DSC (88.4%) compared to other attentional mechanisms (dual: 79.7%, ECA: 80.7%, shuffle: 84.7%, SK: 86.9%). In addition, the DSC of Colon-seg (88.4%) was better than other types of CADs (TransUNet: 84.7%, MultiResUnet: 86.1%, Unet++: 86.7%). The diagnostic accuracy of Colon-seg for each histopathological type was 94.3% for adenoma, 91.8% for PWDA, and 92.8% for MPDA. A deep learning-based CAD for CRC subtype differentiation was developed with pretraining and fine-tuning of abundant histopathological images.

Implementing Dementia Care Management into routine care: protocol for a cohort study in Siegen-Wittgenstein, Germany (RoutineDeCM)

IntroductionDementia Care Management is an evidence-based model of care. It has proven its efficacy and cost-effectiveness and has been applied to different settings and different target groups. However, it is...

Immunohistochemical expression in idiopathic inflammatory myopathies at a single center in Vietnam.

The identification of idiopathic inflammatory myopathies (IIMs) requires a comprehensive analysis involving clinical manifestations and histological findings. This study aims to provide insights into the histopathological and immunohistochemical aspects of IIMs. This retrospective case series involved 56 patients diagnosed with IIMs at the Department of Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, from 2019 to 2023. The histology and immunohistochemical expression of HLA-ABC, HLA-DR, C5b-9, Mx1/2/3, and p62 were detected. We examined six categories of inflammatory myopathy, including immunemediated necrotizing myopathy (58.9%), dermatomyositis (DM; 23.2%), overlap myositis (8.9%), antisynthetase syndrome (5.4%), inclusion body myositis (IBM; 1.8%), and polymyositis (1.8%). The average age of the patients was 49.7 ± 16.1 years, with a female-to-male ratio of 3:1. Inflammatory cell infiltration in the endomysium was present in 62.5% of cases, perifascicular atrophy was found in 17.8%, and fiber necrosis was observed in 42 cases (75.0%). Rimmed vacuoles were present in 100% of cases in the IBM group. Immunohistochemistry showed the following positivity rates: HLA-ABC (89.2%), HLA-DR (19.6%), C5b-9 (57.1%), and Mx1/2/3 (10.7%). Mx1/2/3 expression was high in DM cases. p62 vacuole deposits were noted in the IBM case. The combination of membrane attack complex and major histocompatibility complex I helped detect IIMs in 96% of cases. The diagnosis of IIMs and their subtypes should be based on clinical features and histopathological characteristics. Immunohistochemistry plays a crucial role in the diagnosis and differentiation of these subgroups.

A Set of Acupuncture Needles in the Late Qing Dynasty Collected by George Soulié de Morant

Abstract In the early 20th century, French vice-consul George Soulié de Morant encountered acupuncture during his visit to China, and then brought it back to France. After more than 100 years, his collection was transported from Paris, France to Kunming, China, and later recognized as a Chinese national third-class precious cultural heritage. Currently housed in the Museum of Western Studies on Chinese Medicine at Yunnan University of Chinese Medicine, this set of instruments includes one needle holder converted from a fan-shaped holder, ten acupuncture needles, and eleven paper tags handwritten in English with names of diseases and body parts. This article attempts to present the basic information and historical appearance of this set of late Qing dynasty acupuncture instruments by reviewing the collection and related research on acupuncture instruments, consulting acupuncture professionals, measuring the detailed information of the set of instruments, and employing a method of translating and summarizing the content of the attached tags.

Gandouling induces GSK3β promoter methylation to improve cognitive impairment in Wilson's disease

Ethnopharmacologic significanceCognitive impairment is a serious clinical manifestation of Wilson's disease (WD) in the nervous system. Gandouling (GDL) is a hospital preparation of the First Affiliated Hospital of Anhui University of Chinese Medicine. Previous studies have found that GDL has an ameliorative effect on cognitive impairment in WD. Aim of the studyWe aimed to explore the molecular-level regulatory mechanisms underlying cognitive impairment in WD, and provide evidence supporting GDL as a promising candidate drug for the treatment of cognitive impairment in WD. We found that GSK3β was significantly up-regulated in the brain tissue of C3He-Atp7Btx-J/J (tx-j) mice in the WD gene mutant model, and the monomer components of GDL could combine well with GSK3β. Therefore, in this work, we used Behavioral tests, Hematoxylin and eosin (H&E), Nissl and Terminal deoxynucleotidyl transferase dUTP-biotin nick end labeling(TUNEL) staining, Ultrastructural morphological observation by Transmission electron microscopy (TEM), bisulfite sequencing (BSP), Quantitative real-time polymerase chain reaction (RT-qPCR), Western blot, immunofluorescence, network pharmacology, molecular docking, and related methods to study the effects of GDL in tx-j mice and HT22 cell to clarify the effect of GDL on cognitive impairment in WD. ResultsIn this study, MWM, NOR, H&E, Nissl TUNEL and TEM results showed that GDL could promote the repair of learning and memory function, improve the morphological damage to hippocampal neurons, and maintain mitochondria integrity. In the HT22 cell experiment, the CCK-8 method showed that GDL increased the viability of copper-overloaded cell models. The study found that GSK3β may be a target of GDL for the treatment of WD cognitive impairment through network pharmacology. Western blot and qRT-PCR results confirmed that GDL significantly increased the expression of proteins and mRNA in DNMT1, Nrf2, and HO-1. BSP showed that GSK3β promoter methylation was lower in the Model group than in the control group, and the promoter methylation of GSK3β was further reduced after intraperitoneal injection with decitabine, and GDL could ameliorate this pathology. ConclusionGDL demonstrates a protective role by inducing GSK3β promoter methylatio, regulating the GSK3β/Nrf2 signaling pathway in WD.

Development and validation of a prediction model for heart failure in patients with heart valvular regurgitation.

Patients with heart valvular regurgitation is increasing; early screening of potential patients developing heart failure (HF) is crucial. From 1 November 2019 to 31 October 2023, a total of 509 patients with heart valvular regurgitation hospitalized in the Department of Cardiovascular Disease of the First Affiliated Hospital of Guangzhou University of Traditional Medicine were enrolled. Three hundred fifty-six cases were selected as the training set for modelling, and 153 cases were selected as the validation set for the internal validation of the model. A predictive model of heart failure with the following nine risk factors was developed: atrial fibrillation (AF), pulmonary infection (PI), coronary artery disease (CAD), creatinine (CREA), low-density lipoprotein cholesterol (LDL-C), d-dimer (DDi), left ventricular end-diastolic diameter (LVEDd), mitral regurgitation (MR) and aortic regurgitation (AR). The model was evaluated by the C-index [the training set: area under curve (AUC) 0.937, 95% confidence interval (CI) 0.911-0.963; the validation set: AUC 0.928, 95% CI 0.890-0.967]. Hosmer-Lemeshow test (the training set: χ2 10.908, P=0.207; the validation set: χ2 4.896, P=0.769) revealed that both the training and validation sets performed well in terms of model differentiation and calibration. Decision curve analysis showed that both the training and validation sets have higher net benefits, indicating that the model has good utility. Ten-fold cross-validation showed that the training set has high similarities with the validation set, which means that the model has good stability. The occurrence of heart failure in patients with valvular regurgitation has a significant correlation with AF, PI, CAD, CREA, LDL-C, DDi, LVEDd, MR and AR. Based on these risk factors, a prediction model for heart failure was developed and validated, which showed good differentiation and utility, high accuracy and stability, providing a method for predicting heart failure.

A CROSS-SECTIONAL STUDY ON THE PREVALENCE OF STUNTING AMONG ELEMENTARY SCHOOL STUDENTS IN LAHORE

Objective: Our study aims to determine the prevalence of obesity and stunting in Pakistani children between the ages of03 to 12 years.Study design : A Cross-Sectional StudyDuration and place of study: Community Medicine Department University College of Medicine and Dentistry,UOL, Lahore from jan 2022 to jan 2023Method: The study included 65 children between the ages of 3 to 12 years. Age, sex, weight, and height were recordedfor each enrolled patient after obtaining the parents of any minors’ informed written permission. The demographicstatus of mothers was also noted. In relation to the weight of the patients that were included, the frequency of stuntingwas noted. The whole set of data was analyzed using SPSS 28.0.Results: In this research, out of 65 youngsters, 40 (60.4%) were male and 25 (39.6%) were female. The childreninvolved in the study had a mean age of 04.08±13.38 years and a mean weight of 16.15±11.49 kg. Childrenmeasured 104.05 +/- 1.18 cm on average.n-38 (56.4%) of the patients were underweight, n-43 (33.6%) werefat children, and 05 (06.2%) of the patients were very underweight. According to maternal status, the majority ofthem came from low-income families. There were 10 (12.2%) stunted children, of whom 04 (5.4%) were fat andthe remaining 07 (12%) were underweight. Of the ten children with stunting, five (54.6%) were female and four(37.3%) were male.Conclusion: This study highlights a exceptional occurrence of stunting amongst number one school youngsters inLahore, with a great proportion being underweight. Addressing maternal socioeconomic status and imposing focusedinterventions are crucial to mitigate the weight of stunting and promote healthful increase and development in thispopulation.Keywords: Stunting, Children, Lahore, Socioeconomic Status

Prevalence of Diabetic Nephropathy among Patients of Type 2 Diabetes at Tertiary Care Hospital Lahore

Background: Diabetic nephropathy is a significant complication of Type 2 Diabetes Mellitus, often leading to chronic kidney disease (CKD) and potentially progressing to End-Stage Renal Disease (ESRD). Approximately 90% of individuals with diabetes and hypertension may develop ESRD in the later stages of the disease. Objective: The study aimed to determine the prevalence of diabetic nephropathy among patients with type 2 diabetes at a tertiary care hospital in Lahore. Methods: This retrospective study included 100 reports from the chemical pathology and microbiology laboratory at Fatima Memorial Hospital, Lahore, covering renal function tests (RFT) such as Urea, Blood Urea Nitrogen (BUN), Creatinine, and estimated Glomerular Filtration Rate (eGFR), as well as HbA1c levels and Albuminuria. Data collection involved accessing electronic medical records (EMRs) to obtain comprehensive clinical data, including patients' medical history, duration of diabetes, glycemic control measurements, blood pressure, and prescribed medications. The study included patients with type 2 diabetes and kidney disease, excluding those without renal disease. Ethical approval was obtained from the Institutional Review Board (IRB) of FMH College of Medicine and Dentistry, adhering to the principles of the Declaration of Helsinki. Data were analyzed using IBM SPSS version 25, with categorical variables expressed as frequencies and percentages and continuous variables as mean ± standard deviation (SD). Correlation analysis was conducted, with a p-value of less than 0.05 indicating statistical significance. Results: The study included 100 participants, with 53% being male and 47% female. The mean age was 59.19 years (SD = 18.812), ranging from 18 to 91 years. Albuminuria was present in 88% of participants. Elevated serum creatinine was observed in 93%, HbA1c levels &gt;6.4% in 68%, high urea levels in 87%, and eGFR &lt;60 in 14%. Correlation analysis showed a significant positive correlation between HbA1c and eGFR (Spearman's rho = 0.432, p &lt; 0.001) and between urea and serum creatinine (Spearman's rho = 0.701, p &lt; 0.001). Conclusion: The high prevalence of albuminuria and elevated renal function markers among individuals with type 2 diabetes underscores the importance of early detection and comprehensive management. Regular screening for urinary albumin, stringent glycemic control, and optimal blood pressure management are crucial for preventing the progression of diabetic nephropathy.

Evidence - based practice competency among nursing students at the University Of Medicine And Pharmacy At Ho Chi Minh City And Associated Factors

ABSTRACT Background: Evidence - based practice (EBP) in healthcare is an essential trend for improving patient safety and care quality, making it crucial to ensure EBP competency among nursing students. This study aimed to assess EBP competency among nursing students and identify associated factors. Methods: A descriptive cross - sectional study was conducted on 230 nursing students in second, third, and fourth year in the University of Medicine and Pharmacy at Ho Chi Minh City. An online survey questionnaire was emailed to the students during the sampling period from ... Results: The participants had an average age of 21.2 ± 0.97 years. The majority were female (89.1%) and of the Kinh ethnic group (85.7%). The average EBP competency score of the students was 3.56 ± 0.39. Specifically, EBP - related competencies of the students were at a moderate level or higher (&gt; 2.61), with the highest average score observed for attitude at 3.77 ± 0.45. Factors such as research and EBP course grades, confidence levels in computer skills and English proficiency, frequency of EBP application, completion of the thesis, and participation in research clubs all positively influenced students’ EBP competency (p &lt; 0.05). Knowledge, skills, and attitude regarding EBP are closely related. Students with good knowledge usually have good skills and a positive attitude towards EBP (p &lt; 0.01). Conclusions: Nursing students demonstrated EBP competency at a moderate level or higher. The identified associated factors provide a foundation for enhancing the role of EBP among nursing students.

Exploring attitudes to research involving human subjects among Vietnamese university students: establishing a prospective longitudinal mixed-methods student cohort at the University of Medicine and Pharmacy at Ho Chi Minh City.

Research capacity is increasing in low- and middle-income countries (LMICs), with progressive development in the range and complexity of studies being undertaken, often in collaboration with high-income country partners. Although senior local stakeholders are typically involved in ensuring that research is conducted according to accepted standards for ethical and scientific quality, to date there has been little exploration of the views of younger generations around the ethics of research involving human subjects. We present our protocol to establish a longitudinal mixed-methods student cohort at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam, that is investigating students' views around the ethics of clinical and public-health oriented research. We use a synergistic approach involving initial deliberative engagement activities ( e.g. science cafes, debates) to inform participants about complex concepts, prior to formal quantitative and qualitative methods (surveys, focus group discussions and in-depth interviews) that are designed to explore the students' views in detail. We focus in particular on dengue research, i.e. research that addresses a locally relevant disease with which the students are likely familiar, and probe their thoughts on such themes as appropriate remuneration for research participants, involvement of vulnerable groups, use of human challenge trials in LMICs etc. A snapshot of the cohort and its activities after one year is also presented; among 429 active students, primarily from the Faculty of Medicine, the proportions of male and female students were similar, the majority were from southern or central Vietnam where dengue is endemic, and available data indicates the cohort to be representative of the expected spectrum of socioeconomic groups. The cohort provides a unique resource to investigate the views of young people on medical ethics, an important but hitherto underrepresented group in such discussions. Feedback indicates a clear interest in contributing thoughts and ideas to the development of clinical research in Vietnam.

Clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride on mild-to-moderate depression

BACKGROUND Depression is a common, chronic, and recurrent mood disorder that has become a worldwide health hazard. Fluoxetine hydrochloride, a common treatment method, can inhibit 5-hydroxytryptamine (5-HT) recycling in the presynaptic membrane; however, the efficacy of a single drug is inadequate. At present, mild-to-moderate depression can be treated with acupuncture of ghost caves, but the clinical curative effect of combined therapy with fluoxetine hydrochloride has not been sufficiently reported. AIM To evaluate the clinical effect of acupuncture at ghost points combined with fluoxetine hydrochloride in the treatment of mild-to-moderate depression. METHODS This retrospective study included 160 patients with mild-to-moderate depression who were admitted to Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated to Shanghai University of Traditional Chinese Medicine, between January 2022 and June 2023. Patients were separated into a single-agent group (fluoxetine hydrochloride treatment, n = 80) and a coalition group (fluoxetine hydrochloride treatment combined with acupuncture at ghost points, n = 80). Pre-treatment symptoms were recorded, and the clinical curative effect and adverse reactions [Asberg Antidepressant Side Effects Scale (SERS)] were assessed. Depression before and after treatment [Hamilton Depression Scale (HAMD)-24], neurotransmitter levels [5-HT, norepinephrine (NE), dopamine (DA)], oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were compared. RESULTS The total efficacy rate was 97.50% in the coalition group and 86.25% in the single-agent group (P &lt; 0.05). After 2, 4, 6, and 8 wk of treatment, the HAMD, self-rating depression scale, and SERS scores of the coalition and single-agent groups decreased compared with pre-treatment, and the decrease was more significant in the coalition group (P &lt; 0.05). After 8 wk of treatment, the levels of NE, DA, 5-HT, and SOD in the coalition and single-agent groups increased, while the levels of MDA decreased; the increases and decrease in the coalition group were more significant (P &lt; 0.05). The PSQI scores of the coalition and single-agent groups decreased, and the decrease was more significant in the coalition group (P &lt; 0.05). CONCLUSION Acupuncture at ghost points combined with paroxetine tablets can safely improve depressive symptoms and sleep disorders, regulate neurotransmitter levels, and reduce stress responses in patients with mild-to-moderate depression.

Decoding Wilson disease: a machine learning approach to predict neurological symptoms.

Wilson disease (WD) is a rare autosomal recessive disorder caused by a mutation in the ATP7B gene. Neurological symptoms are one of the most common symptoms of WD. This study aims to construct a model that can predict the occurrence of neurological symptoms by combining clinical multidimensional indicators with machine learning methods. The study population consisted of WD patients who received treatment at the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from July 2021 to September 2023 and had a Leipzig score ≥ 4 points. Indicators such as general clinical information, imaging, blood and urine tests, and clinical scale measurements were collected from patients, and machine learning methods were employed to construct a prediction model for neurological symptoms. Additionally, the SHAP method was utilized to analyze clinical information to determine which indicators are associated with neurological symptoms. In this study, 185 patients with WD (of whom 163 had neurological symptoms) were analyzed. It was found that using the eXtreme Gradient Boosting (XGB) to predict achieved good performance, with an MCC value of 0.556, ACC value of 0.929, AUROC value of 0.835, and AUPRC value of 0.975. Brainstem damage, blood creatinine (Cr), age, indirect bilirubin (IBIL), and ceruloplasmin (CP) were the top five important predictors. Meanwhile, the presence of brainstem damage and the higher the values of Cr, Age, and IBIL, the more likely neurological symptoms were to occur, while the lower the CP value, the more likely neurological symptoms were to occur. To sum up, the prediction model constructed using machine learning methods to predict WD cirrhosis has high accuracy. The most important indicators in the prediction model were brainstem damage, Cr, age, IBIL, and CP. It provides assistance for clinical decision-making.