Category: Statistics

Pak J Pharm Sci. 2026 Jan;39(1):292-298. doi: 10.36721/PJPS.2026.39.1.REG.15702.1.

ABSTRACT

BACKGROUND: Pediatric acute laryngitis and laryngeal obstruction can be severe enough to require tubes inserted into the airway and assist with breathing. Dexamethasone is commonly used to treat pediatric acute laryngitis and laryngeal obstruction, but the factors determining the need for intubation despite corticosteroid therapy remain unclear.

OBJECTIVES: We aimed to determine the rate of intubation and mechanical ventilation required, identify risk factors for these needs and examine the outcomes in pediatric patients who still require intubation despite dexamethasone treatment.

METHODS: A cross-sectional study at Jiangxi Children’s Hospital included 160 screened patients with 150 pediatric patients with acute laryngitis and laryngeal obstruction, conducted from January 2020 to December 2024. All patients were given conventional dexamethasone treatment either orally or via IV. Patients were stratified into two groups: Those who required intubation and those who did not. Demographic variables, comorbidity factors, lab values and satisfaction with dexamethasone treatment, with additional support from nebulized epinephrine, were extracted. The variables were then determined via multiple logistic regression analysis.

RESULTS: Among the 160 screened patients, 30 (18.75%) required intubation. Independent risk factors for intubation despite dexamethasone treatment included female gender (OR = 4.07), comorbid pulmonary and systemic disorders (OR = 7.30), increased neutrophil-to-lymphocyte (N/L) ratio (OR = 1.167 per unit increase), and elevated IgM levels (OR = 1.221), all with P < 0.05. These factors were identified as significant predictors for the need for intubation despite steroid therapy.

CONCLUSION: Despite the widespread use of dexamethasone, the intubation rate remains high in pediatric patients with acute laryngitis and laryngeal obstruction. Identifying females, comorbidities, neutrophil-to-lymphocyte ratio and high levels of IgM as risk factors can assist healthcare professionals in arriving at an early diagnosis.

PMID:41482799 | DOI:10.36721/PJPS.2026.39.1.REG.15702.1

Pak J Pharm Sci. 2026 Jan;39(1):261-270. doi: 10.36721/PJPS.2026.39.1.REG.13940.1.

ABSTRACT

BACKGROUND: Women with hypertensive postpartum syndrome (HDP) are more prone to negative emotions that affect their recovery, while magnesium sulfate has an anti-anxiety effect.

OBJECTIVES: This study aims to evaluate the efficacy of magnesium sulfate therapy, administered intravenously or intramuscularly, in preventing complications such as eclampsia and managing blood pressure (BP) in patients with hypertension.

METHODS: This research adopted a quantitative research paradigm and participants were assigned to the intervention and the control groups (70 participants each). The control group received their regular postpartum medical care that included antihypertensive medications and health education but did not receive magnesium sulfate treatment and designated physical rehabilitation. The data collected were then sorted and categorized genetically and were analyzed using the SPSS software program version 25.0 to enhance reliability of statistics.

RESULTS: The intervention group demonstrated significant improvements across physical, emotional and functional recovery, including BP compared with the control group. There was significant lowering of both systolic (-20.1 mmHg) and diastolic (-14.2 mmHg) BP, reduced fatigue, improvement in quality of life and decrease in pain (All P < 0.05). A regression analysis confirmed the treatment and health promotion as the positive indicators of the recovery rates while body mass index (BMI) and increased baseline diastolic BP as negative indicators. The convergence of pharmacological and non-pharmacological approaches made postpartum management more effective in terms of short-term as well as extended health problems.

CONCLUSION: These results are a robust starting off point for the application of a more comprehensive postpartum care framework in clinical care.

PMID:41482796 | DOI:10.36721/PJPS.2026.39.1.REG.13940.1

Pak J Pharm Sci. 2026 Jan;39(1):117-122. doi: 10.36721/PJPS.2026.39.1.REG.14416.1.

ABSTRACT

BACKGROUND: Severe brain injury patients often require effective analgesia and sedation to manage pain, agitation, and inflammatory responses, which can impact clinical outcomes.

OBJECTIVES: This study aimed to analyze the effects of ketamine combined with remifentanil on analgesic sedation and inflammatory factors in patients with severe brain injury.

METHODS: Sixty patients were randomly divided into a remifentanil-only control group and a ketamine combined with remifentanil group. VAS, SAS, BCS, Ramsay scores, inflammatory factors (TNF-α, IL-2), and adverse reactions were compared.

RESULTS: Compared with pre-operative levels, both groups showed significant reductions in VAS, SAS scores, TNF-α, and IL-2 (P < 0.05). Compared with the control group, the combined group exhibited significantly lower VAS and SAS scores, higher Ramsay sedation and BCS scores, and lower TNF-α and IL-2 levels (P < 0.05). There was no statistically significant difference in adverse reactions between groups (P > 0.05).

CONCLUSION: Ketamine combined with remifentanil provides better analgesic and sedative effects in severe brain injury patients, effectively reducing pain and agitation, improving comfort, and suppressing inflammatory responses, demonstrating good clinical application value.

PMID:41482781 | DOI:10.36721/PJPS.2026.39.1.REG.14416.1

Pak J Pharm Sci. 2026 Jan;39(1):61-73. doi: 10.36721/PJPS.2026.39.1.REG.14772.1.

ABSTRACT

BACKGROUND: Psoriasis represents a chronic autoimmune dermatosis that necessitates the implementation of both anti-inflammatory measures and UVA-UVB photoprotection.

OBJECTIVES: This study aimed to evaluate the phytochemical profile, antioxidant capacity , photoprotective efficacy, and anti-inflammatory potential of Tagetes erecta flower extracts (TEFE) prepared in different solvents.

METHODS: In this study phytochemical analysis and antioxidant properties were performed in various solvent extracts of Tagetes erecta flowers. Photoprotective efficacy was assessed using critical wavelength (λ_c) and SPF measurements under different exposure conditions. Anti-inflammatory activity was evaluated via heat-induced protein denaturation, heat-induced hemolysis, and hypotonicity- induced hemolysis assays.

RESULTS: The result indicated that TEFE contain all the secondary metabolites known for their skin-protective properties. The highest TPC was observed in the methanolic and ethyl acetate extracts, measuring (0.7733 ± 0.0024 and 0.7729 ± 0.0007 mg GAE/mg), respectively. The acetone and ethanolic extracts exhibited the highest flavonoid contents (17.553 ± 0.1064 and 14.904 ± 0.506 mg Rutin/mg) and flavanol contents (4.279 ± 0.268 and 3.829 ± 0.1002 mg Rutin/mg), respectively. At all concentrations, TEFE exhibited λ_c greater than 370 nm, indicating broad-spectrum photoprotective properties. At 800 ppm, TEFE demonstrated SPF values of 29 without exposure, while SPF of 40.2 under sunlight and 32.80 under UV exposure were measured. The Statistical analysis revealed significant differences in photoprotective activity across all tested concentrations (P<0.05).TEFE showed considerable inhibition of protein denaturation, with IC₅₀ = 527.845 µg/mL and exhibited concentration-dependent membrane stabilization, with a maximum inhibition of 69% in heat-induced RBC lysis and 22% in hypotonicity-induced RBC lysis.

CONCLUSION: These results advocate for a novel phototherapeutic strategy for addressing photoprotection in psoriatic skin and require further clinical research in dermatological preparations.

PMID:41482776 | DOI:10.36721/PJPS.2026.39.1.REG.14772.1

Pak J Pharm Sci. 2026 Jan;39(1):1-9. doi: 10.36721/PJPS.2026.39.1.REG.15013.1.

ABSTRACT

BACKGROUND: Galactorrhea, an abnormal milk secretion, is frequently triggered by medications that influence prolactin levels.

OBJECTIVES: This study aimed to identify high-risk drugs for drug-associated galactorrhea (DAG) and explore their characteristics using data from the FDA Adverse Event Reporting System (FAERS).

METHODS: We analyzed 6,195 DAG reports by applying four disproportionality analysis algorithms (ROR, PRR, MGPS, BCPNN) to detect positive signals.

RESULTS: The analysis of 6,195 reports showed that DAG was most prevalent in patients aged 20-40 years, with a slight male predominance (55.52%). Oral medications were the primary cause (68.99%). A total of 32 drugs were strongly associated with DAG, with antipsychotics being the most frequently implicated class (N = 12), followed by antidepressants (N = 7) and hormone-related drugs (N = 6). Risperidone had the highest risk (ROR = 346.71) and report count (N = 3,378).

CONCLUSION: This study provides a comprehensive list of high-risk drugs for DAG, offering critical data to guide safer prescribing and improve pharmacovigilance. Clinicians should be vigilant in monitoring for suggestive symptoms like galactorrhea, amenorrhea and sexual dysfunction, especially in high-risk individuals on long-term treatment with prolactin-elevating medications. These findings underscore the importance of patient safety and inform clinical practice.

PMID:41482770 | DOI:10.36721/PJPS.2026.39.1.REG.15013.1

Cancer Med. 2026 Jan;15(1):e71466. doi: 10.1002/cam4.71466.

ABSTRACT

INTRODUCTION: The relationship between insufficient sleep and prostate cancer incidence is unclear. Our goal was to investigate the association of sleep duration, restless sleep, and prostate cancer incidence and aggressiveness, and whether race influences any sleep-prostate cancer association.

METHODS: The Southern Community Cohort Study (SCCS) recruited study participants from 12 Southeastern states from 2002 to 2009. The cohort included nearly 35,000 males, predominantly African American (AA, 67%). Sleep exposures were measured via a baseline questionnaire at enrollment, which captured weekday and weekend sleep duration, weighted average sleep duration, and restless sleep. We used Cox proportional hazards models and multinomial logistic regression models to estimate associations between sleep and prostate cancer incidence and aggressiveness.

RESULTS: During follow-up (median 10.9 years), 1345 men developed prostate cancer. Shorter sleep duration (< 6 h), in comparison to optimal duration (7-8 h), was suggestively associated with a decreased risk of prostate cancer in the overall cohort (adjusted hazard ratio (HR) = 0.83, (95% confidence interval (CI): 0.68-1.01) for sleep average; HR = 0.79, 95% CI: 0.65-0.95 for sleep weekdays; and HR = 0.81, 95% CI: 0.66-0.99 for sleep weekends), and among Black men (HR = 0.77, 95% CI: 0.62-0.97 for sleep average; HR = 0.76, 95% CI: 0.61-0.94 for sleep weekdays; and HR = 0.74, 95% CI: 0.59-0.94 for sleep weekends) when stratified by racial groups. Sleep duration and restless sleep were not associated with prostate cancer aggressiveness overall.

CONCLUSION: Shorter sleep duration was suggestively associated with a decreased risk of prostate cancer, but sleep duration was not associated with aggressive prostate cancer. Stratified analysis suggests a reduction of prostate cancer risk among Non-Hispanic Black men with < 6 h of sleep, compared to those sleeping 7-8 h. This is an intriguing finding, and further research is needed to assess the impact of confounding factors on racial differences in prostate cancer development.

PMID:41482760 | DOI:10.1002/cam4.71466

Int J Cancer. 2026 Jan 2. doi: 10.1002/ijc.70325. Online ahead of print.

ABSTRACT

The effects of cofactors on the impact of body mass index (BMI) change on breast and endometrial cancer are rarely investigated. This cohort study included cancer-free women who underwent national health examinations in 2010-2014 (Cohort 1) and 2009-2013 (Cohort 2), with follow-up through 2021 and 2017, respectively. BMI at baseline and follow-up was combined and categorized into 25 BMI change patterns. Cohort 1 (2.24 million) had 30,323 breast and 5465 uterine corpus cancers, while Cohort 2 (1.46 million) had 8580 breast and 1170 uterine corpus cancers. In Cohort 1, persistent low BMI was associated with a reduced risk of both cancers, particularly in postmenopausal women and never-smokers. However, persistent overweight, obesity I/II, and BMI fluctuation (loss or gain) were linked to an increased risk of both cancers, particularly in postmenopausal women and ever-smokers. Among premenopausal women, substantial BMI loss was associated with increased breast cancer risk. In postmenopausal women, a transition from overweight to underweight (adjusted hazard ratio [aHR]: 4.63, 95% confidence interval [CI]: 1.15-18.59) and from overweight to obesity class II (aHR: 4.06, 95% CI: 1.01-16.30) significantly increased uterine cancer risk. Among smokers, most BMI changes did not show significant association, except for persistent obesity I (aHR: 1.57, 95% CI: 1.01-2.43) and progression from obesity class I to II (aHR: 4.03, 95% CI: 1.97-8.26). Cohort 2 findings were largely consistent with those from Cohort 1. In conclusion, persistent high BMI and further BMI gain were associated with increased risk of both cancers, particularly in postmenopausal women and never-smokers.

PMID:41482754 | DOI:10.1002/ijc.70325

Int J Gynaecol Obstet. 2026 Jan 2. doi: 10.1002/ijgo.70791. Online ahead of print.

ABSTRACT

OBJECTIVE: Obstetric anal sphincter injuries (OASIS) are among the most serious complications of vaginal delivery. While various prediction models have been proposed, most fail to stratify risk by parity and commonly rely on birth weight, a parameter unavailable during labor, rather than estimated fetal weight (EFW). The aim of the present study was to identify maternal and intrapartum risk factors for OASIS in term vaginal births and to explore parity-specific associations.

METHODS: This retrospective cohort study included all women who achieved or intended to achieve vaginal delivery of a live, singleton, cephalic fetus at term (≥37 weeks) at a single tertiary center. Maternal, obstetric, and intrapartum data were extracted from electronic medical records. EFW was usually obtained sonographically, or clinically when no recent ultrasound was available. Multivariable logistic regression analyses were performed for the whole cohort and stratified by parity.

RESULTS: The overall rate of OASIS was 0.46% (102/22220) for the entire cohort. Stratified by parity, the prevalence was higher in nulliparous women compared to multiparous women (67/7309; 0.92% for nulliparas vs. 35/14911; 0.23% for multiparas). Overall, nulliparity, vacuum-assisted delivery, and increased EFW increased the risk for OASIS. However, following stratification by parity and adjustment for confounders, the only statistically significant risk factor among nulliparous women was vacuum-assisted delivery (adjusted odds ratio [aOR]: 2.474, 95% confidence interval [CI]: 1.520-4.026, P < 0.001), while among multiparous women, previous cesarean delivery was associated with OASIS, (aOR: 2.018, 95% CI: 0.507-8.024, P = 0.013). Neither EFW nor second-stage duration remained significant in stratified models.

CONCLUSION: Traditional indicators such as second-stage duration and EFW did not reliably identify women at risk of OASIS in this cohort. The strongest associated factors were first-time vaginal birth and vacuum-assisted delivery, with previous cesarean delivery relevant among multiparous women. These findings highlight clear parity-related patterns that merit further investigation.

PMID:41482750 | DOI:10.1002/ijgo.70791

J Dent Educ. 2026 Jan 2. doi: 10.1002/jdd.70111. Online ahead of print.

ABSTRACT

PURPOSE: This mixed methods study, framed by Kolb’s Experiential Learning Theory, explored allied dental students’ perceptions of alginate versus digital impression techniques at a US dental assisting and dental hygiene program in 2024. The central research question was, “What are students’ perceptions of taking maxillary alginate impressions as compared to a digital scan of the maxillary arch?” and the sub-question was, “Do students have a preferred technique?”

METHODS: A mixed methods approach enabled a deeper understanding of student perception through qualitative analysis related to using both the alginate impression and digital scanning techniques, and quantitative analysis related to evaluations of the final impressions and scans. Using Kolb’s Experiential Learning Theory as a guide, this research study was centered around a concrete experience with hands-on learning and then student reflection related to the experience and their perceptions or abstract conceptualization. A convenience sample of 30 dental assisting and dental hygiene students currently enrolled in a dental materials course participated. Data collected via questionnaires, behavioral observation, and impression/scan analysis were analyzed qualitatively and quantitatively. Coding was used to identify key themes in students’ perceptions of alginate and digital impression techniques.

RESULTS: Five themes were derived from data collection for both maxillary alginate impressions and maxillary digital scans: emotions/feelings, technique/process, benefits, and drawbacks/obstacles. Overall, participants preferred using digital scanning over alginate impressions. Most students (79% n = 22) perceived alginate impressions as more time intensive despite objective time data suggesting otherwise. There was a statistically significant difference in the average time to complete an alginate impression compared to the digital impression. There was no difference in digital impression quality between dental assisting and dental hygiene students, and dental assisting students expressed more apprehension when using the alginate impression technique compared to dental hygiene students.

CONCLUSION: Echoing previous research, students recognized the advantages of digital scans, such as improved patient education, comfort, and ease of cleanup. Conversely, they shared concerns about the time constraints and rushed feeling associated with alginate impressions, also previously documented.

PMID:41482741 | DOI:10.1002/jdd.70111

Pediatr Allergy Immunol. 2026 Jan;37(1):e70274. doi: 10.1111/pai.70274.

ABSTRACT

BACKGROUND: The frequency of false negatives in exercise provocation tests (EPTs) when evaluating exercise-induced allergic reactions on desensitization (EIARD) remains unclear. This study aimed to determine the frequency of allergic symptom induction after a negative EPT result in patients at risk of EIARD and to identify its associated factors.

METHODS: This retrospective cohort study analyzed 109 patients aged 5-18 years who underwent EPTs between February 2012 and March 2023 to assess EIARD after wheat oral immunotherapy (OIT). EPT was performed in all cases after rush OIT and in high-risk cases after slow OIT. Patients with a negative/indeterminate EPT result were monitored for 1 year. Individuals who developed allergic reactions during exercise after wheat ingestion were categorized as “Event+” and were regarded as having false-negative EPT results. Patients without events were categorized as “Event-“. Candidate factors between the Event+ and Event- groups were compared using nonparametric statistical tests.

RESULTS: Among 53 patients with negative/indeterminate EPT results, 14 (26.4%) experienced allergic symptoms during follow-up (Event+ group). Higher ω5-gliadin-specific IgE levels at the time of EPT were significantly associated with Event+. No other factors (i.e., age, sex, allergy severity, or exercise intensity) showed any association. All Event+ cases occurred outdoors, suggesting a possible influence of environmental factors.

CONCLUSION: False negatives occurred in 26.4% of pediatric wheat-desensitized patients with EPTs. Our findings highlight the need to periodically monitor EIARD after negative EPT results. Future studies should explore methods to improve the accuracy of EPTs and identify predictive markers of EIARD risk.

PMID:41482726 | DOI:10.1111/pai.70274