Tag: pubmed

J Diabetes. 2025 Sep;17(9):e70156. doi: 10.1111/1753-0407.70156.

ABSTRACT

BACKGROUND: This randomized controlled trial (RCT) was designed to evaluate the effects of sitagliptin on diabetic foot ulcers (DFUs).

METHODS: This was a randomized, open-label clinical trial. The participants were assigned to either the control group, which received standard conventional therapy alone, or the sitagliptin treatment group, which received an oral administration of sitagliptin (100 mg once daily) in conjunction with standard conventional therapy. The primary endpoints were the ulcer healing rate and adverse reactions. The secondary endpoints included the time to ulcer healing, peripheral blood CD34+ endothelial progenitor cells (EPCs) count, serum levels of stromal cell-derived factor-1α (SDF-1α), and glycosylated hemoglobin A1c (HbA1c).

RESULTS: A total of 62 subjects were enrolled in this trial, with 31 individuals assigned to each group. One participant from each group was lost to follow-up. Posttrial analysis revealed that, compared with the control group, the sitagliptin group demonstrated a significantly greater reduction in ulcer area and improved efficacy in terms of ulcer healing (p < 0.05). Although not statistically significant (p = 0.071), the sitagliptin group also tended to have a shorter ulcer healing time. Additionally, the sitagliptin group presented significantly greater numbers of CD34+ EPCs and higher SDF-1α levels compared to the control group (p < 0.05). No statistically significant difference in HbA1c levels was observed between the two groups (p > 0.05). No adverse events associated with sitagliptin treatment were reported.

CONCLUSIONS: The DPP-4 inhibitor sitagliptin may facilitate the healing of DFUs independent of its glucose-lowering effects, potentially by enhancing the mobilization of CD34 + EPCs in peripheral blood.

TRIAL REGISTRATION: Registration number: ChiCTR 2000029230, Approval date: 2020/01/19.

PMID:40948240 | DOI:10.1111/1753-0407.70156

Cardiol Young. 2025 Sep 15:1-7. doi: 10.1017/S1047951125109554. Online ahead of print.

ABSTRACT

BACKGROUND: Patients diagnosed with hypertension (HT) are at high risk for end-organ damage. With changing living conditions and access to healthcare facilities worldwide, the rate of diagnosis in childhood is increasing. In this study, healthy children were compared with a group of pediatric patients diagnosed with hypertension. Cardiac findings in the hypertensive group were compared at presentation and at six months. We aimed to determine the discriminatory value of epicardial adipose tissue (EAT) measurements as an early imaging marker for cardiac involvement in children with HT compared to healthy children and to determine its prognostic feature for HT treatment response.

METHODS: Fifty-nine primary hypertension patients and 76 control patients aged 0-18 years were compared. EAT values measured between the healthy group and the patient group and at the beginning of treatment and subsequent follow-ups in the patient group were evaluated with M-mode measurements.

RESULTS: There was no difference between the groups in terms of sex, and age. EAT was found to be significantly higher in the patient group than in the healthy group. There was a statistically significant difference between the EAT measurements evaluated before and after treatment in the patient group.

CONCLUSIONS: Hypertension is an important cause of morbidity and mortality. Using EAT measurements as a noninvasive parameter may provide information about early cardiac involvement due to HT. EAT is promising as an imaging marker that can be used in diagnosis and follow-up.

PMID:40948230 | DOI:10.1017/S1047951125109554

J Cosmet Dermatol. 2025 Sep;24(9):e70456. doi: 10.1111/jocd.70456.

NO ABSTRACT

PMID:40948229 | DOI:10.1111/jocd.70456

Microsurgery. 2025 Sep;45(6):e70111. doi: 10.1002/micr.70111.

ABSTRACT

BACKGROUND: The aim of this study is to compare the traditional triple innervation technique with a new version, designed to reduce eye-mouth synkinesis. To reduce unpleasant synkinesis, the authors proposed changing the connection between the masseteric nerve and the injured facial nerve, analyzing the outcome in terms of reduction of synkinesis and power of contraction of the mimic muscle. The traditional technique conveys the quantitative stimuli from the masseteric nerve to the temporofacial branch and from the hypoglossal nerve (30%) to the cervicofacial branch. Traditionally, the stimulus coming from the masseteric nerve is directed in that way to both the orbicularis oculi and the great zygomatic muscle, leading to eye-mouth synkinesis. The evolved technique connects the masseteric nerve more distally on the branch directed to the great zygomatic muscle and the hypoglossal nerve (30%) to the main trunk of the injured facial nerve. Long-term follow-up could be interesting to check what happens to the eye without the stimulus coming from the masseteric nerve.

METHODS: Exactly 32 patients were included, subdivided into two groups based on the type of surgical technique. Static symmetry, voluntary movements, and synkinesis were evaluated with eFACE software.

RESULTS: Both techniques allowed to obtain excellent outcomes: pre- and post-operative parameters showed a statistically significant improvement in both groups and no differences between the two groups, except in palpebral fissure width forced eye closure, in oculo and midfacial synkinesis: a significant reduction of synkinesis was evident in the evolved version group.

CONCLUSIONS: The new triple innervation offers significant improvements in reducing synkinesis, ocular and mid-facial muscle spasm, leading to a more relaxed tone at rest.

PMID:40948226 | DOI:10.1002/micr.70111

Anal Chem. 2025 Sep 15. doi: 10.1021/acs.analchem.5c03642. Online ahead of print.

ABSTRACT

This study refined the nontarget fingerprinting approach for accurate source apportionment by combining online solid-phase extraction with liquid chromatography-quadrupole time-of-flight mass spectrometry in data-independent acquisition mode, enabling both source concentration estimation and compound-level attribution. We established dilution curves (100 to 0% v/v) for three representative point sources and applied the nontarget source apportionment approach to five laboratory-prepared mixed samples. A total of 2489, 5750, and 6585 qualitative fingerprints (including both MS¹ and MS² features) were established for each source; their peak areas showed statistically significant and consistent associations across the dilution samples (r = 0.51-0.98, p < 7.2 × 10^-10) and mixed samples (r = 0.38-0.91, p < 3.1 × 10^-5). Linear and nonlinear regression models were applied across multiple dilution ranges to establish quantitative fingerprints, combined with a two-step approach for source apportionment. Incorporating MS² data alongside MS¹ increased the number of quantitative fingerprints by 29.1-39.6% across three representative sources and enabled accurate source concentration estimates (0.79-1.32-fold of actual values) in mixed samples. Analysis of compounds with peak areas >10⁴ in mixed samples showed that the majority compounds (63.9-81.5%) had estimated peak areas closely aligned with observed values (0.5-1.5-fold), indicating reliable and meaningful interpretation in compound-level source apportionment. This study enhances the efficiency and robustness of source estimation and deepens environmental insights, underscoring the potential of nontarget methodologies to enhance our understanding of contaminant distributions in environments.

PMID:40948219 | DOI:10.1021/acs.analchem.5c03642

J Coll Physicians Surg Pak. 2025 Sep;35(9):1180-1184. doi: 10.29271/jcpsp.2025.09.1180.

ABSTRACT

OBJECTIVE: To explore the challenges and opportunities associated with the implementation of formative assessment (FA) practices in medical colleges of Peshawar.

STUDY DESIGN: A cross-sectional study. Place and Duration of the Study: Four Medical colleges, two private (Rehman Medical College, Northwest School of Medicine) and two public (Khyber Medical College, Khyber Girls Medical College), in Peshawar, Pakistan, from November 2023 to April 2024.

METHODOLOGY: This study used a validated questionnaire to gather quantitative information about the challenges teachers face and the present use of formative assessment in the medical college. The sample included four medical colleges, two private and two public sectors, with a total sample size of 258 medical teachers. The data collected were analysed employing descriptive statistics, including frequencies and percentages, which were used to summarise the demographic characteristics and responses to the questionnaire items.

RESULTS: The quantitative study revealed that 88.4% (n = 228) of the medical teachers believed that they understood the concept of FA. Similarly, 86% (n = 222) felt they clearly understood the distinction between formative and summative assessments. Additionally, 81.4% (n = 210) considered feedback to be a crucial component of FA. In contrast, 62% (n = 160) believed that FA to be an approach primarily used for grading and certification. Only one-third of participants frequently conducted FA and provided feedback to students, whereas almost half stated they did so only occasionally. About the adding of FA scores in final course, semester, or overall grade, over half of the participants reported doing it occasionally, while 28.8% (n = 74) of participants revealed doing it routinely.

CONCLUSION: Despite most of the participants expressing confidence in their understanding of FA, a discrepancy was identified between teachers’ perceived understanding and their actual practice of FA. Although many participants acknowledged the significance of FA, the low proportion of teachers who practise it regularly raises concerns about the implementation of this valuable tool in medical education.

KEY WORDS: Formative assessment, Medical colleges, Challenges, Peshawar, Practice, Teacher.

PMID:40948167 | DOI:10.29271/jcpsp.2025.09.1180

J Coll Physicians Surg Pak. 2025 Sep;35(9):1159-1164. doi: 10.29271/jcpsp.2025.09.1159.

ABSTRACT

OBJECTIVE: To evaluate the predictive power of the ARISCAT (assess respiratory risk in surgical patients in Catalonia) score for postoperative pulmonary complications (PPCs) following major urological procedures.

STUDY DESIGN: A descriptive study. Place and Duration of the Study: Department of Anaesthesiology and Critical Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkiye, from January to December 2023.

METHODOLOGY: A total of 140 ASA I-IV patients aged 18-85 years who had elective major urological surgery were included. Records were kept including patient demographics, surgical technique, comorbidities, length of postoperative hospital stay, ASA scores, preoperative pulmonary risk scores (ARISCAT), and any PPCs occurring during hospitalisation. Appropriate statistical analyses were performed using Chi-square or Fisher’s exact tests for categorical variables, Mann-Whitney U and Student’s t-tests for numerical variables, and ROC analysis to evaluate the predictive power of the ARISCAT score for PPC incidence.

RESULTS: Of the 140 patients who had major urological surgery, 24 (17.1%) experienced postoperative pulmonary problems. The findings showed that the development of PPC was significantly correlated with the ASA and the ARISCAT scores, the amount of intraoperative fluids administered, the length of the operation, and a body mass index of 25 or above.

CONCLUSION: The ARISCAT risk score system was shown to be a simple, repeatable, economical, and effective method for forecasting the occurrence of PPC in major urological procedures. In terms of forecasting the growth of PPC, it was found that the ARISCAT score outperforms the ASA score. It was believed that implementing effective preventative measures, morbidity and mortality rates could be decreased when high-risk individuals were identified.

KEY WORDS: ASA score, ARISCAT score, Postoperative pulmonary complications, Major urological surgery.

PMID:40948164 | DOI:10.29271/jcpsp.2025.09.1159

J Coll Physicians Surg Pak. 2025 Sep;35(9):1153-1158. doi: 10.29271/jcpsp.2025.09.1153.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of a novel CAD/CAM-guided crown preparation technique compared with conventional manual methods in fixed prosthodontics.

STUDY DESIGN: A randomised controlled trial (RCT). Place and Duration of the Study: Department of Endodontic Dentistry, Hefei Stomatological Clinic College, Anhui Medical University, Hefei Stomatological Hospital, Hefei, China, from February 2023 to 2024.

METHODOLOGY: Sixty patients requiring single-unit ceramic crowns for mandibular premolars were randomly divided into either the CAD/CAM-guided group (n = 30) or the manual adjustment group (n = 30). The CAD/CAM group utilised intraoral scanning, digital design, and 3D-printed adjustment guided crowns to achieve precise tooth preparations, while the control group relied on the manual undercut adjustments. Operational efficiency, preparation accuracy, prosthetic fit, survival rate, and patient satisfaction were evaluated. Data were statistically analysed using the independent t-test and Chi-square (χ2) test at a significance level of p <0.05.

RESULTS: The CAD/CAM group exhibited significantly shorter preparation times than the control group. No statistically significant differences were found in preparation accuracy, prosthetic fit, clinical success rates, or patient satisfaction between the two groups.

CONCLUSION: CAD/CAM technology effectively reduces the clinical operating time for tooth preparation. While maintaining clinically acceptable outcomes, it has promising application scenarios.

KEY WORDS: CAD/CAM-guided crown preparation, Fixed prosthodontics, Preparation adjustment, Traditional manual adjustment.

PMID:40948163 | DOI:10.29271/jcpsp.2025.09.1153

J Coll Physicians Surg Pak. 2025 Sep;35(9):1141-1146. doi: 10.29271/jcpsp.2025.09.1141.

ABSTRACT

OBJECTIVE: To assess the impact of varying levels of controlled hypotension on cerebral oxygenation and examine their association with postoperative delirium and cognitive dysfunction among individuals undergoing rhinoplasty or septoplasty.

STUDY DESIGN: A randomised double-blind study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Hitit University, Corum, Turkiye, between May and August 2024.

METHODOLOGY: Seventy ASA (American Society of Anesthesiologists) I-II patients (aged 18-65 years) undergoing elective rhinoplasty or septoplasty were randomly assigned to two equal groups. Group A (n = 35) received anaesthesia with a target mean arterial pressure (MAP) of 50-57 mmHg, and Group B (n = 35) with 58-65 mmHg. Assessment of cognitive function and delirium was conducted using the Mini-Mental Test (MMT) and the Delirium Rating Scale-Revised-98 (DRS-R-98). Continuous variables were analysed using the independent samples t-test, Mann-Whitney U test, or Friedman test, depending on data distribution. Categorical variables were compared using the Chi-square test. A p <0.05 was considered statistically significant.

RESULTS: Delirium was significantly more frequent in Group A than in Group B within the recovery unit (31.4% vs. 5.7%, p <0.05). DRS-R-98 scores were also notably higher in Group A than in Group B during both recovery and at the 24-hour mark (p <0.05). There were no statistically significant differences identified between the groups in MMT scores at 24 hours (p = 0.100), 7 days (p = 0.457), or 3 months (p = 0.114). Prolonged operative duration emerged as an independent risk factor for delirium in the recovery phase (p <0.05).

CONCLUSION: Controlled hypotension with MAP levels reduced to 50 mmHg appears to be safe with respect to medium- and long-term cognitive outcomes. However, the increased rate of early postoperative delirium in this group highlights the importance of close neurological monitoring during the immediate recovery period.

KEY WORDS: Controlled hypotension, Cerebral oxygenation, Delirium, Cognitive dysfunction, Rhinoplasty, Septoplasty.

PMID:40948161 | DOI:10.29271/jcpsp.2025.09.1141

J Coll Physicians Surg Pak. 2025 Sep;35(9):1135-1140. doi: 10.29271/jcpsp.2025.09.1135.

ABSTRACT

OBJECTIVE: To investigate the causal relationship between socioeconomic status (SES) and corneal diseases.

STUDY DESIGN: Two-sample Mendelian randomisation (MR) analysis. Place and Duration of the Study: Department of Pharmacy, Eye Hospital, Wenzhou Medical University, Wenzhou, China, between May and September 2024.

METHODOLOGY: The genome-wide significant single-nucleotide polymorphisms (SNPs) (p <5 × 10-8) associated with educational attainment, household income, and occupational status were selected as instrumental variables (IVs). Linkage disequilibrium (LD) clumping (r2 <0.001) was applied to ensure independence, and SNPs with F-statistics <10 were excluded. Corneal disease outcomes were analysed using inverse variance weighting (IVW) as the primary method. Sensitivity analyses, including Cochran’s Q-test for heterogeneity, the MR-Egger for interception, and MR-PRESSO for pleiotropy, were performed to assess robustness.

RESULTS: A significant negative association was observed between educational attainment and corneal ulcer risk in the univariate MR analysis (IVW OR, 0.77; 95% CI: 0.66-0.92; p = 0.003). In the multivariate MR (MVMR) analysis adjusting for household income and educational attainment, occupational status showed a significant association with corneal ulcer risk (IVW OR, 0.91; 95% CI: 0.82-0.99; p = 0.041). No significant associations were observed with other subtypes of corneal diseases.

CONCLUSION: These findings indicate that genetic evidence that lower socioeconomic status, particularly lower educational attainment and occupational status, is associated with an increased risk of corneal ulcer. Targeted public health strategies to improve socioeconomic conditions in disadvantaged populations may help reduce the burden of corneal diseases.

KEY WORDS: Socio-economic status, Corneal diseases, Mendelian randomisation, Corneal ulcers.

PMID:40948160 | DOI:10.29271/jcpsp.2025.09.1135