Pakistan BioMedical Journal

Effectiveness of Passive Chest Physiotherapy with and without Mechanical Percussion among in Patients Children

Mohabbat Ali — 2025-08-31

The main cause of damage to lung tissue is pneumonia, a disorder marked by pulmonary inflammation or infection and brought on by a range of infectious agents. Objectives: To compare the benefits of mechanical percussions and chest physical therapy for pediatric hospital admission patients. Methods: A randomized controlled trial was conducted in the Pediatric Intensive Care Unit and the General Ward of Memon Medical Institute Hospital in Karachi, Pakistan. The study investigated 68 children who experienced lower respiratory tract infections and were hospitalized for an extended duration. The children ranged in age from one month to five years. The exclusion criteria encompassed patients with acute asthma, cystic fibrosis, pulmonary embolism, malignancies, rib fractures, spinal fusion, hemorrhage-prone diseases, recent neurosurgery that precluded head-down positioning, and pulmonary emboli. Participants were randomly allocated to either the experimental group or the control group. The experimental group underwent mechanical percussions during chest physiotherapy, whereas the control group received standard chest physiotherapy. The final assessments included the Modified Respiratory Distress Assessment Instrument (mRDAI), the Face, Legs, Activity, Cry, CONSOL ability (FLACC) scale, the Wang Clinical Severity Score (WCSS), oxygen saturation (SpO₂), heart rate, and respiratory rate (RR). Evaluations were conducted both before and after the chest physical therapy session. Results: Improved FLACC ratings, a lower heart rate (p<0.05), and better scores on the mRDAI all point to notable changes in the experimental group following the intervention. Conclusions: Mechanical percussions in chest physical therapy clearly improved heart rate, the mRDAI, and the FLACC.

Comparative Analysis of Serum Trace and Heavy Metals in Hepatitis B, C, and D Patients from Shaheed Benazirabad, Pakistan

Zulfiqar Ali Dahri — 2025-08-31

Trace and heavy metals play essential roles in liver metabolism and immune regulation, but their imbalance may exacerbate complications in viral hepatitis. Objectives: To compare serum levels of key trace elements (zinc [Zn], iron [Fe], copper [Cu]) and heavy metals (lead [Pb], cadmium [Cd], chromium [Cr], aluminum [Al], arsenic [As], manganese [Mn], nickel [Ni], cobalt [Co]) among patients with Hepatitis B (HBV), Hepatitis C (HCV), and Hepatitis D (HDV). Methods: A cross-sectional study was conducted on 130 patients (aged 15–70 years) in Shaheed Benazirabad, Pakistan (2022–2024). Serum metals were quantified using Flame and Graphite Furnace Atomic Absorption Spectrometry (FAAS/GFAAS). Statistical analyses included ANOVA/t-test for normally distributed data and Kruskal–Wallis/Mann–Whitney U for non-normal data. For metals with concentrations reported below the method's limit of detection (LOD), a value of half the LOD (LOD/2) was assigned for statistical analysis. This common strategy minimizes bias and allows for the inclusion of all data points in the analysis, preventing the loss of information that would occur from exclusion. Results: Cr was significantly elevated in HCV compared to HBV (p=0.0035). Manganese (Mn) was significantly reduced in HDV compared to HBV (p=0.011). Other metals (Zn, Fe, Cu, Pb, As, Al, Cd, Ni, Co) showed no statistically significant differences, although trends of accumulation were observed. Conclusions: Elevated chromium in HCV and reduced manganese in HDV suggest that hepatitis type influences metal homeostasis, potentially contributing to disease progression.

Glycemic Index and Load: Key Dietary Factors in the Pathogenesis of Insulin Resistance: Glycemic Index and Load

Muhammad Irfan Bashir — 2025-08-31

Insulin resistance is the key parameter in development of type 2 diabetes and also leads to various metabolic disorders globally. Recent evidences demonstrate the vital role of glycemic index (GI) and glycemic load (GL) in glucose metabolism and insulin sensitivity.

The glycemic index determines how quickly carbohydrates-rich food elevate the glucose levels in the blood. While Glycemic load represents both quality and quantity of carbohydrates which are consumed. Actually, these factors are directly involved in glucose spike in the blood that is further responsible of insulin secretions. An increased demand of insulin can increase the secretions of insulin from pancreatic beta cells. Increased level of insulin (hyperinsulinemia) can cause insulin resistance. It happens when cells in the body, specifically in muscle, fat, and liver tissues show less response to insulin's signal to take up glucose from the bloodstream.

Recent studies has demonstrated through various randomized clinical trials that there is an important link between GI and insulin resistance. They showed that low GI-index foods can reduce the spike of blood glucose level which further can reduce the insulin secretions that can reduce the insulin resistance. A high GI-index diet can cause metabolic dysfunctions in non-diabetic adults [1]. Another research linked higher dietary GI and GL with increased pancreatic steatosis risk, describing the metabolic burden that high GI-index diet affect the pancreatic health [2]. Furthermore, some investigations have suggested that diets with high GI and GL could exacerbate insulin resistance, potentially very serious outcomes in inflammatory conditions such as COVID-19 [3].

All these studies recommend dietary modifications to control or reverse the type 2 diabetes. The use of low GI and low GL based diet can protect individuals from type 2 diabetes. Specifically, we have to modify our daily diet like grain flour, white rice, starchy vegetables, and sugary food. All these foods are high in GI and GL. More concerning for type 2 diabetes patients if they are taking medications but don’t want to modify their diet, they are just supressing their type 2 diabetes with medicines not cutting the roots of this dietary disorder. People got this disorder from their dinning tables but for cure they rely on clinics only, it is better if they first change their food placed dining tables. May be this modification can protect them from continuous visits of clinics and pharmacies. Public health policies and clinical guidelines should incorporate the GI and GL considerations to reduce the growing burden of insulin resistance and its complications effectively.

In conclusion, understanding about GI and GL is very important in both diabetes management and prevention. These factors will open new strategies to cope the type 2 diabetes and other metabolic disorders as well. Future research should continue to design the low GI and low GL based personalized nutritional approaches for reducing the insulin resistance.