Pakistan BioMedical Journal

Knowledge, Attitudes, and Practices Regarding Obesity and Type 2 Diabetes Mellitus among Middle-Aged and Elderly People in District Narowal, Pakistan

Fri, 28 Feb 2025 00:00:00 +0000

Type 2 diabetes affected 95% of people in Pakistan and rest of the globe. Diabetics increase is approximately to 69.9 million from 40.9 million by 2025 unless preventive measures are taken. Objective: To evaluate the knowledge, attitudes, and practices regarding obesity and type 2 Diabetes Mellitus among middle-aged and elderly people in District Narowal, Pakistan. Methods: A cross sectional study was conducted from December 2022 to May 2023. Simple random sampling was used for the selection of diabetic patients. Socio-demographic information, diabetes-related knowledge, attitudes, and practices were gathered using semi-structured, pre-tested questionnaire after taking verbal informed consent. Following analysis, appropriate tests were performed on the data using SPSS version 25.0. Results: Out of 300 patients, 241 (80.33%) were overweight or obese. The mean knowledge score was 21.51 ± 6.13 for men and 20.57 ± 6.29 for women. Attitude scores averaged 35.96 ± 14.33 for men and 33.55 ± 14.03 for women. Practice scores were 17.06 for men and 4.53 ± 4.72 for women. No significant differences were found between weight groups in knowledge (2,297) = 1.72, p-value > 0.18, attitude, or practices. Conclusion: The low evaluations for the same suggested that the survey participants' attitudes, knowledge, and practices toward diabetes were deemed inadequate.

Lived Experiences of Direct Care Givers of Stroke Patients in Khyber Pakhtunkhwa, Pakistan: A Qualitative Study

Hizbullah Khan, Dildar Muhammad, Sabiha Khanum, Zeenaf Aslam, Shaier Khan — Fri, 28 Feb 2025 00:00:00 +0000

Each year, approximately 15 million new people are diagnosed with strokes across the globe. Stroke is a profoundly debilitating condition that extends its impact beyond the individual affected, placing a significant burden on the caregivers. Objectives: To explore the lived experiences of direct givers of stroke patients in Khyber Pakhtunkhwa, Pakistan. Methods: In a qualitative study, purposive sampling technique was used in which the caregivers fulfilling the inclusion criteria of the current study were recruited. After ensuring the ethical considerations, total eight in-depth interviews were conducted, and the data saturation was achieved. Interviews were audiotape recorded, transcribed and then thematic analysis approach was followed. Results: The data of eight participants were included in the analysis. Five themes emerged from the data: early disappointment, economic burden, impact on personal life, impact on social life, and coping mechanism. Conclusions: Caregivers often face a multitude of challenges when taking on unexpected responsibilities of care of the loved ones. These difficulties encompass physical demands, psychological strain, social isolation, and financial burdens. Healthcare professionals should consistently educate caregivers on patient care and regularly evaluate their need for counseling and psychological support. Providing caregivers with essential knowledge and addressing their emotional and mental health needs are crucial for ensuring effective and compassionate care for patients.

Comparison of Outcomes of Kidney Transplantation in Diabetic and Non-Diabetic Patients

Fri, 28 Feb 2025 00:00:00 +0000

When opposed to long-lasting dialysis, kidney transplantation offers patients with end-stage renal illness a higher chance of mortality and a better standard of life. It is still up for debate whether kidney transplantation is more beneficial for diabetic individuals in contrast to those lacking the disease. Objective: To compare outcomes of kidney transplantation in diabetic and non-diabetic patients. Methods: Data from 100 patients was collected from Sheikh Zayed Hospital Lahore, Pakistan. The following variables were assessed to compare the consequences of transplants in patients with and without diabetes: per graft fluid collection, superficial infection of the wounded area, cut-off hernia, shallow injury dehiscence, cellulitis, seroma, fascial breaking down, deep wound contamination, hypertension, and mortality and recuperation. Fisher’s exact test was applied to test statistically significant variances in outcomes and p-value≤0.05 was considered significant. Results: A statistically significant variance was observed in per graft fluid collection among diabetic and non-diabetic kidney transplant patients i.e., 68% vs 32% respectively with p-value≤0.05. A significant difference was observed in the occurrence of incisional hernias between the two groups, with a high rate in non-diabetic patients. Facial dehiscence also showed a statistically significant difference, with a higher incidence in non-diabetic patients (p=0.010). Conclusions: It was concluded that diabetes significantly impacts certain post-transplant outcomes, such as fluid collection. In contrast, other outcomes like incisional hernia and facial dehiscence are more prevalent in non-diabetic patients who had kidney transplants.

Frequency of Functional Depression and Coping Strategies in Medical Students and Doctors

Fri, 28 Feb 2025 00:00:00 +0000

Functional depression, marked by intermittent depressive episodes while maintaining normal functionality, is common among medical professionals and students. Understanding the prevalence of functional depression in these populations and identifying effective coping mechanisms is crucial for supporting their mental health. Objectives: To determine the Frequency of functional depression and coping strategies in medical students and Doctors. Methods: This cross-sectional study was conducted at FRP-Medical College from June 2022 to May 2023, involving 260 participants (160 medical students and 100 recent medical graduates). Participants completed an online questionnaire distributed via WhatsApp and email, with informed consent obtained electronically. The study utilized the 21-item Beck Depression Inventory (BDI) to assess depression severity and the 28-item Brief-COPE questionnaire to evaluate coping mechanisms. Data were analyzed using SPSS version 23.0. Results: The questionnaire was distributed to a total of 260 individuals (160 were medical students and 100 were medical professionals). The mean age of undergraduates and doctors was 20.53 ± 1.12 years and 28.77 ± 3.63 respectively. A high frequency of functional depression was noted in which (57%) of undergraduates and (53%) of doctors had functional depression (p=0.017). Female students were more inclined to be affected by depression than their male competitors (p=0.041). The family structure and marital status, on the other hand, were not linked to depression. Conclusions: The findings demonstrated that medical scholars are a susceptible population with high rates of mental morbidity, including anxiety and sadness. Moreover, problem-focused coping methods were the most adopted by them.

Analysis of Genetic Variants of ANGPTL4 Gene Responsible for Atherosclerosis Severity in Cardiac Patients

Fri, 28 Feb 2025 00:00:00 +0000

ANGPTL4 gene is a major factor in the onset of atherosclerosis and exacerbation of its severity. ANGPTL4 regulates lipoprotein lipase (LPL), but its inhibitory effect causes decreased triglyceride clearance. The E40K mutation reduces ANGPTL4 oligomer formation, reducing LPL activity suppression. Objectives: To correlate ANGPTL4 N-terminal chain variations with atherosclerotic cardiovascular disease severity in Pakistani individuals, enabling diagnosis, treatment, and prevention. Methods: A case control study was conducted at Surgimed Hospital, Lahore on 100 Pakistani cardiovascular patients and 50 healthy control subjects. The N-terminal chain of the ANGPTL4 gene was sequenced revealing 14 individuals (9.33%) were heterozygous carriers of the ANGPTL4 gene variant (rs116843064; G>A, E40K) in our population (n=150). Results: Among the participants, four (2.67%) individuals had severe atherosclerosis with heterozygous genotype (GA), eight (5.33%) had mild atherosclerosis with heterozygous genotype (GA), and two were healthy controls (1.33%) with heterozygous genotype (GA). This study showed the significant association of E40K variant of N-terminal chain of ANGPTL4 with less likely chance of severe atherosclerosis in our cardiovascular patients. The E40K alters the regulation of lipoprotein lipase, affecting lipid levels and impacting cardiovascular health. Conclusions: E40K mutation carriers exhibit a lower risk of severe atherosclerosis in cardiovascular patients due to better lipid profiles as HDL levels were lower in non-carriers and higher in carriers.

Effectiveness of Mindfulness-Based Cognitive Therapy on Quality of Life among Oral Cancer Patients Undergoing Chemotherapy and Radiotherapy

Rajesh Kumar, Yasmin Amarsi, . Badil, Adnan Abdul Jabbar — Fri, 28 Feb 2025 00:00:00 +0000

Cancer is the second leading cause of death globally, with oral cancer representing a significant portion of head and neck cancers. It disproportionately affects developing nations, including Pakistan, where it is the second most common cancer. Oral cancer patients often endure treatment-related side effects, leading to reduced quality of life. Evidence suggests that mindfulness interventions, particularly mindfulness-based cognitive therapy, can improve quality of life by addressing psychological distress and promoting emotional resilience. Objectives: To assess the effectiveness of mindfulness-based cognitive therapy in improving the quality of life of oral cancer patients undergoing chemotherapy and radiotherapy. Methods: The literature review used various electronic databases: PubMed, Academia, Science Direct, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar. The PRISMA flowchart approach documented the literature review process. We included 26 out of 294 studies that fulfilled inclusion criteria in the final review, which included the last five years, and researched the effects of mindfulness-based cognitive treatment on quality of life among oral cancer patients. Data were synthesized using quantitative methodologies to identify similar findings across studies. Results: Research indicates that mindfulness-based cognitive treatment significantly improves the quality of life for oral cancer patients receiving chemotherapy and radiotherapy. Conclusions: It was concluded that these findings provide baseline data for this study highlighting the significant impact of mindfulness-based cognitive therapy on improving the quality of life for patients with oral cancer receiving chemotherapy and radiotherapy.

Therapeutic Effect of Fennel Seeds in the Management of Obesity

Fri, 28 Feb 2025 00:00:00 +0000

Obesity is characterized by complex disorder associated with the accumulation of abnormal and huge amount of fat inside the body. Diabetes, metabolic problems and cardiovascular illnesses are only a few of the serious health hazards associated with obesity, a complex and multifaceted condition. Traditional treatments, especially those derived from herbal therapy, have drawn attention as supplemental approaches to obesity management. As popular herb in cooking and medicine, fennel seeds (Foeniculum vulgare) have been shown to have probable health advantages, including helping people to lose weight. It is thought that fennel seeds' active ingredients, which include flavonoids, fiber, and essential oils, work in a variety of ways to prevent obesity. These include lipid metabolism changes, improved digestion, and appetite control. Fennel seeds may assist people lose weight by increasing feelings of fullness, enhancing fat burning, and controlling blood sugar and cholesterol levels. Furthermore, fennel's antioxidant and anti-inflammatory qualities might provide metabolic health even more. Regardless of encouraging initial data, additional clinical studies are required to completely clarify the mechanisms and prove the effectiveness of fennel seeds in the treatment of obesity. This review examined the use of fennel seeds in the treatment of obesity, emphasizing both its traditional medical use and scientific foundation.

Deliberating Effects of Sedentary Lifestyle on Young Adults: A Review of Literature

Hira Iqrar, Maham Mohsin, Vaneeza Ahmad, Misbah Qayum, Wajida Perveen — Fri, 28 Feb 2025 00:00:00 +0000

The term sedentary behavior means "any activity that occurs during the day that involves sitting, laying, or reclining that requires less energy than or equal to 1.5 metabolic equivalents (METs)." Six or more hours a day of sitting or lying down combined with little or no physical exercise during daily activities define a sedentary lifestyle. According to international guidelines, adults should perform at least 150 minutes of moderately vigorous physical activity each week, which equates to 30 minutes/day for five days/week. Adults also require 2 days of muscle strengthening activity every week. About one-third of adults over the age of 15 worldwide suffer from poor health due to inadequate physical activity. Negative effects of sedentary behaviors include a risk of stroke, cancer, high cholesterol, high blood pressure, cardiovascular disease, obesity, diabetes mellitus, osteoporosis and depression. Short bursts of inactivity paired with irregular physical activity contribute to improved wellbeing.

Mesenchymal Stem Cell-Derived Exosomes in Clinical Trials

Nihat Dilsiz — Fri, 28 Feb 2025 00:00:00 +0000

Mesenchymal stem cells, also known as MSCs, are pluripotent stem cells originating from embryonic mesoderm that can develop into a range of cell types and self-renew. Because of this property, MSCs are an effective treatment for various types of diseases. MSCs are widely distributed in the body and can be obtained from bone marrow, umbilical cord, umbilical cord blood, embryo, adipose tissue, dental pulp, skeletal muscle, amniotic fluid, skin, and other tissues. Among these, human umbilical cord-based MSCs are easy to collect and isolate, have a more effective immunomodulatory function and proliferation potential than other MSCs, are natural, non-invasive, and do not raise ethical questions. They also exhibit minimal immunity and proliferate readily in vitro. These cells have attracted the attention of many researchers due to their powerful tools for treating various diseases.

Extensive research studies on the clinical applications of MSC-based therapies including cancer diseases, heart, neurological, and orthopedic disorders have been carried out in recent years. However, compared to intact MSCs, MSC-derived exosomes offer many potential advantages when used as therapeutic agents. First of all, their application prevents the transfer of cells that can have DNA damage or mutations. Second, the exosomes are small (30-100 nm in diameter) and move easily, while MSCs are too big to move through capillaries, and most of them don't make it past the first pass capillary bed. Third, unlike whole cells, exosomes can be transported and stored at low temperatures for lengthy periods of time without losing bioactivity. Furthermore, their lipid bilayer walls can protect content molecules' bioactivity in a complicated physiological environment. Fourth, exosomes can be quantitatively applied to patients in a clinic to improve clinical outcomes and can be engineered through exogenous exosome modification or endogenous cell bioengineering to acquire specific properties ((Hu et al, 2022; Dilsiz, 2024).

Therapeutic deliverable exosomes are emerging as viable cargo delivery vehicles because to their natural intercellular communication, great biocompatibility, low immunogenicity, low toxicity, lengthy blood circulation ability, and aptitude to traverse a range of biological barriers. Since exosomes are membrane-bound nanoparticles, they usually create a lower immune system reaction than stem cells. This makes exosomes more biocompatible and enhances the possibility that a therapy will be successful. Exosomes are easily made from cultured stem cells and can be stored for a longer period of time in optimal conditions. This makes MSCs possible to produce exosomes in high quantities and use them to treat various types of diseases. Based on preclinical research, 39 clinical trials are now investigating the use of MSC-derived exosomes for a range of disorders (available online: http://www.clinicaltrials.gov/) some of which have published their results.