Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Apr 2017
Meta AnalysisThe Efficacy and Safety of Iodine-125 Brachytherapy Combined with Chemotherapy in Treatment of Advanced Lung Cancer: A Meta-Analysis.
The aim of this study was to systematically review the efficacy and safety of iodine-125 brachytherapy combined with chemotherapy in patients with advanced lung cancer. PubMed, MEDLINE, EBSCO, FMJS and Web of Science were searched to obtain randomized controlled trials (RCTs), published in English and Chinese, until February 2016. The evaluating indicators were complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), overall response rate (ORR), disease control rate (DCR), one-year overall survival, two-year overall survival and adverse events. ⋯ The results showed that iodine-125 brachytherapy combined with chemotherapy was superior to chemotherapy alone in CR (risk ratio [RR] = 3.66, 95% confidence interval [CI]: 2.08 to 6.44, p<0.001), PR (RR = 1.47, 95% CI: 1.16 to 1.86, p=0.001), ORR (RR = 1.85, 95% CI: 1.54 to 2.22, p<0.001), DCR (RR = 1.19, 95% CI: 1.10 to 1.29, p<0.001), one-year overall survival (RR = 1.46, 95% CI: 1.12 to 1.92, p=0.006) and PD (RR = 0.20, 95% CI: 0.09 to 0.43, p<0.001); meanwhile, there was no significant difference in two-year overall survival (RR = 1.30, 95% CI: 0.72 to 2.37, p=0.39). In terms of adverse events, the combination therapy significantly increased the incidence of neumothorax (RR = 4.93, 95% CI: 1.94 to 12.55, p=<0.001); however, no significant differences were found in the incidence of other adverse events. This study indicated that the combination therapy of iodine-125 brachytherapy and chemotherapy could improve the therapeutic efficacy of advanced lung cancer without increasing the incidence of adverse events, except pneumothorax.
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To compare the mean Vitamin D level in patients with alopecia areata (AA) with age and gender controlled matched healthy controls. ⋯ Serum Vitamin D levels were significantly lower in patients with alopecia areata compared to healthy controls.
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J Coll Physicians Surg Pak · Mar 2017
Observational StudyHomeostatic Model Assessment for Insulin Resistance (HOMA-IR): A Better Marker for Evaluating Insulin Resistance Than Fasting Insulin in Women with Polycystic Ovarian Syndrome.
To assess the utility of HOMA-IR in assessing insulin resistance in patients with polycystic ovary syndrome (PCOS) and compare it with fasting insulin for assessing insulin resistance (IR). ⋯ Insulin resistance is common in PCOS and it is likely a pathogenic factor for development of PCOS. HOMAIR model performed better than hyperinsulinemia alone for diagnosing IR.
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J Coll Physicians Surg Pak · Mar 2017
ReviewMotivating and Demotivating Factors for Community Health Workers Engaged in Maternal, Newborn and Child Health Programs in Low and Middle-Income Countries: A Systematic Review.
This systematic review aimed to synthesize primary research on motivating factors of community health workers (CHWs) for maternal, neonatal, and child health (MNCH) in low and middle-income countries (LMICs). Peer-reviewed literatures were systematically searched in five databases. Identified studies were then screened and selected for inclusion. ⋯ Recruitment of community health workers for maternal, neonatal, and child health relies largely on individual level of motivation. At retention, individual level motivating factors remain influential; and community and health system begin to influence motivation positively. But, overall health systems in low and middleincome countries are demotivating the health workers rather than motivating them.
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J Coll Physicians Surg Pak · Feb 2017
Comparison of Harmless Acute Pancreatitis Score with Ranson's Score in Predicting the Severity of Acute Pancreatitis.
To determine the predictability of harmless acute pancreatitis score (HAPS) in determining the severity of acute pancreatitis (AP) and compare it with Ranson's score. ⋯ HAPS is effective in rapid identification of patient who will run non-severe course of AP. Assessment can be completed within one hour from presentation. Ranson's score, although more accurate, takes 48 hours to complete.