Journal of Evidence-Based Medical Research
type: channel
description: The Journal of Evidence-Based Medical Research (JEBMR) is a peer-reviewed, open-access journal dedicated to publishing high-quality research that applies the principles of evidence-based medicine. It aims to bridge the gap between research and clinical practice by disseminating studies, reviews, and meta-analyses that support informed healthcare decision-making. The journal welcomes submissions from all fields of medicine, public health, and healthcare policy, with a strong focus on methodological rigor, clinical relevance, and global applicability.
publisher: Acadentium Research
language: en
publication name: Journal of Evidence-Based Medical Research
issn: 3107-1996
items: Role of Tumor-Infiltrating Lymphocytes in Predicting Pathologic Complete Response in HER2-Positive Breast Cancer: An IMRAD-Based Analysis
items: Systematic Review of Artificial Intelligence–Based ECG Algorithms for Early Detection of Left Ventricular Dysfunction
items: Association Between Lipoprotein(a) Levels and Recurrent Ischemic Stroke in Young Adults (<50 Years): A Prospective Cohort Analysis
items: Cervicothoracic Non-dysraphism Intradural Lipoma: A Case Report and Surgical Outcome
items: PREVALENCE OF EGFR MUTATIONS IN STAGE III–IV NON-SMALL CELL LUNG CANCER: A SINGLE-CENTER STUDY FROM VIETNAM
items: Acute Appendicitis Presenting as Right Ovarian Torsion in a Teenage Girl - A Case Study
items: Early Prediction of Type 2 Diabetes Using Deep Learning on Continuous Glucose Monitoring (Cgm) Data - A Systematic Review
items: Role of Virtual Reality-Assisted Distraction in Reducing Labor Pain and Improving Delivery Outcomes
items: Severe Dengue Presenting as Acute Myocardial Infarction in a Young Patient: A Case Study
items: Effect of Blood Flow Restriction Training on Quadriceps Muscle Performance Following ACL Reconstruction: A Systematic Literature Review
items: The Intersection of Sleep Disorders and Postoperative Pain: A Narrative Review of a Bidirectional and Understudied Relationship
items: Nanotechnology-Based Insulin Delivery Systems: A Review of Progress and Challenges
items: Leveraging Mobile Health Technologies for Improved Hypertension Control and Patient Adherence
items: Harnessing Artificial Intelligence for Smarter, Safer, and More Compassionate Healthcare Systems
items: Prevalence of Musculoskeletal Disorders and Their Risk Factors among Professional Gardeners
items: Effects of treadmill training with and without weighted ankle cuffs on gait parameters in children with down’s syndrome
items: Antibacterial Prevalence of Multidrug Resistant Pseudomonas Aeruginosa from Critically Ill Patients
items: Effects of Reverse Walking with And Without Whole Body Vibration on Postural Balance and Quality of Life in Children with Cerebral Palsy

Role of Tumor-Infiltrating Lymphocytes in Predicting Pathologic Complete Response in HER2-Positive Breast Cancer: An IMRAD-Based Analysis
type: item
description: Background: Tumor-infiltrating lymphocytes (TILs) have emerged as a promising biomarker reflecting the host immune response in breast cancer, particularly in HER2-positive subtypes. Their role in predicting pathologic complete response (pCR) following neoadjuvant therapy remains an area of growing clinical interest. Objective: To evaluate the predictive value of TILs for pCR in patients with HER2-positive breast cancer undergoing neoadjuvant therapy. Methods: A comprehensive review and synthesis of existing clinical studies assessing stromal TIL levels and their association with pCR in HER2-positive breast cancer patients treated with chemotherapy and HER2-targeted therapy were conducted. Relevant studies were identified through systematic database searches, and findings were analyzed to determine correlations between TIL density and treatment outcomes. Results: Multiple studies demonstrated a strong positive association between higher TIL levels and increased rates of pCR. Patients with elevated stromal TILs showed improved responsiveness to trastuzumab-based regimens. Quantitative increases in TILs were consistently associated with higher pCR rates, suggesting a dose-response relationship. Additionally, TILs were linked with improved long-term outcomes, including disease-free survival. Conclusion: TILs represent a robust predictive biomarker for pCR in HER2-positive breast cancer. Their integration into clinical decision-making could enhance patient stratification and guide personalized therapeutic strategies.
subject: Articles
  topic: section
subject: Tumor-infiltrating lymphocytes
  topic: keywords
subject: immuno-oncology
  topic: keywords
subject: HER2-positive breast cancer
  topic: keywords
subject: neoadjuvant therapy
  topic: keywords
subject: pathologic complete response
  topic: keywords
creator: Maliha Sahreen Hossain
creator: Kazi Foyeza Akther
creator: Sinigdha Islam
creator: Tamanna Akter
creator: Banasree Roy Urmi
creator: Sayed Hossain
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-09-05
publication date: 2025-09-05
doi: 10.66687/jebmr.1.02.2025.22

Systematic Review of Artificial Intelligence–Based ECG Algorithms for Early Detection of Left Ventricular Dysfunction
type: item
description: Background: Left ventricular dysfunction (LVD), particularly left ventricular systolic dysfunction (LVSD), is a major precursor to heart failure and is often underdiagnosed due to reliance on imaging modalities such as echocardiography. Artificial intelligence (AI) applied to electrocardiography (ECG) has emerged as a promising non-invasive, cost-effective screening tool for early detection. Objective: To systematically review the diagnostic performance, clinical utility, and limitations of AI-based ECG algorithms for early detection of LVD. Methods: A systematic literature review was conducted across major databases including PubMed, Scopus, and Web of Science. Studies evaluating AI-enabled ECG models for detecting LVD were included. Data extracted included study design, population, model type, and performance metrics such as area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity. Results: AI-ECG algorithms demonstrated strong diagnostic performance across multiple studies, with reported sensitivities up to 95.6% and high negative predictive values . Deep learning models were capable of detecting subclinical LVSD up to two years before clinical diagnosis . Both single-lead and 12-lead ECG-based models showed promising results, although most studies relied on retrospective datasets. Challenges identified included limited external validation, variability in datasets, and lack of interpretability. Conclusion: AI-enabled ECG represents a transformative approach for early LVD detection, with potential to improve screening and risk stratification. However, further prospective validation and integration into clinical workflows are required.
subject: Articles
  topic: section
subject: Artificial Intelligence
  topic: keywords
subject: Heart Failure
  topic: keywords
subject: Left Ventricular Dysfunction
  topic: keywords
subject: Electrocardiography
  topic: keywords
subject: Deep Learning
  topic: keywords
creator: Zahidul Mostafa
creator: Asif Manwar
creator: Maliha Sahreen Hossain
creator: Rasheda Yasmin
creator: Mitun Roy
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-12-19
publication date: 2025-12-19
doi: 10.66687/jebmr.1.03.2025.21

Association Between Lipoprotein(a) Levels and Recurrent Ischemic Stroke in Young Adults (<50 Years): A Prospective Cohort Analysis
type: item
description: Background: Lipoprotein(a) [Lp(a)] is a genetically determined lipid particle with pro-atherogenic and pro-thrombotic properties. Emerging evidence suggests its role in ischemic stroke, particularly among younger populations, but its association with recurrent stroke remains inadequately explored. Objective: To evaluate the association between elevated Lp(a) levels and the risk of recurrent ischemic stroke in young adults (<50 years). Methods: A prospective cohort study was conducted including young adults diagnosed with first-ever ischemic stroke. Baseline Lp(a) levels were measured and categorized using clinically relevant thresholds. Patients were followed for recurrent cerebrovascular events over 12–24 months. Multivariate Cox regression analysis was used to assess the independent association between elevated Lp(a) and recurrence risk. Results: Elevated Lp(a) levels were significantly associated with an increased risk of recurrent ischemic stroke. Patients with Lp(a) ≥100 nmol/L demonstrated higher recurrence rates compared to those with lower levels. The association remained significant after adjustment for traditional vascular risk factors. Subgroup analysis indicated a stronger association in patients with large artery atherosclerosis. Conclusions: High Lp(a) levels are an independent predictor of recurrent ischemic stroke in young adults. Routine screening of Lp(a) in young stroke patients may improve risk stratification and guide secondary prevention strategies.
subject: Articles
  topic: section
subject: Lipoprotein(a)
  topic: keywords
subject: Atherosclerosis
  topic: keywords
subject: Young adults
  topic: keywords
subject: Stroke recurrence
  topic: keywords
subject: Ischemic stroke
  topic: keywords
creator: Asif Manwar
creator: Maliha Sahreen Hossain
creator: Mohammad Mohibul Alam
creator: Susmita Saha
creator: Md. Shakil
creator: Prianka Saha
creator: Rajib Kumar Malakar
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-06-29
publication date: 2025-06-29
doi: 10.66687/jebmr.1.01.2025.19

Cervicothoracic Non-dysraphism Intradural Lipoma: A Case Report and Surgical Outcome
type: item
description: Background: Cervicothoracic non-dysraphic intradural lipomas are rare benign spinal tumors that can cause progressive neurological deficits due to spinal cord and nerve root compression. These tumors are challenging to manage due to their dense adhesion to critical neural structures, which often renders complete excision unfeasible. This case demonstrates that subtotal resection can effectively balance symptomatic relief and preservation of neurological function. Case presentation: A 24-year-old male presented with a 2-month history of progressive neck pain, hand numbness, and limb weakness. Magnetic resonance imaging (MRI) revealed a cervicothoracic intradural lipoma causing significant spinal cord compression without intramedullary signal changes, suggesting reversible compression. Posterior decompression and subtotal resection were performed using a surgical microscope. The tumor, pale yellow and soft, was adherent to the spinal cord and nerve roots, necessitating the deliberate decision to leave a small residual portion to minimize neurological risks. Postoperatively, the patient demonstrated marked neurological improvement, including reduced pain, resolution of numbness, and full recovery of muscle strength. A follow-up at 20 days confirmed clinical improvement, with MRI showing substantial reduction in spinal cord compression. Conclusions: Subtotal resection is a safe and effective surgical approach for managing symptomatic cervicothoracic intradural lipomas, particularly when complete excision poses significant risks. This approach allows for significant symptom relief while preserving neurological function. The absence of intramedullary signal changes on preoperative MRI served as a favorable prognostic factor, indicating reversible spinal cord compression. Long-term follow-up is crucial to monitor residual tumor growth and ensure sustained clinical stability. This case highlights the importance of individualized surgical planning and cautious intraoperative…
subject: Articles
  topic: section
subject: Non-dysraphism intradural lipoma
  topic: keywords
subject: Spinal lipomas
  topic: keywords
subject: Benign spinal tumors
  topic: keywords
creator: Thi Bich Phuong Lam
creator: Van Tan Nguyen
creator: Minh Tien Vu
creator: Nguyen Trong Huu Phan
creator: Thien Thanh Le
creator: Tuan Bao Duong
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-08-29
publication date: 2025-08-29
doi: 10.66687/jebmr.1.01.2025.16

PREVALENCE OF EGFR MUTATIONS IN STAGE III–IV NON-SMALL CELL LUNG CANCER: A SINGLE-CENTER STUDY FROM VIETNAM
type: item
description: Lung cancer is one of the most common types of cancer in Vietnam, with non-small cell lung cancer (NSCLC) being the most prevalent histological type, accounting for up to 80%. Targeted therapies using TKIs have been confirmed to be effective in patients with EGFR mutations. However, the level of effectiveness, response, or resistance to different generations of TKIs depends on the specific type of EGFR mutation. Therefore, testing for EGFR mutations plays an important role in prognosis and treatment decisions. Objectives: 1. To determine the rate of EGFR gene mutations in stage III–IV NSCLC patients. 2.To evaluate the relationship between selected clinical characteristics and EGFR mutation status in the study population. Subjects and methods: A descriptive study was conducted on 56 stage III–IV NSCLC patients who underwent EGFR mutation testing and received treatment at Gia Lai General Hospital from January 2023 to November 2025. Results: The EGFR mutation rate in the study was 37.5%. Exon 19 (Del19) and exon 21 (L858R) were the most frequently detected mutations. Females had a higher likelihood of harboring EGFR mutations compared to males. Non-smokers exhibited a higher risk of EGFR mutations compared to smokers. Conclusion: The EGFR mutation rate in this study is similar to that reported by most domestic studies. The relationship between EGFR mutation status and clinical characteristics observed at Gia Lai General Hospital is consistent with findings from other studies in Vietnam and worldwide.
subject: Articles
  topic: section
subject: Non-small cell lung cancer
  topic: keywords
subject: EGFR mutation.
  topic: keywords
subject: molecular biomarkers
  topic: keywords
creator: Hung Dinh Nguyen
creator: Trang Thuy Thi Nguyen
creator: Be Thi Dao
creator: Tuan Dinh Dao
creator: Dung Thi Thuy Nguyen
creator: Tuan Cao Nguyen
creator: Anh Ngoc Thi Trinh
creator: Thuong Thi Luu
creator: Tuan Bao Duong
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-08-30
publication date: 2025-08-30
doi: 10.66687/jebmr.1.01.2025.15

Acute Appendicitis Presenting as Right Ovarian Torsion in a Teenage Girl - A Case Study
type: item
description: Background: Acute appendicitis is the most common abdominal surgical emergency in the pediatric population. In adolescent females, its diagnosis can be challenging as gynecological pathologies, particularly ovarian torsion, can present with similar symptoms. While both conditions are recognized, the phenomenon of appendicitis perfectly mimicking the clinical and radiological features of ovarian torsion is unusual and can lead to significant diagnostic and management delays. Case Presentation: A 16-year-old female presented to the emergency department with a 24-hour history of acute, severe right lower quadrant pain, nausea, and vomiting. Physical examination revealed localized tenderness and guarding. A pelvic ultrasound, ordered to rule out gynecological pathology, showed a peripherally located, hypoechoic right adnexal mass with absent Doppler flow, highly suggestive of ovarian torsion. No clear, non-compressible appendix was identified. Based on these findings, the patient was taken for an emergent diagnostic laparoscopy with a presumptive diagnosis of right ovarian torsion. Intraoperatively, the right ovary and fallopian tube were found to be viable and normally positioned. Instead, a severely inflamed, retrocecal appendix was identified, which was adherent to the right pelvic sidewall, causing secondary inflammatory changes in the right adnexa. A laparoscopic appendectomy was performed. The patient recovered uneventfully. Conclusions: This case highlights a critical diagnostic pitfall where acute appendicitis, especially in a retrocecal position, can clinically and radiologically mimic ovarian torsion. It underscores the limitations of ultrasonography and the importance of maintaining a broad differential diagnosis in adolescent females with acute abdominal pain. A low threshold for diagnostic laparoscopy is essential in such ambiguous cases to ensure correct identification and treatment of the underlying pathology, preventing unnecessary oophorectomy and manag…
subject: Articles
  topic: section
subject: diagnostic laparoscopy
  topic: keywords
subject: pelvic ultrasound
  topic: keywords
subject: retrocecal appendix
  topic: keywords
subject: adolescent abdominal pain
  topic: keywords
subject: diagnostic dilemma
  topic: keywords
subject: ovarian torsion
  topic: keywords
subject: acute appendicitis
  topic: keywords
creator: Rana Muhammad Azam Tariq
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-11-28
publication date: 2025-11-28
doi: 10.66687/jebmr.1.03.2025.14

Early Prediction of Type 2 Diabetes Using Deep Learning on Continuous Glucose Monitoring (Cgm) Data - A Systematic Review
type: item
description: Background: Type 2 diabetes mellitus (T2DM) is a major global health burden characterized by chronic hyperglycemia resulting from insulin resistance and β-cell dysfunction. Despite well-established diagnostic criteria, early detection of individuals at risk remains challenging. Continuous glucose monitoring (CGM) provides real-time, high-frequency glucose data, offering a dynamic view of glucose fluctuations that may precede overt diabetes. Recent advances in deep learning (DL) have created opportunities to analyze these complex time-series data to identify early glycemic irregularities predictive of future diabetes onset. Objective: This systematic review aims to synthesize and critically evaluate existing evidence on the use of deep learning algorithms applied to CGM data for early prediction of type 2 diabetes. It explores the types of models developed, their predictive performance, validation strategies, and methodological quality. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, an electronic search will be conducted in PubMed, Embase, Scopus, IEEE Xplore, and Web of Science from inception to October 2025. Eligible studies will include original research using deep learning methods (e.g., recurrent neural networks, convolutional neural networks, transformers) to predict T2DM onset or progression using CGM data. Two reviewers will independently perform screening, data extraction, and risk of bias assessment using the PROBAST tool. Extracted data will include study characteristics, model architectures, input representations, and performance metrics such as area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and calibration. Narrative synthesis will be provided, and meta-analysis will be performed if sufficient homogeneity exists. Results: The review will summarize key findings regarding the performance of deep learning models in predicting early T2DM, highlight methodolog…
subject: Articles
  topic: section
subject: Predictive Modeling
  topic: keywords
subject: Early Detection
  topic: keywords
subject: Continuous Glucose Monitoring
  topic: keywords
subject: Deep Learning
  topic: keywords
subject: Type 2 Diabetes
  topic: keywords
creator: Kaniz FatemaTuz Zahura
creator: Tamanna Akter
creator: Kazi Foyeza Akther
creator: Mitun Roy
creator: Prianka Saha
creator: Sinigdha Islam
creator: H M Kaiser
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-11-28
publication date: 2025-11-28
doi: 10.66687/jebmr.1.03.2025.13

Role of Virtual Reality-Assisted Distraction in Reducing Labor Pain and Improving Delivery Outcomes
type: item
description: Background: Labor pain is one of the most intense forms of acute pain experienced by women, and inadequate management can negatively affect both maternal and neonatal outcomes. While epidural analgesia remains the gold-standard pharmacological intervention, it is associated with side effects, high costs, and limited availability in low- and middle-income settings. These limitations have increased interest in non-pharmacological alternatives such as Virtual Reality-Assisted Distraction (VRAD). Objective: To critically examine the role of VR-assisted distraction as an innovative, safe, and patient-centered adjunct for labor pain management, and to explore its implications for clinical practice, adoption barriers, and future research. Methods: This review synthesizes evidence from clinical trials, observational studies, and experimental research evaluating the impact of VR-mediated distraction on labor pain, maternal psychological outcomes, obstetric indicators, and neonatal health. Additional literature on implementation factors, patient education, and health system integration was also analyzed. Results: Across multiple studies, VR-assisted distraction demonstrated significant reductions in perceived labor pain, anxiety, and stress through its immersive multisensory engagement of sensory, emotional, and cognitive pathways. VR use during labor has been associated with higher maternal satisfaction, shorter active labor duration, fewer obstetric interventions, and improved neonatal outcomes, including higher APGAR scores and enhanced maternal–infant bonding. Beyond analgesia, VR has shown potential as a tool for patient education, emotional support, and empowerment during childbirth. However, its implementation is influenced by factors such as device cost, equipment availability, staff training, and cultural acceptance. Conclusion: VR-assisted distraction represents a promising non-pharmacological complement to traditional labor analgesia, offering holistic benefits for…
subject: Articles
  topic: section
subject: Maternal and Neonatal Outcomes
  topic: keywords
subject: Non-Pharmacological Analgesia
  topic: keywords
subject: VR-Assisted Distraction
  topic: keywords
subject: Labor Pain Management
  topic: keywords
subject: Virtual Reality in Obstetrics
  topic: keywords
creator: Kazi Foyeza Akther
creator: Rahat Noor
creator: Mitun Roy
creator: Prianka Saha
creator: Tamanna Akter
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-11-28
publication date: 2025-11-28
doi: 10.66687/jebmr.1.03.2025.12

Severe Dengue Presenting as Acute Myocardial Infarction in a Young Patient: A Case Study
type: item
description: Background: Dengue virus infection is a worldwide arboviral hazard that is typically characterized by fever, aches, and, possibly, excessive plasma loss and blood loss. Though subclinical cardio-involvement is a frequent occurrence, it is a noteworthy and daunting clinical challenge to manifest in a syndrome so indistinguishable with acute myocardial infarction (MI). The case highlights the important overlap between cardiology and infectious disease. Case Presentation: A 32-year-old previously well male patient, having lived all his life in an area with endemic dengue, presented with acute crushing chest pain, electrocardiogram (ECG) showing ST-segment elevation in anteroseptal leads, and a highly elevated high-sensitivity cardiac troponin I level (15.2 ng/mL), which meet the diagnostic criteria of ST-elevation MI (STEMI). He has given a recent history of febrile disease. Physical evaluation demonstrated relative bradycardia and lab results were important in terms of thrombocytopenia and leukopenia. An increase in positive dengue NS1 antigen was a sign of acute infection. Emergency coronary angiography showed normal coronary arteries, which exclude the possibility of atherosclerotic disease. The eventual diagnosis was severe dengue myocarditis and faking STEMI. The management was changed to supportive care and the symptoms were completely resolved and the cardiac function started recovering significantly. Conclusions: The case demonstrates that dengue virus may lead to the development of a severe acute syndrome of myocardial injury that is clinically similar to STEMI. There is a great possibility of overdiagnosis and unnecessary anticoagulation or invasive coronary surgery, and this could prove detrimental in the backdrop of thrombocytopenia and a systemic viral disease. In young, endemic, patients who have STEMI-like manifestations and a febrile prodrome, greater clinical suspicion of dengue myocarditis is urgent. Coronary angiography is the gold standard of a defi…
subject: Articles
  topic: section
subject: dengue fever
  topic: keywords
subject: myocardial infarction
  topic: keywords
subject: myocarditis
  topic: keywords
subject: ST-elevation, troponin
  topic: keywords
subject: coronary angiography
  topic: keywords
subject: viral cardiomyopathy
  topic: keywords
subject: thrombocytopenia
  topic: keywords
subject: bradycardia
  topic: keywords
subject: type 2 myocardial infarction
  topic: keywords
creator: Rana Muhammad Azam Tariq
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-10-02
publication date: 2025-10-02
doi: 10.66687/jebmr.1.02.2025.11

Effect of Blood Flow Restriction Training on Quadriceps Muscle Performance Following ACL Reconstruction: A Systematic Literature Review
type: item
description: Background: Owing to disadvantage of conventional rehabilitation, there is need for specific intervention to overcome muscle atrophy or deficits following anterior cruciate ligament reconstruction (ACLR). This clinically significant quadriceps muscle deficiency led to knee pain and biochemical disruptions. Objective: The study aimed to determine the effectiveness of blood flow restriction therapy (BFRT) in the enhancement of clinical outcomes such as muscle strength, muscle size, patient-reported outcomes, and functional performance. Methodology: A systematic review was conducted following Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 guidelines. The literature was searched on PubMed, Scopus and Cochrane library. The search was limited to only articles written in English and published between 1st January 2020 and 31st August 2025. Risk of bias (ROB) was assessed using Cochrane Risk of Bias (ROB) 2.0. The narrative synthesis and data driven iterative approach was used to synthesize evidence. P-value < 0.05 was taken to determine statistical significance. Results: The initial database search yielded 105 articles. After removing (20) duplicates, the titles and abstracts of 85 articles were screened for relevance. Sixty (65) articles were excluded due to irrelevant titles and abstracts. One article did not retrieve full text. The remaining full text of 19 articles was assessed, and 7 met eligibility criteria. The 7 RCTs were included to synthesize evidence. Conclusion: BFRT reported mixed effectiveness for patients underwent ACLR. One model for BFRT incorporation in ACLR rehabilitation emphasize its use in the early post-operative period (2-8 weeks) with low-load resistance training (<30% 1RM) and then implementing it mid-term when high load training (>70% 1RM) is not tolerated. There is clear evidence that 80% or higher AOP/LOP is the ideal dose for muscle strength and size. However, evidence also synthesized that BFRT as an adjuvant t…
subject: Articles
  topic: section
subject: Anterior Cruciate Ligament
  topic: keywords
subject: ACL Reconstruction
  topic: keywords
subject: Blood Flow Restriction
  topic: keywords
subject: Training
  topic: keywords
subject: Quadriceps muscle
  topic: keywords
subject: Muscle performance
  topic: keywords
creator: Abdullah Munir
creator: Muhammad Haider Farooq Khan
creator: Muhammad Mubashir Abdullah
creator: Muhammad Shafique
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-10-02
publication date: 2025-10-02
doi: 10.66687/jebmr.1.02.2025.10

The Intersection of Sleep Disorders and Postoperative Pain: A Narrative Review of a Bidirectional and Understudied Relationship
type: item
description: Background: The relationship between pain and sleep represents one of the most significant yet insufficiently researched interactions between physiological systems during the perioperative period. Evidence indicates that pre-existing sleep disturbances, such as insomnia or sleep-disordered breathing, are strong predictors of postoperative pain intensity, higher opioid consumption, and increased risk of chronic postoperative pain. Objective: This review aims to examine the bidirectional interaction between sleep and postoperative pain, highlighting its impact on rehabilitation and recovery, while proposing strategies for improved perioperative care. Methods: Relevant literature was reviewed to evaluate the effects of postoperative pain on sleep architecture, including changes in sleep continuity, slow-wave sleep, and rapid eye movement (REM) sleep. Clinical and mechanistic findings on the reciprocal relationship between sleep disturbance and pain were also analyzed. Results: Postoperative pain was found to fragment sleep, reduce restorative sleep stages, and impair overall sleep quality. Poor sleep, in turn, heightened pain sensitivity, interfered with rehabilitation, and delayed recovery. This cyclical relationship is rarely addressed in standard perioperative care despite its clear impact on patient outcomes. Conclusion: A paradigm shift is required in perioperative medicine to incorporate preoperative sleep screening and targeted multidisciplinary interventions for sleep and pain management. Implications: Future studies should focus on mechanistic and clinical investigations to break the cycle between pain and poor sleep. Integrating sleep-focused assessments and interventions into perioperative care pathways could reduce opioid use, improve recovery, and enhance overall patient well-being.
subject: Articles
  topic: section
subject: Sleep Disorders
  topic: keywords
subject: Postoperative Pain
  topic: keywords
subject: Recovery
  topic: keywords
subject: Opioids
  topic: keywords
subject: Obstructive Sleep Apnea
  topic: keywords
subject: Multimodal Analgesia
  topic: keywords
subject: Perioperative Care
  topic: keywords
creator: Felgir Josué Noé Herrera Palacios
creator: Pablo Xavier Anda Suárez
creator: María Fernanda Desirée Rojas Herrera
creator: Richard Adrian Vergara Trujillo
creator: María José Rengel Chalco
creator: Danny Alexander Utreras Freire
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-10-02
publication date: 2025-10-02
doi: 10.66687/jebmr.1.02.2025.9

Nanotechnology-Based Insulin Delivery Systems: A Review of Progress and Challenges
type: item
description: Background: Diabetes mellitus is a chronic metabolic disorder characterized by impaired insulin production or action, leading to hyperglycemia. Conventional insulin delivery methods, such as subcutaneous injections, are limited by poor patient compliance and inability to mimic physiological insulin secretion. Objective: This paper reviews the recent advancements in nanotechnology-based insulin delivery systems, examining their mechanisms, advantages, challenges, and potential for clinical application. Methods: A comprehensive literature review was conducted focusing on lipid-based nanoparticles, polymeric nanoparticles, aquasomes, and electro-responsive systems. Studies exploring AI integration in insulin delivery were also analyzed. Results: Nanocarrier-based delivery systems enhance insulin stability, allow controlled release, improve bioavailability, and provide opportunities for personalized diabetes management. Despite progress, challenges such as formulation stability, scalability, regulatory barriers, and patient acceptance remain. Conclusion: Nanotechnology offers promising strategies to revolutionize insulin delivery. Future research should focus on smart, glucose-responsive systems, biocompatible materials, and streamlined regulatory pathways to facilitate clinical translation.
subject: Articles
  topic: section
subject: Nanotechnology
  topic: keywords
subject: Insulin Delivery
  topic: keywords
subject: Diabetes Mellitus
  topic: keywords
subject: Nanocarriers
  topic: keywords
subject: Controlled Release
  topic: keywords
creator: Kaniz FatemaTuz Zahura
creator: Tamanna Akter
creator: H M Kaiser
creator: Rajib Kumar Malakar
creator: Sayed Hossain
creator: Ripon Chowdhury
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-10-02
publication date: 2025-10-02
doi: 10.66687/jebmr.1.02.2025.8

Leveraging Mobile Health Technologies for Improved Hypertension Control and Patient Adherence
type: item
description: Background: Hypertension is a major global health challenge and a leading risk factor for cardiovascular morbidity and mortality. Despite effective pharmacological and lifestyle interventions, suboptimal adherence to treatment and limited patient engagement remain significant barriers, especially in low- and middle-income countries. Mobile health (mHealth) technologies have emerged as promising tools to address these gaps by supporting adherence, enabling self-monitoring, and fostering behavior change. Objective: This study aimed to explore the role of mHealth technologies in hypertension management, focusing on their impact on treatment adherence, patient engagement, and self-care behaviors. Methods: A convergent parallel mixed-methods design was employed, combining a cross-sectional online survey (n = 150) and semi-structured interviews (n = 30). Participants were adults aged 30–70 years with primary hypertension who had used at least one mHealth application for a minimum of three months. Quantitative measures were guided by the Technology Acceptance Model (TAM) and Health Belief Model (HBM), while qualitative interviews captured lived experiences and contextual factors. Statistical analyses included t-tests, ANOVA, and logistic regression; qualitative data were analyzed using thematic analysis. Results: mHealth usage was widespread, with 91% of participants using apps for blood pressure tracking, medication reminders, or lifestyle monitoring. High-frequency app users demonstrated significantly better adherence scores (p < .01) and more consistent blood pressure self-monitoring (p < .001). Qualitative findings highlighted empowerment through self-monitoring, integration into daily routines, and motivation via feedback and gamification. However, barriers such as technical difficulties, lack of personalization, privacy concerns, and digital inequities—particularly among older adults—limited sustained use. Conclusion: mHealth technologies offer significant potential …
subject: Articles
  topic: section
subject: Hypertension
  topic: keywords
subject: mHealth
  topic: keywords
subject: Patient adherence
  topic: keywords
subject: Self-management
  topic: keywords
creator: Khandaker Md Faiyaz
creator: Musarrat Farzana Dola
creator: Debnath Suchinta
creator: Asma Akhter Radia
creator: Tasmia Afrin
creator: Maisha Shabnam Anam
creator: Maliha Sahreen Hossain
creator: Abdullah Al Masud
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-10-02
publication date: 2025-10-02
doi: 10.66687/jebmr.1.02.2025.7

Harnessing Artificial Intelligence for Smarter, Safer, and More Compassionate Healthcare Systems
type: item
description: Background Artificial Intelligence (AI) is transforming healthcare by enhancing patient safety, improving operational efficiency, and supporting compassionate, human-centered care. From predictive analytics to voice-enabled companions, AI offers the potential to improve clinical outcomes while preserving empathy and trust in care delivery. Objective To highlight the diverse applications of AI in hospital and clinical settings, emphasizing its role in advancing patient safety, enabling proactive care, preserving human connection, and ensuring ethical, skill-conscious integration. Methods A narrative synthesis was conducted using publicly available reports, peer-reviewed studies, and authoritative online resources published between 2023 and 2025. Exampes of AI use cases were extracted from literature on smart hospitals, predictive healthcare models, patient perspectives, voice AI tools, and ethical implementation challenges. Results AI implementation has reduced medication errors by up to 80% through systems such as Computerized Physician Order Entry (CPOE). Smart hospital environments integrating AI, IoT, and robotics have improved workflow efficiency and clinical decision-making. Predictive models in palliative care enable timely, value-aligned referrals, while home-based AI monitoring systems have reduced hospitalizations by up to 70%. Assistive AI preserves human interaction by automating administrative tasks, with patients expressing strong preference for retaining clinician-led communication. Voice AI agents provide emotional support to isolated patients and streamline non-clinical workloads. Ethical challenges include potential skill degradation, as observed in over-reliance on AI-assisted colonoscopies. Conclusion AI can make healthcare smarter, safer, and more compassionate when applied as an augmentative partner to human expertise. Balanced, transparent, and ethically guided integration is essential to maximize benefits while safeguarding empathy, trust, and…
subject: Articles
  topic: section
subject: AI
  topic: keywords
subject: Healthcare
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subject: Patient Safety
  topic: keywords
creator: Irzam Mushtaq
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-08-14
publication date: 2025-08-14
doi: 10.66687/jebmr.1.01.2025.5

Prevalence of Musculoskeletal Disorders and Their Risk Factors among Professional Gardeners
type: item
description: Background: Work-related musculoskeletal disorders (WMSDs) are a significant occupational health issue, particularly among professional gardeners due to the physically demanding nature of their tasks. Prolonged awkward postures, repetitive activities, and heavy manual labor contribute to the high prevalence of these disorders. Objective: To systematically review the prevalence, associated risk factors, and preventive strategies for WMSDs among professional gardeners. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Searches were performed in Ovid MEDLINE, CINAHL, EMBASE, and the Cochrane Database of Systematic Reviews for studies published up to May 2022. Inclusion criteria were peer-reviewed studies focusing on professional gardeners and reporting prevalence or risk factors of WMSDs. Data extraction included study design, population characteristics, outcomes, and risk assessments. Quality appraisal was performed using the Newcastle-Ottawa Scale and JBI tools. Results: Fifteen descriptive studies met the inclusion criteria. Across studies, the most affected body regions were the lower back, knees, shoulders, and neck. Common risk factors included repetitive bending and twisting, heavy lifting, prolonged kneeling, and use of non-ergonomic tools. Prevalence rates for WMSDs were consistently high, with lower back pain being the most common complaint. Ergonomic interventions, training programs, and improved tool design showed potential in reducing injury risk. Conclusion: Professional gardeners face a high burden of WMSDs, primarily due to physically strenuous tasks and poor ergonomic practices. Targeted preventive measures, including ergonomic modifications, worker training, and health monitoring, are essential to reduce the incidence of these disorders. Keywords: Musculoskeletal Disorders, Professional Gardeners, Ergonomic Risk Factors, Occupational Health, Work-Related Injuries
subject: Articles
  topic: section
subject: Work-Related Injuries
  topic: keywords
subject: Musculoskeletal Disorders
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subject: Professional Gardeners
  topic: keywords
subject: Occupational Health
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subject: Ergonomic Risk Factors
  topic: keywords
creator: Faisal Ghafoor
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-08-14
publication date: 2025-08-14
doi: 10.66687/jebmr.1.01.2025.4

Effects of treadmill training with and without weighted ankle cuffs on gait parameters in children with down’s syndrome
type: item
description: Background: The disorder known as Down syndrome is characterized by the presence of an additional chromosome in certain individuals. Within the human body, chromosomes are like little "packages" of genes. It is possible to have Down syndrome (DS), which is often referred to as trisomy 21, if a third copy of chromosome 21 is present, either in its whole or in part. Objective: To compare the effects of treadmill training with and without weighted ankle cuffs on gait parameters in children with Down’s syndrome. Material & Method: Recent clinical trial was randomized. Ethical committee authorized research. After informed permission, patients were enrolled in the research based on inclusion criteria. Simple random sampling yielded 25 samples each category. Everyone was split into two groups. A group underwent treadmill training with weighted ankle cuffs, whereas the other received merely treadmill training. Both groups received conventional therapy—strengthening, and trunk training. The workout had 10 reps/session. Treadmill training for infants (with the help of attendant) lasted for 6 minutes, 4 days a week at 0.18m/sec. After informed consent, gait assessment rating scale and Berg balance scale were used to determine balance and gait characteristics. We gathered data before and after 6 weeks of therapy. Treatment lasted 6 weeks, 1 hour every day, 4 days a week. Comparing improvement before and after 4 weeks was done in SPSS 26.0. Result: The findings indicated no significant difference between groups (p > 0.05). Rejecting the null hypothesis. Treadmill training with ankle cuff improved gait parameters in children with Down's syndrome more than treadmill training alone (Group B). Conclusion: The study found that treadmill training with weighted ankle cuffs offers more clinical benefits than treadmill training without cuffs in improving gait parameters like cadence, cycle duration, and swing time. Additionally, treadmill inclination positively affects hip, knee, and ank…
subject: Articles
  topic: section
subject: Down Syndrome
  topic: keywords
subject: Posture
  topic: keywords
subject: Gait Parameter
  topic: keywords
creator: Asma Iqbal
creator: Bushra Ejaz
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-08-14
publication date: 2025-08-14
doi: 10.66687/jebmr.1.01.2025.3

Antibacterial Prevalence of Multidrug Resistant Pseudomonas Aeruginosa from Critically Ill Patients
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description: Background: Pseudomonas aeruginosa, an adaptive pathogen leads to broad-spectrum infection in human. The treatment of infection is difficult as Pseudomonas aeruginosa is innately imperious to numerous antibiotics. Objective: Therefore, the aim of this study is to investigate multiple drug resistance (MDR) pattern of Pseudomonas aeruginosa. Methods: For this purpose, laboratory based positive samples from different sources including blood, urine, peritoneal fluid and tracheal swabs were selected and then processed for the isolation of MDR Pseudomonas aeruginosa. Bacterial spp. was isolated and purified by using standard microbiological practices. Purified cultures were processed for the bacterial identification by using different staining techniques, morphological, physiological and biochemical analysis. Final characterizations was performed, on the basis of 16S rRNA analysis. For this purpose, genomic DNA was extracted and 16S rRNA primers designed. Gene amplification of 16S rRNA was performed with the help of 16S rRNA primers in TaqMan polymerase chain reaction. Attribute of MDR was assessed by performing antibiotic drug sensitivity reaction. Results: Antibiotic reveled the resistance of Pseudomonas aeruginosa against multiple drugs. For instance, 47% Pseudomonas aeruginosa were resistant to carbimipenem, 46% were resistant to meropenem, 37% were resistant to tazobactam, 56% were resistant to ciprofloxacin, 49% were resistant to gentamycin, 44% were resistant to cetazidmine and 53% were resistant to levofloxacin. Results showed lowest resistance towards tazobactam and highest to ciprofloxacin. The attribute of highest resistance against ciprofloxacin was further evaluated by gene amplification of ciprofloxacin resistant Pseudomonas. Aeruginosa. Gene amplification revealed the 90% ciprofloxacin resistant strains contained the ParC gene. Conclusions: In this study, we concluded that selected Pseudomonas aeruginosa showed high resistant pattern against ciprofolxacine …
subject: Articles
  topic: section
subject: Pseudomonas aeruginosa
  topic: keywords
subject: Antibacterial
  topic: keywords
subject: Drug Resistance
  topic: keywords
creator: Amna Abbas
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-08-14
publication date: 2025-08-14
doi: 10.66687/jebmr.1.01.2025.2

Effects of Reverse Walking with And Without Whole Body Vibration on Postural Balance and Quality of Life in Children with Cerebral Palsy
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description: Background: Cerebral palsy is the most common cause of spasticity and physical disability in children, and spasticity is one of the most common problems in those with neurological disease. It produces non-progressive brain abnormalities, resulting in mobility difficulties and influencing sensation, perception, cognition, behavior, and communication. Spasticity, dyskinesia, and hyperreflexia impair motor control of walking, reaching, and object-gripping precision Objective: To determine the effects of reverse walking with and without Whole-body vibration on postural balance in children with cerebral palsy. Methods: In this randomized clinical trial, 22 subjects aged 6–12 years from both genders and confirmed diagnosis of cerebral palsy having GMFCS levels I & II were included. The study was conducted in Hussain Memorial Hospital, Lahore, over the duration of 6 months. The subjects were divided into two groups; Group A was treated with (Whole Body Vibration + Reverse Walking), and Group B was treated with Reverse Walking alone. They received treatment sessions for 3 days/week for 3 months. Outcomes were measured at baseline and at 12th weeks. Data was analyzed by SPSS version 26. Results: It shows statistically significant results as p= <.001. So, we reject the null hypothesis. Indicates that the mean difference in group A is more than the mean difference in group B, which shows that the whole-body vibration + reverse walking was more effective than reverse walking alone in improving postural balance, reach, and quality of life in cerebral palsy. Conclusions: The current study concluded that reverse walking with and without whole body vibration was effective in improving postural balance, reach, and quality of life in cerebral palsy children. However, whole body vibration and reverse walking provide more clinical benefits than reverse walking alone in improving postural balance, side reach, and quality of life. Whereas both techniques were equally effective in improvi…
subject: Articles
  topic: section
subject: Cerebral Palsy
  topic: keywords
subject: Whole Body Vibration
  topic: keywords
subject: Quality of Life
  topic: keywords
subject: Reverse Walking
  topic: keywords
creator: Hira Adrees
creator: Maham Masood
rights: Copyright (c) 2025 Journal of Evidence-Based Medical Research
date: 2025-08-14
publication date: 2025-08-14
doi: 10.66687/jebmr.1.01.2025.1