Pakistan Journal of Medical Sciences最新文献

{"title":"Correlation of risk factors for ischemic stroke with uric acid/creatinine ratio and cerebral vascular hemodynamic index (CVHI) in physical examination population.","authors":"Xue Bai, Hui Wang, Jiangzhe Li, Jinjin Xu, Pan Cai","doi":"10.12669/pjms.41.3.9912","DOIUrl":"10.12669/pjms.41.3.9912","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk of ischemic stroke, uric acid/creatinine ratio, cerebral vascular hemodynamic index (CVHI) and risk factors of stroke in physical examination population.</p><p><strong>Methods: </strong>This was a retrospective study. Four hundred cases undergoing physical examination at physical examination center in Baoding No.1 Central Hospital from January 2023 to December 2023 were selected as subjects, and their general data were collected. They were divided into low ratio group, medium ratio group and high ratio group depending on the uric acid/creatinine ratio, and were classified as high-risk group, medium-risk group and low-risk group as per CVHI, the general data of all subjects were compared and analyzed.</p><p><strong>Results: </strong>Multifactorial Logistic regression analysis was performed after assignment of stroke risk factors as dependent variables yielding that advanced age, smoking, alcohol abuse, hypertension, diabetes mellitus, BMI, hyperlipidemia, and hyperuricemia were risk factors for ischemic stroke(<i>P</i><0.05). Those with high uric acid/creatinine ratio were markedly higher than those with medium and low ratio in the proportion of alcohol abuse, hypertension, diabetes mellitus, and hyperlipidemia, with statistically significant differences (<i>P</i><0.05). Obesity, advanced age, smoking, hypertension, diabetes mellitus, and hyperlipidemia were obviously higher in the high-risk group for stroke than in the medium- and low-risk groups, with statistically significant differences (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>Risk factors for ischemic stroke predispose to older age groups, and are linked to underlying medical conditions, especially in those with high uric acid/creatinine ratios and those at high risk of stroke. The SUA/Cr ratio is negatively correlated with the CVHI score.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"804-809"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of nerve conduction velocity slowing and its association with the severity of diabetic polyneuropathy, duration of diabetes and glycemic control in diabetic patients.","authors":"Saba Zaidi, Ayesha Abdul Samad","doi":"10.12669/pjms.41.3.10397","DOIUrl":"10.12669/pjms.41.3.10397","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the nerve conduction velocity in diabetic patients and its association with diabetes duration, control and severity of diabetic polyneuropathy.</p><p><strong>Methods: </strong>This prospective, observational study involved a hundred and thirty-nine patients who underwent nerve conduction studies in the Neurology Department at Liaquat National Hospital during the years June 2023 till May 2024. In all patients, the medical history was taken by direct interview regarding demographics, diabetes duration and recent HbA1c. For the assessment of diabetic polyneuropathy, the NDS-neuropathy disability score was used. The acquired data was entered into SPSS Statistics software for analysis of significant associations between these variables. Statistical significance was defined as a P-value below 0.05.</p><p><strong>Results: </strong>In this study, we investigated 139 patients with a mean age of 62.20±12.03 years, comprising 60.4% males. The mean HbA1c was 7.46±1.09%, and the mean duration of diabetes was 10.78±7.75 years. Most patients (75.5%) had poor glycemic control, with 92.8% having Type-II diabetes. The mean neuropathy disability score was 5.63±2.39, with 80.6% of patients experiencing neuropathy. Nerve conduction velocity slowing was detected in 54.7% of the patients. Notably, significant associations were found between nerve conduction velocity slowing and diabetes duration (p=0.019), and neuropathy disability score (p=0.000).</p><p><strong>Conclusion: </strong>Our findings indicate that male gender, poor glycemic control, and a longer duration of diabetes are associated with slowing of nerve conduction velocity. Additionally, the severity of neuropathy, as measured by the Neuropathy disability score, further strengthens these associations, highlighting its significance in assessing diabetic neuropathy progression.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"699-705"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of ERAS-Based Rapid Bladder Irrigation on TURP and HoLEP in the Treatment of Benign Prostatic Hyperplasia.","authors":"Shuhui An, Haoxuan Yang, Qingsong Meng","doi":"10.12669/pjms.41.3.9751","DOIUrl":"10.12669/pjms.41.3.9751","url":null,"abstract":"<p><strong>Objective: </strong>To explore the positive effect of rapid bladder irrigation in postoperative BPH patients by collecting and analyzing the efficacy and complications of TURP and HoLEP treatments for patients with benign prostatic hyperplasia (BPH) under ERAS care.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 197 BPH patients undergoing surgical treatment at the Second Hospital of Hebei Medical University from April 2022 to February 2024. All patients received rapid bladder irrigation under ERAS care, which involves flushing the bladder with a larger volume of saline solution in a shorter time postoperatively compared to conventional bladder irrigation care. Afterward, clinical data and postoperative irrigation indicators for each group were collected and analyzed.</p><p><strong>Results: </strong>Patients in the T1 group were observed with larger prostate volume, longer operation time, and more intraoperative blood loss than those in the T2 group, but with shorter duration of indwelling urinary catheters, shorter irrigation time, and shorter hospital stays (P<0.05). Meanwhile, the H1 group saw lower mean irrigation volume and shorter irrigation time than the H2 group. Differences were found between the T1 and H1 groups in terms of mean irrigation volume and irrigation time (P<0.05), Additionally, patients in the T2 group had lower prostate volume than those in the H2 group, with differences in mean irrigation volume and irrigation time (P<0.05).</p><p><strong>Conclusion: </strong>ERAS concept complements rapid bladder irrigation, which shortens the time to self-care recovery and discharge, thereby facilitating faster postoperative recovery for BPH patients.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"693-698"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of probiotics combined with metformin and a calorie-restricted diet in obese patients with polycystic ovary syndrome.","authors":"Jin Luo, Zhenyu Li, Zhibin Wang, Yashuang Ding, Peng Gao, Yuping Li","doi":"10.12669/pjms.41.3.10554","DOIUrl":"10.12669/pjms.41.3.10554","url":null,"abstract":"<p><strong>Objective: </strong>To explore the efficacy of probiotics combined with metformin and a calorie-restricted diet in obese patients with polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>Clinical data of 141 obese PCOS patients treated in the 73rd Group Army Hospital from June 2021 to December 2023 were retrospectively analyzed. Patients were grouped according to the treatment records: metformin group (n=69), patients treated with metformin and a calorie-restricted diet) and combined group (n=72, patients treated with probiotics combined with metformin and a calorie-restricted diet). Levels of endocrine hormone indicators, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Fasting blood glucose (FPG), gut microbiota status, and Body mass index (BMI) were compared before and after the treatment in two groups.</p><p><strong>Results: </strong>After the treatment, the levels of endocrine hormone indicators, HOMA-IR, and FPG in both groups were significantly reduced compared to pre-treatment levels and were significantly lower in the combined group compared to the metformin group (<i>P</i><0.05). Abundance of gut microbiota and Shannon Wiener diversity index in both groups significantly increased after the treatment and were markedly higher in the combined group than in the metformin group (<i>P</i><0.05). Treatment led to a significant reduction in the body mass index (BMI) in all patients (<i>P</i><0.05). However, post-treatment BMI was comparable in the two groups (<i>P</i>>0.05).</p><p><strong>Conclusions: </strong>In obese patients with PCOS, adding probiotics to the metformin and calorie-restricted diet regimen is more effective in regulating hormone levels, improving blood sugar and insulin resistance, regulating gut microbiota status, and reducing BMI than metformin combined with calorie-restricted diet alone.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"657-661"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The human cost of Type-2 diabetes mellitus: Uncovering the hidden burden on quality of life.","authors":"Shireen Javed, Mahaneem Mohamed, Benash Altaf, Wan Syaheedah Wan Ghazali","doi":"10.12669/pjms.41.3.10841","DOIUrl":"10.12669/pjms.41.3.10841","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of Type 2 diabetes mellitus (T2DM) on quality of life (QOL) and compare it with healthy subjects.</p><p><strong>Method: </strong>This case-control study was conducted at Aziz Fatimah Hospital and Aziz Fatimah Medical and Dental College, Faisalabad, Pakistan, from May 2023 to January 2024. A total of 170 subjects were included in the study through purposive sampling technique. Fasting and random blood glucose levels were measured using an enzymatic colorimetric test. HbA1c was determined with the Bioherms A1C EZ 2.0 Glyco-hemoglobin Test Kit. QOL was assessed using the Short Form-36 version 1 questionnaire. Statistical analysis was performed using SPSS version 26, with p ≤ 0.05 considered significant.</p><p><strong>Results: </strong>The study included 86 T2DM patients and 84 controls, with a mean age of 49.23 ± 12.59 years. Among the participants, 44.7% were male and 55.3% were female. T2DM patients scored lower in physical functioning, limitations due to physical health, bodily pain and vitality subscale compared to controls (p = 0.003, 0.050, 0.030, 0.000 respectively). Both groups had physical component summary and mental component summary (MCS) scores below 50, indicating impaired QOL. MCS scores were significantly lower in T2DM patients than in controls (p = 0.002). Females scored lower in vitality (p = 0.0005) and bodily pain (p = 0.031). T2DM patients with less than five years of duration had lower SF-36 scores than those with longer duration.</p><p><strong>Conclusion: </strong>T2DM impairs quality of life, especially in females and those with less than five years of disease duration, who face a greater negative impact.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"712-718"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the chemotherapy effect of albumin-bound paclitaxel combined with pirarubicin and cyclophosphamide on breast cancer and the effects of PCR, ORR, and CBR.","authors":"Youzhong Liu, Ke Gong, Songlin Yuan, Yong Xu","doi":"10.12669/pjms.41.3.9861","DOIUrl":"10.12669/pjms.41.3.9861","url":null,"abstract":"<p><strong>Objective: </strong>To explore the chemotherapy effect of albumin-bound paclitaxel combined with pirarubicin and cyclophosphamide on breast cancer and the effects of PCR, ORR and CBR.</p><p><strong>Methods: </strong>This was a retrospective study. During the period from January 2022 to December 2023, ninety patients with breast cancer who were treated in The First People's Hospital of Changde City were included as the research objects. Based on the principle of randomized control, the above patients were divided into the control group (45 cases, treated with pirarubicin and cyclophosphamide) and the observation group (45 cases, treated with albumin-bound paclitaxel combined with pirarubicin and cyclophosphamide) by the random number table. Compared the chemotherapy effect and safety of the two groups.</p><p><strong>Results: </strong>After treatment, the PCR, ORR and CBR of the observation group were higher than those of the control group, while the levels of CA152, CA125, TPS, HER-2, Ki-67 and EGFR were lower than those of the control group, and the differences were statistically significant (<i>P</i><0.05). The incidence of adverse reactions was 33.33% (15/45), which was slightly higher than that of 28.89% (13/45) in the control group, the difference was not statistically significant (<i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Albumin-bound paclitaxel combined with pirarubicin and cyclophosphamide is a safe regimen that can further enhance the effect of neoadjuvant chemotherapy in the treatment of breast cancer, and it has a certain value for dissemination in the treatment of breast cancer can further enhance the effect of neoadjuvant chemotherapy in patients, which is of certain value for clinical promotion.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"769-773"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and validation of nomogram model for chronic postsurgical pain in patients after total knee arthroplasty: A retrospective study.","authors":"Shenghao Zhao, Ying Hu, Ye Li, Jie Tang","doi":"10.12669/pjms.41.3.11525","DOIUrl":"10.12669/pjms.41.3.11525","url":null,"abstract":"<p><strong>Objective: </strong>Chronic postsurgical pain (CPSP) after total knee arthroplasty (TKA) is the most common postoperative complication in orthopedics. This study aims to explore the risk factors for CPSP after TKA and construct a nomogram model.</p><p><strong>Methods: </strong>This retrospective study included clinical records of 430 patients who received TKA treatment at Wuhan Fourth Hospital between January 2020 to January 2024. Patients were randomly divided into a training cohort (n=301) and a validation cohort (n=129) in a 7:3 ratios. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm and logistic regression analysis were used to identify the independent risk factors, and a predictive nomogram model was established based on the identified risk factors. The concordance index (C-index), calibration curve, receiver operating characteristic (ROC) curve and decision curve analysis were used to assess the predictive accuracy and clinical application value of the nomogram model.</p><p><strong>Results: </strong>Six risk factors for predicting CPSP were identified, including preoperative anxiety, preoperative depression, preoperative pain, duration of tourniquet use, pain upon discharge, and postoperative C-reactive protein levels. The nomogram model demonstrated sufficient predictive accuracy, with the area under the curve (AUC) values of 0.761 (95% CI: 0.689-0.833) and 0.806 (95% CI: 0.700-0.911) in the training cohort and validation cohort, respectively. The C-index of the training cohort and validation cohort were 0.733 and 0.761, respectively. The calibration curve shows good consistency between the predicted risk of the model and the actual risk of CPSP. Decision curve analysis (DCA) demonstrated the clinical applicability of the model.</p><p><strong>Conclusions: </strong>The nomogram model established in this study for predicting CPSP after TKA has good predictive value and may be used in clinical practice to identify patients at high risk of developing CPSP after TKA.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"780-787"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower urinary tract symptoms and hematuria in Rheumatoid arthritis (LUTH-RA) study.","authors":"Abrar Ahmed Wagan, Paras","doi":"10.12669/pjms.41.3.8316","DOIUrl":"10.12669/pjms.41.3.8316","url":null,"abstract":"<p><strong>Objective: </strong>To determine the frequency of hematuria and lower urinary tract problems in rheumatoid arthritis cohort.</p><p><strong>Method: </strong>This cross sectional prospective study was conducted at department of Rheumatology Indus Medical College Tando Mohammad Khan from August 1, 2022 to March 3, 2023. Total 229 patients were selected after written and informed consent; demographic details were taken. Bristol Female Lower Urinary Tract Questionaries' (BFLUTS) was filled and all male participants were asked for ultrasound scan of prostate and freshly voided midstream urine was collected for microscopic hematuria.</p><p><strong>Results: </strong>In this study the prevalence of Lower Urinary Tract Symptoms (LUTS) was (77.3%) and microscopic hematuria (34.5%). Major symptoms of LUTS were: nocturia (69%), bladder pain (35.4%), leaking before going to toilet (40.6%), frequency of incontinence (24.5%), nocturnal incontinence (27.9%), sex life spoiled due to urinary symptoms (22.7%), avoid situation where no toilet (30.1%) and overall interference of life (32.8%) cases. A significant association of DAS-28 with LUTS and microscopic hematuria was seen (p<0.01).</p><p><strong>Conclusion: </strong>Lower urinary tract problems and microscopic hematuria are common in both genders, and severity of RA, increases LUTS and affects quality of life.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"876-879"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steps initiated for sustainability of faculty mentorship program at Aga Khan University Medical College: A mixed method study.","authors":"Rehana Rehman, Fauzia Khan, Tazeen Saeed Ali, Rahila Ali","doi":"10.12669/pjms.41.3.10856","DOIUrl":"10.12669/pjms.41.3.10856","url":null,"abstract":"<p><strong>Objective: </strong>To investigate and address challenges in faculty mentorship for sustainability of Faculty Mentorship Program (FMP) at Aga Khan University Medical College (AKU-MC).</p><p><strong>Methods: </strong>This is a mixed method study conducted from June 2021 to December 2023 at AKU-MC. It comprises of the exploration of qualitative insights into the challenges faced by mentors, mentees, and administrators, also incorporating quantitative measures of success to evaluate the sustainability of the program over time. Data was retrieved from four Focus group discussions (FGD) with mentors and mentees, eight in depth interviews with the administrators of FMP and leadership. Challenges of faculty mentorship were further identified by a panel discussion and briefing sessions with faculty members of different departments at AKU-MC. Challenges identified by three data sets were presented to the FMP committee, discussed in forum meetings and recommendations were proposed for the sustainability of the program.</p><p><strong>Results: </strong>During the interviews, mentors revealed 'Limited Training and 'Lack of Recognition' as key challenges whereas mentees mentioned deficient skills in planning developmental goals. Administrators mentioned the need to enhance the visibility of the program as well as to update the resources. Panel discussion highlighted the need for recognition of mentors and providing them with protected time. Departmental meetings endorsed the need for sequential training of both mentors and mentees. To address these challenges educational grand rounds, international conferences and webinar were conducted to enhance the visibility of the program. Mentors were acknowledged by appreciation emails and tokens of appreciation. A series of workshops to enhance mentoring skills were planned and executed.</p><p><strong>Conclusion: </strong>The FMP at AKU-MC has devised a stepwise strategy to address challenges in faculty mentorship. This approach emphasizes collaboration with departments and the active involvement of leadership. By incorporating rewards, recognition, and a series of workshops, the program aims to foster a strong mentorship culture within the university. These efforts align with the objective of investigating and resolving mentorship challenges to ensure the sustainability of the Faculty Mentorship Program at AKU-MC.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"798-803"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Developmental Dysplasia of Hip in Pakistan: Insights from the Paediatric Orthopaedic Registry Pakistan (PORP).","authors":"Anisuddin Bhatti, Marium Habib Soomro, Muhammad Amin Chinoy, Atiq Uz Zaman, Muhammad Aslam Baloch, Pervez Ali, Mansoor Ali Khan, Umair Nadeem, Muhammad Badaruddin Zafir, Muhammad Jamil, Asif Peracha, Mehtab Ahmed Pirwani, Zakiuddin Ahmed","doi":"10.12669/pjms.41.3.10922","DOIUrl":"10.12669/pjms.41.3.10922","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine prevalence, risk factors and geographic distribution of Developmental Dysplasia of the Hip in Pakistan and to assess the cumulative outcomes of various treatments used and propose recommendations to establish preventive strategies and best treatment practices in Pakistan.</p><p><strong>Methods: </strong>This multicentric retrospective study was conducted with analysis of data from DDH section of PORP registry of Pakistan. The data was uploaded by 1,3-11 authors, which were treated during last three decades. The evaluation parameters included 25 variables of basic demographics of patients, geographic prevalence, characteristics of DDH and related risk factors. The data was also analyzed to know methods of treatment used and cumulative outcomes in various age groups and severity of dysplasia.</p><p><strong>Results: </strong>The study included 755 patients with 1,107 affected hips, aged one day to over eight years. Of these, 86.25% were diagnosed after 18 months, 11.7% were over eight years. Among 104 neonates, 23% had neonatal screening. The female-to-male ratio was 3:1. 21% had history of DDH in family, and 24% were from remote rural areas. 46.6% had bilateral DDH. 48.43% patients had significantly obtuse acetabular index >45°. The acetabular index (AI) found highly associated with age bilaterally (p=0.001). 88% of normal unilateral hips had AI <30°, and 11% have moderate dysplasia of 30°-45°. 129 patients were treated non-operatively with 83.72% success rate at minimum three years follow-up. The failure rate of Pavlik harness was 25%. Six hundred twenty six (626) patients underwent open reduction with 70.42% success rate at minimum one year follow-up. Most failures in conservative and operative treatment were on one side of bilateral cases. Late complications over 10 years follow-up was short femoral neck offset, coxa magna and residual acetabular dysplasia.</p><p><strong>Conclusion: </strong>This study leverages PORP registry data to identify DDH demographics, risk factors, and treatment outcomes. It highlights the need for establishment of MSK screening protocols, to diagnose DDH at earliest, to prevent development of disability of late treatment and enhance best practices in DDH management.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 3","pages":"668-675"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}