Journal of the Pakistan Medical Association最新文献_第4页

Predic tors o f i n-hospital m or tality in patients requiring tr an sfer to the me dical in tensive care unit.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.20092

Huzefa Jibril, Muhammad Azhar, Ainan Arshad, Safia Awan, Syed Ahsan Ali, Muhammed Tariq

{"title":"Predic tors o f i n-hospital m or tality in patients requiring tr an sfer to the me dical in tensive care unit.","authors":"Huzefa Jibril, Muhammad Azhar, Ainan Arshad, Safia Awan, Syed Ahsan Ali, Muhammed Tariq","doi":"10.47391/JPMA.20092","DOIUrl":"https://doi.org/10.47391/JPMA.20092","url":null,"abstract":"Objective: To identify the factors associated with higher odds of in-hospital mortalit y among inpatients requiring transfer to the medical intensive care unit.Methods: The ret rospective audit was conducted from Ap r il 1 to September 30, 2023, at The Aga Khan University Hospital, Karachi, Pak is t an and com prised dat a from January 1 , 2018, to December 31, 20 22, of patients initially admitted to the general ward or high dependency unit in the Department of Medicine who required transfer to the medical intensive care unit during hospitalisation. Data was analysed using SPSS 23.Results: Of the 601 patients with mean age 53.6±17.4 years, 373(62.1%) were males. Overall, 321(53.6%) of the patients expired while in the hospital. Patient s w hose t r ansfer t o the intensive care un it wa s initi ate d withi n 48 hours of admission had l o wer in-hospital mortality co mpared to those whose transfer wa s initiated beyond 48 hours of admission (p=0.004). Patients with a his to r y of autoimmune disease or mali gnancy as co -morbid conditions, o r a primary discharge diagnosis of sepsis had higher odds of in-hospital mor tality (p<0.05).Conclusion: In-hospital mortality in patients requiring transfer to the intensive care unit was found to be very high. Early transfer to intensive care unit could lead to improved survival rate.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"429-433"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does intraoperative neuromonitoring during thyroidectomy reduce the risk of hypoparathyroidism?

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.10752

Zehra Zeynep Keklikkiran, Ezgi Tatlisu, Muzaffer Akinci, Gamze Citlak

{"title":"Does intraoperative neuromonitoring during thyroidectomy reduce the risk of hypoparathyroidism?","authors":"Zehra Zeynep Keklikkiran, Ezgi Tatlisu, Muzaffer Akinci, Gamze Citlak","doi":"10.47391/JPMA.10752","DOIUrl":"https://doi.org/10.47391/JPMA.10752","url":null,"abstract":"Objectives: To evaluate the effect of intraoperative neuromonitoring on postoperative hypoparathyroidism after bilateral total thyroidectomy.Methods: The prospective study was conducted at the General Surgery Clinic of the University of Health Sciences Haseki Training and Research Hospital, Turkiye, from February 2016 to December 2020, and comprised patients who had undergone bilateral total thyroidectomy. They were evaluated for recurrent laryngeal nerve damage, hypocalcaemia and hypoparathyroidism. Further, it was explored whether the use of intraoperative neuromonitoring had an effect on postoperative complications between experienced surgeons with >5 years of experience and lessexperienced surgeons with <5 years of experience. Data was analysed using SPSS 15.Results: Of the 64 patients 59(92.2%) were females and 5(7.8%) were males. The overall mean age was 47.7±10.8 years. Experienced surgeons operated 38(59.4%) patients, while the less experienced operated 26(40.6%). The most common complications were transient hypocalcaemia 38(59.3%) and transient unilateral vocal cord paralysis 9(14%). There was no significant difference between experienced surgeons and less experienced surgeons in terms of postoperative complications (p>0.05).Conclusions: The use of intraoperative neuromonitoring during bilateral total thyroidectomy reduced the risk of hypoparathyroidism regardless of the surgeon's experience.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"388-392"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Squamous cell carcinoma; a rare complication of long-standing renal stones: Case report and an overview.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.20471

Hamad Ali Shah, Asaf Alam Khan, Syed Munim Hussain, Muhammad Arsalan Ali

引用次数: 0

Unveiling the enigma: Thyroid-like follicular carcinoma of the left kidney.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.11427

Nauman Zafar, Saud Iqbal, Shujah Muhammad, Nadeem Bin Nusrat, Assad Ur Rehman, Saira Imtiaz

{"title":"Unveiling the enigma: Thyroid-like follicular carcinoma of the left kidney.","authors":"Nauman Zafar, Saud Iqbal, Shujah Muhammad, Nadeem Bin Nusrat, Assad Ur Rehman, Saira Imtiaz","doi":"10.47391/JPMA.11427","DOIUrl":"https://doi.org/10.47391/JPMA.11427","url":null,"abstract":"Thyroid-like follicular carcinoma of the kidney (TLFCK) is a rare renal cancer, not aligning with established renal cell carcinoma subtypes. Histologically akin to primary thyroid follicular carcinoma, TLFC poses diagnostic challenges due to absent thyroid immunohistochemistry markers. This case details a 40-year-old army personal, previously hypertension-free, presenting with bilateral flank pain and severe haematuria. Imaging revealed a 5.5 × 5 cm calcified lesion in the left kidney, suggestive of renal cell carcinoma (T3aN0Mx). Immunohistochemistry confirmed the diagnosis, with positive Paired box gene 8 (PAX8), Cytokeratin 7 (CK7) and Carbonic anhydrase IX (CAIX) and negative Cluster of differentiation 10 (CD10), Alpha-methyl acyl-CoA racemase (AMACR), Cluster of differentiation 117(CD117), Thyroid transcription factor 1 (TTF1) and thyroglobulin. The tumour was confined to the kidney, with clear margins. Subsequently, signs of metastasis prompted systemic treatment initiation with immunotherapy and tyrosine kinase inhibitors, emphasizing diagnostic intricacies and therapeutic complexities associated with TLFC.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"485-487"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of family support on psychological adjustment of physically handicapped adolescents.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.10737

Madiha Zainab, Mamoona Ismail Loona, Seema Zahid

{"title":"Effect of family support on psychological adjustment of physically handicapped adolescents.","authors":"Madiha Zainab, Mamoona Ismail Loona, Seema Zahid","doi":"10.47391/JPMA.10737","DOIUrl":"https://doi.org/10.47391/JPMA.10737","url":null,"abstract":"Objective: To assess the effect of family support on psychological adjustment of physically handicapped adolescents, and to assess gender differences in this regard.Methods: The cross-sectional study was conducted in Rawalpindi and Islamabad, Pakistan, from May to July 2023, and comprised male and female physically handicapped adolescents living in joint family systems. Data was collected using standardised tools, including Family Support Scale and Psychological Adjustment Scale. The relationships between perceived family support and psychological adjustment were explored. The relationships between perceived family support and psychological adjustment were analyzed using descriptive statistics, correlation, t-test and regression analysis via SPSS version 22.0.Results: Out of total 150 individuals participants were 56(37%) and male participants were 94 (63%). The age range for the participants was 13 to 18 years (15.5±1.8) Increased family support meant increased psychological adjustment (p<0.05). There was no significant gender difference (p>0.01) in this regard.Conclusions: Family support was a strong predictor of psychological adjustment among physically handicapped adolescents, while gender difference in this regard was not significant.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"383-387"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stereotypical depiction of Erdheim-Chester Disease on Tc-99m MDP skeletal scintigraphy.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.25-23

Syeda Azam Najam, Xain Tauqeer, Aamna Hassan, Kashif Siddique

引用次数: 0

Effects of physical therapy on improving disc height index, postural stability, pain and function in persons with discogenic low back pain.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.20384

Muhammad Osama, Aamer Naeem, Sameen Tariq, Sumera Mushtaq, Furqan Ahmed Siddiqi, Sabah Afridi

{"title":"Effects of physical therapy on improving disc height index, postural stability, pain and function in persons with discogenic low back pain.","authors":"Muhammad Osama, Aamer Naeem, Sameen Tariq, Sumera Mushtaq, Furqan Ahmed Siddiqi, Sabah Afridi","doi":"10.47391/JPMA.20384","DOIUrl":"https://doi.org/10.47391/JPMA.20384","url":null,"abstract":"Objective: To determine if physical therapy is capable of improving disc height index, pain, functional disability, lumbar range of motion, postural stability and gait in persons with discogenic low back pain.Methods: A quasi-experimental study was conducted at the Foundation University College of Physical Therapy, Foundation University, Islamabad, and Radiology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan, from May 2022 to June 2023, and comprised patients of either gender having postero-lateral disc herniation and discogenic low back pain. Pain was assessed using the visual analogue scale, disc height index was measured via magnetic resonance imaging, postural stability was evaluated using the Biodex balance system, lumbar range of motion was measured via inclinometer, and functional disability was assessed using the Oswestry disability index. Treatment protocol spanned 2 weeks and consisted of 5 supervised sessions per week. The protocol included interferential therapy combined with heating pack, Mckenzie's extension bias protocol, manual lumbar traction and rotational mobilisation. Data was collected at baseline and postintervention. Data was analysed using SPSS 21.Results: Of the 22 patients, 18(81.8%) were males and 4(18.2%) were females. The overall mean age was 40.13±10.08 years, mean weight was 70.54±11.38kg and mean height was 160.58±13.52 cm. A significant improvement was noted in terms of all outcome measures post-intervention compared to baseline values (p<0.05) except for cadence (p>0.05).Conclusions: Physical therapy showed promising results in terms of improving disc height index in subjects with discogenic low back pain, along with pain, functional disability, lumbar range of motion, postural stability and gait.Clinical trial number: https://clinicaltrials.gov/study/NCT05326594.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"378-382"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of pulmonary function tests and vitamin D level in pre and postmenopausal women.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.11432

Saima Zareen, Faraz Ahmed Bokhari, Sibgha Zulfiqar

{"title":"Evaluation of pulmonary function tests and vitamin D level in pre and postmenopausal women.","authors":"Saima Zareen, Faraz Ahmed Bokhari, Sibgha Zulfiqar","doi":"10.47391/JPMA.11432","DOIUrl":"https://doi.org/10.47391/JPMA.11432","url":null,"abstract":"Objectives: To assess the increased risk of vitamin D deficiency in postmenopausal women, and its correlation with pulmonary function decline in both premenopausal and postmenopausal women.Methods: The cross-sectional, comparative study was conducted at the Physiology Department, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, Pakistan, from May 2019 to May 2020. Healthy premenopausal women having regular menstrual cycles aged at least 40 years were placed in group 1, while healthy postmenopausal women having no menstruation for the preceding 12 months with maximum age 55 years were placed in group 2. Serum vitamin D levels were determined using enzyme-linked immunosorbent assay, and pulmonary functions by spirometry. Groups 1 and 2 were divided into hypovitaminosis and vitamin D-sufficient subgroups 1A, 1B, 2A and 2B. Data was analysed using SPSS 21.Results: Of the 120 female subjects, 60(50%) were in each group. Mean age in years of group 1(premenopausal group) was 46.03±2.35. Mean age in years of group 2 (postmenopausal group) was 52.72±1.43. Mean body mass index was 23.0± 2.59kg/m2 in group 1 compared to 24.14±2.76kg/m2 in group 2. Mean serum vitamin D level was 42.91±16.94ng/ml in group 1, and 27.42±6.70ng/ml in group 2 (p=0.001). The percentage predicted value of age for forced expiratory volume in 1 second, forced vital capacity, and the ratio between the two in group 1 were 82.95±2.75%, 83.10±2.65% and 0.998±0.003% respectively. In group 2, the corresponding values were 79.48±1.20%, 79.12±1.40% and 1.004±0.010% (p<0.05). The values for forced expiratory volume in 1 second, forced vital capacity, and the ratio between the two were significantly different in subgroups 1B and 2B compared to 1A and 2A (p<0.05).Conclusions: Vitamin D deficiency was found to be related to the deterioration of pulmonary functions in both premenopausal and postmenopausal groups.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"414-417"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Frequency of complications in ultrasound-guided percutaneous nephrostomy: An analysis using the modified clavien classification system.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.21201

Muhammad Danial Iqbal, Mushtaq Ahmed, Ahmad Waleed, Tanzeel-Ur-Rahman Gazder, Syed Rabiullah, Hafiz Muhammad Saad

{"title":"Frequency of complications in ultrasound-guided percutaneous nephrostomy: An analysis using the modified clavien classification system.","authors":"Muhammad Danial Iqbal, Mushtaq Ahmed, Ahmad Waleed, Tanzeel-Ur-Rahman Gazder, Syed Rabiullah, Hafiz Muhammad Saad","doi":"10.47391/JPMA.21201","DOIUrl":"https://doi.org/10.47391/JPMA.21201","url":null,"abstract":"Objective: To determine the frequency of complications following percutaneous nephrostomy using the Modified Clavien Classification System in patients with urinary tract obstruction in a tertiary care setting.Methods: The observational study was conducted at the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, from August 18, 2022, to February 17, 2023, and comprised individuals of either gender aged 16- 70 years who were experiencing different types of urinary tract obstructions. The patients were subjected to percutaneous nephrostomy, and they were monitored for 15 days after the surgery. Complications post-procedure were noted using the Modified Clavien Classification System. Data was analysed using SPSS 26.Results: Of the 90 patients with mean age 50.19±14.70 years, 53(58.9%) were males and 37(41.1%) were females. Grade I complications were observed in 37(41.1%) cases, grade II 8(8.9%), grade IIIa 11(12.2%), and grade IVa in 1 (1.1%) case. No complications were observed in 33(36.7%) cases. Complications were not significantly associated with age, gender, body mass index, site of insertion and comorbidities (p>0.05).Conclusions: The most common complication observed in patients with urinary tract obstruction was grade I, followed by grade IIIA, while grade IVA had the least common incidence.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"447-450"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A comparative of multiple rib fractures with embracing fixators and riblocking titanium plates.

IF 0.8 4区医学

Journal of the Pakistan Medical Association Pub Date : 2025-03-01 DOI: 10.47391/JPMA.20047

Wu Wen, Yong Qiao

{"title":"A comparative of multiple rib fractures with embracing fixators and riblocking titanium plates.","authors":"Wu Wen, Yong Qiao","doi":"10.47391/JPMA.20047","DOIUrl":"https://doi.org/10.47391/JPMA.20047","url":null,"abstract":"Objective: To compare the clinical efficacy and safety between embracing fixator and rib-locking titanium plate in the treatment of multiple rib fractures.Methods: The retrospective study was conducted at the Sichuan Province Orthopaedics Hospital, China, and comprised clinical data from January 2020 to December 2022 of patients with multiple rib fractures. The patients were divided into the embracing fixator group A and rib-locking titanium plate group B. Data was analysed using SPSS 22.Results: Of the 100 patients, 50(50%) were in each of the two groups. There were 35(70%) males and 15(30%) females in group A with mean age 51.38±10.62 years (range: 25-62 years) compared to 33(66%) males and 17(34%) females with mean age 51.48±10.93 years (range: 27-65 years) (p>0.05). Surgical duration and incisional length were shorter, and the blood loss was smaller in group B compared to group A (p<0.05). Three months after treatment, the visual analogue scale VAS) score of group B was lower than group A (p<0.05). All markers of pulmonary function significantly improved both groups (p<0.05) compared to baseline values, but group B patients showed more and better improvement than group A (p<0.05). There was no significant difference in terms of the incidence of complications between the groups (p>0.05).Conclusions: The rib-locking titanium plate treatment for multiple rib fractures showed the advantages of minimal trauma, simple operation, minimal bleeding, low postoperative pain, significant improvement in lung function, and no increase in postoperative complications.","PeriodicalId":54369,"journal":{"name":"Journal of the Pakistan Medical Association","volume":"75 3","pages":"424-428"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0