Journal of the College of Physicians and Surgeons--Pakistan : JCPSP最新文献

{"title":"Clinical Features and Coinfection Factors of Severe Community-Acquired Pneumonia with <em>Mycoplasma Pneumoniae</em> in Children.","authors":"Sheng Wang, Fang Deng","doi":"10.29271/jcpsp.2026.04.483","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.483","url":null,"abstract":"<p><strong>Objective: </strong>To characterise the clinical features of children with severe community-acquired pneumonia (CAP) associated with Mycoplasma pneumoniae (Mp) infection and to identify factors influencing polymicrobial coinfections.</p><p><strong>Study design: </strong>A descriptive study. Place and Duration of the Study: Department of Internal Medicine, Anhui Provincial Children's Hospital, Anhui, China, from January to December 2023.</p><p><strong>Methodology: </strong>A retrospective cohort study was conducted on 207 hospitalised children aged <16 years with confirmed CAP who underwent BALF testing due to severe symptoms, antibiotic-unresponsive fever, or unclear aetiology. Those with chronic comorbidities were excluded. BALF pathogens were detected via multiplex PCR and metagenomic next-generation sequencing (mNGS). Patients were divided into Mp mono-infection and coinfection groups; demographic, clinical, and laboratory data were compared, and logistic regression analysis was performed to identify factors associated with coinfection.</p><p><strong>Results: </strong>The coinfection group was significantly younger (4.12 ± 2.83 vs. 6.56 ± 2.47 years, p = 0.013) and had longer hospital stays (11.21 ± 4.26 vs. 9.90 ± 3.68 days, p = 0.049) than the mono-infection group. Inflammatory markers differed significantly: the coinfection group had higher IL-6 (28.64 ± 8.03 vs. 15.86 ± 14.21 pg/mL, p <0.001), but lower IL-2R (1774.15 ± 104.18 vs. 2157.39 ± 382.76 U/mL, p <0.001) and ESR (30.31 ± 14.79 vs. 40.08 ± 13.66 mm/h, p <0.001). Logistic regression confirmed IL-6 (p <0.001), IL-2R (p <0.001), and complications (p = 0.0281) as independent factors associated with coinfections, while chest CT findings showed no correlation (p >0.05).</p><p><strong>Conclusion: </strong>Younger age, elevated IL-6 levels, reduced IL-2R levels, and the presence of complications are closely correlated with polymicrobial coinfections in children with severe Mp-associated CAP.</p><p><strong>Key words: </strong>Pneumonia, Mycoplasma pneumoniae, Paediatrics, Coinfection, Metagenomic sequencing, Clinical characteristics.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"483-488"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Detection of Oral Leukoplakia from Intraoral Images.","authors":"Gaye Keser, Hakan Yulek, Filiz Namdar Pekiner","doi":"10.29271/jcpsp.2026.04.526","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.526","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of deep learning-based diagnostic software in identifying oral leukoplakia (OL) lesions from intraoral patient photographs.</p><p><strong>Study design: </strong>An observational study. Place and Duration of the Study: Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkiye, from February to November 2024.</p><p><strong>Methodology: </strong>A dataset comprising 222 anonymised retrospective intraoral images, confirmed as OL via incisional biopsy, was labelled using the polygonal annotation tool in CranioCatch software. Expert reviewers validated all annotations. The dataset was split into training (n = 178), validation (n = 22), and test (n = 22) subsets. The models used for lesion detection included YOLOv5, YOLOv8, Mask R-CNN, and U-Net. The model's effectiveness was measured using the confusion matrix. Precision, recall, and F1- score performance provided quantitative assessments of the model's predictive capabilities.</p><p><strong>Results: </strong>YOLOv5 demonstrated the highest performance with an F1-score of 0.845, sensitivity of 0.967, and precision of 0.750. YOLOv8 followed closely with an F1-score of 0.760, sensitivity of 0.871, and precision of 0.675. In contrast, Mask R-CNN and U-Net showed comparatively lower effectiveness, achieving F1, sensitivity, and precision values of 0.408, 0.588, and 0.312 for Mask R-CNN, and 0.629, 0.518, and 0.800 for U-Net, respectively.</p><p><strong>Conclusion: </strong>YOLOv5 and YOLOv8 models outperformed Mask R-CNN and U-Net in accurately detecting OL lesions. These findings highlight the promise of artificial intelligence in facilitating early diagnosis of potentially malignant oral conditions. As datasets expand and algorithms improve, the clinical utility of such AI systems is expected to grow, contributing to timely intervention and improved patient outcomes.</p><p><strong>Key words: </strong>Oral mucosal lesions, Oral leukoplakia, Deep learning, Artificial intelligence.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"526-530"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiscale Embedded Gene Co-Expression Network Combined with Mendelian Randomisation Analysis for the Molecular Pathogenesis of Breast Cancer.","authors":"Yang Wang, Rui Xie, Huiming Zhang, Zhicheng Ge","doi":"10.29271/jcpsp.2026.04.468","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.468","url":null,"abstract":"<p><strong>Objective: </strong>To integrate multiscale embedded gene co-expression network analysis (MEGENA) and Mendelian randomisation (MR) to identify new pathogenic factors associated with breast cancer (BC).</p><p><strong>Study design: </strong>A descriptive study. Place and Duration of the Study: Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China, from January to December 2024.</p><p><strong>Methodology: </strong>The raw mRNA expression data were downloaded from the Cancer Genome Atlas (TCGA) database, and differentially expressed genes were used for MEGENA analysis. MR analysis was applied to explore causal relationships. A sensitivity analysis using leave-one-out tests ensured robust results. Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) were used to examine the functions and mechanisms of the newly identified targets.</p><p><strong>Results: </strong>MEGENA analysis identified 257 targets. The MR analysis demonstrated that ALOX15B (0.874; 0.809-0.943; p = 0.001) and TLE3 (0.807; 0.667-0.976; p = 0.027) were associated with a low risk of the disease; while the genes FAAH (1.064; 1.003-1.129; p = 0.038), HDGF (1.158; 1.012- 1.326; p = 0.032), KLF5 (1.110; 1.020-1.208; p = 0.015), LSM4 (1.071; 1.001-1.145; p = 0.046), and TNS1 (1.073; 1.015-1.135; p = 0.013) were associated with a high risk of BC. Six (ALOX15B, FAAH, HDGF, KLF5, TLE3, and TNS1) of these seven genes have been further validated for their reliability through sensitivity analysis. These six genes are closely correlated with immune cell infiltration and multiple tumour-related pathways.</p><p><strong>Conclusion: </strong>This study demonstrated the causal effect of six key genes on BC and provided a potential molecular link between these genes and BC.</p><p><strong>Key words: </strong>Breast cancer, Mendelian randomisation, MEGENA, Biomarker, Immune infiltration.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"468-475"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between SYNTAX Score and Neopterin Levels in Patients with Chronic Coronary Artery Disease.","authors":"Zeynep Yapan Emren, Sadik Volkan Emren, Oktay Senoz, Levent Elmas","doi":"10.29271/jcpsp.2026.04.439","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.439","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between the Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) score and neopterin levels in patients with coronary artery disease (CAD).</p><p><strong>Study design: </strong>An observational study. Place and Duration of the Study: Cardiology outpatient clinic, Bakircay University, Cigli Research and Training Hospital, from August 2023 to August 2024.</p><p><strong>Methodology: </strong>Thirty-five patients over the age of 40 with CAD and 33 healthy controls were enrolled. Exclusion criteria included active infection, malignancy, recent acute coronary syndrome (within six months), recent trauma or surgery, cerebrovascular events, use of steroids or immunosuppressants, liver or renal failure, significant valvular disease, thyroid disorders, and stenosis <50%. Comparisons between categorical variables were performed using the chi-square (χ2) test. Differences among single-, double-, and triple-vessel disease groups were analysed with the Kruskal-Wallis test. The association between SYNTAX scores and serum neopterin levels was assessed using Spearman's rank-order correlation (ρ). A two-tailed p-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Patients with CAD had significantly higher neopterin levels than those in the Control group, median (IQR): 6.5 (4.3-12.9) nmol/L vs. 5.0 (3.5-7.5) nmol/L, (p = 0.028). Elevated neopterin levels were found in individuals with more extensively stenosed coronary arteries [single-vessel disease: 4.9 (4.1-7.79) nmol/L; double-vessel disease: 7.2 (4.3-8.9) nmol/L; triple-vessel disease: 16.5 (13-23.6) nmol/L, p = 0.002]. Patients with triple-vessel disease demonstrated the greatest neopterin elevation in post hoc comparisons [single vs. double vessel: p = 0.426; double vs. triple vessel: p = 0.022; single vs. triple vessel: p = 0.001]. Neopterin levels showed a strong positive correlation with the SYNTAX score (Rho = 0.61, p <0.001).</p><p><strong>Conclusion: </strong>Neopterin elevation in CAD patients is associated with both higher SYNTAX scores and increased numbers of critically narrowed coronary arteries.</p><p><strong>Key words: </strong>Coronary artery disease, SYNTAX score, Neopterin, Inflammation, Atherosclerosis.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"439-443"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Dose Tamoxifen for Noninvasive Breast Disease: A Meta-Analysis.","authors":"Na Wang, Lili Gong, Gang Hu, Chunmei Ye","doi":"10.29271/jcpsp.2026.04.520","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.520","url":null,"abstract":"<p><p>Tamoxifen is a classic endocrine therapy for breast cancer; however, conventional doses of tamoxifen have serious side effects. Therefore, it is crucial to prioritise the treatment of low-dose tamoxifen. Databases were searched for related studies before November 23, 2023. The overall incidence of breast events, ipsilateral tumour events, and contralateral breast events decreased significantly in patients treated with low-dose tamoxifen. There was no significant difference in mortality from breast cancer (p = 0.767). However, mortality due to non-breast cancer causes was decreased statistically (p <0.001); the overall mortality rate reduced after taking low-dose tamoxifen (p = 0.002). There was no significant rise in the occurrence of endometrial cancer among individuals who received low-dose tamoxifen treatment (p = 0.577). The total incidence of adverse events did not increase at the same time (p = 0.216). For patients with noninvasive breast disease, low doses of tamoxifen can be chosen for prevention and treatment to reduce the risk of breast carcinoma. Key Words: Low-dose tamoxifen, Meta-analysis, Breast.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"520-525"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Intracranial Hypotension Syndrome.","authors":"Li Lin, Xinglin Wen","doi":"10.29271/jcpsp.2026.04.558","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.558","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"558"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and Molecular Profiling of Breast Cancer in Pakistan: A Missed Opportunity?","authors":"Amna Batool, Urooj Bhatti","doi":"10.29271/jcpsp.2026.04.431","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.431","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"431-432"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on the Combined Application of Gastroscopy and the Rapid Urease Test in Paediatric Gastric Disorders.","authors":"Xiaoyu Song, Hongzhi Lu, Cuihong Zhao, Tongtong Ma, Dawei Tian, Guoliang Zhang","doi":"10.29271/jcpsp.2026.04.489","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.489","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the accuracy, safety, and clinical value of combining gastroscopy with the rapid urease test (RUT) for diagnosing gastric disorders in children.</p><p><strong>Study design: </strong>A descriptive study. Place and Duration of the Study: Department of Gastroenterology, Maternity and Child Care Centre of Qinhuangdao, Qinhuangdao, China, from January 2024 to June 2025.</p><p><strong>Methodology: </strong>This study included 100 children aged 4-14 years undergoing diagnostic gastroscopy. Multi-site biopsies from the gastric antrum, incisura angularis, and corpus were evaluated using the RUT. Histology and the 13C-urea breath test were the gold standard methods for diagnosing Helicobacter pylori (H. pylori) infection. Diagnostic performance was assessed using sensitivity, specificity, and the area under the ROC curve (AUC).</p><p><strong>Results: </strong>The overall H. pylori infection rate was 31%, with a significantly higher rate in children aged ≥10 years (n = 18, 42.9%) than in those <10 years (n = 13, 22.4%; p = 0.029). The combined approach showed 96.8% sensitivity and 97.1% specificity, with an AUC of 0.961, outperforming gastroscopy alone (AUC = 0.770). The procedure was safe, resulting in only two minor adverse events.</p><p><strong>Conclusion: </strong>Gastroscopy combined with the RUT is an efficient, accurate, and safe method for simultaneously diagnosing gastric lesions and H. pylori infection in children, supporting individualised treatment.</p><p><strong>Key words: </strong>Paediatrics, Gastric disorders, Gastroscopy, Rapid urease test, Helicobacter pylori, Diagnosis.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"489-492"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Imaging Features with Pathological Subtypes and Clinical Risk Factors in Adenoid Cystic Carcinoma of the Head and Neck.","authors":"Wanyi Shao, Yingyu Dai, Shan Huang, Yonghao Liu","doi":"10.29271/jcpsp.2026.04.553","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.553","url":null,"abstract":"<p><p>Adenoid cystic carcinoma is relatively rare in the head and neck, and the early imaging features are not specific, so the misdiagnosis rate is high. Through multimodal imaging examinations, the imaging features of various pathological subtypes were analysed, combined with clinical manifestations, to provide radiologists with a more accurate diagnosis basis and improve the rate of early diagnosis and the ability to identify subtypes. Key Words: Head and neck tumours, Adenoid cystic carcinoma, Computed tomography imaging, Magnetic resonance imaging.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"553-555"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic and Microbiological Profiles in <em>Hidradenitis Suppurativa</em>.","authors":"Dilek Mentesoglu, Selda Pelin Kartal","doi":"10.29271/jcpsp.2026.04.531","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.04.531","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the results of swab cultures obtained from lesions of patients with hidradenitis suppurativa (HS) and their antibiotic resistance.</p><p><strong>Study design: </strong>An observational study. Place and Duration of the Study: Department of Dermatology and Venereology, Ankara Etlik City Hospital, Ankara, Turkiye, from October 2022 to May 2024.</p><p><strong>Methodology: </strong>A total of 123 patients aged ≥18 years diagnosed with HS, from whom swab cultures were taken from purulent lesions, were included in this study. Data on the Hurley clinical staging system of HS, disease duration, previous antibiotic use, the areas of lesions from which cultures were obtained, and the results of culture and antibiotic resistance were recorded. Descriptive statistical methods were used to evaluate the data.</p><p><strong>Results: </strong>The mean age was 39.1 ± 13.7 years in 35 (28.5%) female and 88 (71.5%) male patients. The mean duration of HS was 156 ± 140 months. Patients were mainly classified as Hurley 2 (n = 73, 59.3%), Hurley 3 (n = 33, 26.8%), and Hurley 1 (n = 17, 13.8%). A total of 113 patients (91.9%) had a history of antibiotic use. The highest growth in culture was observed in lesions obtained from the axillary region (n = 75, 61%). Skin flora were observed in swab cultures in 94 patients (76.4%), and non-skin flora grew in 29 patients (23.6%). Among the 29 patients, the most common was Staphylococcus aureus (n = 11, 37.9%). The highest rates of resistance were observed to ampicillin (n = 11, 8.9%), clindamycin (n = 7, 5.7%), and penicillin G (n = 7, 5.7%). Antibiotic resistance was detected in the antibiograms of 23 patients with non-skin flora. The highest resistance rates were observed to ampicillin (n = 11, 47.8%), clindamycin (n = 7, 30.4%), and penicillin G (n = 7, 30.4%).</p><p><strong>Conclusion: </strong>Given the predominance of skin flora in HS lesions, biological agents may offer more effective long-term management than antibiotics for patients with HS.</p><p><strong>Key words: </strong>Antibiotic treatment, Antibiotic resistance, Hidradenitis suppurativa, Biologic treatment.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 4","pages":"531-535"},"PeriodicalIF":0.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}