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

{"title":"RENAL Nephrometry Scores and Perioperative Outcomes in Open Partial Nephrectomy.","authors":"Nadeem Bin Nusrat, Sana Kundi, Assad Ur Rehman, Nauman Zafar, Sarmad Imtiaz Bajwa, Saira Imtiaz","doi":"10.29271/jcpsp.2024.12.1524","DOIUrl":"10.29271/jcpsp.2024.12.1524","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of RENAL nephrometry scores in guiding open partial nephrectomy for renal malignancies and comprehend perioperative factors influencing outcomes.</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Urology, Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan, from September 2017 to June 2023.</p><p><strong>Methodology: </strong>The study includes 48 eligible patients undergoing partial nephrectomy for kidney cancer. RENAL scores, preoperative CT scans, patient data, and tumour specifics were collected. Perioperative outcomes, including Clavien-Dindo classification for complications, were recorded. Patient characteristics, tumour details, and continuous variables such as estimated glomerular filtration rate (eGFR) were analysed using IBM SPSS version 20.0.</p><p><strong>Results: </strong>The study included 48 patients (33 males and 15 females) with a median age of 53 years and a median RENAL score of 8. Clear-cell carcinoma was the dominated histological type (70.83%). The average follow-up duration was 30 months. The RENAL score correlated significantly with ischaemia time, blood loss, tumour size, drainage day, and catheter out day. Postoperative elevation in serum creatinine was associated with male gender and eGFR.</p><p><strong>Conclusion: </strong>Partial nephrectomy is highly effective for small, locally limited renal tumours, providing favourable outcomes with minimal complications. Tumour size is crucial for reporting, aiding research, and patient counselling. Despite limited correlation with complications, the RENAL nephrometry score remains valuable for defining renal mass characteristics and precise planning in complex localised renal cell carcinoma operations.</p><p><strong>Key words: </strong>RENAL nephrometry scores, Perioperative outcomes, Open partial nephrectomy, Retrospective analysis, Renal tumours, Renal mass characteristics.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1524-1529"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795877","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":"Are Hyperlipidaemia and Insulin Resistance Risks For Sarcopenia?","authors":"Mustafa Tuna, Bilgehan Kolutek Ay, Hatice Incebiyik","doi":"10.29271/jcpsp.2024.12.1473","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.12.1473","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether insulin resistance and lipid metabolism disorders could be associated with sarcopenia.</p><p><strong>Study design: </strong>Cross-sectional descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation, Sanliurfa Training and Research Hospital, Sanliurfa, Turkiye, from December 2023 and May 2024.</p><p><strong>Methodology: </strong>The study included 135 patients who met the inclusion and exclusion criteria. Data such as age, gender, body mass index (BMI), lipid profile, fasting blood glucose, C-peptide, and insulin levels were collected. Following sarcopenia screening, participants were divided into two groups for further examination, and the correlation between sarcopenia and other parameters was assessed.</p><p><strong>Results: </strong>BMI levels were significantly higher in the sarcopenia group (p = 0.003). Triglyceride levels were also significantly elevated in the sarcopenia group (p = 0.001). The number of patients with dyslipidaemia in the sarcopenia group was higher compared to the non-sarcopenia group (p = 0.003). Correlation analysis revealed a positive association between sarcopenia and BMI, insulin resistance, high triglyceride levels, and the presence of dyslipidaemia (p = 0.002, p = 0.032, p = 0.002, p = 0.004, respectively).</p><p><strong>Conclusion: </strong>This study suggests that high triglyceride levels may represent a risk factor associated with sarcopenia and that sarcopenia may be associated with conditions such as high BMI, insulin resistance, and dyslipidaemia. Controlling lipid levels could be beneficial in reducing the risk of sarcopenia.</p><p><strong>Key words: </strong>Chronic disease, Hyperlipidaemia, Hypertriglyceridaemia, Insulin Resistance, Sarcopenia.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1473-1477"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796611","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":"Clinical Insights and Outcomes in Community-Acquired Acute Bacterial Meningitis <em>versus</em> Postoperative Bacterial Meningitis.","authors":"Hanife Nur Karakoc Parlayan, Asli Haykir Solay, Begum Ruveyda Aksoy, Dilek Bulut, Mahsa Hojabri, Irfan Sencan","doi":"10.29271/jcpsp.2024.12.1441","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.12.1441","url":null,"abstract":"<p><strong>Objective: </strong>To compare the demographics, clinical characteristics, and in-hospital mortality rates between community-acquired bacterial meningitis cases and postoperative bacterial meningitis.</p><p><strong>Study design: </strong>Analytical study. Place and Duration of the Study: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from 2016 to 2022.</p><p><strong>Methodology: </strong>A total of 153 patients diagnosed with bacterial meningitis were included and categorised into two groups: 95 (62.1%) with community-acquired bacterial meningitis (CABM) and 58 (37.9%) with postoperative bacterial meningitis (POBM). Demographics, clinical features, laboratory, paraclinical findings, treatments, and outcomes of the cases were compared. Data were retrieved using a standard data collection form from the electronic medical records.</p><p><strong>Results: </strong>A substantial portion (58.8%) of all patients had comorbidities. Fever was the common symptom in all groups. Headache, neck stiffness, nausea, and vomiting were more often observed in the CABM group (p <0.001). Upon admission, the CABM exhibited higher levels of white blood cell count, C-reactive protein, and procalcitonin (p = 0.017, p = 0.004, p = 0.007, respectively). Overall 33.1% had positive cerebrospinal fluid cultures. The overall mortality rate was 26.8%. POBM was associated with longer hospital and intensive care unit (ICU) stays (p <0.001). Shorter treatment durations, lower Glasgow coma scale scores (GCS), higher Charlson Comorbidity Index values, and elevated markers of inflammation were related to mortality.</p><p><strong>Conclusion: </strong>This study illuminates the differences in clinical presentations and outcomes between community-acquired and postoperative bacterial meningitis. It also suggests that factors such as lower GCS scores, comorbidities, and elevated inflammation markers at the last follow-up may be associated with unfavourable clinical outcomes in bacterial meningitis.</p><p><strong>Key words: </strong>Postoperative meningitis, Central nervous system infection, Cerebrospinal fluid, Antibiotics.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1441-1447"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796720","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":"Growth Differentiation Factor-15 <em>versus</em> Human Chorionic Gonadotropin in Pathophysiology of Nausea and Vomiting of Pregnancy.","authors":"Sameen Aftab, Qazi Muhammad Zarlish","doi":"10.29271/jcpsp.2024.12.1548","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.12.1548","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1548"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796733","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":"High-Risk Influential Factors for Cardiovascular Diseases among Young Adults.","authors":"Xiaowei Wang, Tianhong Yang, Jinxiu Liu","doi":"10.29271/jcpsp.2024.12.1539","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.12.1539","url":null,"abstract":"<p><p>The aim of this study was to compare high-risk influential factors for cardiovascular diseases among different young adults. It was a retrospective study carried out from January 2020 to 2022. A total of 700 young adults who underwent a physical examination or were hospitalised at the Baoding No.1 Central Hospital, Baoding, Hebei, P. R. China. The participants were divided into three groups: Young social health examinees (n = 300), who underwent physical examinations in January 2020; young medical workers (n = 300), young hospital employees who underwent physical examinations in January 2020; and young myocardial infarction patients (n = 100), who were hospitalised with myocardial infarction from January 2019 to 2021. Analysis was performed on the cardiovascular high-risk influential factors of different young adults. The proportions of males, smoking history, drinking history, hypertension history, lack of exercise, high stress, obesity, fatty liver levels of serum uric acid (UA), body mass index (BMI), diastolic blood pressure (DBP), systolic blood pressure (SBP), and weight in the young myocardial infarction patient group were higher than the other two groups while the HDL levels were lower than those of the latter two groups (p <0.05). The proportions of drinking history, hypertension history, lack of exercise, and high stress levels of UA, DBP, and SBP in the young medical worker group were higher than those in the young social health examinee group (p <0.05). Multivariate analysis revealed that males, high stress, obesity, high DBP and SBP levels were independent risk factors for cardiovascular diseases in young adults (p <0.05). High-risk influential factors of cardiovascular diseases in young adults include males, high stress, obesity, high blood pressure, etc. Key Words: Young people, Cardiovascular system, Medical workers, High-risk influential factors.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1539-1541"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796735","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 Seborrhoeic Dermatitis and Hypertension: A Potential Clinical Correlation.","authors":"Tazein Amber, Saadia Tabassum, Shiyam Sunder, Muhammad Zain Mushtaq","doi":"10.29271/jcpsp.2024.12.1547","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.12.1547","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1547"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796714","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":"Comparison of Intrathecal Morphine <em>versus</em> Ultrasound-Guided Regional Analgaesia Techniques for Post-Caesarean Recovery Quality.","authors":"Mahmut Semih Akdag, Munise Yildiz, Nur Gozde Kulhan, Mahmut Sami Tutar, Betul Kozanhan","doi":"10.29271/jcpsp.2024.12.1411","DOIUrl":"10.29271/jcpsp.2024.12.1411","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of ultrasound-guided regional analgaesia techniques on postoperative recovery and compare them with those of intratecal morphine (ITM) in obstetric patients undergoing elective caesarean delivery (CD).</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Konya City Hospital, Konya, Turkiye, from January to December 2022.</p><p><strong>Methodology: </strong>The study involved six groups of 30 patients each, categorised by postoperative analgaesia: ITM, posterior transversus abdominis plane block (TAPB), lateral TAPB, transversalis fascia plane block, posterior quadratus lumborum block, and erector spinae plane block. Recovery was assessed using the Obstetric Quality of Recovery Score-10 (ObsQoR-10) at 24 hours, whereas satisfaction was measured with a Likert scale. Time to the first analgaesia, total opioid consumption, nausea, and the need for antiemetics were compared.</p><p><strong>Results: </strong>ObsQoR-10, satisfaction, and numerical rating scale scores were consistent across groups (p >0.05). The lateral TAPB group required more opioids and had earlier analgaesic requests (p = 0.009 and p = 0.05, respectively). ITM was more likely to cause nausea and pruritus compared to regional analgaesia techniques (p = 0.062 and p <0.001).</p><p><strong>Conclusion: </strong>Ultrasound-guided regional analgaesia techniques provided similar postoperative recovery and patient satisfaction levels as ITM. Moreover, regional analgaesia techniques, except lateral TAPB, may offer similar alternatives to ITM within multimodal analgaesia strategies for CD.</p><p><strong>Key words: </strong>Caesarean delivery, Multimodal analgaesia, Patient-reported outcome, Regional analgaesia techniques, Quality of recovery.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1411-1418"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796721","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":"Detection of <em>Rotavirus</em>, <em>Norovirus</em>, and <em>Astrovirus</em> Causing Acute Diarrhoea in Children by Multiplex PCR in a Tertiary Care Hospital.","authors":"Khushbakht Alam, Eijaz Ghani, Muhammad Ali Rathore, Saifullah Khan Niazi, Hina Saeed, Misbah Noor","doi":"10.29271/jcpsp.2024.12.1464","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.12.1464","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the use of a multiplex real-time polymerase chain reaction (RT-PCR) test in detecting three viruses namely Rotavirus, Norovirus (genotypes 1 and 2), and Astrovirus that cause gastroenteritis in children under the age of five years.</p><p><strong>Study design: </strong>A cross-sectional study. Place and Duration of the Study: Department of Virology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, from January to July 2023.</p><p><strong>Methodology: </strong>A total of 87 children having acute diarrhoea and less than 5 years of age were included in this study from the outpatient clinic. Multiplex PCR was performed for the detection of three viruses: Rotavirus, Norovirus, and Astrovirus in stool samples of patients using a commercially available PCR kit. The data were analysed using Statistical Package for Social Sciences (SPSS) version 27:00.</p><p><strong>Results: </strong>Out of total 87 children, aged 2.5 ± 1.5 years, 56 (64.3%) were positive for multiplex RT-PCR and 31 (35.6%) were negative. Rotavirus was identified in 24 (27.5%) children as the most common cause of acute diarrhoea, followed by Norovirus in 20 (22.9%), and Astrovirus in 7 (8%) patients, while co-infection with multiple viruses occurred in 5 (5.7%) of the cases.</p><p><strong>Conclusion: </strong>This study revealed viral aetiology as a significant cause of acute diarrhoea in children. Multiplex PCR in the healthcare system can make it easier to identify, treat, and control the upsurge of diarrhoea. Prompt diagnosis of viral causes can lead to the prevention of unnecessary use of antibiotics.</p><p><strong>Key words: </strong>Multiplex polymerase chain reaction, Rotavirus, Norovirus, Astroviridae, Diarrhoea.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1464-1467"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796729","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":"Effect of Blood Component Transfusion on Coagulation Function in Postpartum Haemorrhage.","authors":"Tianming Yan, Huiqun Xu, Fengling Li, Bili Zhang, Qiang Hong, Yijing Wang","doi":"10.29271/jcpsp.2024.12.1542","DOIUrl":"10.29271/jcpsp.2024.12.1542","url":null,"abstract":"<p><p>Postpartum haemorrhage (PPH) is a serious complication of pregnancy. In this study, patients with PPH were treated with blood component transfusion, and the effectiveness of blood component transfusion and its influence on coagulation function were analysed. This retrospective randomised controlled study evaluated the clinical data of patients with PPH who were admitted to the Department of Blood Transfusion at the First Affiliated Hospital of Xiamen University, from January 2021 to December 2021. In 2021, 84 patients received treatment at this hospital. Patients transfused with a 1:1 ratio of red blood cells (RBC) to cryoprecipitate showed a significant improvement in coagulation levels compared to pretreatment. The combination of RBC, plasma, and cryoprecipitate in a reasonable proportion effectively improves coagulation function in haemorrhage puerperae, showing a good clinical treatment effect. It is worth promoting. Key Words: Postpartum, Blood component transfusion, Coagulation, Resuscitation rate.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1542-1544"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796732","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":"Predictive Factors for Major Bleeding in Patients Undergoing Percutaneous Nephrolithotomy: A Clinical Prediction Study.","authors":"Teng Qiu, Xiao-Tao Hu","doi":"10.29271/jcpsp.2024.12.1478","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.12.1478","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate major bleeding risk factors in percutaneous nephrolithotomy (PCNL) for upper urinary tract calculi and validate a prediction model.</p><p><strong>Study design: </strong>Analytical study. Place and Duration of the Study: The First Affiliated Hospital of Wannan Medical College, Wuhu, China, from January 2019 to August 2023.</p><p><strong>Methodology: </strong>Major bleeding was defined as a decrease in haemoglobin of ≥20 g/L compared to preoperative levels. A retrospective analysis of 468 PCNL patients identified risk factors for major bleeding using univariate, LASSO, and logistic regression analyses. Nomogram models were developed using R software, with ROC and calibration plots assessing the model's accuracy. The bootstrap method provided internal validation, and DCA evaluated clinical utility.</p><p><strong>Results: </strong>Independent risk factors included diabetes (OR = 4.17), staghorn calculi (OR = 3.41), operative duration (OR = 1.01), and staged surgery (OR = 2.75). The model showed high discriminative ability (C-statistic: 0.783) and alignment with observed outcomes. Internal validation confirmed robustness (C-statistic: 0.728).</p><p><strong>Conclusion: </strong>The predictive model for major bleeding during and after PCNL, focusing on diabetes, staghorn calculi, operative duration, and staged surgery, is highly accurate, aiding in the PCNL risk assessment.</p><p><strong>Key words: </strong>Upper urinary tract calculi, Percutaneous nephrolithotomy, Major bleeding, Risk factors, Prediction model.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 12","pages":"1478-1483"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796743","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}