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

{"title":"Comparison of the Combination of Interscalene Block and Superficial Cervical Block Anaesthesia with Interscalene Block Anaesthesia in Shoulder Surgery Operations.","authors":"Abdulhakim Sengel, Selcuk Secilmis, Evren Buyukfirat, Nuray Altay, Veysi Yazar, Mehmet Baki Bilsel","doi":"10.29271/jcpsp.2025.06.769","DOIUrl":"10.29271/jcpsp.2025.06.769","url":null,"abstract":"<p><strong>Objective: </strong>To compare shoulder surgery patients who received interscalene nerve block (INB) and superficial cervical block (SCB) anaesthesia with those who received only INB anaesthesia.</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Faculty of Medicine Harran University, Haliliye, Turkiye, from October 2020 to April 2023.</p><p><strong>Methodology: </strong>A total of 60 participants aged between 18 and 75 years, belonging to the ASA I-II physical class and scheduled for arthroplastic and arthroscopic shoulder surgery, were divided into two groups. Group I received INB + SCB; Group II received only INB. Variables were compared as per the objective.</p><p><strong>Results: </strong>There was no significant difference between the groups in terms of demographic variables. There was no significant difference between Group I and Group II in VAS scores at the 1st hour; however, a significant difference was observed at the 3rd, 6th, and 12th hours, with lower VAS scores in Group I.</p><p><strong>Conclusion: </strong>Combined block method resulted in lower postoperative pain scores, longer pain-free periods, less opioid requirement, and higher patient satisfaction. Therefore, the INB + SCB combination will be a safe, less time-consuming, and highly effective alternative to other anaesthetic methods in arthroscopic and arthroplastic shoulder surgeries.</p><p><strong>Key words: </strong>Anaesthesia, Brachial plexus block, Cervical plexus block, Regional anaesthesia, Shoulder, Surgery.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"769-773"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259748","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":"Preliminary Survey Report of Eye Cancers in Pakistan.","authors":"Tayyab Afghani, Haroon Awan, Asad Aslam Khan","doi":"10.29271/jcpsp.2025.06.784","DOIUrl":"10.29271/jcpsp.2025.06.784","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the magnitude of eye cancer and its annual frequency, extrapolated from major eye care centres of the country.</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Data were obtained from ten dedicated eye care institutions of three provinces of Pakistan, from January to December 2022.</p><p><strong>Methodology: </strong>This is the report of the first eye cancer survey in Pakistan under the auspices of the National Committee of Eye Health. Eye care institutions, along with major stakeholders involved in the prevention and control of eye cancer, were requested to provide the annual data on tumours of the eye as well as information related to the situation analysis of eye cancer services.</p><p><strong>Results: </strong>The number of eye tumours reported in one year was 1705; 51% were malignant and 49% were benign. Eight hundred and seventy-seven cases of eye cancers were diagnosed in a year; 38% were eyelid cancers, 31% were intraocular tumours, and 16% were ocular surface tumours, while 15% were cancers of the orbit. KPK had the highest percentage of eyelid cancers (72%), and Sindh had the highest percentage of intraocular cancers (40%).</p><p><strong>Conclusion: </strong>It is estimated that there are 4 cases of eye cancer per million population of Pakistan and an almost similar number of benign eye tumours. Thus, it is estimated that 8 cases of eye tumours per million population are examined annually. Cost and lack of facilities were found to be major limitations towards eye cancer control.</p><p><strong>Key words: </strong>Eye malignancies, Eye surveys, Pakistan, Ophthalmology, Tumours of eye.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"784-788"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259759","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":"Neurilemmoma of the Seminal Vesicle: An Unexpected Rare Case During the Treatment of Liver Abscess.","authors":"Mingyang He, Junzi Liu, Qiyu Liu","doi":"10.29271/jcpsp.2025.06.811","DOIUrl":"10.29271/jcpsp.2025.06.811","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"811-812"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259757","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":"The Effect of Magnesium Sulfate Infusion on Postoperative Opioid Consumption in Abdominal Hysterectomy: A Randomised, Double-Blind Trial.","authors":"Ilke Tamdogan, Dilek Yeniay, Esra Turunc, Fatma Alkan Bayburt, Sadettin Oguzhan Tutar","doi":"10.29271/jcpsp.2025.06.681","DOIUrl":"10.29271/jcpsp.2025.06.681","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of magnesium sulfate infusion on total opioid consumption following abdominal hysterectomy in a clinical setting.</p><p><strong>Study design: </strong>Controlled, randomised, prospective, and double-blind trial. Place and Duration of the Study: Department of Gynaecology, Giresun Gynaecology and Children's Diseases Training and Research Hospital, Giresun, Turkiye, from November 2023 to April 2024.</p><p><strong>Methodology: </strong>A total of 48 participants were randomly assigned to two groups: Group M (magnesium sulfate infusion) and Group N (placebo). Participants in Group M were administered a bolus 20 mg/kg MgSO4 in 100 mL of saline over 15 minutes prior to induction, followed by 20 mg/kg/h until skin closure. Participants in Group N received an equivalent volume of saline. The primary outcome was total opioid consumption within the first 24 hours, while secondary outcomes included pain scores, remifentanil use, haemodynamic parameters, and adverse effects.</p><p><strong>Results: </strong>Postoperative opioid consumption during the first 24 hours was significantly lower in Group M (35.6 ± 15.2 mg) compared to Group N (44.9 ± 14.1 mg), with a p-value of 0.032. Pain scores were also significantly lower in Group M at 24 hours (p = 0.008) at rest, at 4 hours (p = 0.022), and 6 hours (p = 0.041) during movement. No significant differences were observed in remifentanil consumption, haemodynamic parameters, sedation levels, or nausea between the two groups.</p><p><strong>Conclusion: </strong>The intraoperative administration of magnesium sulphate significantly reduced opioid consumption and pain scores following abdominal hysterectomy. These findings support its use within multimodal analgesia strategies.</p><p><strong>Key words: </strong>Analgesia, Gynaecologic Anaesthesia, Hysterectomy, Magnesium sulfate, Patient-controlled analgesia, Postoperative pain.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"681-687"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259718","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":"Accelerated Development of Brucellar Spondylitis after Self-Modification of Treatment.","authors":"Bo Liu, Wendong Xie, Zhiqi Zhang","doi":"10.29271/jcpsp.2025.06.807","DOIUrl":"10.29271/jcpsp.2025.06.807","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"807-808"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259742","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":"Bilateral Medial Medullary Infarction: A Rare and Devastating Stroke Subtype.","authors":"Weiwei Gao, Lijuan Cai, Renjing Zhu","doi":"10.29271/jcpsp.2025.06.809","DOIUrl":"10.29271/jcpsp.2025.06.809","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"809-810"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259744","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":"Extracorporeal Shock Wave Therapy in Shoulder Rehabilitation: Unlocking Motion and Reducing Post-Surgical Pain.","authors":"He-Bei He, Min-Cong Wang, Yong Hu, Cheng-Long Pan","doi":"10.29271/jcpsp.2025.06.749","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.06.749","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) in improving pain, range of movement, and functional outcomes in patients with shoulder stiffness following rotator-cuff repair.</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Department of Orthopaedic Surgery, The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, China, from January 2021 to December 2023.</p><p><strong>Methodology: </strong>Patients with postoperative shoulder stiffness after rotator-cuff repair who underwent ESWT (two sessions per week for four weeks) were enrolled. Outcomes assessed included shoulder range of movement, pain levels (numerical rating scale), Constant- Murley scores (C-M), and American Shoulder and Elbow Surgeon scores (ASES). Data were collected at baseline and at 1, 2, 4, and 6 weeks, and repeated-measures ANOVA was performed to assess changes over time.</p><p><strong>Results: </strong>Sixty patients participated in the study. Significant improvements were observed across all parameters (p <0.001). Shoulder range of movement increased at all follow-up intervals (p <0.001). Pain scores decreased from a mean baseline of 7.81 ± 1.64 to 2.05 ± 1.61 at six weeks. Functional outcomes improved significantly, with C-M scores rising from 48.45 ± 9.78 to 78.50 ± 4.20 and ASES scores increasing from 46.08 ± 13.53 to 79.14 ± 4.29 by the end of the study. No adverse effects or complications related to ESWT were reported.</p><p><strong>Conclusion: </strong>ESWT significantly enhances shoulder mobility, reduces pain, and improves function in postoperative rotator-cuff repair patients. It offers a safe and effective alternative for inclusion in rehabilitation protocols.</p><p><strong>Key words: </strong>Rotator-cuff repair, Extracorporeal shock wave therapy, Stiffness, Functional rehabilitation, Analgesia.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"749-754"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259752","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":"Factors Associated with Ischaemic Stroke Development Despite Oral Anticoagulant Therapy in Patients with Non-Valvular Atrial Fibrillation.","authors":"Emre Ozdemir, Muhammed Mucahit Tiryaki, Zeynep Emren, Ozgen Safak, Enise Tiryaki, Aysen Suzen Ekinci","doi":"10.29271/jcpsp.2025.06.712","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.06.712","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of the most popular risk scores (CHADS2, CHA2DS2-VASc, and ATRIA scores) in predicting stroke events in patients with non-valvular atrial fibrillation (NVAF) who were already receiving oral anticoagulant therapy (OAT).</p><p><strong>Study design: </strong>An observational study. Place and Duration of the Study: Department of Cardiology, Ataturk Research and Training Hospital, Izmir Katip Celebi University, Izmir, Turkiye, from January 2020 to December 2023.</p><p><strong>Methodology: </strong>Patients with NVAF who were on OAT were divided into two groups. Group 1 consisted of patients who had not experienced a stroke while on OAT, and Group 2 consisted of patients who had experienced at least one stroke while on OAT at the time of inclusion. Continuous variables were presented as mean or median values and were compared using Student's t-test or Mann-Whitney U test, depending on the type of data distribution.</p><p><strong>Results: </strong>There were 162 patients in Group 1 and 129 patients in Group 2, the majority being females. The median age of patients was 76 years (IQR: 71-82) in Group 1 and 75 years (IQR: 68-81) in Group 2. Comorbidities were statistically similar in both groups except for hyperlipidemia. Treatment for atrial fibrillation (AF) was also statistically similar in both groups. The CHA2DS2-VASc and ATRIA stroke scores showed statistically significant differences between the groups. In univariate analysis, hyperlipidemia and ATRIA stroke score were >8, and in multivariate analysis, only ATRIA stroke score was >8, which showed a correlation with estimating the risk of ischaemic stroke (IS) events under oral anticoagulation (OAC). The ATRIA stroke score showed a strong correlation Spearman's rho test and in the ROC curve.</p><p><strong>Conclusion: </strong>The CHA2DS2-VASc, CHADS, and ATRIA risk scores have proven effective in primary IS prophylaxis. The ATRIA stroke score system for secondary prevention appears to be more effective than the most popular score systems.</p><p><strong>Key words: </strong>Non-valvular atrial fibrillation, ATRIA stroke score, CHA2DS2-VASc, Oral anticoagulation, Ischaemic stroke.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"712-716"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259753","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":"Integrating Artificial Intelligence for Patient Safety in Pakistan: Opportunities, Challenges, and Lessons from Low- and Middle-Income Countries.","authors":"Sonia Ijaz Haider","doi":"10.29271/jcpsp.2025.06.679","DOIUrl":"10.29271/jcpsp.2025.06.679","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 6","pages":"679-680"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259756","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":"Osteomyelitis of the Heel Due to Delayed Treatment of a Left Heel Fracture in a 5-Year Girl.","authors":"Zhiqi Zhang, Wendong Xie, Xiudong Liu, Chao Zhang","doi":"10.29271/jcpsp.2025.03.397","DOIUrl":"10.29271/jcpsp.2025.03.397","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 3","pages":"397-398"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589047","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}