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

{"title":"Rare Epithelioid Sarcoma of the Scalp Involving the Left Parietal Bone.","authors":"Pengjuan Zhao, Wendong Xie, Guangsu Zhang, Chao Zhang","doi":"10.29271/jcpsp.2025.02.261","DOIUrl":"10.29271/jcpsp.2025.02.261","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"261"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400962","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 -592 C/A Polymorphism of <em>Interleukin-10</em> Gene and Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients.","authors":"Muhammad Anees, Usman Ali Bajwa, Irfan Elahi, Muhammad Raza, Muhammad Shahbaz Pervaiz","doi":"10.29271/jcpsp.2025.02.147","DOIUrl":"10.29271/jcpsp.2025.02.147","url":null,"abstract":"<p><strong>Objective: </strong>To establish the association between -592 C/A polymorphism of interleukin (IL)-10 gene and Diabetic Nephropathy (DNP) in Type 2 Diabetes Mellitus (T2DM) patients.</p><p><strong>Study design: </strong>Comparative observational study. Place and Duration of the Study: Department of Nephrology (in collaboration with Biochemistry and Advanced Research Centre for Biomedical Sciences (ARCB)), Mayo Hospital and King Edward Medical University, Lahore, Pakistan, from January to December 2021.</p><p><strong>Methodology: </strong>The study included 282 patients with T2DM for ≥5 years, and aged ≥40 years. Patients with and without DNP were placed in Group A and B (n = 141 in each group), respectively. After drawing samples, deoxyribonucleic acid (DNA) was first extracted from whole blood, then amplified via specific primers, and finally genotyped through the polymerase chain reaction and restriction fragment length polymorphism (PCR - RFLP) method. Median and interquartile range (IQR) were used to describe the skewed data and frequencies were used for categorical data. Mann-Whitney U test was used for comparison of data groups. Chi-square test was used to establish an association.</p><p><strong>Results: </strong>The median age of patients was 50.0 (12) years in Group A and 54.0 (11) years in Group B. Male-to-female distribution was 39 (27.7%) / 102 (72.3%) in Group A and 49 (34.8%) / 92 (65.2%) in Group B. The -592 C/A polymorphism of IL-10 genes was found more frequently in Group A 72 (51.0%) than Group B 63 (44.7%) without statistical significance (p = 0.283).</p><p><strong>Conclusion: </strong>The current study showed that the presence of single nucleotide C/A polymorphism at the -592 position of IL-10 gene in T2DM patients does not influence (increase / decrease) their susceptibility to develop DNP.</p><p><strong>Key words: </strong>Type 2 Diabetes Mellitus, Diabetic Nephropathy, Interleukin-10, -592 C/A, Single nucleotide polymorphism.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"147-151"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401105","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":"Attributes of Digital Leaders in Health Professions Education.","authors":"Sana Iqbal, Mashaal Sabqat, Zainab Akbar, Yawar Hayat Khan, Raheela Yasmin","doi":"10.29271/jcpsp.2025.02.229","DOIUrl":"10.29271/jcpsp.2025.02.229","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the essential attributes of effective digital education leaders (DELs) in health professions education (HPE), aiming to refine digital leadership development and advance digital learning environments in healthcare education.</p><p><strong>Study design: </strong>Qualitative research with exploratory study design. Place and Duration of the Study: Department of Medical Education, Riphah International University, Rawalpindi, Pakistan, from February to July 2021.</p><p><strong>Methodology: </strong>Semi-structured, in-depth, open-ended interviews were conducted with 18 health professions education leaders from the medical and dental institutes of Pakistan. The participants were selected through purposive sampling and had experience of leading online / blended education systems. The interviews were conducted online, audio recorded, and transcribed verbatim. A systematic process of iterative data collection and analysis was employed. Manual thematic analysis was done to analyse the data. Codes were organised into 13 sub-themes, which were consolidated into three overarching themes by discussion and consensus amongst all authors.</p><p><strong>Results: </strong>Three themes emerged including social, strategic, and personal attributes. Social attributes included social intelligence, promotion of diversity, and networking intelligence. Strategic attributes comprised innovative vision, digital intelligence, adaptability, and flexible leadership style. Personal attributes encompassed motivation, role modelling, openness, self-awareness, agility, and learning through errors.</p><p><strong>Conclusion: </strong>Healthcare educational institutions can use the identified attributes of DELs to inform the development of targeted training programmes and aid in the strategic selection of leaders to lead their digital transformation.</p><p><strong>Key words: </strong>Digital leadership, E-leadership, Leaders in the digital era, Higher education, Medical education, Health professional education.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"229-233"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401107","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":"Effectiveness of Cardiac Rehabilitation on Health-Related Quality of Life in Coronary Artery Disease Patients in Low and Middle-Income Countries.","authors":"Aliya Hisam, Zia Ul Haq, Zohaib Khan, Sumaira Masood, Jill P Pell, Patrick Doherty","doi":"10.29271/jcpsp.2025.02.221","DOIUrl":"10.29271/jcpsp.2025.02.221","url":null,"abstract":"<p><p>This meta-analysis of published studies was conducted to determine the effectiveness of cardiac rehabilitation (CR) in terms of health-related quality of life (HRQoL) in post-coronary artery disease (CAD) patients in low- and middle-income countries (LMICs). Eighteen studies were identified from six countries (Malaysia, Iran, Brazil, Turkiye, China, and Pakistan) totalling 2,620 study participants with a mean age of 57.43 ± 7.9 years. Significantly higher mean physical (13.48, 95% CI: 7.75 to 19.21, p <0.001) and mental (11.52, 95% CI: 4.44 to 18.60, p <0.001) component scores were observed in the CR group compared to the usual group. The myocardial infarction- specific MacNew QLMI domains also showed significant mean differences (1.59, 95% CI: 0.97 to 2.21, p <0.001). This systematic review and meta-analysis showed significant improvements in physical and mental HRQoL in the CR group compared to the control group among post-CAD patients in LMIC. Furthermore, the myocardial infarction-specific MacNew QLMI global domain shows significant improvement in the CR group compared to the usual care group. Key Words: Acute coronary syndrome, Cardiac rehabilitation, Quality of life, Short-form 36, MacNew quality of life after myocardial infarction.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"221-228"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401116","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":"Antimicrobial Efficacy of Nanoparticle-Coated Gutta-Percha: A Systematic Review.","authors":"Samira Adnan, Abhishek Lal, Maham Muneeb Lone, Jamshed Ahmed, Isma Sajjad, Huma Shareef, Muhammad Sohail Zafar","doi":"10.29271/jcpsp.2025.02.213","DOIUrl":"10.29271/jcpsp.2025.02.213","url":null,"abstract":"<p><p>This systematic review aimed to evaluate the use of different nanoparticles for their ability to impart antimicrobial properties to conventionally inert gutta-percha when it is coated with nanoparticles. After registering with PROSPERO (CRD42023420939), the search was conducted using the PubMed, Cochrane, Scopus, CINAHL, and Google Scholar with predefined keywords. The research question was constructed on PICO as \"Does gutta-percha coated with various nanoparticles provide antibacterial activity against root canal microbes compared to conventional gutta-percha points?\". A total of five relevant in-vitro studies published in English were included. Nanoparticles used for coating included nanopropolis, silver-curcumin, chitosan, silver, and zinc oxide. Micro-organisms tested comprised of Enterococcus faecalis, Escherichia coli, Staphylococcus aureus, and Candida albicans. Higher concentration of nanoparticles and prolonged coating duration resulted in increased antimicrobial activity, irrespective of the type of nanoparticle, as compared to conventional gutta-percha. The highest risk of bias was identified in reporting of blinding, randomisation, sampling techniques, and sample size calculation. Fewer studies, as well as heterogeneity of methodologies and results preclude the recommendation of a specific nanoparticle for coating gutta-percha. Key Words: Antimicrobial efficacy, Endodontics, Gutta-percha, Micro-organisms, Nanoparticles.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"213-220"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401103","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":"Radiographic Assessment of Craniofacial Morphology and Airway Dimensions of Parents of Cleft Lip and Palate Patients.","authors":"Erum Amin, Qurat Ul Ain Tariq, Adnan Babar, Ramsha Nawaz, Zoya Ahsan","doi":"10.29271/jcpsp.2025.02.197","DOIUrl":"10.29271/jcpsp.2025.02.197","url":null,"abstract":"<p><strong>Objective: </strong>To assess and compare maternal and paternal craniofacial morphology and airway dimensions of parents of children with unilateral or bilateral cleft lip and palate (CLP).</p><p><strong>Study design: </strong>A cross-sectional study. Place and Duration of the Study: Department of Orthodontics, the Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from September 2022 to March 2024.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted on lateral cephalograms, posterior-anterior cephalograms (PA, Ceph), and orthopantomograms (OPG) of 44 parental pairs of cleft lip and palate patients. Fifteen radiographic variables were used to analyse the craniofacial morphology, dental and soft tissue patterns, and airway dimensions of parents of CLP children. Frequencies and percentages for paternal and maternal skeletal, soft tissue, and dental craniofacial variables as well as airway dimensions of parents were calculated and compared.</p><p><strong>Results: </strong>The majority of fathers and mothers presented with class I sagittal skeletal pattern with no facial asymmetry and normal maxillary and mandibular lengths and were normodivergent. However, a trend of a relatively greater percentage of increased lower facial height was seen in fathers and decreased lower facial height was seen in mothers. An increased percentage of protrusive upper lip was found in fathers. Dental inclinations were normally inclined in most of the parental pairs. Upper and lower incisor proclination was found in a greater percentage of fathers. Upper incisors were retroclined in a greater percentage of mothers. The airway dimension was normal in the majority of parents, however, percentage of narrowed upper and lower airways was greater in fathers.</p><p><strong>Conclusion: </strong>Parents of patients with CLP showed craniofacial morphology comparable to norms of the population with some distinct characteristics.</p><p><strong>Key words: </strong>Dentofacial deformity, Condyle, Sella turcica, Facial clefts, Malocclusion.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"197-202"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400958","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":"COVID-19 Associated Neuromuscular Disorders - An Electrodiagnostic Perspective.","authors":"Muhammad Tawab Khalil, Uzma Akhlaque, Umer Younas, Sana Arshad","doi":"10.29271/jcpsp.2025.02.254","DOIUrl":"10.29271/jcpsp.2025.02.254","url":null,"abstract":"<p><p>This cross-sectional study aimed to describe electrodiagnostic (Edx) findings of neuromuscular disorders (NMD) associated with COVID-19 infection. Patients with history of COVID-19 infection and neuromuscular symptoms were included. After documenting the demographics, detailed examination and nerve conduction studies / electromyography (NCS / EMG) were performed. Descriptive statistics were determined. Polyneuropathy was the most common electrophysiological diagnosis (n = 22, 40%) and amongst these, Guillian Barre Syndrome (GBS) was the most common (n = 13, 23.6%). Patients with history of invasive ventilation had 2.5 times the risk of developing myopathic disorder [OR 2.5, 95% CI 0.6 - 9.9] and 2.6 times the risk of developing neuropathic disorder than those who did not require invasive ventilation [OR 2.6, 95% CI 0.8-8.5]. Polyneuropathy is the most common NMD associated with COVID-19 infection. Patients with history of invasive ventilation after COVID-19 are susceptible to develop neuropathic disorders. Further studies are needed to establish the causality of this correlation. Key Words: Polyneuropathy, Myopathy, Moneuritis multiplex, Facial nerve palsy, Critical illness polyneuropathy / myopathy, Neuromuscular junction disorders, Guillian barre syndrome.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"254-257"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401114","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":"An Insight to Hyperhomocysteinaemia in CKD Patients of a Tertiary Care Hospital, Karachi.","authors":"Nadia Yaqub, Adnan Mustafa Zubairi, Fatima Kanani, Maliha Zubairy, Ayesha Iftikhar","doi":"10.29271/jcpsp.2025.02.180","DOIUrl":"10.29271/jcpsp.2025.02.180","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the frequency and association of hyperhomocysteinaemia (HHcy) in different stages of chronic kidney disease (CKD) patients.</p><p><strong>Study design: </strong>Cross-sectional, descriptive study. Place and Duration of the Study: Department of Chemical Pathology, Indus Hospital and Health Network Karachi, Pakistan, from July to December 2022.</p><p><strong>Methodology: </strong>Blood samples of 100 known CKD patients were collected for this study. The estimated glomerular filtration rate (eGFR) was calculated from the CKD-EPI calculator for CKD staging. Plasma homocysteine (Hcy) and serum creatinine concentrations were analysed on Abbott Alinity I and C analyzers, respectively. The SPSS was used for data compilation and analysis. Descriptive statistics were calculated. The association of HHcy with CKD and other variables was assessed using the Chi-square test as appropriate. A p-value of ≤0.05 was considered as significant.</p><p><strong>Results: </strong>Out of total 100, 52% males and 48% females known CKD patients were included in the study. The mean age of the patients was 50.62 ± 16.29 years. The median eGFR, serum creatinine, and Homocysteine were 18 ml/min/1.73m2, 3.48mg/dl, and 20.07 μmol/l, respectively. The percentage of CKD patients in each stage was 7% in stage 3a, 18% in stage 3b, 30% in stage 4, and 45% in stage 5. HHcy was observed in 79% of the CKD patients and among them 7.6% patients were in stage 3a, 19.0% in stage 3b, 31.6% in stage 4, and 41.8 % in stage 5.</p><p><strong>Conclusion: </strong>Patients with CKD were found to have HHcy indicating a very high level of prevalence in CKD patients, especially in the late stages. Hence, Hcy can be considered as a predictor of advancing disease. Timely interventions are required to prevent future adverse outcomes and improve the quality of life in CKD patients. However, a significant association was not seen between Hcy concentration and eGFR stages in the current study.</p><p><strong>Key words: </strong>Hyperhomocysteinaemia, Estimated glomerular filtration rate, CKD-EPI calculator, Mortality, End-stage renal disease, Cardiovascular disease.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"180-184"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401102","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":"Role of Deep Brain Stimulation in Treatment-Resistant Depression: A Way Forward.","authors":"Umar Nadeem, Tehreem Fatima, Abira Khan","doi":"10.29271/jcpsp.2025.02.262","DOIUrl":"10.29271/jcpsp.2025.02.262","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"262"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400967","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":"Effects of Esketamine on Haemodynamics and Inflammatory Stress Response in Elderly Patients Undergoing Proximal Femoral Surgery.","authors":"Xuandong Jia, Xingzhi Liao, Maitao Zhou","doi":"10.29271/jcpsp.2025.02.141","DOIUrl":"10.29271/jcpsp.2025.02.141","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effects of esketamine combined with iliac fascia block on haemodynamics and inflammatory stress response in elderly patients undergoing proximal femoral nail anti-rotation (PFNA) surgery.</p><p><strong>Study design: </strong>A single-centre randomised controlled trial. Place and Duration of the Study: Deparment of Anaesthesiology, the 904th Hospital of the Joint Logistic Support Force of PLA, Wuxi, Jiangsu Province, China, from January to December 2023.</p><p><strong>Methodology: </strong>Eighty elderly patients undergoing PFNA surgery in the authors' hospital were selected as the research objects, regardless of gender, aged >65 years, with a body mass index (BMI) of 18-28 kg/m2, and the American Society of Anaesthesiologists (ASA) scores of II-III. Eighty elderly patients were randomly divided into the following two groups: The observation group (esketamine combined iliac fascia block) and the control group (remifentanil combined iliac fascia block). Heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) were recorded at entry (T0), incision (T1), 15 minutes after incision (T2), and at the completion of surgery (T3). Before and 24 hours after surgery, interleukin-6 (IL-6) and C-reactive protein (CRP) were measured. Recovery quality was recorded 24 hours after surgery. The patients' anaesthesia-effect on adverse reactions were recorded during and after surgery.</p><p><strong>Results: </strong>There was a significant difference between the two groups in the following indices: HR, MAP, and SpO2 at T1 (p <0.05). The values of IL-6 and CRP in the control group were prominently higher than those in the observation group 24 hours after surgery (p <0.05). The quality of recovery-15 (QoR-15) score of the control group was prominently lower than that of the observation group. The total incidence of adverse reactions of the control group was prominently higher than that of the observation group (p <0.05).</p><p><strong>Conclusion: </strong>Implementing an anaesthesia regimen of esketamine combined with iliac fascia block for elderly patients undergoing PFNA surgery can help maintain haemodynamic stability and suppress the inflammatory stress responses.</p><p><strong>Key words: </strong>Esketamine, Iliac fascia block, Internal fixation with anti-rotation intramedullary nails in the proximal femur, Haemodynamics, Inflammatory stress response.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 2","pages":"141-146"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401118","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}