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

{"title":"Prevalence of Overweight and Obesity in Infants and Their Association with Breastfeeding Practices.","authors":"Ariba Siddiqui, Rozina Muhammad Iqbal, Anosha Muhammad Aslam, Arshalooz Jamila Rahman","doi":"10.29271/jcpsp.2026.08.1028","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.08.1028","url":null,"abstract":"<p><strong>Objective: </strong>To find out the prevalence of overweight and obesity and to examine their association with breastfeeding practices among infants aged 9-12 months.</p><p><strong>Study design: </strong>A prospective cross-sectional study. Place and Duration of the Study: Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan, from March to August 2022.</p><p><strong>Methodology: </strong>A total of 211 infants aged 9-12 months were included using non-probability consecutive sampling. Sociodemographic data, breastfeeding practices, and dietary diversity were recorded through a structured questionnaire. Anthropometric measurements were obtained. According to the WHO growth standards, weight-for-height z-scores were computed; scores above +2 standard deviations were categorised as overweight, while scores above +3 standard deviations were classified as obesity. Logistic regression was used to examine the link between breastfeeding practices and overweight/obesity, adjusting for confounders.</p><p><strong>Results: </strong>Overweight and obesity were observed in 23 (10.9%) of infants. Overweight and obesity were more prevalent in infants receiving non-exclusive breastfeeding, with 22 out of 120 (18.3%) affected, compared to only 1 out of 91 (1.1%) among exclusively breastfed infants (p <0.001). Logistic regression showed that exclusive breastfeeding was associated with a 96% reduction in the odds of excess weight (aOR = 0.04; 95% CI: 0.01-0.31; p = 0.002). Other variables, including maternal BMI, birth order, and dietary diversity, were not significantly associated.</p><p><strong>Conclusion: </strong>Non-exclusive breastfeeding practice was found to be a significant contributing factor for overweight and obesity in infants. Promoting exclusive breastfeeding could be an effective strategy to reduce early childhood obesity.</p><p><strong>Key words: </strong>Overweight, Obesity, Breastfeeding, Infants, Exclusive breastfeeding, WHO growth standards, Maternal BMI.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1028-1033"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687254","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 Sleep Duration and Hypertension Development in Women: A Meta-Analysis.","authors":"Yan Bai, Deying Kong, Jie Hou, Li Bai","doi":"10.29271/jcpsp.2026.08.1045","DOIUrl":"10.29271/jcpsp.2026.08.1045","url":null,"abstract":"<p><p>This study examined the association between females' sleep duration and the development of hypertension (HTN). Searches were conducted in Embase, PubMed, Cochrane Library, Web of Science, CNKI, VIP, and Wanfang databases up to March 15, 2024. Using RR as the effect measure, the combined RR and 95% CI were calculated using Stata 15.0. A total of 10 articles, comprising 12 cohort studies, were included in the meta-analysis. Inadequate sleep duration is associated with HTN in women (RR: 1.10, 95% CI: 1.06-1.13, p <0.001). However, long sleep duration was not associated with HTN in women (RR: 1.00, 95% CI: 0.96-1.05, p = 0.958). Short- and long-sleep duration groups showed no publication bias. Subgroup and meta-regression analyses indicated that age and variation in the operational definition of sleep duration were the principal sources of heterogeneity. In age-stratified analysis, both <50 years (RR = 1.19, 95% CI: 1.11-1.28, p <0.001) and ≥50 years (RR = 1.06, 95% CI: 1.00-1.12, p = 0.036) showed increased HTN risk among women with short sleep duration. The dose-response association was L-shaped; using 4 hours/day as the reference, the lowest risk was observed at approximately 7.5 hours/day. For women, insufficient sleep duration is linked to a higher risk of developing HTN. Key Words: Hypertension, Women, Sleep duration, Prospective cohort study, Meta-analysis.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1045-1053"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687272","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 Systematic Review and Meta-Analysis of a Liquid Biopsy-Based Multimodal Approach for the Diagnosis of Pulmonary Nodules.","authors":"Ren Shuang Cao, Tian Jiao Huang, Zhi Heng Lin, Fan Yang, Fei Liu, Feng Gao","doi":"10.29271/jcpsp.2026.08.1054","DOIUrl":"10.29271/jcpsp.2026.08.1054","url":null,"abstract":"<p><p>Liquid biopsy demonstrates clinical utility as a non-invasive tool for discriminating malignant tumours from benign pulmonary nodules, as evidenced by recent research. This systematic review compared the diagnostic performance of current clinical modalities for pulmonary nodules, aiming to generate evidence-based solutions to address the underdiagnosis of malignant nodules and the overdiagnosis of benign lesions. A Bayesian bivariate random-effects model was employed to perform meta-analysis across diagnostic categories, followed by meta-regression and subgroup analyses. Results were visualised using summary receiver operating characteristic curves. Subgroup analysis revealed that liquid biopsy-derived multimodal diagnostic models achieved superior performance (sensitivity: 90.2%; specificity: 83.6%) compared to CT-based evaluation (81.5%, 67.9%) and risk prediction models (68.7%, 70.6%). These findings indicate that multimodal models integrating liquid biopsy, radiological features, and risk prediction significantly outperform single-modality approaches, thereby potentially addressing diagnostic imbalances in pulmonary nodule assessment. Key Words: Liquid biopsy, Pulmonary nodules, Multimodal diagnostic model, Comparative diagnostic test accuracy studies.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1054-1062"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687310","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":"Application and Integration of Generative AI in Medical Education Vary Across Regions: Why Is This an Important Consideration?","authors":"Farooq Azam Rathore, Fareeha Farooq","doi":"10.29271/jcpsp.2026.08.1095","DOIUrl":"10.29271/jcpsp.2026.08.1095","url":null,"abstract":"<p><p></p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1095-1096"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687258","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":"Cryosurgery: The Renaissance of Freezing Oncology.","authors":"Saeeda Baig, Saviya Kashif","doi":"10.29271/jcpsp.2026.08.1097","DOIUrl":"10.29271/jcpsp.2026.08.1097","url":null,"abstract":"<p><p></p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1097-1098"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687236","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":"Prediction of Post-COVID-19 Pulmonary Fibrosis: An Integrated Approach Combining CT Radiomics and Clinical Characteristics.","authors":"Mujuan Wang, Pei Huang, Min Jiang, Bing Fan","doi":"10.29271/jcpsp.2026.08.1069","DOIUrl":"10.29271/jcpsp.2026.08.1069","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a predictive model for post-COVID-19 pulmonary fibrosis (PCPF) by integrating CT radiomics features with clinical characteristics to facilitate early identification and intervention.</p><p><strong>Study design: </strong>An observational study. Place and Duration of the Study: Department of Radiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China, from December 2022 to January 2023.</p><p><strong>Methodology: </strong>This study enrolled 223 patients with COVID-19. Chest CT images and clinical data of the participants during their hospitalisation were collected. Follow-up chest CT scans were performed 3-12 months post-discharge to assess for PCPF. Participants were randomly divided into a training set (n = 156) and a testing set (n = 67). Using the least absolute shrinkage and selection operator (LASSO) regression, six optimised radiomic features were identified, and radiomic scores were calculated (Rad-scores). Univariate and multivariate logistic regression analyses screened clinical features, identifying age, lesion location, length of hospital stay, and lactate dehydrogenase (LDH) as independent predictors. Subsequently, a radiomic model, a clinical model, and a combined nomogram model incorporating Rad-scores and clinical predictors were constructed.</p><p><strong>Results: </strong>The combined nomogram demonstrated superior prediction. In the testing set, the areas under the curve (AUC) were 0.833, outperforming the clinical (AUC = 0.687) and radiomic (AUC = 0.811) models. The DeLong test confirmed that the nomogram significantly outperformed the clinical model (p < 0.05). Calibration and decision curve analyses verified the nomogram's excellent fit and provided substantial clinical net benefit.</p><p><strong>Conclusion: </strong>The nomogram model based on CT radiomics and clinical features is promising for predicting PCPF.</p><p><strong>Key words: </strong>Computed tomography, COVID-19, Post COVID-19 pulmonary fibrosis, Radiomics, Nomogram.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1069-1075"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687249","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":"Hip Mass: Breast Carcinoma.","authors":"Aimun Shabbir, Asif Husain Osmani","doi":"10.29271/jcpsp.2026.08.1099","DOIUrl":"10.29271/jcpsp.2026.08.1099","url":null,"abstract":"<p><p></p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1099-1100"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687266","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":"Frequency of Crescentic Glomerulonephritis in Adults Presenting with Acute Kidney Injury.","authors":"Bushra Sikandar, Mubarak Mohammad, Aiyesha Humaira","doi":"10.29271/jcpsp.2026.08.1018","DOIUrl":"10.29271/jcpsp.2026.08.1018","url":null,"abstract":"<p><strong>Objective: </strong>To determine the frequency of crescentic glomerulonephritis (CRGN) in adults presenting with acute kidney injury (AKI), defined according to the latest Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.</p><p><strong>Study design: </strong>A cross-sectional observational design. Place and Duration of the Study: Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan, from April to October 2023.</p><p><strong>Methodology: </strong>A total of 152 renal biopsies were obtained through a non-probability consecutive sampling technique, including all patients aged ≥18 years, of both genders, who presented with AKI and underwent renal biopsy. Demographics, clinical signs, and symptoms of CRGN were recorded. Data were stratified based on age, gender, and laboratory findings (serum creatinine (sCr) and serum urea). A post-stratification chi-square test was applied.</p><p><strong>Results: </strong>Most participants were females (n = 97, 63.8%) with a mean age of 37 ± 18 years. Only 12 (8%) patients had CRGN. However, the majority of patients with AKI had acute tubular injury (n = 56, 36.8%), followed by cortical infarction (n = 27, 17.8%). No Significant difference was found between age (p = 0.814), gender (p = 0.143), serum urea (p = 0.117), and sCr levels (p = 0.229).</p><p><strong>Conclusion: </strong>The study identified a significant but low prevalence of CRGN (8%) among AKI patients. This finding provides a crucial insight into the burden of CRGN in a developing country such as Pakistan, highlighting the need for heightened clinical awareness and diagnostic vigilance.</p><p><strong>Key words: </strong>Acute kidney injury, Adults, Crescentic glomerulonephritis, Frequency, serum creatinine.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1018-1022"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687316","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":"Haemostatic Efficacy and Safety of Suturing, Ligaclips, and Hem-o-Lok Clips in Laparoscopic Nephrectomy.","authors":"Akhtar Nawaz, Asif Khan, Muhammad Waqas, Muhammad Saad Hamid, Anwar Ul Haque","doi":"10.29271/jcpsp.2026.08.1011","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.08.1011","url":null,"abstract":"<p><strong>Objective: </strong>To compare the haemostatic efficacy and safety of suturing, Ligaclips, and Hem-o-Lok clips in laparoscopic nephrectomy.</p><p><strong>Study design: </strong>A descriptive study. Place and Duration of the Study: Department of Urology, Institute of Kidney Disease, Peshawar, Pakistan, from January 2020 to December 2024.</p><p><strong>Methodology: </strong>This study included 200 patients (aged 15-60 years) undergoing laparoscopic nephrectomy for non-functioning kidneys. The exclusion criteria were bleeding disorders, incomplete records, unrelated open conversions, and bilateral cases. Patients were grouped by ligation method: suturing (n = 53), Ligaclips (n = 74), and Hem-o-Lok clips (n = 73). Outcomes included ligature slippage, blood loss, transfusion, conversion, complications, adjacent injury, and length of hospital stay. Data were analysed using ANOVA/Kruskal-Wallis tests, chi-square/Fisher's exact tests, and multivariable regression analysis.</p><p><strong>Results: </strong>Baseline demographic and clinical characteristics were similar across groups (p >0.05). Haemoglobin reduction was lowest with Hem-o-Lok clips (0.70 ± 0.30 g/dL), higher with Ligaclips (1.00 ± 0.20 g/dL), and highest with suturing (1.20 ± 0.30 g/dL; p <0.001). Hospital stay was longer with suturing (median 4.0 [4-5] days) compared with Hem-o-Lok (4.0 [3-4] days) and Ligaclips (4.0 [3-5] days; p = 0.03). Conversion to open surgery occurred only in the Ligaclips group (9.6%), with none in the Hem-o-Lok or suturing groups (p <0.001). Regression analysis showed diabetes as the only independent predictor of complications, with higher odds of ligature slippage (OR = 6.71 [1.02-50.68]; p = 0.046) and injury to adjacent structures (OR = 8.38 [2.29-33.47]; p = 0.002).</p><p><strong>Conclusion: </strong>Hem-o-Lok clips provide relatively reliable ligation during laparoscopic nephrectomy in terms of haemoglobin reduction, hospital stay, and conversions to open surgery.</p><p><strong>Key words: </strong>Laparoscopic nephrectomy, Hem-o-Lok clips, Ligaclips, Suturing, Vascular ligation, Surgical complications.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1011-1017"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687306","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 Paradox of an Arboviral Pandemic Stalled by an Empty Sting.","authors":"Moiz Ahmed Khan","doi":"10.29271/jcpsp.2026.08.1085","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.08.1085","url":null,"abstract":"<p><p>This opinion piece provides a critical examination of the new rhetoric surrounding arboviruses as potential drivers of future pandemics, particularly in sub-Saharan Africa and South Asia. Although dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) are significant public health threats in these regions, the author contends that their reliance on arthropod vectors inherently constrains their ability to cause pandemics. Overestimating the dangers of these infections can lead to resource misallocation, promote public distrust, and dilute the impact of health interventions in already fragmented health systems, with Pakistan serving as a prime example. The piece also warns against the alarmist use of the term \"pandemic\", advocating a balanced approach rather than sensationalist reporting, which could divert attention from public health priorities. Instead, it promotes a balanced, evidence-based evaluation of risks proportionate to ecological realities. In short, the article calls the attention of the scientific community to the merits of building regional capacities, promoting clear communication, and resisting the temptation of sensational but unlikely global health forecasting regarding arboviruses. Key words: Arboviruses, Epidemic, Epidemiology, Pandemic, Healthcare systems, Viral transmission, Pakistan.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 8","pages":"1085-1087"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687268","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}